Now, question number true, I am going to give you a certain examples, is art a window to the troubled mind. For a long long time, we have used art as a window to try and understand, whether people are having difficulty. We have people have used art to imagine things, you know when you read something, you have to imagine and sometimes your responses to what you see might evoke or might give somebody an idea of what you are suffering. Let me just go to, this is an artist called William de Kooning, have you heard of William de Kooning? He was an abstract painter, William de Kooning developed Alzheimer's disease. He first started by doing this kind of painting, I thought I had a better painting. He initially would draw like this and as he developed Alzheimer's painting, his painting lost its coherence and became less complicated and towards older life as you see, this painting becomes less and less and less coherent. Goya, Francisco Goya started off painting like this and as he grew older, he started getting loss of vision, loss of hearing and he probably developed mental illness because of lead toxicity, which probably came from the lead paints, the white paints that they used and he started doing this, which was more darker and darker and darker and darker. This is a patient with a particular kind of dementia and he started off when his dementia was undetected by painting this and the doctor who was seeing him, got him to paint this throughout his illness until he died and this is his original cartoons, which became more and more menacing as his illness progressed. These were his caricatures of self. Similarly, we are aware that people who have body image disturbance, I am not going to go into the neuroscience, but they perceive their body differently. This person of course, you know and who kept throughout his career thinking of his body as more different, more different and he went and had a whole lot of surgery done. I am not going to go into the science of this because you know, but no, but basically, so some of the things that people have done, psychologists have done, have used artistic representations to try and gauge, you know difficulties. One of these tests is called projective tests, which are still used frequently by psychologists. There are things like the Rorschach Inglot test, because this is a satirical thing of the Rorschach Inglot test about how George Bush took a Rorschach Inglot test.  Then you use things for children called draw a person test, you know and by getting the kids to draw, you make assumptions about how their mental health status is and this is again called Rosenzweig picture frustration test. So, basically the point I am trying to make is that you can use some of these and these have been used to get an understanding of your mental state. The last section that I would like to end by is art is therapeutics, can we use art as a tool to improve or treat pathological states of brain functioning. Now, is a growing body of scientific work that suggests that art training can improve cognitive functioning. Now, basically practice of various art forms involves different areas of the brain and there has been some work which showed that if you give people, you show people pictures of people dancing or a video of people dancing. The brain areas which are activated during this particular thing of seeing people dancing are the same brain areas which are activated during mathematical reasoning, because they overlap strikingly with the areas which occur when you are watching people dancing. So, often what happens in the arts and a lot of my artist friends do that, they want to justify teaching arts saying you know what teaching arts will give people a chance to become illustrators here. Now, there are much better chances of becoming illustrators in TV studios or doing this and I get very upset with them, because I tell them that you know why people should be taught, why children should be taught arts, because it makes them better mathematicians. Why people should be taught dance or music, because they will be able to solve problems better, because exercising one part of the brain exercises another part of the brain which is used for totally different activities. So, training students in arts may change the structure of their brains in the way they think and there is enough evidence for that. Putting a violin in the hands of a child may help him to do math better and there is emerging evidence for that. Learning to dance or paint improves the child's spatial ability to learn or to read and there have been studies which have shown that you know teaching children music can actually improve their reading skills.  So, music has been helped has been used to help injure to treat the injured brain especially in people who have depression. Music has been helped in has been used to help people with Alzheimer's dementia. Do not go into this this is a very busy slide, but a group of people with dementia were taken to an art museum and these are people who could not remember what they had eaten that day and when they were asked what did you see and the one old gentleman made a very good point. He saw Picasso and he could not name the painter although he knew a lot about painting he had forgotten all about that. He said this fellow has learnt to paint paint in a different way you know which means that watching the painting made him use one part of his brain that he was not using and he interpreted the painting with the parts of his brain that were still working. So, painting or watching paintings helped this group of people recruit areas of the brain which they were not normally using you know the parts of the brain which were getting demented were preventing them from using you know working properly in their everyday lives, but getting them to recruit other areas of the brain seemed to help them. Mindful art therapy you know it is about mindfulness when you take a brush as I explained earlier you have to be mindful and this is very useful for children who cannot be mindful you know children who have attention deficit hyperactivity disorder etcetera you train them to do this and side by side what they do learn the brain learns to sustain attention which is very necessary for these kids. So, which brings me to arts therapy for a whole series of people with brain and mind disorders I am not going to go into details, but there are various art interventions for example role play and psychodrama you know and sculpting has healing effects because in the human brain the hand has greater representation in the brain than say the leg or other parts of the body. So, when you use your hands to do things you actually massage much larger areas of the brain side by side which are used then for other things.  So, it drifts away from the fundamental social skills of meeting other people responding to other people and often you will find that in today's day and age there is a lot of violence that happens among young people because they have not realized how much or how little it takes to hurt the other person and this is classic. If you look at these bulletin boards and things where people are always flaming each other you know I am shocked and surprised by the amount of violence and hatred and vitriol and acid there is in these online conversations, but you can get away with it.  So, the next time you meet another human being which may be two years later you have no qualms in taking a stick and poking it through you have no qualms about taking a rod and poking it through somebody's private parts. So, in a way this whole digitalization that is occurring and taking away from our social skills is actually making people more and more and more violent and difficult. The effect is apparently strongest in these people who are digital natives people in their teens and 20s who have been digitally hardwired since toddlerhood. I would like to focus on the fact that technology while it gives us great gifts is also creating a decline in visual imagination is also creating a decline in problem solving everything is on the internet I can Google everything. So, I really do not have to do too much of thinking because somebody has done it before if I have to do an assignment it is already done you know. So, it is make life immeasurably useful, but it is made life less human and in that sense you know art makes you more human. I would like to read out what professor Susan Greenfield who was the head of the royal academy said in her speech. She said the current teenage generation is headed for mass loss of personal identity by spending inordinate quantities of time in the interactive virtual two dimensional cyberspace. It is as if all that young gray cortical matter is being scattered and defoliated by a kind of cognitive agent orange depriving them of moral agency imagination awareness of consequences which is what I was talking about. The substitution of virtual experience for real life encounters the impact of spoon fed menu options as opposed to free ranging enquiry you know a decline in linguistic and visual imagination you know bro and atrophy of creativity contracted brutalized text messages lacking the verbs and conditional structures essential for complex thinking computer games are emphasizing process over content method over meaning in mental activity and this is worrying. This is worrying because as I explained the consequences that we are seeing in a few short years is brutalizing, but we do not want to lose the internet we do not want to lose Facebook. So how do we balance the gifts of both and in that context you know and in the context of what we as neuroscientists have learnt about art you know art education utilization of art and the word is conciliance of using science to investigate art and using art to inform science I think is a way forward that we need to examine far too long these have been seen as you know two different rooms and nobody from this room will come to that room and nobody from that room will go into that room. And we now understand as far as the human brain is concerned art is science and science is art thank you. We also see find the flower to be beautiful isn't it, two things like one is is there a neural footprint of what the butterfly has in ours and the other thing is like they do not have that much big brain and volume as we have. It is not the question of big brain I mean since you brought up big brain women have smaller brains than men do but it is now accepted as of two weeks back they are more efficient brains because all the non essential parts have been trimmed and it is about trimming in the human brain but that is a different question the question that you asked is are the butterflies processes you know part of our processes and the answer is yes you know so the last two days have been asserting that nature is a very stingy processor of things evolution uses the same processes ad nauseam over and over again it does not make new processes. So the same genes which are used for color perception have been retained through you know the higher the so called higher evolved animals but having said that the bower bird or the butterfly actually makes art for art sink for enjoyment they do it for a particular purpose they do it for the purpose of looking for nutrition finding nutrition or ensuring genetic survival. We are the only species you know which actually creates a work of art and says hey come watch it I get nothing out of it other than the fact that you say wow wow beautiful now a days of course I get a little bit of cash but most of art was created the cave of lasco were not created to sell at you know Sotheby's auction they were made because somebody just wanted to represent you know mammoths woolly mammoths running you know the people who made the chola bronzes made it because they were enamored by the beauty of women you know or vice versa but so in that sense art is slightly different because most of art is in the strict evolutionary sense is non-functional what do you do with it you can't eat it I don't know whether I have answered your questions no it was a non-technical answer it was a more emotional answer. So they see a vision stimulus let it be a picture or whatever then if you ask them to draw again the same thing they come up with a very what is a their own representation absolutely which is I mean which explains the Rasa as he said the abstract level of correct so then like would you say that this one is the way that information is stored no what I was saying was that in children process the information differently from adults and that is because they see it in parts whereas we learn to put everything together and make a three dimensional representation because we are using these things and having used it for a very long time we have refined the process you know it is very simple if a child is asked to kick a ball the child has to decide that I am standing here and then has to kick the ball you know three times out of four the child is going to fall is going to miss the ball and but then he or she will manage to do it after having put all these things together you do not even have to think twice right because the same processes you are doing but in your brain they have got by doing it so many times they have got become an algorithm where you do not have to go through the to all the component processes does the act of perception for art depends upon the prior knowledge from person to person absolutely that is you know some of the slides that I was showing showed that if you are aware of the value of that your perception of that object changes which is why some people are able to sell shit for whatever amount of money and I mean it both in the figurative and the real sense no no no I did not say development of imagination does not have I said there are stages so there are stages where there is pretend play pretend play does not happen in if you take a one year old take two one year one year olds and put them together they will never play with each other this one will go playing his or her one one and a half years old will play with his or her toys that one will play with his or her toys you know it is almost as if the other one did not exist when you become two or three you start saying give me yours give me yours then when you are four or five you actually engage together to do pretend play let us play house house or whatever yeah so it goes through stages and these stages are dependent on brain maturity and some kids cannot do that because their brain does not mature for example autistic kids can never play with another child they would rather play with their mechanical toy and they will do it very well they will