The Dr. Hyman Show - Food Justice: Why Our Bodies And Our Society Are Inflamed with Dr. Rupa Marya and Raj Patel
Episode Date: September 8, 2021Food Justice: Why Our Bodies And Our Society Are Inflamed | This episode is brought to you by Thrive Market, Athletic Greens, and Pique Tea A large part of my work in Functional Medicine is addressing... inflammation. I talk a lot about how the food we eat, and our current food system as a whole, promotes inflammation and leads to chronic disease. But it’s not just our bodies that are inflamed, it’s also our societies and our planet. Covid has only made racial disparities even more apparent, while the disasters that result from climate change continue to climb in frequency and severity as well. It’s all connected. I can’t tell you how excited I was to host Dr. Rupa Marya and Raj Patel on this episode of The Doctor’s Farmacy, to dig into decolonizing the food system to address the inflammatory state of our world and our bodies. Dr. Rupa Marya is an Associate Professor of Medicine at the University of California, San Francisco where she practices and teaches Internal Medicine. Her research examines the health impacts of social systems, from agriculture to policing. She is a co-founder of the Do No Harm Coalition, a collective of health workers committed to addressing disease through structural change. Raj Patel is a Research Professor at the University of Texas at Austin’s Lyndon B Johnson School of Public Affairs, a professor in the University’s department of nutrition, and a Research Associate at Rhodes University, South Africa. He is the author of Stuffed and Starved, the New York Times bestselling The Value of Nothing, co-author of A History of the World in Seven Cheap Things. A James Beard Leadership Award winner, he is the co-director of the award-winning documentary about climate change and the food system, The Ants & The Grasshopper. He serves on the International Panel of Experts on Sustainable Food Systems, and has advised governments on causes and solutions to crises of sustainability worldwide. This episode is brought to you by Thrive Market, Athletic Greens, and Pique Tea. Thrive Market is offering all Doctor's Farmacy listeners an extra 25% off your first purchase and a free gift when you sign up for Thrive Market. Just head over to thrivemarket.com/Hyman. Athletic Greens is offering Doctor’s Farmacy listeners a full year supply of their Vitamin D3/K2 Liquid Formula free with your first purchase, plus 5 free travel packs. Just go to athleticgreens.com/hyman to take advantage of this great offer.  Take advantage of Pique’s limited time special offer on your first order of Sun Goddess Matcha and the other delicious teas at piquetea.com/hyman and use code HYMAN for 5% off + free shipping when you purchase 2 or more cartons. You may also get a free bamboo whisk while supplies last!  Here are more of the details from our interview: The root causes of the rise of inflammatory disease around the world (12:21) How external stress creates disease and illness within our body (20:10) Monopolies and corporate dominance in the food industry (27:17) The anatomy of injustice (39:15) How has our food system been colonized, and what does a colonized food system look like? (42:38) Why singing is medicine (45:36) The populations with the most biodiverse gut microbiomes (48:05) The link between chronic disease and our political and economic structures (54:51) Going beyond food security to food sovereignty and nutritional security (1:06:42) Our food system and climate change (1:20:25) Learn more about Dr. Rupa Marya at https://rupamarya.org/ on Facebook @aprilfishes, Instagram @aprilfishes, and on Twitter @drrupamarya. Learn more about Raj Patel at https://rajpatel.org/ and on Facebook @RajPatel and on Twitter @_rajpatel. Get a copy of Inflamed: Deep Medicine and the Anatomy of Injustice at https://www.amazon.com/Inflamed-Deep-Medicine-Anatomy-Injustice/dp/0374602514/ref=sr_1_6?dchild=1&keywords=inflamed&qid=1627477973&sr=8-6
Transcript
Discussion (0)
Coming up on this episode of The Doctor's Pharmacy.
Truly what we need to do is reimagine every way in which we relate to each other in the web of life.
Because the ones that we've inherited, the ones that have been handed to us through a colonial capitalist cosmology,
are making us sick and making the planet uninhabitable for human life.
Hey everybody, it's Dr. Mark.
I travel all the time, so at this point I have packing down to
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Now let's get back to this week's episode
of The Doctor's Pharmacy.
Welcome to The Doctor's Pharmacy.
I'm Dr. Mark Hyman.
That's pharmacy with an F,
a place for conversations that matter.
If you care about the state of our food system, if you've been hearing about the ways in which food injustice affects so many poor and indigenous and African-American, Hispanic people in our country, you should listen to this podcast.
Because you're going to learn a lot about the origins of our sick nation and the structural problems with our society that drive disease.
And maybe, just maybe, challenge the idea that you can get well by going to your doctor's
office.
That maybe wellness and health don't really happen in the doctor's office or the hospital.
They happen in the communities where we live and the environments that we grow up in.
And I'm delighted to have two guests today.
I actually have two guests, but our guests today are both extraordinarily esteemed folks who have inspired me and are
doing extraordinary work in the world of food and food justice. First is Dr. Rupa Maryak. She's a
physician, an activist, a mother, a composer. She's a rock star, I guess. That's most impressive
to me. And she's been in 29 countries playing music for thousands
of thousands of people, including the themes of social justice and many other things. So
she's also a doctor and associate professor of medicine at the University of California. And
she practices and teaches internal medicine. She looks at the impact of our social systems
from agriculture to policy to policing and how all those things affect us and our health.
She's a co-founder of the Do No Harm Coalition, which is a collective of healthcare workers committed to addressing disease through structural change.
And we're going to talk a lot about what structural change means because I think it's an important concept that's absent from medicine for the most part. And she's also at the invitation of the Clota Health Leaders committed to setting
up the mini Wakoni Health Clinic and farm at Standing Rock in order to change medicine and
food for those cultures that have been so oppressed for so many years. Dr. Raj Patel,
also his work has been a huge inspiration for me. He's a research professor at the University of
Texas in Austin, Lyndon B. Johnson School of Public Affairs. He's a professor at the University
Department of Nutrition and a research associate at Rose University, South Africa.
He wrote a book called Stuffed and Starved,
which was a big inspiration to me
as I wrote my book, Food Fix.
And he's the New York Times bestselling author
of The Value of Nothing, which I want to read.
It sounds good.
And a co-author of A History of the World
and Seven Cheap Things.
He's done so many wonderful things,
including making films. He's helped with the Green New Deal. He serves on International Panel
of Experts on Sustainable Food System and his advice is advising governments on cause and
solutions to the crisis of sustainability worldwide. So welcome, Rupa and Raj.
Thanks so much, Mark.
Thank you, Mark.
Yeah, it's really great to have you. And I'm so excited for this topic. It's one of my favorites.
And I thought about it. I've written about it a lot. And I it's really great to have you. And I'm so excited for this topic. It's one of my favorites. And I thought about it.
I've written about it a lot.
And I've had the chance to work in underserved communities.
I've had the chance to work in developing countries.
I've had the chance to work on Native American reservations.
And this person where I worked for four years in the Hogan Reservation.
And I've been to a lot of these places where you talk about these health disparities and these health issues.
And the problem is that, you know, you talk about this idea that seems to be a little bit hard for people to digest and swallow, this idea of colonization,
that our food system and our society has been colonized. And we're like, oh, well, you know,
yeah, we were, the British had the colonies and we were colonizing America. And we had India being colonized by the British.
And it was a huge era of colonialism, which essentially was taking and stealing all the natural resources from countries that were new and unexplored and using them for the wealthy in these nations.
But in our country, we don't really think of our country being colonized that much, but it really is. If you look at the extraordinary health disparities,
if you look at the challenges in certain communities where life expectancy can be
anywhere from 10 to 40 years less, I mean, we have the developing world statistics right here
in America. I mean, the Pima Indians, their life expectancy is i think 46 right and they're
they get diabetes at the age of 30 years old about 80 of them have diabetes you know that's a symptom
of colonization and and i i really didn't um to really fully understand this this concept of
structural changes that you talked about and and i'm just giving a little preface for everybody so
they know the context we're talking about them I'm going to start asking you guys questions.
It's not just me talking, I promise. Because I've experienced a lot about this and I want to share
my experience and then sort of take off on that. And I went to Haiti after the earthquake and I
met Paul Farmer who wrote a lot about this idea called structural violence. And this is really
what you're talking
about. What are the social, economic, and political conditions that drive disease?
And he found in Haiti, he could cure TB needs, AIDS, not by better drugs or surgery, but by
simply having community health workers. He called it accompaniment. We accompany each other to
health. And he dealt with the structural issues of poverty and lack of water and sanitation and
lack of having a watch. They don't want to take your TB meds, which have to be on a certain
schedule.
And he really showed the world that this model of addressing the structural changes really
works for infectious disease.
And Bill Gates and the Clinton Foundation, all these have used his model.
But what occurred to me down there, and I think you clearly have outlined this in your
book, Inflamed, which really has just come out.
Incredible book. Everybody should get it you you talk about the the uh chronic disease pandemic
being also one that's related to structural violence and it's not just infectious disease
and lack of water sanitation and poverty but it's also all these obesity related issues heart
disease diabetes cancer all these things that are really breaking our system and are causing economic havoc and making COVID so much worse.
And you talk about that.
You know, those are really structural issues.
And that sort of got me thinking about it.
And a few years ago, I was also on a rafting trip on the Green River with a Native American Hopi chief and a Ute chief.
And the Hopi chief was very overweight.
