Good Life Project - Medicine 3.0: What Got Us Here Ain’t Gonna Get Us There

Episode Date: July 3, 2014

If the body is a whole, connected system, why does modern medicine so often treat it as a calamity of isolated causes, effects and symptoms?A blend of hippie herbalist, science prodigy, bestselling author and Yale-trained physician , functional medicine doc, Aviva Romm, MD, sees medicine differently. She looks at each patient as a person, rather than a bundle of symptoms. A fully-integrated system where everything affects everything and the true remedies for pain, disease and unease often need to unfold as less of a tactical strike and more of a system-wide reset.Romm is fast becoming a leading voice in a radically different approach to medicine. One that, by the way, is making tremendous strides in treating a growing list of "diseases" and symptoms that mainstream medicine and traditional drug-based therapies struggle mightily with.In this weeks' episode, we dive deep into the frontier of medicine, covering everything from the microbiome (critters in your gut) to epigenetics and how the choices your grandparent's made affect everything from your risk of disease to your state of mind.We also explore Aviva's fantastic person journey, growing up in New York, attending famed Bronx Science High, then heading into the worlds of herbs and midwivery before coming full-circle to train in and then become a leading voice in functional medicine.Watch this week's episode here, and be sure to listen and subscribe on iTunes so you never miss an episode and you get to take each juicy conversation on the go. Hosted on Acast. See acast.com/privacy for more information.

Welcome to Good Life Project, where we take you behind the scenes for in-depth, candid conversations with artists, entrepreneurs, makers, and world shakers. Here's your host, Jonathan Fields. Hi, I'm Jonathan Fields, and this is Good Life Project. My guest today is Aviva Ram, who is a functional medicine doc who's kind of on the cutting edge of really figuring out and deconstructing health and exploring ideas like food as medicine and all sorts of other heretical things. So, awesome to be hanging out with you.

Really nice to be here with you, too. Mayday, mayday. We've been compromised. The pilot's a hitman. I knew you were going to be fun. On January 24th. Tell me how to fly this thing. Mark Wahlberg.

You know what the difference between me and you is? You're going to die. Don't shoot him, we need him. Y'all need a pilot? Flight risk. The Apple Watch Series 10 is here. It has the biggest display ever. It's also the thinnest Apple Watch ever, making it even more comfortable on your wrist, whether you're running, swimming,

or sleeping. And it's the fastest charging Apple Watch, getting you eight hours of charge in just 15 minutes. The Apple Watch Series 10, available for the first time in glossy jet black aluminum. Compared to previous generations, iPhone Xs are later required. Charge time and actual results will vary. So, I want to learn more about your personal journey a little bit first. And then I actually want to, like, let's pinpoint some really interesting things that a lot of people have come to me with. And I'm sure, like, I'd love to, I'm also really curious about, like, what are some of the big things that you explore and you work with people on every day,

but tell me more about you. So right now you're hanging out, you're practicing this kind of fascinating world of functional medicine. First, tell me what functional medicine is. And then I want to take a little bit of a step back with you to find out how you got here. Okay. So functional medicine to me is summed up best by the functional medicine tagline, which is amazing, which is changing the medicine we do and the way we do medicine. And so it's about looking at connectivity instead of separation. So for example, I'll give you a true story from my practice. I have a little girl in my practice who's five.

She had a fever a year ago. Normal pediatric recommendations from the pediatrician, put the baby on around the clock, ibuprofen and Tylenol and fever passed, cold passed, all went fine. But about a month later, the five-year-old ended up with horrible gastritis. She had inflammation in her stomach, really sick, stomach pain all the time, had to be put on this medicine called Prilosec, which is one of the most popularly prescribed medications now. Yeah, it's even prescribed for like six-week-old babies for reflux, which may be appropriate sometimes. But anyway, so my little patient, cutie girl, fast forward another month, ends up with joint swelling in her knuckles, her wrists, her knees. She basically had arthritis.

And the pediatrician said, well, let's just keep her on the stomach medication, and then we'll get to treating the joint problem later as if it was like true, true and unrelated. Whereas in my worldview and how we see things in functional medicine, this is actually really connected and both are really treatable. So I see kids like this frequently and some of them end up on medications like methotrexate, some pretty intense immunosuppressive medications that have, they're big guns with big consequences. Whereas what I did with this little girl was just talk with mom about diet, some simple herbal medicines, you know, just to heal her gut, getting her off this medication that was just talk with mom about diet, some simple herbal medicines, you know,

just to heal her gut, getting her off this medication that was like suppressing stuff going on in her body. And voila, a few months later, she's got no joint swelling confirmed by the rheumatologist and pediatrician, no stomach ache. She's completely off the medication. So it's, it's looking at that connectivity of systems. And then it's also really looking at the whole person. So it's all about, and for little kids, usually life is pretty good. You know,

sometimes they're stressed, but sometimes there isn't like, I've got another little kid in the practice who's really struggling with some stuff. And mom and dad are going through a big time relationship kind of debacle and divorce. And sometimes these things play out in people's lives. So we kind of take like a bottom up at a top down view of like looking at how your life affects your health, how your health affects your life and all the pieces in between.

It's less like treat the symptom on a pinpoint level. It's more, okay, what's going on systemically that may be producing all of these symptoms. And is there some way to sort of like function on that level? Exactly. And it's also like we do treat symptoms because we want people to be comfortable while they're getting well. And then there's this whole piece of like looking at the person in the context of their environment and in their world. So people are hearing a lot about probiotics and the microbiome these days. So we look at that and we take a really big picture view. Like, are you getting food that's organic, that has an opportunity for organisms to grow?

It's really like looking at the whole life. It's really fun. Yeah. No, it sounds amazing. And it sounds also, I mean, it sounds like there's some overlap also. At one point, I looked at doing so many different things, but at one point I was going down the Chinese medicine and acupuncture and herbalist rabbit hole. I did a whole bunch of research on the field and one of the things that was appealing to

me was that if you go to somebody like that, they'll ask you what your symptoms are, but then the diagnostic process is not so much symptoms-based. They just look at the big energetic systems, meridian stuff, and they're looking for the systemic things, and they just assume that if they treat the systemic problems, the symptoms are going to resolve themselves. So it's like there's an interesting overlay there, I think, to a certain extent. Definitely. And Chinese medicine, Ayurveda, they get really cool on other aspects too

that functional medicine sort of looks at, but it's more the individual functional medicine doctor. I look at it because my background is herbal medicine, so that includes some training in Chinese medicine. But actually looking, like you said, at the energetics of the person. So a lot of patients, they'll come in like, I tried every diet. I tried vegan. I tried this. I tried that.

