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Episode 185: Is effective health care possible, Sharing health info w sick friends
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dear dr. Lyle given the profitability of prescribing pills and surgical procedures do you believe that the mainstream medical industrial complex will ever reach a tipping point and head in the direction of actual true health care as opposed to the current system of what basically boils down to disease maintenance the what the way the world works so the way life works is that that organisms respond to incentives so each each person or each Mouse or moose is simply running cost-benefit so the the current system is is what it is I wouldn't say it's just a tease management I don't think we can characterize medicine with one description in other words there's there's people emergency room physicians that are in there all their entire shift with their whole staff and doing nothing other than trying to save that person's life is ingeniously as possible and there's surgeons that are you know putting people's knees and arms and hips back together and there's people that are cutting cataracts out of eyes and helping people see so yeah I'm not one to sort of take take the whole thing in total however I understand the questioners frustration and that for many chronic disease processes they're not really interested in in any kind of serious education for patients in order to help them understand what they could do to help themselves it's not cost-effective there's no incentive for them to do it it isn't that they want people to continue to be sick it's just that it's too much trouble they're not they're not in the business of attempting to engineer behavior change in the face of the pleasure trap or anything else it's just not their job and so so do I think that that that's going to change and the answer is no I think the pleasure trap is a is a vastly underestimated motivational dilemma and I don't think that education is in general very effective or likely to be very effective with you know it's only like they'd be helpful for a very small percentage of the population with unusual motivation unusual intelligence and and conscientiousness you don't have to be a genius but you have to have have to be having an unusual combination of three things you have to have sufficient intelligence sufficient motivation and sufficient conscientiousness those three things are rarely housed in the same individual and when they are and they're exposed to the information that we talk about people can make spectacular recoveries for those of us that know that this is true it's frustrating to watch this sort of you know I heard go over the cliff as it were but that is the way it's going to be and that's because because this problem is essentially we're looking at the the potency and control of human instinct and instincts in general and the impact they have on behavior and so it's going to continue to be what it is that we're seeing now and with all kinds of little slivers of excellence all over it sort of sparkling through but the general model is going to be the model that you see not because it's inherently evil it's inherently giving people what it is that they're going to want which is going to be a quick fix to whatever it is that they would ails them and in that process they're going to be very very profitable and steady and stable as an industry and so that's what's gonna that's what you're going to get for the rest of our lifetimes and whether or not there's any motivation or excuse me any revolution that or evolution towards something very different it takes place in the future it will be a long long ways in the future it's not going to be in our lifetimes it's a because hmm I know dr. Goldhamer used to tell me and he said this before is that the only motivators that he's seen is when people are on people have enough pain debility or they fear imminent death yeah in other words he's yeah that's a that's a sort of a somewhat jaded Goldhammer II and view of the situation but not too far off there are certainly people that with sufficient intelligence and conscientiousness they don't have to be in any pain they could simply be access to the information and they don't have to be in that much fear they've just happened to be unusually conscientious and they can grab a hold of the appropriate information head the right direction and and get good results for themselves so that but but what he's saying has a lot of truth in it and it's it's similar to what it is that I'm saying that this is not something that 25% to people are going to do is they're they're gonna say well gee you know I don't want to be a diabetic like my father and have my toes cut off now that I I heard Dean Ornish talk you know I'm gonna do what he says to do now that's not going to happen it's going to be 1% 2% of humanity that will will wake up and essentially seize this opportunity to change their destiny the 98% won't that it doesn't mean that they're that they're pathetically stupid or incredibly low in conscientiousness etc it just means that they're people and they're people that are facing I mean there's a reason we call it a trap and it's one hell of a trap and the subtitle of our book is mastering the hidden force that our minds health and happiness and it's because it is a hidden force it's not it's not easily observed and seen and understood and and it's also that we could have said you know mastering the the Titanic hidden force it added their words the forces is is very strong and it's it's enough to defeat the humans that are that are within its reach and it basically does which most people are going to go through this life generally not horribly compromised by the pleasure trap but to some significant extent and and as they go into later years post 50 and they start to wind up with health problems that are chronic as a result of this they're going to wind up in modern medicine in modern medicine scare and if they heard differently they're not going to have