#521 Drive My Car

Stefan is an adult living with type 1 diabetes.

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DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.

Scott Benner 0:00
Hello friends, and welcome to Episode 521 of the Juicebox Podcast.

Today, we're gonna speak with Stefan. He's had diabetes for a couple of years. It's actually an adult in grad school. So it's not that old. And he's not that young. But he is just starting to get used to type one. I love this conversation with Stephen. It's got a really interesting job, and some great insights. While you're listening, if you would do me the favor of remembering that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, I would appreciate it. And further if you'd remember to always consult a physician, before making any changes to your health care plan. were becoming bold with insulin that I would appreciate as well. I have a little time here. So I don't I want to remind you that the podcast is full of series, how we eat with different people's eating styles, defining diabetes, which are diabetes terms easily and simply defined in short episodes. That's with me and Jenny Smith, Jenny's a CBE, and she's had type one for 30 years. She's also with me on the diabetes pro tip episodes, which I think we should all listen to.

This show is sponsored today by the glucagon that my daughter carries, g vo cuyp open, Find out more at G Vogue glucagon.com forward slash juice box. We're also sponsored by the Contour Next One blood glucose meter if you're using a blood glucose meter, and I think that's all of you, you all have one, right? Please tell me you all have a meter. Anyway, if you're using a blood glucose meter, you want one that is accurate, easy to use, and easy to hold. If that's the case, look no farther than the Contour. Next One blood glucose meter. Learn more at Contour Next one.com. forward slash juicebox.

Stefan 2:17
I'm Stefan powerblock. Um, let's see 20 years old now. I've had Type One Diabetes for two years. I don't know I'm a mechanical engineer. And I'm a grad student while currently in grad school. So working on a master's degree well with Type One Diabetes, which is still relatively new to me. It's awesome.

Scott Benner 2:43
That's awesome. Well, first of all, let's put that degree into practice and get that sound to stop happening. I was still happening. You're talking I'm like, you know, for a guy with a mechanical engineering degree. I would think he could get that sound to stop.

Stefan 2:59
Man, she I unplugged it now. Maybe now I just got to stand like Stockstill. Are you talking

Scott Benner 3:03
with your hands? Or? No, I'm, well, I'm shaking my head. I don't know. Maybe that's it. Sorry. Don't Don't, hey, here's my direction. Don't overthink it. And please stop doing that at the same time. Just don't move. There's only been one noise. In a recent episode. It actually went up today that I found kind of soothing while I was listening to it. And it was someone. I put up an episode today with Shirley and she's from South Africa. By the time someone hears me say that it'll be like last year, probably. But there were crickets in the background. And I was like, This is lovely. Like, there's just this like, quiet blend of crickets behind me. And I thought the whole time we were recording I thought I'm going to leave this and this is great. And in the middle, I sat to edit it in every quiet space where she wasn't talking. I just chopped the crickets out. I hated it. Like this is like go and I'm just imagining myself editing your show six months from now. And just taking out the make me cry me cursing at you and you don't even realize. But but so you're 28 you're diagnosed and you're 26 you're obviously getting a fairly advanced degrees that are going on for for some time, your professional student at the moment or do you work as well? I work full time. Geez, what are you super smart? Stefan? What's going on her? Oh, heck no. Are you kidding me? That's my assumption. If you can go to grad school, be a mechanical engineer and be working at the same time that your three brains and they're all working simultaneously. What How do you find yourself doing that? Are you just Is there something you're striving for? Do you like being in school? what's the what's the draw?

Stefan 4:43
Oh, yeah, no. So my my undergrad I loved my undergrad. And I just wanted to continue. You know, I was thinking like research in the end item. I'm an automotive engineer specifically. And you know that space is getting more and more interesting. As time goes on with fully electrics and hybrids coming out, so

Scott Benner 5:04
yeah, do I want a Tesla truck? Stefan Yes or no? What do you think? Ah, depends on if you like the way it looks. Here's what I want. I'm going to be 50. So my wife tells me I'm going to be 50 in the summer, which is now not a running joke throughout the years of the podcast, but just a really great indication that I lose track of my age every once in a while. So I was really sure I was going to be 49 Kelly tells me I'm going to be 50. I did the light math. I think she's right. So I'm sure we could do the math together if we needed to, but I'm pretty sure she's right. And I found myself thinking, I want to own and drive daily an electric car, even if it's just once just to have the experience. So I don't know what one would be affordable for me. But I definitely just want the experience one time, I don't even know if I like it or not. just seems like it seems like the world took a big leap ahead. And I'd like to, you know, I'd like to walk alongside it for a little bit and figure it out. I kind of similarly have thoughts about rap music. That I don't understand that I'm still like, this is a very popular, I should try to understand this. Oh, yeah, no, you should. Absolutely. Right. You know, I don't want to be that old guy who's just like, that's not how we used to do it, and then sit down and just watch reruns of football games from when I was 30. I want to try to keep up a little bit. Tell me, can we go into your job a little? What do you do? That's I find that really interesting.

Stefan 6:33
Yeah, so I work with internal combustion engines. So they all run software, basically, that tells the car, like, how it's running, what it's doing. So I calibrate that.

Scott Benner 6:48
If I gave you a 327, small block out of a 60s, Chevy, would you have the first faint idea? How it works? Or what to do with it? Like, do you have to learn it from the ground up? Or can you come into something like this, like, do do classic combustion engines really not exist anymore in someone like yours thinking?

Stefan 7:08
Well, so the the principles have remained the same, right? So you just have spark air and fuel that hasn't changed, but the way it works? Now, you know, with electronics and fuel injection, there's sensors on everything, hardly anything is really mechanical anymore. It that's definitely not something that you can just jump into. I mean, I'm not even two years into this job. And it's like, it's like the learning curve is so steep, everything's a whirlwind every day. It's like, you feel like you're drowning and slowly clawing your way out of some hole. And you still and then, you know, you go to a meeting with all these other people, your managers, your supervisors, and you realize that they are head and shoulders more knowledgeable than you. It's pretty incredible. Just you start feeling the sunshine on the crown of your head coming out of the hole. Someone just jams you back down again. Yep, absolutely.

Scott Benner 8:04
That kind of sounds like diabetes a little bit. Yeah, learning curve on diabetes, like, Oh, I think I'm getting it and then all of a sudden, your honeymoon and you're like, Oh, I didn't understand this at all. And yeah, I just got a note from a person who, this morning. And it's a mom of a younger boy. And she's like, I don't understand, like, everything I do doesn't work down. I was like, yeah, there's not enough insulin. She's like, why not? I was like, I don't know. Like, you definitely need more though. And, you know, you got to, you know, keep turning it up. like something's changed the kids growing, you know, puberty. I don't know what, you know, I have no idea. But obviously, you're right. It was just interesting how she was thrown right back to where she started. And even though she had all the tools to handle it, the one leap she couldn't make was the more than doubling of the Basal insulin. There's something about 100% in people's heads that make them feel like that's the biggest number in the world. So if your Basal insulin, what's your Basal it's on our currently about 30 unit today. Okay. Hold on a second, divided by 24. All right, that goes on once Oh, boy. Here we go. We've six I'm getting to it. I've already read like one probably like 1.3 an hour or something like that. Right? So I'm like that. So if if your needs suddenly doubled, for some reason to three units an hour it that stops most people like they could somehow understand if it went to 2.6 but there's something about more than doubling were interesting enough if they've set a max bazel range in their pump, which is usually just done for safety reasons. Like you have a max Bolus and Max Basal right if they've set a max so you know the doctor says look your bait your your kids basil rate is point two. So I'm going to set the max basil it I don't know One, because we don't want you to mistakenly give the kid two units an hour, right? And then a couple of years later, suddenly the kid needs 1.5 an hour and they hit the max, it stops them. Why is that? Stefan? Why am I asking you? And why is that? I don't know. But I totally get it.

Stefan 10:17
I mean, I remember Oh, man, when I, when I saw when I first was diagnosed, sent out of the hospital, like, Oh, we could go into that experience, too. Because, wow. Like, I don't know, if it's different when you're younger, or Well, it's gonna be different, right? Because I think your parents get the download of knowledge versus you. But like, for me, it was like, here's a book on diabetes more catered towards type twos. Here's your insulin, take this much. Good luck. You know, yay,

Scott Benner 10:50
they probably thought you're an engineer, you'll figure it out. Oh, my God. Heck now. Well, that's interesting, too, because there are segments of people that I see handled diabetes differently. I've been saying this a lot lately, but nurses who are parents of children are kind of traditionally not good at it originally, because there's something about their training that doesn't jive with how diabetes is actually managed day to day. And so they hit this kind of this firewall, but engineers seem to really get it in a different way. And most of them can put it into practice eventually, but it takes them a little longer. It's just very interesting getting to start meeting more and more people who fall in the buckets. And to see the similarities between them. It's so I imagine one day you're a one C will just be 5.3. And there'll be nothing you can do that will stop that from happening.

Stefan 11:43
But I can only hope I can only hope. What's your setup? What are you using? So I'm on deck, I have a Dexcom. And then I'm on the tandem t slim

Scott Benner 11:53
XCOM. And t slim. Got it? And are using an algorithm with the T slim or no?

Stefan 11:58
Yeah, I have the control IQ set up on there. Is it working? Yeah, yeah, it's working. There's some cheat that I've had to do, you know, off the book, to get it to work better for me.

Scott Benner 12:13
You want to share them with me? is one of them. Leave it in sleep mode all the time. I

Stefan 12:16
hear people talk about that a lot. Absolutely. 100% This thing is in sleep mode.

Scott Benner 12:21
Why what what's the difference between the two.

Stefan 12:24
So I don't know, I was finding that in normal mode. So in normal mode, it will give you those correction boluses those mini correction boluses. But by the time you get them you're already at like 180 or above. Whereas in sleep mode, it kind of it jams your range tighter. So I don't remember the exact numbers, but I won't let you go above a certain amount. It will but you know, it starts to feed in more basil above a certain amount, and then take it away a certain amount. And those numbers are tighter.

Scott Benner 12:59
I it makes me feel like this is conjecture completely. But it makes me feel like they were looking at the algorithm. They're like, Alright, well, this works. But we'll call this sleep mode because it works really well. It'll be more aggressive when you don't have foods we can keep somebody lower and more stable like this. We probably should just call it more aggressive mode. But we won't do that. We'll let people figure it out for themselves. Like Don't you feel like there's two settings like one for everybody and one for the people who want to be like aggressive?

Stefan 13:29
Yeah, it's it's like, normal mode is like the wonky line mode. And for me sleep mode is the let's keep it nice and straight. No, no.

Scott Benner 13:38
That is that simple. Like so you get the rises that food in normal, that take forever to come back down. But then when they do come back down, they come back pretty level.

Stefan 13:48
Yeah, in sleep mode, if I'm in normal mode, I'll get those rises, then it'll do the correction Bolus. They won't move. It won't move. It won't move. And then, you know, inevitably I pick up the pump fiddle with it. give myself a Bolus. And then like, you know, turned around and I'm in the 50s.

Scott Benner 14:03
So for you normal mode should be called What if I only ate 30 carbs a day mode? This would be great. Alright. Normal mode, or please don't have a slice of pizza mode. Right? Don't you even think about that Chinese mode? What did you want them? What again? No, no, no, no, you need sleep mode for that. Right. Anyway, that's why I think they should go back to you know, ridiculous speed. What was that movie that oh my god. Do you ever have half a thought pop into your head, but not the whole thing? That just happened to me? Oh, you mean? Is it Spaceballs? Where they have plaid? And then ridiculous. It's Spaceballs, right? I think so. Yeah, ludicrous. speed. It's ludicrous speed. There you go. I was so far off on all of that. My God. Someone will email you know, that was wrong. You know, there's part. So there's part of you that's like, oh, people are listening. Like it really feels good. And then there's part of you. That is like, please leave me alone. I gotta get you to get your phone to stop. Beeping. Can you do that?

Stefan 15:08
Yeah. Sorry. Give me one second. Listen, do whatever you have to. Yep. Well, you're gonna hear the wonderful swish noise. That's fine. Oh, you know, it's not my phone. It's actually the you can hear iMessage

Scott Benner 15:23
Yeah. Wow. So ready, top left corner, apple, sell System Preferences. Yep, sounds, sale. Under sound effects, play sound effects through headphones, turn the volume all the way down. Play sound effects through headphones, see the slider for alert volume? Yeah, just turn the volume all the way down the slider all the way out. Oh, my God, that's amazing. That's what I was talking about, about, they only want you to use these things if you really, really want to use them, because it took me about four hours one day to figure that out. Just like people asked for transcripts of the show. And I'm in my third month of adding transcripts to the website. And the process is just arduous and painful. And it takes up so many hours. And I'm almost done. And if it doesn't help get a scrape. Like if some if I don't get an email from somebody media is like, thank goodness, you added transcripts to this show. I'm gonna be pretty disappointed, I guess. And if you're doing that, then I got to see the ones for this one, just like bing, bing, bing. That's a lovely. So what I was, I guess what I was getting at is it's interesting, right? These algorithms are coming out. That are being you know, our news is loop right now. But we're super excited to use Omni pod five. But there is that part of you that's like, I hope it's gonna let me be aggressive. Like I want to be aggressive. Like I hope it doesn't. And I can't see how they don't know that. That there's probably two different segments of people using it. But anyway, that's what I think of when I see sleep mode. I think sleep mode to me seems like, yeah, here, here's your cheat to be more aggressive. We'll call it sleep mode. But it sounds like it works great. It really does. I think algorithms in general, are. I don't even know how to say it. But but for people who have pomps, who can afford glucose monitors, that whole setup. I can't imagine anybody wouldn't want it. At least from my perspective. Jenny and I were talking the other day. It's December right now 2024 perspective. And Jenny and I were talking about, I was telling her what I wanted to do with her in 2021 on the show, cuz she only has a limited amount of time. And you know, we're trying to figure out how to use it. And then I started talking about what I want to do in 2022. And she's like, are you planning for two years from now? And I was like, Yeah, because everyone who's paying attention to algorithms and pumps is super excited for it once it today. But the majority of people don't know what's coming, don't know what it is and wouldn't use it if somebody told them. And so I think of it as a an education process that will go on for years. Really, you know, I mean, just keep in mind that right now more people use MDI than use pumping into in 2020. And not that I'm saying you have to use one or the other, I'm just saying that the adoption of things is very slow. And that there's an argument to be made, that you're really only reaching newly diagnosed people because people who are settled with something that they believe is working, are very, very, very scared to change. So and change has to be super simple. And I mean, honestly, Stefan, was it super simple to learn how to use that Tucson? Oh, yeah, absolutely not. That's what you want. Right. But now people have to believe that that's true. So I think that's a bigger hurdle is reaching people who are already set. And, and making them believe that it would be reasonably simple to change to something that would end up being monumentally better? I don't know. That's, trust me, that's a harder thing than then you might think.

Stefan 19:13
And probably some of it, too, I think maybe comes from maybe, you know, distrust of computer algorithms. But like, from my perspective, it's something that I work with all the time, like you would be if you don't like computers, and you don't think that, you know, they can do stuff, then man, you want to stay away from cars, because everything that we do now for how the engine works is run through a computer and we build model after model after model after model with it. And it's absolutely incredible. I mean, you can give it you know, back to, you know, engines again, you can give it a certain amount of air a certain amount of fuel and this model will tell you Alright, here's the speed you're at, you know, here's how much torque you're making. Here's what You need to do with it.

Scott Benner 20:02
When you know why the car I have currently has collision avoidance, right? And so when you're buying it, the guy says his car is collision avoidance. And I'm like, what does that mean? He goes, Well, theoretically, you shouldn't be able to drive into a brick wall. And I'm like, say it again. And so he's like, I think he goes, I think, right? I think if you went outside and drove at the building, the car would stop. Even if you had your foot on the gas. And I'm like, should we go try that? You know, I think it's like, I'm up for this, you know. And he laughed a little. And he's like, it's a new feature. I honestly, I've never talked, anybody's used it by law. And the number of months later, my wife and I went to DC, actually, to see yo yo ma play. And we were coming home, and I was getting back up on the highway in a place I'd never been before. And it was this sort of long on ramp that merged up onto a roadway that of course, was that was over my head. So I couldn't see what was ahead of me. But more importantly, you were coming through trees on your left, so that you couldn't even see what was coming from behind you. So I'm picking up speed, picking up speed thinking I'm about to merge onto this, you know, probably fast running highway. And as I'm coming up, everything is just stopped in front of me. And I take a split second to see Can I just get over now. So I checked my mirror, I realize there's a car there that I can't get over. And I'm making the decision to put my foot on the brake. And everything in front of me was closer than I thought it was. Now I want to be clear, I believe I would have stopped the car. Like it wasn't that it wasn't like the car was eight feet in front of me. But before I could get my foot off the accelerator onto the brake, I could feel the break get sucked out from underneath of my foot. Some alarm went off in the car. And it came to an abrupt stop it never tailed it didn't fish tail, it just room and stopped. My wife yelled, what was that? I was like, wow, this car really can stop itself. And that was pretty much the end of it. It was startling. But it was fascinating how well it worked. You're telling me that that was done with a computer algorithm? And little and little cameras?

Stefan 22:17
Yep. Little cameras and a computer algorithm.

Scott Benner 22:20
No kidding. You understand how that works?

Stefan 22:23
Not quite, because that's not that's not in my department. But I mean, so I don't know how deep you probably not that deep. It's basically looking at how far away what's in front of you is how close it's getting and how quickly it's approaching. And then it makes that determination. Oh, there's a car there. Let's break and there's no, because this guy's not doing it.

Scott Benner 22:45
So there's a drop dead moment where the algorithm decides if we wait past this line. We're not we're gonna hit this thing. So I'm taking over now. I don't I have to tell you it worked spectacularly well. And when I the next time I went in for service to guys like any problems the car and I recognize them. I was like, No, but hey, interesting story. And I told him about yo yo Ma, not about the concert, but about coming home from it. And he said that really worked. It was funny, how astounded. He was the salesperson, like wow, that really worked. And I was like it worked. I said, I don't know if I was going to hit them or not. I don't think I would have crushed the car in front of me. But I do think I would have impacted it. You know what I mean? And and so what you're saying is, if we can do that, then an algorithm can definitely change your Basal rate with a little bit of predictive information. Yeah, Yeah, no kidding. Yeah, it's super, I can't imagine. Listen, I'll tell you that Arden started using. So again, I have to say, poor Arden, I imagine I'll die one day, Stefan and my children in a way to connect with me. We'll go back and listen to this podcast. And then Arden is going to start making a tick sheet on the side every time she heard the words Arden's period. But Arden gets her period too long, right, she gets it for too long. And sometimes it's heavier than it should be. So we made the decision at the beginning of her last period to put her on a really low dose of birth control pill to see if the hormones couldn't regulate this like no lie today. She came in and said to me, I'm not bleeding anymore, but I still have a little bit of blood. And this is the 11th day of my period. So by the time this ends, she'll get like a week's respite, and it'll come back again. So she's not just getting it for too long, but she's sometimes getting it twice in a month. So anyway, a very reasonable reason to try this because we've done a lot of other things that haven't impacted so we're trying this Arden's basil rate right now is a unit and a half an hour since she started taking the pill, but was point nine an hour before the pill and It took me a day or two to see that, okay, the pill started to impact or that my settings weren't going to, to be able to overcome this. And I just zoomed, I zoomed it right up. And I have to be honest, I just looked at the graph. And I was like, the outcome I'm having here to me seems like she needs about a half unit more an hour. And I threw it in and saw what happened, I then turned her insulin sensitivity stronger. by a couple of points, I think we went from 42 to 40, maybe. And she's very settled. Now, like her blood sugar has been like 88. For, I'm going to lock it because I've been astonished how long it's been since I made the settings. So I made the setting changes last night around nine. It took until about three in the morning to work. So from 450 this morning till now, which is now like 1230, in the afternoon, her blood sugar has been between like 80 and 95. So my new settings are working. And now I'll make decisions about carb ratio at meals, like let's see if that changed or not. That'll be the next thing. But point is, because of the algorithm, I really was just pushing up gently on some levers, basically, just I'll just make this stronger. And I know this is going to work. I don't know how long it would have taken me to figure the same thing out without an algorithm. I'm guessing about three weeks what it took me. So I think they're just astonishing. And really exciting. Come Yeah, got Oh,

Stefan 26:35
no, no, I was gonna say and once you get over that, like, initial fear of changing settings to I think that, yeah, it the algorithm coupled with, you know, that willingness to experiment safely. Like, that's that that was a game changer for me, you know, like listening to this podcast, kind of the, you know, deciding, yeah, let's be bold, and, you know, like, so my first big change was, I don't know if it was the end of the honeymoon or coming like out of. So I was diagnosed in March. So coming out of the winter and into the summer, like I was having, you know, I was at initially maybe nine units of basil a day. And I was going low, like crazy. And then I pushed it down to four, you know, and slowly it's been creeping back up. So you know, that I remember that first change was like, let's do this, see what happens. And then the next change when I went back up, that that was really scary, like, you know, from four units, then to, I think it was like, I doubled it to eight units a day. And now here I am at like, 30.

