That’s why we don’t screen for stuff. Metabolic syndrome has been around for a long time. It has been ignored because it is complex. It has four or five factors. Then, the fatty liver thing caught me by surprised. I am shocked. Just imagine back in the 1990s, it was all alcohol-related liver disease.  The idea that fatty liver disease has now transitioned. That’s normal now with the new generation that is growing up.  Fatty liver disease is now an epidemic. Yet, it has been a slowly emerging, silent epidemic that is eating people alive.  Our blind spots are part of what I think you [Mitch] are saying about mental models.  Our mental models are blinding us to massive situations.  I’m not sure what we call that: a lack of curiosity.  There is the Cane developmental model—who identifies the fixed mind-set and the growth mind-set. Mitch, you talked about the explicit and intrinsic mental models.

Bill B

Mitch is talking about a concept that comes from Chris Argyris and Don Schon who were teachers of Peter Senge. Jay Forrester at M.I.T. was also one of Peter Senge’s teachers. Peter got the best of everyone.  There is the espoused theory that Mitch is talking about. It concerns what we tell people are the principles by which we operate.  The other mental model is what they call “theory-in-use.” This is not what we espouse but what we actually operate by.  The problem is that what we operate by is what Mitch is saying is something of which we are not really aware.  Or it is self-sealed. It is something that we are not supposed to discuss. The mental model that Jeremy identified is very powerful in health care: if we can’t treat it, we don’t talk about it.

Mitch, as the one person who is not a physician, I will speak for the 89% of the people in the world who are not physicians.  What is the mental model being engaged with regard to the issue of high fructose corn syrup—a topic we first addressed during our last forum.  You are saying today that it is a chemical, not a food. The prevalent mental model is that it is corn–and corn is good.  For instance, back in Maine right now we are consuming wonderful corn. This the best time of year right now for corn.  So, corn is wonderful.  So, how could corn syrup be bad for us?  I think the mind-set that would shock people is the re-definition of corn syrup as a chemical rather than a food. I grew up in Illinois and we had corn all over the place. But it was horrible tasting, because it was for feeling hugs and other livestock (and perhaps now for producing corn syrup). So, I grew up thinking corn was horrible.  Then, we moved to California where you could buy corn that you could actually eat. It was wonderful—so how dare you suggest that corn syrup is not a lovely food. How could it possibly be a chemical that is killing us.  That is shocking. So, to get back to what Bill G. has been talking about: how do we find a way for people to recognize that this is scary stuff?  It is not like that nice cob of corn that you are going to get down at the local food market.

Jeremy

As you know Bill B., we are in an environment that is saturated with scary stuff. So, adding additional scary stuff to our diet has major health impact.  That’s what really gets challenging. How do you challenge a mental model without flipping a person into wishing for an autocrat leader to make life simpler for them? How do you get people to think about scary, disturbing matters themselves, without having to turn to leaders who will reassure them that everything is find and nothing is scary?

Bill B

The problem is that corn links to wonderful memories.  On Labor Day, all over America, we are supposed to have corn on the cob and chicken.  The last thing in the world that we want is to find out that some evil thing is a derivative of food that is very close to us. What we have always enjoyed is now associated with something that is scary. That is the most frightening thing of all –this is an intimate enemy.