Part I Jeffrey Bland Bastyr Lecture June 2009

Improve function. And so I'm kind of an interesting foot in both worlds because I have this foot. Having known as I'll go through the pioneering fathers and mothers, I didn't really recognize at the time that I was kind of, as a young man, mentored by them. And now that they've all deceased now, I think my responsibility is kind of transitioning this knowledge over to the next group of people, which are you all that are going to take this in the way that you feel appropriate in the future in your practices. So that's kind of my role, as I've seen now, having reviewed this material, lots of Long island introduction to what they're here, but now I'll get into the material. So, you know, what we are all at right now is a really remarkable transition in healthcare. And this part that I'm discussing with you this evening is a small part, but not an insignificant part of the overall philosophical that's occurring right now. Philosophical change. I, I would call it even a paradigm shift. Use Thomas Kuhn's language in healthcare. And so when I was in Montreal recently, I had, I was at McGill. And as you know, McGill is this incredible legacy of discovery there. Ponce elie, being a McGill professor, probably the most singularly important discovery in health sciences and medicine in the last hundred years. You know, compounding the term or appropriating the term stress from physics over into physiology. In fact, if you do a Google search on the word stress as it relates to medicine, you'll find that it is the most often cited single term called medical lexicon today. It's really kind of a tragedy that he never won a Nobel Prize in medicine and physiology. There's probably a reason for that, which I could go into if you wanted to. But he certainly would be considered one of the pioneering discoverers of this field that we all share now, the mind body connection, the relationship of adrenal fatigue and stress and how that relates to a whole variety of diseases. So. So it was very different than the Pasteur model of disease. Remember, Louis Pasteur had this vector disease model. A bug creates a disease, so you have a pneumococcus bacteria, produces a disease called pneumonia, for which you have a drug called penicillin. And that model was a very, very viable model to birth pharmaceutical medicine, wasn't it? A bug produces a disease which produces the need for abra. And so that is kind of a simple model of disease that probably everybody could memorize. If all diseases were that simple, we'd all be great doctors because we could probably just Know the disease, know the bug and give the drug, everything would be fine. But unfortunately, that model had a limited applicability to the complex metabolic disorders like diabetes or cardiovascular disease, or arthritis or digestive disorders, or attention disorders, or depression or dysphoria or. I mean, the list goes on, right? These chronic age related dysfunctions are, are much more complex, not produced by just a single bug, producing a single disease for which a single pill will treat them. So Hans Selye really got us to recognize that a interaction of that person with their environment would create a resonance in their body that was either functional or dysfunctional, resulting in either health as a trajectory through their life as they travel through their life or disease. And the disease that they got was not always the same disease. Some people got peptic ulcers, some people got heart attacks, some people got hypertensive disorders with stroke, some people got atherosclerosis. So the diseases were multiple from a single connection of environment of that person to their genes to create an outcome called their phenotype. Right. So that's a whole different model of disease than a bug causing pain disease to produce the need for adref. Am I okay so far understanding that kind of difference? So this is a major shift in thinking that occurred with Celia. And it's actually now all these many years later, which is now 70 plus years later. It's still hard selling medicine, isn't it? Because it seems soft, that somehow stress or environmental perturbations could translate through a body in such a way over decades of living to be associated with the outset of a disease. And because we like to find the cause of the disease rather than the environment, the ecos of the disease, ecos being the home of the disease, the ecology of the disease. So this little thing I'm going to show you was very striking to me because I got up early in the morning, it was a beautiful morning in Montreal, and I was going to go for a run and I could see the campus up there with the grounds. And I thought, I'm going to run up the campus and run around the campus and, and really give touchstone of this incredible intellectual legacy. And as I was running up the main street there, up to the campus, lo and behold, I came upon this sculpture, the illuminated crowd. 1985 was the year of its production. And I thought, oh my word, like I'm being touched this moment by a very, very important metaphor. So what is the illuminated crowd? This was Raymond Mason. A crowd is gathered facing a light, an illumination brought about by, I'm Going to call it an event, a new idea, right? In culture, that's a metaphor. I'd like you to hold on because I'm going to show you the sculpture here. Right, So a new idea, an idea that people never thought of before. An idea that doesn't seem reasonable at first. An idea that actually challenges the paradigm of the time or the mindset of the time. An idea that requires a different kind of conceptual framework from which you would see your own universe. Okay, so that's the context of the sculpture. Now, what does it look like? It looks like this. It's a very, very fascinating representation of these figures that are bigger than life. This is a little like the sculpture garden in Norway for those of you who have ever been to Oslo, to the famous sculpture garden. The difference here, however, is that these figures represent a specific response of society to an illumination, to a light looking into a new idea. So what do you see right at the front of this assembly of people? You see people with great amazement, receptivity to the idea, pointing, looking, their expression saying, wow, look at this new way of looking at the world. Or look at this new concept. This is really great. But as you move back in the crowd, towards the end of the crowd, what do you see? You see that idea becomes deluded. And the people start eventually at the end of the crowd, which I'll show you in a moment. As we move back towards the end, they start developing chaos. The chaos of no clarity, the chaos of confusion, the chaos of, well, life is tough. It's filled with famine and pestilence. And the light never gets back to them. Right? The light never gets back to them. It only gets through the first couple of layers of this crowd, the illuminated crown. So when you get to the very back of the crowd, here's what you see. You see all the back end of the things that we don't like in the world. The inhumanity, the pain, the suffering. So that the question that is raised by the sculpture, at least to me, as I was running up to McGill to think about Cellier, was, oh, my word, how do you make the light bright enough to radiate through the whole crowd? How do you get infect a society with an idea that creates the transition of belief into something that will have a greater opportunity to reduce human suffering, to produce better health outcomes, to realize human potential so that it's not wasted with people that are ill health and low energy and fatigue, and all the other things that come up that steal from us are vitality. So that was the sculpture. Now maybe you on that morning walking with me would not have had the same impact. But as Pasteur once said, when asked how did he come up with his idea about bugs creating disease, he said, well, chance favored my mind for this observation.