Precision Medicine Quotes

There was a language specific to all things. The ability to learn another language in one arena, whether it was music, medicine, or finance, could be used to accelerate learning and other arenas, too.

Psychiatry, as a subspecialty of medicine, aspires to define mental illness as precisely as, let’s say, cancer of the pancreas, or streptococcal infection of the lungs. However, given the complexity of mind, brain, and human attachment systems, we have not come even close to achieving that sort of precision. Understanding what is “wrong” with people currently is more a question of the mind-set of the practitioner (and of what insurance companies will pay for) than of verifiable, objective facts.

Precision medicine is a data driven, knowledge driven, compassion driven, social intelligence driven, genetically compatible tailoring medical treatment and prevention systems for individual patients.

In the post-Covid world, the mathematics of chaos theory will experience a greater relevancy as it is applied across a broader set of science disciplines, especially epidemiology, precision medicine and climate science. - Tom Golway

I am a sick man. ... I am a spiteful man. I am an unattractive man. I believe my liver is diseased. However, I know nothing at all about my disease, and do not know for certain what ails me. I don't consult a doctor for it, and never have, though I have a respect for medicine and doctors. Besides, I am extremely superstitious, sufficiently so to respect medicine, anyway (I am well-educated enough not to be superstitious, but I am superstitious). No, I refuse to consult a doctor from spite. That you probably will not understand. Well, I understand it, though. Of course, I can't explain who it is precisely that I am mortifying in this case by my spite: I am perfectly well aware that I cannot "pay out" the doctors by not consulting them; I know better than anyone that by all this I am only injuring myself and no one else. But still, if I don't consult a doctor it is from spite. My liver is bad, well--let it get worse! I have been going on like that for a long time--twenty years. Now I am forty. I used to be in the government service, but am no longer. I was a spiteful official. I was rude and took pleasure in being so. I did not take bribes, you see, so I was bound to find a recompense in that, at least. (A poor jest, but I will not scratch it out. I wrote it thinking it would sound very witty; but now that I have seen myself that I only wanted to show off in a despicable way, I will not scratch it out on purpose!)

Mainly, though, the Democratic Party has become the party of reaction. In reaction to a war that is ill conceived, we appear suspicious of all military action. In reaction to those who proclaim the market can cure all ills, we resist efforts to use market principles to tackle pressing problems. In reaction to religious overreach, we equate tolerance with secularism, and forfeit the moral language that would help infuse our policies with a larger meaning. We lose elections and hope for the courts to foil Republican plans. We lost the courts and wait for a White House scandal. And increasingly we feel the need to match the Republican right in stridency and hardball tactics. The accepted wisdom that drives many advocacy groups and Democratic activists these days goes like this: The Republican Party has been able to consistently win elections not by expanding its base but by vilifying Democrats, driving wedges into the electorate, energizing its right wing, and disciplining those who stray from the party line. If the Democrats ever want to get back into power, then they will have to take up the same approach. ...Ultimately, though, I believe any attempt by Democrats to pursue a more sharply partisan and ideological strategy misapprehends the moment we're in. I am convinced that whenever we exaggerate or demonize, oversimplify or overstate our case, we lose. Whenever we dumb down the political debate, we lose. For it's precisely the pursuit of ideological purity, the rigid orthodoxy and the sheer predictability of our current political debate, that keeps us from finding new ways to meet the challenges we face as a country. It's what keeps us locked in "either/or" thinking: the notion that we can have only big government or no government; the assumption that we must either tolerate forty-six million without health insurance or embrace "socialized medicine". It is such doctrinaire thinking and stark partisanship that have turned Americans off of politics.

Even our behavior and emotions seem to have been shaped by a prankster. Why do we crave the very foods that are bad for us but have less desire for pure grains and vegetables? Why do we keep eating when we know we are too fat? And why is our willpower so weak in its attempts to restrain our desires? Why are male and female sexual responses so uncoordinated, instead of being shaped for maximum mutual satisfaction? Why are so many of us constantly anxious, spending our lives, as Mark Twain said, "suffering from tragedies that never occur"? Finally, why do we find happiness so elusive, with the achievement of each long-pursued goal yielding not contentment, but only a new desire for something still less attainable? The design of our bodies is simultaneously extraordinarily precise and unbelievably slipshod. It is as if the best engineers in the universe took every seventh day off and turned the work over to bumbling amateurs.

By this point, I had learned a couple of basic rules. First, detailed statistics are for research halls, not hospital rooms. … Second, it is important to be accurate, but you must always leave some room for hope. I came to believe that it is irresponsible to be more precise than you can be accurate. (essentially, - specificity/precision; + truthfulness/accuracy)

I am a sick man.... I am a spiteful man. I am an unattractive man. I believe my liver is diseased. However, I know nothing at all about my disease, and do not know for certain what ails me. I don't consult a doctor for it, and never have, though I have a respect for medicine and doctors. Besides, I am extremely superstitious, sufficiently so to respect medicine, anyway (I am well-educated enough not to be superstitious, but I am superstitious). No, I refuse to consult a doctor from spite. That you probably will not understand. Well, I understand it, though. Of course, I can't explain who it is precisely that I am mortifying in this case by my spite: I am perfectly well aware that I cannot "pay out" the doctors by not consulting them; I know better than anyone that by all this I am only injuring myself and no one else. But still, if I don't consult a doctor it is from spite. My liver is bad, well--let it get worse!

Defining philosophy as “an activity, attempting by means of discussion and reasoning, to make life happy,” he believed that happiness is gained through the achievement of moral self-sufficiency (autarkeia) and freedom from disturbance (ataraxia). The main obstacles to the goal of tranquillity of mind are our unnecessary fears and desires, and the only way to eliminate these is to study natural science. The most serious disturbances of all are fear of death, including fear of punishment after death, and fear of the gods. Scientific inquiry removes fear of death by showing that the mind and spirit are material and mortal, so that they cannot live on after we die: as Epicurus neatly and logically puts it: “Death…is nothing to us: when we exist, death is not present; and when death is present, we do not exist. Consequently it does not concern either the living or the dead, since for the living it is non-existent and the dead no longer exist” (Letter to Menoeceus 125). As for fear of the gods, that disappears when scientific investigation proves that the world was formed by a fortuitous concourse of atoms, that the gods live outside the world and have no inclination or power to intervene in its affairs, and that irregular phenomena such as lightning, thunder, volcanic eruptions, and earthquakes have natural causes and are not manifestations of divine anger. Every Epicurean would have agreed with Katisha in the Mikado when she sings: But to him who’s scientific There’s nothing that’s terrific In the falling of a flight of thunderbolts! So the study of natural science is the necessary means whereby the ethical end is attained. And that is its only justification: Epicurus is not interested in scientific knowledge for its own sake, as is clear from his statement that “if we were not disturbed by our suspicions concerning celestial phenomena, and by our fear that death concerns us, and also by our failure to understand the limits of pains and desires, we should have no need of natural science” (Principal Doctrines 11). Lucretius’ attitude is precisely the same as his master’s: all the scientific information in his poem is presented with the aim of removing the disturbances, especially fear of death and fear of the gods, that prevent the attainment of tranquillity of mind. It is very important for the reader of On the Nature of Things to bear this in mind all the time, particularly since the content of the work is predominantly scientific and no systematic exposition of Epicurean ethics is provided.25 Epicurus despised philosophers who do not make it their business to improve people’s moral condition: “Vain is the word of a philosopher by whom no human suffering is cured. For just as medicine is of no use if it fails to banish the diseases of the body, so philosophy is of no use if it fails to banish the suffering of the mind” (Usener fr. 221). It is evident that he would have condemned the majority of modern philosophers and scientists.

Between stimulus and response there is a space. In that space is our power to choose our response. In our response lies our growth and our freedom.” —VIKTOR FRANKL, author, neurologist, psychiatrist, philosopher, and Holocaust survivor

Some people charge that Obama is a socialist. He isn’t a socialist in the precise sense of the word. He supports corporate medicine, central banking and international banking elites, the military-industrial complex, and, with great exuberance, the surveillance-industrial complex.

I am a sick man.... I am a spiteful man. I am an unattractive man. I believe my liver is diseased. However, I know nothing at all about my disease, and do not know for certain what ails me. I don’t consult a doctor for it, and never have, though I have a respect for medicine and doctors. Besides, I am extremely superstitious, sufficiently so to respect medicine, anyway (I am well-educated enough not to be superstitious, but I am superstitious). No, I refuse to consult a doctor from spite. That you probably will not understand. Well, I understand it, though. Of course, I can’t explain who it is precisely that I am mortifying in this case by my spite: I am perfectly well aware that I cannot “pay out” the doctors by not consulting them; I know better than anyone that by all this I am only injuring myself and no one else. But still, if I don’t consult a doctor it is from spite. My liver is bad, well — let it get worse! I have been going on like that for a long time — twenty years. Now I am forty. I used to be in the government service, but am no longer. I was a spiteful official. I was rude and took pleasure in being so. I did not take bribes, you see, so I was bound to find a recompense in that, at least. (A poor jest, but I will not scratch it out. I wrote it thinking it would sound very witty; but now that I have seen myself that I only wanted to show off in a despicable way, I will not scratch it out on purpose!)

