Interview with Kirsten Karchmer

Dr. Pentland: Hey, everybody welcome to another podcast episode from the Golden Cabinet. I am so happy to be here today with Kirsten Karchmer. I will get to her decorated CV in just a moment and introduce her. If you haven't been here before, it's a new podcast that is primarily for acupuncturists and helping them grow their practice. We've got a YouTube channel, so subscribe there, Facebook page and the goldencabinet.ca is the website. I don't know where you're watching this.

Without further ado, we're here with Kirsten Karchmer, welcome.

Kirsten Karchmer: Hi.

Dr. Pentland: Because of what you sent in, like I said, I am just going to read it. Kirsten, we talked a couple days ago, and I felt really bad after, because a) I had to go quickly, and b) I had to go pick up a sick child from school, and this is all such a gold, let's just have this energy in the podcast or recording, anyway, I apologize, Kirsten. Here we go, Kirsten Karchmer is a health tech pioneer and women's health expert. She has pioneered proprietary infertility assessment and treatment protocols that optimize fertility while improving patients’ overall health. She's a Board Certified reproductive acupuncturist and former president of the American Board of Oriental Reproductive Medicine. She is also the CEO and founder of Conceivable, a technology enabled fertility solution at 1/100 the cost of IVF and the Viv wellness, VIV wellness, is that right?

Kirsten: Viv.

Dr. Pentland: Viv wellness, Women’s health revolution committed to eradicating PMS and cramping, which is awesome. I'm excited to chat about that too. In 2013, Kirsten translated her successful clinical programs into her technology enabled platform that uses machine learning/AI to provide affordable and impactful reproductive solutions. Karchmer was named one of Texas women in technology to watch and Conceivable, which we will get into. Your technology was named one of the most innovative health tech startups from MedTech in 2015 - that's so awesome, Kristin. Best Fertility App by Healthline in 2016, and has been featured in FoxNews, the New York magazine, Tech Crunch Huffington Post and MHealth. I am blown away. I'm so excited for you. She lectures internationally on women's health, the future of integrative medicine, and using technology to better serve patients, providers and healthcare systems. Kirsten has been recognized as one of the top female start-up founders to watch, the recipient of the Texas Trailblazer award for her innovation in health care and, is also a Huffington Post contributor.

Now you know why I wanted to read it.

Kirsten: I feel like shy now.

Dr. Pentland: I put on a red lighting so I look red anyway. Kirsten and I have known each other for quite a long time, and that connection happened probably through the ABRM, and just spending time in Texas. I remember going to some southern barbecue places that Steve Ray Vaughn used to go to or something. I've just always loved her energy, and I'm really excited to have a chance to chat today. So, I'm going to turn it over, and I don't know where you're going to go, but maybe you can kind of give a call’s note since most of our viewers here will be acupuncturists. You could speak to kind of how you got started there, and maybe even some of your influences and your evolution through practice, and into, my god what we talked about the other day, your deals with Apple. Anyway, I'm so excited. So, square one, you were a small child and acupuncture helped you, or I don't know, go ahead.

Kirsten: Well, actually, I was a linguistics professor at the University of Texas and I had been diagnosed with multiple sclerosis when I was 19 years old. I couldn't walk, I had a lumbar puncture that wouldn't close, and every like hour or two, enough cerebrospinal fluid would leak out, then I would pass out. I could start to feel it, it was like as if somebody was turning a dimmer switch and just like ‘shhhhh’, and I'm like, oh, I'm going to pass out. Because enough cerebrospinal fluid would leak out ,and it would start to dequilibrize. I would lie down. Even if I'd be teaching, I'd be like, hold on, I got to lie down and I'd lie down. Then it would equalize a little bit and then I'd get back up and teach some more. I was sleeping in the bathrooms all day long, I was really sick. And somebody suggested, they said, you should go see an acupuncturist, and I was like, f*** that, that's like going to a psychic. I mean, there's no way I was going to do that, but I already had surgery, and they're like, well, you don't have any other choices, you can't just keep laying down everywhere you go all through the rest of your life. Finally, I went, and I went to go see who ultimately became one of my teachers. He basically came in and started feeling my pulse. I hid my chart, I hid my cane, and he started feeling my pulse, and I was a very bad patient. And he says, oh, you’re so tired, and I was like, whatever, everybody's tired. And he keeps feeling my pulse, and he's like, oh, you cannot digest energy, you cannot digest food, and I was like, okay, I do have a lot of digestive problems. Then he keeps feeling and he says, you have muscle weakness, and I said, actually, I have multiple sclerosis. And he starts clapping, he's like, oh, that makes perfect sense, that makes perfect sense. And I was like, what are you talking about, and so then he basically sort of gives me the Chinese medicine talk, but what he told me was the beginning of where I got today. That's why this is important. He said, when you were born, your constitution was very strong and your disease was very weak, you were born with your disease. And he said, but you're like a hard worker. He's like so you worked, worked, worked, worked,  worked, worked, worked, worked, and your constitution got weaker, weaker, weaker, weaker, weaker, and your disease got stronger and stronger, and he goes, and then when you turned 19, finally, your disease got stronger than your constitution, and now you are here where you are today. And our job is to fix your constitution, and if we fix your constitution, then you should go into remission. And then that's what happened. Then I went to acupuncture, plus, I was like, holy crap, this is the bomb!