you know give them a Lego set they will do all kinds of things much better than the other kids but person to person imagination not there will go whichever way you want we have very difficult questions let me tackle your first one your your second one first how does the mind distinguish between good and bad the mind does not distinguish between good and bad the mind is taught good and bad by environmental circumstances but having been taught that we have error detectors which tell us is this the direction I want to go in you know if I step like this will I manage to cross the wire or won't I manage to cross the wire you know if I pick up this thing will he get upset with me or won't he get upset with me you know and we have processes in the brain which do that we have processes in the brain which act as breaks which is one part of the brain which grows later so a younger person does not have the capacity to restrict himself or herself a small child will go and pick it up without thinking that should I ask or shouldn't I ask an adolescent is more likely to do something impulsively without thinking of the consequences than an adult is because an adolescent lacks that part of the brain I mean in full maturity which are the breaks of the brain which says hang on wait think and then do so there are processes for that but as to whether something is good essential the value judgments these are things human beings have learnt over time you know for example is killing people good or bad you know is a difficult question because we are all taught killing is bad but then we will be the first one to say hang x y z and that is good because it you are acting on behalf of the larger mob you know so these are slightly difficult questions and these are shaped by our social circumstances shaped by our education if you are in the south of the USA hanging is good but if you are in New York state you would go out on parade saying hanging is bad so I don't know does that answer your second question but the first one was this is a whole talk by itself it is actually 20 talks by itself now by that I understand you to mean that that consciousness has to exist before anything else exist which means a sense of self has to exist before anything else exist I am therefore I think now this actually comes from a much earlier understanding which is this whole mind body dichotomy that the mind is somehow different from the brain isn't it what we are more and more realizing is that the mind is actually created because of crosstalk of different neurons in the brain and yet if I say this I will be guilty of oversimplification reduction you add absurdum because it can't be just that however once you kill the brain and brain activity stops there is no mind so the truth lies somewhere in between I am afraid I am not competent to answer that question because as neuroscientist we really don't know but more and more the evidence points to the fact that you know between the these circuits the positive and the negative doing circuits somewhere the mind is constructed but the mind is also constructed out of what we have learned out of what many generations have learned and put together you know these whole cultural memes etcetera this is difficult question to answer. Can aesthetic be generalized can something be built which everybody thinks looks nice. What do you think yeah I tend to agree that you know there are some things that you will react to human brains will always react to missing information like I showed this dappled things you will always look at something as but aesthetics also has a major cultural component to it that there are certain things you like because you been taught to like it you been taught to value it like sitar music so again the answer lies somewhere in between and as a neuroscientist I have learnt you know to stay in the equator never to stay either on the north pole or the south pole you know. When we are imaging any conditions in the f m r i we managed to put one condition at a time so when we are trying to image the influence of music on a mind so how close are we mapping that particular condition because multiple conditions cannot be taken at a time in the f m r i which is a problem you know you cannot really have very complex phenomenon and say that we are responding to this which is why I was laughing at this whole thing of the neurosynema you showing people cinema you know what people are reacting to you know are they reacting to the music are they reacting to the editing etcetera. But it is slightly easier when you are playing one snatch of music and you are showing response to that and yet you can never be sanguine that this is the exact reaction to this so often you know when we talk about this as scientists we say this perhaps may be related to this may be associated with that right now there are no causal explanations what is there are associated or associated observations this is associated with this nine times out of ten this is the association of brain activity that is associated with listening to this particular thing so I cannot make assertions I can make suggestions asking that you must have observed many experiments in those experiments are how consistent sir are these. So, if we take ten subjects at a time you say twenty random samples at a time and play a music so during those conditions how close are those subjects so showing similar activities similar neuronal activities when they are imaged. They are because see what you do is you create conditions where one group of people are given a particular condition another group of people are not given a particular condition or given a a a placebo condition.  So, you create as as comparable a condition as possible you can always knock holes in my experimental condition, but we will have to create better and better conditions remember that these the some of the data that I presented are things which have been done for the first time it is a brave new world you know and you know the last thing that I told you guys was that art and science have to talk to each other. Otherwise this is not going to happen and now art and sciences started talking to each other, but our languages are so different somewhere you have to start and I totally agree with you that the conditions that you create to study these have to be refined more and more and more. Sir, where does belief has to influence everything? What do you mean? Sir, any belief sir how is belief going to influence anything sir if we are taking any condition at that time say music in a how how deep is the core of belief. By belief what do you mean you are talking of faith. Sir, belief any sort of belief sir belief that say even we come through a culture we have made to believe that music can make us feel better. Sir, this is belief sir how is belief that belief part is going to influence. It does it does no I showed you evidence which says that you know something is shown to be valuable your response changes and if something is shown to be non valuable your response changes. Now, if you are going to get in belief faith religion etcetera these are complicated subjects you know and we are no longer we are we are not there yet. These are these are valid subjects for enquiry, but these are so complicated because there are so many multiple elements there we are no longer we are just at this stage of very simple enquiry here you are right these questions need to be asked. I do not think we still have the tools to answer them you should think up you know how to ask these questions you are. So, you should ask these questions. I will learn from art students. You will have to create the conditions, but you are absolutely right you are saying something here. With this art and science like talking to each other coming together what I feel I could be wrong we are mostly looking at the science of arts rather than the art of science. And is it not that the science of art is actually taking away the artistic side of arts as he said that is there something that can generally appeal to everyone. So, you are trying to create more professional kind of things and that. And why is that not artistic? Because it is basically more say professional oriented or materialistic kind of thing. So you are not just creating art for the sake of arts you are doing it because you want to sell it to a larger audience. And it can through the media and all it can also be used not only for selling your stuff for money, but also for you know propaganda and many other. And art for arts sake does not sell itself for money? Not necessarily I could it could sell, but that is not my primary intention. It is your primary intention and today when somebody creates a painting you do not create it to hide it in their room. Very few people do. Yeah, but they do some people do. Well some people do most people who do science do it just for the joy of learning. See I get a little concerned when one makes this whole this distinction again you are creating two rooms that the artists do it for pure love and happiness. And the scientists have got a what is the word you used a materialistic bent and they want to find bricks and mortar. That is the very the very cold water on the dialogue that we are trying to create. That is the that is the older way of thinking what we should actually be thinking is that can we help each other understand each other. There is no shame in saying that look like I said how can I be bored in a better way how can you be creative in a better way. If I have the way of learning how to be happier and it has come through scientific knowledge would you throw it away saying that it is a materialistic way of getting happier. This is the philosophical discussion that we are having, but it is this whole schism between north pole art and south pole science which I do not think is helpful any longer today. We need to come as I said to the equator where you know there was a there was this writer called Edmund Wilson I do not know whether you guys have read him. He created this word called conciliance where one discipline merges with the other discipline and becomes stronger for it both both become stronger for it and that is something that has to happen. Maybe I will just put my question in a different way. We are trying to understand art through the mirror of science is it to improve art or to increase its marketability. It is to improve your understanding. It does not need to lead to something it needs to lead to knowledge. Why cannot it just need to knowledge to lead to increase knowledge. Sir, may I add something. Sure, sure please. Sir, knowing the molecule constituent of anything does not take away subjective experience Sir, if we know the molecule constituent of sugar, know where it takes away the sugar sweet when you are having it. So, this is a very similar I think the gap that is created in art and science and in India I have always found this that the students are groomed in a way in which they have their sense of anti-science is created and they are always groomed in a way in which they come out and attack science that science too materialistic. Sir, and I just simply want to add that if we know the mechanism of anything, know where it takes away the subjective experience of anything and art is a subjective experience and right now whatever it is explained. Sir, it speaks of the mechanism how the subjective experience are working in the human body. So, that know where it takes from us how it should be. So, what is the particular experience of art and this is nothing do with demeaning art or being dismissive of poetry literature. How would you react to that. I mean basically that is a totally different dimension again I am not opposed to trying to understand the process. I am just a bit worried about for example, that you mentioned neuro-cinema. Now, why is it that you actually neuro-cinema or for that matter neuro-marketing why do you want to understand all that what is the ultimate use that it is going to be put to. So, I am basically worried about that. Yeah, but then see that is depends on how you use a particular invention. Now, you can use dynamite for various things you do not necessarily have to put it into a waste coat and you know bust you know kill people. You can use it for other things you can use space travel for a particular thing you can use it to shower rockets on your enemy. So, why something is used and the potential for harm for anything is something peculiar to human beings that human beings will find harmful uses for anything. So, but that does not necessarily mean that one should stay in a cave and not venture out and see the world and create things and find you know new knowledge. So, that is a Luddite argument that is a Luddite argument is not it that one should not have more knowledge because it can always be used to to destroy you are not happy with that. Sir, in those brain images how do we interpret those images that is more activity in one region and that region is what that region is a dedicated region of the brain. It is not a localized. It is localized, but it is there are no dedicated regions in the brain, but there are regions which we know subserve certain functions, but the brain keeps talking to each other I mean the areas of the brain keep talking to each other. So, now we know and this these are earlier studies earlier studies looked at this f m r i they looked at areas where there was increased activity increased utilization of oxygen in the brain. So, you assume that there is increased activity because more oxygen is being burnt, but now what we are the areas that we are moving into obviously none of those things are here is you are now looking at circuits areas that fire together work together you know and that is very interesting, but it is in its infancy. So, people are now looking at circuits for example, this resting state potential I showed you a picture I did not elaborate, but people areas which rest together are probably talking to each other are gossiping with each other and areas which get activated together they are also circuits. So, we are now able to see which circuits get activated when you know certain things are done and that does not mean that that circuit is dedicated to that no no it is not dedicated as I said the brain is very very I mean the you know nature is very stingy it does not have different circuits for different things uses the same thing for different purposes you know this whole that that was this whole earlier thing where you felt this part is for this that part is for that used to do mapping of the bumps on your on your skull. Now, it is far more complicated than that and far more economical than that.