It is well known that at the coronation of kings and queens, even modern ones, a certain curious process of seasoning them for their functions is gone through. There is a saltcellar of state, so called, and there may be a caster of state. How they use the salt, precisely--who knows? Certain I am, however, that a king's head is solemnly oiled at his coronation, even as a head of salad. Can it be, though, that they anoint it with a view of making its interior run well, as they anoint machinery? Much might be ruminated here, concerning the essential dignity of this regal process, because in common life we esteem but meanly and contemptibly a fellow who anoints his hair, and palpably smells of that anointing. In truth, a mature man who uses hair-oil, unless medicinally, that man has probably got a quoggy spot in him somewhere. As a general rule, he can't amount to much in his totality.

Like the DSM-V, the RDoC framework conceptualizes mental illnesses solely as brain disorders. This means that future research funding will explore the brain circuits “and other neurobiological measures” that underlie mental problems. Insel sees this as a first step toward the sort of “precision medicine that has transformed cancer diagnosis and treatment.” Mental illness, however, is not at all like cancer: Humans are social animals, and mental problems involve not being able to get along with other people, not fitting in, not belonging, and in general not being able to get on the same wavelength.

The Tree of Life was an ancient symbol of interconnection, fertility, and eternal life—precisely because of this legendary tree’s fruit. Fruit is part of our essence, a basic element of who we are. We cannot survive without fruit on this planet. It outweighs the nutrition of any other food. Yet the current “health” movement toward low-carb diets has put fruit on the endangered species list, with the goal of making it extinct. Is this denial? Ignorance? Foolishness? We’re not talking about uneducated people who are driving the trend. We’re talking about smart, highly intelligent professionals with advanced degrees in medicine and nutrition. If they’re advising patients to shun fruit, it must be because of their training, the misinformation out there, or their own selective interests. Have you heard of book burning? If the anti-sugar war keeps up its momentum, fruit trees will be next to go up in flames.

we have no good metrics for a place’s success in assisting people to live. By contrast, we have very precise ratings for health and safety. So you can guess what gets the attention from the people who run places for the elderly: whether Dad loses weight, skips his medications, or has a fall, not whether he’s lonely.

Psychologists often make a distinction between mistakes where we already know the right answer and mistakes where we don’t. A medication error, for example, is a mistake of the former kind: the nurse knew she should have administered Medicine A but inadvertently administered Medicine B, perhaps because of confusing labeling combined with pressure of time. But sometimes mistakes are consciously made as part of a process of discovery. Drug companies test lots of different combinations of chemicals to see which have efficacy and which don’t. Nobody knows in advance which will work and which won’t, but this is precisely why they test extensively, and fail often. It is integral to progress.

Men's rights activists tend to make a series of valid observations from which they proceed to a single, 180-degree-wrong conclusion. They are correct to point out that, worldwide, suicide is the most common form of death for men under fifty. It's also true that men are more likely than women to have serious problems with alcohol, that men die younger, that the prison population is 95 per cent male and that the lack of support for our returning frontline soldiers is a national disgrace. So far, so regrettably true. They are incorrect, however, to lay any of this at the door of 'feminism', a term which they use almost interchangeably with 'women'. [...] No, sir. No, lads. No, Daddy. That won't help us and it won't help anyone else. Men in trouble are often in trouble precisely because they are trying to Get a Grip and Act Like a Man. We are at risk of suicide because the alternative is to ask for help, something we have been repeatedly told is unmanly. We are in prison because the traditional breadwinning expectation of manhood can't be met, or the pressure to conform is too great, or the option of violence has been frowned upon but implicitly sanctioned since we were children. [...] We die younger than women because, for one thing, we don't go to the doctor. We don't take ourselves too seriously. We don't want to be thought self-indulgent. The mark of a real man is being able to tolerate a chest infection for three months before laying off the smokes or asking for medicine.

But “people” went beyond practice. How a doctor interacted with their patient was just as important in helping a sick person as the science and the cost, and so “people” includes that doctor’s personal imprint, or style. Graham’s style had pried out key information from Sam. It had allowed him to evaluate the diabetes with a more precise scientific lens. “People” was medicine’s art.

it is precisely their genius for interpretation that puts religious leaders at a disadvantage when they compete against scientists. Scientists too know how to cut corners and twist the evidence, but in the end, the mark of science is the willingness to admit failure and try a different tack. That’s why scientists gradually learn how to grow better crops and make better medicines, whereas priests and gurus learn only how to make better excuses.

Medicine was religion. Religion was society. Society was medicine. Even economics were mixed up in there somewhere (you had to have or borrow enough money to buy a pig, or even a cow, in case someone got sick and a sacrifice was required), and so was music (if you didn't have a qeej player at your funeral, your soul wouldn't be guided on its posthumous travels, and it couldn't be reborn, and it might make your relatives sick). In fact, the Hmong view of health care seemed to me to be precisely the opposite of the prevailing American one, in which the practice of medicine has fissioned into smaller and smaller subspecialties, with less and less truck between bailiwicks. The Hmong carried holism to its ultima Thule. As my web of cross-references grew more and more thickly interlaced, I concluded that the Hmong preoccupation with medical issues was nothing less than a preocupation with life. (And death. And life after death).

The weakest sufferers are precisely those who are least able to appropriate the future and its good things. If this be true of the weak, and if the strong find it irritating to be medicined with soft fictions, or presented with anything but sound truth, the popular method of consolation appears to be excluded altogether. If my own life were to be lived over again, I should, from the strength of this conviction, convert most of its words of intended consolation into a far more consolatory condolence. Never

Having a body, we have seen, does not entail knowing a body. Whereas a cow automatically eats whatever grasses supply needed nutrients, people must determine for themselves what to put into their bodies, with the result that there is room to make mistakes. Mistakes arise, in part, from ignorance. Yet ignorance is not the only problem produced by this arrangement. The fact that we are not compelled by our bodies' precise needs—understood as particular kinds of food and drink, rather than food and drink tout court—allows the formation of desires that have little or nothing to do with the needs on which bodily health depends.

[...] if he then should wish to perform rites belonging to many different forms, claiming to use them concurrently as means and ‘supports’ of his spiritual development, he will not really be able to combine them except ‘from the outside’, which amounts to saying that what he accomplishes will be nothing else than syncretism, which consists precisely in this kind of mingling of disparate elements that nothing really unifies. [...] This situation is similar to that of someone who, hoping to secure his health the more effectively, makes use at one and the same time of many different medicines the effects of which neutralize and destroy each other and sometimes even provoke unforeseen reactions harmful to his organism. There are things that are efficacious when used separately but that are nonetheless radically incompatible.

Among the most virulent of all such cultural parasite-equivalents is the religion-based denial of organic evolution. About one-half of Americans (46 percent in 2013, up from 44 percent in 1980), most of whom are evangelical Christians, together with a comparable fraction of Muslims worldwide, believe that no such process has ever occurred. As Creationists, they insist that God created humankind and the rest of life in one to several magical mega-strokes. Their minds are closed to the overwhelming mass of factual demonstrations of evolution, which is increasingly interlocked across every level of biological organization from molecules to ecosystem and the geography of biodiversity. They ignore, or more precisely they call it virtue to remain ignorant of, ongoing evolution observed in the field and even traced to the genes involved. Also looked past are new species created in the laboratory. To Creationists, evolution is at best just an unproven theory. To a few, it is an idea invented by Satan and transmitted through Darwin and later scientists in order to mislead humanity. When I was a small boy attending an evangelical church in Florida, I was taught that the secular agents of Satan are extremely bright and determined, but liars all, man and woman, and so no matter what I heard I must stick my fingers in my ears and hold fast to the true faith. We are all free in a democracy to believe whatever we wish, so why call any opinion such as Creationism a virulent cultural parasite-equivalent? Because it represents a triumph of blind religious faith over carefully tested fact. It is not a conception of reality forged by evidence and logical judgment. Instead, it is part of the price of admission to a religious tribe. Faith is the evidence given of a person’s submission to a particular god, and even then not to the deity directly but to other humans who claim to represent the god. The cost to society as a whole of the bowed head has been enormous. Evolution is a fundamental process of the Universe, not just in living organisms but everywhere, at every level. Its analysis is vital to biology, including medicine, microbiology, and agronomy. Furthermore psychology, anthropology, and even the history of religion itself make no sense without evolution as the key component followed through the passage of time. The explicit denial of evolution presented as a part of a “creation science” is an outright falsehood, the adult equivalent of plugging one’s ears, and a deficit to any society that chooses to acquiesce in this manner to a fundamentalist faith.