And I just can't lose weight or I can't clear up whatever my symptoms are. But sometimes you have to look at the energetic piece. Like maybe that morning shake is too damp for that person. They need something more warming in the morning. They need ginger tea, not a cold smoothie. Which is definitely not what I would assume most functional medicine docs would be like going to that place also. Right. Because that's definitely the Chinese medicine influence moving in there. Exactly. It's sort of how I got brought into functional medicine. It was a big open invitation. So my background is midwifery and herbal medicine. And then I went to med school.

When I came out, there were a bunch of offers from functional medicine practices. I think they really saw some gem also in what I was doing and had to bring into it, which was that botanical medicine piece, kind of a woman-centered approach, and then this energetic piece. So let's talk about this since you just brought it up, the woman-centered approach. Take me deeper. What is it, and how is it different, and why does it matter? Why would people want that? Yeah. So I think the context of a woman-centered approach really came out of a time that's a little bit different than now. Like there weren't as many cool guys like you,

who are clearly just in touch with our feminine. I don't know if I qualify it as the way under like the cool label, but it's sort of a woman-centered approach. It's sort of a rebound of a very patriarchal model of medicine, which is, don't worry, honey. I'll take care of that symptom for you. Don't worry your pretty little head about it. That ran through everything from obstetrics to general medicine. And a woman-centered approach, really, it can be practiced by anyone.

You don't have to be a woman. It's really a patient-centered, it's a listening-centered, it's about connection. Not just tell me what your symptoms are and let me write a prescription for you, but I want to hear who you are. And you push the pad and the pen away, or you push the computer away. It's like sit back and listen because you really want to know because there's healing in connection. There's healing that comes from what some people call placebo,

but I think that there's something else going on there. I know you talk about somewhere in some of your work or a video you have about emotional contagion. I think emotional contagion, that connection, that heart-centered feeling that a physician can have, which has been more associated with sort of a womanly kind of way of connecting, is where that woman-centered approach comes from. But it's really just about human connection and hearing the story, listening for the clues of the health problem in the story or the clues of the imbalance in the life that may lead to certain food choices, for example,

or not sleeping well or any number of things. Yeah. I mean, since you brought up emotional contagion, there's another really kind of psychological effect that fascinates me called the Pygmalion effect. Tell me. And I'm probably going to butcher it, but my understanding is that Pygmalion effect is essentially, well, here's a case study to relate. The example that I was taught to illuminate it. So researchers went into a classroom. They're teachers, little kids.

And they basically test all the little kids. Then they tell the teachers, listen, these whatever number, X number of kids, these five kids tested off the charts genius. Oh, I've heard this. Yes. Right. But you can't tell them and you can't treat them differently. Right.

And then they actually track the behavior and they have the cameras. And then at the end of the season and then the semester, they tested all the kids again and these five kids test off the charts smart. But the big reveal is that the kids were completely like everybody else before they did that and they realized the teachers like would treat the kids you know like a hundred different ways just slightly differently in ways that would enable them to actually really thrive and flourish on a level that the other kids didn't and the teachers weren't even aware of this and i wonder if that's part of what happens in medicine that when you had sort of

um that when you have some sort of health and healing professional and they think that somebody is exceptional or in their mind they're like, this person is going to beat this, they're going to get through it, they're curable, they're going to... That they end up transmitting that in a hundred different ways that they don't even realize they're transmitting to a patient. And in some way, the patient receives that and activates their immune system or whatever it may be to actually change the healing outcome.

Absolutely. I feel like one of the things you asked, kind of what I'm exploring, what I'm playing with a little bit right now, is this connection between my work as a midwife and my work as a physician. So when you midwife someone, labor is not always easy. Life stuff comes up in pregnancy, sort of how we live and our backstory can impact how we birth. And there's a lot of need for support.

And so a lot of what I did as a midwife was hold that space where I believed in the other person even when their belief in themselves was faltering hmm all right it's like I I can see this happening for you and I'm gonna be here with you no matter what so there was like relationship connection someone holding space and then transmitting that I believe in you it was interesting recently I had a patient who came in and she's been sick for a lot of her life. And I asked her, so what does being well look like to you? And she just kind of diverted.

She was like, right back to talking about her symptoms, right? And like, why is this happening to me? So I reiterated. I was like, so what does being well look like to you? And she had no idea what I was... She couldn't even conceive it. She couldn't. There's got to be this really interesting dynamic maybe i'm just totally making this up

where it's like you want to hold this hope you want to project it you want to allow somebody to believe that after you're like living with illness with pain whatever it may be for decades maybe that as far back as they can remember they can't remember how there's hope yeah right Yeah. Right. At the same time, is there a risk of setting somebody else, someone up with false hope? This is a brilliant question. Yeah. And how do you work through that? Yeah. So I'm sort of an incredible pragmatist and I really have honest conversations with people

about that. And I think that's what that question is, what does wellness mean to you? Because if somebody says to me, I've had 10 out of 10 pain my whole life. And it started when I had a skiing accident and I had eight fractured vertebrae and now they're fused. And every time the weather is damp, I'm like, okay, so what can you live with? And if they say to me, well, I want zero out of 10, I'm like, okay, that's probably not realistic. What can you live with and feel good about that? And then let's set a realistic goal and I'll work with them to set a realistic goal. But then there's also that piece that health is more than just sort of, as the World Health Organization says, like the

absence of illness, right? There's also how we live our lives and how we adjust and how we cope. And I think sometimes what happens is, and this can happen with a lot of things, right? It can happen with a job that you're not happy with or a relationship that you're in and you're stuck in. We get in these mindsets where not only do we have the physical situation that we're dealing with, but then we have our self-talk about it. And sometimes that negative self-talk just amplifies it. So it's like you can have pain and watch a totally hilarious movie, and for that 90 minutes you forget about your pain.

So sometimes it's an attitude shift that I help patients, and that's sometimes the healing. It's going from like, why is this happening to me? To, okay, this is happening. This kind of sucks, right? This really, or it really sucks. And I have to adjust to this. How am I going to find the coping skills?

It's interesting because I went through like that whole process. I have tinnitus. Oh gosh, terrible. Came out of nowhere like five years ago, four years ago. And you know, like 50 million people have it. Big whoop, 17 million people. I know all stats now after going out. It four years ago. And, you know, like 50 million people have it. Big whoop.

17 million people. I know all the stats now after going down. It's amazing what you learn when you have something, right? And then 2 million people, basically, they'll tell you the lies are largely destroyed because they have it on level. Oh, yeah. I had one patient who tried to kill himself several times just because of it. And when you get it, you start to look online. Like, don't ever do that.

