April 20, 2013

Mental models

TEDMED 2013…now I get it

Read Time 7 minutes

I just got back from the 2013 TEDMED conference at the Kennedy Center in Washington, DC.  I’ve always enjoyed watching TED talks online, but I’d never been to the actual conference.  I was told the experience is very different.  That was an understatement.  I don’t even know where to begin.  I don’t think anything I can write about this week will come close to actually sharing my experience, but I’ll try.

I was one of 50 speakers/performers, but the conference is about much more than the 50 of us.  There are nearly 2,000 participants and unlike most conferences where people are spread out over different sessions and ‘breakout rooms’ (a term that, to this day, makes me laugh out loud – I keep picturing a room with broken down cardboard boxes on the floor and nylon pants and 80’s hip hop), at this conference we all experience it together.  No parallel processing.  That it also takes place in such an epic building, overlooking the Potomac River, is another story.

To answer the first question you may have, I do not know when my talk will be on line, let alone where.  It could show up on the TED and/or TEDMED websites.  I’m told it will be no sooner than 6-8 weeks, and probably closer to 3 months.

This was not a typical Peter Attia talk. Information density was somewhere between zero and small. When I was preparing for the talk I had the complete privilege of working with the TEDMED editorial team.  Talk about an All-Star team.  These people are too talented for words.  It was simply amazing to be in their presence.  Jay Walker, the curator of TEDMED (and one of the most intuitive people I have ever met) gave me the most valuable advice when I was preparing my talk.  He said,

  1. Leave your “M.D.” and “McKinsey” personas off the stage.  While those are your comfort zones, get out of those zones.
  2. Don’t try to “teach” people a bunch of facts (even though you love facts); don’t try to “prove” how smart you are; don’t even try to “convince” people of anything.
  3. Engage both sides of your listener – their intellect and their emotion.
  4. Be authentic. The audience cares less about what you know, and more that you care at all.

This was really hard for me!  I love to teach, and I love data, and I’m much better at engaging intellect than emotion.  But with that advice, and the amazing help of Marcus Webb (TEDMED’s Chief Storyteller), I gave it a shot.  In a few months, I suppose, you can be the judge.

There were so many moments this week that just shot me back onto my heels – moments when it didn’t seem like “this” could be happening.  I’d love to share a few with you.

Meeting the man who gave my favorite TED talk of all time

Before you read another word, watch the 2011 TED talk given by Ric Elias.  Seriously. STOP READING THIS NOW AND WATCH IT.  I have watched this talk, perhaps, as many times as I’ve watched all other talks combined. Probably every 3 or 4 weeks, actually.  Why? Because, unfortunately, that appears to be the frequency with which I need a little reminder of what matters more than NuSI. A few months ago I mentioned this to Jay.  He said, “Do you want to meet Ric? I’m happy to introduce you.”  That was like asking a 15-year-old girl if she wanted to meet Justin Bieber.  Except I didn’t scream as loud. And Ric is way cooler than Justin.

The day after my talk, I was introduced to Ric and we spent about an hour together. It was a unique experience to understate it.  Too often when we meet people we “feel” like we know (due to their celebrity), we’re often let down because we build them up to be more than they could ever be.  Amazingly, and I don’t say this lightly, the person Ric is far exceeded the image of Ric I had, based on a 5 minute video.  He’s one of the rare few I’ve met (one day I’d like to write a book about this short list of folks) that I could imagine dropping everything I was doing to go and work with and for them.  Every man should aspire to be half the father Ric has become since that flight.

Medical school connection

The day before my talk, I was backstage trying to figure out where everything was, and I looked up and saw Zubin Damania!  You may not know who Zubin is, or even his YouTube alter-ego, ZDoggMD (though you’ll definitely want to check out his video on screening for testicular cancer, among many others).  But here’s the thing…the last time I saw Zubin was 13 years ago when he was my intern on my internal medicine rotation at Stanford.  For 8 straight weeks Zubin had me rolling on the floor laughing (and enjoying every single moment of being in the hospital with him).  Zubin is sui generis.  I remember staying up nights on call with him, asking him, “Are you sure this [medicine] is the best use of your talent?  I mean, you’re too damn funny and talented to do this!”