He and his wife were severely overweight, diabetic, on insulin shots, drinking Coca-Cola,
and just kind of, I mean, he was the head of one of his clans and did all these incredible
traditional ceremonial rituals in his culture.
And I said to him, you know, Howard, you can change your diabetes. You can reverse it.
He's like, what do I have to do? And I said, well, you have to not eat sugar and all the
starchy stuff you're eating. And he's like, oh, well, that's going to be a problem.
I said, why?
He said, well, because we have our traditional Hopi ceremonies
and we have our traditional Hopi ceremonial foods.
And I'm like, well, what are they?
And he's like, well, cookies and cake and pies.
And I'm like, those are not your traditional foods.
They're the Indian fried bread, which is deep fried flour and trans fats and lard.
And another woman was on that trip who
was the Ute community. And she said, you know, they have a word for people who become really
large on the Native American reservations. They call it kamad bad, meaning they've eaten all the
commodities that the government surplus has shipped to them. So the government, all the food
that is just leftover food, flour, sugar, you know, Crisco, basically trans fats, they sent to
the reservations and that's
what they started eating, and they became morbidly obese. So these are the real changes, and we
cannot address our healthcare crisis. We cannot address our economic crisis, our social crisis,
unless we address the food system issues that underlie the structural problems that are driving
disease. So I can't tell you how excited I am by your book because it really is the first time I've seen this laid out so clearly and so well and in such a
simple way to understand and calling out things that really need to get called out.
So thank you for writing it. Thank you. Thank you for reading it.
So that was a long-winded introduction. I'm sorry about that. But I'd like you, you know,
we're going to talk about the two decades you've spent
studying how these social structures,
this structural violence predisposes
these marginalized groups to illness.
And how is health and these,
how are these two things connected?
Yes.
So I think you hit the nail on the head
when you're looking at these, the KMOD bod.
But I just want to emphasize that this isn't just a problem of marginalized people,
people who are suffering under the brunt of colonialism,
the worst.
So our indigenous friends,
our undocumented community,
Black community in the United States,
people who are suffering the worst social oppression
have the most profound expression of
inflammatory disease. But in fact, everybody in industrialized nations is subject to getting
these diseases. And what we looked at in this book is really, you know, going back 600 years
to where a cosmology of thought came from Europe to this land to what was, you know,
was now called the United States of America. This understanding of, or the misunderstanding of life
as, you know, humans over here and everything that's wild in nature over here, us being separate
from the web of life or man over here and woman over here or mind over here and body over here, us being separate from the web of life, or man over here and woman over here,
or mind over here and body over here, these errors of Cartesian dualism that were part
of the ways of organizing structures of power in an era of colonial conquest of the rest
of the world.
So it's much easier to take someone's land and take their wealth and take their resources
and enslave
them if they're seen as subhuman or actually they're not really doing anything with that land
in the first place. So let's just go take it over. And so that error of thought really has set us up
to having very shallow medicine, shallow ways of addressing how we're getting sick and why we're getting sick.
So when someone who is, you know, part of the elite or wealthy or white, let's say gets diabetes,
we offer medicines, we offer insulin, we offer injections, pharmaceuticals,
we don't offer an analysis of all the ways that critical relationships that support our health
and well being have been disrupted by colonial capitalism. And that is what we're looking at in this book is really
the root causes of the, um, inflame, the rise of inflammatory disease around the world. Um,
and, and that is, you know, when you're talking about diabetes and obesity and cardiovascular
disease and Alzheimer's and cancer and even depression and suicide.
All of these things have been tied to inflammatory phenomena in the body.
And so we see that in our research and analysis, Raj and I, what we have seen is that the social
structures and the environmental structures around the body are the place where the disease
is. And the body's immune system
is just reacting in an evolutionarily conserved way, in a proper way to damage and the threat of
damage. And that response is the inflammatory response. So it's not like we're doing something
that's abnormal or wrong.
The body is simply trying to correctities in the world around the body are the damage
that is provoking an inflammatory response in the body. And so usually the inflammatory response
when there's damage is activated to correct the damage, to restore what we call homeostasis,
the body's optimum working condition, and then it turns off.
Unfortunately, in a colonial capitalist society, all of us are subject to ongoing damage,
because the air is polluted. And because the water, the groundwater, even if you're growing
organic wine, you're pulling from groundwater that's been contaminated by glyphosate. So there's actually no way to avoid the insinuations of environmental poisoning that has happened through the corporate control of our food system and our and our policies. looked at very deeply in this book is the summation of exposures, whether it's police
violence, whether it's breathing the air here in East Oakland, whether it's being able to afford
healthy food. These kinds of things add up into a toxic combination. When you talk about the Pima folks having 80% of them having diabetes,
it reminds me of the impact of colonial expression in Lakota, Dakota territory,
where I'm working to help set up a clinic with the community there. The Mini Wichoni
Health Circle is what we're calling it now. It's a clinic and a farm.
Which by the way, is a radical idea. Bringing healthcare and farming
together should be universal, but it's something that's really radically new.
Well, it's actually radically old. And so for these communities-
Well, for sure, but not in America.
Well, yeah. So these folks, when the Missouri River was dammed, so when that dam went up, it flooded the cottonwood forests that the Lakota, Dakota, Nakota people used to get their food and medicine from.
So they used to go and have this relationship with these forests.
And once they were flooded, they became completely dependent upon the commodities that were sent by the state. So
they became more sedentary. They didn't go out and harvest. The buffalo were exterminated. I think
something like 60 million buffalo, the largest genocide on this land. And so they lost those
crucial contacts with their food and medicine ways. And they always knew that medicine and food were connected. It was never separate.
And so that is really an exciting connection to see that it is actually in the literal changing of the flow of rivers.
So it's not abstract.
It's not metaphorical.
It's the literal changing of the way rivers run has changed the way our bodies are responding. And indigenous people
have been most impacted here in this land. Yeah, it's so true. And you talk about
the idea of inflammation. I mean, the same story happened in the Hopis where the Colorado River
was dammed and all their related growth food and their traditional food ways were all disrupted.
And again, they're so obese, like the guy I met on the rafting trip.
But you talk about the inflammation and how it's actually a natural response to what's
happening.
And so when you cut your skin and you get bacteria, your body sends an army of your
immune system to go create inflammation and redness and swelling and tenderness.
That's all a good thing to deal with an acute injury.
The problem is that we're constantly injuring our bodies in the same ways
we're cutting ourselves by the food we're eating, by the stresses we're under, by the structural
environments of poverty and disenfranchisement and lack of a sense of a locus of control and
other traumas that are even worse, you know, sexual trauma, physical traumas.
All these things get really written into our
genes. They get written into our biology in ways that you're describing in your book.
So Raj, what was sort of unique for you as you began to sort of think about this from a medical
perspective? Because your focus has been on, you know, capitalism and colonialism and food systems
from a sort of political and structural view at a very high level. Although you talk about the
health impacts, you know, how did this sort of change your thinking about what we need to be doing around our food and food systems?
Well, thanks for asking, Mark. And I mean, part of the journey for me was realizing that there's,
there are so many pathways to and from health. And learning how these circuits work within the body
helped to help me to make connections between the circuits that I was seeing
outside the body in terms of flows of life and flows within the economy. So, for example,
through the sort of work with Rupert, I was able to finally sort of wrap my arms around
a statistic around debt, for example. I mean, in the United States, there's a vast explosion
of consumer debt. And right now, as we record, there's the end of the eviction moratorium,
which means that a lot of people are going to be finding themselves either with much higher rent or
on the streets and unhoused. Now, the debts that come with that are an acute form of capitalist stress.
And who should swoop in?
But the financial, the sort of robber barons of finance offering things like payday loans.
For listeners who don't know, I mean, if you have a payday loan of, say, 300 bucks, you'll probably end up paying at payday loan rates about $800 back. And those kinds of loans are incredibly
stressful to manage. And they manifest themselves-
Isn't that called usury and illegal in what organized crime usually does?
Well, yes. In other parts of the world, it's illegal. And in the United States, it's licensed.
And that's because we are at the apex of this kind of predatory capitalism.
But what I didn't fully appreciate was how that stress works through our body, through our microbiomes, through our guts, through our skin and through our endocrine system.
And finally, you know, drives us towards despair and stress.
And so a statistic that I came across when we were researching this that certainly blew me away.
And I think Rupa was less surprised because she understood the mechanisms.
But, you know, when you if we were to abolish payday loans, the suicide rate in the United States would drop by 1.9 percent.
And the fatal overdose rate for narcotics would drop by 8.9 percent.
Now, you know, one can trot that out in an economics discussion or in a medical discussion.
When you do it in both, I think you get the full kind of span of how the bodies, our bodies, everyone's bodies are stressed by the kinds of everyday rough and tumble of capitalism.
And we, you know, unless medicine opens its eyes to saying, you know, a good medical intervention here would be to ban payday loans.
Then we are stopping short of how it is
that we might heal one another. No, that's what we're so bad at in medicine. So what Raj was just
describing that an actual structural change. So we've gotten good at now noticing the structural
determinants of health, but we have no training in how to understand where those structures came
from, why they were put there, and then how to dismantle them.
