#she must test her hypothesis until she has conclusive data

[ironrad]

Tony walking outside:

Peter running and belly flopping into the lake:

Tony:

Peter groaning in pain:

Morgan: Try again, Petey, my teacher said spiders can use surface tension to walk on water

Peter: Maguna PLEASE this is the SEVENTH try

Morgan: You have 8 legs, don’t you?

Peter: WHAT

Tony walking back inside:

[happyhollow-mellowmarsh]

History of a Spirit

There’d been rumors among a few magical conspiracy theory and research forums... of an odd blog that popped up out of nowhere one night. Upon first look, it seemed like any old ordinary jokes and oddities blog, but after a notable figure did some data mining on a whim... something else entirely appeared to viewers were they to enter the right combination of keys.

Then, and only then, would one find the research notes of one Shaela Allaway in her adventures as a recent member of the fey. Videos and text posts detailing new information on magic, or simply experiences she had encountered. You clicked the latest video.

“Ah, there we go.” A somewhat posh Edinburgh accent came along with the view of a woman with messy red hair and a very large brown coat. Oh yes, and she was also an elf with the green of her eyes swimming in a black where the white of normal eyes would be. She was excited. Smiling and also a bit hectic. Her face was weirdly close to the camera as she messed about with what sounded like writing utensils behind the camera which seemed to be resting on a desk of some sort. It was a bit hard to tell the quality due to the angle. Just that it looked vaguely wooden. That was if you were a person weird enough to try and discern that sort of thing as Shaela Allaway’s charming face filled the screen. 

Eventually she pulled back, putting her hands together with a notepad between them. “Alright! Let’s get this video under way! Hello!” She waved, her smile bright and wide. “As you likely know I am Shaela Allaway. Leading researcher of fey culture, history, and mythos. Now that I am a fey myself, and magic, I have been researching other things within my time of adventure among the magical plains. Those who have been watching my videos and reading my adventure blog would well know. But today, we are at my home, as I wanted to talk about something curious that I don’t think many people have really looked into. Even the Great Witches.” As she said this she lifted one hand to her side as if she was showing something off that should be sitting in the palm of her hand. This was something most viewers from earth would not know of or even be able to see. “Minor Elemental Spirits, being one of the many names they have. I for one prefer to call them Sprites and will do so for the remainder of this video for personal ease. In any case, Sprites are a curious thing. See, in the past upon discovery they were designated as a fey entity. They actually do look vaguely fey like when they choose to take a corporeal, non elemental form. Of course more recently we have come to know that they are in fact not fey, and are instead a form of elemental. Each Sprite is being made of a single coalesced magical element, with a faint soul, and rudimentary personality. Now unlike other elementals, they seem to operate in a slightly different manner. The reason for which I can get to shortly, but my hypothesis on that reason existing I think, would be a good segway.” Moving her platformed hand back down, Shaela moved through her notes before settling on a specific page. “Alright.” She looked back at the camera and the carefree look she had at the beginning was nearly melted away at this point. At this moment she was a highly learned individual on various related subjects, speaking on theories and information with a near zealous interest. “Now I must point out this is all personal theory that I am about to go into. As currently there is no known reason for why Sprites exist or why they exist the way they do. There are several working ideas but nothing is concrete. As for my hypothesis, it relates to their weak soul and basic personality. Essentially my working theory is that when a soul has lost its tether to reality and dissipates, there is a chance that at that time there will be an existing high concentration of a specific elemental energy in the area. If there is such a high concentration and there is a strong enough fragment of a soul yet to dissipate as the soul ceases to be, that the magical energies will bond to said soul fragment. Creating a being made of said element with a weak soul and a personality based on whatever fragment of that soul was clung to. Of course, and I must say this again, it is only a hypothesis at this moment. But, that leads us into why I am curious over how they are made, and why they are different.”. 

Flipping through her notes a little more, eventually Shaela takes a breath, and continues her little lesson. “So the properties of elementals are well known. They are a being composed of one or more elements in a raw state given a strange elemental based soul. Their use in magic is also well documented. Elementals have for ages been known to be good for allowing humans unaligned with or unable to use a specific element to use said element if they have one of the beings at their disposal. They are also known to enhance the magical capabilities of magic users already skilled in whatever the correlated element is. This is the beginning and end of their functions in magic. Outside of more grimm matters. Sprites are different. Sprites have highly specific abilities available to them in correspondence with their personality and aligned element. For example.”. Shaela looks around and then motions her hand to an empty space to her left near her head. “One of the Sprites who I have around me is associated with death magic, and has a relatively sinister personality. So I have found whenever I wish harm to something or potentially death to it, this Sprite uses it’s magic to bend reality to increase the potency or probability of such results. It is a very specific effect but not without potent magical power to do so. Sprites seem to concentrate all of their magical will into said single result. Though there are some oddities within it. For example.”. 

Shaela again moves her hand, now motioning to her other side. “These two sprites are technically one in the same entity despite being two. If you divide them, neither has nay magical power aside from their base existence as an elemental life form. But together, they have the power to give whatever they wish good fortune. They bend the very will of reality so that whoever has their favor, has unquestionably better luck. I have tested it time and time again. You can only win coin tosses so many times in a row before the evidence is conclusive. But they also have another curious point!” Shaela smiles and raises a finger as if she is speaking to a class of buzzing students. “They can change the targeting of their magic to give somebody terrible horrible luck! In this way, I actually think that it is possible all Sprites possess this trait! Their powers are highly specific, but can be used for weal or woe! It is all very fascinating! Along with that it seems they can affect humans without them even knowing! I can not speak of who due to not wanting to ruin their situation, but I have known of normal humans who were given benefits in their daily lives that were just assumed to be natural talent that actually came from such Sprites who had taken a liking to them! It is all very fascinating!” Taking a deep breath, Shaela closed her notebook and snapped it down onto the desk by the camera. “Unfortunately that is all I know as of now but I will say if I have any further breakthroughs. The next time you all see or read from me, it will be from within the depths of the magical realm for devils and demons. I have a soul to look into trading for something I am not at allowance to discuss. Until my next update, Shaela Allaway, signing out!” Without an actual physical fanfare, Shaela simply leaned forward into the camera lens and then- click. Darkness came with the end of the video. 

[radiumeater]

Alcoholics Anonymous is famously difficult to study. By necessity, it keeps no records of who attends meetings; members come and go and are, of course, anonymous. No conclusive data exist on how well it works. In 2006, the Cochrane Collaboration, a health-care research group, reviewed studies going back to the 1960s and found that “no experimental studies unequivocally demonstrated the effectiveness of AA or [12-step] approaches for reducing alcohol dependence or problems.”

The Big Book includes an assertion first made in the second edition, which was published in 1955: that AA has worked for 75 percent of people who have gone to meetings and “really tried.” It says that 50 percent got sober right away, and another 25 percent struggled for a while but eventually recovered. According to AA, these figures are based on members’ experiences.

In his recent book, The Sober Truth: Debunking the Bad Science Behind 12-Step Programs and the Rehab Industry, Lance Dodes, a retired psychiatry professor from Harvard Medical School, looked at Alcoholics Anonymous’s retention rates along with studies on sobriety and rates of active involvement (attending meetings regularly and working the program) among AA members. Based on these data, he put AA’s actual success rate somewhere between 5 and 8 percent. That is just a rough estimate, but it’s the most precise one I’ve been able to find.

I spent three years researching a book about women and alcohol, Her Best-Kept Secret: Why Women Drink—And How They Can Regain Control, which was published in 2013. During that time, I encountered disbelief from doctors and psychiatrists every time I mentioned that the Alcoholics Anonymous success rate appears to hover in the single digits. We’ve grown so accustomed to testimonials from those who say AA saved their life that we take the program’s efficacy as an article of faith. Rarely do we hear from those for whom 12-step treatment doesn’t work. But think about it: How many celebrities can you name who bounced in and out of rehab without ever getting better? Why do we assume they failed the program, rather than that the program failed them?

When my book came out, dozens of Alcoholics Anonymous members said that because I had challenged AA’s claim of a 75 percent success rate, I would hurt or even kill people by discouraging attendance at meetings. A few insisted that I must be an “alcoholic in denial.” But most of the people I heard from were desperate to tell me about their experiences in the American treatment industry. Amy Lee Coy, the author of the memoir From Death Do I Part: How I Freed Myself From Addiction, told me about her eight trips to rehab, starting at age 13. “It’s like getting the same antibiotic for a resistant infection—eight times,” she told me. “Does that make sense?”

She and countless others had put their faith in a system they had been led to believe was effective—even though finding treatment centers’ success rates is next to impossible: facilities rarely publish their data or even track their patients after discharging them. “Many will tell you that those who complete the program have a ‘great success rate,’ meaning that most are abstaining from drugs and alcohol while enrolled there,” says Bankole Johnson, an alcohol researcher and the chair of the psychiatry department at the University of Maryland School of Medicine. “Well, no kidding.”

[...]

AA truisms have so infiltrated our culture that many people believe heavy drinkers cannot recover before they “hit bottom.” Researchers I’ve talked with say that’s akin to offering antidepressants only to those who have attempted suicide, or prescribing insulin only after a patient has lapsed into a diabetic coma. “You might as well tell a guy who weighs 250 pounds and has untreated hypertension and cholesterol of 300, ‘Don’t exercise, keep eating fast food, and we’ll give you a triple bypass when you have a heart attack,’ ” Mark Willenbring, a psychiatrist in St. Paul and a former director of treatment and recovery research at the National Institute on Alcohol Abuse and Alcoholism, told me. He threw up his hands. “Absurd.”

