20 Episode results for "Professor Of Family"

Expert Panel Recommends Wider Use Of Daily Pill To Prevent HIV Infections

NPR's Story of the Day

02:28 min | 2 years ago

Expert Panel Recommends Wider Use Of Daily Pill To Prevent HIV Infections

"Support for this podcast and the following message come from American pest as the leading provider of safe, sustainable pest control solutions across the DMV. Let American past help you to take back your home or business. From menacing pests visit them today at American pest dot net. A federal task force of medical experts is out today with a recommendation to reduce HIV infections. The US preventive services task force says doctors should offer a daily preventive pill to healthy patients who are at high risk of. Hiv NPR's Alison Aubrey has details back in two thousand fourteen the centers for disease control and prevention began recommending a pill. It combines two anti retroviral medications and it's a powerful tool to prevent HIV infections by as much as ninety two percent. But today only about one in ten people who are good candidates for the pill. But just called true vodka are taking it John F, laying is a professor of family medicine at Virginia Tech and a member of the task force behind the new recommendation. He says he hopes more providers will talk to their at risk patients about taking the daily medication which is also known as prep prep is highly effective at preventing HIV, if taken. Every day. The treatment gap is most pronounced among black and Latino men and Hyman Scott of UC, San Francisco who directs clinical research at bridge, HIV, and the San Francisco department of public health says one obstacle to the drug is cost. The list price is about twenty one thousand dollars a year. We have patients who go to the pharmacy and are told that they have to pay thirteen hundred sixteen hundred dollars for their month's supply of Travolta, and they may have access through some programs, but it's not immediately apparent to them. Scott says they do work with patients to navigate coverage options, and the new recommendation may sway more providers to expand coverage of the drug task force member, John F, Ling, says the goal is to prevent as many new HIV infections as possible. We've done a good job in medicine at being able to treat HIV in the sense that it's now become essentially a chronic disease for most people, but we still have a problem with HIV infections up to forty thousand. Per year. The recommendation is published in the journal of the American Medical Association. Allison Aubrey, NPR news.

HIV John F San Francisco Hyman Scott Alison Aubrey DMV Allison Aubrey journal of the American Medica NPR US professor of family Virginia Tech Travolta UC Ling thirteen hundred sixteen hundr twenty one thousand dollars ninety two percent
S2 E9 Suicide USA

The Adventures of Memento Mori

28:12 min | 2 years ago

S2 E9 Suicide USA

"In fact just recently with this new. CDC statistics suicide is on the rise in the US. It has been since the nineteen nineteen nineties. which is a trend? You don't see other Western powers and other Western countries. John Gun professor of Family Science and Human Development at Montclair MHM Clare State University and John Gun Suicide August. My research is in suicidal behavior. Generally theories as of suicide respect wasn't protective factors but anything under the umbrella suicidal behavior. I'm entrusted in the be happier. Die Trying episode. I learned that America was the the most medicated and the third most depressed country in the world I also discovered that in the US deaths by suicide have steadily gone up every every single year since nineteen ninety nine upon receiving my email asking about this alarming statistic. John invited me to his home. I'm for a cup of coffee in New Jersey. I think what drew me to. The topic is the fact that as long as we've been studying it we really still don't know as much as we should good and there's a lot of unanswered questions so I have to be honest with you. I've been avoiding the topic of suicide in this show. Lot of people have asked to do it as you probably can tell. I'd like to have a natural way into the topic to have some personal missile component to it and I just never had that suicide connection like I. Don't you know I. I have ten gentle friends that they've had People close to them commit suicide. But I've never had anybody that I know are certainly anybody in my family commit suicide. So I've been avoiding it because it's a hard topic. It is a hard topic and I have been waiting it but think about how dull life would be if we only have the easy conversations and maybe there's still a lot of unanswered questions around suicide because we just aren't asking enough of them. Maybe we all have been avoiding the topic so I invite you to join me and John Gunn at his kitchen table in New Jersey for a cup of coffee and an awkward conversation in and season two episode nine suicide. USA from the Jones Story Company. This is the adventures of Memento Mori six guide for learning to live by remembering to to die the podcast explores mortality. Here's your host. Ds Moss Are there any other species of animals all the planet that have suicidal tendencies. Most likely not back in New Jersey at the kitchen table with John Gun there are use social species like ants and bees. That die I to protect their their group. But it's not really suicide. There's a cognitive floor. You have to hit to a certain extent to be able to die by suicide and animals simply don't have the intelligence eligible to do. So would you say is like consciousness. yeah you have to understand when you have to understand that you exist in that you're going to die you have to understand how to implement your own death You have to understand what death is. All life forms in nature from bacteria to be chimpanzees are hardwired for survival at all costs except US Homo. sapiens who display the paradoxical anomaly of voluntarily taking our own lives ponder this did are forging forefathers have suicidal tendencies four his suicide a byproduct of human cognitive evolution or a byproduct of civilization itself. So if we are as All other animal species designed for survival. Why would we commit suicide? So if you look at neurological research if you injure someone to something that's painful physically to someone at activates certain areas of the brain if you then put them through a situation where they're ostracized. Mr rejected socially it activates similar neural networks. Physical pain would physical and emotional pain can stimulate the same parts of the brain. Say for example. You put your hand over a flame. The neural network get stimulated and the brain tells your hand via the pain. Ouch and it moves now. Now imagine a psychological fire. The same neural network get stimulated as before and pain is still generated but this time there's no hand to pull away from that emotional flame and the pain continues on and so my argument is that we are really attuned to social rejection because we're a highly social species and so interpersonal loss social rejection activates pain and that pain builds and let's psychological pain is what actually really causes us to die by suicide. We want escape the pain. It sounds obvious. But that's simple. reframing instantly changed the way I viewed suicide people don't want to die why they want relief from their pain in the last episode we talked about the happiness industrial oh complex how governments and corporations monitor and measure our emotional states through technology for National Security and Prophet in addition to that society Zaidi willingly accepts the fact that the Buhl in the facebook collect our personal data so much data that they know what we're going to do before we do now l.. Ponder this since they already have the data you think they should use that information for good to help identify somebody in need to significantly enhance suicide research to possibly save a light in the meantime. Here's the data. We currently have through good old fashioned academic research. So the number one predictor of. You'RE GONNA die by suicide. As if you've had a previous attempt this is based on the interpersonal psychology theory of suicide that argues that people who die by suicide aside having acquired capacity for it. You have to be able to stare down fear of death and you have to be able to to a certain extent you have to have increased pain tolerance because you know we make it look easy in media we make it look easy and movie and television trials but suicide is actually difficult you know. Your body's biologically geared to survive So there's fear fear there's pain So people who die by suicide typically have repeated exposure to self injury. They have made previous attempts. Just because they've acquired fire. The ability to actually enact least self harm is there more likelihood of teenagers committing suicide than you say. Mature adults in their thirties to fifties. no-show the greatest risk is actually later in life. A teenagers do attempt more so there is is a significantly greater attempt number amongst adolescents high-school college on put the death by suicide really. Your prime risk age is midlife is his men in their mid life into older ages in the worm at the core episode we spoke with my Philosophical Spirit Animal Sheldon Solomon who explained that the more labels we identify with the easier it is for the perception of ourselves and our world view to be manipulated and distorted win. Death is made salient. So I've been trying my handed some Buddhist practices for the last few months detaching from the unnecessary labels detri- being a self identification expoliation. So to speak but I do identify as a man my preferred pronouns are he him his and mathematically I am midlife putting me in the highest risk group so for every three male deaths by suicide. There's one female death by suicide. It's pretty significant. Yeah and then it actually flips in the opposite for attempt so women attempt at almost a three to one ratio. They attempt three times more than men but they die. Less often is because because men or the talking method here to do men just to use guns more typically males use more. I hate to use the term effective but more lethal means So firearms for example. Something like seventy five percent of firearm firearm first attempts are fatal so men do typically use more lethal methods and firearms is the biggest contributor to suicide in the United States in fact if and we often ignore it when we talk about mass shootings and gun control but The mask the vast majority of people who die by the gun violence in the US or suicide not murder order not mass shootings. So that argument I would assume from the NRA or the gun lobbyists or gun supporters nurses that they would have found a another way anyway they would shoot themselves in the head there. Then there's GonNa jump off a bridge anyway so that that's what they argue that the evidence doesn't doesn't actually support it. What the evidence does support? Is that if you restrict access in one method you don't tend to see increased rates in another method but does controlling access to potential methods of suicide like guns infringe on the rights of others. Is it a case of addressing the symptoms and not the real issues. You can't be borne being more prone to being suicidal than that others. So there is to a certain extent genetic influence But it's not as it's not particularly strong but there is increased risk of suicide if you've had prep apparent die by suicide or Kalou Sibling as most behavioral scientists will tell you it's hard to differentiate the impact of genetics vettix from the impact of environment. There is some predisposition Most likely to to the development of mental illnesses which contribute to death by suicide is there is a correlation between mental illness of some type Depends on who you ask so. The majority of the research finds that suicide occurs in in the presence of a mental illness at a very high degree of ninety ninety five percents of the bigger theorists in the field which is algae would argue. You always have a mental illness when you die by suicide but there's no real causal link So we know suicide. Mental illness are interwoven but mental. Illness doesn't call suicide because the majority of people who have mental illness don't die by suicide in the majority may not even suffer suicidal thoughts. Is there a correlation with people that are recovering from serious trauma with yes. There is some research with regards to combat exposure. There's elevated rates of suicide typically amongst people who've faced childhood sexual abuse so trauma does play a role again. I think it's probably just one factor of many that contribute to death by suicide. The inability how to reach out for help is another contributing factor particularly for men in Midlife. I started this episode by saying that suicide hadn't hadn't impacted my life but I discovered last week that it nearly did. I was on the phone with my dad. Giving him the low down on this episode recapping capping my conversation with John Gun and then I made a bad joke about being in the High Risk Group of suicide in America normally he laughs at my bad jokes but this time he didn't didn't this time there was an awkward silence. He broke it by telling me that he had been suicidal in Midlife at the same age that I am now he shared how divorce disability loneliness helplessness and a general lack of purpose in life drove him to want to end it uh. He shared the time. He attempted to jump off a bridge and how for year every night he slept with a loaded shotgun and every night he had had to convince himself not to pull the trigger. Most alarming is that he thought he didn't have anybody to talk about it and now twenty five years later her realizes that he just didn't know how my dad didn't pull the trigger but many others do and so I share the story because because well my dad asked me to. He encourages those who find themselves struggling with suicidal thoughts and have a difficult time communicating emotion to take take that first step in asking for help. He also encourages friends and families to pay attention to possible signs because as will learn after the break death by suicide may be far more common than you think and Palos feller provocateurs that believe death is topic was talking about. We need your help spreading the word Viva slightly odd yet. Endlessly Fascinating conversationalist at your next party and tell your friends about the adventures of Memento Mori have show show ideas. Contact us on site. Remember to die DOT COM. Be Sure to stay up to date with the quest for enlightenment on Instagram and twitter by following doing at remember to die and now back to the show globally. The number of deaths by suicide is on the decline except for in the United States living in America. You are more than twice as likely to die by your own hand then someone else's but those aren't even the most alarming stats Ruthie. What are the latest CD stats on suicide in America? According to the Centers for Disease Control Suicide is the the tenth leading cause of death in America. That's right tenth. There has been a thirty three percent increase in death by suicide since nineteen ninety nine. This increase includes both sexes all racial ethnic groups and all urbanism levels in the past twenty years only one American state has seen a decline in death by suicide Nevada. The states with the highest percentage increase during the same period. Aw in order not Sokoto. Vermont New Hampshire Utah. Kansas Size Dakota and Idaho not to be super reductive. Can you point to a cause of why America is the country. That suicide is is on the increase. I don't know if we've really established a call sheets. I mean there's a number of reasons why suicide occurs money work relationships addiction emptiness loneliness physical health mental health legal or housing stress as John says it's typically never one single factor. The metaphor he uses is to imagine. You're holding sand in your hand and you begin to pour it out onto a table at first. The sand creates a pyramid but then at a certain point just one more grain of sand makes the whole pyramid collapse. And that's really why it's hard to tell one suicide apart from another is because what that one single grain of sand that one last risk factor that causes the collapse may look completely different for you than it is for me. It's because it's not that single grain rain that makes the pyramid collapse. That is the cause of suicide. It's that build up of risk over time. One of those pyramid collapsing grains of sand is the further effect also known as copycat suicide. It comes from the eighteenth century book the sorrows of Young Brother that tells a story of young man who killed himself because of unrequited. It'd love immediately after the book was published. A rash of suicides happened among young men brothers age and by the same method described in the book in many cases they even found the book on the deceased and research has shown for the most part that if you report on suicide in certain ways you can actually increase increase the likelihood of of Copycat suicides occurring. We discussed the same media driven copycat effect in the deadly news episode as it pertains to mass shootings so things like sensationalizing really giving you know fine detail on the method used when you really attribute suicide too simplistic a single factor can cause it to a car. Those all tend to show increases in suicide. I did a small study looking at Google trends following famous suicides and we didn't didn't find an increase in searches for how to commit suicide or suicide prevention after Kate Spade Anthony Pertains Death But we did find it after Robin Williams we. We did find it to a lesser extent after Chris Cornell after the death of Robin Williams in particular just like young further. A modeling affect occurred the Spike of suicides. That happened after it was first reported was by men of the same. Demographic is Robin Williams and it could be you know if we don't end up finding and it's a type of border effect after Anthony Bourdain and could actually be a byproduct of how the media reports because there is something called the popaginos effect which is actually the opposite of the weather affect the PAP Aquino effect. Based on another eighteenth century. Lovelorn character is the positive effect. Mass media can have on presenting alternatives to a crisis. So it's the idea that media reporting that does it right can actually lower the likelihood of copycat suicides So if you report on suicide in a way that talks about recovery very talks about how somebody almost died by suicide but then there was some kind of intervention or they got their life in order and they didn't die by suicide. Those more positive stories. I'm actually lead to lower rates of suicide in the immediate time period afterwards. So I guess my my ultimate question would be to your knowledge. Has the media media been doing a better job at reporting these things yes generally do better now. So there were the World Health Organization released east media guidelines Believes in the early two thousands. The Canadian Association of for Media. They've they've had their own guidelines and since those guidelines have been least at least news media outlets do tend to much better job but what about artists yes. Journalists should be held accountable the ponder this are musicians novelists silas poets and podcasters obligated to follow the same World Health Organization guidelines. If a person dies by suicide immediately after watching the virgin suicides sites Heather's or dead poet's society should the filmmaker bearing responsibility and that leads me to another question of ethics that that Maryland Universal Amongst University projected as Venezuelan human brought up during our interview and the happiness episode. I know two people that commit suicide aside last year and everyone was like so heard about it and I'm like do have you thought that maybe like that's what they needed and like you should just celebrate. Celebrate their life and not be bummed that you couldn't save them if the pain is too much for a person to bear should society accept and respect their choice of suicide are. Are we making their pain about our pain. When Kate Spade killed herself I worked at a tattoo shop? That day. Eh and there was this conversation about it all day and everyone's like hustle fucked up. How can you do that to an eleven year old like Blah? Because like she left her daughter behind and it's just it's like you have no idea what was going through that person's mind and like maybe that was the only option is the taking of one's own life. The ultimate display of free will of personal liberty. Is it our right. I asked John Van this question after this. And do you consider yourself fun of podcasts. Show it by by donating to the adventures of Memento Mori. Donate ten dollars more. And we'll mail you a surprise. Memento Mori keepsake a hundred dollars or more. We'll we'll give you a post credits. Shoutout to let the world know how much you mean to us. Go to remember to die DOT COM slash. Donate that's remember to die DOT COM so before the break Maryland posed the ethics question if an individual is in hell from which they can't find relief should we as a society be more accepting of suicide as an option so I can see see the argument. In fact I began my training as a suicide under David Lester and he is a renowned. Jessye publishes a lot. He's not always very popular because he wrote a book back in the ninety s called fixing to die in which he argued that there are some people who may not have the potential to get better and if they truly wish first to die by suicide perhaps we provide them with care in that transition. Now he was. He wasn't advocating for it. He was kind of thinking more on a philosophical roots. And I'm to a certain extent I understand that. Pull towards wanting the right to die if I if I came down with a deadly disease and it was going to be a painful the whole process of dying I would want to and My suffering the problem with that is the majority of people who die by suicide. They don't really WANNA die. They just want the pain to stop. There's a popular anecdote that goes like this. The first thought of a man who just jumped off the Golden Gate Bridge was that he realized allies. D- everything that was wrong with his life could be fixed except for having just jumped so if we can alleviate the suffering alleviate. V8 The reason for why they WANNA die by suicide and they can go on to live a healthy productive life. That is what the majority of people who die by suicide want It's not really about death. It's it's about escaping the pain. Howdy as as an organization just as a society what do we need to do to get better prevention prevention money? We don't invest in suicide prevention. Did you know the. US government spends less money on suicide research than it does on sleep research. Did you know that the US government spends less money on suicide research than it does. Nutritional supplement research. Did you know six point. Two million million dollars was set aside for veteran suicide prevention outreach last year but only fifty seven thousand dollars was actually used. That's is less than one percent. We've seen that. If you invest the funding we can crack down on a public health perspective. I mean look at what. We've done with childhood leukemia on different in different forms of cancer. The money is invested. You can see significant improvements. We just don't invest in suicide prevention. At least not yet. If someone's listening to do this show in this episode and start with with a loved one. What can loved ones? What is the the best approach? If they suspect someone close to them is suicidal. Ask them we tend to really avoid talking about it and there's a fear among a lot of people that you can make someone suicidal by asking them if they are in there you can't you can't make someone suicidal by asking if they're struggling with suicidal who settled thoughts or if they want to die by suicide the most you can have is an awkward conversation and at the end of the day and awkward conversations a very small price to pay if a potentially saves the life and then if if someone is feeling suicidal and they recognize what is the the best first step reaching out to their loved ones if they can There's also hotlines to call the suicide prevention hotline on. There's even specific hotlines for veterans For if you're LGBTQ plus. There's just the Trevor Project has its own hotline just reaching out for help when are the unexpected outcomes of my explorations into death is that I have a new appreciation for science and rational fought. I like facts and if you consider yourself a rational thinker and like fax to then. I'm sure you'll agree. That steps need to be taken to reduce the number of suicides by firearms. If you just implement things like save storage practices you find a significant decrease in suicide so things like ensuring during that. There's a lock box that the gun goes in and that you store. Munition separately can decrease the likelihood of suicide. Some states like Maryland are implementing. Emergency orders orders. That allow you as a family member of if I suspect my wife is severely suicidal. I can go to the courts and say I'm really worried about her. I'd like to take away her guns and they can temporarily give the family or give the police the right to confiscate the firearms until the crisis has averted and they're finding that those those laws actually are significant not only in lowering the likelihood of suicide but then they also can potentially impact things like mass shootings. Because you're taking a firearm away from someone who's in a crisis being safe and exercising sizing rational thought does not have to equal losing second amendment rights and one last thing to ponder as a country with a continuous increase increase in death by suicide. What is our responsibility as a society when it comes to the mental wellbeing of our fellow citizens I think think just be nicer to each other? That's the message. I've gotten over the years doing this. We just nicer to each other. It would play the biggest just roll. There was a suicide note left by a young man who died off the Golden Gate Bridge and it said if one person smells that on the way I won't jump and he died by suicide now. Who knows if no one smile at him or if he was just so cognitively constricted from the pain but I think it speaks to that that need for connection that need to just be kind to each other and provide support and have those awkward conversations? The only wrong conversation about suicide is the conversation that never happens. Thanks for joining me on another episode of the adventures of Memento Mori. And thank you John Gun for the awkward conversation and a special thanks to our one hundred dollars or more contributors. Thanks for keeping the lights on. Here's your shoutout Jimmy Gonzales. Rickie harmon. Lyle Livingston Cheryl Emory Pierce McBride. Shirley Moss Kate Louise Stone Lonnie Ortega Scarlet DA and Katrina Hayden. Donate one hundred dollars or more and you can get a shout out of your very own. Just go to remember to die DOT COM slash donate. I'm the `small back again next time. For more the adventures of Memento Mori the episode was produced by Josh. HOW DONNA DS? Moss and Hannah beal. Fi music composed by market believe this has been a production of the Jones Story Company until the next time remember to death.

United States John Gun America Memento Mori New Jersey Memento Mori Golden Gate Bridge Midlife John Maryland World Health Organization Kate Spade Jones Story Company John Gunn professor of Family Science an CDC NRA Robin Williams Montclair MHM Clare State Univ
Episode #39: How To Teach Your Kids About Money

The Most Hated F-Word

46:28 min | 4 months ago

Episode #39: How To Teach Your Kids About Money

"Should i give my kids. Money should make them work for the money. Should i talk about money. When is it too early to talk about money with my kids. Join me with my guest. Dr ashley lieber black on how teach your kids about money like it or not you me and everyone else. We all have a relationship with money and for the most part. It's a complicated one. My name's shawn welcome to the most hated effort podcast as a certified financial planner. I wouldn't take you on a journey as we throw out the technical finance books and shift our focus towards our minds are money and what matters. Most if you're looking to improve your relationship with money and build true wealth you're in the right. Spot finances does not need to be the most hated edward. Oh no it doesn't finances that it does not need to be that was hidden f word and that is why we are doing this. Podcast if you've been enjoying this podcast if you've been joined the guest of this podcast. Please do me a favor. Head over to apple podcast and leave a review. It really would mean a lot to me so thank you. As a father of two. This episode was extremely informative for me. And even if you don't have kids the lessons and insight learn from this episode will help you navigate your own money relationship and also what you learned about money from your parents what i really appreciate it from. This episode was how ashley with us you listeners. I myself the latest research. What is that research telling us around how kids learn about money from their parents. The reason why appreciate her insights and this episode is because often we hear many times individuals perspectives and experiences on how they teach their kids bomani and often these suggestions are very valuable and we can gain insight but the thing about individual suggestions are experiences is that they're just that their individual and for being a father. I have learned that kids are so different. Each kid learns different. And what worked for one kid doesn't necessarily work for another kid. Of course we can learn from individual situations of other people's success stories. But the thing that. I really appreciate it from this episode. Is ashley shares with us. What is the latest research show us. What effectively works on how to teach your kids about money. Through research has looked at hundreds of different kind of kids families and environments and during this episode she shares with us the common practices and suggestions that work for the greatest number of people how to teach your kids about money. Enjoy welcome back to the most. Hated effort podcast. Today i am pleased to have dr ashley. Lebron black ashley is an assistant professor of family life at brigham young university in provo utah. She received a phd family studies and human development from the university of arizona. Her research focuses on family finances. Which we're definitely going to be talking about today. Including couple and socialization ashley has published twenty seven peer reviewed articles which is a lot actually and and is on the editorial board for the journal of family and economic issues. She is the chair of family. Financial wellbeing focused group for the national council on family relation and co of the finances topic network for the society for the study of emerging adult hood ashley. Welcome to the show. Thanks so much sean. Yeah i'm excited to talk to you today. Maybe it's because. I have two kids. I have a wife so this is a very applicable conversation for me but i think it's applicable conversation for everyone. We're going to be talking about talking socializing talking with your children about money and your spouse if we just keep on the children but nonetheless i think these are skills that are transferable to even conversations that we have about two ourselves and often on this podcast. We talk about the stories that we tell ourselves. They're the most powerful stories in our lives because they create our reality. Create our future self because we are story making machines and we apply meaning to those stories. And i think it's really important that we hear from people like you to hear your story what you're doing your research. What have you have found in the research. And so that we can apply it to our our own lives so the name of storytelling. Maybe just tell a bit about your story how you got to studying and do near the in the fields who picked and then we'll get into the research site but yeah yeah for sure so i grew up in utah went to brigham young university for my undergraduate and my story stories kind of a lesson in how powerful a goodman or can be i started. My undergrad is an art history. Major and just for fun took a class called strengthening marriage and family by his name is dr jeff hill and at that semester. He asked if. I wanted to be teaching assistant. Assistant for the core enjoyed. It sounds like i'm sure could use some money and i because that was really fun. I took other family live courses in ended up making it my minor and eventually ended up making in my major in anyway was planning to you. Know kinda take off after. I graduated and then Maybe go get a degree in like marriage and family therapy. Maybe the therapist and then one day my last semester of my bachelor's degree i had two professors that that one that i had mentioned that i worked with all through college and then another one to who i was close when they both within a week of each other sat me down and said hey. You'd make a great professor. You know. do what you want with your life but just so you know like you're cut out for this you could do it. Sounds like why okay. Like i never dreamt that bag and anyway so i. I ended up staying view. For a master's in marriage famous human development which is like a pre phd research heavy stats masters and phd. The university of arizona in family studies and human development. And i'm a professor so mentors can really shape life. Trajectory waste of my experience as far as getting in finance that jeff held up fester. I mentioned he was research in family finance and so after he became a teacher a stint he asked founded by a research assistant. And i was like okay and so for awhile family finance which is what i was gonna research until i figured out what i was actually passionate about but i became super passionate about family finance. So that's still what. I'm doing today while i mean we speak of inflection points and what an inflection point he had on your life to to make that suggestion in line with stories we all have our own money stories. Is there anything. Guess is outside the research again. I apologize for that. However this is this is our story but looking back now zooming out and looking back at your past are learning moments are situations are teachings that your family taught you about. Money are things you observed now as an adult that drew you to being interested in family finances. Yeah couple of things. Come to mind my. I have awesome parents. So couple things one when i always about probably about ten years old and i'm one of five kids parents my siblings and me down and off. We'd been acting like kind of spoiled or entitled recently. But they sat down and they got out the monopoly in we had and they counted out in monopoly money. They said this is how much we make every month. And it's like a tenure. Although wow like so much money and from that stack. They counted out this. How much are mortgages every month. You know just to live in this house. It cost this much and then they counted out. This is how much our cars cost. This is how much we have to finish to buy groceries and just eat food utility. Just be warm and be able to turn their lights. And basically once they got through all the necessities there was like a a whittal stack at the end and so that was hugely. I opening at the kid to you. Know i. there were several take First of all. We're really lucky. We have all our needs met and we even have a little bit leftover the end you know and just a realistic view of this is how much real world costs. Life is expensive and then You know just to lessen title that we can have some of the things that we want. Kids were really blessed but this is why we say no to some things because this is the lowest staffer working with the end of the day. So that was very impactful. And then another time i remember. We lived in a more up for middle class neighborhood and my mom once took us. We were driving. Actually why don't you get de tour today in. We went in drove through the most like low income trailer park neighborhoods which i had never even seen before in my privileged upbringing. It was super eye opening to just see how other people even down the street. Live much less people For parts of the world and then after that he said actually why don't you take it a step further and so for christmas that year instead of just getting a whole bunch of unneeded gifts. You know we already had toys and stuff. We decided to go take christmas to a family that my parents knew through. Were having a really hard year. That experience helped me to kind of you know get outside of my selfish little bubble and realize that money can be used as a tool to help other people to now having studied and researched financial socialization from parents to kids. My my gut wants to say so. How'd your parents do. But i won't go on regardless of there's no right answer that but these are again we talked to invite him points inflection points in our lives that i do feel that as parents sometimes. We don't realize that those experiences are so memorable in our children's minds that shaped their ultimate reality. Because i know for my two kids are two and four they. I could tell them now. My for he's on five he questions thing now but they just take everything that we say as truce so yeah as parents trying to do the best. They can for their children around money having conversations. What is your research shown you on how i how do kids. Let's go there for. How do kids actually learn from our parents just when we sit them down from monopoly or there more play great question. The research has found that while researchers doing researcher found that there's kind of three main as that kids learn about money from their parents and by the way in the research it's by far parents have the most impact on kids financial learning like more than the influence of like school financial. Literacy classes media appears work experience combined. People learn so much about money from their parents. Weather parents are being intentional about it. Or not so really. Yeah so it's it's you know hugely important that we try to be intentional. And that's like i would say any parents who are actually thinking. Oh how you know. How many teaching kids about money. That's like an awesome. I doubt because they are gonna learn so much from you whether you mean to or not so So there's yeah there's three main ways that can learn about money from their parents. The first is a through modeling stoic. The example that parents set for their kids again whether on purpose or not you know as humans we learned through observation especially kids. Watch their parents and like you said however parents do it must be right so our parents manage money. Kids learn from that as to how they should manage money and then the second way is of more what you're saying parent challenge financial discussion. Whether it's like sit down conversations or just you know in passing white kids asking questions or the grocery store things like that in the third in. Maybe the most important way is we call. Experiench fell learning so kids. Actually learning through hands on experiences with money in south Are especially on more privileged. Kids are kind of shielded from hands on experience as money to their future detriment because we know now that actually getting practice handling and managing your own money even the little amounts as a kid builds your financial self efficacy in confidence. You feel handling money which is associated with lots of good financial outcomes later in life so it's important for kids to be given room to make mistakes with money in like a safe environment. Where parents are there to help. Kino kind of explain what happened. Maybe what you can do differently later and there's not learn long term consequences hopefully kids. You know we're not giving them too much money so it's better for kids to learn through mistakes when they're growing up than when they're emerging adults later in you know we're talking about much larger chunks of money so david those are the three ways happened to more about any of those three. But you know it's awesome of parents can be intentional about all three approaches and you know using if kids can learn from a good example and from us telling them how to do and then actually getting into practice that it's really powerful condo. I jot down notes here. Thank you for those three now. One word he said that. I just want you to explain. Minorities itself but financial efficacy or self. Efficacy gives us explain to listeners. Yes what that means yes. Financial self efficacy is how confident you feel managing money. It's funny because all of us once we all had we have to manage money. It's not really a choice we we you know there's finances that we have to deal with the people who are more confident that they are capable at managing money that are good at it regardless of whether they actually are not. If you're more confident about it then you tend to have more healthy financial behaviors you more financially independent and more financially satisfied with your situation. This is an observation but from your research is that i think that's the big point because often we try to educate the heck out of people so that they can become technically sound and they know how to speak balanced their budgets. But if they don't have that self efficacy or that competence in themselves. I'm hearing that your guys research. The researcher reading is is showing that that self efficacy is more important. And the reason why i really want to highlight got is because you said a key thing on touch now. Is that experiential learning so the monopoly. Maybe i want expand on the value of allowing them to make mistakes and i have had many conversations with parents about on teaching them about money. My parents didn't teach me about money. So i'm teaching them about money. I'm given the money and they got to save half of it. Spent half of it and do this do this and as i hear them talking. I'm almost like it's very rigid approach. Nfo's the child. I'd be like oh okay. But i'm scared to make a mistake. So can you speak to the link between given them time space to make a mistake and building. That self efficacy. Yeah totally. i think. There's yeah there's some good things what you're saying in probably some. I mean everything. We just parenting general. You know you've got to have some limits with some latitude if we only give kids strict limits and they never have room to make mistakes or grow or actually make choices for themselves but if we give them too much latitude they never learn. Actually what's correct behaviors and things like that so the same could probably be applied here to experience a learning that teach them some credit principles may give them some limits than. Yeah if you're not giving 'em room to actually make financial choices. They'll never learned to make their own financial choices and then after they leave home. You're not there anymore. You know to be telling them every little thing to do with their money so the goal is that by the time they leave home their self sufficient with money that they you know they have that self efficacy. They're confident handling only because they know how to do it because they've you know they've done it themselves without you having to tell them exactly how to spend every sense Are there experiential learning. I guess situations that can that some are more healthy and maybe some that are more harmful that you've seen are just the fact of doing it. The point here. I think the main point is is doing at yes and there's all three of the methods of you know how kids learn can be applied to any particular financial topic or financial principle that want to instill in them. So if you want your kids to know about saving than like with experiential learning you would take them to. The bank can have them actually opened up their own saving account or maybe half an save a certain percentage of their money towards long-term goals or whatever so yeah i think whatever the whatever financial principal or financial knowledge. You're trying to pass onto them. You know you can show them that you do that you can. You can model that behavior for them you can. It's probably important to have discussions with them about good financial knowledge. They need to know about that subject. Then you know the kind of real capstone actually instilled in their own financial values and attitudes and behaviors is going to be them actually getting to put that into practice. Which for any financial topic. They're going to need to actually have money. So that's like step one for parents is somehow get money into your kid hands and various opinions about allowances or go to allowances or bad. You're tied to chores chores and we haven't really seen definitively in the research whether there's a better way or a. You know not good way to do that. So i would say could just kind of choose however you think will work best for your family. How exactly to get some money to kids hands. But i'm Use that as their money for them to put into practice the things that you're trying to teach them yeah. I'm glad you bring up the allowance. Part because i hear that often what i'm hearing you say is don't get caught up in the nuance of allowance. Whatever you call it. These three areas potential not potentially as the energy should be put on his financial discussions modeling behaviors in allowing time and space for experiential learning. When we talk about financial modeling. I can assume that it's important that we have healthy behaviors so that we can model healthy behaviors right. Let's talk a boat if we haven't taken some time to understand the role money the money story. That's going on in our our minds. Could there be a counter factor. I'm assuming there's a counter effect if we don't have a healthy relationship and our imparting on our children yeah great question we actually were still kind of exploring this on the research but preliminarily what we've seen so far. Is that so if parents are good with money. You know if there would call good money. Managers their kids and if they give their kids opportunities to observe that so you know some parents are great with money but if budget behind closed doors will never learn from that good example so i if parents are good with money and facilitate for kids to actually observe that then yeah that is associated with those kids later. When they're emerging adults age eighteen to thirty we see those kids having more healthy financial behaviors than if parents aren't money but even parents who aren't great with money themselves. We found that sometimes change especially parents who like intentional about just trying to teach them anyway even though they they know that they're not perfect with money kids can actually learn really important lessons from their parents. Poor financial behaviors. So yes sometimes you know. Sometimes it does have negative effect. If parents aren't great with money but especially for teaching kids or trying to learn together then kids are able to as they grow up. Learn more about money themselves able to identify what was good is not so good in their parents behaviors and fix it in their own. Okay oh interesting. As you're explaining that part made me think of situations we hear all the time. We're there might be generational wealth into families and money's passed onto people and it might get spent quickly in some cases it might not bought. We might also look at family companies. We see this all the time where the sun gives given for the most part of the company and the company may be doesn't survive the next generation. Go like this speaks to your point earlier about building that confidence creed that self efficacy which is more important than the skill in itself. So i think that's just really refreshing for parents. To know is that we might not have an abundant amount of money but inviting that skill of confidence is extremely important when we look at these financial. Yeah what about the relationship. I have with apparent so. Let's go back to the company. Say i'm a big company. This is hypothetical. And i'm working ninety hours a week making tons of money of a nice trust fund. I'm trying to teach my son and bringing them into the company or my daughter and you know there might be some hostility. Because i was never around. How does the actual parent relationship impact the child being able to learn these healthy financial behaviors to create. Healthy comes in their future. It's a great question and one that yet. We have research supporting the fact. That parents financial Financial teaching efforts are either helped or hurt by their relationship. They have with their kids so parents who are warm with their kids close with their kids. Like if you're familiar with attachment styles kids securely attached to their parents financial lessons they're trying to instill in their kids are going to be more internalized than if you don't have a great relationship with your kids so yeah that's actually a precursor to before even try to teach them about money or get them on board with whatever your financial values are they're not gonna listen to unless they feel loved and hurt and cared for by you and there's trust there so yeah the that not a place day really anything. Parents are trying to do their kids. Parenting efforts much more successful. If there's a warm relationship there. I just had a flood of thoughts of like people who've chased money are pursued money and made money pretentiously but jeopardize relationships how they then tried to repair those relationships with money. And you know it's disheartening. Because we might be fed or prescribed certain vision that you make this money. You're to be happy but time just flew by. I like what a lot of a lot of what you're saying is for the most part relatively simple. Spend some time with your kid. Make sure that they enjoy being around you each monopoly or whatever and you don't need a ton of money to be able to make financially like a successful outcome. Yeah yup that's great as apparent listening based on your knowledge and your research on these three elements say. They're listening in brow like me new. We've re dive into money conversations with your into the research. This is what we live and breathe every day. Apparent listening has to go to work. As take care of the kid poopie diapers has to do all these things that like really strength. Our cognitive bandwidth and hearing this information might sound so like good but it might. It might sound overwhelming. What would you say to a parent listening. Who are like okay. I want to start doing this. But maybe i mean when you said having that healthy relationship with your kid i'm like oh i hope i have that i mean what about that time when are eleven cry too long and this house. I know it can be over. What would you say to parents listening. Who really really want us to create those skills in their children to build that financial efficacy. Great question let me. I speak to parents who might be overwhelmed and then let me speak to parents who might be like financially stressed. Perfect suffer parents. Who are just. You know busy overwhelmed. They're already trained to do all these other parents. Parenting advice left and right now from all sorts of places and so that like he said on top of everything else. Parents have going on in their lives. They can feel like too much. So there's this phrase we call good enough parenting where you're probably not going to mess up your kids too much. If you're a good enough parent at least you know or if your kids turn out crappy anyway. It probably wasn't your fault so it would be good enough parent where you know. The most important things are their basic needs are taken care of physical needs and emotional needs and then on top of that is just. You know i've seen on the cake so if you if you have capacity to. Maybe she one thing in each of the methods that you are going to try for the next year and then a year later you can evaluate what your kid needs you capacity foreign and try something new in each of the three categories. But you know maybe think k. As a power my kids learning from my example. So either yourself make one positive change in your own finances or navy. Just think of a way that your kids could observe you. Maybe you not change where you budget budget out on the kitchen table in light your invite your needs to come watch your something. So one thing in that category discussion. Maybe just one sit down. Conversation about one. Financial topic with your kids experiential learning. Just do make one change to give your facilitate financial experience. His feerick so don't have to do all three methods for every financial topic. But just start small and you'll probably is. You know we practice things. They become more natural. Don't take as much time or effort so if start. They'll probably just do these things more without it feeling so overwhelming. That's that's not advice for parents who are going through hard financial times themselves that yeah people are. Parents are sometimes worried that talking about money or anything related to money is given to be stressful for their kids. They don't want to pass on that. Financial stress Their kids and there's a few things that we've learned about that so the first is that if there's financial stress in the home kids aren't gonna be feeling it anyway already. Impacting them in can actually lesson. I can't stress if it's out in the open talked about in. If they not something that they you know welcome questions about so that you can then ease their mind. So it's good to explain to kids what's going on. Researchers found just being open about the family's finances in general is really good for kids learning about money. And and i you know they're they're stressed when when times are hard that they now a you know they use the parents in charge of it all and it's all going to work out and they don't need to worry about it but it can also make them more understanding when you say no to purchases or they can they can get on board with the you know tighter family budget. Maybe you need to make family cutbacks. It can become more of a team thing than a struggle between parents and and then kids from your financial struggles. They can learn really important lessons because a will most likely go through hard financial times themselves later to a lot of us do it one time or another and so can be really helpful for them to see demonstrated okay so you can make cutbacks or just various coping strategies that you're using making learn from those and it gives them a realistic idea of just how financially difficult life can be sometimes of so on the ladder example here. Is there a certain age that you guys have seen through your research that a child might be mature enough to process that financial difficulties or stress. Don't do about financial difficulties stress specifically in terms of age but teaching kids about money in general we found the even like toddlers pre-schools or already learning bay sake financial behaviors financial attitudes financial knowledge. So whenever parents asked me how young should. I start trying to teach my kids about money like literally as early as possible like win their toddler. You can already give them. You know very small amounts of money and kids. That young already can practice allocating money to different places or saving for eighteen. Years is just beyond their capacity. But maybe you know saving up to buy a big toy. They can see that when we don't spend money immediately we can get bigger things are you know are giving kids that young especially can can really internalize generosity can actually become a really fun thing for them so would ever financial topic or or financial distress their the family. I would say every at every age should be happening but always we want to be doing it in a developmentally appropriate way. So for example you wouldn't try to explain to your five year olds the difference between a traditional on a roth. Ira right that's beyond them. You know that's not going to end well but you can teach them about investing in how money can grow or you know so so. I guess to answer questions about the financial stress. A five year old might not understand exactly all the reasons why bid the you know. They'll understand that we you know money's a little tight. We don't have as much money as we sometimes do. And so these are the things we're doing about it and we'll be okay. I really like your idea of being open to let your children know that. There's some financial stress. Where's the balance between off loading that stress. The children like financial investment verses healthy conversation. Because i agree like letting your kids aware 'cause they're feeling anyways being making them aware that can help them with developing good habits in research. Have you seen when it could get negative towards. I said the financial investment. So yeah i think the reason for financial disclosure in about families finances should be for the purposes of teaching kids. it should. it should be very clear. Always the the family's finances are the parents job that kids never feel like that's their responsibility so that should be like a learning opportunity for them and not something that is in any way their responsibility to figure out. So that's probably the distinction. I would put on that. Yeah no that's great is who is serving Serving me to relieve stress or my trying to help my children. Yes definitely yeah as you were talking. I was thinking maybe earlier. When you're talking that i need to name. This title this podcast. Something like the good enough parenting money advice. Podcast and over over the christmas break. My wife and i wanted to watch the movies and i have never watched this movie but bad moms and i don't know if you've seen it. I recommend it to many movies. But i ended up watching bad moms to as well. It was really good but essentially. It's the good enough. Mom and i liked that advice around money that it doesn't have to be perfect. Good enough. I like that term nice. Yes super interesting and super important because we are treating these children they look up to us with their whole worlds and i like how you brought up earlier that it doesn't matter if we're not talking to them about money. They are learning by watching and feeling this stress. The non stress the money so by the way that applies more to just financial angel topics. Saving your budgeting but also just general financial values in attitudes or your money story like kids are also picking up on that so you know just regardless of imparting all this financial knowledge in financial literacy to our kids you know parents are definitely also passing on like you said like are people more important than money or you know what is what is money like tool for. Why do we want money. So yes i think those kinds of things. Also kids are picking up from parents whether they're intentional or not but when parents are intentional i think they can pass on some really important. Just valleys of money in ways of thinking about money that surpass just you know the nitty gritty of finances. Yeah the story behind money. I mean in our family money. Have you come across resources. That parents could utilize 'cause you made a really interesting distinction at the top of this conversation is that there's so many agencies and organizations trying to develop financial literacy to enter into the schools and so forth but if our biggest impact is the parents. Have you come across any resources in your research. That parents could utilize if they want to sharpen their skills and question. There's a great book. That i read that i thought was really good. It's called the opposite of spoiled. That was a good one. I'm hoping that is more of this. Research comes out in the weeds. Researchers do your job of spreading the reserve does the ivory tower that. There's there's some things happening. That were financial literacy. Courses are trying to involve parents markets and realizing that the vast majority of financial education programmes don't have a long term impact but financial parenting does so. If you know they're they're trying to wedge those more involved more because they're realizing how important ongoing daily influence over eighteen years. Of course that you know is gonna matter so just hoping in the in the broader culture in sphere. That people are thinking about parents more when they're thinking about financial education and how to improve financial literacy but others honestly not a ton of resources yet that have have already gotten there so yep buck i guess there's so many programs out there that are targeted individuals trying to enhance your own financial literacy. So i guess. Parents want to brush up themselves on anything. They hoped that you can't snow in their adults. That would probably Well maybe you guys have to do project at your university is creating the good enough parenting money guide and the senate well. The university of arizona is actually one of the first right now. They're in partly because of the research that we've been doing their their piloting right now. A program that involves a teenagers and parents and teachers parents about money teaches teenagers about money but then most importantly teaches parents outta teach teenagers money because keep going beyond the program so excited about that. Wow i don't want to open up a whole conversation room money because that's a whole nother topic. Yeah what would you say though so. I mean this isn't done in isolation when we start modeling financial behaviors toward kids and doing experiential learning with our kids couples. Start dating because they're tracked to to each other. They go on dates. They find it fun. They dress up. Make it attractive. And then they get married or they have kids and then they start getting bills and like so what. What are you valuable money. And we're very much ingrained by the time we have that money conversation. This is a big topic. But in the context of talking with children it might have caused the conversation to realize that maybe our money dialogues. Don't align what would you say to people. And i'm sorry to ask you in such a short time. But if if there's a couple which there are many couples who don't see eye-to-eye or having a block round money. Let's pick on one specific thing in financial conflict that you've seen in your research that can help reduce that blockage Yes and this could actually be applied to mismatch Conflict about any topic. Is that the more that you can. Couples can work together as a team and approach their money as equal partners with equal power in decision making even if they don't agree if they can find some sort of compromise and then at the end of the day. They're doing this together as a team. It's not there's no blaming it's not everything's not your fault. We decided this together and then of course couples would have to actually respect that Actually follow that whether it's the budget or Spending decisions or whatever but we've anyway yes a couple of finance research. We've found that couples who have equal power in expanding decisions couples who have joint bank accounts couples who are approaching their money together as a team to do better another piece of that. There's in the really fun new. I think area. That's being studied is financial infidelity. What we're calling it and a surprisingly large amount. A couples have financial infidelity. Going on which doesn't have to be big. But even just you know hiding purchases from your spouse or having like a little stash away that they don't know about anything like that. Were actually really negative consequences for relationships almost to the point of sexual infidelity in the negative consequences. That has that basically the message that sends. You don't trust your partner or your actually team about this You know various reasons. So i would just encourage couples to really reflect on whether they're engaging in any of that financial infidelity. Why and how how much they actually are acting like equal partners in their financial decisions. That equal that equality. I feel like just so critically important. I mean you started with that. And i think just hearing what you're saying if someone has tendencies of acting in the in the financial infidelity i like your point of what's the caused that and i think it's a both perspective was. Why would i suppose be doing that. What am i doing in my not allowing power. My not letting voice be heard and it's easy to take a victim. Well look what they did. They i know you bought that off. This is komo. Take the clothes clause and be like no. This is not new. There's i've had this for a long time. There's probably deep seated financial conflict as you now. has you know. It's different than other types of conflict because money is so what are deep. Values are so tied to in. It's you know it's also has powered you know as a power so there's all sorts of things that make financial conflict really well. I should say everyone of course good discussions and even a disagreements about money a really good really negative financial conflict. That's that's just really a relationships for kids and stuff like that and so it's really important for couples to be. I aware of the really important like ideas that you talk about in terms of. What is my story with money. What is what are my cognitive processes with me. Why do i make money. Decisions i do. And if couples can you know individually understands their money values and choices better and then talk together about you know so. Do we have a mismatching values here. You know why are we having this financial conflict. How can we compromise. How can we respect each other more in anyway. Yeah by that communication the quality just so so important. Maybe there's an another approach to this program that you guys can build for based on this podcast at your university is is the program actually teaching the children about money but underneath it's getting the parents to open up and start talking about money so there you guys can carry a apparently program that helps the kids. But it's actually helping mom and dad and my last question is i usually ask. Imagine golf and ninety years old looking back at your life writing a letter to your children's children's but before we record it you don't have any children but if you were writing the letter to your future. Children children are with the wisdom that you learned through your life about in relationship to money could be around parenting children. Whatever that is. What would you write in that letter. Hang my number. One piece of advice would be be intentional. Whether that's about your on finances or teaching kids about money or talking you know android money with a partner is whatever it is. I think too often all of us go through life just kind of on autopilot and we don't actually stop and think does my budget and spending money actually reflect what i care about or you know is how i'm treating my spouse or You know the ways that we talk about money aligned with what we actually care about or am i passing onto my kids. You values that are actually care about being intentional. Of course is you know as humans were not gonna be perfect in our actions are sometimes going to differ from you know what what we would actually want ourselves to do. But i think the more that we just try and put forth an honest effort in trying to live intentionally. Have that flex about am. I living my life. The way that i actually truly deep down want to and if not like what changes bigger small joining to make too so that at the end of the day in the the life i'm happy and don't have regrets about about just lied on autopilot. Living the way that my neighbors laver living the way that my parents did not actually stopping to think. Whether is how i wanted to thank you for that. Financial regrets is something that i think is over. Lifetime is one of the biggest regrets people can have so that helps. You know just enclosing. This conversation is making me. Think about people think about generational wealth building that generation wealth but what an immense power just. The education are teaching our kids about our values around money actually can go generation to generation because as we know stories are so powerful and they preserve cultures and they certainly for generations can preserve our money story. And it doesn't have to be about buying the biggest and best thing that could be about that intentional. You talked about love. well ashley. Thank you so much for joining me on this conversation. I appreciate it. We'll have to talk about couples one day and i mean you give really good insight there for the last ten minutes. Thank you so much for your time. Thank you shy fire. I hope you enjoy this week's episode. I love having these conversations learning and gaining insight from people like ashley. Thank you for tuning in. If you've been joined these episodes and hearing from guests like ashley please head over to apple podcasts. And leave her view until next week. Have a great one.

ashley university of arizona brigham young university Dr ashley lieber bomani dr ashley Lebron black ashley journal of family and economic national council on family rel dr jeff hill utah provo shawn goodman edward sean apple jeff david sun
[Unedited] Rachel Naomi Remen with Krista Tippett