the the tenacity and the and the intelligence and the motivation to actually take themselves into a new direction that isn't their fault that just means that it's it's kind of like it's kind of like if we're trying to teach people advanced mathematics you know sort of post differential equation mathematics and it was extremely important there for their lives that they learn it most people simply couldn't do it there would be a percentage of people that could do it and and they would if they could if they'd be if it was you know you you get out of prison if you can get a 90 percent on this final and I don't know Maxwell's equations analysis or whatever the hell it is the ninety ninety-five percent of people simply would not be able to do it even even if it would mean their freedom wouldn't be possible and so this is similar to the problem that we have with the pleasure trap that this is beyond the the skill or talent or whatever it is doesn't seem that complicated but that's because we're looking at it from a particular view from within the system and as as a handful of the people that have the conscientiousness intelligence and for what reddit for whatever reason the motivation to have done this for for us if you're a Colin Campbell or a Caldwell Esselstyn it doesn't seem like it's that tough but that's because you're out of touch just as a fine mathematician we'd be out of touch with the difficulties that a far lesser mind would have when it comes to grasping complex algebra it just seems like it's all logical and you should be able to do this and it shouldn't be difficult to do and you just do it if your life depends upon it you just do it that that that position or perspective literally cannot grasp the the limitations that other people are are having when they face this it's kind of like I've seen it you know in sports since I was a kid were the highly athletic kids like it's just not a problem you just jump up and touch the rim it's like yeah I don't have those fast twitch fibers and so I can't just go up and touch the rim and I can remember Alvin and I playing with a guy when we were injured in high school we could easily get up and soar to the rim and I remember Alan saying God he just makes it look so easy and he did his name was Jim and he had spectacular leaping abilities and we watched him and it's like man it's just so much easier for him and and that's true with with the facility with which some people can handle the pleasure trap it's just so easy for them but they don't understand what it's like to be in in the rest of humanity and the rest of most of humanity will you could just imagine sort of a person's forget in the middle of the velcroed let's go down one notch below the middle of the bell curve and let's just go there for IQ so we're going to take a 25th percentile person it's gonna try to see through you're gonna go to the doctor and you're supposed to have enough independent thinking to say you know what a friend of mine just told me that this book which I can't read contradicts what all the doctors in my health care system say and yet you know if I'm sufficiently independent and I go against all my instincts for pleasure-seeking and and essentially tell my doctor you know what I think you're wrong and I'm not going to take your medication I'm going to eat this food and said and the doctor says you're crazy and it's gonna you know be very dangerous for you if you do this it's like how many of those 25th percentile IQ Minds have the capability of doing that like I don't know one in five thousand and we're not talking about outlying people here we're talking about real live regular people and then even if we go up to someone with sufficient intelligence to maybe have the independent judgment to to read that book and to to consider that the arguments are logical and look at the empirical support so we're talking about a 75th 80th percentile mind how many of them are are sufficiently disagreeable that they would actually go in the teeth of what it is that their physician would say and then how many of those that are sufficiently intelligence officially disagreeable have the conscientiousness to actually consistently go against against the poll of the pleasure drop you start to see the magnitude of the problem and the problem was not engineered by corporate by you know greedy corporations what what capitalism does is it flows resources towards what it what people express that they want through their willingness to trade their hard-earned labor for whatever product or service that you have and the product or service that that has emerged has been give me a pill and I'll feel a little bit better and give me a pill and reassure me that this is you know the way to go on this thing and so what has emerged out of the marketplace that john d rockefeller was seeing more than a hundred years ago would be a fortune was quote patent medicine and and so that's what they did and then of course you know it does get somewhat evil as they burrow their way into the government and take over state territory and rig the system against competitors etc all that is true but none of that's you know true with respect to your personal individual doctor and the system as it is now it's just sort of like the law of gravity just is and so this is now going to essentially have everybody under its influence pretty much and it's it's not we can't characterize it in the way that we might because there's so much genius and goodwill and capability within the system as we look at it in broad spectrum that we can't we can't ignore that now we can't flush it all away with a wave of the hand and say these are the bad people and the evil this is the dark this is the dark side or this is the the bad force you know this is the Empire no it's not as simple as that and so because it's not as simple of that as that you know now the comp now the argument becomes much trickier like actually this part of what it is that they're saying and doing is very ineffective and it's leading you down the wrong path and this is what you