Medicine 3.0…

Last week I found myself on the other side of the stethoscope. 

After a frantic ER visit for a fractured finger, I spent the afternoon in the orthopaedic fracture clinic; this time as a patient, not the junior doctor I used to be. 

It was a strange feeling being the patient for the first time in a while and it drove home just how disorienting and impersonal our system can feel when you’re lying on the gurney rather than calling the shots.

Even though I’d once scrubbed in on bone reductions and managed broken wrists, finger fractures have never been my specialty. 

Lying there, I realised that every patient carries an invisible load of anxiety: “Are they listening? Do they understand my pain? Why must I repeat my story for the third time?” 

Some providers radiate genuine empathy but are hamstrung by 10-minute appointment slots. Others are brisk to the point of brusque, not because they don’t care, but because they simply can’t slow down.

Over those hours, I reinforced one core belief I feel is key for everyone navigating the medical system; being your own advocate in healthcare is essential. 

Here are a handful of questions I now consider standard issue, no matter which clinic or ER you walk into:

1. “What exactly is my diagnosis, in plain English please?”
   

2. “Why did you choose this test or treatment, and are there alternatives?”
   

3. “Can you show me on this diagram/model where the problem sits?”
   

4. “What are the next steps, and what should I watch for that signals deterioration?”
   

5. “How urgent is follow-up, and who should I call if I don’t hear back?”
   
   

These are very basic generic questions which would serve most people (who don’t have a medical background) well. Keep scrolling to see a detailed PDF of questions you can use for advocacy after surgery!

Things I Wish I Knew Before My 30s…

Money is a weird subject.

Everyone wants some… or more.

It’s equal parts envied, taboo, hailed and despised.

There’s a deep irony in the way we chase money: we sprint after a mirage, convinced that cash itself will fill the void inside us. 

Every time we “win” a financial lottery, the reward center of our brains perks up, but it soon adapts, leaving us back where we started. This is the hamster wheel in our neurons: pleasure fades unless it’s tethered to something more enduring than a bank balance.

So, is it wrong to want money? Not at all. 

Money is simply the most liquid form of the value exchange we unwittingly perform every day. No one parts with dollars because we’re charismatic or charming (although those help); they pay us because we’ve created something they believe is worth trading for. The secret, then, is not to chase money; but to chase value or chase the creation of that value.

Think of the artist who composes a song so haunting it rewires your emotional circuits. Or the engineer who solves a logjam in global logistics with a clever algorithm. Think of the teacher who cracks open a child’s mind, unleashing curiosity. In each case, money flows as the byproduct of value. Money is just the trail of breadcrumbs left by genuine contribution.

When you orient your goals around external rewards, you risk becoming prey to anxiety and disappointment. But when you shift your focus inward, toward mastery and service, you tap into intrinsic motivation. The prefrontal cortex of your brain lights up when you solve meaningful problems, and oxytocin floods when you help others. These are the true currencies of a thriving life.

A few life lessons I’ve learned that I wish I knew sooner: 

1. Reverse the chase. Instead of asking “How do I make more money?” start with “What value can I uniquely offer?” The money will come.

2. Measure impact, not income. Track how many lives you’ve touched, problems you’ve eased, ideas you’ve sparked.

3. Embrace the long game. Value compounds like interest; small, consistent contributions yield massive returns over time.
   
   

In the end, money is just the echo of the value you create. Make value your focus, let money follow.

The Best Beans for Cholesterol?…

Here’s a gut punch of nostalgia: …beans, beans, the musical fruit. The more you eat, the more you toot! Remember that?

But it turns out that beyond being flatulence in a can, a daily serving of beans could also play a pivotal role in helping to lower cholesterol levels.

Researchers from Illinois Institute of Technology recently conducted a 12-week trial in 72 adults with prediabetes that pits one cup of canned chickpeas or black beans per day against an equivalent serving of rice.

Key findings from the study

• Cholesterol: Participants eating chickpeas saw their total cholesterol fall from 200.4 mg/dL at baseline to 185.8 mg/dL after 12 weeks; a drop of 7.2 percent.
  
  

• Black beans v chickpeas: The black-bean group showed no significant cholesterol changes, suggesting chickpeas have something special up their sleeve.
  