Scott Benner 27:43
Yeah. And can you imagine if you were stuck in your head with like, we'll try moving at 20%. And then wait a few weeks and see what happens. And then try it again, we would take you years to get to where you are right

Stefan 27:56
now. All the while you'd be raging at people with your high blood sugars and lows and not having a great time. Well, and not

Scott Benner 28:03
only that, but I'll tell you that the the weird cyclical, merry go round you get on is that you push the basil up not enough. So your blood sugar gets high. So you make some grand correction to your blood sugar at some point, which drives your, your your blood sugar low, then you show it to your endocrinologist who sees a bunch of lows throughout the day. And you know what they do? They make a base agent, they take your basil away, because like, oh, you're getting low all the time, we'll make your basil lower. When the truth is, you need the basil higher, so that you have better results around meals. You're not rage Bolus and high blood sugars, not creating adenomatous deficit of insulin away from active food in your system crashing low. And that's that's it, it literally the outcome tricks most people into doing the exact opposite of what they're supposed to do. You need more basil so you don't get high so that you don't have to over Bolus so that you don't crash low, not you're not getting low because of the basil, you're getting high because of the basil being off and too weak. That is I'm always astonished and how even doctors don't get that like because I get to hear from a lot of people. I'm not saying all doctors but I get to hear from a lot of people who are having incongruous experiences between the podcast and their doctor. And the doctors trying to push their basil down while the podcast is leading them to believe that they should probably have it a little higher. And you can't make those people believe that you just can't. It's impossible for some reason. And then you get stuck, you know, and it's a it's a stock that could could be on you forever. It's really yeah, sad, you know?

Stefan 29:52
Yeah, I mean, it took me I think I rotated through two endocrinologist so far, like the first one was I was like, No, no, I got this. It's my steering wheel. You know, it's your diabetes, but my car that we're driving kind of a thing is it was a little odd.

Unknown Speaker 30:08
As I use that metaphor, yeah. Oh, well, it sounds fun.

Stefan 30:15
But, uh, and then that my second endo, she was like, you know, I want to work with you. Let's see. And then, you know, three months later, I was like, No, you got this, you know, keep on keeping on with what you're doing. Excellent. And that was like that. For me still being new at this hearing, you know, the, like, You got this, you can do this, you kind of know what you're doing. That was like really big, really, really big confidence booster. That's not to say that, like everyday is perfect. Some days definitely suck. But yeah, I know, I

Scott Benner 30:52
know. I don't know if I ever said it here. But I'd say to people a lot when I'm speaking to them privately. And you know, at the end, I'll say, look, nothing I told you, while we were talking today was advice. Like, I'm not a doctor. And please don't take this as medical advice. I said, but I can give you one piece of advice. I say, I think you understand this better than you believe you do. You should trust your gut a little more. And basically, it's like a verbal pat on the ass. Like before they run out on the field. Like, I think that's something that people desperately need at times, which is just the idea of like, maybe I am right about this. Instead of living in that flux, where the information coming from your physician is so different than what you're seeing in your real life, that you just make the assumption that you're misunderstanding what you're looking at. And it's so frequently the opposite. Although there is a kind of inverse to that, which is, when people are making decisions with their settings are so far off, I do tell people a lot. Look, we just made a big change to your basil, a big change to your carb ratio, we've changed the sensitivities, you're going to start seeing things. And you're going to try to apply what you know about diabetes. And what you know about diabetes is often completely wrong. Because your settings were so wrong. You're having these outcomes, not unlike the low Basal causing low blood sugars, the kind of thing you've been having these outcomes for so long, you don't understand what you're looking at anymore. I sometimes say please just forget what you think you know, and start over from day one. Now that your settings are much closer to where they need to be. You know. Anyway, a married dating. No, single Good for you. No dog, no dog. Look at you're really listening to this show. I appreciate that. Tried to joke about this with my wife's somebody that my wife worked with over zoom the other day when they were kind of talking at the end of the meeting. And Kelly just says it all wrong. She's like Scott tells people don't get married till you're 30 and don't get a dog for sure. And try not to have kids. My kids are in the room. My dogs looking at me. My wife's there. I'm like, it's not what I mean. Exactly. I'm saying you don't really know yourself into your 30s dogs are a lot more work than you think they are. And you know, the kids think I'm joking about because I love having kids, but they really don't pay back in any tangible way. It's all very feely, you don't I mean, if you're looking for a boost from having children, it's it comes in ways that you can't trade in for other things, just in case you're wondering. But but that's uh, you sound like you're hard at work. How do you work full time and go to

Stefan 33:37
school? Ah, it's time management, which I'm terrible at. It's it's kind of it's a haphazard I think, for me. Yeah. Like, if I manage my time, then I make a plan and then I find 50 ways to kind of blow that plan up. And I excuse it all. So it's it's the it's haphazard,

Scott Benner 34:02
you know, for sure in the 70s people would call that common sense. And in the 2000s here, they would tell you have ADHD. Right? I think not working makes a lot of sense. I'm always looking for ways to get away from this. And by the way, this Coronavirus thing has been terrible because the days are blending into weeks. And I'm in the hours. I don't even care about the hours anymore. So I'm doing these things were like at nine o'clock at night. I'm like, well, I've done everything I meant to do for today. I just sort of restart the next day I'm like well, I guess I'll go work somewhere like I can edit a show for next week I guess or instead of just taking time for respite because there's no respite because my whole life is respite. It's just I'm all in this house. The house doesn't seem like relaxing home base anymore. Does that make

Stefan 34:54
sense? No, I get that there is like no more. I think work life balances is is not a thing. Any more?

Scott Benner 35:00
No, no 24 hours a day, you just put stuff where it fits. And I'm not 100% Sure, it's a bad idea. But I don't know how it would work. If the world opened back up again. I could say like, you know, go outside or go do different things. Like the other day, I was driving past this thing. And it was like an indoor indoor skydiving, I was trying to imagine it must be fans blowing up from the floor. I don't know. I was like, Yeah, I would do that. And then I thought, well, that's not going to be open. I can't do that. And by the time I can do it again, it's probably gonna go out of business. Right? Like, how is that gonna make it through a year of not operating? But yeah, it's something about the home, like my home has become. This, this is close to what I imagined it must feel to live on the International Space Station, I guess is just sort of like everything's utilitarian at this point. You know, well, how does how does? How long did you have diabetes before your algorithm?

Stefan 36:01
So I, before I started pumping, I was on MTI for a year.

Scott Benner 36:12
g vo hypo pan has no visible needle, and it's the first pre mixed autoinjector of glucagon for very low blood sugar in adults and kids with diabetes ages two and above. Not only is chivo hypo pen simple to administer, but it's simple to learn more about, all you have to do is go to G Volk glucagon.com forward slash juicebox. g Vogue shouldn't be used in patients with insulin, Noma or pheochromocytoma. Visit g Vogue glucagon.com slash risk.

The word meter has a number of different definitions, the rhythm of a piece of poetry, the basic pulse and rhythm of a piece of music. It's a unit of measurement. And it means a device that measures and records the quantity degree or rate of something. That Contour Next One blood glucose meter is a little bit of all that kind of smushed together, it's a little bit of poetry, it's got a lot of rhythm, it's definitely going to measure the glucose in your blood. And it's going to measure it very accurately and easily. And whilst doing it, it's gonna feel nice in your hand, and the lights gonna be bright, and soft and loving. I don't think the light is loving, but it does really illuminate where you're trying to get blood from at night. so damn handy. Seriously, though, there are a lot of meters available. Very few of them are actually accurate and easy to use, I think you should take a minute to look at Contour Next one.com forward slash juicebox, just to see if maybe you maybe picked the wrong meter. And now you'd like to update yours with the better one, which by the way may be cheaper in cash than your current meter is right now through your insurance could be true for the strips as well, you may actually be eligible for a free meter. And they have a test trip savings program. These sound like things you should know about. And that's why I'm here to tell you about them today. And to ask you to go to Contour Next one.com Ford slash juicebox and educate yourself. You're carrying a meter anyway. You might as well carry a really good one. What are the main differences between the first and second year?

Stefan 38:40
So for me, it was flexibility. That was the big one. Part of my job is driving cars around, you know, testing them and like it was, for me at least it was very, very scary. The thought of having a low when I was on MDI and driving around, because I was on MDI and I also didn't have a Dexcom I was doing you know, finger sticks. And you know, the thought of being on a test track at 100 miles per hour trying to calibrate a car and your blood sugar goes low. And you know, by the time you go low some sometimes those lows on MDI would happen like that. Those would be like crazy scary, because, you know, I was honeymooning too. So, you know, get in the car test here. I'm at 150 Okay, that's fine. I'm not gonna correct it. And then you know, 15 minutes later that 150 take the one away. You know, here's a 50

Scott Benner 39:36
your pengurus decided at one to work again. And yeah, there we go. squirt a little more in. And oh, wow. So what did you do in that situation?

Stefan 39:46
For the ones that I would feel like I'd feel them at 50 it's, you know, pull over pound some gummies fruit gummies and then just wait.

Scott Benner 39:57
Do you ever get done and go look at your notes and your notes said you Equals Mickey Mouse and you're like, oh,

Stefan 40:03
like, yeah, it was bad. Like, I would look back at what I was doing or whatever. And I would have like no idea what I was thinking. Like, even in meetings if I go low in a meeting, it's like, I'll email everyone afterwards. Like, I apologize. I was rambling. I have no idea what I was saying. I must have sounded really stupid. Don't pay attention. Please.

Scott Benner 40:24
If Christopher Columbus had pistons, let me tell you something right now, where we be. And they're all just messaging each other like in the room. Stefan's blood sugar's low. Should we do something? What the hell is wrong with this kid? Again, this guy would the Columbus thing. You won't let go of it. Well, that's frightening and not funny at all. By the way, just the idea that you know, you could be I mean, honestly, you're incapacitated, but you don't look so. Right. Right. Yeah. And then the next step from that is, hey, did anyone else see Stefan have a seizure today in the meeting that you know, you don't? You're trying and I guess you're trying very desperately not to be thought of that way at work as well. Right?

Stefan 41:09
Yeah, yeah, that's so um, I am one of two type ones in our department. I only ever knew this one other, this one other co worker, and I knew him before I was diagnosed. So now there's two and yeah, I just don't want to be stuff on the diabetic, you know?

Scott Benner 41:28
Yeah, I feel that I very much. use that as a guiding light. When Arden was younger, I didn't want Arden to be the little girl that passed out at school. You know, and at the same time, I didn't want her to be walking around with these insanely high blood sugars.

Stefan 41:47
Right. And I mean, like, the other the, my coworker, too, you know, it's before I was diagnosed, people would talk about how he's, he's had episodes at work. And, you know, people don't know what to do. They just kind of like, what they found him seizing at his desk, and they had no idea what to do. So they just call 911. And by the time, you know, they came and gave them his glucagon. You know, he lost three months of memory. Wow,

Scott Benner 42:17
really? Oh, that's terrible. Oh, he just killed me. That was really terrible. That sounds like it went on for a very long time. Yeah, yeah. And and he had never, and probably for similar reasons that you just described, probably didn't want to tell people like, Hey, listen, if this ever happens to me, because it freaks people out. You know, hey, if this ever happens to me, can you just open this red box, and there's a needle? Yeah, now the needles pretty big. Don't let that bother you. You're gonna squirt the water into the powder. Now I want you to take the powder in your hands and rub it back and forth dissolves. Now we're gonna redraw the powder out into the needle. I just like you to stick this in the deepest part of my ass and push this plunger down. And then and by the way, please don't pay attention to the needle because it's gonna hurt me. Not you. Yeah. Blah, blah. Meanwhile, I'm holding a demo of the G vote hypo pen right here. And I see why that was a good idea. I just kept it on my desk. For some reason, after I was talking about it one day, it just reminds me of what an amazing idea it is that it's just cap off, pushed down, done like that. That's the kind of thing that you need, especially in that stream. Because imagine if your co worker could have said to somebody, hey, listen, I've got this pen here. You know, this should ever happen. Just you know, anywhere. Just hit me with it real quick. And it will save them. Did he have any other long term deficits?

Stefan 43:36
Now now it just took them a while to kind of remember like who he was and what he was doing at work. Wow.

Scott Benner 43:44
Hmm, yeah. So now that sticks with other people, and then they never let go of it. And then like you said, You're all of a sudden your stuff on the diabetic and expectations for you are lower, unnecessary, you know, unreasonably so? Or you're stuck doing a campaign of, you know, education throughout the building to bring everybody else up to speed. And I mean, how are you going to do that? Even? You know,

Stefan 44:07
yeah, yeah. Good. Yeah. So reasonable concerns. Absolutely. Yeah. And now and to is it was MDI was just, yeah, the lack of flexibility. Okay, that's what was killing me. But at the time, when I was on MDI, it was definitely the more affordable option because I didn't have insurance when I was diagnosed.

Scott Benner 44:32
Oh, because you were still a student and you just got this job not that long ago. Okay. Yeah.

Stefan 44:36
aged out of my parents plan. I you know, I thought I'm healthy. I don't care. I can wait until my job kicks in. I don't need health insurance.

Scott Benner 44:45
Yeah. Yeah. Teenagers. Then your pancreas kicked out. And then yeah, yeah. So you were just so when you talk about that you didn't have a job at the moment, right, but you had diabetes.

Stefan 44:57
So I was I was still Working the same place I'm working now, but I was a co op, I say,

Scott Benner 45:03
okay, so no insurance yet. Right? And so how do you make those decisions? So you've got you have an income, but you don't have insurance, you just get the needles and the insulin and that's it some cash

Stefan 45:15
trips. So what really so I say, I don't have a dog, but now you can hear my sister's dog.

Scott Benner 45:22
Don't feel like you have to explain your lies to find just tell me about this.

Stefan 45:27
So yeah, for me, it was honestly I like, Oh, man. This is gonna sound so silly. But like the first script that I got out of the hospital, I completely like broke down crying. So like 27 year old in the hospital crying like in this nurses lap, basically. Because that that though, was $700 for a bottle of Lantus and one, vial of humor log, and then some syringes. Honestly, what I did, I relied on my endo for samples. I explained the situation and it's like, I you know, can you samples?

Scott Benner 46:13
samples? samples? Yeah. Put your hands out, please. Yeah. Because $700 was not something you had?

Stefan 46:23
No, not not. And that was, you know, $700 a month.

Scott Benner 46:27
Right. But would that have done? So be clear for a second net without telling us your net worth or something like that, but, you know, a large chunk of your monthly income $700? And yeah, what would you have had to Did you have anything big enough in your life to cut out to make up that money? I don't even imagine you did.

Stefan 46:45
At the time. Yeah, that was that was huge chunk. I mean, I could have given up my like my car, but then I wouldn't be able to go to work.

Scott Benner 46:53
Or your I'm sure all of your charitable giving, you could have just cut back on. Yeah, I do wonder what they think when they're like, it's just $700. Like, what do you think I'm doing over here? Exactly. Right. I just stopped writing my big check out to United Way like I always do, and it's a it's a it's a very strange space when you are one of those people, the people who are not covered by insurance, and don't have just scads of expendable cash, I don't know anybody that feels like they have scads of expendable cash. My brother and I were talking recently, you know, in our, our financial structures are pretty different from one another, but in the end, at the end of the month, he's got no money leftover and I got no money leftover. It's just, you know, it's it's not like, it's not like suddenly you make a little more money. And while we it's it just sits in a pile at the end of the day, you know, yeah.

Stefan 47:48
And, you know, I coupled that with like, student loans and, you know, living by myself, I moved back in. Yeah. With my parents. That was the only way I could make this work. These weren't and then, and then it's not only that $700 a month for the insulin, it's the hospital bill. Yeah.

Scott Benner 48:05
Yeah. How much was that? Do you remember? Oh, man. 300,000. Okay. Yeah. Hold on a second. So, after you filed for bankruptcy, tell me what a $300,000 hospital bill first you negotiated it down, right?

Stefan 48:21
Yeah, yeah. Well, they there was some. I remember like in the ICU, they were trying to give me like, there was heparin shots every day. They were trying to give me these like laxatives. I have no idea why.

Scott Benner 48:37
Because they were $1,000 a pill.

Stefan 48:39
Yeah, like the nurse would come in. She's like, a heavier heparin, and I have your laxatives, I'm like, What do I need that for? You know, go away?

Scott Benner 48:46
Yeah. You know, I, um, when my iron got very low. A couple of years ago, I took myself to the emergency room. Now, the oddity was that I had been working with a physician for almost a year, we were just up to the part where I was about to get the iron infusion, and I almost fell over. So I ended up in the emergency room. And they kept me overnight, which I was like, fine with. And the next day, this woman walks in the room like, Hi, I don't know you. She goes, I'm the neurologist. I'm here to check you over. I'm like, no. And she's like, well, you almost passed out. I'm like, you need to get out of here. I was like, my irons low. And she goes, you have insurance. And I went I don't care. Like get out. I was like No, like, don't I get why they were doing it. And I even get that I wasn't gonna really it wasn't gonna hit me out of pocket. Like maybe it would ended up costing me $50 more to have her do it. But I'm like, I'm here because I have low iron. I almost fell over because I had no ferritin in my body whatsoever. And my red belt blood cells were not carrying oxygen any longer. So I don't I'm good. And and then she was literally on the heels of a cardiologist who wanted to do an EKG and I was like, No, like, I mean, who else is out there trying to get paid is how it felt like you don't I mean, like I was like, is it Is the candy striper gonna come in and tell me about our Etsy store in a minute? Everybody get out of here, you know, like I got the iron I'm leaving now.

Stefan 50:10
Oh, yeah, no, absolutely. It was like the guys at the endocrinologist that I saw for 15 minutes a day sent me a bill. And I was like, You didn't even like talk to me. You just said you're doing well keep it up. And then the diabetic educator would come in and let's go through your booklets

Scott Benner 50:25
Way to go, buddy. That's gonna cost you three grand. Oh, yeah. We I used to have a joke. I would tell my wife, I was like, I think the endocrinologist only touches Arden once a year, because there must be a law that she has to physically contact her. Because, you know, we, you know, our visits are always with her nurse practitioner. Yeah. And it was like that for a long time. And the doctor never came in. But once a year, the doctor would come in and literally, like, put her hand on her shoulder or something. And I'm like, I think there's something going on here that I'm not aware of. And then we'd see her once here. Now the The hospital has now changed since then you actually see the doctor at every visit now, which was not the case in the past. But back then. That was always my thought. I'm like she's just touching her so that she can legally say I touched her. Because she didn't do anything. Like she was just like she'd come in and put her hands on her somehow. And then ask her how she was feeling. And then look at the chart and go oh, you're doing great. You have any questions? Yeah. Yeah, what I know the questions they asked, by the way.

Stefan 51:28
Yeah, I totally get that too. I say endocrinologist. Like I've been moving around endocrinologist. I think I've met the endocrinologist once, and it's Yeah, it's been the nurse practitioner who helps me.

