Dr. Boz Part 2 – Keto for Brain Health, Addiction, and Memory Loss | Annette Bosworth MD

Annette Bosworth, you are sentenced. You are gonna have to serve underserved populations. [laughter] That'll teach you.

Uh, it takes me over 2,000 hours of service to get them signed off because the attorney general signs off on them himself. Yeah, that's a fun story, too. Like, by the grace of God, he said fully expunged. Changed case law that you can have six felonies for the exact same moment and have them expunged in the state of South Dakota.

Wow. Well, now I don't have any felonies and the medical board still wants my license.

What? Yes.

What? And I had no place in my brain for that ketogenic diet to lower her numbers by 70%. That is that's that is that wasn't supposed to be possible. And well, by God, now I'm all in.

What? It was a Jag Grant. Cuz I know, right? I'm like, this was the best and they didn't know and it was like [laughter] every moment of this podcast where I'm like, and that's got to be out of twist. Those are like the biggest ever. This is [laughter] maybe one of the biggest twists [gasps] yet.

The attorney. Well, the investigation gets resolved because now I've got a now I've got a bigger platform. I've got people looking in and there's this unresolved Medicare investigation. I can't get a lawyer in the whole state to represent me in front of the attorney general in this iron Medicaid fraud thing. And you want to hear God? So, my sister and my husband are headed to uh the state capital to debate the attorney general on this Medicaid fraud. And we know something's happened because the feds were all around and then...

Wait, are they are they attorneys? No. Hell no. They're just lovers of me, right? Like I shouldn't be there because they'll arrest me if you make it easy for them, right? So Chad and my sister go and they're headed to Pier and they've we have friends that'll come out of the woodwork and say, "Here's what you should say. If I was your lawyer, this is what I here's what you should do." Nobody's willing to step in the light.

Okay. All right. So, as uh on the way to Pier, South Dakota, Chad's got Google alerts set on his phone, and the Google alert that comes across is the one piece of evidence that they're using saying she should have done oral iron. It's not FDA approved under the age of 18. And on the drive to Pier, South Dakota, guess what got FDA approval? [laughter]

Like, wow. And the attorney general is yelling at Chad, "If she were here, I'd put her in jail." And he goes, "At least I would know. There's a roof over her head and food to eat. What else have you got?" And he sat there for like six hours, nobody coming back in the room. And they came back in the room and said, "I'll only sign this if she agrees to pay all the legal fees that the state has used to investigate her and that we will admit there is no wrongdoing."

So that was that. Yeah. So that got taken care of. But now, while that part's done, I'm still running for US.

You're fully into the US Senate run. And here, you know how I started out this podcast saying, you know, I was built to to do public speaking somehow, right? I can feel that when I'm in front of people. It comes alive. It's like the, you know, you're doing what you're designed to do. Well, you put me in front of a bunch of old men in South Dakota. I'm the cutest thing that's running for Senate in years. Everybody else is an old white man that's overweight and a typical farmer of, you know, South Dakotan. My biggest opponent is an insurance salesman [laughter] who is the governor. Uh, but and he's running for the United Senate.

Oh, so you do have a headwind against you if he was the sitting co is the sitting governor at the time. Wow.

So yeah, that's a big deal if if moving over into a Senate run.

Right. So I'm doing this. We're doing and I send out some letters and I get up, you know, do the pulpit, you know, you do these things little around South Dakota and you get up in the county of Aurora County, county of Davis, you and you talk to the Republicans and you say, "Here's what I think the problem is, and here's where I come from." Well, you're a farmer's daughter in South Dakota. The whole damn state's red, so that doesn't really separate you from anything, but I run my own business and I'm in medicine and here's the things that are messed up and I have served the poor. They have no idea how to deal with that. What do you mean? You're a humanitarian that's a Republican? Like, uh, and it was fun. I was like, what would I do in these? I don't know what I would do that. I've never thought about that. I was willing to say that. Not the talking head. You got to know every answer. I think that's the same in medicine.

You back to transparency, right? I don't know how to I don't I can't pick out Iran versus Iraq. I don't know. I'm from South Dakota, right? I don't have to know that yet. If you get me in a place, I can learn, but I don't know. I know that I learned how to shoot a gun at a very young age. And the first date I ever went on with my husband was ski shooting, and I won. And what you've told me offline, you've castrated more pigs than [laughter] I'll probably ever eat.

Yeah. So, I've done the farming thing. I mean, Christy Noem was running for the same at the same time. So, she she's been same age, same time. Uh...

And yet you've given lectures on the female orgasm. [laughter]

Yes.

Your resume [gasps] is wide [laughter] on all sides of the fence. So yeah, you you get it rocking and rolling and um...

And the momentum is good. So you have you have to send you have to keep a report. So the one thing my husband was really good about, he's like, hired somebody from the state of Florida who had never had an audit go wrong in a campaign and we don't know what the hell we're doing. I've never run for the school board, let alone United States Senate. And in that process, we just said, "Just don't screw up the math. This is where they would audit you." Like this tracks. I have never failed an audit. Just show me the rules. So, we follow the rules. We have an, you know, somebody else make sure they're doing the books exactly as we should. And I'm getting burned out because there's a clinic. I'm I'm now out of Medicaid fraud. Clinic's back open. I get to be my the version of me that I was dreaming about. And I'm taking, you know, students to Haiti. That's been fun. I that that kind of all got taken care of once the Medicaid fraud. I'm back in good graces everywhere.

I should I should interject this because I think a lot of people who observe politics from a distance don't realize this. Unless you yourself are a career politician, you can't actually assume you're going to win. And you can't spend the money, right? You can't just ditch your whole life and all of the work in your career assuming that you've got it in the bag and there's no point you can sell it, divest, and all that stuff. No, because you might not, right? And if you don't, then you're you just gave up everything. To to roll the dice. So yes, if you're enjoying success at the same time moving toward what you wanted to get to as a doctor, that's still your original plan A. Yeah. Maybe it's plan B if you win the Senate, but you can't count on the winning the Senate, right?

And honestly, I really like that I the engagement in the discussion. You go to some of these political things and again, uh, I'm from a small town. We would if the if the governor came to town, we would go look. We would be around it. But they have these weird, I mean, you don't notice [clears throat] it till you're on the circuit with them saying, "What do you mean you all have the same answer? That's such [ __ ] You didn't even think about it. You somebody told you to answer that way." And so I love that the discussion is now a physician is standing on the stage saying, "You guys, you do not want Obamacare. If you think it's difficult for me to serve you now, wait till the government is the only one in charge and it lives in Washington D.C. that I am so far removed from challenging a rule that comes upon you."

That's right. So, this being 2012, that would have been the very hot item at that time.

So, it was a perfect it was a perfect storm for a young physician who's running my own business. I'm I'm not s I had been bought out by corporate. Now, I'm out of corporate. So that makes it much easier. I don't need anybody's permission now. And I've been I've been, you know, scrutinized. I've been Medicaid frauded, right? Headlined homeless. Okay, that's a great story. And so I got burned out and Typhoon Yolanda hit the Philippines. And my husband's really good at taking care of me. He saw me burning out trying to get the clinic back to, you know, what it would have been had I not done the two years non-compete and and then doing all this politics. And he said, you know, we got a call from the Red Cross or what whatever the organization was saying, we know you've gone to Haiti dozens of times. We have a Red Cross building in uh Tacloban. Uh, it's where the hur it's where the typhoon hit. We don't have a provider. Would you come serve for a week or so? And I'm thinking, hell no. I don't have time for that, Chad. He goes, "You need it. Let's take your political team and do it."

Yeah. And we hop in a plane and we go to the t to Tacloban. And it was great. It was probably there's a there's a few moments of in your life that change you. And we're serving on this team in I've done this a lot of times, right? I know what uh looks like to get their supplies and serve the people. I've never been to the Philippines before, but it's not it's there's a lot of similarities to underserved population. And these ladies will not sit down and eat food. They make this food. You come back from the clinic and you've worked at 1260 and it has this beautiful plate of fish that's just awesome. And I was being bossy and saying, "You need to sit down and eat with us. You need to sit down and eat with us." And they're very quiet people. At first they're just polite and not telling. But the third night I get really bossy. No, you are going to sit here and eat my fish. She goes, "But doctor, I don't know if that fish ate my sister." Two-thirds of their community was gone. Her sister's gone. They're catching the fish right out on a little paddle boat while I'm at the clinic. And it just mean there's moments where your life changes saying, "Yes, I can be bossy and authoritative. I know that's how God designed me, but there are times where you just need to shut up, girl, and read the room."

It's um it's worth emphasizing for people who weren't following the news at that time. And to be sure, the new that there wasn't cameras there like there would be in a western country, that was one of the most devastating things that happened to a country ever. in I think the last decade, maybe the last I it was and um full disclosure, my wife is full Filipino by the way. Um, but it it was absolutely horrendous what happened. But I do want to also capitalize on what you were just mentioning and I think a lot of people who've never really experienced what it is to dedicate themselves to service don't understand. I didn't understand this until later in life when I was in this kind of a position. There really is a a kind of getting in touch, you know, whether you want to think of it as a higher power or the universe or the Dao or whatever. There's absolutely something that cannot be described. It can't be described until you know what that is. To to serve for what just objectively to everybody is just a greater purpose.

Amen. Like just to do this thing that's helping others in such a profound way. And it's not crisp and clean. It's not the Hollywoodized version. Often it's difficult because you also can't tell where you can stop because often that the you can't easily stop because it seems like all you can do is abandon it after you've started, right?

And you never feel done, right? Because there's always so much more to do, right? I remember thinking I was irritated because it's like the cockroaches. I've never heard cockroaches go up a wall as bad as it was in the Philippines. And it was everything was wet and you couldn't get dry and even if you tried to hang your clothes up, it was just And on the last day of being in the Philippines, I uh those ladies gave me these pearls.

Oh, wow. Those exact pearls. These pearls. And they're flawed. And I like that they're flawed. And they strung them together and they gave them to me. And every time I put them on, I ask God, help me to to know that you can see what I can't because I'm in the Philippines and I'm getting 12 felonies at that moment and I don't know it. I have my campaign director who's with me though, a lawyer who knows how to do politics and he's at the Philippines and he served with me right there. And I take this gift from these ladies who taught me about shut your mouth. Look, there's something you can't see. Trust that and just shut up and do what you've been called to do. Quit looking for accolades or praise or Facebook posts. Just know that God's got you right here. And I put those pearls on and I thought, "Oh, they're flawed. They're not like the shiny ones you buy at the airport. They're like me. They're flawed." And the man who's with us is a campaign manager who tells me the rules. I don't know the rules. I've never run for anything in my life. But I left a a petition. You have to get 2,000 signatures to run for US Senate. You can't start doing it till January 1st. You have till March 1st to do it. You got to get 2,000 signatures. I went to the Philippines during that time and I sent an email out to my patients saying, "I know you don't want me to do this. You're just glad I'm back in business and just starting the clinic, but I feel I know I was called to do this and I want to run for US Senate. I need you to sign the I need 2,000 signatures. Support me by writing your name on the petition." So while I was away, my sister signed it, the staff signed it, several preachers came in and signed it, and they were dated during the days where I was earning a pearl necklace from the folks with me, but I was clearly out of the country and I couldn't witness the signatures.

So you so that was a requirement on the... Well, it says I do duly swear that I I witnessed signatures. Now, let me just put this in context and I am not excusing this, but when you do get petitions, if you've ever ever gotten a petition, tried to say or had somebody sign something, okay, whoever is holding the clipboard is the one who's witnessing it. But how most things go is you go to a basketball game and you pass the pass the petition throughout the people at the basketball game. Right. Okay. Who witnessed it? Okay. The the spirit of the law is that you're not getting signatures of dead Indians in South Dakota, which happened. No, these are real people. You don't have to fact check. Uh, you ask them if you're Republican, you can sign this one. If you're Democrat, you get to sign for the Democrat. I'm not running as a Democrat. I'm running as a Republican. Only Republicans can sign it. Are you a Republican? Okay. Sign your name. No IDs are necessary. And we got like 12,000 extra or 1,200 extra. So, we were way over the $2,000 2,000 signature mark, but there's six petitions that get called because they were signed off by me during the time when I was in the Philippines. And they were the petitions that were at my clinic. and they were sent home to a preacher said, "Have your have your uh parishioners sign this if they're willing and send it back." So, did I witness it? No. That's what the judge said. But if you weren't out of the country, again, not to excuse it necessarily, right? But it likely never would have been challenged, right? Because of and I and it so fun fact I at one time got gigs being one of these people that collects signatures. I'd be outside of a grocery store that'd be like one place for example um this was in Golden, Colorado they wanted to pass this uh 1% growth cap so you couldn't grow more than 1%. And I remember at the time, you know, the sheet, it has a whole bunch of lines where there's the what the person fills out, their name, their signature. Um, I think there was a date, but definitely the the name and the signature, and then there was like some text that was down at the bottom, right? And the text down at the bottom, um, I remember this myself that there was a place for me to sign, right? That's the person who collected the the signatures. I genuinely just didn't. And grant I was young at the time, but I just didn't I was like, "Oh, this is how I get my what was it? 50 cents a signature or something like that. Great money." And I'm just like signing it and I'm I'm rolling it along. Again, I think both you and I share this in common, which is that, hey, we own mistakes. If mistakes are made, you own them.

I already know a little bit of what's coming next. You already mentioned the F-word, felony. [clears throat] Obviously, we have this sense of what is a speeding ticket versus what is a misdemeanor versus something crazy super serious, right? What's ahead is not a speeding ticket. I'm the first person in the history of the United States of America to ever be charged with this felonious behavior, let alone tried and convicted.

And I should mention one thing. When you first told me this, we were sitting next to each other at a dinner. You remember that? Yep, I do. I don't tell very many people this story. It's like, do your life, don't focus on this. I'm more than my worst headline. And I had one of those moments later in the night where I was like, I just had to have misheard some of those details. And so I did hit the Google after that. Wasn't a lengthy in-depth investigation, but it was I want to say maybe 20 minutes. And sure enough, I did. I googled people. I was like, is this like a new thing? Is there just a new like genuine hardcore interest in like prosecuting candidates to that extent? And again, not in depth, but of what I've read, no, the commonplace scenario is if there's technicalities that can be found, it's to throw the the petitions out. I had extra.