In network models of the interactome, these truncating mutations can be thought of as the removal of one node along with all its edges - a node removal. Nonconservative missense mutations of amino acids in the protein core that lead to major folding problems, protein aggregation, and premature protein degradation can also be modeled as node removals. At the other end of the mutational spectrum are small in-frame indels or missense mutations. These can preserve protein folding, but may modify the active site of an enzyme or affect the binding to another protein or macromolecule. In network models, these mutations, which specifically perturb a single molecular interaction, have been labeled as edge-specific or "edgetic". While investigation of the precise interaction defects associated with point mutations is of course not new, the term edgetic promotes a subtle yet meaningful archetype shift from conventional gene-centered models, which emphasize consideration of which specific edges are affected by a mutation, complement and extend classic gene-centric models, which ascertain only whether a gene product is present or not present and neglect less overt alterations of a given gene or gene product.

I want to convince you that intellectual property is important, that it is something that any informed citizen needs to know a little about, in the same way that any informed citizen needs to know at least something about the environment, or civil rights, or the way the economy works. I will try my best to be fair, to explain the issues and give both sides of the argument. Still, you should know that this is more than mere description. In the pages that follow, I try to show that current intellectual property policy is overwhelmingly and tragically bad in ways that everyone, and not just lawyers or economists, should care about. We are making bad decisions that will have a negative effect on our culture, our kids’ schools, and our communications networks; on free speech, medicine, and scientific research. We are wasting some of the promise of the Internet, running the risk of ruining an amazing system of scientific innovation, carving out an intellectual property exemption to the First Amendment. I do not write this as an enemy of intellectual property, a dot-communist ready to end all property rights; in fact, I am a fan. It is precisely because I am a fan that I am so alarmed about the direction we are taking.

Although these digital tools can improve the diagnostic process and offer clinicians a variety of state-of-the-art treatment options, most are based on a reductionist approach to health and disease. This paradigm takes a divide-and-conquer approach to medicine, "rooted in the assumption that complex problems are solvable by dividing them into smaller, simpler, and thus more tractable units." Although this methodology has led to important insights and practical implications in healthcare, it does have its limitations. Reductionist thinking has led researchers and clinicians to search for one or two primary causes of each disease and design therapies that address those causes.... The limitation of this type of reasoning becomes obvious when one examines the impact of each of these diseases. There are many individuals who are exposed to HIV who do not develop the infection, many patients have blood glucose levels outside the normal range who never develop signs and symptoms of diabetes, and many patients with low thyroxine levels do not develop clinical hypothyroidism. These "anomalies" imply that there are cofactors involved in all these conditions, which when combined with the primary cause or causes bring about the clinical onset. Detecting these contributing factors requires the reductionist approach to be complemented by a systems biology approach, which assumes there are many interacting causes to each disease.

If you can’t make a good prediction, it is very often harmful to pretend that you can. I suspect that epidemiologists, and others in the medical community, understand this because of their adherence to the Hippocratic oath. Primum non nocere: First, do no harm. Much of the most thoughtful work on the use and abuse of statistical models and the proper role of prediction comes from people in the medical profession.88 That is not to say there is nothing on the line when an economist makes a prediction, or a seismologist does. But because of medicine’s intimate connection with life and death, doctors tend to be appropriately cautious. In their field, stupid models kill people. It has a sobering effect. There is something more to be said, however, about Chip Macal’s idea of “modeling for insights.” The philosophy of this book is that prediction is as much a means as an end. Prediction serves a very central role in hypothesis testing, for instance, and therefore in all of science.89 As the statistician George E. P. Box wrote, “All models are wrong, but some models are useful.”90 What he meant by that is that all models are simplifications of the universe, as they must necessarily be. As another mathematician said, “The best model of a cat is a cat.”91 Everything else is leaving out some sort of detail. How pertinent that detail might be will depend on exactly what problem we’re trying to solve and on how precise an answer we require.

It should be clear by now that whatever Americans say about diversity, it is not a strength. If it were a strength, Americans would practice it spontaneously. It would not require “diversity management” or anti-discrimination laws. Nor would it require constant reminders of how wonderful it is. It takes no exhortations for us to appreciate things that are truly desirable: indoor plumbing, vacations, modern medicine, friendship, or cheaper gasoline. [W]hen they are free to do so, most people avoid diversity. The scientific evidence suggests why: Human beings appear to have deeply-rooted tribal instincts. They seem to prefer to live in homogeneous communities rather than endure the tension and conflict that arise from differences. If the goal of building a diverse society conflicts with some aspect of our nature, it will be very difficult to achieve. As Horace wrote in the Epistles, “Though you drive Nature out with a pitchfork, she will ever find her way back.” Some intellectuals and bohemians profess to enjoy diversity, but they appear to be a minority. Why do we insist that diversity is a strength when it is not? In the 1950s and 1960s, when segregation was being dismantled, many people believed full integration would be achieved within a generation. At that time, there were few Hispanics or Asians but with a population of blacks and whites, the United States could be described as “diverse.” It seemed vastly more forward-looking to think of this as an advantage to be cultivated rather than a weakness to be endured. Our country also seemed to be embarking on a morally superior course. Human history is the history of warfare—between nations, tribes, and religions —and many Americans believed that reconciliation between blacks and whites would lead to a new era of inclusiveness for all peoples of the world. After the immigration reforms of 1965 opened the United States to large numbers of non- Europeans, our country became more diverse than anyone in the 1950s would have imagined. Diversity often led to conflict, but it would have been a repudiation of the civil rights movement to conclude that diversity was a weakness. Americans are proud of their country and do not like to think it may have made a serious mistake. As examples of ethnic and racial tension continued to accumulate, and as the civil rights vision of effortless integration faded, there were strong ideological and even patriotic reasons to downplay or deny what was happening, or at least to hope that exhortations to “celebrate diversity” would turn what was proving to be a problem into an advantage. To criticize diversity raises the intolerable possibility that the United States has been acting on mistaken assumptions for half a century. To talk glowingly about diversity therefore became a form of cheerleading for America. It even became common to say that diversity was our greatest strength—something that would have astonished any American from the colonial era through the 1950s. There is so much emotional capital invested in the civil-rights-era goals of racial equality and harmony that virtually any critique of its assumptions is intolerable. To point out the obvious— that diversity brings conflict—is to question sacred assumptions about the ultimate insignificance of race. Nations are at their most sensitive and irrational where they are weakest. It is precisely because it is so easy to point out the weaknesses of diversity that any attempt to do so must be countered, not by specifying diversity’s strengths—which no one can do—but with accusations of racism.

Thyroid. Test Thyroid Stimulating Hormone annually. The test is called TSH and could indicate thyroid problems if too high. In such cases, energy levels will be low, and exercise will have less benefit. The standard “too high” level is 4 uiu/ml (or miu/L), but the warning bells should chime at anything above 2.5. For men, a doctor should be seen if this is the case and total testosterone is below 350/dl. For women, T3 and T4 should measured, and a doctor seen if they are low. We cannot give a precise number here, because different labs use different tests for this one. So here “low” should be taken to mean low according to the lab report. The cure for a weak thyroid is levothyroxine, a very inexpensive prescription medicine.

Today, multiple major waves seem to be arriving simultaneously—technologies like the cloud, AI, AR/ VR, not to mention more esoteric projects like supersonic planes and hyperloops. What’s more, rather than being concentrated narrowly in a personal computer industry that was essentially a niche market, today’s new technologies impact nearly every part of the economy, creating many new opportunities. This trend holds tremendous promise. Precision medicine will use computing power to revolutionize health care. Smart grids use software to dramatically improve power efficiency and enable the spread of renewable energy sources like solar roofs. And computational biology might allow us to improve life itself. Blitzscaling can help these advances spread and magnify their sorely needed impact.

If machine learning can help reveal relationships between genes, diseases and treatment responses, it could revolutionize personalized medicine, make farm animals healthier and enable more resilient crops. Moreover, robots have the potential to become more accurate and reliable surgeons than humans, even without using advanced AI. A wide variety of robotic surgeries have been successfully performed in recent years, often allowing precision, miniaturization and smaller incisions that lead to decreased blood loss, less pain and shorter healing time.