Well, let’s just say, nothing I saw this week surprised me.  Zubin is a rock star and the world is a better place because of his humor and brilliance, and the way he actually combines them. Zubin’s talk was, without question, the peak of TEDMED 2013 entertainment.

If that wasn’t enough, two days later (the day after my talk), a woman stopped me in the lobby and said, “Peter, I really loved your talk.  Thank you for sharing that story.  I hope other doctors hear this message.” I thanked her and we chatted for a minute, the whole time I’m thinking, “Gee she looks really familiar…,” when it finally hit me.  This woman, Dr. Ramona Doyle, an amazing pulmonologist, taught me respiratory physiology 16 years earlier at Stanford!  What made this so special, though, was hearing what she does today.  In addition to her “day job,” she runs a free clinic for uninsured patients in South San Francisco.  Her stories were amazing.  She seemed happier than ever.

The most moving talk

The last talk of Session 7 (there were 10 sessions, each with 5 speakers, for a total of 50 speakers/performers), was given by author Andrew Solomon.  Since you’ll all be able to watch this for yourselves in 2 months or so, I won’t say much. But, if you think back to Jay’s advice to me, Andrew gave a seminar on how to do this.  Andrew is a very special man, and though I was only able to speak with him for 10 minutes backstage, it was clear that he was cut from a different cloth.  A very special cloth.  When his talk began, I thought I knew where he was going.  And I was looking forward to it.  But where he went instead, well, I can’t describe the emotional rollercoaster.  If you can only watch one talk, and I hope you can watch many more, Andrew’s is the one to watch.

Greatest human spectacle

Charity Tillemann-Dick, a remarkable singer, who has undergone a double lung transplant due to primary pulmonary hypertension, simply lit up the room with her soprano voice.  I just could not imagine for the life of me how this woman could sing with such a beautiful voice not powered by her ‘native’ lungs.  In Charity’s case, there was also a deeply personal reason I was so touched by her story.  It highlights the importance of organ transplantation. As she shared with us, life is neither a marathon, nor a sprint.  It’s a relay.

After her talk (and song), I caught up with her back stage and shared the story of my friends, Jeff and Teena Webster, who lost their son Aaron in September 2009, one day before I swam from Los Angeles to Catalina Island – a swim I dedicated to Aaron.  Aaron’s story is both tragic and glorious, as 13 people now live with a part of Aaron in them, including a man who was probably a week away from death due to liver failure.  Today, that man has a tattoo on his arm that reads: Aaron Webster, my hero. 

Best line of the week

Spoken by a juggernaut of a woman, the amazing America Bracho, who is empowering impoverished communities in Southern California by creating participants out of patients, left an impression on me.  Sounds crazy until you hear her tell you and then watch her show you. Make sure you watch her talk when it’s out.  Like Andrew’s talk, this moved me to tears.

She was asked, essentially, can this model she has deployed work with anyone?  She said, “no, you must choose the right people.”  The clincher: “Recruit the heart. Train the brain.”  As someone obsessed with building a great team, truer words have not been spoken.

Most surreal moment

A team of artists created portraits of each speaker, which hung as banners.  A man named Robert Brinkerhoff, who I had never met until my talk, created the following image of me.  I realize this may sound strange, but this struck me as very touching.  Someone who didn’t know me put that much time into trying to represent me?  Very humbling.  Thank you, Robert.

