This will be about 11 minutes. So thanks. I'm Ken Kawamoto. I'm from the University of Utah. I was recently recruited there to direct the operational clinical distance board knowledge management, obviously not just for personalized medicine, but for all traditional medicine at the health system. And I'm also a faculty member in biomedical informatics. So before I begin, I just need to give a few disclosures. I am or have recently been a consultant to partners in Flexion and RAND. I also was formerly a consultant for a relagent and formerly a co-owner and consultant for a company called Clinica that's in this space. I have no financial competing interests related to open CDS, which is the open source technology I'll be discussing today. So today my objectives are to first describe what clinical distance board or CDS is. I think this is an audience that probably is familiar with the term, but may need a little bit more information on it. And I want to specifically talk about how it can help bridge the translation gap for personalized medicine. And then I'm going to identify requirements for scaling distance support for personalized medicine on a national scale, and then describe an open source standards-based distance support resource known as open CDS that through actually funding from the NHGRI through a current development award I was able to start for enabling distance support for personalized medicine. So I'm going to begin with a definition. So clinical distance support can be defined as the provision of pertinent knowledge and or person-specific information to clinical decision-makers such as patients and clinicians to enhance health and healthcare. And by supporting evidence-based decision-making, clinical distance support can support the translation of evidence into practice. So for example, when we looked at clinical distance support systems that have been evaluated through randomized control trials, we found that when they provide patient-specific care recommendations that are automatically provided within clinical workflows, they significantly improve care quality in over 90% of randomized control trials. So just to give you a sense of what people typically mean by distance support in this field, here's an example, disease management dashboard that I created while I was back at Duke Health System. So this is a disease management dashboard available to clinicians as a part of the electronic health record system. So when you pull this up, for example, here for diabetes, it'll show you care metrics that the American Diabetes Association says you need to worry about. It pulls in the relevant patient data when things were last done, the last values were, and a bottom line, very actionable recommendation on what you should do. So this was very well-liked, used very widely at Duke. So when you think of what this kind of technology can do for personalized medicine, I think there's a few points where it clearly makes sense. So for example, for test sorting, you can definitely recommend an indicated test. So as clinicians are working, you can imagine that you would get some sort of reminder or pop-up or whatnot that says, hey, did you know that for this type of patient, you should be doing this genetic test to make sure that you don't get an adverse event? Or perhaps more importantly, you can recommend against a test with dubious clinical utility. So you can imagine a clinician is about to order a test and you know that this shouldn't be done. You can say, well, you know what? You probably shouldn't be doing this and this is why. You could also personalize test interpretation. So instead of getting a genetic test result back that says, here's the genotype, and in general, this is what it means. You can imagine that it can be combined with clinical data to provide a personalized risk assessment and care guidance. So the key part there is you need to pull in the clinical data at the same time to provide that guidance. Also as our next speaker, I think we'll be talking about, you can clearly make use of family health histories to, for example, tailor preventive care guidance for cancer prevention. And of course, you can manage therapy. So for example, distance support can help you provide genetically informed pharmacotherapy guidance. So this is an example of a Warfarin Pharmacogenetic Dosing System that I developed while I was at Duke. So this is for a commercial order entry system called Nikesen. So you can see here, you collect a number of relevant clinical data. Also identify the patient's relevant genotype. And then other relevant factors like previous doses. And based on that, you provide very specific care recommendations on what the dosing should be for this patient for Warfarin. So I think some of these examples show, I mean, I think intuitively and based on review of the evidence, this approach is very effective. It can really help provide better care. The problem with this approach is that distance support has been very limited in its scale. So despite decades of demonstrated effectiveness of these kind of tools, distance support is not widely available. So for the practicing clinicians here, unless you happen to work at one of the leading institutions for developing these kind of systems, you typically have fairly low or no distance support available in your clinical practice. So this happens because most distance support is designed to only work within specific institutions in health IT systems. So it's great that you have a paper in the New England Journal showing that this kind of approach for distance support works, except 20 years later, most people still aren't able to do that in their clinical practice. So we still are trying to scale up traditional distance support capabilities that have been validated for decades. My main point here is that unless we focus on scalability, distance support will have a limited impact on personalized medicine for decades to come. So here's an example. Here's a New England Journal paper called Protocol-Based Computer Reminders, The Quality of Care and the Non-Perfectibility of Man. Great paper, randomized control trial had several hundred rules on disease management, adverse event prevention that showed this improves care. The notable part about this is it was published in 1976. So this was published before I was born. Right? So this is a, and we are still trying to replicate this capability across most health care systems. You look at the rules here, most health care systems do not have the rules that were validated in this randomized control trial in the 1970s. So the question becomes, what's needed to scale distance support for personalized medicine? So we published a paper on this topic that where we thought through this, and I'm particularly interested in the space also because I co-chaired the distance support work group for a group called HL7, which is the standard setting body for health IT. So there's at least three main components. So one, you need to standardize the representation of relevant patient data. If people talk about diabetes differently, medications differently, or observations differently, you're never gonna scale this. So this is for both clinical and genetic data needs to be standardized. You also need centrally managed repositories of high-quality computer-processable medical knowledge because if you don't know what you should do, you're not gonna be able to do anything. And you also need standard approaches for leveraging this knowledge to provide patient-specific advice. So what I'm gonna talk about briefly now is a tool called OpenCDS, which is an open source, standard-based, freely available distance support platform designed to enable distance support at scale. So through funding from the NHRI, I was able to start this initiative. It's certainly intended to support and address the requirements for a national distance support infrastructure for personalized medicine, but it also encompasses more traditional medicine as well. So some key components of this, it uses standard data models. So I won't get into the details, but a lot of my activities over the past several years has been defining and getting adoption of some of these models as international standards. It can also leverage various knowledge resources. So looking at all these different knowledge resources that are available, it can leverage them both when they're externally internally developed. And it provides a standard approach for EHR systems to leverage these kind of resources over the internet through what we call web services call to obtain patient-specific advice. So this has grown into a fairly large collaboration. There's a number of collaborators from both the public and private sector and actually a fair amount from outside the US. And these are all folks who are interested in pursuing a standard open source approach to creating the infrastructure for this kind of distance support that scales. So without getting into technical details, I'm just gonna show you how this kind of approach works. So you have a very simple diagram, given institution with an electronic health record system and their data sources, and then you have open CDS as a care guide and service. So what you can see here, for example, is this is the Duke electronic health record system in this kind of approach when a clinician clicks on, oh, I want the disease summary for this patient. Patient data is collected, sent to the service over the web, of course using standards. And then again, using standards, you get care advice that's generated, return back to the system so you can do things like this disease management recommendation screen I showed a little bit earlier. Here's another example. So as I mentioned, this approach isn't restricted to particular types of knowledge representation. So here's warfrendosing.org, which was mentioned yesterday, and I think a lot of people are familiar with. So it's a website that provides genetically guided warfrendosing. So if you'll notice with the screenshot I showed earlier, it'll say here, it says dosing guidance received from warfrendosing.org. So we showed how we can use the standard wrapper and they can provide this information. And just to show you what we have in terms of the actual web-based authoring platform, so without going into details, I'll just show that there's a web-based authoring for example, human readable decision rules, decision tables, so for example, this is for a vaccination schedule and this all allows you to provide these kind of recommendations. And our latest addition of, for example, decision diagrams. So you can see here, this is how we're encoding family history, risk analysis for identifying if a patient that increases for BRCA mutations. So just as a status, we are releasing a 1.0 release later this month. We already have a beta release that's available to interested parties and we have a multiple ongoing initiatives. So I'll close with some recommendations. So I think it's really important to make this in support, a core component of the personalized medicine vision. I think without it it's gonna be difficult for clinicians to make sense of this. We also need to consider and prioritize scalability for distance support. So like I mentioned, if you don't consider this, we'll have nice funded, published New England Journal papers in 2015 that shows this is a great way to improve patient care in 2050, which is about how long it's been since that New England Journal paper. We'll still be trying to figure out how we do it in most healthcare settings. You should leverage also relevant resources, open CDS is one I described