Absurdity of an idea is precisely the criterion of a great idea.

Most so-called doctors may boastfully proclaim to you that you must be concerned about making a lot of money in the practice of medicine, but keep in mind, that's precisely what practice of medicine is not about. So, reply to them with utmost realization of the purpose of medicine, "if you want to make a lot of money, then you should better go into business, not in medicine.

The Historical Setting of Genesis Mesopotamia: Sumer Through Old Babylonia Sumerians. It is not possible at this time to put Ge 1–11 into a specific place in the historical record. Our history of the ancient Near East begins in earnest after writing has been invented, and the earliest civilization known to us in the historical record is that of the Sumerians. This culture dominated southern Mesopotamia for over 500 years during the first half of the third millennium BC (2900–2350 BC), known as the Early Dynastic Period. The Sumerians have become known through the excavation of several of their principal cities, which include Eridu, Uruk and Ur. The Sumerians are credited with many of the important developments in civilization, including the foundations of mathematics, astronomy, law and medicine. Urbanization is also first witnessed among the Sumerians. By the time of Abraham, the Sumerians no longer dominate the ancient Near East politically, but their culture continues to influence the region. Other cultures replace them in the political arena but benefit from the advances they made. Dynasty of Akkad. In the middle of the twenty-fourth century BC, the Sumerian culture was overrun by the formation of an empire under the kingship of Sargon I, who established his capital at Akkad. He ruled all of southern Mesopotamia and ranged eastward into Elam and northwest to the Mediterranean on campaigns of a military and economic nature. The empire lasted for almost 150 years before being apparently overthrown by the Gutians (a barbaric people from the Zagros Mountains east of the Tigris), though other factors, including internal dissent, may have contributed to the downfall. Ur III. Of the next century little is known as more than 20 Gutian kings succeeded one another. Just before 2100 BC, the city of Ur took control of southern Mesopotamia under the kingship of Ur-Nammu, and for the next century there was a Sumerian renaissance in what has been called the Ur III period. It is difficult to ascertain the limits of territorial control of the Ur III kings, though the territory does not seem to have been as extensive as that of the dynasty of Akkad. Under Ur-Nammu’s son Shulgi, the region enjoyed almost a half century of peace. Decline and fall came late in the twenty-first century BC through the infiltration of the Amorites and the increased aggression of the Elamites to the east. The Elamites finally overthrew the city. It is against this backdrop of history that the OT patriarchs emerge. Some have pictured Abraham as leaving the sophisticated Ur that was the center of the powerful Ur III period to settle in the unknown wilderness of Canaan, but that involves both chronological and geographic speculation. By the highest chronology (i.e., the earliest dates attributed to him), Abraham probably would have traveled from Ur to Harran during the reign of Ur-Nammu, but many scholars are inclined to place Abraham in the later Isin-Larsa period or even the Old Babylonian period. From a geographic standpoint it is difficult to be sure that the Ur mentioned in the Bible is the famous city in southern Mesopotamia (see note on 11:28). All this makes it impossible to give a precise background of Abraham. The Ur III period ended in southern Mesopotamia as the last king of Ur, Ibbi-Sin, lost the support of one city after another and was finally overthrown by the Elamites, who lived just east of the Tigris. In the ensuing two centuries (c. 2000–1800 BC), power was again returned to city-states that controlled more local areas. Isin, Larsa, Eshnunna, Lagash, Mari, Assur and Babylon all served as major political centers.

Human bodies are extremely complicated and over the years I learned three important things about them, none of which I had been taught by lecturers or professors at my medical school. First, I learned that no two bodies are identical and there are an infinite number of variations. Not even twins are truly identical. When I first started to study medicine I used to think how much easier it would be for us all (doctors and patients) if bodies came with an owner's manual, but the more I learned about medicine the more I realised that such a manual would have to contain so many variations, footnotes and appendices that it wouldn't fit into the British Museum let alone sit comfortably on the average bookshelf. Even if manuals were individually prepared they would still be too vast for practical use. However much we may think we know about illness and health there will always be exceptions; there will always be times when our prognoses and predictions are proved wrong. Second, I learned that the human body has enormous, hidden strengths, and far greater power than most of us ever realise. We tend to think of ourselves as being delicate and vulnerable. But, in practice, our bodies are tougher than we imagine, far more capable of coping with physical and mental stresses than most of us realise. Very few of us know just how strong and capable we can be. Only if we are pushed to our limits do we find out precisely what we can do. Third, I learned that our bodies are far better equipped for selfdefence than most of us imagine, and are surprisingly well-equipped with a wide variety of protective mechanisms and self-healing systems which are designed to keep us alive and to protect us when we find ourselves in adverse circumstances. The human body is designed for survival and contains far more automatic defence mechanisms, designed to protect its occupant when it is threatened, than any motor car. To give the simplest of examples, consider what happens when you cut yourself. First, blood will flow out of your body for a few seconds to wash away any dirt. Then special proteins will quickly form a protective net to catch blood cells and form a clot to seal the wound. The damaged cells will release special substances into the tissues to make the area red, swollen and hot. The heat kills any infection, the swelling acts as a natural splint - protecting the injured area. White cells are brought to the injury site to swallow up any bacteria. And, finally, scar tissue builds up over the wounded site. The scar tissue will be stronger than the original, damaged area of skin. Those were the three medical truths I discovered for myself. Over the years I have seen many examples of these three truths. But one patient always comes into my mind when I think about the way the human body can defy medical science, prove doctors wrong and exhibit its extraordinary in-built healing power.

Ultimately, though, I believe any attempt by Democrats to pursue a more sharply partisan and ideological strategy misapprehends the moment we’re in. I am convinced that whenever we exaggerate or demonize, oversimplify or overstate our case, we lose. Whenever we dumb down the political debate, we lose. For it’s precisely the pursuit of ideological purity, the rigid orthodoxy and the sheer predictability of our current political debate, that keeps us from finding new ways to meet the challenges we face as a country. It’s what keeps us locked in “either/or” thinking: the notion that we can have only big government or no government; the assumption that we must either tolerate forty-six million without health insurance or embrace “socialized medicine.

John’s adolescence was marked by loss. When he was thirteen his father died, swiftly followed by his two sisters. Shortly after he turned seventeen his eldest brother, James, whose progress through his chosen medics, career had taken him to London, became unable to work due to ill health and returned to the farm, lying for days on one of the beds that pulled out from the walls of the two-roomed cottage like drawers, coughing himself to death at least while John watched or was nearby; and I find it hard to imagine, now, when death is largely hedged about with treatment plans, when it does not often come senseless out of nowhere, but can be postposted, or if not, then at least explained, what grief must have been like when that boundary was a curtain you could put your hand through. It is easy to think that when death could be so quickly turned to, a matter of mistral and all families counted lost children in their numbers, that loss must have been a blunter thing- that having so much practice, they must have been better at it, or inoculated, that it cannot have been for them such devastation, this laying waste- as the birth of a tenth child might be of less account in a busy week than the loss of a pair of, so that the date of it was not looked for until later, when it was found to have been forgotten. It is easy to think that in an age without anaesthetics, when legs might be hacked off on kitchen tables, teeth pulled sigh pliers taking gobbets of jaw and gun away with the , that pain must have been somehow a less precise, less devastating thing, the alternative being unthinkable- that it was just the same but persisting, could only be endured, to universal to allow concession; and so John Hunter watched the bodies of those he loved carried out of the tiny farmhouse one by one, making their last journey to the church, and afterwards he went about the business of his day, he went to school or to the fields, and then at last, summoned by William, the sole surviving brother he barely remembered, he went to London and, did not return.

The womb of the world births us. My filth comes from the same earthwork that gives rise to all stories. My interior light connects me with all the other creatures that inhabit this world of rocks, air, grass, woods, and water. My genetic code links me inextricably with all of nature. I enter the medley in the river of life with the ability to respond as life unfolds before my childlike eyes. My homemade medicinal poultice might not be of any benefit to other people. Nonetheless, we should each write our stories because each of us aims to attain a greater degree of awareness of our own authenticity. We owe a moral obligation to our family, friends, and ourselves as well as to the community to make a determined effort to wring the most out of life. We must applaud all efforts to investigate the human condition. Even if my writing amounts to nothing more than a clumsy attempt to travel the same tracks other people burnished with much more insight, clarity, precision, and style, it is an act of self-definition to ascribe to any philosophy. Philosophy represents a living charter; it is a life of action.