Attia_Brinkerhoff_LR

Closing thoughts

I don’t know if they will ever read this, but if they do, I really want to thank the following people at TEDMED for guiding and encouraging me to share my story, which I was very reluctant to do.  There are so many people behind the scenes whose names I don’t know, but who I owe my gratitude.  I really want to thank Jay Walker, John Benditt (and Gary Taubes, who suggested me as a speaker to John), Lisa Shufro, Lindsay (none-of-my-boys-are-named-Harry) Potter, Pritpal S. Tamber, Jon (the-apple-doesn’t-fall-far-from-the-tree) Ellenthal, Alyssa Picchini Schaeffer, and Marcus Webb, without whom I could not have told my story.  And, Steve Maler.  You gave me the confidence I needed to be so vulnerable, my friend.

I have no idea how I got to be one of the people there this year.  I felt such a responsibility to give back to TEDMED, as I’ve received so much from TED and TEDMED over the past 7 or 8 years.  Though Ric Elias’ talk is my favorite, there is a huge tie for second place (including Virginia Breen, who I just happened to sit beside by random luck during Andrew’s epic talk – once you’ve seen Virginia’s talk and Andrew’s talk, you’ll understand why this juxtaposition was so powerful).  The talks I fall in love with are simply the ones that move me the most.  I spend my whole day learning things.  What I crave is inspiration.

A day after my talk, a woman came up to me in the common area.  She was crying. Just sobbing.  She said she cried through my entire talk.  She couldn’t figure out why.  What was I saying to bring out such emotion, I thought? I apologized. But then she said the most insightful thing that, I think, explains why some of these talks just really move us.  She said, “Peter, it wasn’t what you said, or even how you said it.  You just made me look at myself differently.  These emotions pouring out of me are about me, not you.  You just gave me a different way to think about myself.”

I think that sums up why these talks are so special to me.  It’s about the mirror inside me and everyone else.  I did learn many things this week and met people I want to know better. But for 3 glorious days on the Potomac, I didn’t think about my world or my vision.  I simply got inspired and moved by everyone else’s.

Photo by Mike Wilson on Unsplash

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313 Comments

  1. Thanks for sharing Peter — I watched the Elias video (a few times…) and can’t wait to see your TEDMED talk!

  2. OK. I’ll be the first commenter to admit that I would rather read one of your articles 5 or 6 times until I get it than click on a video link. But, hey, I think I understand your mission, and I support it. We need to reach as many people as we can.

    So, even though a 17-minute Ted talk doesn’t get me that I excited, I plow through the comments thinking I might pluck some new gem about ketosis or quantum mechanics. Instead, I find that you are getting a cool $40 million to fund some really high-quality investigation of low-carb living. I had to do some Googling to figure out what that was all about.

    This is incredible! You are the Vihjalmur Stefansson of the 21st century! It might even be bigger than a Ted talk.

    Yeah, a Ted talk is pretty cool. But I don’t think people will be writing about your Ted talk a hundred years from now. Seriously good research, on the other hand, could be of world-historical significance. I’m celebrating. I hope you are too.

  3. Peter, thank you for sharing your favorite TED talks by Ric Elias and Virginia Breen and Elizabeth Bonker. This may sound funny to you, because your blog and a TED talk are such very different things, but I am just as inspired and moved by your writing as these talks. We have such a need for the information you seek to make available, and the passion you have for its pursuit burns as bright as Elizabeth’s desire to speak, and Ric’s and Virginia’s desire to be there for their children. Honestly. The work you are doing inspires the h— out of me. And I see from other comments, I’m not the only one.

    I am glad to know how moved and inspired you were by TEDMED 2013. Keep feeding that fire!

    • I have wanted to praise you for the influence, teaching, guidance, inspiration, etc but some many have already commented. I second Laura’s comments which were right on. Thanks Laura.
      I look forward to Cholesterol Part X. Sorry for my over-anticipation but my first NMR shows more particles than any example I have seen.

  4. Peter – I can’t watch video at work, but I’ve made a mental note to catch Ric’s talk later.

    I just want to thank you for your enthusiasm. I’ve watched more TED talks than I can count and I’ve started to get burned out on them a little bit with the TEDx brand. I have an unfortunate tendency to get cynical and jaded and your post reminded me that there’s still a lot of great stuff out there and that it really does have the best of the best when it comes to speaking.

