BYRON HINTERLAND RETREAT - Circadian Living by Regenerative Health Retreats

Episode Transcript
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Speaker 1 (00:00):
In this episode of the podcast, I speak with Dr
Gary Fetke.
Gary is a retired Australianorthopedic surgeon whose
selfless efforts to improve themetabolic health of his diabetic
patients withspecies-appropriate nutrition
was met with fierce andsustained attack over a number
of years that almost resulted inthe loss of his medical

(00:22):
practice.
In this episode we discussGary's story, his perspectives
on healthcare and medicine today.
A reminder that you can see DrFetke live in person at
Regenerate Melbourne on Marchthe 23rd at 75 Reed Street in
North Fitzroy.
For more information and tograb some tickets, follow the

(00:44):
link in the description below.
Enjoy this episode with Dr GaryFetke.
Gary.
Thank you for joining me.

Speaker 2 (00:51):
Pleasure, max Good to catch up again.

Speaker 1 (00:53):
Now maybe you could explain for my audience the
series of events that kind ofbrought you from you know, maybe
euphemistically just arun-of-the-mill orthopedic
surgeon, maybe euphemisticallyjust a run-of-the-mill
orthopedic surgeon practicingclinically, to becoming what I
believe is definitely acelebrity doctor in some niche
circles.
So can you break that down forus?

Speaker 2 (01:19):
I've got a golden toilet brush over my shoulder
there which explains my entireorthopedic career.
My registrars gave it to mebecause I have it very proudly.
I thought what on earth arethey giving me a golden toilet
brush for?
But they'd actually said that,effectively, my practice was
cleaning up everyone else's poo.

(01:42):
So whenever the worst patientsand the most complicated
patients seem to come, you know,across my way and you've seen
that thing where people say, oh,can someone volunteer to do
that, all those who can help outstep forward.
And then I just found out fordecades that my colleagues just
kept stepping back and mycolleagues just kept stepping

(02:03):
back.
So I had a practice of takingon the most difficult problems
on a weekly basis and part ofthat was diabetic foot
complications.
So here in northern Tasmania,ultimately I said, okay, I'll
see what we can do for them,because they're just like a
leper colony scenario Don'ttouch them.

(02:26):
Don't touch them whatever.
I mean without being too crude.
Right at the beginning there'sa fungating smell of dead flesh.
And you know, at your clinicthere my clinics were called
Fetke's FDAP, fructose-free,fungating Foot Folly Fridays.
I never found out what the FDAPmeant, but it was very much

(02:51):
that I had.
You know, if someone got a deepinfection in a joint
replacement, they often end upin my clinic or in my practice.
I was doing a lot of salvagework salvage trauma, salvage
infections and with that comessalvaging.
I've tried to salvage diabeticfoot complications and over the
years I've always embracedsomewhat new techniques and

(03:15):
interesting techniques.
But then what was originallyjust an occasional case of a
diabetic foot complicationamputation toes, amputation leg
just literally became a tsunamiand it was well and truly beyond
my control to manage all of thecomplications.
So, essentially, if you come upwith, if you're overwhelmed

(03:37):
with the complications, you comeback to the root cause analysis
.
And if you can come back to theroot cause analysis and I think
, which is that you know I'llsimplify it easily If we
actually put the wrong fuel inour cars, the cars are going to
run poorly.
And if we put the wrong fuel inour bodies and we complicate it
by the way we run our cars andrun our bodies, then all of a

(04:00):
sudden we find out that you getcomplications.
So I'll state that diabetes andobesity are lifestyle-related
conditions, primarily related todiet and other consequences
which we can delve down, butprimarily related to diet.
So, essentially my crime in thesystem was that in 2012, 2013,

(04:27):
so a fair while ago I came upwith a nutritional model of
modern disease just a hypothesis, where I looked at the basics
of the biochemistry of the foodwe eat.
And so that, in a nutshell, wasthat the combination of sugar,

(04:48):
refined carbohydrate andpolyunsaturated seed oils
creates inflammation in everysingle corner of the body.
Every single blood vessel,every single cell becomes angry
and inflamed.
We can add on to that otherlifestyle things that have you
know, cropped up over time, butthe modern, standard Australian
diet, the SAD diet, the moderndiet, is in fact, an
experimental diet which has onlybeen with us for most

(05:11):
particularly the last half ofthe 20th century.
Maybe started being introducedat the beginning of the 1900s,
but nonetheless it's been anexperiment which has been an
abject failure.
So by simply doing the oppositeof that cutting back on sugar,
cutting back on refinedcarbohydrates, getting rid of

(05:32):
the seed oils, putting proteinback into the diet, complete
protein, which is ananimal-based protein I was able
to turn around the health ofthese people's feet literally by
prescribing in hospital eggsand cheese, you know, incredibly
dangerous.
And the further I went down thatpath, we realized we can

(05:54):
actually reverse diabetes, putit into remission, and so I
started talking about the perilsof sugar.
And then I can still rememberBelinda, my wife, who's speaking
in Sydney and she's well knownin this field as well.
She said, oh, you've got to geton this thing called social
media.
You've got to get on Facebookand start telling it.
So I quickly developed a littlewebsite called nofructosecom.

(06:20):
I ended up on this thing calledFacebook and within 48 hours I
was targeted by a representativeof the Coca-Cola industry.
He was targeting me and callingme all sorts of interesting
things and, because I'm anorthopedic surgeon, one of the
great things about being asurgeon is that you're stubborn

(06:42):
and arrogant, I suppose, is theother thing.
So when you actually thatyou're stubborn and arrogant, I
suppose, is the other thing, sowhen you actually realize you're
right, you're going to stick byit.
Well, I did so the more Ilooked into this topic, which is
now almost commonplace.
But I can tell you, in 2010, 11, and 12, when I was starting to
put this model together, it waswell and truly on the outside

(07:03):
of the spectrum of what peoplewould be looking at, and
certainly not in the realm of anorthopedic surgeon to be
looking back at biochemistry.
Anyway, I started talking aboutit publicly, started trying to
actually look at hospital foodand point out how bad it was,
and the more I became notoriousin that field for speaking out

(07:26):
about it, the more I becametargeted.
And so, by 2014, and we've gotall this on going back in time
and getting hold of all sorts ofinternal data I was targeted by
the breakfast cereal industryin Australia for my actions

(07:50):
because their breakfast cerealsales were down in Australia and
New Zealand and these sevenpeople were to be targeted
against them and I was the onlydoctor on that list and they
were in a paid relationship withthe Australian Diabetes

(08:11):
Australian DietitiansAssociation and they had KPIs to
promote the benefits of sugarand cereal to the Australian
population.
Bearing in mind, these are thepeople writing the dietary
guidelines who are involved inthem, and so it wasn't long
before I was reported to APRA,the medical board, for being

(08:32):
dangerous and working outside ofmy scope of practice.
I ended up being reported threetimes.
Each time we know it was adietician.
One of the times I got reportedbecause I inappropriately
reversed someone's type 2diabetes on national TV.
It's called the SavingAustralia Diet on Channel 7 on
the Sunday night program, theSunday program.
Anyway, we turned someone'sdiabetes around over a period of

(08:54):
several weeks.
It actually didn't take thatlong, but nonetheless the
program ran over several weeksand so I got reported to the
medical board for actuallyinappropriately being involved
in managing someone's diabeteswithout drugs and with just
purely a lifestyle intervention.