Dr. Pentland: What was going through your mind when he said that? Did he hit something like that you were like, ahh, he is on to something maybe?

Kirsten: It was just like an ancient Chinese secret moment, Spence. It’s like when you tell patients anything, when you explain why they're not getting pregnant or why they're sick, and they're like, ohh, I get it. It's just that moment that I say like when people's light bulb goes off. I always ask acupuncturists that I'm working with, because I do a lot of consulting with acupuncturists, and acupuncturists have to do so many jobs, and it helps to reduce burnout if you can figure out what you’ve liked to do. Like, where the juice is in clinical practice for you, and do more of that and delegate the rest. So, for me, the moment that I get the most juice seeing patients is that moment when I explain it, and they go, ohh. Because they get hope in that moment, that's the first time that they have hope that something can be different. That's mostly what was going on. I was like, I believed. I was like, okay, I think this guy knows what he's talking about, and I had been to a lot of fancy neurologists, and they're just trying to make me take drugs, and no long-term clinical trials. I was like, I'm not testing any drugs, forget it. Then I went to acupuncture school, and while I was in acupuncture school, there was a brand new gynecology professor there from China, who really didn't speak much English. I mean, his English was very hard to understand, and having been a linguist and lived in Asia, I started being his translator. And so I just stayed with him everyday, just basically translated what he would say. In the end, I started noticing that the menstrual cycle tells you everything, and that if you fix the menstrual cycle, everything gets better, you cannot have a perfect menstrual cycle and still have any serious health problems. If you keep looking at the menstrual cycle for the feedback system, and unlike anything else, it feeds back every single month. I just got more and more interested in that, and when I graduated from acupuncture college, there was no hardly any reproductive acupuncturist in the whole country. I just decided that I am going to be the fattest fuck in the country. I always tell acupuncturists, whatever it is that you want to be for your practice, you have to declare it and start living into it. Don't say, I'm going to be, just be it, and catch up with your vision, step in. That's sort of what I did, and then I studied a lot of western medicine and really was into the western medicine side of it for a long time. We had a really busy practice, we had three clinics in three cities, and we were taking care of several hundred patients a week and fertility patients. But I still struggle, because it's expensive to come to us. It's very cost prohibitive, and even though we did all kinds of things to try to make it more affordable for people, even if we gave it at half-price, it'd still be cost prohibitive for most people. So, in 2013, I was at a conference, and there's like seven million women who can't get pregnant in the US, there are 100,000 IVF cycles for seven million women, and there at that time only 1000 board-certified reproductive endocrinologists. I was like, I only helped 10,000 in 20 years. This is not okay. So, I set out to try. I was like, I know how to help people. Very well. But I can't scale this in an affordable way, and I'm going to have to do something different, so I stopped seeing patients and I read books for a whole year. I had no idea like how I wanted to help more people, and I was like so poor, I was bitching about being poor all the time, and my friends were like, well, if you just went back to work, you could be rich. I was like, no, I got to do something here, I got to do something here. It was just like, how can I help more people. Then I was in an online yoga class, and most people don't notice me, I'm very introverted, and I don't like classes of any sort, and like Lauren will never sit by me. Because he's like, please, don't sit by me, I'm like talking and making problems and stuff. Anyways, at the beginning of a class, he said, so I want you to think of where you're blocked, what's really blocking you in your life. As you're doing the yoga today, as you're pushing up against the limits of your physical body, and you're breathing into it, I want you to imagine that's like letting all the blockages go. And I was really starting to get freaked out, like, I can't solve this problem, I cannot solve this problem. And in that flipping yoga class, I stretched into something, and all of a sudden, I looked at the computer, and I was like, f****** technology, of course, that's how you do it! I pulled the smartest guy I knew, Rob Kruszewski from my team, another acupuncturist doctor, and I said, I can't do this by myself, will you come build this with me. We took two years to build a Conceivable platform, we took 800 questions that we would possibly ask somebody. We're basically teaching an algorithm to do exactly what we did in our clinic. It took 800 questions that we could potentially ask somebody in a consultation. We wrote them. Our whole office was whiteboard, every surface, floor, ceiling, tables, walls, everything. So, we wrote all the questions like, do you have insomnia, yes/no, do you fall asleep, stay asleep, blah, blah, blah, all of those things. And then we systematically went through and said, if you say yes to this question, what else do you have to say yes to. If you have night sweats, what else will happen, you will not have cervical discharge. Because as we were building, we limited ourselves to can we make a really good Chinese medicine diagnosis in 20 questions. 20 questions plus basal body temperatures. That got us to Conceivable, and then we did a pilot, we built the technology. It's pretty f****** cool technology, they used the technology, it asked them the 20 questions, and they start collecting basal body temperatures, and the questions you would ask during the phases of the menstrual cycle. It makes a constitutional diagnosis, it prescribes herbs for each phase of the menstrual cycle, customized formulas. It ships it to them, or if they're in the U.S., 300 clinics use our herbs, and so if they're using our herbs, then their patients can just use the technology. It makes customized menu planning for each phase of the menstrual cycle, it then teaches them how to cook, what's in the menus, because I feel like this is one of the problems that people don't cook because they don't know how to cook. It does customized behavior modification for them, for each phase of the menstrual cycle, and then there's a whole stress curriculum.

