Survival

We talk a lot about fixing healthcare, but none of it matters if the people delivering care cannot survive the system themselves.

More than half of physicians in America report burnout.

The same is true for nurses. These are not small numbers.

These are the people holding the entire system together, and they are exhausted.

When physicians tell surveyors they are thinking of leaving the workforce, we should be listening.

When nurses say they cannot sustain the pace, we should be listening.

And when clinicians at every level say the loss of autonomy is breaking them, we must listen.

Burnout is not a personal failure. It is a signal that the system has pushed its workforce past the breaking point.

When the work becomes more about documentation than healing, when decisions are dictated by insurance algorithms instead of clinical judgment, when autonomy disappears, purpose disappears.

That is when people walk away.

If we want a healthcare system that works, we need to protect the people doing the work.

That starts with restoring autonomy, rebuilding meaningful patient connections, and giving clinicians space to practice the medicine they were trained to deliver.

Healthcare will not heal until the healers do.

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Heart Attacks, What else is going on?

What causes heart attacks besides, placque and cholesterol? 

How do you explain the guy in his early 30s or 40s who exercises daily, eats clean, has normal labs, coronary calcium score of zero, yet drops from a heart attack?

No warning. No plaque buildup. Perfect LDL. Someone considered very low risk
The LDL model of heart disease is broken
It can’t explain why:
- half of heart attacks happen with normal LDL
- many with high LDL never have heart issues
- veins never clog unless turned into arteries
- you can have a massive heart attack with clean arteries
Instead of questioning the model, cardiology just keeps lowering the “optimal” number
LDL IS NOT THE INITIATOR. Something upstream must break first.
👉 The Missing Physics

Arteries aren’t designed to be scraped by blood
They’re lined with hydrophilic tissue that forms structured water (exclusion zone water aka EZ water) which is a gel-like negative layer that excludes blood components like:
- RBCs
- platelets
- bacteria
- LDL

If EZ is intact: blood never touches the arterial wall --> so no injury --> no inflammation --> no plaque
This is never even mentioned in the flawed “cholesterol clogs” narrative

So what is plaque?
Histology shows ~87% clot + repair material

Sequence: Damage --> clot --> repair --> plaque
(NOT: LDL --> plaque --> damage)
Plaque forms where flow becomes abnormal (high mechanical stress)
And heres the paradox:
People with severe plaque often feel fine bc the body builds collaterals (natural bypasses) to restore flow

Meanwhile, many heart attacks happen with no major blockage at all
They arent blocked pipe scenarios..they are:
- clotting failures
- autonomic stress failures
- flow collapse under oxidative stress

NOT “you ate too much butter and red meat”
So what destroys this EZ Water?
- circadian disruption
- chronic stress
- glucose heavy metabolism year round
- high O6 / AGEs
- poor mitochondrial function
- nnEMFs (alone reduce EZ up to 20%), low sunlight, no grounding
- pollution, metals, BPA
- oral infections

These steal electrons --> collapse EZ --> expose artery --> raise clot risk
What protects the artery?
Everything that supports EZ water + mitochondrial redox:

- sunlight (IR especially)
- cold
- sauna
- grounding
- mineral-rich water
- animal fats & metabolic flexibility
- strong HRV/parasympathetic tone
- darkness at night so melatonin can repair endothelium

When EZ is strong = endothelium protected
= smooth flow =RBCs repel (no clumping) = clots hard to trigger

That’s the real prevention strategy

So again heart disease is not:
- an LDL issue
- a saturated fat issue
- a cholesterol issue

It’s blood physics + redox issue

The danger starts when EZ collapses

So instead of obsessing over LDL, protect the environment your heart pumps through
Modern cardiology only saves you once you’re dying
If you want to avoid the table, stop breaking EZ water and start building it
Sunlight. Movement. Grounding. Dark nights. Low oxidative stress.

That’s how you protect the most energy hungry organ in the body

Key Changes in the Aging Gut Microbiome

As people age, their gut microbiome changes, leading to reduced diversity and a potential loss of beneficial bacteria, which is linked to an increased risk of age-related diseases and frailty. This process, sometimes called "biome-aging," can be influenced by diet, lifestyle, and medications, and may accelerate physiological decline. Interventions such as dietary changes, prebiotics, and probiotics are being explored to counteract these negative effects and promote healthier aging. 