Speaker 1 (09:11):
I mean, it's a Kafkaesque charge, really, isn't
it?

Speaker 2 (09:16):
It was, but the trouble is the medical board
were taking it seriously.
They ended up getting anutritional expert one of the
biggest leaders, know leaders inaustralia and the world to
actually give evidence and hesaid it was outside of my scope
of practice.
He, however, failed to declarethat he was actually working for

(09:37):
the breakfast cereal industryat that point in time, which
opened up a whole pandora's box,of which Belinda's, I'll say
the world expert.
On opening up that box and then, saying so, finding out who are
the vested interests shapingour dietary guidelines, who are
the vested interests shaping ournutritional guidelines, our
diabetes guidelines?

(09:58):
Most of the medical guidelinesin the world, not surprisingly,
have been manipulated and thereare vested interests in it.
And you can chase it back tobig food and big pharma, sorry,
pushing a plant-based agenda,pushing a pharmaceutical agenda
to try and get us hooked ondrugs for a lifetime, for a

(10:20):
lifetime of profits for thesecompanies, when the primary aim
is to actually give themlifestyle-related management.
And if we just so, essentiallyif you did the opposite of what
I'm talking about, which is goback, get rid of this industrial
diet that we've got, move backto an ancestral diet, a diet
that we actually were meant toevolve on or which we did evolve
on.
Then, all of a sudden, it comeswith this enormous amount of

(10:43):
health and wellbeing.
And the more I got into trouble, the more study I did.
I virtually did a PhD involvingnutritional biochemistry, which
isn't taught to us in medicalschool, started looking at the
physiology of healing, and allthe time this is starting to

(11:04):
grow in momentum to the factthat, yes, there's low-carb,
healthy-fat keto diets.
There's more and more researchcoming along showing the
benefits of a lifestyleintervention, which are, in fact
, far more powerful than thepharmaceutical ones.
But, not surprisingly, you comeup against more and more
blockades.
There was blocking of research.

(11:24):
I couldn't get anything throughan ethics committee.
I couldn't work out why until Ifound out that the person on
the ethics committee wasblocking it was best friends
with the head of dietitian atthe hospital and just go.
So I mean the story went that,essentially, I was reported
three times to the medical board.

(11:44):
I was threatened to have mylicense to operate taken away
and ultimately they came outwith a ruling saying that I
wasn't allowed to talk about it,even though I was getting
patients that were gettingbetter and getting control and
getting healthier, and blah,blah, blah, coming off
medications, deprescribing.

(12:05):
And so when that announcementcame out it literally was just
after I'd presented to a Senateinquiry about the failings of
the medical board and the wholeAPRA process.
I felt that I was intimidatedand harassed.

(12:25):
So I actually reported themedical board for harassment and
they were actually found guiltyof that.
And then ultimately, throughthe National Ombudsman and five
years of stress and pain andfinancial cost, that enormous
amount of stress to the family,the National Ombudsman saw that

(12:50):
my case needed to be reviewed.
It was reviewed and it wastossed out in four weeks and
then I was given an apology.
But by this time the cat's outof the bag that if we have
continued down this path of anultra-processed food diet, then
we've, not surprisingly broughtupon our sickness and poor

(13:12):
health.
And so I've in fact gone up anddown from that point of
nutrition and in medicine and soI've got this keen interest
slash, understanding right backto regenerative agriculture.
And looking at you know, Idon't know if you've heard you
know, half quoting Roosevelt andextending it, but the health of

(13:35):
the people depends on thehealth of the food.
The health of the food dependson the health of the soil and
it's linear.
You know it's all involveduntil you actually accept that.
So we ourselves live on someacreage and I've got the chooks
out there and the sheep.
And I went and got my gunlicence in case of Armageddon

(13:59):
because I need to have myanimal-based proteins and fats.
I need to have my animal-basedproteins and fats.
But at the other end we'velooked into the vested interests
and the guidelines, not justhere in Australia but in New
Zealand.
We've been involved in tryingto rewrite the dietary

(14:20):
guidelines.
In the United States I'mcurrently involved in trying to
change things in diabetesmanagement for the Nordic
countries and we have been ableto achieve now that low carb or
therapeutic carbohydratereduction is now in the National
Diabetes Strategy.
It's been adopted by theAustralian Diabetes Society and

(14:43):
Diabetes Australia as bestpractice.
So it's taken 15 years for whatwas just flamingly obvious that
you can reverse people'sdiabetes in a couple of days,
get them to avoid most of thecomplications which they're told
they're going to have.
You know they're told they'regoing to have, and all it

(15:03):
required was an animal-basedcomplete protein, complete
healthy fats, completemicronutrients, minerals and
vitamins.
And you know great surprise tome we actually don't need
carbohydrate, despite all themyths of our dietary guidelines

(15:24):
saying it should be 50%.
You know, and all theadvertising and literally the
propaganda that's been shoveddown our throats at a
biochemical level because that'swhere you can't argue with any
of this stuff, and I know you'redoing the stuff at a

(15:44):
biochemical, cellular level withthe light therapy I'm talking
about it from a nutritionalaspect, at the cellular level.
At the biochemical level, youcan have an opinion as to
whether or not you and I areright, but if you can't argue
against us at a biochemicallevel, that's just the facts.
Thanks for your opinion, butthese are the facts and so over
time I go through differentpoints when I'm a bit more

(16:05):
passive and a bit moreaggressive.
In some respects I'm almostover it.
In that it's up to you.
The information is there.
You know we're in a Westernworld, we're in Australia.
You've got access to goodinformation, good science.
You've got access to good food.

(16:25):
You've got good access to goodinformation, good science.
You've got access to good food,you've got good access to local
farmers, local suppliers, andwe either do all of this and
turn around our health tsunami,our sickness tsunami we embrace
this or we're screwed, and so Idon't feel as though this is.
You know, I actually ask peoplewhen they say, oh, have you

(16:47):
heard of low-carb, have youheard of keto?
Oh, can you buy low-carb beerthere?
And I say yes and I say okay,so we're winning.
The public are aware of it.
Now we need to let the publicknow that it's actually best
practice not to eat crap.
Yeah, it's incredible, I meanthat's a long answer to it,
sorry.

Speaker 1 (17:08):
No, no, that's where I think that provides very good
context for your story and forpeople to understand your
perspective.
I want to ask you about theprocess and specifically
reflecting back on what I canimagine was an incredibly
stressful and all-consumingprocess, especially the
uncertainty of it.

(17:28):
So, looking back on everythingthat you went through, it really
seems like attacking you wassome kind of hail Mary by these
entities in the face of whatseems to be an inevitable push
towards a species-appropriatenutrition.