Scott Benner 51:38
Yeah, no, no, the whole system's a little weird, obviously. But yeah, it's just, I'm always baffled when they're, they're like, do you have any questions? That would be like, literally, if you put me on a rocket, and you were like, hey, you've got to figure out how to fly this rocket to the moon. Go ahead and ask your questions that will get you to that end. Right. I'd be like, I don't know what questions to ask about that. Because I've never flown a rocket before. And by the way, spaces in my head a lot, because I'm going to interview April next week. And April works at NASA. And she was super excited for that. That's so cool. Yeah. But anyway, I guess that's just in my head for some reason. But yeah, I am. I'm fascinated by that. Like, what questions do you have? Like, could you not like if, if, Stefan, I'll tell you right. Now, if you put me in a room with somebody who was just diagnosed with Type One Diabetes, I would not need them to speak. And I could, I could have them leave that room better off than they were when they got in. They don't need to ask, I don't need to know what they don't know. I know what I know. And I know what they need to know. I don't understand why you have to know what's in their head Exactly. About management stuff. I'm not saying you shouldn't talk to people hear their fears. Understand stuff like that. I'm just saying like, it's an odd thing to say you're the teacher and then not want to say anything. So it's like a Can you really not. I sounds pompous. But I could explain diabetes to you in 45 minutes in a way that would put your agency in the sixes? Like, how is that not? Like how this works? freaks me out a little bit. Anyway, I'm sorry, did you have anything you want to talk about? We're like an hour and I should probably have asked you was there a reason you're on the show?

Stefan 53:24
I don't know that. That's it's the big thing was like, I wanted to give back a little bit. Your show helped me a lot. It was basically like what? So like I said, I left that hospital with like a pamphlet that was very generally written and then like some booklet from I think, Eli Lilly, or something like that. And it was like this podcast and some YouTube videos, which that was my diabetes education. Because, you know, they tell you, you get out of the hospital, they say, oh, by the way, make an appointment with your endocrinologist as soon as possible. So then, you know, you call up your endocrinologist and it's like, yeah, we can fit you in three months from now.

Scott Benner 54:05
Well, might be dead in three months.

Stefan 54:07
Yeah. Yeah. That was like, Well, I'm just newly diagnosed. Can we push this up? And she's like, well, we can try for something in like a month and a half.

Scott Benner 54:18
Yeah, right. Like, my mom had to have surgery one time, and it was really important. They're like, we can do this in eight weeks. I was like, Can she last eight weeks? like is that the play here? Really? So I had to find the podcast.

Stefan 54:31
Ah, Google. Honestly, it was just googling, like, how to type one diabetes.

Scott Benner 54:39
stuff on you're telling me you even lost your Google skills when you got type help. stuff on type one help now? How to question mark,

Unknown Speaker 54:52
please, please.

Scott Benner 54:56
This is Google Search effort just like type one diabetes. Please help me. By the way, if I thought that's what people googled, I would set my SEO up on it. But I'll tell you search engine optimization is ridiculous. It is fascinating to see that when put to it, how similarly most people ask questions. It really is interesting. Like the Way questions are asked are here, I'll give you a little inside baseball on the podcast, right? Did you ever hear the 911 episode where the person came on? Who was a paramedic? I don't know. I don't think I've listened to that one yet. So it's true. It's a terrific episode. And it absolutely worked out completely opposite of how it was supposed to. And here, here's how I explain it to you. through understanding SEO, because there is a listener of the podcast, who does it professionally, who was very kind and helps me with it. She told me, hey, people abundantly. Google about diabetes, tattoos, type one diabetes, tattoos, she's like, you should do an episode on that people were really interested in it. And I was like, Huh, I don't know how interested I am in it. You know what I mean? Like, I was like, I don't know if there's like a whole light conversation in there. So I started thinking about it. I thought, well, why do people have these tattoos? Mainly, they have them because they want you know, EMTs, or paramedics to see that they have type one diabetes in the event of an emergency. So then I started researching, and I found this person who has just this fantastic paramedic podcast. And I reached out to her, and I got her to come on the show that took months. Like this whole process, like I know, it feels like I'm just like, Hey, I just talking to the microphone, but like, so I'm doing all that. I get her on. I don't know her thoughts or feelings at all, on any of this. And I asked her this question about, you know, type one diabetes. tattoos, they must be really helpful. Like, that's the vibe I'm coming from. And she stuns me by saying, No, you should not rely on those. And I was like, oh, and so the entire episode that you hear, which I think turned out really well was not nearly what I expected it was going to be when I started it. Like, if you really listen back to it, you'll hear a pause, where you hear my brain go, Oh, good. Scott, what are you going to do now? She just said those are not a good idea. And then I leaned on other questions I hadn't we end up having this great conversation about what it's like to be a paramedic or an EMT in an emergency situation with a type one, what type ones could do some things that they think they you know, that people might think are obvious things to do that aren't. And she was it ended up being terrific, but it all came from search engine optimization.

Stefan 57:45
So I'm not so funny that you bring that up too, because that like before this whole Coronavirus hit that I was planning on going and getting a debt it was gonna be a type one debt not not like a emergency tattoo, but just something like type one related like, Hey, you know, you know, commemorative or I don't know,

Scott Benner 58:05
well, you can still get a tattoo but from what I understand, don't expect that that means a paramedics gonna know you have Type One Diabetes from your tattoo, even if you like people listening now might be like, well, what if I just put it in an obvious place? You should go listen to her conversation. It's when she describes what it's like to be a medical person in that situation. And what goes through her head. Her name is ginger lock. She's fantastic. It's Episode 387. But But you'll you'll believe when you get done that a T one D tattoo is not an absolute slam dunk or maybe even close to letting an emergency services person No, you have diabetes,

Stefan 58:47
that basically unless you put it on your forehead,

Scott Benner 58:50
you will you know what, it's funny. She I said to her like, well, what if you put it in a really obvious place? And she said, Do you really think I'm looking at your tattoos while I'm trying to save your life? And I was like, that's a good point. You know, like, like, that would be like if you were having a heart attack. And at the end of it, you were dead on the floor and the EMT looked at your wife and said, the artwork in this room is lovely. Know, you're like, you're like Why are you looking at that like Couldn't you have been paying attention to his EKG, maybe that would have saved them. And so the idea is, is that if they look for the the bracelets, and the a necklace, I think she said but they're running their hands. It's not as visual as you would think. It's very interesting. She explained it obviously way better than I could. But I'm lucky to have that episode as part of the podcast, I feel like but it happened almost by mistake. So I was just trying to, you know, find content that people would find interesting that I thought they wanted and instead I ended up giving them something they needed. They didn't know they needed and I didn't know it existed, which I think harkens back to something I said earlier, you know which is why would you Put a person in a room and ask them what they need to know. They don't know if they knew they wouldn't be there asking, you know? Anyway, okay, so what kind of tattoo where you're gonna get?

Stefan 1:00:12
So it was kind of dumb, but you know, it probably like a syringe or something. Yeah,

Scott Benner 1:00:19
I would put you in a car, a test car hanging out the window crazed big bug eyes, writing down gibberish on a clipboard. That's what I would do with a blood glucose meter, just flashing flow. Yeah, I'm now expecting that three years from now a car is going to hit the it's going to hit the market, and people are going to get in and be like, this car works terribly. Like, like, I wonder, I wonder if the guy who was working this all out his blood sugar was 45 while he does this thing hesitated all the time. So I can I ask, we're over your hour. But can I keep you for a little bit? Yeah. Oh, cool. I have questions. So if cars are this specific, and they work this well, how does sometimes they not work? Like my computer either works or it doesn't. There's no middle ground. But how come once in a while, my car still, like feels like it didn't get a chance to warm up on a cold morning. Like it's reminiscent of a carburetor and 1985 or something like that. Is that? Is that the mechanical stuff not operating the way it should even though? You know I'm saying?

Stefan 1:01:30
Yeah, so I guess it could be one of two things either. Yeah, the mechanics or something's broken mechanically, but there's also like, engineering is really the art of I guess, good enough. And fudge factors. Like we there's still a lot that we don't know how it works. And we can't really reduce it into a mathematical equation. So you kind of fudge factor stuff. And this is close enough. And it works most of the

Scott Benner 1:02:01
time. Yeah, that kind of stuff. how impactful is it? Are you were you a mechanic before you did this? Like, are you a grease monkey? And like, like, privately or no, and if not, is that harmful to your job? Or? No,

Stefan 1:02:15
no, I was I think it helps like, for being an automotive engineer to have an interest. Um, so my dad, he's a mechanic like full out mechanic owns a shop wrenches. And you know, I would go in on summers and help.

Scott Benner 1:02:30
He owns wrenches. I have an app. How does your dad See that? Does he look at you like, what a letdown? Or is he amazed by like I am. I'm amazed by what you do. But I'm just I'm wondering if he's so steeped in like, just let me get my hands in there. I'll figure out how to make it work.

Stefan 1:02:47
Yeah, yeah. Usually the mechanics harbor disdain for the engineers.

Scott Benner 1:02:54
So so we did attempt to follow in your father's footsteps. You made him hate you. Yeah, there you go. Ever the disappointment against the farm again? Wait, what's wrong? No, that's just really it's interesting. Because, I mean, I had a, like, I have a seat that goes up and down right in my back seat folds down. And it just sometimes would go down and get stuck. Or sometimes it would go down and it felt like it hit a limit. It wasn't supposed it would pop back up again. So I told them, you know, hey, this happens. Oh, yeah, we'll take care of it. We'll take care of it. The third time, I was like, Look, you gotta fix this. Like, they just don't tell me you're gonna take care of it again. Have a keep happening. So I came back in the guys like, Oh, it's gonna work now. And I was like, What did you do? He goes, Oh, we just swapped out the whole seat. Yeah. Which to me sounded like we don't know what's wrong with this thing. So maybe a new seat will work better? Yeah, pretty much. Is this why mechanics look so clean? Now when I see them at like, when you go into a car dealership, the guys that work on the cars are clean as clean as the salespeople they just don't have a title. And yeah, it's swapping parts. It. So do you think so? So a person now is more of a technician than a mechanic?

Stefan 1:04:09
Yeah, absolutely. There's like so much electronic parts. And some of the systems are so complicated, like a turbocharger for, you know, smaller turbocharged engines. If something goes wrong, just replace it, you're not going to either it's not going to work right? If you rebuild it, or you're just never gonna find what's wrong. Well, we're like transmissions transmissions are like this big, magical black box that hooks up to the engine and makes wonderful things happen. Make cargo magics. Make cargo. Like I can't explain those to you. But

Scott Benner 1:04:40
those get replaced. I had a new car once it had an issue. They came in and they replaced the part. The issue persisted. It happened again, the third time it went in. I said to them when I sent it in, I'm like, what's going on? And they're like, we have a bad batch of parts. And it was the thing that kept the car from operating right? It's not driving the car. And so, in 24 hours, the company contacted me and said, We are not going to try to fix your car again, because the New Jersey lemon law states that after the third fix, if this breaks again, we just we have to take the car back and we have to designate it as a lemon, which means we can't sell it again. But one day, we'll get through these bad parts. And this will never be a problem and your vehicle, right? They bought the car back for me shelved the car. And with a with a business plan of sitting on the car until the parts were good again, and then they would put the part back in and then resell the car. So I'd like 25,000 miles on a car and they just said Do you still want the same color? And I was like, yeah, and they just gave me a new car,

Stefan 1:05:42
man. Yeah. And either Yeah, either they'll keep it and resell it, or it'll go to you know us and we'll tear it apart and try and figure it out. And if we can't Well,

Scott Benner 1:05:52
yeah, it was fascinating. Like, it wasn't the dealership anymore. Like I got called by the parent company. You know, they were like, We don't want to fix this car again, we know what's going to happen. So are you okay with just taking a new car? I was like, yeah. I am. Thanks for asking. And then nothing happened. Like my, my loan just kept going the way it was. And it was really interesting. You know, and it all did stem from that idea of like, Look, we can't fix the part. So we'll just wait until those parts work better. It's like, wow, that's interesting as hell. combustion engines. The physically don't look anything like. Like the engine. I remember in my car, like a Ford straight six or Chevy 350. Like that stuff. They don't physically look. They're just aluminum boxes now, right?

Stefan 1:06:45
Ah, no, not all of them. No, no, not all of them. Some of them? Yeah, for sure. But, but you know, the way they work is still the same?

Scott Benner 1:06:54
What's the reasoning behind? Trying to keep it looking? Somewhat recognizable to the user? Is that the idea? Or is it that the form factor still works? So why change it? Like why are some so different than others?

Stefan 1:07:10
Definitely, for some of it is it's the form factor that works. The ones that are different, those are going to be like your four cylinders, and stuff like that. keyed. So here's a interesting concept. A lot of engine design is either tied to packaging, because you got to fit it all in there, or actually making the engine more efficient. So you want to keep it as small as possible. And they actually believe it or not as hot as possible within the limits. Right? Because you so work the heat part for Yep, they keep part. It's basically how it works, right? So you have a temperature difference. That's what drives the work. So the more temperature you bleed off into the coolant system, that's more temperature that doesn't go into driving your pistons up and down.

Scott Benner 1:08:03
So energy in general, you're trying to maximize the energy that it's creating, even if that energy isn't motion, it's heat.

Stefan 1:08:11
So yeah, and you want to keep that heat in the motor, okay. Within the, you know, within the limits have the parts that you're using. So for aluminum, you can't overheat your aluminum, but you want to keep it pretty hot.

Scott Benner 1:08:26
That's interesting. I don't know that I'll ever understand completely what you're saying. But it's it is, it's fascinating that that's even a consideration, especially within my lifetime. You know, if you really think about what an engine is, in my lifetime, it's the block and the heads and some pistons and some spark plugs and, you know, a reservoir for oil and not much else. You know, like, there, there was a time when that's really all it was. And to think that you're having considerations like that, and back then they were just trying to get the heat out of it. Right. Like you, you if those motors warmed up too much. They just, they blew up. That's really cool. Wow, what do you think cars are going to look like in the future? Like if you had unlimited resources, financially? If a company did would cars just look completely different? Are we stuck building on top of a an antiquated system?

Stefan 1:09:21
I think some of it Yeah. A lot of it is the limits of materials, like you can eat certain shapes for bodies and things like that you have to have for crashworthiness, or because the parts need to be strong with the materials that we have. You know, you look at some of the cars that push the limits of technology, like those solar powered cars, or those cars that go 300 miles per hour. You know, they look really cool with their shape and their aerodynamics, but they're extremely fragile.

Unknown Speaker 1:09:54
So, so bumping into something at a high rate of speed. Not a good idea.

Stefan 1:09:58
Yeah. You know, it's, it's It's actually really funny you bring that up, I was reading on my window sticker to one of Mike like a car the other day. I didn't know you know how it like, it seems like you get in a fender bender, and it's like 1000s of dollars worth of damage. Yeah. The Federal crash standard, or for bumpers is two and a half miles per hour. So any speed above that is like, disastrous to your pump? gonna wreck it? Yeah.

Scott Benner 1:10:30
My son's pulled forward in his car. And it kind of went over top of like a, like a parking block. And when he backed away from it, it did some damage, pulled it off, it was not even pulled it off. It just did some damage. And I think we ended up paying like 16 $100 to repair the car. Yeah. And it was just swapping parts out. Like there was no structurally nothing, you know, they took some stuff off and threw it away and put other stuff on it. And it was when I saw the bill was like 1600 bucks. Now, I said to my son, like don't pull forward as far as next time.

Stefan 1:11:04
We call that the the parking sensor. Yeah,

Scott Benner 1:11:07
people do that. I found that bang. Yeah. Well, I have to say that I even like the way seating happens in a vehicle. I'm even confused why that's that way. I guess there are real reasons. But there's part of me that wonders like, why can't we all face in towards each other? Or why can't the seats turn 45 degrees at a time? Like, why do I have to face forward? can I face to the right, can I face backwards? You know, like in a van situation like, couldn't that move around? And if that's the case, then does the car really need to be that shaped like there, there's just a lot of ways to go, that I think are too far outside of the of what people expect. And when you get away from their expectations, then that seems ugly or wrong. And then they won't buy it. So you're not incentivized to be too forward thinking, right? You know, I can remember getting a magazine once. And I think it was around 2001. And it was like in 10 years, your transmission will be pushed button. You won't have to move a stick any longer to move your automatic transmission in and out of gear. And then they showed a demo of it. And I was like, I stuff on I'll just beat this out. Because when I saw it, I was like, Mother, you can do it. Now. Why do I have to wait 10 years for it? Like you're doing it right in front of me right now. And then you start thinking about like, well, we have stock, we need to sell that stock. And then we got to make change overs. And we got to make some money, right? There's r&d, we got to sell some cars off of that for a few years to get our money back and to make a profit. And when you really look at the business of it, like once the business shakes out, we'll be able to get this in like 10 years. And now my transmission is a dial. Yeah, yeah, it's not even a button. I just turn it. And I'm starting to wonder how necessary that is. Like, couldn't I yell? gocar? like the way you Google?

Stefan 1:13:01
Yeah. I think yeah, I think you hit it on the head, because it's like, you look back at some of the, like, advances in automotive technology, like, seatbelts. You know, and you see the pushback that there was to seatbelts. Turbo motors, you know, everyone said, oh, they're unreliable, you'll you'll buy, it's just going to be a piece of, it's just gonna blow up on you. You know, and now everything has a turbo, everything has to have seatbelts.

Scott Benner 1:13:31
Yeah, oh, I got it. There are no like, large block engines anymore. In most, you know, most generalized vehicles, like I have a pretty big vehicle and it still doesn't have a huge engine, like by the standards I grew up with. The, I guess it's this is a cubic inches is that how motors are measured in liters, liters. So it means way off. Like, from my understanding of when I was a child to now like my, my vehicle should need a bigger motor in my mind. But the motor that's in it does a great job for it. And, and it's also you know, I see my wife's car or my son's car has like turbo in it. Like I don't even think he's got a motor in his car. Like I think there were like three mice burning cardboard in there. And then on top of it, there's a turbo You know, this magic thing that just makes energy when you need it, not when you don't. It's really is I find it all incredibly fascinating. But like I said, Yeah, I will. So what do you think about what I said about wanting an electric car once? You know I want one? Yeah, that's that easy.

Stefan 1:14:38
Yeah. Yeah. Yeah, it's gonna be coming. I think I'm with you. It's on my bucket list by driving one at least once not necessarily owning it, but I would like to drive one. I

Scott Benner 1:14:49
am worried about the like, adding a charger. Yeah, I don't even matter. Like I'm old now. Stefan, I don't have anything to do. So I don't mind the limited like Like 400 miles on a charge or whatever, it ends up being, you know, 300 400 500 miles on a charge that I'm okay with, like, it's the idea of like having to have someone come into the house and like install this thing. And, you know, like that part, I guess is a is a sticking point for me not enough to stop me from doing it, I guess. But yeah, I just, I don't know, it just seems like I used to tell people. When I was younger, I used to say, this is back when I expect that I would live like a 90 years. And now, you know, as I sit here and talk to you for an hour, my hip will be stiff when I stand up. So maybe I was being a little too generous with how long I was gonna make it. But I used to say, like, I would give away the last 10 years of my life, if I could come back for a year, every 10 years, just to see what happens. I do 100 years. Yeah. And then I started thinking about it. Like I haven't, it's not every 10 it's every 100, right? Like I want to I just want to see like, even if it's just for a year, just enough for me to get my feet wet, find a little apartment, and then be like, Alright, let me see what's changed. And then I disappear again for 100 years and come back. Like I think that would be really amazing. Because we just don't have the we don't have the ability to recognize in modern life, how far things have come so quickly. Like it's easy to say. But, you know, people rode horses as a main way of transportation. Not that long ago.

Stefan 1:16:23
Yeah. And I mean, you know, circling back to diabetes. That was the Advent now insulin was discovered, what, 100 years ago now?

Scott Benner 1:16:31
Yeah. Oh, oh, Stefan, you're delightful. My entire conversation about these cars has been about diabetes. You heard it right. So I the podcast is interesting. I'm not just sitting here saying like ham fisted stuff all the time. Yeah. Oh, by the way. So for anybody who didn't get that as you're listening, everything I just said about technology, and about moving forward and not being scared and trying new things. You're supposed to do that with your type one. That was my that was my tip for the day. I was just slightly slipping it in here because the font works on cars for a living.