and there's multiple other efforts I didn't have time to get into that are specifically focusing on this area, just not in the personalized medicine space that could be leveraged. Also as a note, I think it's important to align with an influence on EHR Meaningful Use Regulations. So for those who aren't familiar, this is the regulation that is driving through various reimbursement models, EHR, FOSI in this country. So in order to have an impact in the space, it's really important for I think the NHRI and relevant parties to really influence that. And I think as a final point, we need to start building this infrastructure now. If we don't do it, divergent and compatible approaches will develop and it's actually a really good thing that a lot of this has not yet been developed because one of the more asses in other aspects of traditional clinical medicine in the space is people have done so many divergent things that it's really hard to get everyone on the same page at this point. So I'd like to acknowledge the NHRI for funding me as one of those few dots at the end of the spectrum. The University of Utah Department of Biomedical Informatics and the Office of the National Coordinator and also a number of collaborators. If you like information, opencds.org has all the information. Basically, if you have a Google-based email access, I can give anybody free access. And I'd like to thank you for your attention and take any questions. I had a question. Are you interacting with some of the large EHR providers now like Epic and some of the others that seem to be? At the University of Utah, we're working with Epic and Cerner installs. There's also a collaborator from a health system called Mainline Health in Pennsylvania. The CMIO, the Chief Medical Informatics Officer there was the head of Disinsported Siemens and just got a contract with them to try to integrate this kind of technology. We're definitely interested and we will certainly be doing it for Epic and Cerner because that's my operational duty to do that at the University of Utah. Okay. And can I just ask you, was it easy to get Epic and Cerner interested in what you're doing and involved or not? Let me preface that to say, I started in August at the University of Utah so we are still getting started. But just as an anecdote, we had some collaborators from Kaiser of Southern California who wanted to work with us because they were having difficulty having Epic do things for them. And so I'm under no illusion that a company that's selling billions of dollars of EHR systems without making any modifications will be that interested in changing the approach they do things. So the jury's still out but I think that's why engagement in the meaningful use process will be very important because as part of some other work I've done I've interviewed EHR vendor executives and they basically say if it's not meaningful use we're not interested right now. Can you show your slide again where it has like with the cancers in the breast cancer? This one? Yes. I need to make a preface there that this is still under development because it uses an open source technology which became available a month ago. So does it ask anything about if there is a male relative with breast cancer has it been tested and if so what the mutation is to be able to take it? I just took the straight US preventive services task force clinical guidance. So none of this, all this is only as good as the source of the recommendation. Yes, sir. Is there a library on the open source server site of these decisions? Is this, does this become something that the community can access or we can with and understand? Certainly the infrastructure is all open source because we've been focused on infrastructure and as I noted we're doing the 1.0 infrastructure release this month and actually some of the base standards on this we just finalized as a standard in September. So we've been focused on infrastructure but we will be making a lot of the content open source. For example, we have a collaboration with the New York Citywide Immunization Registering the Alabama Department of Public Health where they will be providing all of their immunization related distance support all available open source through open CDS. Hi, I'm Mark Hoffman with Serner and great to hear about your work. I think there's two perspectives that at least within our company we have. We feel that clinical decision support is real within commercial EHR systems but at the same time we recognize the challenges of exchanging decision support logic across systems and also recognize that the maintenance in the current model of decision support logic is very cumbersome and so we are working on ways to get past that burdensome maintenance of rules and at least speaking for Serner we see initiatives like yours that provide open source thought capabilities as part of how we can work with the community to move forward so I'd be happy to talk with you afterwards. That'd be great and I'll just mention Serner has a wonderful capability called M-Pages which allows you very easily to integrate this kind of content so right now my headache is primarily on the epic side. Yes. Oh, I think I'm out of time. Thank you.


I am a massive fan of the Teenage Mutant Ninja Turtle franchise. Just in general. This sort of has nothing to do with that. But yeah. No, Teenage Mutant Ninja Turtles is one of my personal favorite franchises just of all time. I love the comic books, the different adaptations of the show, and the movies. Yes, even the Michael Bay ones.  But there is one version of the TMNT, at least in the movie verse, that I think rises above all others. And that is the original 1990 Teenage Mutant Ninja Turtle film. Which is technically an indie movie. Fun fact.  So the original film was an indie movie. Fun. It was mostly made on its own until I got picked up by another studio, Torchlight I think, not 100% positive on that. Yes, the original Teenage Mutant Ninja Turtle film is probably my favorite movie version of the Turtles.  It's highly entertaining, the plot is engaging, all the characters are fun. It has my personal favorite character from the Turtles, Casey Jones in it. And you know what?  Kind of.  Whenever April gets attacked she either tries running away because she knows she can't handle a situation herself, or when the Foot Clan attack her, she straight up pulls a sigh on them. When that gets kicked away from her, she takes her purse and just starts beating them with it.  I'm sorry.  Hell, but beyond that the Turtles are just fun. It feels like honest to God a combination of the original comics with the 80's and 90's cartoon series, which is so much fun because in the 80's and 90's the cartoon was dumb. It was really dumb. I actually don't like the original cartoon very much. There's something for a different video, but one of my biggest issues with the original cartoon is that April serves as a plot device to get kidnapped, to get the Turtles into whatever situation the writers wanted the Turtles to get in, which is dumb. It's really, really dumb. But hey, in this version she can at least do things on her own. She has agency as a character. Hell, there are multiple times when she gets told to back off from a story about the foot clan and she refuses to because hey, that's the angle. It apparently makes sense in this world. But yeah, and actually that is one thing I do have to gripe at this movie.  Seriously, there are multiple points where apparently there are a number of Japanese immigrants who are reminded of these actions of the foot clan, which is supposed to be some super secret ninja clan, but yeah, no, they find like there are a bunch of Japanese immigrants reminded of the foot clan. So April takes up that angle and then the foot clan decides to try and kill her.  The hell. Beyond that, the Turtles each have a very distinct personality in this movie. You have Leonardo who is pretty much the all-rounder character. He is the leader of the group and he just wants everyone to be together, to be able to get along and it makes sense for his character. Raphael is much more burly and angry in this movie and it set off his character arc of he's much more willing to take a loner stance very quickly if he has to. Mikey is the more wide-eyed childish of the group and that's represented in both his design and the way he acts. There's a point in the movie where Mikey, when they get attacked by the foot clan, his initial response is he starts getting into a showboating contest with another guy using nunchucks. Donatello, he's probably least muscular looking but he's also the smartest and most contemplative of the group. Each character, their designs of all the Turtles match their personality and so do their personalities and it's so cool to see. Plus, this movie is just fun. I don't care what anyone says, this movie is one of the most fun rides I've had with a movie in a long time.  Seriously, there are so many moments. Man, when Casey first shows up in this movie and becomes a staying character, it's great because the fight starts and then as soon as they go to attack Casey, one of the foot clan runs by Mikey and just kicks him in the stomach. He runs up and sidekicks him and then continues at Casey. It is amazing and I love that moment, it's just great. But is there anything wrong with this movie? I would argue that there might be a couple of things wrong with it. The plot goes by very quickly. That's not necessarily a bad thing depending on your view but there are a lot of convenient things that happen within the movie to get the plot going. The first one is that Raphael drops one of his sides at the very beginning of the movie.  After the turtle's hideout is completely destroyed they come back and find it empty and Splinter gone. The next day Danny just happens to see Michelangelo in the mirror. Casey just happens to see Raphael in the roof so he just happens to show up while the foot are attacking. It's just coincidence after coincidence that makes the plot happen and that's totally fine. But for me I would have preferred something a little more logical. If that makes sense. Not logical like it can't function logically.  Honestly Shredder's plan isn't even explained in this movie. Does he want to take over the city eventually or what? Because they don't explain that. His plan is kind of just build up the foot clan and that's it. It is literally not explained because he's like there's talk of family is like you're our family this is your family now you will follow me because rah rah rah rah rah but he doesn't explain what he wants to do. It's not explained at all.     Shredder is constantly high that's the only explanation for all of his actions in this movie he is constantly on drugs but yeah this movie is just a lot of fun it's greatly entertaining to watch and it's a lot of fun also the very end shows how the turtles got the catchphrase apparently splinter was partial to cowabunga but yeah that's all I really have I kind of just wanted to talk about one of my favorite movies that's ups down it's just every thought in between that I have on this film not super long video or super complex video I just wanted to talk about it also I needed to get a video up this week but yeah anyway tell me your guys thoughts on the original 1990 Teenage Mutant Ninja Turtle movie if you've seen it haven't seen it if you like it as much as I do or not let me know all of your thoughts in the comments down below anyway I hope that you all enjoyed that video if you'd like to follow me on either Twitter or Instagram links to both of those are going to be in the description down below as always and I hope that you all have a fantastic day cowabunga and as always peace out guys


