Center for Neurobiology of Stress Basic & Translational Science Symposium at UCLA

Searching for Nassim Taleb's epistemocracy ...

... an Ancestral Fitness Epistemocracy in this case:

This Thursday (February 4th, 2010), Professor Aaron Blaisdell and I will be presenting a poster at the Center for Neurobiology of Stress Basic and Translational Science Symposium at UCLA. If you live in or near Los Angeles, come hang out with us as we discuss our conjectures between 12:15 and 2:15 PM--attendance is free, and the festivities will be held in the Neuroscience Research Building Auditorium, with fascinating talks running throughout the day.

Here's the text to our poster:

Where is Evolution in Health?

• Evolution is the default perspective in science.
• Evolution is absent in modern health affairs.
• Modern environments dramatically mismatch our ancestral environments.
• This mismatch burdens and breaks our biochemistries and physiologies.
• Diseases of civilization (metabolic syndrome) underlie current health crises.
• Neolithic (esp. post-industrial) diets cause obesity / diabetes / autoimmune disorders.
• Modern healthcare practitioners struggle to treat patients effectively.
• Healthcare system's financial ($$$) solvency challenge requires cost-effective preventions like ancestral nutrition interventions.

Epigenetic Outcomes from Ancestral Nutrition: Two e-Patient Cases

• Ancestral Health community self-organized online (e.g., blogs).
• Physicians, scientists, health experts, and patients interact to share evolutionary lifestyle insights.
• e-Patients (i.e., you!) access this information and then n=1 self-experiment on their own bodies daily.
• Aaron Blaisdell applied these principles to improve his erythropoietic protoporphyria, a 'genetic' condition, using an epigenetic treatment approach via nutrigenomics (*see Robb Wolf's excellent post).
• Brent Pottenger cured his 'genetic' migraines and sinus infections through ancestral nutrition cooling inflammation interventions (hat tips to Dave Lull).
• Number of actively-engaged e-patients is increasing rapidly.
• Positive epigenetic responses from e-patients spurs further growth through social media networking (Ex. Mark's Daily Apple).

Future Direction in Physiology: A Patient-Driven Approach

• Current generation of children projected to live shorter lifespans than their parents.
• Deviating further from ancestral nutrition traditions will inflate diseases of civilization.
• Nutrition and lifestyle treatments are cheaper and are more effective and rational than pharmaceuticals and surgical interventions in most cases.
• Ancestral Health community can integrate evolutionary perspectives into health affairs.
• Ancestral Health Symposium at UCLA to foster interdisciplinary translational collaborations between experts and patients to restore and achieve health.

We compliment this text with some neat diagrams, pictures, and images, but you'll have to see us in person to get the full view.

Baby steps; one-day-at-a-time.

To good health,

Brent

Where are your bare feet and Vibrams at?

(hat tip to Dave Lull)

I barefoot (hat tip to Brian Geremia) as much as possible, mostly around the house.

I wear my Vibrams when I workout at the gym (I get lots of comments), when I play tennis, when I ride my bike, and when I hit the trails to take hikes.

It feels great.

Parkour!

To good (foot ... & the rest of the kinetic chain) health,

Brent

Comment Highlight: Medical Bricolage by Dr. Doug McGuff & Domain-Dependence of Checklists

Medical bricolage is how to care for the Patient of One.

It's a clinical craft.

It's taking that particular n=1 patient's specific symptoms and presentation at the time, embedded within the context of the care episode at hand (however that unfolds), and then gathering and cataloguing data points actively through careful examination, questioning, and observation in order to deduce how best to proceed iteratively (which always includes inaction as an option).

What does this craft look like in practice?

In response to my previous essay on craft, Dr. Doug McGuff, author of Body by Science, chimed in with an awesome real-world example of medical bricolage in practice:

This weekend I experienced an opportunity for Bricolage during the resuscitation of a septic 3 week old infant. This child presented in respiratory failure (later found to be due to pneumonia and sepsis) and suffered a respiratory arrest upon presentation. We moved the child to the major resuscitation room and performed bag-valve ventilation until it started breathing on its own. However, it quickly had another apneic spell that resulted in a near cardiac arrest (when infants stop breathing their hearts slow way down and will even arrest fairly quickly). I intubated the child (who arrested during the procedure) and then quickly ventilated him until the heart rate came up and the child's vital signs returned.