Yeah. And there's still, we don't know why I have it, but it's here long enough so that we assume it's here for life. So in the beginning, I was one of those people where it was really not good. And I wasn't sleeping, and it was like brutal, brutal, and it creates this horrible spiral. And I tried everything, all the cures, all of this and that, all the tests to make sure this. And I got to a point where I was, it was a really

dark place. And I kind of said to myself, there was this moment where I was like, all right, if this is me for life, then what? So rather than focusing every waking hour on trying to make the sound go away, distract myself from it, you you know like every possible device you're like if this is just it like how do i be okay you know and that was a moment where a lot of things changed you know and it wasn't that it went away it wasn't that i was okay but that was a moment that i changed my energy being like all right let's work on this basic assumption i'm open to the fact that maybe someday something comes along that makes it go away but at the same time time, it's like a sort of like the Buddhist approach. It's like, okay, you know, if this is my reality, how do I get myself most okay with that? And then I started to, that had moved me into whole exploration of mindfulness and tinnitus,

and which I sort of developed my own approach through that practice, and it was transformative for me, and now I'm pretty fine. But it was that same place of saying, I had to get to a point of absolute surrender. And also realizing that, okay, the sound in my head, it's not going to do anything to me. It's not the sound which is causing the distress. It's my response to the sound. This could be there for life and have no effect.

And it's the same thing you were talking about with disease or pain, pain, especially. And that's where I made the association because I started reading that, that, um, like pain is there's such a strong psychological element to the way you experience pain. And a lot of the anxiety that you build on top of it is what makes you feel like there's so much more pain. So I was saying to myself, well, could the anxiety that I'm building on top of it make it feel like the sound in my head is that much louder when it really isn't? It's just I'm not processing it as well. And that created like a whole new journey for me. But I had to hit that moment.

What brought you to that moment? Do you have a sense of like what it was that allowed you to make the shift? Yeah, I hit a point where I was basically like, if this doesn't change, bad things are going to happen. Yeah. And, and, and I, and because I, you know, sort of like reasonably studied in Eastern traditions, I also kind of like started to really think about those things. And, and then again, probably I started to really also remember, okay, there is, there's an interesting body of work on meditation and mindfulness practice and the experience of pain.

I was like, could this work on tinnitus also? And in fact, so I started looking for a mindfulness-based cognitive therapist who specialized in tinnitus. Not an easy find, by the way. But very specific. Very specific. And I found one guy. He didn't specialize in it, but he had it. And he had sort of worked a bit on himself. And I went in and I'm like, could this work? And he's like, you could. It wasn't entirely convincing, but it gave me

hope. Yes. It gave me hope. And I'm like, okay, let me start to play with this. And I had enough of a tradition in understanding the practice and how to build it that I started to really just work with it. was terrifying in the beginning because the classical instruction is focus on your breath but then if that thing keeps coming back to you make that the focus of your practice which means I have to focus on the sound the one thing that I live and breathe to not hear you have like an ohm in your head right all the. So, you know, it was a really interesting process, you know, and it's still, for me, it's a practice, you know, it is a lifelong practice. And I will, like, my practice is there not just because it makes me okay.

And now it's, and you were saying, you know, like, definition of health used to be like, you know, the absence of disease. And for me, it was, that was stage one. But then what you find is that this practice then takes you from the absence of disease, or at least being okay with whatever it is, to then the practice starts to add your ability to flourish on a whole different level. So it actually really just changes the way you exist, the way you relate to people. And I think going through something like that,

it makes you more aware of others' sensitivity, more compassionate, I think. Well, when you have something like tinnitus, it's not an obvious thing, right? So to everyone else, you look fine. Right. It's not like you're in a wheelchair or on crutches. Nobody can see or hear what's in your head. Yes. And for those who are listening or viewing, if you don't know what I'm talking about, it's literally it's this umbrella categorization for a wide variety of sounds that either through a loss

of hearing or brain signals, nobody really knows, your brain starts to generate sounds from the inside out that you hear 24-7. And for some people, they're totally fine. They habituate. For some people, it's brutal. For me, I was in the brutal category. Yeah. So it's...

I'm sorry. I'm glad you're... Yeah. I'm actually like really okay with it now. But anyway, it's this. I'm glad you're yeah, I'm actually Anyway It's this interesting balance of like surrender and hope and sometimes It's the surrender that moves you from hoping for one thing into doing the work to create something else Which is what you really need that given point in time and some of my patients they come to me with Simple, you know, they just want their digestion fixed.

They don't want to take a deep dive. And maybe there's not a reason to. And then we do the probiotics and the digestive enzymes. But for a lot of people, and especially if they have a chronic illness that they've lived with for a long time, I like to think about it. I'm kind of playing with this term transformational healing, you know, that you can shift your health and shift your life. And sometimes you can shift your life and shift your health, and then it's all connected. It's all one big thing.

It's kind of fun. Yeah. The Apple Watch Series 10 is here. It has the biggest display ever. It's also the thinnest Apple Watch ever, making it even more comfortable on your wrist, whether you're running, swimming, or sleeping. And it's the fastest-charging Apple Watch, getting you 8 hours of charge in just 15 minutes.

The Apple Watch Series X. Available for the first time in glossy jet black aluminum. Compared to previous generations, iPhone XS or later required, charge time and actual results will vary. Mayday, mayday. We've been compromised. The pilot's a hitman. I knew you were going to be fun. On January 24th. Tell me how to fly this thing.

Mark Wahlberg. You know what the difference between me and you is? You're going to die. Don't shoot him, we need him. Y'all need a pilot. Flight risk. So you brought up a couple of things that I want to kind of circle back to,

because they're really like buzzy words these days, and they seem to hold some really interesting answers. And, you know, this is the Good Life Project. So part of what we explore is like, what are some of the pieces of the puzzle? And health is a huge one, you know? And it seems like there's some major unlockies that are being explored on a really deep level. And probably functional medicine is, to a certain extent, leading the charge. And one of the terms you brought up earlier was a gut biome.

And then you mentioned probiotics, too. Yes, yes, yes. Tell me a little bit about what this is and what's going on in that space right now. Yeah, so the gut biome is really fun, and it's emerging. And part of why I love it, because it connects me full circle to kind of how I started out with health and medicine, which was connecting around food, politics, organic farming. And it's kind of... So you were a hippie kid. I was actually showing some pictures to our nurse practitioner recently on a plane trip,

and she actually said, I've never seen anybody that hippie, actually. But here's the thing, I'm actually a housing project kid. So I grew up in a New York City housing project. So you were like a hippie actually but here's the thing i'm actually a housing project kid so i grew up in a new york city housing project i'm the housing project kid i can be like all about it but then i uh i went to college really young when i was 15 and okay we had that happen okay so grew up in this housing project um you from new york yeah yeah so for people who don't know new york i went to this high school called bronx high school science which is like this uber competitive right you test in it's free if you get in you go and it was like this two-hour commute every day from my projects in flushing queens this is like a legit projects my husband used to always before he ever visited he

used to say like oh you're just trying to identify you know know, and I was like, okay, we're going to go. And we drove in the neighborhood and his and my kids' jaws just dropped. They were like, mom, my kids were like, mom, you grew up in the hood. So I was in this environment. It's pretty rough. Like all the kids on my floor literally ended up in juvie or pregnant or like one diet of HIV. So I was this sort of outlier talk about the pigmalion effect, right? I was an outlier in a HIV. So I was this sort of outlier. Talk about the Pygmalion effect, right? I was an outlier in a way in that I was like the science fair kid. I won the science fairs. I won the spelling bees. And so in not really so much Pygmalion,

like the teachers, I think, loved it, having a kid that wanted to learn. And so I got fostered along in sort of that Pygmalion way where they saw me. I was Eliza Doolittle. I do a lot, really. So they kind of nurtured me along. I got into science, was at science. And then my first year there, I was like, I really want to be a doctor. And I was doing this heavy commute.