Welcome to the anxious truth. This is the podcast that covers all things anxiety anxiety disorders and anxiety recovery So if you're struggling with things like panic attacks or health anxiety or agoraphobia This is the place for you and I'm happy that you're here this week on the anxious truth We're gonna address a question gets asked every day in the community surrounding this podcast and that question is but what if the anxiety comes back and we're gonna look at one of the basic principles of recovery that often gets overlooked that Means that that question isn't even really a question. So let's get to that now Hello, everybody. Welcome back to the anxious truth. This is episode number 256 of the podcast we are recording in May of 2023 in case you are listening from the future. My name is Drew Lynn Salata I am the creator and host of the anxious truth if this is the first time here listening to the podcast or Watching on the YouTube channel. Welcome. I'm glad you found us And I hope you find the content helpful in some way if you're a returning listener or viewer. Well, welcome back This week on the podcast, we're gonna answer a question that gets asked every day in the community surrounding this podcast Generally by people who are working really hard to overcome their anxiety problems and they're starting to see progress Things are changing and they're starting to get better and then they get stuck and trapped in the cycle of But what if it comes back? I can't stop thinking that I might never get better I can't stop thinking what if it comes back? Now, I understand why people think that when they start to feel a little better and things begin to change They automatically go to yeah, but this can't possibly last what if it comes back And what if it comes back in the end as you're going to see today? Is it even really a question that needs to be asked because you're missing an important part of the recovery process? And I understand why because you're so close to it that you really can't see that Now before we get into the nitty gritty here Just a very quick reminder that the anxious truth is more than just this podcast episode There are books and 250 something other free podcast episodes and a ton of free social media content and workshops and All kinds of goodies that you can find on my website at the anxious truth dot com So if you're looking for more more help more information more things that might be useful to you Head on over to that website the anxious truth dot com and check it out Vail yourself of all the resources and make the best use of them that you can And if you're enjoying this work and it's helping you in some way and you want to find a way to support it All the ways that you can do that are also on the website at the anxious truth dot com slash support If you want to check that out financial support is never required here But always appreciated and no matter what way you choose to support the work that I do Whether it's writing a podcast review or just hitting the like button on one of my youtube videos. Thank you so much I appreciate that you're really helping So let's get to today's topic which is the dreaded but what if anxiety comes back question And I think when we ask that question it reveals that we are seeing The anxiety itself as the thing that changes in the recovery process And here's news. That's not actually what happens We often use explanations to try to I guess teach people what's happening And those explanations often sort of imply and I do this I'm guilty of this Sort of imply that you're changing the anxiety You're turning down the volume. I've I've used that you're turning off the threat response You're lowering the volume. You're lowering the intensity.  Yes, we are changing our level of sensitization There's no doubt about that. I would agree with that But in the end the sensations of anxiety the state of anxiety itself doesn't really change So as a fully recovered person I can tell you That in retrospect I can see that my anxiety didn't change one bit not even a little And you might say how can you possibly call yourself a recovered person and also say that your anxiety hasn't changed? Well, I'll tell you why because I do not live my life anxious all the time anymore. Why is that? Well, that's because I've learned that I don't have to be afraid of how I feel anymore Nonetheless, I am alive and I'm always transparent about this So I can experience anxiety sometimes because I'm just a human being And the idea that we would eradicate anxiety or guarantee that you will never be really anxious afraid or panic ever again is ridiculous Nobody can guarantee that and that's not what you should be aiming for Yet I live as a very normal person That can sometimes like any other normal person experience anxiety sometimes a lot of anxiety on very rare instances I might even experience a panic attack It's just not terribly impactful anymore like it used to be But I can tell you unequivocally and I think most recovered people would probably corroborate this That the anxiety feels exactly how it felt 20 years ago when I was really struggling when I couldn't leave my house When I needed safe people all the time. I didn't want to stay alone. I was afraid of everything I was convinced that my food had been poisoned and I was obsessed with thoughts of death and existence It was not a fun place to be in But I can tell you that the sensations the feelings the experience of anxiety panic and fear Now are exactly the same as they were then So what's the difference? How can I say that most of the time? I am not anxious at all and even if I do experience anxiety it does in no way influence my life It doesn't influence how I make my plans or what I do or where I go or what I want to do It's it's a non issue It's a thing I experience sometimes like anger or sadness or happiness or disappointment or getting the flu That's the way anxiety is in a recovered person's life So is it possible that you'll never panic again? It's certainly possible. I mean that could be that would be great Right, maybe that'll happen. But if it doesn't happen, it doesn't mean that it came back So when we ask the question What if it comes back We're thinking that somehow or other what we're doing in recovery is changing this monster That's been stalking you and attacking you somehow wrestling it into a different form or pinning it down into submission And that's tenuous because what if it gets up? It's strong. It's powerful. It's it's so impactful on me It controls me. I have it pinned down now But what if I'm not strong enough and it comes back? So I understand why you see it that way because of the way you relate to it today But when you realize that the change does not happen in the anxiety the change happens in you Everything is different So I never worry that it's going to come back because I don't have to worry about that That's actually a question that I understand I don't even have to ask So when people say, how can you be so sure of the answer? It's not that I'm so sure of the answer I just know that that's not even a question. That's not a valid question for me anymore And it's not a valid question for most recovered people because what you really want to say is Well, what happens if I feel those things again? And I'll tell you what happens when you recognize that the process of recovery is the process of changing you When you recognize that and you understand that all the hard work you're doing Intentionally doing scary things practicing that triggering you're triggering yourself on purpose To practice and to get better at relating in a more healthy way in a normal way to anxiety and fear and vulnerability and uncertainty You are building a whole new repertoire of skills navigational skills that you don't have today And since you don't have those skills today You feel like that thing just pins you down and just steps on your throat And there's nothing you could do about it because you don't have the skill set to deal with it But as you develop the skill set your relationship with it changes in a huge way And you're the one changing So your heart will still race you might experience dpdr You might feel short of breath you might get rubber legs You might feel nauseous like that's just anxiety doing what anxiety does in human beings It's a very well defined and incredibly predictable response in almost every human being walking the planet So it doesn't change You change you just get really good at dealing with it And I know a lot this is the part where many people who are struggling now will say Oh, so I just have to deal with this like this for the rest of my life No, because you are changing and when you change your relationship with it changes And you don't you learn that you don't have to care so much about it It doesn't have to be the most important thing in your life and the most interesting thing in the room all the time anymore So no you don't deal with it the way you deal with it today because you get better at dealing with it Which means that you stop having to deal with it so much So what if it comes back? Isn't really a concern anymore because we have to recognize that it's not the anxiety that we're changing. We're changing us We change us. We get better at things. We grow. We learn we get experienced. We get wiser We get more adept at navigating through these negative internal experiences And that's everything Because that really changes the equation a lot. You don't see it anymore as an it that comes back When you recognize that you are the part that's changing and not it That leads you to say well, what do I what will happen if I feel it again? Oh, well, I will do this this this and this the things I've been doing I will use my new skills. I will use my new understanding. I will use my new knowledge I will use the wisdom I've gained Like see the difference You stop worrying about it coming back because you just start thinking about it feeling things and not it coming back Well, sometimes I'm going to feel things and now I have I'm really good at feeling those things now So I don't have to worry about it so much. It's not as important as it once was When it was used to be really important now It's not important at all So there is no it I never think of anxiety as an it that can come and get me again It's just a feeling like any other feeling that a person might have when they're living and breathing So this is really important and I understand Why when you were in the early stages or you're struggling you might get stuck in that thought loop But what if it comes back? But what if it comes back because you haven't yet understood that you are changing You don't recognize your own growth You don't recognize your new skill set.  