Welcome to resiliency radio with Dr. Jill, your go to podcast for the most cutting edge insights and functional and integrative medicine. I'm Dr. Jill, your host and with each episode we delve into the heart of healing and personal transformation. Today, we're here to explore the frontiers of health and intricate workings of microbiology and today, especially we're going to talk about radiology and gadolinium and heavy metal toxicity. Now, if you'd like this video, be sure to hit the like icon, share it. If you're listening on Stitcher or Spotify or anywhere you listen to podcast, leave a review. It helps us to reach more people. So without further ado, let me introduce my guest today. Dr. Semelka has been one of the major forces in radiology for three decades. He has been a leading researcher and practitioner in MRI, has pioneered and is leading author worldwide on abdominal MRI, and is the radiologist with the broadest research and publication record for on safety in radiology, having authored major works on informed consent, overuse of imaging, risk of cancer from CT and X-rays, nephrogenic system fibrosis, gadolinium deposition in the brain on MRI, and most recently has pioneered in the medical literature on the subject of gadolinium deposition disease or GDD. Today, we're going to talk about that. So stay tuned. And he's presently the leading author on the subject. GDD is essentially a severe persistent disease secondary to the use of gadolinium based contrast agents and individuals who have normal kidney function. Dr. Semelka has written over 350 peer reviewed articles of radiology and 17 textbooks, including healthcare reform and radiology. He's been one of the most accomplished authors on safety, especially regarding medical radiation, patient information and overuse, as we mentioned. I am so, so delighted to be here with you as an expert and author on this topic that just doesn't get enough attention. So welcome, welcome to the show. Thank you for having me on your program. I'm delighted to be here. You are welcome. And this is such an area of interest because as I could tell in your writings in your paper, and you sent me one of the most recent papers, we'll be sure and link for anyone listening to some of Dr. Semelka's papers and research. So stay tuned wherever you're listening. They're watching this in the notes. You'll have access to all the information we're talking about. Before we dive into gadolinium and heavy metals and maybe the overuse and some of the practices, I would just like to hear a little bit about your story. How did you get into the practice of medicine? How did you choose radiology and tell me just a little bit about your journey into where you've been? Okay, I'll try to make it as quick as possible. I'm actually from Winnipeg, Canada, and both of my parents were physicians. So being medical doctor was the thing that was most apparent to me. Now, I'd originally intended to do plastic surgery when I was going into medicine, but it's a funny way to say this, but my mother was a radiologist. So I was familiar with radiology. And just at the time in medical school trying to decide what I would do with my career, new things like CT had come out and radiology was changing and getting exciting. So it was no longer reading plain x-rays or doing ultrasound. It just came out was CT was on the horizon and then MRI also came onto the horizon and that sort of convinced me to go into radiology. So I did my original training in radiology in Winnipeg, Canada. And then through the course of my training, I became intrigued with the new thing, the new imaging kid in town, which was MRI.  I went to UCSF in California was a fabulous time.  So I ended up going to UCSF for specialized training in MRI of the body. And from there, I went to Germany for six months to work with the research team of Siemens and MR. And then as a Canadian, I went back to Canada for two years. But, you know, the problem is that once you leave a place that's very cold, like once you've left Siberia, and you've gone to, you know, the Mediterranean, it's kind of difficult to still live in Siberia. And I hate to say that to all the Canadians out there, but I just, it was just too cold. And it's funny how, you know, you just need a brief experience like two years in San Francisco, and I was ruined for minus 30 degrees in February in the wintertime. So I came to Chapel Hill, North Carolina, and I've been here essentially since then for 24 years working at UNC as a director of MR services for all of that time, director of Vice Chair of Quality and Safety for part of that time, and Vice Chair of Research for part of that time. And now I'm basically doing some radiology, still focusing on body MR, but I've happened upon, you know, looking after people with gadolinium deposition disease. And I'll tell you, and I'll try to be brief about this as well. How that happened as a director of MR services at UNC. It turned out that a patient who actually has become one of my favorite people and, and I work with her. She and her husband came to my house on a Sunday during the day.  And after that, I had a feeling of burning like my entire body was on fire for months. And nobody knew what it was. And I think it was a gadolinium that I received.  So, you know, then, you know, turns out, senior physician, female physician at UNC also then approached me, not too long after that and said that she also had this disease. And based on that, and the fact that was maybe at the time, the leading author worldwide on the value of gadolinium. I thought, well, who better to write on limitations than me. Now, some of it you could argue maybe it's a feeling of penance and that's maybe true. But I think one of the things that's characterized me in my career is that I really care about the welfare of people. I really put myself in their position, you know, so I can feel what it must be like to go in, get an MR study with gadolinium being told everything is safe. Not to worry, it's the safest thing. Your kidneys are fine. Don't worry about it. Everything will be wonderful.  I appreciate how that would feel like. So I've taken this on as a cause, my cause. And, you know, the good news is that it's kind of easy to diagnose and if caught early, it's also quite readily treatable, looking at all sort of comparable diseases. And I don't know, Jill, if at this point you want me to continue and talk about the diagnosis of GDD or if you have a question you'd like to add in at this point. I just want to comment, first of all, yes, we're going to go to so if you're listening, stay tuned, we're going to talk about diagnosis and treatment. And this is we're literally talking with a world's expert. I am so honored to be here with you, Dr. Simulka, and I just want to say like, on a human to human level, I have such a deep respect already getting to know you and you've told me because what I hear is so often we go to medical school and then after medical school, we think we've learned everything we need to know, right. And then many doctors don't continue learning or being curious. And the first thing that I hear is you were curious about, well, what if what if there was some problem here. And I think way back to the times when they were delivering babies after doing autopsy and not washing their hands right and that started this sepsis and the maternal mortality rate was so high because they were taking this bacteria from the cadavers and then delivering babies. And it was literally doctors causing harm. And you and I took the Hippocratic oath and said first, do you know harm and so part of that I think is remaining curious to could there be some things whether it's a drug work prescribing or procedure we're doing and just remaining open. And I just loved hearing your story because what it shows is this deeply compassionate human being that you are and you were open because it could mean that takes a lot of humility because here you are that world's expert on gadolinium and then to say well what if there could also be some harm. And I want to just publicly honor you for that heart that you have because there are people on all kinds of procedures and things that we do that can have harm because it's the spectrum people right. So let's dive in with that but I just want to honor you publicly for your work and for your humility, your compassion, and your curiosity because it takes a huge heart to do that and to say well what if. So then you did have obviously with these two patients kind of start to question and say what if. So tell us then about how did you determine that there could be possible toxicity. And then we'll talk about like how do you diagnose it in a patient who's having symptoms. You know, the other thing that's kind of, you know, a lot of this also comes with some sadness on many levels sadness of the illness of the patients. But also sadness in the unwillingness of many physicians to see what should be very obvious. And the way I sort of like to think of it is that if you were an eight year old child.  And right afterwards, I felt really very sick. What could it be do you think it's maybe the presentation of lupus suddenly, or ALS suddenly, or is it what you just got put into your body, you know, and to me it's kind of so obvious that that, you know, if you have developed suddenly symptoms that you didn't have before and it came right on after the gallium injection. Why wouldn't it be this. And then the next thing is to figure out, you know, the features of the disease. So one of the things that I think it's very important and maybe it's worth repeating to your audience, a couple of times. But the symptoms that are sort of classical. Another thing that you have to remember is that gallium goes everywhere in your body. Yes. And as we're learning from the COVID virus, where we thought well just a lung thing but we're learning is going everywhere all the tissues yet. And gallium is going everywhere. So the symptoms can involve everywhere because it's going everywhere. But the classic symptoms are. And again, I think because it's given intravenous. One of the more distinctive symptoms that makes it different than many of the, what I would call it part of the group of immune mediated inflammatory diseases. What makes it different, I think, is that the extreme burning that people can can experience. So for me the five classic symptoms are skin burning. A bone pain. And it's not like, you know, what is that pain? It's like a screwdriver being rammed into your bone. And what's distinctive are rib bone pains because, you know, a lot of people have knee pain and so on. And I was like, just the knee pain I have or is it from gadolinium. So any of the bones and joints can can get very painful. Then the other feature is brain fog. So many people and and I know Dr. Jill dealing with the range of diseases that you deal with brain fog is a feature of them as well.  