On Being with Krista Tippett

1:28:21 hr | 3 years ago

[Unedited] Rachel Naomi Remen with Krista Tippett

"Hello beloved on being listeners and friends. Many of you are asking how you can help support the work. We're doing at the on being project if we're fortunate enough to make it onto your list forgiving this year. You can absolutely visit on being dot org slash give your generosity of every kind is gratefully received. Thank you for being with us on this adventure support for on being with Krista. Tippett comes from the fetzer institute, helping build the spiritual foundation for a loving world. Fetzer envisions a world that embraces love as a guiding principle in animating force for our lives a powerful love that helps us live in sacred relationship with ourselves others and the natural world. Learn more by visiting fetzer dot org. I'm Krista Tippett, and this is on beings. Unheard cuts up next my unedited conversation with Dr Rachel Naomi Remington. There is a shorter produced version of this at apple podcast, Google podcasts Spotify or wherever you like to listen. Okay. So Dr ram, and if you wanna just for example, just say Hello. And or what you've had for breakfast or whatever. And we'll get a good voice level. I'm yearning for a Cup of Starbucks Coffee. Is that your credit is Jody there it Jody is here. She's behind the thanks for the good work. We made it I can tell that. This is a much better connection than less time. He just completely eased sound closer. Yeah. Oh. Mitt tatty. How're you doing we? Okay. All right. You want? You would like would you like to hear her? Okay. All right. Tell me what you had for breakfast or lunch. I know it's not lunchtime. I don't know our son lunchtime out here. All what did I have for breakfast? I had a protein drink. Very smart too. Insurance. Yes. In a whole lot of pills to. And a Cup of green tea. Oh, there you go on one minute. Just take tissue out of my purse in case, I need it. Okay. Here we go. Let's sheep near you. Minnesota this the engineer. I'm do want to give you a look ahead that we need to be out of here. Promptly at half past doesn't Russell. Half past. This is this post to run for okay? Hour and thirty is that right? Yeah. Thirty can then we're going to need to be promptly at at that point. That's fine. Completely in the dark about what we're gonna be talking. Well, so am I little bit. Because it's a good conversation. It will surprise us. But I have lots of notes, and I think I just I think I just wanna talk about. I want to base our conversation on things you've written. But kind of talk about how you see the world and move through the world, and some of the observations you make in your work and go from there, and I'll lead us good. So I, yeah, I don't I don't think we have to have a particular agenda, and I've, and then my understanding is that this is going to be a heavily edited. Yeah. It doesn't. I you know, I can simply say, whoa. We write in quite mean that it can. And it doesn't have to be especially linear. We can we go where we go and influence. I'm comfortable already. Okay. I thought you would be. And I have to say this is a little bit unusual for me. Because I before when we were meeting before I had I had spent the day doing my kind of Vulcan mind meld business, which I do which is absolutely immersing myself in you're writing. So I felt that I was right there with you. And and then I had to stop and just put my notes to one son. I came back to my notes. And so I feel a little bit less close than I normally do because I was busy with another deadline, but I'm not worried because now I have you in person. And so I was just gonna say I think the thing is to be a fresh to be close to one another and not to my writings, which rights we're done ten years ago. Right there just a jumping off point. But it's a way for me to to come to know you and to kind of have some ideas of how you think, and so I wanna start with with the premise of what you do and perhaps. Stated in simplified in this sentence. Everybody is a story. Talk to me about just as we start about what you mean when you say that how you've come to that observation. Well by listening. Come to that observation by listening. No, two people are Mike. No two people have the same disease in the same way. No two people heal in the same way. So you may be an expert let's say in diabetes or cancer Crohn's disease. And every time you meet a new person who is struggling with this disease. That person has a completely different story. It has a completely different meaning for that person. And a story, of course, is the container for meaning. It's a vehicle of meaning. It's the way that people have shared meaning with one another. For generations. It's what holds a culture together culture has a story and every person in participates in that story and so- story. In fact, are the the way the world is made up the world is made up of stories. It's not made up of fact, although we tell ourselves fax to to piece together the story. Well, the facts are the bones of the story if you wanna think of it that way, the meaning of the stories were gives it shape and inspiration. What allows the story to change the person who hears it and change the person who tells it is. Well, our density is in the story, not just the facts. I mean, the facts are for example that I have had Crohn's disease for fifty two years, I've had eight major surgeries. But that doesn't tell you about my journey, and what's happened to me because of that and what it means to live with an illness like this and discover the power of being a human being. All that is. How can I put it fleshes out the bones of the story? I think you're make such an interesting contrast also with the fact that we live with all kinds of stories in our culture, we their stories on television, right or the F forms of entertainment as well. As information. But that those stories always have beginnings and endings new save it that the stories of our lives stories as they function in life. Take time real stories. Take time. Real stores have no ending no beginning. I mean, it's simple when you say, but it still feels like a revelation to say that do you know what I mean? But you know, it's almost like using a diamond for paperweight to use stories for entertainment stories. Enabled us to live. There's a powerful saying that we tell each other stories sometimes we need a story. More than food in order to live it. They tell us about who we are. What is possible for us? What we might call upon. The also remind us where not a lot with whatever faces us, and that there are resources both within and in the larger world and in the unseen world that may be cooperating with us at our struggle to find a way to deal with challenges. You know, something that intrigues me. You the structure that your books take? Our chapters that are stories and their stories from your life and their stories from your work as physician. And I'm just curious. Do do you? Do you think that way? Do you process information that way, I think it would be a stretch for most of us? Maybe not maybe most investors never tried this. But I think it'd be a stretch for us to sit down and put our most basic insights into as you say that container of stories. It would be a stretch at all. I christa. You can do that too. I cannot how did you think that way? I'm just curious. I let me just respond to work because there's more to be said about the other story is is a natural means of expression for human beings being have been telling their story listening to other people's stories telling stories from their lives to each other probably since the very beginning. People sat in caves and told each other stories, that's where we get the both the information in the wisdom, which enables us to survive is from stories not from fact from stories so that, you know, when you say people might have a hard time telling their stories most people don't get a chance to tell their stores. Right. And the reason that I hear so many stories I think is that. I I listen, and it's. Very hard to find people who really want to hear really want to know not to figure out what's wrong with someone or to analyze them or to judge them in any way. But simply to know how it is for another person. What wisdom they have gathered on their on their journey through life. What's important to them? What matters. And you know, whenever there's a crisis like nine eleven do you notice how the whole of the United States turned towards the story? I mean where in where I was what happened what happened in those buildings. What happened to the people who are connected to the people in those buildings because that is the only way we can make sense out of life is through the stories, and the facts are a certain number of people died there. But the stories are about the the greatness of being a human being and the vulnerability of being a human being. Do you have in your own life a particular discipline of writing stories down or or let's say of discerning, the contours of the story. No. Do you keep a journal or never all right? Then tell me about the process of writing these books. Well, this was a very funny process because I didn't hear the usual process writing a book is you write a book proposal sort of like writing a grant for a book, and you have an idea, and you met you sort of sell your idea why is it important to people? Why is it different than all the other books that are out there? Why should some publisher be be wanting to partner you in doing this? And I didn't have a book proposal of very old friend of mine. Dean orange who I knew when he was a medical student, right? I was giving a talk one day to his heart group that he runs at the Claremont hotel in Berkeley. And I always tell stories when I give talks I've always been put down for telling stories in the medical profession because this is seen as anecdotal evidence on their one of a kind thing. So therefore, they don't have scientific rigor or or validity. And so I was telling stories to these people with heart disease to remind them of who they were and all their potential to heal and afterwards, he suggested I send a story in to his agent, which I did I sent her a story and. She then he then called her. Apparently and said, you know, this woman has lots of these story. Ten. Right. And this is because you he'd heard you illustrate your talks with them. I mean, this is how you teach. I as I it's just how I teach. That's right. This is actually I don't teach exactly this is how I remind people of who they are. Okay. And offer them a larger perspective on their situation than they presently have. And so are the agents soul. This the story as a book proposal just a single store is only about a page long. And so I then found an editor came out to interview, man. She said, I have no outline. I have no proposal. Write me an outline. Let's sit down Ridenour. I can't ride out once and she got this very Ed took about a half an hour. She realized I was congenitally unable. So she said to me, you know, how do you get your incomes? I mean when someone comes into your office. They start to tell you their problem. You say, okay. Here's the problem. They have to do this. They have to let go of that. They have to readjust their thinking in this way, should take about three months ten sessions. And we'll do is that what you do. And I said, no, I said I have no idea where we're going. You know, when when we sit down together in that first session. She says, well, how do you get your your extraordinary outcomes? And I said, well, I know how to follow up process and I follow the process with impeccably. We we follow the process together, the patient, and I and where we end up is a place that is so much more profound than anything. I could work out in my mind in that first session, and she said fine write the book that way, no outline write down, whatever's important to you offer your it out after I get it right me four hundred pages. Give it to me by this date. So I start from ground zero by computer, and I learn how to use it. I'm not a writer. I'm an author. There's a very different thing. Okay. And so I'm sitting in front of the computer, I've I've got my lessons in under my belt. I don't know how to write a book. But I knew how to tell a story. So I tell the commuter story. And then I can remember none. I tell a computer that story. I remember. No, okay. And is kind of fun, you know, and so for for for for about seven or eight maybe nine months, I tell the computer stories, and as I tell them computer more stories, I can remember more stories like peeling an onion. And till finally because I'm doing this for five hours a day. I can remember the very very early stories from my childhood, and it was an amazing experience. But of course, I missed the deadline. I didn't buy down a book. So I sent in these four hundred pages of stories to my editor. And I said, I'm sorry. I now know it's a book about handling, right? And the I've got all the 'lustration here. They are. And it'll take me six weeks to write the book around them. Sorry to miss your deadline. She writes back she. Stop writing. I say why she says it's done. And I am horrified. I say it's a book of stories, and she says, yes, I said, I can't write a book stores. She says why not I'm so upset that I was stammering. I said. It has no footnotes. She says, well, why does it need footnotes? Rachel, and I'm I tell her that if it has no footnotes, it has no credibility. And there's this silence. That's the doctor knows in it at the the scientists in our whole culture. And she says to me, I think you will you're about to discover Rachel what real credibility looks like. And this was true. I mean, I I felt. I felt not good enough because all I had with the stories of my life. And what I discovered in the past ten years since I wrote kitchen table wisdom his that. It's all you need, and it's all anyone else needs. Also, it's all any of us have isn't it? That's all we have in the stories of our lives and the great grace of being able to listen to other people. Tell us the stories of their lives on the kitchen table. We used to gather at the kitchen table and find their to the sharing of our stories our experiences the wisdom to live a good life. You grew up a believe as you say surrounded by doctors and one mystic. Doctors a few nurses, and. That's true. That would have been your orthodox rabbi grandfather and student of Kabbalah Kabbalah before it was a fashion trend very much though. Oh, and he was a flaming mystic. And he was also a magnificent storyteller. Well, what do you mean when you save is a flaming mystic? I mean, describe that to me what that means. It means many different things it can mean a scholarly thing. Like the study of a school of mysticism like Kabbalah, but it's also a way of seeing the world my father my father. My grandfather felt that the world was in constant communication with him that there was a spirit in the world. God in the world that. Could be spoken to and could. Respond at all time that there was a presence in the world that was holy sacred. And that he was in constant dialogue with this. As he went through the events of his day. I think mysticism can be defined in many different ways. I didn't know that. My grandfather was a mystic. No. I just knew that the world that he lived in was the world. I wanted to live in into. You recount this. This idea of of the Kabbalah, which I I had known, but I don't think maybe bit because you're a storyteller it was very vivid for me. But this idea that at the beginning of the creation the holy was broken up. Right. The story allured say tomorrow if. Ginning? This story of the birthday of the world. Yes. Exactly. What are you describe it, actually Krista this? This was my fourth birthday resin this store, and if you'd like I'll tell it. Yes do. Yeah. So this is the story of the person the birthday of the world in the beginning. There was only the holy darkness the ign SAAF on the source of life. And then in the in the course of history at a moment in time this world, the world of a thousand thousand things emerged from the heart of the holy darkness. As a great Ray of light. And then perhaps because this is a Jewish story. It was an accident. And the vessels containing the light of the world, the wholeness of the world broke and the the wholeness of the world. The light of the world was scattered into a thousand thousand fragments of light. And they fell into all the bents and all people where they remain deeply hidden until this buried day. Now, according to my grandfather, the whole human race is a response to this accident, we are here because we are born with the capacity to find the hidden light in all vents and all people to lift it up and make it visible once again and thereby to restore the innate wholeness of the world this very important story for our time that we we heal the world one. One heart at a time. And this. This task is called T Kuno Allom in Hebrew. We restore their connection between the story of the sparks and to Kuna and Jewish tradition. Is are they bound together? They're exactly the same. I didn't know. I didn't. I did not do is the restaurant. Yeah. Right. It's the restoration of the world. Right. And this is of course, a collective task. It involves all people who have ever been born all people presently alive. All people yet to be born. We are all healers of the world. And that story opens a sense of possibility. It's not about healing the world by making a huge difference. It's about healing the world that touches you. Right. That's a round you that world into power is. Yeah. Uh-huh. Yeah. Many people feel. Powerless in today's situation. Right. I mean when you switch to use a phrase like that. Just out of nowhere heal the world, it it sounds like a dream, right and nice sweet ideal completely impossible. So very old story comes from the fourteenth century, and it's a different way of looking at our power. And I suspect it has a suspect that has a key for us in our present situation, a very importantly. Take some say somewhere of that think that three or four me. Well, you know, I don't wanna talk politics here. I'm not a person who is. A political person in the usual sense of that word. But I think that we all feel that were not enough to make a difference that we need to be more somehow either wealthier or more educated or somehow or other. Different than the people. We are. And according to this story. We are exactly what's needed. And to just wonder about that a little what if we were exactly what's needed what? Then howard. I live. If I was exactly what's needed to heal. And I think these kinds of questions are very important questions. And exactly what's needed going back to where we began our conversation. When what you have to work with is precisely the given story of your life. Exactly. Exactly. And you know, the story people will say about a story like the strive to Kudankulam the birthday of the world. Well, you know, how can I make a difference? When I'm so wounded myself. How can I make a difference when I feel so not enough? He no. But you know, it's very wombs that enable us to make a difference. We are the right people just as we are, for example. My own wombs. My own sufferings have enabled me to feel compassion for the sufferings of others without my suffering. Our understand that the the suffering of others are able to connect to them. My loneliness enables me to recognize the loan and other people even when it's covered over to find them where they become lost in the dark and sit with them and to know that just by sitting with them eventually they will find what they need in order to move forward. You know, there was another story in my family. My grandmother of the Mike grandfather's wife. Uh-huh. The rabid sin. My grandfather's. In russia. They were quite poor. And they often fed members of the community being the rabbi's home people came there. So my grandmother was used to making things stretch and go a long way and in this country. Her icebox was filled with food when they came over to America because she had been hungry in in Russia. The the the kitchen was the center of the has the icebox was filled with food every nook and cranny was full to the brim, and it was told in my family that if someone opened the door they the icebox with. Without caution an egg by fallout any break on the kitchen floor. And my grandmother's response to these accidents was always the same. Apparently. She would look at the broken eggs was satisfaction and say today v have a sponge cake. And so perhaps this is about our wounds. You that on the fact is that a life is full of losses and disappointments and the art of living is to make of them something that can nourish others. And you know, when I first was diagnosed I was fifteen years with Crohn's disease. Yeah. Uh-huh. And the doctors came and told me that I had this incurable disease. There was nobody knew what caused it. I would have multiple surgeries, and I could expect to be dead by the time. I was forty. Not my dream as a future as a fifteen year old. I how many years ago is that now. Oh that is fifty two years. Yeah. Okay. But it anyway, I went into shock, and my mother was with me, and she did not not comfort me or cuddle me. She took my hand. And she reminded me of the story. And she said Rachel, we will make a sponge cake. And he was taking me a long time to find the recipe. That's mine. My own recipe for this. But I had a sense of what might be possible. And that I needed to look to find the way for myself. And that's what a story can do. You know, I had never met my grandmother. But oh, you just about all this. She died long before he was born June died young. But this story about her gave me a map for my lights or that is a story. Yeah. I want to I wanna turn a corner of of before Joe until you a story briefly do just that that I went home having having all this in my head and my son who seven. As something of a mystical bent. I bank. I mean children do in a way, but he really they he's got a lot of depth than he's thinking hard. And I told him a story about the beginning of the universe in you know, of at the sparks and the holy flying on he he just he just listened Terry. So rap lay. And he said I like that. And I can. It had landed itself. And when he was going to carry that with him, it was so wonderful. But you know, what is so wonderful to Krista is that I was told this story of let's see a sixty three years ago, and my response to it was exactly the same. And that's that's very important about stories. They touch something that is you men in and is probably unchanging, perhaps this is why you know, parables. All the important knowledge is passed through stories because children love stories and the child and all of us love stories, and I'm not talking about made up story. No. Yeah. I'm talking about real start. Now, you let's talk about what you've done with your life, and you know, the particular places you've taken your love for stories. I mean, you became a doctor and. Initially, you were working European attrition working with premature babies, right? And what you one of the first women on the faculty at Stanford if the medical schools at right? I was wondering the fewer women one of the first women one of the fewer. We certainly were in the minority. The distinct minority back there in one thousand nine hundred sixty five and then you you changed course in medicine. I mean, tell me something of where you went when how your interest changed? Well, I'm not sure if my interest changed I just realized I could live by what was important to me. I was a fluffy major in school, which my father used to laugh about my daughter, the philosopher. And also worry about because how how person make a living some awesome, and I almost didn't get into medical school because I didn't major science. And I had put all that in my back pocket in order to make a difference in the world, you know, to to use myself well to make a difference to the world my plan. Of course was that. I was going to die by the time. I was forty I need to use that time will tell us the game plan. Chris. And in about nineteen seventy two Esselin institute was on in. It was in its heyday. I it's heyday had been going on for bits seven or eight years before that I think too and all the what was called in those days, the Uman potential movement was emerging there. I mean, these ideas of what it means to be a human being that there is an inner life in people all these things that we accept as well, I haven't people always believed these knives our own these no people have not. And so all of this was a merging this whole new way of seeing a human being and everything that all a human being participates in. A whole new way of seeing these things as well seeing illness seeing health seeing love all of these things seeing parenthood. I mean, a whole new way of seeing what what are the tasks of being a parent. And I was invited. Dan. There's part of a research study, they invited twelve of physicians. I was a young professor of pediatrics at Stanford, and they invited twelve physicians men and me, right? And we went down there for a couple of years, and we were funded to go down there and to spend a weekend month with one of the seminal thinkers of the human potential movement, Gregory Bateson people like this. And in spending this time this three days with them. They would share with us their thinking the the things that they had written a Benton published and also their private thinking about the nature of the world in the nature of human beings. And our task was to take this information. Like, for example, George Leonard taught us something called a Kito that nobody had ever heard of. And this was all about how you meet with an opponent. And we were to take that information and look at our own expertise are the fields of of of medicine, disease illness and see. Do these things have any application to the work that we do. And so we would spend the month between the times we were down at Esselin talking about these new ideas and working out a new medicine that was based on the power of human being and not the power of science right necessarily. And at the end of this two years of all the men went back to their practices of medicine pretty much, and I quit Stanford. And felt that I wanted to devote myself to the the building of a new medicine that was good enough enlarge enough to really serve human beings. Given that I now had a deeper sense of what it meant to be a human being, right? And what a human life might be about hang on a moment. Okay. I am losing my earphones. We can't have that. I got him back came. Now. Okay. And I I did you train also as a psychiatrist or or lower. You have really become a professional listener as well as physician haven't is that. Well, I I would say, yes, I'm trained, but I have no credentials. I have spent I would say three thousand hours in humanistic psychology, workshops. Okay, learning various techniques imagery. Symbol symbol work sand tray work poetry, art, anything that would enable people to. To discover the strength in them. Discover who they are. And so I have a very extensive training. But I don't have a degree in psychology or psychiatry. I have taught in schools of psychology. I've taught Helsinki gone, and and all of this. But I am I'm a physician, I'm an MD. It seems to me that you have at the same time that you have worked as it had a medical practice worked as a physician and specializing I believe in working with people who have cancer. Is that right? Yes. That that all came about. You know, I have made very few decisions in my life. It's like I find myself in a situation, and it's very clear what the next step is. And I take that step. And I think this is basically my modus operandi for leading my life. But I wanted well we had grants to study the doctor patient relationship. Okay. And then a new administration came in. And we couldn't get the final piece of funding to finish this work. And I spent six months writing grants, and then ran out of money. I was actually on unemployment. For about three or four months, and I ran out of money and people have been calling me up because I'd been writing about these things and say, can I come and talk to you. My thing my problem, and it's another physician terms that I'm not a psychologist. I'm not a psychiatrist do that. No. These people sick people friends of friends of friends sorts of people. And then when I ran out of money, I said well. I guess I do this. So I found a little office on a house boat in sausalito first office. And a few people came by. And I decided I would go and speak to the my colleagues in the medical community and tell them that I wanted to a work with sick people and with their emotional issues and other struggled to live with disease and also to recover from disease and most of the physicians in the community said terrific who has the time to talk to these Papon, you know, once I run out of treatments. I have nothing. Nothing. More to offer anyone and that's another whole story in and of itself. Of course. And let me send you over my patience and within months at a completely full practice and most of the people were people with cancer, and I began to work as a person who focused my efforts on working with people with think that most of the people your colleagues ended of sending you where people with cancer was that particular life experience that they weren't equipped to handle in its fullness. I think that the hospice movement is fairly recently. This is Bill. This is Bill. This is before that. So that people really did not know how to deal with people who are struggling with the possibility of death. I mean, you knew how to treat the cancer. Yeah. That's what we're we were trained to do in medical school. We're trained differently now on K, but we were trained to do this in medical school to deal with the cancer. But the issues of the person with the cancer was something that we would refer people to psychiatrists. But you know, these aren't crazy people, right? You know, these aren't people who have psychological illness. These are these are people who are confronted with a very very challenging life situation, and who need to mobilize their full strength in the strength of their families in order to meet with these things, and nobody knew how to do that. Nobody had the tools to do it even. So we started writing poetry and drawing pictures and doing imagery and of enabling people to find within themselves the direction, and the strengths they needed to live. Well, despite cancer seems as you say you probably didn't plan this. I'm sure you didn't plan this. But but what you said earlier about how we're all given the lives we have and that that's good enough. And n even what's. Wrong with us is part of what we have. It seems like it's been really important in your medical practice and also in how you've helped other physicians how you've reflected on your profession that you also have struggled in your life with this debilitating illness of Crohn's disease, which you were told was fatal I'll tell earlier, but Chris I don't think it's what's wrong with us seeing you know, sometimes what appears to be a catastrophe. Over time becomes a strong foundation from which to live a good life. It's possible to live a good life. Even though it isn't an easy life. And I think this one of the best kept secrets in America. Right. You say. Perfection has become a major addiction of our time. I mean, we throw that word addiction around a lot. But I've never heard anyone talk about our pursuit of perfection as an addiction. I think perfection is the booby prize life, actually, it's very isolating very separating and is also impossible to achieve. So you're always struggling to become something you're not and could never possibly become because you're being right? But, you know, many this is one of the great sounds funny. I was going to say it's a great choice of working with people on the edge of life. The view from the edge of life is so much clearer than the view that most of us have. It all these years of working with people with cancer. I've never heard anyone say to me, you know. If I die of this disease. I'm gonna miss my Mercedes. And this is these are sometimes people that the pursuit of the Mercedes in the lifestyle that it represents have been the focus of their lives up until the time. They were diagnosed the focus of their lives people discovered that the Mercedes is the booby prize that what seems to be important is much more simple and accessible for everybody. Which is who you've touched on your way through life, host touched you what you're leaving behind you in the hearts and minds of other people is far more important than whatever. Whatever wealth you may have accumulated. Now, what is your understanding of? Why that simple truth that we've all heard said? And it makes so much sense. Why is that hard for us for human beings to take seriously before we get to that edge of life for many of us? I think we get distracted. We get distracted by stories. Other people have told us about ourselves that we are not enough that we will be happy. If we have material goods that material goods will keep a safe on. None of these stories are true. What is true is that what we have is each other? And again, you know, that's so it's lovely and it's clearly true. And yet, we don't we don't live there. We don't live there. And this is why I see people with cancer and other people who have encountered very difficult experiences in their lives as teachers. Teachers of wisdom is as if the wisdom to live. Well is at the moment. The repository of this was our the sick people in our comment on the ill people in our culture. Do you think that's particular to our culture is that true in every culture? I don't know. This is the culture, I know. I donate such a counter intuitive idea in this culture, though, isn't it? Think many people have said, and, you know, a, by the way, the the work with cancer started as a one on one work in my office. But. In about nine thousand nine hundred eighty four five I met, Michael Lerner, quite by accident and together and with some other people. We started something called the Commonwealth cancer help program, which was featured on Bill moyers healing in the mind. Right teen ninety three I know and all the innovation that was Michael's on mangoes, a very extrordinary brilliant, social reformer and the innovation that he put forward was that community was a tool of healing that people suffering from the same illness could help one another to heal into lift. Well, this is way before support groups were available in almost every hospital and in many other places. On. And so we started one of the very very early support groups in the United States. We took people with cancer to the edge of the of the United States right on a cliff. Overlooking the Pacific Ocean and spent a week living together exploring the meaning of this illness for each person, and enabling people to find a sense of direction. We're still doing this. We've done one hundred twenty eight week long retreats had come and will. But this is where I discovered. The gift of living close to someone at the edge of life of living with people at the edge of life and discovering that when the chips are down. What's important is not what we have sought was important. And maybe you could find out about that without needing a nicer as a tuition price, right? What have you learned through your work with other physicians your attempt to listen to other physicians and to kind of let's say work on the healing of the field of medicine. The hat you. I I have spent the last oh thirteen years all working not with people with cancer, but with physicians and with medical students. Now, how did that come about that you started doing that actively? Well, there are couple of again, you know, the next step appears. On in listening to the people with cancer at the retreats. I would hear stories about their experience with the medical system and with people in it. And. Every so often someone would go back and tell their doctor what they had experienced. At the retreat and the doctor would call, and I was the medical director. I am the medical director still at the retreat. And the doctor would say aren't you doing anything like this for us? Right. I began to realize how wounded I had been by my training. The training is abusive. It's fairy very very difficult experience. Details twenty twenty four seven medical school and medical training goes on for years seven seven eight years, you know, and I began to realize how I had been healed by these people with cancer how I had moved from person focused on curing and truly coming to understand that we are all healers of one another that people been healing each other since the beginning, and that my power to cure was a small part of my power to help people. What was wanting to wanting to help my profession as well? The people who go into medicine are extraordinary. You knew I developed a course called the heel. Art. Gosh that was nineteen ninety two. And we I taught at UCSF it's a very unusual course, it's an experiential courses. They usually don't do these things certainly not back then in medical school. And it's about an Ebeling young people to recognize that who they are as important as what they know in terms of what they're going to be able to make a difference in people's lives. And I taught this for all these years at UCSF and then about four years ago we. Disseminated to Yale metaphysical where it worked just as powerfully as did at UCSF last year, thirty three medical schools around the United States taught and this year, we expect forty two or forty three of the hundred and forty medical schools in the United States to be offering. This course to their students. What if it adding that was not there before? It is validating for students the human agenda in illness. It it reminds them that healing is different relationship than curing relationship. And it reminds them of their power to make a difference through their human response and connection to their patients. It's basically it basically reminds the students of the lineage of medicine, you know, I happen to see medicine as a spiritual path. That's my personal thing. That medicine is a spiritual pass, which is characterized by compassion. Harmlessness service reverence for life, a courage and love. The the basic qualities of that. But Graddick oath are not scientific qualities there, the qualities of human relationship, and they are spiritual qualities very, profound spiritual qualities, and we we remind the students of the Linea, and this is young students, and we enable them to see that they belong to it. Exactly as they are that they are already the right people to become physicians. All they need to do is learn the science and learn the facts without allowing themselves to be changed by that process. And anyway, what what is it in that process that I mean, it seems ironic and the story to tell about how destructive medical school can be seem ironic, we do think of people who go to medical school as you say as extrordinary, and as people they are giving themselves over to this. Session that is about healing. And what you describe is a is an experience that is often very devastat. You're okay. Yeah. Now, this is changing. I mean Chrysler it is interesting ago. Yeah. Ten years ago. This course, would not be in in any of these schools. UCSF was forward looking enough to give it a home. You know? But I think the world is changing I think we're recognizing the limitations of our science our science, you know, that that little phrase living better through science. There's no question that we live better through some. But to live well is going to take something more than that. I mean, if I look at myself without the eight major surgeries and the many medications, and I still take many medications. That keeps me alive. I wouldn't be here. But with only these things I'd be an invalid, okay? Right. I I wanted to ask a minute ago when you said you think of that medicine as a spiritual path. And yet, it seems that medicine is also a science at least in our culture, and it seems that at some point and somehow the science overwhelmed, or the scientific mindset, even among those of us who are outsiders. Who are we've you science overwhelmed, whatever spiritual element there is in that. Well, you know, you have to understand how natural that is. I mean when. What I tell you about myself when I was a child I had severe otitis media and developed on. Erin tap says a hap says in the bone of my skull. And soften drugs were available in the Nick of time. And that power. Was of very heavy power. We could do leaders insulin for people with diabetes. I mean, you should you have to think about what this meant all of this. You've seen all this in your lifetime. Oh my God. Yes. This meant huge amount for we thought, we could cure everything. Right. But it turns out that we can only cure a small amount of human suffering. The rest of it is the rest of it needs to be healed. And that's different. It's different. I think science defines life in its own way. But life is larger than science life is filled with mystery, courage, heroism all love all these things that we can witness, but not measure or even understand, but they make our lives valuable anyway. Right. Say a bit destructive aspects of life are also mysterious and unmeasurable. All right. I mean, we can also observe evil and. I think that's true. Of course. That's true. But you know, the the the issue is not to a radical evil. I'm not sure even can be a ragged renegade. I think it's part of the human condition. The issue is to commit yourself to what's important to you. Yeah. I want you. You question the the term objectivity that is part of a scientific framework. I I think that word as a journalist I'll say, it's all, you know, it's a value. That's been held up in many disciplines in culture. And it's coming into question. Yeah. In many disciplines. And and I'm just curious about, you know, is it enough for, you know, are we kidding ourselves? When we say, we're objective, and if we're kidding ourselves. And do we need to look at it all over again. I think. You know, you you make this interesting statement, you say objectivity, and you're you're talking about it. Doctor also makes us far more vulnerable emotionally than compassion or simple humanity uptick. Tippety separates us from the life around us and within us. And it's so interesting. Why are they object? Also, make us makes us vulnerable to burn out because in order to feel the satisfaction inspiration of our work. We need to be touched by it being that then the work transforms us, and and grows us. And otherwise it does not. But I think it's very interesting. You know? Tiffany's cognitive right. And a funny kind of ways, man. But the thing that seems important is that in order to understand life. We need to look at it through many, different dimensions. And that sometimes we understand another person the best and know how to help them the best when we are not object of. There's another simple statement for you. But but we don't always out. Yeah. Objectivity is a bias like. The funniest story in I think this one is in catching table wisdom is. The. This happened at at Sloan Kettering many many years ago when I was say an intern first year did Dr. And we had a man come into the hospital. To die, and you know, people used to come into the hospital die. There wasn't a hospice movement that so that when if you're care was too difficult to achieve at home. You weren't minute to the hospital the die in this man came in all was riddled with cancer. He had on an osteo, sarcoma and his bones. Looked like Swiss cheese, all these lesions were cancer, and there were big snowballs of all cancer in his lungs and in the two weeks or so that he was with us in the hospital all of these lesions disappeared, and they never they never came back Krista. Now, where we in all certainly not we were frustrated obviously someone have this diagnosed him, so we send the slides out to pathologists all over the country. And the pathologists send back the slide sank classic osteo, genyk sarcoma. So then we had a grand rounds and the slides were shown the x rays were shown the man himself was show. And the conclusion of this large group of doctors was that the chemotherapy which had been stopped eleven months before had suddenly worked. Now Barrasso part of the story is that I believed this for the next fifteen years. I never questioned this this conclusion, I think too great a scientific objectivity can make you blind. What do you think? Now, I think that that was one of the purest encounters with mystery that I have ever had in my life. It makes me wonder about who we are. What's possible for us? How this world really operates. Right. I have no answers. Right. But I have a lot of questions and those questions have helped me to live better than any answers. I might find. Huh? In something that I found interesting in when you write about working with physicians that you you try to make them comfortable with loss and to understand that as part of their their jobs their lives their working lives. But again, I mean when you know, you're talking about physicians, but you end up making interesting observations that apply to all the rest of us about loss. Talk to him about what you've learned about loss. Are you wanna here's what? Now, we're initiate a five. Oh, I know. Well, all right, then I'll give you. I mean, here's some smaller. Chris. Okay. Here's the sentence that I wrote down and. The way we deal with loss shapes our capacity to be present to life more than anything else. The way we protect ourselves from loss may be the way in which we distance ourselves from life. I think this is absolutely correct. That is such a shocking thought really, I think it's correct. I also think that no one is comfortable with laws. That being that we're technical logical culture our wish or our our first response. Let's put it this way. Our first response to loss, try and fix it. When we are in the presence of a loss that cannot be fixed. Which is a great many losses. We feel helpless and uncomfortable, and we have a tendency to run away either emotionally or actually distance ourselves. Yeah. Yeah. And fixing is too small a strategy to deal with loss. Right. You know, what we teach the students is something very simple that medical students. Yeah. We teach them the power of their presence of simply being there. And let listening and witnessing another person and caring about another person's loss. Letting it matter letting it matter. And an extraordinary. Do you want to hear a lovely little story of medical school course? We do a six hours on laws two three hour sessions and the students have a very simple instruction. Which is they are asked to remember a story of their of loss from their lives and lost. Let's put it differently. A time. When things didn't go their way when all they were disappointed when all they lost a dream or relationship or even a family member. Right, right Edessa. They get to choose that. And then they spend six hours in small groups talking about their loss and the group has one instruction. Listen generously. Uh-huh. Uh-huh. Now prior to this exercise, we do nother exercise with them where we ask them to remember a time of of disappointment in laws and to remember someone oh help them. What does that person? Do. What did they say? What message are they deliver? That was helpful to them at a hard time in their lives. And then we ask them all. And they they write these these things down very concrete Louis, and then we ask them to remember a time of loss in their lives. I remember someone wanted to help them, but was not of help to them. What did that person do and say in what message did they deliver? And how did they deliver the message and they write that down. And then we make a big list. What are all the things that helped? Right. Listen to me for as long as I needed to talk. Brought me cookies. Talk to me in the same way after my laws as they did before mud. All right. Sat with me. Touched me, brought me food. Right. What were the things that didn't help gave me advice without knowing the full story? Made me feel that the loss was my fault. And they make this big list. So we gather up the wisdom about what helps loss to heal from a group of about a hundred students and faculty the human wisdom, and is all very simple stuff. We say look a hundred people just said this help them you can do this. Let's try it out. And we put them in small groups, and we have them tell each other their stories of laws for six hours of longtime. It isn't. And the only instruction is listen. Generously. So people get an experience of what it's like to be listened to log as you need to talk. And what it's like to listen to other people what happens to other people when you listen to them. And of course, people find their perspective. They find their strength. They're not alone with their with their situation. Sometimes these stories of very very deeply powerfully moving. Yeah. And the losses are large. So here's a little story that I wanted to share with you. A young man called me in between these sessions and said he wanted to tell me a story of something that happened with his. With his patient that morning, and you know, these are these are first and second year students, they have the experience of taking histories from from what they real page medical histories from their medical histories from real patients. So here's a sign. This patient was a second patient, and she came in with a police officer. And he did not realize I saw unsophisticated didn't realize what that probably meant that if will in meant that she was under arrest, and she appeared to be young girl. And he he began to to take the the the history from her any quickly discovered that she'd been on the streets for many years and had been a heroin addict and a prostitute. And as the story started to emerge as he's taking the history, he became more and more uncomfortable. I never met anybody like her. He didn't know how they felt he denied a talk to someone like this. And he couldn't connect to her. And he didn't quite know what to do, and he became more and more nervous as she was telling her story in the form of her history. And he became so nervous that when he came to ask for the family history. He has the wrong question. And he said tell me about your childhood, and she told him a try a story of of sexual abuse physical now. So these trust as who was your father or did you? Simply illnesses of your fighting. Okay. Did you on this? Exactly this starts to pour out Christa. And then he said already choices. I was over my head. He said in in two minutes says to me on the phone. He says, so I left the room. I you mean, you got up the left to any owner. No, he said, I was still sitting there. He said, but in my mind, I left the room. And I said I've got to find my attending physician. He'll know what to do. And he couldn't think of a way to get out of the room to to go and find his attending. And then I remembered the exercise that he had done the week before of listening to the stories of loss of his colleagues, the other students, and how helpful it had been to him to have people. Listen to him when he talked about the death of his grandma, and the effect that listening seem to have on the other students, and he said to himself. Well, I could listen. So he unfolded his arms and legs and said he leaned forward, and he started to listen to her and she talked for about eight minutes. He said seven or eight minutes and the same thing started to happen that happened with the students. He suddenly had a deep appreciation of her strength. Of course, she was a prostitute. I mean, she's been out on the street alone since she was about seven how else would she stay alive? But how strong she had been to find a way to stay alive? And of course, she used heroin. What kind of pleasure was there in this line her life naturally, and he began to have this respect for her just like he had for his fellow students when they were talking about their losses. And at the very end she had looked at him and said. I've never told the story to another person Dr. And I said, oh, what did you say? And he said, oh, he said, I said, thank you. I am so honored that is a beautiful story. It's a perfect story of the healing relationship cannot fix her life. What he can do is restored to her her sense of dignity and her value as a human being which may give her perhaps who knows a place a little place, but a place to stand to maybe do something different. Who knows? Again, it takes me back to how we began talking about the power of stories in human lives than your analogy that the stories that flesh we put on the bones of the facts about our lives and. I, you know, I also here I think it's so powerful to. Just to think about this. Obvious fact, but again, one of these obvious facts, we don't name very often that loss is not just a catastrophic death are it's it's that there are many different kinds of losses in our lives all the time. And then this kind of stunning idea that you bring forth that the way we deal with those losses large and small can really help or get in the way of the the way we deal with the rest of our lives with with what we have. Right. Not just what we've lost. I think this is. So I really do. I feel. We put this most people. Try to hold onto the sing. That is no longer part of their lives. And they stop themselves in their lives in that way. I have come to see laws as stage in a process. It's not the bottom line. It's not the end of the story. What happens next is very very important, and you know, people respond to losses in different ways when I first became ill. I was in raged. I hated all the well people I felt that I was a victim. And this was on fair. I was angry for about ten years. I think all of that anger was my will to live expressed in a very negative way. And people often are angry in the setting of a terrible loss. Are they often feel envious of other people and this is starting place but over time? Things evolve and change. And at the very least people who have lost a great deal can recognize that they are not victims. They are survivors. They are people who have found the strength to move through something unimaginable to them perhaps in the past. And just asking people that question you have suffered a really deep laws. What have you called upon for your strength? Most people haven't even noticed their strength. They're completely focused on their lane on their pain and isn't that natural? Uh-huh. Yeah. Tell me what the. Tuition mystical world view of your grandfather. That's also part of your story. How that sheds light on this explains? This aspect of being human to you. What loss? Yeah. Just this. These are nitty gritty facts about being human had difficult. It can be and how interesting unless I was just going to say it really is the best way to spend the time is. It's the only game in town. Oh, I think that that's too complicated. Equation bang for me. Okay. Well, then let me bring it down to the bit. You just talked about resources people drawn, and I wonder is is duty as a resource for you. I don't want to answer that question publicly. Okay. That's a very private thing. Okay. I guess you know, what I love to give people is a sense of how these traditions can really throw light on how we all live and what we live with. That's that's really what I'm trying to get at it. Just you know, maybe what if I asked you what your grandfather would say. About loss. I had it. I don't I don't know right here. I remember I'm not a person who is of a figure in religion. I know. And that's or do I nor do I write a bit religion. Yeah. I think I've just thinking of the letters that I've received over the years. Literally, thousands of them from people of all different religions and the stories speak to them in the context of their religion. Whatever their religion, maybe whatever their religions, well because has that story. It's it's so to me amazing. A lot of the letters are good percentage of them. Maybe twenty percent Ephraim pastors of various sorts of Austin practice, and Christian pastors and also rabbis who talk about using the stories in in. There are sermons. And how am thank me for the stories and one one of lovely man in Okla Oklahoma City. I I'm as as well known to his congregation as as he is. He he he has used literally dozens and dozens of the stories for to to as taking off points for his sermon. Right. I think something there's something very hopeful all the way through your writing, even when it is about loss and facing death. The heart dark side of being human menu. Do insist and I'm not sure that modern psychiatry system that integrity is based Tiv -able for everyone. That you see it come to people. And sometimes it comes to people in crisis. You say homeless is never lost his only forgotten. But I think you're using integrity in a way as a little different than the. Okay. What was it? What's it better word? What what do you is it homeless? You're talking about wholeness includes all of our wounds. It includes all of our vulnerabilities. It is our thin -tic self. And it doesn't sit in judgment on our wounds or vulnerabilities. It simply says this is the way we connect one another often week connect through our wounds through the wisdom. We have gained the growth that has happened to us because we have been wounded allows us to be of help to other people. Okay. So it's not a moral judgment integrity. Simply means what is true to live from the place in you that has the greatest truth and that truth is always evolving as well. All right. Right. Like that story that doesn't have endings. But yeah. Tex the time of our lives. Yeah. Yeah. And when I say a story doesn't have an ending. For example. Part of my story is you telling your little boy the story of the birthday of the world. That's also part of my grandfather's story. Right. And your little boy has never met my grandfather. But perhaps my grandfather will be woven into his life in some way. It may be a very small way or it may not I don't know. But. In that sense no-one stories ever finished. I want to look behind the glass and see if there are questions, we just have a few more minutes. I feel. Okay. Okay. Okay. Okay. Okay. Just wondering if you could say something about all, right? You were told fifty two years ago that you would you would die by the age of forty. Tell me about your illness now about your health, and where you are sort of physically spiritually at this point in your life. How old are you? I can ask that how old am I? Yes, I could certainly tell you a sixty seven. Okay. I am sixty seven I ten dead these past twenty-seven years. Well, you know, actually, my my illness wasn't a counter with one of the deepest mysteries. I think that's part of human nature, which is the will to live. Uh-huh. And having had this personal encounter with the will to live which is different than the wish to live. It's different the will to live on as an every every living thing, and everyone something primal, isn't it? It's something almost cellular it can't be measured. It's beyond the reach of science. But it sure can be witnessed, and it's inspiring and powerful and very deeply mysterious. Uh-huh. I had the experience just the year. And you know, you wonder about the randomness of an experience like this the year before I was diagnosed is fourteen. I was walking Fifth Avenue with my friends on Saturday morning shopping. You know, we were key fourteen year old kids and all one of us spotted two little blades of grass growing through the New York City sidewalk, not to crack. But right through the cement. And you know, people who I've seen this in other places since then things like this. But we were found I mean, we were fourteen years old. We were sophisticated that we were New Yorkers. We'd never seen this kind of power before. And I remember how how small they were in how green and how tender, you know, new grass. Yeah. And it seemed to me like some sort of a a miracle. This this ability of life to break through obstacles. And that. That innate drive. For full expression. If you will is in us, all sometimes it may enable us to survive in Ellis. Sometimes it may enable us to grow beyond the limitations of an illness that we live with. But it's there and everybody, right? And you're very very aware of that in your own life. Is that what you're saying deserve the our that? I mean, I I live with significant physical problems. I've lived with them for years you too when I travel on an airplane on my clothes and makeup are very small part of what I take with me. I have all sorts of medicine and all of this and on this is the conditions under which I live. I give it as much time as it needs, not one minute, more and not one minute left. I wonder if there's another story you would like to tell that comes to mind. Just out of this conversation. We've been having. Maybe something that's happened to you lately. I don't know. That kind of putting you on the spot. Well, it makes me thing. I actually before we go. I certainly want to express my appreciation to you Krista. What a delight speak with you both on the phone before, you know, when we spoke actually almost a month now at least and today, I hate being interviewed or you do hate it hate it. I am usually talking to someone who has no interest whatsoever in what we're talking about. And is simply trying to get the best whatever. Or who knows it feels so dead that I can't connect to thing in may talk. And it's been a real pleasure to spend this time while I believe in the power in the mystery of conversation. I really, and it's connected to a lot of the things we've been talking about. Oh, gosh. What are you working on? Now. What are you writing these days? Actually, I'm I'm mostly writing articles all things of that sort are. I think about writing another book that's a major on amendments and means moving your home life around. Yeah. What else can I tell you? Oh, let me share with you. I'll lovely poem. Okay. Hey. Yeah. You know, the ways. Well, let's let's step back a curing us. The work of experts. I mean, this what we've been talking about here, curing, the work of experts. Healing is the work of human beings. We heal ourselves. We heal one another we enable each other to grow not only in spite of an illness. But because of it. So all of this and the ways in which we help one another are very old and very powerful. They've lost. None of their power over thousands of years. We get our students to rewrite a mission statement, a personal Hippocratic oath in this course. And they write about what it is. They want their medicine to be. Oh, they don't write about science. They often write about love and about being used well by by by life, and by other people's very powerful. And this is one of these mission statements written by a young man, many years ago now probably five or six in. Our course. And he wanted to be a surgeon, and he says he dedicates this to his future patients. Right. And it goes like, this may find me the mother of the world may my hands be a mother's hands. My heart be mother's heart. May my response to your suffering be mothers response to your suffering. May I sit with you in the dark like a mother sits in the dark may, you know, through our relationship that there is something in this world that can be trusted. Very simple, very old very powerful. We are each enough to heal other people. Thank you so much. I was just such a privilege and a pleasure. I can't tell you. I feel exactly as in liquor store to it so much. I hope we meet some tale. I'm sure we will have no doubt that if we if we don't just chance across each other. I will I will call you when I'm coming if you're ever in this area. And I discover it and you haven't call out I'm going to be. I want to be out in that area. One of these days. And I I will try to come see you. I'd love to do that. Good. Okay. It's a deal. Thank you so much for making the time. Thank you have a good vacationing. Yeah. Okay.

cancer Krista Tippett Dr Rachel Naomi Remington Crohn's disease Chris I United States Mike grandfather diabetes America Fetzer Minnesota apple Dr ram Mitt Russell UCSF Stanford fetzer institute Jody engineer
S6E7: Emily in Conversation with Dr. Ina Park

The Nocturnists

42:39 min | 5 months ago

S6E7: Emily in Conversation with Dr. Ina Park

"At the doctrine is to ensure that all stories comply with healthcare privacy. Laws details may have been changed to ensure patient confidentiality all views expressed. Are those of the person. Speaking and not their employer support for the nocturnes comes from the california medical association to learn more about the visits. Cma docs dot org support for the nocturnes also comes from the patrick j mcgovern foundation. You're listening to the nocturne est conversations. I'm emily silverman. Let's face it as much as our culture delights in talking about sex. We do not relish talking about the sexually transmitted infections which sometimes follow but sti are not just a fact of life there a topic that has been shrouded in mystery and moralizing throughout the history of medicine. Is it time for some straight talk. Today i speak with dr park. A family medicine doctor. Associate professor of family and community medicine at the university of california san francisco and the author of strange bedfellows adventures in science history and surprising secrets of std's. I am sitting here with the wonderful doctor park. I know thanks for being here today. Thanks for having me emily. I would love if you started us off by reading an excerpt from your amazing book. Strange bedfellows strange bedfellows. Attempts to explore the role of best he is our past present and future. It is a journey that goes from the microscopic clashing of to human microbiomes during sex to the big picture of sexual networks appreciating the influence that just a few players have over the sexual health of the many sander through the twists and turns of real people sex lives and debunk common wisdom about s. T. is you'll meet my dear colleagues a scrappy bunch of scientists and public health workers who have chosen to vote their lives to this field. Then i've thrown in the details of my own journey the tale of a studious korean girl who ended up spending her days between other people's legs living. This book is a peek into my weird and wonderful world. And i hope you'll love it as much as i do. Thank you for reading that. And i have to ask. How did you get to be so passionate about t. ice. I got really excited about the topic. At i first at university of california berkeley where i did my undergraduate work and i started off as a sexual health pure educator i had just noticed i had become sort of a go-to person for my friends to talk about their sex lives with and as well as the aftermath and testing in pap smears and whatever. And i think it's because i was pre med and all of my friends were not That i became the default go-to person. I joined this education group and i started actually doing post test counseling around hiv as well as s t is and then also counseling folks before they were going in for their first cervical cancer tester pelvic exam and then i also traipsing around two dorms and frat houses and sorority houses and whatnot Doing live demonstrations with plastic penises and condoms and doing distribution which culminated on national condom day. When i was a junior where i dressed up as a huge condom from head to toe with just might face showing and did a demo front of over one hundred people at uc berkeley with a banana and a condom and wrote about medical school. Actually believe it or not. I love this image of you standing in front of a crowd head to toe and a condom outfit and one of the things i love about this book is how you bring a sense of joy and play do. The topic of sex t. is which is so important because it's a topic. That's so covered with shame and stigma. And i guess what i'm wondering is why do you think there is such shame and stigma associated with this topic. I feel like at least my sex education coming up through my secondary school. Years was more abstinence focused and when you are more abstinence focused then if that abstinence is the ideal than having sex is not ideal and then certainly if you end up with a consequence of sex such as an sti while then you're getting sort of your just desserts for violating. You know what i mean. This idea that we have about having sex before marriage as being some sort of sin. So i think societally there are a lot of issues related to our views on sex. I think we have a servant unhealthy view of it. And don't think of it as sort of a natural part of development. When i was coming up through my middle school sex education we were shown lots of pictures of as she is and the worst case scenarios around them and so i feel like that set us up for the fact that if you actually got an sti that you should feel ashamed that you might get rejected from a partner because they might think that you were quote unquote unclean. So i think it really starts early. And so i think those attitudes are very difficult to change. Which is why. I was very intentional. About creating sort of a joyful light and funny approach to the topic. Yeah i feel like when. I was in middle school. We also focused on the bad parts of sex and didn't really talk about the positive aspects of sex and the joy and the pleasure and things like consent and Things like that so definitely resonates actually some of my favorite chapters in the book which were also some of the most unexpected where the ones where you explore the culture. Thanks so you write a lot about sex toys. The rabid appeared in sex in the city about pubic hair. Brazilian waxing vagina dazzling right right about vaginal steaming and the jada eggs and that'll controversy right. Was it fun to dive down this rabbit hole of the culture of sex. And what were some of your takeaways from that part of the journey. Oh it was great. Because as you know emily's and miniature professional interests bleed and jere personal interests so you know. I think sex is fascinating anyway and we were talking about sort of my origins. With with the whole sexual thing. I remember spending a lot of time because we had educators from good vibrations. Which is those listening. It's a local sex toy store in the bay area as well as in boston. And i've always been interested in sex and pleasure as well so those parts of the book were the most fun to write the things that were really painful in difficult. Were writing about topics that were so serious so heavily stigmatized and trying to write them was sort of a light hand and try to still infuse humor without making fun of something. Because the last thing. I'd wanna do is for people to feel more stigmatized than they already do. Yes i was very impressed by the research that you did. You even took a trip to brazil to try out and understand brazilian whack seeing so i mean when you did that where you're thinking to yourself okay. I'm gonna write a book about all these different things. So i'm going to go do this now or was more like. Oh i've already done these things. So now i'm going to piece them together. Our international as to research society has a meeting every two years. And when i heard it was going to be in brazil and i knew i was going to be writing about pubic care. Just because i started noticing that none of my patients had any. And i was really interested in exploring that phenomenon but possibly because of the career that i chose. I just haven't had time to deal with my own pubic grooming. And so i said well there's no better place to get your hair taken off then by the people who know how to do it. well which is the brazilians. Because for folks who haven't been to brazil. The swimsuits in rio are like little strips of fabric that barely cover the orifices that there's supposed to be covering so the brazilians are very good at desolation. And i was very intentional about having that piece. And i wrote a lot of that chapter when i was there. Actually doing it in real time and i love how you look at these questions through the lens of science and you don't really cash judgment for or against you just talk about. This is what's happening. These are the trends. this is. what's back by science. This is what's this is what could be harmful. I wanted to pivot a bit and talk about sti. Because that's obviously the focus of the book and one of the most striking moments was when you compare these two anecdotes so first we meet a guy who has a girlfriend in nevada girlfriend in california and he has sex with them back and forth and then we meet another guy who lives in one city but has twenty five different partners in the last three months. And you tell us that it's actually the first guy who ended up getting tested and having an sti and the second guy who tested negative And then you go on to explain to us why the number of people you have sex with actually doesn't have as much as to do with your risk of contracting is as you would think so. Can you explain to us a little bit about how this works. Part of the issue comes down to how you engage in sexual relationships. The patient who had twenty five partners but had not ended up with anything was actually sort of being serially monogamous. Some of these relationships were only lasting like a day or a week or whatever is that he was having sex with one person ending the relationship having sex with the next person ending the relationship and so it was happening sequentially like that whereas the person who was having the relationships with the two women was ping pong back and forth between them and i talk about the fact that actually having concurrent relationships or being in a community where there's lots of concurrent relationships happening is actually what fuels the spread of. Ti's is an hiv by the way whereas if people are serially monogamous especially if they're testing in between partners then actually that's a much less efficient way to transmit as ti's but one thing. I just wanted to point out. Emily is that. I guys have done a lot of work around racial equity on your podcast is just that in some communities especially for folks who are heterosexual that men are either incarcerated or missing from the population due to violence and there are literally in some communities not enough men to go around for all of the women that want to have sex with men and therefore we end up in a situation where khun currency is driven by the fact that there are literally not enough community members to go around for everyone to have just one partner and that is part of reason. Why black americans are more likely to catch sti such as honoree rea- not because of different sexual practices not because of differences in condom use but simply because of this idea of currency that is forced because of these structural racial issues. Such as mass incarceration. So it's like you don't think about gonorrhea being tied to mass incarceration. But i tried to bring you there. You know what. I mean through my storytelling. You really did bring me there. And it was just so heartbreaking to see how all of these different pieces of society are connected from the medical to the legal and all of those other parts. Yes so. I think what it means. A policy perspective is like really really have to double down in communities of color in funding organizations. That are doing this kind of sexual health work in affected communities and it just means that we really need to focus resources even more heavily because we have to try harder to reach folks because of medical mistrust as well and just simply because there's more currency and more infections so we need to work harder to control them and you talk about how public health researchers actually have these giant maps in my mind. I was imagining like minority report. Like standing around this three dimensional map where you said they almost look like dandelion blossoms. Tell us a little bit more about these maps. How do they work. And how do people use them to track down and control is. I feel like everybody. Who's listening is going to be familiar with. Contact tracing now but at the time that i was writing that chapter a lot of people weren't but those maps you're talking about are really mapping people sexual connections so those people that look like little dandelion blow balls they call them are in the center and then some of them have dozens and dozens of little spikes coming out which which represent all of their sexual partners in the span of a year or two years or whatever time period you choose there's going to be connections between all of these people. Some of whom have many sexual connections some of whom have very few sexual connections but you can actually see that over time. A lot of people actually are sexually connected with just one or two degrees of separation and that there are really key people in a community that actually bridge high risk networks together or bridge a high risk network to a low risk network and therefore are able to spread sti or hiv from one community to another and so the whole idea around contact tracing which by the way the whole concept of contact tracing started for syphilis back in the thirties is to try to disrupt connections right by getting people in seeing. Who is the person that might have infected you upstream and who are the people that you may have infected downstream and trying to interrupt those chains of transmission and as you know that for covid nineteen. We had a really difficult time. Because i think things got out of hand before we could really nip things in the bud and and we have seen as well in. Cdc's preliminary data prior to the pandemic that we were in the same situation with as ti's including ziff was for which we do lots of contact tracing still in the united states. And you talk about how there are individuals in the middle of the dandelions blossoms. And how they're called core transmitter. Yes and it's somebody. I can't remember if it's your voice or a quote in the book. Says i prefer not to think of these people as high risk. I prefer to think of these people as affectionate alluring and charismatic. Feel it when you're in the room with them that was actually one of the contact tracers and he's great. His name is charles fan and he said you are in the room with them. And he's like. Wow i feel this allure or this kind of sex appeal thing even though he's very professional but what he's saying is that some people who end up crossing his desk over and over he's like this person is really charming and charismatic. And i can see why lots of people wanna sleep with them. And he said it's not because they are necessarily the most physically attractive hunky person or whatnot. But it's really because he was saying that some people are very good at putting people at ease and with sex. It can be a little bit rate. So he's the people that are good at putting other people at ease in the bedroom. Tend to have lots of sex and can sometimes end up with lots of s is depending on what type of networks playing in you mentioned contact tracing and i wanted to talk a little bit about the sex detectives. Yes which you talk about. How they're in some ways closet anthropologists closet ethnographers and they're really embedded in the community. And you talk about one person who showed up at a sex party to do some testing and then took a soak in the hot tub on the way out and you talk about another. Who gave out his cell phone number to the community and then often his kids would be fielding calls from sex workers who were calling the house with questions so tell us a little bit more about this. Is this a lost art. Do we still have these sti detectives out in the community who are embedded and they really know people and they track them down or is this something of the past. I think with this increasing move towards meeting partners digitally and with the pandemic contact tracing has had to be performed primarily online and in person. The heyday of that sort of in person. Just sort of hanging out at places of interest was really in the seventies and and to a lesser extent in the eighties but once we hit the mid nineties and the rise of chat rooms and then obviously it's smartphone apps a lot of the contact tracing has to be done online. And don't get me wrong. I'll just use an example from the city of san francisco when there was a pregnant woman who had and she was not housed and the contact tracers went out found the community where she was living in under a freeway. Overpass and found partner has got them tested. So there's still this whole outreach component to contact tracing and there always will be but i think just because of the nature of the beast and the fact that right now we're so limited in terms of what we can do in person that some of this whole online and digital contact tracing is going to be here to stay and you talk about. How sometimes the social media dating apps will actually reach out to people to let them know they have sti. Was you know what i'm some. Health departments have been able to do which i think is really cool. Emily is that they are able to create their own profile on an app such as grinder or tinder. And so you will get a message and in-app message from the department saying hey not looking for a date just letting you know that you may have been exposed to something. Come on in and get tested. Here's the places you can get tested serving as a resource. And for the most part they try to use something that makes them look like an institution but for some of the apps they required like an actual headshot one person. I talked to was saying. I think people may get a shock. Because they're like oh this guy's really cute and you're like oh wait actually telling me have an sti. They don't actually want to go out with so that would be a highly disappointing interaction. I think on an app. Yeah and there's a story about how someone was diagnosed with something and they were asked. Who are your partners. And they said. I don't know his name. But here's his photo right and they looked at the photo and he was standing in front of a gym so they went to the gym and then they actually set up a table of pamphlets that was like about a different topic was about it was a bike helmets and they just sat there and case to the joint for two or three hours and then they saw the person walking but they didn't even know his name they really just had the picture from the app's profile and they said well he we know he goes to this gym in downtown san francisco. So we're just gonna case the joint until we see that person and then they casually sauntered up to them and said hey. Let's pull you back into a room here at the gym and you know you have syphilis. And that person was really quite surprised and taken aback but this is like the extent of the detective work. That's done i mean. These folks are amazing. And i'm super curious. Because i know you have lots of physicians who listened to the nocturnal as well as other healthcare providers. Were contact. tracers something that you were familiar with before the whole covid nineteen pandemic catch. You interacted with them as a clinician before i had never interacted with a contact racer as a clinician before the contact tracing specifically. I wasn't familiar with until covid. Nineteen and then we learned that there are all these people around the city librarians and other furloughed workers who were coming together out to become contact tracers for the first time. So maybe that is a workforce that could be mobilized the future and not just during pandemics but for sti work. Well that's my hope right. You know we invested so much in public health infrastructure because we had to during this time and then my fear is that if that funding completely goes away that all of those folks will then also lose their jobs. And i really think that some folks were doing covert nineteen contact tracing and learned those skills about interviewing and eliciting information could really be re purposed into doing worker on s. t. is i don't know if they're the same intersection of people. You know the people that love. Sgi word may not be the same people who wanna do cove nineteen contact tracing. But i think if we could it would really go a long ways in terms of addressing the epidemic because people are already starting to have sex again. So i think the whole sti is going to blow up You talk in the book about all the different success stories with. Sti's so you talk about penicillin for syphilis. You talk about antibiotics. Gonorrhea you talk about pap smears. Hpv and how. The rates of cervical cancer have plummeted. Which is all really good news but then you said something really interesting. Which is that now in some ways. Teenagers have come to see. Ti's as kind of no big deal like almost as if they're inevitable and there's the fatalism around them like. Oh if i get it. It's no big deal. I'll just take antibiotics and call it a day and you say in the book that fatalism is a double edged sword. So can you talk a little bit about that. Because i thought that was a really interesting conundrum. Yeah i mean. One of the people that are interviews name maria trent and she studies mostly african american young women in baltimore and she was reflecting that we are towing this very fine line. We wanna d- stigmatizes infections. Who want to normalize the fact that almost everybody is going to get an sti at some point in their sexual lives and we also want people to take it seriously because the truth is of course that if you have untreated especially committee or a gonorrhea for folks who have reproductive potential like they can ascend into the upper genital tract and cause pelvic inflammatory disease scarring topic pregnancy and all of these negative consequences. And yet i also want people to feel sex positive. And they're empowered about their sexual health. So i am towing this very fine line. And i don't know exactly what the most effective message is. But i think what. I'm trying to say right. Now is really on more on the side of normalizing the fact that almost everyone will get these infections and not to say that you shouldn't take them seriously but the way i wanna frame it is that people should take charge of their sexual health knowing that there can be negative consequences to be tested regularly for example. But you're right. I mean some of maria. Trent patients are like everyone i know has had committee is so i don't really care i'm not gonna take it seriously. I don't feel anything. So why should i actually spend my time going and seeking care and getting treated for something that does not have any symptoms so she is really also towing that line of trying to explain the consequences without scaring people. And i think that's what we have to do. In general as providers right because. There's been so much stigma around it so we definitely don't want to create fear but at the same time we do want people to have a healthy respect for is for the things that we fear or the things that we have an aversion to. We turn away from them right. We are repulsed by them. We run away. So i think for something like as she is or any topic. That is really highly stigmatized. I think that stories can draw people in. And i think that stories can break down stigma which is why i think it's so important to us storytelling. When we're talking about this and other stigmatized topics. Yeah you talk about storytelling in the book. And how it's powerful but that power can actually be wielded in a negative way and you use the example of hp vaccine deniers and you said. I think all it took was five to ten minutes of an ordinary person reading heartbreaking story on a website that had an anti vaccine flavor before they changed their minds. So how do you think about that like are we just bad at using storytelling and the anti vaccine are good at using storytelling. I've thought about this. And i think what you're doing with the nocturne assists and really having stories lead in in the educational piece around different aspects of medicine. I think that's actually less common than what we typically do is specially with each other is that we are using data and we basically show each other a lot of charts and figures and we talk about results from studies and statistical significance. And the truth is is that for the public and when we're trying to do things related to public health. Nobody cares about that. And what is more convincing to people are actual people stories. So if you go to a government website and you see a lot of data and figures in one in four people will have this that or the other and then you go to a website with an anti vaccine flavor as you put it. And you read a heartbreaking story of how someone had terrible consequences that they think is related to the vaccine. What is going to stick with you. Those data pieces or this. Really compelling and heartbreaking story. I know the answer for me. And i'm a parent and so when we talk about people whose minds are changed by anti vaccine website. We're talking mostly about parents here. And those are the people making the decisions vaccination for their children. So i actually think that we need to do more of what the anti vaccine folks are doing but using stories that are rooted in science and speaking of stories one of the stories. I love most in this book. Is the story. Hugh sitting on a plane in las vegas next to this woman. And you have this really funny line where you were like. This was clearly a very religious woman. And here i was a pro-choice mother heading to educate prison populations about and The woman turns to you and she says what do you do. And why are you traveling and you hesitate so tell us what happened next wall so that plane time like before you're going to a conference like the sacred time we're like nobody can email your bother. You and. I'm always worried that if i tell the truth about what i do to somebody sitting next to who's going to judge it then i'm going to ruin my relaxing me time. You know what i mean. And so i always just wonder. Do i want to go there. And do i feel like i have the energy to defend myself if i need to but i could not believe this woman's reaction i mean. She's literally wearing a sweatshirt. That is airbrushed that says jesus saves on it and she's wearing a cross and i was like i don't know how my information is going to land on them. But she was so into it and then she whispered at me. I had sex before. I was married. And i said me too and then we just started talking. Because she's the mother of two kids and she said i fully expect children to have sex before they get married. I would really prefer that. They did so that they knew what they were getting into. And i thought it was a really beautiful way for folks who were diametrically opposed on abortion rights and political leanings or whatnot to make a shared bridge over the fact that we wanted our kids both to be really sexually healthy and i feel like we're missing all those little opportunities right now because we're not traveling together we're not interacting with each other and we are just yelling at each other from echo chambers on social media but that is a perfect example i feel like of how she probably got off that plane with maybe a different view of sexual health as well as ti's and i got off that plane with a different view of what a bible study leader who teaches zimba. Might think about my field and what we do so it was great. It was actually one of the first things i wrote in this book. And one of the last things that actually went into the chapter in the end. Yeah i love that moment of connection between you and her and how you said. It defied my preconceived notions and that is what storytelling it does in the book. You talk about this concept of sexual health. And i wanna talk about that for a minute and as we're talking about it there's a sentence i wanted to hone in on which i highlighted like three times in the book which is that americans have a basic embarrassment around acknowledging that we our parents our friends and our children are sexual beings. So talk a little bit about that. Well i think acknowledging the fact that sex is normal and that we are all for the most part sexual beings of course. I want acknowledge that some people are sexual and happy that way but for most of us we are sexual beings and just acknowledging that is the very first step to being sexually a healthy because if we acknowledge that that is normal and okay and doesn't always have to be done in a the hetero normative confines of a man and woman marriage right. I think we will go a long way in starting to understand that there is a lot that comes along with sexual health. Not just the simple act of penetration. Whatever type you like. But all the issues that you and i talked about a little bit before we started the podcast around consent around pleasure and then of course. The unintended consequences of sex like s. t. is hiv and other infections and then of course pregnancy and contraception. I mean there's so much that's there but if we don't even acknowledge that it's normal and we don't even begin to talk about it then. We can't even open that door to sexual health because we're just stuck at. It's something that i do. it's private. I don't talk about it. I don't explore it. I don't discuss it. And i don't discuss it with my kids. And then we get stuck in the patterns that we're in right now. I think we carry this with us. Those who work in healthcare into medicine sometimes and then some of us could break this down with patience but sometimes even those of us who do work in the healthcare space actually have a hard time talking about it ourselves. You may feel pretty comfortable with it. But i'm curious to hear your experience and if you know about some of your colleagues as well who might have a hard time talking about sex. Yeah it's not the easiest thing to talk about. I think i'm pretty comfortable talking about it. But i imagine there are others. Who aren't as comfortable. I still remember as a medical student doing the pelvic exam on the standardized Since and i love by the way that part of your book where you're the standardized patient for the pelvic exam because the original person got her period. It wasn't feeling well until you stood in for that was my debut and my closing night as a they call them now. Gynecologic teaching associates. That was my one and only time. But yes i have done a live pelvic exam in front of an audience and one of your students famous. He fainted and i'm so curious to know he's actually a gynecologist out there somewhere now. I would love to know that you. I don't have anything. Dramatic going on with my vulva or cervix or anything like that. I just think he had never seen an exam. And i just to see one with someone he knew as the model and the room was too warm. I mean there are so many things that set him up. But yes he was on the floor and i was in stirrups with no pants on so i couldn't help him so everybody else had to rush to his aid. Yeah that was just as a funny story. And i think an extreme example of just how uncomfortable people are in the presence of these relations and in the presence of these body price and in medical school. They teach you how to take a sexual history. I remember when i was a student. They taught us one way today. I feel like they teach it very differently. We were tied to ask. Do you sleep with men. Women or both how i realized there are many other ways of asked and i think the other piece of it too is the conversation around sexual orientation and gender identity has become very very murky and i think sometimes people trip up over these topics because they don't want to say there i know they don't wanna offend and so yeah for all of these reasons it can be difficult to talk about And the way that you talk about it which so easy breezy or really inspires me. I mean do you think you can teach that. Can you teach someone that comfort. Well so. I don't know that you can teach the comfort but can we just say. Can you fake it till you make it. You know what i mean. I think we can teach you how to say the words. And can i just give a little plug. Because cdc we'll be putting out a revised guide to taking a sexual history. Because i was also in the school of men women or both and now obviously we can ask just to put words in people's mouths if you want to say what is the gender of your sex partners so leave it. More open ended so that someone could say i have a partner who's non binary or partner who's trans or whatever and just acknowledging the fact that there are more genders than just male and female. So i think we can teach people the words to say what people's internal experiences of comfort may or may not get there. But i think it's like with anything else. The more you practice the better that you get at it and i know some people. Don't ask at all because i've had patients say to me. No one's ever asked me that. Never what do you mean. No one's ever asked you so. I know that some people are just not going there because they don't know what to say so really hopeful that if we put out more guides on a national level to say here's some examples of language you can use that even if you don't feel comfortable using it at least you can say the words and people appreciate it. Your patients really appreciate it. You mentioned earlier talking to kids about sex. Your kids make all of these humorous appearances throughout the book. There's one scene where your children are fighting over this curly stuffed animal and it's a syphilis stuffed animal and they're arguing over who gets to have syphilis and you talk about how the conversation about sex is really difficult these days because there's so many different topics to cover like hook up apps and consent and pornography and masturbation and pleasure an sti hiv in sexual orientation identity like there's just so many different dimensions to it and for us since you're an expert. It's probably pretty easy but for other folks. How do you recommend that. They talk to their kids about sex. And sti's i actually refer folks to a website through keene source dot org. It's literally called talk with your kids. Dot org what it does that. I think is helpful at it. Lays out a timeline of the age. At which you could potentially talk about the following topics and it also gives some sample language like we were saying before like i'm not comfortable about i'm going to fake it and pretend that i am and so i think that is helpful because i think as a parent is super overwhelming like. When do i talk about which topic. And what do i say my friend. Peggy ornstein talks about this in both of her books about talking with the kids in the car. So you don't have to make eye contact and just simply opening the door by even mentioning those topics like the fact that i mentioned the word masturbation to my son even though he doesn't wanna talk about it now he may come around and actually he knows that the door is open and that actually happened. My thirteen year old asked me about it yesterday. I brought it up like the year before and he covered his ears with his hands. And said i can't hear you. i'm not listening. And then yesterday he came running. Asked me about it. you don't have to know the answer to everything either. You can also say we put a pin in that and let me come back around to it and then you can actually get educated yourself online but it's super important to break it up. It's not one talk. You don't get to have the talk. It's like three dozen little talks but you have time and something like talk with your kids dot. Org can help organize. When i'm going to talk about everything at the end of the book you talk about michael palin and his manifesto eat food not too much mostly plants and you go on a search for a manifesto of your own which proves difficult and what you come up with at. The end is have sex with people that you like So tell us how did you come up with that. And what does that do especially that piece at the end. People that you like. I tried to make it. Just like michael pollen's his eat food right not too much mostly plant so i wanted to say like have sex not too much and then i kind of failed at the mostly plants thing you know what i mean so then i had to scrap that and i wanted to come up with something short and i came up with two things number one. This whole idea that. I was raised with was. You can't have sex until you're married. That's what i was told so. Meaning you can only have sex with people that you love and we just know that. That's a very high bar to set. I x can. I just say so. I can't give that advice. Because that's not what i've always done myself and i think if you have sex with people that you lake or at least someone that you know something about then if an sti enters the picture you're better equipped to deal with it and i think you're less likely to feel a ton of regret what i've noticed as well especially folks that are having casual sex where there isn't like this huge love investment but at least if they think the person is a decent person that they are better able to cope with an sti diagnosis. The people that have the most regret or who the most upset say to me. Oh my god like. I don't even know that person's name. I don't remember anything about them. And i cannot believe now i have to deal with this or that person is kind of an a hole or a jerk and i don't know why i slept at them but i was just bored or lonely and so having sex with people that you find at least something redeeming about i think doesn't shield you from s. She is but i think it might shield you from regret. And isn't that what we're trying to do in life in general is like trying to live without regrets. Yes definitely i could not agree more. Well we've covered a lot of ground here today i know. Is there anything else you'd like to share with our audience that we haven't touched on so two things so just to wrap of the whole michael pollen thing. My friend actually sent that section of the book to michael pollen and he thought it was funny and he came up with have sex not too much mostly humans but i told him like that's too kinky even for me so i'm not putting it in but i thought that was a great idea on his part. Yeah i mean. I think it's probably interesting for people to know that in january of two thousand twenty one. Cdc released some new estimates at one in five of us actually has an sti right now. So just i want folks to stew on that and just realize how incredibly common these are and we're all gonna get at least. Hp probably at least one other s. i in our lifetime. So they've been around with us ever since human beings have been having sex so they're not going anywhere and we just need to get used to them and learned how to live with them. Well i just can't recommend this book enough. It's funny super educational and for anybody who's interested in women's health. Obgyn reproductive rights lgbtq. There's just so much in here so check it out. It's called strange bedfellows. Adventures in the science history and surprising secrets of. Std's dr park. Thank you so much for being here with me. Today thank you. Emily was so great. Thanks for listening. This episode of the nocturne is conversations was produced by head of story development. Atalay puzzle and edited and mixed by john. Oliver are executive producers. Alley block. Our director of operations is rebecca groves and original. Music is from yosef monroe. Additional music is from blue dot sessions. The doctrine is made possible by the california medical association of physician led organization that works tirelessly to make sure the doctor patient relationship remains at the center of medicine to learn more about the visit. Cma docs dot org. The nocturne is also made possible by the patrick j mcgovern foundation. If you've enjoyed listening give us a rating and review on apple podcasts to contribute your voice to one of our upcoming projects or to make a donation to support our work visit our website at the nocturne usc dot com. I'm your host. Emily silverman see you next time.