Unknown Speaker 1:17:03
It's pretty sneaky, right? It's the font, don't you think? Yeah, absolutely. Not like your dad. It just pulls you into a room and remind you what a letdown you're everyone's

Scott Benner 1:17:13
by a wrench, you bastard. design them better like that. I have an air book. I'm good. Okay, thanks. my MacBook Pro takes care of everything your wrenches, though. That's, that's, it's just to me. It's, it's about moving forward. It's about not getting stuck. It's about not having such a preconceived idea that you can't break yourself free and try more or try different. I think you always have to have a little bit of that explorers feeling and you're like, I want to know what this is. And yet to lose the fear to, or at least find a place to pack the fear away. You know, do it Stefan does when he goes over his parents house, just cry in the car and then run forward. Okay. You just dad's probably a lovely man. And I'm just maligning him in your relationship. Are you kidding me? He'd be Catholic. Okay, good. But But yeah, I mean, seriously, it's, it's, you know, in simpler terms, you do not want to look up 10 years from now. Look at your diabetes setup, and think, Oh, well, no one doesn't like this anymore. Why is that? Because what that probably means is that your care is not where it could be. And a lot of times, that also means simplicity, ease, flexibility, use, you know, all that stuff. I'm not saying you shouldn't do MDI. I know a lot of people who inject with pens are syringes who do a really amazing job for themselves. I'm just saying, Look up once in a while and see what else there is. Maybe some of its cool, get into an ugly car and drive it. You know, just because you think it's ugly. Just all that really means is it doesn't look like what you're used to. And now I need people to donate $80,000 so I get a Tesla truck, so that I can really live my dream here. cybertruck That's the one. My daughter's like, That thing is ugly. And I'm like, I don't care. I said the 15 year old boy and me that imagine the future thinks that's

Stefan 1:19:12
right. Absolutely. The thing that thing is like it's like, oh man, I remember when I first saw it when it was being unveiled. It was like this thing is wild. Like forget every Lamborghini this thing is wild.

Scott Benner 1:19:29
I loved it. When I heard the story. It's too big for modern garages. They have to scale it down. I was like, Don't you dare I'll leave it outside. You're telling me it's that big. And it's basically a slot car. I was like, I have to find out what it's like to drive a tri motor cyber truck. Like I want to know why a pickup truck needs to go zero to 60 in under three seconds. I don't I don't know that there's a function for it. But I really want to experience it one that reminds me of is that As a motorcycle rider for a long time, when I was much younger, and one morning, we were I'll let you go after this. I'm sorry, One morning I was, it was I was working, it was a Saturday right? And, and they were selling concert tickets like a half an hour from my job. And I had it in my head that I could sneak out of my job. And I could make it to this place buy these tickets, which I think were Ozzy Osborne, and get back without anyone noticing. Because it was super early, the tickets went on sale at 6am. My bosses didn't come until eight, I had it in my head, I could work this out. So I'm up on this highway 530 in the morning, on my motorcycle, I used to drive a GS xr 750. And so I'm heading down the street, there's no one out there, I want to be clear, no one and I'm on this highway. And I am just going like I am going as fast as I can. And when the cop pulled me over. He said I was going 135 miles an hour over the speed 105 miles an hour over the speed limit. And he seemed very upset because he was screaming a lot. And it's the first time I've ever really thought about it. Because I don't know if people understand speed. But once you become accustomed to it, and you're not afraid of it, you don't feel it the same way. So I was going 105 I was going 140 miles an hour. Like he must have caught me in like the 50 feet of this like highway where it got there was a light. So it went down to 35. You know, like the highway was like 60. But then there was a traffic light in the middle of it. So that's the scam I guess is the pull you over in there, you probably usually gets people going 16 to 35. But he got me going, you know 114 to 35. Anyway, I eventually got out of that ticket, which is a great story. I could tell you another time. But it left me with the feeling of wonder how fast this motorcycle really goes. And so I looked down one day and the speedometer said it went 165 miles an hour. And I was like I'm gonna try that one day. So in the middle of the night out on a lonely highway, I took that bike up to 165. And I held it there for about two seconds. And then I backed it down and never went that fast again in my entire life because it was insane. It was everything about it was wrong. There's just there's no reason to do that. And, but it's fun. I Stefan I couldn't focus on anything. He felt like I couldn't focus a mile down the road. Like stuff was just flying past me like a movie. You know, you couldn't find focus, you were just like I kept thinking if I hit something like a small stone in the road or a pothole like I'm gonna die, you know, but I did it just to see if it would do it. And it was nuts. It really was. And I had that very similar feeling about those about like, the electric cars are fine. Like I understand they work like slot cars, like you just all of a sudden have all the power that you need. But I don't have every design of every Tesla I don't like so I don't think about them. But that truck was just so different. That I thought well that's different enough to I don't care that it's not palatable to me like somehow they went past my expectations for ugly, indifferent. And like loop back around behind me. It's probably

Stefan 1:23:22
it's probably Yeah, it's probably cars are starting to look so alike. You know, like every sedan looks like every other sedan. Yeah, nowadays. That Yeah, that's it's so wild and out there. And it's really like love it or hate it.

Scott Benner 1:23:36
Yeah, no, I agree with you. You can't sometimes you can't tell different card manufacturers apart anymore. They're just they're so similar. And they're they're shapes. And it's almost like they all buy the parts at the same place and just put them together slightly differently is what it feels like. Anyway, all right, I'm going to say goodbye to you. And I'm going to ask you where who you work for after we're not recording anymore, so nobody else gets to know that but I want to know. All right. Thank you so much for doing this stuff. I was really chatty today. So I hope this was good for you. But yeah, no, thank you, Scott. No, really and seriously, I didn't I cut you off from saying really nice stuff about the podcast because it's um, it's lovely, but sometimes it makes me uncomfortable. And, and then I joke my way through it and it just gets weird, but I really appreciate that the show helped you and I appreciate you want to let other people know. But I didn't have it in me today for you to say it. Like I don't know why the douche chills would have been too much for me for some reason. I hold on one second. A huge thank you to one of today's sponsors. Je Vogue glucagon, find out more about chivo Kibo pen at G Vogue glucagon.com forward slash juice box. you spell that GVOKEGL Uc ag o n.com forward slash juicebox I'd also like to thank the Contour Next One blood glucose meter for fitting so well in my daughter's bag in my hand and doing such a terrific job of giving us accurate results that we can make good decisions with Contour Next one.com forward slash juice box. Links in your show notes links at Juicebox Podcast com

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#520 Chuck Alpuche, Insulet EVP, COO

Chuck Alpuche is the EVP and COO of Insulet. He oversaw the creation of the Omnipod manufacturing floor and he has a very deep voice.

You can always listen to the Juicebox Podcast here but the cool kids use: Apple Podcasts/iOS - Spotify - Amazon Music - Google Play/Android - iHeart Radio -  Radio Public, Amazon Alexa or wherever they get audio.

+ Click for EPISODE TRANSCRIPT

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DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.

Scott Benner 0:00
This show is sponsored today by the glucagon that my daughter carries g vo hypo pen. Find out more at G Vogue glucagon.com forward slash juice box. Hello friends and welcome to Episode 520 of the Juicebox Podcast.

Back in 2019, I was invited to speak at the Omni pod headquarters in Massachusetts, I gave a little talk to all the employees about why what they do is so important to people like me and my daughter and everyone like you. While he was there, I was given a tour. I didn't just get to see the offices. But I saw the actual place the production floor where on the pods are made. And let me tell you it is as futuristic and as amazing as you can imagine. Anyway, this tour was given to me by a man named Chuck and by how on assuming he was I had no idea of the important position that he held it insolent. He's just very humble. And I found his sincerity and his excitement about the production to be infectious. And I've wanted to talk to him since then, but he's not the kind of guy who gives interviews so it took me a little while but I'm really excited for you to hear Chuck story about how we got to Omni pod, how they designed the floor where the production happens and and so much more. Please remember while you're listening that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan. We're becoming bold with insulin. Just one ad today somebody get it out of the way for you right now so we can listen to chuck straight through. g vo hypo pan has no visible needle, and it's the first pre mixed autoinjector of glucagon for very low blood sugar in adults and kids with diabetes ages two and above. Not only is chivo hypo pen simple to administer, but it's simple to learn more about. All you have to do is go to G Volk glucagon.com forward slash juicebox g vo shouldn't be used in patients with insulin, Noma or pheochromocytoma. Visit g Vogue glucagon.com slash risk. Just a second here. Before we get started, I need to tell you that Chuck's voice is incredibly deep. It is so deep that his recording equipment has trouble capturing the the richness and timbre in his voice. If you put Chuck next to Sam Elliot, and gave him lines from The Big Lebowski, you'd think to yourself, hmm, Sam Elliott has a really high pitched voice,

Chuck Alpuche 2:50
Potter's and folk. So it's got you got to get back to do another plant tour.

Scott Benner 2:55
Oh, well. Alright, so we're recording now. So just I'll introduce, I'll introduce you. So

Unknown Speaker 2:59
you don't have to.

Scott Benner 3:00
That'll be easy. I'll do that later. Just let me tell you that the minute I left the plant tour that I took, which now I think might have been a couple of years ago, it feels like I thought I want to interview this person. Because I just wanted to, I wanted to understand how you get to a position in your life where you're the right choice to design a manufacturing floor. So I know that sounds like maybe not what you expected. But, Chuck, I want to know where you went to college and what you thought you were going to do with your life and what path you took.

Chuck Alpuche 3:34
So that's a great question. And I grew up in Philadelphia. My family's still down in the Philadelphia area. I went to school down there. I actually started studying food science because I grew up in the restaurant industry. And I thought that, you know, that's what I was going to do. And growing up, I started thinking to myself, you know, you're working all the holidays. And, you know, is this really what I want to do with my life the rest of my life. And so I changed majors I actually moved over to business with an emphasis on industrial engineering, organizational dynamics at the University of Pennsylvania, which sets it simply, too. So when I graduated, I had a brief stint with the Detroit Lions that didn't last long with injuries and then got a job with PepsiCo. Okay, hold

Scott Benner 4:26
on. So you just you just skipped right over the fact that you sounds like you played for the lions for half a second. So did you play? Did you fail? Do you play football at Penn? No, no, I

Chuck Alpuche 4:36
did in my undergrad Delaware Valley University. Okay. Yeah, so I did skip over it because it was such a long time ago. It was only a year right. Then I hooked up with Pepsi in Philadelphia and started off as a third shift sanitation supervisor which is critical in plant food processing plant and then moved around with Pepsi. To go different parts of the country back to headquarters in New York, I ran their international operations, I ran our concentrate operations, which was a GM assignment. And then I moved to and ran North American operations. And I retire after 30 years to the day, one of the last corporations with the full pension and benefits, which was excellent. So I retired. And there's wanted to spend more time with family with all the travel that was required in my role as a head of operations, especially internationally. It was a prime time to spend with my family, especially my kids are so important to me and everything to me. So I would wake up and make them breakfast, driving to school, go play some stuff, pick them up at school, was just a wonderful time of my life and the perfect time to be able to retire. But then I started getting calls for consulting. Pepsi folks are everywhere running businesses, and I was consulting starting operations and supply chains for a lot of companies, internationally and domestically. Some folks were asking me to come back full time, which I had said no, I was enjoying my balanced life, as I called it. And then I started consulting for excellence. I got the confirmation that and that was a real easy one to say yes to full time. So I've been full time for five years now. Yeah.

Scott Benner 6:29
The I guess it might sound odd to some people, you know, Pepsi, insulin pumps, but it's the process of setting up the floor and understanding materials and workflow. That kind of stuff is, I would imagine, excuse me, I would imagine runs over top of anything, you're manufacturing, right. It doesn't need to be food. It doesn't need to be a medical device. It's it's, I mean, like, why would they? I know you said there's Pepsi people everywhere. But do you know how they found you? Do you know why they were looking for you? In select?

Chuck Alpuche 7:03
Yeah, yeah. So the Chief Human Resource Officer was x PepsiCo. So he knew me at Pepsi. He actually called home I wasn't home. My wife that answered and said, Brad call and we'd like you to look this company up. And I'll be honest, I looked him up. And this was December 2015. I looked them up online. And I said buddy calls back I'm not here. I'm not gonna consulting. A lot of positive news. Online back then in 2015. With product recalls and warning letters from the FDA I saw nothing positive from our Potter's but then bad call it and I did answer. And he said, No, come and meet the new team and see the product and all the potential we have. So because of my relationship with Brad I did. I came up I met Pat and Shea see their commitment to turn this place around. I said, Yes, I look consultant and about six weeks into consulting. They had started talking to me to do full time. I commute from Connecticut every week. Stay up here. I just love what we're doing. I love our mission. I love our team. The potential the trajectory for growth and changing people's lives living with diabetes, is why I'm still here five years later, after retirement,

Scott Benner 8:23
do you have any personal connection to type one or type two diabetes?

Chuck Alpuche 8:27
I have family members and when I traveled internationally, I have very, very good friends I still keep in touch with especially when I travel overseas to visit my sights. Live with diabetes. My daughter's best friend I got to see firsthand as grown up she was our star athlete in school. And I got to see what she had to go through living with diabetes what her parents has carried me caregivers had to live through and I just said I want to change change that left I want to change it like for that individual and then more individuals. Yeah. To me it's it's personally why I'm here five years later, still don't want them doing it to me to Connecticut

Scott Benner 9:14
and not being a short order cook and a golf pro.

Chuck Alpuche 9:19
No, not at all. Not at all. Again, I that was fun while it lasted but you know to your question on why Pepsi they here it's and I always say to folks is PepsiCo taught you quality first. That was our focus in every single plant. I had dozens and dozens of plants reporting to me. When you're producing billions and billions of cans and bottles a year you better get it right as you get a lot of folks sick very quickly. So believe it or not because it's soda. As we said the focus on quality was job one and when I came here I expected the biggest In 2015, the warning wasn't quite there. So I just wanted to bring that mindset here. Why?

Scott Benner 10:07
I think you definitely have there's, my daughter's been using Omni pod since she was four. And she turned 17 the other day. And the company has clearly not just, like turned a corner that would that wouldn't be giving it enough credit. It's somebody inside said, we're going to do this differently. And it just changed direction. In my opinion. I i've always, I mean, if I'm being honest, Chuck Pryor, I always

Chuck Alpuche 10:34
thought it was a company set up to be sold. And now it feels to me like a group of people who want to make insulin pumps. That's exactly right. And that's the biggest compliment that me personally and my team that we can get is I tell folks and I did a call last week with with a potter was in the audience and said, It's been three and a half years since they had upon fail. That's the couple of minutes that we get, yes, you saw our plant. We built a world class manufacturing operation here. But the pride is the quality improvements that have come out of that plant and our plants in China.

Scott Benner 11:12
So when you got there in 2015, what was can you say what some of your first direction was? But what were your ideas?

Chuck Alpuche 11:23
Let's see what there was many of them. You know, it was interesting, we have single days of inventory. We didn't have very good relationships with suppliers. And to make quality starts with every single component. We have dozens and dozens of components in there. But we had to get those more reliable, more consistent. So my number one priority first was to work with our suppliers to improve quality and consistency and reliability. And I think we've we've been working out for five years and continue to work it. Secondly, you saw the act of manufacturing, as I said is one of the first things I was very, very surprising to chasing the team's credit. I was surprised that, you know, a device that people's lives depended on to monitor diabetes was single sourced out of China. Again, I ran an international operation, I've been to China 100 times plus, I knew the volatility. So as we build capacity to support our growth, it was also to build outside of China for risk mitigation, redundancy. And that's where that's where the idea of I came from. So that was our supplier quality, redundancy, risk mitigation and building capacity. And that's where actin various manufacturing facility came from. So that's what I focused on first when I got here, right?

Scott Benner 12:54
I have to admit, when I saw it, I didn't know what I was gonna see. And there's this giant, you know, it's a cleanroom, right? It's it's completely sealed. There's, there's people working in there, there are robots moving things around the machinery that's that's putting things together and producing things. It's it looks like it's out of a movie. Like if I took a camera in there and did some close up shots and intersperse them in a Marvel film, you'd think I was making Tony Stark's costume. You know what I mean? Like, it really is fascinating. And does that come? Like when you decide to do that? You just say hey, I'm gonna, I'm gonna stay here full time, you get you're in charge of that project. Is that right? That's correct, right? Do you then bring in a team? Or do you can you how do you build the team that's going to make this happen? We

Chuck Alpuche 13:41
brought in a team of very, very experienced automation engineers, upgraded the engineering department. I brought two other folks out of PepsiCo that used to run my operations out of retirement. And I say that because I think that says a lot about intellect and ambition that people come out of retirement to come and work here. But I knew I could depend on them to focus on quality first, they got the mindset, it starts with every single component. So one of them moved to China to fix the operation over there and improve the operation, while the other one manage the day to day building the active manufacturing and he had built plants for me at PepsiCo. So it's bringing in the right mindset, the right experience. And we wanted to build a world class manufacturing facility. So to your point on robotics and automation, it's funny folks up towards that it looks like a transformer movie. So it's funny cinema. It is but of all the robots. What we're really proud of that you don't say you may have remembered I pointed out the blue flashing that was taking place at the different cells as we call where we're building the sub assemblies, to eventually become a pod is the quality, the camera technology that we put in In each of the assemblies, there's 47, or seven camera technologies that are measuring every single quality attribute that wasn't measured before. And you know, a 10th of a second, we can decide, pass or fail. And by doing that, you're almost guaranteed if you will a perfect pot at the end

Scott Benner 15:20
of the production. Does the does the system learn? does it teach itself?

Chuck Alpuche 15:27
Well teaches us with the data collection, we're collecting so much data, as I said, over 2 billion quality metrics per year per line, we're gathering the data, then we take that data and we work back with our component suppliers, globally so that we can transfer those learnings to China manufacturing, which are distinct components. So they're teaching us, I don't know if I would say to robotics, or teaching or learning themselves, but we can adjust our automation and robotics based off of those learnings. Yeah.

Scott Benner 16:01
So the more pods you make, the more data you have back, the better decisions you can make in the future on things. Absolutely. What's the what is the rate of rejection does? Do you see a lot of part Yeah, I

Chuck Alpuche 16:14
don't want to get into specifics, I will say in the beginning, much higher than I would have ever anticipated. Again, but as I said, from the beginning, working with our suppliers to get more reliable, more consistent with quality. So we had a fairly high rejection rate from any manufacturing, best practice standards. But that has significantly significantly reduced the waste and scrap because, again, over the years, a couple of years just with those learnings, and all that data we've collected, we're able to go back with data to those suppliers and improve their systems and processes.

Scott Benner 16:51
Oh, I see. Oh, okay. So you have these better relationships. And I guess that even makes it easier for you to walk back and say, Hey, guys, look, this is coming like this. This is what we think will fix it, and then they work with you and get it together.

Chuck Alpuche 17:05
Absolutely. And it's all data driven. It's it's not emotions, it's no feelings. It's strictly the data coming off of that camera technology I talked about.

Scott Benner 17:14
It's amazing. You're making me for some reason, think about automated driving like Tesla, like they talk about all the time, they need more cars driving on the road to get into more situations so they can get more data and, and keep fine tuning. It's

Chuck Alpuche 17:29
really, really fascinating. It is powerful. Yeah, people always say it really is, especially on our pod when you're talking dozens and dozens of components and you know, 10s of millions of pounds a year that we're producing that many gather a lot of data. Absolutely.

Scott Benner 17:44
You got more than a couple days worth of back log made now. A couple months, maybe? Yes. So when when COVID happened, and and things are starting to not move around the world as quickly. You had a you had a couple of months to. But did it ever get in? Do you ever gotten to a place where you thought who would this is closer? Were you able to keep your your stuff flowing? No.

Chuck Alpuche 18:11
I guess the camera technology, the quality improvements we're making with our components are what we're most proud of. But I would say the unexpected. We talked about when we were building acting to support our growth, but also for risk mitigation, redundancy. It proved itself in the, you know, in the pandemic, we did not skip a beat. As we continue to grow double digits, we did not miss one shipment to one of our customers. And we're very proud of that. Because a lot of a lot of supply chains for going down scaling back. People don't realize we have plants in China and lost production capacity in China when COVID hit their first I had packed into continue to produce. And then when it came here, we got China back up and running. So we had both facilities running, we have lots of inventory that was never a risk to our partners, which we're most proud of. And that was the benefit of building an active and having a redundancy here closest to our largest customer.

Scott Benner 19:14
That's comforting. I mean, as a person who, you know, I watch my daughter put on a pot every three days. So it's got so much to do with her health and her the ease that she lives that you have to think of it just going away is frightening.