Typically, we will administer a paralytic so that we can completely take over the child's breathing in order to spare it of the work of breathing. However, as we were preparing to administer a paralytic, we began to notice an unusual pattern in this child. Whenever it was breathing under its own power, the vital signs were perfect. Whenever he would have an apneic spell, his oxygen saturation would plummet and he would arrest even though we were ventilating him optimally via the endotracheal tube. Everyone involved (me, nurses, respiratory therapists) noticed this pattern and all agreed to withhold paralytics. We then developed a perfect rhythm of matching our bag-valve ventilation to the child's spontaneous respirations. Within 5 minutes, we began to notice that the child was now matching HIS respirations to our bag-valve ventilation.

When I spoke to the pediatric intensivist, I explained our observations. I expected him to recommend the standard procedure of administering paralytics, but to his credit, he felt very strongly that we should continue in the same pattern that had been working for us. There was no good physiologic explanation for this, but unless we were augmenting the child's own breathing pattern, things would just crash.

It was a very stressful resuscitation, but the child did well. This was a great example of Bricolage and of how you (for unexplainable reasons) can kill someone with templated medical care.

Talk about a positive Black Swan in emergency medicine.

Dr. McGuff's exemplary experience of adaptive and creative deductivist decision-making (improvising, as Brett would say), as communicated in Dr. Sandeep Jauhar's excellent book review, "One Thing After Another" (thanks to Dave Lull), of Dr. Atul Gawande's latest masterpiece, The Checklist Manifesto, speaks to the domain-dependence of checklists/templates/standards/protocols/et al. --> They are sometimes applicable and effective support modalities in some known (concrete) engineering and repetitive (acute) intervention procedure domains, but they often prove ineffective and fail quickly in other more uncertain, novel domains (like in Dr. McGuff's case) in the following ways that the ever-insightful Dr. Jerome Groopman captures magnificently (hat tip to Dave Lull):

That may account for the repeated failures of expert panels to identify and validate "best practices"? In large part, the panels made a conceptual error. They did not distinguish between medical practices that can be standardized and not significantly altered by the condition of the individual patient, and those that must be adapted to a particular person. For instance, inserting an intravenous catheter into a blood vessel involves essentially the same set of procedures for everyone in order to assure that the catheter does not cause infection. Here is an example of how studies of comparative effectiveness can readily prove the value of an approach by which "one size fits all." Moreover, there is no violation of autonomy in adopting "aggressive" measures of this kind to assure patient safety.

But once we depart from such mechanical procedures and impose a single "best practice" on a complex malady, our treatment is too often inadequate. Ironically, the failure of experts to recognize when they overreach can be explained by insights from behavioral economics. I know, because I contributed to a misconceived "best practice."

In my personal reflections, I've contrasted Dr. Groopman, author of How Doctors Think, and Dr. Gawande on these clear differences for some time (non-surgeon vs. surgeon, unknown vs. known, population vs. individual, etc.), and I have seen Dr. Groopman acknowledge domain-dependence straightforwardly and insightfully, as above, but have yet to see Dr. Gawande do the same. From my view, Dr. Groopman spends more time--which seems wise--considering the messy/uncertain cognitive (heuristics & biases) deduction domains, before we decide to 'operate', as Dr. McGuff did perceptively when he responded appropriately to the feedback he kept receiving from that child. Once the decision has been made to 'operate', a concrete task/objective is at hand--a mediocristan procedure like landing a plane--that is more amenable to 'checklist manifesto' infusion. Deciding whether or not to put a plane in the air in the first place in the face of bad (as well as nonlinear & chaotic, extremistan) weather is an entirely different ball game.

Dr. Doug McGuff landed a plane in a hurricane.

That's craft in practice at its finest.

You can't template that.