uc berkeley syphilis dr park patrick j mcgovern foundation emily silverman brazil emily san francisco cervical cancer california medical association Emily gonorrhea jere maria trent pelvic inflammatory disease sc khun university of california ziff bay area
COVID-19 Roundup With Dr. Katherine Gergen Barnett

Boston Public Radio Podcast

49:13 min | 10 months ago

COVID-19 Roundup With Dr. Katherine Gergen Barnett

"Support for boston. Public radio comes from mclane middleton for over one hundred years mclane middleton has been dedicated to serving its clients and its community offering guidance through the complexities of today's legal system with locations. And wilburn and boston mclean. Dot com rowdy marcher. Yagan listened to boston. Public radio eighty nine seven. Gb h logan. Jim got all that writes. Obviously just eat a little reorientation during the news. I'm back in the game. jim. I think you are so the. Us is now on a precarious place with corona virus cases climbing at alarming rates across the country. I think one hundred fifty thousand new cases average last week in massachusetts. We're not too long ago. We were national success story. We've seen the highest count of new cases since may as we head into winner where the virus becomes more efficient spreading. What can we do to protect ourselves and others about thanksgiving. And how hopeful can we be about the moderna and pfizer. Vaccines joins take our questions and more importantly all yours on the current state of corona viruses. Dr catherine gergen barnett. She's the vice chair. Primary care innovation and transformation in residency director of the department of family medicine at boston medical center and be you medical school. Dr gergen barnett as always a really glad to have you so much for having me back and by the way the number if people wanna call her is eight seven seven three zero one eighty nine seventy mardi check the email at bp are w. h. Dot org but as always the preferred route is the phone dodgers. Thank you for joining us today. So first of all we know things are not great here in massachusetts and worse hearing these stories out of utah. Wisconsin that kotas iowa nebraska. So how how bad are things well. They're pretty dire across the country. I think you know we every day. We hear news about states and governors. Who you know are finally putting in orders. Mass and starting to close indoor dining and closing bars gyms particularly dire Our stories coming out of north dakota where i think there has been You know the intensive care unit beds are no longer available and population set really. Didn't believe Covid nineteen was true or didn't believe the severity of it are now getting very ill and some dying and even on their death fed really resenting that this is true so you know the the the reality is pretty pretty damn a. Also while i believe recently the bad news out of massachusetts is the case new case numbers of grown. the deaths and hospitalizations are not growing as fast. But if i remember correctly deaths usually track a new cases or trail them by roughly three weeks. So it's likely we're going to have a pretty tough go right here as well. Yeah we're all we're all becoming epidemiologists as we follow the kirkland rocking so it is amazing thing you know the skills that we've all picked up so the fact is you're you're exactly right. The good news is for massachusetts is that we are seeing the highest rates of Infection in young healthier people which tends to mean that there's less hospitalizations and certainly less likelihood of going on a ventilator what we continued to worry about. Is that the young healthy people. Can dan Unfortunately infect people that they love who are older with chronic conditions You know who are more likely to get second need to go on a ventilator and the second piece we just unfortunately while we do see trends of young people tending to stay healthy They of course Can get ill is well. You know we're going to talk to a couple of minutes about about the vaccine news. Which sounds quite great. It's not tomorrow but at least it's very positive. But you'll have to say the closer we get to thanksgiving. We took calls from listeners. About a week about thanksgiving and i was sort of understanding an open minded about what people are doing and they miss people they love and if they're careful the closer we get to this and the more the numbers rise dr the more my sense is you almost have to be out of your mind to do an in person thanksgiving with anybody from outside your household particularly since you now know that. It's likely this thing is not going to go on forever that vaccines are within sight. What advice are you giving patients and others when they ask you thanksgiving related questions. I'm with you. My thinking has continued to transform around this. I think we all wanted to several weeks ago. Thanks okay well if you get tested before you go and then you're really safe when you travel and then you get tested when you you know actually land wherever you're going or have the opportunity to quarantine well maybe just maybe It makes sense. But i think increasingly states where they have very high rates massachusetts. Were certainly kind of barreling to the higher numbers were really Public health and physicians and and community members are increasingly. Asking people to please. Just have this thanksgiving. The you know like no other thanksgiving where you really just with your loved ones people. You've already been putting with Gabba meal web. And then you know you can be creative. Maybe you can take a outdoor hike with massillon and lots of distance And and there's lots of other ways to celebrate gratitude and thanksgiving besides just sitting around a lot of food For a number of hours with to do not work for you but thanks giving but you know that is really a great idea really when you think about it. I know upset jim. Because he's the mountains of food is something he's looks forward to every year exactly. But but you could do these. I mean you could have outdoor. I mean it could be called raining. That ruins everything. But if it's not you could do a lot of things outdoor around around around the fire pit or like you said you know take blue hills. Take a hike. Something like that. Also pick not. I'm not the expert. Obviously you are dodger. But pick a date in may or june for your defacto thanksgiving from twenty twenty so you have something to look forward to. It's just. I worry that. I'm sure you do even more doctor the headlines. We're going to see right before. Christmas are about what a superspreader day Thanks a thanksgiving was yeah. Look i think there's all kinds of ways we've had to be creative and We have done so well for so long being creative. And i think as you alluded to jim news around the vaccine is is positive in a way that perhaps we could actually just say you know with shasta a few more months sit. I think think outside the box In in the way that you connect to people you love our number eight seven seven three. Oh one eighty nine seventy if you have any questions For the doctor. She's going to be here with us to the top of the hour. Eight seven seven three one eighty nine seventy and the pr. Email is be pierre w. g. b. h. dot org. You're just a couple of quick things. I wondered about first of all. I saw this great picture from the houston medical center where the physicians that are in the room. All they got the mass on the shields on the head pieces. I mean they're basically invisible except for their is but now they're wearing these massive pictures of themselves her around their neck so the patient could see with the physicians. Actually look off brilliant. I mean it's a great. It's a great Picture because frankly you would have no idea what these people look like. Because all you can see is there is there is. That's one thing. I thought was really neat. But the other thing i thought was really upsetting was that we talked early on about how the numbers could go up if you didn't do the right things and obviously we're not doing the right things in all different parts of the country that we are still looking at that. Four hundred forty thousand people dying deaths apparently going up by mid-march if we don't mend our ways us that's like double where we are. Now look if you do the calculus and you sort of graph it out. That's that's absolutely right. I want to go back to that. That story about the humanity I just love that idea. I wanna bring that to our hospital But something if you nurses have been doing a emc from the very beginning is printing out photos that family members send in For people who were in the icu or hospital and putting it all over their walls. Because you know they're they're alone and isolated. What what a wonderful way to kind of use technology that's available to ask. Can we spend a minute before we get the coals and there are a lot of them at eight seven seven. Three zero one. Eight hundred seventy. We're about two minutes away from you. And then the doctor will answer anything. Related corona virus that. You have questions about until she has to go the vaccine when when something. What's old tired line when something sounds too good to be true. Then it must be too good to be true from what i've read. I've read veraciously about the the pfizer and particularly the madeira of vaccine. And i say particularly because not only is the efficiency rate or efficacy rate. Whatever it is even higher ninety. Four point five allegedly. But it doesn't have to be kept at as low a temperature which is good if you wanna get the ultimate vaccine at your pharmacy your doctor's office or whatever. What's your sense of of timetable. We're hearing for people who do what you do for a living. Maybe as early as december older people people people with immune deficiency issues Maybe as early as then and then for the general population maybe april and may. Is that what you're hearing as. Well dr yeah so look at the boca that vaccines are are gonna go quickly to the fda and try and get emergency use authorization And then the ideas that were hopefully in have about sixty million doses by the end of the year and as you indicated those are really. I go to a frontline workers you know. I really want to underscore at a place like boston. Medical center and so many other places around the country. I'm really thinking about. Who are those frontline workers. So you know really Recognizing that people in the healthcare industry. Of course you know. We're grateful to be considered But also simultaneously thinking about all the people who work on transportation all the people who work in food for the people who are getting so sick and are continuing to be kind of Left a little bit In the in the gap the air and and really you know. I want us all to be An advocating for that to also be first in line doctor. Yes so ideas. Sorry i was just gonna say so so to finish that thought the idea that I think the vast majority of the public will then have something available of in summer. We're talking to dr kathleen gregg burnett. She's a vice chair. Primary care innovation. Transformation residents director at boston medical center. Doctor we were talking last time trying to narrow about sports and how. It's incredible that people that were playing. Nfl tackling each other and falling all over each other. I don't see many transmission on the players and we talked about the idea of having to be in a place a for fifteen minutes in mostly inside next to someone who's infected an alert email sent us the latest from the cdc which says it's not fifteen minutes. Continuously is fifteen minutes so that means you could be next to mom for two minutes at the cocktail hour next month for another five minutes during the main meal next among again at desert. And then you're up to fifteen minutes and that's it is that what the That that is correct. That data actually came out of the cdc Several weeks ago based on what we were saying actually in a singular case which then you know drove the data In vermont and in a prison system where one of the people working in the prison was tending to a bunch of people who were Ended up being cova positive and spent very little time with each person You know within that timeframe but over the course of twenty four hours spent fifteen minutes Expose and then became positive. So that's exactly what that means You know again we. We are continuing to learn a lot about the way that this virus works but one of the things that were coming to understand it is. It's not just that you are considered You know contact tracers risk if it's fifteen minutes at one time But rather it's much too so you know really. How do you add that up. I think that makes everything very difficult. Oh let's go to the phones. Let's talk to myra. Norton you're on with doctor was dr laura. Hi thanks for taking my call. Sure I have a friend who's very involved as a development of a statement for kobe and he tells me yesterday about the during the study that that was done in a hundred people and ninety five of them with the placebo and only five received the actual treatment. That's not so thank you so much for calling in on asking 'cause That requires some clarification so so the majority trial was actually done on thirty thousand people and half of those people recite received the placebo which is for water and half the people received a vaccine And there was actually ninety five cases total of covid nineteen And ninety of those cases were in the placebo so ninety of those ninety five where the people who received the salt water and only five of those people who are who actually received the maderno vaccine and interestingly all of the severe cases were those who also received because cbo so and not only was a protective of getting it but it was protective of getting you know in a severe case so for calling and asking such an important question i am so glad that my recalled not just because of how important the question was. You said dr gergen barnett but because all of us get little snippets of information and make large conclusions about small things often the turn out to be wrong and the lesson that i hope we've all learned usa as we all become sort of amateur epidemiologists as we have to be throughout. This is when you hear something about an issue related in the corona virus. It really matters and is important. Double check do a little research yourself. Do don't just take it as gospel particularly if it's coming from one person in particular but check out the information not to get political but for just one second great thing about the biden win is that we're not gonna have the cdc doing crazy things and then readjusting the weeks later or the fda saying crazy things and readjust them to placate the leader of the free world. President drugs at clarkson and when we not that is all over and so that should that should really. I hope i mean. I would think dr everybody having the same message. The health experts epidemiologists and the president. United states i think is going to help i think i am. I'm so looking forward to having a unified messages. That are coming from experts in public health. Who are not going to be undermined. Yes and very much looking forward to that day. That's of course if you don't watch the new trump tv which will be founded some december so kaelin kaelin. You're in stoughton. You're in boston public. Radio your own doctor burnet hi. Hey how's it going great. hey So i had a question I heard Madonna representatives Talking about vaccine in that it could potentially cause some mild like symptoms. I was just wondering if when you're showing these mile like sometimes will you be contagious. Showing symptoms from the back. Game gray helen. So those mild flu like symptoms. You know are sort of the the hallmark of a lot of vaccine so probably people who have gotten vaccines recently or even the flu shot recently Knows what that feels like so Importantly though to really look at the way that both and madonna have made this vaccine so they have created like a little bit of a genetic code so they're not putting any of the virus into your body. There's no live. Virus is going in. There is not even a kill viruses going in They're putting in something. Called messenger are noaa. Which is again a piece of genetic code in order to stimulate your body to make a protein that looks like corona virus so when you get exposed to coronavirus your body's has oh i know this protein and i can fight it so in other words everything getting put into your body is is not the virus cannot make you sick and you will not have covid. Nineteen when you get the vaccine answer in break. Clear kaelin thanks for the call. You know what. I read yesterday in the new york times story about moderna doctor was this success. The apparent success of this m. r. n. a. technology or just describing is very good news going forward on infectious diseases. As a whole. Is that of you. Your share yeah absolutely. You know we've never had a messenger. Rene been approved by the fda. This pretty hot. Some pretty novel technology and one that we thought Would be very helpful. Because what you can do is you can actually make it very quickly With you know evident by the fact that we this is kind of breaking all timelines that we've ever seen in terms of creating a vaccine The problem with messenger. Which is exactly what we're reading about is it. it's a bit more fragile and so I actually read those great article which compared You know so the importance of protecting these vaccines and you know. Ultra cooler cool. Temperatures is sort of The idea of an eminem Like know melts in your mouth. Not your hands so like how do you know. Put shells on top and protected and kind of freeze so. I thought that was a very good analogy for for people who are visual learners before we go back to the calls. Someone called us last week actually with a question. We said we'd ask you which was may be impossible to ask for just two to vaccines as far ahead even without a burden see youth use authorization. Yep it's likely they're likely to get it. Maybe by the end of november is are people going to have options come next year. Let's assume for argument's sake of the dozen that are nearing conclusion. If most of them get approval is the average person going to be able to choose what they want saying. I want the one. That's ninety four point five the moderna versus the blank or is the likelihood. Good that at different venues. You're going to have a one size for everybody. You know. I think we are going to see a lot of these racehorses. Continue down the track in terms of the other vaccines that are being developed. And if there is a vaccine that is Even more efficacious and easier to store and easier to distribute than either the ones that have been pushed to date that i imagine You know we'll have some front runners that being said you know pfizer. Madeira has blown off the doors of what we were expecting. And what we're hoping for so being the numbers that hoping for even seventy would have been great. Yeah i was. I was sort of thinking. Fifty to seventy is you know. We thought anything greater than fifty percents Efficacy we would you know. The fda would approve But the fact that we're looking at close to ninety five percent is is excellent news. we're talking with dr. catherine gergen barnett from boston medical center. I'm getting emails about people. That are contemplating. Barbara's one she's contemplating elective surgery. On december first other people. That are worried about you. Know regular tests blood tests the colonoscopy thing colon cancer. Didn't you go to the dentist the other day you want to somebody the dentist. I got my teeth cleaned. It's the same deal i know. Yeah and it was. It was kind of nervous about it. Even though we were everybody was messed up except for me but so what about those kinds of things. Getting your teeth clean. Electric surgery colonoscopy blood tests et cetera. Well look at what happened in the beginning of the pandemic is a massive shutdown of all kinds of elective procedures and routine healthcare mate nights We are all working very hard on the hospital. Level and i outpatient clinics to maintain the safety of those kinds of places You know for instance if you need to get a quote. Ask me if you need to get those blood tests. I'm still very much encouraging my patients to come in to get their sugars tested to get their cholesterol tested You know if it's Plastic surgery you know. Maybe you could defer it but there are things that you know. We're really really maintaining safety in these places long as we can look before. Let's greg i'm getting an email from a friend of mine. Three of them on the same question. We'll get to that. Greg amherst tiger inside line to you. Jim by friends of mine. Go ahead greg. Pleasure being on Jim and marjorie love your show. Thank you So my question here is given that the pfizer vaccine in the modern a vaccine or mri vaccines Impression that that would be stored at negative eighty degrees c Because of arneses. And i was. I was curious about how madonna was able to lower that i know they were looking into. Why awful his ation. Otherwise known as freeze drying. And if that's the case why why wouldn't visor wouldn't be able to do that greg. I was thinking the exact same thing. And i forgot it. That's a great question. The freezer issue why moderna able to stabilize it at a much more elevated temperature below zero but not ridiculous like fis earth. Yeah you know you. You all are not alone in that question. I've i've also kind of reading about this if you know it seems like a massive disadvantage that fives are Needs to be it's minus seventy degrees celsius. Which is you know as cold as a winter day in the south pole You know that it needs to be capped whereas as you indicated madera is you know basically minus twenty which is a regular freezer The the the scientists that i've been following about it said we were not sure you know. Maybe they know the technology better than i don't know the answer to that but the fact is we just have to trust the data that they have that's come out in terms that efficacy And move from there. But i'm sure there will be more stories That will evolve letting us know more about that as soon as you figure that out gregor we read about. We'll share it with you. You know doctor before we take a break you said is cold as winter's day in south pole as soon as donald trump starts drilling. There won't be quite so called. Mother analogy so this friend of mine is a. We often joke about this. And i i am not a margie. Knows this. I'm not quite as social and out in the world is some other people are and he is very. He's really into physical contact. Kind of thing is the discussion. We've had i used to handshakes on my show. So i like that too. He sent me an article last week from the new york times about hugging. And oh yeah. And unfortunately i haven't seen it in a week so i'm gonna get a little bit wrong but it was not an anti science based article but it was not anti hugging craig marjorie ready to correct me if you're wrong. It basically said if you both have a mask on and you turn your faces away from each other. Do not talk when you're hugging. Don't have it be extended physical conduct contact and something else. I forget what it is moderate. You may remember. But i guess on physical contact for people who are really missing it and they're really psychological deficits as a result of not having it from what i read and a lot of people who depend on physical contact for lots of reasons. Is there a safe way to be hugging doctor. I you know. I love that question I actually i wrote an op. Ed for the globe right in the beginning of this pandemic all about the handshake. We have to get rid of this. The idea of the handshake Anyways right it's it's very kind of aggressive. You know form of communication. And all that being said is is massive public health disaster handshakes are just. They're disgusting for like every hour. And signing a deal you know inside the boardroom and i'm a hugger. And i really missed hugging and i've actually You know started to kind of follow some of that science as well and and you know if you think about it and he keep your mask on and you don't say anything and you keep your faces you know as far away as possible and you keep the hug brief you know. I think. I think it's probably the benefits outweigh the risks. Great confirmed i think. That's great. Show about how you. If you can't hug somebody you can get a robot and hug the robot jim bites the robots not really the agree. Yeah well you're in love with it operated anymore. We gotta take this boston. Medical centers dodger. Kathy grigor barnette. She's taking our questions about the coronavirus. A number is eight. Seven seven three. Oh one eighty nine seventy emails. Cpr w. g. b. h. Dot org prudan eighty nine seven. Gbh austin public radio in meet the team see listings and more at homes by burning dot com public radio. She's marguerite i'm jim braude. If you're just tuning in we're joined by. Dr catherine gergen burnett. She's going to be with us almost to the top of the hour. She's the vice chair of primary care innovation and transformation residency director in the department of family medicine at boston medical center and be you medical school. She's answering any questions. You have about anything relating to the virus. Eight seven seven. Three zero one eighty nine seventy. The lines have been full for most of the hour. So if your word you're not gonna get in if you email or bp are at w. g. b. h. dot org. There's a good chance of marjorie. We'll pick up on your question. Let's go to don. I'm sorry just hold one second marjoram. I there is. This is an interesting. I e mail from l. In new hampshire. she said. Could you please ask dr gerkin barnett to explain to people that they do not need to be afraid of corona virus genetic material injected into their bodies. I hear this is a scary idea for many people who do not understand how viruses work in general doctor. Thank you yeah. Thank you so much ele i i you know. I hope that. I laid this fear with one of the earlier. Callers specifically thinking about how the vaccine can give you As we are told sort of Achey flu like symptoms that it is not because of being injected into your body it is a piece of synthetic genetic material that will help your body fight corona virus But again you are not getting the virus put into you and it will not make you sick and also is it okay. We're both your autoimmune. If you have auto immune diseases this email. Jen says other. Vaccines are not recommended. Oftentimes for people with those kinds of difficulties such great question. John you know one of the things that I have mentioned. In recent days as to what the difference between efficacy of a vaccine ineffectiveness of a vaccine efficacy is really what we're seeing right now. In terms of the journal sort of being close to ninety five percent and visor being around ninety percent which is a really looking at the participants in their trial. who happily come from different kind of you know different populations in slightly different ages But you know that being sent generally healthy people So are not you know at this point. Knocking tested at great rates and people with autoimmune. Diseases So i think the data is still out on that. I'm sure there will be a lot that is going to be sad about that To make sure that we're really keeping people safe From what i understand it will be safe for people with autoimmune diseases but obviously That needs to be further tested. Let's go to danielle. You've been patient your providence with dr gergen barnett. Hi danielle hi jim. Murray thank you so much for taking my phone. I mclaren. Thank you dr. I have a question about thanksgiving So i am twenty eight. And i'm in an age group. Where a lot of the people closest to me are kind of laughing at the idea of doing something differently for thanksgiving this year which is frustrating and a different topic in itself. But i have been today at home for the past two weeks. I've had the opportunity to work from home. So i'm thankful for that but i'm wondering if it's still a wise idea to go and visit my mom in massachusetts for thanksgiving. I did have to make a emergency vet appointment today. And after i visited and people were not wearing their math properly. I i'm nervous. What gone yell after. The doctor gives you an expert response. I'll give you my response. That i said what the hugging i ball daniel. I'm so glad for your call. I actually i wanna address sort of a bigger question for people in your age group And then address your particular question so there was a great article on the front of the club to the really talking about how there's very high rates of covid nineteen in in twenty to twenty nine year old and there's a lot of punitive conversation around you know own you know it's really people out partying and they're out at bars and Rather than sort of a compassionate response and saying well. What's happening here. Why you know what's happening in this age. Group are people needing to actually go to work or do they live in a multifamily place or you know. Many many other factors that could the driving up these rates And the fact that you're you know you've been so careful so clearly wanting to connect your mother And i'm you know. I'm so sorry that you had to go this emergency vet appointment Do worry that that broke your two weeks of quarantine And that it makes it much more challenging to go. See your mother Again my my greatest advice is for people not to be connecting but You know seeing people in person and having a sit down dinner inside at being said there are a lot of people who are talking about risk mitigation. So there's not you know you can never take your risk down to zero senior mother. The the risk free situation with lead not seeing her But could you eat outside by a fire pit you know far away or Cred you get tested before you go and tested. You know when you've been there for a few days so i. I don't have an easy answer for you I do think the the you know again. The lowest risk would for you to be not to go But it sounds like you really would like to see her so trying to take a lease risky situation as you can go. Y'all before you made the call what were you what. Where do you think you were going to end up on this decision and why I have been fifty fifty about it. I know how safe that. I've been But i'm more trying to protect her. I'm not worried about getting it from her. I'm worried about giving it to her. So i kind of i feel like i've decided that i may still go. But maybe wear a mask the entire time that i'm indoors with her and trying encourage her to eat outside with me or eat in separate rooms. It's more just i. Yeah yeah yeah. Yeah yeah i totally understand that danica. Let us know what you do. Thanks for your first calls. Drop us an email or give us a buzz after thanksgiving eight seven seven. Three zero one. Eight thousand nine hundred seventy. I'm not sure you can answer this. One in light of the the question that was asked before dr ed from ohio. I don't know if he tweeted this in or emailed or whatever wanted to know if pfizer would consider essentially working with modern meaning. How likely it is that would happen. So that pfizer could replicate whatever process. So it's easier to store in less extreme temperatures. I'm guessing it's not that easy to change your Methodology right in the middle of the process. When you're about to get an approval. But i don't really know do you. Yeah i. I don't know that i mean i think at if you You got the two of them. If you've got pfizer to change his technology that would be amazing. But i think we are going to want to have as many vaccines out there as possible. And there are you know pfizer will work For large urban populations They can be distributed in large numbers. And they you know there's capacity for this minus seventy degrees celsius So i really. I don't want to throw the baby out with the bathwater. I think it's it's actually a a wonderful breakthrough technology as well And we may see again. That fis works really well for cities and maderno works really well for more rural areas where you can store it longer in the freezer you know a thank you for the whatever. It was the location. By whatever i just fall. Yeah are you confident. A doctor that whatever infrastructure needs to be in place to get this from these These manufacturing facilities to real people is is is good. I mean i mentioned last week and this may have been totally unfair I was watching sixty minutes a week ago. When this general per knows head of operation warp speed was on. And i have to say it was almost like an snl routine it. This is what the guy said. This is the head of operation warp speed. Who sang have everything under control. While these systems said he goes home at night every night and google all the terms that he didn't understand during the day during the discussions. I thought he was kidding. He was not kidding. Are you convinced that the infrastructure is in place to get this effectively from manufacturing to to my arm or your arm or martyrs. I actually saw that same sixty minutes and watched it with my i. You know. I was impressed by his humility that fact that he has all those little Acronyms up and he needs to be looking everything up all the time. But i but i you. I think there was look. The fact is is He he clearly is has a huge operation behind him. There are lots of smart people working on this twenty four hours a day And and i. And i think we are sort of building. The train tracks as the train is leaving the station. But i feel confident that we are. you know. we're going to have at least a capacity for this first round and we're during the first round. We need to be building capacity for the general population. One follow up on the martin. If i can. I'm sorry is we all know that those who have suffered most from the virus are part of the population that suffered most on virtually everything in this society low income people people of color which is in great part the clientele that you serve at boston medical center. Do you have any more confidence that even though we've heard all the fancy rhetoric about this and the good news was i think. Thirty seven percent of the people in the trial with madonna were people of color which is a good number from what i understand. Do you have any reason to hope that the way. The vaccine is distributed as more equitable than the way healthcare's distributed to such country. Look i think it's gonna again a lot of advocacy To ensure that its distributed equitably And i think simultaneously we need to be working on building up trust in those communities For this vaccine there's been shading warmest correct. There's been so much mistrusted zone Over the last six months. And and i in fact i have Patients who i've known for years and i'm very close to and we have very candid conversations and for the first time they're even afraid of the flu vaccine because they There's you know there's been a lot of sort of government You know Fingerprints over a lot of the vaccine conversation. So you know the the analogy sort of the story. That i think is important for us to remember again where the polio vaccine is remembering you know elvis presley lifting up his shirt sullivan show And can be like i anna presley ianna presley do that or barack obama or you know people who we've had a lot of trust in And show us that. It's you know it's okay to proceed And i think these things are really important. You know doctor because obviously the time of year. We're getting an awful lot emails about thanksgiving and people going through elaborate precautions woman that just called and had to go to the rapid vet appointment. This other person christian just said you know. She's she and her daughter had been quarantining for five days. They're going to get the pcr tests. Not the rapid the one. That's really much more definitive for thanksgiving but the family is eighty year old parents. One who has an autoimmune condition than often be a two month old baby there. I mean it sounds to me like what you're saying is even with all those precautions. If you're going to be inside at the dinner table for two hours on thanksgiving yes. That's just a bad idea period. No matter what you do. I think that there is risk. Yeah we'll be inherent anna. And i think people really need to recognize that there is risk and see what kind of rest they're willing to tolerate. So ideally if we're trying to be on the cautious side here what we should be doing for thanksgiving is outside around the fire pit or just not doing this big long. Yeah yeah yeah. I think differently about the food part of it right now. Really the highest risk. The highest risk is being endorsed together with your mass off likely having Eating likely having several glasses of wine our family sometimes do your guard really going down and and And then you know obviously am not at all trying to scare police. I think it's really just human nature. This is how we connect we especially if you've created a really nice meal you wanna linger over it so you know how could you Again it doesn't have to be that you miss all the fun part of the meals. But maybe you do you know a really great pie outside Or you know or eat very separate parts of the house. As is i think the at one of our callers suggested But that kind of takes away from some of the pleasure being together So again thinking outside the box. how about this maureen. I'll beating inside and everybody's just take your decision of labor. And whatever said lydia. You've been very patient to your natick. your own. with dr gregory burnett. Thank you very much for your call. Hi hi thanks so much. Love the show. Thanks a couple of my. I'm a widow pretty well as of two years and i have one son lives with for near you know nearby and we hugged. We put our masks on mass on inside and we we do a good hug before he leaves looking away without talking. You probably been doing that all along. Because i'll be damned if i don't go i love that. Yeah so i have a couple of things one is. I wondered if we can just if tv would start listing the people besides pbs which beautiful job on the news hour of of sharing people's stories from all over But like in the vietnam war and when we just we you know we faced the reality. I can't believe we're all that we have to go over thanksgiving. You know like we can't just see it as an opportunity to help one another. It blows me away. So i'm thinking the hospital should refuse to see people who didn't wear masks. I know they can't do that. But what can we do to get this across to people. Okay doctors i was i. I'm really personally i just. I'm so grateful you share that story of you and your son hugging. Just you know brought me a lot of joy. Look a you know every we all we all want to get through this together. We all want to get through this tunnel and get to the other end and be back end quote unquote normal life I think again. I think there's been so much politicization so much hatred so much not listening to one another So much listening to very different news. Sources that you know one of my things. I think a lot about. And i know i'm not alone. Is how do we so compassion for each other. How do we start to listen to one another and recognize you. Know what are people afraid of What are they most need what they most want. How can we kind of think creatively about finding some of that for people rather than just labeling good and bad you know i know the mask call has been very challenging part because it's been such a fractured message in our country and every state has done it differently and if we had a federal you know response to mass. It might have been different but we did you. I hope we get there in january But until then you know. I really encourage us to engage with curiosity with people. You don't agree with and see what's happening. Why are they resisting. And and how can we get each other some sort of middle ground. By the way. Can i just read a text. That speaks to this thanksgiving thing. Another one from a friend of ours shall remain unnamed. Everyone on our families cooking various parts of the meal were meeting outdoors at two pm on thanksgiving for a champagne toast and exchanging bits of the meal with each other than everybody takes it back to their own place to enjoy the festivities safely. I think that is a fabulous idea like forget the turkey just have d'oeuvres or something or whatever it is share with every time you take it home and you have a toast outside. Yeah that's great. Can i add i. Can i add a layer to that though. When you're when you're giving up all these delicious goods have just one person who's math not love to has set of utensils. It would be so sad if he were to all that effort and then everybody kind of help themselves. And then somebody was osita and they've been all over the ten zero. Yeah this is again thanksgiving. But it's not about the day itself is about kids coming home from college. Someone just emailed and said both kids coming home from college. Their athletes at college. The tested more frequently. But what do you recommend when they come back to their parents house. Quarantine them in their rooms. Retest them when they arrive. Not being aside the home but the two kids are gonna come home to their parents. Were they do. So if they're athletes they school. They're probably as the person said getting tested quite a bit so they need to be tested for three days prior to coming home and then not do any more athletics not do anymore seeing people And then after they arrive they really should quarantine and wait at least three or four days and then they can get tested again and then they can see their parents again. That is not a no risk situation. But it's minimizing the risk. Hey dodger thank you so much for this is really great. It was hugely helpful having thanksgiving out in the national park. Yeah billion now. Thank you very much need to take care of you to catherine gergen barnett is the vice chair of primary care. Innovation and transformation residency director of the department of family medicine at boston medical center at boston university medical school and we thank her again very much. Her time. coming up boston biz commish. Surely young. it's here to go over the latest headlines massive layoffs at the marriott the cost of shutting everything down next and eighty nine seven. Gbh boston public radio.

fifteen minutes mclane middleton boston medical center massachusetts pfizer department of family medicine boston dr gergen barnett fda boston mclean Yagan Dr catherine gergen Dr gergen barnett kotas cdc moderna ninety five percent jim pierre w seventy degrees celsius
NPR News: 06-11-2019 8PM ET

NPR News Now

04:58 min | 2 years ago

NPR News: 06-11-2019 8PM ET

"Live from NPR news in Washington, I'm Jack Speer. The house has voted to enforce subpoenas against attorney general Liam barred, and former White House counsel, Don Mcgann through the courts, the resolution passed today, allowing house committees to sued the Trump administration over subpoenas. They've already issued and others. They may issue in the future. Here's NPR's tame MAC in a party line vote, the house of representatives approved the resolution the latest ratcheting up of tensions between congress and the administration both Mcgann embar have declined to comply with subpoenas from the House Judiciary committee in its probe of the Trump administration. The measure also authorizes the chairs of other house committees to pursue legal action to enforce subpoenas for documents such as Trump's tax returns. Republicans pointed to the Justice Department's willingness to provide some documents to the House Judiciary committee, which was announced Monday. Trump supporters say that going to court rather than continuing negotiations could lead to a net. Negative legal precedent. Tim Mack, NPR news. Washington. House speaker Nancy Pelosi continues to push back on talk of impeachment proceedings against President Trump below say today saying such a move is quote, not even close in terms of having the support from House Democrats, it would require to carry out a vote Bozhidar press conference today said her stock goes up every time Trump attack cer- as you did last week. Trump made his remarks after it was reported. The speaker had privately told Democrats during a meeting, she would rather see him out of office, and quote in prison than impeach. Dozens of House Democrats have called on Pelosi to begin impeachment proceedings, the leader of the southern Baptist convention is using his denominations, annual meeting convinced church members to pay more attention to the problem of sex abuse by church. Leaders in Paris. Tom Jones says pastor JD Greer seeks to make it the southern Baptist congregations number one issue, Southern Baptists make up the largest US Protestant denomination. But their leaders have been slow to recognize how many Baptist ministers have. Engaged in sexual misconduct, particularly with minors. Pastor JD Greer in his opening sermon answered those who suggest making the abuse crisis, a top priority could distract from the obligation to spread the gospel. This is not a distraction from the mission brothers and sisters, protecting God's children is the mission of the church southern Baptist. Congregations have a high degree of Tommy, but the meeting will consider new ways to discipline. Those churches, that do not deal aggressively with abusers in their ranks Tom gjelten, NPR, news prices at the wholesale level took a slight bump up last month in the latest sign. Inflation remains relatively well-contained Labor Department announced states producer price index which measures the cost of goods before they head down the pipeline at consumers was up just one tenth of one percent stocks after opening sharply higher this morning gave back their gains as technology shares retreated. The Dow was down fourteen points. You're listening to NPR. Protesters. In Hong Kong, opposed to a measure, that would allow criminal suspects to be extradited to mainland China for trial continued to gather outside the semi autonomous Chinese. Territories legislature, with fertile demonstrations and strike actions. Planned protests over the weekend brought hundreds of thousands of people into the streets in prompted a police crackdown on Kong as largely retained its own legal and social institutions after its return to Chinese rule in nineteen Ninety-seven. The us preventative services task force has a new recommendation aimed at preventing HIV infections. And Allison snobby reports the task force is recommending doctors offer their high risk patients a daily preventative pill. This CDC already recommends true vodka a drug made of to antiretroviral medications has a powerful tool to prevent HIV infections. But fewer than ten percent of people who could benefit from the medication are taking it and researchers say the gap is most pronounced among. Black and Latino men, here's task force member, John Epping, who's a professor of family medicine at Virginia. Tech prep is highly effective at preventing HIV, if taken every day appling says he hopes more primary care providers will talk to their at risk patients about taking the daily medication. Allison Aubrey NPR news online retail giant Amazon says, it's getting out of the restaurant delivery business. The company announcing today it's four year old business venture failed to take off, mid fierce competition from rivals like grub, hub ubereats and door. Dash Amazon, restaurant's. Delivery service was available to prime members and twenty markets. This is NPR support for this podcast and the following message come from frame bridge. They make custom framing easy and affordable frame. Your art in photos at frame bridge dot com or visit their new stores located on fourteenth street and Bethesda row. Get fifteen percent off your first frame bridge order with code NPR.

President Trump NPR NPR House Judiciary committee NPR Don Mcgann Washington Trump Nancy Pelosi White House Allison Aubrey NPR Pastor JD Greer Amazon Jack Speer frame bridge church southern Baptist Tom gjelten Southern Baptists
For Her Head Cold, Insurer Coughed Up $25,865

NPR's Business Story of the Day

06:34 min | 1 year ago

For Her Head Cold, Insurer Coughed Up $25,865

"Shocking medical bills can tell us a lot about dysfunction in our healthcare system so each month. NPR and Kaiser Health News take a look at an example. December's bill of the month starts with a simple cold and takes us on a roller coaster ride through dubious lab billing practices and science correspondent. Richard Harris has our story from New York City. There's no question that medical bills are often higher inexpensive neighborhoods. And there's no question that this corner of New York City not far from grammercy. Park is one of the most expensive bits of real estate in the country. But still you have to ask if you go to a doctor with a cold sore throat. Should you expect a lab bill that tops. Twenty eight thousand dollars. That's what a Doctor Manhattan specialty. Care just off Park Avenue South charged Alexa casten. I caught up with this forty year. Old Public Policy Consultant at an office uptown. I started getting are really sore throat and so I decided to go. The doctor are to see if I had strep throat. I was leaving on vacation that next week overseas and so I just wanted to like have some antibiotics in case. It didn't go the appointment with Dr Arroyo Fatto La he was quick. She says a throat swab and a blood draw and she was out the door with her prescription for cold. Went away pretty quickly and she enjoyed her vacation. Yeah I get back about ten days later. There's several messages on my phone and I have an email from the billing department at Dr Patel. His office they tell her that Blue Cross Blue Shield is mailing her family a check for more than twenty five thousand dollars to cover some of the out of network lab tests. The actual a bill was over. Twenty eight thousand dollars but the doctor says they won't collect the twenty five hundred dollar co-pay. I thought it was a mistake. I thought maybe they meant two hundred fifty dollars. I couldn't fathom in what university would go to the doctor for a strep throat culture and some antibiotics. I would end up with a twenty five thousand dollar bell. This is perfectly normal. The doctor's office kept assuring her and they sent a courier over to her house to pick up the check. Did the doctor tell you what tests she was running. No did she tell you that. She was sending things to a clinician rape lab. That was out of network. No definitely not you went back back and forth a little bit with the billing people right you were. You made it clear that you are unhappy about this. Yes I made it very clear that I was unhappy about it in fact she told them she would report the doctor to the New York State Medical Board the tests question turned out to be DNA. Probes that we're looking for a smorgasbord of viruses and bacteria. Dr Renita Shourie. Sorry professor of Family Medicine at Georgetown. University School of Medicine sees no reason to run them in my twenty years of being a doctor. I've never ordered any of these tests. Let alone long seen any one of my colleagues students And other physicians order anything like that in the outpatient setting. I have no idea why they were ordered. Maybe maybe for a patient in the intensive care unit or with a difficult case of pneumonia. There could be a reason to run these tests. She says the ones for influenza are potentially useful. But there's a cheap rapid tests that could have been used instead there about two hundred and fifty viruses that cause the symptoms for the common cold. And even if you didn't know I know that there was virus a versus virus be. It would make no difference because there's no treatment anyway so no reason to run these tests. Alexa Kasdan also wondered whether running these tests and running up. Her insurance. Bill is even legal. Were Show Martin an attorney in Overland Park. Kansas who specializes in medical billing says that depends on the details. There are a lot of state law issues that could be involved. And there's a Lotta contractual issues. That could be involved in this particular issue. New York state eight has a surprise. Billing law patients need to be informed if they're in network. Doctor is referring attest to an out of network provider and to warn people that they could end up with a big bill. Real state laws also limit cousy relationships between doctors and labs that could be at play here. Insurance companies also have contracts with doctors say making insure lab tests are done in network but billing expert Martin says insurance companies aren't monitoring most claims as they come in most claims processing even for something a claim like this that you and I would read it after the fact and thank Gosh. This just seems outrageous to pay this much money for these. These types of lab services are often completely automated. There's never a human set of eyes that look at the bill and decide whether or not it gets paid the lowest prices in this case about twenty times the going rate in that Manhattan Zip Code Martin says in if the throat swab had been sent to lab core which is in the network for casten lab as it would have charged the insurer about six hundred fifty dollars rather than the more than twenty eight thousand dollars for essentially the same tests. It's Dr Fatality. Did Not respond to requests for comment and even though Alexa Kosten didn't have to pay practices like this still cost us. Martin says does she may not be paying anything on this particular claim but overall if the group's claims and costs rise everyone all the employees and their spouses. Paying into the health plan may eventually be paying for the cost of this after we started asking questions about this cast carrier Blue Cross Blue Shield of Minnesota launched launched an investigation. They acknowledged that review process failed to flag. This extraordinary bill. This at the doctor's office had not cashed the check so they put a stop payment Emmett on it while they dig deeper. Martin says people can take issues like this to their insurance company or state regulators or do some of their own legwork before leaving the doctor's office I always ask where they're sending my labs or where they're sending my images so that I can make sure that that's in network with my health insurance company. Dr Majoria Georgetown suggests taking an active role in your medical care. It is okay to ask your doctor. Why are you ordering these tests? And how are they going going to help you come up with a treatment plan for me and I think this is important for patients to be empowered and ask these questions rather than face with unnecessary testing unnecessary sairy treatment and in this case also outrageous billing and what did the twenty eight thousand dollars tests reveal about the cause of Kasdan sore throat. Not a thing she says. Everything was negative. Richard Harris N._p._R. News.