Part of the problem is our one-size-fits-all approach. Alcoholics Anonymous was originally intended for chronic, severe drinkers—those who may, indeed, be powerless over alcohol—but its program has since been applied much more broadly. Today, for instance, judges routinely require people to attend meetings after a DUI arrest; fully 12 percent of AA members are there by court order.

Whereas AA teaches that alcoholism is a progressive disease that follows an inevitable trajectory, data from a federally funded survey called the National Epidemiological Survey on Alcohol and Related Conditions show that nearly one-fifth of those who have had alcohol dependence go on to drink at low-risk levels with no symptoms of abuse. And a recent survey of nearly 140,000 adults by the Centers for Disease Control and Prevention found that nine out of 10 heavy drinkers are not dependent on alcohol and, with the help of a medical professional’s brief intervention, can change unhealthy habits. We once thought about drinking problems in binary terms—you either had control or you didn’t; you were an alcoholic or you weren’t—but experts now describe a spectrum. An estimated 18 million Americans suffer from alcohol-use disorder, as the DSM-5, the latest edition of the American Psychiatric Association’s diagnostic manual, calls it. (The new term replaces the older alcohol abuse and the much more dated alcoholism, which has been out of favor with researchers for decades.) Only about 15 percent of those with alcohol-use disorder are at the severe end of the spectrum. The rest fall somewhere in the mild-to-moderate range, but they have been largely ignored by researchers and clinicians. Both groups—the hard-core abusers and the more moderate overdrinkers—need more-individualized treatment options. The United States already spends about $35 billion a year on alcohol- and substance-abuse treatment, yet heavy drinking causes 88,000 deaths a year—including deaths from car accidents and diseases linked to alcohol. It also costs the country hundreds of billions of dollars in expenses related to health care, criminal justice, motor-vehicle crashes, and lost workplace productivity, according to the CDC. With the Affordable Care Act’s expansion of coverage, it’s time to ask some important questions: Which treatments should we be willing to pay for? Have they been proved effective? And for whom—only those at the extreme end of the spectrum? Or also those in the vast, long-overlooked middle? For a glimpse of how treatment works elsewhere, I traveled to Finland, a country that shares with the United States a history of prohibition (inspired by the American temperance movement, the Finns outlawed alcohol from 1919 to 1932) and a culture of heavy drinking. Finland’s treatment model is based in large part on the work of an American neuroscientist named John David Sinclair. I met with Sinclair in Helsinki in early July. He was battling late-stage prostate cancer, and his thick white hair was cropped short in preparation for chemotherapy. Sinclair has researched alcohol’s effects on the brain since his days as an undergraduate at the University of Cincinnati, where he experimented with rats that had been given alcohol for an extended period. Sinclair expected that after several weeks without booze, the rats would lose their desire for it. Instead, when he gave them alcohol again, they went on week-long benders, drinking far more than they ever had before—more, he says, than any rat had ever been shown to drink. Sinclair called this the alcohol-deprivation effect, and his laboratory results, which have since been confirmed by many other studies, suggested a fundamental flaw in abstinence-based treatment: going cold turkey only intensifies cravings. This discovery helped explain why relapses are common. Sinclair published his findings in a handful of journals and in the early 1970s moved to Finland, drawn by the chance to work in what he considered the best alcohol-research lab in the world, complete with special rats that had been bred to prefer alcohol to water. He spent the next decade researching alcohol and the brain.Sinclair came to believe that people develop drinking problems through a chemical process: each time they drink, the endorphins released in the brain strengthen certain synapses. The stronger these synapses grow, the more likely the person is to think about, and eventually crave, alcohol—until almost anything can trigger a thirst for booze, and drinking becomes compulsive. Sinclair theorized that if you could stop the endorphins from reaching their target, the brain’s opiate receptors, you could gradually weaken the synapses, and the cravings would subside. To test this hypothesis, he administered opioid antagonists—drugs that block opiate receptors—to the specially bred alcohol-loving rats. He found that if the rats took the medication each time they were given alcohol, they gradually drank less and less. He published his findings in peer-reviewed journals beginning in the 1980s. Subsequent studies found that an opioid antagonist called naltrexone was safe and effective for humans, and Sinclair began working with clinicians in Finland. He suggested prescribing naltrexone for patients to take an hour before drinking. As their cravings subsided, they could then learn to control their consumption. Numerous clinical trials have confirmed that the method is effective, and in 2001 Sinclair published a paper in the journal Alcohol and Alcoholism reporting a 78 percent success rate in helping patients reduce their drinking to about 10 drinks a week. Some stopped drinking entirely.I visited one of three private treatment centers, called the Contral Clinics, that Sinclair co-founded in Finland. (There’s an additional one in Spain.) In the past 18 years, more than 5,000 Finns have gone to the Contral Clinics for help with a drinking problem. Seventy-five percent of them have had success reducing their consumption to a safe level. [...] In the United States, doctors generally prescribe naltrexone for daily use and tell patients to avoid alcohol, instead of instructing them to take the drug anytime they plan to drink, as Sinclair would advise. There is disagreement among experts about which approach is better—Sinclair is adamant that American doctors are missing the drug’s full potential—but both seem to work: naltrexone has been found to reduce drinking in more than a dozen clinical trials, including a large-scale one funded by the National Institute on Alcohol Abuse and Alcoholism that was published in JAMA in 2006. The results have been largely overlooked. Less than 1 percent of people treated for alcohol problems in the United States are prescribed naltrexone or any other drug shown to help control drinking. To understand why, you have to first understand the history. The American approach to treatment for drinking problems has roots in the country’s long-standing love-hate relationship with booze. The first settlers arrived with a great thirst for whiskey and hard cider, and in the early days of the republic, alcohol was one of the few beverages that was reliably safe from contamination. (It was also cheaper than coffee or tea.) The historian W. J. Rorabaugh has estimated that between the 1770s and 1830s, the average American over age 15 consumed at least five gallons of pure alcohol a year—the rough equivalent of three shots of hard liquor a day. Religious fervor, aided by the introduction of public water-filtration systems, helped galvanize the temperance movement, which culminated in 1920 with Prohibition. That experiment ended after 14 years, but the drinking culture it fostered—secrecy and frenzied bingeing—persists.In 1934, just after Prohibition’s repeal, a failed stockbroker named Bill Wilson staggered into a Manhattan hospital. Wilson was known to drink two quarts of whiskey a day, a habit he’d attempted to kick many times. He was given the hallucinogen belladonna, an experimental treatment for addictions, and from his hospital bed he called out to God to loosen alcohol’s grip. He reported seeing a flash of light and feeling a serenity he had never before experienced. He quit booze for good. The next year, he co-founded Alcoholics Anonymous. He based its principles on the beliefs of the evangelical Oxford Group, which taught that people were sinners who, through confession and God’s help, could right their paths. AA filled a vacuum in the medical world, which at the time had few answers for heavy drinkers. In 1956, the American Medical Association named alcoholism a disease, but doctors continued to offer little beyond the standard treatment that had been around for decades: detoxification in state psychiatric wards or private sanatoriums. As Alcoholics Anonymous grew, hospitals began creating “alcoholism wards,” where patients detoxed but were given no other medical treatment. Instead, AA members—who, as part of the 12 steps, pledge to help other alcoholics—appeared at bedsides and invited the newly sober to meetings. A public-relations specialist and early AA member named Marty Mann worked to disseminate the group’s main tenet: that alcoholics had an illness that rendered them powerless over booze. Their drinking was a disease, in other words, not a moral failing. Paradoxically, the prescription for this medical condition was a set of spiritual steps that required accepting a higher power, taking a “fearless moral inventory,” admitting “the exact nature of our wrongs,” and asking God to remove all character defects. Mann helped ensure that these ideas made their way to Hollywood. In 1945’s The Lost Weekend, a struggling novelist tries to loosen his writer’s block with booze, to devastating effect. In Days of Wine and Roses, released in 1962, Jack Lemmon slides into alcoholism along with his wife, played by Lee Remick. He finds help through AA, but she rejects the group and loses her family. Mann also collaborated with a physiologist named E. M. Jellinek. Mann was eager to bolster the scientific claims behind AA, and Jellinek wanted to make a name for himself in the growing field of alcohol research. In 1946, Jellinek published the results of a survey mailed to 1,600 AA members. Only 158 were returned. Jellinek and Mann jettisoned 45 that had been improperly completed and another 15 filled out by women, whose responses were so unlike the men’s that they risked complicating the results. From this small sample—98 men—Jellinek drew sweeping conclusions about the “phases of alcoholism,” which included an unavoidable succession of binges that led to blackouts, “indefinable fears,” and hitting bottom. Though the paper was filled with caveats about its lack of scientific rigor, it became AA gospel. Jellinek, however, later tried to distance himself from this work, and from Alcoholics Anonymous. His ideas came to be illustrated by a chart showing how alcoholics progressed from occasionally drinking for relief, to sneaking drinks, to guilt, and so on until they hit bottom (“complete defeat admitted”) and then recovered. If you could locate yourself even early in the downward trajectory on that curve, you could see where your drinking was headed. In 1952, Jellinek noted that the word alcoholic had been adopted to describe anyone who drank excessively. He warned that overuse of that word would undermine the disease concept. He later beseeched AA to stay out of the way of scientists trying to do objective research. [...] As the rehab industry began expanding in the 1970s, its profit motives dovetailed nicely with AA’s view that counseling could be delivered by people who had themselves struggled with addiction, rather than by highly trained (and highly paid) doctors and mental-health professionals. No other area of medicine or counseling makes such allowances. There is no mandatory national certification exam for addiction counselors. The 2012 Columbia University report on addiction medicine found that only six states required alcohol- and substance-abuse counselors to have at least a bachelor’s degree and that only one state, Vermont, required a master’s degree. Fourteen states had no license requirements whatsoever—not even a GED or an introductory training course was necessary—and yet counselors are often called on by the judicial system and medical boards to give expert opinions on their clients’ prospects for recovery. Mark Willenbring, the St. Paul psychiatrist, winced when I mentioned this. “What’s wrong,” he asked me rhetorically, “with people with no qualifications or talents—other than being recovering alcoholics—being licensed as professionals with decision-making authority over whether you are imprisoned or lose your medical license?