Dr. Pentland: There's a stress curriculum, can you touch on that a little bit? I'm curious.

Kirsten: That's going to be the main part of it in the next version too. So, the curriculum is basically a weekly course that they do, that starts out around like, I think that the most important things that women with infertility can do around managing their stress is learning mindfulness, but that's scary. All of those words, like, we imagine the girl that we were building this technology lives in a Podunk town, who doesn't even ever eat brown bread, who's never doing yoga or meditation or mindfulness, it has to be like so neutralized. Everybody, anyone, not just someone who's already into health.

Dr. Pentland: Yes, you are not preaching to the choir. It's so easy to do that, and I'm glad that you stepped out of that. That's great.

Kirsten: Yeah. I think that they need us just as badly as the people, if not more. There's a book called One Small Step Will Change Your Life, and that book was very pivotal for me, because when I thought about how we were going to build the technology for Conceivable, we wanted to build very small steps over a longer period of time. So, at the end of 12 or 24 weeks, they've just made tiny changes, but at the end of the 24 weeks, they've made huge changes.

Dr. Pentland: That’s beautiful. It’s the exact same thing I say, because if you make some sustainable small changes and change your trajectory just a little bit, with time, you will be in a very different space, and that is not scary. You can scare people or trigger them into what I call hyper wellness, where they're like stressed out because they're not making it to their yoga classes.

Kirsten: Yeah, because they then become neurotic about that.

Dr. Pentland: Or they can’t do it and they're stressed out about that. They missed their meditation one morning because their alarm didn't go off, or something, who knows what. Good for you, that's great. The stress part, I'm excited. What's the website for this? Because people are right now probably going, what is she talking about. It's conceivables.com, right?

Kirsten: No ‘s’. Just conceivable.com. We have two websites. One is, we provide software solutions for large companies, we provide Conceivable as employee benefit to large employers, we customize software for people who are completely outside of the fertility space. That site is kind of like we were talking about the other day. Conceivable is not really consumer-facing, we're not really consumer-facing anymore, although patients can definitely access and use the technology. But then we have our professionals. We have shop.conceivable.com, that's our herb line.