Speaker 2 (17:50):
I think I mean I'm not the first person to talk
about carbs and processed food.
I think what hit home to theindustry that were coming after
me is I wasn't a celebrity chef.
I wasn't a celebrity chef.
I wasn't a media personality.
I was a surgeon that wasactually just sick and tired of
amputating bits of dead fleshand that had some resonance in

(18:16):
the public, and part of mydownfall was that I was on
social media.
But the saving grace for thatis that it raised awareness of
the situation.
I'm indebted to all the peoplethat helped myself and others
raise this topic up, becauseit's actually people power that

(18:39):
will actually have taken thisforward.
I'm yet to see.
You know, like the College ofGPs just came out with their
latest guideline developmentguidelines for diabetes
management and, despitetherapeutic carbohydrate
reduction being in the nationalstrategy and adopted by the

(18:59):
Diabetes Society and DiabetesAustralia, they've got it way
down.
Age 100 or whatever.
It's mentioned a couple oftimes sort of as some
experimental thing.
It's just complete BS.
It's not experimental, it'sunbelievably effective.
I've got people who actuallysay they don't have diabetes
when they're at home becausethey're following a low-carb

(19:20):
diet and they've got diabeteswhen they go into hospital and
they've got diabetes when theygo into hospital.
It's just, you know it's.
And so our hospitals, whichshould be pillars, of example,
will just abject failures onthis, and this is one of the
criticisms I kept on coming tothe hospital.

(19:41):
So show me the protein forbreakfast.
Just show me when is theprotein.
Oh, it's in the milk.
So show me the protein forbreakfast.
Just show me when is theprotein.
Oh, it's in the milk.
I said that's not protein,that's a tiny bit of you know
less than a gram of protein thatyou're going to get.
Someone probably needs 80 to150 grams of protein per day.
Where is the protein?
Where is the protein at lunch?
Where is the protein at dinner?
Because it's not coming in theice cream which you're

(20:06):
recommending three times a day.
It's not coming in the biscuits.
It's not coming in the cake,not coming in the chocolate
drinks.
It's just not coming in thefruit juice.
Where is the healthy food forpeople to get better?
And if that's the example weset to people in society, when
they come into hospital, theytake that home.
I got criticized.
I used a slide once where Ispoke to the whole national food
industry, the nationalhospitality industry for

(20:31):
hospitals, nursing homes,prisons.
And my second slide washospital food is unhealthy.
It's killing my patients.
Is hospital food is unhealthy,it's killing my patients.
Anyway, I got reported to APRAfor that one as well, because
they then audited my practice atthe hospital to find out how

(20:52):
many people directly died fromthe hospital food.
And I said it was a figure ofspeech if you set the example.
But nonetheless, the systemcomes down on you quite hard,
apra, in their wisdom act.
I was asked to come back andspeak again to the National Food
Body as a plenary speech and aweek before that, apra asked for
a copy of my talk before I gaveit.

(21:14):
So I sent them an email I saidjust to clarify you want me to
provide a copy of my talk beforeI give it Because they're
investigating me.
So I mean, where's free speechin Australia when it's starting
to be actually overlooked by theregulators?
So I think there are scarytimes.

(21:37):
So as a result of all of that,you know I might be retired from
my clinical practice.
So I'm still not retired frommedical practice.
I'm still heavily involved inguideline reform.
As I say, we're trying to helpout the Nordic countries for
changing the ways that we'veactually been able to change
things here in Australia.
But I also do a lot of supportfor people who are actually

(21:58):
getting caught up in the APRAprocess and if I have an
argument, I don't know a lot.
Most people don't know how bigAPRA is Australian Health
Practitioners I've forgottenRegulatory Agency.
Regulatory Agency I was about tosay Reform Agency, but

(22:19):
Regulatory Agency agency theyhave nearly 800,000 members
doctors, nurses,physiotherapists, paramedics,
ambulance officers and that's asizable amount of the population

(22:42):
who live in fear of theregulator, who are practicing
very defensive medicine in allrealms, who are fearful of
getting reported to theregulator because the process is
the punishment it's slow, it'stedious, it'll drive people down
a very depressive line.
A lot of doctors, nurses, overtime have committed suicide as a

(23:02):
result of the APRA process andthat's why I've presented to
Senate inquiries about theirfailings.
But if and COVID was anotherperiod of time, I actually don't
mind what your opinion was, butyou should have been able to
state what you thought was bestfor your patients.
So I still do a lot of thatwhere I'm helping people caught
up in the APRA process fortrying to discuss sound

(23:28):
management.
And we've got a regulator herein Australia which is, in fact,
yeah, I think they're bothincompetent and malignant.
This is not a politicalstatement, but the trouble is
most people well, people need torealize that medicine as it's
practiced here in Australia isvery, very defensive, where

(23:51):
people don't want to stepoutside of their boundaries or
their perceived boundaries.
They don't want to do thingswhich are innovative because
they're fearful that theguideline doesn't say that.
And that was my naivety,because I was just coming back
to basic biochemistry,instituting a simple lifestyle

(24:11):
preventative intervention on mypatients and seeing results.
And the system came down on mewell, in the most amazing
fashion, and you go, well, I'mjust trying to help my patients
and it's working and it's notcosting anything.
So it's still a long road forall of us.

(24:36):
So my job now, I think, is justto keep mentoring people and
when they do get caught up inthe system, to say actually this
is a shortcut of how you getout of it.

Speaker 1 (24:48):
I guess the first thing that we sign up for when
we become a doctor is toagreeing to a whole bunch of
precepts which Hippocrates issaid to have been the originator
of that relate to ethicalmedical practice, and at the top
of the list is not doing harm.
And somewhere on the list isalso either explicitly or

(25:12):
implied that we are going totreat our patient with the best
of our ability to the best ofour ability.
So I think for the lay peoplesay listening to this podcast,
it would feel or be a surprisesurprise perhaps, maybe not
after the past four years, but asurprise that they might be

(25:34):
getting advice or care that isother than what the doctor might
think is best and it's becauseof factors that are external to
their doctor-patientrelationship.

Speaker 2 (25:48):
Did you take the Hippocratic Oath?

Speaker 1 (25:50):
We did yeah, when we graduated.

Speaker 2 (25:53):
Which uni was that University of.
Melbourne I went to New Southand we didn't take the
Hippocratic Oath.
We do a pledge, but it wasn'tthe Hippocratic Oath.
I mean, you've got to watch outfor the Hippocratic Oath.
It said thou shalt not buggerthou patience it was a one-nose
version.
Yeah, but it wasn't actually theHippocratic Oath.
So we took a pledge which hadthe sensible elements of the

(26:18):
Hippocratic Oath in there.
I'll come back to the.
We can almost go down the pathof education If you, we.
I think it's unfortunate that weare educated in a system of
read repeat reward.
So you go to school, you go to,you know you follow whatever's

(26:44):
in the textbook, whatever you'retaught by the teacher up on the
board, whatever, if you justread that, repeat it, you pass.
And then you go to this placecalled university, which should
be used to be a place ofquestioning and doubt and debate

(27:04):
.
And what's happened?
And you've heard me talk, orI've talked, towards the issues
of when we change the model ofeducation, but now it's so
entrenched, now this read repeatreward.
So if you go to university andyou question your lecturers, you
get into trouble.
They just follow the paradigmand that has flowed right.