Martin New York City strep throat Doctor Manhattan Alexa Kasdan Richard Harris Alexa casten Blue Cross Blue Shield Blue Cross Blue Shield Bill Dr Arroyo Fatto NPR New York State Medical Board Dr Renita Shourie Dr Majoria Georgetown Dr Patel Kaiser Health News Alexa Kosten

Tuesday, May 5, 2020 - The Christian Science Monitor Daily

The Christian Science Monitor Daily

12:46 min | 1 year ago

Tuesday, May 5, 2020 - The Christian Science Monitor Daily

"Welcome to the. Monitor daily podcast. It's Tuesday Nathan. Thanks for joining us. I'm Dave Scott and I'm Rebecca Ulan. You've probably heard the expression pay it forward? Well one hundred and seventy three years later. The Irish are returning a favor in eighteen forty seven in the depths of the great potato famine members of the choctaw nation gave one hundred and seventy dollars worth about high thousand dollars today to Ireland. Why Long Distance Empathy just a few years before some sixty thousand native Americans including the Choctaw Cherokee Creek and other tribes had known suffering starvation and death during a forced relocation march known as the trail of tears today the Navajo nation has been harder hit by covert nineteen than any other native American reservation and many Irish have responded by supporting a gofundme campaign. That's raised more than one point. Nine million dollars for the Navajo and hoping nations in Arizona New Mexico and Utah. Thank you Ireland for showing solidarity and being here for US wrote Vanessa tally. One of the Navajo Relief Organizers Arizona on Monday Joseph Webb donated fifty dollars and wrote in remembrance of your ancestors and their kindness to the people of Ireland. We are one world and one people together. We will get through this. Be Safe clearly. Empathy knows no borders and kindness has no expiration date now to our five stories including protecting meat packers and the. Us Food supply the value of an online college class and the rise of reconciliation within families. Our first story Africa has much to teach the world about addressing a pandemic you combat fear and uncertainty health experts. Tell a reporter by building. Trust respect and compassion. Last month Massachusetts began an aggressive contact tracing program to stop the spread of Kobe. Nineteen led by the international charity partners in health. It's just one example of lessons. Experts are applying for past pandemics particularly the bowl outbreak. That killed more than eleven thousand people mostly in West Africa building ties to communities is so important to the work we do whether it's in Massachusetts or Sierra Leone says John Welsh of partners in health sitting with people and asking. Do you understand what this virus is and what you need to do to stay safe. Do you have the resources to stay home? That kind of knowledge happens through human connection at a person to person level. Those lessons seem especially pertinent in the United States as thousands of Americans have protested lockdown orders when people feel they're being treated children they treat responders like the enemy says non Ponta Trophy and lobby as Zimbabwe a nurse who worked for the World Health Organization during the outbreak. We forget over and over this simple lesson. We learned in West Africa. Listen to communities listen to their fears. Listen to why they are skeptical and then show them that their concerns matter. The story was reported by Ryland or Brown in Johannesburg for the Monitor reporter talks to meat packers in Waterloo Iowa about the realities of being an essential employees in the nation's food supply and protecting themselves and their families. What do you do on the people who help feed? America can't are won't go to work a Tyson pork processing plant in Waterloo Iowa offers a window into the challenges facing workers and businesses amid the pandemic. I understand that we are vital to putting the food out there for not just America but the whole world says one employee who tested positive for Cova nineteen but if we are so vital to doing that why not take care of us. The plant suspended operations on April twenty. Second One of about twenty slaughter houses and meat processing plans to have shut down around the country. Closures will have consequences for consumers and for hog farmers who now have nowhere to send their animals. I was governor. Senators and agricultural secretary have urgently requested. Federal help the pressures on plans to stay open are immense but staying open risk marginalizing the voices and wellbeing of those who keep them humming many of whom felt overlooked now mayors. Legislators and health officials are rowing around waterlilies workers with a local sheriff saying Monday that he was seeing massive improvements at Tyson. The story was reported by Christie's Bryant for the Monitor once the value of a college education. If it's not in person his the expense of an online class worth it. We look at why the GRADS are reevaluating. Their Higher Education Options Plainfield High Senior Devon Post has not enjoyed finishing high school online. He does not have Wi fi and his remote part of Connecticut and using his phone to create a hot spot for his Asian computer has been spotty at best so the idea of paying thousands of dollars for more of the same in the fall does not appeal to him. I need to be hands on. I don't know if the online courses can work for me. He says the first week of May has long been the traditional deadline for high school seniors to choose which college attend but with uncertainty surrounding the ongoing impact of covert nineteen. Many students can't bring themselves to put down the deposit. The decisions they make could have huge ramifications for institutions of higher learning some of which were already cash-strapped before the pandemic meant a financial hit worth hundreds of millions of dollars. I know they're getting a college. Degree is definitely a better start and you get better pay said Mr Post who enrolled at his first choice. The University of Massachusetts Dartmouth. But if they decide to do online this fall. I don't know if I can justify paying thousands of dollars in taking out loans. The story was reported by Harry. Bruin IUS and New York for the Monitor. One survey shows one in three Americans. Her estranged from family members but our reporter looks at why the pandemic is prompting some families to prioritize reconciliation and Grace Jazz. Colton told himself that he'd forgiven adoptive father. But his therapist disagreed on Mr Carlton in Melbourne Australia hurt. His father had been hospitalized with Kevin Nineteen. He had to decide whether to reach out. His father had expressed disappointment. His adopted son supposed lack of achievement. The two men hadn't spoken in six years. I've always felt that he wanted to return me to adoption agency. Because I was faulty says Mr Carlton Who Gay. I can never meet his high expectations. But the krona virus crisis hastened introspection. Everyone is false and I have many faults. He says especially at this time of the world. I'm trying to stop judging people and then you have to forgive them by stripping away. The customs comforts in circumstances once taken for granted. The crisis has led people to reconsider. What's most important and cause some to make efforts towards reconciliation forgiveness wants Mr. Carlton plucked up the courage to call. He felt a calmness. He had an experience during previous interactions. When the nurse told him that I was on the phone I heard. Dad Say Jeremy but it was a nice surprise exclamation says Mr Carlton. I told him I loved him than the conversation. I meant it says Mr Carlton who says he cried with relief afterward. This story was reported by Stephen Humphries for the Monitor. Our Father Stepping up during the lockdown. Taking on more parenting and housework duties. We asked some American deaths to tell us how their roles have shifted. During lockdown focus often turns to the parenting burden on women who already spent more time on childcare and housework but father spend about triple the time on child care per week than they did in nineteen sixty five and more than double the amount of time on housework according to two thousand sixteen report by the Pew Research Center how Couples Negotiate workloads during the pandemic is going to say a lot about our conceptions of gender right now says Daniel Carlson and associate professor of family and Consumer Studies at the University of Utah. I think a lot of people are going to have to come face to face with their own and their partners ideas about who's responsible for what the Monitor asked a few fathers around the United States have the crow viruses change their work and family life and what lessons. They're learning about divisions of Labor in the home. John griswold. A father three from California says he tries to help his wife make time for herself after caring for their children. She has the harder job. There's no ifs ands or buts about it. He says my clients. Don't scream at me when something isn't right. At least not normally. This story was reported by Chelsea. She sleep for the Monitor Now commentary on Ramadan TV. From the Monitor's editorial board people of the Middle East are quite used to the many attempts to reconcile Jews Arabs yet. Nothing has been tried on such a mass scale as a drama series being shown on one of the world's most popular TV channels during this year's month Ramadan. Since the series began to air in April it has dominated viewership ratings. Good time when families gathered around a television in the evening the drama centers on a Jewish nurse living in Arabian Gulf country in the nineteen forties. She and other Jews live peacefully in a village with Muslims and Christians as she lovingly brings healthcare to all all the show has plenty of intrigue it picks inter-religious Harmony before the nineteen forty eight creation of modern Israel and the later rise of intolerant Islamic groups such as Qaeda. The hunger for shared humanity is clear has millions of. Arabs are tuning in to a TV show about people. The three Abraham mcface living together. That's our news. You can find a full length versions of the stories in today's issue or at sea. Us MONITOR DOT com slash daily. Thanks for joining us. Come Back Tomorrow. For our next installment of comfort cooking baking without flour. Today's Christian Science Spiritual Perspective contributor shares. How it can sometimes seem like there's a lot we don't know but her health or economic stability but the realization that God's love is noble and his care reliable brings healing in peace as a father experience when his son became suddenly. Ill confined the column in today's issue or monitor dot com slash. David finally agrees note of gratitude to our staff including two audio production Richards and Jeff. This podcast is produced by the Christian. Science Monitor Copyright Twenty Twenty.

Mr. Carlton United States reporter Ireland Arizona Massachusetts Iowa Twenty Twenty Navajo Relief Organizers Kevin Nineteen Dave Scott West Africa Africa Choctaw Cherokee Creek America University of Massachusetts Da Vanessa tally
The Probiotics Heist

The Indicator from Planet Money

09:24 min | 2 years ago

The Probiotics Heist

"N. P. R. Alama Lawn is a pharmacist in Ontario. He Co own some of his own pharmacies and he's the director of pharmacy at Wealth General Hospital. He has seen shoplifters. Take all kinds of stuff usually come in pairs. One person usually distracts the pharmacist who's on duty and and the other person is able to to grab a couple of these items from the shelf. Alum says the birth control section used to be really big people steal morning after pills pregnancy tests and back a little while ago people were stealing sudafed because it can be chemically modified and used to make crystal meth breaking bad actually brought to everyone's wins and olive but this has been a problem over the last few decades. We're talking to threat or boxes. The sinus pills there ain't that many smarts in the world not going to need pseudo-ephedrine great job and see news you can use their God but lately long says a new product is being shoplifted. D- probiotics these are bacteria but the kind of bacteria that are supposed to be good for you. We'll explain them later. alums customers will come in. They'll see the price which can be really the high up to one hundred dollars a bottle and they don't have a prescription because probiotics are a supplement not a drug at least in the US so they get sticker shock. They don't WanNA pay or they can't. I pay so they steal. This basically comes down to affordability and cost but this is not a story about weird. Things get stolen from drugstores. This is a story about products that are unproven and yet we still buy them. The market for probiotics is booming according to the US Department of Health and Human Services the use of probiotics quadrupled between two thousand seven and two thousand twelve and according to grand view research the global robotics industry is expected to reach seventy seven billion dollars by the year twenty twenty five. That's our indicator today by the way seventy seven billion dollars but the jury is out about probiotics addicts. Science is still arguing this out on the playground. Do probiotics work or don't pay. It depends on who you ask yet. We continue to buy them even though we don't know no. I'm telling her shifts in for Stacy Vanik Smith and I'm Cardiff Garcia on today's show. How does a product but such a shaky reputation get on pharmacy see shelves. What can we learn about a probiotic from its price and why are so many customers willing to buy them. I mean it's hard enough to get people to take the medication that that we know does work more all that coming up right after the break support for this podcast comes from the John S. and James L. Knight Foundation helping NPR advanced journalistic excellence in the digital age so probiotics are bacteria they occur naturally in yogurt and fermented foods and a theory either solid or not depending again on who you ask is that if you take take some of the right bacteria and put it in your stomach. It will do good things. According to the Department of Health and Human Services probiotics might help your body's community of microorganisms microorganisms return to a healthy condition after being disturbed and they might produce substances that have desirable effects in influence. Your body's immune response. The government here is no help at all no so so sally instead you talked to a couple of doctors to get some help understanding this. Daniel Marion Stein is a professor of Family Family Medicine at Georgetown and researches probiotics. He says there are a number of indications. These are conditions or symptoms that would call for taking probiotics attics. It's completely unclear to me. Do probiotics work so they definitely work for the proper right. probiotic works works for the right indication not products work for all indications and not all products work for on different indications for his part doctrine says there's no question and there are about eight to fifteen specific indications for which taking probiotics can be effective like if you have a cocky child. Dr Berendsen says there's a specific probiotic biotic that can help for that but that doesn't mean you can just walk into a grocery store and pick any random probiotic. You have to use exactly the strain that's been proven to work but even before we get to the specific strains we already run right up against disagreement in the medical community. Doctor Eric Topol Studies probiotics at the Scripps Research Institute Institute a Nonprofit Medical Research Facility so you're so you're what you're saying just to make sure I understand you. Correctly is nothing out there right now. No product out there now well has proven to be helpful or effective in humans humans right. There's a lot of things that were great in mice sure so with all of this fuzziness outta products like these get on store shelves. The answer comes down to the way the government categorizes different items at the pharmacy probiotics are supplements something that contains a dietary ingredient intended to supplement or enhance the Diet probiotics are not drugs yes before a drug can be sold to the public the FDA has to approve it but with supplements companies are responsible for evaluating the safety of of these products themselves and the companies are responsible for evaluating their own labels and that self evaluation that is how probiotics and up on store store shelves. Dr Marion Stein doctor who was pro probiotics so to speak he says this system has some serious flaws. He did a study looking at just over ninety different different kinds of probiotics. Nothing was illegal but what he found was that if you read the labels two thirds of them had problems we couldn't figure out on most of them specifically typically what their strain was that. We couldn't figure out what their doses was. Sometimes they had claimed that wasn't really supported by the evidence they would claim on immune health when really all their studies as Regina Health and Dr Miran says there's another problem with the labels. Remember probiotics are strains of bacteria so he says that if and when you buy I one you have to know exactly which single strain to buy the many consumers don't understand that concept and so the companies that make probiotics take advantage of that ignorance appearance they use a familiar marketing strategy which is more product equals more value they advertise multiple strange bacteria and then charge more because they're selling you more more and so. Dr Marion says those probiotics ones that advertise multiple strains. Those are the ones with the most problematic labels what so the more expensive you've bottles the more expensive brands tended to have like sketchy or labels with less helpful information yeah and that's not surprising to us actually that these sort of hypothesized not to say that because you'll see these things. I just dump in different strains or not even strangers different species. You know well they have. We just don't know what they are. and they say you know we fifty billion or thirty billion. It's like a variety pack of bacteria like mysterious strain or species but detriments. Dean says that is not the way medical research works bacteria are complicated and expensive to study. You have to do it strain by stream which is why he says. The cheaper products the ones with just one kind of bacteria have the most helpful labels ones that clearly list evidence of what the probiotic inside supposed to do so why do people buy products looks like these the ones where the evidence is still not agreed on actually. That's the easy part Sally. We'll buy anything it's cheap. Pizza ponies me a pizza for opponent. Hey fits on the shelf. I'm putting it in the shopping cart. I don't care what it is now. Look Doctor Eric Topol again. He's a doctor who says probiotics are a scam. Unless you're a mouse. Here's what he he has to say about that. People pay a lot for a lot of things so you know they buy waters that cost several dollars you know are no different than tap water and a and if products are expensive probiotics. Some people are gonNA steal them in. Here's something that both of the doctors you spoke with Sally agree on. They say we need more regulation. Dr Topol says probiotics are just one example of the many medical products that don't have enough government oversight could be stem cells. It could be hydration duration clinics. It could be Ketamine Clinton you know there's so much of the stuff that is outside of the purview of the FDA and of course the total says probiotics belong in that space so what is a consumer to do with all this confusion. Sally herships help us out well we could look on the FDA's website which oh I did and I found a super helpful page titled. Is it a cosmetic a drug or both or is it so but I think I have a better answer. Oh yeah until toby reach a place of consensus on probiotics card. If you'll just have to trust your Gut oh wow you went there. This episode of the indicator cater was produced by Lena Sons Gary edited by Paddy Hirsch. Our intern is Nadia. Lewis indicator is a production of NPR uh-huh.

Eric Topol Sally herships FDA US Department of Health and Hu Daniel Marion Stein US N. P. R. Alama Lawn director Ontario Wealth General Hospital Dr Marion Dr Berendsen Ketamine Stacy Vanik Smith Dr Miran toby intern NPR Regina Health
His Sympathy Cramps

Feeling My Flo

11:13 min | 2 years ago

His Sympathy Cramps

"I started my period at eleven. <hes> i remember when i started growing breasts and is there like hard lumps on your chest and they hurt to touch and i was like what is going on my name's p._j. Brooks i am a trans man and <hes> i don't longer have periods technically but yeah i still experience some stuff. Welcome to feeling my flow a podcast for all things period. I'm communiqu ashani p._j. Uses he him pronouns. He grew up in california and arizona in a <unk> big family and like all of us. He wasn't sure when that first period was going to happen at age eleven. It came unexpectedly on a day that p._j. Was at his grandmother's house. I think i called my mom mel's lake. I'm bleeding for my vagina right now. I don't know what's going on and she was like i think he just started your period and i was like i'm freaking <music> out. Like what do i do next pages. Mom told him to tell his grandmother. She's going to the store to buy pads. Periods were a reality for p._j. Now and that was pretty tough for him. Every single period on like constantly reminded that i have a uterus and like i don't want one and i'm bleeding for no reason. I don't even want to birth kids so i'm just there with my thoughts. Having a period can cause gender dysphoric which sometimes happens to people who experience it's a mismatch between their bodily appearance or function and their gender identity. This was the case for p._j. Who came out as trans in college but we'll get to that later in the episode luckily as p._g. Entering into his teenage years he found someone to lean on his mom. They grew really close. I have so many great memories as with my mom but i think one great memory was my fifteenth birthday. <hes> she got the day pass for universal studios and for disneyland and and we basically spent the whole weekend together she knew i was getting into film and art so that's why she universal studios and i was like you know like you listen to me. At the time of the disneyland trip it had been four years since that first period and p._j. Notice that in the days before his body menstruating did he he'd get really bad cramps. After the first time it progressively got heavier so every period from then got heavier and heavier and worse and worse by high school. I was taking vicodin for my cramps. I'm now is leaving school early every first day because it would be so bad that that i just i couldn't focus. I couldn't do anything with peaches. Describing is called p. m. s. or premenstrual syndrome and when we started digging into p._m._s. for this episode assode we found out there's a lot of information flying around about what it is and how it affects people. We wanted to get a medical opinion so our producer. Mia went to visit dr yells at a board certified family physician. Dr swift is a professor of family medicine at columbia university and runs a women's health practice in new york city and so we will talk about p._m._s. a commune a lot of things but the main thing it means is that there's a change doctors wicca says about eighty percent of people report different kinds of mood or physical changes in the days leading up to ministration and sometimes they continue into your period area d- the symptoms themselves are really common <hes> bloating backache joint aches exhaustion like just profound tiredness for no good reason with with respect to emotional or psychological or psychiatric symptoms feeling really sad discouraged negative thoughts about yourself. The people you think llanview poor sleep and even on night sweats but the thing about p._m._s. that everyone has their own experience of it. Take me for for example. I tend to get ravenous cravings for meat. My body bloats in my emotions. Get intense just the other day. I found myself crying in over a bunch of puppies in the window of a pet store and the fact that i couldn't take one home i mean i like animals but not that much. That's what my p._m._s. is like <unk> but depending on the symptoms their options for how to treat them. There are ways to minimize the pain and bleeding. If that's what's happening crew other by using over the counter medicine like bupropion advil motrin the birth control pill can reduce pain and bleeding tremendously but if you really feel like it's interfering with your ability to be you then then you should seek treatments. That's just what p._j. Did when his p._m._s. was interfering with his life i had went to a doctor. She just kind of prescribed me some pain medication indication that was that we'll be right back with more on that. Thank you for listening to feeling my flow a podcast that sees and talks about ministration as an event that happens to all types of bodies n._f._s. monitors in different ways. I'm communiqu ashani the host and i want to i invite you to join the feeling my flow community by supporting us on patriot on making the show for you is our passion but there are real costs like studio time and travel and sound engineering off your support means that we can keep making beautiful show and we want to celebrate you joining us for federal month will give you a personalized shout out on social media for ten dollars a month out of feeling my flow glossy sticker and for twenty dollars or more a month also namedrop you in a future episode visit patriot dot com slash feeling my i flow. That's f. l. o. To join us and now back to our episode fast for two years and p._j.'s live started changing in some big ways he started college and because of the hormones he was taking he wasn't experiencing ministration anymore so now that i don't have a period it was like thank thank god. I don't have this anymore. I don't have to spend money on things that i don't need you know pads in like medications. College is also so <hes> p._j. Met someone special. Can i just take my jacket off because i moved out when i talk in very expressive. I can't help it. That's zoe. Johnson preaches girlfriend when we interviewed them. She's six gender which means her gender identity matches with what she was assigned at birth and her pronouns or she and her are they. I met through a mutual friend in their college cafeteria. She commented my basketball shorts. One time literally one time and i developed a crush. That's right after that. I i literally just like look nice like i like your outfit and then he like lifted me and he was like like the ways that thank you is like the cutest because you're like thank hugh. I was confused p._j. Started spending a lot of time together. They really clicked. There's a lot of love. There's nothing but love definitely more than two some something this. It's amazing in one word but it's also hard to sum up something so complex as well because i think our relationships very complex part of that complexity initially had to do with zoe's period every month when's always p._m._s. set in. She was dark cramping and craving certain foods. Am i mean when i get my period. I mean sometimes you get a little bit snappy but i think it's only win like you haven't eaten i'm and then i know i have to feed you. I mean her favorite food. Is nachos a lot of the time it's pasta. I liked to fill up with like steph says she could feel comfortable and then like go to sleep but every time zoe started messing p._j. Started cramping right alongside her. We usually get cramps around the same time and that's what really irritates me. They call them. P._j.'s sympathy cramps. I mean there was a time recently. <hes> i think right before you got your period. Yeah we were both at work and i had gotten really really bad cramps hence. Oh it's like those moments like dude. You know i get. It's cute but it's like knock you. The idea of it is here actually living at their sympathy. Cramps reminded me of another instance when a person experiences the physical symptoms of a loved one. It's called sympathetic pregnancy. It happens when otherwise healthy six gender men experienced pregnancy related symptoms while they're partners are pregnant things. He's like abdominal pain. Backaches even changes in appetite to figure out if zoey and p._j. Sympathy cramps sympathetic pregnancy. Mia axe doctors wicca gotcha well the experience of paint so subjective and complex. If someone sufficiently empathic they can open themselves up to certain kinds of experiences so pain is not a difficult experience to conjure up for zoe and p._j. When they sat down to talk about it they ended up reflecting on some deeper deeper aspects of their relationship. It's definitely a weird thing in our relationship because sometimes she forgets that i've had a period before <hes> that's because because i think you're trans. Nece is like more impressed upon like you than it is on me because i just see you as like p._j. The guy a new year selfish p._j. The trans men sometimes yeah so like it doesn't registered in me that you have had a period which i feel like it. Should i mean it doesn't really matter either either way but the reality of it is when she bleeds through her pants and i'm like you don't have to be embarrassed like i've led to my pants before we just gotta do this and this listen. You're gonna be okay that embarrassment that something's always still struggles with. I carry a lot of shame about like my period. Then i don't really know why are we came from but with p._j.'s help she's learning to change the way she thinks about her period like my partner always tells me it's a very normal thing time period. If you've got questions about premenstrual syndrome talk with the nurse practitioner doctor and if you're unmanageable a medical geico professional cup you find the right option for you address it feeling my foot was a resource to help. You start important conversations at critical moments when you're deciding. What kind of measure product is right for you. We're here to inform. Entertain and empower visit us at feeling my flow. That's out oh dot com and follow us on twitter facebook and instagram join the conversation. Thanks for listening. Thanks to jay born roslyn al monte shout out to our advisory board for weighing in earlier drafts up. This episode was produced by me a warrant our sound engineers carolina rodriguez. Our intern is emma forbes. We're production of lindsay williams and co host community kashani.

Cramps zoe cramps premenstrual syndrome universal studios P._j. partner Brooks mel basketball lindsay williams carolina rodriguez arizona california geico Mia emma forbes columbia university abdominal pain new york city
COVID-19s impact on routine breast cancer screening

The Current

21:30 min | 7 months ago

COVID-19s impact on routine breast cancer screening

"I am speaking to you at a moment of grave crisis. I'm jeff turner and this is recall. It's a series about history not the ancient past but history that still hot to the touch in this versus and i explore a revolutionary political movement. That brought a modern democracy to the brink. You can find recall how to start a revolution on the cbc. Listen app or wherever you get your podcasts. This is cbc podcast. Almost a year into this pandemic and fewer women are getting mammograms in canada. Doctors are worried that that could have serious consequences especially if it means a delayed cancer diagnosis in the first few months of the pandemic thousands of routine cancer screenings were put on hold anna maria pair. Coney waited months for a mammogram and she joins me now. Annamaria good morning. Good morning. I'm going to and i apologize for this. I'm going to ask you questions. I guess are pretty personal. But it's important to hear from you. So i really appreciate you being willing to talk about this. When were you supposed to get a mammogram. Well it would have been Back in march of twenty twenty. And why didn't that happen. well Everything closed down because of covert and that that was It was it was closed. And then i had to wait about six months to finally get into get a mammogram. Was that a routine screening. Or was that something that that you had been scheduled to get For a referral reason. From dr no. It was a routine screening. Do it every two years every year Was that what was that like waiting. I mean again. It's sort of the unknown but but we're sort of in limbo well at the time. I didn't think much of it We you know. There is no history of breast cancer in my family. So it's like okay. Postponed not a big deal. When did you get the mammogram Indicated end of august. And what happened. well About a week later or four days later. I got phone. Call that they found The call a a spot on the imaging. And i had a small tumor in. What am i what went through your mind when you got that call You know it was. It was kind of a not much. I'll be honest. I guess of a shock A little bit cervical Thinking okay Okay read and what do we do now. That was basically it i. I was surprised. Definitely surprised because i wasn't you know there's no history you don't expect you figure you're okay. And they found something on on a lymph node as well. They found a very tiny It's called a mic which is If you put your pen to a piece of paper and you get that tiny dot. That was the size of it. It was very very very tiny on one of the lymph nodes and because of that I had to have I guess the routine is you. Take five five lymph nodes are taken out to make sure that everything is clear. Besides that one note did your mind go back to the six months or so where you couldn't get the mammogram and wonder what was happening in that interim after the diagnosis later on i did You start thinking. Well if i had gone sooner. Maybe that tiny the on my lymph node. Maybe it wouldn't have spread to the lymph node. And maybe i didn't have to get that particular surgery done. It's it's you know. I mean they. They cut through it. It's they give you a nice Four inch cut. I guess so. I think they from the muscles and you know a little bit longer and recovery. So that's probably the only thing that kind of went through my mind. The size of the tumor. Maybe there would have been a bit of a difference. It was very small to begin with so You know the stage of the cancer wouldn't have may not have changed. That's basically it I'm glad that you know they find opened. I was finally able to get in because obviously the longer you wait. The more of a chance that the cancer was spread. So you've had treatment now. Yes i went through Obviously the surgery and Around radiation i actually very good. Oh i do have a little bit of that comes to side effect but other than that I'm i'm doing very well. I was saying in the introduction that mammograms screenings for cancer are down across the country because of the pandemic. And we're gonna talk more about how that's happening across the country in a moment but there are a lot of people who would find themselves in a position that you were in where things were closed. The couldn't go in for screening. You couldn't get You know your your routine physical routine checkup or what have you. What advice would you have for people who find themselves in that situation. The situation that you find yourself in waiting for that screening waiting unfortunately it has tight right The waiting part of it it can it can you know. In retrospect now it could be frustrating. Especially if you have a history of breast cancer in the family I like. I said i didn't think much of it but know i wish i had to go. I was able to have gone back in march. Maybe there would have been a difference. I don't know. I'm glad you're doing ok now and i really appreciate talking to you. Yes i doing very well. Everything seems to be going to waste supposed to so it's great. We're going to hear. Thanks again good to talk to you. Thank you anna. Maria perricone waited for a mammogram. She was unable to get at the beginning of the pandemic subsquently As you heard Diagnosed with a tumor has undergone treatment. We reached her in toronto. These delays are worrying for physicians including my next guests. Dr jean sealy is a professor of radiology at the university of ottawa. Head of the breast imaging section at the ottawa hospital. Doctor i shall offers is a physician with women's college hospital in toronto. Good morning to you both in your doctor. Sealy what do you make of what we just heard from annamaria there. I is her story a common story. It's very typical so anna. Maria made a really good point. She had no history of breast cancer and seventy five percent of women who get breast cancer. Have no family history or risk factors. So it's it's important that we screen all women who get breast cancer and that starting age thought forty on We had a marked decrease in screening. In fact we stopped in march when the pandemic stirrup started and we only started screening back up gradually resuming in june. So there's a three month gap in the Time period where we screened. And even now we've not been able to resume a normal screen volumes because we're using all the safe procedures for imaging so it were capacity is reduced by about eighty it down to eighty percent of what it was before covid so marie is very typical of many many women in the province of ontario and across canada. Especially is that your understanding of what's happening right across the country yes. I'm the president of the canadian society breast imaging and speak with sedition colleagues and technologists across the country. And we're seeing this across the country though. It's very typical. What about for you dr. lofter's you work in the center for women's cancers at your hospital. What are you seeing in your own practice. Yeah thanks i'm a. I'm a family physician vic- from that perspective. And i also work at the peter go for women's cancers and this is something that the clinicians the educators and researchers there are seeing concerns about And you know there's a very logical fear that people have about coming in because of you know we're spending global pandemic but what we're worrying because we're seeing. I'm women who are at school to come in for screening. They're scared to come in when they have a wrestling from. Happened other worrisome symptom. Because they're worried about coming in and catching coded so you know. There's a real worry the system just about like what are the long term effects going to be arthur and cancer diagnosis including cancer. Hindsight is twenty twenty. I mean dr silly talked about just stopping the screenings in march and we heard that For annamaria as well was that. I mean doctors you think in hindsight was that the right decision. Obviously we're in the midst of a pandemic and everything changed very very quickly in those days in march but it was stopping the screenings. The right decision you know. I think it's even too early to be talking about hindsight. I think we're gonna look back at a lot of decisions that have been made During colder to reflect reflection if they were at the right or the wrong decision. I think it was the decision Best decision to make at the time based on what we knew. But i think now we need to focus on that gradual. There's i'm sure to save a gradual resumption of screening in nineteen ninety-five. A college student disappeared on a trip across the usa. I report him missing right away. Went take it so. His mother started investigating the case file. I started going through install people that wasn't interviewed. I joined this mother search for justice or you recording us i. Yeah someone knows something season six available now. Hi i'm josh block. Host of uncover escaping nexium from cbc podcasts. I pull back the curtain on the secret of self help group that experts call a called and follow one woman's harrowing journey to get out. The podcast was featured in rolling stone magazine and named one of the best podcasts of two thousand eighteen in the atlantic listened to uncover escaping nexium on. Cbc listen or wherever you get your podcasts. Dr celia are you seeing nationally. A change in when women would come in for screening there's routine screening but then there might be screening based on something they discovered in self examination or a referral. So the the because when a woman has a lump of symptom Palpable finding or a change in in the breast that no longer is screening is called diagnostic and across the country. We are seeing more women presenting with palpable lumps And their cancers are being detected at a later stage. We're seeing more advanced cancers now than we were before the pandemic hit And i i. I want to emphasize what dr lobsters we you know. Hindsight is is something. I think we did the right decision at the time to stop screaming but what the problem is now is women. Don't know that screening is open. We will not stop it again. We've learned and we've adopted these guidelines. And so we're seeing more women delaying their screening and waiting until they have a lump and this is a significant problem because by the time they have a palpable lump. It's more likely like with anna. Maria to have spread to the lymph nodes and to have spread to the rest of the body so picking it up before symptom happened is much much better. And we know that correlates with a more than ninety percent survival if it's picked up with screening as compared with a palpable lump where it may have this a chance of survival that's reduced to eight percent five year survival or even lower if it's spread to the rest of the body. Tell me more about that. I mean in the six months at this pandemic Would have perhaps derailed or slow down or stopped screening. What would be the change in in that in terms of you know where cats are might be but also as you say survival rates. Well it's too early for us to know and we're starting a study to look at this because we believe that this is a factor that's happening across the country There was a a modeling study done by the group at sunnybrook and they used mathematical model called uncle sam where they estimated that a six months delay in screening would lead to six hundred seventy more advanced breast cancers in canada and two hundred fifty more breast cancer deaths in the next ten years and delaying that even more than six months which may happen with people stopping. Were naturally not referring themselves would lead to an even higher number of deaths so we are seeing this across the country. Seeing that in in your own practice dr. Yeah i mean. We're seeing people who are delaying their screening postponing their routine mammograms on your screening program site actually does have capacity so they are able to take people that we are seeing That hesitation for people to come in thinking. Well you know what. I've already put it off for this long. I'll keep putting it off until the pandemic is quote unquote over And you know. I would encourage listeners to you. Know if if you do call your local breast gaining program site asked them what their protocols are. Make sure that you safe and comfortable. And which. I feel confident that people will go. In one of your areas of research doctor. lofter's is on marginalized populations and we know this pandemic has not hit people equally That that there are different communities. That are being disproportionately impacted by what's happened over the last year or so do we know what sort of impact that might have on on this screening might have on those communities. We we don't have not a lot of evidence not a lot of data that we have available in canada to really tell us that. Certainly you know. There's always the concern that one there are pre existing disparities or inequalities in screening but something that hits the whole film can have disproportionate effect and actually increase those qualities. That's always a worry. And we don't have the data to show that. But except it's on on the lines of all of us who work in the area screening inequality or screen. So tell me more just briefly but that screening inequalities because not everyone is is able to or is taking advantage of the screening that might be available basically we we have our program and for women who are h. Two seventy four. I'm able to get mammograms once every two years in some cases one every year but not every woman is part of the best program on everybody gets mammograms done regularly and we know that particularly particular women are at higher risk of not being screened Because if things that shouldn't matter so things like their income levels things like How long have you been in canada. Folder factors that shouldn't play a role in universal screening program. That they do. And that's what we talk about when we call breath we're speaking about we talk with screen thirty bucks or see. We had a conversation last week on this program about The backlog if i can put it that way in surgeries indeed which were elective surgeries. But what is elective. And what is non. Urgent you know is a bit of a moving target for for a number of different people. And we're seeing this across the country coming out of this pandemic that health consequences are being exacerbated because people aren't being able to get the treatment that they need what needs to happen to clear this backlog caused by the pandemic and and ensure that people are actually getting the screenings that they need in a timely fashion. Well if Dr walter's mentioned that the discrepancies and one of the big areas. Is that our canadian. Task guidelines only recommend screening women fifty to seventy four years of age This is a very outdated recommendation. Because we know that black asian women in the us for example their peak breast cancer incidence occurs in the forties and white women Which the guidelines are based on peak Breast cancer in the early sixties. So we need to have more inclusive guidelines and we need to recommend An communicate to physicians across the country about the importance of screening women went breast. Cancer starts to peak an air incidents. We we really need a national strategy to encourage women to to screen particularly in kobe situation. And as you mentioned these discrepancies That we're seeing with covert are being exacerbated so I think that this is Something that requires a national strategy And not just Dependent on each province or that. Look like a national strategy. I think we need to get Group people who who understand the The issues who are experts in this Aware of the discrepancies and and ways to reach all the provinces to communicate. This better because I i don't think this is going to happen just with small groups. I think this really requires a coordinated effort so i would like to see Us taking a lead on this In canada letter loftus. What are you worried about. When we get to the other side of this people have used the phrase that there could be a sous nami of cancers because it's not just breast cancer rectal cancer other forms of cancers. That may not be screened in a timely fashion. Because of all of the reasons that we've laid out that people would be reluctant to come into a hospital go to a doctor's office or the capacity may not. Just be there when we get through this. What are you concerned about in terms of what we might be facing. I'm uncommitted what exactly that and that concerns so we screen for breast cancer cervical cancer colorectal cancer some of the providence. Have lung cancer screening. And i'm concerned that for all of those kansas where we've made great advances and are able to catch cancer is very early or even when are pre cancers that you know we're gonna lose from about benefit and we're gonna have Just like you said as nominee of cancer you know people diagnosed at a later stage and they would have been and you know thinking about all of the effects that follows down from that. I think we've we've all been rightly so very very focused on covert over the last year but all other health issues that affect us Are still an issue. And i think that one we step out of this world that we're gonna have to really be reckoning without. I was going to say once you step out of the covid world. you're already in a healthcare system. That is i mean. We're we're seeing it right now. It stretched to the limit perhaps beyond the limits physicians nurses people who work in that system are already at their breaking point. So what has to happen to ensure that you can catch up in some ways to deal with that backlog. Yes so. I think One thing we need to do to address the issue we're talking about about cancer is to help us get out of this world so we need to get people vaccinated. We need public health measures in place so that we can get the numbers down kobe so that people do feel safe coming in. I think we need to have conversations like this one where people here that it is. You know breastfeeding program sites. Your physicians offices are doing the best. They can with p. keeping people safe spacing them out. So you know do call your physician's office Do check your screening program site and see if they have capacity to take to take you in. I was actually said. The system is not shutting down again and we have to gradually resume all of these preventive measures that we were doing before. So what do you say just finally to your patients. I mean if they are concerned about coming in we're all being told to stay home and we're nervous but going anywhere. So i think we have divisions and you know i certainly take the time to explain to people that it is safe but are other job website. We actually put up a video walking people through. What's the experience like you know so that people know when you come in and says what's going to happen. You're not going to be sitting in a crowded waiting room like what you're used to before we doing everything that we can. So it's really responsibility for us in the healthcare system to let people know that it is safe to come in dr sealy in the final minute or so. That we have is that message. Do you think enough to get people to feel comfortable. Well i think it's great that you're doing the segment. I think it's really important to remind people that you don't have to have a family history of breast cancer breast cancer And it's safe Your technologist your physician will be wearing a mask. You will wear a mask but you're not gonna get covid your breast screening appointment And you know as i said cancer doesn't stop with covid We we really want to impact the negative connotation of delaying diagnosis. It's going to impact in the healthcare system. You're gonna be doing everybody a favor by getting an early diagnosis. So i really wanna encourage people to to get their screening and that includes all women not just oh vip but all women who should be screened important to hear from you both on this. I appreciate you taking some time to speak with us this morning. Thank you thank you very much. Dr asia lofter's is a physician with women's college hospital and associate professor of family and community medicine with the university of toronto. Dr jean c is a professor of medicine in the department of radiology at the university of ottawa and the head of the breast imaging section at ottawa hospital for more. Cbc podcasts go to cbc dot ca slash podcasts.

breast cancer cancer annamaria cbc routine cancer Annamaria canada anna Maria perricone Dr jean sealy ottawa hospital jeff turner canadian society breast imagin lofter center for women's cancers at dr silly josh block Dr celia
New Phase Of Pandemic Met With Confusion And Exhaustion

Consider This from NPR

20:27 min | Last month

New Phase Of Pandemic Met With Confusion And Exhaustion

"Welcome to consider this from npr. And w amu. After the top story from npr. Stay with us for a look at what's happening here in the dc metro region from the w. Amu newsroom on monday. Kansas city missouri joined the ranks of cities that are reinstating an indoor mask mandate for all residents whether they're vaccinated or not. It's just this feeling like i'm getting slung back into this horror film that i don't wanna be a part of anymore. Crystal wilmore told frank morris of casey. You are that. Although the city isn't in lockdown again even the return of some cova restrictions feels like a nightmare. And it's not as residents where feeling this way. Local businesses aren't crazy about the news. Either it was kind of like. Oh boy hair comes again cape. Blackman is a server at wine works in kansas city. She says the reinstated mask mandate will mean more hassles with customers which will cost her tips. She's really upset but she doesn't blame the public officials. I'm angry at the people who aren't getting vaccinated walking amongst us without their masks on because they can get away with it right now and it responded say disaster that's kansas city mayor quinton lucas because of the highly contagious delta variant cases are up almost eight hundred percent in the city since early june and the fully vaccinated rate in missouri is just over forty percent which is well below the national average. We are in an embarrassing position. A frustrating and disappointing position missouri. I need to take steps to keep our folks. Say lucas says he's following the lead of the centers for disease control and prevention which updated. Its masking guidance. Just last week the cdc's now saying that even vaccinated people are at risk of spreading the delta variant. That's why masking is recommended regardless of vaccination status but there's a caveat. The guidance is for areas in the country. Where the spread of the virus is quote substantial or high. That is really giving people some homework to do. And who likes to get up first thing in the morning and see what the levels of transmission are in your community. That's dr renita missouri professor of family medicine at georgetown university school of medicine. I strongly believe that masking up is the essential thing to do to combat this highly infectious variant that we have now the delta variant. But how it was communicated was indeed confusing. Consider this the pandemic is in a new and dangerous phase. That feels an awful lot like past. Vases we already lived through but this time there seems to be more confusion and more exhaustion from npr meltsa chain. It's monday august. Second support for npr. In the following message come from first republic bank first republik provides tailored financial solutions with extraordinary personal service designed to change the way you feel about banking learn more at first republic dot com member. Fdic equal housing lender. this message comes from npr sponsor. Why zandt a one. To one tutoring alternative to online classes offering live online personalized lessons in more than three hundred subjects. Head to w wisey a. n. t. dot com because it wise and we take learning personally. Npr's planet money. Summer school is now in session. Everything you want to know about investing from expert guests professors. You classes every wednesday to labor day and the planet money podcast feed. It's considered this from npr now. The cdc's updated guidance to return to masking was based in part on data from cova outbreak. Last month in province town massachusetts. It's a popular vacation spot on cape cod and the study looked at four hundred sixty nine reported cases. Three quarters of those cases were fully vaccinated people and all of this unfolded in a state. Where almost seventy percent of eligible adults were vaccinated another sobering detail. The study didn't find a significant difference in viral load. That's the amount of virus in infected persons carrying when it came to fully vaccinated people versus unvaccinated or partially vaccinated people. It is not a welcomed piece of news that macking is going to be a part of people's lives who have already been vaccinated that cdc director rachelle wolinsky last week along with the updated masking guidance. The agency also recommended that students and employees at k. Through twelve schools. Wear masks this upcoming school year. The science continues to change. Here's wolinsky on friday speaking with fox news and while that is neither simple nor easy to convey. It's my responsibility to keep the american people safe and as that science cove is going to be with us forever. Dr hamish adul- jaz an infectious disease. Doctor at johns hopkins university. This is a new respiratory virus. That's established itself in the human population. Efficiently spreads. It's not something that can be eliminated so we will have cova cases and it is going to become tamer more like other respiratory viruses because of the impact of the vaccine told. Npr that it's important to remember that even when vaccinated people test positive in these breakthrough cases. The risk of severe symptoms and hospitalization does decrease dramatically the overarching goal and many people. Forget this was not to eradicate cove in nineteen. That's not possible but to defend. I do think we're well. On the way to defending in taming this virus as more people get vaccinated and more people get natural immunity. We are going to see this. Turn itself into a seasonal corona virus that we deal with your in and you're out but aren't threatened in the way we have been in the past all right so let's get to the question on a lot of people's minds right now. Should i go back to masking up for me. The main issue was that new advice to mask up indoors was tied to where you live whether you live in a place with quote unquote substantial or high corona virus transmission. That's dr renita story from georgetown. University again remember she made the point that scrolling through your phone each morning to see the case rates in your county just doesn't sound like the most appealing homework. How often do you check it. It is such a confusing message and given that the delta variant is now the dominant variant in the country. I think a clear and perhaps more helpful message should have been something more uniform and universal. I spoke with missouri about these new guidelines. About what best practices look like as people are trying to stay safe but ideally not lose all of their new found. Freedom i mean practically speaking how difficult is it to do this kind of messaging clearly and effectively lake. Should we cut them some slack. Here i am a very very big. Cdc fan and i think they are the number one public health agency and the country. If not in the world. But i take it back to the original sin as i would call it was back in may with the reversal of the mask. Mandate and i think at the time the message was that if you were vaccinated you get to take off your mask and you'd be safe and and perhaps they thought that it would get more people to get vaccinated but that's not how the public read the message and a lot of people took it to mean that's a pandemic was over. It wasn't over then and it really isn't over now. But i think once you remove a restriction. It's really much more difficult to reinstate it and we all know that masking is a highly political arch affair these days. Can we talk about how politics are additional hurdle here no matter what the science i mean. There are a lot of people out there who think that masking requirements are a violation of individual autonomy. A lot of people who don't believe the data around vaccines how do doctors and scientists overcome that counter narrative. We pull our hair. We take a deep breath every day. We talked to people who don't believe in the science and it's hard and it takes a lot of patience but it takes more than the patients and the education on the one on one basis with doctor to patient or nurse to patient. this kind of misinformation. Disinformation requires a national intervention and changing policies changing recommendations frequently. It's definitely not helping the cause of sending uniform and consistent messages that the public can't believe in well. I'm also wondering missouri if you think that all this confusion regarding these new mask guidelines if that's actually distracting from the more important message here and that is people should just get vaccinated one hundred percent overall. We focus perhaps too much. Unmasking and masks are effective in preventing transmission. But i think ultimately vaccination is our best path to ending the pandemic in the cdc and the administration and all of us in the healthcare system. We need to come up with renewed efforts to get as many people vaccinated as possible in the us and in other countries because without more vaccination this pandemic is not going away. Mask on or off. Dr so we just heard that masking is into a good long term solution for the pandemic and that what it really comes down to. Is that more. People just need to get vaccinated. We've had dozens and dozens and dozens of people who've responded and written in and said i went and got the vaccine today or yesterday with 'cause it. This is mark. Valentine's speaking to here now on the half of his brother phil. Who's currently hospitalized with cova. Nineteen said you know. I made the decision based on my situation. But i know now that a lot of people didn't get the vaccine because i didn't get the vaccine. That is what i would like to correct. Fill is a conservative radio. Talk show host based in nashville and he's been a prominent critic of cova precautions and the vaccines take politics out of it. It's time for us to get together and five. This thank collectively. And just put all the conspiracies in microchips and all that business aside and go get vaccinated and don't put your family through what his wife unrest. I'm going through the people not taking the vaccine report. That the not very worried about kotik. Dr robert blended is a professor of health policy and political analysis at harvard university. Anybody been involved in vaccine. Campaigns knows that the step is i. People get worried. Just think about polio. When i was a child my parents just in our heads. These pictures of kids in iron lungs and children who have disabilities the rest of their life blended opole in the spring with the robert wood johnson foundation which we should note is an npr funder and the harvard teaching chan school of public health. And it found that there's a growing distrust towards agencies like the cdc and national institutes of health. So he says there needs to be a different approach in order to boost vaccination rates he spoke with. Npr's kelsey snell we've seen in the last few weeks an increase in vaccinate so there is some movement but i need to make a point of something that happened here north miami a collapse of a building where ninety eight people guide their pictures. Were all over the paper. How terrible it was. The president came down with a family. The governor did we have thousands of people dying every month. Their pictures are in anywhere. It's human stories that move them and they're not human stories. I don't know that. Susan just died that i know i know about her story. I don't know how grieving family is. So it's a question of personal connection with the stories that are being told that the numbers that people are seeing yes critical care. Physicians and nurses went on social media. And said i'm doing with people near death and they're begging for vaccine and they're saying they're sorry they didn't take it. Well that's a story that really could impact how people were saying. I'm not gonna take this vaccine. Think because it's people like that and they realized that they could be worried if they were going to be in that. Icu that's who people would trust and it would have to be local. And that's why the decision of the sixty medical organizations to recommend health organizations requiring their employees to absolutely take the vaccine has a chance of having a big secondary effect and these are all organizations that have local in community hospitals clinics medical groups and as they try to move their own employees forward. They are going to have an educational effect and they're not going to be seen as anything to do with washington. You so you believe that. Those changes will drive regular everyday people who might not have the vaccine to go and then get the shot. Yes and now. Here about it locally. And it'll be their voices alabama tennessee mississippi. Saying you just can't come to our hospital. You're endangering people's lives and it'll be a local voice of clinicians and they're likely to have people dealing with the critically. Ill and i emphasize this all the time. You want to talk about those get critically ill. It's like again when i was a child. Most people polio did not end up the iron lung by for parents that picture. It could be your child. A had a staggering impact on them. But we're now pushing a vaccine on people who aren't sure their risk of dying here and that's the message has to change and it has to come from people you trust for medical device which means if i live in nashville. It's gonna be a physician and nurse at institutions. I go to the tell me this. That's dr robert blended professor of health policy and political analysis at harvard university. You're listening to consider this from npr. I'm elsa chang. And i'm jonathan wilson with w amu with dc's indoor mask mandates set to take effect on saturday and the delta variants spreading quickly across the region. One local epidemiologist says the city's announcement is timely. Our reporter margaret barthel has the details. Dr amira roa's is an epidemiologist at george mason university. She says she's worried about sewing. Vaccinations and the emergence of the delta variant basically if you are unvaccinated and you're not taking the proper precautions you will get infected so it just makes sense at this point to go ahead and reimpose the mass mandate the mandate comes two months after the district lifted. Its original mask. Mandate into day after federal officials recommended indoor masking for all in areas with significant community spread of the current virus. It's not clear when the new mask mandate will end. Rose expects current a virus cases to continue to go up more and more children. Go back to school. We'll be seeing more people. Moving around kids tend to have mild cases of the krona virus but could spread the virus to other people. virginia governor. Ralph northam has recommended indoor masking but has not required it. Maryland also has no indoor mask mandate. It's considered this from npr. And w amu amid a week of high profile incidents of gun violence in dc including the murder of six-year-old. Nyah courtney mayor. Muriel bowser has been criticizing the dc superior court that has led to an unusual back and forth with the chief justice. I spoke with my consider. This co host. Rachel courteous to explain what this all means so. Dc's mayor mayor bowser of course a called delays at superior court quote a public safety crisis. Why is she saying that. Mayor bowser says there's a bottleneck happening at the courts and this is the data. She's using as of this june. They're more than ten thousand one hundred criminal cases pending there. And you can compare that to fifty seven hundred in january twenty twenty. It's important to remember that unlike states. Dc doesn't have control over its courts even for most local prosecutions in. It's also important to say. The dc superior court isn't unique in facing a backlog of cases. We're seeing that throughout the country or so we now know. The criticism of the dc superior court lead to something rare public response from dc superior. Court chief justice anita josie herring. What did she have to say. The chief justice told us that the courts have been operating throughout the pandemic. even if they've done that work a little differently that most court proceedings have happened virtually. She told us she decided to speak out on this because she wanted to make sure that the public knew that the courts have been working throughout the pandemic and dc superior court. Associate judge. juliet j mckenna. Who presides over the criminal division said that the criminal division has dealt with more than seven thousand cases over the past fifteen months through diversion agreements trials and more and that those numbers continue to ramp up and she says that even though jury trials only started this spring. They're actually just a small part of what the criminal division does most cases the overwhelming majority of cases in criminal division or not on a trial track. We'll never proceed forward to trial. That's always been the case both in superior for and in courthouses all across the country or right so it seems like both the mayor and her administration have data and the courts have their data to quote. I mean how do we parse through the two sides of this argument. I talked to misty thomas. She's the executive director of the council for court. Excellence and she says that the mayor said it isn't detailed enough to reach a conclusion. The data cited by mayor about number of cases pending at superior court and longer stays than usual at the jail personally. Don't actually tell us anything particularly specific about whether the courts have altered their procedures. Judges have altered their decision making during the pandemic in a way that can show us a connection to the incidence of serious violent crime in our community. So we asked dc police. Chief robert conti. About how many of these more than ten thousand pending cases have to do with violent crimes he said about five hundred or serious felony cases in the courts response to the mayor also didn't parse out which of the cases they site actually have to do with gun violence so ever is throwing these numbers out there but they're still a lack of clear data and while we're talking about the courts relationship too violent crime we should also know that. Dc's homicide rate was rising in the two years before the pandemic those numbers aren't coming out of nowhere and the increase in homicides preceded the courts pandemic related restrictions. Okay let's turn a different but certainly related issue. There are vacancies at dc superior court. Do we know what role that's playing. Yes and this is a place where dc mayor. Muriel bowser and the judges at the superior court agree with one another. There are a dozen vacancies on the court right now and everyone says we want congress to fill those. Those judgeships haven't been filled since before the pandemic and the mayor and the courts agree that these vacancies need to be filled to help deal with all of these pending cases. And get rid of that backlog. Thanks for joining us for consider this from npr. And w am you listen again next time. And we'll make sense of the major stories happening in the washington region and elsewhere in your world. I'm john wilson.

npr missouri dr renita cdc Crystal wilmore frank morris mayor quinton lucas georgetown university school o first republic bank npr rachelle wolinsky kansas city dc superior court Dr hamish adul Npr confusion dc
Matt Baker Pt. 1