One consistent feature stood out: The samples all displayed a striking depletion of white blood cells within the lymph nodes and bone marrow, precisely the tissues that become packed with the feverishly dividing cells of lymphoma patients. Two Yale pharmacologists, Louis Goodman and Alfred Gilman, who had contracted to study the therapeutic effects of nitrogen mustard, made the connection. In a burst of imagination they entertained the possibility that the war gas possessed a dual nature, that it was a strange Jekyll-and-Hyde compound that could exist both on the battlefield and within a physician’s clinic.

The program is grounded in 10 design principles, the aim of which is to create innovative solutions to intractable health problems....In other words, do not be content with the status quo. The remaining principles include several obvious but often overlooked themes in routine patient care: value each person, be human, be human-centered, codesign, facilitate connections, treat with dignity, and provide a stage from which the hardest, most important stories may be told.

Are [the arts and the sciences] really as distinct as we seem to assume? [...] Most universities will have distinct faculties of arts and sciences, for instance. But the division clearly has some artificiality. Suppose one assumed, for example, that the arts were about creativity while the sciences were about a rigorous application of technique and methods. This would be an oversimplification because all disciplines need both. The best science requires creative thinking. Someone has to see a problem, form a hypothesis about a solution, and then figure out how to test that hypothesis and implement its findings. That all requires creative thinking, which is often called innovation. The very best scientists display creative genius equal to any artist. [...] And let us also consider our artists. Creativity alone fails to deliver us anything of worth. A musician or painter must also learn a technique, sometimes as rigorous and precise as found in any science, in order that they can turn their thoughts into a work. They must attain mastery over their medium. Even a writer works within the rules of grammar to produce beauty. [...] The logical positivists, who were reconstructing David Hume’s general approach, looked at verifiability as the mark of science. But most of science cannot be verified. It mainly consists of theories that we retain as long as they work but which are often rejected. Science is theoretical rather than proven. Having seen this, Karl Popper proposed falsifiability as the criterion of science. While we cannot prove theories true, he argued, we can at least prove that some are false and this is what demonstrates the superiority of science. The rest is nonsense on his account. The same problems afflict Popper’s account, however. It is just as hard to prove a theory false as it is to prove one true. I am also in sympathy with the early Wittgenstein of the Tractatus Logico-Philosophicus who says that far from being nonsense, the non-sciences are often the most meaningful things in our lives. I am not sure the relationship to truth is really what divides the arts and sciences. [...] The sciences get us what we want. They have plenty of extrinsic value. Medicine enables us to cure illness, for instance, and physics enables us to develop technology. I do not think, in contrast, that we pursue the arts for what they get us. They are usually ends in themselves. But I said this was only a vague distinction. Our greatest scientists are not merely looking to fix practical problems. Newton, Einstein and Darwin seemed primarily to be seeking understanding of the world for its own sake, motivated primarily by a sense of wonder. I would take this again as indicative of the arts and sciences not being as far apart as they are usually depicted. And nor do I see them as being opposed. The best in any field will have a mixture of creativity and discipline and to that extent the arts and sciences are complimentary.

HT-1 This point is difficult to access, as it is well protected by the structure of the human body. HT-1is a bilateral Vital Point that is located in the armpit at the junction of the inner arm with the torso. It is associated with the Heart Meridian and is the point that the internal aspects of that meridian leaves the inner torso and emerges close to the surface of the skin. It does not have a direct connection to any Extraordinary Vessels, but is highly sensitive to attack. Traditional Chinese Medicine state that this is a no-needle point in many related textbooks. On the surface, this point would appear to be a difficult one to access during an altercation, but it is accessible. HT-1 becomes easily accessible if the opponent’s arm is raised, which occurs in the short instances that they are throwing a punch. A quick finger thrust or one-knuckle fist strike can easily activate it, but it requires a fair amount of precision to land. Combat science teaches us that precision generally diminishes during an altercation, but I add the above variant for those that would be willing to put in the training time for achieve such a strike. Just remember that the likelihood of landing such a technique during an actual altercation is remote, even with copious amounts of practice. A more realistic attack to HT-1 is when you have used your opponent’s arm to take them to the ground. Once established, as a generally rule of thumb, it is advised that if you have established control over an opponent’s arm that you should maintain that control until you deliver a blow that ends the fight. So, with that in mind, one of my favorite attacks to HT-1 after driving an opponent to ground while having established and maintained arm control, that you jerk the arm towards yourself as you throw a kick into this Vital Point. The type of kick will be dependent on the positioning of your opponent. If he is bladed on the ground (laying on one side with the arm you control in the air) a hard side kick or stomp works well. If the opponent starts turning, or squaring his shoulders towards you as he hits the ground in an attempt to regain his feet, then a forceful forward, or straight kick, can work. I would suggest working with a training partner to determine the various configurations that a downed opponent would react when you maintain control of one of their arms. Notice that I did not advise that you kick your training partner in HT-1, which is ill advised since it theoretically can cause disruptions to the heart and according to Traditional Chinese Medicine theory even death. Again, this technique is not for demonstration or sport-oriented martial arts, but mature and thoughtful training practice can provide a wealth of knowledge on how best to attack a Vital Point, even if it is not actually struck.

The Power of Funghi on

Our bodies are apothecaries. We convert our expectations into chemical reality.” —NORMAN COUSINS, American author, journalist, and professor

The FDA agreed. On August 30, 2017, after a unanimous vote by an exuberant advisory committee (“potentially paradigm shifting”), the agency gave its green light to June’s modified T cells for ALL—its first approval ever for a cell-based gene transfer therapy. The Novartis brand name is Kymriah, a play on “chimera.” In 2018, the FDA approved it to treat several types of non-Hodgkin’s lymphoma. (It joined Yescarta, a similar product from Kite Pharma.) Based on some promising trials,

Huang was skeptical when his doctors told him there was a new drug option called semaglutide (sold under the brand name Ozempic). The doctor had seen some astounding results from this new drug, including a 50 percent drop in HbA1c levels and a weight loss of as much as 50 pounds. What’s more, these dramatic improvements could happen quickly—sometimes within a couple of months. Huang’s doctor mailed him some Ozempic pens, which he would use to inject himself with this groundbreaking drug once a week. He started on a low dose, which was then slowly increased. In the past, Huang had experienced almost every side effect under the sun from his medications. But you know what? With Ozempic, he experienced no side effects at all.

Heck, if you have $1 billion but your primary habitual emotions are frustration and anger, then your life isn’t wealthy—it’s poor!

Years later I realized that our lives are controlled by three decisions. You’re making these decisions right now even as you’re reading this story. And how we make these decisions determines the quality of our life. The first decision we all make is… DECISION #1: What we decide to FOCUS on

DECISION #2: What does this MEAN?

DECISION #3: What am I going to DO?

I learned that under stress, angry people got more angry and sad people got sadder. Happy people looked for the good. In the most difficult situation, caring people were focused on helping others. Once we realize that our emotional home shapes our relationships, our careers, our parenting styles, even the level of intimacy we accept or reject, we can actually start to have a different life.

To remind you, the Human Genome Project took about a decade to sequence a single human genome, completed in April of 2003 at an approximate cost of nearly $3 billion. Today Illumina’s latest generation sequencer has the potential to sequence your genome in an hour and for $100—or 87,600 times faster and 30 million times cheaper.

Although celiac disease is typically thought of as a “gut problem,” more precisely, it is a body-wide inflammatory disease that manifests in the gut. Celiacs, it turns out, can have poor teeth for a couple of reasons. One, gut inflammation can lead to poor absorption of minerals, making the teeth generally weaker and prone to decay. And two, enamel defects commonly seen in celiacs make teeth vulnerable to cavity-forming bacteria. In children, celiac disease often presents as failure to thrive, anemia, digestive symptoms like diarrhea or constipation, or a distinctive rash on the skin. Rosa was too healthy. She had hit every milestone in her development, and her height and weight were above average for her age group. She had no signs or symptoms of anemia, digestive symptoms, or rashes. But in addition to her cavities, she did have another symptom common to celiacs: frequent canker sores.

I don’t want to achieve immortality by being inducted into the Hall of Fame. I want to achieve immortality by not dying.” —William De Morgan

Perhaps to make you feel a bit better about what we all endured in 2020, history provides some valuable comparisons to remind us how far we’ve come in handling pandemics. Consider the following: Between 1347 and 1351, the bubonic plague, the most fatal pandemic recorded in human history, caused the death of 75 to 200 million people in Eurasia and North Africa, and wiped out some 30 to 50 percent of England. They never found a cure.

The 1918 influenza pandemic (also known as the Spanish Flu) was the most severe pandemic in recent history. It was caused by an H1N1 virus with genes of avian origin. It’s estimated that about 500 million people—one-third of the world’s population—became infected with this virus. The number of deaths was estimated to be at least 50 million worldwide, with about 675,000 occurring in the United States. This virus is still with us today, and is the reason for our annual flu shots.