And that's what we see with COVID. As soon as we saw the racial disparities, everyone's talking about it, but no one has come forth and said, let's do universal basic income. So all of these
folks can just stay home and ride out this wave. Instead, it's been the cattle prodding of black
and brown workers back to serving the interests of Jeff Bezos so he can go on a joyride. So that's the
kind of grotesque lack of care for each other we're seeing manifest here. So we have the ability
to notice and to describe in medicine, but we don't go that extra step at prescribing a change because modern medicine is a part of that colonial
capitalist project that this land was colonized by medics, missionaries, and military. And so
that, you know, that we have to understand that what, what we are a part of so that we can
actually effectively leverage and push on points of pressure to change the things that would actually bring real population level health outcome changes.
That's really true.
I think we have to go back.
And I know in my electronic medical record at Cleveland Clinic, you know, we now have this new feature, which is your social determinants of health.
And you kind of, but then it's like, well, now what?
Like, what do you do?
We still are seeing one-on-one patients in the office hoping we're going to fix them
when what happens in the office isn't really the main determinant of health.
80% of our health happens outside the clinic.
And I'm not going to cure diabetes in my office.
It's cured in the farm.
It's cured in the grocery store.
It's cured in the kitchen, at the restaurants.
That's where it's cured.
And I think we don't even talk about that.
And as a doctor, I'm so shocked that you actually have gotten this because we basically learned the exact opposite, right? We can fix everything. Just come to us. We got you.
Just follow these instructions and go home. And it's just a farce. And it's why we're seeing
escalating costs, escalating rates of all these inflammatory diseases. And it's something we
don't really talk about what to do. And I want to get into what to do about it because I think that
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Now let's get back to this week's episode of The Doctor's Pharmacy.
But Raj, you said something I want to sort of push back on a little bit. You talked about this idea,
both of you sort of touched on it, and I just want to push back around this idea of colonialism and
capitalism. One, are they the same thing? And two, is capitalism inherently the problem or is it a corrupted
capitalism that is causing the problem? Meaning it's basically rigged and geared for the wealthy,
but not for everybody. And it's not really truly free market because if it was free market,
then all the externalities and costs would be built into the price of the goods you're buying.
So a price of Coca-Cola would be probably $100.
Looking at the impact on soil, on pollution, on the degradation of our water systems,
and air quality, and climate, and health.
And I mean, you know, we'd be paying for this stuff four times.
That would be the price.
So how do you sort of frame it in a way that, you know, people are listening to,
well, you know, what are we expecting, communism?
Like, what's the answer?
Well, let me take a stab at that. First, by just sort of explaining that there are lots
of different kinds of colonialism. And there's long histories in the history of human civilizations
of one civilization coming in and displacing or altering another. You see that throughout Asia,
you see that even on the land that I find myself on, It used to be Tonkawa land, and then it was invaded by the Comanche Empire,
and then it became temporarily part of the Spanish Empire, then part of Mexico,
and then now the United States. So there's a palatest on the land. So colonialism is one
thing where just one power comes in and occupies and dominates another. I think capitalism is this sort of tendency not towards competition and to free markets, but actually to monopoly.
And I think that that's the important thing to remember here when we're talking about capitalism is that, you know, and you know this well, Mark.
I know that this is a kind of softball question, but you know this well through your work in your study in Food Fix, for example, and thinking about how food corporations work.
The way that capitalism has worked in the food system has not been to generate an abundance of free markets and competition and true costs being revealed, but exactly the opposite.
Right. If we know the report came out from the Rockefeller Foundation a couple of weeks back saying, look, the United States spends $1.1 trillion on food every year, but the damage
caused by these corporations, which they haven't been managed to make other people pay for,
is $2.3 trillion. So for every dollar we spend on food, more than $2 need to be spent cleaning up
what these capitalist corporations have created. So what we're saying
is that capitalist colonialism is a way of breaking relationships between people and between people
and place and the rest of the web of life. It's a way of concentrating power in the hands of a few
people rather than democratizing it. And so what we're excited about is actually, what would it be
like to have free exchange? What would it be like to have people be sovereign over their decisions
in a way that pure economic theory suggests they might one day be? And we kind of
like the idea, for example, of competing ideas. And that's why we like science a great deal. We
like the idea of level playing fields. But unfortunately, colonial capitalism has kind
of prevented those from happening. It has. And you're right, the monopolies are true.
You look at the food industry,
we see all these brands, literally hundreds, thousands of brands, but there's nine companies that own all the brands. If you look at the chemical and seed and ag companies, they were
100 like 20, 30 years ago. Now there's like six that provide all the chemicals and seeds.
And we see this consolidation, the monopolization the structural changes that
that really undermine um the ability to actually start to create change because all of a sudden
it's like there really was democratization of our food system then then new ideas could bubble up
and change could happen and people would be able to sort of implement um alternatives and now it's
very very tough and these behemoths you know like nest like Nestle and, you know, Mondelez and all these giant Pepsi, Coca-Cola, these giant companies are so dominant
that it's very hard to get them to shift. I mean, they're thinking about, they're looking at,
they're feeling the pressure from our culture, but it's really tough. So as you guys have come
to sort of understand this and understand the structural violence and understand the colonization of our society in general, how have you understood the food colonization?
Because I think it's something that's new.
And these terms have been tossed around like food apartheid and food colonization and the decolonization of food and medicine.
What is that and what does it mean? And what do we do?
So I just want to take a moment to point out a couple of the things that you've said, Mark, that
hit on because I was trained in the same medical system that hit on kind of the errors of thought
that we are trying to move away from in our book. One of them was talking about the immune system as
unleashing an army, right? So what we talk about in our book is One of them was talking about the immune system as unleashing an army, right?
So what we talk about in our book is that the immune system, these metaphors that we use as in,
you know, the invisible enemy, that's COVID. And, you know, we're fighting disease, and we're off
there with these, you know, these armies of white blood cells. The militaristic imagery is coming from that same time of colonial conquest. We think
about self versus other, and that's an error of thought of how the immune system actually works,
which is to repair damage. That is what our bodies are trying to do. We're not out there fighting an
internal epic battle in our bodies. Our bodies are simply trying to restore the optimum working condition. So that, and then to posit that the opposite of the violent system of colonial capitalism
is communism.
And to use the language of like Red Scare.
I knew people were thinking that.
I know, I know.
And that's why I want to address it.
I want to address it.
Because we are, again, this is not a dichotomy.
We are sophisticated, highly imaginative, amazing creatures that have a whole repertoire of ideas and creations and experiments and expressions that go beyond the dichotomy between, you know, an economic system that is currently destroying the planet and everything that supports human life on it. And, you know, another economic system that we've seen
exist in authoritarian models that doesn't feel particularly inviting. So I just want to
share that. In terms of what decolonizing medicine and food means to me, it starts with the concept of deep medicine, which is what we have conceptualized as being an analogy to deep ecology.
So deep ecology is the understanding of ecology beyond and outside a human-centered approach.
That life around us is vital and beautiful and amazing and deserves to be respected regardless of its
utility to human beings. It's not simply there to be used by us. It's to move away from the
Judeo-Christian framework of humans up here and the rest of life all down there.
The word in the Bible was dominion, which means to rule over.
Exactly.
As opposed to the word, which really was in the original Hebrew was stewardship.
Exactly.
And what's interesting-
Which is more of care and not, you don't own it.
You're basically a steward of taking care of it.
It's a very different framework.
Exactly.
A kinship.
And that's what, you know, in that beautiful book, Braiding Sweetgrass, Kimmerer's book,
she looks at the myths, the stories of Sky Woman, who was the Kirk, that creation story is a story full of relationship,
as opposed to Eve, which is the severing of relationship and the banishment from the garden,
and you don't get to eat anymore from here. And now you get to menstruate and be in pain, you know,
so just the whole framework is, you know, what kind of reality, what kind of story do you want to live with?
And what we're saying is that, you know, deep medicine is understanding it's those relationalities that were actually interrupted through a colonial capitalist framework.
And we joined those two together because it's the way that capitalism spread.
And it was the architecture of cosmology, the way of understanding who we are in relationships
to things.
Things needed to be severed in order to exploit them.
You needed to be able to see the mountain as inanimate in order to mine it and riddle
it with holes.
You needed to see the river as not a person in order to pollute it.
You needed to see the salmon as a commodity in
order to not sing to it. So you could club it over the head and rip out its eggs, which is how they
farm salmon. I mean, it's the most grotesque thing I've ever seen. And so I think that deep medicine
is understanding that health cannot be pursued on an individual level, that health can only be attained in proper relationship to each other and the entire
web of life.
And so those activities that we can do around our food system that reawaken, rehydrate our
ancient relationships to seeds, to water, to soil, to each other are going to be a part of that practice of
decolonizing our food system. And it is directly anti-capitalist. It is saying there's no place
in this for turning profits and, you know, consolidating power and, you know, having
dominion, you know, as an executive having dominion over the workers in the fields um so it's about
honoring and respecting um our dignity and the dignity of all the entities around us that support
our health and that are vital for our health and i feel like for me as a doctor nowhere is this more
exciting um so this shows the gap between the practice of medicine and how we're being educated
in medical schools and the even the cutting edge of the science right now, there's like a 30, 40, maybe 60 year gap.
So we're still being taught of the digestive system as this tube that goes from your mouth to
your anus and like food goes through the sieve, right? But it's in fact a whole rich forest.
And that forest needs to be tended like an ecologist um and so that's
you know deep medicine is really understanding those relationships and putting them into good
practice and it's ecological medicine well it's yeah it's beyond it's like the ecologies of
our social ecologies our political ecologies our our biological ecologies and and that um
you know those are ways of thinking of medicine
that are so exciting. And my medical students who are especially black are coming up to me,
um, wanting to quit medical school, um, because they know the science. They're like, what we're
learning in medical school is not scientifically, it's not actually based in the real science
that that's here right now in front of us. Well, it's 20th century.