Key changes in the aging gut microbiome

• Reduced diversity: The overall variety of microbes decreases with age.
• Shift in composition: There is often a loss of beneficial bacteria like Bacteroides and Bifidobacteria, along with an increase in potentially harmful bacteria like E. coli and other Proteobacteria.
• Increased inflammation: Aging is associated with increased inflammation, and the gut microbiome can contribute to this through increased "leaky gut" and the production of pro-inflammatory compounds.
• Impaired function: The microbiome's ability to aid in digestion, produce short-chain fatty acids (SCFAs), and support immune function declines with age. 

Effects of age-related microbiome changes

• Weakened immunity: Changes in the gut microbiome can weaken the immune system, leading to a reduced response to vaccinations and a higher risk of infection.
• Increased disease risk: The altered gut microbiome is linked to a higher risk of age-related diseases like atherosclerosis, hypertension, and neurodegenerative disorders.
• Frailty: The decline in gut function and integrity is a contributing factor to frailty, a hallmark of unhealthy aging.
• Metabolic issues: Changes in the microbiome can negatively impact metabolism, contributing to poor digestive health and other metabolic problems. 

Potential interventions

• Diet: A balanced diet rich in fruits, vegetables, and fiber is crucial for a healthy microbiome at any age. Avoiding processed foods is also recommended.
• Prebiotics: These are fibers that feed beneficial gut bacteria.
• Probiotics: These are live microorganisms, often found in fermented foods or supplements, that can help restore a balance of gut bacteria. However, their use in the elderly requires more research.
• Synbiotics: These are a combination of prebiotics and probiotics.
• Lifestyle: Staying physically active and avoiding pollutants like alcohol and tobacco can also support a healthy gut environment. 

Fecal Transplants

    Some Some patients suffer from an overgrowth of the baceterium Clostricium dificile as a r

    result of antibiotics.  Fecal transplants have not gained any support.

    While more research is needed to fully understand the causal relationship between           microbiome changes and aging, interventions that support a healthy gut micrmise for     improving health and potentially slowing the aging process. 

Facebook has been pitching me an over-the-counter vagus nerve stimulator.

Lately Facebook has been pitching an over-the-counter vagus nerve stimulator.

And it seems like vagus-nerve content is showing up more often — in posts, videos, consumer products, books, workshops, and webinars.

When life feels overwhelming, a simple solution can offer a sense of control.

But most people aren’t dysregulated because their vagus nerve is weak or untrained.

They’re dysregulated because the demands around them exceed what any healthy nervous system can carry.Many of these promise a “vagus nerve hack” to ease stress, anxiety, burnout, inflammation, trauma, or gut issues.

I understand why the idea is appealing. And I understand the science. I’m a cardiologist who treats conditions involving the vagus nerve.

Workload. Sleep disruption. Loneliness. Trauma exposure. Financial pressure.

No breathwork routine or device can address these.

Hacks can help in the moment.
They don’t change the conditions that keep people exhausted.

And when they don’t work, people often blame themselves instead of the system.

A healthier path means shifting the question from “how do I activate my vagus nerve?” to “what do humans actually need to feel safe, supported, and whole?”

People need:
• rest
• connection
• psychological safety
• community
• boundaries
• humane workloads
• cultures that care

Because the real regulator of the human nervous system is not a hack.
It’s the environment we’re living in.

What does the vagus nerve do?

The vagus nerve is a crucial part of the autonomic nervous system and plays a significant role in various bodily functions, including:

Digestion: It helps regulate the digestive process.  

It serves as a direct connection to our second brain in the digestive tract.It influences heart rate and blood pressure.

Breathing: It controls involuntary breathing functions.

Immune Response: It is involved in immune system responses.

Mood Regulation: It affects mood and stress levels. 

Overall, the vagus nerve connects the brain to the gut and is essential for maintaining homeostasis in the body.