need to do you need to reject that and do this it's like I forget it now now we're back to talking about 1 or 2 percent of the people in in the country and in the world are capable of having this kind of judgment in this kind of conscientiousness and follow-through so yeah the modern medicine as you see it is what you're going to get and that's not going to change not in this century yeah I hear you know very often here at the faceting escape and with you know talking with patients is when they when they do get a reversal up there for example high blood pressure or type 2 diabetes and they've had it for decades yes and just eating a healthy diet and you know doing the fast and whatnot all these things can do it better than the medications sure is I hear often that a little bit of disappointment there appears to be a misunderstanding about what they should have been getting at their medical doctor's office with regards to these chronic diseases yeah they're they don't have any illusions that the the emergency room doctors supposed to tell them how to you know reverse some of thing you know but but they feel a little bit let down and it's okay and there's a spectrum so what's going on there well yeah a little light goes on and and that's because it would be it's kind of like let me let me give you a let's suppose that you traded for a long time with oh I don't know let's say let's say it's a plumber and or I mean I'm trying to think something else so there's uh let's suppose that you are no better thing is let's suppose some lawn service you know was mowing your lawn and they were charging you you know I don't know forty eight dollars every time you had a pretty good-sized lon and and you like the guy you know what I mean and he did a good job hurts him seemingly a pretty good job which he did and then you find out from the guy around the block who that's a very similar deal I mean has a very similar yard to you that he's charging him twenty eight dollars and there's a feeling of kind of betrayal like you've been had it's like what is that and so this is what's going to happen when someone comes to the fasting escape and and or they grab a book by John McDougall and they read it and they make some changes and they find out hey how come for the last fifteen years I've been on this medication I've been fearing you know an early demise and we've been doing watchful waiting with the medications and you know because we know there's side effect and then I do this and it's gone and it's over and I don't have to think about this and worried about this and I'm actually in control I mean there's a sense of having been had there's a sense that that the physician on the other end of this you know did they know and if they it's kind of like a political thing like who knew and when did you know it you know out of it and and if you didn't know how the hell is that possible like how could you be so well-educated so intelligent and in principle well-meaning and not know something that is unbelievably basic and so this is I think this is the sense and you know if you walk out of the fasting escape and have had a 10-year pathology reversed in a couple of weeks you'll walk out you won't forget that and you know that's where many of us have have bends it's like wow now I know it's essentially now I can't trust them about anything and it gives you a very jaundiced eye and then of course the more you look into it there's a there's a tremendous reason to be suspicious said and have a jaundice eye about medicine so I mean the more of I've looked into cancer treatments and various and assorted conditions the more I walk away shaking my head and rolling my eyes like that's just a bunch of smoke and mirrors and misery you know in order to grab two hundred fifty thousand dollars out of an insurance plan like this is you know I think the people and there are quote doing what they can but but in so many cases there is no influence there's no there's no profit at all from cancer treatment it's a it's a tremendous money-making scam in many cases not at all so this is that this now becomes the problem you know with your specific cancer you know is this is what they have nothing of it an expensive scam or do they actually have something and you know the problem is in every case you know you you have to you have to be one of those people that can do this differential equations you know you have to look up the science you have to then do your own meta analysis because you can't necessarily trust in the individual study you got to look at all the dots you got to translate their stats into something that means something to you as opposed to what it is that how they present the stats it's like yeah I'd like to see the thing at the end that this means the estimation of the effect size of this treatment means that the average patient who gets this treatment as opposed to not getting this treatment you know lives in additional 63 days that's what I want to see like let's let's translate this into the actual stats that means something to human beings instead of things that are completely obscured and then our publishable behind you know P less than five in scientific literature and therefore quote statistically significant how many people know the difference between statistical significance and practical significance they don't even know that two different questions on the table who knows that you know a few people that took statistics as an undergraduate somewhere and got A's okay so you know it's sort sort of infuriating the labyrinth that you wind up in if you're actually trying to make a decision for yourself about you know some mutilating or dangerous or incredibly painful heroic procedure that they've come up with so is there a reason to be to be frustrated with the with the medical system absolutely however it's like a it's like the law of gravity you know it may be frustrating but at some point you have to realize it is what it is and and it's not going away it is going to be what it's going to be and for you for anybody that's in