Chuck Alpuche 19:28
Ya know, it's we're not allowed to miss shipments to our partners as we always talk to our folks. And as you saw, the tour we have printed on the walls is every platter every time and it just simply means that we are able to ship the pod every single time and customer expects it. And it works every single time as intended.

Scott Benner 19:48
taxon so I have a question because I know people listening wonder all the time, like do you think the form factor of the pod will ever change?

Chuck Alpuche 19:58
We're always looking at improvement, the form factor, you know, we do hear from our customers, they would prefer a smaller pot. On the other hand, we also hear we would like a larger reservoir. So there's a lot of work on, you know, innovation form factor improvements. Do I think that someday? Yes, I mean, we are always going to look at improving the pod. And we have a lot of customer demands, but it's how do you make a smaller pot with a larger reservoir, but we have a lot of great folks in our innovation team in r&d that are working on those projects especially.

Scott Benner 20:35
That's excellent. That's now how, if you made a shift in I don't know, let's say it was narrower but wider. I'm just making something up. How do you how do you seamlessly transfer from what making one to the other in your act implant? You have to retool? And I mean, what kind of a kind of a process in your mind would that be?

Chuck Alpuche 20:59
Nobody some retooling? Obviously, but we knew that we had to be flexible, you will become less flexible with automation and robotics, obviously, than our China facilities, which are much more manual. But we knew that we would need the flexibility for change. You know, we also run the pod for Amgen, or Leicester, which is a different type requires a changeover. So there is some flexibility in automation and robotics. When you're up close, you will say that some are just basically rubber arms that can be transferred out. So

Scott Benner 21:43
yeah, that's interesting,

Chuck Alpuche 21:44
we'll be able to change for the innovation that should never stop or slow down or innovational

Scott Benner 21:49
attacks on what, um, how many pods? Can you get through there in a day?

Chuck Alpuche 21:57
We don't share exact numbers, but I don't think that's public. Okay. But very high speed that folks didn't think was imaginable. It is a amazing device. So complex with so many components, the speeds that we are running today, I have to say, Okay,

Scott Benner 22:19
alright, that's fair enough. It's is it making more today than it did when I was there?

Chuck Alpuche 22:25
Absolutely. I see. Yes, I mean, highly automated lives, highly technical, require some way of uptime. If we've been saying and show folks, the team has done a great job of ramping up and learnings. We put our second line in as you know, eventually we'll have our third line up and running by the second half of this year. And as you saw on the tour, we built capacity for fourth line. So as we learn, we improve and build into the next line and then make the improvements on the current line. So yes, we are running a lot more pods. And we did that a couple of years ago when you were here. That's that's really something.

Scott Benner 23:01
Alright, I have a question that I don't know if you can answer or not. If you are making new products that are coming out sometime, are you? I'm assuming that they run through the same line as the one you have now?

Chuck Alpuche 23:15
Yes, okay. Yes. So that's a good example, dashboard run inactive, just like arrows and eventually op five and Jen. Yes. Okay. So

Scott Benner 23:25
you run shifts, arrows, pods run for a while, and then dash pods run and on the pod five eventually will run through there as well. Absolutely. Very cool. I don't know how to ask this. Do you use? Do you start producing on the pod five pods before you have the okay from the FDA? Or do you wait for the moment and then start making them and then create a back a backlog of them and then make it go public? What's the way to do that?

Chuck Alpuche 23:58
It'll be our comfort zone based off our questions from the FDA is we may build a little bit ahead of time at risk, meaning there's very low risk based off the questions in a submission. Because we want to make sure that we have product available, that we're highly confident that the FDA will approve and so we will have some product that will today it's approved, we're ready to ship to our partners. That's right. That's the risk we take financially. And we did discuss that in our meeting is based off the FDA feedback and a comfort level. How are we? And how much do we want to produce ahead of time that the minute it's approved that we're available for shipment?

Scott Benner 24:39
How this is maybe a really like geeky question, but does the algorithm because the algorithm is going to live on the board? I'm right in Omnipod five, did that change the power that you have to like the batteries the same? I guess is the question. Well,

Chuck Alpuche 24:57
that's a very good question. I mean, because they are Rhythm is different, regardless whether it's on a pod or in a PDM. We're taking much more data collection, much more metrics on the on the pod five, yes, it does use more power. But, again, the benefit of building act and also, especially in Massachusetts building, our US manufacturing is we are right here on site with our r&d team. So we work very, very closely with them. No one that has more power, we're able to work with our battery suppliers to and we've significantly improved the performance of our batteries. Also,

Scott Benner 25:36
no kidding. Yes, I have to admit the the setup, there's kind of uncommon, it feels uncommon, like you're in an office that I was there to speak. So I'm you're in an office setting, then you go to a big room, you're speaking to somebody, and then you just walk down the hall and go through a couple of doors, and then suddenly, you're in a manufacturing place. It's, it's kind of, there's something I thought while I was there, this is kind of great, because everybody's in one spot. If and that does really bear out, I guess, like being all in one location is valuable for you.

Chuck Alpuche 26:07
It's very, very beneficial. A lot of folks ask, you know, how can you build manufacturing in Massachusetts, and be cost competitive, etc. But there's so many benefits of being on site with our r&d folks, our global engineering teams, our global purchasing team, you know, supplier engineering to work with our suppliers with real time data, especially if we have component concerns. So there's a lot of benefits of being on site right here, folks can you know, walk down the home and work with the manufacturing folks for immediate problem solving? Now?

Scott Benner 26:45
What's the, in your mind? What inside of the pod? is the most delicate? Is the Is it the injection process? Or like? What do you most amazed by this happening inside of that little thing? I guess is my question.

Chuck Alpuche 27:02
Well, I'll tell you, there's so many. I mean, when you next time you come we might have to go in the cleanroom. So you get up close and personal when you see the intricacy of the components. You know, our chassis I call, it's the transmission, it makes the pipe work. You know, the kanila forming the geometry required, and we automated that to make sure that we can be as consistent with the curves and forming your nail heads, etc. It's probably the kanila format is probably the most fascinating part of the process with inside the pod that amazes me. Okay. All right.

Scott Benner 27:51
So you're I'm gonna ask a question. I've been dying. This is such a strange question. But But Chuck, the people listening are going to be thrilled to ask, okay, great. So when you when you put the pot on, you start the process for insertion. There's this clicking that happens. And it's not Oh, and then the the insertion happens, the insertion doesn't always happen. On the same number of clicks, is that clicking tension building? Like, what is that whole process? What's happening when I'm hearing the clicking?

Chuck Alpuche 28:24
It's just the release of the Kenya. So I don't know why there be multiple clicks. It's something I'll take back to my team, but it's just the release of the Kenyan

Scott Benner 28:37
skin. Okay, so yeah, it's not it's not that the it's not that the candle is moving. There's this I always take it as a building of tension. But is that not right is the is the needle always at the correct tension?

Chuck Alpuche 28:51
Very, I will say, always at the specific tension levels that are supposed to be which are extremely tight tolerances.

Scott Benner 29:01
So when you push the button, and it goes, and it's just kind of goes, click, click, click, and then bang, and it goes, bangs the wrong word, but it goes, right sometimes, like, I watched my daughter, like, she counts them in her head. 1234 like she's trying to read it yourself. But sometimes, sometimes it'll go like six, and she'll be like, oh, six. And I just don't I guess I'm dying to understand what that is only because it is though. So while I'm giving you feedback, and not that I think you could change it, but I think that that click being audible is if you could make one thing different about the pod, I bet you making that click audible would be what most people would vote for.

Chuck Alpuche 29:46
Okay, I will definitely take that back to Archie.

Scott Benner 29:49
I have no idea if it's something you can do.

Chuck Alpuche 29:50
I don't know quite frankly, I will commit that we can do we can easily look at it. We have extremely tight tolerances for that one. emila discharge Yeah, we'll look at that. super interesting.

Scott Benner 30:04
I just I'm fascinated by the whole thing actually. Are you involved at all with the, with the adhesive process? Or is that just a part in your mind? I mean, obviously, it's because it's a components, political component. Because it's Here's to the skin of the planner, I'm involved in just as I am with the batteries in the canyon. So yes, I'm involved. So is the dance with adhesive always strong enough to hold the pot on, not so strong that it causes skin irritation is that the

Chuck Alpuche 30:40
is that kind of salutely. And I've learned more about adhesives since I've been here than I ever thought I would know about adhesives. But that's exactly the science behind it is, obviously we can make it much stronger. But you know, you don't want to irritate the skin, you know, so what's the right balance for three day wear waterproof, without irritating the skin. So we work very, very closely, as I said, with all our suppliers, but also with our adhesive suppliers. I'm always trying to prove that. And again, we learned a lot. We didn't only build manufacturing redundancy, but we built redundancy of all of our components also. So that even when some of our component suppliers went down for COVID, we always had a backup. It's the same with our adhesive. And that's why I learned a lot about adhesive. I thought it would just be as simple as calling a three amber so on and so give us an idea. So for the pilot, it isn't it wasn't but we we do have a second supplier. And that is the science behind the a piece of us. That's really interesting.

Scott Benner 31:45
Any any surprises? like learning about the medical, the medical world? Did anything really shock you? was it? Was it impactful meeting people that have diabetes? Because there's something that sticks with you Like if if you were out of this for 10 years, and I asked you, you know, What do you remember about this? Well, what do you think it is?

Chuck Alpuche 32:11
It's where Potter's come to talk in our town hall meetings, we had the ribbon cutting, we had a met the groundbreaking. The Potter stories, how this device has changed people's lives positively helping more simply manage diabetes. And I said I got I saw what my daughter's best friend went through. And her parents always remember the potter stories more than building an act and or survival for COVID. With supply, I mean, they're all great things. And a team deserves all the credit. But the potter stories and you know, folks laugh, you know, I'm a driver driver. Results focused. But when I heard a potter stock, I'm a big baby, I've got tears in my eyes, I'm crying. That's what it's about, you know, the ribbon cutting when our Potter smoke. I had to get up and talk afterwards. And I couldn't. It's that's what I will remember. And as I said the biggest compliment is not building a world class manufacturing as we did in folk setting. It's the quality improvements we made in hearing folks say that they haven't had a failure in three and a half years of upon failure. So that's that's what it's about. That's what I'll remember.

Scott Benner 33:29
Yeah, I really, I think she should get a ton of credit because I know you guys have people come in to talk to the employees all the time so that people who don't have a connection to type one diabetes can understand why the device is so important. And I've given that talk before at a national sales meeting, and I looked down at one point, I was like, I am making everyone cry.

Unknown Speaker 33:51
I didn't mean I was one of them. me Oh, it's okay. I thought oh, I didn't I didn't mean to make everyone cry like

Scott Benner 33:59
it but but it is really great too. I mean, because honestly, somebody has a, you know, they have a certain skill, they're looking for a job. They're not necessarily out in the workforce, saying to themselves, I want to impact the lives of people with diabetes, they they get a job. And it's I think it's really important for them to understand what this thing does. It's not just a it's not just a stapler, you know,

Chuck Alpuche 34:19
it isn't I can say that with all sincerity. As I said, as I was retired, I commute, you know, three hours every weekend, just about, you know, I live up here in an apartment by myself away from family. But it really is about positively changing people's lives living with diabetes. And that's why I'm still here. And that's why we're all here.

Scott Benner 34:41
Yeah, I have a couple more questions for you. And then I'll let you go. First of all, I want you to know I was a little nervous because you are giving me a run for my money with how deep my voices I'm gonna sound like a soprano in this episode of the of the podcast, but I'm also excited to be talking to someone who doesn't hear any of my Philly accent and thank you Strange so

Chuck Alpuche 35:02
well, it's cuz we're both from Philly. Finally, go here, both of us with our Philly accent water. Where's the,

Scott Benner 35:12
the emails about the word water that I get are just unrelenting. I know, I don't say it correctly, but I can't stop myself. When I say it correctly, it seems wrong to me. So I'm stuck. So I, if you can, I just want to ask you a question about on the pod five is significant impact on people's lives? You think?

Chuck Alpuche 35:39
Oh, absolutely. Yeah. You know, you just look at all the pivotal data, the clinical data, I, that's, I can't wait for the launch of Omni pod five, I think it's significant. takes it to a whole nother level of improving people's lives living with diabetes, managing their diabetes, I've seen the videos, as I said, from partners and caregivers. We've shared them with our suppliers to make sure they understand the importance of their role in making sure that we always always have the best quality product, especially for this new launch. I think it's one of the most anticipated launches in the diabetes, med device industry in history. So I'm very, very excited. To be launched quickly,

Scott Benner 36:34
I am too I keep imagining people who have struggled for a long time, and have never been able to really figure out how how to use their insulin in a real, you know, in a in a well timed way. And just the idea of that being lifted off them, you know, somebody with an A one C in a in a in a high range that that could possibly within months see something significantly better. Is, is very exciting. Because I what I do, I think helps people but everything still reach and scale. If I if I can't, if you don't hear the podcast, you're not gonna know. And so and to put something on someone like this that would remove that from their life is I'm, I'm very, very excited. So I'm very excited. I'm very excited for what we've been able to do and the 30 days of freedom, the Omnipod promise to be able to offer to as many folks that want answers. There's no reason to wait. That's excellent. Now, I've been telling people for a couple weeks to just just get it and something new comes out. You can get that too. So

Chuck Alpuche 37:39
yeah, that's really why wouldn't you get this note, because it's the best platform out there. It will be the best quality, I'll continue to focus on that. I just can't wait. I'll Chuck

Scott Benner 37:50
I'd like to get one of those pods signed by you one day, I'm gonna hang it up on my wall. I really appreciate you doing this taking the time I I genuinely mean this when I tell you that since the day I left there, I thought about talking to you. So it's not it's Don't worry, it doesn't come into my head every day. But I have it up on a on a wish list that's hanging in my office and I'm gonna I'm gonna scratch your name off of it right now. I really appreciate you doing this.

Chuck Alpuche 38:16
Well, no, I'm honored. And I thank you is your welcome back for tour anytime it's changed significantly since we were here a couple of years ago, as I said, we put the second line in a third been installed ready for, you know, validation second half of the year. We're proud of it. But this is really a team effort. It's not just me. We have a great, great team here to truly focus on our mission.

Scott Benner 38:41
No, I I agree with you. I think that the people who have who came in and and were part of that restart, and that they're building on top of with it just gets more and more exciting as it goes along. So they talked me out of retirement. So it's a great team. I have to tell you, I think that that means a lot. I would imagine that people who are closer to retirement understand what you mean, maybe a little more than younger people. But that has to be a big leap to just it's it's not like you were sitting at home wondering how to pay your bills, right like you

Chuck Alpuche 39:13
were done with a pension and benefits. And it's not that at all. It's as I told folks at the national sales meeting, even referred to earlier is there's not many times folks in their career can really make a difference in people's lives. I mean, at Pepsi, it was fun. And I got to see the world I've toured you know, dozens and dozens of countries, etc visit. It's fun, right? But you're really impacted people's lives and it makes it a lot easier to wake up and come to work every day. Yeah,

Scott Benner 39:41
I agree. I don't think I am touching as many people as you do with that, but I am I feel very lucky to do a thing that I enjoy that also helps people I didn't even think I would get that in my life ever actually. So it's a great film. Yeah, it really is. Such like I'm gonna next time I meet you in person. I'm assuming now that I'm thinking about this Pepsi thing you've seen more than your share of Super Bowls in person.

Chuck Alpuche 40:06
I always had tickets but I never visit I always gave them to my team. I enjoyed having my own little Super Bowl party at home. I never went he never went oh no kidding. Well, we always had tickets. I just passed them on what are you trying to seem like a great guys this thing's

Scott Benner 40:22
over Chuck people already liked it. You didn't have to say that.

Chuck Alpuche 40:27
Well, I did it for my own reasons. Awesome. I enjoyed my place. The Superbowl was a lot of work for the Pepsi folks, you know, our customers there. So it wasn't the Super Bowl party that people think it was a lot of work also, so it was easier to do the Super Bowl party.

Scott Benner 40:47
Well, I really appreciate you doing this again. Thank you so much. Thank you, Scott. Yeah, thank you. Okay, take care you too.

A huge thank you to one of today's sponsors. Je Vogue glucagon, find out more about chivo hypo pen at G Vogue glucagon.com forward slash juicebox. you spell that GVOKEGL Uc ag o n.com. forward slash juicebox. Thanks so much to chuck for coming on the show. I'm super excited about what's coming from Omni pod. I hope you are too. I really want to thank him because I don't think this is the kind of thing he does usually. Can you imagine having a voice so deep that a microphone can't properly capture it. Chuck and Sam Elliot and Sam Elliott is a distant second. Real quick. If you don't get the Sam Elliott references, you really need to go watch The Big Lebowski. I'll be back soon with another episode of the Juicebox Podcast.

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#519 Sunk Cost Fallacy with David Copeland, Ph.D.

David Copeland, Ph.D. is the father of a child with type 1 diabetes and a professor of Psychology.

You can always listen to the Juicebox Podcast here but the cool kids use: Apple Podcasts/iOS - Spotify - Amazon Music - Google Play/Android - iHeart Radio -  Radio Public, Amazon Alexa or wherever they get audio.

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DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.

Scott Benner 0:00
Hello friends and welcome to Episode 519 of the Juicebox Podcast.

On today's episode, I'll be speaking with David Copeland David is the father of a child with Type One Diabetes. But that is not nearly why he's on the show today. David is also an associate professor of psychology at the University of Nevada, Las Vegas. And he's kind enough to be on the show today to answer a few of my questions. Not the least of which is what is sunk cost fallacy. Now, don't stop your player. Don't go oh sunk cost fallacy with Scott What? Just stick with me on this one. Okay. It's an interesting look into how our minds work, and how maybe they impact us when we make decisions about things like I don't know, life stuff, or maybe even diabetes. While you're listening, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, please always consult a physician before making any changes to your health care plan. We're becoming bold with insulin. I promise you this will be interesting. I promise sunk cost fallacy and other things.

This episode of The Juicebox Podcast is brought to you by touched by type one, a wonderful organization helping people with type one diabetes, learn more about them at touched by type one.org. Or you can find them on Facebook, and Instagram. Before we start, I want to remind you that if you're a US resident living with Type One Diabetes, or a US resident who is the caregiver of someone with type one, I would love it, if you'd go to the T one D exchange and fill out their survey. It's at T one d exchange.org. forward slash juicebox. Others who have done this already have contributed to their registry. And because they share their experiences over the past two years that he won the exchange has gathered the stories of nearly 15,000 people to better understand how the community is doing overall. And in the future. They'll identify trends and improve T one D care with the answers to the survey that you can give. You can give those answers at T one d exchange.org. forward slash juicebox. When you do that, you're going to be helping research for type one diabetes. And you'll be helping me a little bit because I'm going to get a little bit of money every time one of you signs up. T one d exchange.org. forward slash juicebox. I've done it It took me about seven minutes. And it really was super easy, completely HIPAA compliant. totally anonymous. The questions were not difficult. I did it on my phone. You could also do it on your computer. It's not a big deal won't take long at all. Alright, let's get to David, and talk about how your brain works. And how it sometimes it tries to fool you.

David Copeland, Ph.D. 3:11
My name is David Copeland. I'm a professor at the University of Nevada, Las Vegas, otherwise, typically known as you nlv. I've been a professor there for about 15 years now and I originally got my degree from the University of Notre Dame.

Scott Benner 3:25
You know, I said to my wife that you went to you and Lv and she looked right through me. And I thought for a minute thought and I was like, she doesn't watch college basketball. no memory of the right and rebel. Because if she would have grown up when I grew up, and I said you lie to her, she would have been like, yes, also, I believe Randall Cunningham son is a quarterback there, right?

David Copeland, Ph.D. 3:46
I not aware about the son, but I know Randall was Randall

Scott Benner 3:51
tech. Yeah. And I'm from Philly. So Randall Cunningham was the first like, real athletic quarterback in the league. In my opinion. Some may argue Warren moon, but you'd be wrong. Sun Moon was more of a thrower. So yeah, I know. I'm just telling you, Randall Cunningham. I saw Randall Cunningham do things that would just like fry your mind like leap over men who were standing up or get knocked down to basically do a push up to keep themselves off the ground, pop back up and throw the ball 90 yards and

David Copeland, Ph.D. 4:22
one new i think i think i remember some of those. I'm visualizing right now.