(27:26):
You get into trouble, they justfollow the paradigm and that
has flowed right down throughinto guidelines.
So there's a guideline forantibiotic management, there's a
guideline for this.
There's a guideline for thatthere's dietary guidelines which
are for to make for healthypeople.
I'll briefly mention that theguidelines Australian dietary

(27:50):
guidelines are for healthypeople and if we take some US
data the last lot which islooking at metabolic health
93.2% of the US population aremetabolically unwell.
It's probably the same here inAustralia, plus or minus a
little bit, which means that thedietary guidelines are actually
relevant for only less than 7%of people.

(28:10):
So one of the things I've beenpushing for the last several
years is let's ignore thedietary guidelines.
Let's come up withcondition-specific guidelines
for health and well-being, butwith primarily a dietary intake
and well-being, but withprimarily a dietary intake.
And guess what?
Every single one of thoseinterventions is the same.

(28:30):
It's an ancestral diet.
My mantra is eat fresh, localand seasonal whole food based on
your culture and environment,avoiding added sugar and
processed food.
That's it.
So that's the best managementfor diabetes.
It's the best management formental health problems.
It's the best management as aprimary, as an adjunct therapy

(28:52):
in cancer.
It's bowel disorders.
Every single thing comes backto putting that in there.
So forget the dietaryguidelines, which have been
written by the food industry.
So if we have this model ofread, repeat, reward, and you've
gone through universityrepeating it.
And then you come out intopractice and the guidelines say

(29:15):
do this, even if it'snonsensical and I'm happy to
discuss all sorts of guidelines,whether or not it's cardiac
ones or bowel ones or diabeticones.
When you realise that thepeople writing the dietary
guidelines or the diabeticguidelines or the cancer
guidelines or the cardiac onesor the cardiovascular disease,

(29:37):
they've been written by peoplewho have effectively funded
completely by the pharmaceuticalindustry, I'm just going to
call it out.
It's just, you have such afinancial conflict of interest.
I was supposed to give somelectures at a university and I
won't mention which state, butthe Dean of Medicine blocked it

(30:06):
after agreeing.
And then, with a little bit ofinvestigation, I wrote to him
and said are you stopping mefrom giving these lectures to
the medical students because ofthe $225,000 that you've been
paid for in direct consultancyfees by Pfizer, and I think it
was Nova Nordisk in directconsultancy fees by Pfizer, and

(30:29):
I think it was Nova Nordisk.
That was the end of ourcommunication, because I'd
called him out.
I said you're stopping thisbecause of that.
So anyway, my slides were givento someone else and the
lectures were given to themedical students, but with my
name crossed out on it so youcan get around it, but the fact
is, wtf.
What is the dean of medicine,the gatekeeper of medical

(30:51):
student education, receivinghundreds of thousands of dollars
in money from thepharmaceutical industry, not for
research I've got problems withthat but in direct consultancy
fees?

Speaker 1 (31:04):
Yeah, it's so deep.
It goes very, very deep to andagain it comes back to this idea
of the doctor and the patientand the reality is is there is
in many, almost always there's athird party involved and that
third party is not obvious but,as you've talked about, when,

(31:27):
say, it's the renal guidelinesor the guidelines for
hypertension, there's a subtleconflict of interest in the
honoraria that these professorsof cardiology took and then
they've gone on to dictateessentially practice for the
whole of our profession.

(31:48):
So I'm not sure too many peoplereally understand the depth of
that conflict of interest.

Speaker 2 (31:56):
Well, I talk about it also being a generational
education, so you can actuallytrack our dietary guidelines
back to 1923 with the formationof the American Dietetics
Association, and back to 1917with the Flexner Report in the
US, which was commissioned byCarnegie of Steel and

(32:19):
Rockefeller of Oil, and they gotrid of holistic medicine at
that point in time in Canada andthe United States and with that
came the birth of thepharmaceutical industry.
I'm putting a whole lottogether very quickly.
And then our medical educationwas conflicted because of that,
because if you wanted to go to auniversity in the US,

(32:43):
Rockefeller would say look, I'llbuild this building for you if
you follow the modern model.
And so we ended up being.
Our textbooks have been writtenby vested interests.
Our teachers have been taughtby those with vested interests.
They have their own vestedinterests.
So at some point in time you'vegot to work out is it endemic or

(33:05):
is it complicit or both?
And for me it was just acomplete awakening and I
realised how much of myeducation had been corrupted,
maybe inadvertently, but I'vegot a questioning mind and it
just wasn't right and it justwasn't right.

(33:26):
And so it's just you know, oneof the things I found in all of
my research on it is there is nosingle biochemical pathway in
the body that requires you toingest carbohydrate, glucose or
fructose or any polymer of that.
There is none, Just zero.
Yet how come we've literallybeen told we have to have 50% of

(33:49):
our diet as carbohydrate?
Well, that comes from theprocessed food industry.

Speaker 1 (33:54):
Amazing it is, and I've done a couple of episodes.
Obviously, I talked to yourlovely wife, belinda, a year or
two ago and also to a veryinteresting gentleman, matthew
Lischak, who wrote a book calledFiat Food, and to me that I'm
not sure if you've read it, butthat gives the most complete or

(34:16):
I guess you could use the wordroot cause analysis on the
explosion of processed foods inthe latter half of the 20th
century, and it essentially came, and still does come, down to
monetary debasement and theeffect that had essentially on
nutritional debasement, wherehigh-quality animal-based
proteins and fats were replacedwith highly refined food

(34:37):
products to mask inflation.

Speaker 2 (34:45):
Well, it's yes and, excuse me, I think the social
experiment is an abject failure,whether or not we're looking at
food, we're looking atpharmaceutical, we're looking at
light.
You know, we briefly talkedbeforehand that you can't get.
I can't get red light in myhouse if I'm building something

(35:14):
and there's almost a blackmarket for an incandescent globe
.

Speaker 1 (35:17):
I'd love to get your perspectives on that, because
you mentioned that you've beenusing some red light therapy,
some photobiomodulation,clinically as well.
So what's your perspectives onthis modality as it relates to
your diabetic foot treatment?

Speaker 2 (35:37):
It works.
So when you start recognisingthat sunlight is critical for
our well-being, it's only amatter of time to work out which
of the wavelengths are actuallybetter for this or that, and
that's where a lot of theresearch has gone.
I often tell the story of theold heat lamps which were used

(36:05):
in.
You know I can still rememberhaving a heat lamp with some
sporting injuries as a teenager.
A lot of people remember theheat lamps and it was probably
not the heat that was beneficial, it was probably the wavelength
.
In retrospect I started, youknow, fiddling around with it
and, to be fair, the firstdefinitely got something caught

(36:28):
in.
I've been mowing out in thepaddock the.
You know I had several, sevenor eight patients with
tendinitis and I sent them to ared light clinic and everyone
should know that people work ascompensation.