I don't I don't have anything to do this guy isn't running anymore She's not running anymore. She's not calling her safe people. He's not staying in the house anymore. Like I guess we're okay I'll just go wait until I'm really needed And then things change So I cannot stress enough how one of the things I would ask you to do after listening to this podcast episode is Really consider that are you changing your anxiety or are you changing your relation to it and your skill set? and your understanding And your your default response set that's what's changing in recovery Now I do understand also that that doesn't jive with the way a lot of people approach this problem If you approach it as a body problem if you approach it as a problem that requires some sort of nervous system regulation If you are constantly approaching it as a trigger problem where you need to avoid your triggers Triggers are all over the place and you never get to avoid them all So it will seem like this very tenuous recovery That can be shattered at any time Because you're trying to control things or fix things that are kind of beyond fixing As opposed to understanding like oh wait a minute. I'm just going to let those things be whatever they are And I'm going to get really better at dealing with them. I'm changing. I'm the one that's changing not it And then when you accept that and you understand that you start to see it Through experience through through actual real life when you're doing it day in and day out Then I'm changing not it happens because you stop looking at it as an it. It's no longer a special it What if it comes back is no longer a question because I never really look at anxiety as it anymore with a capital i it It the thing right it's it's not a thing anymore. So I don't have to think about it coming back I just think about having all the different experiences and emotions and states that people have and Just good at dealing with them now just like you will get better at dealing with them as you go through this process So What's the moral of the story here the moral of the story here is give yourself some credit Because you are the one changing and growing and getting better and smarter and Faster and stronger and wiser and and so many different options that you're giving yourself now When your only option used to be retreat run hide and avoid And that got you into the sort of that dark place that you're trying to get out of now And you don't have to do just that anymore So you are changing give yourself the credit you are making progress It is staying the same you are changing around it and therefore in a way nullifying it because You you won't worry anymore that it comes back when you're not afraid of it anymore and you know you're capable So I know that the last bit of resistance to what i'm talking about in this podcast episode Usually comes from people who are struggling today and I get that if you are Or who are new to this or maybe just starting to go down the road of recovery And they will think but I don't understand if I have this experience in two years that i'm having today That's not progress. That's not recovery. I can't be recovered if I feel the way I feel today But when you say that you're actually missing the point because you haven't had enough time and you have not lived the experiences yet You're projecting the today version of you into the future and the today version of you won't be there in the future So the the 2006 version of drew isn't here in 2023. He he doesn't he's not here He changed like 2023 drew is very different than 2010 2006 drew So when I feel the same things that he felt it's a different version of me feeling them And relating to him in a totally different way So the resistance to this idea and the argument if you feel the things it means it came back And how can I call that recovery and that's beyond my control is based on you projecting the today version of you Into the future when that today version of you theoretically because of this process that you're working on so hard I commend you for that the today version of you stops existing You're a better version of you. You're a wider deeper smarter wiser more capable Version of you with way more options than today has today version of you has So please keep that in mind when you want to get stuck or when you get stuck in the thought What if it what if it comes back? But what if it comes back? But what if it comes back remind yourself that? Oh, this is today me worrying about how today me Would feel if i'm still today me in five years But I won't be that person in five years every day I get a little different and since i'm the part of this that's changing not the anxiety Every time I learn something new Every time I try something new every time I practice something every time I have a different outcome that I used to have I am getting further away from the scared Limited avoidant hiding running version of me that a hundred percent would think that I should if I feel this way It's a disaster You just won't think that anymore because you are changing so you won't even ask the question anymore What if it comes back? It's very hard for you to conceptualize that and when people ask me that question and I try to answer it I often get blank stares, but that's because I can speak to you from years down the road You don't have those years yet So I guess i'm asking you in a certain way to to just take it at face value when I tell you When a recovered person tells you when somebody who's got a five-year head start on you tells you these things You have to understand that oh They have five years worth of experiences that I haven't had yet They learned all the lessons. They see their change. They see their growth. They see their new strength I haven't had the chance yet To see that in myself. I'm working on it So what if it comes back is in a question the question is like how do I keep changing? How do I keep improving? That is the better question if you want to fixate on a question fixate on that one because The answer to that question precludes asking the first So there you go That's a thing I haven't said in a podcast in a while Evidently it used to be a thing I would say all the time, but there you go That was like 17 minutes of me just near ranting at you. I hope it wasn't too much I I feel like I gave you a fire hose of words here because it's something that I feel really strongly about and I Want to express it. It is clearly as strongly as I can to you Being worried that it's going to come back doesn't mean that you have to be worried about it coming back That's just a today version of you having a today worry about a version of you that doesn't exist You don't want in the future So it's okay to just leave that fear there. What if it comes back? All right? Be afraid that it'll come back then go do something Go do something instead of deciding that thinking that means you shouldn't do anything That would be the worst mistake you could make. I keep thinking. What if it comes back? Okay, then go ahead and think that because you can't decide to not have a thought But while you're thinking that go keep changing and learning and improving and getting stronger and wiser and deeper and building those options Then the question that you're so worried about won't even matter anymore. Trust me on this one And that is episode 256 of the anxious truth in the books on trying to You know answer the question What if it comes back and giving you the reasons why that question doesn't even have to be a question because You change not the anxiety. You know the podcast episode is over because Music That is as always at the end of the podcast Especially recently is afterglow by my friend ben drake who wrote that song at least in part inspired by this podcast in words That he heard here and he's letting me use it ever since which i'm very grateful for So you can find that song and more about ben on his website at ben drake music dot com If you pop on over there tell them i sent you and tell them i said hello And i'm going to ask you as always if you are listening to the podcast on apple podcast or Spotify or some app or platform That lets you rate and review the podcast leave a five star rating if you like it And if you really like it maybe take a second and write a quick review Because that's how more people find the podcast and we get to help more people that way which is why i do this to begin with And of course if you're watching on youtube or this one listening on youtube like the video leave a comment I will circle back and answer you i promise i do it a couple times a week and subscribe to my channel hit the notification bell So you know when i upload new content And that's it. We are done for this week Work on these things keep moving forward every little step matters It really does because even when you're worried that you'll never get better or it might come back The best thing that you can do to that is go ahead and get better even while you're worried about that I know that sounds ridiculous, but that's your job, and I know you can do it Thanks for listening. I will see you again next week


You need a financial advisor with the freedom to focus on your specific needs. Whatever your goals, Reid Potter can create a game plan tailored to you. Call Reid at 432-0777 at Pikeville, Kentucky to learn more. As fundraising and relief efforts are expected to continue for the victims of the recent storms in western Kentucky for some time, plans are already underway for a benefit concert to be held in downtown Pikeville early next year. We spoke with Austin Shuck of the Appalachian Pioneer Project, one of the organizers of this event for more information. So it's Nicholas Chamberson and Leah Blevins. And if you don't know who Leah Blevins is, if you had the Black Keys and Dolly Parton combined on a project, and it's like an Appalachian baby that makes like this rock star like Dolly Parton. And then the last guy is probably who I think is one of the most talented up and coming of like the people under like 25 and under. His name is Clark Sexton. He is from Preston'sburg as well. And so we're doing that in partnership with a few different local businesses and then some other places that aren't local. So let's like the really cool part is how receptive everybody's been to wanting to help. And so there's like a thrift shop that just opened in the last year in Pikeville called AppCycle. And they're going to be helping this partner up and Alley on Main is going to be doing a night where they benefit part or they donate part of the proceeds from a night to the event. And then Solstone is going to be doing a partnership with us, something along those lines as well. And then the Scout Guide is a publicist company that works in Lexington. And so through the, so we're all kind of trying to put this like gift package together, maybe it'll be three or four. And essentially what it's going to be is a variation of local musicians like albums, t-shirts, swagger, and then also experiences in Pikeville, Preston'sburg, Lexington. And so it might be like a gift card or it might be like 10 sessions to this new gym or something like that. So a lot of people are pitching in to help. And also you, Pike, is going to be helping us to collect supplies. So we've had a lot of people that are pitching and obviously broken thrown is hosting it. So it'll be at the Great Hall. So that's going to be January 7th at 7pm. For Shuck, tragedies like those that hit the citizens of Western Kentucky are incredibly personal as he and his family have also suffered from a similar event in the past.  When your house actually gets blown away, even if you have like not the best situation, it's really, really challenging to say like, hey, this is, we have literally nothing. But the thing is, is that you start to realize all the things that really matter. All these material items that you have really the important things in your life or health is what's important. And the fact that you're alive is what's important and hopefully you have a community of people that are willing to band together and be there for you in this time of crisis. Because like I said, when I experienced it, you really have this sense of really have nothing and a lot less involvement happened. And so it's really cool to see that so many more people are showing up for them in this time of crisis.