[chimchiminiekookie]

Ghost in a Shell | 01

Summary: In the year 2049, premature deaths have been reduced to the highest degree with the introduction if the concept of cyber replacement. Damaged body parts could be replaced with cyber limbs, from its creation, the successful replacement of brain and the owner’s memories were the goal. All efforts to achieve the goal were all unsuccessful, until you, the first full cybernetic brain recipient met Jungkook.

Word count: 3,199

Paring: Jungkook x Reader

A/N:

In the year 2049, premature deaths have been reduced to the highest degree with the introduction if the concept of cyber replacement as first introduced by genius Kim Namjoon.

Damaged body parts could be replaced with cyber limbs, from its creation, the successful replacement of brain and the owner’s memories were the goal, a feat that Namjoon had researched a great number of years, after five years of little to no success, Kim Namjoon ultimately scrapped the idea of brain replacement with emotional ties attached, and resumed to his life now as a University graduate.

Those with cybernetic brains resumed their home lives, despite losing their memories and their emotions, while those with nowhere to go (which were a great many) were either kept at the laboratory or were let go to do the hard labor nobody else was willing to take.

You had no family, but you were also lucky enough not to be sent away.

The Jeons were a married pair of scientists who worked at the lab. Both of whom held high positions, through the modernization and expansion of the limbs and body parts that could be used. But they were what societh called sympathizers. There were a lot like them, but the loud ones were the ones who believed the only function of cyber replaced species belonged in the working class. Sympathizers were a group of people believing in the impossible integration of the cyber brained into everyday life. As their top priority was to continue the research Kim Namjoon had started so diligently on.

You awake to smoke greeting you in a round metallic room where a large portion was dedicated to a number of computer screens from every which way in the chamber you emerged from, the next thing you see are two individuals in white as they waved at you.

You step down from the chamber amd onto the platform where you look down at them from the angle. You tilt your head, “Salutations, I am 01001010000101. How may I assist you today?”

The man looks at the woman nervously, almost passively, who were these people?

The woman clears her throat, “Uhm, well it says here-” she tapos the wooden clipboard, “Your name is actually Y/N, according to this here data sheet, you’re the first person to receive a chip taking control of all functions of the brain.”

You nod stiffly, “That is affirmative-” you squint your eyes a the woman, “Ms. Jeon Somin.”

“How did you-?”

You take the sign of her silenced question to continue, “One precise tube from the computer connects me to the laboratory database. I am familiar with its information based from a mere glance as my cyberbrain was merely wading in the computers amd records of Creator Kim Namjoon’s company.”

“Do you remember anything about your old life?” The man cuts in.

You shake your head, “Searching… searching… searching… no record could be found on a former life. I am only able to recall the moment I was created, Mr. Jeon Junhyung.”

The two stare at each other, whispering.

“As a full disclosure, I am required to inform you that I know how to read lips.” You blink at them, “You wish to take me with you in order to integrate a more human behavior and to test your hypothesis of the development of the human brain around the machine until I regain my humanity through the 3.333333333333333336% chance that your hypothesis is correct.”

The man scratches the back of his neck, “Do you disagree with our decision?”

You go through the experiment approvals from the laboratory's database and shake your head, “Negative, according to the company files, this was a project in  the making from the beginning, if it is to help secure a better future for the company, then I can only agree.” you begin to walk down the stairs to the couple, “Where will K be staying?”

The short Jeon Somin laughs, “Oh honey! Where else but with our family?”

You blink a few times at the woman, family? What is this family? Is this the relationship between creator and output? If this is the case, Namjoon was your only creator, therefore your only family.

You tilt your head, “F-f-fa-mily?”

Mr. Jeon shrugs, “input the word ‘family’.” he starts to lead the way out of the round room, “It’s a bit small, as it’s just me, Somin, and Jungkook at home. However, with the only recent approval of the project, you might have to rely on Jungkook to teach you.”

You furrow your eyes, running a quick check on a Jeon Jungkook of two cybernetic scientists and what you find is a young boy, nearly the age of 11, in a jersey, “Sports? Possible connection to Jeon Jungkook.”

Ms. Jeon Somin stops in front of the door to the passenger seat of the car, “Yeah  he plays soccer, how'd you know?”

You sit in the back seat as the car starts, “I was able to run a simple background check based on the limited information I was given.” you click the seatbelt on as your stomach starts to churn all of a sudden, “I also have come to understand that the company, now under the control of Kim Seokjin, Namjoon’s older brother, is requiring the two of you to introduce the concept of cybernetic organs throughout the world which means you will not always be at your house. I shall properly care for the boy, Jeon Jungkook.”

Mr. Jeon Junhyung laughs nervously, “Well Y/N, that’s very kind of you, but we’re actually leaving you to him. He’ll be taking care of you.”

You blink at the man, “Researching… researching… researching.” your head snaps in the direction of Jeon Somin, “Data probability estimates a 1 in 50 chance that I will be properly cared for by the young boy Jeon Jungkook.”

Ms. Jeon Somin fidgets nervously, “Y/N, sweetie, about that habit you have of researching, we’d like it if you started lessening your use in order to help our cause that you can become part of society once again.”

“Command accepted, I shall lessen use of information gathering to only topics foreign to me.”

The car comes to a halt in front of a big enough house, not too extravagant, but not too small either, the correct housing for a familial unit of around 6-7 humans.

“You coming, Y/N?” the open door that Mr. Jeon has held open for you beckons like a call for freedom, whicn you take your first step out of, noticing the small tremble in your legs.

“Thank you, Mr. Jeon Junhyung.”

“Ah, Y/N. You don’t have to call us by our whole names, just simply call me Somin, and my husband, Junhyung.” Somim grabs your hand and leads you inside, up the stairs to your room.

“You know, Junhyung and I were very nervous about taking you home.”

You squeeze her hand, “I understand, Somin. The induction of a completely foreign body into your house,ust be what my creator, his emotion on my predicament before the transplant as ‘terrified’. He input that the squeezing of the hand is a successful action to lessen the terror.”

She laughs quietly, “Well yes. That djd help, but we were only nervous because you weren't like the other units in the lab, you must mean a lot to the company… You were placed in a cryogenic sleep which means that this must have been your age when you were created. It just seems sad that your family never came for you.” she wipes her eyes.

You reach over to grab her wrist, “Somin, it seems you are leaking a liquid body fluid, shall I run a quick diagnosis on your current condition?”

She laughs again, patting your head, when she feels it, the scar behind your ear where the chip was implanted, “Goodness no! I am completely fine just happy that you're here with us.”

“Humans secrete liquid from their optic nerves when elated?” you tilt your head in confusion.

She shrugs, “Yeah, I mean I guess some but more so when they’re sad.”

“Mom? Dad told me to bring this up here. Is someone stayin-” A boy around the age of 18 finds his way to the room, “Oh.” he turns to Somin, “Is this her?” he points a finger in your direction.

Somin nods and jumps up and down vigorously, “Uh-huh! Isn’t she beautiful? Aren’t you excited?!”

He sets down the bag and seemingly heavy briefcase in front of you, “I guess, but like what did you get replaced? You look more human than cyborg to me.”

“Jeon Jungkook! That is a word not allowed in this house! She isn’t a cyborg-”

“It is quite fine, Somin. I do not feel offense.” you turn to the boy, “I do not know if I am feeling emotions, but my heart had sped up quite a bit possibly due to the fact that I was expecting an 11 year old boy to be Jeon Jungkook, this is my human integration feeling what I may only hypothesize as Surprise as my cyber brain tries to make sense of it.” You reach out a hand which he takes, “Greetings Jeon Jungkook, I am called Y/N. To answer your question, my optic nerves were replaced and my brain completely functions and thinks based on a chip implanted behind my ear and into my brain.”

He lifts an eyebrow, “You’re staying with my family?”

“Family is defined as Jeon Somin, Jeon Junhyung, and Jeon Jungkook. So in conclusion, I shall be staying with family.”

He looks over at Somin, “Did you two start her correctly? She isn’t familiar with basic terms.”

You look over at the two, talking about how they would start to help you adjust to normal life, was this ‘family’? What about Kim Namjoon? You notice Jungkook, still clad in his soccer uniform, his face had a smudge of dirt, while his hair was wet from sweat.

“Shall I bathe Jeon Jungkook?”

“Y-yahh! What the hell are you on about? He yells behind him in his scurry to hide his reddening face, he slams his door shut.

“Did I offend Jeon Jungkook?” You offer a quizzical look at Somin.

She pats your back, an action which has your body reacting to it by calming against her hand, “Well, how about we start with calling him Jungkook and not offering to bathe anyone hm? Ne’s just embarrassed.” She giggled into her hand, “Let’s start unpacking, shall we?”

“These… these are mine?” you examine the clothes, compared to the maroon hoodie and sweatpants you were currently wearing, “They are very feminine, quite full of character.”

Somin shrugs, “Well, you had a room back at the lab, we took everything in it and incorporated it here, these were the clothes left behind, along with this strange briefcase we haven’t even tried to open.”

You looked at the article of clothing so long, you tried to will yourself to remember something, anything, “This belonged to the me who was completely human.” you scan the items, trying to find even just a picture from perhals anything you had seen during the few months you were active when you first got made, however nothing came up.

