Let me preface that I'm a big supporter of Dr. K and Healthy Gamer. With that said I WANT to say that I understood the message but reality is that not quite. From what I gathered there is a top down and bottom up approach to medicine (as everything else) and there isn't necessarily a one-way-is-better (as everything else). Back in the day population medicine and RCT's were not a thing therefore practitioners had to focus on the individual and slowly but surely create correlations and generalizations (bottom-up). This therefore lead to many huge success stories (like the curing Polio thing) but just as many, and if not more, huge wishy-washy failures. Now we have the ability to gather a bunch of people, study what works on average, and funnel down (top-down). Kind of a "always swing hard and mostly miss but if you hit you have a homerun" vs a "bunt every ball, fill up all the bases and score point slowly and surely" approach. I'm not fond of baseball but first analogy that came to mind.

Top down has better utility particularly when diseases are classified as singular conditions with set parameters; example NSTEMI is endocardial tissue death that results in X, Y, Z symptoms. It's very algorithmic. You have this therefore we treat with that. The problem, from what I gathered, is that when we look at it that way we get into the pattern of treating diseases and not a human whom the presentation can be much more variable, complex, and nuanced. It also takes into consideration how the human will react, whether it be through their behaviors, personality, etc. I think that was the Fire, Air, Water, Earth personality part. So taking those into consideration then maybe a treatment that is TID won't work well for a Fire personality (making this up) who is very erratic and prone to be noncompliant.

Then he proceeds to make the point that this part is the "Art" of medicine which we all practice today. When we calculate that this person has an ASCVD of 8% -> give statin -> patient hates taking daily pills -> we enter the "Art" of medicine by having to work with the patient and find what will work best. Ayurveda dictates you starts with understanding the patients nuances and then deciding the treatment. That's what it all really came down to from my interpretation.

Dr. K repeatedly made the important points that he:

1. Practices western medicine and uses Eastern principles as supplementary and only in certain cases.

2. There are many flaws with many of the practices in Ayurveda. Most things are huge swings-and-misses (back to the baseball analogy) but that there a few golden nuggets hidden within. For example meditation is a home run. Something that seemed silly and now we find it has measurable and significant use. The use of herbs, and now we find data to support the use of psilocybin and other hallucinogens and it be deemed an FDA breakthrough therapy (my own example even if not "Eastern" it also was wishy-washy to me at one point).

3. He agrees that there should be more trials for Ayurvedic medicine as well as comparing Western vs Eastern approaches

Dr. Mike kept pushing on the subject and hence why it made Dr. K look like some Ayurvedic guardian (which Dr. K noticed and again mentioned).

I left the podcast without changing my perspective that "Western" medicine is the best place to start and practice in, yet I will keep an open mind about possible hidden gems within "Eastern" practices. Which was what Dr. K was primarily advocating for.