So the and then the other feature is pins and needles sensations that can be anywhere. And the pins and needles, again, is a symptom that's classic for small fiber nerve disease. And the other feature that I like to focus on is fisculations. So muscle twitching that could be anywhere. So those are sort of the five classic symptoms but then beyond that, you know, we could talk just about all the different symptoms but the other second grouping that's very common are people will describe a head pain that they don't call like a headache it's a head pain. And I think the best description of it is that it's like having a swimming cap put on your head, but what is three times too small. So it's like a constrictive pain. Then vision is quite common hearing is very common cardiac arrhythmias and bowel bowel abdomen is usually stasis so alias type patterns, and then imbalance patients can experience incredible imbalance. So those are, I think the most important symptoms to to the people should know that they may have and unfortunately at this point in time, most of the patients with disease this disease, they've made their own diagnosis. Yes, because they've gone in to see their doctors, the doctors will say, hey, it can't be gadolinium because you have normal kidney function and the only people who have problems with gadolinium are patients with poor kidneys who get nephrogenic systemic fibrosis. So it's kind of tragic that most of the time the people who come to me, they've made their own diagnosis. Hey everybody, I just stopped by to let you know that my new book, Unexpected, Finding Resilience through Functional Medicine, Science and Faith is now available for order wherever you purchase books. In this book, I share my own journey of overcoming life threatening illness and the tools and tips and tricks and hope and resilience I found along the way. This book includes practical advice for things like cancer and Crohn's disease and other autoimmune conditions, infections like Lyme or Epstein Bar and mold and biotoxin related illness. What I really hope is that as you read this book, you find transformational wisdom for health and healing. If you want to get your own copy, stop by readunexpected.com. There you can also collect your free bonuses. So grab your copy today and begin your own transformational journey through functional medicine in finding resilience. So I noticed that in your bio as I read that in normal kidney function, which again for most physicians are worried about abnormal kidney function because if you're listening, you don't know all the medical technology here. Our kidneys are filtering these dyes and things that we put into our body. That's our natural way between liver kidney and that's one of the organs. So if your kidneys aren't functioning as a healthy filter, of course you could have more toxicity from something you put in intravenously. But what you're saying in your article and today is that many people are complaining of symptoms with totally normal kidney function, which again, for us medical professionals, if you're listening, you should be aware of this as well. What percentage would you say? And interestingly, I just want to say a little backstory. My interest in this, I wrote an article and I think that's how we connected and I am not the expert, but just like you, I saw a handful of people that came back and said, the day of my MRI, this is what happened. And it sounded just like what you described the burning, the brain fog, the neuropathic kind of neuropathy, numbness, tingling, a lot of those symptoms. And same as you, I said, well, huh, could it be connected? And I didn't assume anything. I just was open. And then I started reading more about some of your articles, the stuff you've published. So the same way that you came to this was as well for me when I heard patients complaining. So now that you've been writing, I'm sure you get contacted a lot, but say you have a thousand or 10,000 patients who get a gadolinium MRI. What percentage might have GDD? Have you do have any sort of statistics on this? Yeah, I'm glad you asked that because I think the next, the next question is who gets it and how frequent is that risk? Yeah. One of the things I think one of the reasons why radiologists don't want to accept the diagnosis is because they fear it will create a sense in the public that it's extremely toxic and nobody should get it. They don't want the gadolinium and they don't want to get MRIs and so on. And I think they have that sort of chicken little fear of running around and worrying that the sky is falling. But one of the first things I tell also to people who are going to get an MR and email me in our sort of panic about it. So one of the things that I say, first off, is it's relatively uncommon in the general public. About one in 10,000 people will get this disease. So that's one of the excuses that I have that radiologists and other physicians may not want to accept it because they may not have seen it. The other big problem of radiologists, which includes me and my former life, is that we never see patients. You're in the dark room, right in the basement of the hospital. And patients will guess what? You don't know if there's some lasting problem that they get. I mean, it just is that simple. So about one in 10,000 people can get it. So it's not that common. The people most likely to get it, Dr. Jill, as I look at you are people like yourself are white women, first off, but then you add onto it the areas that you have done a lot of work in. So anything that sets off your immune system, anything that I consider in the cluster of entities of T cell dysregulations, which includes regular autoimmune diseases like rheumatoid arthritis, but the whole grouping of conditions like chronic inflammatory syndrome or chronic fatigue syndrome, or even mole toxicity, fibromyalgia, chronic Lyme disease, chronic viral disease. These are all conditions that have set your immune system off. So it has a T cell dysregulation. And I'll give you a Latin quote that I'm very fond of that makes me think of all of these. And that is abyssum invocat.  Oh, so true. So once again, it's like it's primed, right? Your immune system is primed when you have a lot of these infectious toxic things that have triggered an immune response. Exactly. So another chemical can add to that load. Right. So many, many of the people come in, though they will have a history of what you could call multiple chemical sensitivity syndrome, or the other things that I mentioned in that sort of cluster of unusual immune mediated diseases. And once you have one of them, you're a setup for getting another. And that's why one of the things that I worry about, for instance, with the COVID long haul and the COVID vaccine long haul. So once you have one of these conditions, and what we do nowadays with everybody who has some sort of weird neural thing is they get an MR with gadolinium. Right, right. And if you look at that, you know, in a number of people, particularly if they get repeat gadolinium injections, then you have gadolinium deposition disease, and that then becomes your dominant inflammatory condition. Well, the good news is that we can actually treat that. But one of the things that I do want to emphasize, and this is a good point to do this, Dr. Jill, and that is if somebody is sick from gadolinium the first time through, before an MR, we have a check sheet that would give patients about things, you know, do you have like cardiac pacemaker clips in your brain and so on. You have to ask people, have you had a previous gadolinium injection? Yes. And did you have persistent symptoms afterwards? Because quite often what happens with the first onset of GDD, it may go away in a few months. So they will get this like burning and brain fog and then it goes away. Yeah. And then, you know, they're better. But with each successive MR scan, the disease becomes more ingrained and more difficult to remove, and you get progressively sicker and sicker. So a number of my individuals, they have this and they get neural symptoms and then, whoa, how are we going to investigate neural symptoms? We'll do another MR with gadolinium and the month later they're worse. Oh, maybe it's a progressive and neural condition like MS. Let's do another MR with gadolinium. So I have patients that have had maybe 15 gadolinium injections in a row, all of them to investigate what was started after the first. Wow. Wow. Yeah. So. Well, and I have that. Go ahead.  I mean, white men are probably the next most common group, but the combination of having a pre-existent something that you describe as the entities that I mentioned and the ones that you specialize in. You're a setup for getting this. It's so fascinating because women we know have four or more times the autoimmune risk, which is kind of in this realm. And that makes a lot of sense. One just thought personally that I think a lot of women may be facing. I'm a breast cancer survivor. I had breast cancer at 25. So of course, my follow up could involve MRIs as a young woman with dense breast tissue and I've had multiple with gadolinium.  It's pretty hard to do a non gadolinium MRI for the breast. Is that correct? So I've always been told the rule. Yeah, they, they would not want to do that. Now, not to say that it can't be done, but in part, I think, you know, we, for a number of reasons, we want to have the least likelihood of making a mistake. Yeah. There's good reason, like the best thing for the patient. And there's the other reasons that, you know, radiologists and absolutely. And that's what I want to say too. That's why we overuse. Yeah. Yeah. And I remember just in my early forties and some of the screening where I found a lump and it turned out to be nothing, but I had, I think two MRIs in the same year. And then it was, they were recommending a third. It was like every six months and they were all with gadolinium. Now I have not had any side effects or symptoms. Thank goodness from gadolinium. But intuitively on that third one, I thought, you know what, I'm not going to take a risk of one more gadolinium MRI. And again, I had multiple and I've had other ones as well. So this isn't something that I totally avoided, but it was interesting because even me personally, I thought, you know what, I don't think that's worth the extra risk of getting a third MRI within 18 months with gadolinium. And so I chose not to, and it turned out to be all benign and everything was okay. But there is this, I maybe talk about this because as a radiologist, you're trying to diagnose disease, help patients identify cancers, brain tumors, multiple sclerosis. And so with some of these things, the gadolinium is really, really important because it enhances certain tissues. Do you want to talk first to the patient, but also to the doctors about, because even as I'm an MD, but I'm not a radiologist. So sometimes I'll call someone like you and say, for this condition, do I want contrast or not contrast? Maybe just first mentioned to the public and to the doctors, why would we do a gadolinium enhanced MRI versus a non-enhanced MRI? What's the kinds of things we'd see differently? Well, as a general rule, with gadolinium is, if you think of sort of the broadest range of all organ systems, gadolinium allows you to see the presence of enhancement and the absence of enhancement better than anything else. So if we're looking for small tumors, so my particular area of expertise is the liver and pancreas and I guess the other organs in the upper abdomen. My, if you're looking for a small hepaticellar carcinoma to look for the pattern of enhancement that cancers have, you kind of don't want to miss them. Now the question is, how often should you do these studies and can you interleave other MRs without contrast? And I think a lot more thought has to be done in minimizing the number of times you may do the optimal study. So yes, it's by and large extremely helpful for looking for cancer, but can you use that enhancement template on a new study without contrast and then just transfer where you saw the enhancement and look at the morphology of that now. I think a lot more attention and focus and this may be something that artificial intelligence would readily be able to do. So I'm just, you know, in my earlier years, we were, we thought that gadolin was the safest water.  