Yeah. And so if there was if there was like whatever the six sheets or something for which something could be said, it'd be like, ah, no, these these would not count. We're going to have them thrown out to which you could still technically petition against it depending on what the nature of the collection was, right? But no, this was not a throwing out sheets kind of thing.

Oh, you're running. So why why would they what was their motivation? The question I asked you first was why would the clear what was their motivation to not be transparent that Clearary must have made a mistake in your data? What's the motivation? Well, the attorneys, the attorney general of South Dakota had his job because the governor gifted it to him, appointed him, never had to run, had run subsequently and won. But that's a different way to get a job. So, you're in the attorney general's office. You've got the job because the governor, this smoking hot chick on stage doing a great job, is one of your competitors. She's a nothing burger. Never been in politics. Doesn't know what she's doing. But every time I go to one of those events, you you can you can feel the attraction. Like I walk into a room and the crowd around me is instant and the crowd around the governor is not. And then you keep going and like, okay, maybe it's because I'm new. Okay, I'm a girl. The boys versus whatever. And the quarterly earnings come out. So, if you give somebody $200 on a federal election, you have to document where the $200 comes from. Anything below $200, you don't your name doesn't show up on the list. You don't have to report it. So, the quarterly earnings come out and the governor has about 20 uh donors on his list and he's raised $750,000 for this race and the average size of check is 10 whatever it turns out to be there, right?

Yeah. For so few donors, that's a lot of money. You look at my quarterly earnings and there's nobody on the list, but I have $780,000. And my husband goes, "Oh [ __ ] we're in trouble." And that's the day the black van starts parking outside our house. The like...

And this is because the average was actually $45. Our average donation was $45.

Wow. Wow. That is so grassroots.

Absolutely. Especially for a Senate campaign.

Well, Senate, you can send to the country, right? So, I have this story to tell. I did what was right and not in a martyr kind of way, but to say, "Look, I didn't have I still got debt. I still had all those bills to pay. I just started selling [ __ ] I mean, I put our wedding rings in for the last payroll into a to pay and say, I just can't sign it, Chad. I can't admit doing wrong. It's not wrong." And then and then you tell the story and you send letters out and people send you money and say send it to the people in Florida because I don't want to touch it in a way that doesn't get somebody cross-checked and that turns out to be a huge part of fact check me go look at how we raise the money.

Yeah. And within so then they had to find something. So, you know, the only other person that's been charged took it takes two years for him to be charged for the exact same crime, maybe 18 months for filing a petition and not having this sign. You know the answer to this?

I don't actually. As my husband.

Your your husband. [laughter] He signed two of the petitions and the attorney he ran against the attorney general in South Dakota when nobody else would.

Okay, correct me if I'm wrong. The nature of the crime, it's technically perjury. Perj... and then filing of false documents. So each piece of paper got two felonies. One was perjury and one was filing of false documents. Again, I don't want to m I don't want to minimize. I don't want to equivocate. However, I am at least tuned enough into politics to have myself lived through so many times of so many cases where there is overtly shown perjury. Again, we're we're on the same page. will acknowledge where wrong can be called out or whether it's a mistake or not regardless. But it lawyers themselves will say perjury is almost never prosecuted, right? And where it is, it's because usually there was something of enormous egregious harm. Something you know such as um falsifying medical records where it actually could have enormous relevance towards the outcome of patients but particularly towards a patient pool, right? Something like that. This is really still very stunning to me even after I digested it before to hear it again, especially this deeper version of the story which I don't know if you've ever gotten to this level of detail in another podcast.

No. Um, what happens next?

So they've this is so the day before the election is when they arrest me. [laughter] So much like your announcement, but right before your big fundraising, don't race the crisis, Dave. That timing is God's given you a gift there.

Yeah. Now, my gift is a lot more pain. Uh, I get arrested. So, who's going to vote for me? Nobody. See, she should have never run. Everybody that said, "What are you doing?" You know, this is South Dakota politics. South Dakota. [sighs] You're not qualified to run. Told you so. Look at the mess you've made. So embarrassing for the family. And finding a lawyer to stand against the attorney general.

It's a totally different ballgame than what you just went through. Right. Right. Like you you just went through what was such an exhaustive fight that it put you in an RV after you sold everything just just to put forward the energy for the fight.

Right. Right. You don't you don't get all your money back. [laughter] So that happens. It's real. And now you're facing something far more serious.

Yeah. And and I need a good lawyer. Right. I need a good lawyer. I visited 50 of them. Nobody would stand against the attorney general. Like he's he holds a grudge. I'm not doing it. No way. I'll do research for you on the side, but I'll I never need my name in the You can go prohawk Vich or know per se. Do go represent yourself. I'm like, represent myself against 12 felonies? Are you nuts? And and then the politics get even worse. So they don't persecute me in the city where the crime happened, which would be the place where I serve. I have people. It's my church. It's my I have friends. Pick a jury pool from there. Now they go to Pierre, South Dakota, where there's 10,000 people who either golf or patron the politics in town. That's why you're there.

The attorney general's team is there. The jury is from there. And I mean, one just one year of legal fees is over $1.3 million.

Wow. Like there's there's a whole bunch of pain ahead.

Medical debt doesn't seem so bad now.

Oh [laughter] [ __ ] [gasps] And ironically, I mean, we know everybody. We know people in Pierre, my family, Chad's family, they're there and they whisper. They're like, "Yeah, you just you've been turned into a verb. We'll 'Bosworth' you if you stand against us." And I think it's fake. And then I hear it in a couple of podcasts where I'm like, "Oh [ __ ] there's a thing in South Dakota where what's the top news article of the year?" So when I'm running, I'm the top news article when they're persecuting me. So three years running, I'm the top news article by a mile in South Dakota. Like I can't go anywhere. My kids are incredibly formative years like 12, eight, and six where you've they've been to the to Haiti. They've served with me. They have gone to the they know who we are as a couple. And now uh they don't they go and their English teacher says, "Your mom's that felon. I see she's in the paper again." And that that affects a kid. Right.

Wow. I don't remember the next part. How in the world did you end up?

One of So let's just talk about the one place that I think is ironic. So I go to the Philippines with the lawyer, right? Yeah. And so he gets called to the stand to to testify against me. I told her not to sign them. Like Joel, you signed a petition, too. You were in the Philippines and you signed off a petition, too. Could it have been that you advised this is okay? But boy, he got a really good political job as soon as that trial was over. So 12 felonies for six felonies for perjury, six felonies for filing up false documents, and then all the cards start falling. The medical board's calling for my license because I could have taken a deal. Instead of 12 felonies, we'll just do one, but you still have your medical license that will be at risk if you do that. So I'm like, "No, I'm not doing that. I'll go to trial." So we go to trial. We lose. Um, it was over Memorial Day weekend and the jurors had people visit their businesses over the weekend in the black vans. It's It sounds conspiracy, so I even hate saying it out loud, but like it took two years for them to tell us. I mean, it's family. They tell the family, "Here's who came to me over the weekend. Here's who came to me over the weekend." They're in Pierre, South Dakota. It's 10,000 people that live in the whole city. And when the black vans show up, everybody sees it. And then eventually they get drunk and they tell it and they say, "This is what this is what I was told to do. You get convicted of 24 years in prison. My kids are sitting right behind me." They live-streamed the whole trial and I have to put my own appeal in because nobody's going to appeal it. So I wrote my own case of appeal and people come to me in the shadows and say...

Can I sorry, 24 years so you're you're you have no record?

Yeah. Right.

This is like has this ever happened? And so I'm is there...

Chad did get arrested for it when he he got arrested for it too. He only had two petitions and it was while he was running against the attorney general, but they took his down to a misdemeanor.

So in the trial, there's a later chapter.

So you have an A/B test saying, right? Like, okay, [laughter and gasps] it's all politics. Will they take a deal? Not this high-profile. Um, nope. We want her to have at least one felony. Get her out, you know, stop her from doing what she did. I don't I don't know why he was so he just wouldn't let go. Like I'm still have a medical license. So I'm in front of the judge and he's saying 24 years in prison and my like my whole world stops. I can't feel air. And then he says something where so you get sentenced, you get the conviction and then what the sentencing is happens a month later. During that month, people wrote letters to the judge. Now I didn't know that was like a big thing. And I get there and there's a stack of papers on the judge's desk. And so he sentences 24 years in prison, all the things. And he says, "But I'll probate it for the most hours of community service ever awarded in the state of South Dakota. We'll give you 500 hours of community service, but you have to serve the poorest people here." [laughter] And I thought, "Oh my God, he must not have read those letters. [laughter] [gasps] Those are my people."

Annette Bosworth, you are sentenced. You are going to have to serve underserved populations. [laughter] That'll teach you. Uh, it takes me over 2,000 hours of service to get them signed off because the attorney general signs off on them himself.

Yeah, that's a fun story, too. Like you got So, you have a court service officer, right? You got to check in. Am I running running the country? Do I have to wear an ankle bracelet? What? How are you going to keep track of me? Right. And this really wild person. I'm like, "No, I'll I'll serve in Pine Ridge, which is the poorest county in the state, and I'll drive, it's eight hours from my home, but I'll do my service work there so that nobody argues that it's an underserved population." And I go to the jail, and I I buy for a job for free and say, "I'm have a medical license. I'll serve your people." And it takes I'm white, they're brown. There's rules. You got to sit I had to sit and wait for my interview for like eight hours just sit there and said we wanted to know if you would be able to handle our culture so it's kind of a test can you sit there and wait your turn so I got the job or whatever you call that and then I have to take it to Pierre because my court service officer which is supposed to be in close proximity to the person so you can keep track of them not in Sou Falls in Pierre so I got to drive from Pine Ridge to Pierre so I drive up there and I sit there and say okay I'm going to it's my first week I've served hours. I sit down and he says, "Okay." And he's very nervous. I'm famous, infamous, whatever it is by this point. And so he says, "Let me just go check something." And I see him. You can see out the window that he was walking across the street to the Capitol. And I sit there for about an hour and he comes back and he said, "Well, I got most of them approved." I thought, "God, I thought I I've never done this before. Maybe there's another person that approves them." So, it takes me about 10 days to get back to Pine Ridge to serve the next time around and people are weird this time. Like I asked them to sign off on the hours because I just did a workshop for your, you know, pay did the stuff. And he's like, "Well, um, did you go to the bathroom?" I said, "What?" Well, last time when you left, I got a call from the attorney general.

What? [laughter] That he called the people on the in the jail that signed off on my community service hours saying it says she worked 12 hours straight. Did she take a bathroom break? I mean just trying to [ __ ] with him, right? I'm like they're already scared of him. So, it will it will take me 2,000 hours of service to get 500 of them signed off and and then we appeal it and we appeal it, you know, try to we go through the process and we get to the Supreme Court and we have a case in front of the South Dakota Supreme Court.

The state Supreme Court. Yeah.

Yep. And they say indeed that's not perjury. It was abuse of power. That's not perjury. But the filing of the false documents, she still has six felonies. And so by this point, I've served out my 2,000 hours. It's now a year and a half later, and it's really hard to build a clinic when you're a 12-time felon. But I have a few people that [laughter] And I've written a book in this time. This is a time where my mother got very sick and needed a daughter and I was teaching her the ketogenic diet.

Hold that thought. There's got to have been at least a little bit of a voice in the back of your head that said, "Maybe this just isn't for you. Maybe you shouldn't be a doctor. Definitely don't get back into public life." That's Come on.

God. Right. I if I never have my picture taken again, it was too soon.

I have got um I want to say 29 episodes recorded as of this moment. maybe like the 30th. 24 of them have aired. [sighs] It's going to be tough for anybody to beat out your your story [laughter] of of ups and downs because I I just I really have to um Robert Kills may be the the competitor, but I I got to say yours your absolute tenacious drive again even after having already gotten the felonies and now you've gotten the community service. You didn't have to spend more money on more lawyers.

Yeah. No [ __ ] To still fight it further, right? You again could have just backed out, said, "I think I'm going to head this other direction. I've already taken enough heat."

Here, I guess. So, 12 felonies got six reversed still are there. So, then I I'm going to have my medical license taken away if I don't get those gone. If I if they stand. So I got to serve in that time. This is now a year and a half now that Supreme Court has ruled. Unless I can get that judge, the one with a stack of papers, same judge has to do it. Couldn't he give me suspended suspension of it like um where they erase it? Uh...

Expunged.

Expunged. Yes. Each state calls it something different, but if you have a DUI and then you go to the thing and you rehab and you're dry and you're going you've done all the stuff and now they can erase it. Okay. But that's for one felony. I have six.

And nobody's going to I've asked some lawyers, tried to find a lawyer, will you take it to the judge with me and ask if we can get these expunged. And they're like, it's not going to happen. It's six. It's against the law. It's against the law. Nobody will do it. Nobody will do it. Nobody will do it. Um I find a guy who says, "If you pay me $15,000, I'll do it." [laughter] Or whatever. I don't remember what the number was. Just pay me a lot. like, "Okay, I have I have a friend who will write the brief for you. Just need your signature on the bottom." So, he writes the brief and we get to the place where it's this moment. We drive to Pierre, South Dakota. This guy is the judge is going to retire in about a month. So, if he retires, you can't expunge somebody else's ruling or something like this is our last chance. And I mean, Chad does this. He's a Yeah. So, we're driving around the courthouse cuz I'm so scared to get out and we don't we don't want any cameras to know they're there. Like, usually they all know when I'm coming and there's cameras everywhere, but there's not cameras there at this time, which is like a blessing. And we're both pretty well known. So, let's get me in and not Chad. But, so we're driving around the courthouse and he's praying out loud. God, you know where her heart is. If you want her to be a doctor, give us the result that everybody says is impossible. And he must have drove around that courthouse 20 times.

And I got out and I walked up those stairs, sat in there, and you know, if the judge wants me to show repentance. You know what? I am sorry I made a mistake. I'm sorry I spent any of the state's money on the mistake I made for running for US Senate. It was never my intention. I take full responsibility for the mistake of signing the petitions. And by the grace of God, he said, fully expunged. Changed case law that you can have six felonies for the exact same moment and have them expunged in the state of South Dakota.

Wow. Well, now I don't have any felonies and that medical board still wants my license.

What? Yes.

What? [laughter] Okay. Yeah.

But just to recap, this has nothing to do with medicine, right? Right. This has to do with the petitions, correct? There's no do did do they cite anything with regard to your...

Have that Medicaid in front investigation.