I was actually on the debate team. I was like this champion debater at Bronx Science, which was a big deal. Commuting back and forth. I keep stopping you, but there's so many things. So many people never reach a moment where they're like, I really want to be this. Yeah. And at 16, you're like, boom. Yeah, I was 14, actually. 14? Yeah, I was 14, and I knew I wanted to be a doctor, and I loved writing.

So I was like, doctor, writing, doctor, writing. And so I wrote this letter to Johns Hopkins University medical school and said, would you be willing to take me early? And they wrote me back this really, I thought they would ignore me, but they wrote me back this really nice letter. I wish I had it, but I don't. And they said, you're a little young for our medical school and you have to go to college first, but here's this great school in western massachusetts that takes smart kids and it was this early college called simon's rock i got a scholarship i went and within about three months i was a hippie kid really hippie kid like i actually grew dreadlocks and like

i was in the whole thing this was 1981 so it was way before there was even something called alternative medicine right yeah so i went there for a year wanted to stick i just got this passion for learning about plants and um i was like learning about factory farming so i went vegetarian so it's not just medicine at this point it's just like deep dive into environment and how everything connects. Exactly, yeah. So one thing led to another, like learning about food politics led me into learning about health politics and the history of medicine. And the part that really kind of stoked me was the history of medicine and women and midwifery. And it was fascinating.

And so I just took a left turn really off this path to, you know, Doogie Houser-dom or something like that and moved to Boston, found a midwife who would apprentice me. She was this midwife working in Roxbury, Massachusetts, which is like kind of like the ghetto experience of Boston. I was just like this white girl taking the train to these like rasta muslim homes studying midwifery it was it was like a pretty radical immersion in so many things like how other people live what's what what are your parents thinking about like right now it's like we've got this we've got a prodigy brilliant kid he's going to be a doctor they go and then you end up in sort of like, you know, a challenged neighborhood in midwifery. Right. Yeah. So I'm just curious, because I'm like, I'm always processing like, okay, how do people handle like the external support systems and the potential

judgment when they're sort of along this path? Yeah. So my family, like my parents were totally disconnected from each other. My dad really was not in my life at all. And you know, my mom was interesting. She kind of rebelled and left her childhood home, not as early as I did. And part of me leaving home was the commute, but also like living with a single mom in a housing project environment, there was a lot of tension. It was pretty fraught. So in some ways, she was probably too hands-off, which wasn't the best thing, because there was sort of no guidance and no supervision. But on the other hand, it was like, whew, I just went exploring.

And I kept in touch with her. I had a boyfriend at the time whose parents lived there. His dad is like one of the most famous philosophers living still in the world and the mom of the philosopher and they had been really alternative. So they kind of let me stay at their house and then I got a job and I was doing beadwork and selling it in Harvard Square for real, for real, paying for my midwifery books and my herbal medicine books. And, you know, one thing just led to another and I ended up with this amazing life as a midwife and herbalist kind of before those things were on the map and

teaching my clients to eat organic and raise their kids healthy. And was amazing so we're what trim so that was kind of the journey no i was right i know i was asking about gut bio but i was just curious about it yeah so yeah so the gut biome piece is really a powerful kind of revelation i think in modern medicine because the question is really are we the home for all these microorganisms that are living in our gut? Or are they the home? Are we sheltering them? Who's in charge here? And really, what it is that we now know that we're inhabited by a bazillion, we actually don't really know how many, but multiple millions of various microorganisms that have innate intelligence to the point where, for example, a colony of one kind of organisms can recognize that there's a dominant colony of another kind

of organisms that might use up all the food. So they go into a more dormant state. They don't proliferate as much. We know that the microbiome in our gut... So the microbiome is sort of the term that encompasses sort of almost like the whole of all the different organisms almost functioning like an organ or a community within us. And they're part of us. They're not really separate from us. We're just cohabitating our bodies, right, and our planet. And what's really fascinating is we know that they do so many things. For example, there have been studies looking at mental health and microflora. So the kinds of gut flora that one person have are going to be different than another person. And depending on what you have in your gut, it may make you more anxious or more depressed.

Or they may utilize your food and create different gases that affect your mental health. Or, for example, two different people can have an identical diet. They can be twins. They can be identical twins with the same diet, the same exercise, but one, let's say, went to Mexico and got some kind of like Montezuma's Revenge, came back with a disrupted gut flora, and now they're gaining all this weight on the exact same sort of caloric intake and expenditure. Just because the flora in their gut is different.

Yeah. So it's really fascinating. Another thing that the gut flora are really important for is metabolizing estrogen. So for women's health problems, a lot of things like PMS and fibroids and fertility problems, and they call it polycystic ovarian syndrome, which is sort of like a combination of diabetes and hormone problems. The microflora all has a role in it. Right. And it seems like I keep hearing about it all over the place.

Yeah. And having had some exposure to the functional medicine world for probably going on 20 years now like the very very earliest days um it the term is not new or maybe microbiome is a relatively newer term but like you know really focusing a lot on gut and gut flora and yeah um so it's kind of interesting because for you guys it's almost like yes now the world is like finally like you know like the microbiome is sexy yes like everybody wants to know that and your poop is sexy yeah and i mean it's so fascinating too because the things that you just said was connected to i think for um a lot of people would be counterintuitive okay we get that maybe it helps in digestion and yeah and but you

know like okay critters in your intestine make you either anxious or ocd or depressed or calm or relaxed or serene or able to handle stress better so like there's a direct time between the things that are living in your intestine and your state of mind yes and between your state of mind and the things that are living in your intestine so for example if you have a lot more stress then you're you're not getting as good gut um as good blood flow to your gut lining and so that affects the quality of what's in there and that affects the quality of the food uh or the ph for example of that environment so that can shift what's growing in there if you're stressed and not making the best food choices for example that can also affect because a lot of sugar feeds certain gut bugs more than it feeds others and