(36:50):
Patients with tendonitis neverget better.
Anyway, I think seven out ofthe eight got better.
I said hang on, this stuffcan't happen.
I mean, you don't want tooperate, you don't want to make
their problem worse, you want tolet time let them heal.
But the majority of them hadsome, you know, significant
benefit.
So I actually bought three redlight units.
They're called a baby bear, amama bear and a bubba bear, just

(37:14):
three different sized ones,near infrared and and um and uh
and red.
So 660, 840 nanometres, simpleunits, commercially available,
easily available, not tooexpensive.
And so I used it a bit onmyself and then I loaned it to

(37:34):
staff members when they came tome as patients and I said, look,
you know me, I'm alwaysthinking outside of the box.
And then they all felt somebenefit.
So everyone I loaned a unit tobought one for themselves.
So this is interesting.
And so since then we now knowit has a role in inflammation

(37:56):
and pain management.
So I started using red lighttherapy, particularly after knee
replacements or slow to recovertherapy.
You know, musculoskeletal pains, and until you put it on you
just don't know.
And often the results are veryquick.

(38:18):
Often the results are over along period of time.
I've got good friends who havehad a beautician business for 30
years.
I was talking to them about itand they said oh, you're such a
slow learner, fetke.
We've been using red lightphototherapy for facials for 25
years.
I said have you, you know howcome?
And they took you know, I'm not, it's just we in the medical

(38:41):
profession, because it's not inthe guidelines.
It's outside of traditionaltherapies.
We've been behind thenaturopaths on some topics like
sugar for decades.
I'm not saying everything innaturopathy or everything the
beauticians do is good.
I'm just sort of saying some ofthese practices have been
working outside of thetraditional medical fields.

(39:03):
We just were a bit immune toknowing about it.

Speaker 1 (39:07):
Yeah and look.
The first data that emerged inthe field of red light therapy
was some researchers,essentially using a ruby laser,
finding that the fur was growingback and the wound was healing
quicker.
On a mouse that had I believeit was an excision they were
doing some kind of cancer tumorresearch, and so I mean wound
healing is probably the oldestof the indications and perhaps

(39:32):
has the strongest evidence basefor healing that cancer.

Speaker 2 (39:36):
One is where they shaved the rats for the
procedure.
It wasn't actually the woundhealing, it was where they
shaved the rats.
The hair grew back very quicklyin that red light therapy.
I mean it's an accidental find,but again, if you've got
something which is cheap,potentially effective, with no

(39:57):
major side effects, then itshould be instituted as to be
considered in a management plan,particularly when you've got
the cohort of patients that seemto be coming at me.
So all I was doing in myclinical practice is let's see
what we can optimize.
This is what I can do.
What can you do to make youbetter metabolic health, better

(40:24):
healing potential, betterclinical outcomes?
And the important stuff aboutit all is it can be turned
around within days and certainlyweeks.

Speaker 1 (40:37):
Yeah.

Speaker 2 (40:39):
And that's a blow away.

Speaker 1 (40:40):
Yeah, and it all does come back to the mitochondria
and you know I've done lots oflectures and podcast interviews
on it and really you mentionedabout the fuel substrate and
really putting animal fat andinto burning animal fat as the
energy substrate in themitochondria, as opposed to

(41:02):
whatever the contents of refined, ultra-processed foods are, and
then, additionally, doing theseother lifestyle things which we
mentioned red light therapy,obviously.
Lifestyle things which wementioned.
Red light therapy, obviously,fasting, cold exposure all can
play a certain role depending onthe patient and, as you say,
gary, the condition of whichdiabetes, in my opinion, is one

(41:24):
incarnation of mitochondrialdysfunction.
It disappears and you just haveto get the ingredients and the
inputs right.
That's at least how I thinkabout it.

Speaker 2 (41:36):
There was.
I'll need to come across it foryou.
Have you seen that Chinesepaper showing circulating
mitochondria?

Speaker 1 (41:45):
Cell-free mitochondria.

Speaker 2 (41:47):
Yeah, the cell-free mitochondria.
Yeah yeah, I'm fascinated bythat because I'm wondering why
some of the we get a generalizedbenefit.

Speaker 1 (41:56):
Yeah, from local.
The ascorbyl effect, whichseems to underlie a systemic
benefit of localized red lighttherapy.

Speaker 2 (42:04):
yeah, but I'm wondering whether or not that's
actually via the circulatingmitochondria.

Speaker 1 (42:10):
Yeah, I think it is.
I think that's one keymechanism, absolutely.

Speaker 2 (42:15):
Again, I think we're on the cusp of it opening up as
a whole topic but it's notmainstream for the reasons that
it doesn't fit into someone'sblock of guidelines.
You know there's work you'll beaware of, showing reversal of
macular degeneration.
You know improvement in thataspect.

(42:37):
I was actually having newglasses the other day and went
down and had to check them.
Was having a chat to theoptometrist and he said, yeah,
they're using red light therapyand so they're just using
different spectral lighttherapies.
Getting into the clinicalpractice Amazing, it's exciting

(42:58):
times.
James Mookie's written a paperabout macular reversal of
macular degeneration, a seriesof case studies with a
therapeutic carbohydratereduction, low carb, all
happening within several weeks.
He's had a practice for decadesof where you'll look down and
see a patient who's come alongwith macular degeneration
problem with the eye.

(43:19):
Nothing's changed for years andyears and years.
He puts them on a low-carb dietand all of a sudden the things
improve.
We're not talking about cure,we're talking about improvements
, dramatic improvements, andI've seen all the pictures or
not all the pictures he's shownme a lot of them about.

Speaker 1 (43:34):
Wow, this is just diet, lifestyle, optimal light
therapy tick, it's, it, it is,and that was Dr Glenn Jeffery's
work at UCL.
He showed that the retinalcells, their mitochondria, which

(43:55):
they have massive amounts of,were absorbing the light and was
helping prevent death of thosecells.
So absolutely huge.
I want to ask you about, Iguess, the protocol now in the
area of your practice, and arepeople still able to follow or
choose a lifestyle-basedapproach for their diabetes in

(44:16):
in that area that you, that youwere working in, or what's the
status of of that um for thatpatient group?

Speaker 2 (44:24):
I've got some here left.
Feel free to tear it out now infront of the.
Here's a situation which iscurrent guy in his 40s, out of
control, type 2 diabetes,carrying too much weight on half
a dozen medications.

(44:44):
He works in a pharmacy who areon board with what I'm talking
about.
His own wife is a pharmacist atthe hospital and the pharmacist
he works with said you shouldhave a chat to Gary, his wife,

(45:04):
who works at the hospital.
I am a nutcase.
I'm just out on the spectrumnot to be considered, even
though this is part of thenational strategy and best
practice for Australian DiabetesSociety.
It's huge to be able to saythat, but they have adopted it
once it became their idea.
But anyway, it's another wholestory.

(45:26):
So he's gone against his wife'swishes.
He's lost 8 kilos, his diabetesis under control.
So are we winning?
Yes, some pharmacists are onboard with it, some doctors are
on board with it and they'resupportive, but yet we've still

(45:46):
got an establishment that thinksthat I'm this crazy guy, but
I'm now the crazy guy quotingthe guidelines.
Now, who's crazy?
Is it the establishment thatisn't embracing the guidelines?
Because that's essentially whatI've been trying to do, if we
can get this into the guidelinesand one of our agendas has
always been people say what'syour end point?