Okay. All right. [laughter] [snorts] And there was uh when I first opened my business, I h I hired a physician assistant before she had taken her boards and she was at the shelter with me. She was doing the teaching with me. She was shadowing me like a med student would. But they gave me a sanction that I hired her before her before she was licensed. She had taken her board. She Yeah. There was something her license hadn't gone through. There's a two-week period in there where there wasn't a license. And when they went back to find this Medicaid fraud, they found that mistake when they were looking for problems. So now I've I've got a sanction in my my history. But here we are.

This is tough. So now I have to decide what what the hell would I do if should I should I uh I mean, I you get to go in front of the medical board again. Now I got to find another lawyer be in front of the medical board or I got to go myself and...

You're just so hellbent on being a doctor [laughter] that like when you have to fight this hard like...

Yes. Um, so it's it's a lot of procedures at this point where you you argue your case in front of a the judge that is now going to help with the medical board. The medical board has to hear it. They send their people in. We send our people in and the board talks and, you know, I know the people on the medical board. It's against the rules for me to talk to them, but they're they're my colleagues. They've been in medicine with me. There's only 2,000 doctors in the state of South Dakota. So, I know these people. And in the shadows they're like, "Yeah, we think it's [ __ ] but we're not in charge." Like, I think you're the ones voting. There's only six of you or whatever it is.

But it's called do your job.

I know, right? That same moment where you say, "What are you in it for?" And there's a couple of old-timers in there that just had really strong honor. But I think that's why I think that's where the ruling came from, too, is um they would agree with whatever the judge said. So, we get in front of the judge. We rehash the case. We show him this has nothing to do with medicine. Despite those sanctions that were on my license for Medicaid fraud, there was no wrongdoing found. Praise God we stuck to that. Uh, and this paperwork thing was first time I'd run a clinic. I didn't know I couldn't hire her until it's a rule that I'd never done it before. So, um, no patients were ever harmed. Patient care is good. Status is are good. But it's exhausting, right? And in the ma in the back of this, there's the blessing that I think I have a few patients and I I see them and the clinic is, you know, it's limping because I still have all this politics stuff to do and I write a book. I lose a bet with my husband uh as my mother is going through her cancer story. And you know, personally think, okay, the stress of your daughter being in the headlines is part of this. Like, this is a chronic inflammatory cancer and I'm not helping. And she believes in me and she loves me, but it is hard to watch that.

About what year is this?

2015.

2015. Okay.

Yeah. And she gets I mean, she walks through the clinic door and I don't have to You can see it from across the room. She looks gray. She's been having a hell of a time for the last year taking antibiotics most of the time because like one out of 500 of the white blood cells are functional and I'm I mean the other beautiful part is I had the time to study. You get a busy practice and there's no time to study and there's no time to really learn. You go to CME and you hope to shove it in your brain enough to do the answers and get the CME points and go away. But I was able to really lean in. I mean I I was peak brain performance. That's what my clinic did. That's what the patients were coming traveling across the state to see me. One of the few few places they could get that thorough of care for getting a brain back online. And when you do a good job, it's a small state. They talk. So then the next guy comes and the next guy comes and nope. I I pay cash. I not playing that game anymore. I don't need anybody auditing me ever again, right? [laughter]

Because you know there are people actively coming. The van still parks outside the house twice a week. It's crazy. It's still like it's like four...

Years later, at this point. Like the amount of money spent on, on, on, whatever, whatever they called it. He doesn't like to lose. So he's lose. He lost. And that's the part that I think is the human part of it. Like, why did he hold on so tight? Probably the same reason I'm holding on so tight is I was designed to do this. And God, if you're gonna take it away from me, okay, but if you give me the privilege to do it, I will honor the people who trust me. I will do what's in my heart to say, I don't have to read every scientific paper. I don't have to Nick Norwitz my way into that, but I can do a great job with the gifts you've given me. And in that story, I have to serve the patient that is most dear to me, my 71-year-old mother, who says, "I'll be dead in six months because that's better than taking the chemotherapy again." It mushed my brain. She made every piece of clothing for me until the age of 10. She was a seamstress. She didn't know what a sewing machine was after the second round of chemotherapy. It took us six months to teach her how to do it again. She was just back to making, to doing things on the sewing machine.

This is another thing, by the way, that I think gets Hollywoodized a bit too much. You watch the show that shows, oh, going through chemotherapy and how do you know? Cuz they lose their hair, right? And you know, it's not pleasant. But these hardships, I think, are not very well portrayed in media to really understand just how severe chemotherapy can be.

Yeah. But and and you're like, "Okay, cancer is this awful thing." And every textbook says this is the only way I can treat you, Mom. I took you to the best people. I don't know what else to do. I don't know how to fix this. This isn't my lane. I mean, I do the other thing. I can see everything's falling apart. But and CLL is terrible. You're going to die with it, maybe not of it.

And then I hear a podcast between Dom D'Agostino and Tim Ferriss and they're talking about peak brain performance and the NASA and the Navy SEALs and injuries from scuba diving and having seizures and then how do you get their brain, all the things they're doing to get these peak, the peak brain performance. Hyperbaric oxygen? Check. We've got that. They've got a protocol for TMS. We've got I've got one of those machines. I'm doing exactly what they're doing except they started with ketones and I'm like, "What?"

It is November of 2015, 2016 that I hear this podcast. You can fact-check that. And it takes me like four months. I don't want to tell anybody because I'm kind of embarrassed. I don't know what I mean, keto acidosis. What are you talking about? And so I'm looking at it. I can't find anybody else to talk to about it. And I'm kind of like the Scarlet Letter, like if I'm doing something weird, do not do anything weird. [laughter] Do not do anything weird.

Right. Right. That same voice right in the back of the head. It's like, [laughter] don't find another. Right. Also, it's I just to set the time because 2015 is when I learned about LCHF, low carb, high fat. Oh, yeah. Two keto dudes. Yeah. Two keto dudes. But that even then, I want to say that was a year or two later. Later, right? Yeah. Keto, which is what we call it now, was back then called the ketogenic diet. But even then, it was considered the extreme of low carb, high fat, right? It wasn't keto. Wasn't really like it is today.

Oh, and my husband would make such fun of me. You cannot say the word keto. You cannot use the word ketosis. You sound [ __ ] You nobody is going to care. You got to find a different word. I'm like, I low carb, high fat, that's is bad. I mean, I it was weird, right? And I'm like, I don't want to be weird. I don't want to be weird. [laughter] [gasps]

And then I So I called the librarian and so by this point, I've been expelled from the medical school, but the librarian knows me. I've I was you know, and and so she snuck me in [laughter] to get into the things I needed and said, "I just need to study this. I'm gonna close the clinic for like three days." Which was probably, you know, it's it's plenty of income for what's happening in my life right then, but it was also, "I can't let go of why do they do this? What's up with this?" And like you can't find it anywhere, like like the real science behind it, like it's all old.

I I experienced the same thing on the internet. I would hear about it being originally discovered for the for epilepsy, but I don't know if you ran into this. I did I did this. I literally said, "There has to be a reason they stopped using it, right? For this whole like decade after decade there's there's something there's got to be some. Is this just some weird fad? Is that what's going on?" I think Gary Taubes is probably my favorite person who ever really dove into this and said, "Well, it was stupid why they didn't, you know, keep it up. It was, you know, insulin, okay, sure, but it still doesn't negate all the good stuff." And it was just like Depakote was easier and the medicines were sexy.

And as you look, you're like, so. And look, I'm I'm just and I have to interject this because I've seen this time after time with doctors and I think the stretches back until the beginning of time. As soon as there is a profession that getting back to that toolbox, they're like, "Aha! Here's what I can do to feel like this medication is the way by which on I can provide, provide to my patient something I I can provide." Right. It's very difficult to coach a patient through lifestyle changes, but there have been plenty of doctors who have. Right. They're less and less than ever compared to. And I've talked about this on the show as well. My dad's dad talked about his doctor who is his age, and that doctor was the one that came with the case and was like, "Hey, you need to be eating more vegetables. By the way, you should be getting outside more. You don't have any tan at all." Right? He would that was that was the lifestyle. That was the doctor I want today. Right? Is the the one who. And it was hell to get him to prescribe anything. And the moment he prescribed anything, he was trying to get you back off of it as fast as possible, right?

That's perfect. That's the school you want. That's what you want, right? But even back then, even in the '20s, the '30s, oh man, it's just so hard to have people on a ketogenic diet. And to be fair, to be fair, we didn't understand vitamins as well then, which is why those earlier keto shakes were poor nutrition-wise and so forth.

But the problem is, the problem is that the concept of treating the whole person of getting in there with what's got to change in their life altogether to get to the state of endogenous ketone production. Right. Right. To actually become ketogenic to that degree versus, "Ah, I got a pill." Right? "I got this drug." You can you get that sense as to why it is doctors, and I'm I'm trying to say this on their behalf at the same time, could feel so attracted. That there's ego in everybody that does this. You you get to this lane, you're the doctor, you're the priest that's in the white coat. And that authority comes with the, "Well, I better do something that nobody else can do." Anybody can tell them to do the ketogenic diet, but nobody else could write Depakote. That's that's protected in our profession.

And this is what brings me around to the complaint. Fine. If you know about all the best drugs, for goodness sakes, let them have an option. Yes. If there's another way, you the doctor should know and should tell your patient. Right. I listen and I I'm getting a bit on my own soap box here, but I can say that in 2001, 2002, etc., I can understand why a lot of doctors who are treating, say, epilepsy, may not have had the same background knowledge of something like keto because frankly, the schools were not teaching them. Right. In 2026, I'm sorry, nobody has any excuse anymore at all. And thank goodness for Metabolic Mind for doing and advancing all the research into all these other mental illnesses like what we feature in our movie with people finding a new lease on life for things like bipolar, such as Robin Doblin's story, right? For goodness sakes, again, if you're a doctor, by all means, be aware of all possible medication. That's a solution. And don't get me wrong, the diet isn't a cure-all for everybody. Sometimes you need combination therapy, but please be sure that they're aware. Right. Don't assume that it's not sustainable or that you already know that this this patient probably can do it anyway, or just not know about it at all. Okay. All right. Off. It's just it's just. I'm an engineer and and it's my fault if I don't know about the technologies I'm working [laughter] and how they solve my problems or your problems if I'm serving you. Okay. All right.

So, here's the number one patient though. My mother. Your mother. Yes. And keto is not for cancer. Keto's keto is for this brain thing. I'm going to be I I want to do a better job for the patients that come to see me. I'm gonna. And so it was literally the brain totally of your mom that brought you to keto, right? Not the cancer.

Well, it'll come to me in a minute. So she's having a problem. She's having a problem. She tells me about the problem in the spring of 2016. That's what the conversation from Dom D'Agostino was in 2015. Okay, that's in like November. And I spend like two, three months like taking these pockets of time when I get to sneak into the med school library and research this and find [ __ ] I gotta find hardly anything. So I'm asking this, you know, the librarian can help the staff for the medical teach professors, but I'm excommunicated. So I'm asking her to do these research things for me on the side because I can't find it. Like, am I doing it wrong? Why can't I find information on this? And is are they crazy? So I I then decide I get some keto ketone strips and I'm gonna figure out how to pee a freaking ketone. And I fail for like eight weeks straight. And we come to Memorial Day weekend where there's a ruck a rock hike around the city of Sioux Falls for 22 miles. And I tell my husband, "I'm going to do this. You can the kids can come with me. You can uh pick them up halfway. I'm going to do the whole thing, but if I don't pee a damn ketone after this, I'm calling this junk science."

[laughter] And so I get done with 22-mile hike and I I mean I really think I was that insulin resistant was what was happening is I I just couldn't pee a ketone. I'd taken the carbs down and I'd done all the things I tell my patients to do and I was farting around with net carbs and okay then I peed a ketone and then I was scared to ever touch a [snorts] carbohydrate again because I'm like, "I'm going to you know, go back into this." But for weeks I was just it was amazing. All right.

So, now I come to this appointment with my mom, which is six weeks later, and I've now gotten a few of these articles where there's a, you know, a couple research teams saying there's something about the metabolic processes of cancer, especially those that are like linked to autoimmune or have that replication growth factor from insulin thing. By this time, you know about the Warburg effect? Yep. Read that. um had um I'm signed up to go to Dom's first metabolic uh Dom D'Agostino's first metabolic science thing, but I haven't gone yet. It's it's going to happen that next summer. And my mom's in the middle of going through this. Like, "All right, Mom. Uh do you trust me? Um, he wants you to have chemo. Um, we know that it's going to knock it down by 30% if you have the chemo, but that's also what happened last time where you went offline and you didn't remember anything for a while." And she asked me this thing that patients sometimes I ask, I mean, but sometimes I lie. They say, "If it was you, what would you do?" And when I worked for corporate medicine, you needed to tell them the guidelines. But it was also busy enough that they didn't ask very often. But in your private clinic and especially in the season I'm in where I'm able to see patients slower, they'll come to me with, "Here's what here's what they said I should do. Would you tell me what would you do?" And you can lie, but you cannot lie to your mother. And I said, "Mom, do you trust me with your whole life? Because I think we should get in that car and drive a 100 miles to the family farm and I'm going to teach you what a ketone is. We're going to do a ketogenic diet for six weeks and see what happens." And her memory was [ __ ] Uh, but she could follow simple instructions. So I said, "All right." I we went to the house, cleaned out the pantry full of all these carbs and you know, canned peaches and all the stuff that my mother has just she's a prairie woman. I got an apocalypse can come and I can eat for. We threw it all out. No, Mom, you can't have it in the house. Dad, you can have sardines. Oh, I get to eat sardines. Mother hated sardines. But we cleaned up her environment. Got her some PTON strips. We don't have FaceTime at this point. We're just calling, but I can. I get back to home, have Chad come to the farm and get me the next day and got it cleaned out. Mom, this is the plan. I'll do it with you, Mom. I'll do it with you. And we're talking on the phone and she she sounds better, but I think placebo. I want her to win. And but she's not asking for antibiotics. It's during three weeks and God, it's been a year since I've gone three weeks without giving her antibiotics. And then, you know, she's peeing a ketone. She sends me a picture of it. Uh, I got, you know, so I've proven ketone. Both doing a good job. Get to the six-week point. She comes back to Sioux Falls and the oncologist is my friend, head of the med school, see one of the secret people who said, "I get what you're going through is political. Stay the course. You're one of the best teachers. The students love you. Stay the course." So, I have these little whispers over this traumatic time where I trust him, but do I trust him enough to show how weird I'm being with my mother? [laughter]

And so, I'm sitting there in the hospital waiting for her to come in because his clinic's in the hospital. Bottle. And she walks through and it's like the sunlight is behind her and she walks through the door and the gate doesn't look like her because she's been hobbling for a while and she's this woman's not hobbling. And she the light clears. I can see her face and it's it's not gray and it's it's my mom. It's she's alive. It's she's happy. And so we get the blood drawn and then we have to wait for the processing. So, we're in the waiting room and um and it's a long time waiting. So, let me get in the clinic in the room and I can hear them outside. "Where are the records? Call them because she lives so far away from 100 miles away. The chemotherapy was supposed to happen at a remote setting and they've got the blood work back, but they can't find the records for the prescription of chemotherapy that they've provided because we didn't go."