the reach of a podcast you know that's at this intellectual level you you are among the people that are smart enough to actually read the materials that are necessary to to give you in a you know an informed opinion about what the real situation is and you've actually got the names of the people and the organizations that are that have the talented people within them that can actually help you get an informed opinion about you know what your situation is and what might be the best moves but that's not within the reach of everybody that's a so the the great you know the great Empire you know will continue and and they're not worried about us and they're not worried about any of our criticisms the Empire never needs to strike back yet it simply owns the landscape and the world will continue to be like you know to essentially be caught in its flypaper yeah I can imagine it gets frustrating and this for for people who have care you know loved ones who are succumbing to this and this is actually has to do with our next question so here dr. Lila I've listened to all of your webinars with Gustavo chef AG etc and you often talk about not worrying about trying to convert others to the True North mcdougal way of eating instead we should just focus on our own die and let be we'll find this information on their own if or when they're ready mm-hmm this is fighting our desire to earn esteem by bringing this new information to our modern-day version of our Stone Age village right so this approach works very well for me at work and even with friends but in church this week I felt very guilty no one is specifically asking me for nutrition advice but every single week we hear about and pray for different members of our congregation mm-hmm that have everything from kidney stones to cancer to high blood pressure everything in between all of these conditions could be helped by a whole food plant-based diet I don't feel comfortable saying this much about my diet at church but I feel very guilty about not speaking up if information that I have could actually help someone who's suffering do you have any recommendations for this yes I do depends upon you know sort of what how the person feels how assertive they are etc a great book in the world I don't know I'm sure it's out of print but I don't know that there's an equivalent could be you'd have to look and see I can't remember when I read the start solution I can't remember anything about it sort of it's old it's I mean I just I remember feeling that it was comprehensive and very good but one of my favorite books that was ever done was thing called MacDougall's medicine a challenging second opinion and what I liked about that book is that it it actually it went through sort of conditioned by condition and it gave a second opinion there was probably like a dozen chapters and so I would so if I had this issue and I had a church and I was going to and there was people that we were praying for that were in serious trouble for example I might have myself a little stack of challenging second opinions or something else and or copies of forks over knives for example that's even easier for people and I might I might say to them listen you know I don't I don't know if this could help you at all I really don't have any idea I'm just a little person but you know I watched this video and it seemed pretty inspiring and it just seemed like these people are saying that that we can sometimes do things that can help ourselves quite a bit you might just want to take a look at it just if you feel like it that's what I do and that's how I'd say it so that way you're you're not being pushy you're not telling them you're not making any promises nothing you're just giving them a possibility to get exposed to information and then they can take it on their own oh yeah well when I think about it I would probably give them Forks Over knives because it's a it's a I I don't know how you give people things these days I guess everything does different people do things on Netflix they don't have DVDs anymore but I still have DVDs the but you might yeah it means there may be some way to communicate that and it could be as simple as yes I don't know just a your your a little card with a get-well card with a little note in it about Forks Over knives and then you hand it to him you say yeah I just wrote that down on there for best wishes to you but I don't what do I know it just I thought it was an amazing story and and I don't know maybe there might be something in it for you now that now we don't have some preachy little situation where it's uncomfortable that you're you're saying that there's a whole new way to do things and they should look into it and they can take charge of this and blah blah we don't set up a haywire dynamic this way if we do it super subtle super super sideways and very pleasant and soft and tentative if we do it that way we're not going to set anybody and that that's how you can get that message to people that you want to get it to fantastic hmm yeah it's a very tough one I the patients here at fasting we're always talking about how they want to bring this to people in their lives and you know we use your steam strategy and you know ultimately you really you really can't force anybody to eat this way or live this way you can't really bring bring it as much as I guess like you said the top there's a few percentage of the population that can do it and are open enough to do it and yes listen to it but ya just wanna you want to make it possible as gently as possible for them to to pique their curiosity so that they look into it themselves and that's it now if you have done done that if you have simply very gently found a way to get to bring this to their awareness that is it you're done and there's no there's no profit in pushing and selling it past that point this has to be something that people have to be sort of inherently interested curious and it has to hit them as logical or interesting and then from there once exposed to something you know as as good as forks over knives for