Seth Roberts’ Final Column: Butter Makes Me Smarter

As a tribute to the world-changing man Seth Roberts I am re-blogging his final column, submitted to the website BetaBeat.com just before he unexpectedly died while hiking last weekend. I met him over a year ago and he was shy yet child-like in his curiosity and wonder. Seth is already missed but has helped so many people take charge of their own health by tenacious self-experimentation and the philosophy that in our own “experiments of one” we can find something close to a happy and healthy life. Seth is NOT in a better place. He should be here, still doing his beloved work. -Andrea

Betabeat

(Wikimedia Commons) (Wikimedia Commons)

Note: Seth Roberts submitted this column to Betabeat before his untimely death. We publish it now with a heavy heart and per his request will be making a donation to Amnesty International.

A few weeks ago my sister sent me a link to an article (“Butter is Back”) by Mark Bittman, the New York Times food writer. I told her I’d clicked on a link to the article but had forgotten to read it. She was incredulous. How could you not want to say “I told you so”?

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$12K For 25 Stitches: American Healthcare is Broken (Part 1)

Part One of several posts about how health care can be a heck of a lot better in this country.

It’s about the least surprising thing to say when talking about health and medicine in the western world: it’s totally fucked up. The system doesn’t serve people in the best way for their health, opting instead in many cases for pure survival. And that’s just the actual medical establishment, the place folks end up when something is going really wrong, whether it’s emergency trauma or the culmination of a chronic illness.

The pieces of health are not just what it takes to not “spend your last 10 years in a diaper and a wheelchair” (a genius post by Chris Kresser, who lured me into a lot of this research about 5 years ago by those very words). No, the pieces of health are far larger than just showing up at the doc’s office or the hospital when things are really wrong (or even just somewhat painful).

Emergency medicine in our society is extremely effective (and expensive), so if you are in a car crash, even if you don’t have money, you can and will get “fixed”. That means you’ll have bones pinned together, skin sewn up, fluids replaced, and (hopefully) infections prevented or addressed.

Original source: Broken Heart Source Image

Original source: Broken Heart Source Image

But even if you are faced with a relative trauma, the current state of the system can take down to slivers the savings of most average adults. Take, for example, something that happened just a few days ago at a massive health conference in Austin, TX called Paleo f(x). Darryl Edwards, one of the activity gurus, ended up with a mis-timed head butt and split open his eyelid. He didn’t think it would need intervention at first, but then he was convinced it wasn’t just a scratch by folks who kept noticing the bleeding gash.

Once he finally figured out that he really did need stitches, someone wanted him to get an ambulance. BUT. Because Darryl is from the UK, an ambulance would be about $4K right out of his pocket. Ok, so he should find someone to drive him to the ER. BUT. Emergency rooms have pretty long wait times. It was suggested, “go to urgent care”. Finally, word got around to the wife of a local dermatologist. He was taken right to their office and was taken care of, sewn right up to the tune of 25 stitches as a favor to a fellow health guru for no charge. The dermatologist told him that it would normally cost about $12K. TWELVE THOUSAND DOLLARS.

Even before the ambulance when it was looking like $4K out of his pocket, Darryl considered getting on a first class plane back to UK so that he could walk into a local doc and get things taken care of for free. The fact that someone without insurance considers a transatlantic flight in order to NOT spend about $16K on stitches is, a little, crazy.

In the next few blog posts I’ll go from panic-inducing examples like this to somewhat of a means to a solution. It involves the word OWNERSHIP. And we’ll get there.

Eating Disorders Can Kill Your Body OR Spirit

Pop quiz: which clinical mental disorder has the highest mortality rate? It’s not bipolar disorder. It’s not schizophrenia. Rather, it’s that heady place where out-of-whack brain chemicals meets up with out-of-whack societal beauty standards and renders a person incapable of eating enough to maintain their physical existence: anorexia nervosa.

Everyone knows that anorexia is horrible-tragic-shocking, but one thing it does have going for it – it is VERY visible.

Do you have any doubt that this person (who is in their 20s, by the way) has a problem?

Ilsa Paulson

That’s Ilsa Paulson, who looked pretty normal in high school, only to turn pro after college and got lean. Really, really lean.

On the other hand, how about this person?

Hollie Avil

Yep. That’s Hollie Avil, who retired from triathlon at age 23 because of trauma from eating disorders, depression, and general breakdown.

That’s the rub – in a strange and bizarre way, anorexia is easier to spot and therefore intervene. I’m not saying that such interventions are successful – there’s a good reason why those mortality rates are NOT falling – but for some sufferers who have hope of recovery, it can make a critical difference to hear someone say, “I really care about you and I think you might be harming yourself. Please know that I love you and want you to not die.”

But for every obvious case, there are likely hundreds who suffer almost in silence. Ironically, they can suffer more because if they don’t look the part of the eating disorder patient it can be internalized as a failure – a failure to successfully execute this disease that they identify with control and perfection.