I said, "Mom, just." And you didn't tell. "Don't tell anybody. Just keep the this medicine. They're not going to notice. They're going to check on you in six weeks. Let's just do this for six weeks." So, they can't find the records anywhere. And she gets to the in there and I'm I know something's up either. I mean, she looks amazing. So, my my gut is saying, "Okay, the chemo was supposed to lower her numbers by like 30%." It must have done that. And so, he walks through, he's about to walk through the door. And right before she he walks through the door, I said, "Okay, mama, checking out. Just don't say anything. If he asks what the hell is going on, I don't know how to explain [laughter] this." [gasps]

So, he walks in, he sits down, and he says, "What have you been up to?" [laughter] And she looks at me and I'm like, "Not much. You've been riding your bike recently?" Like totally trying to small talk it like, "No, I mean, why are the numbers so good? I can't find the chemotherapy. What have you been doing?" And I'm like biting my lip literally saying, "I don't know how to explain this. I just got out of the newspaper headlines. I don't want to show one of my people who did say you're a good doc, you know, stay the course. I don't want to show him I'm being weird." And so we just sit in silence and we win. He speaks first and says, "Well, whatever you're doing, keep it up. Come see me again in six weeks."

And I had no place in my brain for that ketogenic diet to lower her numbers by 70%. That is that's that wasn't supposed to be possible. And well by God, now I am all in. I am signing up for do I'm going to two keto dudes is the first one I attended saying and I met Dr. Westerman there Westerman there and he did a really big. Also in this podcast. Oh, he did a really big moment for me. So he was there and I'm scared to death and like, "Don't Google me. All you're going to find is 12 felonies." [laughter] And I but I want I'm hungry. Is anybody else seeing these results? Am I crazy? And here's this Duke physician with research and a clinic that he uses the key. I'm like, "Oh my god." And I got to hear him speak and then we were having brisket or something and he sits down besides me and says, "Well, what can I do to help you in this?" And all I kept thinking is just that you that you've I mean, just being here did it. Like there are other people out there that have success with the ketogenic diet because I've got these sticky notes of how did I teach my mom? Where did she run into trouble? Where was the plateau? What am I supposed to do next? I don't have a textbook to look at. I've got to figure it out. And by now she's a year into it and is in the best health she's ever been in.

And that's when I lost a bet to my husband saying I was really sure I was right. I was very bossy. I made a bet and he says if I win this bet, you have to write that book. Is is the is the details of the bet private? Yeah. Well, you know, it's one of those places where I was really bossy and I can't even remember what the bet was. I've gone back and I said, "Wasn't this about the bet?" And he thinks it's one thing and I think it's another. So, he's. But you both agree that you lost. Oh, yeah. And the part of the loss is that you have to write a book. You have to stop what you're doing and write for four months. You can only do clinic two half days a week to get the book done. Like it can't be this playtime book. You have to sit still and write the book. And I think, oh, I I'm going to I knew I was right. I've been to that moment a few times in my relationship. I was wrong. And I wrote this book and I published it and I think like for real 12 people bought it cuz a 12-time felon. Are you kidding me? [laughter] [gasps]

And then I started putting the little lessons on YouTube and I was [ __ ] at my husband for that, too. Nobody's watching. I have like 12 followers, Chad. I mean, I've had whatever a couple thousand. And then I I one weekend I got over 100,000 subscribers. Wow. And that and then the clinic was back up and doing well by this point and I people calling all over the country trying to come see me for a ketogenic diet. Like nobody's paying for that and you you're not going to want to pay me when you see that all I'm going to tell you is to read the book. And so I'm like, "I don't know how to make a business out of it, right? I'm like, you should just do what's in the book." Yeah, [laughter] just do that. But it it becomes a thing and I start um in fact I was super frustrated with how many people wanted to come see me that you know, how do you capitalize on this? Again, I'm the weirdo in medicine. I don't need any more attention in South Dakota for being weird. Um.

Well, this is one through line is that you're interested in innovating, but it has to work, right? Right. Like that's. And um I I actually do want to get to I don't want to speed run too much because this is like. That's the hardest part of the story is to get to the part where I get to the other side. So you're you're you're on this other side. Keto's Keto is blowing up while you're blowing up, right? Your subscribers as of today, you're at a million, right? Over a million. Yeah. Yeah. Right. Your um but something about the program that you have it as it currently stands resonates with me very well in that it comes back to the scaling issue that you're talking about. The the one-on-one is important for individualized doctor-patient care, but it's actually it's for very specific solutions, right? Exactly. But when it comes to a diet and lifestyle change. I am a big believer and health coaches and nutrition coaches are the ones that turn me on to recognizing this strongly. It helps to have a group scenario. Absolutely. A group where you're not just accountable to the person leading the group bringing the program, but to each other, but importantly, that you feel that sense of camaraderie. Yeah. You feel that sense of uh accountability with each other. Right. You have the greater weigh-in and it can help to help you to deal with what so many people are dealing with, particularly when trying to adopt something like keto, which takes a lot of adherence. Right. Is that you have a lot of other people in your life that are not necessarily on board. Some may even ridicule you for it. Some may say, "Yeah, that's fine, but can you at least for this day, like just for this day while the parents are visiting and you know grandma's going to make her her pie, right? Just go along to get along." Just. And if you knew you only were disappointing one person, [laughter] the doctor, then you're like, "I'm just going to tell Annette on Monday I'm sorry I couldn't do it." But when you know you're in with this whole group and they're you're all rowing together, right? [snorts] You feel that greater sense of deep accountability.

It's why AA works, right? I mean, I look at that peak brain performance and say several of the major clients were trying to get over an addiction. How do you get a brain healthy after an addiction? What happens if you relapse? And you look at what how do you really get that patient to change a behavior? Especially in the world of addiction, they're coming from usually a life where trauma hit them somewhere and they just couldn't sweep it all back together. So, this drug helps them cope. Okay, you take away the drug, you got to figure out that coping something. Some behavior you don't have, you need. So, how do you teach an adult that? Well, they must see it. Mirror neurons in the human brain and primate brain are real. How do you how do you learn a behavior you've never seen? um you you can read about it, you can write about it, but to do it, you must see it. I'll give you my favorite example for teaching mirror neurons. So, I come from this farming family where the the men are manly men and the women serve the men and and arguing is you you don't back down. You fight, you argue, that's part of life, okay? And then you walk away and you settle it. [snorts] So, it is not an accident that the first two years of Chad asking me on a date, I said no. But I loved arguing with him. He's a firstborn male. I'm a firstborn female. And we argue. Oh, I love it. It's like one of the first boys I've been around that I couldn't win the arguments. And I would just crush them like a bug. The other ones, right? This is great. So, we are about a year into dating. Um, no, we're a year into marriage. We're in Sol we're in Park City, Utah and we are doing that thing again where we're fighting and I know I'm right and he is yelling and I am yelling and in the middle of the yelling he says, "You're right, I'm wrong." And I can feel the moment because I'd never seen anybody do that in the in the. I mean, you're going to lose the argument if you say that, Chad. You can't do that. That's against the rules. That's not how this goes. But I I couldn't even I was just speechless. I had never seen that. I remember the moment I learned that my brain saw something it had never seen. And to this day, I use those words. It's probably not as graceful as my husband uses them, but they are there. I learned that by watching it.

And when you look at people who come into the ketogenic diet, they've found food as their comfort. They found food as their crutch. God forbid it's the politics fault for the wrong food pyramid and they got addicted in the processed food in the season of the world for food engineering that they are victims of. But on top of that, they've learned if you really want to get on the other side of a ketogenic diet, the kind that you can live in and not have this, it's a struggle. They have to find themselves in the moment where Mom's pecan pie isn't the enemy. It's the emotional part that you are saying yes to when you eat it and that you're not willing to touch because it's going to cause a roar when you say, "I just can't eat that. It doesn't make me feel. It makes me feel sick." So now you're offending some. There's there's all kinds of problems there.

And and on top of that there's um and something I like to cover a lot is is it really going to just be that slice of pie? Yeah. You know, it's just like alcoholism is an excellent analog, right? Excellent. Because virtually everything that's in the book, you can apply back to food addiction. Yes. And food addiction may not be your problem, but it's probably part of the problem or you wouldn't be chatting with us. Right? If you're having a conversation about struggle with your diet after you dialed in the right macros, right? Then it's not as simple as a deficiency that you needed to meet. It's that there's something above and beyond that that you've got to address. Yeah. And it's it's um it's frustrating when we're in a culture with massive saturation of super success stories. Yeah. So the Fitfluencer online, they're like, "Yeah, I was 350 pounds and then once I did this and had this supplement, everything got better. Now I'm crushing it. Look at this. Look at how much I'm benching now and how much." And and I I probably state this way too many times, but I feel like it's never enough times. I feel like we should be celebrating the stories of people who struggle, they get up, they struggle, they get up, but they keep their eye on the prize. They ultimately find this better place and always are mindful that they might fall down again, but you know what? They're they're just not going to stop. And it may take a lot of work, but that's the real that's the more common story.

No, that's the I I still think that's that is chronic disease management. That is internal medicine 101. How do you see where the plot is headed and say, "Okay, I can show you how to stay sick. That's what this plan looks like. Unless we put a fork in the road and you can say, 'Oh, let's get that GLP-1 drug in them and everything's going to get better.' Okay, we can add a hormone and you're going to see some change, but you're going to have that same person looking you in the mirror. There's behaviors behind this disease process that you have to address. My drugs will not fix those. I can bridge you for a hot minute, but that's the best you're going to get if you don't look in the mirror. It's real."

Yeah. There's another major theme in what I've watched you discuss, not just in podcasts, but also in your videos, which absolutely speaks to me. The B. You know what? Actually, I want to bring this up again because I I I think I had this with Nick before. So, I want to see if you'll come to the same place that I did. I want you to imagine two identical twins. They live the same life, eat the same foods, etc. until age 20. One of them then falls off and lives a life that takes them towards metabolic syndrome fully for the next 30 years. Okay? They connect again at age 50, right? One is all five of metabolic syndrome. The other has been actually living a very healthy life, kept everything in check. And then for the next three years, they re-sync again towards a healthy diet and lifestyle. Three full years. They look pretty close to the same again. Are they basically the same on the inside? Hell no. Of course not. No. Not even close. No. Because one of them has gone through severe insulin resistance syndrome and even if you can recover a lot quickly, depending on your individual circumstances, right? Are you really the same inside? You have a lot of remodeling to do.

Oh, it's absolutely. I mean, the the part that really has become I think patients are become maybe it's my perspective patients becoming more aware that yes, the weight's going to come off, we can do that, but it is the 30 years of excess growth hormone called insulin that you are that you have to undo. You want to see why dementia happens in people? It's trash in your brain that you never took out. You want that trash to come out? The Nobel Prize in medicine in 2015 says autophagy is real. But it means the glucose goes down and the ketones go up. It's math. And if you don't do the math, you if you don't do that, if you only take out the trash, autophagy to your brain a couple times in a week after 30 years of not doing it, you're still going to have a bunch of trash in three years, right? Your dementia risks are still there, right? And brain is easy to think about because everybody's worried about it. But there's still trash in in your, you know, ear wax, hair. There's still trash in all of the cells. You want that life to be restored. You have to spend time undoing the trash. And you know, I I do like the hope that that 30 years of disruptive eating of high insulin. Is it reversible? And there's a whole bunch of things that I would I mean, I'd go back to the suicide. If he would have changed that at 20, we could have saved a life. But I've got the same patient now who's 50-something on the, you know, immune modulators for Crohn's and for his autoimmune disorders. And you say, "Could you reverse it?" And the textbook says, "No, it's not possible." But I have people who've reversed it. You're like, "Good job. I I don't even know how to like I'm so blown away that that advanced of a disease could be reversed in a ketogenic state."