  

• Inflammation: Chickpea eaters had a significant reduction in high-sensitivity C-reactive protein (hs-CRP) at week 6, although by week 12 the difference no longer reached statistical significance. Black beans, however, did produce a modest but sustained anti-inflammatory effect.
  
  

What mystical secret do chickpeas hold?

Chickpeas are not just a glob of fiber and protein but a complex cocktail of soluble & insoluble fiber (≈8 g/cup).

These fibers are fermented by our colon’s microbes into short-chain fatty acids (SCFAs) like acetate and butyrate, which help regulate liver cholesterol synthesis and promote healthy bile recycling.

Little known and lesser acknowledged chickpea compounds include polyphenols & saponins; these plant compounds can inhibit intestinal cholesterol absorption and feed beneficial bacteria.

Finally, I’d be remiss if I didn’t mention the hit of plant protein (≈15 g/cup). The protein may indirectly support metabolic health by improving satiety and moderating blood-lipid responses.

The microbiome connection

Beans are classic prebiotic fodder. In the chickpea arm, researchers are now digging into stool samples to see how the gut ecosystem shifted; tracking SCFA production, bifidobacterial blooms, and changes in microbial-derived metabolites (fancy way of saying useful bacterial poop) that might explain the cholesterol and inflammation wins. 

Early hints suggest chickpeas may foster a more diverse community of SCFA-producers, whereas black beans distribute the benefit more evenly between anti-inflammatory pathways.

Zero cooking drama

Participants ate the legumes straight from the can; no fancy recipes required. This “real-world” design underlines how easy it is to slot a fiber-rich bean cup into your lunch (and how un-funny the resulting gas may be).

If you’re worried your arteries resemble a cholesterol sludge pit, you could consider swapping that rice side for a cup of chickpeas and let your microbiome work its magic. Just be prepared to warn your coworkers about any “musical chairs” episodes in the breakroom. And if you’re in the black-bean camp, don’t despair; they still help quell inflammation, even if they can’t have as great an impact on your LDL cholesterol.

P.S If you want to learn more about the gut, microbiome science sign up to my newsletter dedicated to bring you short, snappy actionable tips on this:

P.P.S only sign up if you’re really obsessed with gut stuff and the microbiome!

Cancer & Exercise

Is exercise is medicine…?

Well wait till I tell you something pretty mindblowing…

In what may be one of the most practice-changing studies of the decade, a Phase III randomized trial has shown that structured exercise reduces colon cancer recurrence by 28% and reduces all-cause mortality by 37%. 

The trial; enrolling 889 stage III colon cancer survivors across the U.S., UK, Australia, France, Canada, and Israel between 2009 and 2023; randomized participants to either a three-year supervised exercise program (n = 445) or a one-off “healthy lifestyle” booklet (n = 444) (PMID 40450658).

Exercise arm: Twice-monthly supervised sessions with a certified trainer for year 1, then monthly for years 2–3

Home target: 3–4 brisk “walk-equivalents” per week (45–60 min each), delivered in any modality patients preferred (cycling, swimming, etc.)

All the participants were followed up for a median of 8 years.

Key outcomes:

• Recurrence/new cancer risk ↓28% at 5 years in the exercise group versus control
  

• All-cause mortality ↓37% at 8 years among exercisers
  
  

These reductions are on par with (or exceed) many adjuvant chemotherapy regimens, yet come with zero pharmacologic toxicity.

The science behind the sweat

Exercise exerts multi-layered anti-cancer effects:

1. Modulating insulin & IGF-1: Physical activity improves insulin sensitivity, lowering circulating IGF-1; a growth factor implicated in tumor progression.
   
   

2. Anti-inflammatory cascade: Regular moderate-vigorous exercise downregulates pro-inflammatory cytokines (IL-6, TNF-α) while boosting anti-inflammatory mediators (IL-10).
   
   

3. Immune surveillance: Movement enhances natural killer cell activity and cytotoxic T-cell function, sharpening the body’s ability to patrol for residual cancer cells.
   
   

4. Gut microbiome (my fave obviously): Exercise shifts gut microbial communities toward SCFA-producing bacteria, which reinforce intestinal barrier integrity and suppress oncogenic pathways.
   
   

Could this shift global guidelines?

With hazard ratios rivaling many drugs and no serious side effects (except sweaty underwear), it’s hard to imagine that clinical guidelines won’t soon elevate “exercise prescription” to the standard of care for colon cancer survivors. 