Now I spend a lot of time thinking about how soon I want to do it. Wait, right, exactly. Right. So there's that what we probably not that maybe Dr. Jewel have different discussions on different aspects of imaging the future. But for instance, you know, the, the reliance of other technology that we imaging wise that we don't inform of patients of the risk to me is hate to say it, but it's shameful. So there's a great enamor of pet and pet CT, but the radiation doses in pet CT are enormous and the new, the new radio traces that are coming out, they sound great. And some of them do wonderful things. But what is the dose and what is the risk to the patient.  So one group that really seems to avoid talking about safety and to me, it's unconscionable. Yeah. You know, again, just for those listening, you may not, you and I know about radiation and doses, but you want to just briefly talk about like a regular x-ray chest x-ray versus a CT versus a nuclear med test. And for the consumer who maybe doesn't know what they're getting kind of the numbers of how much more radiation they're getting with some of these studies compared to a regular chest x-ray. Okay. Well, now it's interesting before I got into the MR and the gadolinium safety, I was really focused on CT and radiation. And I like to think that that work because I would say that it was one of the first maybe the first university radiologists to write about this subject. Now there was a cardiologist who wrote in. It's funny. I wasn't aware of his work, but some months earlier, Eugenio Picano from Italy on the same subject of radiation doses. But at the time, most body CTs involved and I'll just have to use these units. Okay. Sure. 10 millisieverts of radiation. Now, if you look at the FDA website on radiation risk, 10 millisieverts in a 40 year old male is associated with a one in a thousand chance of cancer. Now, a lot of people will use that number and translate it to everybody else, but it's not the case too. Because, you know, you think you know about medical radiation, you think, well, 10 millisieverts is one in a thousand of cancer. Well, in a one year old female, 10 millisieverts of radiation is associated with something like one in a hundred or one in 200 chance of cancer. So an entirely different ball game. So what happened in the evolution of CT, which is one of the things, you know, that great things do happen in medicine. It was sort of, you know, 10 millisieverts and many children were done at adults things and so on. But through the course from about 2005 to 2010 CT scanners were designed to deliver less radiation doses and protocols were designed to to also have less scanning. So nowadays, where where a typical abdomen CT was 10 millisieverts, maybe 15 years ago, now it's maybe three millisieverts. Wow. And the other thing that's important to keep in mind and it's, you know, it's it's difficult when to tell people when there's a risk. And there was a study that was done by the VA system, maybe 20 years ago published in New England Journal that described, you know, if the risk is something like one in 40,000, you should probably inform patients that there's that risk. So I think with, you know, a lower risk, I think patients should be aware of it, but aware that the risk is relatively low. Okay, and even though in the radiation literature, the sort of radiation biology literature that they have described there's no lower limit of risk. The lower limit I use is one millisievert. So right now one millisievert would be a brain CT to suggest that one brain CT done is probably not a huge thing. Now, in contrast, when you talked about chest X-rays, that's about 0.01 millisieverts. So about 1000, the amount 1000 is the amount of radiation. Now, PET CT combines both PET and CT. And traditionally that radiation dose is 20 millisieverts. So we'd have to go to the books and then calculate what is the risk. And again, not only and you as a female physician, you also know that most of the risks and so on have been determined for males, but it's different for females and not enough research has been done on females. But the risks are then much higher and you can't just simply do them every three months and say, well, there's going to be no problems. Particularly, I sort of in a dark humor think about if you're doing this every three months in a cancer patient and 10 millisieverts is a 1000 chance of cancer and 25 millisieverts is maybe 1 in 300 chance of cancer. You're given something that can cause cancer to people who already have shown you they can develop cancer. So it seems on the surface a little bit crazy. So that's why I recommend that you interleave them. So again, interleaving PET CT, which for many things is really the gold standard but interleave it with regular CT. Some things could be interleaved with ultrasound. Some things interleaved with MR and if it's not with gadolinium MR is extremely safe. So I just think that there has to be a lot more bot placed into these things, but it needs to be people like myself are interested in safety. And right now, you know, right now, my time is focused on this one area of gadolinium toxicity and by extension, actually heavy metals and general toxicity. Yeah, so hang on. If you're listening, we are going to get to treatment in just a moment, but this is so important because the other thing that I hear you saying is where I see clinical practice. Someone said, Oh, well, I really need a pet and a pet scan and I really need this or and patients are starting to demand and a lot of times physicians were trying to please the, you know, insurance and the patients and trying to balance all these needs. And sometimes when a patient comes and really, really request an imaging, you know, we disorder it and we don't think but I think that as if you're out there listening to your patient. I think it's your responsibility as well to know the risk and to not over ask for the things and again, we as physicians, number one, it's our responsibility informed consent, but I want patients to know to that there's no thing without a risk that you ask for, whether it's a drug or treatment or an image and just knowing and starting to understand that is important. So I want to be the first to say I want to educate physicians and patients about the benefits and the risk. So thank you for being on the forefront. Let's turn to treatment because obviously you have studied GDD. And it sounds like you've given us kind of the set of symptoms. Is there a diagnostic criteria? Is it mostly a clinical diagnosis? So let's go like, what is diagnosis really look like? And then what do we do for treatment? So the diagnosis really at this point is generally most people develop symptoms within 24 to 48 hours, but it can extend beyond that to at least a month. So I accept these new type of symptoms like I described new symptoms within a month period. GDD is is a likely entity and maybe the obvious entity. At this point in time, our first treatment is actually the best diagnostic tool to confirm that the patient has GDD. So I'll sort of interleave into treatment as we talk about diagnosis. The best treatment. And again, this actually applies to all heavy metals. And again, to me, it's kind of obvious, but people don't necessarily understand the obvious. But if you're trying to remove a metal from the body, you want to use a key later, which has the strongest adherence to whatever metal it is you're looking at. And one of the analogies I've used is the magnet crane game that used to be present in like grocery stores where you have a crane with a magnet on it and all these little stuffed nasty animals and plastic rings and so on. And then it sticks on that and it transports sometimes all the way through, but oftentimes read releases it, which with metal terms, we call redistribution. And then it will take it over and drop it into the shoot sometimes. So you want to have something that's really powerful that hangs on and stays hanging on and doesn't really release it. So, so we call that and we call that the stability constant. So, you have to know the stability constant. If you're going to use a key later now a number of people just randomly use key laders, but you have to know the stability constant with the metal that you're interested in. And it's knowable. It's a lab measurement, but it is knowable. And if it isn't, if the manufacturer hasn't determined it yet for that metal, then maybe you shouldn't do it because there's others where the stability constant is known. For instance, with with gadolinium, the most stable key later currently on the market is DTPA. Yep. So now I'm just using by memory numbers. So these aren't the exact numbers. But the key later that's oftentimes used is EDTA the stability constant and actually the log stability constant but stability constant is 17 for gadolinium with EDTA. For DTPA and gadolinium the stability constant is about 20. So in log terms, actually it's maybe 20, it's higher than that. It's actually around 22. Yeah. So 17 versus 22. So that actually by log scale is something like 300,000 times, and those are the right numbers. That's not, I'm not making a mistake. 