Twenty to thirty minutes before lunch and dinner, you simply swallow three Plenity capsules along with two glasses of water. The tiny hydrogel particles in these capsules expand by about one hundred times inside your stomach as they absorb the water around them. The result? You feel fuller and less inclined to overeat.

I would suggest that our biggest problem is that we think we’re not supposed to have any.

So how do we create an extraordinary quality of life? There are two worlds we need to master: the external world and the internal world. I call these the science of achievement and the art of fulfillment.

The science of achievement is how to turn your dreams into reality. And while that’s not the subject of this book, that’s what I’ve spent most of my life teaching people through my books, events, and private coaching. But the second skill I would attest to is even more important, and that’s mastering the art of fulfillment

However vast the darkness, we must supply our own light.” —STANLEY KUBRICK, legendary American filmmaker

If you can’t win, change the rules.

My dear friend, Ray Kurzweil, speaks about a concept called “longevity escape velocity.” It’s an intriguing notion that in the near future, science will be able to extend your life by more than a year for every year you are alive. Once that happens, we can begin to think about true longevity.

Ray’s prediction is that we’ll reach longevity escape velocity in the next ten to twelve years. Professor George Church of Harvard Medical School echoes that same time frame.

Moore thought this was pretty amazing and he predicted that this trend might continue. Well, it has for fifty-five years. Moore’s Law is the reason the smartphone in your pocket is a thousand times smaller, a thousand times cheaper, and a million times more powerful than a supercomputer from the 1970s.

Exponential Growth in Storage Consider data storage, which is critical for the genomics world today. The 3.2 billion base pairs of your genome correspond to about 725 megabytes of data, or 0.75 gigabytes of storage. In 1981, if you were to store your uncompressed genome, a 1-gigabyte hard drive of storage cost half a million dollars. Today, it’s 50 million times cheaper at under 1 cent per gigabyte.

Exponential Growth in Computation How about computation? In 1971, Intel put out its first computer chip, the Intel 4004. It had 2,300 transistors on it, at $1 each. Intel no longer actually tells you how many transistors are on their chips, but the recent Core i9 had 7 billion transistors at less than a millionth of a penny each. This represents a 27-billion-fold increase in price performance in forty-five years.

Now again, all of this may sound a bit overwhelming, but in reality, you could do all these tests—the CCTA test for heart disease, the MRI and GRAIL test for cancer, and the blood tests for metals and hormones in a few hours. The metals test and the hormone

But before you turn the final page, I hope you really take a moment to commit to live in a beautiful state, no matter what happens. A beautiful state isn’t perfect. It’s better than perfect. It’s messy, playful, full of fun. It’s being generous with yourself and others, and not taking yourself too seriously. It’s working to keep getting better to foster a life filled with joy and happiness and meaning. It’s finding something or someone you want to serve more than yourself. Because that’s the true meaning of grace—a life well lived—a life of service and a life filled with love.

YOUR 7-STEP ACTION PLAN FOR LASTING RESULTS

STEP ONE: DECIDE & GET THE INFORMATION YOU NEED 1. Decide what you truly want for your life physically. What is the result that you’re truly after? Do you want more energy? More vitality? More strength? More flexibility? Do you want to start to rejuvenate your body? Revitalize it? Bring more youth to it? 2. Get the information that you need. Get yourself tested, so you can maximize your energy by: Knowing whether there are toxic metals in your system that are getting in the way of your well-being. Knowing if your hormones are in balance, which can make a giant difference in how you feel day to day. And then ideally, do the things that will give you peace of mind for yourself and for your family. Get the GRAIL test plus a full-body MRI so that you can know that there’s nothing to be concerned about with cancer. GRAIL can even be done even in your home, with a simple blood test. If it’s appropriate, I would consider scheduling a CCTA Test so that you know exactly where your cardiovascular health is and what needs to be done to stay strong and healthy for years to come. Consider getting the Alzheimer’s Test so that you know if you’re genetically predisposed, and also come up with a lifestyle plan that will reduce your risk. If you do this far enough in advance, there are a variety of tools in this book that can make a difference. Who’s in your family or friendship base whom you would like to also make sure gets tested to look out for their well-being and help them to maximize the quality of their life. Last, if you want to have some fun, you can discover what your true age is. As I mentioned earlier, I was thrilled to discover that my chronological age of 62 is only 51 years biologically. I think you’ll be surprised. If it’s not where you want it to be, there are so many things within these pages that you can do to change it.

STEP TWO: REVIEW YOUR EDUCATION If you’ve read this book, congratulations! You’ve given yourself a tremendous education. But knowledge isn’t power; it’s potential power. Decide what tools do you want to access today. And what do you want to keep track of in the future? 1. Are stem cells something that you want to pursue for some aspect of your life or for someone in your family? 2. Do you want to implement Dr. Sinclair’s Four Vitality Ingredients that help reverse biological aging? Or tap into the energy force of NMN? 3. Or, are there some technologies that you’ll want to keep track of so that you have them when you need them? Perhaps the Wnt Pathway for Osteoarthritis? 4. Is there anyone in your family or people you know whom you want to share information with about what you’ve learned here in the big 6—heart disease, diabetes/obesity, stroke, cancer, autoimmune disease, and Alzheimer’s? 5. Are you going to keep track of Gene Therapy and CRISPR and some of the transformations it’s creating? 6. Do you know anyone who has Parkinson’s or severe addiction who could feel relief from focused Ultrasound without brain surgery? Make a list of the things that you want to act on and things you want to keep track of, so that if you or anyone you know who needs help, you’ll have answers that you can share with them and that they can consider with their doctor. Just create a little checklist for yourself. The book is here. It’s the ultimate resource you can go back to as often as you need.

STEP THREE: MAXIMIZE YOUR ENERGY & REGENERATION Consider what aspects of Vitality Pharmacy (Chapter 10) might help you accelerate your energy, your strength, your vitality. Or help you to recover from challenges you may be facing. 1. Are you going to expand your capacity by optimizing your hormones through H.O.T. (hormone optimization therapy)? 2. Would peptides be something you may want to consider? Are there any peptides that you’d like to look into that could make a difference in anything from your immune system to sexual desire and drive? 3. What are some of the pharmaceutical-grade supplements that you might want to have to start your day with energy or to get yourself to sleep at night without side effects? 4. Or would you like to tap into NAD3 or other NMN-like products to maximize your energy and vitality? STEP

STEP FOUR: CREATE A PLAN FOR SLEEP & LIVING PAIN FREE Remember, the third pillar of health besides diet and exercise is sleep. And it profoundly affects how your diet gets processed or whether you even feel like exercising. So what’s your plan? Can you schedule seven hours and track your sleep with an AI device? Will you make some of the changes that will make it easier for you to get a deep and restful sleep so you feel vital? And if there’s pain in your body, or in someone you love, which of the tools do you want to use to free yourself? PEMF? Pete Egoscue’s techniques? Counterstrain? Relief treatment to free up your tissue and nerves? Are you going to do things to support your back, like a simple Back Arch?

STEP FIVE: DEVISE YOUR MAXIMUM LONGEVITY LIFESTYLE What are three to five things that you want to commit to do? You’re not going to do them all. What are the things that you think could make the biggest difference? 1. Is it eating more live foods? Reducing your sugar? Perhaps going on a 10-day cleanse to break the pattern and reset your system? 2. Would you cut 300 calories from your daily food intake—one bagel a day—and see a significant change? Would you want to implement one of the new FDA tools like Plenity to curb your appetite? Or Wegovy to shut off the hormone that creates hunger? 3. If you have pre-diabetes or diabetes or know someone who does, what do you want to use out of that chapter to make the changes so that you don’t have to live with it anymore? 4. You could even decide to cut back on caffeine and increase your water intake to half your body weight in ounces per day to increase your hydration. Are you going to practice breathing patterns that help you to relax and move your lymph, like the breathing pattern of 1–4–2? 5. Will you change your food environment so you’re not triggered by putting fresh foods near you, as opposed to as many packaged and processed foods? 6. Will you tap into the power of heat and cold to give your body a healthy shock that help protect you from disease and extend your healthspan? This is all about designing your lifestyle in a way that’s most fulfilling for you.

STEP SIX: MOVEMENT IS LIFE: WHAT IS YOUR FITNESS PLAN? Given that exercise can reduce your risk of cancer by 40 percent, cut your risk of a stroke by 45 percent, and slash your risk of diabetes by 50 percent… 1. Will you just work out ten minutes a week with something like OsteoStrong? 2. Will you create a plan with Billy Beck III, that you want to act on for free? You’ll get your design to start with for free. 3. Do you want to make exercising fun through VR, by playing through Black box? You’re not even realizing you’re working out, because you’re playing a game.