Scott Benner 4:27
absolutely insane. One time it was third down and we were trapped in our own end zone. And they had him punt. So who even know you can do that you can apparently punt whenever you want to. And it's third down he punts from our end zone. I believe it's the longest punt in NFL history. Get like rolled out at the wall. Yeah, cuz no one is back there probably kept rolling. No one was thinking he was gonna pump but he like really struck the ball. Well is my point. The man was an athlete, as I'm saying. And you went over and that's why my wife didn't understand what I was saying. So anyway, I really appreciate you doing this. I am going to tell you for a moment that your response made me feel like warm about the podcast. Because I had this feeling like I was like, I wonder what I couldn't wish for that might not happen. Like because yours is a real? Like I said online like it, can anyone come on and talk about sunk cost fallacy and I was like, no one's gonna respond. And then there you are. On a nerd like me. Excellent happens to know that, to be honest, you saw it, where you're like, finally, I'm being called on.

David Copeland, Ph.D. 5:39
Well, at first I thought, you know, I was in a different, you know, Facebook group or something like that, you know, for, you know, teaching related issues or something like that. And so then I was like, Oh, wait, no, this is juice.

Scott Benner 5:51
So when you? You know what I'm asking this question later. First, tell me what your connection to type one is.

David Copeland, Ph.D. 5:57
My daughter who is currently three years old, it was diagnosed as a type one diabetic at age of 14 months. So So we've been dealing with this for about two years now.

Scott Benner 6:08
Wow. That's pretty damn young.

David Copeland, Ph.D. 6:12
Yeah, so are and when we first met with them, he said, I've seen younger, but not very often.

Scott Benner 6:18
I mean, I don't know that you're trying to win that race. But you're pretty close. That's although i think i think there's a woman who gave birth to a baby that had type one. I can't I can't get that story straight or fine. seem to find her. But I've heard some crazier stories. But I mean, Arden was, you know, just turned two. And I remember feeling like she was, you know, a fetus though. Like she was so little.

David Copeland, Ph.D. 6:44
Oh, yeah. She's, I mean, it was tough at first, you know, seeing her in the hospital with, especially all the tubes and wires, you know, attached and everything when they first admitted her. But she has been a champ throughout this whole process. And you know, she'll have a little bit of resistance here and there. But she's, she's really good in terms of, you know, she knows it's time for your shot, for example, and she'll point to where she wants it. And, Wow, she's ready to go. No,

Scott Benner 7:10
not there. Over here, buddy. Right here. Arden does the same thing. I'm like, hey, it's time for a pump. And you can see her looking around herself. I don't know if anybody makes like, if that makes sense that actually what am I saying? everyone listening knows it makes sense to them. But I can see Arden kind of visualizing her body and she then she kind of chooses a place. So only child, your 17th kid like where does she fall in the family.

David Copeland, Ph.D. 7:33
She's our first child. And we read this past year, we have a son. He's now about nine months old. And so far, he's showing those signs. But as he's only nine months old, so we're keeping our fingers crossed and hoping for the best with

Scott Benner 7:47
David, obviously, the magic number is 14. So you can't you oddly feel that way. Like you have to get past 14 months.

David Copeland, Ph.D. 7:55
Oh, I know that it can happen in pretty much any time. And so so it's one of those things that we just you're just gonna progress through life. And it might happen and it might not.

Scott Benner 8:06
So it's just one of those things you have to accept. You don't have that kind of unrealistic idea. Like my dad had a heart attack when he was 46. And I'm gonna have like, you don't feel like that?

David Copeland, Ph.D. 8:15
I don't think we think of it as inevitable I think you can think of is in terms of probabilities. And that Yeah, because you know, sibling has it has diabetes, that there's a maybe increased probability of the second child having it as well. But I don't see it as inevitable or once we get past the marker, we're fine. You know, right. It's just always one of those things where Yeah, it's there's a chance.

Scott Benner 8:41
No, I I think that's a I think that's the right way to think about it. I just think that people's minds sometimes jump to you know, they started seeing connections that don't exist, and then they start believing in them. But

David Copeland, Ph.D. 8:52
oh, yeah, our minds, our minds like to put things together. That's why that's why there's conspiracy theories.

Scott Benner 8:58
Yeah, no, you don't. You don't think all that stuff didn't really happen to you? I like I like hearing about the, the UFOs. And I don't I can tell you that for certain. I don't know, if they're, you know, flying saucers and people from other planets and stuff like that. I have no idea that really very well could be in there very well might not be. But I know when people talk about it. It's fascinating to listen to them speak about it, because they have they have built in all of these like, well, you know how you can really tell? And they're like, well, what you just said doesn't have anything to do with reality. But okay.

David Copeland, Ph.D. 9:30
Well, that just there's been some recent reports out of the government that they're, they're saying that there are unidentified objects being reported by Navy pilots and things like that. They're actually admitting to this. But the key idea here is that it's literally an unidentified object. It's not saying it's a UFO with little green men in it. But that's where people's minds automatically jump to. Yeah, but the connections together, you really

Scott Benner 9:51
only have to read the first three sentences of anything that the government said or the news story to realize that what they're telling you is there's something moving around We think, and we're not sure what it is. Thank you. What a revelation.

David Copeland, Ph.D. 10:06
These things are funny though, because if you look back in history back before their aircraft, you know, people, when people see things up in the sky, they thought they were witches or something like that. And so it's all a matter of you know, what our current belief system and society, you know, has in their pop culture views.

Scott Benner 10:22
Yeah, I do love it. When you start hearing people give you reasons, and I'm making air quotes. You can't see me and neither can anybody else. And you're like, I think that's the plot of a movie I saw made is what you just said there. You know, wouldn't it be crazy if this happened? I'm like, I think it did happen. I think Steven Spielberg directed it, I think, I think you're confusing your thoughts with something you've seen before as a child. But nevertheless, and I like I said, honestly, and I'm not just like playing both sides of the argument. If I looked out the window, and a flying saucer landed, and people got off, and I'd be like, Huh, no, Kevin, like, I'm not telling you it couldn't happen. I'm just saying, I love hearing people talk about

David Copeland, Ph.D. 11:00
it really, I think one of the cool things about is that it really connects to my field, because it really kind of illustrates the idea that we don't always see things that are real out there. We over interpret things in our minds, and we place meaning on things that might be very meaningless, because, you know, we want to see patterns, we want to see, you know, make sense of the world. And so we just, we don't like things that were that are just two seemingly random.

Scott Benner 11:28
So I I feel like if I understand correctly, that the concept of sunk cost fallacy can be considered from two pretty specific points of view, right, like, from an economic point of view, an economics point of view, and from a psychological is that about fair?

David Copeland, Ph.D. 11:49
Yeah, and I think I think the two areas, you know, overlap quite a bit. But it's the basic idea of sunk cost fallacy is that we don't necessarily make a decision based on what's logical OR rational, or in our best interest based on the current moment, we also will bring into play factors or behaviors or experiences or things we've done in the past, and bring it into the the current decision. So So yeah, so it's not just a rational, logical computer, you know, making a decision based on the current pieces of information. It's bringing past for lack of a better term baggage into play as well.

Scott Benner 12:29
So is this something that is just the thing you see sometimes in people, or is it just incredibly common amongst everyone?

David Copeland, Ph.D. 12:39
It's, it's actually pretty common. Now. We're in psychology, a lot of times when we talk in generalities, we're talking about patterns that we see. So we test a group of 100 people, and we see this pattern amongst 60 of them or something like that. So. So yeah, we're not saying it's going to happen to each and every person in each and every circumstance. But we're saying it's a pretty common pattern that you see, yeah,

Scott Benner 13:01
you can kind of isn't it interesting to say this before I say the other thing, that you can see something like this in another person, and very, very frequently cannot see it yourself at all?

David Copeland, Ph.D. 13:14
Oh, yeah. We were not the best judge judges of and evaluators of ourselves and our own performance. And in abilities, we tend to be a little bit biased. And it led us to be a little bit more on the optimistic side of things. But, but yeah, we can be a little bit more realistic, and, and I think, unbiased when it comes to looking at other people and evaluating them. So yes, sometimes it's a lot easier to see it in someone else.

Scott Benner 13:45
So I just the generalized, made up example of a sunk cost would be I bought a plane ticket. And I bought boots, and a stick to climb with and a hat to keep the sun out of my eyes. And when I get to the mountain, and it looks like it's going to erupt, I'm still climbing it anyway. Because I put all this effort into getting here when common sense would tell you, this hill you were planning on climbing now looks like a volcano and we should run away.

David Copeland, Ph.D. 14:11
Yeah, I mean, I think you've nailed it on the head that, you know, if you just take in this snapshot of the moment, you're there, you arrive that morning at the mountain, and you're deciding, am I going to climb it? Or am I not going to climb it? The rational choices if it's going to erupt? Or there's horrible weather or whatnot, is to say no, it's not worth it, I might get hurt or even die, you know, in this endeavor. Whereas the sunk cost fallacy basically brings along all these things that you've done beforehand, such as buying those plane tickets, you've invested all this planning all this time, all this all these resources, all this money. And so you said to yourself, I put all this into it, I'm going to do Oh, anyway.

Scott Benner 14:50
So when you notice that the person asking about this wasn't on a teaching website, it was about this is the thing you follow for type one diabetes, which by the way, we'll talk about later and I appreciate your following But did you immediately understand why he asked?

David Copeland, Ph.D. 15:07
For me, it was one of those where I'm thinking to myself, okay, what's, you know, one of the cool parts about a lot of these biases that we talked about within psychology and cognition, is that there are applications to them. Otherwise, it's, you know, what's the point of talking about them, if you if the, you know, if it's not happening in real life, and so so, you know, I'm racking my brain a little bit, you know, thinking myself, okay, what's the application here? What's the kind of perspective here, and so one of the things you look at is, you know, I can see it from a perspective of maybe the approach someone takes to treating diabetes. So for example, maybe they're investing themselves and their time, energy and effort into a certain way of treatment. And then maybe there it comes a point where maybe they learn from someone else, or from their doctors, or from another source, that maybe there's a different way, maybe just even a tweak or a completely different way to to approach things. And they might be hesitant to make a change, because of all the time and energy and effort that they have already put into the prior

Scott Benner 16:13
approach. So yeah, and it for me, it struck me but but I started thinking about, I don't remember why I was thinking about it one day. And I thought, This is what I see with people who have had Type One Diabetes for decades. And it might be that I tried to help a person who had had type one for like, 30 years or more. And they wanted a change. Like they didn't, they couldn't take what was happening anymore. And had reached out to me privately. And I said, I I'd be happy to see if I can say something that, you know, might make sense. And it didn't matter what I said or what I suggested, or how I explained it. It was every time met with No, that won't work, or I can't do that, or this isn't right. And I finally just said, like, you know, you asked me, this is my opinion, like, it's cool. If you don't like it, you know what I mean? Like, I'm alright with if you don't want to do it is I'm not here to push myself on you. I was trying to help. But why can't you make the leap? And it was fascinating, because everything they were doing was leading to these like failures, but they weren't dying, you know what I mean? Like they were existing? Yeah, couldn't break away from it. And

David Copeland, Ph.D. 17:31
I think, you know, what you have coming into play is, you know, can maybe, you know, put, I'm not trying to diagnose it, per se, but I can say, you know, some of the difference

Scott Benner 17:41
is David just got a lot of a lot of electric noise from you. I couldn't hear what you said, What happened there? He said, What comes into play? And then you were gone?

David Copeland, Ph.D. 17:53
Can you hear me now? Yes. Okay. What comes into play here is potentially a number of different biases or heuristics, you know, that, that we you know, identify it from a psychological perspective. You know, there can be something for examples, such as the confirmation bias. Confirmation bias is a big one where we let our prior beliefs influence, you know, what we learn. And so essentially, this is why it's very hard to change people's views on a lot of things. Because when you, for example, teach them something or expose them to new information, if it doesn't fit nicely into their prior worldview, they sort of ignore that new pieces of information, and maybe only pick up the pieces that fit into that prior worldview, okay, and so, so people just basically want to confirm their existing beliefs rather than challenge them. And so, so learning new information or new approach can sometimes threaten that. And so, so that's one of the reasons why people kind of, you know, will dig in their heels, you also have the idea that our brains are somewhat lazy, for lack of a better term. You know, our brains require energy, just like the rest of our body, you know, we don't, if we don't have to, we don't necessarily want to get up and run five miles if we don't have to. And so the, you know, our brains kind of a similar manner, where if it doesn't have to think too hard, it's going to want to think in in very, the path of least resistance, if you will, and usually that's going to be in doing a habit or an approach that you're very familiar with, and you're gonna stick to it.

Scott Benner 19:28
Interesting. So the, the, you can look at a person and they physically appear to you like someone who's like, I'm just not gonna try very hard. This is working well enough. But there's an actual physiological component to that, which is, I don't have to expend too is that to save your energy in case you have to run from a tiger or something, or

David Copeland, Ph.D. 19:47
Yeah, I mean, like I said, it's just kind of an idea of, you know, our bodies just you know, want to, you know, just the same way we conserve energy from running you know, our brains gonna possibly conserve energy from overthinking if it doesn't have to. Wow So, you know, our brains an organ just like any other parts of our body?

Scott Benner 20:04
Is there a cut off where people, generally speaking, Don't Want to learn more? Like what like, because, as you were saying that all I could think was like, why would you want to not hear another idea? Or the truth? Or, you know, or whatever, like, I mean, if I, if I thought something for years that I was, like wrong about, I'd want to hear about it. And I understand it would be uncomfortable for somebody to challenge something, because you probably, I'm assuming your brain starts doing that thing. And you start thinking about kind of subconsciously, all the decisions you've made based off of this idea. How many times have I been wrong in the past, like wanting to not be wrong? Like I get all that, but it is,

David Copeland, Ph.D. 20:44
I think the key idea is they don't think of themselves as wrong, necessarily, because the past behaviors or approaches have been good enough. And so to them, it's like, well, why mess with it? You know, I know what I'm doing here. And a lot of times people have hesitancy about making changes, because they're afraid of they take action to alter their behaviors or alter their approach. And then let's say a problem occurs, they're going to feel really bad that they were the direct cause of it, because they didn't stick to their prior approach is that well, this never would have happened if I just stuck with my old approach.

Scott Benner 21:19
So if we all just keep our hand, our heads buried in the sand, then there's no problem. Wow. And that's how a lot of personal relationships ended up going. Right? Like, nobody wants to talk about anything for fear that it will explode the situation instead of heal it.

David Copeland, Ph.D. 21:33
Yeah, it's more of the thing that why rock the boat because it could create something worse. And you know, but in real reality, you know, if there's data out there that, for example, it shows that maybe that new approach is more probably, from a probability perspective, much more likely to lead to better outcomes. Our brains are most people, you know, don't think in terms of data and probabilities. We're not that good at that. And, you know, we can think that way, if we, you know, put ourselves you know, put our thinking hats on and say, okay, you know, I want to digest the numbers I want to think of from a rational perspective, but that takes a lot of energy and efforts. You made me think of

Scott Benner 22:14
the the idea of Moneyball for data driven baseball training. Like, like, if somebody came up to you and said, Hey, you know, your favorite team is going to try swinging in a different launch angle. Now we're going to see what happens. I don't know why people don't go Hmm, I wonder what would happen if they did that? Let me say, like, why do they feel so much? like no, you can't change that. That's not what baseball is. And like, I don't know, just understanding the angle your bats at versus not understanding the angle your bats that doesn't change baseball, again, might change your approach. And maybe you'd find out later that it doesn't work for you. But I don't understand the the unwillingness to even allow change, it's something that doesn't really impact you even

David Copeland, Ph.D. 22:56
it lets it's really just it, I think it's it's, that's a good, good analogy, because it took a while for other baseball organizations to really switch over into that Moneyball type of a mindset. A lot of teams were very resistant for a while. And even when the you know, the Moneyball team started winning more, they were still, you know, digging in their heels, because this is like, no, my, I've been doing this for years, I know how baseball works. And this is the way I'm going to approach it, I'm going to, you know, we steal bases, we hit for singles, you know, things like that, and we don't get anything, you know, you're not supposed to take walks, you know, those all those types of things, you know, from the old school baseball, that was just how they did it. And that was the approach. And they kind of scoffed at the new ideas, and people who did make the switch benefited from it.

Scott Benner 23:47
And so agreeing that maybe it's agreeing that something that you don't understand might be better makes you obsolete.

David Copeland, Ph.D. 23:55
And then, and, you know, and you know, it's it's a whole new world, in some regards, like I said, the executives in baseball today, they're all looking at things from a analytical perspective, they're crunching the numbers, they're making the decisions about which guys to retain on their team or design a free agency. And, you know, maybe which pitches for pitchers to throw more often and stuff like that. They're using data for that. And, you know, people wouldn't think otherwise nowadays, but you know, 10 2015 years ago, that just wasn't the approach for most individuals. And their worldview was, Oh, no, you don't throw that many curveballs, it's off, you know, fastball and slider, you know, and that's it, you know, or something like that. And you keep your to your to bread and butter pitches and whatnot. And that was just that was the worldview that was the way they viewed the game from that. Those are their core principle values. And if you're going to come in with the data perspective, that was going to change those core values, and people don't want to make that overhaul in their heads.

Scott Benner 24:59
I think That, um, the interesting thing is that they act like it will be the disillusion of the thing they're talking about, like, it will just disappear. But I think I don't, I'm gonna, I'm gonna show here that I didn't go to college in a second. But there's this kind of thought exercise, right? Like if, if you leave ashore on a ship, and through the course of your travel, there's another ship next to you that has all the parts. So every part that your ship is made out of, is on another ship next to you have a spare part ship. And through the travel of your of your, your time, you ended up replacing every part on the ship during the the, you know, the trip, did you arrive in the same ship that you left it? Right and everything? There's a that's a it's like, I'm sure you'd studied that when you were nine, right? What is that? I guess? Yeah. But is it called?

David Copeland, Ph.D. 25:54
Well, it's just the idea of, you know, kind of slow, steady changes. And, you know, and sometimes that is an easier way to do things, especially when people are resistant to overhauling the whole way they approach something, you know, it's kind of like, if it's like that death by 1000 paper cuts kind of an idea. Where if you just make slow, incremental changes that people won't resist, because they seem so small and minor, that you can eventually keep adding on top of each one, you know, each of the previous ones still, eventually you've made significant change. The drawback, too, is it takes a while to do that. And you have to be steady and consistent with it. But but it can be a way to avoid upsetting people who are having their core beliefs challenged, and then resisting it with everything they can, you know, muster.

Scott Benner 26:45
So is the use of I've heard people say that, you know, as far as progress goes, that you're born, you know, there's sort of that like, like, how do you explain it the best like, like everybody thought there'd be peace in the world because of the hippies in the 60s, right. But now the hippies in the 60s all have like $2 million in the bank, and they're getting ready to retire. So they stop their fight somewhere, and they're off doing this other thing. So there's this idea that you have this, this youthful exuberance to change the world through your teens and your early 20s. But then at some point, you make a baby and the baby needs to be safe. And then you sort of, you know, you keep moving down that, that that path until your best interests don't look like things changing or improving. And so you hear people say, Well, yeah, we'll we'll get that fixed when this generation dies off. And they stop resisting it, is that really just how it has to be? it? Well,

David Copeland, Ph.D. 27:47
it doesn't necessarily have to be, you know, that extreme per se. But I think one of the things that, you know, kind of, you know, just kind of fits into this whole, you know, idea that you just described is just the idea that, when we're younger, we don't have so many habits, if you will, or ways of thinking that are so ingrained over decades. Whereas as we grow older, as adults, we start really establishing this, these mindsets and these habits, and these approach ways of approaching issues in life. And we're really ingraining them and as long as they're working good enough, we're gonna stick with them.

Scott Benner 28:23
Yeah, I, I keep myself honest, by listening to rap music, because I am not inclined to enjoy it. And yet my son likes it. And I figure he must know, like, he wouldn't be listening to something that's terrible. And, you know, you always think of like, you know, at some point, I mean, the way I think is, you know, at some point, somebody's parents were yelling at somebody because they were listening to Elvis Presley, right? And then and then it was Pink Floyd. And then it was Aerosmith. And then it was Metallica and Guns and Roses, and that it's whatever it is now. And so I think to myself, to try to keep that muscle limber, I, I listened to pop smoke and other rap.

