n=1 Medicine: The Problem of Induction & Caring for the Patient of One

The Patient of One archetype is my mythologizing effort in n=1 medicine.

It captures the true spirit of medical practice: the care of individual patients.

However similar or diverse we (patients) appear, we are all ultimately individuals who require medical care that respects our inherent individualities.

But what about that ever-lurking problem of induction (thanks to Dave Lull)? That 'all swans-were-white ... until-we-discovered-a-black-swan-that-falsified-that-theory' continual challenge.

How do we deal with that?

n=1 deduction differs fundamentally from n=1 induction.

That's how.

We do our best on the falsification/deductivism front. We take logical principles that have been tested--as Richard at Free the Animal has done already--and we self-experiment with them on our own bodies. We falsify conjectures--"eating ___ is non-inflammatory," for instance--and then edit them out of our working story systems. We zero in on health, however tentative, that way.

We are all limited by personal experience in collecting data points--that will never change--but we can each act as 'lab rats' for each other in the sense that we share our n=1 journeys openly and honestly (while retaining respectful personal privacy). Our journeys shared collectively then turn into conjectures that we each can attempt to refute individually. Then, those yet-to-be-refuted principles further guide our ways.

But what we are really getting at is habit formation: domain-dependent habit formation in n=1 deduction in order to avert n=1 induction.

This process, perhaps, requires the following steps:

1. Identifying the territory; recognizing the domain

2. Recalling the heuristics that have yet-to-be-falsified in navigating this terrain

3. Perceiving details of this specific case

4. Selecting a course of action or inaction in this specific case

5. Observing feedback

6. Initiating reaction

7. Reflecting on the entire process

8. Re-editing the map of this territory

9. Refining the consequences of actions in this domain

Or something like that; our brains do it in a snap anyways.

In terms of agency, we all are experts in and have unique access to our own bodies for self-experimenting; but, when it comes to more acute forms of n=1 medicine, the co-pilot aid of medical professionals is at play, and these are the realms and situations that I am curious to learn more about from both doctors (and nurses, etc.) and patients in light of the reality that these entities must partner effectively to navigate the complexity of specific, novel patient care cases.

It's the crux of developing habits that help practitioners deal with the problem of induction while caring for individual patients.

Medicine doesn't treat populations; it treats individuals.

It cares for the Patient of One.

That's what I am thinkering with currently.

To good health,

Brent

m=1/n=1 Cartography: Myth as Mentor

Epistemocrats make maps.

It's m=1/n=1 cartography.

Aaron Blaisdell knows: his pigeons and rats build cognitive maps for foraging, among other things.

Beliefs are our decision-making heuristics--myths--embedded within our cognitive maps (encoded in our neural circuitry networks) that we develop iteratively, as recursive and nonlinear updating functions, across time as a result of thinkering (thinking + tinkering) in our local ecologies: we are, after all, local animals inhabiting an increasingly global world. As organisms, we respond to the textures of our environments--stimuli--in our own unique ways, and we interact with time-sensitive feedback in this manner each and every day. Upon reflection, we quickly realize that this bottom-up process produces vast complexity almost instantly, so what do we do to sort through this fractally-dense forestry effectively: we make maps.

We act as cartographers, as mapmakers, in the face of uncertainty, in the face of opacity.

m=1/n=1 cartography is the practical application and the thinkering link--the bridge--between Personal m=1 my-thology (our individual beliefs, story systems, cultural traditions, et al.) and Patient of One n=1 self-experimentation (our individual experiences, tinkering bouts, testing efforts, trial-and-error solution searching pursuits, et al.), and this messy yet elegant sketching activity proceeds within the Barbell framework (thanks to Nassim Taleb) under the deductivist/falsification modus operandi (hat tip to Dave Lull).

It proceeds by testing, falsifying, re-editing, iterating, followed by continued experimenting (a la Seth Roberts).

Repeat.

