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What Is Meaningful Inquiry? · Truth in Motion with Dr. Jocelyn

• 0:02
  SPEAKER_00: Welcome to Truth in Motion with Dr.
• 0:05
  SPEAKER_00: Jocelyn, where insight, clarity, and wisdom help you thrive.
• 0:11
  SPEAKER_00: In our last episode, we landed our first week on hope.
• 0:15
  SPEAKER_00: We talked about a body made to heal, one that is repairing you right now, without asking your permission.
• 0:22
  SPEAKER_00: And we looked at hope itself, tikva, a cord you can hold on to.
• 0:28
  SPEAKER_00: At the end of that episode, I told you that this week we would step back and ask, what must be true for us to look honestly and meaningfully at health?
• 0:38
  SPEAKER_00: And we'd begin laying the foundation for understanding evidence-based medicine.
• 0:43
  SPEAKER_00: So today we start at the very beginning.
• 0:46
  SPEAKER_00: Why do we ask questions at all?
• 0:49
  SPEAKER_00: What makes an answer meaningful?
• 0:51
  SPEAKER_00: Is research the only way to find a truth?
• 0:54
  SPEAKER_00: And why does everyone today want medicine to be quote unquote evidence-based?
• 1:00
  SPEAKER_00: Here's the heart of it.
• 1:02
  SPEAKER_00: Every question we ask stands on answers we've already accepted.
• 1:07
  SPEAKER_00: What is real?
• 1:09
  SPEAKER_00: How do we know?
• 1:10
  SPEAKER_00: And what we're made for.
• 1:12
  SPEAKER_00: Most of us never choose them.
• 1:14
  SPEAKER_00: This week we start learning to see them.
• 1:18
  SPEAKER_00: As always, let's start with why this matters.
• 1:21
  SPEAKER_00: Maybe you've heard one of these sentences.
• 1:24
  SPEAKER_00: There's no evidence that works.
• 1:27
  SPEAKER_00: But that isn't evidence-based.
• 1:29
  SPEAKER_00: Maybe you heard it from a doctor, maybe from a news story, maybe you heard it from your insurance company in a letter telling you they won't pay for something you needed.
• 1:39
  SPEAKER_00: These sentences can end a conversation.
• 1:42
  SPEAKER_00: They can close a door on care.
• 1:45
  SPEAKER_00: Let's start with the question itself.
• 1:48
  SPEAKER_00: Why we search?
• 1:50
  SPEAKER_00: Every piece of research starts the same way.
• 1:54
  SPEAKER_00: Someone has a problem and they want to solve it.
• 1:57
  SPEAKER_00: That's true for you at your kitchen table.
• 1:59
  SPEAKER_00: Why am I so tired?
• 2:01
  SPEAKER_00: It's true for a family.
• 2:03
  SPEAKER_00: Why does diabetes keep showing up in ours?
• 2:06
  SPEAKER_00: And it's true for whole communities.
• 2:08
  SPEAKER_00: Why are so many children developing allergies?
• 2:12
  SPEAKER_00: Our word research comes from an old French word, reserché.
• 2:18
  SPEAKER_00: It means to search closely, to look, and to look again.
• 2:23
  SPEAKER_00: And that raises a deeper question.
• 2:26
  SPEAKER_00: When do we get a meaningful answer?
• 2:29
  SPEAKER_00: The first meaning is the obvious one.
• 2:31
  SPEAKER_00: A meaningful answer solves the problem.
• 2:34
  SPEAKER_00: The pain goes away, the child breathes easier, the number comes back into range.
• 2:39
  SPEAKER_00: I like results, and I'm guessing you do too.
• 2:42
  SPEAKER_00: Researchers have formal ways to judge whether an answer really solves the problem.
• 2:47
  SPEAKER_00: Two of them matter for you.
• 2:50
  SPEAKER_00: The first is the difference between statistically significant and clinically significant.
• 2:56
  SPEAKER_00: Statistically significant means the results probably is not a fluke of chance.
• 3:03
  SPEAKER_00: Clinically significant asks a different question.