Undoubtedly, checklists/templates can shape/reinforce habits based on known past failures to avoid false steps in certain concrete/repetitive procedural situations, but they cannot tame complexity, uncertainty, and provide prescriptions/proscriptions (especially in longitudinal, less controlled settings) for the care of individual patients in their specific cases. Respect for the limits of knowledge (epistemology) must rule the day then. We must always, as Nassim Taleb suggests, factor for the unseen.

Somewhere, there's a transition phase/step between these two fundamentally different domains--a transition that sage physician bricoleurs like McGuff, Jauhar, and Groopman understand intimately: it's their craft that they speak about, after all, born out of experience and extensive reflection and introspection. That's being human in the practice of medicine; it's caring for Patient of One human beings by being a humble human being in the first place.

Like Seth Roberts' Theory of Human Evolution reiterates (hat tip to Dave Lull and Professor Aaron Blaisdell), we can make our livings in diverse ways if we identify the roles that crafts play in different domains. When it comes to healthcare domains, clinical crafts provide the foundational backbone of medicine; a backbone that is best equipped to bend but not break when bricolage carries the day.

That's, at least, what I say.

m=1/n=1, as always.

To good health,

Brent

Where have all the crafts gone?

"Be human: tinker," Nassim Taleb likes to say.

In education and human development (which nearly encompasses everything, if you think about it), this statement leads to the following heuristic (thanks to Dave Lull and Brian Frank):

Education is itself a craft — over and above (or underlying) everything else.

If it's n=1 nutrition education, deduce (like Sherlock Holmes), on your own terms, for yourself, what real ancestral foods to eat, to not eat, and to test further by self-experimenting. All that matters is your heritage/lineage, your genetics/epigenetics, and all the other "givens" (as Keith likes to say) that define and influence your specific Patient of One case.

Context matters.

If it's n=1 life-long learning, deduce (like Socrates), on your own terms, for yourself, what real ancestral wisdom to heed, to cast aside, and to test further by trial-and-error thought experimenting (a la Einstein). All that matters is your personal thinkering--your thinking (m=1 searching/reflecting/mythologizing) that leads to tinkering (acting/responding/creating).

Craft matters.

Bricolage is craft: a thinkering craft. Human beings embrace crafts; we survive thanks to crafts--just consider how medical practitioners flourish under trauma and emergency conditions, demonstrating vast human potential for working 'miracles', yet struggle considerably to fix our broken bodies when they fail at the hands of the chronic diseases of civilization. We thrive on the concrete; we do our best but tend to struggle with the abstract. We're human. Bricolage is human. Bricolage involves taking whatever happens to be available, thinking about it, then tinkering with it, just to see what happens, to create new things, build useful products, and fix broken pieces. Nutritional bricolage is self-experimenting with energy intake: (1) searching: we strain, research, reflect, reason, question, and then, finally, make the choice to (2) fuel our physiologies with certain ingredients, the fundamental building block materials that our physiologies must interweave to produce our bodies.

And I am not about to just put anything in my body.

So, I search actively and diligently through my ancestry; I search throughout human (and non-human) history, and I search through the PubMed Anthology of Mythologies for conjectures that seem most reasonable, logical, and safe for testing on my own body. Remember, we can't opt out of nutritional bricolage--we have to eat and drink! This critical craft is built into the human condition, whether we like it or not. And, if you have to play the game, you might as well excel (which usually entails failing quickly, rebounding, and fighting back stronger than before, each and every day). We know that predicting the past may be just as difficult as predicting the future. Thus, when we look backwards, whether studying evolutionary concepts, societal conditions prior to war, or how we trained the week before an event, causation will be murky at best. However, here's where craft can help. Craft encourages us to focus on the conditions immediately in front of us: the kitchen (domain), the chopped up vegetables (ingredients), the pastured eggs, etc. that we work our hands into and toss around to make delicious suppers throughout the week. In this immersion, we learn cause and effect tentatively--some spice here produces a new flavor there, which we later test for reproducibility; eggs and bacon cooked in coconut oil sure taste good and satiate hunger effectively (so far); and, the deductive reasoning list expands exponentially. But this exponential expansion is sustainable; it's insatiable but sustainable because the lessons learned in the kitchen have real-world, local context (just what our brain's neural networks need): we embed these gems in our nutritional culture, just as we do in the gym with our personalized physical culture.