“Exercise is medicine” is no longer a slogan but an evidenced based survival strategy.

P.S For deeper dives into medical and health topics check out my podcast here:

Fruit Juice & Fatty Liver…

You may have come across various fear-mongering headlines about the dangers of fruit juice, smoothies and eating fruits in excess and the “sugar load”.

Whilst there are kernels of truth in many things you read about online, the science is often what separates sense from fear.

When you sip a soda, candy-sweetened tea or a glass of fruit juice, you’re delivering a quick blast of fructose straight to your liver. 

Unlike glucose; which must pause at the enzyme “checkpoint” (hexokinase) in cells throughout your body… fructose meanwhile slips past unnoticed and lands almost entirely in the liver. There, enzymes frantically convert the excess sugar into fat, setting the stage for nonalcoholic fatty-liver disease (NAFLD).

BUT (this is where the nuance comes in to save the day!) whole fruit tells a very different story. 

The soluble and insoluble fibers in fruit pulp act like a drip-feed system, slowing fructose’s entry into your bloodstream and creating a feeling of fullness that naturally limits how much you eat. 

When you strip away the fiber; by juicing or concentrating fruit into syrups… you’re essentially gulping down a high-octane fructose cocktail that ambushes your liver.

A large multicenter European study of 24,000 adults found no harm… and even a slight benefit when fruit-juice intake was kept below two 150 mL servings per week. Above that threshold, NAFLD risk climbed, mirroring what’s seen with other sugary drinks.

So practical takeaways for you:

• Chew, don’t slurp. Prioritize whole fruits to harness their fiber and plant polyphenols.
  

• Choose wisely. Berries, pears and citrus pack a low glycemic punch and rich fiber content.
  

• Moderate juice. Treat fruit juice as an occasional treat; keep it under two small glasses per week.
  

• Diversify. Rotate your fruit choices to access a broader spectrum of protective nutrients.
  
  

Eat With Your Hands…

There’s something primal… and profoundly human about eating with your hands. 

Long before forks or chopsticks, our ancestors foraged, kneaded, and broke bread (or tubers, or fruit) with their fingers. But beyond cultural nostalgia… science shows that our hands are cued into digestion in ways that silverware can’t touch.

1. The cephalic-phase:

As you pluck a morsel with your fingertips, tactile receptors in your skin and mechanoreceptors in your fingers fire a rapid-fire signal up your sensory nerves. 

The brain interprets “food incoming,” and the cephalic phase of digestion ignites; saliva flows, stomach acid ramps up, and digestive enzymes like salivary amylase enter the mix before you even bite. Studies show that this early “prepare-to-digest” response improves nutrient breakdown and can moderate post-meal blood sugar spikes.

2. Enhanced flavor through haptics

Texture is a cornerstone of taste. Haptic feedback… our perception of pressure, temperature, and shape deepens flavor perception by integrating touch and taste in the gustatory (taste region in brain) cortex. When you feel the graininess of millet or the cool slickness of cucumber on your palm, your brain weaves a richer sensory tapestry than it does with a fork. So food tastes more vivid and more memorable… and you tend to eat more mindfully, chewing slowly which is also better for gut health.

3. Microbial cross-talk 

Our hands host a community of microbes that overlaps with gut flora. While hygiene is paramount (wash before you eat!) gentle transfers of benign skin bacteria may actually seed our digestive tract with beneficial strains, subtly bolstering microbial diversity. Early research suggests that greater microbial variety correlates with more robust gut barrier function and resilience against pathogens.

4. Mindfulness and satiety

Engaging your hands keeps you present. You become acutely aware of portion sizes, temperatures, and textures… and you’re less likely to rush. This slower pace gives your vagus nerve time to relay satiety hormones (like cholecystokinin and peptide YY) back to the brain, so you stop when you’re comfortably full, rather than when your plate is empty.

Easy practical tips:

1. Wash thoroughly, but don’t sanitize into sterility. A gentle soap rinse preserves beneficial skin microbes.

2. Start small. Try finger-friendly foods… grilled veggies, sushi, flatbreads… before plunging into steak with your bare hands (maybe do this at home only!)

3. Savor each bite. Notice how texture’s sticky, crunchy… enhance taste.

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