Hello and welcome to NewsClick. I'm Paranjoy Guha Thakurtha and with me here is senior journalist Urmilesh and the two of us are today going to discuss the sting operations conducted by Cobra Post on more than two dozen media organizations which apparently indicate that the phenomenon of paid news is widespread across the mainstream media. So how corrupt is the media in India and to what extent do these revelations if you like or these covert operations where a reporter Pushpa Sharma disguises himself as a representative of a Sangatan which is supposed to be a pro-Hindu organization meets representatives of various media organizations and says we are going to pay you large amounts of money in the form of advertising. Some of it is going to be in cash. You start with advertising about religious matters and then the advertising gets a little more aggressive and finally in the run up to the 2019 general elections the advertising could get quite aggressive and there would be targeting political leaders like Rahul Gandhi, like Maya Vati, like Akhilesh Adav not referring to them directly but calling them Fappu and Bhua and so on and so forth. Urmilesh Ji, how significant are these revelations by Cobra Post? Paranjaya, if you ask the truth, I personally do not like the String operations and journalism very much. I am a traditional journalist. I have also never done anything like that. But these String operations, I mean the things we know, between the journalism of so many years, the experience we had, the facts we have, we all know that this is happening in the media. Who will know more about the paid news in our generation? I mean you were part of that 2010 exercise also, press conference in India. We will talk about it. Yes, we will talk about it. But what I have just done, look at the significance of it, the importance of it is that what we know about things, what is happening, with false evidence, with facts, with images, with voices in front of the public. So we will have to accept the importance of this String operation. Those people who used to not give importance to the journalism of String operations, or those who did not pay much attention, because we used to think that we have to go to the ground and report, do analysis, that is our job. More than access journalism, we wanted to have a spot reporting, a narrative, I mean journalism, things like that. So this is the first one. The second one is that, look, before the paid news, someone used to make the MLMP election, someone used to make it in other matters. But here, a whole ideology, a whole organization, a whole party, a whole wave, that is involved in how to give money and how to make people stand up, how to change the content, and how to influence all the channels. So even if a journalist has brought these things in front of him as a father, as a father, but this can happen in the media, and this is happening, this clearly shows it. You know Urmilesh, like you, I have spent 40 years in journalism in India. I have never conducted a sting operation. And honestly, I've always felt that there is something unethical about it. But you mentioned the 2010 report of the Press Council of India. Yes, I was a member of that subcommittee. Me and Srinivas Reddy, we together drafted that report. It was a 70 page report. And then after the report, it was presented to the council. There was a huge hue and cry. There was a discussion. There was a debate. And finally, what was presented to the government at that point of time was a very short version of the observations and the recommendations. And although this report, this 71 page report, 36,000 words was leaked because there were 30 copies in circulation, it did not become an official document till a journalist called Manu Mudkil, he moved the Central Information Commission and the Central Information Commission ordered the Press Council of India to put it on its website, which is available there. It's a public document. And over there, it mentions that it was not unanimously approved the contents of it. But wait, why am I mentioning this? Right through in that report, that 71 pages, we did not have what in English you would call smoking gun evidence. Did you kill anyone?  No, it was all circumstantial evidence that there were indications that money had exchanged hands all below the table, all surreptitiously. There were no checks written out. There was no receipt. So you could argue that the only way you could highlight paid news was through a sting operation. What are your views on this? Look, through a sting operation, these things can be brought forward. But what we want to say is that, as you can see in the report, in Madhya Pradesh, there is a minister who has been there for a long time. There is still a minister. You are aware of his entire case. Now he got a clean sheet from the High Court. A clean sheet? Overruled election commission? Yes. In that, without any evidence, the sting operation came to light. Because the news about his rally, the news about him, just before elections, all the same things were published in the newspapers. It is reminiscent of Ashok Chauhan, the former chief minister of Maharashtra. Yes. And you know a lot about Ashok Chauhan. There were many such events in Uttar Pradesh in which one of the leaders, one of the leaders of Biba Daspad, Bahubali Uttar Pradesh, was their religious wife, who was fighting elections. In that case, everything was discussed. You are talking about Mrs. Yadav? Yes. Deep Yadav's wife. Deep Yadav's wife. But the minister in Madhya Pradesh, Narut Tamishra, In fact, her name is a bit like yours. Umlesh Yadav. Yes, yes. Mrs. Umlesh Yadav. I am a little different. I am Umlesh. She is Umlesh. And you know for the first time, she was the first MLA, who was barred by the election commission, from contesting any election for three years? But Paranjay, this democracy is so strange. She was barred. But the brothers who made the paid news, the channels, the small tablets, no one was against her, when the evidence was in front of everyone. So in this country, there is an act against a constitution. A constitution or a minister, is based on his clout or evidence. But what is the point that an act against a brother, an act against a channel, this is the power of our country, this media, this is the power of power, power within the court. If this is power, then it is very black power. It is black power. This is strange. You know, you were talking about these instances. Even in the case of the former chief minister of Madhya Pradesh, Ashok Chavan, finally, Sorry, I beg your pardon. It is Maharashtra, Ashok Chavan Ji. The same matter. It went from the election commission to the high court. Finally, what was it? This is what he had told us. You know, just because some newspapers are publishing identical reports under different bylines, how do you prove? Now it's interesting. The proof is the issue. And even when we looked into it from the point of view of the as a part of the subcommittee of the press council of India, this whole issue was many times you had candidates who stood for election who said, yes, I have paid money. And this comes within the expenditure limits. But the concerned media organizations the newspapers, the television channels, the companies that own them, they would always deny it. They would say, where is the proof? Where is the proof? I have seen many great leaders of the country, especially the Prime Minister, in his statements, that yes, there is no news without paying, such leaders like us. He once said, and we are all shocked. But at any time, on the media organizations, because there is a big question in our country, that you are walking through the press council. After all your efforts, what happened in the press council? The press council of the press council of the media, what was their way with your report? We all know. It's all in the public domain. Yes, it's in the public domain. Secondly, the regulators of the channels, whether it be anywhere, that self-regulation has been completely denied. I mean, there is no meaning. But yes, we also believe that there are issues like this or other people's issues. I mean, whether it be related to bad news, whether it be related to reading, we, in any way, as a regulator, as a regulatory authority, as a mechanism, we don't even want the involvement of this state. Because we all know the state of our country is free of charge. Right now, we are on the 137th number in the world. In fact, that was what it was called, the operation. One operation, 136. I would have suggested to write it 132. Anyway. So, I am saying that we know that to make this state a regulator or an intervention of this state, if it is, it is so dangerous for a country like ours. But still, I have to say that an independent regulator should be there, which is not a government. It can be the government's role model. Look, Umele, how many of our authorities are there today? Just look at the statutory authorities. One of them is the Press Council of India. It is a quasi-judicial body and act of parliament. It has no power to punish anybody. Exactly. Only recently, they agreed with the DAVP, the Directorate of Audiovisual Publicity to deny some newspapers advertisement. Till then, they had not even done that. Forget, you know, finding somebody, the Press Council of India doesn't have the powers. You have the TRAI, the Telecom Regulatory Authority of India. You have the Ministry of Information and Broadcasting. You have, within the Ministry of Information and Ministry of Electronics and Information Technology, you have CERT, the Computer Emergency Resource Team. And then, you have the self-regulatory bodies, the news broadcasting, standards, authority. Whatever recommendation they made, they refused to accept it. As in the case of Zee News? In the case of Gohar Raja, we have seen that Zee News refused to accept it. And even after apologizing, it became fine again. Mr. Gohar Raja, nothing happened. And I have to say that Mr. Khullar, when he was in TRI, around Khullar, he gave many important papers and suggestions. But I still think that the government did not think about it and did not talk to anyone. And in order to regulate news portals and websites, a government committee was formed.  