Yet, outside of the gym and the kitchen, a simple question keeps striking me as critical to our contemporary setting:

"Where have all the crafts gone?"

We need to resurrect craft to pull us out of this mess.

During the debt expansion, crafts were outsourced, downgraded, ignored, and left to float away. "Careers" and "jobs" propped up on debt displaced concrete, tangible hard skills that used to rule the day. We became less human as a result. Craft makes us human. Education is entrusted, in part, with fostering human development. Education needs to re-embrace and teach craft. That's how people develop. Our natural passions for learning emerge through tinkering, through discovering, practicing, and mastering crafts. Crafts provide sustainable sustenance for leading lives. Crafts fulfill us; we feel good about and take pride in producing our own pieces of artwork to share with the world energetically.

A beautifully cooked meal is a piece of art. A graceful and powerful workout is a piece of art. And, we like art.

When (debt) bubbles pop, craft rises to the surface as the modus operandi for searching and acting in the face of opacity. We can learn by grace--bubble or not--rather than by hard knocks by reestablishing the humble role of craft in modern society, one tinkering bout at a time.

Where have all the bricoleurs gone?

Their crafts have catapulted humanity so far.

We could use a positive Black Swan strike to carry us far.

I wish for craft upon a shining star.

To good health,

Brent

Practicing Environmental Fluctuation: My n=1 Thermal Variation Tinkering

Humans are adaptive organisms.

We constantly change in response to varying environmental stimuli. In Body by Science, Dr. McGuff maps this as stimulus --> organism --> response in order to create a simple yet effective framework for viewing our (epigenetic) interactions with our environmental stressors. When we, as Seth Roberts does magnificently, self-experiment with lifestyle choices, we are essentially thinkering with the stimulus piece of this biological equation in hopes of fostering healthy biochemical responses from our physiologies.

One way to harness this equation is to work with thermal variation within the context of our local ecologies. The epistemocrat archetype embraces Nassim Taleb's Barbell diversification strategy, and in this spirit, we can apply this approach to incorporate thermal variance in our daily lives. Most of the time (~90%), we expose our bodies to our local ecological conditions in line with regional seasonality. Then, for a small amount of time each week (~10%), we intentionally expose ourselves to environmental variations.

How does this map manifest in practice?

In my current n=1 self-experimental case, I have deduced the following thermal fluctuation practices:

1) Work out during different times--and thus temperatures--of the day.

2) Mix in steams (humid) and saunas (arid) before and after workouts.

3) Swim (cold water) and lounge in the hot tub (warm water) following intense dry-land bouts in the insulated gym.

4) Vary the water temperature during showers, from cold to medium to hot.

5) Your turn ... ?

These are simple clinical applications of *Heat Shock Hormesis* (*see more splendid notes by Dr. BG*) concepts that I have been practicing (thanks to Art DeVany) for quite some time enjoyably (and yet-to-be-falsified, more importantly).

What's my m=1 my-thological 'story system' behind this thinking? Simple, our ancestors survived by adapting to rapidly changing, fluctuating environments. That's one m=1 thread to use as venture capital funding for starting this type of self-experimentation. Remember, skin is the largest organ in our bodies--it's critical to our sensory abilities--so contemplating what we expose these precious cells to makes good physiological sense to me.

If you have other thermal fluctuation practices that you have deduced in your specific Patient of One case, let me know--I am always looking for ways to diversify my external stimuli exposure safely and effectively.

And, speaking of interacting with our environments safely and effectively, make sure to read and reflect on Nassim Taleb's latest Notebook entry, "120: Climate Change and 'Too Big' Polluters" (warm thanks to Dave Lull, as always), to see how Nassim applies epistemic humility--decision-making in the face of opacity (incomplete knowledge)--to construct hyper-conservative environmental policy proscriptions (that is, what_not_to do).