It's not 21st century thinking.
Well, it's enlightenment.
It's even beyond.
I mean, it's so far gone.
And it needs to reassert itself because the lines of power within medicine and those hierarchies are recalcitrant to change.
And that's exactly what decolonizing medicine is, is to change them, to move them.
You know, it's so true.
I actually, my daughter's starting medical school in a week from today.
And I said, look, I said, you're going to get brainwashed.
Here's what they're going to teach you.
Here's the real story.
And I'm not paying for medical school unless you read these books.
And I'm going to put your book on the list of what she needs to read.
And you should, you know, for everybody listening, we're talking to Raj Patel and Dr. Rumaria.
And they have written an incredible book, really an incredible book that changes our
thinking about why we're so sick, why we're so overweight, why our health care system
is so burdened.
And this book, I think, is going to be a pivotal shift in our thinking.
It's called Inflamed Deep Medicine and the Anatomy of Injustice.
And in terms of the anatomy of injustice, I'm going to switch over to you, Raj, for a minute, because I think you gave a beautiful explanation of deep medicine.
You know, what is the anatomy of injustice and what are you talking about and how did we get the food system we got? Well, I mean, the reason we chose the idea of anatomy of injustice is because we've structured this book as a kind of anatomy.
It's an introduction to the immune system, to the respiratory system, circulatory.
And we go through a number of bodily systems, as one might in one's first year of medical school. So, you know, the idea of
presenting things anatomically is something that we're sort of taking from the world of medicine,
but we're transforming it. And we're, along the journey, trying to really delve into precisely
the kinds of histories you're asking about, Mark. How do we get here? And a lot of the error comes in thinking that
there's one entity of society over here. And that society was initially populated by white men who
had property and the working class and women and indigenous people and enslaved people were
firmly outside that alongside nature and the rest of the world. And then gradually,
more and more humans were sort of invited into society after having fought for that right. But what that sets up, though,
is, as Rupa was saying, the possibilities of being able to exploit and take things from the land.
And so really, the sort of first moments of what we understand now as the world food system
were birthed in the 1400s with the island of Madeira and sugar plantations in the Atlantic.
And then really, you know, the ball gets rolling in 1492 with the arrival of Columbus in the
Americas, in the Western Hemisphere, but then also with the clearing of Jews, for example, from Iberia,
the sort of arrival of the modern nation state and its technologies of finance and exploitation
and racial purity happen in the same year
and it's not an accident.
And it's food corporations in particular
who are very interested in this sort of rolling colonialism
of a frontier of where can we find the best land,
where can we find the cheapest labor, where can we find the cheapest food products. And, you know, the first products
of colonialism are precisely the food that comes back or the cotton or the tobacco. It's all about
agriculture. And that's important to bear in mind because, you know, when we think now of, well,
of course, the United States isn't colonized. You know, contraire, the wealth of this country was
made possible through
food and agriculture, and there's still a fairly large debt to be redressed. And again,
as we mentioned earlier on, those debts are amounting every day because the corporations
that now run our food system have 600 years of practice of making other people pay for the costs
that they generate. It's so true.
The true cost of food concept that the Rockefeller Foundation
put a report on recently is staggering.
It's actually how I started my book, which is talking about
what is the true cost of the food we're eating in our human community
and in the natural resources and our economic resources.
So what are the real costs to our social, our natural capital and our human capital?
I mean, those are real phenomena that we're not really addressing at all in our thinking
about how to solve some of our biggest problems.
So I want to sort of get into a little bit about, before we get into the sort of link between systemic inequality,
trauma in families, inflammation, the immune system, chronic disease, I want to sort of talk
about, you know, what do you mean by the colonization of our food system? Like, give
an example of what that looks like. Is it all the bodegas in underserved communities that are only serving junk food?
Or is it more than that?
Well, I mean, I'll take a crack at this just because I grew up in a bodega in Britain.
That's what my parents did.
And, you know, and for folk who are not watching this, I speak with a posh British accent because my ancestors were colonized by posh British people.
And, you know, I found my way back.
But again, you know, my parents are from Kenya and from Fiji.
So, again, outposts of the British Empire.
And, you know, there's there's that sort of long history of direct exposure to it.
And, of course, now my parents were the canaries in the coal mine for the British food system, you know, as we transition to the standard
American diet, SAD, as I'm sure your listeners will know, is referred to in the literature,
but the standard American diet came to Britain and who was in the frontline, but, you know,
folk who had been exposed previously to poverty and therefore were more predisposed to developing type 2 diabetes and
heart disease and had histories of that. And so the British Asian community has far higher rates
of type 2 diabetes, for example, than white British people. Now, a colonized food system
is not just about crap sold from stores that my parents had, for example. But also, I mean, it's about a severed relationship
to understanding where that food comes from and what counts as food and what counts as medicine.
This goes back to something that we began our conversation with, which is, how do you know
that something is a medicine? The way you know is because a doctor has told you that it's medicine.
But how do you know that something isn't medicine? Again, a doctor has told you, well, you know, that's not out, you know, it's not licensed, and therefore,
it isn't a medicine. Now, one of the ways that we are trying to sort of pierce that is by saying,
look, there's a cosmology in which, you know, under colonial capitalism, that, you know,
food and medicine was split up. But actually, there are lots of healing traditions in which
food and medicine are, you can't draw a line between them.
Almost everyone except ours. Everyone except ours.
I think if we have that as a reference point then, Mark, that ought to serve as an indication of how
broken our understanding of food and medicine is. And that's what it is to be colonized,
is to think, oh yeah, this thing where half the ingredients I can't even pronounce is food. Whereas this beautiful plant, which I have not recognized yet, which grows around me
every day, I don't know whether I can eat or not. That is a colonized food system.
Yes. And I think that so Lakota elder Candice Ducheneau, who we quote in our book,
she would say to us, she would say to me, you know,
we have a concept of medicine where everything around us is medicine. You don't just get medicine when you're sick. Medicine is what you interact with every day, several times a day to keep you
well. So reaching out for that plant is medicine. That sage is medicine. Being with the buffalo
fur, that's medicine. Singing a song, that's medicine.
And, you know, we can look at that as, oh, how trivial and cute that is, those savage natives, you know.
The way that colonial thinking organizes indigenous knowledges and wisdom and then then scientific truth. But in fact, when you look at the data around
singing, for example, and vocalizing and chanting and what it does to the vagus nerve and how it's
activating the parasympathetic nervous system, it's actually driving down inflammation. It's
an anti-inflammatory experience. And so what we've seen is that a lot of the indigenous,
from the tribes that I've interacted here in Ohlone territory, where I'm speaking to you from today to Lakota territory, is that a lot of the things that they call medicine are actually things that are quite anti-inflammatory.
That's right.
Which is fascinating. You know, is it a surprise that many of those societies were organized in a way that didn't have the, you know, hoarding of resources that we see with, you know, our society?
Or did they understand that somehow that hoarding might be inflammatory or might lead to more disease? So I think that one thing that surprised me in writing the book was understanding, not surprised me, but it was nice to see it written and examined.
That what we call indigenous knowledge or traditional ecological knowledge, for example, is a kind of a science.
And it's a science that occurs over millennia.
It is peer reviewed, but it's transmitted through oral history.
And it's peer reviewedreviewed, but it's transmitted through oral history, and it's peer-reviewed in a different way.
But that doesn't mean it's somehow less valid.
It may be more, it turns out.
It may be more effective.
Exactly.
It's not just a quaint throwback to the past.
It's actually addressing the question of why are we sick and how do we get better? So when you look at the microbiome science, for example, so this great paper came
out by the Sonnenberg lab in Stanford saying that, you know, if you're talking my language,
poop, I like to talk about poop. Well, here, this is like interesting things. So, so, you know,
if you eat fermented foods for 10 weeks, you know, the more you eat, the more biodiverse
your gut becomes. And then 19 different levels of markers of inflammation will fall, right? And that's,
that's great. That's grand. That's helpful. But the same Sonnenberg is off trying to commodify
the crap out of the indigenous people who've actually protected their microbiota. So when
you look at the rates of biodiversity of the gut microbiome, the urban US dweller has the least
biodiverse guts on planet Earth. The most biodiverse guts are indigenous people whose
cultures are still intact, hunter-gatherers whose cultures are still intact. And the more biodiverse
the gut are, and we're still trying to understand the science behind this, but what we found is that a greater biodiversity of the gut is associated with lower levels of inflammatory
disease from everything from inflammatory bowel disease to depression and diabetes and obesity.
And so this guy Sonnenberg is off trying to, you know, take the poop and, you know,
turn it into a rewilding of the gut. And here's your, here's your indigenous poop.
Here's your poop from a biodiverse gut, go and turn it into a rewilding of the gut. Here's your indigenous poop. Here's your poop
from a biodiverse gut. Go and take it. That's why I'm going to write a book called Paleo Poop.
The problem with that is that you can't take just the poop without taking the entire cosmology.
You cannot separate the biological thing from the whole system of relationships that supported that ecology.
That ecology is intact and biodiverse because of the ways in which those people are in relationship
to the web of life. And that cannot be approximated. It cannot be bottled and sold.