Epistemocrats test out maps; they falsify maps that lead to negative results while continuing to navigate cautiously (skeptically) with the co-pilot aid of yet-to-be-falsified ones. And, epistemocrats sometimes operate sans maps entirely, depending on the landscape at hand.

Maps capture tenets, precepts, and principles--as Art DeVany's Evolutionary Fitness, Mark Sisson's Primal Blueprint, Doug McGuff's Body by Science, and Seth Roberts' Shangri-La Diet book-maps do for health and fitness--that will hopefully help diverse individuals make decisions in their specific situations, in real-time, on the fly, by applying meta-rules and general schemas full of grace nudges. Unfortunately, though, misleading maps--like Value-at-Risk, to name a finance example; or, the Food Pyramid, to name a nutrition example--give individuals false senses of bravado coupled with false senses of security, encouraging folks to leverage themselves out (sugar is like debt), stretching themselves too thin, because their maps suggest that they are moving about territories devoid of consequential risks (this is what existing 'first-dollar-coverage' health insurance products in the United States do for patients). Then, as epistemocrats are well aware of, all of the sudden, these thought-to-be-dormant minefields erupt and negative Black Swan strikes puncture consequential holes through these maps and falsify the faulty cartography underlying their mythologies. So, then, we must engage in the art and science of mapmaking carefully (humbly), as much as possible, in light of the limits of being human.

Paradoxically, the more we recognize and then characterize domains where the limits of being human are most consequential (as Nassim Taleb has done with his Fourth Quadrant), the better we become at m=1/n=1 cartography; the better we become at averting catastrophe while simultaneously maintaining exposure to the envelope of serendipity.

Striking this clinical balance, finding and practicing this meritage blend amidst complexity (and acute instances of chaos along the way), is not easy, of course, but epistemocrats work diligently to develop their opportunistic generalist mental tool boxes in hopes of surviving and thriving gracefully.

Enter Joseph Campbell (hat tip to Brian Geremia, mythocrat) as one source of perceptive grace:

In 1940 Campbell attended a lecture by Professor Heinrich Zimmer at Columbia University; the two men became friends, and Campbell looked upon Zimmer as a mentor. Zimmer taught Campbell that myth (rather than a guru or spiritual guide) could serve in the role of a personal mentor, in that its stories provide a psychological road map for the finding of oneself in the labyrinth of the complex modern world.

Myth as mentor, I suspect, is a valuable component of m=1/n=1 cartography. Within my Barbell portfolio of maps, vibrant myths (conjectures and anecdotes) abound that inform my decision making daily. Like Robb Wolf said recently, "I just need to point out, the existence of the Universe is largeley anecdotal…" And, anecdotal evidence, within the context of conjectures and refutations, fuels the rich milieu of many medical literature genres (patients' stories serve as one foundational medium). Personally, when I contemplate medicine, I have hybridized two mentors--a hero with two faces--who compose insightful, complementary mythologies via essays regularly:

• Dr. Jerome Groopman, author of How Doctors Think
• Dr. Atul Gawande, author of The Checklist Manifesto

Both of these physicians are healthcare cartographers; they've thinkered their ways through mapmaking over the years, in large part, by writing. Atul Gawande recently released his latest narrative, The Checklist Manifesto: How to Get Things Right, which communicates his efforts to map surgical procedures more effectively in order to increase patient safety, taking a nod from the aviation industry (hint: it works magnificently). Gawande's ecology of surgery, though, is more concrete, planned, and routinized, in many ways, than is Groopman's world of experimental oncology. Consequently, their views on medical decision-making emerge from distinct perspectives. For me, Groopman rounds out Gawande's 'checklists' nicely by exploring the cognitive psychology realms of medicine, contemplating thinking when it comes to diagnosing, prescribing, and treating (hint: the heuristics and biases, Kahneman and Tversky domains). Both Groopman and Gawande recognize and embrace the inherent uncertainty and opacity that pervade the clinical practice of medicine--they continually reflect on the humble limits of being human when they author essays. Then, when I read these essays, I engage in myth-as-mentor m=1/n=1 cartography. Their mythologies, in effect, mentor me--they shape my personal development as a healthcare epistemocrat; they influence my thinkering.