Whether structuring your Heat Shock Hormesis efforts or considering how best to interact with your local ecology conservatively, defaulting to ancestry, the Wisdom of Mother Nature, seems wise to me. That's the baseline starting point (*see Jeff Erno's note), and the burden of proof is on everything that iterates and deviates from there.

As Keith Norris says, "Training for athletics and training for life are two different things," and epistemocrats realize that training for life requires entertaining many different conjectures (and disciplines) all at the same time. So, perhaps, next time you go to the gym or out for a workout, tinker a bit here and there with some thermal variance conjectures and just see what happens to your physiology (I suspect it's an important part of the immune system function equation; priming the body's ability to handle novel, unexpected flux).

Remember, it's always n=1 with me, but it's an individualized n=1 that I share openly and honestly.

Really, though, it's just a logical extension of my thinkering model for biotechnology.

To good health,

Brent

Muscle, Smoke & Mirrors: The Unseen, Serendipity & Faith

(Above: Muscle, Smoke & Mirrors by Randy Roach)

PRIMO,

Randy Roach respects the unseen. He recognizes the limits of disrespecting Mother Nature's evolutionary wisdom that is embedded in our ancestries. He speaks to this throughout his book when he focuses on the value of ancestral traditions in diet and health practices. The depletion of the soil and the industrial manufacturing of fake foods strike him as particularly detrimental to our health states.

He also values n=1 philosophy; he expresses this as n=1 individualized Physical Culture:

"[M]uch of our very nature is often expressed through our own personal Physical Culture. Exercise, diet, hygiene, educational, and spiritual pursuits all play significant roles in shaping the impact of our individual presence. Obviously from these variables alone the philosophical permutations are tremendous in terms of governing one's own Physical Culture. ... For some in the pursuit of a richer enlightenment, it's a constant seeking of a symphonic balance between the conditioning of the body, the cultivation of the mind, and a continuous unfolding growth of the spirit, all the while maintaining a harmony with their natural environment. In actuality, everyone practices their own Physical Culture whether or not they're even aware of its meaning."

In Volume I of his book (Volume II appears to be due out soon), Roach develops this notion of holistic n=1 Physical Culture by working his way through the history of "bodybuilding" during the 19th and 20th centuries. Through this journey, he infuses insights on the worrisome changes in the nutritional practices of those engaged in the Iron Game (which also reflect the larger shifts by mainstream society). Real Foods like butter, eggs, pastured meats, raw dairy, and other ancestral traditions lost favor to vegetable oils, refined sugars/carbohydrates, trans-fats, protein powders, and other heavily processed 'things'. Prior to the inception of these trends that took hold near the middle of the 20th century, low-carb/moderate-to-high-protein/high-lipid real-foods ancestral diets were embraced as keys to health for many, including Physical Culturists. Bodybuilders self-experimented widely with their energy intake patterns for years, and many of them arrived independently at ancestral tradition themes--these inputs helped produce the best physiques.

Muscle, Smoke & Mirrors also features my ancestor, Dr. Francis M. Pottenger, Jr., MD, prominently (*see Price-Pottenger Nutrition Foundation). According to Roach's account, Dr. Pottenger's insights on raw dairy influenced early bodybuilders and health-conscious folks uniquely. The topic of raw dairy always makes me think of 'the unseen'--those components of existence that defy our senses, despite our technological advances. Pasteurization certainly destroys elements of real raw dairy in the name of sterilization, but Pottenger's cat studies showed that these simple changes lead to varied body compositions and health states in felines. Using Dr. Pottenger's research as a source of mythologies for n=1 self-experimenting, many bodybuilders included raw dairy (both milk and cheese) as core components of their diets with much success. In combination with the insights from Dr. Weston A. Price, DDS, the Physical Culture community resembled an Ancestral Fitness Epistemocracy (AFE) up until about the middle of the 20th century! Food processing and steroids, of course, changed everything abruptly (sadly and unfortunately), but hidden within the rich history of Physical Culture is quite a healthy tale of nutrition that Randy Roach tells nicely.