And that is what, you know, that we, we, it's important to name that as a part of the same
capitalist sickness is that you can't, you cannot do that. You have to reenter these relationships. There's no easy destroying it. And they know how to live on this earth without inflammatory disease. And they've been doing it for 30,000,
maybe since time began, they've been doing it forever. And so that's to me as a person on this
earth working in health and concerned about the future of our planet for my children and
grandchildren. That's extremely exciting, is to enter relationships
with those folks, reciprocal, respectful relationships, and to help the Indigenous
people in my community reclaim that land, that knowledge, that power that's in their lineage,
and to support them in that work. So that is, you know, I feel like the future of medicine.
Because what you're really intimating here is that as a society, we have a soul sickness
and that our souls have been disconnected from the origins of life, from our land, from our food,
from our communities, and that we're seeing this epidemic of both mental health issues that
you talked about earlier, Raj, from the suicide rates, or was that you? I can't remember.
And the sort of the disconnection and the isolation and the sort of the social
disempowerment as really being a soul sickness that needs to be healed by finding
our place in the family of things. And that's what you're talking about. And I, I think it's
a beautiful notion, a beautiful idea. And, and for someone who's been working in the food system for
years and thinking about it for years, the challenge to me is I don't have any, any argument
with, with the framework of what you're talking about.
But given the way our society has been completely dominated by this colonialist capitalist model
and the way in which our populations have been so disenfranchised and aren't even aware
that they're disenfranchised, the internalized racism, the internalized structural violence,
how do we emerge from that?
Because other than just radically changing our society and
radically changing our policies and radically changing our economic structures, how do we begin
to address this pandemic? Because as someone who's on the front lines of chronic disease,
it's a staggering phenomenon. I can tell you, I started doing this 25 years ago. And I look at my slides from like 1996.
And I'm like, wow, I keep having to change the slides.
Because it's like, there was 30% obese, then 40, then 50, then 60, then 75.
And diabetes, chronic disease should be like maybe 3 out of 10 people.
Then it's 4 out of 10.
Then it's 5 out of 10.
Then it's 6 out of 10.
It's like every year I have to change my slides.
And it's getting worse and worse. And yet we understand
it more and more. And somehow we're not able to bridge that gap. How do we do that?
I would say, first of all, I just want to give a shout out to-
Everybody read your book.
No, to Jack Forbes. Read another book called Columbus and Other Cannibals. He was a Native
American scholar here at UC Davis. And he talks about the spirit sickness, which is called, he calls it wetiko or windigo,
which is an Algonquin word.
And it's literally the spirit sickness of colonial society and societies that dominate
each other.
He calls it like a vampire that you're sucking the soul off of other living creatures or other entities in a non-reciprocal,
non-respectful way in order to support your own life, in order to support your own.
And that this society is sick. He calls it a spirit sickness. And so the cure,
Mark, is a radical re-imagining of our society. And the good news is, is that will address not
just the rising rates of inflammatory disease that you've noticed, but also the burning of
our planet. And so there is no tiny tweak we can do. There is no little, you know, just to move
this around. There are things we can push for right now, Medicare for all, a Green New Deal. There are large policies we can try to move with. But truly what we need to do
is reimagine every way in which we relate to each other in the web of life. Because the ones that
we've inherited, the ones that have been handed to us through a colonial capitalist cosmology,
are making us sick and making the planet uninhabitable for human life.
And it's urgent that this happens soon.
And that we start this.
It seems like the world leaders have no idea that chronic disease has
anything to do with our, you know, political and social structures.
Like they're just, they're just, well, the disease happens over here.
And, you know,
the economy happens over here and they're not really related, but it's,
it's, it's, it's really such a profound connection.
Well, and you'd think the pandemic
would kind of nudge people into the right direction.
Having spent a year under lockdown,
you would think that there'd be
some sort of rising consciousness
between the origins of zoonotic disease,
the way in which industrial agriculture
spits out more and more of these zoonotic disease, the way in which industrial agriculture spits out more and more of these
zoonotic diseases at rates that have already created outbreaks in other parts of the world,
and where in 2007, we had the H1N1 outbreak as a result of a pork processing facility.
These kinds of things are ongoing. And there are sort of small things that we can offer as
promissory notes, like, for example, buy organic and sustainable and, you know, go to your farmer's
market, find out where your food comes from, have conversations about how workers are treated,
find out about the land. But don't think that that's the work. That's just a reminder to yourself
that you've got to, you know, in the same way that instead of saying I'm fighting something
off, which I said the other day, I sort of corrected myself.
It's like, no, I'm learning to live with something.
And that, you know, just little sort of twists in the way that you think about things are important, not as a substitute for the big work of change and for working together in movements and in organizations.
But, you know, they're little things to remind you that the world isn't the way it should be.
And therefore, you know, eating organic is not a protest. It's not a way of making sure your body is a temple and the rest
of the world burns to the ground. But instead, it's a way of saying, no, you know, everyone's
body ought to be treated with respect that I'm treating mine and the workers in the field are
being treated by not being exposed to pesticides, but we can do better. And it's a reminder we can
do better. And that, you know, there are so many movements we chronicle in the book that are doing
better. So Raj, you are not a chronicle in the book that are doing better.
So, Raj, you are not a lightweight when it comes to understanding food systems and the global food system and agriculture and the industrialization of it and the consequences it's had on humans, on the earth, on our water system, on everything. And, you know, you sound super optimistic, which is exciting to me. But I just want to sort of ask you from your big tent framework, what are the practical steps that we have to do to move this forward?
I mean, it just seems that we're so stuck in a polarized society where we can't even agree on the most basic things, the injustices that are blaringly obvious.
I mean, we can't even get Congress to agree that the insurrection at the Capitol was a problem. I mean, you know, we're talking about
just the most obvious things. And yet, we're talking about here much more subtle ideas.
Well, I don't know about that. I mean, it's important to have a pessimism of the intellect
as well as an optimism of the will. You know, one can't think that just by putting daisies into
the mailbox at Nestle, everything is going to be fine, that there's clearly a lot of work to do.
But there is quite a lot of agreement, if not in Congress, across America and the rest of the
planet, that things like monopolies are bad. Regulating them is a good thing. No one likes
to be shafted by a big
company. It doesn't matter what your political orientation is. Unless you are the owner of that
political company, there's this large corporation doing the shafting, then you're unhappy about the
situation. And there is quite a lot of anger around the ways that food companies are treating
us. And that is turning into certain kinds of legislation. Of course, it's being fought tooth and nail by the industry. But one of the other things about this pandemic
that I learned about and that bolstered my sense of possibilities for change is precisely what
happens when governments are good at saying no to things. We should be getting them to regulate
and to reduce the levels of freedom that food corporations have so the rest of us have more freedom. But in the meantime,
there are amazing organizations that are in the frontline battles for climate change and equality
and food is a central part of the story. I mean, listeners may not have heard about
big protests in Colombia, but the first demand of student protests in this violent protest in Colombia was food sovereignty. In Peru, we've just been seeing some contentious elections there.
But communities that had zero cases of COVID, the indigenous communities, were sending food
out to the people who had, you know, where food was in short supply because the government had
failed, the private sector had failed. People are capable of taking care of one another in ways that
the food company prevents, the food industry prevents, and sometimes government prevents too. So I think
the good news lies in the fact that government can change, and saying no to corporations is
something that governments seem increasingly ready to do after this pandemic. And also,
you know, just injecting cash into the economy, which didn't seem thinkable, you know, two,
three years ago, now is something that governments recognize they can and should have been doing all along.
But then the other thing is recognizing people power and recognizing around the world that people are taking care of each other under COVID through gifts of food and exchanges of food in ways that aren't getting reported in the New York Times, but are certainly happening on the ground.
Yeah, it's staggering when you look at the implications of our food system and COVID. I forget the food insecurity, lack of access, the fact that we throw half the
stuff out and half the people are hungry. But when you look at the recent trial, I mean,
analysis published from Tufts, 63.5% of all hospitalizations from COVID and probably
the same amount of deaths proportionally are related to poor diet and
the consequences of that diet creating inflammation, hence your book Inflamed, that predispose people
to more severe COVID. And that's an entirely preventable thing. When you look globally at
the threat of COVID, the threat of COVID is the threat of hospitalization and death and
overwhelming our healthcare system. That's the real threat. And yet that threat is
almost entirely mitigated by changing our food and food systems. So I don't think we're grappling
with that well. I mean, I'm working on policy stuff, but it's hard even to get the government
to pay for medically tailored meals for diabetics, even though we know that food is the treatment for
diabetes, right? And yet there's no lack of evidence or data on that. It's such a simple thing and yet it's not reimbursed and it's a challenge. Well, we're giving a talk. I'm going
to be giving a talk in San Francisco to the board of supervisors around this work we're doing in
Ramatushaloni territory here. So we are, I started a nonprofit this year called the Deep Medicine Circle.
And our work is to heal the wounds of colonialism through food, medicine, story, and learning.
And one of our first actions or projects is the rematriation of 38-acre farm to the original people, to the Ramatishaloni people, and to farm under their leadership using agroecology, where we hire farmers as healthcare workers. Essentially, they're being paid as much as the
doctors to grow food that is then liberated from the market economy and goes straight up to San
Francisco to give to urban people who are being oppressed by hunger. And that, you know, if we take our food system and we just
remove the profit motive and we just say, okay, we are going to pay these farmers to steward our
soils, to steward the water and to grow the food that is going to be given to improve people's
health. Now there's discussion in the public health department meeting with folks there about,
well, why aren't we doing this on a large scale in San Francisco?