example I don't know if there's some militant person with a bunch of tattoos in purple hair then you send them to what the health you know so they can be all upset about the conspiracy okay but if they're a normal person I would I would send them to two forks over knives and and I think that that's a li fulkerson has a beautiful voice and personal style that that feels very honest which he is as a narrator and as the as the guy who goes through this sort of transformation of his own thinking and you know it's a I think they Brian Wendell you know and his team just did it just did an outstanding job and I think that that's our that's our our best calling card for opening somebody's eyes but without you know without us forcing it we it's just a chance that they'll sit back and take this in and then that you know we let these experts like Campbell and Esselstyn and mcdougal speak and speak for themselves to speak for this perspective and that's that yeah yeah I recommend that you know when people people ask me about it I do I do your seem strategy and then you ask him you know you may want to watch Forks Over knives because it's such a well done movie and it's on Netflix so yeah it's really easy just to do that alright so our next couple of questions have to do so this one has to do with a clinical psychology student mm-hmm so dear dr. Lyle I'm a clinical psychology doctoral candidate mm-hmm and I will have my first round of patients this fall I'm nervous excited but mostly curious what concepts and theories from evolutionary psychology have you found most useful in your clinical work and what are the one or two things from evolutionary psychology that I should focus on to help better serve my patients better yet if there are any mistakes that you see young clinicians make that I can avoid what would those be what are those for some background I'll be mostly working with a college aged population along with members of the community who range from young adolescents to retirees who present with various symptom ology we get the kitchen sink thrown us and so to combat some of my unease I'm continually reading books off of your reading list moving along with primary source material any suggestions or help would be much appreciated Wow doctoral student clinical psychology that's great and they're they're starting to absorb they're starting to learn now evolutionary psychology if they're reading books that I recommend in terms of what one or two things are we going to do so what what are two things do you need to make a bicycle alright so the it's a system of thinking and the way that I approach things is is quite a bit different than then it's done in any other therapy style and so the so I can't I can't sum this up and one or two things there's actually a whole host of technique that goes into how it is that I go about trying to hone in on the issues and then how it is that we work the problems so so I I would say that the be patient if you're go ahead and and probably do what's going to be an eclectic version of of humanism with cognitive therapy is probably what most most people are taught unless you're in some dynamic school at which point you're being taught some you know 19th century crazy crap that you know that that is not likely to be the case you're probably being taught and exposed to sort of a mishmash of Rogerian support along with some cognitive therapy ideas and that's fine for now and so just just stumble forward as best you can with this and this there's nothing no experience like like just being thrown in and having to talk to some bright young people about what what's what their struggles are and then stay tuned because myself and some colleagues are are at work essentially putting together materials to help clinicians and laypeople problem-solve from from this perspective and so those will those will be finished by the time you're finished with your scholastic career and you'll be ready then a thoroughly facile with the ideas of of the conventional schools at this point I think you need to there's no there's nothing like being grounded by your own experience and in what the conventional people say before you then go and do it differently and then you get to experience the difference so do your best and then stay tuned that's what I would tell you to do fantastic hmm alright dr. Lao we've got a little political question here so should have Gen Hawk for this woman yeah well we'll get her back dear dr. Lisle I'm a regular listener here over in the UK mm-hmm and I've just listened to an episode where you dispelled the fallacy of bottling up emotions mhm very persuasive and instructive my question is this given that many core characteristics of personality are protocol e predetermined the big five and that the evolutionary process of blind variation is bound to produce extremes from Whitney to select potentially useful new traits mm-hmm aren't there always bound to be some individuals in society who are likely to experience impulses to commit violent acts yes with particularly horrific consequences when gun laws allow comparatively easy access to lethal weapons mm-hmm in the bottling up episode you said that some people are bound to be shitheads mm-hmm and so aren't they're always bound to be Psychopaths and no amount of moral education religious observation or societal conservatism could ever eradicate the problem of mass killings I would be fascinated to hear your views on the subject yeah I'm not sure what what they're asking are they then is there a is there a sort of are we are we inferring when as you read that Nathan are we inferring that the person is is then saying what what what do I think about gun control then as a result it sounds like it I think that they're if they're from the UK which has really really tight gun control laws mm-hmm they may be kind of it sounds to me like they're they're coming up with some dissonance of mm-hmm you know our laws are this way but you know they're flying you know there but we're seeing they're trying to justify these these laws right hey there