A new study was recently published suggesting that sugar, not obesity, causes diabetes. The data is as convincing as the 1960s studies that link cigarettes to lung cancer:

For every 12 ounces of sugar-sweetened beverage introduced per person per day into a country’s food system, the rate of diabetes goes up 1 percent. 

The study controlled for poverty, urbanization, aging, obesity and physical activity. It controlled for other foods and total calories. In short, it controlled for everything controllable, and it satisfied the longstanding “Bradford Hill” criteria for what’s called medical inference of causation by linking dose (the more sugar that’s available, the more occurrences of diabetes); duration (if sugar is available longer, the prevalence of diabetes increases); directionality (not only does diabetes increase with more sugar, it decreases with less sugar); and precedence (diabetics don’t start consuming more sugar; people who consume more sugar are more likely to become diabetics).

The photo is from a wonderful site, Sugar Stacks.

We’re really looking for students that are innovative, that think out of the box,” Charney says, “the Zuckerbergs of the world that would go into medicine instead of [creating] Facebook.

New York Medical School Widens Nontraditional Path For Admissions : NPR

This is exactly what I was talking about in my TED talk. Creative, outside-the-box thinkers are crucial in redefining healthcare and making it sustainable. We don’t need any more traditional-thinking doctors to maintain the status quo. This makes me think of the Shirky Principle:

“Institutions will try to preserve the problem to which they are the solution.”

We need less institutional types, and more creative doctors.


How is Sherpaa different from a primary care doctor? That’s a question we’re always asked at Sherpaa.

Sherpaa is your guide and advocate throughout your entire healthcare experience. We are:

  • accessible, local, well-networked doctors
  • who communicate via email and phone
  • who will treat you when appropriate
  • and/or guide your entire healthcare experience from beginning to end

Our doctors are salaried. They are paid for good communication and doing what’s best for you. They understand that healthcare is extremely confusing and difficult to access and their primary goal is to guide you, treat you, and make healthcare crystal clear and efficient for you.

Traditional primary care doctors see patients in their office and see as many as they can to maximize their revenue. They are paid for office visits and procedures. The more they do, the more money they make. Their main focus is office visits in the exam room. If they are emailing you or talking with you on the phone, they are losing money. If they refer you to another doctor, once you are out of their office, you are on your own. Coordinating your care takes a huge amount of time and that time is not reimbursed. They are not paid to be your advocate in an increasingly chaotic healthcare industry. No professional works for free, especially when their time is valued at $200 an hour.

Let me compare and contrast the traditional vs. the Sherpaa experience. This is a true story that recently happened.

With a traditional primary care doctor:

You visit her in her office. During her exam, she notices you have a lump/nodule on your thyroid. She says you should go see an endocrinologist. She gives you a referral and a name. You leave the office and now you’re on your own. If you forget to ask a question, you can make another appointment. You call up the endocrinologist and are told the next appointment is in six weeks. You anxiously wait the six weeks. The endocrinologist says you should see a head and neck surgeon and they give you a random name. You leave their office and call up the surgeon. The surgeon’s receptionist tells you the next appointment is in 5 weeks. You take the appointment and, again, you anxiously wait. You arrive for the appointment and are told the surgeon recently stopped accepting your insurance. You’ve got a lump on your thyroid and you’re on your own. You call your primary care doctor and are told the next visit is in 3 weeks. And so on and so on…

With Sherpaa:

You visit a primary care doctor who finds a nodule on your thyroid. You leave the office and shoot our doctors at Sherpaa a message via our app. We call up the PCP and ask about the findings. We’re told it’s a 4cm nodule. Your PCP recommended you see an endocrinologist. We call up our endocrinologist and get you in to see her tomorrow. After the endocrinologist sees you, he texts us his recommendation for you to see a head and neck surgeon because you’ll probably need a consult to get the nodule taken out. We call up our head and neck surgeon and get you in to see him in 2 days. We give the surgeon a call immediately after you’ve seen him to find out next steps. Within a week the nodule is found to be benign and removed.

It’s a wildly different experience. Sherpaa is just doing what doctors should be doing— being accessible by any means necessary, communicating well with you, treating you when appropriate, and guiding you and acting as your advocate throughout your healthcare experience making healthcare crystal clear for you.

photo from Eugene Smith’s, Country Doctor.

Moves is disrupting Fitbit, the Fuelband, and all those other nonsensical gadgets. 

I’ve been using Moves for about 2 weeks now and I really, really love it. It’s an app that essentially functions as a pedometer and runs in the background tracing where you’ve been throughout the day and measuring your steps. 