Why don't we have a people's farm so that if you live in the city of San Francisco, no one ever goes hungry?
So I think like this study from Tufts, COVID is a great opportunity to reframe, recast and demand our rights to be healthy and our rights to dignified health care, both for our patients and our workers. We should
not be seeing nurses in trash bags because they simply don't have enough PPE. As healthcare
executives are making record profits, and we're being forced on the front line to be in less than
safe conditions. And so the push for Medicare for all here in California, we have AB 1400. I'm on the Healthy California for All Commission.
I was appointed by the governor to reimagine financing in the state of California for our
health care system.
And it's a really hard time for people to get up and say, yeah, we really need those
health care insurance companies because people are fed up with the financial abuse.
That is an extractive system where the money that's put into it is extracted for executive salaries and not going directly to benefit patient care and provider safety and well-being.
And what's happening right now, Mark, in the hospital where I'm working at UCSF and in the Bay Area is nurses are leaving.
They're leaving the job.
So now we're in the midst of this Delta surge and we don't have,
we have a staffing, we have a staffing shortage. So what does that mean for the workers that are
there? They're working even harder. And so this is truly, so like with this farm, we were calling
the initiative farming is medicine. I'd love to tell you more about it as it goes up and live.
We're doing the same thing on the largest rooftop farm in the West Coast is in
Oakland. So all that food will be given to a food pharmacy at the UCSF Pediatric Clinic right next
door. So we have doctors and farmers hanging out together. We have community workers who have
occupied housing for the sake of mothers not being homeless in Oakland, moms for housing.
Dominique Walker is one of our interns on that rooftop. Those interns are teaching the doctors. And so that's the exciting milieu of cross-pollination and
systems-level thinking that only these kinds of creative collaborations can bring about.
And that's because we're dealing with systems- failures, systems level problems. We need more minds than one.
We need all of us in there together.
And we're extremely creative.
That's where my optimism comes from is the deep creativity of human beings.
We can do this.
So you think it's going to well up from the bottom as opposed to being legislated?
Well, it should be legislated, but it should be legislated from the ideas of those who are the most impacted.
It's true.
This all reminds me of this summer program I went to when I was in college called the Institute for Social Ecology.
Oh, you went to that?
Yes, I did.
You heard about that?
Of course.
Murray Bookchin, this crazy anarchist guy, post-Gashian anarchism.
We had courses in biological agriculture.
Now we call that agroecology, energy efficient shelter, holistic health, all these concepts, anarchism and women's studies.
And we actually went down to Brooklyn, I mean, the Lower East Side, and we built rooftop farms.
And before anybody was building rooftop beds on the top in New York City.
And we cleared out all the abandoned parking lots and made farms and gardens in the cities.
And it was just like, you know, to hear these ideas, this is not new thinking, really.
These are ideas that have been around.
And it's just we've had this juggernaut of the food industry getting more and more consolidated,
the ag industry more and more consolidated, and disrupting our health in tragic ways that it's almost been invisible. And now suddenly it seems like we're waking up
to go, wait a minute, like what just happened here? This is 40 years ago. It wasn't like this.
You know, when I was growing up, we didn't have those levels of disease and obesity. I mean,
when I was born, I think, you know, it was like the obesity rates were like, I don't know, like 4%. And now they're like,
you know, 40%. So it's really a staggering change. And it's almost happened so fast that we can't
accommodate to it. So going back to this idea of the colonialization of our food system,
you've described that pretty well. The other concept you mentioned is food sovereignty. So food sovereignty
seems to be the antidote for colonializing food systems. How do you find food sovereignty?
And how do we get there?
Well, so food sovereignty emerged from peasant movements in the 1990s who said, look, food
sovereignty is the opposite of food security. People may be familiar with the idea of food security as being this thing where you have enough food to lead a healthy and productive life.
That's the definition of food security. You know where the food's coming from and you're able to access it.
But as critics point out, you can be food secure in prison. Food security says nothing about how you get your food.
It says nothing about your power to control the pipeline or what it is that you're eating.
So, you know, you can be given prison food and a bag of vitamins and everything's going to be fine.
And in some ways, the sort of crazy end of the medicalization of our food system wants to do just that, you know, keep things as they are. Perhaps, you know, we'll substitute meat with oatmeal or, you know, some other kind of crazy invented synthetic
protein, but then, you know, add vitamins and continue exploiting the environment until we
arrive at the sixth extinction in its full glory. Or we can move to something that involves much
more democratizing of our food system.
And the data suggests that when you democratize the food system and when you put power in the hands of communities that are sovereign,
they're much better able to take care of land.
And it's much more carbon sequestration, climate resilience and welfare increasing than if you let either the government or the private sector take care of it. So food sovereignty is an attempt by communities to own the policy process around food.
And a good example of that comes from the Los Angeles Unified School District.
They're the largest school district in the United States.
They decided that they wanted to change their food system to do five things. You want to pay workers better, improve the local economy, take care of animal, improve animal welfare and improve nutrition and a measure of sustainability as well.
And all of those five things become a non-dollarized way of counting change.
So rather than changing the metrics. Yeah, exactly.
And so rather than dollarizing, which was a mistake that actually anti-tobacco activists made in the 1970s, they said, all right, tobacco industry, let's put a dollar value on the number of people you killed.
And the minute they did that, they lost the moral high ground and they had to convert suffering into
dollars. And in that conversion, humans always lose and corporations always win. So instead of
making that conversion, you stick with multidimensional indicators that you can track
over time. So you're measuring your progress. And now all of a sudden,
you have a non-dollarized but measurable and actionable framework
for making sure that your local economy
and animal welfare
and all the rest of it gets better.
And their good food purchasing policy now
is about community control
for over 5 million students.
Yeah, I mean, a good food purchasing strategy
is a great way to think about
changing our food system.
But that's all we're doing.
Yeah. And for those who don't know what that is, it's a program developed to look at how schools purchase food based on certain values that you spoke about.
But they're looking at how do we do that for corporations who buy food, for the government, who is probably one of the biggest food purchasers.
When you look at all the federal agencies and institutions that the government runs in the state, local and federal hospitals, hospitals, schools, prisons.
I mean, we literally, I mean, I don't, I had a friend who was Japanese and she told me
this incredible story of how in Japan and the prisons, they feed the prisoners whole
foods.
They feed them like a macrobiotic like diet, which is known to calm them down, to regulate their behavior,
to equalize their mood, to lessen violence, right? And they know, I don't know how they
figured that out. Here, we know that if we swap out the diet of kids in a juvenile detention center,
that the violence goes down by over 90%, restraints go down by 75%, suicide goes down by 100% just by
getting kids off of junk food and eating some real food.
Probably not even the best food, just not the crap and a little bit of good food.
That's the power of this model. And we have to start to reimagine our approach to
thinking about this that doesn't keep us stuck in the lack. Actually, you know what? I think
even if we have food security in America,
we don't have nutrition security and they're, they're quite different. Food security is
I'm on food stamps. I can have, you know, two liter bottle of soda and a giant bag of chips,
Ohio cookies, and I'm food secure because I have enough calories. That's going to cause you to
feel sick and not be functional, not work and be depressed and inflamed. It's not nutrition
security, which is access to real whole foods. It's going to promote health be depressed and be inflamed. It's not nutrition security, which is access to real
whole foods that's going to promote health and well-being and help you advance. And I think the
structural changes that we're seeing in our society that are from the food system and the way you
describe it is really driving some of the worst challenges we see around social justice, around
racism. I mean, just the life expectancy drop that we saw in the last report of three years in black and Hispanic communities. We should all be going, wait a minute, why is this happening?
What's going on? What's the cause of it? And yes, it's more than just food. It's the traumas,
it's intergenerational issues, but food is such a central piece of that. And it perpetuates a cycle
and seems to me one of those levers like Archimedes' lever to actually change
the whole dynamic of what's happening in our society from sickness and the consequences of
our food system to one that's more able to create a healthy society. And we just are so far from
that. But I have rays of hope. I see these things happening on the margins. I see what you're doing,
Rupa, and the things you've been talking about, Raj.
And I get really inspired to think, wow, there are a lot of people thinking about this and
working on it.
And I think you're doing the hard work, which is fantastic.
I want to sort of change the subject a little bit and talk about how, as a doctor, you somehow
figured out that farming was medicine and that we can't separate healthcare
from food cultivation and how we grow our food and the agricultural systems?
Well, I married a farmer. That helps. But before that, I actually made a,
when I was single, I said, okay, I either want to work with someone who's saving seeds
or they're a computer hacktivist. And that was my, like, I had it nailed down to like the-
A computer hacktivist?
Yeah, a computer hacktivist. I don't know. That was when I was touring around the world.
What is that? I don't even know what that is.
But for me, it's because of my work in music and where music has taken me as a socially conscious artist. Um, and, and the life I've created for myself,
insisting upon my role,
my work as a physician artist, um,
because it was in the touring and the curiosity of my own,
own, um, mind as I was reading works like Roger's work work, as I was traveling to Athens during the financial
collapse of 2008 and 2009, hanging out with the anarchists there who were taking over the
botanical gardens and turning it into tomato fields and growing food and putting up pop-up
clinics to address how people were committing suicide in the streets. And so I was grateful to be welcomed through my music into communities
who are continuing to do what we're calling deep medicine,
that they've made these connections, that they've understood them,
and that they're organizing practices around these connections to advance health.