David Copeland, Ph.D. 29:04
I mean, I think I think what you're getting at with that idea is it's you're really getting at the idea of whether things are unfamiliar to someone, and whether exposure gradually leads to more familiarity to, to an idea. And when you become more familiar with an idea, it's that is It's not scary anymore. You know, when you don't know anything about, you know, know anything about a topic, you know, it can be really scary, you know, if, let's say, for example, the metric system is, you know, something, you know, if for people, you know, 50 years ago, you know, when the when the metric system was, you know, when they're making attempts to you know, convert people to it. Those who were not at all familiar with it, maybe didn't get it at all in their early schooling. Were just like, Oh, hey, what are you talking about metric and I'm using, you know, ounces and you know, pounds and miles per hour, I'm fine with that stuff. Let's not make any changes. Whereas people maybe who have a little more exposure, you know, let's say maybe Our generation where we've grown up, and we learn about grams and kilograms in school and meters. And maybe we're not using that all the time, but at least we're we have more familiarity with it. So we might not be as scared of that type of concept. If everyone, you know, third proposal out there, yeah, let's start making the conversion of metric system really, you'd be like, Oh, well, yeah, I guess I see liter bottles, you know, in the store, you know, not all that. It's not always just gallons. And so you have a little bit more familiarity with something. And so it's a little less scary to you, because you've been exposed to it.

Scott Benner 30:33
I always when I'm imagining endocrinologist hearing the show, I always imagine that it either falls on someone who thinks, Oh, that makes sense, even though it's not what I usually say, let me hear more what you hear from people, or it falls on, you know, the we don't change, this is how I do it. And I don't want to hear anything different. That won't work. And that's, I mean, partially why ash to come on and talk about it's partially because I believe that more endocrinologists are listening to the show. Now, it's partially because I think that people have had type one for many decades might be rigid about new ideas. And it's also about, listen, I want to be in the heads of people who right now are on the cutting edge, like the bleeding edge of how to take care of their diabetes, because I'm telling you all that five years from now, you know, 10 years from now, there's going to be something else, and there's going to be a better way to do it. There's always going to be a better way. And you I am in my heart, I want to I want to know the better way, as long as I can. Like, you know what I mean? Like, don't get me wrong. If I'm at five at one point, I'm like, Listen, I got to stick with this music player, because this new thing you kids got, that's a hologram. I can't make my fingers work. Like I'll stop at some point. But But I just think you need to, for your health. Stay on the edge of what this is?

David Copeland, Ph.D. 32:00
Well, yeah, and I think the the 85 year old example is kind of a good one, too. Because maybe at that age, you want those well established patterns and habits, you know, because if you're showing any type of cognitive decline, you don't want to, you know, to be sitting there thinking, Oh, what was this new approach is that, you know, do I do this, that or this, you know, and you don't want them overthinking it, and forgetting, you know, important steps, and maybe just following that routine is good for them. But for people younger, yeah, I think an openness to new experiences can be a very good thing. You had mentioned doctors as well. And I think there's two important perspectives to take on that. Number one, doctors can be just like the rest of us, they can, you know, cling to that prior worldview, those previous beliefs that they maybe learned earlier, and they, you know, hold their ground and stick to those even when there's new evidence out there. And then another perspective is, and this is something I'm seeing more, you know, in college classes is I'm seeing more pre med students taking psychology classes, because of the emphasis that they can have great advice, but if they don't take human nature and human, you know, psychology into account, they might not convince us or convey teach us how to do things in a way in which we're actually going to follow through and do that. I mean, a doctor can tell a patient Yeah, you need to lose weight. That doesn't mean the patient's gonna go home and lose weight, they have to present that to them in a way that's going to motivate them and get them to actually implement a plan.

Scott Benner 33:28
Yeah, so it's not just enough? Well, that's really something I brought up with. One of the psychologists that I had on the show recently might not be out yet. I'm not sure. Where I said, like, it's nice that we're getting together and talking about this stuff. But you know, most people don't put it into practice, right? Like, it's, it's, it became popular because of the internet, like, I'll get together, and I'll give you the 10 steps to make your sex life better. You know, like that started back in magazines. And you know, I'll do this, it doesn't mean somebody reads and goes, Oh, yeah, I'll do all these things. I do want my sex life to be better. Like, it's not how it happens. And when these things get more and more difficult, I think sometimes these conversations can serve to make people feel worse instead of help them because they're like, Oh, so you're telling me there is an answer. And I'm not taking it. And so it makes you feel like not only you're doing something wrong, but then somebody gave you the answer, and you ignored it, you almost feel like you're doing it wrong twice. So the idea, you know what I mean, the idea of getting someone to something is much more important than the something out if that makes sense.

David Copeland, Ph.D. 34:31
Well, and it's part of it, too, is Yeah, people just won't typically just change on a whim. They're like, you give them piece of information. They're Okay, I'll change you know, I'm there. And you're like, oh, wow, that was easy. It doesn't really work like that. Typically, you have to have the individual want or really want or need to make a change in order to really follow through, they need that little you know, kind of motivation to it. And, you know, and also you got to make it easy on an individual. You know, if there's There are barriers in the way you like, you know, it's like the whole idea of like with weight loss, if you still fill your fridge up with, you know, cookies and cakes and ice cream, you know, you're gonna walk past that fridge in the kitchen, and you might have the belief that, hey, I'm going to lose weight. But you know, that barrier of it being right there in front of you, you know, as the temptation is probably going to be too much to pass up. So you really have to get it to the point where someone really wants to make that change that, hey, you know, what, what I'm doing is good enough. But this could be really significant better. And I want to make, you know, improve my health, or my child's health to the point where I'm going to follow through and, you know, expose myself to these new ideas and implement them, right,

Scott Benner 35:43
sort of the, the people get kind of caught up in kind of that zero sum thinking, I guess, where, like, I have an idea, my ideas, the idea. There's no other idea, like, leave me alone. That's the end of it. I mean, when we see it, I mean, listen, I don't care what side of the argument you're on politically, you're, we're all being manipulated. And I'm not saying it like, it's some, you know, like, there's UFOs, what I'm saying is that, that it's marketing, right, everything is marketing. As soon as someone figured out marketing, we were all in trouble. Because Because someone figured out to say something to you, or to choose something from your childhood, or to you know, ignite one of those, those fires inside of you, that makes you defend an idea because you think baseball is going to be ruined by something. And then people who are trying to get you to cast a vote or buy a soft drink or something like that can reach into your brains and, and drive you in a direction that that you might not want to be in, if you were left on your own to stand at the mountain and say, Okay, I'm here, it was my intention to climb up the mountain, but it's on fire. So I'm going to go home.

David Copeland, Ph.D. 36:58
And that's one of the interesting things about that topic. And that issue is that you can use those powers for good or bad if you you know, depending on your perspective, you know, if you think of, for example, marketing, or maybe even tech companies, how they make our smartphones, so addictive nowadays, you know, you would say, okay, they're using those powers for evil, if you will. But we can use a lot of those same principles for good, when you're talking about changing our behaviors, you know, a lot of the things, for example, with their smartphones is based on very simplistic behavioral types of issues such as like, you know, like our, our smartphones almost work like slot machines, if you will, in that you get random bouts of force alert, or some kind of new new announcement or something like that from one of your apps. And by doing that, it makes it more addictive. And you can't put it down just like someone who's at a slot machine. And every once in a while it gives you a when you get that victory, and it once makes you keep going. And so so yeah, you have those little things. And we can use some of the same things with us. Like, for example, one simple thing you can do with when you're trying to change your own behavior, is if you successfully do it, reward yourself, you know, give yourself a simple reward, you know, for doing something, you know, do something that you've always wanted to do, or make a purchase you wanted to make or go on a trip or whatever it was, and your bed, essentially, it's just like, you know, giving that dog a treat after they successfully rolled over. You're doing it to yourself, you're basically rewarding yourself and increasing the odds, you're gonna do it again. Hmm.

Scott Benner 38:29
So take the way that that manufacturer manipulates you and manipulate yourself to do something good.

David Copeland, Ph.D. 38:37
Yeah, that's me, it's almost as simple as that. I mean, obviously, they're using algorithms and, you know, and in technology tools to to implement that. But But yeah, you know, we can do this, you know, similar basic things in our own lives.

Scott Benner 38:53
I guess that's what a chore chart is for a kid, right? Like, you fill in the line. And when you get to the end, you take a toy out of the thing or whatever, you get to go somewhere to a restaurant or whatever it ends up being. And so yeah,

David Copeland, Ph.D. 39:03
we'd like for my daughter, you know, in this over the past year, we were dealing with potty training, you know, and we were debating about well, you know, how do we you know, reward the behavior to, you know, to encourage it, and, you know, is one of those where, okay, well, you know, she's she has, you know, type one. And so do we use candy? Do we use, you know, like a toy we don't What is it? Essentially, regardless of what it is, it just needs to be something of value that the person is going to see is you know, a reward that's going to reinforce the behavior,

Scott Benner 39:31
you make me think of this person that I spoke of earlier, when I said to them, Look, if you if you do this, then you won't have the same outcome. And they were just so sure that it was going to go wrong. They almost kind of they skip to the end without trying the thing. And I'm wondering now, if there was, I mean, it's an adult like, I don't know how you would incentivize an adult in that situation, but there has to be something you know, you know, I'm jumping around here a little bit, but

David Copeland, Ph.D. 40:01
I think i think i think one thing from from your perspective is you have to understand is that not ever, ever, not everyone is exposed to the ideas or the information is going to make a change, because there's so many people out there who are fine with their current good enough approach, that it's just from the get go, there's a percentage of people who aren't even going to be receptive to it, they might think it's a good idea, but they're just not even gonna apply it to their own lives. It's kind of that other percentage that you're really dealing with.

Scott Benner 40:29
Yeah, and when it's a personal thing, I honestly, if I'm being honest, I don't care. Like if you're on a path to something that's not as good as it could be. And you're happy with that, like, right on, like, I'm fine with that. I don't care. I don't, I don't pretend to want to manipulate people into having a different outcome. But if you're sitting there thinking, This isn't right. But I don't know how to break free of it, that feels sad to me, you know, the edifice, and

David Copeland, Ph.D. 40:57
I think it's just, you know, the person has to want to make the change, or in some cases even need to make the change, you know, and the need comes more from there's something really wrong with the current approach. And, you know, it could be somebody who's just hitting too many lows, or, you know, staying up 300 too much, or something like that. And then it turns into, you know, a need at that point, you know, it's like, you can tell someone you know, who's smoking, you know, oh, you need to quit smoking, it could lead to cancer, you need to quit smoking leads to cancer, you tell them year after year, if they visit their doctor, and they don't see it as a need, because they don't have cancer, but then maybe one time they get diagnosed with cancer, and the doctor is like, Listen, seriously, you need to quit smoking at this point. And now suddenly, they're a little bit more motivated to actually try something else.

Scott Benner 41:41
So have you heard me say, I think anecdotally, I have not spoken to enough people who have changed their health, be for another person, that I'm almost positive that that's what happens to people. Like, if you can't do it for yourself, you could do it for a child, or for a spouse, like I've just met too many people who said, You know, I decided to get my blood sugar's together when I met this woman, or this man, because I suddenly could picture a long life with somebody, or I didn't really care until I had a baby. And then I realized I needed to be here for the baby. Like is that I mean, from your perspective, and from your, your learning is that a real thing that happens to people,

David Copeland, Ph.D. 42:28
there are certain things in the world that can be very strong motivators. And you know, you know, politicians have learned that, you know, instilling fear in people can be a very strong motivator, in some cases to get them voting certain ways. But as you noted, to, you know, caring for someone can be an also an extremely powerful motivator. I think a lot of people when they're single, maybe you know, and childless, will kind of maybe write it off, you know, but then once you become a parent, you know, it kind of it's, you know, there's a, you know, lights a flash in your head that suddenly that little person in your life is extremely important. And you're willing to do anything for that person. Yeah.

Scott Benner 43:06
I don't mean to jump around, but I feel like I have you here now. So anxiety is at an all time high in society. Is that fair to say?

David Copeland, Ph.D. 43:15
I don't know if I'd say all time high. But I'd say that, I'd say the pandemic is probably triggered, and maybe exacerbated some aspects of it. Yeah. Do you buy into the the idea

Scott Benner 43:25
that we have nothing to do with our focus? Because life is easier. And so smaller and smaller things? Feel like the worst thing that's ever happened to us?

David Copeland, Ph.D. 43:38
Yeah, there, I mean, there's something to the fact that focusing and thinking too hard on on certain issues can cause anxiety. I think one of the big things about his anxiety is when we feel that it's outside of our control, is that's a really big kind of contributor to anxiety. And when we're able to, you know, exhibit some control over a situation or change an approach where we do have control and we can make changes to it. Yeah, a lot of cases you do see anxiety decrease a little bit in there. I don't want to talk too much on you know, making claims there because I'm not a I touch on anxiety in some of my the areas that I research, but it's not, you know, kind of the focus of what I do.

Scott Benner 44:24
No, that's fine. I just I listen, the what I can confirm that I know fits in a thimble. Okay. But it's hard to imagine that we went from people who like won World War Two to, you know, a friend of mine that I had in high school I haven't seen in 30 years said something a little cross on Facebook, and I think it was directed at me and now I'm melting down. Like it's a weird it's a weird shift in a short amount of time and less that used to exist and I just not aware of it because I didn't live at that point.

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David Copeland, Ph.D. 46:15
Well, I think one of the things we have to look at is that, you know, fields such as psychology are relatively new in terms of their emergence, you know, we're talking, you know, 20th century and 20. Now, 21st century, and, you know, we have no real data besides anecdotes or stories, you know, from his store from history, as to what really was going on in the past, and they're very well could be lots of cases of, you know, of high anxious individuals, you know, throughout history, but we didn't really have measures and, you know, there weren't, you know, psychologists around, you know, to really study it, you know,

Scott Benner 46:51
is that the natural progression of healing, then, like you're hiding it, and then a generation learns to let it out. And then another generation learns to deal with it, like, is it not? Is it your sort of your piece of building the bigger fabric of society, like, maybe we're all not going to get the fix that thing for us, but we're moving the whole group forward?

David Copeland, Ph.D. 47:16
Well, I think I think what happens is when when a topic or an idea is, you know, kind of in his infancy, and people don't know much about it, we use techniques that we think work, and they could be superstitious types of things that you try out, or maybe were passed down, you know, from family members. And, you know, they seem to work or seem to do the job. So you do it. But it takes, you know, kind of a field to emerge to really start investigating a topic and exploring it and putting these ideas to the test to say, Hey, is this effective? What about this versus that which one's more effective? And, you know, then maybe you start tweaking the techniques to say, Oh, this one works. But what if you tried this, you know, changing part aids to a one or something like that. And now suddenly, you have a new approach to it. And the more people you have that are investigating exploring topics, you know, the more likely people are going to throw out new and innovative, you know, solutions to it.

Scott Benner 48:11
Well, so there's no sort of back to where I said to the therapist earlier, that, you know, I feel bad, because you're pointing out, we're pointing these things out. But there's no tried and true way. Like there's no steps one through 10 that make this better, like you, you know, your therapist usually says, go to therapy and talk it out. And maybe you can get through it. Which seems like the best at the at the moment. But what do you do when it's something like? I mean, the stuff we've been talking about confirmation bias, sunk cost fallacy, like how do you stop yourself from doing those things, especially if you don't even know you're doing them?

David Copeland, Ph.D. 48:47
I think one of the first things are to know are that psychologies, psychologists, and psychology professors, and researchers, have been shown to be susceptible to some of these things as well, maybe not to the same extent as the general public, but it is measurable. And so sometimes, you know, you get a chuckle out of it, like, Oh, this study investigated the confirmation bias with psychology professors versus the general population, right. And, you know, this, the psychology professors actually showed too. And so it's one of those things where it's human nature, but I think there are ways to minimize it. And part of the ways to do it are to start becoming aware of some of these things, you know, start understanding that, yeah, there are different ways to make decisions. And yes, I can be influenced by my prior beliefs, prior experiences or emotions. And maybe I need to just sit there and think about right now, in this moment going forward, what are the pros and cons of going down path a versus path B, you know, regardless of what happened beforehand, you know, you can learn you know about these types of approaches and you can make improvements.

Scott Benner 49:53
I have to say that one of the more difficult things that I've done is to say settle on an idea and put it out into the world. Because I am most of the time of the, the opinion that the thought I have is the best thought I could come up with. But it doesn't mean there's not a better thought and more likely there might be one. And I keep looking for one of my one of my favorite exercise, like, you know, thought exercises, is to try to imagine what lies beyond what I don't understand. I and

David Copeland, Ph.D. 50:29
I enjoy. And I think that I think that perspective is, you know, a great way to, you know, to approach things because, you know, one of the things you want to do is you want to tell yourself that there might be approaches, and there might be people out there learning things that are different and possibly better than what I know about. And now of course, it's very important to to take into account the source of information, especially with, you know, you know, what we've seen, you know, in recent years where people are using, you know, social media or YouTube videos as their exclusive news sources, you know, you want to ideally be using things that have been tested, where there's some data behind it, you know, where it's coming from, you know, somebody who's studied it, and it has some expertise in the topic. You just don't want to take, you know, advice, you know, from your neighbor, Bob, or something like that, you know, just because Bob said, so that must be true. Yeah. So So yeah, you have to take the source involved, as well. But I think it is a good first step to realize that my knowledge, my information might not be perfect. There might be some better ideas out there.

Scott Benner 51:31
I saw what you just use such a nice, like, example, you're like, you know, I believe Bob, but maybe there's more beyond Bob, I was like, literally thinking like Flat Earth conspiracy. Like what you said that, like I I'm fascinated that, and if anybody's listening who believes the earth is flat, you can still get diabetes, like, stuff for me, but I think you're wrong. And I think there's enough examples of why your might be wrong to to get me in that camp. But what makes someone want to believe it so fervently, because I have to tell you, David, I believe the world is a sphere. Yes, but I don't have enough Karen, that I don't have a dog in that fight enough to get into an argument with you about it. I can only be like, I if you said to me, it's flat. I'd be like, ah, alright, man. Yeah, I couldn't sit here and work myself up over that. But you could but what you don't mean,

David Copeland, Ph.D. 52:27
but I think what you're what you're kind of conveying in there is, is something that emerges is that, you know, whether or not that person believes that the world is flat, or that it's more of a, you know, sphere or round, you know, object is that, ultimately, in their day to day life, 99.9% of the time, that belief, regardless of which one they have doesn't matter so much. You know, they're, you know, the only time it might as if they stop themselves from travel, do taking a long trip, because they think they're gonna go over the edge, you know, or something like that. But, but other than that, you know, that belief really isn't going to have an effect on their day to day life. And so, so yeah, so I think I think your idea there were, your choice to not engage on that particular one is probably a good one, because it really doesn't have that big of an effect. Whereas maybe something was someone's house, that could have a big major effect.

Scott Benner 53:20
I even think about when I started the series within the podcast about how people eat, I got notes from people, like you can't do that there's going to be big arguments as like, first of all, I don't care. And secondly, like, I don't think there's really big arguments, I think that we, we do this thing where we we've told ourselves if if you're on the internet, right, or if you're on Twitter, or Facebook or Instagram, we we've convinced ourselves that that's everyone's opinion. And it's really a fairly small percentage of the people on the planet are even on social media. So there are there are things happening online right now that people online believe are the most important thing in the world that most of the people on the planet are completely unaware of, and could not possibly care less about.

David Copeland, Ph.D. 54:12
Oh, yeah. I mean, we we have a very egocentric worldview in that we we think our own interests, and our own beliefs are the most important things in the world. And and yeah, and we we emphasize and elevate that and projected on other people and think that they also are going to highly value those beliefs in those perspectives and those topics right and so so yeah, we think those sorts of things. But yeah, it really a lot of it goes back into you know, digging our heels into our own current belief system. And you know, you can present for example, you can present people all the you know, all this evidence that, you know, drinking heavily in smoking isn't good for a long lifespan. But if they have a belief that that doesn't matter, they're going to find that one example of their you know, Aunt Karen, you know, who smokes like a chimney and live to be 90 Six years old. Yeah. And they're gonna say, you know, see, look, look at aunt Karen there, that scene doesn't matter.