(46:08):
We say our end point wasachieved last year, which was we
would like to see low-carbtherapeutic carbohydrate
reduction be seen as bestpractice, or at least a practice
in the management of type 2diabetes which should be offered
to patients and they should besupported if they wish to do it.
It's pretty simple.
We've gotten to that point, yetthe establishment still says

(46:33):
it's crazy.
Now there's a whole lot of otherpolitics and names and all
sorts of things which I'm notgoing to air.
My dirty laundry about, howmany barriers we've had to come
up against, how many clashes.
I gave you one little clashexample with the Dean of

(46:53):
Medicine, but it's just been anongoing assault.
So once I cleared my name, thatliterally opened the floodgates
for me.
I said I can talk about thisnow and we can take it further,
and it also means you can talkabout it and others can talk
about it.
You are not going to getreported to the medical board,
or you might get reported, butyou will not get into any

(47:14):
trouble for talking about awell-structured, complete diet
for yourself, your patients andthat's all it needs.
To come back to the MedicalBoard here in Australia and
South Africa and Sweden.
Those are three test cases.
I was one of those.

(47:35):
They're not going to go backthere because we've got them on
the science, we've got them onthe politics, we've got them on
the vested interest.
It's the best thing for people.

Speaker 1 (47:46):
Can you talk a little bit about that point where
there is a, I guess, differencein guidelines or what's accepted
practice compared to where, ifthey say what you were
discussing and using effectively, which was therapeutic
carbohydrate restriction, andcan you speak to that

(48:06):
discrepancy and does a doctorhave to go through the process,
this drawn-out, protractedregulatory process, to fight
that battle essentially, or isthere going to be a time and a
place where that is no longergoing to be so tedious?

Speaker 2 (48:24):
I think with what we're talking about, there's no
battleground anymore.
It's finished.

Speaker 1 (48:29):
I mean dietary-wise yes, but say in other areas
ground anymore.

Speaker 2 (48:35):
It's finished.
I mean dietary wise, yes, butsay in other areas I think
here's I've got lots of commentsto make about that guidelines
are guidelines, but what we'vedone is we've allowed guidelines
to become rule books.
There's a statement itself, andso we've got a problem with and
I keep saying it's a guideline,it doesn't matter what it is,
it's a statement itself, and sowe've got a problem with that
and I keep saying it's aguideline.
It doesn't matter what it is,it's a guideline.

(48:56):
And guidelines are there forthe population the average to
median population and maybe twostandard deviations.
Well, it just happens to bethat all of my patients are more
than two standard deviationsaway from the mean.
So if you give individualizedpatient care and you have some
metrics that you work withwhether or not it's the

(49:18):
appropriate blood investigationsor imaging investigations and
you're individualizing patientcare that's why I love glucose
monitors.
There's CGMs that you can puton there.
I don't care if I'm outside ofthe gonads For this person.

(49:38):
Their blood glucose is bestcontrolled by.
So if you're givingindividualized care, informed
consent and appropriate care andfollow-up, that means you're
involved and you're actuallycaring for them, rather than
group practice sort of things.
Oh, here's your script and offyou go and see someone else next

(49:59):
time.
Then I just there's enough.
We've created in the last 10years.
There's enough shaky enough ofa body of opinion to shake the
guidelines, whether or not it'sthe cardiac ones.
You know there's people speakingup about cholesterol and

(50:20):
statins and the perils ofputting people on statins
long-term when it's ill-advised.
So one of the things I talkabout.
With people who've got highcholesterol I say okay, go along
and get a lipid subfractionanalysis and a coronary artery
calcium score and then find outwhat you really need to be
managed with.
One of the cardiologists herein town said he had a go at me

(50:44):
one day.
He's a friend, but he saidwould you stop doing those lipid
subfraction analyses?
And people ask you why am I anorthopedic surgeon?
I can vaguely get around itsaying I'm doing that because
the patient came to me withmusculoskeletal pain and they're
on a statin.
Therefore I want to find outwhy they're on a statin and I
want to try and advise their GPto look into it further.

(51:06):
Long answer, but that's how Iget around it.
I could do a coronary arterycalcium score for the same
argument, because you put peopleon these drugs which are coming
to me and complaining aboutmusculoskeletal pains.
But anyway, the long and shortof it.
He said would you stop doingthese lipid subfraction analysis
?
Because on the standardcholesterol profile he wanted to

(51:29):
put them on a statin.
They came back with the lipidsubfraction analysis and it said
hmm, actually they don't needit.
So I said well, look, allthey're doing is reducing their
carbs and processed food.
I said why don't you try ityourself anyway?
I didn't see him for a whileand then I saw him again he'd
lost 12 kilos.
Wow, whether or not you'retalking about diabetes or mental

(51:55):
health, mental health is beingbroken open now, not just for
mental health, but alsoneurodegenerative disorders,
parkinson's in particular,dementia that there's a role
there for diet in the equation.
The same thing in cancermanagement, I think.
I mean you've gotten emailsfrom me.

(52:17):
You'll see that my byline atthe end of it is science evolves
by being challenged, not bybeing followed.
And if we stop challenging,that is the scientific method,
that is evolution.
That is just the way allscience evolves.
The moment we stop challengingor we persecute people for
challenging, then that is theend of our scientific pathway.

(52:42):
Acquiring yeah, that's the endof society.
If we just stop questioning,then everything that we're faced
with on the planet, right?
This second is perfect?
Of course it's not.
Yeah, and so that that's so.
But the trouble is the systemset up to not lay the question

(53:05):
two, two points on that.

Speaker 1 (53:07):
The point you made about guidelines and
individualized care they, itseems almost like a paradox of
being able to give fullyindividualized care if we're
following population-based orguideline-based medicine,
because by the fact of theirexistence they're unable to
account for all the uniquecharacteristics of the patient

(53:32):
sitting in front of you.
So that was to me the originalgenesis of evidence-based
medicine was supposed to blendthe best available, was supposed
to shape clinical practicebased on the best available
evidence used in conjunctionwith clinician discretion.
But, as you say, it's become sofar towards rule-based medicine

(53:54):
instead of really allowing thatclinician discretion.
The other point I wanted tomake is and maybe this comes
back to your kind of regulatorybattle, which was the definition
of scope of practice, becausesomeone might say to you okay,
dr Gary, but if you're notacardiologist and you're playing

(54:16):
with pharmacotherapy and heartfailure, why is it?
You're potentially out of yourscope of practice, and just to
use that as an example.
So how do we take that intoaccount when perhaps challenging
paradigms or exploring bettertreatment options for our
patients?

Speaker 2 (54:35):
I'll come back to the first part of your statement
and I'll come back to thesegment, just by way of example,
with guidelines.
Most people aren't aware thatmost drugs that have ever been
brought onto the market weretested on 70 kilo males.
They weren't tested on women.
They weren't tested on women.
They weren't tested on children.
They weren't tested on pregnantpeople.