And and this is and this is kind of my larger message on that which I think you'll agree with. It may be that it's not fully reversed air quotes. Right. Right. Is it reversed enough? Yeah. Like in the case of Nick Norwitz, he has ulcerative colitis. It's not gone. It's not as if being on keto means it no longer exists. That it exists. It's just it's effectively reversed for him. Right. Right. That correct me. His last biopsies were all normal though, right? I I would have to have him answer that question, but I think [clears throat] so. Yeah. But like for example, there's. So so let me just just play with that for a minute. So that's an autoimmune disorder and it is the antibodies exist to attack that part of his uh intestine, his large colon. Okay. So the antibodies exist. Are they attacking it? So that is disease. What you're saying by reversing the disease, does it mean he doesn't have the potential to make the antibodies? No, I'm not saying that. I'm saying is it attacking the cells? And that's the part that I did not think was reversible. Right. The So, in a sense, what we're what we're really trying to zero in on is the activity, right? The pathology activity, the root cause activity, right? Has that ceased? To the best of our knowledge, yes. Right now he does experiments. And then it flares. And then yeah, the experiments can bring bad outcomes. um it's it's and by the way, I have my own stories that I've shared on here with like carb swapping and other introductions and other perturbations, if you will, that have had inconsistent but sometimes bad effects. Right. But I believe for myself that I have some I don't know how much some portion persistent pathological insulin resistance. Yeah. Some amount. Sure. I I think once you've activated that in most adults, it'll come right back to haunt you pretty quick. Yeah. I have It's possible. I hear lots of different variations of this. It's possible I have some amount of burnt out beta cells on my pancreas. I believe it. Okay. Am I better than when I started this? I am. I've lost a lot of weight. A lot of people on the not pro-low carb side will say that's all it really is is the loss of the weight, yada yada. Um, but getting back to the identical twins, I'm a big believer in the much like what you're talking about, the trash takes time. A lot of trash can be taken care of quickly, right? A lot of times it really is. It's amazing. You can see like reversal of health like you're going to die there. I have patients where I'm like, "But I will try to help you, but all signs point to death in the next six months." And six months later, they look 30 years younger, like at least at least 10 years younger. They it's amazing how. I don't know what to tell you for the future, but keep doing that because this there is something powerful that you're supposed you're supposed the plotting line is death and you should have been there and now you look amazing. And they are taking out trash every day. They are looking at numbers in the morning. They are doing the long game. They fall off the wagon. They find a way to get back on that the numbers game saying, "Follow the math. You can do this." And you know, I do think that's where the the praise points come from that if I look what do I hope to be an influencer for in this career that's got all kinds of past history that we've just gone through. It is that you don't need to be a doctor to teach this. You sure as hell don't need to be a doctor to do it. And you can monitor yourself and teach your doctor how powerful it is to be consistently keto by by doing the one thing that physicians do pay attention to when a patient gets healthy. When you say you're going to be on this forever, you're going to do this forever and you come back and they're 60 pounds down and their numbers look good and their A1C's in the fours and you're like, "What the hell did you do?" Now you can teach a physician that I hope the career that I I lead teaches people well enough to do this thing so that we do not end up 20 years from now saying, "Boy, we had the uh Maha administration put nutrition into medical schools, but keto hasn't made the list. It's 20 years later. Nutrition's on the list, but keto is not." You know, I think you have to be on the front lines saying, "Show a doctor what it looks like to do the Nick Norwitz thing to reverse ulcerative colitis when everybody was saying you're going to die or you got to let me take your colon out." And he did it. That he gets haunted by it when he farts around. Okay. He knows how to not do that, too. That's part of it. Another part of it, though, is going back to the oncologist for your mom. Did you become a big keto advocate after that? No, he he winks and nods and he did read the book. So, but too weird, too weird. That's that's the bigger problem, right? And I and I don't say that pessimistically. I'm a big believer in the 10% rule. I'm I'm a believer that, you know, when when let's let's take smoking. I don't think that um enough of the population believes that smoking is just non-negotiable goes at 10% and then 20% the next decade and then 30% the next decade. What often happens is there's a tipping point, right? And that first 10% that gets us to the tipping point, that's actually super hard. Yeah. But then once there's enough of people you trust who are pretty intelligent in the middle and you're like, "Oh, you know, now that Dan thinks such and such, I'm starting to I'm a big believer in that." And it's I'm counting on it for my research because my gosh, the lipid hypothesis, I mean, there's so much buy-in and structure underneath it. You're a brave man to do it because it's [laughter] real. Oh my god. But I believe that it's just going to take good data and yeah, as the last year has shown us, there's a lot of systemic things we have to work against. But that said, do I think that it eventually helps to turn the tides? I think it does. Um, it it does take seeing this efficacy though. Mhm. It helps the more that this stuff not only appears in the literature, but it shows up in things like the documentary. The I I'm going to be talking about this in my speech this in the conference. By the time this airs, it'll be the conference will be over. So, I've already said it, but I'm going to draw upon everyone's interest that thank goodness for social media. Oh, yeah. Not only did it help me, you know, make this study happen, but while we need to get this good science in literature, do you think I'm counting on the the lipidologists and the cardiologists? Oh, right. To carry our research forward. You're you're counting on the grammar roses. You're counting on the people to be the food the the feet doing what you can you can teach and learn in a space that doesn't require the the infrastructure. But I'm also counting on the Annette Bosworths. I'm counting on the Eric Westmans. I'm counting I'm counting on uh the Kinberries and the Sean Bakers. I'm counting on the voices that can say, "Hey, this is good science and this is what it's showing us." And for that to get because that's the only way it's going to get out there. This is low carb, keto in particular, they are ultimately grassroots movements, the real thing. There's no there's no uh landmark study on keto where a bunch of doctors around the world were like, "I want to put my patients on a low-fiber high-saturated fat diet." H I mean, do you remember the two keto dudes? Yeah. I mean, that was one of the first. I mean, I think they were funded so that they were consistent because how else could they have just afforded to do that on their own? Maybe maybe they weren't funded, but it was just regularly talking about all of the. Oh good lord, it's a good thing you don't have degrees cuz the every institution would have squished them like a bug. It was like 2016, right, when they were talking about that, right? And it was fascinating. I was like, "Yes, this is exactly what I'm seeing, but I don't want to say it." I mean, even me, like, let let the people without a medical degree do it. let the people I mean, the people who had the space to do that and of course now it's a different game meaning you can be a physician and talk about this without the attacks. But I you know, so do you think there's a 10% hit from providers yet? Where do you think we're at? How how far away? I think we're halfway on the I think we're like 5%. I mean, look, let's look at the literature alone. How many how many papers have you seen that have in the title of the paper low carb or my favorite keto like. Oh. Have in the title and then once you get into the details, it's nothing like a low carb diet. The the standard. Oh, I've been busted by that several times looking at a paper thinking, "P, they'll bring it to me and I'm thinking headline looks good, the study was terrible." Like that's that's crap. There's nothing you can learn from that. They they weren't measuring ketones. They weren't really in a ketogenic state. They were just. One of my favorites was they were um trying to link low carb to higher mortality. And once you got into the details, you find that they were going by proportions. I think I remember this one, too. So the people with the low carb actually had the highest total calories, but the proportion of carbs was lower relative to the first the first sextile, I think, or something like that. Like, okay. But why? They get the headline they wanted. So then in all of the talks at like the AHA, so forth, you'd see that shown and I whatever, right? It's so the bottom line is, is there a hard wind blowing against keto, especially today? What do you think? I I think so in the literature right now on social media, I think that I think there's a p there's more of a push towards keto. I do too. Don't that's why I wondered like I have a better finger on the pulse of the social media side of what what they're saying. I find it very attractive. I mean, just go even back to Dire of CEO November of last year and um and then this just the momentum in that past year for the number of times I mean number two podcast in the world, I think he's done a ketogenic talk like six times. Like they almost, you know, when they got into things didn't want to have me on or they was like, "Well, you're really good candidate, but we've already had six of the keto talks in the on their podcast when they thought they were saturating the market." And of course, that came out and it did well. But the the.

point was they were worried about that, too. Like, oh, are we too weird? Is it are we too keto too frequently? But it didn't hurt those views, right? You had a huge number of views. And notably, he knew a lot.

Yes. To add to the conversation, so it's clearly top of mind for him as well.

Mhm. So yeah, I think on the air campaign, if you will, that's coming there, right?

Yeah. But it says a lot that there is so much resistance in not just the literature, but also in these institutions, right? The institutions are not big fans of keto that I've seen.

Nate, [clears throat] in fact, somebody texted me the other day that is on a medical school uh curriculum writing and said, "Oh, we got the guidelines." and she had taken my class, the 21-day class, saying, "Just watch what I would do if you were a cancer patient or or a seizure patient. Join this class." And she's like, "Well, now that the curriculum has changed, everybody's going to want to satisfy the curriculum. You should write this keto curriculum." And I thought, "Okay." The fact that she has the idea that med students would want it is well endearing maybe. [laughter] But I don't think it's gonna I think you're going to see the nutrition guidelines stay away from keto in the medical just the institutions alone they're going to call it fringe. Where's the evidence? And I think you can find it. I think Westman and you know Brett Sher those are two places where you just say just watch the literature that they quote, right?

Um, they're they're pretty good. And now, of course, my good friend and yours, Nick Norwitz.

Yes. Who is on a meteoric rise. He makes he makes so much content, high quality content so fast that it intimidates all of us.

I know. It's just when my patients say, "Have you seen what Nick Norwood says?" I'm like, "No, I I have to schedule time to keep up with [laughter] Nick Noritz."

He's he's his own CME, right?

Yes. Exactly. But that's that's a that's where I think you'll get a tipping point. I mean I'm really thankful for him to do it.

With it really adds. I can tell you patient stories. I can show you what it looks like to to what reverse chronic disease and and I really think when I see the space for other physicians to come to this place you say oh I'll never be as big as you know pick some of the influence don't do don't think that as you see patients and your experience of translating Nick Norwitz doesn't see patients. He is a science guru, but you're a primary care physician. Your influence is more than Nick Norowitz. You have a relationship with that patient, right? And you know, putting out a few little videos or whatever it is you want to do in the social world is or Twitter to say enter the space of discussion.

And your patients will come. You will see this transition. I I don't think you should be afraid to do that in today's world.

No. And it's it's time, right? Like it's kind of like there's a degree with which it was lesser known out there, but now there's enough science to back it. Be part of that 10%.

Don't you want to be able to look back and say, "Yes, I was one of those folks that was skeptical at first, wasn't myself practicing it, but because I'm a physician, right, I need to care about this."

M. So I want to get to I want to get to your program because it's the first that I had ever heard where there seem to be people on one or the other side of the fence. Either um they're like no lifestyle lifestyle lifestyle. These GOP one agonist they're they're great for a lot of people who cannot do anything with their lifestyle. Um, but frankly you really should just aim for this full stop. Don't don't do the drugs at all. Then you've got absolutely this entire generation that's like it's the best, right? Be on it as long as you have. Like there's just there's definitely a number of people are just like going to be on it indefinitely. That's just what it's going to take. People who get off it, they end up gaining the weight back and often there ends up being an even worse distribution of fat versus muscle. Just just stay on it. Stay on GLP-1 agonists. Um, the worse off you are, the more maximal your dose. And then I hear at I believe it's hack your health this new program that you have and I'm like oh my gosh this now makes sense.

Tell me about it.

So I have done it three times now which is I've done my the 21-day which is think of it as a three-week. You remember when they used to put patients in the hospital to do a ketogenic diet. It's practically that intense that if you take patients and say, "I know you think you're stalled or you're a carnivore that hasn't had that you're flatlined or you're kind of keto, but if you want to reverse medical problems, you need to be therapeutic ketosis, you're going to have to have good, I put this in air quotes, Dr. Ba's numbers, which is really the glucose ketone index, that GKI. You're going to have to have good ratios between glucose and ketones to get this reversal." [snorts] And so I just finished the eighth class of this. So let's back up to those first five classes before I added this extension class which has a GLP1. You will find people shocking themselves like I can't believe that I feel so good within three weeks of you know we put them on 20 total carbs. We get them to day seven and they're in a >> emphasis [clears throat] total carbs. Total carbs not net carbs. And then by day three we have them synchronizing to the keto mojo. So everybody in your little group of 10 sees what's your morning sugar, what's your morning ketones. So you prick your finger, you're accountable with data, and you're in a small group of changing behavior mirror neurons. And by day seven, I have them starting the 72-hour sardine challenge where the only thing on the menu is sardines. Watching to see what resurrects out of yes, you finally got your carbs total 20 under that for the first week. Now I give you a really good challenge of.

So what's their diet for those first seven days?

20 total carbs is the maximum and it's chronometer proven. Like I don't care what your glucos total carbs are and use the best app out there so that we can measure you.

Now some people come in in an eating window that they want to stick to or not. And I'm like, "Okay, do your thing, but don't go over 20 total carbs and show me your numbers." I don't care what your eating window is as long as your morning fasting numbers are at least less than 100 for glucose and your ketones should be hitting around one if you're doing if you're trying to reverse medical problems. You got to have more ketones than 0.5. Okay. So then they start they look around and they start to change behavior. And we teach some things in there like you're going to you're old. You cannot eat at 8 o'clock at night. That just isn't going to work. You got to get your eating window in the daylight hours. So some basic concepts that are taught in that time but not just taught. You have to do them. And then you find yourself at the middle of the night raging for something. And that's the part where I think you got to be in life with them to do this. You can't just say, "Go do it." So we're meeting every day, Monday through Friday with that small group, and you get a live lesson from me Monday through Friday for those three weeks. So it is a hightouch. I mean, there's like 15 hours a week that they're committing to this class. It is very hightouch, but holy [ __ ] do we get outcomes. So they do the sardine challenge. We get to see the numbers rise. They kind of go back to their eating window and then we challenge them to a water fast starting on the final Sunday of that week. Uh, 72 hours is the goal. Nobody goes above that but you everybody can get to 36 hours. So everybody does a 36-hour fast water only fast and some get to 48 and many many get to 72 hours of fasting.

And it's easier because of the fact that they're now fat adapted.

Yeah. That third week I have new mitochondria on my side and we have the data for that. Right. You can see that they come in crippled. Um, you know, one of the things I'm going to do my lecture on is to show this man who fasted for 21 days and he came in with broken mitochondria. Like, and that's the problem with his story is he's flogged the [ __ ] out of his body trying to do this. He took the maximum dose of GLP1 of Trzepatide, the good one, GLP, GIP, the combo one, uh, for two years. Didn't lose a pound and had an A1C close to 10 by the time those two years are over. Why? Because he was a broken meta their mitochondria were not they're not health they're just crippled limping along to support his body. He tries to fast he ruins a few more things uh because he's not healthy enough to fast. You need some mitochondria in there. So he starts the class and he went through the class in the fall of 2025. Um, and of course he's super disappointed all the way through. He's kind of disagreeable in many ways that at the end of the first week his blood sugars are down. He he shows up with them in the 270s and so they're down to like a two 160 or something by the end of the first week, but it takes um all the way through the 21-day class for him for his blood sugars to get into the teens. Meanwhile, instead, what he had done during the 21-day water fast before he met us was he had 0.7 ketones at the end of 21 days. That's terrible. That's what you would get if you skipped breakfast. But at the end of that um first week, his ketones were like two. Why? He's eating high fat. He first of all, just stop being so stressed out. He I mean, he was just white knuckling. I got to get better. I got to get better. And he was hopeless. His hope was gone. And like I'm going to die. I don't know what I'm going to do. I've done everything I can try. I fasted for 21 days and I didn't get results. How how is there any hope? And at the end of the first week, he's pretty good. After the sardines, he's better. And then he does a 72-hour water fast gets like ketones of five or something. I mean, really an overshoot, but who cares? That's new mitochondria. He couldn't do that at the beginning of that class. And then I had given this talk saying all right we will write you a prescription for a micro dose a small a 0.6 milligrams of trespatide if you've passed the class. Meaning if you show up to class and you never make a ketone, you're not the person I want to be. You're not you're not in the right spot. You should go to a different channel. But if you're making ketones by the end of this boot camp and you want to see me reverse chronic disease, I'll show you what happens when we use a little hormone in the state of advanced nutritional ketosis. So here he had just gotten off of like four months ago the highest possible dose of that 15 milligrams a week. I'm putting him on 0.6 like what is it? Four, the tiniest of doses. And he didn't want to take it at first. And I said, you know, uh uh his name's Dan. You know, Dan, I know you came in here pretty hopeless and you think that at the end of this you're doing better because your blood sugars are one teens and your ketones are five, but what you don't see is you've got you don't have time on your side to reverse these medical problems without some help of staying in an advanced state of ketosis. You're at least four years away of being perfect if I would say what what would be my estimate to help you feel better to get all those medical problems to go away. And at this point, he doesn't think he can reverse them. And I said, "No, I bet you can. Give me 12 weeks of this extension class where I take you out of that advanced nutritional ketosis. You cannot skip the first three weeks. I need you in a in making good ketones before that hormone goes in." But at 0.6 six milligrams he took for the next 12 weeks. And it's just so joyful because he's checking his glucose and ketones every morning. You get to see this. And he thinks nothing's happening. Well, that drug takes about four weeks to really do great things. I mean, that's a steady state at four weeks. But if I had to describe what's the most powerful part for somebody like chronic disease problem got new baby mitochondria trying to help him but now you need to make sure that that lipolysis happens that they become fat forward is what I tell the patients you need fat to be what your cells prefer to use as a fuel which means you need to stay in ketosis and what happens with chronic disease especially that due to an insulin excess over the last you know 30 years is insulin insulin resistance is going to haunt you. You You will find that suppression of ketones and the rise of the blood sugar again as your body gets used to that newer dose of insulin that you're at. It's lower than what it was. Good job. But I needed to go lower again, lower again, lower again to get you to a place where you can get off the drug. Let's hope. But you're off the drug because you you really have healed from some of these problems. Again, when he started this, I didn't I didn't know if he could heal. I mean, he's pretty sick. He's got heart failure. He's got I mean, I tell people to do a shin print and it's put your thumb on the shin bone and it shouldn't leave a dent when you push it for 30 seconds. But when I can bury my thumb in his shin, we have a picture of it where you're like, you know, we usually me measure thumb prints in millimeters. Like, can you feel it? We're measuring his in inches.