Crimes of Passion

46:58 min | 1 year ago

Matt Baker Pt. 1

"Due to the graphic nature of these crimes listener discretion is advised this episode includes discussions of violence and sexual assault that some people may find offensive. We advise extreme caution for children under the age of thirteen. Haley smiled as she strolled around her. Grandmother's backyard mingling with the crowd at the family barbecue. Her uncles bickering among themselves. Her Aunts Were Gossiping. In the corner and her younger cousins were chasing each other around shrieking with delight all the chaos was oddly comforting but it was also a bit. Overwhelming ailey decided. She needed a rest from her family. The fourteen year old walked around the side of the house to a quiet part of the yard just as she was about to breathe a sigh of relief. She heard a noise behind her. She rolled her eyes and turn to see Matt Baker following her. Her stomach churned at the site of his smile. Matt wasn't intimidating exactly is big eyes and round face made him look like an overgrown kit and had five foot seven. He was barely taller than Haley even so there was something creepy about her cousin's husband. He didn't smile he leered. Haley didn't understand why her cousin Kerry was with him. Ailey quickly turned back around and try to ignore Matt but he edge closer to her and spoke softly in her ear yester- whether she was wearing any underwear under her skirt. Haley froze feeling her skin. Crawl she couldn't seem to find her voice to tell him off instead. She just ignored him until he finally left her alone. After all Matt was family. What else could she do? I in this crimes of passion a podcast. Original the legal definition of a crime of passion is violent crime that occurs in the throes of extreme emotion leaving no time to reflect on the consequences but in this. Show we explore. How relationships sometimes lead us to criminal activity. How does a husband and wife become killer and victim or killer and co-conspirator if there's a thin line between love and hate what manipulates our relationships into deadly results? You can find episodes of crimes of passion and all other park asked originals for free on spotify or ever. You listen to podcasts to stream crimes of passion for free on spotify. Just open the APP in type crimes of passion in the search bar at podcast. We are grateful for you our listeners. You allow us to do what we love. Let us know how we're doing reach out on facebook and Instagram at podcast and twitter? Act PODCAST network. This week we'll talk about Texas Baptist preacher Matt Baker and his wife Kerry Kerry thought she'd married a decent Christian man the perfect person to start a family with but carried in realized that Matt was a Predator with a decade long history of sexually harassing and assaulting young women. When Kerry started to suspect the Truth Matt Search for a way out of his marriage next week will discuss the tragedy that was initially overlooked by the authorities. We'll also talk about how the Waco community eventually mobilized to uncover the dark truth. Matthew Baker seemed to have grown up in chaotic household. His Parents Barbara and Oscar operated a group home for foster children in his hometown of curve. Ill Texas about an hour. North West of San Antonio Matt describe the environment as warm and comforting saying I learned Christian love. We were all brothers and sisters when they were in our house they were family but some of his foster siblings told a different story. Decades later a number of women came forward and said Matt's parents were abusive. They recalled incidents in which Matt's Father Oscar groped and sexually assaulted them one woman described Barbara as very harsh with her words very degrading. She used to be little people and make them feel inadequate and wrong. Barbara encourage some of the foster children to make fun of others with mental and physical handicaps but Matt refused to accept these accusations against his parents and denied any abuse. Perhaps his parents treated their biological children differently from the others. His mother leader described him as exceptionally well. Behaved saying I can honestly say I can't remember ever punishing Matt. That's hard to believe I know but it's true when Matt graduated from High School in Nineteen Ninety. Most people probably would have agreed. With his mother's assessment. He had a spotless reputation and received a partial scholarship to Baylor University in Waco Texas there. He majored in Church recreation and specialized in athletic training. But beneath the wholesome exterior Matt was hiding a predatory aggression as part of his studies. He worked as a trainer with the university's football team during his sophomore year. He met a young woman named Laura Wilson another student in the same athletic training program. One afternoon Laura was assigned to clean one of the student locker rooms and Matt offered to help. Matt made her feel uncomfortable right away. She said his behavior started out as simply obnoxious. He continually poked her with his broom. She repeatedly asked him to stop and he finally did but moments later he cornered her in a stall. Laura said that Matt picked her up and dragged her own to a bench. He forced her onto his lap in groped her between her legs. She screamed and fought but he ignored her after a few minutes. He let her go. She later said he didn't stop touching until he was ready to stop till he had gotten whatever it is he god. Then he left the locker room. Laura was left in shock afterward. She reported the incident to the head athletic trainer who promised her that he would take care of the matter. Laura later discovered that Matt had merely been banned from extracurricular activities. Not only that. But he'd started rumors about Laura calling her a liar. Many of Laura's classmates took his side over hers. Her mental health suffered both from the attack and the bullying she endured because of it she ultimately dropped out of Baylor. This wasn't the only accusation against Matt Baker at the time just weeks after attacking Laura while he was visiting his home in Curve Ville. He attended a party with his ex girlfriend from High School. Dna Errands Dina and Matt Hung Out at the Party and word. He came home with her. Her parents were out for the night and once they were inside the House Matt began kissing and Groping Dina out although they had dated before matt suddenly seemed different more aggressive. Dina recalled having to use all my strength to keep him from taking my clothes off me. He only stopped. When they heard her mother returned home Dina was unsettled by the encounter but she ultimately brushed it off. Matt got away clean in the spring of Nineteen Ninety two. The twenty year old returned to Baylor for a new semester. Instead of facing discipline for any of his actions he was given more opportunities one of his church recreation teachers. Jake Roberts offered him a job at the First Baptist Church of Waco Jake reportedly later said if I'd known about what happened at Baylor with that girl I wouldn't have hired him absolutely not but I didn't. No one told me as part of his duties at First Baptist Matt help run the Church youth summer camp in the summer of nineteen ninety four a nineteen year old woman named Kerry Doolan was hired as a camp lifeguard. Carry was a vivacious outgoing young woman. She had just completed her freshman year at Texas Tech University in Lubbock but she had decided to leave and come back home to our family in Waco. After her first year she felt there were too many parties and temptations at Texas Tech. She also thought that by being close to the Religious Baylor University. She might have a better chance at meeting. A Nice Christian guy to date and eventually marry when Kerry met Matt Baker a rising senior at Baylor and church employees. She thought she found the man she was looking for. A classmate said we were baptised. Girls Looking for the right man to settle down with and Matt talked a lot about faith. He sounded like a good boy. Active in Church and that was very appealing before it. Continue with Kerry psychology. Please note that I'm not a licensed psychologist or psychiatrist but I have done a lot of research for the show. Sociologists Stacey Keogh George conducted a survey at a small Christian college and found students were under immense pressure to get engaged before they graduate. Professor George wrote the Tagline Ring by spring signifies the tongue-in-cheek ambition of many traditional Christian College and university students to be engaged by the spring semester of their senior year while students and faculty may joke about the marriage obsessed culture it dispenses a social psychological burden that follows students particularly women throughout their undergraduate experience. Carey's eagerness to settle down letter to pursue Matt and he responded in kind. They began leaving work at the same time each night. And arriving together in the Mornings Matt made regular appearances at Carey's family dinners and parties and brought Kerry back to Carville to meet his own parents. The meetings were cordial but neither the Dulan's nor the bakers were thrilled with a couple. They all thought their kids were moving too fast but matt. In Kerry didn't care by midsummer. They were engaged curious. Parents threatened to withhold her school tuition if she went through with the wedding but she insisted that Matt was the right man for her. She didn't want to wait on August. Twentieth Nineteen Ninety four just a few months after meeting twenty two year old Matt Baker and twenty year. Old Carrie Doolan we're married. Carrie may have sincerely believed that Matt was the clean cut young man he claimed to be. She likely didn't know about Laura Wilson's accusations against him but months predatory behavior continued even at the First Baptist Church of Waco where he and Carey worked the same summer Matt and Carey began. The relationship. Matt allegedly pestered a teenage girl for sex. She reported his behavior. But it came to nothing. Matt's boss Jake Roberts said it was A. He said she said situation. I told him he needed to be more careful to not be alone with teenage girls. Who worked at the camp leader that summer? He reportedly sexually propositioned custodian as well she told her boss but Matt continue to deny these allegations because women had no proof. Matt was allowed to continue to work at the church. Eventually carry heard about these accusations but instead of having second thoughts about her husband she became defensive. She complained to her appearance. That women at work were flirting with Matt and then accusing him of sexual harassment as revenge when he rejected them. The vicious rumours infuriated Carey. She dunker nails into her palm as she stormed out of her parents house. Could these women say horrible things about Matt he lived a clean wholesome life committed to God? And when Kerry looked into his eyes she saw only love and tenderness Kerry wondered. Could these women be jealous? Maybe they struggle to live virtuously themselves and couldn't handle seeing her and Matt Succeed. Kerry continued a few Ma. She started her car and made the journey home. She caught herself speeding and forced herself to slow down. She didn't understand what was going on with her but she was realizing that being married was harder than she thought not because of Matt but because so many people around them seem to want them to fail. Kerry couldn't let them win. Her marriage had to be a success. She had to prove that dirty tricks in lies would never bring them down. She'd show everyone friends and enemies alike that love always one in the end. Kerry's parents saw how the accusations tore her up inside though they had initially been weary of the relationship. Now that Matt and Kerry were married they tried to support their son in law. Kerry's mother Linda later said we thought if he truly done these things he'd certainly be fired when that didn't happen. We believed him though Matt was never fired. He did turn in his resignation. In the fall of Nineteen ninety-five he graduated from Baylor at the end of the fall semester and took a job at the family. Why directing the Children's after school program in January of Nineteen Ninety six a few months after he'd started the job a CO worker claimed he groped her tried to kiss her and forced her to touch his genitals. However she didn't report this incident at the time carry remained unaware of her husband's behavior by then she was pregnant with their first child on April Twenty Second Nineteen ninety-six. She gave birth to their daughter. Kenzi over the next few months while Kerry devoted herself to the new baby twenty four year. Old Matt's pattern of abusive behavior escalated in June of nineteen ninety six three teenage girls at the Y. filed reports against him claiming. He was pressuring them to have sex when they came forward. The CO worker heat assaulted also told her story. Matt was immediately terminated from his position. He told Carrie that he'd only been trying to give counseling to the young women and they'd misinterpreted him. Kerry believed him around her. He was gentle. Even timid family members described her as the Alpha in the relationship Kerry couldn't picture her mild mannered husband attacking anyone even if carried out at his explanation. She couldn't bring herself to say it out loud. She may have felt that questioning Matt when against her. Faith one of the passages. She highlighted in her Bible included the first wives submit to your own husband asked to the Lord. This was something Kerry felt. She needed to work on. Perhaps she thought the verse required her to remain loyal to Matt. No matter what anybody else said left without a job Matt started a new path. He enrolled in Baylor's seminary school with the goal of becoming a minister Kerry to enrolled in the undergraduate school to finish her degree in education. Whatever happened in the past? She was determined to ignore it. She remained committed to Matt and their life together. Unfortunately for Kerry Matt was equally determined to continue victimizing. The women around him up next matt hides a secret. Life from Kerry as a couple suffers an unimaginable tragedy. Hi there have. You had the chance to check out the new podcast original daily float. It's a fantastic. Two to three minute. Podcast meant to inspire uplift and motivate your day. Three hundred sixty five days a year daily quote is hosted by my good friend. Kate Leonard each day she shares a meaningful quote from history and gives you the context in meaning behind it and right now. I am thrilled to be able to share. Today's episode with you. The quote comes from Canadian singer Songwriter. Poet and novelist Leonard Cohen. If you enjoyed this episode make sure to follow daily quote free on spotify or wherever you get your podcasts. Good morning and welcome to daily quote. A podcast original. I'm Kate Leonard. Today's quote is from the poet and singer. Leonard Cohen from his Song Anthem. He sings there is a crack in everything. That's how the light gets in Leonard. Cohen would have been the first to admit that life was far from perfect. There are flaws in everything. But it's precisely these imperfections that allow real beauty to shine through without the bad. We can't appreciate the good. We must continue to live and love knowing that the future will never quite work out exactly the way we plan but even so hope keeps us going by embracing our mistakes and looking at them as just another part of life. We can begin the hard work of better in the end. The light will fill the cracks and make our efforts more stunning than we can imagine. So instead of focusing on where you fall short of expectations try and find beauty to celebrate. Even when things go wrong there will be opportunities to improve. Share love and make life worth living. We merely have to follow the light. Daily is a daily podcast. Follow on spotify to make it part of your morning routine and let it inform the rest of your day. Daily quote is a podcast original. If you're listening on spotify you can share this quote with your friends on social by tapping the three dots in the top right corner of the episode. Page scrolling down to share and selecting your sharing option of choice. Remember you can find new paths positively every day of the year. Follow daily quote free on spotify. Or wherever you get your podcasts. Now back to the story by the fall of Nineteen Ninety six twenty five year old Matt Baker and his wife twenty two year old Carey had been married for over two years carry had just given birth to a new baby girl though the family looked to be on the right track in many ways matt was still a stranger to carry. He was a sexual Predator who had assaulted several women at work in school but no matter how many of his victims came forward Kerry couldn't or wouldn't accept the truth. It didn't help. That Matt always seem to get away with his behavior facing few consequences for example a teenage girl who lived in the house behind Matt and carries told her mother. That Matt had asked her if she'd ever kissed a boy he then grabbed her and forcefully kissed her himself but the girl's Mother didn't know whether to believe her. She thought the girl might be exaggerating. So nothing came of the assault by Nineteen ninety-seven Matt had been fired from one job for his predation but no criminal charges had ever been brought against him in November of that year his first victim from Baylor University. Laura Wilson decided to file a police report. It had been six years but she still suffered from nightmares and trauma from the incident. Unfortunately the statute of limitations had passed so again. Nothing came of it around that same time on November twentieth Kerry gave birth to a second daughter Cassidy Carey was elated with the new baby with Matt and the two girls. She had the family she always wanted. It seemed the bakers were blessed by God. The following Spring Matt was hired as a pastor at Williams Creek Baptist just outside of Waco he and Carey were warmly welcomed by the small town although reactions to his preaching style where mixed Matt Reference Modern Life and pop culture in his sermons to the point where some of the older congregants complained that he didn't preach enough from the Bible but the style resonated with younger members of the church his tone was more relaxed and less reproachful than the Baptist ministers they were used to he preferred to focus on love acceptance and forgiveness rather than sin in his sermons. He emphasized a does not matter about our past. Jesus takes us into his family while might lead. The congregation at the Pulpit Carey took on an active role in the churches. Well she led the Youth Group Top Bible Study and council teenagers. The family thrived but around November of nineteen ninety eight tragedy struck. Just after Cassidy's first birthday. The girl fell ill. She couldn't keep down food or fluids. She was initially diagnosed with the stomach bug but when she improve Matt and Kerry took her to the hospital there. The girl had a seizure an MRI reveal that the toddler had a brain. Tumor Cassidy was transferred to a children's Hospital and rushed to the operating room surgeons warned the baker that surgery would be risky. They weren't certain weather cassidy would survive it hours later. Doctors managed to remove the tumor but the girl remained in critical condition. She had developed. Almeria Dima and required a respirator to breathe. Doctors induced a coma to give the child a chance to fight for her life. Carey was devastated for her baby. She wrote in her journal. It is so hard to understand why this happened but all I do is pray. Matt is being so strong. He is so solid as usual. Kerry looked at her husband and saw only the best in Him. His flaws were invisible to her but despite the fact that his child was lying in a hospital bed gravely ill matt's thoughts weren't on his daughter instead. He was searching for his next victim. In January of Nineteen Ninety eight carries cousin. Lindsey came to the hospital to visit Cassidy. She brought a friend twenty year old. Aaron Calverley with her while Lindsay Kerry wherein cassidy's room Aaron weeded in the hospital. Game Room chatting with some of the younger patients Matt wandered in and founder there. Aaron told Matt how sorry she was that his daughter was sick. He responded by calling her beautiful and stroking her thigh even told her the hospital had given them a private room to stand during Cassidy's recovery and asked if she liked to see it. Aaron was horrified. All she could think to do was move away from Matt until Kerry and Lindsay returned when Aaron told Lindsey about the encounter. Lindsey wasn't surprised. Many members of Kerry's family thought Matt was creepy. Just didn't know how to tell Kerry with cassidy sick. She had enough to worry about so. The family kept quiet over the next month. The toddler's condition improved enough. That in lead February. She was cleared to return home. She still required tubes to assist with her breathing and eating but her parents learn to clean and care for them at home. They also hired a nurse to help them. During the day at Night Cassidy wore a monitor. That sounded an alarm if her breathing stopped. Her family. Took every precaution to keep their baby. Healthy and doctors were optimistic about her recovery. But on the night of March Twenty First Nineteen Ninety Nine. That all changed around midnight. Matt went into check on the girls to make sure they were sleeping then returned to tell Kerry they were fine but less than ten minutes later. He decided to check on them again. According to Matt that's when he discovered that cassidy wasn't breathing for whatever reason they hadn't turned on her breathing monitor that night. Kerry leader told family members. That Matt didn't think the toddler needed it? Matt called for Kerry to call nine one one and he began performing. Cpr on his daughter when an ambulance arrived first responders rushed the child to the hospital. But doctors couldn't revive cassidy. She died early that morning. March twenty second for Kerry. The grief was overwhelming at the funeral. Her parents had physically support her so she could walk to her child's grave but many other members of the family were shocked at Matt's reaction. He didn't seem upset at all carries aunt. Nancy later. Said you don't have to cry. But it didn't seem right that he walked around like it was any other day. As people gave their condolences. It looked like Matt enjoyed the attention. Carry me over. Lived some of Matt's behavior in the past but his non-reaction to their daughter's death finally attention Matt didn't seem to feel any pain at all. You returned to work as minister of his church just a week. After cassidy's funeral Kerry couldn't understand it. Unfortunately marital problems are common following the death of a child. One nineteen eighty-seven studied by Darren. Lehmann Camille Wortman and Alan Williams found that divorce rate among bereaved parents was as high as eight times. The norm another nineteen ninety. One study by John Defraigne a professor of family and community development at the University of Nebraska. Lincoln found that a grieving parent may indirectly blame his or her spouse for their child's death as a way of dealing with the pain Kerry asked a friend. Why is it tearing me apart and Matt's acting like nothing happened? She even wondered if Matt was relieved. That cassidy was gone. It almost seemed like he had viewed her illness as an inconvenience and was happy. That things could finally get back to normal. In her journal Entries Carey wrote letters to her late daughter. In one she pleaded. Help Me Fall in love with your daddy again. Carry sat at the table and stared down at her journal. She felt lost at sea. Just getting out of bed. Each morning seemed impossible. It wasn't just the grieve. It was the loneliness she felt so completely alone she and mad. Were supposed to be in this together. Both of them had lost their child. But it seemed the burden fell entirely on Kerry's shoulders Matt seemed a world away like he'd already moved on to some happier future. She couldn't catch up to him and she didn't want to. Not if it meant letting go of her daughter Kerry pushed away from the table and began to pace back and forth. Perhaps she was being too hard on Matt. Maybe he was just trying to keep the family functioning. Maybe she wasn't being fair. The pain might be unbearable for him to and he just didn't know how to show it Kerry Clung to that thought it had to be the truth. The idea that they'd lost cassidy and he'd simply moved past. It was too cruel to believe carries feelings or conflicted but as always. She wanted her marriage to work. She tried to steer her life in a positive direction in November of nineteen ninety. Nine about eight months. After Cassidy's death Kerry told friends that she was pregnant again in May of the year two thousand. She graduated from Baylor University with a degree in education on July eighteenth. She gave birth to her third daughter. Grace despite these welcome changes Kerry now twenty six years old still struggled with anxiety and grief over cassidy staff. That fall doctor prescribed her ambien to help her sleep after trying. It carried cited. She didn't like the way the drug meter feel and never refilled the prescription. Instead she purchased a mild over the counter sleep aid a generic version of the drug Unicom but other worries plagued. Her at one point carry discovered that their bank account was overdrawn due to phone sex and pornography website. Charges Matt told her their debit card had been stolen. Whatever other troubles they had in their marriage Kerry still trusted Matt and accepted his excuse curious in prepared to confront that possibility that he was capable of lying to her face so she did her best to move on. Meanwhile Matt had trouble Securing Permanent Minister position over the next few years. The family moved often as Matt bounced around from Church to Church. Even when he wasn't being accused of harassing women he seemed to Rub many congregants. The wrong way one. His former church member said he was arrogant. Another claimed he'd caught Matt brazenly lying on several occasions. Everywhere he went matt seemed to cause problems but carry still. Couldn't face that reality carries aunt. Nancy said blessed carries heart. She just wanted to believe in Matt. She defended him through thick and thin in two thousand five. The family returned to Waco now. Thirty one carey took a job. Teaching third grade at the nearby elementary school. Thirty four year old Matt found a position as a chaplain with the Waco Center for Youth Detention Center for teenagers with behavioral problems. A few months later he was also hired to lead the congregation at Crossroad Baptist. Church in Lorena. A suburb of Waco just like always carry was Matt's biggest cheerleader. She encouraged co workers and friends to join the small crossroads church. She was proud that he'd found a new flock. Of course Matt was anything but a noble shepherd. He soon became interested in one of his new church members. Twenty three year. Old Woman named Vanessa Bulls. Vanessa was recently divorced with an infant daughter. Lily Kerry had a soft spot for Vanessa and lily because she thought Vanessa's baby looked like her own loss child cassidy. She mentioned the resemblance to more than one friend throughout the fall of two thousand. Five Kerry didn't realize that Matt had noticed Vanessa too and his feelings were anything but innocent coming up. Matt has an affair with deadly consequences now back to the story thirty one year old. Carrie Baker had endured the devastating loss of her young daughter. Cassidy but by the fall of two thousand five. She regained high hopes for her future. She had a wonderful teaching career. Many supportive friends and family in her hometown of Waco Texas and two beautiful young daughters. She believes she had a wonderful husband as well. A thirty four year old Minister Matt Baker was hiding a history of abuse and harassment against women for years. Matt had terrorized women. He worked with by groping them or making sexual comments. He had also made some of Carey's friends and family members uncomfortable. He wasn't necessarily violent what them but when he talked to carries female cousins and nieces his comments were suggestive and flirtatious. One of the members of Matt's New Church in Waco soon discovered the site of him. Twenty-three-year-old Vanessa was the daughter of Larry Bulls the music minister at Crossroads Baptist. Vanessa have been living with her parents in separating from her husband and often attended church with them. Vanessa leader described herself as a strict southern baptist. Perhaps she saw the Church Minister Matt Baker as an unquestionable authority figure in one of our first encounters with Matt. She was sitting alone in the church. He came over sat next to her and commented. Whoever finds you is going to be a lucky man? He told her that he often council people going through a divorce. He thought he might be able to help her. The exchange stuck with her later in December of two thousand five. Vanessa attended a church potluck. She was talking to friends about her. Divorce being finalized joking about eventually dating again afterwards. She found herself alone in a hallway with Matt. He asked if she did her pastor he went on to say he had a. Septa me and was free of. Std's so she wouldn't have to worry. When Vanessa asked if Matt would really cheat on his wife he told her Carey is clueless the following month. Vanessa's parents left crossroads to attend their old church in Troy. Vanessa continue to attend services whereas other women had rebuffed Matt's advances. She was interested. She later said that was a point in my life where I wasn't thinking straight. She was a single mother with home or steady income. According to Vanessa she wasn't exactly attracted to Matt but felt safe with him because he was a preacher. Matt began calling her regularly at her parents house. He said it was to offer her counseling but he seemed to spend most of their conversations criticizing Kerry. He called her a bad mother and cold wife. He even claimed she to kill herself once before shortly after their daughter's death he said she tried to take too many pills and he stopped her. Now he told Vanessa that he regretted intervening eat. Wished he'd let her kill ourselves so he'd be free in early. March after weeks of speaking on the phone Matt invited Vanessa to his house. While carrying the girls were at school. He claimed that he was still interested in providing divorce counseling. When Vanessa got to the Baker's House Matt asked to hold her hand so they could pray together then he kissed her and let her to the bedroom where they had sex if she had any regrets afterward he used his position as minister to soothe her. He reportedly told Vanessa. You don't need to feel bad. It doesn't matter what anyone does. Just ask God to forgive you. Kerry didn't know about Matt Vanessa Bulls but she sense that something had shifted in their marriage. Matt didn't seem interested in having sex with her anymore but when she brought it up with him he turned the blame on her accusing. Kerry of pushing him away. Kerry couldn't understand it. She knew despite Matt's denials that he had changed she didn't know why Carey Press Matt to explain what was going on instead. He attacked her. E cleaned that Kerry treated him like a Butler Cook and babysitter rather than a husband. He cast himself as a blameless father who did everything for his little girls while Kerry didn't give him any credit for it even insinuated that Kerry was partly responsible further daughter death because Kerry had prayed that the girl would be free from pain. Curious deeply hurt by Matt's words after that exchange. She called her mother Linda to tell her the marriage was in trouble. She thought they might be headed for divorce. Linden important the relationship was to carry. She urged her daughter to try to make it. Work Kerry pressed the phone or ear trying to keep herself from sobbing. She didn't know how to explain to her mother that her entire world had shattered. She'd always try to stay so positive to present the best picture of herself. Her family and her marriage even after the hardship in grief. She prided herself on staying strong and optimistic. How could she face anyone now? That she'd failed at the most important thing in her life. She was supposed to be a good wife. A minister's wife loyal and encouraging she was supposed to tend to her marriage like a garden but she'd been careless now they'd forgotten why they loved each other carried till the deep breath and trying to clarify her thoughts. Perhaps her mother was right. The just needed to put in the work. She had to remind Matt how much she loved Him and force him to remember how I felt about her. Instead of divorce Carey decided that she and Matt needed to boost their sex life. Kerry told friends that they were trying to go on date nights and revive the romance but she may have felt doubts that she didn't share with her friends or with Matt around this time she wrote in the margins of her Bible. Lord I am asking you to protect me from harm. I am not sure what is going on with Matt but Lord helped me find peace with him in April of two thousand six. She visited her doctor told him she was suffering from anxiety. She wanted a prescription for xanax. But her doctor disagreed and prescribed an antidepressant instead. Carey was aggravated assisted. That she didn't feel depressed on her way out of the doctor's office. She ripped up the slip that afternoon Matt Trove. Her home from the doctor's office at one point they stopped at a stop sign and carry opened the car door for a breath of fresh air. Matt grabbed her as if he thought she was going to jump out. Carrie laughed as she recounted the story to our family later she seemed amused at how overprotective Matt had been but Matt told the story differently he said that Carey had tried to leave from the speeding car while they were on the highway. He seemed to want everyone to think that Kerry was suicidal. Others may have seen this as a sign. That Matt was worried about his wife. Only Vanessa Bulls had reason to believe otherwise. As Fair progressed Matt became more and more bitter about his marriage. He complained Vanessa that he was tired of Kerry. He didn't want to get divorced because it would ruin his career as a minister but he wanted her out of his life. According to Vanessa Matt began concocting outlandish ways to kill carry and get away with it. He talked about tampering with the brakes of her car. Arranging a drive by shooting or hanging her to make it look like a suicide at the time. Vanessa thought he was exaggerating. Matt also begins scouring the Internet for ideas on his work computer. He researched overdoses and prescription drugs. For years. Carry had refused to see match shortcomings but once he started plotting her death. She finally seemed to sense that he might be dangerous. One night she opened Matt's briefcase and found a medicine bottle filled with crushed up pills. She asked mad about it and he told her that one of the troubled teenagers from the Waco Center for youth must have hidden the pills there while he was at work. When Kerry checked again later. The bottle was gone on Monday. April third Kerry visited a therapist Joanne Bristol. Who had helped her. After Cassidy's death. She told Jillian about the ups and downs of her life. She steamed proud of her work at school and her daughters progress but she said that her marriage was off track. She told her therapist. I think Matt's having an affair then she added. I think Matt's planning to kill me as soon as she said it. She backtracked in laughed. It off carried told the therapist. She was being ridiculous. Matt would never hurt her. She then change the subject to our hopes for the future. She talked about her goals. She said she wanted to spend more time with her children and work on her marriage. She left the session feeling optimistic. Though carry had a gut feeling that something was wrong. She ignored it. People often downplay their own instincts according to neuroscientist and medical doctor. Cairo Bob Annette. When an instinct doesn't conform to our self image. We often try to deny it. She stated our subconscious is constantly screening every experience action with the question. Is this me or not? We buy clothes eat food or post things on social media that fits the image of while rejecting anything that is not me including an instinct that goes against two. We think we are carries. Instincts told her that Matt was dangerous. But this conflicted with her image of Matt as a Pious Minister and herself as his loving wife confronting reality would force to admit that everything she believed about her life and marriage was ally that she had been ignoring the warning signs for years. She couldn't bear to admit she'd been deluding herself. So carry continued on as if nothing was wrong on Friday April seventh. Carry Hannah job interview to teach at a middle school. She left feeling overjoyed. She called her mother to say it had gone well after the interview. She went to the elementary school where she worked. She chatted with other teachers about her summer plans and discussed a party. She wanted to attend that Saturday for her grandmother. She had no idea. That Matt was at home on the phone with his mistress. Vanessa Bulls Matt complained that he was depressed. All he wanted was to be with. Vanessa he was tired of life getting in the way of their love then. Matt told her his plans for the evening he was going to kill. Carry Baker. Thanks again for tuning into crimes of passion. We will be back Wednesday with part two of Matt Baker Story. We'll talk about Matt's deadly plot to be with his mistress and the lengthy battle to bring him to justice. You can find more episodes of crimes passion and all other podcast originals for free on spotify. Not only spotify already have all of your favorite music but now spotify is making it easy for you to enjoy. All of your favorite park asked originals like crimes of passion for free from your phone tap or smart speaker to stream crimes of passion on spotify. Just open the APP and type crimes of passion in the search bar and don't forget to follow us on facebook and Instagram at podcast and twitter at Parkas network. We'll see you next time. When true love meets true crime crimes of passion was created by Max Cutler and his park studios original executive producers include maximum Ron Cutler sound design by Trent Williamson with production assistance by Ron Shapiro Carleen Madden Aaron Larson? This episode of Crimes Of Passion was written by Christina. Tammy's with writing assistance by Abigail Cannon. I'm Laney hops. Remember you can find new paths positively every day of the year. Follow daily quote free on spotify. Or wherever. You get your podcasts.

Vanessa Bulls Matt Matt Baker Lindsay Kerry Matt Vanessa Bulls Cassidy Carey Kerry Doolan Waco Matt Succeed Tumor Cassidy Baylor University Matt Trove spotify Nineteen Ninety Laura Wilson Texas High School Vanessa Bulls facebook First Baptist Church of Waco
How to Cut Down on Sugar, With Kathleen DesMaisons and Dr. Yoni Freedhoff

The Upgrade by Lifehacker

46:22 min | 1 year ago

How to Cut Down on Sugar, With Kathleen DesMaisons and Dr. Yoni Freedhoff

"Hello and welcome to the upgrade the podcast from the team at life. Hacker where we help improve your life one week at a time. I'm Yeah Melissa. Kirsch editor in chief of lifer. And I'm Alice Bradley. Life Hackers deputy editor. And today. We're talking about sugar. You know. Sugar the White Devil. The Shadow shadow the Devil's candy playmate of Satan guests the devil itself everywhere. You look. There's news about how sugar is making fat. It's making you tired. It's making you stupid than why must it be so delicious. I cannot answer that question but I think we're going to talk to people who can we are. Some studies have shown that high sugar diets are linked to impaired memory as well as reduced brain volume. It's also been associated with an increased risk of depression and of course study showed that it's been linked to uh-huh BCC and diabetes and cardiovascular disease and yet it's so delicious you know. Alice is killing cruel. I'm eating a snickers bar right now. It has been recorded this well. Well at least you're not eating Wipe flower because that's GonNa true one bite and you'll be my God. Yup Our producer Michaela Heck spoke with addiction specialist Kathleen dame as zone. We talked about her approach to gradually cutting down sugar. The really ironic thing thing is because we've done this background ahead of time. And basically rewire the brain going. Off of sugar is a non the event Kathleen HD addictive nutrition and is the author of potatoes not PROZAC simple solutions for sugar addiction. Note here that the concept of sugar addiction or food addiction is contested in the field of science and in medicine and we're not trying to claim any particular stance on the issue. We're just interested interested in what these people say. Which is why we also have Dr Yoni Friedhof on the show today? Dr Friedhof is director of the Bariatric Medical Institute in Ottawa and the author of the Diet facts why died fail and how to make yours work. Our Senior Health Editor score. I spoke with Dr Friedhof about the controversy around quote Unquote Sugar Addiction Addiction and got his tips for how to reduce your sugar intake. The other thing that's really crucial. I think in trying to decrease sugar is eating in a pattern that for the individual leaves them more happily satisfied. Hails yes Melissa cost me about your relationship with sugar and bequeathed established already that I am something of a fan really really I yeah. I've got a sugar sugar to like. You haven't just melting sugar. One that would be delicious the decision yeah like riddled with cavities. But all your are in one tooth bills sugar tooth Sugar to Israel bad. Yeah or sugar to the sweet talker. Yeah I've I'm I'm I'm fish. I guess if there is such a thing as a sugar addict I'm thinking I meant what does that look like I feel that I need to have dessert after every meal including breakfast. Wow Yeah what is breakfast is it looked like it is like a ball the Sunday but sometimes I just like I just have to have something a little bit sweet design little like maybe a couple of nibbles granola or something like or I. I just have a sweet breakfast. which is your granola? which is my as you know one of my favorites? But you're not like drinking two liter bottles of coke. No I tried right ovoid I I feel like if I'm going to be ingesting sugar. It's going to be in the solid form. Yeah Yeah So. It's like a sweet treat. We treat like a sweet treat. Yeah I think that's fine. I personally personally think it's fine in balanced like I don't Overdo it and you know I don't know even if I did overdo it occasionally. Don't judge me well it's killing you. She's they talk about your relationship with sugar. I mean we can talk about my relationship with sugar. What's what's your she? Now have no relationship with sugar. Because I'm not eating any sugar must have been It's it's been tough. It's been I can tell you. Probably precisely how many minutes Now the sugar. That's tough gave up all sweeteners in October. And I thought that would be very easy because I don't have sugar tooth like you do but it turns out that I have a fake sugar to And there are various studies. Let's say that you know. Fake sugar is just as bad for you and increases your glucose levels in the same way that actual sugar does. I don't know what's true around that but I know that trying to give it up has been a real challenge for me and have you felt any differences as has improved things for you with your mood or you know it. Hasn't it's actually source. Well my mood is pretty bad. Because I can't have sweetener in my coffee and I have talked to you about this a lot but I don't don't see why I can't and maybe hand but for right now I'm just trying if you're addicted to something it's worth you know or if you want to see if you're addicted to something why don't try giving it up and see what happens right. Yeah and it turns out that whether or not you apply the term addiction to my relationship with sweet things. I had a much more complex relationship with my morning coffee than I knew. And you know I could say I don't have a sweet tooth but I was during two cups of what was essentially you know for taste purposes melted coffee ice cream. Yeah every morning in the form of coffee so delicious ashes and so I. I felt like a tiny bit superior or lucky that I didn't need to have dessert all the time I needed. Basically two cups of ice cream every every morning and maybe one in the afternoon. It's really had a weird effect on my mood. I'm a little bit sad and I'm still grieving. It's been several months and I'm still sort of grieving. The loss of it and every morning. You drink a beer coffee too aesthetic and then you throw it at me which we've got to get got a bad habit. Well you know I'm just trying to wake you up all right. Let's experts and now it's time for the interview. Are I guess. Today is Kathleen Dehmazang author of the sugar addicts total recovery program and potatoes not PROZAC simple solutions for sugar addiction. Kathleen is also the founder of radiant recovery online international community focused on healing what she calls sugar sensitivity Kathleen chatted with our producer. Michaela heck thanks so so much for coming on the upgrade today Kathleen or really happy to be with you so to start. I'd love to hear a little bit about how you got your start in nutrition. Yeah well I started out as the director a Rehab Center and I was looking for solutions to enhance what we were doing. Typically alcohol and Drug Rehab isn't very successful and so I was. I wanted to find find something that would help. People get better longer started talking to everybody and I realized that almost us all of the people that we were working at stopped using alcohol and drugs and then they started using lots and lots and lots of sugar and did their whole behaviour related to that was somewhere to drug behavior. And this was really intriguing to me so I had an internet the time and I sent her to the library and said see if you can find anything on sugar. This was quite a while ago. There wasn't very much but there was one article in one Berry Obscure Journal that made a reference between the connection between between alcohol and sugar and I thought well that was really interesting because I was myself theory attached to sugar so I started playing with the idea of using food as part of a treatment protocol and was astounded. And how much better I felt and so I began working with people in the clinic Were you would you be willing to try some experiments in Sunday's Whatever it whatever you tell us to do we'll do it? And so we began looking at ways of basically cle- enhancing what they were eating and also taking out the sugar so he didn't just say okay. We're going from sugar intuitively. I knew at that point. Does that was not a smart idea. Our a good approach to deal with it and what happened was people who had never been able to get sober started getting sober and staying sober and I thought well this is fascinating so basically decided to go back to school school one. Find out what was going on because there really was anyone looking at that point. In time I developed a whole theory about Out Sugar Sensitivity and that some people are born with a genetic vulnerability to addiction that somehow connected into sugar and the sugar is sort of the first drug leads into that whole Delta many different kinds of problems so tell us a little bit more about what sugar sensitivity is. Well basically it's a term that I coined to describe what I believe is a package today. We'd probably call it a matrix because that's how people referring to things like this but it involves the having a blood sugar that is more volatile than normal so when a sugar sensitive person has a carbohydrate hydrated has sugar baguette a larger biochemical reaction to it. They're they're blood. Sugar spikes up higher in drops quicker and it's not that it necessarily goes lower. It's not the same as Sipe Lacina but you get this very quick slope so you feel really good and then you feel. I'm terrible and that that's related to an overproduction of insulin. In the second part is being bored with lower levels of Serotonin and serotonin affects your mood. And also your ability to say no. So if you have low serotonin you'll say I'm not gonNA eat that cookie. I'm not gonna eat that cookie and then the cookie jumps into your mouth that quality. I'm feeling like you want to say no. But not being able to and the third piece is being born with a lower level of a brain chemical uncle called Beta endorphin Beta endorphin effects affects your mood. How you feel about yourself? So if you have low Beta endorphin could you might be very successful. Have Lots of money have a partner that you would door but you feel inadequate and hopeless anyway away. So that package of Balto blood sugar low serotonin in low Beta endorphin my hypothesis. This is an still my working concept of it. Isn't that package of those three things as a profound effect on how people deal with the world whether other whether they liked sugar whether they like other addictive substances or behaviours in I know you have a sugar sensitivity test. Can you tell us what that is in. You know how somebody can determine whether or not their sugar sensitive so what you do is you imagine you're walking into into a kitchen and you're the only one they are. This is an important thing. There's no one else there to judge what you're doing and that there is a plate of chocolate chip cookies on the table and the question would be what to do and when I asked the second asked this question to a room full the five hundred people and the people who would self identifies being sugar sensitive will all start laughing before. I even asked the question now. Surfing at the idea of a plate of worm chocolate chip cookies. Coming out of the the people who are not sugar sensitive will sort of sit they look at me and say well what do you mean am. I haven't heard by which time the people should sensitive. I've already eaten the whole plate so basically. What kind of emotional response do you have to even the idea of chocolate chip cookies? So you've you've touched on this. A little bit briefly you're talking about low serotonin levels or low Beta endorphins. But can you talk a little bit about you. Know what happens with our brain chemistry mystery when we have something really sugary well at the at the basic level if we have hit sugar feel really good because sugar evokes a biochemical response this very similar to having alcohol or taking aching opioids or using heroin are having oxy cotton. You feel really good. Your self esteem goes up. You feel happy. You can feel euphoric for depending upon how much you have and how sensitive you are to it so a person who is sugar sensitive would have even one on chocolate chip cookie and just feel really really good and good about themselves whereas the person who's not sure sensitive could have a bite and and say well okay. I'm not really hungry so I'll leave this for for later. Sugar sensitive personal would never leave it for later so walk us through through the seven steps of radiant recovery the seven steps that you cover in potatoes at PROZAC. Well I think the important thing gene is to not think you should just take a sugar out. That's what people typically do and sugar sensitive people are typically impulsive. Ziff for side is okay. I'm just getting ready to or doctors. All you need to take the sugar out and people distracted and then feel absolutely terrible. Because if you do that you go into drawl so the the idea of the of the seven steps and these are steps that are outlined in my book potatoes not PROZAC so the first step is to have breakfast. Most people skip breakfast or don't have breakfast until they you get to the office and then it's ten thirty or eleven and they're falling off the cliff and they're crazy so the idea is to have breakfast within within an hour of getting up to have enough protein for your body weight and to have some kind of complex carb which means means having some oatmeal or having some whole grain bread or having a whole Grain Bagel. It doesn't have to be sexy or anything. Anything like that is having breakfast at surprisingly takes a while for people to master and then step two is keeping a journal and the point of that is knowing what you eat in win putting in amounts putting in times so you learn to recognize ignites what you're actually having because if you're using a lot of sugar her is actually an in these EAC at an anesthetic. So we forget and we don't remember we've had and we don't really feel what we've had if we're using modest sugar so the journal donal starter snap process Cyp. Three is having three meals a day and having not grazing but actually Josh starting and stopping. So it's practice in learning how to say no. It's very hard for people to learn to just have three meals us because people can either skip meals as a way of not what they believe is the way of not getting fat or they will just sort of grace as their way through the day so training yourself just to have brecca's lunch and dinner and moving whatever sugared this trick the we sneak in there doing move the sugar to the meals and it's very non-prescriptive and very kind so that would teach people to eat real food good food then the first step after you've asked that is you. Add a potato in the evening three hours after dinner and that actually has significant effect on your brain chemistry which tells people find really bizarre to think of our culture decide as Juno. Potatoes have been badly maligned. But they're really wonderful and very healthy and also a baked potato with skin skin and some butter actually creates. What seems to be the perfect amount of insulin to alter brain in chemistry? And there's very complex cascade of how your brain sends large neutral amino acids across the the blood brain barrier and the one of the amino acids is trip to his little and it doesn't compete well with with all the other amino acids trip to fan. The Amino acid your brain uses to make Serotonin and so the potato evokes an insulin. Response in the escellent takes the other big amino acids off to the muscles Leaves little trip to fan without any competition and so took the fan hops across the blood brain barrier and gives itself to the SEROTONIN factory sacrifices itself and says take me take me. So what Matteo does is actually increase the level of Serotonin. So the potato helps you be able to have impulse control so we seek it in three hours after dinner dinner. which just happens to be time that it's most effective is not a magic thing? So that's part of step four. The other. The party is to take vitamin B Complex C. and zinc and I just chose those because they enhance carbohydrate. Great Metabolism so now got we've been building nece and we still haven't taken the sugar which is very significant. People have a very a hard time with that. They want to get it out. Like why can't I just don't it and I will keep saying what we do. We're rebuilding ending your brain. I getting you ready to do this. So they'll go to set by changing from what I call white Switches refined carbohydrates to whole grains to Brown things now culturally. That's an ending now. People know what that is. We first started. Nobody really thought about that. And then we get to step six and this is the point in which we say. Okay now you get to take sugar out in the really ironic thing is because he's done this background ahead of time and basically rewire wire. The brain going off of sugar is a non event. There's very little stress. It's not a big deal. It's it's like okay. I can just take out the desserts. It's not you know we're not having ice cream every night on o'clock anymore so it's easy it's it's not painful and sometimes people are office. Sugar already may not even realize it video games I heard of him. I'm Maddie Meyers. I'm Jason Try and I'm Kirk Hamilton. And we're the hosts of Kacoos split-screen. We get together each week to talk about the biggest news from the world old of video games. We also discussed the game. We're playing from the most elaborate blockbusters to the most interesting games. We're joined by a variety of guests from the world of video games from legendary Sunday developers to famous streamers. TV host to one time we had on an NFL kicker find us at DOT COM or wherever you get your podcast. What are some of the effects you've seen as worked with people throughout the areas towards eliminating sugar from their diets? What have you observed the most important? The thing is a change in self esteem which is really was the most remarkable to me. Initially I thought it was the you're not feeling in crazy or you're not feeling your moods even how your depression goes away. Your your anxiety goes away. Your reactively league goes away and you just feel calm and relaxed but the thing that actually caught me off guard and seems to be. The most profound change is that the underlying feeling of self worth goes up dramatically so instead of feeling like an impostor their self worth batches who they are. If that makes sense it does. Do you think that let's because they have felt helpless against you. Know their desire for sugar for so long and now they have this new found willpower. Our against it or do you think has more to do with the change in brain chemistry that comes from drastically reducing the sugar in your diet. I I think there's a whole series of things. One of them is. Yes the psychology of not feeling out of control anymore. I think it's because the Beta endorphin different function is restored. An increasing Beta endorphin increases self esteem. And that we know that that's a scientific thing that Beta endorphin rebels are correlated with self esteem. And when you're being endorphin level all is low. You're using sugar to take care of it and you stop doing nat first of all you do feel kind of disoriented and okay and at a loss but part of what step seven is learning how to do life things that enhanced Beta endorphin light hiking or exercising orch having really good food or having could sacks or we're having nice environments are being around beautiful things all of those ways Endorphin without spiking it. Josh it really is a change. In brain function is not psychological. So how long does it take for people to feel like they've they've dropped the bad habit of sugar. I'm going to give you an answer. This little different from the question. Sugar sensitive repulsive. They generally WanNa do it all in about a week. Do all seven steps in week. which horrifying so I tell you how? How long is what what I would consider if you have a motivated person? WHO's ready to do it? What would be the ideal time to work through the steps? I'd say committee six or nine months. That would be what I would consider a good time. Some people it takes some you know two years I on step three some and I've had people do it in a week and it doesn't make it better if you go faster and the whole model and I don't know if this was clear to you on the website but we try to be it Kinda funny and not bill intense about it because addiction is kind of a grim scene and so we try to to help people to have fun and enjoy themselves and that seems to calm everybody down. I think that's really important for people here because I can imagine people listening may be trying this out and thinking you know if they've maybe spent let's say four weeks at step three that they're not making enough progress or they're not doing a good enough job or maybe they'll never get there so I think that's that's good to hear exactly this very different approach in imagine giral overnights Kathleen. Thank you so much for talking with me today. I'm really really enjoyed it The next our interview with Yoni Friedhof associated professor of Family Medicine at the University of Ottawa and medical director of the Bariatric Medical Institute. An ethical evidence-based interprofessional weight management center. Dr Friedhof is the author of the Diet. Fix why diets fail and how to make your work as well as the blog. Weighty Matters Musings of an obesity medicine doc and certifiably cynical realist. Our senior health editor Beth. School Recchi's spoke with Dr Friedhof about why doctors and Dietitians find the concept of sugar addiction. Controversial he he also gave us his own recommendations reducing Sugar Consumption High Yoni welcome to the upgrade. Thank you so we recently spoke with Dr Kathleen Day Maison who pioneered the terms sugar sensitivity and sugar addiction. So can you tell us like what's your take on whether sugar or any kind of food is actually addict and is that a helpful way to talk about it. So I'm definitely not a specialist in addiction medicine. I will say that it's IT'S A it's a way to talk talk about it. That might work well for some and not for others and I think it matters and song glad you've spoken with some experts about it in our experiences here and I've been practicing obesity medicine for sixteen years. I'm not sure I've ever met anybody who I would be describing as addicted to sugar. But I've met many self described sure graphics The I suppose that there's just a difference. I'm not sure how to delineate it properly in medically between something that you would describe as an addiction which has ramifications using that word or someone who is struggles to control the consumption consumption of something like sugar in larger quantities. I have zero doubt that there are people who struggle more than other people perhaps as a consequence up differences in the way their brains are wired for rewards. I have no doubt that sugar is one of the main things people struggle with although. Oh I've never met anybody who struggles to control pure sugar. Generally speaking people struggled to control combinations of sugar and fat or sugar. Salt ultimate fat. People aren't struggling with big bags of white stuff. But yes there is definitely people out there who find. It's very difficult for themselves to control. Roll their intake of sugar. So is there a good way to think about sugar and our cravings for it if it's not an addiction like you know. We do crave some of these sugary foods. Sometimes is there a good way to think about that to help us understand. Why are our brains are so into this? We'll cravings are interesting for me. I lump everything together. In a way that perhaps his nonscientific and described hunger as whenever we eat foods in quantities quantities or with choices that we can't justifiably explained. There's no good reason for us to choose that in those choices may be contrary to our desires for health for Wade or whatever that I describe as hunger so cravings wise for instance. We'll see many people. People who cravings are dependent on things that are modifiable so people might crave sugary foods if they've missed meals and snacks in their morning morning times and it's the afternoon evening or night and suddenly. They're they're cookies are calling to them from their cupboards but when we get them eating very differently throughout the daytime with an emphasis on tidy in fullness sufficient quantities of calories sufficient amounts of protein in many cases those cravings disappear. So it's it's hard to describe necessarily as cravings rather than describing them as physiologic drive for lack of a better way to put it but if a a person's cravings are modifiable by patterns of eating that does for me challenge the notion that there's an addiction rather yeah I think of addiction or struggle as the natural consequence of having hormones in a physiology that tells us it's time to eat and where you You know the sugar of provide readily accessible calories as does fat which is why again. People often will crave both not just one so so people talk a lot about sugar when they talk about cleaning up their diet or eating healthier. So can you talk a little bit about whether sugar is uniquely bad for us. Sorry suggest that it tends to be part of a package of unhealthy eating so I think it would appear as if liquid sugars so Jews as soda That sort of thing may have some unique concerns in problems. Generally speaking sugar is something. That's easy to consume in excess and as a consequence provides nights quite a lot of calories. There's also you know common. Medical problems like diabetes both type one and type two where sugar may be a challenge to the treatment and the management of that condition and so in regard to sugar. The goal for any food really is or any indulgence is the smallest amount of it. A person needs to be happily satisfied and that question is what is the smallest amount. That question is dependent in part on physiology impart on patterns of eating in part on our social lives. And so it's a very individualized thing. What is too much what is too little and I? Don't I think that any person doctor or otherwise can identify a specific amount for an individual. But as I'm sure you are aware and probably we are discussing in this episode. There are limits that people like the World Health Organization a dietary guidelines folks put on the amount of added sugars. We'd want in our diets but generally speaking other than liquid sugars. I'm not sure we can vilify sugar very directly in creating a unique problem blue whereas the over consumption of calories as a whole in ultra processed foods as a whole that might be an easier case to sell so. Do you have recommendations for somebody who wants to cut down on their sugar specifically like if they notice that it's you know a major calorie source in their own Diet Moso easiest way that doesn't involve counting at all is to try. Hi to reduce the reliance on on both liquid calories because they generally come from sugar. It's usually either sugar alcohol. So reducing liquid calories that are sugar-based and just introducing ultra processed foods. So that's for people who aren't necessarily looking to want to Kennedy the sugar you might add to your own cooking from whole ingredients at home is likely going to to be less than the sugar is that you'd find in ultra processed foods and certainly from a beverage perspective. It's an easy target again. The goal being the smallest I amount that a person needs to be happily satisfied on not suggesting everybody needs to suddenly start cooking every single meal from scratch but slowly improving that aspect of our lives may help to reduce sugar over all the other thing. That's really crucial. I think trying to decrease sugar again is going back to what I was saying about. Cravings and hunger is eating in a pattern that for the individual leaves them more happily satisfied now. There is no right of meal frequency but one thing that appears appears to be quite uniform. Is that protein matters quite a lot to society and so ensuring that every single meal and snack is inclusive of a protein sources. Something that people can do to help with society. I would argue that. Anybody who struggles at night could look to changing their daytime patterns of eating to see if in turn that helps and there are also medications now that are useful in the management of cravings and hunger that in fact appear to be safe and effective. You've that people could discuss with their physicians. You've spoken before about how being overly restrictive about some part of your diet can be counterproductive. Can you tell us a little bit about why that is disc- when it comes to overly restrictive diets we know for instance that they are the number one trigger for the development or the recurrence of binge eating disorder and so when people are overly strict about their diets at may backfire over time. I'm definitely aware of people who feel that. Abstinence is the way to go when when it comes to something like a food. They can't control I've not had great success in seeing people stay abstinent. long-term there may be clinicians nations out there who are better than me at helping people with abstinence. But our approach really here is to focus on tidy on fullness on thoughtful indulgence in May mean not having foods in our homes that we struggle with but it likely in our offices doesn't mean you should never have this that or the other I really do feel. It's about the smallest amount of these foods. We need to enjoy our lives and trying to eliminate them altogether for many people leads them ultimately to quit their efforts. Overall food is not just fuel. It provides comfort changing stress hormone levels. It's the root of many celebrations if not all of our celebrations. It's the world's oldest social network and when people I guess stop allowing themselves to take pleasure from food or to celebrate with food or to socialize allies with food I worry that those efforts however well intentioned may fail over time and I'd rather a person lost less weight and eight more imperfectly but actually sustain their efforts long-term then to the overly strict for a temporary period of time only to quit all all efforts when they just can't stand it any longer. So what do you think about like short term like detox or reset kind of things like you know cutting out sugar for ten days or something is does the fact that you know. It's temporary make it better or worse. Maybe so maybe for some people it's useful I in people talk about stuff like whole thirty. We all the time. I definitely don't think it's a long term strategy nor do I necessarily think it's meant to be a long term strategy. Some people might find it useful. Just as a means to almost almost reboot their relationship with food and start from scratch. We don't approach things that way here but I'm sure there are. There are people who succeed with it. I I think that's the other thing that people ought to keep in mind is that there are success stories with every approach. So if anybody tries to suggest there's is the best there very either conflicted or ignorant or both and so for me to suggest that no you should never do that. I wouldn't but I've certainly not. It's not a practice. We a US here regularly. Although I'm definitely aware plenty of people will like to try these sorts of a temporary removals of various foods and if that intern leads them to come out the other end and cook more frequently and be more thoughtful. Well that sounds terrific if it leads them just to have a you know a temporary restrictive diet and then they're back to normal. I'm not sure how helpful that is. Clay so I've got a slightly different question so we know you're an expert in weight loss and that's probably the topic. A lot of people are thinking about at least in part when they think about cutting sugar but what about people who just want to be healthy no matter what their weight is should they approach eating differently or are you know sort of in the same way. No I think it is the same right so I think that healthy living really doesn't depend on a person's weight meaning meaning that all the same things that we recommend to our patients here. I live with myself. I try to exercise as much as I can enjoy I eat regularly with the protein inclusive meals and snacks. I try to minimize hunger. I try to reduce my indulgences to the smallest amount needs to be happily satisfied reduced my restaurants but I still go. I reduced my processed foods but I still have them. I sadly reduced alcohol. But you know you gotta do what you gotTa do. I guess we're wait may have a role to play is in the two questions the is it worth it question. And what's the smallest amount. I need to be happily satisfied just as would any diet responsive of chronic medical condition. So if I had struggled with my weight my answers to those questions might be different if it because I might be able to be satisfied fight with less because I don't have that condition as part of my sort of Matrix of thinking about what's worth it was not worth it. Certainly I know that if I were to develop in type two diabetes might eating pattern would change dramatically from where it is right now because suddenly when I'm evaluating the is it worth the question of what's the smallest amount I need to be happily satisfied question. I've got a medical condition superimposed on how I consider those answers but the the same principles apply to everybody for sure so one thing. You're great at is calling out popular myths misconceptions about dieting or nutrition Any particular ones. You'd like to spotlight at the moment. I guess the main one we've already touched on. It is that there's a right way for everybody you know first of all there isn't so there's there's there's no data that suggests there's one best diet you know. There's data out there on all sorts of diets from fasting diets to Kito diets to low fat diets to Vegan in diets. At the end of the day. They all seem to be just as good or just as bad as each other. As far as weight loss goes there may be some slight differences in regard to their impact on specific. Chronic diseases like type two diabetes but at the end of the day all the matters is a person likes their died enough to sustain long-term adherence that that is is king. But there are plenty gurus out there who want you to believe that there is a right way or a best way to go and that is the biggest and most problematic missed out. They are right now. I think the other big one is that there's you know that there's patterns of eating that are so remarkably good for you that they are more important than just going through with the basics of healthy living as a whole and I think you can get a really long way just focusing on cooking from whole ingredients exercising as much as you can enjoy not smoking being vaccinated Sleeping well cultivating your relationships. Not Drinking too many calories and moderating your alcohol. Those are the things that mattered. The most we get so caught up in the minutia of healthy living that I think we forget those big ticket items are really probably enough to get us an. I'm extremely long way as far as preserving our health and protecting ourselves as best. We can thank you so much for talking with us today. And now it's time for upgrade of the week where we talk about that one tiny thing making a big difference in our lives Melissa in your upgrade so my upgrade this week is worm castings dope anymore. Why what's not clear? I'm Joe many. Thanks so worm. Castings are an organic form of fertilizer. That is produced from earthworms squirms. Okay sometimes worm castings are called Verma cast is it like their skin is elected Shimmy author skin. And you get you get it. That's what I like to. I think it is so worm. Castings are worm shit. All right and there used as a natural fertilizer. And I have been adding warm castings to my house plants. which as we know I am? I'm quite capable of murdering with out the slightest provocation and it actually works. I'm fertilizing my plants and I have replanted some of my plants in half amazing potting soil. Half worm castings no and it does not smell like poop chur. It looks like soil. It's it's actually like an inky black soil and it's just filled with a lot of good nutrients it's a natural fertilizer. And so it's really do half-and-half it's not like a little sprinkling. No you can do a little sprinkler. Okay on I mean a a healthy sprinkling on the top of your plants on the top of the soil or you can actually mix it with the soil and you can buy it at you. I Know Your Garden Center. Yeah Your Garden Center yeah. Isn't that what you call it. I think so your Garden Center your Amazon Dot Com lows use amazing. Probably target all right any other big box stores. You WanNa name check Costco at at Costco. BJ'S SAM's Club. I'm sure you can get like a nine hundred pound bag. So if you have a farm modell's modell's Dell's does not carry worm castings. Okay Okay you say so sorry. I'm just feeling Sally Sugar. Did you know okay okay. What's your upgrade Melissa? My upgrade is something that you recommend it to me. So you're GONNA be mad at me for taking it or maybe it will be pleased with me. It is a podcast. Oh I think I know what it is. Oh no I mean come on I support you. Got The podcast. Is My brother my brother and me which is a delightful podcast with the mcelroy brothers where they supposedly give advice but mostly they are just incredibly silly and hilarious and it's it's been around for ten years. Many listening are saying well Duh. Of course my brother my brother meets podcast but I have never listened to it. I don't know why some people are saying They're pretty Friday. That sounds like not your cup of Tea Alice. If it is my cup of tea it turns out. It's very much like not because they're very silly and they're very very funny. Any they'll answer questions from readers and also they'll do Yahu questions which include things like is dirt a spice if not not but you know it is might be my favorite. What is warm casting anyway? They're just they're really funny and I love them so much. It makes me so happy. Listen to and it's been. It's been some tough some tough times in the Bradley household. UGH We can say. Let's UNPACK. Here's what's happening Yeah you know when things are. Things are down plus January which socks. Oh yeah and I needed needed a laugh. Laugh you to pick me up. Yeah and it has done it for me. So thank you Michael Wright brothers why God turned. Okay Okay thank you get one welcome. That's our show. The upgrade is produced. Just by Michaela Heck and Brad Fischer mixed the episode please rate US and Apple podcasts and leave us a review it really helps other people find the show but more importantly it helps us feel feel better about our lives yes also subscribe and subscribe you can also read just by calling us at three four seven six eight seven eight one zero nine leaving voice mail or or write to us at upgrade at life packer dot com. You can also find us on twitter at life hacker on Instagram at Packer Dot Com all one word and on facebook facebook at facebook dot com slash. Tucker you can sign up for life hackers daily newsletter full of tips and tricks and hacks at live dot com slash newsletter letter. And you can find show notes for this and every episode of the upgrade every symbol episode. One life hacker dot com slash the show.

