When I ask patients about their so called “healthy” eating, they often tell me they cut out red meat, as this has been the recommendation for decades. Turns out, it’s completely wrong.
Ruminants — such as beef, bison, goat, sheep, deer, elk, and moose — have a four-chambered stomach that performs biohydrogenation, acting as a natural “biofilter.” This process greatly reduces the amount of polyunsaturated fatty acids (PUFAs) that end up in their meat and fat. PUFAs, particularly those abundant in seed oils (such as soybean, corn, and canola oil), are highly unsaturated fatty acids that are unstable and prone to oxidation. These oils can go rancid on the shelf and oxidize more readily in the body compared to more saturated fats. Linoleic acid, the primary omega-6 PUFA in most seed oils, is one of the most prominent examples. It has more double bonds, which makes it unstable and easily oxidized at high temperatures when cooking — think every fryer at a fast-food restaurant, except Buffalo Wild Wings, which uses beef tallow. (Ironically, beef tallow was used for the original McDonald’s fries from 1949 to 1990.)
If cancer is only a genetic disease, as we’ve often been told, then patients have no agency. What good does it do to take control of your life? Why fight?
Fighting is what makes us human: enduring hardship, enduring suffering, and having the agency to say, “I will not die today.” It’s a cheesy line from a long-lost Leonardo DiCaprio movie set on a deserted island, where he’s telling a tall tale about facing a shark. (It turns out it was just a baby shark.) But the point remains.
Intermittent fasting (IF) is protective in an emergency. It is a tool that should be used regularly so it can be called upon more easily when it’s unexpectedly needed.
An emergency can be defined in many ways by different people. I’m not talking about a major trauma like a motor vehicle collision (MVC) or a heart attack. I’m talking about time delays and disruptions that throw off our plans.
Everyone will face time delays at some point in their life. Some things get delayed or prolonged. Sometimes time gets compressed and preparation time is lost. Most of us don’t work a predictable 9-to-5 office job with complete control over our schedules. This is especially true in public safety—particularly on dogwatch (the night shift)—where intermittent fasting can be incredibly valuable.
When you’re with someone in the ER, good for you. I see plenty of patients with no one. Through life circumstances and personal choices—i.e., the two things that all humans are victims of—they are alone. This doesn’t bode well for an ER visit with no one helping you navigate all the information and details that an ER visit entails. It doesn’t bode well for your long-term health either, as having community is a crucial piece of overall health.
There are two thresholds when it comes to medical complaints in the ER: distress and disaster.
The distress threshold is the point at which patients decide to come to the ER. Whatever is bothering them, they feel it needs medical attention right away.
The disaster threshold is the point at which a patient requires an immediate procedure, specific treatment, medicine, hospital admission, surgery, or specialist intervention.
“Life is pain, Highness.”
— Dread Pirate Roberts, The Princess Bride
“Suffering is a precondition for existence.”
— Jordan Peterson
It’s not realistic to believe you will go through life without any pain, hurt, illness, or discomfort. It’s also not realistic to expect that the ER can immediately eliminate those symptoms whenever you decide it’s time. The body simply doesn’t work that way. Healing takes time.
I frequently see patients who have broken a bone and explain that bones generally take about six weeks to heal. That’s a general rule, of course, and it varies somewhat depending on the patient and the injury. My youngest daughter broke her collarbone when she was a toddler. I have a video of her doing the “wheelbarrow” just two weeks later with no apparent discomfort. If you’re older or in poor health, however, six weeks may not be enough. There is very little that Big Medicine can do to meaningfully speed up that natural process.
“Ozempic Face” has become part of the popular lexicon to describe the facial changes people experience after losing significant weight on GLP-1 medications. It generally refers to the sagging skin and hollowed-out appearance of the face associated with rapid weight loss.
What no one talks about is what these patients looked like before the weight loss.
I see this every day in the ER, where the vast majority of my patients need to lose weight. Statistically, a very large portion of the population is overweight or obese.
At times in my career, my job has become less about actually practicing medicine—especially at a small rural hospital. Instead of seeing patients, I often feel like the quarterback of the transfer game. This is not unique to my hospital or health system. Across the country, providers are doing the same thing on literally every shift. Even at medium-sized hospitals that lack certain specialties, a great deal of patient transferring still occurs. This is simply how the game is played.
If my hospitalist isn’t comfortable keeping the patient or we have no beds or no nurses available to care for them, I start calling larger hospitals that are closest to mine. The main campus of the same health system as my hospital is about an hour away and has essentially all the specialties I could need. They can handle nearly any complicated medical or trauma patient. However, they’re across a state line, which sometimes creates additional challenges.
If you go to the ER expecting to see a specialist, go during the day. Your odds are a little better than at night. Very rarely do specialists come to the ER in the middle of the night. The rest of Big Medicine—besides the ER—does not really operate 24/7. Yes, at large hospitals, there are always many specialists on call. But it takes a real emergency for them to actually come to the ER.