300,000 times more stable. So you would think, well, geez, if the whole basis of this is to hang on to the metal, shouldn't I use a thing that it's most likely to hang on to it? Because if you don't hang on to it, what happens is you re-release it back into the body and then it goes to somewhere else. Yeah. So the other critical thing about the diagnosis when I talked about chelation, so we will chelate with DTPA and the things that I look for to confirm the diagnosis is if you were sick from the gadolinium when it went in, and you're still sick from the gadolinium, when we remobilize it in your body and it goes into the circulation, should make you sick again, right? Yes. So we call that gadolinium removal flare. So you have to have gadolinium removal flare if you have gadolinium deposition disease, otherwise you have something else. And the other flare that's sort of very interesting that you also have to have is what I call gadolinium equilibration flare, and that comes on about three weeks later, because what happens with metals and heavy metals in general is that it's distributed in the body in various tissues at various strengths of adherence, and then in some repositories it's very durable. So using gadolinium and lead is very similar in this regard. The two largest areas that gadolinium goes to are the skin where it's easy for us to remove gad and the bone where it's difficult. So DTPA can remove gad directly from bone but doesn't do it that well. So what we then rely on is what's called Le Chatelier's principle, which is everything strives to be an equilibrium. So the gad removal flare occurs immediately. And at the same time, if you've used a porculator, you will get gadolinium redistribution flare. They both occur immediately. About three weeks later it becomes most noticeable of gad re-equilibration flare. And what that reflects is since a lot of the gadolinium you've removed has come from skin, some of it from brain and other soft organs, very little from bone, what happens if at one point you, you know, bone was here, skin was here. Well you've pulled it out from skin and now the difference is huge. So re-equilibration is now bone moves back to bring in gadolinium to skin. So that happens in force at about three weeks. So you will get a re-equilibration flare at three weeks time. And that has to occur as well. And that's very distinctive. And people will panic and think, oh my God, now I'm getting worse again and this didn't work, the circulation didn't work. No, this is what has to happen. And what's important for me to tell patients, and I think that's important for all patients, they want to know what they're going to feel. They don't want it to be a mystery. So I tell them you have to have a removal flare and you have to have a re-equilibration flare. If you don't, then you don't have the disease. Now, with time I've learned to manage that more. So we start by giving people lesser amounts of chelator to begin with and we give them IV steroids. And we generally then try to increase the amount of chelation with time and decrease the steroids to have a balance.  So we use the steroids as we use acute hypersensitivity reaction management and we also use the steroid taper, as you would with any sort of severe allergy. This makes so much sense because I'm in the world of I've done stuff with lead and metals chelation. So I know that EDT is better for lead. DMSA is better for mercury and we don't mix those two because, again, this coefficient of basically the Crane analogy, I love that, so Ablegol. And then I also deal with toxic mold in the environment and the accumulation in the fatty tissues. And so I know that as I'm detoxing a patient, same thing, they're mobilizing that from their tissues into the bloodstream with the liver and the kidneys are filtering. But if I mobilize quicker than they can excrete, which is exactly what you're talking about, then they get actually they're mobilizing their blood is actually almost like toxic for metals or or from, for my case, the mycotoxins and they get really sick. And I'm always as a doc have to really check in carefully because I know I can mobilize very quickly and make them very, very ill, but I don't want to because I have to make sure they're excreting that load. So I really love that you described it and can so relate to the patients that I've treated on a different level. And even like you said, framing the expectations because often I say, okay, this is what you should expect. If this XYZ happens, that's okay, but if it goes on to be this thing, you need to call me right away and we need to so really brilliant that you have discovered that and, you know, and also understand that it's going to be, we call it somebody's a herxheimer, the Jack's herxheimer reaction, which isn't very specific, but in a way it's just mobilizing and excreting and getting stuck in between. Now one thought is from my experience with metals is the kidneys are a big like that's where we do a lot of our metal detox through the urinary tract and the kidneys. Have you seen elevations in creatine or a kidney function disturbances during killing or during the process. And do you do anything specific besides hydration to support the kidneys. That's actually also very, that's a very interesting point as well. And I think after this I'd like to circle back to talk about how to manage toxicities. Yes. But so I'm telling you that so I don't forget myself. But you know, gathering was going everywhere so it's also going to the kidneys. And since we're removing gadolinium from soft tissues including the kidneys. My empirical thinking and it's sort of borne out the times that we've looked at it is a kidney function actually improves as you're getting you're pulling out of the prank him of the kidneys, the gadolinium to put it into the urinary system to have it removed. So in fact, if anything the renal function improves. And that's why, you know, I don't really use, although I'll, I'll get a measure of the renal function to begin with. I don't really use that too much to prevent me from from doing treatment because really in this disease, the only treatment is to get rid of metal. You have to go through that don't you that process. You know, so the thing that I think is also very important and it's interesting how with different toxins, the emphasis is slightly different based on the nature of how, how treatment and recovery goes. So I think for all toxins. The first step is to not get it ever again. Right, the prevention is way more important right if we could just read. Yeah, the first treatment.  Yeah, don't get it. Because you have T cell dysregulation gadolinium and you will react to it. So that really works for everything.  Exactly, let's not get that exposure. The first, the first rule of treatment. There's a whole big, big popular community out there of mold avoidance right so it's funny because it's almost like not made fun of because it's a very real thing but it's the same idea like everybody thought about that way why don't we just avoid it. So, then the next two forms of treatment are detoxification and removal. You know, I have found, and this is not an area that I'm an expert in and in the future. I think I'd be interested to pick your brains on different aspects of detoxification because I know that you're great expert in this. But for me, the most important thing about getting people healthy is to get their general diet healthy. And if you think about it, that's probably works for everyone in the population that's why we're such in such a bad. condition as a public, because we eat all these foods that are highly processed. So natural foods, limit the amount of sugar, as much as you can, you know, probably limit, you know, the amount of gluten you get. Limit somewhat the dairy and just and do physical activity and try to, you know, get fresh, clean air. And that kind of works for everything. Now there's nuances in different, you know, food groups and, you know, for instance, the food that I like to focus on from a heavy metal point of view is kale, which should be fundamentally the healthiest vegetables. But in the modern era, and that's what we have to always update our learning on. In the modern era, because of the nature of it being a cruciferous vegetable, that's very good at concentrating sulfur. Exactly. And it also concentrates thallium. Yes. And cesium. So when I look at the year, so I get urine's critical for evaluation is we get 24 hour urine. I always want to get them before and after chelation, because I want to know what their baseline is. I want to know how much I pull out of various metals. Yeah, which, which, and I don't just look at gadolinium so I get the panel. I use doctor's data, but you know, I think does the same. I get the panel of metals. Yes. And we also, it makes common sense that they also interact. Yes. It turns out that DTP as a great job of removing both lead and gadolinium and gadolinium. And you have to see what the other metals to what extent it removes others, because mercury is very variable, as you know, because there's inorganic and organic varieties of mercury. I'm now in the phase where I'm looking at, you know, I've sort of been forced into the phase of not only dealing with gadolinium where I started, but now I have to think about all these other metals, and also have to pay attention to what else they may have, which is mold, chronic Lyme and so on. So it's one of those things, right? Like I said, I'll say, same way, I was like, I'm never going to do Lyme or mold is complex. I don't understand it. And then you have to if you really want to help people because it's inevitable out there. These tick borne infections are creeping into the suburban environments and more and more common. One thing interesting, I love what you said about food, because one of the things I always say is just clean air, clean water, clean food. We start with those very, very basic principles, and that's like half of detox, and it sounds so simple. It's not always easy to do, but it's such a foundational principle, just like you said to start. You mentioned toxicity. So let's come back to like when you're treating a patient, what do you do to help them deal with the reactions in our last few minutes or so. Let's talk just a little bit about that. Okay, so I treated like they're going to have an acute hypersensitivity reaction. So I give them, and I prefer methylpregnase alone, which is solumedrol in IV form and then in pill form, because it's already methylated and a number of individuals, maybe a quarter or third, have an MTHFR gene variant. So I sort of take that out of the equation, assuming everybody has it. So I use methylated that and I used to use the methylated claretin. So claretin is methylated claretin and singular, which is a very nice combination. Dermatologists use it all the time. I now generally use adorax, which is also an antihistamine, but it's been used in PTSD patients. Because one of the things I find with all of my patients, and Jill, I'm sure you do in your patients, is that they're very anxious and very nervous.  