that can throw things out of balance so it goes round and round and you know what i love about it too is that there's so much more consciousness about food and organics and the environment right and a big piece of my evolution and what I believe in as a physician and healer is that what happens in our communities, what happens on our planet, what happens to our soil, it affects us, we affect it. And so there's so many parallels, right? When we think about agriculture and we think about organic agriculture and we think about building a healthy compost pile to feed the soil or putting good nutrients in the soil and like the plants flourish compared to poor agricultural practices like growing one food

in the same field year after year pouring on pesticides and depleting the soil the exact same things happen in our body so if we we eat good quality food, we actually build, there's literally like a soil base in the intestines that this microflora lives on and thrives on. And then the more variety of foods that we eat, of healthy foods that we eat, the more variety of good gut flora we have. And then kind of the parallel to the pesticides is the more antibiotics we take, which are like so overused. It's actually considered an antibiotic resistance. It's like this major global crisis, yet we just keep pouring them on,

and they're affecting us, and they're affecting the environment. Right. And I guess it's such a complex ecosystem. Where do you even start to figure it out? I mean, it seems like also we're in such the early stages of really understanding what's happening there. Absolutely. Well, I guess maybe let me back up and even question more. So in theory, if you're coming out of like when you're first born, you're coming out of your mother relatively sterile.

Where does that bacteria come from? Yeah. Like initially, like how does as a bacteria populate the microbiome in the beginning you can yes so we're really not sterile when we come out we shouldn't be sterile when we come out so we come out and you know our faces and our heads are coming all smushy through our mom's vagina and we get bacteria up our nose and in our mouth. It sounds really gross, but it's true. And so we're coming out of this very not sterile environment,

and we're getting colonized as we come out. So that's like the initial colonization. It is the initial colonization. And then if we breastfeed, this is one of the coolest things to me. So it used to be thought, even just a decade decade ago or so that breast milk was basically sterile. It was just protein and fats and nutrients and antibodies. But now we know that not only is breast milk teeming with microorganisms, but every mom's microorganisms are different. And not only that, they adjust to her baby's needs. So the microorganisms of a breastfeeding mom who has a premature baby, for example, will adapt based on that interaction between the baby's mouth, the baby's flora, and the mom's milk.

It's crazy. How does that happen? I don't even know. I mean, this is really new research, but it's really fascinating. It's so fun to get to do something where i'm just kind of geeked out all the time like this wonder and fascination and then i get to use it and and make a difference with it so we're not sterile and part of what we're seeing is that like right now in the united states we have over a 34 c-section rate so one in three babies is born

by c-section every c every C-section, just for protecting mom from infection because it's major abdominal surgery, mom gets an antibiotic, which means mom's getting it, baby's getting it. And then that affects mom's breast milk too. So not only is baby getting a dose, but mom's getting a dose. So we know that babies born by C-section, for example, are more likely to develop eczema and asthma. And we know that if they're treated with a probiotic at birth, they're actually less likely to develop that problem. But interestingly, we also know that babies born by C-section, for example, later are more likely to develop things like inflammatory bowel disease, which is totally related to the gut flora,

and even obesity, which is also related to the gut flora. So, you know, for me, the work that I still do, I'm not practicing as a midwife anymore, but as a physician and a functional medicine doctor is partly around this advocacy of how do we help more women who can birth naturally, birth vaginally, because it really does have an impact on this next generation. Right. And does that mean also that, well, I guess of course it means this, but that a mom, what they're eating throughout pregnancy is going to have a pretty substantial impact on their child's, their newborn's gut flora. It definitely can.

Absolutely. The gut flora, immunologic changes that happen. There's even some suggestion that baby's taste preferences are formed in the womb by just chemicals from the foods that baby gets on their palate. So definitely, yes. So do dads play a role in this at all? Yeah, they do. It's interesting. I had a kid come into the practice just recently, and the baby's four months old and has pretty severe eczema. And mom has no symptoms at all, but dad, when they conceived the baby, was at the worst flare of digestive problems and eczema he'd ever had in his life. So we were talking about it, and we definitely know that DNA affects baby from dad and from mom. So we know things like smoking and dad's whole life leading up to mom getting pregnant can definitely have an impact.

And I guess also epigenetics these days. Another big term, isn't it? Huge. That's such a big buzzword. And the last thing that I saw, and I'm curious whether you know whether this is true or not, but someone was saying that if you accept the basic argument that your genes are not your fate, but the state of your genes are your fate, and that you actually have a significant amount of control over whether certain genes are turned on or turned off,

and they become expressed and cause all sorts of different things from disease to flourishing. And that a lot of whether it's turned off or turned off is lifestyle choices. It is. And that it's the last thing that I'm reading is that it's heritable. Like the state, whether it's turned on or turned off, is actually then passed on generations. It is. So it's interesting. I had a patient the other day who said, I know I'm always going to be fat. My mom was fat. My grandmother was fat. And she said, it's just in my genes. So we started talking about this and we started talking about, it's not just the genes that are inherited. It's the food choices. It's the lifestyle choices, right? So if mom and grandmom ate certain foods, you probably

grew up eating those foods. So those genes actually got turned on from the very beginning. And that turned on state is actually inherited. Yes, absolutely. And we know that that can start in pregnancy, whether mom gets enough folic acid, for example, and the proper kinds, certain foods that the moms get. But I also want to be careful. It's so easy to start feeling super guilty

or like for people to feel really pressure. Right, because it's like, okay, like these things I did 10 years ago are now going to affect two generations from now. Right, well, it's interesting. Like some of the studies recently that have been coming out looking at kids and autism, because the rate has just gone up to one in 68 kids is now considered on the spectrum. Huge, big report that just came out.

And one of the considerations about what might be causing this has nothing to do with mom and baby, but actually grandmom. So did grandmom smoke? And how did that affect the eggs that I got? Because as a woman, your eggs are formed and are fully there when you're in your own mom. So basically, my eggs were already there when I was in my mom. And so what my grandma did affected my mom, affected me. And so we're looking at generations of... So I want to be careful that people... I want my patients, I want people who are listening to feel like,

yes, I can totally transform my life. But then there's also some... There's almost an act an aspect if we're really serious about this of activism that has to come in because there's just a ton of stuff in the environment that is doing this to us that we're not doing to ourselves so i mean it's like you can't take a fatalist approach where it's like okay we have two generations that have given me this not just the gene but the turned on state for you know like which increases my you know like the propensity for obesity or something like that.

Then the big, lingering question is, can I do something? Is there a behavior, is there a lifestyle change, is there nutrition, is there something I can do to change that state or to turn it off or whatever it may be, or is that just, it is what it is? You know, I figure it this way. We're just figuring this out now right like we didn't even know genes existed until like 1960 like right everything is changing all the time and there are so many reasons to have good lifestyle choices it makes us feel good it's

good healthy for the environment you know it's just there's so many reasons that doing it in a sort of goal-oriented way the evidence may change in 10 years. So do it because it feels good and do it because you want to. And I tell my patients all the time, like, let's look at this as a great experiment. You know, this is a great experiment in doing everything we can to optimize your ability to thrive and be vital. And I think there's a— How do patients—how do they deal with that? Because they're going to want to hear, no, just tell me it's going to be vital. And, um, I think there's, how do they deal with that? Because they're going to want to hear, no, just tell me it's going to be okay. Like, tell me I can like do this.