When it comes to mapmaking, myth-as-mentor, I suspect, adds value to cartography when we approach it all the right way.

In fact, it seems quite ancestral to me.

We're trying to map out reality--which presents formidable tasks for everybody--but better maps do exist, especially those that focus on consequences instead of probabilities (given the fragility of our prediction abilities).

That being said, I will end with one prediction to close out the year: we will all act as m=1/n=1 cartographers throughout the year in 2010!

Cheers!

To good health,

Brent

Comment Highlight: Jake, Art DeVany, & Cartography

Better maps do exist.

Art DeVany's upcoming book will be one such epistemocratic map (and I look forward to reading and reviewing it).

I want to thank Jake for chiming in to my previous post and spurring this installment of Comment Highlight:

Jake said...

You should include Art DeVaney in your maps. Both Dr McGuff and Mark Sisson both credit Art for much of their science.

He reads your blog and has said so.

I want to give credit where credit is due.

Art knows: I am thankful for his gracious mentorship during the past few years.

I've told him so multiple times in our behind-the-scenes exchanges (silent evidence for the rest of the world). I also displayed my gratitude during my BIL:PIL presentation recently.

The story goes like this: Nassim tipped me to Art. Art tipped me to Mark. The rest is history.

From there, I explored the rest of the Ancestral Fitness Epistemocracy.

I link to Art's Web site (arthurdevany.com) in my conceptual bricolage definition of this thinkering epistemocracy and also every time that I use the phrase: "self-experimenting with all things Paleo / Primal / Evolutionary / Ancestral / and Beyond."

And now, almost three years into this tipping point cascade--a positive Black Swan strike--having escaped the pain of those chronic migraine headaches and frustrating sinus infections that plagued me for so many years, I want to reiterate that I am very thankful to Professor Art DeVany (and Nassim and Mark, et al.) for helping me along the way (thanks to Dave Lull and many others, including my mom, as well).

If you peruse my archives closely, you will see that I have been linking to Art DeVany's work fervently for over two years. Many of my essays center on or include Art's perceptive insights. It was easier to link to Art as a resource when his essays were available to the public.

Art DeVany is a cartographer: his Evolutionary Fitness map for health decision making is where I had my serendipitous epiphany, as did Nassim, as did many others out there who are participating in this epistemocracy that has self-organized in the Blogosphere around the spirit of n=1 self-experimenting with ancestral mimicry (where useful and fruitful and in combination with modern science and technology).

From Art, I learned the value of mimicry; the vast importance of the multifractal math behind healthy heart beats; the practical applications of stochasticity and kurtosis in energy expenditure patterns; the practice of intermittent fasting; the far-reaching benefits of high-intensity, low-duration exercise; the need for thermal fluctuations; the keys to good posture and developing that healthy 'X-look'; and, the list goes on and on and on (luckily).

In one of my recent essays--"Black Swan Health Policy"--I said this:

And there are many perceptive leaders--like Art DeVany--who entered this vibrant health and fitness space well before me, so I want to respect everyone's territory, autonomy, and unique approaches to mythologizing and tinkering.

To be sure, I stand on the shoulders of giants--platform builders--and there are many people who deserve credit for advancing the art and science of health (from Atkins to Eades to my ancestor, Francis Pottenger, to _____ et al.). When you are a bricoleur, a self-experimenter, you value everyone's unique contributions to the milieu of mythologies to test out on your own body.

Art DeVany & Evolutionary Fitness are so foundational to my m=1 my-thology and my Barbell portfolio of maps that I sometimes forget to state so explicitly.

That's where my quest began: Nassim tipped me to Art. Art tipped me to Mark. The rest is history.

It's 'm=1/n=1' cartography.

To good health,

Brent

Body by Science: An Epistemocratic Map for Health Decision Making

(Above: Dr. Doug McGuff, M.D. discusses his perceptive thoughts on health)

Better maps do exist.