And maybe do exercises, maybe tai chi or yoga or something to help you calm down because the cytokines involved in GDD are similar to the cytokines in stress. So they compound. So try to minimize the additional cytokine we see in depression anxiety. So it's no wonder, right? Because we're actually seeing the cytokine response on the brain and nervous system. So if anything, if you're out there listening, you're like, yeah, but I can't help it in a way you can't because your nervous system is creating the anxiety from the cytokines. But the truth is, like you said, we still have to deal with it, right? We still have to do whatever we can to calm that system down. Yeah. So so just to briefly touch on actually, I think one of the the works that I'm most proud of of all of my career is we did a small study looking at serial dynamic cytokine response to chelation. Yeah. And what what actually was an example of a normal. So I like you, Dr. Jill, I myself have received a number of gadolin injections. And I have like 13. I've had 13 injections. Wow. And for many of them, getting gadolin in a Louis Pasteur sort of way test for for reactions. So I didn't want to subject patients to it. And then, of course, did all this before realizing about gadolin deposition disease. I wouldn't have done that. Right. And I know about GDD at the time. But now, you know, the good news is that I'm now the perfect example of somebody who has a lot of gadolin in them. And the other thing is that, you know, people, you know, physicians so doubtful that gadolin, you know, stays in there. Yeah. Well, what I find is many people have that medieval thinking of the four, the four humors. Yes. Yes. But don't actually look into it. So it's very easy. If you don't think that gadolin is still there. And I know you're wrong. Yeah, the way that you can look at it is do chelation with DTPA. And you can get gadolin out of anybody who's received, even if it's many years in the past, particularly if they've had a number. So I, my cytokine response, and this is the thing. So we did very short duration, like one minute, five minute, 10 minute, 20 minute, 30 minute, an hour and 24 hours. And I did this work with the Stanford immunology center. So I wanted to work with, with a group that you could not question their, you know, ability. I didn't want to use just some local group of characters. So we came up with the cytokine response that they'd never seen before because they'd never have done dynamic cytokines. And chelation, but it would be the same with vaccines is the ideal setting because you're suddenly getting an impact on your immune system. So you can test exactly. So we saw patterns of cytokines peaking at different times. Now the problem is, you know, there was four normals and 10 patients. And as, as a physician yourself has done a lot of research, you realize, you know, to get truly meaningful data to separate, you need in the neighborhood of hundreds of thousands. If you look at the research that's done on asthma where they have all these different panels of cytokines that they've shown with the different types of asthma. Those are probably thousands of patients in each of these groups. And guess what, you know, studies of that nature are in the multi millions of dollars. So we self funded it. So I wanted to fund because I wanted to get the work going. I didn't, you know, for the sake of patients, I didn't want to wait, you know, I'm going to apply for a grant and right a year. They'll say, well, you could get it, but you need to do this.  So I wanted to treat people right away as soon as I could. So very interesting stuff. I'd love to do larger studies, but it's a lot of money. So I think the answer would be with cytokines. But what I was struck by is that I've had 13 GPC as we did a number of people who had pretty bad GDD with just one injection and we studied them at three months so they would get tremendous flares from doing sterilization. And at the time, because I wanted to see a pure flair, we didn't give steroids to them. We just did, you know, did flair steroids after the fact a day later, but not at the time. So they had tremendous flares. But this is a thing that I found fascinating at the time. Their overall cytokine amounts being released were not that high. The highest in all of all of the people, the highest was me by far. The highest highest was a patient with disease who had four GBCAs. But this is the fascinating thing about cytokines is that, and this is one of the things that I tell people, you know, maybe you don't like the diagnosis of GDD and you're thinking whatever it's ruining everybody's lives by talking about it. But looking at the normals like myself, to figure out what we are doing that is not causing reaction to gadolinium, maybe the answer to many autoimmune diseases, what cytokines am I releasing to prevent me from getting sick? Because my cytokines were like 10 times anybody else's and yet no symptoms. So the thing is that most of the cytokines are regulatory cytokines are suppressing cytokines. Well, like IL-10 we know, right? Like IL-10 is effective. I haven't had a genetic deficiency in that. And I've had a lot of inflammatory issues because I have maybe half a quarter production of IL-10. And IL-10 is a cytokine. But what it does is it calms that response. So fascinating with your study.  That's amazing. Well, I'm gonna, if you're listening, if you're a doc, if you're anyone who wants to know the research, wherever the notes are for where you're listening, I will be sure and include Dr. Zemalka's research. I could talk to you for hours. This is so fascinating. And I really want to go back to just thank you for being the kind of person that you are, the kind of doctor that you are with curiosity and compassion and that combination I think makes the greatest people who discover, like really this is a discovery that's going to change the way we practice medicine in a good way because there is a place and there has been a lot of things, a lot of life saved with gadolinium MRIs and imaging. But now that we know, it's always like I say, once we know what we know, we can't go back, right? Now that we know that you've brought this to the forefront, we have to be stewards of this wonderful technology. What? And if you could go back to your younger self, you know that you're telling us about in Canada and then realizing this new technology and the power there and obviously you've done an amazing thing with your career. But what would you go back to tell your younger self knowing what you know now? Anything that any advice you give or encouragement or things that you would say to your younger self? You know what, Jill, you're asking me something that I was hoping I would have time to mention, but in a different way. But I would tell my younger self the words of Sir William Osler, patients listened, or sorry, doctors, listen to your patients. They're telling you the diagnosis. I would tell my younger self, listen to what patients are telling you at all times. Oh my goodness. That's where like the mic dropped. But the truth is like that is where we as healers need to go. I've often said that heard that and continue to need to be reminded if we can just be present with our patients and really listen. We have everything that we need there in that encounter, right? If we just listen and remain curious. Well, Dr. Samalka, I am truly honored to have this time with you and to learn more about you and your work. I hope we have another chance to talk. And I'm just so grateful for you going to that deep level and making the discoveries and then bringing this information because I as a physician need it to help my patients and you've laid the foundation. So just a huge thank you from me and all the other docs out there and the patients for all of your work.


Hello. Good afternoon. Good afternoon. I'm announcing you. Ah okay. Good afternoon. As you can see from the steadily dwindling ranks of attendees, Debconf is drawing to a close. However, after Debconf is before Debconf, so here is your preview for next year's Debconf in Curitiba. Hello, everyone. I'm Paulo. Here we have the local team in Brazil, from Brazil. Daniel, Samuel, Lucas Canachiro, Arturo, Ziqueira, and Alan. Probably, and Valessio is there with the yellow shirt. Probably, you saw everybody here on the last days, and I would like to talk about what you have, what you are planning to Debconf in Brazil. This is our logo. This animal is this animal. It's a tamanduá, and we are using it because he is a very good animal, and he has a problem to be extinct from Brazil. Well, welcome to Curitiba. I'm going to show a video to you that we will talk about Brazil, about Curitiba, in English, by the way. This is a place in Asia with its tradition and capacity and overcoming obstacles. All these places are here, in Curitiba, in southern Brazil. The origin of the name of the city is in the Tupi language, spoken by Brazilian Native Americans, meaning land of the pine trees. For over 300 years, this city has been attracting people from all over the world. The city currently has 1.8 million inhabitants and 3 million in the metropolitan region. It is one of the most innovative cities of its time. In the 1970s, the city designed an efficient mass transit system, inducer of urban grove. The system's integration enables reaching any district with this just one fare. The city established environmental protection policies by implementing large public parks, as well as a waste recycling program. Today, it has one of the world's highest green area per inhabitant ratios. It is also known in Brazil for the cleanliness of its streets and the attitude with awareness of its citizens. Curitiba has one of the country's best educational standards. It has four universities, among which the oldest one in Brazil. The city also offers major centers in technological education, plus a basic education network featuring excellent indicators in educational outcomes. Curitiba and its metropolitan region have facilities of countless companies from all over the world. This is the outcome of incentive policies added to the local high level of quality of life, to its enterprising posture and educational level of the population. The city is serviced by a modern airport and is a mere 100 kilometers from one of South America's largest export ports. It is located at an important highway crossroads between São Paulo, the largest city in Brazil, and the countries of the Americas. Uruguay, Argentina and Paraguay. It is located close to important tourist attractions such as Vila Velha, site of an impressive geological formation and Iguaçu Falls, one of the planet's seven wonders of nature. The city has an intense cultural life with theater festivals, major shows and international events. It is also one of the country's main gastronomy and hotel park hubs in Brazil. Curitiba. The world is here. Welcome. So we find this video from the city hall Curitiba and it will show to you because it's very nice. It's in English and they show many images from the city and some cities around Curitiba like Foz de Iguaçu and Vila Velha. If you can go there before or after Debrecon. Well, in July we have a temperature, a little freezing, so for us at least, between 7 and 20 degrees Celsius. But sometimes we have zero or one Celsius, which is very good for us. So we have snow in 75 in 2013, as you can see. And this is Daniel's grandmother in Jordan, no storm in Curitiba for a few minutes, maybe 5 or 10 minutes. We have snow there in 2013. And we know how to make snowman, right? Nice. We'd like to show some photos about Brazilian food like coxinha. Brigade, coxinha is soft, yes, and the brigade is sweet. We have with chocolate, we have feijoada, Brazilian barbecue and a lot of fresh salad. So don't worry with vegans or vegetarians, we have a lot of food. By the way, even the people that eat meat, we have salad too. It's very usually in Brazil, we have a buffet with rice, beans, beef and salad too. It's very usually for us, fresh salad, like lettuce, tomatoes and everything.  