You look over at Somin, quietly folding your clothes, as sh hummed quietly to herself. You clenched your fist, feeling nothing at what most humans would believe should be a sentimental moment. You were human, but all of your humanity had left you, leaving behind a ghost of your former self, one that you could not even remember.

“If it is something I cannot remember, it is something not worth recalling.” is all you simply say in a futile attempt to calm down a tugging in your heart that practically begged to be acknowledged.

You examined their positions sat at the table directly in front of you as you tried to mirror their movements to incorporate a more human like stance, rigidly, you clasped your hands together, setting them on top of the table and stared back at the married couple, completely ignoring all the food that was set in the center or the table.

“Using my parents as models for normal human behavior isn’t the best idea.” Jungkook comes down from the stairs, a towel hung around his neck as he rubbed one side of his hair with it vigorously as he took a seat next to you, “I mean look at them, next thing you know, their hands are gonna get dipped in the food from climbing the table to get a better look at you.”

“It’s just so amazing.” Mr. Jeon stares at you in complete awe, “We’ve been waiting for this day for so long that we don’t even know how to get started.”

You look over at Jungkook, drinking from his glass, which you also mirror with enthusiasm.

“No, wait. Here.” He grabs the glass from your hand, and pours in a clear liquid that you identify as H2O or its most common name, water.

He hands it to you, watching you down the content without pause, “After I hand it to you, you’re supposed to say thank you.”

You look from the glass to Jungkook, “I offer my gratitude.”

He snorts a laughter, “Just thanks is fine.”

You nod in his direction, “Understood.” You reach for the pitcher of water, ready to drink all of it.

“Wait!” Jungkook grabs your wrist, “You're supposed to put it in the glass first.”

“My apologies.” You make a quick scan on your current condition, “It appears that the re-introduction of water has reminded my brain of thirst. 0.32% of humanity restored.”

Mr and Mrs Jeon stare at each other in awe, “Kookie! You’ve done it already! 0.32% is already an improvement!” Somin jumps up to run to him and squish his cheeks between her palms, “I knew that I was right when I told your father that you should be the one to teach Y/N basic human interaction.”

He stared at his mother kn confusion, “Wait.” he pushes her hands off his cheeks, “I’m going to tech her? I never heard that part of the project.”

Somin retreats back to her seat slowly and nervously, “Ehem… well Kookie, we were hoping you could help-”

He crosses his arms over his chest, “By take care you mean you want me to teach her huh? Like have her tailing me at home.”

Junhyung grasps the back of his neck, rubbing it, “Well you see Jungkook, we were hoping you could help us a bit more. As much as we’d love to teach her, a new project we have in line at the lab is being especially endorsed by the company and that means-”

He sighs loudly, “And that means that you two will be gone, locked up in that lab for who know jlw long and you don't even have the time to give your full attention on this project you both asked for, let alone your kid.” He shrugs, “Well, what else can I do? It’s nothing new around here. In fact I’d be even more surprised if you two actually came home or are even just around when i need you to be.” He pushes his chair back loudly, walking away from the table, without even a second glance at Soin began crying.

You tilted your head in confusion, “Suspicions on Jeon Jungkook’s biological autonomy remains, despite recent analyzation,” you note to yourself out loud.

Junhyung leads Somin upstairs and comes back down to fix up the kitchen area, “ You know,” he calls out all of sudden with a chuckld, “He’s not a robot.”

You turn your head towards him, “ I apologize, perhaps I took the indifference of human feelings he seems to have as proof of his unhuman biology.”

He waves a hand around, “It’s nothing, besides, the only reason we leave him all the time is because we know he can handle it, he’s a bright young man, who can already take care of himself without our help, and we just wanted him to grow into that.” he smiled at the dished in his hands with what you believed was sorrow.

Somin visits you that night, just as you were sat on the bed, “Good evening, Somin. I have analyzed that you are feeling better now.”

She sits on the armchair right next to the bed, her eyes were puffy from crying earlier and she sniffled trying not to remember Jungkook’s harsh words earlier, “Yes, well it comes with being a mother. I love him no matter what happens.”

“Love?” You stared at Somin in the eyes, was this what that tender look was about?

“What is l-love?”

She stares at the ceiling in thought for a moment, “You know, I never actually thought about it.” she giggled lightly, “I think that once it’s there, you’ll know.”

“Are you in this love?” you quietly break her gaze.

She soothes your hair, a familiar feeling nagging at you in the back of your mind, “Of course! I’m in love with Junhyung, I love Jungkook, and even though you’ve only met me, I also love you.” She smiled kindly at you.

You nod in determination, “I shall accept this love you are willingly giving to me.”

She giggled at your excessiveness, “I can’t wait for you to start getting more human, just so I can embarrass you with the things you did when you first got here.” she laughs.

“Embarrass?”

She nods vigorously, “Anyway, Jungkook will tell you all about it tomorrow, we’ve only just gotten your credentials, and it seems you were a senior in high school, just like Jungkook, so we gathered everything you need, however we start at the lab tomorrow so you’ll need to ask Jungkook to help you get enrolled tomorrow, but be sure to get there before 1 because their office closes at 1 on Sundays.” She gestured towards the large envelope in her hand, “We already talked to the school board, and they have already given the go signal to have you start school. However, it’s already been a few weeks in so it may be slightly harder to make friends, but I’m sure Jungkook will help you get settled it.”

“Understood.” you turn to look at her and the  over the the tool box near her feet, “Will I be plugged in?”

Shed nods, gesturing towards the small powered generator by the bed, “For tonight, but after this one, you’ll be sleeping on your own, are you nervous about that?”

It takes you awhile to absorb the question, “I do not comprehend ‘nervous, but with the thought of hibernating without my generator, my heart rate speeds up.”

She gives you a reassuring smile that eases the constant thumping in your chest,”Don’t be, you’ll do great.” she kisses the top of your head before connecting the thick cord to the area where the chip was inserted.

“Is that nervous?” you place a hand softly over the thumping organ in your chest.

“Yes, but being nervous is good sometimes.” her soft smile is the last thing you see before your hibernation begins.

[possiblyimbiassed]

What happened to Sherlock? The game is on!

Here’s a thrilling, really dramatic scene from TSoT:

John seems desperate here; a person very important to him ;) is about to die – either from suicide or from a mystic criminal we haven’t identified yet. John’s wedding has become a crime scene! So he orders Sherlock to solve it… But wait a minute - does he now? Why then is John saying that Sherlock is not a puzzle solver?

I mean, we do know that he’s been a drama queen ever since S1, don’t we? Shooting the wall, sulking when John criticizes him, faking his own death in front of John, disguising himself to surprise John after two years, making John forgive him while pretending that a bomb is going to explode…  And in HLV and TAB, Sherlock himself even says that he can’t resist a ‘touch of the dramatic’.

But he has also been a puzzle solver – that’s Sherlock Holmes’ MO. That’s what the Holmes stories always have been about in every adaptation, right? And yet John tells him now that he’s not a puzzle solver!? And then, in spite of this, he still says “the game is on – solve it!”

I always found this conversation a bit weird, seeing as it’s Major Sholto who is the drama queen in this case; it’s he who threatens to kill himself behind a locked door, not Sherlock. But now, in hindsight after Series 4, I finally think I ‘get it’. In fact, I believe they said it already in Series 1, TGG:

Why should we wait for Sherlock to solve the puzzle, when it can take years before S5 airs? This is something new! And John says Sherlock is not the puzzle solver. I believe John’s message from TSoT is directed at us, the audience. Look at John in the last TSoT picture above – for a moment he’s looking away from Sherlock. This is our case – our game, and I believe we’re meant to figure out what has happened to Sherlock!

Because after TSoT, Sherlock is no longer solving puzzles; he fails his cases and has completely turned into Drama instead. We’re supposed to figure out what happens here – not with Major Sholto, but with Sherlock. Look at this girl from TGG. She’s hungry, but Sherlock has given her food for thought money for food, if she helps him to solve a puzzle; I think she’s us! 

And in TLD, Shakespeare Sherlock couldn’t have said it clearer:

I think we have a crime case to solve – in fact I believe the whole show is a case for us, the audience, to try to solve. We’re not meant to just consume BBC Sherlock for entertainment, as passive viewers; It’s a crime case carefully laid out before us, complete with victim, suspects, murder weapon, venue and everything. And I think we’re supposed to use Sherlock’s methods - the science of deduction - to solve it. So, why not have a go? After all, we have plenty of time on our hands until S5 airs. ;)

This is the introduction to a series of metas where I’ll try to see if it’s possible to deduce what has happened to Sherlock. To read the following installments, click theses links: [Part I]   [Part II]   [Part III]   [Part IV (1 & 2)]  [Part V]  [Part VI (1 & 2)]  [Part VIII (1 & 2)]

In this exercise I’ll also try to provide links to a series of truly brilliant metas from different people in this fandom, which are all a great inspiration. And please bear with me if this introduction is getting a bit long (you can find most of it under the cut).

To solve this, I think we’ll need to try to use Sherlock’s methods. On his website, “The Science of Deduction” he gives a fairly brief description of his methods:

This is what I do: 1. I observe everything. 2. From what I observe, I deduce everything. 3. When I've eliminated the impossible, whatever remains, no matter how mad it might seem, must be the truth.