And their advancement of health is far
beyond in terms of impact, what we're able to do in the hospital or as an individual with
individual patients. And so that was really inspiring to me as a healer, as a thinker.
And it was through my music and that, you know, I was invited to accompany the Frisco Five hunger strikers
who were protesting police violence in San Francisco
on the steps of the Mission Police Department with a hunger strike.
And I walked up to them and introduced myself,
and one of them was like,
oh, you totally played on stage with me in Golden Gate Park.
Do you remember like five years ago, eight years ago?
I was like, oh, yeah. So they knew me through the music scene. And that knowledge of what I was
doing through music said, you can come here and be our doctor, come and help us in this struggle.
And from that was the invitation from California natives to go out to Standing Rock during the
pipeline protest, because they saw that I understood these links between social oppression
and racism and state
violence and health and long-term impact on community health. And so for me, the advice I
give to the medical students of the Do No Harm Coalition, our organization of now over 2,000
healthcare workers committed to structural change through to address health problems,
is to just is to not silo themselves in medicine to allow themselves to be broad,
to insist upon their artistry and those things that bring them joy, vitality, and also to work
directly and taking orders from communities that that they love, and, and to become a part of working with those folks. And so that,
that has been beautiful. And, you know, as we're putting up the greenhouse on the Ramita Shaloni
farm, every week, every Sunday, there's a whole handful of medical students who come down who are
like learning how to use a wrench. And, you know, they're like, this is fascinating, but it's
beautiful for them because they're getting to see the connections directly. Like what happens when land is rematriated? What happens when Greg Castro,
one of two families who are Ramatishaloni because the genocide was so successful on the San Francisco
Peninsula, the first land holding in 250 years. What is it like for him to be back there singing
those songs? What is it like to plant those oak trees in the middle of these agricultural fields? Because that was California natives food. What is it like to
bring back the hazelnuts? And so I recommend that you look at the work of Martin Reinhart. He's at
up in Michigan, or is it Minnesota? He's in Anishinaabe territory. And he is a native
scientist who did the decolonizing diet program.
And he was looking at how following a decolonized diet, so by some of it was actually gathering things from the reserves.
Some of it was going and shopping for buffalo meat as opposed to chicken.
But he was able to get himself off of biological agents for inflammatory bowel disease.
And he saw some real changes in blood pressure and for indigenous people. So there are exciting
projects happening. This is a movement. It's a growing movement. It's an exciting movement.
And we hope that this book can just uplift the good work that's happening around the world.
It's so powerful. It just reminds me of a story where I was visiting my daughter in Utah,
which was a park ranger in Arches National Park.
And we were canyoneering one day and there was a few other people on the trip with us.
And we rappelled down into this kind of area where there's this giant arch.
It was kind of a little tricky rappel.
But as we were rappelling, there was like a flash flood.
And so it was a completely dry thing, became this waterfall. And we got stuck down there. The other
people got separated. And I was stuck with this guy who was a first nation man from Canada who
was a doctor. And we started chatting and he's like, you know, my family's from this island off
the coast of British Columbia. And, you know, westernized and went to medical school and started eating Western food.
And I became diabetic and overweight and high blood pressure.
And I was feeling terrible.
And then I sort of started to pay attention to what my grandfather was eating.
And my ancestors were eating the fish and the berries and the hunting and gathering.
And I started to eat that way.
And everything went away.
All my diseases went away.
And there's another incredible study from Australia
where they looked at the aboriginals.
And this nutrition scientist years ago,
it was in the 80s, I think,
they found a number of aboriginals who'd been urbanized
and who ended up in cities
and had developed all the Western diseases,
you know, overweight, high blood pressure,
diabetes, heart disease.
And they still remembered how to hunt and gather. And she took them from their cities and just threw them back in the outback and said, okay, do what you used to do. And within
like six or 12 weeks, everything went away. All their diseases went away. So while it might take
decades to get these diseases, often these problems can be reversed within weeks or months by dealing with the root cause of the inflammation. And I love the title of the
book, Inflamed, because it speaks to not just the biological inflammation, but the emotional
inflammation, the political inflammation, the sort of inflamed nature of our divided society
and the chaos that we're seeing now. And it addresses a lot of those issues in a way that
are really fresh and new. And I think anybody listening to this who really wants to
have a fresh perspective on how do we get out of our crazy situation we're in now with burgeoning
chronic disease, this COVID epidemic that's crippling the world, with the economic stresses
on society. And we didn't even touch on this, and I want to spend a few minutes touching on this,
on the ecological, environmental, and climate impacts of our food system. You should read this book because it
sort of lays it all out. And I think it's really an important contribution to our thinking. And I
hope every political leader in this country gets that book. And I know a bunch of them,
and I'm going to give it to them personally. So I think it's important. Let's pivot a little bit
and talk about the environment and climate and the way in which our food system has disrupted our natural relationships with nature.
And it has also led to massive ecological and environmental damage and climate change may um you know be mostly the result of our food system up to third to half
of all greenhouse gases can come from some degree to to be drawn back to the food system well that's
exactly right i mean mark you've written about this so eloquently over the course of your writing
that the the food industry is precisely in the in the business of turning rich diverse bio you know
ecological zones into dead sort of green desertss, I think is the best way of
describing it, right? Where one thing is allowed to live and any other intrusion from the web of
life is annihilated chemically, whether it's weeds, whether it's insects, whether it's whatever
else, that it must die. And that's the way that monoculture proceeds. And as a result, we're seeing catastrophic declines
in insect populations and in biota across the web of life.
I remember when I was a kid,
I used to reliably, when you go outside for a bike ride,
come back with flies plastered on your teeth
because that's what they,
the world was alive with them.
And it's been ages since I've experienced that
in just a range of settings,
because the biosphere is so widely contaminated. Wait, wait, I just got to stop here. That's such
a huge statement you made. And I remember my job used to be washing the windows in the car. I was
a gas station jockey. And you had have to scrub your window with all the flies.
And they were big too.
And they're huge.
And it never occurred to me, but I realized, I don't remember
the last time I've done that. I don't remember
the last time I drove overnight
or long distance and had my window covered
with bugs. Where have all the bugs gone?
That's not a good sign.
That is one of the indicators of
there isn't an industry behind that other than the agriculture and the vast arsenal of pesticides, which are in our bodies right now.
If we've been anywhere near a field or anywhere near the food system, we carry a lot of these chemicals, which are, you know, in some cases will last for generations in our bodies. That is one trace of industrial agriculture.
But, you know, the clearing of forests to grow soy, to be able to feed pigs, or, you know,
to be able to feed livestock that then become our burgers. There's a vast amount that industrial
agriculture does to the food system. And it is certainly one of the reasons why we have these
sort of catastrophic, you know, we're seeing catastrophic weather events. But then there's
just the straightforward loss of our relationship with the natural world. I mean, the other side of
the term inflamed is that fire is healing. That, you know, inflammation is, as Rupert mentioned,
a natural process of the body trying to restore homeostasis. In native and indigenous food systems,
fire is part of a Sweden food system. I know that the term hunter-gatherer is one that people
will have grown up with, but actually a more precise term is Sweden, because hunter-gathering
is one of these colonial terms to describe what the colonists saw. They didn't see all the tending
that was happening after you burn through and after you replant.
And so, you know, the idea of the Sweden agricultural system
is something that is incredibly rich
and knows how to live very well with biodiversity
and is misidentified as being,
oh, you know, people walking around
picking up what they just saw,
as opposed to being responsible
for cultivating that stuff over generations.
So, you know, all of this is to say
there are other ways of thinking about fire and about how to live with the things in the web of
life. And industrial agriculture doesn't just annihilate the locales for that happening,
but the knowledge behind how it is that we might live in those locales more sustainably.
Yeah, incredible. How about your perspective on that, Rupa?
Oh, everything that Raj just said. What he said.
What he said.
You know, we're working with at our farm this incredible, incredible woman,
Sage Lapena, who's the daughter of Frank Lapena, a California native scholar.
And Sage was raised with all the traditional ecological knowledge keepers
here in California.
She's Namtapamwintu.
She's Pomo.
And she works as a plant medicine woman in one of the tribal health clinics in Sacramento.
And she's coming out to the clinic or to the farm.
She and I together will be seeing patients together in a decolonizing medicine clinic in Ohlone territory.
So just south of Half Moon Bay.
In two years, we'll have that clinical work up and running. But when Sage, who also was working for the EPA and watershed
restoration, so on this 38 acre farm, 22 acres are riparian woodland corridor, and there are alders
and cottonwoods and the biggest nettle I've ever seen. I mean, towering at like nine feet high, beautiful,
huge nettle, which is an incredible anti-inflammatory food and medicine.
You don't want to walk through it because it'll prickle you.
No. But we're about to harvest the seeds this weekend, which will be really exciting,
really high in omega-3s, really great for vitality, balancing hormones. And Sage,
the first time she came and we were cutting a trail through this riparian corridor um there was so much medicine everywhere
there was elderberry there were nettle there was um all these native california foods um and the
the forest had been completely neglected um people know, what we're calling conservation, this is our conservation
zone of the farm, is a place of great neglect. And in reality, when Portola landed at the mouth
of the river that runs through the farm, all of his crew got sick. They were looking for Monterey,
California, and they ended up finding San Francisco, but they were there at the mouth of
the river for four or five days. And it was the people who lived on that river who came and healed them with the food and the medicine from
that watershed. And so I think that, you know, to imagine a food system that is an actual tending
and relationship, as opposed to an extracting, is something that Western society has very little concept of because all of our economies are based on extraction.