STEP THREE: MAXIMIZE YOUR ENERGY & REGENERATION Consider what aspects of Vitality Pharmacy (Chapter 10) might help you accelerate your energy, your strength, your vitality. Or help you to recover from challenges you may be facing. 1. Are you going to expand your capacity by optimizing your hormones through H.O.T. (hormone optimization therapy)? 2. Would peptides be something you may want to consider? Are there any peptides that you’d like to look into that could make a difference in anything from your immune system to sexual desire and drive? 3. What are some of the pharmaceutical-grade supplements that you might want to have to start your day with energy or to get yourself to sleep at night without side effects? 4. Or would you like to tap into NAD3 or other NMN-like products to maximize your energy and vitality?

By now, you’re familiar with Horvath’s clock, a way to determine someone’s biological age. Horvath’s team discovered that menopause speeds up cellular aging by an average of 6 percent. The research and resulting arguments “very, very strongly suggest that the loss of hormones that accompanies menopause accelerates or increases biologic age,” said Horvath to Time in 2016.

Our deepest fear is not that we are inadequate. Our deepest fear is that we are powerful beyond measure.… Your playing small does not serve the world.… As we are liberated from our own fear, our presence automatically liberates others.” —MARIANNE WILLIAMSON

SEEING Seeing is one of human beings' highest features. It's an extraordinary experience that helps you to grasp your own vastness. There are, of course, different levels of vision. Our constant aim will be to escape the lower astral clear-sightedness of the trance-medium psychics and to step into the ‘vision of Truth’ or self-vision, which is like an eruption of all mental limitations. A key difference between these two ways of vision is that the pictures that stream into the consciousness are attached in the latter. On the other hand, one of the ways to achieve the sight of Truth is to become less interested in what you see and focus more on the act of seeing, enabling your state of consciousness to grow by seeing. Then you arrive at a completely different experience and comprehension of the world. One can never completely turn what is ‘seen’ into words because the perception transcends the mind's common logic. Therefore, real sight feeds the Spirit and dissipates the soul's false perceptions. ‘Seeing’ should not be seen simply as a device of interpretation, but as an experience that has in itself a transformative meaning. Seeing is an extended form of perception. It's an ‘ontological amplification,’ which means a way of being more. When you think in these terms of clairvoyance, you're much less likely to be deluded by the lower astral vision hallucinations. One of the common mistakes of beginners is to expect their normal vision and physical eyes to see celestial realities as if unexpectedly auras and supernatural entities were to be attached to the pictures of the world obtained through the brain. This cannot function because the normal cognitive perception is precisely the blind part of yourself. The first thing to do to start seeing is to get out of your head.

SEEING Seeing is one of human beings' highest features. It's an extraordinary experience that helps you to grasp your own vastness. There are, of course, different levels of vision. Our constant aim will be to escape the lower astral clear-sightedness of the trance-medium psychics and to step into the ‘vision of Truth’ or self-vision, which is like an eruption of all mental limitations. A key difference between these two ways of vision is that the pictures that stream into the consciousness are attached in the latter. On the other hand, one of the ways to achieve the sight of Truth is to become less interested in what you see and focus more on the act of seeing, enabling your state of consciousness to grow by seeing. Then you arrive at a completely different experience and comprehension of the world. One can never completely turn what is ‘seen’ into words because the perception transcends the mind's common logic. Therefore, real sight feeds the Spirit and dissipates the soul's false perceptions. ‘Seeing’ should not be seen simply as a device of interpretation, but as an experience that has in itself a transformative meaning. Seeing is an extended form of perception. It's an ‘ontological amplification,’ which means a way of being more. When you think in these terms of clairvoyance, you're much less likely to be deluded by the lower astral vision hallucinations. One of the common mistakes of beginners is to expect their normal vision and physical eyes to see celestial realities as if unexpectedly auras and supernatural entities were to be attached to the pictures of the world obtained through the brain. This cannot function because the normal cognitive perception is precisely the blind part of yourself. The first thing to do to start seeing is to get out of your head. Therefore, one of the constant reminders provided in this chapter will be: stop looking if you want to ‘see.’ Stop processing and analyzing images, in other words, as you are used to doing with your brain. Don't bother to see. And you work from your heart as you try. Let yourself switch into another state of consciousness and let ‘something else’ happen.

and are willing to put in the effort. Martine decided to become an expert in pulmonary hypertension.

I spend most of my Mondays with blood. I am a hematologist by training. I study blood and treat blood diseases, including cancers and precancers of white blood cells. On Monday, I arrive much earlier than my patients, when the morning light is still aslant across the black slate of the lab benches. I close the shutters and peer through the microscope at blood smears. A droplet of blood has been spread across a glass slide, to make a film of single cells, each stained with special dyes. The slides are like previews of books, or movie trailers. The cells will begin to reveal the stories of the patients even before I see them in person. I sit by the microscope in the darkened room, a notepad by my side, and whisper to myself as I go through the slides. It’s an old habit; a passerby might well consider me unhinged. Each time I examine a slide, I mumble out the method that my hematology professor in medical school, a tall man with a perpetually leaking pen in his pocket, taught me: “Divide the main cellular components of blood. Red cell. White cell. Platelet. Examine each cell type separately. Write what you observe about each type. Move methodically. Number, color, morphology, shape, size.” It is, by far, the favorite time of my day at work. Number, color, morphology, shape, size. I move methodically. I love looking at cells, in the way that a gardener loves looking at plants—not just the whole but also the parts within the parts: the leaves, the fronds, the precise smell of loam around a fern, the way the woodpecker has bored into the high branches of a tree. Blood speaks to me—but only if I pay attention.

Immunomes Project, which uses AI and machine learning to home in on the most significant blood biomarkers. Their conclusion? The best gauges of our inflammation level—and our inflammatory age—are about 7,500 proteins. Edifice has condensed this large set to a core panel of five protein biomarkers—and their predictive power is startling. They can foretell frailty seven years before it happens. They can predict cardiovascular aging—arterial stiffness and heart thickness—even in currently healthy people. The Edifice blood test and iAge metric is also able to pinpoint people with undiagnosed autoimmune diseases. This technology is up and running today, and should be commercially available by mid-2022. It costs $250 per test, or you can get a subscription service for $60 per month. But Edifice isn’t stopping there. Once you know your iAge, what can you do to improve your outlook? Beyond lifestyle guidance, Edifice Health will also offer personalized supplements—currently under study by an Institutional Review Board—to improve a client’s inflammatory profile.

Personalized, precision cancer medicine depends upon two crucial steps: detecting the patient-specific genetic mutation, and delivering a targeted drug for that mutation. We’ve succeeded at step one, having identified thousands of gene variants, far more than we can possibly investigate.

The period of disarray I lived through in the run-up to those choices is typical of the chaos that so often confronts women during menopause. At this time of our life, one way or another, and whether we choose eventually to go with its flow or insist on resisting its tide, chaos is going to come knocking at our door. As someone with an unreasonable need for control over my own life, I’ve always feared chaos; but chaos, it seems, was precisely what I needed in order to break free. Insight into the strong medicine that chaos brings comes from the word’s origins: it is derived from the Greek khaos, referring to the void which was said to exist before the cosmos was created. Chaos, then, contains the seeds of new life, the seething potential out of which an entirely new universe might be born. As Nietzsche said, “One must have chaos in oneself to give birth to a dancing star.”14 Chaos is the beauty of uncertainty; it unbinds us so that it can create us anew. In his book Timaeus, Plato declared in this context that chaos also incorporates the concept of chora: it is “a receptacle of all becoming — its wetnurse, as it were.” For me, this time was nothing if not a time of becoming. An old story had been consumed, and the ingredients for a new story were just beginning to assemble in the mixing bowl.

At the same time, some researchers wonder whether acetaminophen is impacting something as critical and fundamental as our emotions. One Ohio State researcher who examined this found that study participants who received acetaminophen versus a placebo had a harder time feeling “positive empathy” for strangers, which matters because the ability to experience empathy is associated with more stable romantic relationships and more successful careers. “Just like we should be aware that you shouldn’t get in front of the wheel if you’re under the influence of alcohol, you don’t take [acetaminophen] and then put yourself into a situation that requires you to be emotionally responsive—like having a serious conversation with a partner or coworker,” Dominik Mischkowski, an assistant professor at Ohio University who studies the relationship between pain and social behavior, told the BBC.