SEGUNDO,

Comment Highlight: Professor Aaron Blaisdell chimed in to my previous post on 'faith', which I defined in terms of Opacity (incomplete knowledge a priori):

Even scientists have faith in the sense that any hypothesis or conjecture or any exercise in counterfactual reasoning must rest on making certain assumptions. The assumptions are the rules that govern how the system works. We play with parameters and processes within this carefully defined, circumscribed system. That is, we have faith that our assumptions are valid. We must recognize, however, that these assumptions usually have not been tested and are taken on faith as a matter of convenience; of getting off the ground. Good scientists, however, recognize that for real progress to occur, all of their assumptions must be recognized and tested--either sooner or later. Some assumptions may defy testing, but that doesn't mean they shouldn't be subjected to careful scrutiny. It is unfortunate--but all too human--to turn assumptions into blind faith rather than tentative, "let's just assume for the moment for the sake of convenience" faith.

I use rational models as an assumption in my experiments. I assume rats are rational in that they have been designed by evolution to make decisions in an optimal manner based on information they've acquired through experience. This is just an assumption of convenience, and it is used as a heuristic. I don't mean to imply that rats ARE rational, only that a rational model makes testable predictions about their behavior under certain conditions. I test their behavior under those conditions. If I find their behavior is consistent with the rational model, I don't take that to mean that I was right in that rats are rational. My very next experiment can still falsify this assumption. And it should be tested repeatedly and systematically so I don't become dogmatic about accepting this assumption blindly.

To summarize, I think faith (assumptions) are critical to advancing theory, but should be tested and revised according to the dictates of empirical scrutiny.

Parkour!

Some people have faith in experience; some people have faith in a deity; we all have faith in combinations of things; but, regardless of these sources, we all have faith, at the margin, in something. Faith allows/permits action (as Nassim Taleb says, "Beliefs are decision-making tools"). Faith plays a transitional role in the thinkering equation as we move from thinking to tinkering, from searching to acting.

When it comes to dealing with the envelope of serendipity, we all must admit that we place faith in something greater than ourselves when we take leaps of faith--we act--to pursue novel options as they emerge unexpectedly in our lives. Consider Dr. Doug McGuff's recent humble reflection ("Chance") about taking a leap of faith when John Little approached him about co-authoring Body by Science:

It wasn’t until today (Sunday January 10th) that I realized my WOW was done on the 1 year anniversary of BBS’s release date. It has been a fantastic year. I shudder to think that I almost did not agree to John Little’s offer to collaborate on this book.

A priori, Dr. McGuff had no idea things would turn out for him the way that they have, but as Nassim Taleb recommends, positive Black Swan opportunities surface from the envelope of serendipity in unpredictable ways, so when a thread--a ray of light--appears that seems like an opportunity, the next move is to pursue this "chance" to its logical conclusion. In Dr. McGuff's case, that logical conclusion manifested as Body by Science, an epistemocratic map for health and fitness decision-making. What a feat in the art of maximizing serendipity (thanks to Dave Lull)!

I suspect that examining the roles that faith--however we define 'faith' individually--plays in our own lives will position us better to act on these promising chances when they present themselves transiently, out of nowhere. I respect that dynamic: I do not know where these glimmers of hope may lead, but I pursue them tirelessly and intensely right away to see what unfolds in front of me. Sure, many of these leads lead nowhere quickly, but we have no way of knowing that a priori. Faith and serendipity are interlinked intimately that way. Bricoleurs embrace that reality.

TERCERO,

Nassim posted an addendum essay--"Why I Walk"--to his quote in the recent New York Times article, "The New Age Cavemen and the City." The first paragraph of Nassim's "Why I Walk" essay introduces Professor Art DeVany and Dr. Doug McGuff: they both influenced Nassim's thinking about health and fitness tremendously. In many ways, they really just opened Nassim's eyes to the applications of his own ideas in the domains of physiology--talk about serendipity in thinking of the Ah-Hah! variety.