  5. Hi Peter,
    I was at TEDMED 2013 too and I put your talk in my top ones as well. It was great. I’m an MD dealing with obesity in the First Nations populations in British Columbia (fortunately with good success). I have been following Gary Taubes since he wrote Good Fats, Bad Fats and have been incorporating that into my teaching ever since. I know there are lots of ways to help people with their obesity and I am open to all tools. I look forward to seeing how your research gives us all further tools to help our patients and ourselves.

    • Pam I am so happy to hear that someone in Canada is trying to help First Nations people. I’m a Canadian nurse working in a dialysis unit in Alberta and I see everyday how this people are dying thanks to the advice to eat healthy grains.
      I would like to see more doctors like you.

  6. Alright, I will be the second one to say that there are much better things than TED. TED is cool for introducing people to new concepts, but not very useful for those that want more than just an introduction. Don’t get me wrong I have watched many hours of TED, but have been mostly disappointed by the lack of substance.

    What I love about your site is your detailed analysis of biochemical systems and how they relate to human health. This country has a major public health problem and your foundation is a well needed tool.

    I have noticed that you are not posting as frequently:-( I really enjoy reading your technical posts. Whenever I see a new one I get very excited:-)

    As for the talk by Ric Elias, I found it interesting, but you would seem to have a greater purpose than just being a great father. Your foundation could make a real difference in a great many people lives. If successful, that is something you will be remembered for 100 years in the future.

    • In the TED format it would be impossible to introduce deep, new content. There are no shortage of conferences out there that do that — I’ll be speaking at one this weekend where I’ll provide detailed molecular explanations of cholesterol synthesis. TED is not trying to replicate that. So I think your disappointment with the lack of substance may be because of your expectations, not a failure of TED. It would be like me saying I’m disappointed with my dog’s ability to do long division. Is it my fault or his? His purpose isn’t to do long division. Lots of other tools for that, right? I realize you’re being very complimentary to the work I’m doing, and I really appreciate it. And you’re definitely right that my posting frequency is down. But I disagree completely with your last statement. You see, being a great father matters more to me than anything, *especially* a blog (and especially on the days when I get nasty emails from people telling me to go F*ck myself…can you imagine what it feels like to get 10 of those per week?). So my rank order in life is: My family > NuSI > My life (and sanity) > Blog. I hope you can respect this, or at least understand it.

    • Lauren…such kind words. Thank you. From you blog post, it’s clear you understand how difficult that talk was for me and how vulnerable it felt. I really appreciate your comments.

  7. Dr. Attia,

    TEDMED was fantastic, and your perspective on the confab is the richest I’ve found, yet. You invoked Feynman, above, and I just love that guy. I’d like to join the conversation, here, add a few observations of my own from TEDMED and then pose you a question. Forgive me for the gambit and amble of this post, my intention is to add to the atmosphere of sharing you’ve created on this site and maybe spark some more.

    First, a few thank you’s ad hominem. As a physician, I’m very pleased with your career focus. We are too commonly prescribing advice that is not built on the bedrock of evidence. Ironically, because nutrition is extremely important and accessible, it has been one of the most abused victims in healthcare. The first step everyone on this post can do is “stay in the question.” We need to train ourselves to be comfortable with ambiguity. Many reading this post may be surprised that suggesting perhaps the quality of the food, and not just caloric quantity alone, is driving a global health crisis quickly upsets a lot of people. It is an ambiguous question and the human mind naturally resolves ambiguity. We are a nation of deciders, GW Bush was the decider, etc. Well, turns out a lot of our decisions stink because we made them without (1) considering the evidence judiciously, and (2) we didn’t have evidence to consider in the first place. Thank you for helping us out of this mess, Dr. Attia!