But what is actually deduction? Is it really a science? According to Wikipedia, logical deduction (or deductive reasoning) is “the process of reasoning from one or more statements (premises) to reach a logically certain conclusion”. Which means that you also need to back up your statements, you need to know that your premises are true (or false), before you can use them to deduce the resolution of your problem. And here is where the actual science kicks in, I believe. Science is based on observations, facts, data that has to be collected. “Data, data, data…”

For anyone not familiar with the scientific method, what I can say is that the procedure is usually something like this:

1. You make observations about the world around you (”I observe everything”).

2. Your observations make you curious; you start asking questions.

3. You formulate a hypothesis, to explain your observations (”I deduce everything”)

4. You make some predictions that you can test (T6T and TLD: “It’s possible to predict the future if you have access to the blah, blah and blah…” Here’s where Sherlock gets a little fanciful I believe :) But in theory he’s right)

5. Now you need to collect more data – evidence - to see if the outcome is as you expected, or if you have to change or reject your hypotheses. Your peers will want to participate in this testing process, perhaps to try to debunk your ideas. (I’m not sure this is the case with Sherlock, though. But at least he does use a Conductor of Light for inspiration ;) Mostly he does the testing himself, though: “When I've eliminated the impossible, whatever remains, no matter how mad it might seem, must be the truth”).

6. If several of your predictions turn out true, you may have enough stuff to set up a whole theory; a model of explanation. If there are competing theories, you’ll be wise to pick the one that has the most explanatory power, the one that can answer most of the questions that have appeared.

7. To verify and/or refine your theory, you’re back to point 1.

If this was a scientific paper, and I was a scientist, I’d put in references to a lot of other studies by other scientists. And if I’d like to have it published in a scientific context, I’d need it peer-reviewed first. But this is just a blog post, so what I can do is to propose some hypotheses of what happened to Sherlock, provide some suggestions for explanations, and try to back up my ideas with evidence, and also with links to some brilliant analyses from other people in Sherlock fandom. :)  

Example:

Observation: In T6T many scenes seem weird, characters are acting OOC and the plot line is incoherent.

Question: Why does John seem to type his blog posts on a jpg-file?

Hypothesis: This is actually just someone’s imagination, that’s why things are not at all realistic. 

Prediction: “If a character is just imagining T6T, then the things that we see John write on his blog in T6T will not appear on the real blog”. 

Testing with new data: No new posts have, as of date, appeared on John’s blog since before HLV. It even says right out that the blog is no longer being updated. This data indicates my hypothesis might be true. But I would need more evidence to really believe this.

More observations: In T6T we see ‘Mary’ jumping in front of a bullet while it’s being fired:

Question: How can ‘Mary’ do something that is physically impossible?

Conclusion: “When we eliminate the impossible, what’s left must be the truth, however mad it might seem”. Thus, this is just someone’s imagination.

Actually there’s loads of evidence supporting this idea, and I’m not going to go into them here, since so many people have already done it. Some people claim that it’s John Watson’s head we’re inside, but in my opinion these theories have been de-bunked long ago by @loudest-subtext-in-tv, for example by this logical reasoning about the end of TLD: Sherlock could only know Mary was telling him to wear the hat if she’s a figment of Sherlock’s imagination instead of John’s. Or this: “John can’t remember stuff like the waterfall scene from Sherlock’s mind in TAB”. Instead, I subscribe (mainly) to the so-called EMP theory, which suggests that we’re actually in Sherlock’s extended mind palace, where he’s running scenarios to figure out what to do about John. EMP theory was proposed long before S4 aired, by @monikakrasnorada, @gosherlocked and @the-7-percent-solution - truly brilliant people! You can read up on it here.  

So – what about Sherlock; what happened to him?

For a start, after viewing and re-viewing this show ad nauseum - and still finding it amazing - we need to ask some questions and put up some hypotheses about what has actually happened to Sherlock. 

And that’s what I’m going to try to do in a series of meta here – ticking off the hypotheses below, one by one, trying to back them up with evidence, and finally reach a possible theory. It will probably take quite some time, because there’s a lot of data to collect, and a lot of analysis to be made, but time is all we have before S5, right? ;)

Here below are the hypotheses I’ll try to go through: 

(Disclaimer: some of them are not my own to begin with; they are inspired or even suggested by other people and the fandom discussions on tumblr. For example #2 is definitely @raggedyblue’s idea).

1. John’s blog is the most truthful account of the actual events.

2. The show up until John’s wedding is Sherlock reliving their story together in his MP, after reading John’s blog.    

3. The weirder scenes from ASiB to TSoT means Sherlock is influenced by drugs.

4. At some point in time between TSoT and HLV, Sherlock takes an overdose of drugs and ends up in coma. (1, 2)

5. Almost everything we see happen in HLV, TAB and S4 is Sherlock ‘running scenarios’ in his mind, based on a mix of his earlier memories and movies he has watched.

6. In the show’s ‘reality’, Sherlock is slowly dying, which also has implications on a meta level. (1, 2)

7. By TFP Sherlock has managed to figure out some essential things about John and the importance of staying alive, and he has managed to get in touch with his own repressed emotions. (1, 2)

8. John is not the father of ‘Mary’s baby. (1, 2)

9. What remains to be solved in S5 is most of all how to defeat the villains of the show; homophobia and heteronormativity.

I’ll tag some more people in case they might be interested in this:

@sarahthecoat @tjlcisthenewsexy @ebaeschnbliah @fellshish @loveismyrevolution @sagestreet @sherlockshadow @darlingtonsubstitution @devoursjohnlock  @tendergingergirl @kateis-cakeis @csi-baker-street-babes

[cribcrate22-blog]

Diet Doctor Podcast #3 – Dr. Jeffry Gerber and Ivor Cummins

Ivor Cummins: Great to be here, Bret.

Dr. Jeffry Gerber: Thanks, Bret.

Bret: The first thing I want to talk to you about is I learned from you guys you have to be very careful who you choose to write a book with. Because then you’re sort of stuck with that person, right? You guys are doing so much together, probably so many joint interviews, you are scheduled to talk together at the conference today and now we even have you sharing one microphone.

So maybe I want to ask you if you’re happy with your choice, but I don’t know if we want to talk about that right away, so instead talk to me a little bit about of what led up to your book “Eat rich, live long, the power of low-carb and keto for weight loss and great health”. Give me a little bit of the background. What inspired you to write this book and what led to it?

Ivor: Well, Jeff your history with low-carb goes back a lot longer, so maybe give your history first?

Jeffry: Yes, Brett, it actually ties into your original question. So I’ve been interested in nutrition for over 20 years. As you know, I am a family physician having done this for now 30 years almost and about 20 years ago I started to teach myself about nutrition after patients had approached me, family members approached me, I had some experience with losing 40 pounds on my own and just realized we didn’t learn much about nutrition in medical school.

You know we maybe had two hours or less and so like all of us we taught ourselves. And so it was about four or five years ago that I had met Ivor. I had a particular interest not only in nutrition but cardiovascular disease. And I always joke if it wasn’t for cholesterol we’d probably all be on a low-carb diet.

So at any rate, four years and a half years ago this chemical engineer out of nowhere puts up this video, “The cholesterol conundrum” and I immediately contacted this guy and I realized how connected we were that the engineer from one walk of life and the doctor from the other walk of life, our paths crossed at this opportune time and realizing that we were both focused on diet and cardiovascular risk and I had said back then to Ivor, we had done a little private video Skype and I said to the guy, “I think we need to collaborate”.

And you know he said, “What’s the happening?” and then he said to his wife, “Who is this crazy doctor from Colorado that wants to collaborate?” And so essentially this is what it’s turned into.

Bret: That’s fantastic.

Ivor: And the genesis of the cholesterol conundrum was around 2012 I got some very poor blood tests. I won’t go into details, but multiple doctors I consulted couldn’t really explain the two key things about any challenge.

You know, what’s the implication for mortality/morbidity and what are the root causes that would drive those blood metrics. And basically not getting any answers I began to research intensively on… within weeks I was on carbohydrate metabolism as the cause.

Bret: Yeah, we see it time and time again, someone has this personal experience that sends them on this is path of discovery and they end up with a low-carb diet as being such a powerful treatment for what they’re looking for and yet we were taught nothing of that. We were taught nothing of that in medical school and residency, so I’m amazed that you had been practicing this way for more than a decade.

And at that time these conferences like Low-Carb USA or Low-Carb Breckinridge didn’t exist. So how do you feel now when you come to a conference like this and they ask you or ask the crowd, “How many people are physicians?” and so many hands go up? I mean you must feel a little bit of pride in that.

Jeffry: Yeah, when I first got involved with it in the year 2000 I was on my own. And interestingly it wasn’t until I think 2005. Still on my own I had done my own research, reading medical journals, fascinated with the metabolic syndrome, understanding how that was a root cause, but in 2005 the first person I reached out to on social media was Jackie Eberstein, who was the nurse of Dr. Atkins.

And my hands were shaking, I somehow found her website, found her email and I thought that this person would never reply. And she replied right back and she was lovely, she was warm, she answered all my questions, so that was kind of the beginning. And, you know, the Internet social media was nothing back then, but slowly but surely it grew.

I connected with Jimmy Moore and we really have to give him credit, because if it wasn’t for him, I really don’t think this community would be as connected as we are. So to his credit as well I became a member of an obesity Society.

And it was funny back then, there were a lot of physicians and myself and Dr. Eric Westman would walk around the room and real quietly say to the other doctor, “I’m low-carb. Are you low-carb, doctor?” And you had to really like…

Bret: Keep it on the down low.

Jeffry: Keep it on the down low and slowly but surely it’s grown, Dr. Westman became the president of the society and that’s really helped to make, I think, physicians aware and, you know, we’ve just watched this blossom ever since. And Ivor and I both attended the summit in Cape Town South Africa from Tim Noakes. This was back in 2015. And we thought it would be a great idea to bring conferences to the United States.

So with my co-organizer Rod Taylor we have conferences in Colorado, we have one coming up next year in 2019 in March in Denver, and like you said it is just rewarding to see healthcare professionals attending these things, because honestly they are the guys, they’re the gatekeepers that need to learn this first. But we also love having the general public and these events that we’re at today really helped to bring everybody together and advance nutritional science.