I think they love it. You know, I really, like I had a patient who wrote me an email recently and he's struggled with some pretty serious depression and, um, very intense fear of death for about 10 years. And he said, you know, nobody's really ever listened before, like really listened. And then kind of just giving me a ray of hope that I wasn't alone in this, that you're not like selling me a bill of goods. Like I can actually trust what you're saying

because you're right here with me. It was this beautiful email, but it was like, okay, we're in this together. We're going to experiment. You're going to get, you're going to get some better. And let's kind of see where this goes together. I think people get, they get excited about it. Yeah. And there's a powerful word again. Yeah. And I see so many people get better. Like sometimes I'm at work and I'm just, I really, I've actually asked patients, I've actually said to people like, are you really that much better? Or are you just telling me that because you think I want to hear it? And like, and I'll say to my patients, like, don't ever BS me.

This is your time. You're paying to be here. All I ever want to hear is the truth. Like if it's not working for you, if this diet lifestyle plan, too many supplements, whatever it is, tell me because it's got to work for you. And they're like, no, I'm really, I'm not having migraines that I've had for 15 years. Or like I have regular digestion now, or I, my anxiety is gone and I'm off of these medications that I've been on for 15 years. I'm like, I still get like, really? Because all the stuff I learned in medical school can't be changed or altered. So much of it can.

I don't always know the why. I don't always know what things could be measured in a study. I don't know how much of it is instilling hope and how much of it's the probiotic or the magnesium or the, you know, what it is. Or maybe it's just altogether. I think it is know there's some sort of just gestalt symbiotic thing that goes on is there anything you're telling about um like

is it really legit i am a friend of mine's chiropractor who's much more than a chiropractor and it's like just multimodal and um and and he'll ask you like after he treats you like after a session he'll be like, okay, do this. And how much better is it? It's better. And he's like, give me a percentage. And you're like, it's this percentage better. And I'm like, why are you asking that?

He's like, because anything less than 20%, you're just trying to please me. He's like, I know that. So he's like, anything less than that, I just write it off as it's not real. Yeah. You know, and it's a similar thing probably. It is. The the flip side is really interesting too like we do these medical symptom questionnaires and i saw this when i was in conventional practice too where we had these depressions questionnaires that were kind of like mandated for our clinic and sometimes people get so used to being sick for so long that they don't realize they're getting better until you kind of lay it out. And you're like, wow, okay. So you used to have migraines every day and now you're having

them only once every three weeks. And they're like, oh yeah. Well, I used to not have a bowel movement. Bowel was like a big deal for people, right? Like I used to not have one except every three days and now I'm going once or twice a day. and you point it out and they're like wow i actually am feeling better but they got stuck in a role because it sometimes certain roles become part of a way of life and they also become ways that other people around us right and you start to relate to us define yourself by exactly right And you define those relationships. And people define you by how you've been for years. The big piece of what happens in functional medicine, ideally,

in good medicine, ideally, is creating a partnership. And that's, I think, part of the woman-centered model. It's not me doing it to you or me doing it for you. It's us doing this together. And how do I get your buy-in in it? And if the patient isn't following the plan, like there are a lot of people out there that are labeled difficult patients. And I like to step away from that and say, okay, well, what does that mean when a doctor says someone's a difficult patient? It usually means they're not following

the things that the doctor told them to do. It's like a difficult toddler or teenager. You're not picking up your room when I told you to. Why are you not doing that? And for me, it's like, okay, well, what about the plan isn't working for you if you're not able to follow it? Did I not explain it well? Is it too complicated? Is it too expensive? Are you feeling too unwell to cook for yourself? How do we shift that so that you can get lit up by this and get engaged? And probably simply the fact that you're asking changes everything. I hope so.

I've seen that with different people that I've worked with where I would probably have labeled them difficult, whether it's an entrepreneur, whether it's somebody that I'm consulting with somebody, and they're blowing up. And then you realize at a certain point that for some people, they're never heard or seen at any other place in their lives. And what they're struggling so mightily is just to be seen, just to be heard. And a huge part of the process of like changing the experience for them of being

a difficult person and for you, them being difficult is actually, instead of trying to rush them out as fast as possible because they're difficult, we don't want to be around them, which trust me, I've like, I've been there and I've been on both sides of that equation. You're like, okay, let me just hit reset on the way that I'm going to move into this engagement and let me just create space and listen. I'm just like ask questions and let them talk. And I found that there's like a magic that happens when you do that, where it's just the fact that you're the only one in their lives that's actually shutting up and holding space and listening

and asking them questions that are reflecting the fact that you're actually listening and responding to them. It's powerful. That alone makes a huge shift. And that person who's like the difficult person all of a sudden becomes somebody who you develop a really treasured relationship with. Absolutely.

Sometimes you just unlock some wicked cool story. It's so cool when it happens, yeah. Yeah, like the person who was adopted at five and had this hard-knocked life, and you would never have known it. Recently I was talking with someone, an amazing woman, and I found out she had had melanoma eight years ago.

And I'm like, oh, okay, that's where that little kernel of like life perspective comes from in this person who's kind of faced death right like they face the situation if you're looking for flexible workouts Peloton's got you covered summer runs or playoff season meditations whatever your vibe Peloton has thousands of classes built to push you. We know how life goes. New father, new routines, new locations.

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glossy jet black aluminum. Compared to previous generations, iPhone XS are later required. Charge time and actual results will vary. Mayday, mayday. We've been compromised. The pilot's a hitman. I knew you were gonna be fun. On January 24th. Tell me how to fly this thing.

Mark Wahlberg. You know what the difference between me and you is? You're going to die. Don't shoot him. We need him. Y'all need a pilot. Flight Risk. Like you, I think you love stories.

I do. You love stories. I love them too. I mean, I'm always curious about people's stories and their whys. So what was the kernel for you? What was that little kernel that lit you up? When? When I was younger? Right, when you were younger, but also with what you're doing now.

Because you were clearly, you're sitting here and you're lit up. You know, I really love life. And I feel a lot of gratitude. Maybe it just comes naturally. Sometimes I have to work at it. Sometimes I have to find the gratitude. What is it? The kernel. I think it's two things. One is, have you ever heard Mary Oliver's poem? She's an older woman. She's in her 80s. She's a beautiful poet. I'm going to get you some of her poems. But in one of her poems, she asks the question, so tell me, what is it you're going to do with your one wild and precious life? And I think about that, right? I've had a not too

wild ride, but kind of a cool ride. And I do really feel like my life is precious. And I'm sort of a quintessential healer. I don't feel at rest in myself unless I'm engaged in service too. So I get to do what I love. I get to live a life where I'm nurturing and helping people. I get to be the doctor that I wanted to be. I get to be a writer and see people transform and see them get lit up. So maybe that's what it is.