• 3:07
  SPEAKER_00: Is the change big enough for you to feel it?
• 3:10
  SPEAKER_00: Researchers even have a name for the smallest change a patient can actually notice.
• 3:17
  SPEAKER_00: They call it the minimal clinically important difference.
• 3:22
  SPEAKER_00: A treatment can lower pain scores in a way that is statistically real and still too small for anyone to feel.
• 3:30
  SPEAKER_00: That isn't a meaningful answer for the person in pain.
• 3:34
  SPEAKER_00: The second is what gets measured.
• 3:36
  SPEAKER_00: Family physicians call it patient-oriented evidence that matters.
• 3:41
  SPEAKER_00: Does the treatment help you live longer, hurt less, or do more of what you love?
• 3:47
  SPEAKER_00: Or does it only change a number on a monitor or a lab report?
• 3:51
  SPEAKER_00: Here's why that matters.
• 3:53
  SPEAKER_00: In the 1980s, doctors knew that irregular heartbeats after a heart attack predicted sudden death.
• 4:00
  SPEAKER_00: Suppress the irregular beats and you save lives.
• 4:04
  SPEAKER_00: The cardiac arrhythmia suppression trial tested two drugs that did exactly that.
• 4:10
  SPEAKER_00: The monitors looked better.
• 4:14
  SPEAKER_00: But patients on the drugs died of arrhythmia or cardiac arrest at more than twice the rate of those on placebo.
• 4:22
  SPEAKER_00: The trial was stopped early.
• 4:25
  SPEAKER_00: The number improved, the patients didn't.
• 4:29
  SPEAKER_00: A meaningful answer is measured in people, not only in numbers.
• 4:35
  SPEAKER_00: But there's another kind of meaningful answer.
• 4:38
  SPEAKER_00: Sometimes the answer is seeing the problem differently.
• 4:42
  SPEAKER_00: Let me tell you a story.
• 4:44
  SPEAKER_00: For most of the 20th century, stomach ulcers were blamed on stress, spicy food, and too much acid.
• 4:52
  SPEAKER_00: Patients were told to relax, drink milk, and take antacids.
• 4:58
  SPEAKER_00: In the early 1980s, two Australian doctors, Barry Marshall and Robin Warren, noticed a bacterium living in the stomachs of ulcer patients.
• 5:08
  SPEAKER_00: Almost no one believed them.
• 5:10
  SPEAKER_00: Bacteria couldn't survive stomach acid.
• 5:13
  SPEAKER_00: Everyone knows that.
• 5:15
  SPEAKER_00: So in 1984, Marshall drank a culture of the bacteria himself.
• 5:20
  SPEAKER_00: Within days, he was sick with inflamed stomach lining.
• 5:24
  SPEAKER_00: Today we know that bacteria, it's Heliobacteria pylori, also known as H.
• 5:30
  SPEAKER_00: pylori, is one of the two biggest causes of stomach ulcers.
• 5:35
  SPEAKER_00: The other is anti-inflammatory drugs like ibuprofen.
• 5:39
  SPEAKER_00: And in 2005, the two of them received the Nobel Prize.
• 5:44
  SPEAKER_00: The better answer didn't come from asking the old question harder.
• 5:49
  SPEAKER_00: It came from asking a different question.
• 5:52
  SPEAKER_00: That's another meaning.
• 5:54
  SPEAKER_00: And there's one more.
• 5:56
  SPEAKER_00: Sometimes a meaningful answer changes the person who asked.
• 6:00
  SPEAKER_00: You go looking for a fix and you come back knowing yourself, your body, or God a little better.
• 6:07
  SPEAKER_00: The problem may still be there, but you aren't the same.
• 6:12
  SPEAKER_00: But before we go further, there's something I need to say.
• 6:15
  SPEAKER_00: I want to be honest with you.
• 6:17
  SPEAKER_00: Research the way we usually mean it is not the only way people have looked for truth.
• 6:23
  SPEAKER_00: Modern research grew up mostly in Europe and later in America, in the early 1600s.
• 6:29
  SPEAKER_00: The English philosopher Francis Bacon urged people to stop relying only on old authorities and to learn by careful observation and experiment.