SCIENTISTS HAD KNOWN since the late nineteenth century that tobacco smoke contains carbon monoxide. Victorian scientists had even been able to calculate the amount of gas in the smoke: up to 4 percent in cigarette smoke, and in Gettler’s own choice of tobacco, the cigar, between 6 and 8 percent. Gettler’s latest work theorized that chain smokers might suffer from low-level carbon monoxide poisoning. He speculated in a 1933 report that “headaches experienced by heavy smokers are due in part to the inhalation of carbon monoxide.” But his real interest lay less in their symptoms than in how much of the poison had accumulated in their blood, and how that might affect his calculations on cause of death. He approached that problem in his usual, single-minded way. To get a better sense of carbon monoxide contamination from smoking tobacco, Gettler selected three groups of people to compare: persons confined to a state institution in the relatively clean air of the country; street cleaners who worked in a daily, dusty cloud of car exhaust; and heavy smokers. As expected, carboxyhemoglobin blood levels for country dwellers averaged less than 1 percent saturation. The levels for Manhattan street cleaners were triple that amount, a solid 3 percent. But smokers came in the highest, higher than he’d expected, well above the nineteenth-century calculations. Americans were inhaling a lot more tobacco smoke than they had once done, and their saturation levels ranged from 8 to 19 percent. (The latter was from a Bronx cab driver who admitted to smoking six cigarettes on his way to Gettler’s laboratory, lighting one with the stub of another as he went.) It was safe to assume, Gettler wrote with his usual careful precision, that “tobacco smoking appreciably increases the carbon monoxide in the blood and cannot be ignored in the interpretation of laboratory results.”     THE OTHER NOTABLE poison in tobacco smoke was nicotine.

there is no guarantee that the time freed up by our newfound technological efficiencies will be made available for the human touch. A look at the modern history of industrial computerization would have one lay odds that this squishy stuff will be precisely what is sacrificed on the altar of productivity, particularly once every word, touch, and minute is measured, analyzed, and priced out.

In WMS, the temperaments are considered obsolete and therefore are rarely invoked as the causal agents of a disease. The humors have been replaced by precise molecules such as cholesterol, hemoglobin, and dozens of other measures that appear today on any routine blood work. So, the general health or sickness profile of the Unani concept, based on either dystemperament or humoral imbalance, or both, has been replaced by a series of single, isolated indicators as the basis for diagnosis and treatment. It is exactly here that the modern physicians fail to connect the details supplied to them by the remarkable achievements of modern science. And here the medicine of Avicenna offers a rationalization that is currently missing in modern medicine.

The death of awe in our culture has left us with an oddly credulous cynicism. We are cynical, suspicious of established government, education, technology, and medicine. Yet our cynicism is the recycled remnant of dashed hopes and broken faith, precisely because, having lost sight of the God who is worthy, we have invested such trust in these institutions to save our civilization and us.

While Keith Taylor, then, might dismiss questions of "whether Vietnam 'belongs' to Southeast Asia or [North] East Asia" as "probably the least enlightening in Vietnamese studies," it could equally be argued that it is precisely Vietnam's historical, geographical, and cultural location at the frontier of different, identifiable, and historically sedimented cultural formations that makes its situation so distinctive and interesting.

Interestingly, even though MinuteClinic employs no doctors in its clinics, it has never been sued for malpractice. The reason is that malpractice lawsuits arise primarily in cases of mis-diagnosis and flawed therapeutic judgment.16 Because MinuteClinic practices in the realm of precision medicine, its diagnoses are precise and its therapies predictably effective.

An even stronger study on aging and the Transcendental Meditation program, performed with greater methodological precision, was conducted by researchers at Harvard and published in the Journal of Personality and Social Psychology in 1989. This study analyzed elderly people who were introduced to the Transcendental Meditation program. In a short time they showed numerous beneficial changes, and ultimately lived longer, on average, than patients in a control group that did not practice the Transcendental Meditation program. The positive results were noted to endure when a follow-up study was conducted more than ten years later.

In nature, ecosystems consist of fauna and flora, climatic characteristics, soil conditions, geologic features, and a host of other interacting influences. Similarly, the precision medicine ecosystem is made of many interacting components, including patients, clinicians, researchers, laboratory services, CDS software, genomic databases, smartphones, servers, claims data, mobile apps, biobanks to store clinical specimens, and EHRs. EHRs need to serve as gateways to this ecosystem. And for the EHR to become an effective conduit, it needs a way to organize these diverse sources in a way that lets clinicians and patients make more effective diagnostic and treatment decisions.

The Game-Changer in Diabetes Management: Continuous Glucose Monitors Continuous Glucose Monitors (CGMs) have revolutionized diabetes management, offering real-time insights into blood sugar levels like never before. In this article, we'll delve into the significance of CGMs, their benefits, and why they are a game-changer for individuals living with diabetes. Understanding Continuous Glucose Monitors Continuous Glucose Monitors are wearable devices that constantly monitor glucose levels in the interstitial fluid, providing users with real-time data on their blood sugar levels. Unlike traditional finger-prick tests, CGMs offer a continuous stream of information, allowing for proactive management of diabetes. Benefits of Continuous Glucose Monitors Real-Time Monitoring: CGMs offer instant feedback on blood sugar levels, enabling users to make informed decisions about their diet, medication, and lifestyle choices. Early Detection of Trends: CGMs track glucose trends over time, allowing users to identify patterns and adjust their management strategies accordingly. Improved Diabetes Management: With continuous monitoring, individuals can better manage their blood sugar levels, reducing the risk of hyperglycemia and hypoglycemia episodes. Enhanced Quality of Life: CGMs provide greater freedom and flexibility, reducing the need for frequent finger pricks and offering peace of mind to individuals and their caregivers. Why CGMs Are a Game-Changer Precision Medicine: Continuous Glucose Monitors enable personalized diabetes management by providing individualized insights into glucose fluctuations and responses to various factors. Empowerment Through Data: CGMs empower users with valuable data, enabling them to take control of their health and make informed decisions in collaboration with healthcare providers. Continuous Innovation: Advancements in CGM technology, such as improved accuracy and connectivity features, continue to enhance the user experience and expand the capabilities of these devices. Integration with Digital Health Ecosystem: CGMs seamlessly integrate with mobile apps and other digital health platforms, facilitating data sharing, remote monitoring, and telehealth consultations. Conclusion Continuous Glucose Monitors represent a significant advancement in diabetes management, offering real-time insights, personalized care, and improved quality of life for individuals living with diabetes. As technology continues to evolve, CGMs will play an increasingly vital role in empowering individuals to live healthier, more active lives while effectively managing their condition.

In comparison with the mode of life of whole millennia of mankind we present-day men live in a very immoral age: the power of custom is astonishingly enfeebled and the moral sense so rarefied and lofty it may be described as having more or less evaporated. That is why the fundamental insights into the origin of morality are so difficult for us latecomers, and even when we have acquired them we find it impossible to enunciate them, because they sound so uncouth or because they seem to slander morality! This is, for example, already the case with the chief proposition: morality is nothing other (therefore no more!) than obedience to customs, of whatever kind they may be; customs, however, are the traditional way of behaving and evaluating. In things in which no tradition commands there is no morality; and the less life is determined by tradition, the smaller the circle of morality. The free human being is immoral because in all things he is determined to depend upon himself and not upon a tradition: in all the original conditions of mankind, 'evil' signifies the same as 'individual', 'free', 'capricious', 'unusual', 'unforeseen', 'incalculable'. Judged by the standard of these conditions, if an action is performed not because tradition commands it but for other motives (because of its usefulness to the individual, for example), even indeed for precisely the motives which once founded the tradition, it is called immoral and is felt to be so by him who performed it: for it was not performed in obedience to tradition. What is tradition? A higher authority which one obeys, not because it commands what is useful to us, but because it commands. What distinguishes this feeling in the presence of tradition from the feeling of fear in general? It is fear in the presence of a higher intellect which here commands, of an incomprehensible, indefinite power, of something more than personal there is superstition in this fear. Originally all education and care of health, marriage, cure of sickness, agriculture, war, speech and silence, traffic with one another and with the gods belonged within the domain of morality: they demanded one observe prescriptions without thinking of oneself as an individual. Originally, therefore, everything was custom, and whoever wanted to elevate himself above it had to become lawgiver and medicine man and a kind of demi-god: that is to say, he had to make customs a dreadful, mortally dangerous thing! Who is the most moral man? First, he who obeys the law most frequently: who, like the Brahmin12, bears a consciousness of the law with him everywhere and into every minute division of time, so that he is continually inventive in creating opportunities for obeying the law. Then, he who obeys it even in the most difficult cases. The most moral man is he who sacrifices the most to custom: what, however, are the greatest sacrifices? The way in which this question is answered determines the development of several divers kinds of morality; but the most important distinction remains that which divides the morality of most frequent obedience from that of the most difficult obedience.