Maybe I have to think out loud, but I think it's seeing people get lit up and feeling like if there's one little bit of my wild and precious life that can take one little bit of suffering down a few notches for someone else, that really lights me up. And get and i'm geeked out about the stuff so it's fun it's like it's fun it's like this continuation of just like clearly you have a massive love of learning and discovery and i do i have a lot of wonder a lot of curiosity i think that's a bit of it for me too is you know know, when I've got something going on with myself, if I'm like stressing out too much or down on myself, I try to get curious about it rather than

judge it. And I try to get curious about other people rather than judge. And I think that's all. Okay. So it brings up a really interesting thing. And I've been having this conversation with a couple of people lately. It's around this idea of curiosity. We've been doing this for about two years now. And I'm always looking for sort of like common patterns and traits and words that people use all the time. So people who are out there really shaking the world and doing big things and loving what they're doing, like what are the drivers behind that?

And curiosity is very likely the single biggest common shared trait. But I hesitate to call it a trait. And I got really curious. And I was having this conversation with somebody recently. And I was like, is curiosity trainable? Like, do you just have it or not have it? And if you have it, you're that person who devours knowledge and you want to learn. And you just excel and fly and make a difference.

And if you don't have it, it's a trainable. Can you teach curiosity? So I did a little bit of a deep dive in the early stages, but I have to do a lot more. What do you think? I'm a geek also. What do you think? And I came upon this one paper, and from somebody who kind of broke it into two things, he defined it as state curiosity. You're the person who just, from the time you were two, you

wanted to know everything. You were asking questions. You were the kid that wouldn't shut up because you were always asking questions. Right? And then there's trait curiosity, which is like, you get curious about a very particular thing, but you're not just generally curious about the world. It's like, you go down the rabbit hole in this one particular rabbit hole, which kind of helped me a little bit with the understanding of, but it still didn't really, yeah, the still question for me is, can you train either of those? And my sense is that state curiosity, if in fact we accept that that is sort of like a dual existence there,

it's probably fairly difficult to train, but trait curiosity, because the language you used was, how do I talk to myself in a way to reframe it as, how can I be curious about this rather than something else? So it's almost like you're going through a mental process to incite curiosity somewhere where your approach would have been something other than curiosity. Absolutely. I was one of those kids.

I mean, I would literally have three projects going on at one time. Like my mom would say, even as a little tiny girl, I never just watched TV. I was watching TV and knitting or writing a book or something. And I was the kid who went around the neighborhood collecting rocks and got some goggles when I was like six and was cracking them open with a hammer. I created an electromagnet in third grade. I was really curious about the world around me. And at the same time, I'd make curiosity about the things that would sometimes become obstacles. And I'm not always good at it.

Sometimes they're just obstacles and I'm just whining and moaning like the next person. But I do believe that curiosity is something that can be shared as a concept with someone who may just have not thought about it before. It's like people who haven't thought about what wellness means to them. Maybe they just never thought, oh, I can think about this a different way. Rather than seeing my labor pain as this horrible thing that's attacking me, I can get curious. Like, hmm, what does that feel like? A lot of like what you did sounds like with the tinnitus. Let me go into it rather than away from it. Because it's like the path of least resistance you're going in. You're doing that deep dive, which I love that expression. I've been using that a lot. It really says a lot about

how I'm kind of thinking about things or feeling about things. So it is one of the things I'll say to my patients actually, or just people I'm working with in consulting and counseling is, okay, so like, there's a problem here. We can like look at it as a problem, right? Or we can get curious, right? It's like math. You can say, oh my God, this is a problem or it's a puzzle. Is it a problem or is it a puzzle? So it's just a reframe. And I think that it's a habit, right? Like anything is a habit. If you try to reframe often enough, then it does sort of become a way of life. And I'm glad you brought up the term reframe because that is a huge, I think that's the tool. You know, that is, I think that's a tool that's, some people just have, some people don't have, but it's, it's an absolutely teachable process. You know,

how do you identify, like, here's the circumstance, maybe I can change it, maybe I can't, but I'm telling a story and asking a certain, I'm asking certain questions and telling a certain story and giving certain answers about this circumstance. Are there other questions? Are there other stories that I can tell? Are there other answers that i can pull out of it that process outside of like the world of therapy which uses it on a regular and highly effective basis right maybe art yeah but like in out there in the common world especially and it's funny because i operate a lot in the world of entrepreneurship and business it's not taught it's just not taught and it is such a massively important process especially um in spaces of innovation and stuff like this where you've got like constant things which are going to rock you

and throw you back and if you don't learn to reframe and ask the questions that allow you to see the possibility not just the disruption but disruption and then okay what's the possibility behind the disruption you're dead in the water but i think it's a it's a bigger life skill also so i'm glad you just made the link between betweenraming and curiosity because I guess that's sort of like one of the big tools. Yeah. We could talk for a long time about this. I know, we could.

It's fine. It's not taught in medicine either, and I think this is one of the shifts that functional medicine has the potential to make in the way medicine is practiced. you know there's naturopathy there's herbal medicine there are a lot of different modalities out there that are really great medicine a conventional medicine is so fixed in its mindset right this is how we do it it's always been done this way and if we can prove in a study that's good enough that also sort of reflects our belief system and reinforces our belief system. Okay, maybe we'll make a change. And one of the beauties about

functional medicine is that it's a language that is recognizable to conventional physicians. It's a biomedical language. It allows for spirituality. It allows for personal growth. That's all part of it. That should be part of good medicine too too but i'm kind of excited about this little bit of a trojan horse possibility like ah on the surface it's a gift and it is a gift yeah but it may start to allow a reframe and i but until conventional medicine as a system allows itself to get curious then it's sort of fixed in its own problems, right? And there's a lot of problems. So I'm hoping that as a system, like, can a system get curious?

You know, can a system shift? That's a fascinating question. And obviously you're so much more tapped into this than I am. So I'm on the opposite. I'm on the consumer side. Yeah. Right? And I talk to a lot of consumers. And my sense is that there is such a vast and deep and growing increase in curiosity

among the general population about alternative approaches that that may be the thing that then sort of like reverse engineers, it's going to be more of a groundswell from the patient who's driving like the demand for a different approach, a more curious approach up through the practitioner. Absolutely. It's so funny. I was talking to my husband recently, and I use that term reverse engineering. Like how do we reverse engineer? How do we say, okay, well, what's it to me when I think about it, it's like, okay, what's the goal? What are the actions that are required to get to that goal? And then what's it to me when I think about it's like okay what's the goal what are the actions that are required to get to that goal and then what's the mindset or the spiritual approach or the

emotional space that allows you to either meet those actions to shape the goal or gets in the way of it and if the goal of medicine is really to serve and heal. That's not what most people are finding right now. My wish is that medicine would shift because of curiosity and reverse engineering. I think that the shift is going to come because conventional medicine recognizes that the alternative world is just an absolute cash cow. And the medicine as an industry, because it's really not health care.