Scott Benner 55:04
You know, it's, that's the same, the same muscle that gets used for people are like, I don't want to dig in and get a real job because I might be Kanye West one day or Drake or, you know, the best. The, I don't know, the the best softball player in the world or whatever you're trying to be like it, you know, you need to realize that those people are are an anomaly. Like right there, they're a collection of luck, hard work, you know, more luck in maybe how their body works, if they can sing or run or whatever it is they can do. And you're only aware of them, because of the way social media works now, right? Like, even 25 years ago, you didn't know how much money like a wide receiver made, that that was not not even something you were aware of.

David Copeland, Ph.D. 55:53
And, and a lot of it too, is just depends on what's valued at the time, you know, that, you know, 100 200 years ago, nobody would care if you could dunk a basketball. Yeah, but now, you know, that's, it's a popular sport, that's entertaining. And so if you can do that, you're you know, you're gonna, you can make yourself millions of dollars, right. So, you know, it all really matters, what is valued by people and what they want. So,

Scott Benner 56:17
I have a question that you might or may not have input on, but why is it comfortable to pick someone out in the world, who you deem as not as smart as you not as good as you are? not as popular? not as successful? Like, why does it? Why do we like to find things that were better than? I mean, did I just get out myself? Nobody else thinks that way. I'm not saying I feel like that all the time. I do see people do it. Like, yeah, it's, it's pretty, it's,

David Copeland, Ph.D. 56:51
you know, I think it's fairly common. And I think I think it can be a boost one's ego and their confidence. And, you know, no one ever wants to, you know, feel like the the kid you know, picked last gym class, you know, because they're, they're not as good and not as talented. Everyone wants to feel like they're good, they have you know, skills and they can do something better than each other. And, and part of it also in this kind of bleeds into the, you know, the social psychology world to where we like to categorize the world into groups. And, you know, we have our in group of people who are like us, and we have the out group of people who are not like us, and things associated with our in group are all positive and good, and we like, and things associated with the other groups are bad and different.

Scott Benner 57:33
That's where that's the fascinating thing about watching people argue about how they eat when they have diabetes, like that, like, I think in the end, everybody's saying the same thing. Like I, I found a way to do this thing that leads to stability and health and happiness. And they can't just be happy that they found it, and it's working for them, anybody who's not doing it, they feel like they want to ram it down the other person's throat. But you only see that online, it doesn't exist in the real world. I've never seen two type ones meet each other in the real world, and be like, I'm low carb, and the other ones say, I'm not and then they have a fistfight like that. It doesn't it. So what happens online? Why do people feel so confident? To be so aggressive with their ideas online?

David Copeland, Ph.D. 58:21
Yeah, I think of them as like keyboard warriors, or, you know, kind of cyber bullies in the sense. But it's, it's really one of the big things about it is it's the feeling of being anonymous when you're online. And, you know, researchers speculated for a while there that that's why, for example, messageboards, for a while, we're just random people making comments. And then eventually they switch them where you have to log in with your Facebook ID, you know, to make a comment, because they thought, oh, adding your name, and you know, Facebook identity to it is going to make people feel a little less anonymous, and maybe slow it down. And I don't remember seeing any data as to whether that had a major effect, or not. But my impression is that it hasn't had that big of an effect. Because I think just hiding behind the keyboard, people feel a little bit more anonymous. I usually, you know, when I talk about this, this idea with students, I usually use the example of you know, driving versus pushing your shopping cart in the grocery store. You know, when you're driving on the highway, you're gonna see people left and right, you know, cutting in line or cutting other people off. And in the car, you're anonymous, you know, nobody really sees your face, you're gonna drive away, they're never gonna see you. But in the grocery store, you're not going to be you know, standing there right in front of the checkout line and have another person just cut you off and go in front of you. Because they're right there in front of you, you know, face to face. And so there's, you know, you lose that level of being anonymous in that circumstance.

Scott Benner 59:46
But do you agree with maybe you won't agree with what I'm about to say, but I don't think people in a personal situation like the grocery store, I don't think they're having thoughts like, Oh, I'm going to get in front of you. I'm going to cut you off. I want to win. That seems to go away. When the anonymity goes away, like even the desire

David Copeland, Ph.D. 1:00:03
does, though. Yeah, and I think that's just the the, the the whole lack of or presence of anonymity, you know, can just alter how you approach the whole situation.

Scott Benner 1:00:14
Yeah, in a second I am. I try very hard to apply that. The, the concept from it was a god, what's his name? Hold on a second. Isn't it funny I think about this constantly. And his name is David. David Foster. Wallace was a writer, he I think he committed suicide many years ago. But he he gave a speech at a college commencement. And it's, it's available now you can read it online or buying the book for him, or I think you can hear him on YouTube still, but it's called This is water. And at one point during it, he makes this point that has stuck with me forever, that the, these aren't his words, but here's the idea, like someone will cut you off in traffic, and they're a jerk. And maybe most of the people that cut you off in traffic are a jerk, but one of them has to go to the bathroom really badly. So what would it hurt for you to just imagine that every time you get cut off somebody who's in a dire situation, they really need to go, where they're going? And like, what would it hurt you to just believe the best in people. And I

David Copeland, Ph.D. 1:01:21
know that that's another egg angle that a lot of people we make assumptions, you know, very easily. And part of is just because we don't, we're dealing with incomplete information about the world around us and every other person been. So it's as easy for that's why we make stereotypes and stuff like that, too. But yeah, we're drawing assumptions all the time. And we're just going with what's the easiest, you know, assumption that pops in my head. And typically, like, when you're driving, it's the fact that the person's a jerk, right, you know, and trying to cause you harm. Whereas like you said, it's very easily could be a case where someone's having, you know, a bathroom emergency or something else, right?

Scott Benner 1:01:57
I'm about to go do something horrible. And a Burger King, you got to get out of my way. And well, not only do you fill it in with the easiest answer, but I do think it's part of the other thing that I said, where you fill it in with the answer that makes you feel superior to

David Copeland, Ph.D. 1:02:12
Yeah, and, you know, especially when you think, you know, you think of the other drivers as the outgroup. You know, there are others you don't know who they are, they're, they're definitely a part of your in group. Bad Guys, and

Scott Benner 1:02:23
good guys, I boy, I was talking about this with my son this morning. I don't want to say it's a family issue, because then if they hear it, they might know but, you know, let's say people I know that aren't in my house. And there's this one person that everything they talk about, they want the story to be there, the good guy, and there are other people and those people are bad guys. And, and when the bad guys aren't there, they'll make them. Because they don't seem comfortable when there's no drama. Like what makes people comfortable with x. I

David Copeland, Ph.D. 1:02:58
think I think one of the big things is we always try to present ourselves in the best possible way. Because we want other people to like us and you know, we want to make connections, you know, we're humans are social beings. And, you know, we want to make connections, and we want to have friends and, and good family relations. And so we want to and we we think in our perspective, that always presenting ourselves as good and positive and having, you know, you know, making the right decisions on things, you know, is the best way to do that. And so so we're not very good at always admitting fault.

Scott Benner 1:03:33
So if I don't feel good about myself, the next best thing is to make everyone else look under me. So I rise up. In Yeah, that's definitely can be a coping mechanism. Wow, people are so screwed up. I'm gonna have more and more therapists and psychologists and people who think about stuff like this on the podcast, because I, I'm fascinated by all this. And, and, and back to the original point. You know, it's funny, because I just wanted to talk about sunk cost fallacy because I think that people can get too invested in how they take care of their health, and that might keep them from seeing other stuff. But then you brought up confirmation bias, and I was like, This conversation is going to be terrific. So I'm having a very good time talking to you. Can I? Are there ways for me to see my biases?

David Copeland, Ph.D. 1:04:24
I think the simple answer is to recognize that we are not perfect and we don't have all the answers and that ways that we're doing things could be good or acceptable, but maybe not the best. And I think just simply telling yourself that, you know, is, you know, kind of a very good starting point. You know, a lot of philosophers you know, will state that, you know, a high sign of intelligence is admitting that you don't know something and being able to utter that phrase, I don't know. Because because too many people are Afraid of looking, admitting that in that scent making them seem unintelligent. And so maybe they you know, give some kind of other answer confidently even though it might not be the correct answer.

Scott Benner 1:05:12
Well, let me say this because I made it because I'm trying to be funny. I'm not sure if the next thing I'm going to tell you if I was right about or not. But I found myself recently talking to an 18 year old with type one. And this person wanted to wants to do something with their life, they have a goal, right? And they're struggling right now with their blood sugar's, they're probably just not paying quite enough attention to it. It's not a big misunderstanding that they're having. And I don't know what happened, I was maybe having a day. And I was trying to squeeze some things in. And so I'm talking to this person, while I'm on my way to see something else. And maybe my day was getting away from me, I wasn't as focused on being maybe the person that you hear on the podcast all the time. And I just said to them, Look, if you keep doing what you're doing, now, you're going to get to this thing that you want to do later. And you might fail at it. And you're going to want to blame the diabetes. But the truth is, it's going to be your fault. And I thought, like, as soon as I said it, I was like, Wow, it was harsh, like, I shouldn't have said that, like that. But I went back over it again. And I niced it up, and I said it again. But as I must have thought about it for hours afterwards. And I was right. Like they put if this person would put a tiny bit of effort in right now, to kind of tighten up a couple of ideas and get these things working, then this next goal in their life would would go so much more easily, and they'd have a great chance of success with it.

David Copeland, Ph.D. 1:06:49
But and you know what I mean, in the end, I think what you're getting at is a little bit of an idea called the attribution error of when, you know, when I make a mistake, it's due to some external circumstance, you know, affecting me, you know, it's somebody else's fault. So, you know, so to speak, where is if someone else, you know, you know, messes up, then it's something about themselves, they screwed it up, but, you know, kind of an idea. And so I think it really gets back to is that wheat as kind of a coping mechanism, again, you know, for our confidence is we don't like to admit, we're wrong, you know, and, you know, when you know, something goes wrong, we like to put the blame on other things, or other people, and it wasn't ourselves that really, you know, could have done better.

Scott Benner 1:07:33
Yeah, it's, you know, listen, I, I don't, I'm not saying I don't do those things, I want everybody to understand that I don't think David's saying he doesn't do things like this either. But being aware that they exist, is your only real chance to get ahead of them at some point. Otherwise, you know, your life could end up being a series of, you know, things that happen that you think are decisions that might be a lot less about your decision and a lot more about how you feel about yourself, based on what somebody said to you, when you were 10 years old, or you know, that kind of stuff, like I don't want, I don't want to feel like I'm being drugged through life by that kind of randomness. And I just wanted to pick an episode to talk about it here. So maybe other people could have a chance to see their biases and, and stop themselves from getting caught in repetitive decisions that are not the best that they could be for them.

David Copeland, Ph.D. 1:08:30
But yeah, and you know, part of it is that, you know, if you're perfectly fine of envisioning yourself five years from now in the exact same patterns that you're in now, and you're happy with that, maybe maybe you're good, maybe you just stick with what you're doing. Yeah. But if you want to picture yourself in five to 10 years as living an improved life, then you probably have to make some steps to to make some changes so that you aren't doing the exact same things and making the same patterns in your life. And so that you can make progress. And you have to understand that it is possible when you make change, that hey, maybe things you know, you can have some problem run into some problems. That's okay. Maybe you don't do it well enough. Or you don't learn quick enough. And hey, that's okay. We're allowed to fail in life. You know, people think that, you know, sometimes it's unacceptable. But people who are they tried something out, it didn't work, you know, so then I tried something new.

Scott Benner 1:09:24
Yeah. Is that why we break everything down into like these little like slogans so that everybody can wrap their heads around them? Like, you know, people will love to tell you that. millionaires have gone bankrupt like three times before they became millionaires, which is a nice way of saying don't give up.

David Copeland, Ph.D. 1:09:38
Yeah, essentially, it is. The problem with it is it's typically an empty phrase to most people, because most people don't think too deeply about it or just, you know, don't don't

Scott Benner 1:09:49
go back to themselves. Yeah, no, I don't. I've never once thought I'll have a million dollars one day, but I guess I would think most people don't feel that way. But that that That does become the problem is that these things are so they're so empty that they they'll ring true for a moment, but then you can't hear the bells anymore. You know, you're like, Oh, that makes sense. And then it's gone. And yeah,

David Copeland, Ph.D. 1:10:10
like the Nike slogan, just do it is great in terms of, you know, inciting people to take action to you know, make a change or, you know, do something in their lives. But we've heard it so often Now. Now. It's just this random slogan that just bounces off our ears when we hear it. It's super

Scott Benner 1:10:24
exciting, right till I jump up in the air and realize I can't get anywhere near the rim. It reminds me of when my son was super young, he might have been seven or eight years old, his friend is at bat at a baseball game. And the kid's father stands up and yells his name and the kid grabs his attention as he's like getting into the batter's box and says, just hit the ball. And the kid stopped and what? Oh, thanks. Yeah, that was not valuable advice. If it was that easy. A baseball wouldn't be fun to watch and be everyone would be amazing at it. I didn't know I just had to hit it. I appreciate you're doing this with me. And I do wonder if you'll tell me if you think I'm well, if you listen to this, and then tell me what you think. But I don't believe that everybody needs to go out and change themselves. I don't believe anybody has to. But I do think that if people were self reflective, they would change. I don't know if it would be better or worse for them that I can't say. But it would be different. And it would be progress of some sort. Do you think it's odd that I wanted to put this episode into this podcast? You listen to the podcast?

David Copeland, Ph.D. 1:11:35
Yeah, I don't think it's odd at all, I think I think one of the things to understand is that people work in different in different paces. And different people are different in terms of their willingness to try new things, their motivations, their goals, they're wanting to make change themselves. And so I think if people are fine, where they're at, then, then as long as they're getting good enough results, then they can do that. That's their choice. But some people will kind of hope they had better results, but aren't, you know, but that hope isn't enough to get them to make a change. And you hope those individuals can start to see that there is some psychology to this and that, we have to recognize that a you have to get yourself to really want to make the changes, you know, step number one, and then number two, you have to tell yourself that, hey, what I believe in what I'm doing might not be the best ultimate, you know, way of doing things and way of believing things. And maybe I should go out there and listen to other pieces of advice the best, especially from things, ideas coming from experts, and people who have tried them out and found great success with it, I always just think it's been specific focus to diabetes, I just always think find somebody who's doing it better than you and find out what they know that you don't know.

Scott Benner 1:12:51
Like, that just makes sense to me. Like if you're having trouble keeping your blood sugar stable, like, you know, go find somebody that doesn't like see that as hopeful instead of instead of them making you feel bad about it, which is, which is a thing i abrasca guess I don't think that sharing success makes people feel badly. I think sharing success gives people can give them hope they can choose to feel bad about it, I guess if they want but but the idea is pure,

David Copeland, Ph.D. 1:13:16
you know, again, if that information isn't out there at all, then there's not a chance at all that they're going to try something because because then they don't have any ideas because

Scott Benner 1:13:25
of what I said earlier, which is you can't imagine what lies beyond your understanding. Right, so you can watch your blood sugar spike up after a meal, and then crash back down again. But if you don't understand what Pre-Bolus means, if you don't understand how to make your Basal insulin, right, then this is just this thing that happens to you every day, it's just the thing that is happening to you. And if you don't have the words to put to it, or the tools to fix it with, then all you're left with is the idea of like, I know this isn't right, but I don't know what to do next.

David Copeland, Ph.D. 1:14:00
Well yeah, and then at that point, you might just try it through trial and error, try something and by chance it might work you know, and sometimes it could be an effective tool. Other times it could just be random that it just you know you did something and adjust your insulin, you know, regimes just happened to work that day and so you think that this random thing that you did works, but if it's not an effective tool that a lot of other people are using and and you and you don't know about it, then odds are you're not going to stumble upon

Scott Benner 1:14:26
it yourself. Or you might just give up and believe believe it to be unconquerable I saw someone today say something about my blood sugar goes up but then it comes back down. I know my body I know it's gonna do that. And I read that and I did not have the time to respond. But what I wanted to say was is this has very likely little to do with your body and what you know about it and a lot more to do about the fact that your insulin is probably not set up, right.

David Copeland, Ph.D. 1:14:53
Oh, yeah. And when when they think it's an evident when a person thinks is inevitable. It's kind of related to an idea like a learned helplessness It's like an idea of when you think no matter what I'm going to do, it's not going to fix anything, you kind of give up. And but when the reality there might be some real tools out

Scott Benner 1:15:10
there, but I think if people feel that way, if you're listening and you find yourself feeling that way, I mean, I get that that would be a gut punch for a second, if what David just said, you're like, Oh, god, that's what I do, like, you know, but now, you know, don't do it. Yeah,

David Copeland, Ph.D. 1:15:25
that's where if you can hear examples of people, you know, succeeding in overcoming that problem, exposing people to that, then that can, you know, give them inspiration, give them hope to that there is a method out there they can try. Cool.

Scott Benner 1:15:37
Alright, so I'm gonna Thank you for coming on. But I want to ask you one last question before I let you go. So do you listen enough to the podcast that you have a vibe for it?

David Copeland, Ph.D. 1:15:46
I've listened to a handful episodes, I've gone through different sources, you know, with citizen books or conversations with their endocrinologist.

Scott Benner 1:15:55
So you feel but but I'm talking about just me specifically, like the thing I'm laying out like, do you have a grasp of what I'm doing? Yes. Okay. So is it hard for you, when you're listening to something like this with your background? to not see what I'm, how am I want to ask the S? Do you see how I'm trying to help people along? And is it hard for you to listen to something when that when there's a secondary thing happening that a lot of people are listening to don't hear, and maybe you don't know what I'm talking about? I'm interested to know.

David Copeland, Ph.D. 1:16:28
I think I think that providing the information out there is it in its of itself is a way to do it. And I think another thing that's very important is that it's got to be presented in a way there that people want to, you know, listen to it, you know, you if you present it, you could you know, very well present all this information in a very dull, like scientific conference way of just like reading something in a very monotone voice. But if you make something a little bit interesting, you know, add some story to it, then you're actually going to get people's attention to it. And it actually make them want to listen, and that and people want stories,

Scott Benner 1:17:06
right? Like that's Yes, sir, very much. It's a very human thing. I just, I always wonder like, I wonder if a person like you, like, it's almost like sitting in school again, after being through like, the first time you go through you, you just think you're having this experience. And the second time you go through, you're like, oh, the teachers getting me somewhere there there on purpose, moving me from where I am to this other place?

David Copeland, Ph.D. 1:17:29
Well, it kind of gets the idea of when you don't know anything about a topic, most people shy away from it and call it boring, or you know, something that they're not interested in. But as you get exposed and learn more and more about a topic, you'll find people actually develop an interest and sometimes even a passion toward it. And so it's a really kind of an interesting thing. So when you have the availability, the resources out there for people to continue learning, once you kind of snowball up that, you know, knowledge base, then people can really get into it.

Scott Benner 1:18:01
Alright, I appreciate your time. I greatly thank you so much for doing this. You did it kind of on short notice even and I'm gonna put it out pretty soon. So I'm excited about it. Is there anything you want to share with people I know, we were for four seconds, we're like, My daughter has diabetes. And then we were like, jump right into this. But is there anything diabetes wise? I never usually asked at the end. But is there anything about diabetes, you want to talk about that? We didn't? Ah,

David Copeland, Ph.D. 1:18:26
I think just like anyone else, I'm, you know, continuously learning about this. And I think it really to bring it back to one of the points that you'd mentioned earlier. You know, I think that I care more about it, because it's with, you know, an issue with my daughter than even if I think of it was about me. And so I think it's one of those types of things where it's, you know, being a parent makes it you know, a little bit more motivating, even for me to learn more and more about this, this particular topic, and to, to improve, because I want her to live a fantastic life. Yeah. Oh,

Scott Benner 1:19:03
God. Well, what's your Cheers to that, that's a that's a great way to end. Thank you very much. And thank you for inviting me. A huge thanks to David for coming on the show and sharing his expertise with us. I'd also like to thank touched by type one, who you can of course find at touched by type one.org on Facebook, and Instagram. And I just want to remind you one last time, head over to T one d exchange.org. forward slash juicebox. fill out the survey. If you're a US resident, and you have type one diabetes, or you're the caregiver of a child with type one, it won't take but a few minutes, it'll benefit the podcast and it will benefit everyone living with Type One Diabetes even you.

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