• 6:39
  SPEAKER_00: That way of seeing has given us a great deal.
• 6:42
  SPEAKER_00: Antibiotics, clean water, safer surgery, but it is one worldview.
• 6:48
  SPEAKER_00: It isn't how the whole world has always seen life.
• 6:51
  SPEAKER_00: Chinese medicine grew from centuries of careful watching.
• 6:55
  SPEAKER_00: Patterns, seasons, relationships, harmony.
• 6:59
  SPEAKER_00: Many people of faith, including me, also seek truth through prayer and scripture.
• 7:05
  SPEAKER_00: These aren't lesser ways of knowing.
• 7:07
  SPEAKER_00: They ask different questions with different tools.
• 7:10
  SPEAKER_00: And there's another worldview I want to speak to honestly, because many people who look for alternative medicine live in it, and maybe you do too.
• 7:19
  SPEAKER_00: It's the world of metaphysics and manifesting.
• 7:22
  SPEAKER_00: You may have heard, quote unquote, don't claim that diagnosis, or don't give it energy.
• 7:29
  SPEAKER_00: Focus on what you want, not on what you don't.
• 7:32
  SPEAKER_00: Joe Dispenza has done a lot of work here in books like Breaking the Habit of Being Yourself and You Are the Placebo.
• 7:40
  SPEAKER_00: I personally do like Joe Dispenza and I have studied his teachings.
• 7:45
  SPEAKER_00: He teaches that if we keep thinking and feeling the same way, we keep living the same life.
• 7:50
  SPEAKER_00: To change, we rehearse the future we want in mind and emotion as if it already happened.
• 7:57
  SPEAKER_00: The roots go back further.
• 8:00
  SPEAKER_00: The 18th century philosopher George Berkeley said, essay est percipe.
• 8:07
  SPEAKER_00: To be is to be perceived.
• 8:09
  SPEAKER_00: So from this view, studying a problem can feel like the opposite of healing, like you're feeding it, or it's, I would say, anti-manifesting.
• 8:19
  SPEAKER_00: I believe there's real truth here.
• 8:21
  SPEAKER_00: Last week we looked at research showing that people with positive views of their own aging lived seven and a half years longer.
• 8:29
  SPEAKER_00: What we expect does shape what happens in our bodies.
• 8:33
  SPEAKER_00: And labels can become identities.
• 8:36
  SPEAKER_00: Years ago, I wrote that sometimes symptoms or disease labels can become an identity, and that you are more than a set of symptoms or a disease label.
• 8:45
  SPEAKER_00: And I still believe that.
• 8:47
  SPEAKER_00: But here is the honest tension: a lump doesn't disappear because we refuse to look at it.
• 8:54
  SPEAKER_00: Psychologists even have a name for using us using spiritual ideas to avoid hard realities.
• 9:01
  SPEAKER_00: It's called spiritual bypassing.
• 9:04
  SPEAKER_00: And it's worth checking our motives on the other side, too.
• 9:08
  SPEAKER_00: Am I researching to help someone or to feel in control or to be right?
• 9:14
  SPEAKER_00: So where do I land?
• 9:16
  SPEAKER_00: Remember the man by the pool of Bethesda?
• 9:19
  SPEAKER_00: This is from the Bible.
• 9:21
  SPEAKER_00: He had been sick for 38 years and Jesus knew it.
• 9:24
  SPEAKER_00: Jesus didn't pretend the illness wasn't there.
• 9:27
  SPEAKER_00: He asked, quote unquote, do you want to be made well?
• 9:31
  SPEAKER_00: He named what was and he turned the man toward what could be.
• 9:37
  SPEAKER_00: That's my answer.
• 9:39
  SPEAKER_00: Naming a problem is not the same as claiming it.
• 9:43
  SPEAKER_00: Meaningful inquiry looks honestly at what is while holding on to what you want to be true.
• 9:51
  SPEAKER_00: That brings me to the biggest question of all.
• 9:54
  SPEAKER_00: Every healer, every researcher, every parent holding a sick child has wanted the same thing to end suffering.