Bret: Yeah, that’s so true and it seems like the doctors are catching on, but Ivor engineers are leading the way and that’s the fascinating part. And what I really like about most engineers, I can’t group you all into one, but in general the problem-solving skills in the way of thinking things as problem solvers is unique to the world of medicine unfortunately, but that’s sort of what we need and you talk a lot about the Pareto principle and you talk about sort of problem-solving metrics. So give us a little overview of how you think your approach to problems differ than the average physicians approach to health problems.

Ivor: Right, Bret. Well, essentially we use a lot of tools, systematic tools. So there is the Pareto principle, which is a rack and stack of the most important factors based on the evidence and that’s really important. Those comparative analysis, a tool called Kepner Tragoe, where you prosecute all of the distinctions between what the problem is and is not and then you record the inferences.

So it’s kind of like a little epidemiological. It’s looking at all the differences and what might cause them and that can become a very long list. And then there’s hypothesis for against charts, where you look at many hypothesis for a single problem. And we split up many, many hypothesis and they are constantly judged against each other based on the evidence for each individual one and against.

And there’s never any clarity early in a complex problem, especially a multifactor. So you have many, many hypotheses and they are pitched against each other. And that’s an enormously important discipline, which doesn’t really happen in medicine. Usually a hypothesis gains ground, becomes established, the orthodoxy get behind it and it kind of transcends into dogma. So there’s a huge difference.

And then statistical inference and design of experiments to test hypotheses is an automatic part of our life. An autopsy, so intense autopsy with electron microscopes and other tools to dig in and scrutinize the problem at a physical level. And again you don’t have so much of that medicine.

Bret: When I hear you go through this checklist and then I think in my mind how we write guidelines in medicine and they’re so polar opposite. I mean the guidelines are… you get a group of people together that do a sort of a cursory evaluation of the evidence, they come up with their best case scenario and their opinions of what the guidelines should be. That is a far cry from what you just described.

Ivor: And one crucial thing I’ll just add, there are many more tools, but also the experience of decades of using these tools… you less and less make mistakes or jump to conclusions through sheer experience. But a crucial one is to always look for black swans, for contradictory evidence against your hypothesis.

So that’s an enormous part of the time to resolution and success in engineering is you look for negative data that conflicts with your hypothesis and you rapidly kill incorrect hypotheses or you rewrite them to accommodate the conflicting data. And that’s just so central but I must say in nutritional medicine that’s the most extraordinary difference.

Confirmatory data is always looked for to build up more and more evidence to support a hypothesis, whereas one or two conflicting pieces of data could reset the whole team and get you back on the correct path doesn’t happen.

Jeffry: So we do have criteria in medicine that prove or disprove hypotheses. And that’s the Bradford Hill criteria, but we’ve set the bar so low that we don’t look at it like a scientist or an engineer looks at it.

Bret: Right and I wonder how many doctors are even aware of the Bradford Hill criteria. And when you’re interpreting an observational study that shows a relative risk of 1.18 and that makes it as causative, which, you know, that doesn’t even scratch the Bradford Hill criteria, I think it’s just an underused tool for sure.

Ivor: And actually another example of Bradford Hill that just springs to mind, there has to be directionality of dose-response. So cause X supposedly driving Y, as X increases, why should increase? But we have many examples including cholesterol and other things, whether is not a dose-response. Yes so Bradford Hill is excellent actually in principle, but it’s utilization is almost zero from what I’ve seen.

Bret: Let’s get into some of the specifics. So you talked about the dose-response, Ivor. And you spoke about that in your talk yesterday, specifically about coronary calcium score. So I know you’re a big proponent of the coronary calcium score. And one of the things you said was there are 17 studies I think you quoted where LDL does not correlate with the degree of coronary calcium score.

Ivor: Yeah, actually there’s a 2009 paper and a book publication I think in 15, can’t recall the author, but I think it’s closer to 20 and even includes familial hypercholesterolemia studies. And across the board with one exception in 19 studies, there’s a very slight correlation between prospective LDL and coronary calcium. Now coronary calcium is far and away the best metric of atherosclerosis extent and future risk. It beats all the risk factors together.

And it’s because it sees the actual disease process, the calcification that’s the response to injury for this inflammatory vascular disease. But it is interesting there’s almost no correlation with cholesterol metrics. Interest needed do highlight that insulin pops up several times, but not cholesterol.

So I think to engineers working on cholesterol, that and myriads other kind of negative pieces of evidence would’ve caused us to totally retool the cholesterol hypothesis very early in the prosecution of the problem-solving effort. And we have 50 years now where the negative evidence is essentially almost suppressed, but certainly ignored.

Jeffry: So it’s interesting… mainstream, half of the cardiologists think that the calcium score has a benefit, half of them don’t, but it’s interesting when you look at guidelines, they try to tack on calcium score with your AHA risk markers, and what we’re suggesting is that that’s not the right way to use the tools that use… just simply look at calcium score by itself, independent of cholesterol and what I can add is just clinically we see that LDL cholesterol LDL-P is all over the board and it doesn’t correlate with the calcium score.

And this is especially… so we see lots of patients who have been doing low-carb paleo diets and I had many over years where there are these cholesterol hyperresponders where they tend to high LDL-C, high LDL P and many of them have calcium scores of zero, a perfect score of zero, which gives you a 15 year warranty.

Bret: Let’s talk about that 15 year warranty for a second, because I have to be honest, I have a little bit of trouble with that term, because it almost implies the risk is zero. So I think we have to admit if you have a calcium score of zero, your risk of a cardiac event in the next 10 years is not zero. It’s very low, it’s between 1% and 2%, but it’s not zero. So I think that’s important to sort of clarifying the warranty.

Ivor: It’s really important to clarify and anyone that infers from the word warranty it’s zero is mistaking obviously. And the warranty I think there were two papers were warranty was used in the title of the publication and it probably is unfortunate. So one of the largest study showed just from memory that zero scoring middle-age people I think 12 years later at 99.6% were still alive. And high-scoring people 75.6 were still alive.

Now that’s an enormous difference in mortality. So although enormous, there’s no zero, and I think Jeff you probably agree that if you’re zero calcium, there are exceptions. On one end there are people with zero who have rapid progression of atherosclerosis and a soft plaque does rupture before there’s significant calcification to show up in the scan. I mean later you could look and probably find diffuse calcification, but not enough to register.

Interestingly on the other end of the scale there’s a small maybe 1% of people who have huge calcification and who don’t seem to have events and they appear to be the people where the protective effect of calcification, which is to protect the arteries when they’re inflamed, is so advanced and rapidly progressing that they actually end up with massive calcification but relatively stable arteries, they almost have a full metal jacket.

So I think those two corner cases around 1% at each end illustrate the protective nature of calcium, it’s a fantastic evolutionary process, it’s actually bone matrix, it’s identical to bone matrix formation, but of course people rapidly progressing may have their event before the calcification establishes. So around 1% events in the following 10 years for zero versus in your recent paper, Jeff, around 37% for high scores close to 1,000. People just need to see it’s not 100% perfect.

Bret: And that’s a great point to bring up though because I think we can fall into a trap of being sort of overly reassured with a score of zero. It’s not, “Your score is zero, see you later, you don’t have to worry about anything.” It’s, “Your score is zero, but now you’re on our radar screen to follow again to make sure there’s no progression.”

Jeffry: So one other point is criticism of the test is that it doesn’t visualize soft plaque. And when you look at the data first of all, so when your score goes from zero to 1,000, this is independent of whether you see soft plaque or not. If you have a zero score you still have a small chance of having an event.

Now the question is if you can visualize soft plaque, would that change your ability to predict risk for these people that have a low calcium score? So you can do a CTMR, you could do a CT angiogram and then you get to see the soft plaque. But in our experience it doesn’t change the data looking at a CT calcium by itself.

Bret: So Jeff, what do you think about the carotid intima media thickness as a surrogate for that? Obviously again we’re not talking about the specific site we’re concerned about and we’re not even talking about plaque so much. It’s just the thickness of the intima of the carotid artery, but something you can measure quickly without radiation that might be a decent surrogate marker for the soft plaque as well.

Jeffry: Yeah, so again you describe that nice… Well, the intima is just the lining of the wall of the artery and so I don’t know who created the technology, but what he tried to do was to age the blood vessel based on the thickness of the intima. And on literature review it really does not correlate with events and mortality. So it’s interesting, in our office we actually do the CIMT, because it comes along with a limited Doppler.

So the limited Doppler, we’re actually looking for plaque buildup within the lumen itself. And that perhaps is a surrogate test for say a coronary calcium score. It’s not quantifiable quite like a coronary calcium score. The idea is if you could image all the blood vessels in the body and look at the plaque burden, that would give you a great idea about overall risk. But we do like the calcium score, because it’s looking at those tiny little coronary arteries that, you know, you are at risk for heart attack and stroke. So CIMT doesn’t really correlate.

Bret: I’d like to see the rate of change study sort of like with the coronary calcium score that has a fast change or slow change, same for CIMT, and correlate that. I don’t know if the rate of change studies have been done quite as well.

Ivor: No not really. In fact there’s not much really linking CIMT impressively to future risk prediction. I mean it’s a useful tool to quantify and track, but it’s just very weak compared to calcium. Because as you say it’s surrogate in different vessel, there is operator variation, quite large, they have to pick the region, you know, with to mouse clicks.