It's not just the fossil fuel industry.
You just, you know, even organic industrial agriculture
is an extractive phenomenon.
And right next door to our farm, there's an organic farm.
It's a beautiful farm, but it's one of these ones that,
you know, where they are, you know, treating the soil as a substance on which food grows, as opposed to a living being that you have a relationship and a duty and a responsibility to.
And that's a very different framework.
So what we'll be doing on this farm is a blend of TEK, traditional ecological knowledge, mixed with agroecology from the West and experimenting
with how do we create, bring the wild into the farm? How do we create these fingers of interface
between where we're cultivating foods and where we're tending the wilds? And what does that do
for the health of the workers and the health of the foods we produce? And so it's a very exciting
project for me to be a part of, because I'm
learning more than I ever had about farming, and the food system and soil and also California native
culture and how deeply wise it is around health. And to realize that so many people, so many tribes were pushed to, it was a genocide here. And so the reimagining, reawakening of those relationships, the contending with the trauma and the processing and composting that trauma, the crying, the grieving, the reawakening to our duties. Now, one of our elders, Greg Castro,
said to me, he's our farm elder, he's Ramato Shaloni. He says, when we talk about giving
land back, we're not going to be like, okay, now we got the land back, you guys all have to leave.
It's like, we need your help. We need you to help work with us and make this better.
Because it's been so deranged
and we need to work together.
And how do we do that?
We do that under their leadership.
And for Greg, you know, he's like, we don't have our songs.
We have 400 words left of our language.
So for us, that means supporting our Indigenous people and giving them the resources and the
protection they need to do that work, that reimagining, that reconnecting, and that revitalization of their food systems and their cultural and knowledge ways.
I mean, clearly from the Native American perspective in this country, we've botched it.
First, it was the actual physical genocide.
Then there was the destruction of their food through the decimation of the buffalo, like you said, the 60 million bison that were killed. Then there was the damming of rivers and disrupting of their
ability to actually grow and tend their food the way they were. But then there's the commodification
of food that has led to them to be so sick. So we understand this in the Native community very well.
And we have disrupted their indigenous traditional systems. But there's populations in America that
have been brought here from elsewhere, such as African Americans, who were ripped out of their traditional ways, although they did bring a lot of those. And a lot
of the foods in America were brought in the, braided in the hair of the slaves who came over
when they brought their seeds with them to grow the food that now has become part of our culture.
But how do you, because that's a much bigger population and the Hispanic population,
much bigger population, and they're suffering almost to the same degree, I would say, as the Native Americans.
And what do you see as a pathway for them to reclaim their food sovereignty?
It's quite different.
It's quite different, but it's also quite the same.
Because they are, again, the victims of colonial terror from the other side.
The reason I was born in Ramatishaloni
territory is because $42 trillion was stolen from my country. And my parents couldn't imagine a life
without abject poverty unless they left. And so when you say we botched-
So you're basically a refugee from colonialism, essentially.
All of us are. All of us diaspora, I mean, so many of us diaspora people are. And so
I would say that, you know, first of all, we botched, when you say we botched Native America,
like what's happened with the Native American, I'd say we are botching because line three is
still being built and the Dakota Access Pipeline is still putting water through the drinking water
of the Misoze, the Missouri River. So these are active colonialism in the violence towards
indigenous people is an active daily experience that's ongoing today.
It's not a fait accompli. It's not in the past tense. And so that means there is a there's an opportunity to get involved and stop that violence for all of us,
especially health care workers, that we actually have a duty and an obligation to step up and stand up and, and, and, and stand in solidarity with those
people putting their bodies on the front line right now in front of line three. And so there's
that, but then, but what's been beautiful is seeing the partnerships that have happened between
black and indigenous people around food sovereignty and the recognition and the generosity of
indigenous people to understand the connections of colonial terror that other
marginalized groups are suffering under the same system. And so the work that Sage and I are doing
in this clinic is to offer free medicine to the healthcare workers who are being exploited by the
conventional farming operations on the San Mateo coast of California, and to offer it through a
decolonizing perspective that will help them
in a different way than maybe just going to the free clinic. And so I think that the opportunities
are to build transnational solidarity between all of us who've been impacted by colonialism,
and that includes Europeans, because where did the original colonial terror started? It started in
the enclosure of the commons, the advent of private property in Europe. It started in the enclosure of the commons, the advent of private
property in Europe. It started in the removal of women from their positions of authority around
herbal medicine and medicine systems and the tending of the commons. It started through the
same kind of severing of these critical relationships that maintained our health
in order to advance a capitalist agenda. And so there's what I'm
trying to say is there's room for everybody in this work. We all have different kinds of work
to do, but we can all roll up our sleeves and get involved. That's so great. So as we sort of come
to close it, I literally could talk to both of you for like a week. And I'm planning on hunting
you down and finding you wherever you live. And I'm going to come have dinner.
I'm going to come to the farm.
And I'm just so thrilled to be able to meet both of you.
But in the conclusion of your book, share with us your vision for the future.
And what are the steps that we need to take to reimagine our food system and the kind of inflamed world we live in at all levels.
I mean, I think part of the journey is the journey that you've pointed the way to, Mark,
which is to recognize that food and medicine are coextensive. And to decolonize is to reconnect. And the way that you reconnect is not to care about something,
but to care with. We're big on the idea of care. And so far, you know, the limits of what appears
to be caring, for example, in the food system is to buy local and organic and shave grown and
dolphin friendly and possibly tuna friendly and whatever
it is. But that's not caring with, that's just a kind of patrician worry about the little people
or the small things or the other sort of individualist approach that severs the self
from the rest of community. So caring with is, and the idea of a care revolution is one that
you can see not only in policies like People's Green New Deal or the Red, Black and Green New Deal, which is also a really important intervention linking indigenous and black communities in the United States around how it is we're going to survive the climate emergency.
But at their heart are ideas about how we need to repair our relationships.
I mean, that involves reparations, but it also involves repairing our broken relationships with the planet.
And the idea there is an agroecological transformation. So not just what happens
on the farm, but what happens to enable things to happen on the farm and on the plate and back
again, these reverberating relationships from farm to fork and back again throughout society. And the upshot is precisely the kinds of work we're all three
of us are journeying towards, a world that is whole, that is healthy, where we have reconnected
with one another through the pleasure of our plates in community. Again, not individually,
but together. And if that means we get a few more insects stuck in our teeth on the way there and
back, that's a good sign.
It's good when I'm biking,
but it's not good for the planet.
How about you, Rupa?
What do you see as a way forward
to de-inflame our world?
Yeah, I think it's to center care.
It is the care revolution.
And it's the care of the planet,
the care of each
other. And COVID is giving us an opportunity. And since we didn't learn it last year, now we have
the Delta variant. And I have a feeling we're going to keep seeing this until we start actually
caring. And I see it as being a dismantling of colonial systems and a creating of different social norms and being a guest here on
a stolen native land and really living as a guest with other communities of people from
different nations who are guests on this stolen land and honoring the indigenous people who are
still here and taking care of their lands. It means, it means stewarding, like you're saying,
being in a stewarding and taking care.
And I can see it and it, and I can see it. And I,
and I have seen moments and glimpses and spaces where this is occurring.
And I'm,
what was most exciting for me about writing this book with Raj was the opportunity to share so many examples with other people so that they might see it and they might venture out of what they think they know to these other places where these experiments are happening, these bold and beautiful experiments.
That's so great. and beautiful experiments. So I, I, yeah, I feel very hopeful. Um, I, I, I've never been afraid
of hard work and, and this is going to be hard work, um, but it's not going to be harder than
my last few shifts with COVID patients. So. No, for sure. I'm just so thrilled that both
you're doing this work and it is hopeful. And I I'm going to buy your book for my daughter.
Who's about to enter medical school. Cause I think I think she will love it. She goes down every Thanksgiving to
Black Mesa in the Navajo reservation to just help them with basic stuff. And then listening to her
stories, it's just heartbreaking. They don't have heat for the winter. So if they hadn't,
like if I had donated $5,000 for her to get a truck and get the wood
and bring it to this old guy in his little hut,
he would have frozen to death.
Like it's the difference between life and death there for them.
And they're so marginalized.
And I think we see this in extreme examples
in those communities, but it happens everywhere.
All of us are disenfranchised, disconnected
and suffering from this soul sickness.
And what you're promising is a way to not just deal with social injustice,
but to reclaim our souls as a species.
And it just touches my heart, and I'm so grateful for your work.
And thank you for being guests on The Doctor's Pharmacy.
Thank you so much.
Thank you, Mark.
That was wonderful.
Yeah, and everybody, make sure you go out and get the book, Inflamed it's a fabulous read and it's it's really one of the most important
books of our time calling out things that really haven't been called out in the way they have so
it's inflamed deep medicine the anatomy of injustice um check it out uh and if you love
this podcast share it with everybody because it's important. And subscribe where you
get your podcasts. Leave a comment. Where have you found a way to reclaim your food sovereignty,
even as an individual? Share it with us. We'd love to hear. And we'll see you next week on
The Doctor's Pharmacy. Hey, everybody. It's Dr. Hyman. Thanks for tuning into The Doctor's
Pharmacy. I hope you're loving this podcast.
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Just a reminder that this podcast is for educational purposes only. This podcast is
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