(54:57):
They weren't tested on elderly.
Most people were about 25 to30-year-old, healthy, 70 kilo
males.
Now you try and find for me apopulation of healthy, 25 to
30-year-old 70 kilo males.
Those don't exist anymore.
Of healthy 25 to 30-year-olds,70 kilo-miles those don't exist
anymore.
So all of our drug therapieshave been tested in isolation.

(55:21):
We don't know what happens whenyou mix two medications
together and the number ofpeople on polypharmacy with
multiple drugs.
It's just an experiment.
That's out there.
So when people say, oh, that'sthe guideline for putting on,
well, okay, you've said thatthere's a guideline there for
this drug, but where's theguideline and the evidence that
it works in conjunction withthis drug and this drug and this

(55:41):
drug?
And so many people go to thedoctor with side effects of one
drug and get given another drugto try and treat the side
effects when maybe they shouldcome off the drug to start with.
So I mean, that's one of theproblems with guidelines they're
just isolationist and they'relooking at a problem with just
diabetes.
Well, okay, the person's got amental health problem, they've
got a cardiac problem, they'vegot a renal problem.

(56:03):
This siloing of medicine hasbeen a tragedy.
How do I?
The simple argument to thatsecond part of the thing is how
do I manage it?
How can I determine my scope ofpractice?
It's really simple.
You and I have got the sameletters after our name MBBS,

(56:27):
bachelor of Medicine, bachelorof Surgery, with a basis in
science, biochemistry, anatomyand physiology.
And you know, the shoulder boneis connected to the elbow bone,
which is connected to the wristbone.
So if someone comes along to me, we've got, as I said, 93% of

(56:53):
the population are metabolicallyunwell.
We've got to stop this siloingof medicine.
We've got to be brave enough towalk outside of our silo.
I'm very proudly published inthe Journal of Gynecology as an

(57:14):
orthopedic surgeon.
Some guys were gynecologists,were named a visiting professor
of gynecology at the hospitaland they were doing a new,
trying to work out a newtechnique for women's
incontinence and trying totighten everything up in the
pelvic floor and they said howcan we actually anchor it?
I said, look, I can put someshoulder anchors in there for
you, which minimized thecomplications of that procedure

(57:38):
dramatically.
And so it was a defining momentfor women's incontinence
management using shoulderanchors.
They've refined them, changedthem now, but I can still
remember the nursing staffsaying I was operating in one
theatre.
I said to my registrar look,I'll be back in half an hour,
scrubbed into a gynecologicalprocedure and we developed a

(58:00):
world-leading technique.
That is because we were notworking in silos.
The guys I was chatting to wethought have you got anything up
your sleeve for doing that?
I went, actually we do.
So the siloing of medicine is amajor concern.
But if I keep coming back tothe fact that if we come back to

(58:23):
basic biochemistry, basicmetabolic health, basic
physiology, they're allinterrelated.
So I had patients come alongwith an arthritic hip, but they
probably also had a lungcondition, they probably also
had some mild cardiovasculardisease, and so my primary
degree you come back towhichever interpretation of the

(58:43):
Hippocratic Oath is first, do noharm and treat the patient as a
whole.
Do not treat them as a hipreplacement or as a cardiac,
which is what happens inmedicine.
Oh, that's outside of my scopeof practice.
No, it is not outside yourscope of practice to have an
opinion in that, and awell-informed doctor has an

(59:05):
opinion.
That's what a generalpractitioner does.
They are supposed to have anopinion on every single bit of
thing they may identify thatneeds some silo treatment there
or there.
So I think we've gotten caughtup in our own regulatory
authorities which have told usto be compartmentalized, told us
to be siloed, authorities whichhave told us to be
compartmentalised, told us to besiloed, and the trouble is the

(59:26):
moment you look outside of yoursilo.
In fact, that was that Netflixseries Silo.
I don't know if you ever saw it.
People just I'm waiting for thesecond season of it, but
nonetheless people think they'recompletely caught in a silo for
100 years.
When one of them escapes andfind out there's silos
everywhere and it's just.

(59:50):
I think we're at a crossroads inmedicine.
Maybe we've been at acrossroads for medicine since
Hippocrates himself, but it's aconstantly evolving situation
and unless you embrace aquestioning mind, a questioning
approach, then you're going tostagnate.

(01:00:11):
I practiced as an orthopedicsurgeon for 35 years and I was
doing things.
I was constantly tweaking tomake it better.
That's what we've got to keepdoing, and sometimes we have to.
You know, ultimately, if you'redriving up the highway and

(01:00:32):
there's this sign saying stop,turn around, you're going the
wrong way sooner or later.
If you don't do it, you'regoing to have a crash, and I
think we've got so manysignposts in society at this
point in time saying you'regoing the wrong way.

Speaker 1 (01:00:47):
Yeah.

Speaker 2 (01:00:47):
And what are we talking about?
Going back to a recommendationof what we did for a couple of
hundred thousand years?
Yeah, it's such a no-brainer.

Speaker 1 (01:00:57):
Yeah, and on the point, two points two of the
most clinicians that I respect,who I've listened to,
interviewed on this show, or.
One of them was ProfessorRichard Weller, now he's a
dermatologist, but his researchhas shown the systemic benefit
of sunlight on all-causemortality and cardiovascular

(01:01:17):
mortality and spoken athypertension meetings.
And the other one was PeliLindquist, who's a Swedish
gynecologist exactly, and he hasdone research again showing the
same thing.
He did melanoma research andshowed that the women with the
highest sun exposure had theless the lowest all-cause
mortality.
So, just like you puttingshoulder anchors into the female

(01:01:40):
pelvis, for you know urogyneindications, it's this
cross-disciplinary perspectiveis what gets patients good
outcomes and pushes medicineforward.
And then, on that point I mean,there's mitochondria in every
organ of the body.
So the fact that andmitochondrial dysfunction or

(01:02:01):
different flavors of it, iswhat's underlying that 94% of
chronic disease that youreferenced.
So again, it's just differentways of answering my own
question about the scope ofpractice and the siloing of
medicine is really we do have aperspective, because if we're
treating the body as a whole,then we're going to be crossing

(01:02:22):
these different specialistboundaries.

Speaker 2 (01:02:31):
We're supposed to, because it's about the patient
first.
At the moment I know somesurgeons, particularly in
Melbourne and Sydney, have justbecome specialised in the
shoulder or the elbow or theknee or the hip, in the shoulder
or the elbow or the knee or thehip.
And I worked for a surgeon inMelbourne many years ago who was

(01:02:55):
a world-renowned knee surgeon,unbelievably good on knees.
But one of his old patientswanted to have a hip replacement
and I watched him do it and itwas terrible.
I went whoa, you do not knowhow to do a hip replacement.
I'm totally siloed.
I'm very.
I've done a lot of foreign aidwork and you can't go over there

(01:03:24):
and be the right hip surgeon orthe left knee surgeon or
whatever.
You have to do a jack of alltrades.
But I still remember it ties inall with I did quite a few
years or going back to Vanuatufor many years Beautiful people.
But when the sun goes down, thepeople go inside their houses,

(01:03:46):
go to bed.
Sun goes up out, they comeagain.
And I was just thinking, youknow they were generally pretty
healthy, except that they wereintroducing Western food.
And wherever you introduceWestern food you start
developing Western diseases andyou know we could talk for
another hour about that from ahistorical point of view.
But yeah, look, we're justgoing up the highway the wrong

(01:04:10):
way.
Turn around, get back.
As I say, eat fresh, local,seasonal, whole food based on
your culture and environment,avoiding added sugar and
processed food, and get someexercise, which is life relevant
, and that can mean any sort ofthing, but it means getting
outside and get appropriatesunlight, and I love Paul

(01:04:33):
Mason's take on light, uv lightthat if your shadow is longer
than your height, that'spredominantly UVA, if it's
shorter, uvb.
So if your shadow is longerthan your height, you know, get
the sun onto your skin.