And you can’t have people who have quite a large intimal thickening, but really have very stable arteries with no real vulnerable plaque and vice versa. It’s just the calcium is vastly better. You did mention an interesting point, the radiation, and I researched that myself out of interest because I often hear this, but machines nowadays are around 1 mSv, which is around the same as a bilateral mammogram. And if you look back at research in the past decades, Chernobyl and even Hiroshima and the nuclear accident in Brazil, the biggest civilian nuclear accident, they tracked the people who had much, much higher exposures than this. I mean much higher. And generally over decades no signal between them and controls. So I think the expert Douglas Boyd who invented the calcium scanner, I interviewed him the other day, he said that that risk is maybe one in 10,000 of some possibility, it’s theoretical for 41 mSv, it’s tiny and it really is a distraction from the topic of how powerful the scan is.

Bret: Yeah, that’s a great point about how we interpret the risk of radiation, because in medicine there’s this concept of ALARA, as low as reasonably acceptable, and it almost teaches us to think of it as a way… it doesn’t matters how high the radiation exposure is. What matters is how much is the test going to contribute to the care. And is it worth it for any amount of radiation exposure?

Certainly a one-time calcium score or following every five years or so. Where I get a little concerned is if someone wants to follow a calcium score every six months or everyone year, because we don’t have data to say that short-term of a progression on happens or what it means, but more of the longer term following. Would you agree with that statement?

Jeffry: Yeah. So interestingly I’ve been working with my hospital next-door, that they’ve had a 64 slice GE machine for quite some time, GE Optima, and last year they purchased the cardiac package. And I’ve been bugging them right next door, I said, “Hey, we got to get this thing set up for calcium scans.”

And I’ve learned a lot because I’ve sat in there with their radiologist, the radiology technician over lunch, we just sit down and just… fascinating stuff. And first of all there’s much less user input error when you do this calcium score. You know, they calibrate the machine and the machine does the calculation to measure the calcium.

And I actually have been looking at the studies. So the radiating dosage, so the effective radiation dosage… So the device puts out a certain amount of radiation, so it’ll measure in DLP units, and I think our machine is about 165 DLP.

So that is what the machine puts out and then you have to do a fudge factor calculation for the effective dosage. So there’s a chest factor. And when we do the calculation, our calcium score is… the millisieverts is about 1.2.

And so you know I’m watching that really carefully and there’s things that the technicians can do so they can make a smaller window and the idea is that really is a small dosage. And if you have a zero score you could probably say that you don’t need any more, but it is okay to track… you can track every 3 to 5 years, maybe sooner if people are concerned.

Bret: Yeah, especially if someone’s changed their lifestyle significantly and you want to see what impact that has. So yeah, I think that’s a pretty good summary of calcium score. Let’s transition to a second about… transition to weight loss.

Jeff, you talked about weight loss in your talk today and what is so interesting is a lot of people come to a low-carb diet for the purpose of weight loss. But would you say weight loss is the most important metric to follow?

Jeffry: No, not at all. So again as I mentioned earlier, my understanding of cardiovascular disease led me to the metabolic syndrome. And so I think why we’re here as engineers and doctors is we’re trying to understand how do treat and prevent chronic disease. And weight loss is just kind of a consequence of doing all this.

Bret: And so, Ivor, when we talk about the mechanisms of weight loss or the mechanisms of improving metabolic health, there’s the debate of the calories in calories out versus the carbohydrate insulin model or some combination thereof when you factor in psychological factors… How do you break down and say what is the reason why a low-carb diet works?

Ivor: Yeah, that’s the million-dollar question. So I will take a shot at it. I think that calories… there is a place for calories, there’s no question. It’s not like the CI-CO, that is simply eat less, move more, because the body is far more complex than that, with myriad hormonal control feedback loops. So I think the primary benefit of a low-carb diet actually is appetite control and management. It’s a really big factor.

So when I went on a low-carb diet, and I’m not speaking N=1, but it’s seen in studies and all over the place, ad lib. low-carb diets have beaten calorie controlled low-fat diets. And we see again and again that when you switch over from a glucose based metabolism to a more fat burning metabolism, appetite comes under your control. In my case it was striking. I was actually shocked within weeks of how I could blithely not have to eat when I didn’t want to.

So I think that’s one of the big factors. Now when your insulin is high and you are hyperinsulinemic, like probably the majority of American adults today, that will tend towards trapping fat and tend against the burning of your body fat, so that is another factor.

But I would say appetite control is the central linchpin with the metabolic advantage that’s being discussed and the lowering of insulin being another strong element, but it’s not fully quantified, I think that’s fair to say. What would you say, Jeff?

Jeffry: Yes, so there’s a lot of factor to consider that it’s not necessarily all insulin. There’s many hormones and signals such as leptin, the gut incretins, we have to all consider that when we are thinking about regulating appetite, but of course insulin is probably the master hormone involved. And when you consider that perhaps two thirds of the US population adults over age 45 are currently diabetic and prediabetic that when you treat them with carbohydrate restriction, you’re going to have most success.

Bret: And I think that’s a very good answer because we like to simplify things and almost to a fault, because we want to know, “Is it the calories in, calories out? Is it the carbohydrate insulin?” And the truth is it’s far more complex than that. That’s basically how I would summarize your answer, so I thank you for that. The next question though Jeff is I’m sure you see these patients all the time in your office that they come in with a stall.

And you can define the stall on different ways, but basically whatever metric they are following, whether it’s their weight loss, whether it’s their insulin sensitivity, it just plateaus and they get frustrated. What kind of advice can you give to people about your general approach? When you see a stall what do you think about… what are your sort of go to top two or three things to ask them to do?

Jeffry: Right, so if you’re insulin resistant you just respond rapidly, your appetite is controlled, you correct insulin resistance and the fat that is trapped in a damper behind insulin… it opens these insulin floodgates and energy just pours out from fat tissue. But what often happens and I mean I’m just thinking of a patient I saw last week… they never lost weight from the beginning even though they were markedly insulin resistant when we measured all the parameters.

This particular person was told by a trainer, “You have to eat 180 g of fat a day. No matter if you’re hungry or not hungry.” And she was heeding the advice and pumping in the fat. And nothing happened. I mean that’s just an extreme example, but the point is that what you are eating at the beginning is not going to be the same when you hit this plateau. And so guess what? Controlling appetite becomes most important. This is what I think about, the quantity of food that you consume, the calories the activity and then it trickles downhill. But we have to make people understand that the quantity of food is really important once you become more insulin sensitive.

Bret: Yeah, very good point. And now to tag onto that a little bit more, to go a little bit deeper into the specifics of the diet… Ivor, this one’s for you as a good Irishman… How does alcohol fit into the low-carb diet and the low-carb lifestyle?

Ivor: Rather well. No, actually alcohol, I think a glass or two of red wine a day is fine. You know, the beers are generally carby. I’ve heard beer described as liquid bread, which is a pretty good.

Bret: A good description.

Ivor: Yeah so I think generally alcohol… interestingly there are studies done in the 60s on humans and calorie controlled, calorie for calorie alcohol replacing carbohydrate led to a slight drop in weight. And then replacing carbohydrate back in instead of alcohol iso-calorific increased the weight again. So well alcohol is the fourth food group.

So we know the protein has the thermogenesis effect, so over 100 calories of protein you eat maybe 75 will fully get into your system and there’ll be losses for heat and fat and carbohydrate around 10% or 15% of losses. It appears alcohol as the fourth food group has losses also because of its metabolism.

But that’s just an amusing aside. I think the advice is, you know, moderate alcohol, particularly something like dry red wine is low in carbs, low in sugar and it’s a pleasurable social thing. But anyone who has any hint of an overindulgence nature, you know, maybe it’s best to avoid alcohol altogether. And drinking excessively will knock people out of ketosis and will lead to many other issues including their work performance and other things also.

Bret: I see it sort of the same way as trying to decide what’s the mechanism of weight loss. Well, you also have to factor in the psychological components of what you eat. So with alcohol how it affects your liver, how it affects your ketone production, but also the psychological aspects of alcohol. Because let’s be honest, we don’t make the best decisions once we’ve had a couple of drinks so we have to factor that in as well, beyond the physiological effects.

Ivor: That’s a really, really important point… I wish I’d remembered to mention. Absolutely, when under the effects of alcohol that’s often where you will do your cheats. You will recharge your hands, you will eat things you would never eat without being slightly affected by alcohol. So that indirect way can certainly lead to failures.

Bret: Let’s talk about your book for a second. It’s a fantastic book, very detailed with great recipes, great scientific descriptions of why this works and how this works and some very practical tips. Can you share with us maybe one of the stories in this book that really jumped out at you, that’s a motivating story for you and your patients?

Jeffry: One particular female who was here last year at the conference had come in to see us… It’s actually a typical story. She was… Actually I’d say it’s not a typical story, it’s an atypical story… So this patient had been going to the diabetes Center in Denver for many, many years and her weight kept going up and up, diabetes was out-of-control, taking more and more insulin.

And it was her partner that had brought to her attention the low-carb diet. So she was very frustrated at this point. And so on their own as a couple they pursued low-carb diet.

Bret: On their own, not recommended by the Diabetes Center, not recommended by any physician.

Jeffry: Absolutely on their own. And by the time they had come to see me she was already losing some weight. And to make the long story short, her A1c was in the range of 12 to 13.

Bret: Wow, that’s high!

Jeffry: She got off insulin, she got off all medication and presently… And it was funny because as we were writing the book, she kept losing more and more weight so we had to update… We had to keep updating the book.

Bret: What a great story!

Jeffry: Yeah. So as of today, and this is probably maybe two years now, she lost over 100 pounds, I believe it’s almost half her body weight. And her A1c is 5 or 5.2.

Bret: From 12 to 5.2 getting off her medications.

Jeffry: Yes.

Bret: That’s a great story.

Jeffry: And you know she went to the elite diabetes center in town and they couldn’t help her.

