Basic Skills for a Robust Life, free of disease (Delivered at SPIEF, 2018)

It was to be my "emperor wears no clothes" moment, one doctor, surrounded by a Minister of Health, high-tech giants in Big Pharma & Big Tech, proposing a low-tech solution to a lifestyle issues that may, quite frankly, be proven to be the final reckoning of our society, nay, of our culture, nay, of our species. After hearing of all the very innovative, very expensive and supposedly, very disruptive solutions, I had my own really disruptive approach to chronic diseases. Here it is.

In his work The Farther Reaches of Human Nature, Abraham Maslow once asserted: :
"We need a different type of human being . . . able to live in a world that changes perpetually, which doesn’t stand still, who are able to face tomorrow not knowing what’s going to happen, with confidence enough in ourselves that we will be able to improvise in that situation which has never existed before. The society that can turn out such people will survive; the societies that cannot turn out such people, will die".

As a doctor, I was trained to deliver bad news. It is a mind-set built into the pedagogy of medicine and a young doctor has more than enough practice doing so during his or her career. But today, I want to deliver a little good news as well, to provide a ray of hope. Let’s get to the bad news first, as a reality check, to set the stage:

Given present trends, World Health Organization (WHO) projects that, in the next 10 years, approx. 388 million people will die due to chronic diseases such as heart disease, strokes, diabetes and cancer. Roughly HALF of those who will succumb to these lifestyle diseases, will be younger than 70 years of age. (WHO). Remember that 70 is the new 50. Losing people in what may be the peak of their intellectual lives seems like the ultimate waste of a human resource!
Causes for these chronic diseases are NOT mysterious: poor nutrition, low physical activity and stress-related activities (tobacco and alcohol). We have not, as a species, acquired the following SKILLS (think functionality) necessary to understand and slow and stop these trends. In a word, we, as a species, do not yet know:
a. how to EAT (in accordance with our Hunter DNA),
b. how to MOVE (in accordance with our Hunter DNA), and
c. how to MANAGE EMOTIONS (how to BREATHE and meditate, because as goes the breathing, so goes the mind), so, as a species, in reaction to stress and anxiety, we smoke tobacco, drink alcohol, and use illicit harmful drugs, some of them prescription drugs.
If we don’t teach these skills to our children, when do they learn them, if at all? In other words, what’s the sense of being an engineer or doctor (extremely useful skills), if the kids lack skills basic to mental and physical health? Note the strategic use of the word "confidence" in Maslow's assertion above, as the linchpin to survival. If the child lacks confidence, derived from self-mastery, that child will lead a less-than-complete life and be a burden to his family and his culture, as seen below.
By 2050, an additional 345 million people who need to be cared for will turn 80 years of age. The vast majority of these people lack these basic lifestyle skills, as evidenced in the statistics cited herein.
This lack of lifestyle skills (how to EAT, MOVE & BREATHE) is costing us dearly as a society, with no end in sight:
a. USA: $2.4 trillion annual health care expenditures are for people with chronic health conditions.
b. Between 2005 and 2015, accumulated national income losses from heart disease, strokes and diabetes:
• China: $ 500 + billion
• Russia: $ 300 + billion
• India: $ 200 billion
Yet, all this said, in 2004, only 3% of health care expenditures in the OECD states went towards prevention (teaching these basic skills) and that has dropped by HALF since then! Epidemiologically speaking, this is a perfect storm for swamping our national economies, just because of lack of basic skills (EAT, MOVE, BREATHE).
Key Point: Now, for the really good news: learning the basic skills of how to eat, how to move and how to breathe are easy to learn and master. It’s formulaic: We need to use the biggest resource in healthcare – the patients themselves. They need to own and run with their health. Whatever issue they have, is an internal problem (such as anxiety, nervous eating, lazy attitude and low willpower) and that is precisely where the solutions are as well, internally. Internal problems require internal solutions.
Until the prime mover in health, the patient, has bought into that model that he has the solutions within, the external is just a time-wasting distraction. All the expensive medicines, diagnostic technological wizardry, personal trainers, shiny new medical centers are not going to cut it as they only serve to convince the patient that the solutions are external, outside of “me”. The patient feels like powerless victim without them, like a beggar sitting on a pile of gold, in need.
Our research over the past 35+ years has taught us that the 3 “E”s will fix this functionality issue definitively, in a simple, effective and cost-beneficial scientific way:
Education: in large groups (we do 500+ in large corporations – that’s real leverage!) develop solid metrics so that the patient can understand where to focus his/her energy. We have written software to establish a baseline Health Age (“BEFORE” photo). This acts to provide an easy “wake-up call” for the patient versus the “hard” wake-up call such as a heart attack, stroke, diabetes and so on.
Encouragement: our research on 150, 000 managers over the past 30 years, has yielded great insights. One is that to effect real change and exchange bad for good habits, about 6 months (24 weeks) are required. Through Gamification for Behaviour Change (GBC), we send weekly missives with EAT, MOVE and BREATHE instructions and weekly points are earned which can be monetized, as an incentive. Actually, this incentive part was quite easy: we just took a page from the “youngbloods” these days, constantly & compulsively gaming on their phones & play stations. Thanks, gamers!
Empowerment: after 24 weeks, patient re-tests him/herself and sees what measures worked and what needs more effort (the “AFTER” photo). Patient is now a changed person: autonomous, inquisitive and on the road back to health and vitality because they have acquired the skills mentioned above. Many have needed to completely rethink their attitudes towards food, their body, their work, their lives. Useful pause for reflection.
Presently, with the support of Sberbank (under the unwavering support of Mr. Herman Gref), we have rolled out in Russia our 24-week program called Mentoring for Self-Mastery, MSM-24, with resounding success by any metric.
Here we see a proactive intelligent corporate culture of robustness and autonomy on display, for real. Other proactive corporate players include SIBUR (excellent proactive & robust corporate culture), PwC, VEB, and many others.
With this sort of investment, Russian managers will have a shot at staying robust, functional and risk-free well into the golden years! First step in the right direction, but many steps are ahead of us!
¬¬Lastly, by popular demand, we have started a MSM-24 Youngbloods, for teaching children[1] these basic skills, by their parents (who else?) and MSM-24 Wisebloods for assisting the over-60 retired folks in the battle to avoid depression and maintain functionality[2].
Let’s stop being so detached and abstract about these manage-able issues. Get involved. Th ere is LOT to be done! Teaching these very basic lifestyle skills (How to EAT (and not EAT, How to MOVE and How to Manage Emotions) to young and old alike will stop the hemorrhaging of prematurely-lost colleagues and family members, as well and critical financial resources future generations will need to develop needed technologies, such as the indoor farming needed during the impending Grand-Solar Minimum (mini Ice Age) and securing potable water.
Instead of blaming us for wasting the human and financial resources, they will erect statues to us in gratitude!
[1] The Ritalin/Adderall Generation will “thank” us. As of 2016, an estimated 6.1 million children in US between the ages of 2 and 17 had at some point been diagnosed with ADHD, according to the Centers for Disease Control and Prevention and survey data.
[2] Depression often occurs in elderly patients who suffer with other medical conditions and disabilities.