Dr. Pentland: You mentioned the herb line and how it is customized within the algorithm to identify the patterns and properly prescribe and ship, and that's for women that are actively using the conceivable app or software. Everything that I've ever created stems from what I did in my clinical practice, and it sounds exactly the same for you. I remember many, many years ago, when I got a tour of your clinic in Texas or in Austin, where you had a huge herbal line in there. Your tincture line, I think that was probably the genesis or maybe you had it already been going for a number of years. So, it all came from that, and you used in the clinical practice, and what you found effective for dosing, for you could choose how many formulas, a few formulas for this or that, but this is all based on mostly from you and Rob's clinical experience.

Kirsten: Yeah. I had more than 26 associates over my whole clinical career and smart people, really smart people, so every single one of them contributed in some ways to this line. The evolution of it is sort of interesting though, because what happened was as I was very serious about using raw herbs when I first graduated, and I only used raw herbs. And I thought that anybody who didn't use raw herbs was an idiot. I was very snobby in my younger years. Now, I'm much more chilled. But then we opened a satellite, and we didn't have room for a raw pharmacy in this clinic in San Antonio. We were pulling raw formulas for 70 patients a week and shipping it to them for about a week. Because then we are like, this is bullshit. Also because it doesn't get there fast enough, it gets really expensive. I thought, well, we were writing hundreds of scripts a week, and I thought, well, the reality is that when I'm writing a raw formula, I'm using the foundations of classical formulas that I like. So what if I took those foundations the way that I like to use them and I started building the modules of each one of those formulas. So, that now it's like Garanimals. Instead of writing a formula that's for Yin deficiency and spleen chi deficiency by combining [20:30], I've already got the blocks. And I've developed the formulas in a way that I know my prescribing system is based on making a constitutional diagnosis, and then breaking that up and applying it to each phase of the menstrual cycle. So even if you have a very complicated diagnosis if you break it up, there's only one or two things you're doing in each phase, so then, you're combining, you have two liquids. You're taking one or two ounce bottle and you're putting, like, well, it's like 30% Yin deficiency and 70% Chi deficiency, and then you're combining. We looked at the formulas over the last 20 years, like, one, what are the formulas that are most commonly combined, and then how do we actually really make them modules, so that we're taking out whether there's too much overlap or we're adding what needs to be harmonized, so that when they meet, they are harmonized. And then we really sort of invented a new way to make tinctures, because what's called a tincture on the market right now are liquid extracts. That's a process where you take herb and you put it in alcohol and you extract it after two ways. Our process takes now almost two months. It's a decoction, glycerin, alcohol, water decoction process and heat process, so you get something that's about five times stronger than anything you've ever used. We like them a lot. They've been described as herbal brandy. That's what people say when they taste it. They're like, mmm, kind of an herbal brandy. Patients go, this tastes like s***. It's still better than the extracts though.

Dr. Pentland: My line is though if it tasted like strawberries, you'd think I was like full of shit. So, here it is, just take it. I mean, if someone's motivated toward their goal, the taste of herbs is, like, if you got used to coffee and beer and they're bitter, so this won't be that different, and it's not for the rest of your life. That's so cool, how those two coordinate. Patients can actually access Conceivable, and, say, someone watching has a fertility or see some fertility patients, they can just send up straight to that site and it will walk them through everything that you're talking about, and then they will only need them for acupuncture after that pretty much - is that correct?

Kirsten: Well, no. If that person is using our herbs, then we give them a code to give their patients. It's like $199 a month if they're getting herbs. If we're prescribing and sending shipping herbs to them, they pay $199 for the service, but if the acupuncturist is using our herbs, then they get a code that their patient can use the software for 19$ per month.

Dr. Pentland: But the herbal prescribing still has to go through the practitioner.

Kirsten: Yeah, we don't want to infringe on the acupuncturist herb sales. That's not good for anybody. We want to protect our partners, like, nobody's going to want to use our software if we're stealing the herb business. And of course, most practitioners want the freedom to be able to do their prescribing on their own.

Dr. Pentland: But if someone was, say, rural and they had no acupuncturists around, it could be a complete system for them.

Kirsten: Yeah, and then, some of our coaches, people are doing coaching, like, in Canada, where we can't send herbs to Canada, but they have patients that they're working with in the U.S., then we can provide the herbs for them.