Body by Science is one such map, written by two epistemocrats: Dr. McGuff and John Little.

Super-slow and highly-intense, that's the energy expenditure coupling and underlying spirit you should be thinkering with when you decide to self-experiment with the Body by Science epistemocratic map for health decision making. That, and a real foods ancestral diet, of course. Like Mark Sisson's Primal Blueprint, which I reviewed recently, Body by Science is born out of experience, from the bottom-up, emerging from John Little and Dr. McGuff scouring the evidence-based literature--the PubMed Anthology as one primary source of medical mythologies--and then testing these conjectures on real people, under real-world conditions: that's ecologically intelligent clinical health science in practice. Human beings are the best animal models for studying human physiology (when safe and appropriate for testing).

My favorite animal model is my own body.

I am a Patient of One, so I approach my health and fitness with a n=1 frame-of-mind. As Dr. McGuff suggests, I attempt to send proper signals to my body to stimulate desired physiological responses and epigenetic adaptations. When it comes to n=1 clinical trials with exercise (energy expenditure, generally), fractally randomized bouts of high intensity / low-duration work provides an efficient and effective hormonal 'kick' for me.

Since this essay is an attempt at a quasi-book-review reflection, and I try not to reveal too much of the actual contents of a book when I review it (hoping folks will actually go read the book instead), I have to say that any health and fitness book that references Nassim Taleb's Fooled by Randomness, as Body by Science (BBS) does, moves up the ranks quickly in my book. Nassim's work is a good heuristic for sorting through information sources. When it comes to BBS, Jeff Erno (@ernoj) is the epistemocrat you want to follow to learn more about and observe applications of the BBS principles regularly. He's even working on a 'Workout Tracker' to help folks organize their experimental efforts in this domain. Personally, I approach my self-experiments with energy expenditure from the portfolio perspective, and I default to Barbell diversification whenever possible. Barbell diversification relies on the formation of a stable foundational platform, the 'tried-and-true' investments that make up 80-90% of your portfolio, upon which you can engage in diversified trial-and-error with novel options (10-20%). Awhile ago, BBS started as a novel option for me. I have been working for some time now to incorporate more and more of the BBS spirit into my trips to the gym. I've started doing more ultra-slow body-weight dips; I've started doing upside-down pushups at super-slow rates, and then again at my fastest pace (I've done the same with leg presses, etc.); essentially, I've been tinkering here and there, which means that I have been diversifying my energy expenditure portfolio nicely. Right now, I feel as if BBS is becoming part of my 'tried-and-true' platform, as a work-in-progress component of my hybridized base. It's my 'm=1/n=1' application of Joseph Campbell's The Hero with a Thousand Faces: the practice of hybridizing role-models, mentors, and heroes in our lives to mimic and learn from. When it comes to exercise, as a student of fitness who wants to feel good, I like to hybridize Dr. McGuff's wonderful insights with Keith Norris' excellent functional power quest (The Power Zone) and Mark Sisson's awesome Primal Laws--it's 'The Hero with Three Faces' that I am primarily thinkering with currently. To me, it appears that each of these bricoleurs fits Campbell's monomyth description of the journey that heroes progress through in mythologies:

Campbell explores the theory that important myths from around the world which have survived for thousands of years all share a fundamental structure, which Campbell called the monomyth. In a well-known quote from the introduction to The Hero with a Thousand Faces, Campbell summarized the monomyth: “A hero ventures forth from the world of common day into a region of supernatural wonder: fabulous forces are there encountered and a decisive victory is won: the hero comes back from this mysterious adventure with the power to bestow boons on his fellow man.” In laying out the monomyth, Campbell describes a number of stages or steps along this journey. The hero starts in the ordinary world, and receives a call to enter an unusual world of strange powers and events (a call to adventure). If the hero accepts the call to enter this strange world, the hero must face tasks and trials (a road of trials), and may have to face these trials alone, or may have assistance. At its most intense, the hero must survive a severe challenge, often with help earned along the journey. If the hero survives, the hero may achieve a great gift (the goal or "boon"), which often results in the discovery of important self-knowledge. The hero must then decide whether to return with this boon (the return to the ordinary world), often facing challenges on the return journey. If the hero is successful in returning, the boon or gift may be used to improve the world (the application of the boon).