The owners of the media the big media, the corporate media and the political class. I want to ask you a specific question. Why Cobra Post's sting operation has acquired a lot of attention is because there are individuals there who are some of the biggest names in the Indian media. Let's talk about the specific case of Mr. Vinit Jain who, as we know, is one of the owners and one of the most important persons in the times group which is one of the biggest media organizations of its kind in in India, in Asia. Times of India says we are the world's most widely circulated English newspaper. They've put out a long statement saying this person Pushp Sharma who posed as Acharya Atal he has a background of I mean there is Delhi police has accused him of various criminal offenses in the past of extortion blackmail. Then they are saying that we never accepted any money and now they are also saying we are conducting a kind of a reversing operation on him because he was trying to blackmail us we wanted to conduct the reversing operation to find out who he was representing. We knew that he was an imposter. What are your views? I mean how do you react to this statement issued by the Times group? See Paranjay, I am a Times of India group that the newspaper has a long time I am Prashant Shakbir he has done a good job in the country I had started my newspaper from the Times group which is a Hindi newspaper and his brothers and brothers Madhuri Dharmzook Dinman Times of India Nobhara Times Maharashtra Times but Vinit Jain who is the managing director of this group has openly said that we are in the business of news not news This was like in Oletta Ken Oletta quoted him in New York New York Times of India group has done a lot of treaties like this The name has changed it is no longer private treaties it is brand Yeah So they changed the brand capital and they started a revenue coach and a lot of things In fact in the Indian media there is a business model especially before the reforms started in the Times of India group and when economic reforms came in India when changes in the entire country were leading Times of India The model is that instead of paying for an advertisement we give you shares of a particular company equity So the question is if your specific question is in general i am sorry I do not have any certificate you may be spreading I will not say anything about them It is to say if you knew about the time of India They will claim we did not know. He was the same man. How is this possible? First of all, you know that this is how an existing operation has already been done. You are media people, do you know that? They say we don't know whether he was actually representing Cobra Post. We thought he was representing this... It's very... It's very... See, if a very serious journalist, or an author, or a scientist, or a social scientist, asks the owner of any media house for an appointment, it's very difficult to meet a big owner, or a CEO, or a managing director. It's very difficult. So you are saying... You meet, you discuss. If those voices are right... No, no. And you must see, before that, he met other people in the group. Do you think because he was offering a lot of money, big bucks? The claim, the Cobra Post's revelations, I have not done any research on that voice. But the things that have come forward, those are the issues of the investigation. There are authorities for them, there are different administration agencies for them. But the things that have come forward, based on that, I can say that if he is suggesting that we will give this much, then on the other hand, there is a colleague of yours sitting there, whose face is not visible at the moment. Okay, okay. So his face is not visible, his voice is coming. In that voice, he is saying that if you are connected in Gujarat, then many of your businessmen, corporate houses, you give them cash and make us payment through Chik.  How will you defend it, first of all. Second, if you have done the string operation. Reverse string. So I have to say that it should be publicly published. What is in it? So that the way the cobra post string is being discussed in the whole country, it should be published on you as well. Okay. Urmilesh, what is being claimed by the Times of India Group or the Times Group is that look, we never got any money from them. We were just negotiating. Yes. There is no agreement, nothing in writing. Second point, they are saying what is wrong if we agree to do some programs on Ram and Sita and Hanuman and the Gita, we can do entertainment programs and comic programs, etc. And this is not, you are trying to paint it. You are cutting and pasting. You are not showing the full report. You are not showing what the Times of India gave as a full rejoinder. You are just being very selective in picking and choosing what you are showing. And then you are trying to make it out as if this newspaper group is trying to promote a Hindutva agenda. So, two points. One, is there being selective in putting out information? And secondly, it's not fair to say that they are going to only promote one kind of agenda because they are also saying we are as Ms. Kallipuri also did, Arun Puri's daughter of the India treated group. That we are, this is an advertisement. Let the advertisement go as an advertisement. You will have no say on the editorial content. I have come to the beginning of this Sting operation, without commenting on it. I would like to pose a couple of questions on the context of today's media. When our country was introduced by Arthik Sudhar, we all, or many of the Arthik experts or social scientists used to think that this is a new generation of Poonjeevat. There are a lot of its negatives. But maybe the positive thing is that there will be a new generation in the society. The cultural or values of the antifugal will increase in that. But Anjai, we want to understand this. I also don't understand that after Arthik Sudhar, after so many international Poonjeevat, so many international Poonjeevat, the consolidation of big corporate houses, the end of small groups or they are eaten by big and small fish. Even after this whole phenomenon, in the media of India, you suddenly see that the conservative thoughts around reforms, the myths, the dharmikta, the adhambar, the karmakand, the sankirna thoughts, how does the glorification get increased? As a result, you will see as many works of Manu Ranjan, especially in Hindi, on television channels. All the works of Manu Ranjan, I will tell you once, I had surveyed in the media, in my work, and that survey was that 95% of the works of Manu Ranjan, on the channels of Hindi, on the channels of Manu Ranjan, they are filled with myths, filled with dharmic adhambar, our those khand kabbi or mahak kabbi, which are completely on the dharmic views.  So you are trying to say, that post liberalization, which is more than 25 years ago, we have seen not only an attempt to glorify Hindutva, Hindutraditions, you are also seeing a distinct right-wing stance in the ideology that is being propagated by large sections of the mainstream media. I would like to add that it is not a very good idea that an Indian-ruling elite at the same time thought that we can consolidate our position with the use of this content and people's resistance can be minimized or minimized. Look, you know very well that when the Vajpayee government came to NDA, when it started, the most private channel was introduced in India at that time. The most licensed private channels were introduced. Today, we are around 900 channels. We are the only country in the world with so many channels to uplink and downlink. It is interesting Arvind Raj Gopal has written a book on this subject. He says it was really Ramayan and Mahabharat. The most widely watched television serial anywhere in the world which in a sense you saw this trend began. You remember that time the streets would be empty and people would be only watching television and if you told your maid to clean the floor and she said, no, no, after the serial we will do it. And it's interesting in 1984 the Bhartijanta Party had two members in the looks and gradually that went up. Now this propagation of what you can say right-wing Hindu nationalism, you could argue that trend began from there and what you're saying it took it got a big Philip post-liberalization let me bring you back to what happened in the last 10 years. Because you have brought in the political economy of the media in India in the last 10 years across the world and also in India what we see is there was a great recession. So whether in America, whether in India everywhere there was a squeeze on income, on expenditure on advertising and marketing services. In many countries it actually came down. In some countries it stagnated. In some countries like India it went up but the rate of growth didn't go up that much. And simultaneous this was a period when the internet expanded. The whole notion of Baudic Sampathik copyright all went for a toss. Everybody wants everything free.  Who pays the writer, who pays the videographer. That's another story. But the point that I was trying to make is that in this context, Indian media organizations, one could argue, have become more dependent on political parties and the government for advertising income. Do you think that what has been shown in the cobra post operation the sting operation also shows that because the finances the revenues of mainstream media organizations have got squeezed their greed has gone up and they're willing to compromise to get more money. See, if you look at the structure of the media houses then there used to be a marketing there used to be people of circulation and people of development and now there are so many departments in big houses and they have new names, completely different names which are usually the new names in the corporate sector Now the question is that there is promotion, salary increase, all these things are based on how much money can be brought from it. It doesn't mean that you are making a writer. It doesn't mean that a lot of people discredit circulation that it will cost us money and that's right it costs the black market the newsprint so now how can we bring more money even if you do anything for it. So your reader, your viewer is listener is first a consumer then a citizen and this whole notion of information is it in the public interest of interest to the public so that all those notions have got turned around so you think that this cobra post sting operation highlights this aspect of the working of the media in India. I think the revelation of the cobra post is that the things we or the media knew properly they have brought it to the public with false evidences I won't say that there are so many evidences because the second aspect can be said that as the Times of India has said in his speech that it has been destroyed and there have been selective things which are of their own choice I don't know about this when the Times of India will bring it to the public then we can definitely say it but I have to say that they have explained the ideology economy and media that the political economy of India what is the relationship with today's Hindutva agenda between Hindutva agenda and the media it is not possible that 95% of the British and English I am saying 95% and I am saying this with full honesty listen to their why do they speak in one voice so many presenters so many you see in Hindi channels the headings, the captions today's religious war it is said where did the people get stuck where did it come from religion religious symbol mythological religion captions you can't put a simple heading you can't put a simple thing that everyone understands you don't choose any other religion you don't choose any religion you don't choose any symbol why do you choose only one religion the second thing is that this language has not been written in Hindi you can watch it the history of Shankar Vidyarthi you see it in the 60s, 70s, 80s see the Hindi literature our tradition has not been cut the way I am saying not only anchor the news you are making the newsroom you are running all of a sudden the political economy is changing the role of the owners the role of the executors the story in the newspapers how a person comes from behind and says that this should not happen take care of it thank you so much Urminesh for in such articulate terms in such wonderful Hindi I can't speak Hindi like you but you have explained the political economy of the series of sting operations done by Cobra Post and placed it in that broader political and economic context in contemporary India thank you so much for being with us it's been a pleasure having this conversation with you thank you very much for watching this conversation between me and Urmilesh which looks at the political economy of the recent sting operations conducted by Cobra Post