endorphin Sally Sugar Dr Yoni Friedhof Michaela Heck Melissa Dr Kathleen Day Maison Alice Bradley PROZAC director producer Josh Bariatric Medical Institute Kathleen HD White Devil deputy editor Senior Health Editor BCC Kirsch Israel
Episode 100 - December 15, 2019 AFP: American Family Physician

AFP: American Family Physician Podcast

36:36 min | 1 year ago

Episode 100 - December 15, 2019 AFP: American Family Physician

"The AFC podcast is brought to you by the American Academy of Family Physicians and by COMP health family physicians are so much more than just a white coat. They're real people with real needs. That's why compelled personalizes every aspect of a physician job search by providing locum tenants opportunities. He's across the United States International locum tenants and permanent placements healed specifically for them. More information is available at COMP. HEALTH DOT COM TOM SLASH FM career. Hey AFP podcast. This is Dr Mike Sevilla and it was so awesome to be on your episode number. Thirteen had a great time. And it's also been great watching the growth of the podcast and all of your success us. Here's to the next hundred episodes. Let's do this podcast. Congratulations welcome to episode one hundred of the American family physician podcast. I'm Steve I'm Herbert. I'm Michelle I'm Melissa and Victoria we. We are residents and faculty mostly residents from the University of Arizona. College of Medicine Phoenix Family Medicine residency. This time on the podcast. We're going to talk about Anglia. Ably Opio the case against coronary artery calcium scoring cirrhosis Baloch severe and we have a point of care guide for deep vein thrombosis Vocis the opinions expressed in the podcast. Our own and do not represent the opinions of the American Academy of Family Physicians the Editor of American family physician or Banner Health to not use this podcast for medical advice. Instead instead of your own family doctor for medical care only take advantage guys. It's episode hundred hundred going to have some special greetings from leaders and Family Medicine as well as some reflections from mar past hosts on their favorite moments. Let's start with a moment. That was actually the favorite of Joe. And Sean Two of our season for hosts. Hey Hey this is joe from season four congratulations. AFC podcast on one hundred episodes. Wow that is impressive. So many great memories. I really enjoyed the time that we broke out those. His tongue depress her nasal clips for our talk. NOSEBLEEDS Geno was a big fan we actually tried to wear them for the whole episode. was just too tough to talk but but in those on then trying to talk was a really fun. Time Management for Interior bleeds is a step wise process. Starting with compressive therapy firm pressure should be applied to bilateral collateral nostrils below the nasal bone for ten to fifteen minutes without interruption. You can use simple compression with fingers or for the faint apart. I I fashion some of these Handy Dandy Nasal clips which are illustrated in figure two. They are just too tongue. Oppressors put together with co ban. Dan and see stadiums very effective. Steve already amounts of yeah go is fully compressed. How's IT feel agenda Shaun I've into it all right if you'd like to take off Ebay all right? Thanks dollas a bill. They're great so in honor of Joe and his nose compression technique. Here's the nose compressed. Congratulations congratulations yes. We will have some actual new medical medical content on episode one hundred. Let's talk first about Ambrogio. Pia Detection and treatment from Doctors Makaay and mcgurk from Columbus Ohio. BAIOCCO go blue. This article was printed at a super pertinent time for me since I just saw pediatric patient in clinic the other day with Anglia. Oh my sister ahead. Anglia also known as lazy when she was a kid. So I'm pretty familiar with it. It's a decrease in best corrected visual acuity and the leading cause of childhood mono ocular ocular vision loss. So her what Causes Ambrogio Pia. It's caused by a problem and vision. Development if visual pathways aren't adequately stimulated infancy and early childhood the brain's visual cortex is affected amply opie happens it typically affects one eye. ocular structures are usually normal on exam but cataracts and eyelid doses concur Anglia's since they disrupt vision. There are several different types of Yoga including strep Islamic when the eiser misaligned and depth perception is affected an any so metric or refracted when there's a difference in visual acuity between the eyes and less commonly Ami Tropic and Deprivation Anglia and who should we be screening well early recognition is key to optimize the likelihood of successful treatment and prevent vision loss the earlier the better actually since kids younger than seven seven years old or more likely to have a good response to treatment the US PS T.F. And AFP recommend screening. All kids from ages three to five friendly COPA. or it's risk factors at least once and the A. P. recommend starting screening newborns. A what are the risk factors for Amplio then Michelle toast this just Age less than thirty weeks birthweight less than fifteen hundred grams cerebral palsy syndromes with known ocular involvement like Down Syndrome and a family history of of Anglia Orchestra Business. Herford these kids for an opera exam. Okay but what physical exam findings. Should I be concerned about. And how do I actually check for Ambrogio. Pia Concerning clinical cues including a wandering eye squinting of one eye toward a call us which looks like head tilting to better align the I.. Nice diagnosis or stir business examine. Examine your patient for cataracts corneal opacity. He's do a pupil exam and assess ocular Motilal. Check eye alignment with corneal light reflection. binocular read reflects test and the cover uncovered test performed vision testing children. Three years older using Standardi- charts and adhesive he says I patch is preferable to include when performing visual acuity tests since kids may peak around and including an Anglia may be missed any three to five year old with visual acuity acuity. Less than twenty forty. In either I or any child five years or older with visual acuity less than twenty thirty two and either I should be referred for a comprehensive OPHTHALMIC Exam Victoria. What about photo screening? It can help detect emily opium risk in younger children. Those are uncooperative. With chart based vision testing or those those who are nonverbal basically the red reflects of both is is photographed and evaluated for signs of uncorrected refracting. Error ocular opacity or misalignment. I'm it it can actually be done with the photo screening APP for Mobile Devices and has a sensitivity of sixty five percent and specificity of eighty three percent. All Right so oh I think I've got a good handle on how to detect. Emily OBEA. So how do I treat it. We have to address the source of the visual deprivation and correct the refracted. Air With glasses. Then then you encourage use of the family I buy hindering the visual input from the better I with patching medications and filters with glasses the use of patching being an attribution drops holden evidence rating a based on our CDs and Cochran reviews in kids with moderate Elio. BIA Patching the non embryo pick you for two hours per day was as effective as six hours for improving visual acuity also six hours of daily patching was equal to fulltime patching and kids with Severe Ambler area treatment with daily Atropine eyedrops is as effective as daily patching in those with moderate ambro PIA also atropine one percent given onto consecutive days per week is as effective as daily use in these kids. Once you're young patient has been successfully treated for Amplio Pia Monitor under them because twenty five percent will have a recurrence within one year overall. I found this article to be rather eye opening John. Cullen here president of the American Academy of Family Physicians and living in and working in Valdez. Alaska just wind minded. Extend my congratulations for the one hundredth episode of the American family physician. PODCAST I listen to you guys whenever I'm doing my traveling which is a lot these days and and just you guys are doing amazing work. Thank you and I love the music. We have a challenge for our listeners. To celebrate break episode number. One hundred if you are among the first five people to congratulate us on twitter for our hundred episode please tag at at a p podcast. You will win one of the coveted limited edition AF podcast t shirts. Also if you're not one of the first five but you have the most creative congratulations on twitter again tagging at AFC podcast before January fifteenth. Twenty twenty we will also also give you a F- podcast t shirt. Happy tweeting some of my favorite moments from our first one hundred episodes have been talking to family medicine leaders news on episode four back in December. Twenty fifteen I talked to family doctor. J W Lee about how our health system needs to be transformed and the HASHTAG. FM Revolution and it was inspired by a group of residents actually from Santa Rosa California. Who started off and with this concept of revolution in terms of t shirts? That reflected Some SAS from family medicine against the stablishment if you will At t shirts that said things like use your whole brain become a family physician. How do we lead ourselves to create the necessary transformation in the US healthcare system to get us to that point where we can make health? Primary and I really do think That leadership piece is where the revolution comes because it's one thing to own attitude. It's another to leverage that attitude and bring it to the table and 'cause the payment system for healthcare to change the way we deliver health care to change and so I think there's a lot of opportunity challenge ahead of us as a community to really bring primary care to every single American. We have an editorial in this issue from doctors men droll and Foy Michelle. Tell us about the case against coronary artery calcium scoring goring. All right I'll set the stage in two thousand eighteen. The American College of Cardiology and the American Heart Association updated their guidelines on the management of cholesterol. They now recommend the coronary artery calcium score as an additional method to help make the decision on whether to withhold or start statin therapy right so the cat scan detects detects calcium buildup in the coronary arteries which supposedly correlates to ASCAP de risk. A score of zero means there's no calcium and the patient in has a low risk any score above zero means there's calcium build up varying degrees and the more calcium the higher the ASC de risk. DOC physicians would use this test if they're patient fell into the intermediate or borderline brisk category using an ASC risk calculator. Keep in mind. The multi-ethnic study of Atherosclerosis or Mesa calculator is the only one that has been validated in a large prospective sample. The idea then is that the calcium score would reclassify patience risk either up or down. When looking at the data from the Mesa Cohort? It showed that patients were reclassified correctly. Eighteen percent of the time and incorrectly six percent of the time. That seems great. But when you look at the actual numbers. There's a one in six chance to reclassification is correct and five and in six chance it's incorrect. But maybe if patients knew their coronary artery score they'd be more adherent to their STATIN therapy well adherence to Statin statin therapy. Even in the presence of known coronary artery. Disease is poor so I really doubt it. Also the recommendation to withhold Stanton's based on a score of zero is based on observational studies. And it hasn't been tested in an RC. Don't forget there's potential harms from the C.. T. Scans themselves. These include radiation exposure incidental. Oh findings up to forty percent of scans that can lead to additional testing and the already discussed misdiagnosis. So with all this in mind. Would you guys recommend this test for your patience hence no no. I'm a hard. No I thought the authors of this editorial really say at best at the end. Although this test may slightly Lee improve future risk prediction the theoretical benefit is outweighed by its potential harms and wrongly simplifying. This complex disease Z's with coronary artery. Calcium testing helps the test hers more than the test did burn. Hi everyone this is is Tricia Eliot. I'm the president elect of Society of Teachers of Family Medicine. I am also a proud family. Doc and I'm the Senior Vice President of Medical Affairs Academic Affairs in research at John. Peter Smith Health Network in Fort Worth Texas. I WanNa give a great congratulations to the American family physician podcast for their hundredth episode. Congratulations accusations and wishing you the very best. Hey Steve loopier from season one just wanted to let you know that my favorite moment looking back was way back January two thousand sixteen gene where you pigs are. all-star hosts Kelsey and Meghan against each other and classic Highschool extemporaneous debate format arguing about the evidence four and against Hepatitis C.. Screening the tension in the room was palpable. And just one twelve week treatment. Eighty four thousand dollars. If we treated every person who has hepatitis C in the United States it would cost two hundred fifty billion dollars. There's no way we have the money for that. This would be one. Tenth of our healthcare dollars would be spent on Hepatitis C.. which while you said caused nineteen thousand deaths when you compare that to something like colon cancer? That's fifty two thousand deaths from Colin. We're not talking about. We're not talking about treating every patient advocacy. We're talking about identifying patients who have tried to see infection doing further testing ignace. See if there's any liver damage done in these patients and treating those patients who show signs of Limor damage and when you look at the CDC who came out with their recommendations conditions in two thousand and twelve nine out of the thirty four members of this working group that recommended these expanding screenings actually disclosed financial conflicts looks of interest with groups that made hepatitis C. Treatments or tests and outside of that working group the CDC Foundation itself has actually received twenty twenty six million dollars in donations since two thousand ten from from those same corporations so instead of just talking about the numbers though. I think another way to look at. This is the ethical allegation that physicians may have to offer the screening tests to patients who are at high risk next up cirrhosis diagnosis assist and management from three authors in Massachusetts Halabja started off. What's the natural progression of liver disease? and WHO's at highest risk for progression services. The most common causes of cirrhosis are viral hepatitis from hepatitis. B and C Alcoholic Liver Disease and Non Alcoholic Seattle Hepatitis. US estimates of ten to twenty percent of patients with the three. Most common causes of liver disease will develop cirrhosis within ten to twenty years increased age and co-infection with HIV and Hepatitis C are known risk factors for progression male gender is also usually associated with increased risk of progression except interestingly in alcoholic liver disease in which females progress more rapidly Michelle. How do I work up liver disease? Although most patients are asymptomatic at the early stages of cirrhosis tip-offs to compensated cirrhosis include fatigue weakness loss of appetite right upper quadrant discomfort or unexplained planed weight loss. Incidentally high liver enzymes may be the thing that prompts suspicion of cirrhosis further suggested by low albumin thrown beside a pina an ast two lt ratio greater than one elevated Billy Rubin and a prolonged P. T. I N. R. G. G. T. and alkaline phosphates. Should also be ordered. For determination of ideology Legiti Order Viral Hepatitis Serology Fairton transparency curation and abdominal ultrasound. Although rarer don't forget to consider autoimmune ideologies and and of course conduct a good family history of Liver Disease Alcohol Use History Andrew View Medication lists for any hypocrisy toxic medications once we have a history physical exam lab and imaging pointing toward liver disease or Cirrhosis Victoria. How do we confirmed that diagnosis laboratory data can be used for predictive calculations like like? Ast Two platelet ratio index fibrosis four score and the NFL de Fibrosis score biomarkers are particularly good for chronic. HEP APP see or non alcoholic fatty liver disease. Standard ultrasound detect St Joseph with ninety four percent sensitivity and eighty four percent specificity but fibrosis and cirrhosis can be missed with ultrasound in ranges of forty to fifty seven percent since two liver biopsy is still the reference standard versus seeing liver fibrosis but noninvasive methods are coming into the spotlight. Transient Ylistaro Griffey. Is a five minute outpatient procedure which uses ultrasound. Onto measure liver stiffness and it's rapidly replacing liver biopsy for fibrosis staging it performs better than biomarker based tools and detecting cirrhosis and with a negative predictive value greater than ninety percent. This methods limitations include decreased reliability in patients with obesity. Assignee's extra hypnotic stasis or excessive alcohol use and you can have falsely elevated results in acute paddock inflammation further management of cirrhosis starts with prevention counseling including Alcohol Avoidance Healthy Weight Management and lifestyle changes prevention of infection exposure from raw seafood are unpasteurized dairy limitations of daily coffee and take two three or four cups screening and treatment of causative factors and avoidance of unnecessary surgical procedures. Medication counseling is also imperative. Patients should avoid and said it's and limit Acetaminophen to two grams day Proton pump inhibitors should also be avoided if possible due to increased risk of SP multivitamins with iron should be avoided waited sedative manslaughter Benz and opiates particularly in hypnotic. Encephalopathy should not be used tri hydroxy inner trouser. Don't instead for severe insomnia the foreman and statins however are safe in liver disease and should be continued. If needed other preventive measures include vaccination for Influenza Hepatitis A and hepatitis Title B for patients with psoriasis and chronic have be they should receive the twenty-three valent pneumococcal polysaccharide vaccination surveillance includes a complete blood count count and PT. I N R every six months for recalculation of a child pugh and meld score with referral for liver transplant for Meld. Scores of fifteen or higher a right upper quadrant ultrasound should be performed every six months to screen for Peta Cellular Carcinoma consider universal or targeted screening for a Safa. Jio Verifies Repeat Daas. Copy every one to two years of small viruses are found in every two to three years if no viruses are found symptom management and psoriasis versus is important for modern societies treat and prevent with mineral- corticoids and salt restriction for large volume of cities especially if new onset or concern for SBP you perform paracentesis treat first episodes of paddock and stuff allopathy with Legos and nutritional support adding campaign for subsequent episodes small frequent meals and late night. Snacks with protein is recommended for preventing malnutrition late. Cramps can be treated with the management of electrolyte imbalances and as needed back Lafon community acquired. SBP can be treated empirically with a third generation cephalosporin or peppers cylinder as backed him. Prophylactic regimens vary depending depending on the presence of an Acute Gi Bleed Child peacecorps and laboratory findings routine use of antibiotic prophylaxis in a site ease without SBP or acute acute leading is not recommended. Hey welcome this. Is Gary Leroy. President of the American Academy of Family Physicians from Dayton Ohio. And I also work at East Dayton health center in Dayton Ohio. I just wanted to take this opportunity to do a shout out to AF P podcast on their one hundredth podcast. Ask congratulations to you. Hi everyone this is running Missouri professor of Family Medicine at Georgetown University in Washington. DC You may have heard my interview on episode thirty four about the power of advocacy. Well I'm still out there marching protesting writing op eds and lobbying along with many students residents and colleagues trying to make our voices heard. We'd love to have you join us. More importantly also join me in congratulating graduating the A. P. podcast on its one hundredth episode. Wow this is simply amazing. Here's to at least one hundred more. Another of my favorite interviews was a serious podcast fan moment for me. Interviewing family physician Sidney mcelroy and her comedian has been Justin mcelroy creators. An host of Saab owns a medical history. PODCAST BACK ON BONUS EPISODE TO MARCH Two Thousand Sixteen. I asked Justin who they regularly. Emphasize is on. The show is definitely not a doctor. What advice he has for family physicians? There's obviously a lot of pressure on doctors to to keep their skills sharp and I think that that has like tremendously important But I think that like just just as important and maybe even more Taxing is to try to keep their hearts soft to remember the everyday they encounter. Somebody Buddy is one of the certainly one of those people scariest days of their entire lives so to to try to keep that top of mind as much as the the new advancements in in medical research and what have you That would be. I think the most important thing they can. Do we have a poem now. Oh entitled Baloch. Severe Reduces Symptom duration similar to also Tamil veer primarily within twenty four hours of symptom onset. Clinical clinical question is block severe a safe and effective treatment of influenza. And you know that this is a good drug name because it has both an X and Z in it it. This poem summarizes a phase three trial which recruited patients twelve to sixty four years with an influenza like illness. The patients were randomized to one of three groups Baloch severe forty milligrams or eighty milligrams depending on patient wait one dose Oseltamivir seventy five milligrams twice daily for five days or matching placebo. Patients were followed up for fourteen days and the primary outcome was time. Time to symptom alleviation. There were one thousand four hundred thirty six patients who were randomized of which just over a thousand had influenza confirmed firmed result by as chain-reaction comparing the groups. The median time to symptom. Alleviation was eighty eight point six hours for Placebo Placebo and sixty five point. Four hours for blocks of year with a median. Difference of twenty three hours the benefit is much greater when patients agents were recruited within twenty four hours nausea and vomiting. Were more common with Oseltamivir with the number needed to treat to prevent an adverse drug reaction with block severe compared with Tam Veer. It was twenty five so the bottom line here is that blocks. Vera has similar efficacy to also Tam here. If given given twenty four to forty eight hours. After symptom onset symptom duration was reduced by only thirteen. Hours this was almost exactly what Dr a Bell L. The author of this poem found in his meta-analysis of awful Tam published in two thousand thirteen blocks of your does not seem worth extra cost in the United States eight blocks of yours one hundred and sixty dollars versus fifty dollars for also Tam Veer and there are no data regarding the effect on complications or mortality nor any data data for patients younger than twelve or older than sixty four the major advantages of blocks of your overall Tampier for those who choose it our convenience because it's a single dose and fewer adverse drug reactions with the number needed to treat of twenty-five there is a steps on blocks of your also in this issue if you'd like to learn more. Here's a dad joke jake invented. Jake is season one founding host assistant podcast editor and Co host. What do you call it when a Group of Wales uses a fishing? Reel podcast I'm Dr Doug Spots. President of the American Academy of Family Only Physicians Foundation and Vice President Chief Population Health Officer of America's health and Hagerstown Maryland. I'm a member of the Pennsylvania Academy of Family Physicians. Congratulations congratulations to AFP. podcast on one hundred episodes. I listened to them all as I commute to Hagerstown for work. I'm looking forward to many more episodes to come. Keep it up. Hey guys this is Kalina from season two of the pot. I just wanted to wish you all. Congratulations on completing. One hundred episodes seems like just yesterday when Avenue and Brad and I were in recording ourselves and thinking back to our season one of my favorite moments when I co hosted was when we were recording our preventive services game show so we realized that the game show needed someone to announce the prizes and are amazing sounded technical Guru Tyler Coles roles. WHO's hilarious quips? During our recordings were sadly never captured because he always lacked a microphone chimed in with about the best game show voice I've ever heard and this time. Thankfully he agreed to let us Mike Him and totally off the cuff announced some hilarious winnings. So Tyler her tell Evan what. He's one winners of the prevention priorities. Game take home a four pack of PNEUMOVAX ten years. Supply of FECAL occult blood test kits and a copy of the prevention priorities home game. Congratulations Evan Thursday. The way back on pilot episode to release December. Twenty fifteen I ask then American Academy of Family. Physicians President Elect Wanda filer. What she you would do if she was czar of the healthcare system? I think that if I could spark one thing I would have fifty eight percent of. US medical students matching in true primary. Care Primary Care Meaning family medicine predominantly staying in primary care pediatric staying in Primary Care Internal Medicine. It is what this country needs. It would solve so many problems including a spending way too much of our gross domestic product on healthcare that would free free up money for education and Housing and food security and I also think give Many of my my members those are one hundred twenty one thousand people Some relief and really change the trajectory of American healthcare to something that this country deserves. Now we have a point of care guide from Dr Polka from Seattle Washington diagnosing. DVD and non-pregnant adults in the primary care setting multiple physician groups including leading the A. F. P. recommend using a clinical prediction rule to assess the risk of D. V. T. prior to obtaining any imaging. Most of us are pretty familiar with the wells score for however a major limitation is that it includes the subjective assessment of whether a DVD is more or less likely than an alternative diagnosis. The Wells score has also been shown in Meta analysis to be less accurate in older patients and in patients with a prior. DVD another clinical prediction. Till you can use the Dutch primary Carol Carol. The scoring is entirely based on objective patient characteristics however it requires Di diamond test to be obtained no further evaluation for. DVD is needed in in a low risk patient with the wells score of one or less and a negative dedom- result or a Dutch primary care rules score of three or less otherwise doppler ultrasound of the affected what did legs should be obtained if an ultrasound is indicated based on your clinical prediction score and as negative for DBT. It is recommended to educate patients regarding symptoms of Pulmonary Mary. Embolism and repeat lower. Extra money ultrasound. Three to seven days so make sure you're using a point of care tool in suspected DVD. Let's let's close out with two more favorite moments from our first hundred episodes. Here's another one from season for high of podcast. This agenda Buchanan wanting to issue a very happy one hundredth episode. I think one of my favorite memories over the years is when Sean made us all very uncomfortable with his physical therapy the antics. Well it just so happens I did wake up this morning with some really bad acute. Low back pain wait. Hold on a second one two three in the world. Are you doing now. Don't mind me I'm just doing some physical therapy maneuvers is to treat my acute low back pain for but don't have a topic to cover takes. I just got to do this. Okay see if it works seven feeling. The burn fuel numbered two fires on to our ten. Yeah he's not stopping. Okay Gimme that script Sola. This works overall the benefit of physical therapy for acute low back. Pain provides a very modest benefit for patient. Asian oriented outcomes with A. B. Strength of recommendation. Should we tell Sean now I think just leave him here. This is Sherry Co Co host from season. Three my favorite podcasts moments are the spontaneous unscripted moments like pop quizzes especially when the hosts don't know the answer like this surprise the US PSTN recommendation. Quiz with Joanna. What is the United States Preventive Services Task Force recommendation on screening for Lipid Disorders Disorders in children and adolescents? Are Joanna. What did you put down D? I don't know thanks for listening to one hundred episodes known Hey Bill what's the N.. T. FOR AN AF P podcast rap J. It's about to be one. Oh yes yeah. We're on a straight from the top of the evidence here omitted and we were planning to bring that Pearl is the podcast. He's forgiven. uh-huh the guys on drugs. Keep God's in the topic Alex Paterson One hundred episodes. Then we're still going strong conduct data going on the Yes. What he thought was a Was podcast practice predicaments. Got You covered there whether there are low or too much choosing wisely and Cochran building up your knowledge with every do it is prevention and trees. Have you had your got practice. Get the whole picture the reduce newborns and Jerry AF. What the cash you know the podcast? GPS CAST Jake. Let's meet the crew. We got Steve with the welcome. Come with taking to the streets in the tyler. Working take time engineering. Wizard are constant magic in shape. Start checking out the bill by the snap. Our teams unmasks the key to it all started with booth making Evans twenty seventeen with Michelle Kelly Joanna Sherry Presley next was Shawn Kemp's Joe podcast mud with you on gold breath holding down now is to listen. Michelle Herbert Hillary borough around out shock. TKO On the US. You don't rest. They're just picking up stating what podcast. The G. Talk podcast. PODCAST was mad. Passover wait what you know like. If our podcast was a medication it would definitely Pasa steps review because it simple you use always going out for the tolerability but it's definitely man at eight seven. Yeah it's a missing Jack. The specialty the world keeps reverend. It'll never get because it's the AF was deep pond cash can it was yourself Thanks for listening to one hundred episodes with US please email us at. AFP podcast at AFP. Dot Org or tweet at a P podcast and remember to tweet us. If you WANNA shirt please. He's rate and comment on Apple podcasts. Our podcast faculty editorial team is Jake Anderson. Steve Brown and circles are resident hosts for all one hundred. The episodes are Jake Anderson. Megan Hunt Kelsey Lewis. Luke Peterson Brett. Daily Kalina Ehrenreich. Peo- Evan work. Joanna Campidoglio Sue Dash Michelle Hamilton Shari. Sorry Presley Kelly Wheeler Sean. Abreu Jenna Buchanan. Kim Kobe Joe Seal. Caroline Block Burger Elissa Cord Seen Victoria crimes. Herbert Rosenbaum Michelle summer. And and Hilary Tamar are sounded technical. Grew is Tyler Coles. Our theme song is written and recorded by family. Physicians Bill dabs Ryan Evans and Justin Jenkins. This podcast asked is brought to you. By the residents and Faculty of the University of Arizona. College of Medicine Phoenix Family Medicine residency. We'll talk to you soon for the next one hundred episodes at the American can family physician podcasts.

United States American Academy of Family Phy liver disease president American family physician family physician Family Medicine Joe Seal Anglia Sean Two College of Medicine Phoenix Fa cirrhosis Jake Anderson AFP University of Arizona AFC Michelle Kelly Joanna Sherry P Foy Michelle J W Lee
How To Stop Overeating, Overspending and Overworking

The Oprah Winfrey Show: The Podcast

38:10 min | 2 weeks ago

How To Stop Overeating, Overspending and Overworking

"Twenty five seasons four thousand five hundred sixty one episodes. I believe the oprah winfrey show was one of the greatest classrooms in the world Rolling never thought of it that line. The moments the breakthroughs. Lol's the connections the occasional ugly. Cry i missing so terribly. I missing every single minute. The moments that matter opening light lessons never allow them to take you somewhere else. I'm bringing them back. It's time to open the ball. I personally chosen these classic episodes to share with you again. Every single person you ever will need shares that common desire. They wanna know. Do you see me. do you hear me. That's what i say mean anything to you. You're listening to the oprah winfrey. Show the podcast when you are stressed or overwhelmed or you juggling family and work do you comfort yourself by eating anybody here do that. I can raise both hands by shopping. Anybody do that. You just feel better when you get something new. Why are you sh- you shop. Relieve stress or overwhelm. Definitely shopping takes care of everything. I can buy a pair of socks doesn't matter what it is. You're just out there. Yes okay okay who anybody here does relieve stress or being overwhelmed by having another drink. Thank you for being the one person who admitted everybody else's like no not that i don't do. Everybody has different ways of relieving stress. Some people they just. Yeah just start yelling. Same things over and over and over again today. We're going to find out how to turn off the desire to do these things. How to turn off the desire to overeat out of turn off your desire to overspend overwork drink. Too much laurel melons helped thousands of people stop behaving in ways that they say they hate but can't seem to stop. Laurel is a professor of family medicine at the university of california in san francisco and she has a new book out called the pathway the pathway and she says that the key to ending excessive behavior is mastering to skills self nurturing and setting limits. What does that mean. What it means is then the best of all worlds we would have been raised with parents and had the skill to nurture themselves so they could give that skill to us and they could set limits with themselves so they would set limits with us and if that happened to happen then by the age of six or eight or ten we'd be able to nurture ourselves and set limits and what that means is we would have to hear this connection. We would have emotional balance connection to ourselves intimacy with others spiritual connections. And i don't know about you but if you have all those connections working moment to moment throughout the day do you really need another cupcake. Do you really need another blouse. Do you really need another drink. It naturally turns off the drive. We soothe and comfort inside whereas all of that is your naming that i'm thinking i don't know nobody. But jesus has you don't have to have morbid all bran but anyway you don't have to have all of it all of the time but you know what life is a lot tougher than it was before a hundred years ago. You didn't need so much nurturing limits inside because what was going on. There was lots of nurturing outside. There was very slow lifestyle. There wasn't a lot of change so people overeat over work overdo all that overstuffed right overdue because they have lost a connection. They have lost this. They do not have sufficient skills and right now. We need a lot of them to be able to connect with themselves and create the kind of balance that makes the extra cookie not so necessary. Okay this is pam and her husband. David david learned that pam has racked up more than eighty thousand dollars in credit card debt. And he's still speaking tour. Today's and pam admits that she just can't set limits and buying things comfort her and now she says her life has spiraled out of control. This is an addiction. I feel like the alcoholic. Who can't stop. And i want to stop families. Says she hasn't found a way to set limits on her spending shop and definitely gives me an high. When i feel bad about myself. I go and buy an outfit. They the more. I spend the better. I'll look in the better off. Feel i have a lot of things with tags on them. I have bought so many exercise videos. Nutrisystem boxes that are opened my basement. We had a tv work perfectly. Fine and i felt we deserved more. So i went out and bought a two thousand dollar tv. I bought this ruby banned for my daughter lilly. Who's too. I had contacted a credit counselling company and they told me your credit card is eighty thousand. I wish shocked. I was very shocked. Our highest single credit card statement is twenty five thousand two hundred eighty one. The debt is like the walls are closing on me but pamela says the worst part about her crushing debt is what she fears. It is doing to her family. My biggest fear is that this was going to forever affect my children's future or my husband's job. This is really hard. I can't breathe. I'm on high blood pressure pills. When i spend i overeat i get anxious. I stay up at night thinking how i'm going to juggle paying this bill or that bill. I take it out on everyone around me. I do too when. I get to staff at my children. And my husband more than i showed. I find quite a few tags receipts from clothing around the house almost every day. He'll ask how are the bills. And i'll say don't worry it's okay. It's okay so to me. There's a little bit of deceit going on not healthy. I'm just afraid that. I have done too much at this point. And he's gonna leave me. Family says that her spending habits really spun out of control a year and a half ago when her eight year old daughter suffered a tragic accident. That pamela feels responsible for. I was backing out of the garage and shit. Her backpack in the backpack caught the door handle and pull the route. I read her over. And i'll never get over it. She broker famer and she is pins interlink. She'll always have that scar. And i'll always feel like i owe so much to hurt in. Its way i spend so much on here. I buy her things and she doesn't even want him. Since the accident. I have no tolerance. My mood swings are horrible. L. e. i'll shop. I'm trying to take some kind of pain away. But he never talked about this. I'm dying inside. And i don't want to feel like this. So pam with us and you want to say to her wanna say. I feel really sad. You've had so many losses. And what i know is that to any of us. We could have a horrible accident in all of a sudden our need for these skills go sky high and that's what happened a year and a half ago and that's when you started all this debt and all this eating but at that moment when that horrible event happened is hard for any of us to have the skill to go inside and feel our immense anger and sadness and fear and guilt in other words connect with ourselves and your husband rather than reaching for food and for spending and so it means you have to in a situation like this because i think everybody who's ever been through anything and if you've lived long you've been through something that tried to take down that you have to learn that it's how you respond to whatever it is you have to be able to go inside yourself and pull out. Whatever that is that's necessary. You have to have the courage to fight back when this thing you have to have this intense courage and you have to have the skill to feel all the feelings. For example. Many women cannot feel their anger in order to heal from a horrible thing. Like this you have to be able to feel angry. Sad afraid and guilty when you and i were working together i couldn't see any red hot anger. Come out of you and what happens is if we don't feel the anger. Our sadness falls off the cliff into depression and we don't come out for a long time when problems get out of hand such as a big big debt. It usually have to look to the couple as to where they passive aggressive and so where was the. Where was it that someone was not saying to each other. I love you sweetie. And i know i wanna rescue you from your problems. But i'm not going to talk about it or as a people pleaser because you're a people pleaser right saying to your husband. You know bucket by that sweetie. And i know i'm going to disappoint you but i've been overspending. So that kind of connection and communication is is less likely to happen if we can't nurture and set limits. What would you say about telling the truth to your partner and also telling truth to yourself if you are in denial. Right in such denial. Where you're lying to yourself about your life. Then how are you going to ever begin to tell the truth to somebody else. Because you're lying to yourself. That's exactly right. The the foundation for intimacy with others in the spiritual is intimacy with ourselves. If we don't know how we feel and what we need and can't spit it out. How are we going to connect with another person. Day whole day working with pam and two other women to get to the root of their excessive behaviors. Perhaps some of the things that she talks about learn can help you or watching. Laurel says it pam to learn how to begin to nurture herself which is what so many women are missing. We just give give give give to everybody else and you don't know how to give back yourself. The first step was to begin to feel your real feelings bill. Your real feelings. And i know that sounds weird. A lot of people because you go. I just feel what i feel but most people. Don't you end up pushing those feelings aside. You bury those feelings. You let other people tell you what you're feeling and so on but you have to begin to feel your real feelings and take out all of your emotional trash because that is what fuels your drive to overspend over eating other things and keeps your life out of balance in the tape. Laurel helps pam make a connection between a painful part of her childhood. And i know people are though here. We go looking at childhood again. Go dragging up my mom on a heart troubles but it's all there. It's all about something that's happened. You have for however many years buried. So we're gonna get painful bottle part of her childhood and her desire to overspend and see how that's connected and maybe this'll trigger something for y'all cash with you right now. What i want you to do is tell the story what hurt. That hasn't been healed from the past. You wanna begin to take out. I'm tired of thinking about my parents. Divorce when i was twelve. Good my mother left. I love her. I speak with her now. I love my father. Did the best. They could at the time. But i've really felt abandoned at that moment. What was it like for you when your parents split up. My mother called up one night and said she couldn't come home anymore. Okay let's just go right into the feelings we're gonna do angry. Sad afraid and guilty. I feel angry has divorced. I feel angry. Because i feel like my childhood. I was robbed. I feel sad that i didn't feel loved. It feel afraid that i'd never see my mother again. I feel afraid that she wouldn't either for my wedding. Keep checking feeling just said it. I still feel like i'm twelve. Second thirty four year old body win. You don't have the skills to feel it. And he'll it your development stops. I still feel like a child. It's a reasonable expectation. That is you take out. This emotional trashy will watch yourself begin to crow. I feel hollow on the inside but nobody around me my family. My children don't see that side. They see you know what happy or pretty mom who wears her makeup as soon as she wakes up in the morning does her hair nice so under all those feelings. There were probably some expectations. You had that you're still holding onto. I felt like i had to grow fast. Even though i feel twelve from that moment on i felt like i had to become an adult in parent myself. But let's double check. What else 'cause. I heard something else in there. What i heard was. I expect at that moment to stopping me. Yes i at that moment. Stop being pam. I want you to think back to that twelve year old in deep inside of you tation a make him he think about so much that i can see it why i have to please because i think i've always been trying to please but my expectation was that i have to please others not myself but i've been policing myself by buying clothes. Is that really please. You know it's what you want not what you need. I expect myself do the best. I can to stay in balance connected to myself. I expect myself to do the best. I can to get my love from me. I expect to get my love from me. And not others fabulous. Wow well that took a while to get there and also it takes. It's one thing to say it. It's another thing to really believe it. Are you there yet. I am getting there my. I'm on the pathway on the pathway. And that's why it's a pathway oprah because what happens is the reason that you feel that way is because over and over again the contact you had over and over and over again. The contact you had early in life told you that you didn't matter so it's not going to be that you can snap your fingers and use this method on one occasion and have it all done because your inner life has read the book and nothing happened for pam to have deeply within her bones. The sense that she matters will take about a year and a half of working in workbooks and on the internet and groups with these skills but the important thing is that it will go away. It wasn't until she got into her feelings very very deeply that she could find that basic expectation that had been emblazoned on her early ali-aliens. Also what you believe. Because one of the things that i teach seminars do around the country is that you you end up becoming what you believe. Not what you necessarily want. The same thing within. The difference between believes is expectations. Is you believe something's going to happen. The expectation is one step further. Yeah i believe that life is unhappy. Because i grew up in happy. That's one thing but that's if you're apparently child you've left yourself on the highway instead. You change it to an expectation. Say i know that. I expect life to be unhappy because my life been happy but i expect myself to do the best. I can start building a happier life. In other words it gives you responsibility and power and instead of just living with how it's been okay. Laurel says the key to learning to nurture yourself is to ask three questions throughout the day. Starting with how do i feel the reason we go down to feelings. His feelings are far deeper than thoughts. We're thinking all day long right but it doesn't connect with us. You have to go under the thoughts to the feelings in other words you see. You won't really know what you need and begin to take care of it until you go right down to your everybody kind of ignored that i saw. Y'all go but that is so fundamental is so undiminished you come down to a feeling and then when you get something am i feel proud. Yeah is very important for pam. Because most of the time when we don't have as many of these skills we need a teeter totter. We're all good and then we're all bad. We're all happy. Then we're all sad we're passive aggressive and we're trying to find balance. It's very important when pam pam to do that you tend to go way highway low right. So let's do your feelings check. Let's say you you feel like pulling going and getting something to eat or getting your credit cards and instead you go for this. I feel skill and you say how do i feel and you come up with one good feeling when difficult one. I'm feeling so satisfied. That i ate that taco because i was thinking not to eat the top appealing today you. I'm so glad. I because i feel so satisfied and did not eat to talk all day. I was going to be thinking if i just had the taco. I wouldn't be like rumbling around looking for something else to give me that ten to satisfy some feeling so satisfied good. yeah yeah. Are you all feeling satisfied very good. And you're feeling proud beyond proud. That i i'm taking this step and don't you feel good knowing first of all that you are in control of this. Yes that something happening outside of you and that you can just all of a sudden wait for it to happen that you are the one who's going to either make it better or are you gonna go into the great abyss right and i don't wanna go there so the kids. It's how do i feel. What do i need and do. I need support and for example. My friend here. Pam has a very hard time like many of us do making requests of others. If we can't receive the love and connection around us we're going to be getting in some way or another. That's not quite as healthy. We're giving you some tools to bring balance to your life by digging deep or begin to discover why you overeat why you over spin and why you work too much. This is tracy who says that she cannot turn off the compulsion to overeat and overwork. I consider myself a said excuse of a woman. I'm an overworking overeating overspending miss. I currently work three jobs on time. Two part time jobs sometimes a four day week. I'll put an average of ten shifts. A work doubles back to back. I work a lot of weekends to my family does not need the money that i bring in from all the jobs that i work. I have a lovely home. I have beautiful gardens that my husband works diligently and making beautiful for me so that i can enjoy him and i don't even have time to spend here at the house to see what is blooming or certainly mesler on guess late at night and and there's nobody here but me and the kids don't know maybe tonight there's times i feel abandoned daughter-in-law quite frequently meshing. That mom's never home at times. I don't have a full-time partner. Since she's he's gone at all the different jobs all the time. Overworking certainly impact the children particularly a little girl. She just doesn't have the time with mom. Disband the we feel. She needs to to grow up and develop. My friends asked me why. I work so much and i think it's because i lack something in my life. Not doing what i really wanna do. I often feel a shame. My friend told me in a very high regard. And i have a lot. I don't tell them about they'd be shocked. Yeah I wanna number one with cheese. I'm a constant ater. I weigh two hundred pounds. You would think with all the work that i do. I wouldn't have time to eat. But i do. I will stop at drive-thrus in between jobs and stuff myself. Always buy meals with cash that way. My husband doesn't know how much i i spend eight. I have issues from childhood that i have not dealt with every day. My father told me. I would never amount to anything. I was useless. I was nothing of as fat lazy stupid. It's that voice in the back of my head. That says no matter what you've achieved no matter what you've done you're still nothing. It makes me very emotional. I feel like a failure sad. I can't seem to set a goal for myself and achieve it. It makes me mad at myself. And even though i've spent years journal laying and digging in searching and opening myself up to new ways of thinking. I'm still this insecure pathetic failure. I feel that. I'm not doing anything meaningful in my life. I'm tired of seeking answers to my problems. With work food and shopping. I am emotionally and physically completely worn out and out of balance in my life so laurel says that tracy is wildly disconnected from her family and herself. Does that mean. It means that she has so much emotional trash and she's so disconnected from herself. That she's so busy with with with spending and eating and working that she can't grieve and just be in her own body connect with their own feelings and be aware of their feelings. She can't she also said she'd lost her spiritual connection. And that's why when you when you have a traumatic event and you don't clean up that emotional trash. The feelings are so difficult in hard that you just turn them up. You just turn off your feelings and when you turn off your feelings you lose all the connections and then your loss the feeling of being abandoned and lost and not able to really reach anything. Sweet and warm and real within her. What we're talking about the really. Your book is called the pathway. And it's about the pathway to your own emotional connection. Yeah connection is a key word and what i think. It's very easy to look at other people who overspend you eighty thousand dollars. I would never do that or my husband be crazy. My husband would leave me. And so say i wouldn't do that but yours is coming out and other ways and i think a lot of people. Overworking is really easy to justify. All right you acceptable. Form of being out of control and only one person said that they over drank stigmatizing. How many people here. Overwork lhasa overwork over exercise people please rescue. They have the same dynamics in the same routes but they're socially acceptable right whereas if you shoot up heroin and if you drink yourself silly and you eat yourself to four hundred pounds and you spend every sent in. The family is not so socially acceptable but they have the same roots. And that's why most of us have more than one excess. So if you spend all your your time and energy on fixing every single problem focusing on the problem you're gonna be broke and you're going to be disappointed instead. Go to the roots and the roots are inside you to pump up these skills to create balance and connection inside their skills and anyone can learn so anybody overspending overeating overworking overindulging any way. Yeah the root is. You're out of balance with yourself in your own. Life is the route you have not do not have enough of these skills given your life situation to be able to connect with yourself and all you have to do is pump those skills up practice them just like going to the gym. Except you're practicing. How do i feel what do i need. What's a reasonable expectation intel. You notice that is just natural. Okay take a look at how tracy makes connection that. Overworking is her way of avoiding her real feelings as raised what they father. That insisted daily. That was useless was baton ugly and unworthy of nothing. That's that voice in my head. That won't ever go away and i hate that. My mother felt that the best way to nurture and raise us was to leave us so that she could find what she wanted. As opposed to what we needed win. No matter what you do now to be successful with your work with your family in your life it doesn't matter no because inside you your mother said you don't matter so you still don't matter today. I'm afraid that if. I don't have all the work that i have then. I have to stop me with me and i don't wanna stop to be with me. I stay busy doing things even though they have no real meaning in my life so this is why it goes from generation to generation to generation. You can see it in your own family. My kids are being abused by my neglect. My kids are going to end up as unstable as i am. I mad that. I've allowed myself to work to eat to spend myself into abyss. I'm mad that i'm not home. What my husband to help him. I'm disgusted in the fact that. I'm not there to help him with the children with the house when i am there. I'm emotionally disconnected from them. I'm so wrapped up in myself and the ugliness of what i think of myself feel horrible that i'm doing the same thing. My mom did to me. Well that is a big o. Connection you yeah realizing that you are number one neglecting your children the way you were neglected and doing the same thing pushing people away pushing them away wishing it's exactly right. Yeah exactly. Did that help you in any way. It tremendously tremendously. It's been it is the capital that has put me over to where i can finally say i think i'm going to be able to deal with it now and just accept that. It's okay and did the best that i could and go on to do better. Now law recommends it. Tracy ask yourself how do i feel. What do i need every hour every hour. How do i feel what do i need. How do you feel right now. Anxious anxious scared scared of having to face it To deal with yourself yes. I think that's so interesting and you know what you know. Millions of people are watching you. Don't let the but millions of people are watching you. And i bet you there are a number of them who identify with what you say that the being themselves is is what they're really running away from yes and laurel says it takes about two years of asking and answering those questions. How do i feel what do need to begin to. Retrain your brain. I understand exactly what you're what you're talking about because what is happening here is for years based on what you were taught about yourself. You grew up as a kid. You believe that you believe that you then reinforce that so even when you don't have your mother telling you you're reinforcing at reinforcing it all the time and for everybody who's tried and failed and try and fail it's not about just getting up and telling yourself something different. It's about completely retraining. Your brain because he's not have thought and og right now. I'm okay correct. And that's that's right and that's why we have to have some compassion for ourselves. So have you started doing the work. Yeah and how does that work for you. What does that really mean. It means being in the moment with myself and taking an tell us an example of when you've had to do this. And what was going on. I had i was headed home yesterday and i had a lot of things to do to prepare myself to leave town for a very long trip and i was very anxious and i was getting overwhelmed and i was starting to feel angry about it and i was driving home and it hit. I start thinking okay. What do you really angry about what he really wrangler about. And i stopped in the moment. I took my pulse and i said i'm angry because i have this emotional trash and then i went on to say okay. Well then that makes me sad. Why does that make me set. It makes me sad because it happened because it happened to me. And then i went onto thinking of what i was going to do about it in that moment in that moment i just started crying. I lost myself because it was like this is so easy and it became so immediately natural. There's so many other things. I'm sure that. I have to do but just those few sentences alone stopping taking my pulse and saying what am i feeling. Now why am i feeling that. Is it reasonable. I asked myself. Is it reasonable to f- to to feel that way about my emotional tracks and absolutely. It's reasonable to feel that way. Now what am i going to do about it. What do i need your. Because he's a follow up question. Do i need support moments moment. All of this is about nurturing and limit and let me being able to nurture yourself and set limits. Good parents give you both nurturing limits. If you just have nurturing leads to indulgence correct. You need to have the balance of dirty limits inside you okay. So you're be being able to give yourself what your parents were not able to give you precisely. That is a process that is a process. Yeah however it's what that means is is not that they didn't love us if they didn't have skills they couldn't give them to us what it's easy to sink into self pity and blame instead take the baton from your parents and give those skills to yourself. Okay thank you tracy. Thank you meet melissa. Now who says she is. The mother of all people pleases is mother of them all aereo. I worry tremendously. I worry that. There's not enough hours in the day to do all the things that i wanna do. Melissa's pretty much everything. I keep a pen and a pad in my purse. I keep one in my goal compartment in my car. If something's not on the list and we've planned the day that's like world war three. We meet friends for dinner. If they're not there on time. I lose it not always. The skin stressed out. I mean she does have high blood pressure and i tried to tell her all the time she just needed. Relax a little bit pretty much melissa's bam bam bam. She has time frame a time schedule. Stay up at night. Worrying people pleaser and i will at times off things for me and my husband tele melissa bar ucar melissa account borrow some money to go to the grocery store until i get page or sure. Sure nobody of course. My husband's always in the background when to take a job tomorrow. That's kind of short notice. But i already down and i'll see what i can do to get you know. Get it all done. She does does various things coping. I mean shopping is something that definitely relaxes. Her shopping makes me happy dress. Shoes house shoes sandals jeans but then the bill comes every month. And it's like did. I buy the credit card bills are bad when my husband and i first started dating i would say i probably weighed about one hundred and fifteen pounds now about one hundred fifty five pounds. This is snack haven salsa and dip granola bars hostess. Anything always makes you feel better better than having it's hard it gets. It gets tough at times. Feel worried that. I'm we'll have enough time out of the day to just look into my husband's is and tell him i love and it's no no for me for my husband laurel says melissa has paper-thin boundaries as do all people pleasers. Yes yeah people pleased have buried thin boundaries. Because there's no acceptance inside. There's no strong nurturing voice inside and usually there's emotional trash from the past of early rejection paper-thin boundaries may meaning. Anybody can awesome at any time. Anybody i know how you feel and what you need. But do i know how i feel and what i need. No what i need in order for me to feel good. You have to like me. You have to love me. Because i don't have that nurturing loving voice inside myself i'm dependent upon it. I'm depended upon your acceptance. Because i haven't gone downside to interface that i am alone and that leads to a false comfort. Aren't people pleasers underneath really angry. Hello underneath all of them. Pleasing and pleasing aren't if you were to scrape the surface great. Go down go down. Go down there. There's a lot of anger there for. There's a lot of anger and there's a lot of despair because they feel so deeply unloved. The early history for most people who are people pleasers was of parental rejection. And so the whole key is to take out that emotional trash. We'll see in a minute and feel our feelings and and will listen a person who is highly thinking oriented which has a problem to it. Those of us who tend to be not feeling oriented like pam was the thinking oriented. Do great in the world we go out and we analyze and we make things happen. We take action however we don't feel so you cannot have a connection without a feeling so we're cut off from ourselves our relationship but they're not connecting and the spiritual and so we end up doing one excess. After another so one of the things that i want you to do. My dear is to disrupt. The obsessive repetitive thoughts. All that list making you're not worrying you're obsessing because over control an obsessive thinking god is a way of getting the illusion of control. The real control you have inside is the practice moment to moment throughout the day of going inside and finding your field says it again the over control on the list listening. May she's worried she's not worried. She's obsessing. Her thoughts are racing. That you're creating that you do have some control. Not only so another words the more you think you think if i can just figure it out if i can just analyze it enough then i can control it. And it's just a complete illusion and yet is it takes a lot of time. It's socially acceptable to analyze everything. But it doesn't give your heart your soul. What you truly need. What do you think about what she's saying. She that's correct. Uh-huh i should absolutely correct if i do something i have to see it. Through to the end there is no everything has to have a beginning middle and end and end. Can't come in the middle and the beginning in the end you just if it happens like that then that's it. I don't want to forget it. You're like this a very famous person might've been emmerson. I don't know who said some people are so busy leading the lives they planned and so you can't leave the life that was meant that be that would be me. I love the most of us have Who don't have enough of these skills had parents who were either too easy on us or too hard on us. Who didn't have any real expectations of us didn't expect much or had rigid harsh expectations. And you had harsh expectations on you and so the harsh expectations went from your dad. And your mom to you. And how was it for you to have those harsh expectations inside of you know gosh. It's like a volcano right about to re and so what you're going to do because that's not genetic it's learn is moment to moment. You're going to begin to switch expectations for my have to be perfect to. I expect myself to do the best i can. I don't have to be perfect to be wonderful. That's my new model. That's going to be written down. I'm oprah winfrey. And you've been listening to the oprah winfrey. Show the podcast if you haven't yet go to apple podcasts. And subscribe rate and review. This podcast. join me next week. For another oprah show the podcast. Thank you for listening at target. Your dollar goes further for just one dollar and eighty nine cents at some sparkle to your picnic with a two liter bottle of coca cola soda physi- fund and a great deal. And that's just the start at target. The low prices never end. Prices may vary.

pam Laurel oprah winfrey pamela tracy David david pam pam mesler university of california lilly laurel san francisco oprah depression Pam melissa
S5: Love: Fred Jablin and Piper Rountree Pt. 2