• 10:02
  SPEAKER_00: Is that even possible?
• 10:04
  SPEAKER_00: Some traditions say no.
• 10:06
  SPEAKER_00: In Buddhism, the first noble truth is dukkha.
• 10:10
  SPEAKER_00: Life involves suffering.
• 10:12
  SPEAKER_00: Many philosophies say we live in a world of duality, light and dark, health and sickness.
• 10:18
  SPEAKER_00: You can't have one without the other.
• 10:20
  SPEAKER_00: Scripture is honest about this too.
• 10:23
  SPEAKER_00: Romans 8 says that the whole of creation groans.
• 10:26
  SPEAKER_00: Jesus said plainly, In the world you will have tribulation.
• 10:30
  SPEAKER_00: But he finishes that sentence by saying, Be of good cheer, for I have overcome the world.
• 10:36
  SPEAKER_00: And in Revelation chapter 21, it promises a day when God will wipe away every tear and there will be no more pain.
• 10:44
  SPEAKER_00: So here's what I believe.
• 10:46
  SPEAKER_00: We don't end all suffering by our own hands.
• 10:49
  SPEAKER_00: That restoration belongs to God, but we are invited to relieve it.
• 10:54
  SPEAKER_00: One person, one family, one honest question at a time.
• 10:59
  SPEAKER_00: That's a goal worth giving your life to.
• 11:02
  SPEAKER_00: When I took my oath, I promised to apply all the measures we required for the benefit of the dis eased.
• 11:10
  SPEAKER_00: Not to end all disease forever, to benefit the person in front of me.
• 11:15
  SPEAKER_00: I find a lot of freedom in that.
• 11:17
  SPEAKER_00: I don't have to fix the world.
• 11:19
  SPEAKER_00: I get to serve the next person who walks through my door.
• 11:23
  SPEAKER_00: And that's where evidence-based medicine comes in.
• 11:26
  SPEAKER_00: Evidence-based medicine grew out of a good desire.
• 11:29
  SPEAKER_00: Doctors realized that many treatments were given out of a habit and some were doing harm.
• 11:35
  SPEAKER_00: In 1996, David Sackett and his colleagues defined it this way: quote unquote, the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients.
• 11:51
  SPEAKER_00: And they said it means integrating that evidence with the clinician's expertise and the patient's own values.
• 11:58
  SPEAKER_00: Three parts, not one.
• 12:01
  SPEAKER_00: So how much of medicine today actually rests on strong evidence?
• 12:06
  SPEAKER_00: Let me give you some real numbers.
• 12:08
  SPEAKER_00: In 2017, Mark Ebel and his colleagues reviewed 3,251 key recommendations used in primary care.
• 12:18
  SPEAKER_00: Only 18% were based on the highest level of patient-oriented evidence.
• 12:25
  SPEAKER_00: In 2019, a review of cardiology guidelines in the Journal of the American Medical Association found that just 8.5% of 2,930 American recommendations were backed by the highest level of evidence.
• 12:42
  SPEAKER_00: And when researchers looked at 10 years of studies in the New England Journal of Medicine that tested standard, already accepted practices, 40% of those practices were reversed.
• 12:55
  SPEAKER_00: They either didn't work as well as everyone thought, or they didn't work at all.
• 13:00
  SPEAKER_00: Now, those were practices someone had reason to question.
• 13:04
  SPEAKER_00: So this isn't 40% of all medicine, but it shows how often accepted practices turn out wrong when someone finally checks.
• 13:13
  SPEAKER_00: I'm not sharing this to tear down medicine.
• 13:16
  SPEAKER_00: Much of it saves lives, and I am grateful.
• 13:19
  SPEAKER_00: A great deal of medicine is still practiced on experience, judgment, and habit.
• 13:25
  SPEAKER_00: And that includes me too.
• 13:27
  SPEAKER_00: So what about insurance?
• 13:29
  SPEAKER_00: Is quote-unquote not evidence-based just a way to deny care?
• 13:35
  SPEAKER_00: In that same 1996 paper, Sackett wrote, Some fear that evidence-based medicine will be hijacked by purchasers and managers to cut the cost of health care.