That’s the gist of this post, during National Eating Disorders Awareness Week, to get you to contemplate people in your life who might be on that edge. Those who could be slipping into habits that lead to a real problem, or those that simply spend years and years and years just under the threshold of a real diagnosis. They can eat just a tiny bit less than they really need (instead of eating a LOT less than they need), while bones are weakening, muscles are atrophying, organs are shrinking (!!!), metabolism is shutting down, the brain itself is undergoing structural changes under one’s skull.

This is not as ludicrous as it sounds – I have weighed 25 pounds less than I do now, and honestly you could look at me and be like, “Ok, yeah, she’s a little smaller, but 25 pounds smaller? She’s not scrawny, like real eating disorder scrawny!” Those pounds came from skin and fat and muscles, yes, but they also came from my organs, and my bones, and my glycogen stores.

Here’s the thing: you can’t help if they are not ready. But I do believe, strongly, that if you care about someone and you tell them you care enough about them to want them to stay in your life, at absolute worst, it CANNOT HURT. Awareness of self is one of the first steps if recovery will happen.

I lost someone recently who “successfully” managed their level of disorder for more than 20 years. It’s true that you can ‘get away with’ a great deal of abusing your body with lack of food – we are remarkably resilient creatures. But not forever. She was a talented runner and no doubt helped by a very low weight (a subject for another post), but in the end her systems were too beat down, taxed, and on the edge to make it through acute dehydration due to the flu. It’s a fucking shitty way to die. My friend loved helping other runners achieve their goals and loved helping kids get excited about running. If a car came barreling down on them while on a run, I have no doubt she would have gladly shoved them aside to take the impact herself. That would have been an O.K. way to go, especially at 46 years old. How she did die should not have happened. But. It. Did.

Finally, she was not just some anonymous friend that I need to hide. She was Susan “Sus” Brozik.

Find your little-bit-skinny, little-bit-obsessive, little-bit-food-paranoid friends and tell them you appreciate every part of the good things they do. If you think it’s not too much, also tell them that their healthy body is the thing that lets them do those awesome things, and you’d love it if they kept their body around for a long time.

Why My Health Plan Was Killed by Obamacare

When I got the envelope in the mail from my private health insurance company, I didn’t think much of it. They send me various stuffed envelopes all the time, usually containing something I just need to file or toss out.

This one, however, was different, beginning with the ominous statement, “your policy will end on December 31, 2013.”

Celtic cancels me

Whoa.

So, I became one of those folks in the group represented by outraged reporters talking about how Obama said, “you can keep your policy if you like it.” and then went back on his exact words. I “liked” my policy, in that it was relatively cheap and gave me catastrophic coverage in the event that I have something happen that could otherwise bankrupt me. I’d be out my huge deductible ($6K) and then not a penny more.

But that sounds like it might never have actually happened: people with plans like mine have had a long history of getting dropped by their company the second it appeared your account might start requiring lots of payouts. Generally the (legal) reason cited is that you withheld information on your original insurance application. Say, your claim involves checking out and biopsy of moles on your skin – the company could say that you didn’t note that you have lots of moles. Or, you are getting treatment for back pain issues but never mentioned in your application that you’ve ever felt a bit of back pain in your life. That’s an undeclared pre-existing condition, and therefore eligible for policy exclusion.

And it gets worse – the internetz are full of these kinds of reports from consumers:

There was no law against this. So if that catastrophe happened, the insurance company could have (and might very likely have) paid out some hospital days or one inital ambulance ride, then called the whole rest of it a separate case (due to that pesky pre-existing or bad application stuff above) and dropped me like a hot potato. No recourse, only bankruptcy. Or a legal battle that you as the patient MIGHT win, but might not.

Then, there is my friend on the East Coast, paying for private insurance that costs far too much and hoping against hope that this whole Obamacare thing that is coming might actually benefit her and her partner. But she is very wary:

I’m afraid to be excited about this

– my friend (self-employed), regarding Obamacare’s having a) much lower costs & b) better coverage than their current plan.
She was rightfully paranoid for a long time, unable to process the very real possibility that her health care situation could, all of a sudden, get WAY better. She and her partner were paying nearly $750 a month for truly shitty coverage while needing periodic care and prescriptions.

A summary of our befores and afters:

  • ME, Before: $120 per month with almost certain droppage after a major event. ME, After: $190 per month with far better basic coverage and no chance to be dropped.
  • Her, before: $729 per month for “insurance” that did almost nothing she needed. Prescriptions were mostly out of pocket because the deductible was too high. Her, after: $341/mo with much lower deductible on prescription coverage. Her out of pocket per year goes from ~$8700 to ~$4100, and that’s just premiums. Nice deal.

And that’s how it works. It has to work that way. I am one of those gravy insureds: I am healthy. I’ll withdraw a few hundred bucks per year or less of my annual premiums in benefits. I am the person who helps to subsidize my friend on the East Coast. I am critical in the system as is everyone like me.

A special thank you to Julie today!