Parcast Presents

59:17 min | 1 year ago

S5: Love: Fred Jablin and Piper Rountree Pt. 2

"Love is patient. Love is kind but sometimes love can be deadly if you enjoy these episodes on. Fred Chaplin in Piper Roundtree. You should check out. The crimes of passion podcast. Every Wednesday will tell a love story that turns into a crime story. Follow Crimes Of Passion. Free on spotify and anywhere. You listen to podcasts. Due to the graphic nature of this week's crimes listener discretion is advised. This episode includes discussions of violence and murder that some people may find offensive. We advise extreme caution for children under the age of thirteen piper. Trying to control her fidgeting as she waited in the airport security line she had heard on the news that after nine eleven. Tsa agents received Special Training In. How do identify a suspicious person? Piper wasn't a terrorist but she was traveling under a false identity. She couldn't afford anyone looking too closely at the stolen driver's license. She carried just calm down. She told herself. Piper exhaled slowly and smoothed down her blonde wig. It was almost her turn at the podium. She had to make it onto the slight. This trip was her best shot at getting her three kids back and without her children hyper wasn't whole every day she ached for them. The TSA agent motioned up hyper with the blue gloved hand. She stepped up to the podium and handed over her paper boarding pass and stolen ide- she could feel her heart beating in her eardrums as agent looked back and forth from the driver's license to Piper's face. She smiled at them. Please let this work. The agent scrutinize the. Id please please please thought. Beiber the agent remarked you know. My daughter's name is Tina to she. Hates it then? He handed the licensed back to Piper and signed mark of approval on her boarding. Pass hyper giggled. Giddy that her gambit worked she replied. I know Tina feel so ordinary sometimes my younger sister Piper. She got the best name in the family. The TSA agent chuckled and motion for the next passenger in line. Have a nice flight. Miss Rowntree Beiber kept smiling all the way to the gate. She was going to get her babies back. Hi I'm Laney. Hobbs and this is crimes of passion a podcast. Original in the legal definition a crime of passion is a violent crime that occurs in the throes of extreme emotion leaving no time to reflect on the consequences but in this show. We explore passionate crimes. How does a marriage progress from husband and wife to killer and victim or killer and co-conspirator if there's a thin line between love and hate what manipulates our relationships and deadly results? Last week we follow the relationship between Fred Chaplin and Piper Roundtree and why after twenty years of marriage. They decided to divorce in two thousand one. The separation was hard on all parties. Both Fred and Piper vying for custody rights of their three kids in the end Fred was awarded. Full custody hyper was destroyed. This week will explore the drastic action Piper took to reclaim her children and the aftermath of a murder. We'll follow the investigation. Eventual arrest and trial at podcast. We are grateful for you our listeners. You allow us to do what we love. Let us know how we are doing? Reach OUT ON FACEBOOK AND INSTAGRAM. At podcast and twitter at Park Cast Network. And if you enjoyed today's episode the best way to help is to leave a five star review wherever you are listening. It really does help us. We also now have merchandise head. Depar- cast dot com slash merch for more information friends and neighbors often described fifty two year. Old Fred Joplin and forty. Four year old Piper roundtree as having opposite personality types. Fred had a more black and white way of looking at the world. Orderly and logical Piper on the other hand was a free spirit incredibly artistic with an outpouring of emotion. Piper saw herself as the consummate nurturer and the epitome of Motherhood According to the Book Die My love by Katherine Casey. She said being the mother is my personality. My thing it's my purpose in life. It's simply when I am at my core. Therefore when Fred was awarded full custody of their children in May of two thousand two Piper felt like her world was ripped away from her before. I continue with Piper Psychology. Please note that I am not a licenced psychiatrist or psychologist but I have done a lot of research for the show. Mia Smith BYNUM. A professor of family. Science at the University of Maryland explored the effects of four separation. Such as losing custody on parents. She wrote forceful separation is particularly damaging when parents feel. There's nothing in their power that can be done to get their child back. That helplessness can lead to a feeling that Smith bynum referred to as ambiguous loss parents. Who experienced this more unable to find closure she said you know your kid is out there but you don't know if you'll be able to parent and take care of your kid again. People become frozen in their grief when Piper found herself in dire financial straits after the divorce she was forced to move back to Texas even further away from her children exacerbating her feelings of loss and four separation. Then in the fall of two thousand four hyper learned that her ex husband had started a serious relationship with a new woman. Suddenly a stranger had more access to her children than she did was able to care for them in ways she could not just by her proximity by the end of October. Piper reached her breaking point on Thursday October. Twenty eighth two thousand and four Piper flee from Houston Texas to Norfolk Virginia. She rented a car at the airport and drove the ninety miles to Richmond. But she didn't notify Fred or children of her trip in state at a nearby hotel instead of with one of her friends in the area in fact when she spoke with her twelve year old son. Paxton in the afternoon on Friday. The twenty ninth. She told him that she was in Galveston Texas on our way home. After a day of work what follows is a version of events that is best supported by the collective evidence. Please note this was not the only version of the morning of October thirtieth presented to investigators that Saturday morning. Piper woke up in her hotel room at four. Thirty a M. She listened to the voicemail on her cell phone went about her morning routine and checked out with the front desk. She got into her rental car just before six. Am The son. Wouldn't be up for another hour. At least under the cover of predawn darkness hyper said her plan in motion. It was only a ten minute drive from the hotel to hearth glow lane but Piper still found herself repeatedly checking the clock watching the digital numbers. Take the minutes away. She tried to channel positive energy so far every step had gone off without a hitch. She wanted that trend to continue. Pipers Cuban this morning would decide her children's fate. She had to be perfect soon enough. She was making the familiar right. Turn down the quiet. Residential Street Piper drove past the house. Where her ex husband and children slept parking the rental car around the curve out of sight. She turned off the engine. The digital numbers read six. Oh Seven A. m. When Piper got out of the car. The slamming of the driver's door drew the attention of a few dogs in a nearby house. Making them bark incessantly. She cursed them silently. Lynn prayed for them to shut up. It was paramount that no one spotted her in the dark. She quickly dashed down the street hiding behind thick tree. Out of view Piper forced herself to stay hidden calming her breath until the dogs quieted down. It was now six fifteen. Am STAYING OFF THE STREET. Hyper picked her way through the neighbors yards. She moved cautiously without drawing the attention of anyone else when she made it to fifteen fifteen hearth glow. Piper stayed hidden in the tree line. A light was on in the upstairs. Master Bedroom Fred was awake right on schedule. The clock read six twenty five. Am It was hard for Piper to return to this house? Now with each visit she noticed more pieces of the home. She knew removed the princess mural she painted in the girls bathroom was wallpapered over the framed family. Portraits replaced with photos that didn't feature Piper several members of the large brood of rescued animals. Were re homed slowly. But surely all signs of Piper's influence or being raced and she knew one person was to blame for these injustices and so much more fred as if summoned Fred. Javelin stepped out of the back door of the house. It was just after six thirty. A M pipers pulse race does. She watched him make his way down the driveway. She worked up her nerve to confront him thinking about all of the things he taken from her. He stole her babies her life when Fred been down to pick up the newspaper. Piper emerged from her hiding place. She conked the thirty eight revolver in her hand. Piper took aim feeling the guns wait. She should have done this months ago when Fred stood up. She called out to him. He didn't have time to respond before. Piper fired. The neighborhood dogs immediately reacted to the noise. Barking Piper dashed across the grass and into the darkness sprinting as fast as she could to the rental car her heart pounding hand shaking from Adrenalin. She fit the key into the ignition and brought the car to life. She grip the steering wheel tight and sped off down the street. She'd been perfect. The dogs weren't the only ones who heard the gunfire that morning according to Katherine Casey's Book Die My Love Fred Chaplains Neighbor Bob. Mcardle was laying in bed already awake on the morning of October thirtieth. He recognized the three successive bangs as gunshots and immediately called nine one one however when the police arrived and did a sweep of the surrounding area. They found nothing out of the ordinary. They told Bob that this wasn't uncommon. Sometimes they never discovered the source of random gunfire after the police left. Bob went about the business of starting his day. He and his wife Doreen God dressed unleashed up their own dog for their customary morning walk when they reached the Javelin House. Bob and Doreen stopped short at something in the driveway. The Sun wasn't up yet when the police searched earlier now in the early morning. Light the source of the gunshots was revealed laying on the driveway next to his car. Was Fred Champions Lifeless Body Bob and Doreen immediately? Re-summoned the police. The police worked quickly to assess the scene. Paramedics attended to Fred Joplin's body and officially pronounced him dead. Neighbors informed the officers that the three javelin roundtree children were so far unaccounted for officer. Robbie rimmer unsure of what he would find inside. The House led a Swat team through the back door. He discovered the children unharmed in their bedrooms. He told them that they needed to leave the house and escorted them to safety. Once they were in a more secure location ovid fall to the special victims unit to inform fifteen year old Jocelyn twelve year old. Paxton an eight year old Kelly that their father was dead in the driveway where Fred's body was found. The forensics team recovered a stray bullet in the grass but no shell casings. An initial search of the property ruled out robbery as a motive. The house was still in order and nothing appeared to be missing. The burglar alarm was deactivated and several valuables remained in plain sight it appeared. The shooter never entered the Javelin home. According to the Department of Justice fourteen percent of all homicides in the United States or perpetrated an intimate partner in addition separated and divorced men and women represented the highest rates of homicide as investigator Koby. Kelly gathered more information from neighbors. Heard a great deal about Fred and Piper's contentious divorce proceedings mel foster who shared a fence with the chaplains told Kelly about the false domestic abuse. Charges Piper filed as well as a libel is psychological profile on Fred. She emailed on mass after the custody decision. The sentiments of the neighbors were echoed by Fred's brother who suggested Kelly consider Piper as a suspect. Dr Markman Schick author of the INTELLIGENT DIVORCE. Wrote domestic violence stems from a loss of control. The perpetrator believes that she is a victim. And that a wrong desperately needs to be righted unless she moves onto another victim or gets carried away in a relationship that has some health engendering energy. She will not let go. Some people simply nurse their wounds waiting for the right moment investigator. Kelly wasn't want to rush to conclusions but he reached out to the Houston Police Department and ask them to locate Piper roundtree. All if they could confirm she was thirteen hundred miles away. It would rule her out as a suspect and at the very least someone needed to inform Piper of her ex husband's death but when the Houston officers arrived at Piper's house she wasn't there. They left a message on her cellphone asking her to get in touch with police as soon as possible. In the meantime Kelly subpoenaed pipers phone records to verify. Paxton's account that Piper had called them from Galveston Texas the day before Friday. The twenty ninth. Kelly also reported speaking with their mother on the twenty ninth but wasn't sure where she had called from. However phone records indicated that Piper Cell had pinged off towers in Virginia. Both on Friday. The twenty ninth and Saturday. The thirtieth one of the Towers Ping the morning of the murder at four thirty a M was less than five miles away from the Javelin House on hearth glow lane. The investigators quickly shifted their energies. Their top priority was now locating piper. Rowntree coming up. Police follow the evidence to track down. Piper now back to the story on Saturday October. Thirtieth two thousand four fifty two year old Fred. Jabarin was found shot to death in his driveway in Richmond. Virginia when police found evidence that Fred's ex wife forty four year old piper. Roundtree was five miles away from the house only hours before the murder. They prioritized efforts to locate her in addition to placing Piper and Richmond. The records indicated that in the hours after the murder. The phone traveled southeast. Norfolk where the airport was located. The Last Ping in Norfolk happened. Close to twelve pm an hour and a half later. The phone pinged in Baltimore Maryland. Over two hundred miles away to travel that distance in such a short amount of time investigator. Koby. Kelly surmised that whoever was carrying the phone had flown from Norfolk to Baltimore. He sent officers to the Norfolk airport with a picture of Piper to ask if anyone remembered seeing her there he also contacted the TSA to check flight manifests. There wasn't anyone by the name. Piper roundtree or Piper Champlin but there was a teen around tree listed on a southwest flight. She was ticketed to fly from Norfolk Virginia to Houston Texas with the layover in Baltimore Maryland. The Flight Times match the Cell Phone Ping activity by the time. Kelly learned this. The plane was due to land in Houston in a little over an hour. He immediately directed Houston. Pd To send officers to Hobby Airport with photos of both Piper and Tina rowntree. Kelly wanted to confirm exactly which sister stepped off that plane and instructed. Hp D. disease any luggage. She carried Houston officers. Brek mcdaniel and David Ferguson arrived at the gate with only minutes to spare. Before the eighty southwest passengers started depleting. The officers stood on either side of the jetway scrutinizing the faces that pass by but none of them resembled Piper or Tina. Roundtree mcdaniel in Ferguson. Asked the gate agent to check the flight records. Lee discovered whoever was flying under the name. Tina rowntree had checked the bag. These sprint into baggage claim hoping that they could catch up to her but by the time they reached the carousel. All the luggage had been collected. And there weren't any passengers in the area mcdaniel and Ferguson reported their bad luck to Kelly. They missed her. He instructed the Houston officers to drive to Tina and Piper Rowntree's homes to see if they could catch up to either one of the women. Kelly also told them he would be on the first flight to Houston the following day when officer mcdaniel reached Tina Rowntree's house at six PM on October thirtieth. Nearly twelve hours. After Fred Javelin was shot he saw a black jeep parked in the driveway. When he ran the license plate he learned the car was registered to Piper. Roundtree sure enough a few minutes later. Piper exited the house and climbed into the vehicle mcdaniel trying to pursue her but eventually lost the jeep after another car. Cut Him off around the time that mcdaniel spotted her in. Houston hyper called her best friend in Richmond Lawn. Ll Loney was despondent on the other end barely controlling her tears as she told Piper. What happened to Fred? According to die. My love hyper seemed indifferent to the news that her ex husband was dead. Lonnie reiterated to her sobbing. No you don't understand. Fred was shot and killed in the driveway at the house. But according to Lonnie hyper only wanted to talk about the kids where they were and when she would be able to pick them up. Stunned Mani told Piper to talk to the police and they hung up around nine PM on October. Thirtieth Piper Officer. Kelly finally connected on the phone again. Pipers only concern was the whereabouts of her children. She said to Kelly. Can You? Just tell me where my kids are? I need to come get my kids there. My kids I have custody of the kids Kelly trying to coax more information from Piper on the divorce and her feelings towards Fred but she was singular in her focus. She wanted the children immediately. Kelly admitted that Fred's will made arrangements for his brother to have custody in the event of his death. That information made Piper furious. She eventually hung up on Kelly and when he called back her phone when straight to voice mail he would be forced to continue their conversation the next day in Houston while Houston. Pd officer Ferguson. Waited for Richmond. Pd officer Kelly to arrive at the airport. On the morning of October thirty first officer mcdaniel said in an unmarked police car in front of Piper. Rowntree's house around ten. Am mcdaniel watch. Pipers black cheap park in the garage ones. Kelly landed he and Ferguson headed over from the airport together. The men knocked on the front door of Piper's house but once again no one answered. Kelly rang the doorbell still nothing. They double the garage through the window. They could see the jeep parked inside. They tried the front door again. Knocking and ringing the Bell Kelly caught pipers phone and he heard it ringing inside the house but no one answered and still. No one came to the door. Eventually they gave up. Kelly mcdaniel headed for Tina. Rowntree's house hoping they'd have better luck with her leaving Ferguson behind if and win Piper emerged. They wanted to be sure they had is on her. However not long after the other officers departed the black jeep. Suddenly zipped out of the driveway. Ferguson gave notifying officers Kelly and mcdaniel. He followed the black jeep to a shopping center. Parking lot and saw Piper emerged from the vehicle he quickly parked in the spot next to her mcdaniel introduced himself and identified that he was a police officer he asked Piper if they could go back to our house to talk but Piper brushed him off. She said No. If you want to talk we can talk here but I. I need to run an errand. I have to get crickets to feed my frogs with that. She walked away from mcdaniel. And into a petsmart he called investigator Kelly with the update the other officers race to meet him at the Strip mall but before they could arrive Piper reemerged from the pet store. She bustled past mcdaniel and climbed back into her jeep. He tried to stop her telling her that police from Virginia wanted to ask her some questions but she slammed the door in his face and turned the key in the ignition as she sped away Piper watched the officer who her in the rear view mirror. She swore under her breath when he hopped into his own car and followed after Piper knew her rights and she didn't plan on talking to any of the cops they could ringing her doorbell a million times. She didn't care hell hole at them. Pitch a ten in our front yard. She knew they didn't have anything on her. This Gomer pyle was on a fishing expedition. She recognized him as one of the police officers at the airport the day before. Thank God she warned the whig if caught her traveling with a ticket in her sister's name she'd been screwed but no one saw her get off the plane and no one saw her in Virginia. She'd been too careful for that when Piper check to rear view again. She realized that another police car had joined the tail. They really meant business. She picked up her phone and called her sister. Pipers voice cracked as she said. Tina I need your help. Tell me what to do knowing they'd catch up with her eventually. Piper led the police to a small office building in downtown Houston owned by an Attorney. Martin mcvay when Piper initially moved back to Houston. She rented office space in McVeigh's practice but operated independently with her own clients. She had put a wooden sign in front of the building with both of their names on it but hers was now painted out eventually. She decided to leave the law for a different job but piper and mcvay were still friends and Tina suggested that his office was a good neutral ground to speak with the police. Inside the building officer Kelly started off by reassuring Piper that Jocelyn Paxton and Kelly were safe and being looked after in fact he offered Piper the opportunity to speak with the children. Knowing how fixated. She was on their wellbeing once they were able to get the kids on the phone Piper spent nearly half an hour talking to them to. Paxton her twelve year old son she said Paxton. Your Dad is dead. I don't want you to be next. Paxton I'm afraid for you guys. You're uncle Mike will inherit everything when you die Paxton. There's probably millions if I were you I'd ask for police protection. She added later. Your uncle is the only one who would profit from this once. Piper hung up with her children. Kelly asked her to clarify what he'd overheard her telling the children want to. You Think Michael. Javelin had to gain from his brother's death. Piper knew that Fred named Michael as beneficiary even if the majority of the estate and insurance money went to the children. Michael would be the one holding the purse strings. She said Fred did not like Michael. I know that Michael certainly hated me. He hated my sister. Any still hates my family. If you look at money if you look at position if you look at opportunity you know the normal type of motives. Michael Jamling inherited two million dollars or so from Fred's death. He was the one who stood to gain the most piper then broke down into tears accusing Michael and fred of keeping her from the children at all cost. Dr Markman ship identifies several character traps that spouses ball. Into during a contentious divorce he would leave will piper as a mixture of the victim and the Avenger. The victim he described is paradoxically ruthless in victimizing anyone. Who they believe hurt them. They have a powerful sense of justice and self righteousness. The Avenger doesn't just want to win. She wants you to lose. She will not be satisfied until you are hurting. The Avenger sees revenge as an end in itself. When the Avenger is combined with the victim character trap such people can lose touch with reality. She will stop at nothing to make. Sure that you cannot be happy according to Katherine Casey's Book Hyper also pointed the finger at the University of Richmond. Were Fred was a tenured professor. She attested that Fred had control of the schools. Three Billion Dollar Endowment and all its employees. Someone from school might have come after him. In actual fact the endowment was closer to one billion dollars and Fred had no connection to how it was spent whatsoever Piper then claim that. Fred had a secret room in the garage. She accused him of growing distributing and using marijuana. She painted him as a major drug player suggesting that one of his competitors may have murdered him. She told Kelly that Fred kept a gun in the house. Maybe someone used it to kill him. Kelly asked Piper where she was the morning of the murder. She dodged the question hemming in hiring but Kelly insisted he reassured her that this was also they could rule her out as a suspect. She finally said I was right here. Kelly asked her to clarify. She was here and Martin. Mcveigh's Office Piper scoffed. No not literally in this room but in the city in Houston. Kelly brought up the phone call on Friday. The twenty ninth. That Paxton reported Piper confirmed that she talked to him on her cell phone while on her way home from work in Galveston. Kelly made a note of this subpoenaed phone records indicated at the time of this call. Pipers phone pinged a tower in Richmond. Not Galveston. She was lying. Kelly asked her to confirm her cell phone number. She told him that she didn't remember it. Then she added that she had more than one phone. He reiterated that he was gathering this information to try to rule her out as a suspect. They needed to know where she was on Friday and Saturday the time surrounding the murder again. She was cagey unwilling to answer. She told Kelly that she didn't want involve her alibi in the investigation. He balked at that. Saying you understand. This is a homicide investigation. I don't care if you were buying cocaine from a minister you know what I'm saying. Piper eventually settled on Tina as her alibi. She stated that she was at Tina's house on Friday afternoon but she wasn't home. Piper saw her a few times that afternoon when she stopped by during work that night Piper had gone out to a bar and met a man but she didn't want to say who she didn't want the police reaching out to him hyper agreed to tell them her full alibi after she had a chance to warn the man of the situation. First after making this agreement investigator Kelly and the Houston. Pd officers paid a visit to Piper sister. Tina rowntree she was aggressive and refused to answer any of their questions until they restored. The three Javelin rowntree children to their rightful custodian. Their mother she promised Kelly that once the kids were safely returned she would happily confirm pipers alibi. The officers left empty-handed the night of October thirty first Piper reached out to her friend. Charles took invited him over for drink. According to die my love Piper s Charles for help coming up with a way to prove her whereabouts on Friday and Saturday. She had been at Tina's house been no one other than her sister had seen her Friday night. She'd gone to a bar met a man but he was married and she wasn't certain of his name. She didn't want to tell the police about it worried that she'd be just about by the conservative. Virginia. Pd Multiple Times throughout the evening. She mused him. How does a person prove where they were on a particular date? Charles Throughout multiple suggestions. Did she have any receipts from the weekend? No she hadn't kept any. What ABOUT CREDIT CARD transactions? No her car had been stolen and her debit card was declined. She'd spent cash the entire weekend. Then Charles suggested that. The police look at her cell phone records. They would be able to tell where she was depending on the tower. She pinged on those days. No she lost her cell phone as she kept shooting down. His ideas. Charles was surprised by pipers priorities. She seemed much more. Focus on how this would affect regaining custody of her children then clearing her name in her ex husband's murder case he felt like she was putting the cart before the horse an echoed investigator. Kelly's words forget being slut shamed. She was a suspect in a murder investigation. She needed to tell the police where she was and clear her name. Then fight for custody. Piper thanked him for his advice then continued pondering on Monday. November first Piper told investigator Kelly that she was unable to meet him and talk about her alibi considering her behavior the previous day he wasn't that surprised instead. He focused on the evidence. The Southwest Airlines ticket and Tina rowntree's name was purchased with a Wells Fargo Debit card belonging to a Jerry Walters in addition to the airline ticket. The card had been used at an online wig store. Someone had paid over two hundred fifty dollars for two wigs. One Blonde and one read they were shipped Jerry at an address. Only a few miles away from Piper's house after police weren't able to identify one of the Rowntree's sisters at the airport depleting Kelly suspected that Piper might have been traveling in disguise. Perhaps she had been wearing a wig when investigator. Kelly called a wig boutique for more information. The sales clerk remembered the order because there was a delay in the shipment of the Blonde Wig it had been purchased at a sale price but the discounted stock had run out the store ship. Only the Red Wig along with a note that explained a blonde wig would follow in a few weeks when it went back on sale. The clerk informed Kelly that A. Woman called N. Demanded they ship a blonde wig to her as soon as possible. Not only did she pay the price. Difference for the non-sale wig. She paid an additional thirty five dollars for expedited shipping to guarantee a rival by October. Twenty seventh one police check. The address had been shipped to they discovered. It was a post office box company. One of the boxes was listed under two names Jerry Walters and Piper Rowntree the same day that the bt clerk received the phone call about shipping the Blonde Wig. Someone attempted to purchase a southwest airline ticket using the Wells Fargo Debit card. The transaction was declined. There wasn't enough money in the account three days later after additional funds had been added. Jerry Walters Card was used at the southwest ticket counter in Hobby airport on a round trip ticket from Houston to Norfolk with a layover in Baltimore. The ticket was issued to Tina roundtree. It became clear to investigator Kelly that in order to uncover the truth about Fred chaplains murder. He had to locate Jerry. Walters coming up. Police connect the final dots in their investigation. Now back to the story on November first two days after fifty two year old Fred chaplains murder police uncovered key piece of evidence the same wells Fargo Debit card. That was used to purchase an airline ticket and Tina rowntree's name was also used to purchase two wigs from an online store. The Post Office box. The whigs were sent to was in the name of both hyper rowntree. End Jerry Walters investigator. Kelly was not yet able to determine how Jerry Walters connected to the rowntree sisters but he felt like he had enough evidence to show pipers involvement and Fred chaplains murder. The Cell Phone Ping's proved she was in Richmond. The morning of the murder ordering the whigs in advance proved she planned the crime flying under her sister's identity proof. She tried to cover her tracks. Unfortunately district attorney wait. Kaiser disagreed worried. How the individual pieces would stack up as a whole in the courtroom even though. Piper cellphone records showed the phone ringing towers in Richmond. It only proved that the phone was there not Piper herself the Wells Fargo Debit Card. Pat The same problem. It was used in Richmond this weekend but there was no way to definitively prove hyper was the person behind the charges. They didn't even have irrefutable proof that it was Piper on that southwest flight. And not her sister. Kaiser told Kelly he needed to find airtight evidence. That Piper was in Richmond on October. Thirtieth ideally a reliable eyewitness knowing that Piper flew in on Thursday and out on Saturday. Kelly felt certain that she must have checked into a hotel in the area. He sent Richmond Petty Officer Truck Hannah to nearby hotels to look for any record of Piper. Stay but he was unable to verify she had checked in anywhere. None at the front desk clerks recognized her photo. However pipers phone had pinged tower right next to a homestead suites at four. Thirty a M. The morning of the murder Hannah had gut feeling that Piper had stayed in that hotel under a false identity on November second officer. Hannah found evidence to back up his intuition in reviewing Piper cellphone records for Leeds. Hanan recognized one of the numbers as he hit called it frequently himself. It was a papa. John's when he reached out to the Pizzeria Hannah the manager. If anyone with allows name Rowntree had placed an order on Thursday October Twenty Eighth. The manager confirmed they had delivered to a roundtree in room. One seventy one at the homestead suites hotel. Hannah felt like you've finally found something concrete. But when he checked with the hotel manager his lead apart. Room one seventy. One was registered to Gerald Smith. The Night of October Twenty Eighth Not Piper nor Tina roundtree. They were back at square one. But by this point Kellyanne located Jerry Walters. He was a fifty one year old oilman from Baton Rouge Louisiana he and Piper had dated for about a year from early two thousand and three to early two thousand four then decided to just be friends however in the last few months. Their romantic relationship had rekindled. Walters reported that the weekend of the murder he had been in Baton Rouge attending a football game and sitting with his dog at the vet's office when Kelly asked about the wells Fargo Debit card. Walters explained that he had opened an account for Piper when she filed for bankruptcy the previous year to help her through a tough time. He told Kelly that when he spoke with Piper on October thirty first she mentioned the debit card had been stolen a few weeks prior concerned about fraud. The next morning Walter slogged onto the account to report the theft while doing that. He saw several purchases made in Virginia in the previous forty eight hours. Piper told him a must have been the thief. She had written the pin number for the account on the back of the card. Walters had shrugged it off and close the account. Kelly asked him why they shared a post office box. Walters insisted that the box belonged to Piper. She only added his name to the account so he would be able to pick up packages for her. He didn't receive any mail there. He didn't know about any eggs. The information exonerated any involvement on walters art and gave more credence to Kelly's assertions that Piper was responsible for Fred's death but district attorney. Kaiser still wouldn't budge on his mandate Warren eyewitness on Wednesday November third. Two Thousand Four. Kelly finally had a stroke of luck. He went back to the South West terminal at Hobby Airport with a photo Piper Rowntree and a copy of the ticket issued and Tina Rowntree's name when he spoke with southwest agent. Kathy Molly. She remembered checking the woman in she remarked on her. Last name thinking it was cute. She said she was a really cute woman nicely dressed. I'm not a lesbian. But she was really attractive and she was wearing a blonde wig. In addition molly informed investigator. Kelly that this woman had checked a gun in her luggage at that. Kelly showed her a photo of Piper asking if she recognized as the same woman. Molly immediately confirmed that the woman in the photo was the woman she had helped. Check in the woman who had checked gun. Molly had spent at least ten minutes with her helping her fill out the paperwork for the firearm and inspecting begun to make sure it had a legally required cable. There was no doubt in her mind that the woman she helped was Piper Alan Bennett's Dante a TSA agent who helped Piper with the gun also spoke with investigator Kelly. He described the weapon as a revolver with short barrel of thirty two or thirty eight caliber with the wood or composite. Grip this description match the ballistics report based on the bullets found at the crime scene. But when Kelly showed Ben Astana picture of Piper he couldn't be one hundred percent sure it was the same woman remarking that her hair was different. That same day Richmond. Pd officer. Hannah returned to the homestead suites for a hail. Mary he wanted to speak with D'Amico James the manager on duty the night of October twenty eighth at first. She didn't remember the name Gerald Smith but when Hannah showed her a photo of Piper she recognized the woman she told him she had a black hat and long blonde hair. It wasn't cold out but she was wearing a hat coat scarf and sunglasses. James Checked her records and reported that Jerry. Lynn had just before nine PM on October. Twenty eighth the reservation for a non. Smoking room was originally in the name. Tina roundtree but when she checked in the woman paid in cash and asked to change her name on the register. James had agreed and updated the name to Jerry Lynn Smith. James didn't think anything of it. Plenty of people did that for many reasons. She remembered that the woman had nervous and agitated. James thought she might have been trying to hide from someone like an abusive spouse in addition to the positive ideas at Hobby airport. And now the hotel in Richmond staff at the car rental agency in Richmond also recognize Piper police uncovered surveillance video from a convenience store. The children woman with a striking resemblance to Piper the wells Fargo debit card had been used there ninety minutes fraud. Javelin was shot in the video. The woman left in the same making model car that Piper had rented from the agency investigator. Kelly prepared to convince the District Attorney. They had enough to press charges but as he was about to make the call to Richmond. Hyper reached out. She was finally ready to tell Kelly where she was on Friday. Night and Saturday morning Piper told him that on Friday. The twenty ninth. She spent the afternoon at Tina's house. Her sister would verify this that night. She had gone to the bar down. The street called under the volcano and met a man piper. Couldn't be sure of his name. It was either Steve or Jerry when Kelly tried to press her on the confusion. Piper got defensive. It wasn't that she couldn't remember but the man had used both the names. Kelly asked if this man could verify she was at the bar. No her alibi was another man named Kevin O'Keefe she gave Kelly his information and encouraged him to reach out Piper also explained that the next day Saturday she emailed a co worker from her home computer. When Kelly told her that they would need to verify that she ignored the question. Pivoting to the next part of her alibi around two thirty PM. On Saturday the thirtieth a neighbor had come over with her daughter selling girl scout cookies. She proudly told Kelly that she bought two boxes thin mints and Caramel Delights. They were her favorites. Kelly exhaled on the other end of the line. He needed to verify this information and then would get back to her piper. Perhaps trying to take his temperature asked if he thought that he'd be able to check her alibi before Monday. She was supposed to attend an emergency custody. Hearing in Virginia That Day Kelly support at the hearing would mean the world to her piper. Didn't like Kelly's reply. He committed to testify to whatever is truthful and then hung up after speaking with Piper Kelly set to work verifying her story but when he spoke with Kevin O. Keith he contradicted her statement. O'keefe's bartow proceeds showed that he wasn't even at the volcano bar on Friday night. Only Saturday night. He had seen Piper there but not on the nights she described Kelly then spoke with a neighbor. She purchased girl Scout. Cookies from the neighbor also contradicted Piper statement. She hadn't bought any cookies. She hadn't even opened the door to talk to them. A large woman in a baseball hat told them through the window that she was sick and asked them to go away. Kelly surmised that Tina pipers older and taller. Sister had been at her house trying to provide an alibi. The final shreds pipers tail evaporated with testimony from Tina's friend. Carol freed police reached out to carol after receiving a tip that she might be involved in the Javelin case terrified that she could somehow be charged in connection with a murder. Carol laid out damning evidence against Piper according to die my love Caroline. Tina spoke on Thursday October twenty eighth during their conversation. Tina told her that Piper had stolen her driver's license and credit card after joking that Piper wouldn't be able to buy much with the card. Tina fell into serious silence. She confided in Carol. I think she's going to do something stupid three days later on Sunday. October thirty first. Tina called Carol in tears. She needed her help. Something terrible had happened according to Carol. Tina confided to her that Piper had flown to Virginia and killed her ex-husband and Tina had helped piper disposed of some evidence. Tina and Carol went to two different dumpsters in the city and recovered. What she thrown away a blonde wig and a purse but Carroll wasn't sure what Tina did with them after Sunday. The next day Monday Carol was once again at Tina's house when Piper showed up when Carol offered her condolences for Fred Hyper replied. I'm not sorry. He's dead just about how it happened. Carol reported that Piper then asked her if she could help her get rid of some things that she didn't want the police to find. Carol said that she was caught up in the drama and agreed to collect some bags and computers from pipes. House to get rid of but by Tuesday. A cold feeling had settled in Carol's Gut. She didn't want any part of this. She drove the bags and computers to the hotel she knew Piper was staying in. She loaded pipers things onto a baggage cart and then paid a valley five dollars to take the cart up to Piper's room. Carol drove away washing her hands of the situation. Carols girlfriend worried about the implications of her involvement. Had sent the tip to the police. She knew if Carol told her story she'd be better off and less likely to face punishment. Kelly agreed with that assessment. So far he saw nothing to charge her with but he needed to determine the veracity of her statement as soon as possible. He drove to the hotel to check the security footage at seven eleven pm on Tuesday. The tape showed Carol pulling up in her unloading bags onto a luggage cart. Then driving away that night investigator Kelly spoke with District Attorney Wade Kaiser. Both men agreed. It was time to bring Piper Rowntree in on Monday November Eighth. Kaiser presented this case to a grand jury. The panel ruled that the collective evidence warranted murder charges brought against paper roundtree at the same time. Piper was attending a custody hearing and Richmond. Virginia she argued with the judge that her ex husband had no right to assigned custody rights to his brother. Instead of the children's mother but the judge did not agree as long as Piper was a suspect in a criminal investigation. The children would remain in. Michael Joplin's care as Piper exited the courtroom. She didn't even have a chance to process her renewed sense of loss. She was met on the courthouse steps by investigator. Kelly who presented her with a warrant for her rest. Pipers sat in defiant silence in the interrogation room. She couldn't believe the audacity of these cops arresting her so publicly like that. Those rubber neckers on the ten o'clock news had gotten their Phil. How dare they treat her like this on the day? She was fighting for her children for her rights. As a mother investigator Kelly tried coax Piper into talking about the morning of October thirtieth. He told her he had a pretty good idea of the truth but hoped that she would be willing to fill in the details. Hyper rolled her eyes. She hoped he choked on a donut. But Kelly was determined. He pulled out a thick file. Folder and display the contents to piper showing her highlighted phone logs and transaction records for a debit card. This was her cell phone her debit card. They were both used in Richmond. The weekend of Fred's murderer hyper shrugged casually. She had lost her phone and her debit card. Several people had access to our purse. Maybe she lost the debit card or maybe her sister. Tina borrowed the card from her wallet. She said Tina takes whatever she wants. All the time Kelly persisted. He showed her a still photo taken from the convenience store surveillance video indicating the blonde woman in the photo. Who does that look like to you? He asked her hoping but in the face of the evidence hyper would come clean but piper knew that she still had control of the situation to convict her the jury would have to believe without a shadow of a doubt that Piper was responsible and no one else. It was Tina's name on the airline ticket Tina's name on the rental car. She pushed the still photo away brushing Kelly off. I'm not sure who that is. It could be mean it could be my sister Tina Kellyanne. Kaiser couldn't believe it hyper Rowntree's defense strategy listed. Throw her older sister under the bus. Hyper trial was slated to begin in late February. Two thousand five. In the meantime Kelly continued to collect evidence. That would bolster the case. He discovered that on October. Twenty six a few days before the murder Piper had gone to a gun range in Houston to practice shooting with a thirty eight caliber. He also uncovered a life insurance policy that named Piper the sole benefactor of two hundred thousand dollars. In the event of Fred's death to confront pipers assertion that it was Tina who had flown to Norfolk and not herself. Kelly checked the parking logs at Hobby airport for the weekend of the murder pipers. Black jeep was recorded in the logs from Thursday October. Twenty eighth to Saturday. October thirtieth when the trial began on February twenty. Second two thousand five. Da Wade Kaiser had a mountain of evidence to prove this case though investigator Kelly had been frustrated by Kaiser's reticence tack during the investigation. Dragging his feet on bringing charges against Piper. He saw the dividends in the courtroom an only five days. Kaiser Buried Piper roundtree. Her defense tried to plant the seeds of doubt in the jury suggesting again and again that it was Tina roundtree not piper. Who had gone to Virginia and Shop Fred Chaplin but Kaiser had a rebuttal on every point Piper alleged that Tina often used her cell phone however phone records and Piper Zone testimony proved that she had called her son. Paxton from her cell phone the day before the murder in Virginia. She claimed that Tina owned a thirty eight caliber gun but there was no record of a gun registered in her name and witnesses from the gun range in Houston place. The thirty eight and PIPER'S HAND. Kaiser stressed to the jury that it was Piper roundtree and not her sister Tina who was on trial. The evidence overwhelmingly pointed to Piper on February twenty seventh. The jury deliberated for less than two hours. They found Piper guilty of first degree murder and the unlawful use of a firearm. The judge at her sentencing hearing said the evidence certainly shows that her intent was willful. Deliberate and premeditated hyper showed absolutely no remorse for her crimes. She was sentenced to life in prison plus three years after her sentencing author of die. My Love Catherine. Casey went to visit Piper during their visit. Piper told Catherine that Fred was an evil man one with many enemies. She detailed a new theory on. Who Killed Fred? Maybe he was having an affair with a male co worker. And someone at the University of Richmond Killed Fred to cover it up understandably. Casey dismissed pipers allegations as of this recording. Piper is incarcerated at the Flu Vanna Correctional Center for Women in Troy Virginia. She spends her time stirring up trouble in two thousand seventeen. She filed a lawsuit against the prison for denying her a Yoga Mat. Inner sell a converted. Buddhist she accused them of violating her religious rights. The action was eventually dismissed. Tina rowntree has made public statements of support for her sister multiple times since the trial. The fact that Piper tried to play that Tina was responsible for Fred's murder doesn't seem to have impacted their relationship. She said in a two thousand fourteen interview hyperion. I are soul sisters. She is my best friend and she is a remarkable person. Tina continues to advocate for pipers. Release calling her conviction a terrifying miscarriage of justice for more information on Fred Javelin and Piper rowntree amongst the mini sources. We used we found. Die My love by Katherine Casey Extremely Helpful to our research. Thanks again for tuning into crimes of passion we will be back. Wednesday with another episode can find more episodes of crimes of passion as well as all of our casts other shows on spotify or anywhere. Else you listen to podcasts. Several of you have asked how to help us. If you enjoy the show. The best way to help is to leave a five star review. Don't forget to follow us on facebook and Instagram. At podcast and twitter at podcast network. We'll see you next time. When true love needs true crime crimes of passion was created by Max Cutler is a production of cutler media and is a part of the podcast network it is produced by Maxon Ron Cutler? With sound design by Michael Lanes ner production assistance by Ron Shapiro and Paul Liebskind additional production assistance by Maggie admire and Carly Madden crimes of passion is written by Abigail Cannon. I'm Laney Hobbs.

Piper Piper Kelly Piper Rowntree Piper Roundtree Fred investigator Tina Richmond Piper Roundtree pipers Houston Piper Psychology murder Tina rowntree officer Virginia Piper Officer Piper Cell PIPER Jocelyn Paxton
#160 DeepakChopra on the Power of Meditation to Unlock Infinite Possibilities | Impact Theory

Impact Theory with Tom Bilyeu

55:23 min | 1 year ago

#160 DeepakChopra on the Power of Meditation to Unlock Infinite Possibilities | Impact Theory

"When you're listening to impact theory impact the impact theory impact theory peg baby. Everybody welcome to impact theory. Today's guest is a multiple time New York Times bestselling author practicing medical doctor and world renowned pioneer in integrative medicine and personal transformation one of the most widely recognized luminaries. In the field of human spirituality. He has written an absolutely staggering ninety books and he shows no signs of stopping often working on multiple books at the same time. He's the founder of the incredibly active nonprofit choper foundation which conducts wide-scale research into human wellbeing. And he's the founder of choper global a modern day health company at the intersection of science and spirituality. He's also a clinical professor of family medicine and Public Health at the University of San Diego and he teaches meditation all over the world including his own. Meditation Center. Demonstrating his unprecedented reach. He's created meditation retreats with Oprah and shared the stage with the Dalai Lama and countless other eminent leaders in the Space Oprah said of him that he is a man who invites you to see deeper into your own soul. So please help me. In welcoming the man that Time magazine named as one of the top one hundred heroes and icons of the century the author of the National Bestseller. Meta human unleashing. Your infinite potential the one and I assure you only Deepak Chopra. It is so good to have you thank you. Thank so thank you so much for joining me. I've had the good fortune actually sitting in the audience. When you were doing one of your guided meditations meditation something that completely changed my life. What I love about your story though is that you took a pretty weird route to getting where you are now. And I'd love to walk through some of that because you started as a pretty straightforward medical doctor. What was that like? When did you begin to think that there might be something more? So I took my training in Internal Medicine Board certified and it went on to train in something new chronology which is the study of hormones and then in Newark New Chronology which is actually brain chemistry. And when I was training this is in the seventies in the Mid Seventy S. We had a new technique or radio. Immunoassays just been discovered The people who actually created the technique were one Nobel Prize in medicine. Roslyn yellow was scientists. I remember you could measure for the first time chemicals. They're called peptides in the brain and what I immediately recognized with. The help of my colleagues was that brain. Chemistry was the clue to the connection between was happening in your inner life and what is happening nearby body. These chemicals called Neuro Peptides Neuro means in the brain peptides proteins. And they're actually. The molecules of emotion serotonin dopamine oxytocin. Opiates people are addicted to create these days. But you make your own. Opiates still and so in fact once we started looking at these chemicals we realized that they were also immunomodulators. The modulated the immune system. Fine tuned if you have a very aggressive immune system you get things like Autoimmune Illness Allergies. If you have a very sleepy immune system. You're more prone to infections and cancer. But these peptides are neuro immunomodulators. That modulate the activists. Fine tune the activity of the immune system so suddenly I saw the connection between mind body and spirit but then I was also actually intrigued by the fact that you could have two patients who had the same illness so the same doctor got the same treatment and had completely different outcomes. One could survive one could die and in between there was a wide range of outcomes that led me to mind body medicine ultimately to integrated medicine so when I started looking at that. What was that sort of process of discovery? I know that you were a child of the sixties. I know that you did. Lsd Like how much of this is showing you. There's something beyond traditional medicine. And and how do you begin to piece those pieces together? What I did St When I was in medical school and twice I was not even twenty at that time and It did give me the insight that are normal everyday experience or what we call. Reality is the hypnosis of social conditioning that actually reality shifts as your consciousness shifts so deported metaphorically I had my first glimpse of the Matrix and I decided that I wanted to not know what we know. What what is the source of knowing? Okay it's not what you know. You know what you know these days you can look it up. Go Google so it's not important to know anybody can find out anything about anything. These days I can look up. How many galaxies on the universe or how does epigenetics work? How does the brain function? That's not the key to creativity. The Creativity and higher consciousness is howdy. Know what you know. What the source of knowing an expense. What is it that knows the expense of the body? What is it that knows the experience of the mind? What is it that knows the experience called the Colorado? And where is that experience happening? A lot of people will tell you. It's in the brain but I can assure you there's no colors in the brain. There's no color red when you look at the red color. There's no color here in the brain or if you imagine the color if you imagine a beautiful sunset or if you imagine what your experiences with your mother or anybody emotions. The brain only shows chemical activity. That's called the hard problem of consciousness. So what is the source? Define that for us. There is some sort of leap that is not understood. Between how these there's some threshold event of all of these atoms. Clustering in this thing that we call it human and the thing that we call the human brain but there's still an unknown moment at which we become conscious. Is that what you're talking about? The hard problem of consciousness is simply stated in one sentence. How do chemicals and items and Niro Chemistry or neuro electricity produced this experience? There's no explanation for this. You're looking at me right now. Let's come into your eyes are invisible. Photons there's no red waves coming to your race okay invisible photons. They have no color. They have no shape. They don't even have units of mass. Okay so they're not they don't have any dimensionality the photons that you use your exposed to right now that are giving you the experience of your own body of meat and this room. That's all that's coming to. You is electrical information. All that's going to your brain is an electrical current. It's called an action potential. But you're experiencing this room you're experiencing your own body experiencing thoughts in fact your experience seeing what we call reality every day. Believe it or not new known. Neuroscientists can tell you how that happens. They can look at what they called. Neural correlates a correlation is not a causation as we know if the Rooster Crows in the morning and the sun rises at the same time. We don't assume that the rooster caused the sun to rise but they are correlated. So your mind. Your brain and the physical world are correlated experiences in deeper realm of existence. Which is not in space or tight. Okay so I want to drill deeper on that. So what is the thing that drives you to end human suffering? What's that like? If you had to put that in a nutshell yes. The purpose of all healers and ultimately evolve physicians should be to alleviate Audrey. Now we've done a pretty good job with alleviating what we call suffering because from acute illness you break your leg get off. Vicks into fix it. Get PNEUMONIA. You take an antibiotic so we've done a good job on what he called. Physical List level for acute illness. But then there's something or chronic. Illness Diabetes Type Two inflammation cancer heart disease. Autoimmune accelerated aging propensity to infections. And we haven't gotten a good job there because what we're realizing right now. That only five percent of disease-related gene mutations of fully penetrated which means they guaranteed the disease. Gene Mutation is a genetic mistake so good example Angelina Jolie had a Baraka gene and chaired mastectomy as a prevention double mastectomy. Because that gene predicts that you would have gotten breast cancer for that by the way there are new technologies that are merging including gene editing so bieber. Now that's possible not for cancer. But for things like sickle cell anemia. You can cut in basic gene talking about crisper. Yeah crisper you can go to pass the gene just like you do an email you read the Barcode. Delete the gene and insert that it affects five percent of people ninety five percent of gene mutations that cause illness related to lifestyle sleep managing stress. And whether you meditate or not you exercise or not. Maybe you do yoga not breathing. Techniques the quality of your emotions nutrition personal relationships social interactions environment connection with nature. Influence your gene activity. We call it epigenetics so we've beginning to do a good job there but we're not there. Let's say you got rid of all? Chronic illness and acute illness would humans still suffer and the answer is yes because unlike other species who have something which is actually quite bizarre is called existential suffering. We wonder why we exist. We wonder why we get old. And can we prevent that? We wonder why we get infirm and lose our memories as we get old. Can we prevent that but we also are afraid of death? Can we prevent that on surveys? Biological death is based on a false premise. Which is your your biology. And you are your body and your mind where I'm going with the heart problem consciousness as you're not your body you're not your mind you're not experience of the world you're the consciousness in which all this experience occurs Due Observer. Thought is to know that you're not at heart to observe and emotion is to know that you're not emotion to observe. The body is to know that you're not this bundle of sensations and perceptions. So who are you? What is it that noise thought? What is it that nozoe perception? The colored is there a color red anywhere in the physical universe or is it just an experience I get into you know? Scientists can tell you the color red exists as a physical entity in the. Us It's an experience in human consciousness not in the consciousness of a backed who doesn't see colors but experiences the echo ultrasound. So what is the color red to a bag? I think this is a good place to go back to your LSD EXPERIENCE. So looking at psychedelics and the impact that they have on people's existential dread over dying so I know the they've done studies giving it to terminal cancer patients and from what I understand it has a pretty radical shift in people's level of fear as somebody who's never done psychedelics. What what is that? Experience of the dissolution of the EGO. Like where's it taking people like? Is there a way for you to sort of metaphorically explain what's happening there? Yes when you realize that everything you thought was real is not real when you also realize that you think you are is not real. I am not Deepak Chopra with this body. Mind Eagle identity that this is a very provisional identity. I Say I'm my body mind. I was once a fertilized ovum. Then I was an embryo. Baby Toddler a young adult. And now this and this will disappear but when you realize that all your name you'll form and everything you see is provisional. Two things happen to some people they have immediate what we could only metaphorically called the dark night of the soul. They go into deep depression because everything thought was real is no longer real including their own name form body and mind. Some people get so scared that they have a bad trip Some people cross that threshold men discover Nirvana or enlightenment and they say wow I thought I was. was squeezed into the volume of a body in the span of a lifetime but I'm timeless being that can morph myself into any experience including the human experience which is amazing but the human experience is also that which causes existence depression so the causes of human suffering since you brought it up. I brought up in eastern wisdom traditions as number one. You suffer because you don't know who you are you confuse yourself with your body mind experience number two you grasp and cling at experiences which are ever necessary and transitory and dream. Like say what happened to your child. It's over what happened to yesterday. It's over what happened to five minutes ago. It's over what happens to these words by the time you hear them. They don't exist. So you know bit can shine. The German philosopher said we are asleep. Life is a dream but once in a while we wake up enough to know that we are dreaming. So what do you wake up to when you cross the threshold you wake up to your True Self? Which is not buddy of mine. But the awareness in which that experiences happening so grasping and clinging added dream is the second cause of human suffering. The third is being afraid of anything. That's unpleasant being abandonment being treated by someone not respectfully so that's you know there's aversion to certain experiences third cause of suffering forth is identifying which is related to with your ego identity and his fear of death. Now they're all connected they're all the same fear and they are not knowing who you are. This is the biggest question that humans are. Everybody should be asking. Who Am I what am I am? I the changing experience of this body which is a perceptual activity and my experience of the changing mind or the changing personality. Because you don't have the same personality when you were kid or maybe ten years ago. What is it at the basis of this? When you start that reflective self enquiry us kiss of who am I would do I want what is my purpose. What am I grateful for? Go into the stillness of meditation. You have what wisdom traditions of revelation revealed truth now. That sounds very grand. I would say just call it insight. Meditation Mindfulness Awareness of body awareness of mind awareness of mental space awareness of the web of relationships awareness with doctorates we call the universe. It leads you ultimately to the awareness of awareness and when you discover that. That's newborn now. Are you familiar with the term pan? Psych Ism yes so I never heard of that before and the boat but interesting so I was GonNa ask if that is so as I understand it. Pens like is is basically the consciousness itself is a force almost like gravity so it is everywhere. There is no moment where enough Adams come together that you have enough complexity that consciousness arises that it is truly fundamental and when I was reading that a human. That's what I thought you were saying. I thought you were saying it. Is this thing that just is ever present? So that's not what you're saying. No it's not but I'm glad that scientists are going in that direction including some very big and very important thinkers and luminaries in both philosophy and science are going in that direction. What they're saying is just what you said that what we call. Consciousness is organized matter wherever there's matter that has gone from atom to galaxy. Okay so mine. And my to go together from atom to galaxy that spans like hokey and got very good Durance proponents luminaries and important minds. Saying that it's a breakthrough because now you're not seeing conscious is just in the brain. You're saying it the universe in the same way as gravity and atoms and electrons. But I'm saying actually there are no atoms there no electrons gravity and force fields Human Constructs. So matter is a useful construct. I'm going beyond pants like them into what is called non duality which means there's only consciousness. It's modifying its up into sensations perceptions images feelings and thoughts and we give names to that we give we give a name to a shape and color and a sensation. Recall it a cup. We call it a hand. We call it the Milky Way Galaxy. We call it atoms and force fields very useful contracts. Otherwise you wouldn't know how to navigate everyday experience if I tell you I'll meet you at the corner of fifty six Broadway Museum. That's rea- but we made up that That notation just like we made up latitude and longitude and Greenwich Meantime. We didn't say it's one time. We made up the galaxies. We made up the body remade up gravity and force wheels by a species of consciousness that is called human so now my question becomes if that is the case and all that exists consciousness. Is there something behind that? Like why has conscious given rise to humans and do you see it going through like an evolutionary thing like? How did we get here? And maybe more importantly. Why did we get here? I don't know if I can on so why other than entertainment but but I can tell you what the the thinking behind this. Is there anything behind consciousness? No you can't get behind that is base level. That's it but that's called pure consciousness. Okay now everyday. Experience is modified consciousness right now which we're experiencing is what we call the waking state of consciousness okay. What do you mean by that? The awareness that I'm aware no the awareness that is experiencing a physical body and physical world with eyes open is called waking consciousness. Okay okay so awareness is modifying itself every time you open your eyes into this experience right and you call it the physical world now if you close your eyes you have another state of consciousness where you don't actually experience the physical world you experienced sensations images thoughts emotions stories. It's like a dream as soon as you close your eyes you're experiencing you might call it daydreaming but there's no difference between what you dream at night. The physical world has disappeared. There's only a mental word. Then you go deeper at night even the mental world disappears in what we call deep. St- deep sleep now. That is the highest intelligence by the way because in deep sleep there's unconscious processing going on this creativity going on that correlations being made that toxins being removed there's a whole resetting of your memories and consolidation of that so in deep sleep even though there is no experience of a physical ornamental world. It's a very intelligent highly. Highly correlated state in which unconscious processing is occurring memories are being consolidated imagination is being refined etc. Even though you have no conscious experience so think of these three states metaphorically like you would think a water becoming ice as the physical world okay. Water as water fluid dreamy water as vaporware even more dreamy and fluctuating ambiguous and contradictory and difficult to grasp. But if you want a little bit beyond that I'm speaking metaphorically you'd end up with what is called the quantum vacuum which is the fundamental ground of existence according to Ans- okay. But you can do that subjectively. You can move from the physical world to the dream world to the sleep world and beyond to what is called fundamental consciousness which is the source of all knowing all experience in wisdom traditions. Its undifferentiated consciousness. How does that differ from non-holiday -ality okay? It's off buds of knowing all noise and all things known it is fundamental ground of existence of the total universe case of non. Duality is to put it really simplistically that there is no subject. Object is just all one thing which I'm seeing you would say is pure consciousness subject object Division is artificial reality is one wholeness into all subjects all objects and all modes of knowing what we have access to a human motive knowing in my book. Human I talk about the butterfly. The painted lady who smells the world through her antenna. Okay Jas the world through her feet sees the world with thirty thousand lenses that move like a kaleidoscope. Here's the world through her wings. What is reality to that little species? Some insects see the world three hundred sixty degrees okay. Because they have. These recall complex is with multiple lenses. You can only see within a certain range there insects. That can see three six degrees. So what is reality? What is up activists? Hope you guys are enjoying this episode. Wanted to give a quick shout out to our sponsors and then we'll get right back to it remember. Our sponsors are all hand chosen. We love these guys that they have something incredibly valuable to offer so. Be sure to give a listen. A lot of these guys are doing special offers just for you. Everyone I wanna tell you about one of my favorite sponsors on the planet audible guys. No I have so many goals that I want to accomplish. And the best way to accomplish a goal whether it is getting fed or becoming a better parent or better leader is to read as much as humanly possible about a specific topic. Finding the time to read is always a pain. It is my biggest obstacle. And if you're anything like the twenty-seven percent of adults that say they haven't read a single book in the past year because they don't have the time than audible. My friends is the perfect solution. Audible allows you to listen to audio books in what I call the Inbetween. Moments transitional while you're commuting cooking exercising gardening or even just relaxing at home. Whatever the case audible makes it easy to listen. Audible memberships include one credit to pick any title plus to audible originals from me. Monthly selection and access to Daily News Digests from the New York Times The Wall Street Journal and the Washington Post as well as podcasts guided meditation programs the performances alias. Comedy and exclusive audible originals. You will not find anywhere else. If you can't decide what to listen to do. Not Worry you can keep your credits for up to a year. Stacking credits is one of the great joys of my life. I love when I have a bunch that I can spend. You guys can download titles and listen offline anytime anywhere. The APP is free and can be installed an all smartphones and tablets and you can listen across devices without losing your spot. Guys this magical. I'm telling you audible is the busin- ass every month. Member get one credit to pick any title plus to audible originals from a monthly selection. So go right now visit audible dot com slash impact war text impact to five hundred. Five hundred trying to make this as easy for you to empower yourself as humanly possible now. I personally recommend principles by radio. This is one of my favorite audio books of all time it is inspired the office culture in the collaborative working flossy. Here impact. Theory is an absolute game. Changer give that one a listen or you can try listening to any one of their titles. You can start listening immediately with one credit to pick any title plus to audible originals from a monthly selection just visit audible dot com slash impact or tax impact to five hundred five hundred. This is the one guys. Give audible a shot man. If you're not on this you're missing out on the chance to learn to get in there right. Take care and be legendary. Everybody I wanNA tell you about our sponsor within Shero watches as you know all about discovering innovative ways to create that extra boost of confidence when men think about their appearance. It always goes through the clothes. Shoes will. What about adding a watch? Might think that watches her super expensive. And that there's no way you could afford one but been Shero has designed watches that when you put it on you immediately know you got more than you paid for and if the people you're trying to impress or anything like my wife. I'm telling you the jewelry can go a long way towards looking the part. That's why then. Shero watches has over twenty thousand five star reviews on their site matter who you are what your job is how old you are aware you live. There will always be an occasion when you want to look your best eight or the job interview. You've been sweating over. You always want to be the one that stands out in the crowd and watch from Venturo. We'll give you that extra confidence boost for any occasion and you won't have to overpay for a watch that looks cheap and disappoint. We all know how expensive a designer watch can be. Ventura watchers is changing. All of that. They believe you deserve to look good no matter what. Your budget and ensure watches is offering a special discount just for impact theory listeners. You'll receive fifteen percent off your entire order plus free shipping when you go to Venturo watches DOT COM. That's he I N C R O and use discount code impact theory at checkout. Sheryl watches offers free shipping thirty day returns and guarantees your watch for two years stress-free shopping with fair and honest prices. Right now go to Vincenzo. Watches Dot Com V. I N. C. R. O. Watches DOT COM and receive fifteen percent off your entire order plus free shipping with the Discount Code impact theory enjoy and be legendary reality. What we call reality. What today science. 'cause reality comes under the heading of naive realism. Einstein was a naive realist. And I'm not saying this in a fashion. It's it's it's a word in the science of Alaska naive realism means. The physical world exists exactly as perceived by the five human senses. Now obviously that's not true. Other species experience the world through different modes of sensory perception. The second aspect of naive realism is that the physical world as perceived by the five human senses would exist even if no one was observing it. Well how do you prove that firstly because we know that the world is more than what is perceived by the five human senses so this leads us to a solution actually of the hard problem of consciousness? Which is get rid of the idea. The world is physical. What we call of the world as physical even your physical body is a perceptual activity and that perception activity for you and me is a human perceptual activity through human consciousness not to back consciousness not through mosquito consciousness not to plant business which would fit in with band sake ISM BUT NON-DURABLE ISM says go beyond that there's only one consciousness that is differentiating undifferentiated differentiating into these different species of consciousness. That form a matrix of conscious beings that are collectively projecting this universe now. I know that you said that you can't answer the question. Why did you ever contemplate? Why like why we would come into? All these manifestations why they would have such different. I think if you say that consciousness fundamental then it must have a desire and the desired must be. I need to experience. Myself and gunships is being undifferentiated. Timeless baseless boundless can only three experience so it modulated itself into these different varieties of experienced almost infinite and we call it the universe universe one song but in that one consciousness. Let's ground this now so you do some really interesting personal practices so I get it. This is all an illusion but you do monastic retreats. You Shave your head. You shave your eyebrows. Do not so through. What's the power in that? The power in that is to suddenly start to become comfortable with questioning your habitual certainties. So if I see what is this. You take a cup right. Well if you're a baby you would know this up this shape. This is a color. This is a form this is. This is a day and it's noise the rest is a story. It's a human story. Recreate it just like we created money or Wall Street on nation states or colonial empires. We take that for reality. So when you when you have time to be still question your habitual certainties. You'll realize that actually we know nothing. Nothing everything we know is made up. It's a human construct and once we are embedded in that human concept. We call it reality. We don't question. What is the source of this experience so taking retreats practicing mindful awareness of body of mind of mental space of the web of relationships the mystery of existence? It Dixon slowly deeper to your true self. Which is the orchestrator of everyday experience? What's the importance of silence? Zuma said God's languages silence everything else is translation. So is it a listening to the subconscious? So for instance. Part of the reason that meditation has been so powerful for me is and I get what you're saying about correlation but as you said it's very strongly correlated so breathing from my diaphragm being quiet. Takes me out of the sympathetic nervous system and into the Para sympathetic allows me to reduce my stress? You've done a lot of research into that. Which is really really fascinating. And it creates a quiet in my mind so that I can tap into the subconscious while I'm awake which has been very powerful and makes me feel far more creative. I'm getting far-flung connections that I wouldn't otherwise get in my mind so it's been very advantageous. Is that the same experience for you with silence or is there something I'm missing? All of that is because the moment you start going into the direction of your consciousness. You go in the direction of homies stasis which is self-regulation. You go in the direction of healing. You activate the panel pathetic. Novus is to talk to me about some of the science around there. That that your your research has baird about because it's pretty impressive. We had people were one week retreat We got the seduction of spirit. Which is a nice name and at the end of the week and before the week we tested them for gene activity and inflammation and many other things we found that genes that cause self regulation and healing good went up some seventeen. Four lower baseline genes that cause inflammation. Which is the common background and chronic illness and chronic inflammation is the Bab background genes that cause chronic information went down the level of the enzyme. Telomerase which influences how we age at a genetic level. Tila meal length went up significantly in some cases forty percent. Now this can all be explained through what we call epigenetics and it's a revolution and many people have replicated. These findings now Our study was done in collaboration with scientists from Duke and Harvard and UCSF and UCSD and scripts and so on but other people replicating finding similar data gnawed exactly identical data. So this is a big revolution for people. That don't know epigenetics. You can give them a quick breakdown. You'll born with twenty five thousand genes from your parents. You also have two million to twenty million bacterial genes in your gut. Bacterial genes called the microbiome. The human genes the genes. You have they interact with each other to produce all the metabolites in your body produce. What you call a biological organism and maintain its out. Epigenetics says that daily experience influences the activity of your genes. So you're done with a deck of cards but now you know how to learn how to play the deck of cards so you can win the game of life if you want to use that metaphor and the gene activities influenced by the things. I mentioned sleep managing stress Exercise Yoga. Breeding Brown am introspection. Mindful awareness emotions nutrition connection with nature. We can change our gen activities that ability to change the activity of jeans. You can't change the cards you were dealt with but you can change their activity but you can also change your microbiome by Jingo died so you can actually change much of your gene expression but the genetic information in your body you can change the microbiome the entire Jin population by changing your diet and following lifestyle. You can change the expression of genes. That's genetics EPI means above epigenetics the sheet of proteins above the genes that response to every experience. You have mental physical perceptual emotional right now walks or some of the things that you do from Going around with the begging bowl to daily Yoga. Like give us some prescriptive stuff for winning at the game of life. Hokey but going around with a begging bowl and all that was just to Experience myself without my identity. The cheviot eyebrows with the begging amongst other beg is And you this South Korea right. Yeah in Korea and you get the sorry in Thailand in northern Thailand but there are monasteries South Korea like that too so it brings you to. Who am I without my biard? Who am I without this identity? That is the purpose of some of these retreats. But of course that's once in a while I take a week of silence also once a year. But here's what I do. Every day I start my day with four questions who am I. What do I want. Who wants to know what is my purpose. And what am I grateful for then? I go into about a two hour meditation video in which is going to stillness now. Do you answer those questions. That's what the meditation is for. That's the magic you live questions. Consciousness moves into the answers because this infinite and there's infinite correlations. We don't have to worry about the answers you know it's an ancient thing ask and you shall receive the unexamined. Life is not worth living so you just practice that every day than I do about one and a half hours to of stillness. Meditation midden towards Mindful Awareness Body Mind and all that then I do yoga so it takes me about three hours to my money routine. I normally don't start my day till eleven. Today's an exception for you and then I normally don't work after five then when I'm giving a talk or on a tour doing media but normally eleven to five and on weekends I write and reflect and I enjoy my life. So what are you doing? If you're working from eleven to five one. What is work and then to when you're enjoying your life. What does that look like? When I'm in New York I walked the streets and I taste and smell and experience the colors and flavors of every country by walking on Broadway. I can go through Koreatown India town Chinatown it little Italy a little Spain Little Portugal. And sailor the sensuality of the experience. And I spend a lot of time doing that by work. I actually don't have any work right now. Other than I write books and give speeches I which is how I learned myself you know. I'm whatever I'm struggling with and trying to solve I write it down and then you know if I see some clarity then I publish it. That's what it's I don't think of. It does work. I think of it as you've said that you no longer think about aging you think that the pursuit of that whole line of inquiry is a mistake. What did you mean by that? I don't not think of aging. I'm seventy three MY NEXT CHAPTER DEBT. So boost so. I think about aging. I'm not bamboozled by the construct. Okay because I don't think consciousness being formless and infinite subject to either birth or death this vacation we're having in on planet earth right now and so might as well enjoy it but debt is not the end of consciousness is the end of a certain storyline in business a certain interpretation of perceptions images feelings and thoughts and the story line is of course the condition. Mind as soon as you're born you sell your India and your mail or you come from a wealthy or poor family. This is your religion. Now you're bamboozled from your true self into this provisional identity so I don't. It's not that I don't think about that. I asked myself what is beyond my provisional identity and dwelt in that and that has a very interesting outcome which is the outcome in every spiritual tradition. There are only three things that happen by the way in religious or traditional experience. Transcendence you know that you are not an entity. In space and time that your true self is formless infinite unbounded border less unfettered free consciousness number one number two you have the emergence of what usually are referred to as platonic truth goodness beauty harmony love compassion joy equanimity and number three loss of the fear of death. There's nothing more important than having those experiences. And they've been part of every wisdom tradition but thousands of this talk to me about love. It's interesting for somebody that started with Neuro Chemistry. Who could probably give me a very detailed breakdown of the neuro. Chemicals involved with love of course ought to dosen but those are models again. Their contracts love is not a sentiment. Love is not an emotion. Love is the ultimate truth at the heart of creation which is unity consciousness. One consciousness differentiating into infinite modes of experience infinite noise infinite modes of knowing infinite phenomenon known all generated within the oneself. Just like when you were just a for at least over you were one steps out. Stem cell pluripotency. It became is became knows that became fingernails. It became hard. It became brain so that one cell differentiated into all these different cells. Each with its own modality of experience like that. The one mind the one consciousness differentiates itself into what we call the universe with every species of consciousness knowing the universe in its own unique way because ultimately there's no universe it's another construct when you're meditating are you seeing images love. Love is the ultimate truth. But what is that like that? Help me differentiate between consciousness being sort of the floor and love being the floor. Are they one and the same like pure love pure consciousness pure knowing pure creativity on the same thing interesting because I think of and look I get it? This is me trapped in sort of the human experience. But I think of love as a as a molecule of motion. I think of it as an experience. It's hard for me to wrap my head around. It's the source of those molecules of molecules of emotion human constructs but is the source of the feeling that you get so I think of my mother right now who is long gone and as soon as I think the word mother I see her image and it's not in my brain there's only chemistry in the images in my consciousness as soon as I think of her. Actually I can hear her voice. There's no sound in my brain but I can hear her voice in my consciousness. As soon as I think of her I feel an emotion. Maybe oxytocin in my brain but I'm not experiencing oxytocin. I'm feeling this immense emotion of joy just by thinking of her. I can even smell her skin when I was a baby. Where did all this come from? Just by thinking of the word mother okay. The word mother in pure consciousness created this whole gestalt of experiences. I call this Kuala entanglement instead of quantum entanglement Kuala means quality of experience sensations images perceptions feelings thoughts ultimately. That's all there is quality a- of qualities of experience we rarefied them be objectified them and we called the molecules. What's your mom like? She was the most amazing storyteller and every day she would tell us a magnificent story before we went to bed but she would stop at what is called a cliffhanger and then she said tomorrow. I want you to end the story for me. Make sure it's a love story with a happy ending interesting. And that's what influenced my entire life. I decided that all stories provisional and the best stories I love stories. That's really interesting. Is that something that you continued with your kids or is that something that continued to. Mike is Interesting bring awareness to storytelling in and of itself or is it most powerful because it primes you focus on something beautiful. It actually does all of the above you know. Humans are different in that we are storytellers. So they be Until about thirty thousand years ago and we had rudimentary language. They were eight. Different types of humans may be more. We are homeless agents which means the ways once we ourselves homer rectus hormone home floor answers on and on they all had a rudimentary language for danger because mating calls food but then we created a language for stealing stories and we decimated every other species because with stories recreated money we could empires. We created colonial states. We created was street. Recreated technology could cyber hacking and whatever else mechanized debt this all the result of our ability to take Roy experience which is perceptions and make a story out of it so once you realize that you also realize that also is a provisional. You're not just stories. You're the author of the stories and that includes all stories including the story that you are a biological organism in a theater of space time causality and this is real. That's a story. Why is it so important to tell yourself a story about gratitude? I know you tell people to focus on that. Gratitude opens the door to abundance consciousness. When I'm feeling grateful for what I already have. I feel fulfilled and joyful and if you have gratitude you gone to experience still at the same time. What do you think the future of medicine is? I think the future of medicine is self regulation. What do you mean meditating? And Yoga and practices that stimulate Vegas nerve and excoriate mind body coordination so meditation Yoga Tai Chi Ci Gong martial-arts knowing how to regulate your mind and body as one unit but in addition to that the are artificial intelligence and the most amazing technology that can enhance that experience of self-regulation. There's already data that you can help children with autism through VR by changing the facial expressions and giving them feedback to you. Know what an emotional wholeness could be or you can change. The image anorexic person has when they look at a mirror or you can get rid of a phobia through the or burns. If somebody has burns you create an environment where they experienced scored you're in snow and so on all through the are it's more effective than anyone treatment and so I see as we create more excursions into a i. I have a version of myself already that I talked to so I can continue what I'm doing. And then I also very engaged in VR and immersive experiences in ritual reality because I believe that we are already virtual reality and we can modify it through extending virtual reality so I think the future of medicine as the most amazing technology with the most amazing understanding of consciousness. That's incredible where can people find your massive library of books? I think better to go to Deepak. Chopra DOT COM or. Just go online and you can find my library. I do have a library of Chopra Library. And if you WANNA find it it's also called I. S. H. A. R. Online Dot Ord and. This is the most comprehensive library on everything to do with integrative studies or Integrative Medicine or integrative cultures. It's I would say there's nothing like this It's the Wikipedia of integrated medicine. It's called the chopper elaborate. It doesn't have just my work. It has the work of everybody in the field of integrative studies whether they're scientists philosophers humanitarian CZ. Or this people like me. We shoot the breeze. What's the impact that you want to have on the world? I just want people say there was this guy. He's gone now pick up from where he left and see how we can continue the exploration. The journey has no ending. The point of arrival is always now like that. All right guys. It is a vast world that this man creates won't even say inhabits that he creates he's written on so many topics and has extended this notion of non duality to so many people and really helped reach countless lives and get people to think in new ways. You can think of him as a human dose of LSD. So I highly encourage you guys to check it out to change your consciousness and hopefully end human suffering. If you haven't already be sure to subscribe and until next on my friends be legendary. Take care everybody. Thank you so much for listening. And if this content is delivering value to you please go to Itunes stitcher rate and review. That helps us build this community and that is what we're all about right now buildings community as big as we can to help as many people as we can deliver as much value as possible and you guys rating and reviewing really helps with that all right guys. Thank you again so much until next time. My friends you legendary take care.