If you put 700 hours into deep locked in focus, into a brand new business, into a skill, into making money, into whatever it is that you're trying to create, 700 hours, it's a lot of hours. Today, we're gonna talk about how to change your life with one simple skill through focusing. So I'm gonna give you a five step process to making sure that you're better at focusing to get stuff done every single day. And if you can take this one daily habit and put it into every single day, I promise you this, it will change your life. Slow and steady wins the race, I promise you it'll help you.  And the reason why I say this is because most people work, quote unquote work, eight hours a day. But in those eight hours, how much do you really think people are getting done?  It's not really any focused, productive work to get stuff done. And I'm not the most talented, I'm not the most skilled, I'm not the smartest person in the room. But one thing that I think I've been able to figure out with my own brain through learning about neurobiology and learning about human interaction, how humans work is I feel like I've been able to get really good at mastering the skill of focus. And I call it a skill and not a talent because I think that anybody can learn to focus when you can learn how your brain starts to shift and starts to move and what chemicals are going through your brain at this time. And it's the ability to literally sit and lock in and focus. And the number one thing that I wanna tell you is every single day, your goal is not to work for eight hours. Every single day your goal is to be completely locked in for just two hours a day. That's it. Full locked in two hours a day. Now everybody has different times that is easier for them to lock in. Some people are morning people, they've got a ton of energy, they've got a ton of focus in the morning. Some people are afternoon, some people are noon. I'm usually my best time to lock in is about 11 o'clock to two o'clock. Somewhere in that area, my brain seems to be like, it's just easier for me to lock in. So you have to figure out what works best for you. And it's just two hours.  This is also gonna be big for people who work for another company, but you don't wanna work there anymore because the average person that has their job and they don't enjoy their job, the average person thinks they have to go home because they hear people like Gary Vaynerchuk who I love, but at the same time, I think that he puts a little bit too much emphasis on hustle and pushes a lot of people away. But instead of going home and working from eight to five and then going home from six o'clock until one a.m., working on your side hustle to build it, I would say go home, eat some food, and then lock in from seven to nine p.m. Or from eight to 10 p.m. Go to bed, get some good rest. Fully locked in for two hours a day at the end of the year is over 700 hours of being locked in. If you put 700 hours into deep locked in focus, into a brand new business, into a skill, into making money, into whatever it is that you're trying to create, 700 hours, it's a lot of hours. Over 700 hours is what you get if you're just doing two hours a day every single day. 730 hours I think is the number, right? That's a lot of hours. It's beautiful because if you are trying to create a business, if you have a business, or if you're trying to leave the place that you are currently at. So I'm gonna give you the five steps to hardcore focus. This is just something that I've learned after talking with Dr. Andrew Huberman and learning about focus through him and also reading some of the stuff that he's put out, other things that we've learned neurobiologically inside of your brain of how to make yourself focus. So the first thing is this, write out a to-do list.   It could be laundry, it could be the dishes, it could be pick the kids up from school and then you're gonna get every single thing, all the things that need to be done around the house, all of that, but then you're also going to get the stuff that really needs to be done. And what I want you to do is I want you to look at that massive list that you just created, 10 things, 20 things, 40 things, whatever it is, and I want you to rank number one, number two, and number three. I want you to identify your three most important things and in my mind, even if you don't get to number two and three but you conquer number one, that's a successful day in my mind. If you can knock out your most important thing every single day, that's a really good day, isn't it? I would love to just get my number one thing done every single day. That's 365 number one things done over the course of a year.  You're gonna figure out what number one, number two, number three is you're going to take a three by five card, and you're gonna write number one at the top, number two, right under that, and number three right under that. You're gonna take the to-do list with all of the other stuff and you're gonna put it somewhere else so you don't have to look at it. You don't have to worry about it and you don't have to focus on anything that is not your most important stuff. And you're gonna take number one, two, and three, and you're gonna set it right next to you so you can make sure you get it done. And you're gonna focus on number one until it's done. And if you don't get it done, you get a half done. Well, you still got tomorrow, you can go back and go to it. So that's number one, it's to write out to-do list and then come up with number one, number two, and number three. The second thing is to create a space that is conducive for focus. What does that mean? For me, I'll tell you what it is for me. For me, headphones. I've got noise canceling headphones. I put them on, I can't hear anything. My girlfriend tries to talk to me, I can't hear anything that she's saying. My dogs are barking, can't hear anything that she's saying. Someone's at the door, can't hear anybody knocking. The only thing I can hear is the music that I'm playing inside of my ears, that's it. Music never has any words to it. It's not a song that I know.  It's called Focus Binarial Beats. That's what I listen to every single day, no matter what. I've literally trained my brain to know that when this song comes on, it's time to get done. It's like a dog that's peeing inside the house.  That's exactly what my brain is doing with this song. Oh, I'm listening to this music, it's time to focus. I'm listening to music, I'm trying to focus. I'm listening to this music, it's time to focus. Literally, I'm training my brain. So create a space that's conducive for focus, whatever that means for you. For me, it means headphones. Number two, turn all of your notifications off. I don't know why people have notifications on their computer in the first place. Like every time they get an email, that sounds terrible and it sounds extremely unproductive to just stop what you're doing to go check an email or do something else, but not me. Turn off all my notifications on my computer. Put your phone in another room. Don't put it next to you, because you're gonna be drawn to it. Put it in another room, give it to your spouse and say, give this to me and don't really get this until two hours from now. Whatever it is that you gotta do. So create a space for focus. There's a few things you can do. Another thing that helps as well, if you're creating space for focus, is create a body that's ready to focus. What does that mean? If you need to do a workout before, do a workout before. If you need to do some push-ups, if you need to do some stretching, some yoga, do that. Do you need some caffeine? For some people, caffeine makes you focus. Actually, for most people, caffeine will make you focus. Too much caffeine will actually make you, it make it really hard to focus. For me, whenever I've got to focus, I put on the headphones, I turn my notifications off, I put my phone in another room and I drink Yorba Mate. For those of you guys that are watching on video, this is what I drink. Literally, it's right next to me. I was drinking it earlier today. It's a company called Guayaki. They should sponsor me. They're not giving me any money. Actually, I give them a lot of money because I have one of these a day. But it's Yorba Mate. Guayaki, G-U-A-Y-A-K-I because I get 40 messages a week about what Yorba Mate I drink. Yorba Mate spell Y-E-R-B-A-M-A-T-E and I take the traditional unsweetened because if you get the sweetened one, it's a lot of sugar and I don't need to sugar crash. So this is what I drink for those of you guys that are watching on video. Here you are. For those of you guys that are listening to the podcast, go on to my YouTube, my Facebook. You can find it. We'll put it up there. So I drink Yorba Mate throughout the day and that's what makes me focus. I don't remember what it is, but there's also a chemical that's inside of Yorba Mate. It's just a tea. That's all it is. Yorba Mate is a plant. Yorba Mate is a tea that's made from a plant. I don't remember what it is, but according to the neurobiologist, Dr. Andrew Hooperman, it's got something that's really good for your brain in there. I trust him. He drinks Yorba Mate when he needs to focus. I've been doing it for years. So that's number two. Create a space that will help you focus. Clear off all of your stuff. Don't have anything on your desk, just your computer, whatever it is you need to do. Number three is to use the Pomodoro technique. Pomodoro technique is 25 minutes on, five minutes off, 25 minutes on, five minutes off. 25 minutes of hardcore intense focus on one thing and one thing only. After those 25 minutes, you take five minutes off. Don't take five minutes off and go to Instagram.  Now that you've been in deep focus, the best thing is to go outside, stare at the trees, allow your brain to go to wandering. You can have a conversation with somebody, whatever it is you need to do.  And I do four rounds of this. 25 on, five minutes off. That's 30 minutes. I do four rounds. That's two hours.  Normally, and that's what helps. So the Pomodoro technique. Also, you might say, well, how do I know when the time is up? How do you know when the time is up? Literally go old school, kitchen timer and put it next to you. And if you're needing to see the time, you can get a clock right next to you, have an alarm clock and have that alarm clock literally go off at 25 minutes. And you don't do anything except for one thing in those whole 25 minutes. And it's intense, intense focus. Cool? Step number four. When you ask yourself, how do I get intense focus?  So what you're actually trying to do is basically see, like if I'm working on the computer, what I'm gonna do is I'm going to stare at the computer screen and try not to blink. When you blink, it actually resets neurologically different aspects of your brain. So when you literally stare at your screen, for those of you guys watching the video, I'm staring at my screen and not blinking. What I'm trying to do is I'm trying to tell my brain that this is what we're going to focus on. This is what we're going to focus on. And my brain will eventually lock in. And what it does is it takes your peripheral vision and it actually starts to narrow it so that you're just seeing the screen. That's telling your brain, that's telling you when you're actually watching your peripheral vision disappear, you're going, okay, I'm getting more focused, I'm getting more focused, I'm getting more focused. And I can tell that my brain is getting more focused on this, now I know it's time to lock in.   Well, that's what's gonna go into number five. Number five is to just start whatever task it is or acting like whatever task it is. And let me explain this is gonna make more sense. Number five is just start. Most people think if they're a writer that they have writer's block. And they think writer's block is a creativity block. Writer's block in most cases is not a creativity block. It's actually a mind and body resistance to a new task. And so what you do is you've got to kind of warm up your mind and body to this new task. And you can use this for however you want to use it if you're a painter you can use this, but I'm gonna use this as an example for someone who is a writer who has writer's block. I'm gonna stare at the screen, which was number four. And number five was just start. I'm gonna stare at the screen and I'm gonna say, today is Thursday. I am wearing a blue shirt. It is sunny outside. It has been raining for the past six days. I live in Austin, Texas. Da, da, da, da.  