Bret: Wow! So not your average case, not your standard case, but certainly shows the power that this can manifest in the frustration, that it wouldn’t be discussed in an elite diabetes center. Now do you see that trend changing with the evidence from Virta health in a peer-reviewed journal that we can get people off their medications? You know, it’s not doctors around town or N=1 stories telling their experience. Now it’s a published article. So do you see the tide changing for that?

Jeffry: Again I’ve been at it for almost 20 years and it’s much slower than I would like, but again we can do it one-on-one, but that’s not going to give us that global message that we’re looking for. So you know hopefully we can infiltrate the ADA meetings, the American Heart Association meetings and bring the evidence to the table in that way and change the tide.

Bret: So what’s next for you guys? Ivor, what’s next on your plate?

Ivor: Well for me it’s mostly conferences in the next few months where we’ll be obviously sharing the book and circulating that. I’m in Glasgow for a British cardiovascular society, I’m in Majorca for Low-Carb Majorca, Low-Carb Houston is on, Estonia has popped up for September, just a kind of health conference there and possibly Cuba in December, a diabetes conference, not low-carb but diabetes and health. And actually quite a few more heading into next year.

Bret: That’s great to hear that it’s a diabetes conference in there, cardiovascular conference in there, so not just low-carb conferences.

Ivor: Well, actually my supporter, and I kind of report to David Bobbitt now of Irish Heart Disease Awareness and we certainly share the focus on getting the message out to wider communities because I think within the low-carb community our obsession is giving people the chance to discover their heart disease with the calcium scan and giving them the solutions which include low-carb, but obviously low-carb is only one part of the multifactor solution.

But the challenges that people within the low-carb community have a good idea for a lot of the science and they are quite ahead of the game and they are even now learning a lot about the calcification scan through our efforts and others. But the huge majority of people are outside the low-carb community.

So it’s really vital for us to get to ordinary people, I mean those people at 52 or 53 of age that are going to drop dead of a heart attack and leave children behind and they are not obese and they don’t smoke, but they have hyperinsulinemia unknown, undiagnosed, they have huge vascular disease that’s going to kill them, but no one gave them a scan to wake them up. So our fixation is to get to those people. So I agree any conferences that are not just low-carb are our primary target.

Bret: That’s a very good point. I love how you brought up that the low-carb is one part of the solution and is so important to emphasize. And in your book you do put a strong emphasis on sun exposure and sleep and stress and physical activities and you have your list of 10 factors and I think that’s really important to fall back on, that we focus so much on diet because it’s something we’re involved in every day and we have such an intimate relationship with food and it’s so complex. But it’s one piece of the puzzle so I’m glad you brought that up.

Ivor: Yeah absolutely, Bret, and again just thinking back to the Pareto principle, people say that heart disease has 300 factors now. It’s apparently 300 that are listed. But obviously by the Pareto principle the top 5 or 10 will account for a huge amount of the disease on mortality and people can’t focus on everything.

So it’s very confusing to tell people too many factors including many lesser ones. And cholesterol can suffer from this problem as well, that is not a primary central factor, it’s an interacting factor. But we like to focus on the top ones, the Big Bang for the book that will save most people.

Bret: Good point. And Dr. Gerber, what’s next for you?

Jeffry: Yes, so I don’t go to as many conferences as Ivor, because I still have my day job as a family doctor and that takes up most of my time. And I have to say, you know, almost 30 years doing it I still enjoy it. There’s passion and helping to take people off medication and giving them tools where they can really make changes is really helpful.

But just a backup in terms of conferences, Ivor and I did attend a really important and interesting conference in Zürich. It was put on by the BMJ and Swiss RE. And the purpose of that conference was consensus. So we actually had the two sides come together and I’m a person of moderation and so trying to find consensus and this was just wonderful. And we hope that we could see more conferences like that into the future. So I pick and choose the conferences that I attend, I’m busy with our Denver conference that is coming up in March 2019 and we’re always looking for interesting topics, keeping it fresh.

We have some of the returned regular speakers and then to find new speakers. And so our mantra for our conferences is that these are for doctors put on by doctors, so we offer educational credit and everyone else is invited.

Bret: That’s great, very good. Dr. Jeffry Gerber, Denver’s Diet Doctor, thank you so much for joining me. Ivor Cummins, fatemperor.com, thank you so much for joining me.

Ivor: Thanks a lot, Bret.

Jeffry: Thanks.

Transcript pdf

Source: https://www.dietdoctor.com/diet-doctor-podcast-with-dr-jeffry-gerber-and-ivor-cummins

[duaneodavila]

To Bring Change, Embrace Imperfect Decision-Making

Introduction

Looking forward to 2019, there’s only one certainty: The legal industry is continuing to change. Everything else is uncertain. The question is whether lawyers will adjust enough to remain a valuable and well-compensated part of it.

The legal industry seems to agree that innovation is the answer to the changing times. We’re talking. We seem to be agreeing. But we’re still not seeing much change. Why?

Our perspectives are so far apart that we’re unable to even recognize the fact that we’re not actually working together for change. In fact, you could argue that we are neutralizing our efforts because our approaches are so disparate.

More Minds Working Together

For change to come from within the legal industry, it’s going to take more than a handful of individuals who agree. We need collaboration on a grand scale, but that level of collaboration requires compromise from people with vastly different perspectives.

On one end of the spectrum, we have a group demanding exhaustive analysis and certainty before taking any step. On the opposite end of the spectrum, we have a group anxious for change. The latter group wants to leap first and ask questions later. How do you get the cautious and the zealous to come together?

Framework for Decision-Making

We need a framework to help us meet in the middle. Something that gets the cautious to take the first step; and something that gets the zealous to accept a smaller step— rather than a blind leap. A decision-making framework that could allow us to work together is “strong opinions, weakly held.” It’s a framework developed by Paul Saffo that helps with timely decision-making despite uncertainty.

To summarize the framework, it starts with an initial hypothesis. It’s a tentative, gut-reaction-level idea. The key is that it’s definitive. That’s the “strong” part. Then you actively gather information to support or disprove the hypothesis. As you gather information, if you’re on the right track you refine your hypothesis…or you may find you need a new hypothesis. It’s imperative to revise your hypothesis—not your facts—if your initial thinking was wrong. That’s where the “weakly held” part comes in. You can’t dig in and double down. It should be easier to let go of a failed thought experiment if you spent less time developing it.

Another benefit of the framework is that it provides a working decision. If the world shifts under our feet, we know how we will respond and we are ready to do so—at least at first. The framework is useful for both planning and reacting in the face of uncertainty.

For legal professionals, using the “strong opinions, weakly held” framework means they may be able to:

Start an innovation project without death by analysis.

Think through a project in a manner that uncovers and addresses biases.

Collaborate with others to get buy-in and better ideas.

Keep the focus on progressing together.

With innovation, it pays to put forth a hypothesis, get to work, and abandon it or change your mind if it wasn’t a good idea after all.

Igniting the Cautious

It may be appropriate to describe 2018 as the year that data and analytics captured the attention of the legal profession. With it, people started to think about adoption and ROI and workflow analysis. I could publish a 724-point checklist of things to research before buying new technology or starting an innovation initiative. But that checklist and the never-ending quest for more data seem to encourage the cautious to be even more cautious.

Data is meant to encourage better decision-making. But the result is that many of the people we need to participate in creating change use analysis as a shield to fend off change.

Paralysis by analysis comes from withholding all judgment until an exhaustive search for data and a thorough analysis is complete. So we must get the cautious to move forward despite uncertainty. For this group, “strong opinions, weakly held” may help them to start.

For the cautious, we need to flip the process. Force a decision at the beginning. Reach a working decision or initial hypothesis over the course of days—not months. Move forward based on the information initially available. Start working and do some research. Use the insights gained from testing the hypothesis to make a new one, test it, and so on. The framework allows the cautious to use data and analysis without requiring that they gather it all before starting. If the cautious are willing to move forward, the zealous will join them in taking the next steps.

Decelerating the Zealous

While many people are enamored with data-driven analysis and its accompanying methodical approach, a significant group of technologists, futurists, and change agents are fed up. Sure, data is great, but they want action. The thirst for change has grown. Only grand-scale disruption will do. And the time to do it is yesterday.

The zealous are excited, and the industry needs that excitement to weather the coming challenges. But jumping to solutions and focusing on shiny, new, and sexy is also leading to a lot of fizzled and failed projects. The cautious see this as evidence that change is bad. To convince the cautious to collaborate with them, the zealous must step back and analyze the problem before assuming the solution.

The “strong opinions, weakly held” framework helps here, too. Team up with the cautious and dare them to dissent. Ask them to poke holes in the new concept. They’ll uncover biases and force you to refine your thinking. You’ll get a better result and more people will support the new direction. The zealous should also be aware that people within their organization are feeling initiative exhaustion and change fatigue, that senior executives are noticing the increasing tech debt and failed implementations. To counter these concerns, the zealous should treat adoption as the deliverable. Whatever change is deemed the solution, getting people to embrace it long term must be the focus.

Conclusion

In law, we know that too much is at stake for us to “move fast and break things.” But we do need to be moving. At this time, any movement that we’re seeing in the legal industry is nearly imperceptible. It will likely remain that way if the cautious and the zealous can’t find a way to work together. The “strong opinions, weakly held” framework just might get us there.

Ivy B. Grey is the Director of Business Strategy for WordRake, which is an editing add-in for MS Word and MS Outlook. She practiced bankruptcy law for ten years before joining the legal tech world full-time in November 2018. She’s also an advisor for PerfectIt. Follow Ivy on Twitter @IvyBGrey or connect with her on LinkedIn.

To Bring Change, Embrace Imperfect Decision-Making republished via Above the Law