So if you have a friend, usually the friends like to hug each other, don't be afraid if a Brazilian wants to give a hug. And the kiss on the face, right? When you meet someone, it's very usually you kiss on the face, but in Curitiba it's just one kiss. But in other cities it's two kisses, and in the other cities are three kisses. It's very different from one city to another, but in Curitiba it's just one kiss because Curitiba is more... Yes, one kiss is enough, right? Well, like I said, you can make tours in Brazil before or after that. In the Paraná State, where Curitiba is, we have Catarata Falls in Fosigua City, that we showed in the video, we have Villa Velha, and probably you will arrive in Rio de Janeiro or São Paulo because these are our international airports. So if you want to stay some days in Rio de Janeiro and São Paulo, it's a great idea. We have Amazonia Flores that is not near from Curitiba, it's far from Curitiba. And the north-eastern region has wonderful beaches, and by the way, I was born there, but I'm living in Curitiba now for many years, but if you like beaches or warm water, you should go to the north-eastern region. So this is a map where you can see Rio de Janeiro, São Paulo, Curitiba, and Porto Alegre, where there was a Debi-Confi in Debi-Confi 4, just to have an idea where is Curitiba. From São Paulo to Curitiba, it's just one hour back plane, or six hours by bus. The travel by bus is very nice, the bus is very comfortable, so if you don't want to go by plane, it's a good idea to go by bus, it's very nice. So let me show, somewhere we will talk about the venue and other stuff. So Curitiba has two public universities, and our venue is going to be on one of them called UTFPR. It's Federal Technological University of Paraná, and it's located in downtown. Here it's on your bottom left. And right next to it, there's a big shopping mall and also a bus stop. And the hotels where we are planning to do the accommodation are located like two blocks away from the venue, so that's not going to be a problem at all. This is the same place where we did the last two mini-debcons in Brazil, or UTFPR, and it has this big auditorium for 109 seats. They also have the mini auditorium with 100 seats, and many classrooms between 20 and 50 seats, and they have these big tables with power plugs in there and also internet plugs. And they are all located on the same campus. And also has a big restaurant inside. The restaurant currently has two floors. There's a photo of the second floor, and we are going to serve the meals there. And this is right in front of the entrance of the auditorium and the mini auditorium. It's like a open garden where we can use it as a hack lab, and there will be Wi-Fi there. And this is like the hall between the open hack lab and the restaurant. So you have everything connected to each other. Also the place for the job fair. The place, the university is very accessible. You can say there are ramps to all of the rooms you need to go. There are elevators also, but probably we won't need to use that because it is all on the ground level. I think maybe one of the rooms is not going to be on the ground level, but it will not be a problem. We are trying to reach some hotels, so there are at least three hotels. It's actually two hotels in one hostel, and this is one of them. And I'm going to show two of them here, and both are like one block away from the venue. We have a national inn with about 200 rooms, and a la Jinha Hotel with 80 rooms. So these are our current dates. And on the last day, it will be a Sunday, there will be a handicraft fair visit, and also a Brazilian barbecue for those who stay there. But all the talks are going to end on Saturday because people have to work on Monday and stuff. And do you want to say something? Here in the hotel, we are showing that room, that conference room, because we will make a hot club inside the hotel too. So we use this space. There are other rooms that we can use to the hack labs, and you probably will have hack labs on the venue and in the hotel. So who prefers to stay at night working or doing stuff, something, can use the hack lab on the hotel. That is it, some comments you'd like? Did I forgot something? Okay. Questions please? Easy questions please. Concerning the hack labs at the venue, you said you have a lot of classrooms. Is there also one big hack lab possible? Probably. We want to use this space, this open space and put some walls. Let me find it here. No, there's no man. Here, we're planning to put some walls around and do the hack lab in this space, all the space that you are looking to. But it will be somewhere there. Then concerning the temperatures, because it's winter in Cape Town, there was no heating in the rooms. How is this in Brazil? There won't be any heating in the rooms, but as you see, the minimum that you will find is five degrees, but that's only in the early morning. So like at 10 o'clock, it's going to be something between 10 degrees and 20. It's not usual to use heaters in there. But to have our conditional in all rooms, all auditoriums, that you can regulate the temperature. So the air condition can also heat? Yes, yes. But, sorry? That's fine. I remember that in Cape Town, when you sit the whole day in a hack lab that was not heated, it was getting very cold for a lot of people. It will be cold for us, so we are... I would like to know how the laws concerning selling alcohol are. And another question, are there any close micro breweries that are able to sell some cakes for us? Thank you. Okay, so there are a bunch of local breweries, and we are planning to connect with them to get some beers and stuff. But we aren't allowed to drink inside the venue, so that's the main reason we are looking for this hotel hack lab. And we want to sell beers in there. But maybe we will also set up a beer truck very next to the venue. But the hotel is one block away, so that should not be a problem. Yeah, there are some beers. Yeah, there are lots of local breweries. I think it's the city with most local breweries in Brazil probably. Yes. More questions? What about using a bike in the city? Is the city very flat or very hilly? Is it common to use a bike there, or is it dangerous to use a bike in the city? I ride a bike daily in Curitiba, and like most of the city has bike lanes, so it should be very easy to ride a bike and also very safe. It's somewhat very plain. You're going to find some hills, but it's not going to be that much, so we should be perfect for riding a bike. And we are looking for... We are talking with a bike rental service to see if we can arrange some bikes to get inside the venue so people can rent them from there. Is the hostel that you mentioned, is that the dorms? As in for people who apply for accommodation bursary? Okay. Yeah, we prefer to use the hotels first. Okay. And if it's necessary, we will rent the hostel too. Okay. Because the hotel is near for the... Yeah, the hostel is not that close as the hotels are. Hi, I want to know if there will be a karaoke. In Heidelberg, we had a karaoke, and it was very fun. Yeah, we hope so. We are planning to make some different things like vegan fare, for example. We are planning to do a... Football game. Football game, yeah. Somebody already challenges. Some kind of table with foods that you can prove there to taste in Brazil, local foods. And yeah, let's go party there too. There are some karaoke bars in Curitiba. Close to the venue also. It's easy to set up in a club. Yes. And what about activities and places to go with children? Yes. I'm not really sure, but there is a zoo. There are lots of parks. If you're into that, you are going to really like it. You will have like at least six options for big parks in there. So there is this zoo, and I know that there are lots of attractions for children, but I'm not sure what they are actually. I know that there's one inside the shopping mall, but it shouldn't be that fun because it's inside the shopping mall, you know. Yeah, every Saturday on downtown, maybe 10 minutes from the venue, the city hall is doing, putting some activities. Yes, to try to play there, to balloons and everything. Like ping-pong tables and stuff like that, chess games. Every Saturday. Hi. Two things to consider while you're planning. One, because you're talking about hack labs in multiple locations, sometimes it's difficult for newcomers, people who are shy, and people who have different times to spread out so much. It's more difficult for people to meet each other if they don't have a central place. So you might think about how to hold people together that way. And the other thing is that food is complicated, and for example, vegetarians will not be happy with salad. Yes, yes. It's more than salad, right? Yeah, it's not meat dinners with the meat removed. It's a different kind of... Yeah, I simplified very much, but we have three persons on the local team that are vegetarians. By the way, one is vegetarian, two are vegans, so they are helping us to make a nice meal. But it looks like you have a challenge with the hack labs if you want to have alcohol and you want to have a number of other things a block away, so I think you'll have a challenge this way to hold people together. Alcohol is the main problem. Yeah. And a warm hack lab where people can sit together. Yes. Unfortunately, time's run out. Thank you very much for all your feedback and questions. Thank you very much for your presentation. Just a little bit. Please send to us all ideas that you have. Don't be shy. We are grateful to receive many kinds of ideas that you have that you would like to see on WConf, right? Thank you very much. And next up is, unfortunately, the last event. It's the closing ceremony. Thanks. Bye.


So till that time, I just want to know that how many of you have ever hear about the garbage collector and I about the G1 that we are talking. Now, the good part of this presentation is that there is no prerequisite. If you are past your college and you are from the engineering background, you can understand garbage collector. You don't even need to know Java. Okay, good to start. So I am Vibhav and I am going to talk about the garbage first collector, which is not so a new collector because we are working from 2006 on this. And now we are telling, okay, we are ready. So it took us 10 years to give this presentation. I am from Java platforms teams and I am involved with garbage collector from long time.  And then I will tell you those greedy customers who are not happy in anything. And then I will explain you how G1 works and then a little bit of technicality of G1 and then very important the logging mechanism and when to use. Yep. So and it's going to be interactive session because we are like 40, 45 people. So we can discuss things as question whenever it comes in your mind. So garbage collector provides an automated memory management for Java, which was not in CC++. So that is very simple. And it is not about finding the dead object. Whereas it is about finding the live object and objects which are not live are called dead. So never think G1, never think GC in terms of marking the dead object because it don't works for the for the cyclic link list and for a lot of other things. Yeah. Yeah. Before going to the details of GC, I will show you a very ever been picture of Java heap structure. Okay. Why that heap structure came out into the picture is the last point. We have something called weak generational hypothesis. And as I mentioned, this is a hypothesis and hypothesis of those things which which are not theory.