If you trust your own Eureka! moments (when those neural synapses connect correctly), then that is part of your faith. Powers greater than ourselves exist, whether you view that through a religious, an epistemological, or a scientific investigation lens. These 'powers' resonate with Socrates' famous saying, "Wisdom is knowing how little we know." Structuring life in response to that insight is what Nassim is talking about when he attempts to turn lack of knowledge into action.

That's the key: epistemic humility unlocks exposure to the envelope of serendipity!

To good health,

Brent

n=1 Philosophy: We all have faith

It's the ultimate insight in n=1 philosophy:

"We all have faith in something," says Dave Lull, my deductivist decision-making mentor.

Don't try to be overly rational, objective, scientific, or even empirical about it: faith permeates all aspects of our lives at all times.

The Problem of Induction, as we will see, makes this phenomenon a reality. Opacity (imperfect knowledge) makes recognition of the existence of a 'power' greater than ourselves a philosophical-debate-winning-strategy.

Like Keith Norris, said, "Everything is spiritual."

Or, as Brian Geremia says, "It's all part of creating your m=1 personal my-thology."

Indeed, it is.

Why? Let's examine this n=1 philosophy of faith in context.

Humans have tried for ages to map out the textures of our existence using symbols, mathematics, and other communication devices (such as statistics), but all these efforts, at the margin, fail or breakdown because we cannot map the future a priori without already having the future in our map. If time is real, and as far as we can tell it exists, we are dependent upon our limitations in the present. In a sense, we are forever blind to the future: this is what Nassim Taleb coins as Opacity--what we do not see (the unseen). Thus, no matter the rationality/science/logic that we apply to deconstructing existence, we all must default, at some level, to faith in something in order to pass our ways into the future. At the margin, the word probability loses meaning: probability implies knowledge of the future. Our futures depend on some level of faith; we must embrace that.

Self-experimentation localizes this faith: we listen to our own bodies in the present in hopes of reacting in ways that improve our experiences in the future. That's one solid localization of feedback loops that I have faith in: I listen to my own body.

It's n=1 'Physician, Heal Thyself' philosophy.

Thanks to my heritage and personal experiences, for instance, I default to the Bible for clinical wisdom in interpersonal relationship matters. It's a resource that sets me free.

So, in essence, through this bricolage process, I am mapping my faith-based, domain-dependent heuristics and testing them in the present in hopes that they will continue to prove useful in the future (that's an intuitive, non-mathematical approach to probability). But, I could be wrong. And, if I am, I will be fine with these falsification events because I am proud of my values now, in the present, however they test out in the future (and a value is not a value unless it determines your behavior in the future; we cannot isolate values from behavior--they are inseparable). Like Fr. McCurdy said, "I don't need to know whether God, truth, and love exist--following them helps me lead a fulfilling life either way."

It seems that the best case scenario would be to fail fast, learn from mistakes, and move on to a better place.

Or, as my bright brother, Kai, states, "We are blind to the future but through faith we can experiment today trusting to see an outcome tomorrow."

In this context, one of the primary goals of (health) science should be to investigate and create tools that empower individuals to set their own physiologies free, on their own terms by listening to their own bodies.

The Bible sets me free interpersonally, emotionally, and spiritually.

The Ancestral Fitness Epistemocracy that I perceive is coalescing nicely in the Blogosphere helps each Patient of One set his/her own physiology free through thinkering. That's the new model for biotechnology that I see emerging vibrantly.

That seems like good self-experimenting deductivist science to me.

But, I could be wrong, which is fine by me.

My faith sets me free.

To good health,

Brent

Parkour!

(hat tip to Dave Lull)

Parkour!

Negative Advice in 2010: Epistemocratic n=1 Choice Architecture

Cheers to the New Year!

Frames and defaults--choice architecture--matter.

Negative advice is epistemocratic choice architecture.

On the epistemocratic Facebook group--"Nassim Taleb's 'The Black Swan' wiping off VAR, Risk Management Models"--Nassim Taleb's 'advice' for 2010 was posted:

"Next year ... listen to negative advice."