    A second thank you for sharing Jay Walker’s advice, above, so lucidly. I think it’s profound advice on story-telling 101 and how to behave with other people in general conversation. Too often we try to convince and cajole others to agree with us, or worse. But we don’t need everyone to always agree, do we? How stultifying to the advancement of nutrition science if we all already agreed that the RDA figured things out long ago and there was no more work to do?

    On reflection of TEDMED, I feel like I passed through the back of the wardrobe into Narnia. As I write this, I still have a child like certitude that that I could return to the Kennedy Center at any moment, enter stage left, and find everyone still there, waiting to strike up conversation. The amazing TEDMED team did their level best to create a world where we could check our titles at the door – free of their restrictive weight for a moment, we were able to exchange ideas and make connections more freely, more solidly. There was only one currency – curiosity – and only one entry requirement – flexibility of thought.

    A Feynman quote was referenced for Jessie – I’m guessing it was something along the lines, “the first principle is that you must not fool yourself, and you are the easiest person to fool.” Feynman was a prolific mind, and he was not averse to giving advice. I love the advice he gave a doting mother for her son who could not explain his physics lessons to her satisfaction. He said, “[T]ell your son to stop trying to fill your head with science — for to fill your heart with love is enough.” Passion like yours is very valuable, Jessie. I would suggest, that by consciously focusing it in two ways, onto others when you meet them and onto your work, you have the rudiments for success. Taking Peter’s advice to conduct honest scientific inquiry – i.e. not being afraid to routinely questioning yourself and others – in addition to those traits… well, you will rule out all other possibilities except success in science, and in life.

    I’ll close my thoughts, before I pose a question, by borrowing more quotes from Feynman: (1) What I cannot create, I do not understand (2) I think I can safely say that nobody understands quantum mechanics. While we probably should not speak in absolutes, I’ll take a risk and say true genius is about recognizing what you don’t know, and relentlessly pursuing discovery. Feynman admitted that, freely, and I am trying to get better at it.

    Here is my question for you, Dr. Attia. I would like to know more about how you have dealt with loneliness during your career. I’m not talking about the loneliness of surrounding yourself with loving family and friends, I am sure you have many. I’m talking about the intellectual loneliness of pursuing a line of thought that is together so iconoclastic and omni-disciplinary, that few people on the planet are capable of wrestling the multi-headed beast to the ground. While we all accomplish more together, and battles in life are never won alone… it’s the scouting, the reconnaissance, the experimentation and then the application that advances human knowledge and well-being. I’d love to hear the human elements that sustain you on your intellectual roaming as you morph from surgeon to consultant to evidence based nutrition scientist to roles undefined.

    Thank you,
    Charles

    • Well, Charles, I must say…in 10,000 comments this blog has received since its inception, I’ve never been so put back on my heels. Congratulations! Your question is so amazing and I can’t figure out how to respond, without writing 10,000 words — something I can’t do. I guess I would just like to thank you for having such piercing insight into my demons and insecurities. I don’t really know the answer to your question, other than to say I constantly remind myself, when I do feel alone, that I am not. When my actions are driven by ego, I feel alone. When driven by service — when really authentic — it doesn’t seem to matter. I hope this sort of explains it.

    • Taking a couple of examples in fiction, Holmes (Doyle, not Downey) and modern interpretations like Monk and House all occasionally touch upon how difficult it is to walk into a room and see so much that others do not see, and dealing with the fact that most people will never see things in the same way. Their intellectual/intuitive loneliness is I think what we are discussing here.

      The internet certainly helps connect with similar people, but getting some critical mass together for interpersonal communications is a challenge. This may help explain your reaction to TEDMED.

      A gentle reminder – the anniversary of Part IX is July 12th…

    • No need to worry Peter, as you have a child – you’ll never be alone. 🙂 While your areas of interest may be outside the current dogma, I would say you’re far from alone in your area of pursuit. It’s not like you’re John the Baptist crying out in the wilderness. I’ve come across a good number of people in the last year who are losing weight and they have a variety of names for the plans, but at the heart they are all using carb restriction to get the job done. The fact that a lot of people have a War on Insulin underway I think is a sign in the right direction. And if you want a good laugh, click on the link below:
      http://www.despair.com/loneliness.html

      Cheers, Dave

      • One of my favorite sites lets you upload pictures and make your own “de-motivational” posters in this exact format. Priceless. I’ve made countless variants.