So much swelling in his legs and and of course he's tired as hell. He that the energy's I mean he's dying inside each cell and every time he tries to do something very disciplined which is fasting or you know he's failing he's failing. So tiny dose of trespatide and within four weeks you see a significant lower in that blood sugar morning fasting numbers. I mean, these are hard to reverse in somebody who's had chronically elevated diabetes. By the time he gets to the end of the 12 weeks, his morning sugars are in the two digits. I can't remember if it was like high 80s or low 90s. Um, but it's not just once, it's consistently. Um, his shin print uh at the on January 1st, you put a a thumb print on his shin and you cannot see one. Unbelievable [clears throat] reversal of chronic medical problems that again if he was perfect it would have taken me four years. He was not perfect and I mean he had a hiccup in there but his numbers uh stayed in advanced ketosis and so you say what I learned. So I've done this three times. I had that extension class three times. I'm in the third class right now. The first class blew my mind. Like stuff I would say I don't know if you can reverse that. I don't know if you can reverse that. 12 weeks later it's gone. And now the drug is gone. Uh, and they're still in an advanced nutritional ketosis. They have figured out the rhythm. They figured out how to do this. Uh, I don't think everybody quit at 12 weeks, but we had several of them run out of the medication because we gave them one prescription. We want you to go back to your primary care showing them what advanced ketosis did and then this tiny dose of a GLP-1 GIP. Uh, so they run out of the drug over the summertime and then of course we reach out and say, "How you doing? Have you gained the weight back?" No, I cannot believe how good I feel. I cannot believe how easy it is for me to make a ketone every day. And obviously, they had practiced this now for a good four months, which you can talk about behavior change, but not only is that a metabolic momentum, but they've now done that thing that you were talking about that's hard. They said no to the peon pie and they said, "No, I can't do that and feel healthy." And what's powerful when they do it in a state of ketosis with this tiny dose of GLP-1 is It's like it speeds up time for reversing of those medical problems. I I'm floored by this. I mean, two other major things that um I've written about, but I just think are stories worthy of saying how powerful this is in reversing problems and one of them is uh addiction.

Um, so the woman writes me, uh, one of the things I did when I was in that jail is I wrote an app for what would be the perfect way to screen a brain for health problems, addiction, mental health, but memory, like what's the perfect assessment to do for brains. And once a year I I show my brains course, and anybody who buys the brains course, I will do an assessment for them. And so she came into my company that way that she was worried about her brain. She must have been watching the YouTube channel. And I usually only talk about this around Thanksgiving time. And then for the month of December, I answer these questions about brains and and then they each get an assessment. So she does the assessment and she's young, like 62, and her brain's not working right. She's got a memory problem. I kind of I'm careful not to just sell my own [ __ ] right? But I'm like, [laughter] you really need to be keto. Uh, I know you came in through the brain stuff, but uh, it's going to sound like a sales pitch, but you really need to be in a ketogenic state. You have a memory problem that I can see on this assessment. And I I'm pretty sure it's from your advanced alcohol use. You've had two shots of whiskey for 40 years. You had a a rift in your childhood that is heartbreaking and terrible, but not uncommon for people who end up on alcohol for the next 40 years. And you have and your brain, yes, you have a metabolic, you've got some weight to lose, but your brain is on the edge of will I be able to help you rescue through this? I know if I tell this 62-year-old to stop drinking, she's going to have two years of depression at least, if we're perfect. But she's not really ready to admit that the alcohol is a problem. She's had it as her friend for longer than her marriages and her, you know, you know, her kids. So now she takes she does some youtubing, gets a halfass ketogenic something something. She loses 15 pounds, feels amazing, but the two shots of whiskey, she puts the 15 pounds back on. And so then the the um the boot camp comes open again. I only do it twice a year. I do it in January and then I do it again after Labor Day. So she joins the boot camp in in Labor Day. Still drinking two shots of whiskey. She takes gets in the class and does a really good job. Her ketones rise pretty nicely. She shaves off 10 or so pounds, but her glucose is reflective of alcohol use every night. Again, hard alcohol every night with husband. They sit down. This is their ritual. And good honor. She's got a good life, but you're the brain is paying the price. So in there I I do cases during that boot camp where they're real life people from class. She wasn't a case but I talked about how memory if you're trying to re if you have a memory issue and you're coming to me saying you have a memory issue. I'm thinking back to my days in the nursing home where you shouldn't when you recognize there's a memory problem we're in trouble. We are 15 years in guys. This is to reverse this. I need you fat forward to all of those brain cells for a good two years. That's hard to do when you got alcohol on board. So she she decides to sign up for the extension class and nothing happens. Nothing happens. Nothing happens. She's still got those high glucose. The ketones are kind of farting around. At four weeks steady state, that's so we that's when we should be able to make decisions on this 0.6 of tricepide. Um, we see nothing. And so we don't know. We said, "Well, let's try to go up to 0.9."

She's being upfront this whole time about still having the alcohol usage.

Yeah. And we don't scold or shame her for it. It's like her life, her choice. She's not, you know, it's not like the judge sent her to me like some of the patients were where you're going to jail if we fail.

Well, again, it's another one of those meet the patient where they're at.

Exactly. Some patients are going to say, "Look, I know this isn't recommended. This is the thing that I need to have as part of my life."

Exactly. That I have that happen with. I can't eat. I can't not eat at night. That's when I feed my kids. So, if that's where we're at, here's what you're gonna have to do. You're gonna have to fast for 72 hours a week, but you can eat with your kids those other four nights. The kind of place where she was struggling. And in her extension, she was fasting for 72 hours every week. That she would do a good job, but as soon as she would break fast, the numbers would go back to looking just like they did in the class. So, she's got a volatile blood sugar. And then we up it to 0.9. But now we are on week six of the drug. And for the first time in my career, I have never seen this before. Her husband gets home, pours the two shots of whiskey. This is the ritual they go through every night. They have supper, but she just lets it sit there.

Dave, that's not how you quit alcohol. You do not do that. That's what That's not what it looks like.

So then she goes, "So I I let it I put it I don't know what she did with it." It gets to the next day. He pours the two shots of booze and she sets there again. I just don't want it. And if a 62-year-old gives up booze after 40 years, their brain gets super depressed. They are down. They are out. They need a community of support. They need love.

They sometimes sometimes it's even dangerous.

Yeah. Oh, right. Like during COVID when things were shut down, we had a a burst of deaths related to alcoholics, right? Not being able to drink their way out of them. Yeah. Right.

So, here she is. Third night, fourth night. We don't know this is going on, but we can see her numbers. And of course, by the third day of no booze, boy, those the ketones are up, the glucose is down. We've got a great Dr. Vos ratio, and by God, she feels good. Now, here's what I can know has happened in the last year. The first attempt of the ketogenic diet cleaned up a few things. The booze probably crippled her from continuing to heal. She joins the boot camp and we get a better another crop of new mitochondria. Okay, but the booze is still crippling her. The trazepatide at four weeks starts to hit the effect and we can see this earlier than this but it's really powerful with somebody who's been using a dissociative behavior. Call it online shopping, call it um food addiction, call it alcohol, call it porn. We see behaviors change when it comes to that fourth week. So, she's at the fifth, I think it's sixth week is when this start to hit that she said, "I just let it sit there." And she's doing this on her own. The nurse checks in with her whatever it was and mentions, "Yeah, I I stopped drinking about it's now been five weeks." What do you mean you you stopped drinking five weeks ago? Like, you stopped stopped? How do you feel? I cannot believe how joyful I feel. Like that's not how this works. You're not You're supposed to quit drinking at 62, feel like [ __ ] for two years. That's what it looks like for an elder brain to stop alcohol. That's how long it's going to take me to replace that those things in your brain. If you do everything right, you're you're five weeks from not drinking. And I'm sure there was some moments where she just said, "I wonder if I can do it another night. I'm gonna put a I wonder if I can do it another night." And now she's at seven weeks when I get involved because I first say she's lying. This isn't what people do. She's lying.

House MD again.

Yeah, right. [laughter] This is not right. This This is way off the patterns. And so I have the nurse call her. No, no, I I did. I'm doing good. That week she went to a Christmas party and somebody handled her glass of wine or some sort of alcohol and she said I had a sip and I worried like like was this going to be the thing? But I put it down. I didn't want it. And I I'm now she got it all the way out to like two and a half months probably. an hour at 3 months of impromptu sobriety in a 62-year-old. And of course, what that fascinates me is you you can't do this without helping them with that hormone. GLP1 GIP is what's it's a brain. Yes, it's made in your gut, but it's in the brain that it's affecting their cravings and their drive. And she had some wounds that I think she's really tried to heal, but the habit remained. I don't I don't just I wouldn't I don't know for certain how well the wounds are healed. I don't think they're all gone in anybody, but they had to be healthy enough that she was able to say, "I don't want this alcohol. It's not doing what it was used what it used to do to me." And so here's again another I've got several other stories but the the two that I've given you are extreme illness where there should be in the nursing home doing terrifically bad performances of their brain within a year of starting that class. Like if you look at August of 2025 when they both started that class, I would have put money on the one guy being in the nursing home because of his heart failure and the other lady being in a nursing home or something similar because of her memory. And by Christmas time, they were the chains were off. They the shackle of what these diseases had done to them were off. Now they're both still on 0.6 of the medicine. And they've asked, "Well, when should I stop?" Like, "Well, first of all, you're going to take this back to your doctors because they're not going to believe you. They're not going to believe how much better you are. I hope they can see it."

It's funny how you're priming for what is the odds on likelihood, right? So, it's kind of it's it's almost like you're saying, "Listen, I already know what's likely going to come at you, and here's how you reinforce."

Right. [laughter] Right. And and to show them here here is what I mean that memory problem of that lady is is an in I mean she shouldn't she shouldn't be doing that well and she is and she is so joyous about how she's like I just I forgot I could feel this good. I mean that's a gift right. Uh, the man the man said the same thing like his his health is that good. Will they be able to stop the medication is the question. Well, I know that if it was 10 mil the the highest dose 15 milligrams No, especially if you didn't correct the behaviors underneath. I'm on the third time around. So, I've got now uh 400 graduated students uh about that. I'd say 300 graduated students out there with 0.6 treasides started after an intense ketogenic season and the reversal in the 12 weeks where we monitored them before we transferred them back to their primary care. I I will do that for the rest of my life. is so inspiring to watch how well they are reversing problems because I do think if you're not in this space of a ketogenic um metabolism, it's easy to write the prescription. I mean, teaching that for those three weeks, it's intense. Uh, I won't skip it. I think you need that. You need to have a really good sense of how to get through the next two years. And that is that group of 10. We don't charge you for that's your thing. They're on their own for that. That those groups of 10 have survived uh since the first class. And in that constant therapy, it's like their own AA meeting once a week. Show up, show your numbers, even when your season is not doing great. If we add trespatide for a season, you still need that support group to to give you the highest chances of survival after this is gone.

And don't underestimate that, right?

So the um so back to the literature. Is this a case series? Are you getting clinical trial together? Anything like that?

Oh, what a question. So the at the last low carb bokeh they they had this lecture on all the things you need to do to have a um to have a trial done or to have case series done and you got to get them all you got to get it certified. Let me tell you, it's so easy.

Are you sure?

Yeah, I'm kidding.

What the [ __ ]

So, I have been the principal investigator. I I I have a trial that I did. Yeah. You want to hear another God moment that I'll quick story? So, I did this app, right? This brain assessment app. And I wanted to prove it was better than a human. Uh, and during So, I've got this brain assessment. I think it's amazing.

When was this?

This was uh I'm I built it when I was doing those 2,000 hours in u Pine Ridge. Okay. So, I'm serving in the jail. I'm seeing how underserved they are and that they just need an assessment to say, "What the hell should you do next?" But it's taking months to get them just a stupid alcohol assessment, which is like 10 questions, let alone a really good assessment to say, "Here's what this brain needs." All right. So, I build it. I start using it. I start teaching people. And I need funded in order to get a trial done. So, I get through the university uh under a friend. She becomes the principal investigator says, "We'll hide your name. We'll apply for the grant and we'll see if we can get this tested. God, she did it. We get approval from the IRB. She then gets cancer and then I get moved into the principal position and they realize, "Oh [ __ ] we just gave this grant to her because I've got scarlet letters all over me right now." Right? Uh, and so then we need funding. Okay. Who would we possibly get funding from in the state of South Dakota? What would be the biggest irony? Where do you think I got a quarter of a million dollars to study this app as a principal investigator?