Blogging, book-writing, and other social media efforts by Doug, Keith, and Mark represent just some of their individual applications of the "boons" (gifts) that they have discovered through real-world experience and reflection, through engaging in my thinkering biotechnology model.

They're trying to improve the world by shaping health and fitness choice architecture.

That's a m=1 my-thology approach full of grace nudges that I appreciate.

But, like Doug reiterates, "Don't take it on blind faith." Instead, take it to the gym and experiment, then iterate.

To good health,

Brent

Tiger Woods: Nassim Taleb's Thanksgiving Black Swan Turkey on Black Friday

(Above: 'The Anatomy of a Blow Up' from Nassim Taleb's excellent essay, "The Fourth Quadrant: A Map of the Limits of Statistics," on Edge)

It was a negative Black Swan strike on a bizarre Black Friday night.

It was an event we didn't expect. It blindsided us, in fact.

The hidden risks were there--text messages, voicemails, rendezvous, affairs--but they built up silently over the years with few witnesses to bear.

And then signs of smoke emerged, trickling to the surface at first, then flooding uncontrollably. Where there is smoke, there is fire. In the case of Tiger Woods: a forest fire. The flames are still burning, the ashes have yet to finish settling.

A hero of Greek mythological proportions fell precipitously, and we are left in the wake wondering: How could such a Dr. Jekyll & Mr. Hyde persona be a reality?

For so many years, he seemed to be a different breed.

But then we see that Tiger Woods is just another example of Nassim Taleb's Thanksgiving Turkey, another entity that excelled impressively while hidden risks built up in anonymity, only to blow up like an avalanche with wild consequences cascading that trump his entire athletic legacy.

A black mark on Black Friday by a negative Black Swan hit: that's three black strikes and you're out in the game of risk management we call living.

So what do we make of this all; what do we learn from this 'Pride before the Fall'?

We learn, yet again, to respect complex systems, such as social systems, by recognizing that long-term sustainability requires effective moral maps: Tiger has access to golf course performance maps that few human beings have seen before, but his human development deficits came back to stab him in the back.

And it was a negative Black Swan stab at that: he had the wrong m=1 my-thology map.

Generalists tend to survive: diversify.

To good health,

Brent

Organizing an Ancestral Fitness Symposium: a New Direction in Physiology

It would be an awesome event: an Ancestral Fitness Symposium.

I've been thinking along these lines for awhile now, so I want to expose this idea to the envelope of serendipity right now: let's make it a reality.

On Friday, I attended the 'New Directions in Physiology' Symposium at UCLA with Chris Owens (@SingleOrigin) and Aaron Blaisdell. The best presentation discussed 'molecular control of body composition'. This speaker noted the protective, anti-aging effects of lean-muscle mass, deriving these conclusions from experimental data collected during pharmacological stimulation of Type IIb muscle fiber development in mice (I call them Mighty Mice). While sprinting, lifting, and high-intensity training were mentioned very briefly as potentially useful, this scientist ultimately (and unfortunately) resorted to the Conventional Wisdom default of drug intervention, which blinded him from taking the next logical step and seeing the congruent lifestyle modifications--ancestral-spirited nutrition being the most important--that could support and enhance effective lean muscle mass maintenance and growth without a pill-dependency to guide the way.