Speaker 1 (01:04:49):
Yeah, and even if it's shorter, then you really
just have to titrate yourexposure to your skin type and
the ambient conditions, becauseyou do need UVB as well.
Maybe we can end on a topic,and it really, I think, ties
into everything we've talkedabout and really why you went

(01:05:10):
through however many seven yearsof regulatory purgatory or
forward, as you've described.
Then there's such an asymmetryof knowledge between the patient
and the doctor.

(01:05:30):
Maybe that's changing with AIand these large language models,
but historically there's beensuch an asymmetry in knowledge
that people had no idea whetherthey were getting best practice
care or not.
So I think that's really thewhy of continuing to ask
questions, which is becausethat's what our patients deserve
and that's what they'reimplicitly asking of us.

Speaker 2 (01:05:56):
You've made me think.
I've thought about this topicof AI in health a lot recently.
I think we're in a situationwhere if you go onto the
internet you can get a wholevariety of opinion and some are
good, some are bad, and Iactually preferred my patients
to be investigating theirproblems and then I'd have to
debrief them and guide them, andI think that's good.
With the advent of AI, I'mconcerned.

(01:06:18):
You've heard of the black swan.

Speaker 1 (01:06:25):
A black swan event.

Speaker 2 (01:06:27):
No, just the concept of a black swan event, and so it
wasn't damp here but apredecessor by about 15 years, a
Dutch seafarer came to WesternAustralia and found black swans,
and up until that time allswans in the world were white,

(01:06:50):
and that single event meant thatit had to change the entire
genus and the nomenclature ofthat.
Swans were not always white,they were black or could be
black, and so that one blackswan, that single event, changes
the entire narrative.
That's why it's called a blackswan.
That single event changes theentire narrative.
That's why it's called a blackswan event.
When people talk about it ineconomic terms, are we worried

(01:07:11):
about a black swan?
It's the unforeseen event thathappens, which just changes
everything.
Well, the trouble with AI.
So let's say, you've got 1,000.
Literature, science, knowledgesays that there's a thousand
white swans and then there's oneblack one.
Well, if AI got hold of that atthat point in time, it says

(01:07:35):
actually, there's, the vastmajority of information tells us
that swans are white.
The AI then generates another10,000 comments for that.
So now we're up to 10,999assessments that swans are white
and one black.

(01:07:59):
The next generation of AI willsay well, all swans are white
and that was maybe just an errorin someone's eyesight.
So if we want to get thesummation of opinion, which is
really just based on thesummation of opinion and the
averaging out of that, we'regoing to get rid of black swans.

(01:08:21):
And so when you try andchallenge that because at point
in time we've done it in our lowcarb groups around the world
you put into chat, gpt orwhatever what you think is going
on, tell us about cholesterol,tell us about this or whatever,
and low carb is still dangerousbecause the vast majority of
information says that it is.

(01:08:43):
So I'm worried about our nextgeneration of doctors who are
very much dependent on, let'ssay, whatever the latest AI
generating information softwareis, and then if that is

(01:09:04):
incorporated into the guidelines, then our ability to question
that is becoming potentially athing of the past.
So I think lots of reasonswe're at a crossroads.
But I think our informationtechnology is brilliant at this
point in time because it'sallowing you and me to have a

(01:09:26):
conversation and it's allowingus to get an alternative thought
pattern out there.
It has allowed us to actuallyget this to become best practice
.
But I'm worried by the forcesaround us, the powers that be,
that maybe, maybe we're going tolose the ability to keep
questioning.

Speaker 1 (01:09:45):
Yeah, it's a legitimate concern and that is
just the resultant from the waythese models get trained, which
is essentially just inputting onexisting data, which is the
consensus.
More of the web pages talkabout consensus management.
Then it's going to spit thatback out, so it remains to be

(01:10:07):
seen how that's going to playout into the future.
But I guess my point was toemphasize that people might be
more informed than historicallythey have been about illness,
for better or for worse.
But it doesn't change the needand it emphasizes the need in my
mind that we as doctors need toalways be asking the question

(01:10:31):
of how can I best treat mypatient.
I think that's the point I wasgetting at.

Speaker 2 (01:10:38):
I agree with that.
Now, I don't want people tothink that I'm pessimistic or
depressed about the future.
I suffer from a conditioncalled hyperpragmatism, so you
actually assess everything andthat's my surgeon in me.
Okay, this is the situationthat's in front of us.
These are our options.
With all the knowledge that Ihave, I think we should do this.
So I think it's aboutpositioning yourself into the

(01:11:01):
future, and I'd like to thinkthat our children have got
questioning minds, and certainlymy grandchildren.
You know they're seven and fourand you're tricking.
You're tricks to them, but Isay, no, I'm making you question
what I'm saying, and so I'mtrying to instill that, and the

(01:11:23):
family always think it's funnywhen I'm trying to, you know,
play psychological warfare withmy grandchildren.
But again, we've got to createa questioning mind.

Speaker 1 (01:11:32):
That's it.

Speaker 2 (01:11:33):
And unless we do that well, you know, brave new world
1984,.
Here we come.
Our thoughts will be controlledfor us.
And again, it's just I see ithappening.
I've been part of the cancelculture.
I get it, but there's stillenough of us around who are

(01:11:57):
questioning.

Speaker 1 (01:11:58):
Yeah, you know it's wise advice.
So, gary, we're very muchlooking forward to having you
speak in Melbourne on the 23rdof March.
So I'll just remind everyonewho's listening that if you want
to come and see Dr Gary Feckespeaking and sharing his
insights on, I'm sure, all thesetopics and more, then, yeah,

(01:12:20):
please come along to that eventand it should be a fantastic day
out in Melbourne.
So, gary, any final comments orthoughts or parting wisdom for
the audience?

Speaker 2 (01:12:37):
I can talk underwater , so I'll be kind to all of your
listeners and let you allescape.

Speaker 1 (01:12:42):
Okay, well, I really appreciate your time, gary.
Thank you for sharing yourinsights and, yeah, your journey
.
I think it's been veryinteresting and instructive.
So thanks again, and we'll seeyou on the 23rd of March.

Speaker 2 (01:12:57):
See you soon.
Thanks for having me.
Bye-bye.

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88. Fighting To Reverse His Patients' Diabetes: Orthopaedic Surgeon Dr Gary Fettke on Nutrition & Medicine

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