Doesn't matter what I type, I'm gonna delete all of it. What I'm trying to do is I'm trying to get my brain and body past the resistance point, which is usually about three to five minutes in.  It's the same reason why we have so much resistance to actually going and working out is because it's just a new thing that our body, our body, our brain and body always resist doing something new, a new task switching. We're inherently lazy. It's just the way that humans are built, right? So that's why if you go into the gym, it's hard to get stuff to go in the gym, but once you're there, it's easy once your body starts moving. I'm gonna start the task that I want to and it's not creativity block, it's just resistance towards the new task. So if you know that you need to write a talk or let's say you need to do a PowerPoint for a talk. You gotta create this PowerPoint.  I'm gonna stare at the screen as long as I possibly can without blinking and basically narrow my focus and tell my brain this is what we're going to do. And then what I'm going to do after I can start to feel myself focused a little bit more is I'm gonna start typing out this PowerPoint and it could just be random stuff. I could put colors down, I could put, you know, whatever it is. This is the talk I'm about to create and I'm literally starting my brain and my body into the task to focus on whatever it is. After a few minutes, you're gonna start to notice that you're getting a little bit more into the flow. Now we get stuff done. Now we start to go through it. Now we have about 22 to 20 minutes left of hardcore intense focus before we have five minutes off. That's step number five is to just start. You lock in for 25 minutes. Then what you do is you take five minutes off to whatever it's you need to do, go to the bathroom, you know, stare at the trees, whatever you wanna do. And then come back, you'll notice that when you come back, you'll already be a little bit more focused than we were before and your focus starts to get better and better and better. And the reason why the Pomodoro Technique works so well, there were studies that were done on human focus. And what they notice is that about 10 minutes in, human focus spikes at its highest and then it just slowly dips off. So if I were to just work for two hours straight, it would spike one time at 10 minutes and then it would slowly drop and drop and drop and drop for the next hour and 45 minutes, hour and 50 minutes. If I go and I do the Pomodoro Technique, I get one large spike at its highest at 10 minutes and then it'll slowly drop and then I'm done at 25 minutes. Take five minutes off and then I get another spike at 10 minutes on the next one. And then I get another spike at the 10 minutes on the next and I get another spike. So instead of having one big spike where I'm at my highest productivity and then it drops for the rest of the two hours, I'm getting four of those spikes of high productivity and I'm using my brain and my body knowing how it works, knowing my space, knowing my brain, knowing my body, knowing neurobiologically how all of this works, I'm using this to my advantage to focus and I'm telling myself, Rob, all you gotta do is two hours. Crank out two hours of hardcore work and then whatever it is you gotta get done outside of that, get it done. But as long as I get those two hours of hardcore focus done, I get more done in those two hours than I do for the rest of six hours, seven hours, eight hours of the day that I'm getting stuff done as well. You have to lock in for two hours. That's all you've gotta do. Hey, thanks so much for watching this video. If you wanna learn even more about Master Your Mind, click right here and watch this video as well. It was on like Donkey Kong comes out of the womb and they're like, oh, I get stuff done. Being this badass productivity machine. If you don't feel like you're disciplined right now, you're not starting behind the eight ball.


So I told you that Brian would have been a better candidate, but he's got a longer distance to travel I guess Yeah So There's a lot of research in in patents which shows huge differences between different areas of technology So Mike Moyer and I for instance have argued that The patent system works well as a property system in pharmaceuticals But that in areas like software and computers it doesn't work well Most of the patent role litigation for instance overwhelming Lee is about software patents So I'm going to talk specifically about so this this is a bigger problem than just universities universities don't have a very large role They're not the main culprit here. There's a bigger systemic problem But it's still important to talk about number one What's the role of universities had it given given the problems in the patent system regarding tech patents software patents? What is their role? What role do they play and in particular? That's that's important to look at because as patent reform efforts have been Attempted in the last several years Universities have been one of the most outspoken opponents of reforms that at least in my view would have helped Ameliorate this problem. So that they're there. They're a large significant political player It behooves us to look at what's actually going on. So the some of the best research that was done was done by Brian Love I'll also refer to research done by Mark Lemley and Feldman Robin film. Yeah I'm getting I must be getting old So anyway from the perspective of the university It appears so Brian Brian did a survey of Electrical engineering computer science professors and and study the universities patents in these areas it appears that there are significant at least informal incentives provided to faculty to patent in terms of Ten year in terms of promotions in terms of raises So the from the standpoint of a scientist And end of the university What are the possible benefits of some of this patenting? One is money. It may help fund more research Two is patents may provide some sort of way of encouraging research and perhaps more directly encouraging commercialization What Brian found out in in in this area at least The patents are not an average a source of money that in fact that the average return in on on a Tech patents is negative universities are losing money on their their Technology transfer efforts in this area although it should be said that that's highly skewed so that a Very small percent of the licensing universities are making most of the revenue So they're the 3% are profitable. You've got 25% who have zero licensing revenues even though they have licenses You've got a lot of them losing money so First reason doesn't seem to hold much weight Second does it help do these patents help spur research? So He asked the question Does it motivate me to do more research? No Does it motivate me to do higher quality research? No What about commercialization? The other picture is more promising Significant number almost half Thought that Patents helped commercialize their research But it's still worth pointing out that the ones it's still a minority. We're talking about that found a positive effect So it's not at best. It's perhaps a weak incentive so the flip side of this is The this problem of universities as patent rolls Oh, so there there are two ways that they they seem to be playing this role One is by asserting their patents without real technology transfer That's something that a troll does and the other is by licensing to patent aggregators, which are trolls so you know the poster example is the eolus patent which was Granted to a University, California Researcher who went off and started a one-person company and began by suing companies that this was in back in 1993 they demonstrated the ability of a Web browser to use a plug-in Now the fact is that that was something that had been done earlier It wasn't wasn't novel and it's pretty fairly obvious idea to anybody in Computers, but nevertheless They got a patent and they actually Prevealed in their first lawsuit which is which is against Microsoft in 1999 They in by 2003 they won a five hundred and twenty one million dollar judgment against Microsoft which was later tailored, but still pretty earth-shattering stuff. It sounds like big money to a university It certainly sounds like a big loss to Microsoft Microsoft settled for some undisclosed amount and then a couple years later Eolus went around and started suing lots of other companies but By 2012 it was challenged by one of these companies and the patent wasn't validated so you have this nearly 20-year history of You know a bad patent causing damage in the tech industry University made some money on it. Yeah, but perhaps not in a very good way So the In terms of universities Asserting their own patents Lemley and Feldman Looked at those situations. So one of the things is you know what a patent roll does is is it goes out it threatens to sue you and Says you know pay me some money And I won't sue and and so what you're buying is not actually technology There's no transfer of knowledge. You're not fulfilling the university's knowledge, you know mission there of Commercializing their knowledge and making it available and distributing to society. You're just getting money What what they're buying is a promise not to sue so that so they looked at the extent that that university demands to private companies Were accompanied by evidence of knowledge actually being transferred So one question they asked was did it lead to new products or features? No Did it lead to transfer of technical knowledge in terms of things like know-how no Did it lead to personnel being transferred? So, you know very typically when there's a spin-out Graduate students will go and take jobs and and they'll help transfer the knowledge that isn't contained in the patent the tacit knowledge So it doesn't seem that At least in terms of asserting patents in this field, you know and again biomedical stuff may be entirely different in this field That university is a really playing a very positive role So the Universities have also played a role in terms of licensing their patents to Patent trolls or what are patent aggregators? Which are companies that buy up lots of licenses and then threaten to sue companies so that I think fairly early the the universities became aware that they were on occasionally thin ethical ice and and and they the autumn put out a A Statement that many universities signed that universities would better serve the public interest by ensuring appropriate use of the technology By requiring their licensees to operate under a business model that encourages Commercialization and does not rely primarily on threats of infringement litigation to generate revenue That's a nice statement Intellectual ventures is the largest patent troll the largest patent aggregator They have patents from over 60 universities Many of those universities are also investors in an intellectual venture. So they they get a financial benefit When intellectual ventures threatens to sue people Caltech alone exclusively licensed 51 patents to intellectual ventures So there's some real I think, you know questionable Behavior going on by universities in this area While there's no doubt, you know, the university actions are very small compared to the to the big players in the patent troll world Still is it's very troubling that they are contributing to the problem by their own actions and also troubling that they're contributing to the problem by playing a role in terms of their political influence in terms of playing an obstructionist role in terms of Significant patent reform that might help ameliorate the problem