    • Thank you for your considered and honest response(s), every one is an opportunity to learn something. I certainly do not intend to point out hidden insecurities nor mean they are unique to you. I am convinced they are shared by everyone, by every single person since we all have transitioned from one place in life to another – new professions, new cities, and, in general, new roles on life’s stage as we hurtle through time. I guess when I think about the ‘price’ of being alone, I am reminded of the reward illustrated by a quotation attributed to Einstein: “The man who follows the crowd will usually get no further than the crowd. The man who walks alone is likely to find himself in places no man has ever been before.” It’s being able to relate those stories and images in your mind sans camera and with emotional connection, that is often the tricky part. I like your distincition between ego and service, it is poignant, and something I will continue to ponder. I guess we all need to remind ourselves we are not alone – not at 1 AM in a lab, nor on the podium delivering iconoclastic research findings, and never a stranger in a strange land. I do think many posting and reading on this page would agree that life is so much more exciting when lived as an explorer! Good luck to you ,and everyone on this post, in your intellectual roamings and purposeful experimentation to advance human welfare.

      • Charles, I can’t take any credit for coming to that realization (ego vs. service). It all goes to my coach who has spent a great deal of time helping me realize the contrast.

    • Charles, and Peter,

      I applaud your appreciation for (self) understanding as a great and daily expedition. Physics gave me mental tools to consider the unknown, and life (between my plans) has provided many spotlit stages from which I’ve explored. Thus I appreciate Ric Elias’ talk first-hand, as with many other over-comers we have met online.

      Thank you both for posting reminders that we are NOT alone, even though we are not frequently connected. Your thread trumps all the tech-TED-Singularity minyans that I frequent.

      Thank you for sharing transparently. I hope to reciprocate value with you both in the future.

  8. Hi Peter,
    Thanks to Denise, I was able to view your talk early and have to say it was one of the most touching talks I’ve ever seen. I am so happy that she is working with a man of such high integrity and intellect. Thank you for introducing this new way of looking at the link between obesity and insulin resistance–who would have thought?

    • Sue, thank you for such kind words. As you probably know, I think the world of Denise and consider myself so lucky to know her and have her be a part of our team.

    • Speaking of Denise MInger, does anyone happen to know when “Death by Food Pyramid” will hit the shelves? The last prognosis was early 2013, but it’s getting late for early 2013. Enquiring minds want to know.

    • David:

      Death by Food Pyramid
      Author: Denise Minger
      Publisher: Primal Nutrition, Incorporated
      Publication Date: 07-16-2013
      ISBN: 9780984755127
      Pages: 288
      Subjects: Health Nutrition

    • Two things to feel wonderful about here: one, to read here that Denise Minger is part of the NuSI team! Two, I just saw the live feed video of all the TEDmed presentations that included yours, and the bits and questions in between them, and, while I really appreciate Charles’ question to you, I believe it is moot as I think it impossible to feel any substantial loneliness when you are that beautifully connected to your patients. That was remarkable. And the whole world is your patient now.

  9. Peter-
    Thank you very much for your effort on this blog. I have learned very much from you, and I am very grateful to be able to use what you have taught me on a daily basis. I have a question that I am dying to ask.

    When it comes to going in and out of ketosis and also achieving long term health goals what is the most important part of managing blood glucose levels? If I imagine my blood glucose as a function of time f(t), should I be worried most about df/dt or the integral ?fdt of that function ie glycemic load over a period of time?

    Maybe the answer is, it depends. I suspect LPL and ketone synthesis are affected by df/dt while metabolic syndrome may be ?fdt. I would love to hear your thoughts.