It is not some goofy thing I have to wear on my wrist or on your bra. It’s not something I have to remember to charge. Fire it up once, and it’s on for as long as you have an iPhone. It may not be as “good” as a Fitbit or Fuelband, but it works just fine, it’s available to everyone with an iPhone for free, and it runs in the background of your life. And, most importantly, I haven’t noticed an impact on my iPhone’s battery. 

It’s a classic disruptive innovation

I bought a Fuelband a few months ago, synced it with my iPhone, and connected it to Facebook. Facebook said “You have 37 friends with a Fuelband. Click here to see how many people have live data in the past week.” I clicked and saw 2 people. I immediately returned it to the Nike Store. I knew that goofy thing would be in some drawer in a month after the novelty wore off. And I don’t like to throw away money for gimmicks.

My iPhone is not a novelty. And Moves now runs in the background of my life letting me know how active or inactive I’ve been that day. Interesting, motivating, and exciting stuff. Congrats to the Moves team. Y’all are killin’ it.

Are you in your twenties? Are you an entrepreneur? Have you been told by your friends, your advisors, and your professional peers that now is your time to build your own life and not worry about things like settling down and having children — especially if you’re a female entrepreneur?

It makes sense, right? This is the only time in your life when you have no ties, no mortgage, no kids to support. This is the only time you can really do something ambitious, if you’re being practical…

This is a noble cause. There is nothing more professionally satisfying as building something. Something you love. Something you can “get behind.” 


There was this girl. This guy. 

Eh, fuck it. You’re busy. You have more important things to do. Changing the world is a full-time job and if you don’t do it now, when will you? 

As with coding and management and matters of finance and marketing, relationships have a learning curve. You learn the basics of “relationshiptiva” (note to copyed: yes, I made up that word): How to deal with sexual etiquette, mundane everyday things, scheduling, and appropriate meetings with close friends, and some equitable plan for who’s supposed to pay for dinner or wash the dishesthis time. These are basics. And if you’re learning them in your thirties, it’s going to be much harder.

But that is not the point. The point is that thirty (or thirty-two, or thirty-five) is not the age when you want to be practicing serious relationships for the first time. Because learning how to develop a meaningful, sustainable relationship and keep it healthy takes some extended practice. You have to get beyond the basics — the sexual negotiations and the decisions about whose clothes go where and how to talk about exes. You have to figure out how to fight well, how to negotiate major value conflicts (if you can — some are impossible), and how to deal with theinevitabilities that come your way.

Relationships are too important to learn how to face those issues at the last minute. You have to go through a few of them to know how to properly conduct one. You have to fail. You have to date a few terrible people. You have to be the asshole yourself sometimes. You have to learn how not to be the asshole. You have to spend tons of time together — so much time that sometimes you feel indistinguishable from each other and you find that both reassuring and disturbing. You have to have a vicious fight and know it’s not ending you and that you’re going to have to work to repair it and that the effort is worthwhile. These things take time.

I think it’s fair to say — with no scientific evidence — that deathbed wishes rarely include, “If only I had put another twenty hours a week in at the office! That slightly cleaner product release would have made all the difference.” But that guy, that girl? You might regret that.

Thank you Elizabeth. More people need to listen and understand this.

(via Why Developing Serious Relationships in Your 20s Matters)


C. Everett Koop, Surgeon General, key figure in AIDS crisis, dies at 96

Here’s Dr. Koop, discussing the AIDS crisis. Koop, who was one of the most high-profile Surgeon Generals in U.S. history, died Monday at 96. Koop, as he mentions above, was known for his role in informing the public during the AIDS crisis. ”I stepped into a job that nobody gave me. I became, more or less by circumstance and pressure, the government spokesperson for AIDS,” he says in the clip above. The Reagan-era appointee took an extremely public role during the era, warning the public of the dangers of smoking and other issues. His stances—including his decision to not call for a reversal of Roe v. Wade despite his personal stance against abortion—infuriated conservatives but won supporters among liberals. No matter your opinions of him politically (he didn’t care, he was just doing his job), he was nonetheless the trusted face of public health in 1980s America.

Sad. He was the first Surgeon General I remember. RIP.

About 30 percent of heart attacks, strokes and deaths from heart disease can be prevented in people at high risk if they switch to a Mediterranean diet rich in olive oil, nuts, beans, fish, fruits and vegetables, and even drink wine with meals, a large and rigorous new study in the New England Journal of Medicine has found.

The magnitude of the diet’s benefits startled experts. The study ended early, after almost five years, because the results were so clear it was considered unethical to continue.

Take the quiz: Do You Have a Mediterranean Diet?

I follow a weak Mediterranean Diet. 

And I also think this is a bit of nonsense. I’m sure most of the benefits here stem from simply eating real food.