Don't know.

Attorneys general's office.

What?

It was a JAG grant because I know, right? I'm like the best and they didn't know and it was like [laughter] so

Every moment of this podcast where I'm like and that's got to be out a twist. Those are like the biggest ever. This is maybe one [laughter] of the biggest twists yet. Where the attorney general's their they approved the funding for me to test the app that I built while he sentenced me into the jail.

Oh my gosh.

It was on a reservation in South Dakota where the app was against. So they were inmates who were in jail for alcohol uh probably related, but um they had mental health issues, they had alcohol issues, they had poverty, they're brown and a bunch of white pe on a reservation. Like the number of people that were over, you know how if you have a marginalized population, you have to have a oversight. There were more people watching the oversight of that study than were doing the study. Yeah. So, but we did it. We did perfect. We didn't make any mistakes and I got to the end and the app is better than the human. It was awesome. It was great. But I have not published it yet. So, that's where I'm like I've been you get to the end and I thought and then I moved out of the state of South. Let me introduce you to my friend Nick.

Who sneezes papers out.

So prolific. Um, you've got to get it published.

Okay.

Yeah.

Okay. [laughter]

Well, it's heavy, right? And nobody pays you for this stuff. It's not The app is amazing. I love it. It's one of my little if if I have one thing on my epitaph, it's that. It's that I took this app of advanced brain assessments and made good of it. But I I left South Dakota right when the trial was done. at if I haven't quit this system I should I should [laughter] I should be a great example of you know you you just you got to we got to get in the we got to get into the literature.

So you know what I am doing. I put it in Substack. I just started saying let me start writing because it's a muscle and yeah.

I have written a paper with um with Nick um the one about the down syndrome patient. I don't know if you ever saw that. Yeah, right. So by god that was a lot of work and it was it was one case. But Nick shot cleanup the best. He was the best writer and he made me look good. So having, you know, back to to telling how what's this case story look like? How do I tell their stories in a way that I want the audience to be the people? Do I think providers are going to read a case study somewhere and change their behavior? No.

No. But this is this is where this is my pitch to the audience. This is my pitch to you.

Tell me.

Both. A got to get in the literature. Eric Westman.

Thank you, Eric. Going all the way same. I have the same story that you have except that I was on a low carb cruise. Nobody knew who the heck I was. I'm uh waiting for Sharon to come back because it was one of the buffet things and I'm holding the table while she goes and gets the first round and then I'm gonna get the second round. And Eric Westman goes and just sits down. He just plops down.

This is This is in his spirit. He does.

It's totally him. Yes. And he goes, "Yeah, your your data looks really good. You need to start thinking about getting this published." I'm like, "Oh, but I'm not a formally trained scientist and I'm not and you have the same look that I did, which is like

Writing these papers is not my, you know, wheelhouse, right? And it's fine. You work with people like Nick, you work with people like Adrien Sodtood. They're they are used to doing it. But now we have this other thing. We have LLMs.

And so the cadence of setting it up because it's not that you're having AI actually write something from fiction, right? Rather, it knows the nature of how you put these papers together. So you have the data, you have the content. There's responsible ways to have AI help people like you and I work with putting this structure together and then really you could help with just you what you want to have is still like a senior author or somebody like an Adrien Sodto who knows what they're doing they just do the last shaping up. But you get that and then you have your ultra high presence online.

Right. So that when you're putting it out there and the physician who's like you were 10 years ago is listening to podcasts is what like what is the oh well Dr. Bos is an actual doctor. Oh, and actually this is published. Okay.

It's social proof except it's more scientific proof, right? [sighs and gasps]

We know. We know. There are grants, but on top of that, there are accolades that are given to these studies that claim to be low carb.

Yeah. That are not what the community, the low carb community would ever consider to be low carb. And I'm not somebody who likes to throw loads and loads of shade, but I make an exception in this case because I feel like I don't mind when there's counterarguments made based on existing data or there's studies designed in such a way but are still at least answering the question honestly. I will say get a bit honory when I feel like science is being pushed forward. That seems at its heart to not be too forthright. So when you say low carb and you're publishing it, I'd like it to reflect what is actually low carb, right?

Your program that you're talking about, what I haven't told you is that I've had somebody tell me about it after I talked about it in a chat.

Oh.

Because they knew somebody who'd gone through it.

Oh.

And sang its praises. They said it was a great program. They really appreciate it. So granted, it's two degrees of separation.

Still. That's nice to hear.

But it does not surprise me. The late um uh Atkins,

Yes. Eric Westman, once again, the OG way back, right, in I want to say late 90s, early 2000s, studied under approached him and said, "It's great that you're putting out this book. It's great that you keep arguing with people saying, "No, this has been working for my patients, but it's not published. You need to make this published, right?"

I can hear Eric Westman saying the same words. I can feel it.

And [laughter] guess what? You're going to run into him in a few days, and I'll be like, "Tell her, Eric. Tell her." [laughter] Well, the the you know how they had the um I think it I don't know if this is true, but there's a team that's helping people like get all the paperwork in order because when I worked for the University of South Dakota, that's how I ended up with that ability to even know how to apply for an IRB in South Dakota was I was part of the university.

Well, I'm not that in Tampa. And how do you start? And I I I actually approached Dom and you know who else works there is Diamond uh is it David Diamond and when I first came to Tampa and thought can I get involved with the university and the barriers were too high and I didn't do it.

I've had plenty of success so I'm doing good work. [sighs]

Yeah. Spoiler alert in case we didn't cover this very well. Your YouTube channel is now massive. You're a massive success across multiple frames now. So if if there's a case to be made for just you know stick it out.

Persistence, right?

Yeah, persistence. Actually, you know, use one more opportunity.

Us. You already know about the advisor uh program that's uh something that's a part of our platform. I don't know if I t I did talk to you about the experiment module. The one that says here's the bundle and then you can then if you scan it and you go in. So Okay. So, I'm going to be talking about even though it's not officially released, it's in beta, but it's relevant to the thing you're talking about because I'll tell you what the master plan has been this whole time. Under owner labs, we have a module. It's in beta right now where basically a person can design an experiment.

Hm.

They design an experiment and then they use own your labs in this timeline based structure because it's presumed that you'll well not necessarily but if you have multiple tests it builds into the structure people who join as to when those windows of time are and can also collect additional survey data information all kinds of things throughout that timeline based on however the study was designed by the person or I should say the experiment was designed by the. So for example, uh one of the most common use cases is get your blood work at the beginning.

Yes. Of thing, then get it at the end of thing. Is it a we're doing it all together for carnivore month? Okay. Then it's datebased. The dates are fixed. However, when you get your blood work has windows to them. So you could choose to have it be one day has to be on January 2nd or it could be like a fiveday window and then when you start there's this other fiveday window or 7-day window or whatever it is. That's if it's fixed in dates but then there's rolling. Rolling is people can set up an experiment. Let's say that it's a 21-day experiment. Whenever you start your first day then you have a window of time at the end that's within this you know however many days of the 21st day right now where I want to take this is while it's just regular users that can set this up at first I want to partner with a private IRB ha.

So that we can rapidly get approval for these what we know are very commonplace pilot experiments that all kinds of researchers want to do. Because we have this weird this weird demand for this middle road where there's a bunch of people who are like me who are citizen scientists who like do our animal experiments. They tell other people about it. They just go get the blood work themselves. And you just trust that they're doing all the data correctly. But a lot of times you have like specific things that you want to be sure they get in their blood work and like oh no I I forgot ceptide. Like no we want to get insulin and ceptide. That's all right. Maybe you know next time around. They're like well I can't do it next time around. It took me like 10 days to organize this. But if I could just throw them a QR code for the whole experiment, right? And then the bundles already preset based on what I designed. And also I want to be sure they tell me what their weight was in the beginning and they tell it to me at the end that they tell me what their sleep levels were at the beginning at the end and it's automatically baked into the outcome.

So it gets published no matter what happens. Right? That's great. But then there's this other end which is an NIH, you know, hundreds of thousands to millions of dollars study that's around blah blah blah and all of the infrastructure associated with it. So pilot studies don't get as much action as they should, right? But often you have researchers go, I wish I could do just like 10 people. But the overhead it's going to cost me, you know, 60 80% of what budget I would need to get just to pay for the admin and to get everything set up where instead for this we we'd be serving that niche where somebody goes, "Oh, you know what? I want to do this experiment. I want to see who'd be in for it, but I do need to get IRB approval." And then if an IRB is already connected with us, knows that we're HIPPA compliant, the tees are crossed, the eyes are dotted, um, we just make sure that we get the IRB before we post it.

So then it can be posted as a legitimate experiment. We h the infrastructure is built right into owner labs.

So that people can not only sign up. I mean, I remember the.

The process for the IRB was insane. Oh my god. Yes. I mean, and I kept thinking they're going to see my name there. It's going to all go to crap and we've got a year and a half. I mean, I think the cost to just fill out and get the process for applica applying to the IRB. We had like $50,000 worth of because you needed professionals like I'll be your epidemiologist and I'll do this and I'll and so then you had to pay them. I'm like, well then but there's no guarantee you got the the IRB to do the thing, right? And then you didn't have money to do the thing. And I'm just like this is a fool's game for somebody in independent practice like not backed by a university.

So what I look, I mean, even just looking at what I, I mean, I started that 21-day boot camp outside of medical practice. This is an education-only process because I still had tales of what was h what was haunting me from South Dakota. I came to Tampa, set up the clinic, and it was during COVID. And the paperwork to get me approved had a had a tail. Who put in it? The attorney general of South Dakota. So, the the paperwork to get an up and going clinic when I first moved to Tampa took me like 18 months and it should have been like two months or something, right? [snorts] In that time is when I did that first class, right? And it is an education only because I'm like, "All right, we can teach this. We can do this at a medical like level of education, but we have them sign off on all this. This is an education program. I'm not your doctor." In that in the spirit of how do you, how do you just not waste time? I mean, because you think of the IRB and the paperwork and the oversight and the number of people saying you can't, you need this when I just said no, we're building this. The class starts in six weeks. I'm not fake newsing this. It might be the only time I do this, but I want to take 200 people through a ketogenic diet and see if I can see the pattern that you get a trickle idea of when you're when you're seeing them one-on-one. You do it in a cohort. The reason doctors like to do this is, medicine is about pattern recognition. Like this happens, that happens. I'm predicting this based on pattern recognition of a human. But you show me 200 people at once. I mean, the first time I I knew how powerful a sardine fast was is in that class going, "Holy [ __ ] look at their ketones." The day after the sardine challenge, I I was way underelling it. That's a brilliant answer. And since then, have done a better job of educating it. It helped me be a better provider. And then, is it safe for them to do a 72-hour water fast? I I I think so. Let's keep a careful eye on them. My god, if you did good on the sardine challenge, I know what's going to happen in the next one. Here's the things you need to watch out for. All based on education. This is not a prescription provided.

When we added the extension class, we have to do that under a medical liability. We had to transfer all the people into the different company. Now, that's meaningful medicine. That's the name of my clinic, meaningful medicine. We had to have them sign this and get the prescriptions in and then monitor them. And what I don't want to become is their primary care. It's a 12-week program where I wanted to see what it could do. And honestly, I did the first program when the whisper of the FDA was saying, "You're not going to be able to order these compounding drugs anymore. 15 days from now, we're going to the judge's order goes into effect that you can't do it anymore." So, we got everybody in the first class like a six-month supply for $200. And I said, "If I only get to do this once, I want to see what it does when you take these advanced ketogenic patients and you put them you it is the tiniest dose." And we didn't know how to dose it. Like I'm talking tiniest dose of trespatide. And I mean I I don't like the word microdosing because it makes it seem like you're underdosing them. When you take whatever it was 140 people and give them 0.6 milligrams of this drug and like 98% of them have wild success. Well, it's not just it's not a m it's the dose. The dose worked. It helped their behavior. It decreased their glucose. had increased their ketones and I saw that in one of those micro experiments that you're talking about now to add labs to that under you know it it's we haven't done that yet.

Yeah, it's a headache. It's a hell. No, this is this is why this is why we want to do it with the platform is it's it's the same thing with the advisor portal, right? Right. So, the advisor portal, the idea is to take that extra work that's involved in like writing a list saying be sure to get this and this and this, right? Um, also be sure you know that you get that back to me, etc., etc., right? The advisor portal that's meant to cover for nutrition, uh, nutritionists, for, you know, health coaches, but also for concierge doctors. Concierge doctors use us all the time, right? And we want to like reduce that pain point to where quite literally they could just send a link and they could say here's my here's my opening position uh labs. Just follow the link and then be sure to check the box that you you're going to share this with me. Right? And then past that point I'm on your advisor list and then you can also take me off at any point in time. Right? And I mean I think what patients often don't know is that you go to these labs as a physician that you don't make any money there. that's not your you make the money for the advice you give based on those uh labs. So then getting the patient to get them in a cost-effective way like in all of this mess I opted out of Medicare Medicaid. So whenever I would go to write a p you know um an order for somebody who has Medicare or Medicaid um I'm not on that. They would have to pay full price. So if I send them to own your labs and say just go pay the cash, it's so much less because they would have to find a provider in their area to do the thing because I'm not Medicare Medicaid and they have Medicare as their primary. So now you're back stuck in this damn loop. But in own your labs, you can say follow the QR code. If you don't want any of those, you can unselect, but there's the bundle that I recommend. Here's what you would do. And it's been it's we've just probably what four weeks into doing this. I don't know if you watch the numbers, but I think we're we just got it all figured out and

No, this is actually the first time I But I was trying to get your team connected. Yeah, because of course I Your team's amazing. They are. Thank you. They work hard. But my team is the one that built this. I Yeah. You know, [laughter] I I miss engineering. I miss software and and all the architecture.

I mean, the politics isn't wearing you out. Yeah, that's the thing, right? It's the give and take, but it's it's true. um you know kind of like why it is I could commiserate with the struggles of feeling like your practice is coming up and that's the thing that probably has the the tightest reward loop. Yes. Right. [laughter] Whereas the fact that so much on the political end has to do with the who you know and who has the power to pull what strings. It's just exhausting. Yeah. Hats off to the good ones out there who are really doing it, you know, for the love of trying to get it right. Right. But it it is true that, and I've said this to my team plenty times more, I get more excited about the dev standups where I get like read in on what's happening next. I'm like, I wish I was in there. Right. [laughter] It's the same thing when you say write these papers up and I think good lord, that's I mean, yes. I mean, it's you do sign a responsibility of, you know, furthering medicine when you enter into medical school. That's part of the part of the game. But damn, I like seeing the patients. I like the puzzle of can I figure out what they're doing and can I help them. That's a much better reward.