The fact that humans existed as other forms of 'beings' for most of universal time, ranging from molecular building blocks in the 'primordial soup' to various anaerobic aquatic creatures, provides an ample story system to inform self-experimentation with anaerobic pathways coupled with oxidative damage avoidance / minimization. For instance, I do my own 'mini-triathalons' as one way to stimulate Type IIb muscle fiber pathways: I move about on land at low intensity (walking) a lot, interspersed with kurtotic sprints (on foot and by bicycle); I swim in a relaxed manner for a bit (always going under water for awhile, mimicking my aquatic ancestors), interrupted abruptly (a fractal fracture) by a few sprints from one end of the pool to the other; and, of course, I lift at different speeds and over a wide range of weights, while also doing 'dynamic yoga' exercises in between. That's a rough skeleton / sketch of my existing fitness bricolage portfolio in ancestral mimicry, and it requires no prescription pills nor pharmacological stimulation outside of my ancestral nutrition regime (unless you count FAGE full-lipid Greek yogurt as a 'steroidal cream', lol).

By the end of the day on Friday, after reflecting on the New Directions in Physiology Symposium dynamics (too much niche detail; not enough interdisciplinary collaboration; and, little translational effort for practical applications in every-day life), Chris, Aaron, and I decided that we should coordinate another 'New Directions in Physiology' gathering that we deem valuable: an Ancestral Fitness Symposium that brings together Bloggers who are self-experimenting (thinkering) with all things Primal / Paleo / Evolutionary / Ancestral / and Beyond as presenters and then invite all those interested in participating in this unique event to attend, participate, ask questions, and socialize.

That's a new direction in physiology that I would like to see materialize.

Comment with thoughts, ideas, et al.

To good health,

Brent

Greek Mythology: Pride before the Fall

n=1 Self-Experimentation: Nutritional Bricolage data point

(Above: @Justine_Lam, an Ancestral Fitness enthusiast, and me following my BIL:PIL presentation in San Diego)


As a Qualitative Self bricoleur, I use pictures as_one way_to capture data points.

Add this photo (thanks to Justine) to the Nutritional Bricolage clinical trial archives; I'm simply cataloging the results of my Patient of One self-experimenting in the Empirical Medicine School tradition.

To good health,

Brent

Human Development: Survival and Thrival Skills

It's an interesting time to be human.

As humans (hopefully) developing constantly, it's also an interesting time to reflect on the practical skills that help us survive and thrive in modern day.

I perceive three such fundamental categories that rise to the surface as critically important and irreplaceable, bubbling up from the ashes of recent collapses and maladies, ranging from numerous bankruptcies to widespread diabetes:

1) Personal health

2) Personal finance

3) Personal mythology

In many ways, people acquire skills in these three domains through processes that occur outside of mainstream educational institutions. Whether mimicking role-models or reading about fitness tips in magazines, people learn practical survival and thrival skills in non-traditional ways. Schools don't teach students personal finance, for instance, but then we somehow expect everyone to go to college and understand what a student loan is, what interest rates are, how to use credit cards and checking accounts, and then go on after college or other forms of higher education and know what a mortgage is (intuitively and formally), what a car loan is, how to save for retirement (what's a Roth IRA again?), etc. Yes, parental figures often teach these skills to children (for better or worse), but if educational institutions exist to provide students with tools that will help them create a living and lead sustainable lives as adults, then it makes sense to me that concepts like the-time-value-of-money should be consistent parts of academic pedagogy starting with students at young ages.

It's a challenging world out there.

Every day, each of us will make personal finance and personal health decisions--tons of them--that will shape our life experiences immensely. While I am very thankful for the traditional schooling that I received from places like Jesuit High School, UC Davis, USC, and others, I also recognize that, in light of the challenges that we have seen on display lately, a few gaping holes do exist in mainstream academia for most people.

Reflection is needed.

In order for students to grow up and utilize the skills that they learned in school to contribute to the economy--work jobs--they must have tools for restoring, maintaining, and enhancing their personal health states and for saving, budgeting, and spending their personal finances. These two activities, deciding how to acquire (nutrition) and store/expend (fitness) energy (personal health) and how to acquire (career) and store/expend (investing) money (personal finance), represent two of the most fundamental categories of survival and thrival abilities in modern day. If you lack skills in these domains, surviving, let alone thriving, will be difficult each and every day.

That's where educational institutions (should) step in.