It's a medical industry in truth. And I say that as someone trained in it. Like, what's the bottom line? How do we get the most patients in? How do we get people out of the hospital quick enough to turn beds over? Like, we used to be given these little cash incentives to get patients out fast enough in the morning. No kidding. Wow.

Yeah. And so you'd end up with these high rates of patients coming back in sicker because they got sent home too early. It's a big problem. So there's a lot of financial incentive and there's a lot of financial boon happening in the alternative world. So that partly may be what shifts things. Also, I think as human beings, we really, most of us, I think if we're pretty

healthy, like connection. And most people that went into medicine went in with some altruistic intent. And then when they come out, that altruism is largely lost. This is really well documented, actually. And then people go along their lives. at some point they either just sort of become what they didn't want to become or they realize that what they've become is out of harmony with their authenticity and their integrity and they get really unhappy with what they're doing. And then they start looking for something different. And so many doctors are so unhappy, like 90% of family or primary care doctors surveyed recently said they would encourage their kids not to go into medicine. Wow, that is a huge statement.

So I think if people get... That's so sad. Yeah, because they're feeling that they're paper-pushing all the time and they've got seven minutes and it's not like they can just... It's not nourishing to them. They go home unsatisfied. And so I'm hoping it's the relational piece that gets people curious. Yeah, it'll be so fascinating. I mean, I'm kind of, I'm excited for what appears to be

pretty tremendous amount of grassroots disruption. Yeah, there's shifts happening. In the industry and yeah, I think if we're having this conversation again in 10 years, hopefully we will. Yeah. You know, reflecting back, I think if we're having this conversation again in 10 years, hopefully we will, reflecting back, I think it's going to be just really fascinating to see how things evolve. Totally. Because it seems like the pace of change is picking up a lot, too. I think that's another piece for me. I'm hugely encouraged.

Like, actually, would we even really have this conversation 10 years ago? Right? Things were so fringe back then, and now it's like Walmart's talking about having organics. I mean, I know there's politics there, but it's exciting to think that this is becoming a household kind of concept, right? Getting well is becoming thriving,

even not just getting well, but thriving is becoming more of a goal. And across the spectrum, I mean, there's medicine, there's like the world of positive psychology. It didn't exist not too long ago. You know, until Martin Seligman stands up and says, like, the cake is half-baked and we're going to bake the other half. Yeah, so I think there's all this convergence going on,

where it's not about the lack of disease or lack of illness. That's part of it, for sure. But we don't just leave people there. It's like, now let's take them from baseline to plus 100 and figure out how to do it i'd love to see this shift kind of meet in the middle and that there is this tremendous shift of conscious consciousness happening and then it's also it's easy to um forget that we have a higher rate of diabetes and obesity than ever even with the shifting we have a higher rate of diabetes and obesity than ever, even with the shifting. We have a higher C-section rate than ever. We have one of the worst infant mortality rates in the

world. And so much of that happens at socioeconomic groups that aren't accessing some of the shifts that some of us are really much more easily able to make. And so how do we make it global? How do we get health care shifted so that it's thinking about everyone getting this, not just people who can pay out of pocket? That's exciting to me, too. Yeah, that would be tremendous. Equal access to the level of care that these days not a lot of people can actually get. Yeah, and I think one of the things I realized, too, is that there's so much talk about improvements

in health care, but it's almost like for conventional medicine, like how do we give more people more access? But if it's more access to answers to the wrong questions. Right. Exactly. Who needs it? Like what? More people are going to get diabetes medications that they don't need. more people are going to get diabetes medications

that they don't need more people are going to get statins that they don't need that cause diabetes and um you know more kids are going to get medications they don't need for diagnoses that don't have one it's just really a system not supporting them so it's so funny because there's so many business analogies like when um i've had clients come to me and they're like okay we want to hire you to market. We need you to bring in as many people as you can. I'm like, okay, but let's actually look at what's your business. And then I'll look at what their model.

And they're like, okay, they have a box where for every dollar that's coming in, they're making 90 cents. Why on earth would you want to put more dollars in that box? So it's kind of like a similar thing. First fix the box. First fix that box. So it's kind of like a similar thing. First fix the box. First fix the box, and now let's drive as many people into that thing, which is putting out more than it's taking in. Then bring it on. And now I'm all about like, okay, let's just get out of that box

and let's build a geodesic dome. Let's build something different. Break it, shatter it. Yeah, I mean, there's importance. There's importance there's importance to what exists but i don't know that we need to fix that model i think this is what we're doing we're creating something new yeah yeah it's sort of like bucky fulminster he's like just build something bigger around it and let the other thing go where it needs to go exactly so

name of this project is The Good Life Project. What did I offer that term out to you, to live a good life? What does it mean? So, I think for me, if I am living a really good life, I'm able to be really present. And being present helps me live a really good life. And what I mean by that is, if my life is good, or if I'm creating a good life, I can be where I am in the moment because I'm not distracted by worries, I'm not distracted by the next thing I have to do.

And so I can really be here right now with you. Or I can be right there with my partner or right there with my kids or right there with my patients. And I think if I'm doing that, then hopefully the person I'm in that relationship with in that moment feels that I've cared. And I think a good life for me, if I were to get to the end of my life and say did i live a good life i would hope people would say wow she really cared like i really felt like she was there with me and and in that encompasses just big love you know big-hearted love listening compassion right because i'm present i'm able to kind of do all that. Yeah, so I think that's probably what it is, presence.

Yeah. Awesome. Thank you so much. Thank you. Give you a hug. Of course. Thank you. Thanks for gathering stories and sharing them. It's a beautiful thing.

I'm Jonathan Fields. My guest today has been Aviva Ram. Awesome functional medicine doc and cool human being, signing off for Good Life Project. The Apple Watch Series 10 is here. It has the biggest display ever. It's also the thinnest Apple Watch ever, making it even more comfortable on your wrist, whether you're running, swimming, or sleeping. And it's the fastest-charging Apple Watch ever, making it even more comfortable on your wrist, whether you're running, swimming, or sleeping.

And it's the fastest-charging Apple Watch, getting you eight hours of charge in just 15 minutes. The Apple Watch Series X, available for the first time in glossy jet black aluminum. Compared to previous generations, iPhone Xs are later required. Charge time and actual results will vary. Mayday, mayday. We've been compromised.

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