    Thanks,
    Sam

    • Great question, Sam. Hb A1C is a pretty good “poor man’s” estimate of the integral of g(t) over time, where g(t) is glucose concentration over time. Not sure what pathological information is captured in dg/dt, since I’ve never seen it reported. Presumably very large (and +) dg/dt is not good, but I’m not sure how to benchmark. No doubt B-OHB production is impacted by dg/dt, as you suggest.

    • In addition to variations in dg/dt between individuals, I was thinking of it as far as food choice. Because as far as I can tell, the main difference between 30g of carbs in soda and 30g of carbs in superstarch is the rate of change of g(t). It seems to me that a high dg/dt causes (through insulin) a decrease in B-OHB, intake of free fatty acids by adipose tissue, and de novo lipogenesis. All of those things I want to avoid, but I wonder to myself how much damage is a sweet potato doing relative to soda?

      Thanks,
      Sam

  10. Your points about TED are valid; I just hold you to a higher standard, my bad. TED is a great place for getting a message out, and I am sure you did a great job.

    Peter, your desire to be a great father is admirable, but that only helps your children. I could go on about how helping the many outweighs the needs of the few, but that is a philosophical issue.

    I am very sorry to hear that you receive hate mail in the quantity described. I am sure this is an unpleasant experience, but please do not be discouraged. Your posts to date have been very helpful and informative to me. You have made a difference in my life and for that I am grateful. I am anxiously awaiting the next installment on ketosis since I have had some strange results experimenting with it on myself.

    Your priorities seem very reasonable, but I wish you had more time for the blog. I can dream can’t I?

    • Well, I appreciate your understanding. And believe me, I love writing this blog, despite the hate mail, because I know that for every person who would prefer to see me dead (according to them), there are probably 99 (or hopefully 999) who do not! But when it’s all said and done, if my desire to help others comes at the expense of my family, I will have failed. So I’ll keep trying to balance things. Keep in mind, though, the work that occupies the most hours (about 80 per week out of a possible 168) is NuSI. NuSI has much more of a chance to help people than my blog. So while progress there will be slow(er), it will be worth it, regardless of the outcome.

  11. Can’t wait till the video’s are released. Really looking forward to it. Sorry to hear about the hate mail. Your 9 posts on cholesterol have been very helpful in my keto presentation that I present to people and I’m really thankful for all your posts.

  12. I have watched dozens of TED and TEDMed talks. I got to see your talk via TEDMedLive. Of all the talks I’ve ever watched, Ed Gavagan’s (http://bit.ly/17TYVeb) ranks #1 and yours is #2 as far as emotion. If this is you outside your comfort zone, you must rock it while in your comfort zone. 🙂 Congrats!

  13. Hi Peter,

    I just saw this article in the NY Times (which I will not ask you to comment on specifically), citing an article in NEJM on the lecithin in eggs being used by unidentified intestinal bacteria to produce a substance (TMAO) that is “linked to increased risk of heart attack and stroke:” http://www.nytimes.com/2013/04/25/health/eggs-too-may-provoke-bacteria-to-raise-heart-risk.html?hp&_r=0

    (I will note that choline, the component of lecithin that is involved in this study, is an essential human nutrient: http://en.wikipedia.org/wiki/Choline)

    There appears to be a similarity with another recent study regarding carnitine in red meat, in which choline is released on the ingestion of carnitine, and is then subject to bacterial action.

    Again, I’m not asking you to comment on these articles specifically. It’s like a game of whack-a-mole — not very productive overall, and they just keep popping up. It probably has to do with the direction of most current research.

    It appears that current conventional research is satisfied with investigating linkages (correlations) instead of causation. It also appears that it is thought to be better to find linkages that agree with current dietary ideas. Perhaps there is more funding in that direction, or probably it is just a matter of going with the current flow, as human beings tend to do.