If education is empowering--that is, it acts as a platform that provides you with tools to pursue your passions and enjoy (derive value, meaning, and fulfillment from) the process along the way--then educational institutions must recognize openly and honestly the current data points that falsify many of our existing approaches to human development. Data points like widespread foreclosures, escalating rates of metabolic syndrome diseases, and _____ (enter your example here) should humble us and then challenge us to rethink the purpose of compulsory schooling in the first place. If compulsory schooling does not teach me hard skills that I can use to work a job or create a living, then what has this process accomplished? If compulsory schooling has not provided me with useful maps for making decisions in the grocery store, at restaurants, or at the gym and has not instilled in me intuitive decision-making defaults (heuristics such as "avoid lots of debt") to employ when new credit card offers come in the mail, when investment decisions arise with my 401(k) at work, or when the Holiday Season arrives and I have to balance good intentions with long-term sustainability, then what has this process accomplished?

I return to a question that I have asked before: Will a child growing up today generate more economic wealth in his/her lifetime than the associated cost of his/her healthcare?

What's the point of this question? The point is to illustrate that, at some level, the goal of existing educational institutions, like colleges, is for students to go on to generate economic wealth: student loans have propped up higher education for the past so-many years at record proportions--it's another example of unsustainable debt-fueling--and students better go on to generate wealth; otherwise, they will never be able to pay back the debts they incurred to attend these institutions in the first place. The associated point of this question is to show that if students are devoting years of their lives to studying in these institutions only to emerge and learn that they cannot generate the economic wealth that they thought they would, what could be done differently going forward given that many of these students sacrificed their personal health states immensely just to make it to today. Hours of studying, worrying, and hoop-jumping coupled with non-ancestral living habits have produced poor health states for many students. It's a disastrous double-whammy of sorts. When you step back and do the math, room for improvement seems logical. If students sacrifice their health in order to pursue the human development paths that we have in place in hopes of eventually securing careers that allow them to lead lives, and then these students fail to generate the economic wealth during their lifetimes to cover the costs of their healthcare expenditures, what was the point of all this activity in the first place? Yes, students develop valuable skills in the process, to be sure, but something is awry when you see so many devastating foreclosure signs and metabolic declines.

This is where personal mythology, my-thology, steps in.

Each of us has faith in something, whether a religion, a spirituality, or a perspective/worldview. It's part of being human. My-thology is the m=1 level of this faith; a faith that is shaped by n=1 experience and self-experimentation. We're individuals. Individuality is collectivity because a collective can only survive and thrive if its individuals survive and thrive in their specific and unique cases. For this reason, individual faith translates into decision-making tools--heuristics like the 10 Commandments--that people can default to in the face of novelty and uncertainty. Our personal mythologies also include our dreams, and our dreams represent faith in a better future, in doing things in wiser ways than we have done them in the past. Yet, when it comes to modern day, in many ways, our dreams could benefit from heeding and integrating some ancestral clinical wisdom because we are not, in part, doing things better than we have in the past when it comes to areas like personal health.

For this reason, my m=1 my-thology includes two dreams:

1) Ancestry: a school that teaches students survival and thrival skills in modern day.

2) Ancestral Fitness: an anti-health insurance co-op that finances healthcare for folks conducting n=1 self-experiments with ancestral mimicry.

Ancestry is a school, an educational institution. Ancestral Fitness is a co-op, a health institution. Both are "institutions" that would attempt to blend the we'd-be-wise-to-learn-from-our-ancestors mythology with the powerful advancements of the information age to equip folks with practical, real-world survival and thrival tools and skills.

That's it. That's enough for one lifetime.

I'll be working on these dreams with friends for awhile, while continuing to attend Dave Lull University in the meantime.

Non-traditional education is a beautiful thing.

Thinker away.

Ciao,

Brent

Part 4: Interview Series with Aaron Blaisdell of UCLA

(Above: Janss Steps at UCLA--a great place for sprints!)


Finally, the much anticipated Grand Finale of the excellent interview series with Dr. Aaron Blaisdell, Professor of Psychology at the University of California, Los Angeles (UCLA).