might be some really bad people out there right so this is a sort of an interesting problem and it's an interesting problem for society is to try to figure figure out you know how to draw the lines and the and so it looks like this and this is a is probably uh this sam harris type of a question and the first of all the answer is that of course there's always going to be by virtue of genetics there's going to be people that are going to be the extreme for low conscientiousness high disagreeable in in high unstable so when we put those three combinations together with just enough intelligence to to plan and and execute on some horrific process then we're going to have some tragedies so the question would be if we lived in a society where where it was increasingly difficult to get firearms could we reduce these tragedies and the answer is undoubtedly so you can think about the the ultimate of this if you had a police state where nobody had any weapons other than the police then it would be virtually impossible to pull off one of these one of these events that you might be able to because somebody could steal their cousin who's in the armies you know rifle and do it anyway but probably not so you could certainly reduce the likelihood of that the question is what's the trade-off and so the you know what are we gonna do are we gonna now say that that people would like to hunt in montana or wherever aren't allowed to hunt because they they we can't have weapons anymore and you might say well no I just want greater control over this or that well you know those are those are absurd and the fact that there there's going to be some they're just going to be merely statistical so if I if I was sufficiently disagreeable it's sufficiently intelligent and sufficiently therefore angry and had some grievance which I probably would have a sufficiently disagreeable and I was low enough in conscientiousness and unstable enough I'm not gonna let the little matter of the fact that I might have to steal my cousin's rifle out for a night get in my way okay or that I may have to buy one on the black market so you start to see that sorry once you once you got you know 1520 million guns there's there's gonna be no practical way to to bottle that up short of some pretty draconian state interference so then you have to decide whether or not you want that state interference and so so I I could envision a society even in America potentially 100 years from now but the the entire culture could have changed enough that the people would strongly vote to say you know what we want all this wrapped up and we don't want all these individual guns and etc we want them all burned and melted down and put into you know steel bars and set out in the desert and etc and that we're all gonna go weaponless okay except for the few highly efficient you know people oh that run the state and their minions possible okay I don't think it's very likely but if the democratic process gave rise to that and there was a second amendment you know amendment of that or repeal of this and the whole society went for it I could you know in principle you could see how such a society would would be and that there would you know obviously this is all just pipe culture pissed or you know sort of futuristic crazy talk so the real question is should we be thinking the cost-benefit through right now and should there be action on this because you see some some of these disagreable but people getting hold of guns and committing tragedies so therefore shouldn't we do something and this it a is it a burning issue right now that should be front and center of the the political landscape etc no I mean it's of course it's worth noting these things but I think when you understand the kind of changes that you would be seeking the magnitude of them and what it is that you would ever likely to get changed and how much those changes would actually any good that they would do I think it's kind of personally I would just shrug my shoulders and say you're not going to move the needle on this by a hundredth of a percent so why even bother this is the world that we have it's whether you're in the in the UK or the United States you live in a magnificent world and you live in a world that's incredibly free where you're extremely safe and that your odds against some tragedy like this are miniscule that's pretty good and part of that part of the price of getting there and part of the price of sort of establishing that freedom was to have been armed to have the populace to have a to have those kinds of to have weaponry available on a fairly widespread basis and it's also as many people would point out I don't know how about how legitimate this isn't at present I'm here but you need to potentially always be having a check of the citizenry against their government and maybe maybe you can't but you know believe me there's been people living in tyranny all over the world for a long time that the reason they're in tyranny is because they weren't armed so the u.s. was you know the United States was made by people that said hey we're not going to have the government dictate to us this and that and so we're gonna have a check and balance against them I think that I think that argument has merit whether or not it will have merit in the future whether it has it now it's debatable but the this is a historical process and things of this nature and these kinds of decisions appropriately change very very slowly with essentially probably changing only with overwhelming evidence and I don't think that we have overwhelming evidence now that we would all be so much better off if we disarmed a population I think that that's a I think that those are you know interests questions worth debating but I don't think that the answer is at all clear so I think it's personally I think it's more interesting to know how much psychiatric medications may be involved in some of these things and that's that's an entirely different question that doesn't get a lot of attention
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