LSD Deepak Chopra New York Times oxytocin founder Nobel Prize DOT Time magazine Oprah inflammation Google Shero University of San Diego Internal Medicine Board Roslyn yellow
Fred Jablin and Piper Rountree Pt. 2

Crimes of Passion

1:00:44 hr | 2 years ago

Fred Jablin and Piper Rountree Pt. 2

"If you haven't had a chance to listen to survival you need to check it out immediately. Survival tells high-intensity stories about people in life or death situations and explores the strategies they use to stay alive. It's truly fascinating search for and subscribed to survival wherever you listen to podcasts, and please don't forget to rate and review. Due to the graphic nature of this week's crimes. Listener discretion is advised. This episode includes discussions violence and murder that some people may find offensive we advise extreme caution for children under the age of thirteen. Piper trying to control her fidgeting as she waited in the airport security line. She had heard on the news that after nine eleven TSA agents received special training in how do I definitely a suspicious person? Piper wasn't a terrorist. But she was traveling under a false identity. She couldn't afford anyone looking too closely at the stolen driver's license. She carried just calm down. She told herself, hyper exhaled, slowly and smoothed down. Her blonde wig. It was almost her turn at the podium. She had to make it onto this flight. This trip was her best shot at getting her three kids back and without her children. Hyper wasn't whole every day. She ached for them. The TSA agent motioned up, hyper with the blue gloved hand, she stepped up to the podium and handed. Over her paper, boarding pass, and stolen ide-. She could feel her heart beating in her eardrums as the agent looked back and forth from the driver's license to bypass face. She smiled at them. Please let this work the agent scrutinized, the ID, please, please. Please thought Beiber the agent remarked. You know, my daughter's name is Tina to she hates it. Then he handed the license back to piper and signed a Mark of approval on her boarding pass, hyper giggled giddy that her gambit worked. She replied, I know Tina feel so ordinary sometimes my younger sister piper. She got the best name in the family. The TSA agent chuckled and motion for the next passenger in line have nice flight miss Rowntree Beiber kept smiling all the way to the gate. She was going to get her babies back. Hi, I'm Laney Hobbs. And this is crimes of passion. Apar- cast original in the legal definition. A crime of passion is a violent crime that occurs in the throes of extreme emotion, leaving no time to reflect on the consequences. But in this show, we explore passionate crimes. How does a marriage progress from husband and wife to killer and victim or killer and co-conspirator if there's a thin line between love and hate what manipulates our relationships into deadly results last week. We follow the relationship between Fred Chaplin and piper Rowntree and why after twenty years of marriage they decided to divorce in two thousand one the separation was hard on all parties. Both Fred and piper. Vying for custody rights of their three kids in the end Fred was awarded full custody. Piper was destroyed this. Week will explore the drastic action piper took to reclaim her children and the aftermath of a murder. We'll follow the investigation eventual arrest and trial at par cast. We are grateful for you our listeners, you allow us to do what we love let us know how we are doing reach out on Facebook and Instagram at our cast and Twitter at parkas network. And if you enjoy today's episode the best way to help is to leave a five star review wherever you are listening. It really does help us. We also now have merchandise. Head depar- cast dot com slash merch. For more information. Friends and neighbors often described fifty two year old Fred job Lynn and forty four year old piper Rountree as having opposite personality types, Fred had more black and white way of looking at the world orderly and logical, hyper on the other hand was a free spirit incredibly artistic with an outpouring of emotion. Piper saw herself as the consummate nurturer and the pit ame- of motherhood. According to the book die my love by Katherine, Casey. She said being the mother is my personality. My thing. It's my purpose in life. It's simply when I am at my core. Therefore when Fred was awarded full custody of their children in may of two thousand two piper felt like her world was ripped away from her before I continue with paper psychology. Please note that I am not a licensed psychiatrist or psychologist, but I have done a lot of research for the show Mia. Myth bynum, a professor of family science at the university of Maryland explored the effects of four separation such as losing custody on parents. She wrote forceful separation is particularly damaging when parents feel there's nothing in their power that can be done to get their child back that helplessness can lead to a feeling that Smith bynum referred to as ambiguous loss. Parents who experienced this more unable to find closure. She said, you know, your kid is out there. But you don't know if you'll be able to parent and take care of your kid, again, people become frozen in their grief when piper found herself in dire financial straits after the divorce. She was forced to move back to Texas even further away from her children exacerbating her feelings of loss and four separation. Then in the fall of two thousand four hyper learned that. Her ex husband had started a serious relationship. Ship with a new woman, suddenly a stranger had more access to her children than she did was able to care for them in ways, she could not just by proximity by the end of October piper reached her breaking point. On thursday. October twenty eighth two thousand four piper flew from Houston, Texas to Norfolk Virginia she rented a car at the airport and drove the ninety miles to Richmond. But she didn't notify Fred or the children effort trip in state at a nearby hotel instead of with one of her friends in the area and fact when she spoke with her twelve year old son Paxton in the afternoon on Friday, the twenty ninth. She told him that she was in Galveston, Texas on our way home after a day of work. What follows version of events that is best supported by the collective evidence. Please note this was not the only version of the morning of Tober thirtieth presented to investigators that Saturday morning piper woke up in her hotel room at four thirty A. M? She listened to the voicemail on her cellphone went about her morning routine and checked out with the front desk. She got into her rental car. Just before six AM, the son wouldn't be up for another hour at least under the cover of predawn darkness, hyper said our plan in motion. It was only ten minute drive from the hotel to hearth glow lane. But piper still found herself repeatedly checking the clock watching the digital numbers tick the minutes away, she tried to channel positive energy. So far every step had gone off without a hitch. She wanted that trend to continue pipers execution. This morning would decide her children's fate. She had to be perfect soon enough. She was making the familiar, right? Turn down the quiet residential street piper. Drove past the house where her ex husband and children slept parking the rental car around the curve at a sight. She turned off the engine the digital numbers read six oh, seven a m. When piper got out of the car the slamming of the driver's door. Drew the attention of a few dogs in the nearby house making them bark incessantly, she cursed them silently Lynn, prayed for them to shut up. It was paramount that no one spotted her in the dark. She quickly dashed down the street hiding behind thick tree out of you piper. Forced herself to stay hidden calming her breath until the dogs quieted down. It was now six fifteen AM. Staying off the street piper picked her way through the neighbors yards. She moved cautiously without drawing the attention of anyone else when she made it to fifteen fifteen hearth glow. Piper. Stayed hidden in the tree line. A light was on in the upstairs master bedroom. Fred was awake right on schedule. The clock read six twenty five AM. It was hard for piper to return to this house now with each visit. She noticed more pieces of the home. She knew removed the Princess mural. She painted in the girl's bedroom was wallpapered over the framed family portrait's replaced with photos that didn't feature piper. Several members of the large brood of rescued animals or rehome d-, slowly, but surely all signs of piper's influence or being raced, and she knew one person was to blame for these injustices. And so. Oh, much more. Fred as if summoned Fred javelin stepped out of the back door of the house. It was just after six thirty AM pipers pulse. Raised as she watched him make his way down the driveway. She worked up her nerve to confront him thinking about all of the things he taken from her. He stole her babies her life when Fred been down to pick up the newspaper piper emerged from her hiding place. She conked the thirty eight revolver in her hand, hyper took aim feeling the guns. Wait, she should have done this months ago when Fred stood up. She called out to him. He didn't have time to respond before piper fired. The neighborhood dogs immediately reacted to the noise barking piper dashed across the grass and into the darkness. Sprinting as fast as she could to the rental car, her heart pounding handshaking from Trenton, she fit the key into the ignition and brought the car to life. She grip the steering wheel tight and sped off down the street. She'd been perfect. The dogs. Weren't the only ones you heard the gunfire that morning, according to Katherine Casey's book die my love. Fred chaplains neighbor. Bob mcardle was laying in bed already awake on the morning of October thirtieth. He recognized the three successive bangs as gunshots and immediately called nine one one hell ever when the police arrived and did a sweep of the surrounding area. They found nothing out of the ordinary. They told Bob that this wasn't uncommon. Sometimes they never discovered the source of random gunfire. After the police left. Bob went about the business of starting his day. He and his wife Doreen God dressed in leashed up their own dog for their customary morning walk when they reached the javelin house, Bob and Doreen stopped short at something in the driveway. The sun wasn't up yet. When the police searched earlier now in the early morning light, the source of the gunshots was revealed laying on the driveway next to his car was Fred chaplains lifeless body, Bob and Doreen immediately re summoned the police. The police worked quickly to assess the scene paramedics attended to Fred chaplains body and officially pronounced him dead. Neighbors informed, the officers that the three javelin Rowntree children were so far on accounted for officer Robbie Reamer unsure of what he would find inside the house led a swat team through the back door. He discovered the children unharmed in their bedrooms. He told them that they needed to leave the house and escorted them to safety. Once they were in a more secure location. It would fall to the special victims unit to inform fifteen year old Jocelyn twelve year old Paxton an eight year old Kelly that their father was dead in the driveway. Where Fred's body was found the forensics team recovered stray bullet in the grass, but no shell casings an initial search of the property ruled out robbery as a motive the house was still in order. And nothing appeared to be missing. The burglar alarm was deactivated and several valuables remained in plain sight, it appeared the shooter never entered the javelin home. According to the department of Justice fourteen percent of all homicides in the United States or perpetrated by an intimate partner in addition separated and divorced men and women represented the highest rates of homicide as investigator Koby Kelly gathered more information from neighbors. He heard a great deal about Fred and piper's contentious divorce proceedings. Mill foster who shared a fence with Joplin's told Kelly about the false domestic abuse charges. Piper filed as well. As the libel is, psychological. Profile on Fred she emailed on mass after the custody decision. The sentiments of the neighbors were echoed by Fred's brother who suggested Kelly consider piper as a suspect. Dr Markman Schick, author of the intelligent divorce wrote domestic violence stems from a loss of control the perpetrator believes that she is a victim and that a wrong desperately needs to be righted unless she moves onto another victim or gets carried away in a relationship that has some health engendering energy. She will not let go some people simply nurse their wounds waiting for the right moment investigator Kelly wasn't one to rush to conclusions. But he reached out to the Houston. Police department and asked them to. Locate piper Rowntree after all if they could confirm she was thirteen hundred miles away. It would rule her out as a suspect and at the very least someone needed to inform piper of her ex husband's death. But when the Houston officers arrived at piper's house, she wasn't there. They left a message on her cellphone asking her to get in touch with police as soon as possible. In the meantime, Kelly subpoenaed pipers phone records to verify paxton's account that paper had called him from Galveston Texas the day before Friday, the twenty ninth. Kelly also reported speaking with their mother on the twenty ninth but wasn't sure where she had called from. However phone records indicated that piper cell had pinged off towers in Virginia both on Friday. The twenty ninth and Saturday the thirtieth one of the towers ping, the morning of the murder at four thirty A M was less than five miles away from the javelin house on hearth glow lane. The investigators quickly shifted their energies their top priority was now locating. Piper rowntree. Coming up. Police. Follow the evidence to track down piper. What would you do to stay alive? Would you drink your own urine? Way through snake infested, water cut off your own arm. You probably wouldn't. But you might be surprised at the links you'd go to in order to sail. Live every week the park cast network show. Survival tells the high intensity stories of people in life or death situations and explores the strategies they use to survive. It also examines the lasting psychological effects of living through a traumatic event, and what it's like to return to normal life. The stories of survival are extrordinary, but the people in them are regular people like you and me, and they exemplify the human spirits ability to triumph over deadly adversity. New episodes come out every Monday search for and subscribe to survival wherever you listen to podcasts again searched survival or visit par cast dot com slash. Survival till listen now survival how far would you go to stay alive? Now back to the story. On Saturday Tober thirtieth two thousand four fifty two year old. Fred Jacqueline was found shot to death in his driveway. In Richmond Virginia when police found evidence that Fred's ex wife forty four year old piper Roundtree was five miles away from the house only hours before the murder. They prioritize efforts to locate her in addition to placing piper and Richmond the records indicated that in the hours after the murder. The phone traveled southeast to Norfolk where the airport was located the last ping Norfolk happened close to twelve pm an hour and a half later the phone pinged in Baltimore Maryland over two hundred miles away to travel that distance in such a short amount of time investigator Koby Kelly surmised that whoever was carrying the phone had flown from Norfolk to Baltimore. He sent officers to the Norfolk airport with a picture of piper to ask if anyone remembered seeing her there. He also contacted the TSA to check flight manifest there. Wasn't anyone by the name piper Roundtree or piper jam plan? But there was a teen around tree listed on a southwest flight. She was ticketed to fly from Norfolk Virginia to Houston, Texas with the layover in Baltimore, Maryland. The flight times match the cell phone ping activity by the time. Kelly learned this the plane was due to land in Houston in a little over an hour. He immediately directed Houston. PD to send officers to hobby airport with photos of both piper. And Tina Roundtree Kelly wanted to confirm exactly which sister stepped off that plane and instructed HP to seize any luggage. She carried Houston officers brek McDaniel and David Ferguson arrived at the gate with only minutes. Despair before the eighty southwest passengers started D planning the officers stood on either side of the jet way. Scrutinizing the faces that pass by but none of them resembled piper or Tina Roundtree McDaniel in Ferguson asked the gate agent to check the flight records, they discovered whoever was flying under the name. Tina Rowntree had checked a bag. They sprinted to baggage claim hoping they could catch up to her. But by the time, they reached the carousel all the luggage had been collected. And there weren't any passengers in the area McDaniel in Ferguson reported their bad luck to Kelly they missed her. He instructed the Houston officers to drive to Tina and piper Rowntree's homes to see if they could catch up to either one of the women. Kelly also told them he would be on the first flight to Houston the following day when officer McDaniel reach Tina Rowntree's house at six p. AM on October thirtieth nearly twelve hours after Fred javelin was shot. He saw a black Jeep harked in the driveway. When he ran the license plate. He learned the car was registered to pipe around tree. Sure. Enough. A few minutes later piper exited the house and climbed into the vehicle McDaniel try to pursue her. But eventually lost the Jeep after another car. Cut him off. Around the time that McDaniel spotted her in Houston, hyper called her best friend in Richmond law. Ni LL law. Knee was despondent on the other end barely controlling her tears as she told piper. What happened to Fred, according to die? My love, hyper seemed indifferent to the news that her ex husband was dead Lonnie reiterated to her sobbing. No, you don't understand. Fred was shot and killed in the driveway at the house. But according to Lonnie, hyper only wanted to talk about the kids where they were. And when she would be able to pick them up stunned Lonnie told piper to talk to the police, and they hung up. Around nine pm on October thirtieth piper. Officer Kelly finally connected on the phone again, hyper only concern was the whereabouts of her children. She said to Kelly, can you just tell me where my kids are I need to come. Get my kids there my kids. I have custody of the kids. Kelly trying to coax more information from piper on the divorce and her feelings towards Fred. But she was singular in her focus. She wanted the children immediately Kelly admitted that Fred's will made arrangements for his brother to have custody in the event of his death. That information made piper furious, she eventually hung up on Kelly, and when he called back her phone when street to voicemail he would be forced to continue their conversation. The next day in Houston. While Houston PD officer, Ferguson waited for Richmond PD officer Kelly to arrive at the airport on the morning of October thirty first officer McDaniel said in an unmarked police car in front of piper Rowntree's house around ten AM. Mcdaniel watched by tres black cheap park in the garage once Kelly landed he and forgotten headed over from the airport together, the men knocked on the front door of piper's house. But once again, no one answered Kelly rang the doorbell still nothing they double check the garage through the window. They could see the Jeep parked inside. They tried the front door again knocking and ringing the bell Kelly, cont pipers phone any heard it ringing inside the house. But no one answered and still no one came to the door. Eventually they gave up Kelly and McDaniel headed for Tina Rowntree's house, hoping they'd have better luck with her leaving Ferguson behind if an windpipe remerged they wanted to be sure they have is on her. However, not long after the other officers departed the black Jeep suddenly zipped out of the driveway. Ferguson gave chase notifying officers Kelly and McDaniel he followed the black Jeep to a shopping center parking lot and saw piper emerged from the vehicle. He quickly parked in the spot next to her McDaniel introduced himself and identified that he was a police officer. He asked piper if they could go back to our house to talk, but piper brush them off. She said, no, if you want to talk we can talk here, but I I need to run an errand. I have to get crickets to feed my frogs with that she walked away from McDaniel and into a PetSmart he called investigator Kelly with the update the other officers raced to meet him at the strip mall, but before they could arrive piper reemerged from the pet store. She bustled pass McDaniel and climbed back. Back into our Jeep. He tried to stop her telling her that police from Virginia wanted to ask her some questions, but she slammed the door in his face. And turned the key in the admission. As she sped away. Piper. Watch the officer who will cost it her in the rear view mirror. She swore under her breath when he hopped into his own car and followed after either knew her rights, and she didn't plan on talking to any of the cops. They could rink her doorbell. A million times. She didn't care hell let them pitch ten in our front yard. She knew they didn't have anything on her. This Gomer Pyle was on a fishing expedition, she recognized him as one of the police officers at the airport the day before thank God. She'd worn the wig if they'd caught her traveling with a ticket in her sister's name, she'd have been screwed. But no one saw her get off the plane and no one saw her in Virginia. She'd been too careful for that when piper checked her rear view again. She realized that another police car had joined the tail they really meant business. She picked up her phone and called her sister pipers voice cracked as she said. Tina, I need your help. Tell me what to do knowing they'd catch up with her eventually piper. Led the police to a small office building in downtown. Houston owned by an attorney Martin McVay when piper initially moved back to Houston. She rented office space in McVeigh's practice but operated independently with her own clients, she had put a wooden sign in front of the building with both of their names on it. But hers was now painted out. Eventually she decided to leave the law for a different job. But piper and McVay were still friends and Tina suggested that his office was a good neutral ground speak with the police inside the building officer Kelly started off by reassuring piper. That Jocelyn Paxton and Kelly were safe and being looked after. In fact, he offered piper the opportunity to speak. With the children knowing how fixated she was on their wellbeing. Once they were able to get the kids on the phone piper. Spent nearly half an hour talking to them to Paxton her twelve year old son. She said Paxton your dad is dead. I don't want you to be next. Paxton I'm afraid for you guys. You're Mike will inherit everything when you die. Paxton there's probably millions. If I were you. I'd ask for police protection. She added later your ankle is the only one who would profit from this. Once per hung up with her children Kelly Astor to clarify what he'd overheard her telling the children, one did she think Michael javelin had to gain from his brother's death piper knew that Fred named Michael as has been officiating, even if the majority of the estate and insurance money went to the children, Michael would be the one holding the purse strings, she said Fred did not like Michael Mino that Michael certainly hated me. He hated my sister any still hates my family. If you look at money, if you look at position if you look at opera, tune ity, you know, the normal type of motives, Michael jam l'an inherited two million dollars or so from Fred's death. He was the one who stood to gain the most piper, then broke down into tears accusing Michael and Fred of keeping her from the children at all cost Dr Markman ship identify. Is several character traps that spouses fall into during a contentious divorce he would Li will piper. As a mixture of the victim and the avenger the victim. He described is paradoxically ruthless in victimizing anyone who they believe hurt them. They have a powerful sense of Justice and self righteousness. The avenger doesn't just want to win. She wants you to lose. She will not be satisfied until you are hurting the avenger sees revenge as an end in itself when the adventure is combined with the victim character trap such people can lose touch with reality. She will stop at nothing to make sure that you cannot be happy. According to Katherine Casey's book, hyper also pointed the finger at the university of Richmond were Fred was a tenured. Professor, she attested that Fred had control of the schools three billion dollar endowment. And all its employees someone from the school might have come after him in. Actual fact the endowment was closer to one billion dollars. And Fred had no connection to how it was spent whatsoever. Piper. Then claim that Fred had a secret room in the garage. She accused him of growing distributing and using marijuana. She painted him as a major drug player suggesting that one of his competitors may have murdered him. She told Kelly that fried kept a gun in the house. Maybe someone used it to kill him Kellyanne piper where she was the morning of the murder. She dawn the question hemming in hauling but Kelly insisted he reassured her that this was also they could rule her out as a suspect. She finally said I was right here. Kelly asked her to clarify. She was here in Martin McVeigh's office. Piper scoffed. No not. Literally in this room. But in the city in Houston Kelly, brought up the phone call on Friday, the twenty ninth that Paxton reported piper confirmed that she talked to him on her cell phone while on her way home from work in Galveston, Kelly, made a note of this. The subpoenaed phone records indicated that at the time of this. Call pipers phone pinged a tower and Richmond, not Galveston. She was lying Kelly asked her to confirm her cell phone number. She told him that. She didn't remember it. Then she added that she had more than one phone. He reiterated that he was gathering. This information to try to rule her out as a suspect they needed to know where she was on Friday and Saturday the time surrounding the murder again, she was cagey unwilling to answer she told Kelly that she didn't want to involve her alibi in the investigation. He balked at that saying you understand. This is a homicide investigation. I don't care if you're buying cocaine from a minister, you know, what I'm saying piper evenly settled on Tina as her alibi. She stated that she was at tina's house on Friday afternoon, but she wasn't home piper. Saw her a few times that after noon when she stopped by during work that night piper had gone out to a bar and met a man, but she didn't want to say who she didn't want the police reaching out to him, hyper agreed to tell them her full alibi after she had a chance to warn the man of the situation. First after making this agreement investigator Kelly and the Houston PD officers paid a visit to piper sister, Tina Rowntree. She was aggressive and refused to answer any of their questions until they restored the three javelin Rowntree children to their rightful custodian their mother, she promised Kelly that once the kids were safely returned. She would happily confirm pipers alibi. The officers left empty-handed. The night of October thirty first piper reached out to our friend Charles Tuke, inviting him over for drink according to die. My love piper. S Charles for help coming up with a way to prove her whereabouts on Friday and Saturday she had been at tina's house. But no one other than her sister had seen her Friday night, she'd gone to a bar in met a man, but he was married, and she wasn't certain of his name. She didn't want to tell the police about it worried that she'd be just build by the conservative Virginia PD multiple times throughout the evening. She mused him. How does it person prove where they were on a particular date Charles throughout multiple suggestions? Did she have any receipts from the weekend? No, she hadn't kept any what about credit card transactions? No, her car had been stolen and her. Debit card was declined sheets. Been cashed the entire weekend. Then Charles suggest. Added that the police look at her cell phone records. They would be able to tell where she was depending on the tower she pinged on those days. No, she lost her cell phone as she kept shooting down. His ideas. Charles was surprised by pipers priorities. She seemed much more focus on how this would affect regaining custody of her children than clearing her name and her ex husband's murder case. He felt like she was putting the cart before the horse an echoed investigator. Kelly's words forget being slut shamed. She was a suspect in a murder investigation. She needed to tell the police where she was and clear her name then fight for custody. Piper thanked him for his advice. Then continued pondering. On Monday, November first piper told investigator Kelly that she was unable to meet him and talk about her alibi considering her behavior the previous day. He wasn't that surprised instead he focused on the evidence. The Southwest Airlines ticket and Tina Rowntree's name was purchased with a Wells Fargo debit card belonging to Jerry Walters. An addition to the airline ticket the card had been used at an online store. Someone had paid over two hundred fifty dollars for two wigs one blonde and one read they were shipped to Jerry at an address only a few miles away from piper's house after police weren't able to identify one of their Rowntree sisters at the airport planning Kelly suspected that piper might have been traveling in disguise perhaps she had been wearing a wig when investigator Kelly called the wig boutique for more information. The sales clerk remembered the order because there was a delay in the shipment of the blonde wig it had been purchased at a sale price. But the discounted stock had run out the store shipped only the red wig along with a note that explained a blonde wig would follow in a few weeks when it went back on sale. The clerk informed Kelly that a woman called in. Demanded they ship a blonde wig to her as soon as possible not only did she pay the price difference for the non-sale wig. She paid an additional thirty five dollars for expedited shipping to guarantee a rival by Cobra twenty seventh one police check the address it had been shipped to they discovered. It was a post office box company. One of the boxes was listed under two names. Jerry Walters and piper Rowntree the same day that the batik clerk received the phone. Call about shipping. The blonde wig someone attempted to purchase a southwest airline ticket using the Wells Fargo debit card. The transaction was declined. There wasn't enough money in the account three days later after digital funds had been added Jerry Walters card was used at the southwest ticket counter in hobby airport on a round trip ticket from Houston to Norfolk with a layover in Baltimore. The ticket was issued to Tina Roundtree it became clear to investigator Kelly that in order to uncover the truth about Fred javelin murder. He had to locate Jerry Walters. Coming up police connect the final dots in their investigation. Now back to the story. Unav- ember I two days after fifty two year old Fred Jacqueline's murder. Police uncovered a key piece of evidence the same Wells Fargo debit card that was used to purchase an airline ticket and Tina Rowntree's name was also used to purchase two wigs from an online store the post office box. The wigs were sent to was in the name of both piper Rowntree N, Jerry Walters investigator Kelly was not yet able to determine how Jerry Walters connected to the Rowntree sisters, but he felt like he had enough evidence to show pipers involvement, and Fred Joplin's murder. The cellphone Ping's proved she was in Richmond the morning of the murder ordering the Whigs in advance proves she planned the crime flying under her sister's identity proves she tried to cover her tracks. Unfortunately, district attorney, wait. Kaiser disagreed worried how the individual pieces. Stack up as a whole in the courtroom, even though piper. Cellphone records showed the phone ping towers in Richmond. It only proved that the phone was there, not piper herself, the Wells Fargo debit card. Pat, the same problem it was used in Richmond that weekend. But there was no way to definitively. Prove hyper was the person behind the charges. They didn't even have irrefutable proof that it was piper on that southwest flight and not her sister. Kaiser told Kelly he needed to find airtight evidence that piper was in Richmond on October thirtieth. Ideally, a reliable eyewitness. Knowing that piper flew in on Thursday and out on Saturday. Kelly felt certain that she must have checked into a hotel in the area. He sent Richmond PD officer truck Hannah to nearby hotels to look for any record of piper. Stay, but he was unable to verify she had checked in anywhere. None of the front desk. Clerks recognized her photo, however, pipers phone had been detached our right next to a homestead suites at four thirty in the morning of the murder Hannah had a gut feeling that piper had stayed in that hotel under a false identity. On a second officer Hannah found evidence tobacco his intuition in reviewing piper. Cellphone records for Leeds Hennion recognized one of the numbers as he hit called it frequently himself, it was a Papa John's when he reached out to the pizzeria Hannah asked the manager if anyone with allows name Rowntree had placed an order on Thursday, October twenty eighth the manager confirmed they had delivered to a Roundtree in room one seventy one at the homestead suites hotel Hannah felt like you'd finally found something concrete. But when he checked the hotel manager his lead fell apart room, one seventy one was registered to Gerald Smith the night of October twenty eighth not piper nor Tina Roundtree they were back at square one. But by this point, Kellyanne located Jerry Walters. He was a fifty one year old oil man from Baton Rouge, Louisiana. He and piper had dated for about a year from early two thousand three to early two thousand four then decided to just be friends. However in the last few months, their romantic relationship had rekindled Walters reported that the weekend of the murder he had been in Baton Rouge attending a football game and sitting with his dog at the vet's office when Kelly asked about the Wells Fargo debit card Walters explained that he had opened than account for piper. When she filed for bankruptcy the previous year to help through a tough time. He told Kelly that when he spoke with piper on October thirty first she mentioned, the debit card had been stolen a few weeks prior concern about fraud the next morning Walter slogged onto the account to report the theft while doing that he saw several purchases. Made in Virginia in the previous forty eight hours. Hyper told him a must have been the thief. She had written the pin number for the account on the back of the card Walters. Had shrugged it off and close the account. Kelly asked him why they shared a post office box Walters insisted that the box belong to piper. She only added his name to the account. So he would be able to pick up packages for her. He didn't receive any mail there. He didn't know about any wigs the information exonerated any involvement on Walter's part and gave more credence to Kelly's assertions that piper was responsible for Fred's death. But district attorney Kaiser still wouldn't budge on his mandate. Morin I witness. On Wednesday, November third two thousand four Kelly finally had a stroke of luck. He went back to the southwest terminal at hobby airport with a photo of piper Roundtree and a copy of the ticket issued and Tina Rowntree's name when he spoke with southwest agent, Kathy. Molly, she remembered checking the woman in she had remarked on her last name thinking, it was cute. She said, she was a really cute woman. Nicely dressed. I'm not a lesbian, but she was really attractive and she was wearing a blonde wig. In addition. Molly informed investigator Kelly that this woman had checked gun in her luggage at that Kelly showed her a photo of piper asking if she recognized it as the same woman, Molly immediately confirmed that the woman in the photo was the woman she had helped check in the woman who had checked at gun. Done. Molly had spent at least ten minutes with her helping her fill out the paperwork for the firearm and inspecting the gun to make sure it had a legally required cable. There was no doubt in her mind that the woman she helped was piper. Alan bene- stanza, a TSA agent who helped piper with the gun also spoke with investigator Kelly. He described the weapon as a revolver with the short barrel. Thirty two or thirty eight caliber with the wood or composite grip. This description match the ballistics report based on the bullets found at the crime scene. But when Kelly showed Bennis Dante a picture of piper. He couldn't be one hundred percent. Sure, it was the same woman remarking that our hair was different that same day. Richmond. PD officer Hannah returned to the homestead suites for a hail Mary. He wanted to speak with two Meco James the manager on duty the night of October twenty. Eight at first she didn't remember the name, Gerald Smith. But when Hannah showed her a photo of piper, she recognized the woman, she told him she had a black hat and long blonde hair. It wasn't cold out, but she was wearing a hat coat scarf and sunglasses James checked her records and reported that gera- Lynn had checked in just before nine pm on October twenty eighth the reservation for non smoking room was originally in the name Tina tree, but when she checked in the woman paid in cash and asked to change her name on the register James had agreed and updated the name to Jerry Lynn Smith, James didn't think anything of it. Plenty of people did that for many reasons, she remembered that the woman had seen nervous and agitated James thought, she might have been trying to hide from someone like an abusive spouse in addition to the positive ideas. At hobby airport. And now the hotel in Richmond staff at the car rental agency in Richmond also recognized piper. Police uncovered surveillance video from a convenience store. The children woman with striking resemblance to piper. The Wells Fargo debit card had been used there. Ninety minutes after fraud Joplin was shot in the video the woman left in the same Macon model car that piper had rented from the agency investigator Kelly prepared to convince the district attorney they had enough to press charges. But as he was about to make the call to Richmond, hyper reached out. She was finally ready to tell Kelly where she was on Friday night and Saturday morning. Piper told him that on Friday, the twenty ninth. She spent the afternoon at tina's house. Her sister would verify this that night, she had gone to the bar down the street called under the volcano. And meta man piper. Couldn't be sure of his name. It was either Steve or Jerry when Kelly tried to press her on the confusion piper got defensive it wasn't that. She couldn't remember. But the man had used both names Kelly asked if this man could verify she was at the bar. No her alibi was another man named Kevin O kief. She gave Kelly his information and encouraged him to reach out piper also explained that the next day Saturday. She emailed a co worker from her home, computer when Kelly told her that they would need to verify that she ignored the question. Pivoting to the next part of her alibi around too. Thirty PM on Saturday the thirtieth. A neighbor had come over with her daughter selling girl scout cookies, she proudly told Kelly that she bought two boxes thin mints and caramel delights. They were her favorites. Kelly exhaled on the other end of the line. He needed to verify this information, and then would get back to her piper perhaps trying to take his temperature asked. If he thought that he'd be able to check her alibi before Monday, she was supposed to attend an emergency custody hearing in Virginia that day Kelly support at the hearing would mean the world to her piper didn't like Kelly's reply he committed to testify to whatever is truthful, and then hung up. After speaking with piper Kelly set to work verifying her story. But when he spoke with Kevin O'Keefe, he contradicted her statement o'keefe's, Bartow. Proceeds showed that he wasn't even at the volcano bar on Friday night, only Saturday night he had seen piper there. But not on the nights. She described Kelly then spoke with the neighbor. She purchased girl scout cookies from the neighbor also contradicted piper statement, she hadn't bought any cookies. She hadn't even opened the door to talk to them. A large woman in a baseball hat told them through the window that she was sick. And ask them to go away. Kelly surmise that Tina pipers older and taller sister had been at her house trying to provide an alibi. The final shreds of piper's tail evaporated with testimony from tina's friend, Carol freed police reached out to Carol after receiving tip that she might be involved in the. Job Lynn, case terrified that. She could somehow be charged in connection with a murder Carol laid out damning evidence against piper. According to die. My love. Caroline, Tina spoke on Thursday, October twenty eighth during their conversation. Tina told her that piper had stolen her driver's license and credit card after joking that piper wouldn't be able to buy much with the card. Tina fell into serious silence. She confided in Carol. I think she's going to do something stupid three days later on Sunday, October thirty first Tina called Carol in tears. She needed her help something terrible had happened. According to Carol Tina confided to her that piper had flown to for Jinya and killed her ex-husband and Tina at helped hyper dispose of some evidence. Tina and Carol went to two different dumpsters in the city and recovered what? Sheet thrown away, a blonde wig and a purse but Carroll wasn't sure what Tina did with them. After Sunday the next day Monday. Carol was once again at tina's house when piper showed up when Carol offered her condolences for Fred piper. Replied, I'm not sorry. He's dead just about how it happened Carol reported that piper. Then Astor if she could help our get rid of some things that she didn't want the police to find Carol said that she was caught up in the drama and agreed to collect some bags and computers from piper's house to get rid of. But by Tuesday, a cold feeling had settled in Carol's gut. She didn't want any part of this. She drove the bags in computers to the hotel. She knew piper was staying in. She loaded pipers things onto a baggage cart, and then paid a valley five dollars to take the cart up to piper's room. Carol drove away washing her hands of the situation care. Girlfriend worried about the implications of her involvement had sent the tip to the police. She knew if Carol told her story she'd be better off and less likely to face punishment Kelly agreed with that assessment. So far he saw nothing to charge her with. But he needed to determine the veracity of her statement as soon as possible, he drove to the hotel to check the security footage at seven eleven pm. On tuesday. The tape showed Carol willing up in her car unloading bags onto a luggage cart than driving away that night investigator. Kelly spoke with district attorney Wade Kaiser both men agreed. It was time to bring piper Roundtree in. On Monday, November eighth Kaiser prison to this case to a grand jury. The panel ruled that the collective evidence warranted. Murder charges brought against paper Roundtree at the same time. Piper. Was attending a custody hearing in Richmond Virginia, she argued with the judge that her ex husband had no right to assign custody rights to his brother instead of the children's mother. But the judge did not agree as long as piper was a suspect in a criminal investigation. The children would remain in Michael Jacqueline's care as piper exited the courtroom. She didn't even have a chance to process her renewed sense of loss. She was met on the courthouse steps by investigator. Kelly who presented her with a warrant for her rest. Piper sat in defiance silence in the interrogation room. She couldn't believe the audacity of these cops arresting her so publicly like that those rubber neckers on the ten o'clock news had gotten their Phil. How dare they treat her like this on the day? She was fighting for her children for her rights as a mother investigator Kelly tried to coax piper into talking about the morning of October thirtieth. He told her he had a pretty good idea of the truth. But hope that she would be willing to fill in the details. Piper rolled her eyes. She hoped he choked on a Donut but Kelly was determined. He pulled out a thick file folder and displayed the contents to piper showing her highlighted phone logs and transaction records for a debit card. This lesser cell phone her debit card. They were both used in Richmond. The weekend of Fred's murder, hyper shrugged, casually. She had lost her phone and her debit card. Several people had access to our purse. Maybe she lost the debit card or maybe her sister. Tina borrowed the card from her wallet. She said Tina takes whatever she wants all the time. Kelly persisted. He showed her a still photo taken from the convenience store. Surveillance video indicating the blonde woman in the photo who does that look like to you. He asked her hoping. But in the face of the evidence, hyper would come clean, but piper knew that she still had control of the situation to convict her. The jury would have to believe without a shadow of doubt that piper was responsible. And no one else. It was tina's name on the airline ticket tina's name on the rental car. She pushed the still photo away brushing Kelly off. I'm not sure who that is. It could be mean, it could be my sister. Tina Kellyanne Kaiser couldn't believe it, hyper Rowntree's defense strategy was to throw her older sister under the bus. Piper's trial was slated to begin in late February two thousand five. In the meantime, Kelly continued to collect evidence that would bolster the case he discovered that on twenty six a few days before the murder piper had gone to a gun range in Houston to practice shooting with a thirty eight caliber, he also uncovered a life insurance policy that named piper. The sole benefactor of two hundred thousand dollars in the event of Fred's death to confront pipers assertion that it was Tina who had flown to Norfolk and not herself Kelly checked the parking lugs at hobby airport for the weekend of the murder pipers black. Jeep was recorded in the logs from Thursday, October twenty eighth to Saturday October thirtieth when the trial began on February twenty-second two thousand five DA. Wade Kaiser had a mountain of evidence to prove his case, though, investigator Kelly had been frustrated by Kaiser's. Netizens tack during the investigation dragging his feet on bringing charges against piper. He saw the dividends in the courtroom in only five days Kaiser, buried piper Rowntree, her defense tried to plant the seeds of doubt in the jury suggesting again, and again that it was Tina Roundtree not piper who had gone to Virginia and shot Fred javelin. But Kaiser had a rebuttal on every point piper. Allege that Tina often used her cellphone however phone records and piper zone. Testimony. Prove that she had called her son Paxton from her cell phone the day before the murder in Virginia. She claimed that Tina owned a thirty eight caliber gun, but there was no record of gun registered in her name and witnesses from the gun range in Houston. Please the thirty eight and piper's hand Kaiser stressed to the jury that it was piper Roundtree and not her sister. Tina who was on trial the evidence. Overwhelmingly pointed to piper on February twenty seventh. The jury deliberated for less than two hours. They found piper guilty of first degree murder and the unlawful use of a firearm. The judge at her sentencing hearing said the evidence certainly shows that her intent was willful deliberate and premeditated piper showed absolutely no remorse for her crimes. She was sentenced to life in prison plus three years after her sentencing author of dime. I love Catherine Casey went to visit piper. During their visit piper told Catherine that Fred was an evil, man. One with many enemies, she detailed a new theory on who killed Fred. Maybe he was having an affair with a male co worker and someone at the university of Richmond killed Fred to cover it up. Understandably. Casey dismissed pipers allegations. As of this recording piper is incarcerated at the flu Vanna Correctional Center for women in Troy Virginia. She spends her time stirring up trouble in two thousand seventeen she filed a lawsuit against the prison for denying her yoga mat and sell a converted Buddhist. She accused them violating her religious rights. The action was eventually dismissed Tina Rowntree has made public statements of support for her sister multiple times since the trial. The fact that piper tried to imply that Tina was responsible for Fred's murder doesn't seem to have impacted their relationship. She said in a two thousand fourteen interview Hyperion, I are soul sisters. She is my best friend, and she is remarkable person. Tina continues to advocate for pipers for lease calling her conviction, a terrifying miscarriage of Justice. For more information on Fred javelin and piper Roundtree amongst the mini sources. We used we found die. My love by Katherine Casey, extremely helpful to our research. Thanks again for tuning into crimes of passion. We will be back Wednesday with another episode. You can find more episodes of crimes of passion as well. As all park has other shows on Spotify or anywhere else. You listen to podcasts. Several of you have asked how to help us if you enjoy the show the best way to help delete a five star review. Don't forget to follow us on Facebook and Instagram at par cast and Twitter at park has network. We'll see you next time when true love needs true crime. Crimes of passion was created. By max Cutler is a production of Cutler media, and is a part of the podcast network. It is produced by Maxon wrong Cutler with sound design by Michael Ling's, ner production assistance by Ron Shapiro and Paul Liebskind additional production assistance by Maggie admire and Carly madman. Crimes of passion is written by Abigail cannon. I'm Laney Hobbs. Don't forget to listen to survival. It looks through the eyes of the world's most resilient survivors as their self preservation instincts are pushed to the limit be sure to search for and subscribe to survival wherever you listen to podcasts, and please don't forget to rate and review.

Kellyanne piper Tina Roundtree Kelly piper Rowntree Fred piper Roundtree Carol Tina investigator Tina Rowntree murder Houston Richmond officer Kelly Astor Virginia piper Rountree Jocelyn Paxton Fred javelin Rowntree Beiber Tina Kellyanne Kaiser