Part I & Part II & Part III


KP = Kai Pottenger
AB = Aaron Blaisdell

KP: Have you learned anything with personal self-experiments that inform your research or potential research prospects?

AB: Not immediately. In the back of my mind, I have thought it would be interesting to look at the role of macronutrients in cognitive tasks that my subjects engage in. Since rats are one of the typical models of health outcomes, it would be interesting to apply it to a cognitive approach. It’s not what I am funded to do--but I do a lot of things I’m not funded to do. It just depends on how feasible it is and how interesting it would be to my community of comparative psychologists. It would be more interesting to the Paleo community. Also, it would depend on how feasible it would be to construct such diets. Everything I buy right now is off the shelf. I don’t know if I have the gumption right now to start doing all that. I have so many other really cool things lined up right now.


KP: Share a little about how you have integrated Ancestral Fitness into your lifestyle as a professor--exercise patterns, eating choices, etc.

AB: I basically do the Primal Blueprint type of exercise. I lift heavy objects a few times a week. I used to do weightlifting, pushups, isolation exercises. In the context of my old diet--cereal, pasta--I gained muscle mass slowly. Especially after having kids, it was totally derailed. In the context of my new diet, just working out two sessions a week, on average 15 minutes, with 2 or 4 exercises--push-ups, kettle bells--I have seen huge changes. I have always been a walker, especially at UCLA, a walking campus. I also found a place to do sprints in the quad in front of Janss Steps. The track is closed a lot at UCLA, so it’s hard to find a place to run. I do sprints every two weeks for 10 minutes. That keeps me in better shape physically even though I actually have scaled back from what I used to do. I work my quads in the quad.


KP: What ways do you see promise in altering nutritional choice architecture for people to help improve their health states?

AB: That’s a biggie. Umm … blow up all the conventional stores. I don’t know. Stuff has to be made readily available. It can’t be prohibitively expensive for the general public. The general public is watching bottom dollar. I see it in my house. My wife is Chinese and wants to buy the cheapest priced head of lettuce or chicken. I go to Whole Foods and get the free range, organic chicken, and my credit card bill shows it. Farmers markets or Whole Foods are much more expensive.

It would also have to work in the food industry--restaurants. If a restaurant fries something, they are using corn oil, and obviously such heavy lobby groups keep that in place. I don’t know what kind of forces need to overcome that. Like McDonald’s switching from beef oil to vegetable oil.

One, people have to have knowledge and awareness. Two, good stuff has to be readily available at the supermarket. Third, the price has to be comparable to the other stuff that’s on sale, otherwise they will avoid it.

That’s why I am interested in primal vending machines. It’s changing the choice architecture landscape. A campus like UCLA might have enough people knowledgeable enough to have a tipping point--as Gladwell would say.

We could make it convenient every hundred yards to dispense healthy options. I just picked up Taleb’s book. Looking through the prelude, he talks about the kinds of entrepreneurial ideas that tend to be most effective tend to be further out in prospective from the conventional wisdom. There is going to be fewer competitors. All the low hanging fruit from this paradigm is already taken so you find the low hanging fruit from another paradigm. This vending machine idea fits that description exactly. Nobody is thinking about it in these terms. It’d be fun--and I could make money.


KP: How did you find out about the epistemocrat blog?

AB: I know I had come across Brent’s name in the comment sections of the other blogs I follow like Whole Health Source and Seth Roberts’ blog. I am actually friends with Seth. We met back in 2004 at a conference. I always knew about his work. It was standard reading when I was a grad student. I met him, and he was talking about variability in rats when he was still a professor at UC Berkeley. It was directly related to stuff I was finding in the pigeons I was looking at, so I approached him about my ideas and how they were related to them. We struck up a friendship and a collaboration, and since then, he has started engaging in the Shangri-la Diet and other stuff. He didn’t have the blog back then. Then I started reading his blog and probably started reading Brent’s blog from there.

A final thanks to Kai and Aaron for connecting for this interview!

To good health,

Brent