    I trust that NuSI will help in reversing this tendency, with funding for let-it-fall-where-it-may research projects that really start out neutral on the outcome, and just look for the facts.

    I guess that is all I would like you to comment on. I began this comment with a feeling of exasperation, even though I knew I couldn’t ask you to address every instance of the same phenomenon. And if you can forgive my ranting too long, can you comment on the general phenomenon?

    If it’s just too big a thing to address all at once, that’s great, you’re doing the right job one step at a time. Please carry on. This is how we’ll get there.

    Bob.

  14. The presentations are still available on the livestream site. http://new.livestream.com/accounts/3320021/events/2005920
    Your presentation is in session 4 and starts at the 1:15:14 mark.
    I had the privilege of attending TEDMED this year and as a long time reader of your website, I was delighted to hear that you were going to be a presenter.

    Your presentation, and others at TEDMED illuminated the empathy that is already present in healthcare today, but is often trapped in the confines of our current, impersonal healthcare delivery model.
    Thank you!
    Jed Batchelder

    • Thanks Jed, just listened to Peter’s excellent talk. Something was nagging at me all through it though – who does he sound like? If I was just listening to the audio, I’d swear it was Jeff Goldblum.

    • Jed, thank you very much for the link.

      I’d appreciate an exchange on your thoughts to transform the “impersonal healthcare delivery model” as that is what we’re working on: internet models to assist the ‘champions’ with.

  15. Hi Peter –

    I was distressed to read that you receive hate mail for your incredibly valuable work. I’m sure ( I hope) you realize it’s not a reflection on you, but rather an indication of how psychologically and emotionally attached people get to their eating, and how threatened they feel when someone convincingly challenges that. For whatever reason, I think people are as defensive about their eating habits as anything in their lives. I can attest to that as a long time LC proponent in a family that loves their “balanced” diets after a big round of chips and dip. I’ve found that proseletyzing doesn’t work! Add to that the bewildering array of contradictory “sound” medical advice about eating and the equally bewildering array of self serving commercial enterprises that have their livelihoods at stake, and you’ve got quite the metaphorical headwind to sail into.

    I guess my point would be that there are lots of people out there who you may not hear from who appreciate your work and, importantly, your willingness to put yourself out there personally as an n=1 study. I would add my voice to those who wish you had the time to add to this blog more often because it has been by far the most valuable resource for me personally (I love your ice cream recipe and your breakfast shake!). You’ve shown me that I can be an athlete on a ketogenic diet (and feel great in the process!). As an engineer, Stanford alum, masters athlete (6 paddling Catalina crossings) and husband to a Canadian, I feel like I have a lot in common with your background. I’m really looking forward to seeing your TEDMED talk when it’s available. Keep up the good work!

    Paul in San Diego

  16. Hi Peter. I’m currently prepping my first TEDx talk (Dying IN Peace to Die AT Peace). Your ruminations have helped me in this, the last 10 days’ runup. My talk’s first section includes a rundown of major obstacles to dying in peace (it’s last half explores a new one and a solution I’ve developed for it). The aha that occurred to me is to frame the obstacle run down in terms of how we failed to recognize, and hence overcome, each one during my parents’ terminal hospitalizations. Simply by including that three word reference (“we failed to…” makes a profound difference because it anchors the talk in my family’s story.

  17. Peter, I also want to commend you for your remarkably brave TEDMED talk. You thought you were going out on a limb but you actually contributed to growing a new branch of medicine’s tree.

  18. Hi Peter, thanks for such a useful website as a resource for low-carb eating – plenty of insightful and detailed discussion on many questions I was having. As a person with no expertise in advanced nutrition or medical science I was hoping you could pass comment on a supplement I’m considering taking. I’m hesitant on it’s safety, it potentially sounds ‘too good to be true’ and I was hoping you could offer some advice. It’s a multivitamin called IntraMAX? (http://www.intramax.co.uk).

    • No insight into this, except that this industry is not regulated and as such most of what is produced is somewhere between harmful and of no value.

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