• 13:47
  SPEAKER_00: He saw the risk from the beginning.
• 13:49
  SPEAKER_00: And it happens, in 2022, the Federal Office of Inspector General found that 13% of prior authorization requests denied by Medicare Advantage plans actually met Medicare's coverage rules.
• 14:05
  SPEAKER_00: Those patients should have been approved.
• 14:08
  SPEAKER_00: But I want to be fair, most denials aren't about evidence at all.
• 14:13
  SPEAKER_00: In marketplace plans in 2023, about one in five in-network claims were denied, and only about 6% of the reasons given were medical necessity.
• 14:24
  SPEAKER_00: Most were paperwork and other reasons.
• 14:27
  SPEAKER_00: And fewer than 1% of denials were ever appealed.
• 14:31
  SPEAKER_00: That last number matters to you.
• 14:33
  SPEAKER_00: If you ever receive a denial letter, you can ask for the specific reason in writing and what evidence they used.
• 14:40
  SPEAKER_00: You can ask your provider to help you appeal.
• 14:44
  SPEAKER_00: Most people never do.
• 14:46
  SPEAKER_00: That's meaningful inquiry in real life, not accepting the first answer just because it came on letterhead.
• 14:53
  SPEAKER_00: So I wouldn't call evidence-based medicine a sham.
• 14:56
  SPEAKER_00: I'd call it a good tool that can be misused.
• 14:59
  SPEAKER_00: And here's the key.
• 15:08
  SPEAKER_00: Unknown is not the same as useless.
• 15:12
  SPEAKER_00: So what is meaningful inquiry?
• 15:14
  SPEAKER_00: I believe meaningful inquiry is asking honest questions for the sake of real people, with tools that fit the question and staying open to answers that may change how we see the problem and change us.
• 15:29
  SPEAKER_00: Here's this week's practice.
• 15:31
  SPEAKER_00: Last week we noticed.
• 15:33
  SPEAKER_00: This week we questioned.
• 15:35
  SPEAKER_00: I want you to pick one belief that you hold about your health.
• 15:39
  SPEAKER_00: Here's an example.
• 15:41
  SPEAKER_00: Pain is part of getting older.
• 15:44
  SPEAKER_00: My labs are normal, so I'm fine.
• 15:46
  SPEAKER_00: There's no evidence for that.
• 15:49
  SPEAKER_00: Then I want you to ask two questions.
• 15:52
  SPEAKER_00: Where did I get this?
• 15:53
  SPEAKER_00: And is it true?
• 15:55
  SPEAKER_00: You don't have to answer it yet.
• 15:57
  SPEAKER_00: Just hold it up to the light.
• 15:59
  SPEAKER_00: Well, let's bring it all together for today.
• 16:02
  SPEAKER_00: A meaningful answer can solve a problem, show us the problem differently, or change the person asking.
• 16:09
  SPEAKER_00: In research, a meaningful answer is big enough to feel and measured in people, not just numbers.
• 16:18
  SPEAKER_00: Research is one worldview among many, and naming a problem is not the same as claiming it.
• 16:25
  SPEAKER_00: Evidence-based medicine means best evidence, clinical expertise, and your values together.
• 16:32
  SPEAKER_00: An unknown is not the same as useless.
• 16:36
  SPEAKER_00: Every question we ask stands on things we've already decided.
• 16:40
  SPEAKER_00: Things such as what is real, how we know what we know, what our bodies and our lives are for, what we assume when we ask, and what we assume about living bodies.
• 16:54
  SPEAKER_00: Most of us never choose those answers.
• 16:57
  SPEAKER_00: In the weeks ahead, we look at each one because when you can see the ground you're standing on, you can choose where to stand.
• 17:06
  SPEAKER_00: Tomorrow we'll ask what science actually is and what falls inside and outside of its reach.
• 17:14
  SPEAKER_00: I'll see you there.
• 17:18
  SPEAKER_00: Keep the conversation going.
• 17:20
  SPEAKER_00: Find your next steps in notes from a fellow traveler, my blog.