As we embark on 2k10, with resolutions (conjectures for testing and refuting) dancing throughout our reflections, heeding Nassim's simple suggestion seems wise to me in two ways:

1) Compliance (stickiness/adherence)

2) Robustness (averting induction)

I composed an essay awhile ago on negative advice, "Negative Advice: Ten Commandments for Health," as an attempt (essays are attempts) to start thinkering with this concept.

In this context, here is an effort to extend my original thoughts:

We must create frameworks for testing and evaluating negative advice: enter n=1 epistemocratic choice architecture.

Folks are more likely to comply with negative advice ("Don't do __") than they are to heed and follow positive advice ("Do __"), for whatever reason (the Ten Commandments provide one survivorship case of support and cognitive psychology research also suggests this phenomenon may be 'true'). Since many people fail to comply with their New Year's resolutions, negative framing may improve compliance rates.

But, compliance with what? That is an important question. We could frame numerous forms of "advice" in negative terms and wreck havoc on our health, as we have done with, "Don't eat saturated fat." Though, noticeably, people have complied very well with that (faulty) negative advice to avoid (good) saturated lipids (to their detriments, unfortunately)!

So, here are some possible Nutritional Bricolage guidelines to get the ball rolling; negative advice based on negative results:

1. Don't consume anything that causes inflammation
2. Don't consume anything that causes allergic reactions
3. Don't consume anything that irritates your mood
4. Don't consume anything that disrupts your sleep
5. Don't eat anything that your grandmother cannot recognize

etc.

(Your turn ... Hint: Don't consume anything that causes excessive mucous production)

I suspect the best approach is to frame negative advice in terms of negative results from self-experimenting (n=1 deductivism in "Putting Science to Work," thanks to Dave Lull). When self-experimenting, the starting-point default, framed in negative terms, should be:

"Don't disrespect your ancestry."

Then, when deciding which self-experiments to engage in, I suspect that following the worst-case-scenario-consequences risk self-assessment thought experiment is helpful, as Dr. Ben Carson suggests (*Please see my previous essay, "Dynamic Hedging Against Uncertainty"):

What is the best thing that can happen if I do this?

What is the worst thing that can happen if I do this?

What is the best thing that can happen if I don't do this?

What is the worst thing that can happen if I don't do this?

I think we should test negative advice conjectures and refute them just like we do with positive ones. Negative advice is more robust than is positive advice because of the asymmetry of knowledge that results from The (Hume/Popper/Black Swan et al.) Problem of Induction. Thus, my approach would be to empirically test, to give an example, "Don't eat saturated fat" against "Don't eat bad carbs" (Vilhjalmur Stefannson did this "Adventures in Diet" test on himself in 1928) and see what results manifest and assess these data points within the context of the negative results guidelines that I started listing above.

So we have two moving parts:

1. Negative versus positive advice in terms of robustness and compliance (research and history suggesting negative advice is more sustainable and increases adherence).

2. Guidelines for evaluating negative advice conjectures, including sources of "wisdom" to listen to (to which defaulting to ancestral mythologies for self-experimentation and falsification provides a foundational platform to start and then bound from).

I see 1 & 2 feeding back on each other in practice.

And, in practice, you will fail (you will "screw up," thanks to Dexter); that's the reality we want to embrace: failing fast by falsifying conjectures while protecting ourselves from blowing up from these refutation procedures, only to regain our balance and take our next steps forward stronger than ever before. It's like muscle-building anabolism. That's n=1 deduction feedback looping (or n=1'ing by OODA looping, thanks to Zach at Paleo Garden for that).

As we know, math breaks down quite quickly in the face of real-world complexity. Applying math intuitively--as we can do by mapping our movement patterns as Levy flights or by visualizing music and healthy heartbeats as kindred-spirit multifractals--seems more practical and fruitful to me in the clinical practice of living. Don't over-mathematize these feedback loops (we simply cannot reason from probability): tap into your Qualitative Self ancestral roots.

That's my jumpstart on this issue for 2010!

I'm passing the baton to you ...

To good health,

Brent