I know. It's a it's my letting you know it's a call to service. It's another form of service. I can package that way. You're gonna you're going to have a better sales package when you say exactly it's an act of service. Don't think of anything else. and that it's easier than it's ever been because because a we have connections. I have connections. I can help set you up, but Nick's H index can just keep rising along with his his own subscribers. Um but on top of that, you know, we have the help to get it into the literature so long as it's good data relative to before. Before writing papers, I mean, it's just it it it was much more uh top-heavy and authoritative, right? I mean, it was funny because when I when these case I said I want to my goal for 2026 is to write at least 12 really good stories about what I'm seeing because I do think it's like, if it's hidden under a under under I mean, if you watch my YouTube channel, but that's a lot of time, but if I have 12 really well-written stories about what happened, what's blowing my mind that I've never seen before, that's what literature was supposed to be, right? But we did not get an IRB. We did not do, you know, we said, "Let's teach these people how to do a ketogenic diet, and then if you graduate, we're going to move you over into medical clinic, and then I'm going to give you a dose for 12 weeks, and then I'm going to send you back to your primary care." Meaning, I I don't want to become their primary care. I think that will I will have no time for the education side, which I do think is rewarding, and I don't think I could have said that even a year ago that I would have said, "How much time in my week do I spend in the education lane versus the service lane?" And I love the service lane. That's where I get energy is seeing patients.

But you're you're so solution-oriented. Like it's exciting listening as an engineer to this doctor who seems hellbent on finding the innovative path towards this success. Right. I think an IRB crushes it. Not [laughter] I'm not going to lie. It does slow things up a lot again. But case studies I mean so you could say if these 12 stories uh you also said I mean I have the data. You should see how they're hard to write. They are like probably at least my team and I work at least 50 hours with all four of us making sure we have the data. Do we have the slides? Do we have the story right? Did we find the good moment of transformation that somebody else is going to care about the story? Like all of that is really important part of storytelling or case studying into the but yes, you should turn all of them into case studies, right? You can you could if you're collecting that much, right? Because they all have great data. It's so fun. Exactly. If you've got good data, then the first few are going to be a pain in the butt. And then you're going to have it within your own system how it is that these things can get turned out. And again, it helps the larger cause and that it makes it more searchable the right keto stories, right? Because it it is like when people one of the biggest things they say about coming into my class is, "Oh, this is the keto diet." Because they've been farting around. I'm like, you're not on the keto diet if you don't make ketones, first of all. So, you got to start there. And I don't want And if you've just been eating things with keto on the package or even my my even 20 total carbs or less when they're severely insulin resistant, I'm like, they're not making ketones anymore. You you have to stimulate the metab. Anyway, I can get on my soap box for a long hot minute.

Um, want to check in with you. How you doing? Do you want to take What time I have no idea what time it is, though. Take a guess. Uh, three. What? Oh, what time it is in the day? It's three. So, you know how long we've been going? Uh-uh. Four hours 47 minutes. No way. Yes. [laughter] Oh my god. What are you going to do with that? I'm going to pay you a I'm going to pay you a huge compliment. You ready for this? Tell me. Tell me. So, I have I've never shared this before. I have a method where I'm very mindful of my guest. Mhm. I'm looking for in my mind around an 85 to 90% operating compared to their first hour. Oh, okay. So, when And there's I'm not going to say what they are, but there's signs that I'm going, okay, this looks like about a good time to wind down, call it down. You're as animated in this last hour as you were in your first. You, if anything, you seem more like revved up. You can watch the tape. I I'm watching it in real time, right? So, if you ever wanted just need to say my husband is going to heaven for sure because he's been dealing with this for 32 [laughter] years when he says go ahead I'll take a break. [laughter] He's like I will I will concede I wanted to have at least one more thing that I was going to ask you about. Sure. I'm good. I you know me I'm good. Yes. Okay. I'm fueled by ketones maybe. So, I should say that's why I was what I was going to say. It was this might as well be an ad for you. It's like of all the guests that I've had and I still can't there's no fatigue signals of any kind. I got one more thing. Okay. If uh No, I'm good. If you're game, I'm game. Let's talk about your husband. Oh. A little bit more because you did have a recent health challenge. Damn, that's a moment. Yeah, we are in Miami and it's not our hometown, right? But we are in Miami and we're hanging out with some friends and we're 54 and 55. We are happily married with a wonderful sex life. But his friend offers him a little blue pill which is uh like the Viagra, but I don't think it was Viagra. And he goes, "Nah, nois. It must have been Cialis. That was it. I don't need it. I don't need it. Uh, you know, peer pressure amongst men." And he takes it. And when the medicine kicks in, he's like, "I can't see you in one eye." And I'm like, "What the [ __ ] did you take?" [laughter] And you Google it and there's It could be from the medicine. It's not from the medicine. I My husband has a rule that says he's been around doctors too long. If I if I drop dead of a heart attack, you're not allowed to call the ambulance. What? You're going to be dead. I'll make my own decisions, but he he you know, you cannot call the ambulance. I do not want a heart stint. You know, he heard too many cardiologists saying, "The market is saturated. We need to find a different way to manipulate the patient." They said that uh and I'm like, "No, Chad, I can do a lot of things, but I can't see inside your eye. We need to go home. We need to find a way.

So, so he's actually minimizing. Oh, yeah. It's that he's lost sight in one eye. Lost sight in one eye. Like, yeah. I have to like I have to cry in my in this male, female, strongest, firstborn relationship we have. Tears are manipulative because it gets them every time. Um, but I don't, so I don't do that. I'm emotionally distraught because I can't help you, Chad. I don't know what's going on. Does this Is it a brain tumor? You've You're one of the healthiest people I know. Uh I I can't imagine what it is. So, there's a famous eye institute about half a mile away, and we go there on a Saturday evening. Yeah, Saturday evening. I'm I was expecting you're like belining to the emergency room, right? Then that's what I mean. Isn't they take emergency visits? It was a Sunday morning. So he took it on a Saturday night. By Sunday morning, I I convinced him you got to let me take you somewhere.

So is he okay? So you guys went to sleep? Yeah. Yeah. Sleep. Yes. No, I mean I didn't sleep much. I mean I worried about him, right? But he sleeps maybe hoping that it's all fine in the morning. Yeah. Like when the drug wears off, it's going to be better. And I'm and I'm looking online saying there's a slight chance that could be it, but I don't think you should risk it. Okay. So, we get to ask Palmer. I'm not even a doctor, but in my mind, I'm already conjuring up all the possible things that Oh, [ __ ] I couldn't sleep. Right. You said, "Did you sleep?" Hell no. I got a differential diagnosis a mile long and I'm thinking, "Oh my god, how did I miss this in my husband? How did I miss this in my husband? It can't be a brain tumor. Is it MS? He doesn't have any other signs of MS." You know, I'm going through the list. Ah, what am I going to tell the kids? You know, all the things, right? God, if I am a widow, what the hell? I'm not going to do so. All that fear, right? So, did you sleep? Hell no. But by morning, I was bent like, "Honey, we need to go get evaluated." So, we go to the Baskin Palmer Eye Institute and like one of the top in the country, God plus, a half a mile away from where we were staying. And I do all the tests and first thing they do is an MRI. Is it a brain tumor? MRI is great.

Really the worst like this. Yeah. And um you know blood pressure is good. Weights every I mean I just done a I was doing an EMR check to see if all my labs were mapping correctly. So I sent him to Quest and I went to LabCorp and we both got all these metabolic labs done like 20 vials worth. Perfect. I mean he's in every way I can measure. He's perfect health. Great health. and the MRI is negative. And so then we start doing eye mapping and his optic nerve is 93% gone. He's got 7% of his optic nerve left. And so they can't they can do the test, but you got to wait a couple of days to see the ophthalmologist. Uh and it's a world expert something something, right? And by now I've spent two days in Miami trying to Google how, you know, what could it be? I can't find anything like what could have taken his eye away.

Yeah. It's because it's so acute, right? Like you'd think it would be degeneration of some kind or Right. The only thing you can find is his the pressures in the eye. You don't ever want to have your intraocular pressure above 20. That's called glaucoma. And his were hanging out at 21 and 22. No, 20 and 22. H. Okay. So, that's on the higher side. Uh, shouldn't be there, but I mean my glaucoma patients have pressures like 40 when they get diagnosed with glaucoma, not 20. So, we get to the doctor and it turns out that his wife talked him into LASIK surgery when our second child was born. Oh, and when you do LASIK, you take away the nerve sensation that the pressure within the eye can be slightly unregulated, not regulated as tightly. Now, one eye is perfect and the other one's not. Um, and it appears no visits to the eye doctor since then have left him 20 years of slowly taking away the optic nerve. And like when your optic nerve dies, the cells die that go to it. And so he's got 7% of his eye left. And it was heartbreaking. It was heartbreaking because I should have made him go. I'm really bossy. I could have made him go. Every time I wanted you, the kids get their eyes checked. I wear contacts. I got to get my eyes checked every year. You should go. And then some of the fights you just give up on. So the guilt of seeing his eyesight disappear. And so the first Substack article I wrote about was that meaning I've been wanting to write about real patient stories and what happens when your health goes off the rails. And the first one I wrote about was Chad. And the second article I wrote was also about Chad saying the thing I said at the beginning of the podcast, seven pillars of health are what 25 years of internal medicine has really done, which is how do you you can't it's not just the labs or how you eat or how you sleep. It is your soul. It is this place where you you have a relationship with God and you honor it. It is a place where you have relationships that last a long time as a reflection of health. You go through times where you are tested and you do the right thing. That's health. And I mean, give your wife 12 felonies and then without a college degree, let alone a a legal a law school degree, he runs for the attorney general, against Marty Jackley as an act of well honey, if nobody else will come to your rescue, I'll run against him. I mean, if you look at the different places in life that his health is an example to me, he wins. So now, every night I sit on top of him to put eye drops in his eyes. [laughter] And in the spirit of being happily married, it's a playful interaction where I said, "Hold still. I this is my job. I'm not leaving you in charge of your eyesight anymore. I'm in [snorts] charge."

[gasps] So, we actually go back to the eye doctor again. He thinks it's worse. Um, because this happened in October and now it's, you know, spring. We've tried to get back into the Baskin Palmer, but there's a lot of old people with eye problems in Florida. And when you come in through the emergency room, we were able to get the appointments, but the follow-up appointments have fallen through every time. And so, we now I'm going to a different place in Tampa. We're just going to say he thinks it's worse. So, we'll preserve the good eye. It's funny because everybody in the world, one of the things I do in in Tampa is a support group on Tuesday mornings at 8:00. I have a keto support group free to the public at the Pinch Chasers, which is the bowling alley. So, my biggest fear of moving to Florida was to not find a good community and uh that's a beautiful community. So, they show up and we talk about keto and they give me advice when things go wrong. Um, but the um the pinchasers have all been they want me to inject stem cells into his eye. Uh, go get stem cell replacement to regrow the optic nerve. I'm like, you get that I couldn't get him to go to an ophthalmologist for a screening exam for 25 years. that we're probably not going to get an eyeball injection any time without some major manipulation. But so I've I've looked into some of them. I looked into like stimulating the optic nerve to regrow it. Um, he tells everybody he's blind because of the keto diet. I say stop that. It's bad for [laughter] brand and it's not true.

So we found levity in in the season, but it is there's a big remorse that we had after he went blind. Um, and the truth is he'd been going blind for a long time and it was it's peripheral vision that comes with glaucoma. Uh, so he did see signs, you know, he he thinks he said it a few times in the past, but when we look at all the different places where from the left side, he's just like he has a cyber truck that has full self-driving and he is very safe with a full self-driving, but from the left side, uh, I mean from the right side there, it's right eye it's um bad. He would miss things over the last year. And that's just not like him, right? But your brain will compensate, right, when it's nice and slow and steady. It took 20 years to do that. So, I had Cynthia Thurlo on as my very first podcast guest and um she had a story of her husband minimizing and it turned out to be a very very serious illness. Um, it's actually a really good podcast, but I brought this up then, I'll bring it up one more time, which is that I think one of the heaviest health risks period is embarrassment. Oh, people feeling embarrassed. And actually, you know, heart events are one of the best examples where you're in a meeting, it's important meeting, don't bother. Yeah. I don't want to bother one even though I'm feeling some intensity. It's it's just 13 minutes until the end and you don't realize every minute counts. Every second counts. Like it's so important that you address that right away. But I could see um I could see this being a man myself. There are a lot of times where I minimize, you know, I want a white knuckle, which is like what you're talking about with the traitor. Yeah. Yeah, going back to your first example, um we think it's a matter of just toughing it out. And if we're feeling some pain, if we're feeling some struggle, hey, you know, comes with life and I don't want to share that. It's kind of I I'll feel like a lesser person if I'm, you know, whining about things, right? Especially something that um um and then you do it to your wife that's a doctor, you know, I'm going to do something about it. So the other part [laughter] of that is be careful what you tell me. I'm going to fix you. That's my job. And you know, he came into the this relationship with all kinds of metabolic health problems and he used to weigh over 300 lb. Wow. Yeah. So his health is in excellent shape. Uh it is excellent shape minus an optic nerve though. Yeah. I'm thankful it's not MS. I'm thankful it's not a tumor. and thankful it's um just one eye and yeah there's all let's keep a close eye on the other one that we have no as they say count your blessings amen right like you can there's a pity there was definitely grieving when I felt like I missed it and I did miss it uh but I also think could be worse babe there's lots of places we can say we got a we win we have a great great marriage great family great purpose we've been through a real difficult season and most marriages would have died. So even without an eye, we win.

All right, I guess that's a heck of a great place to wrap. Annette, where do people find you? Ah, well, find me um on this podcast for sure. I think it is the longest one I've ever done. That's so fun. Uh, let's hope we get them to the end. Uh, YouTube's probably the best place to start. My website's bosmd.com, but most people they want, they come in, their brains are broken. Reading and focusing and filling out forms is not their favorite. So, go watch some YouTube videos, get some bunch of questions answered. Ask chat GPT to interpret those videos if they're above your head, but hopefully they connect to the person. That's what I like to focus on. Thank you for coming on. You bet, Dave. I'm here to support what you're doing, too.