Dr. Pentland: As a Canadian, I mean, we have 30 million you have 300. so I mean, a lot of cross-border activity happens when you're Canadian. There's just  no doubt about it. That distilling process that you went through of the diagnostics, which I think everyone drinks the kool-aid going through Chinese medicine school, because it's like, wow, it's this complete system of looking at a human being, and diagnosing them and fitting into patterns, and then there's treatment associated. It's like we’ve all been there, but you've taken it clearly to the next level and created this machine learning AI. This is where we kind of cut off our call again. I'm so sorry, because I was so curious, this is where this AI that you are patenting or have patented, used this to expand – I’m just fumbling.

Kirsten: Currently, there's no AI. It's sort of in the roadblock, but it does have the ability to learn. What happens is the algorithm makes a diagnosis on the back end, and then it prescribes what it wants, just like what you would do. Even in our clinic, we would prescribe for the whole month. If you're working at a constitutional level, you're not putting your fingers into the dikes to try to stop the bleeding. As the algorithm continues to collect data basal temperatures, cycle parameters and energy and stress and all that stuff, it's then looking for 20% improvement every single month across the board. If it's not, then the algorithm is going back and looking like is that because the person wasn't engaged in the behaviors that they need to be doing in, or because the hypothesis was wrong, and then modifies the diagnosis, the treatment plan, the deliverables and all of that.

Dr. Pentland: So, there's a system of check-ins or feedback the patient has to be giving in like the form of the webform somehow that they every week give feedback on or something?

Kirsten: No, just on their app. They just log in to their app, they put their basal temperature in and then it only asks them a few questions every single day. So if they're ovulating, it's asking do you have cervical discharge, have you had any mittelschmerz, whatever.

Dr. Pentland: But it is really actively connecting with the patients like that, that’s so great.

Kirsten: What I really like best about the whole thing that people don't appreciate as much as I do, is the basal body temperature. I looked at 250,000 basal body temperature charts to come up with my theory about basal body temperature charting, and so I identified like this particular basal body temperature profile, where they're like in the low 97's in the follicular phase, and like 98.2ish in the luteal phase. So, we superimpose that on to the basal body temperature chart so that the patient can see how close are you to being in an ideal state. What I always say is, we're looking for the average. So, even if there's some sawtoothness, what you're lacking is like averaging 97.2 in the first 14 days of the cycle, and so it actually tells them the average. And if the temperatures are really high, if your patient came in and your temperatures are really high, you'd be giving advice about like making sure that you're hydrated, eat more pineapple. Your temperatures are a little bit too high so make sure that you're doing this, drink hibiscus tea, whatever. And so every time they put in information, the feedback is the feedback that we would have given the patient. Like TechCrunch said, it's like having your fertility expert in your back pocket. Because you're getting to engage, and our patients in our clinic even really like it because they're like, I feel like you're with us every day as opposed to once or twice a week. And it's also tracking how many hours of sleep they had, how many servings of vegetables they had, how many glasses of water they had, and if they took their herbs or not. It's even telling them what herb got prescribed for them, so it shows them the bottle. It's like you should be taking two drops of formula three times a day of unwind.

Dr. Pentland: You should be needing a refill today.

Kirsten: Well, we send it to him.

Dr. Pentland: That's my next question, compliance. When they check off something like, oh, I didn't take my herbs, or I didn't do X, Y or Z, does it somehow encourage them or is that a time where you guys can reach out, you're notified?

Kirsten: It is a completely humanless experience. Only in the first version. It was very intentional, because we wanted to pilot, like, one of the things we were trying to suss out is were the success rates in my clinic so good because like I'm just a schmoozer, like, the human experience of being with me, or actually what we're doing. And so we wanted to make it a completely digital experience to see will anything happen, what are the results from that. Definitely, if they're not tracking, it'll say, hey, tracking is really important. The other thing is that we developed a predictive analytics tool accidentally inside the technology. I always have this thing that I say that you're not fertile or infertile.  You're more or less fertile and that you have a lot of control over that. If you think I'm fertile or infertile, it's like a death sentence. It's like having cancer. The algorithm is scoring all the time on the back end to be able to know what to prescribe and things like that. We thought, well, we'll visualize that score as your conceivable score.

Dr. Pentland: Self-competitiveness is cultivated, right?

Kirsten: Well, a little bit, and also more importantly to see that what you do or don't do is moving the needle every day in one direction or the other. And what we found in the pilot was so interesting is that we thought, because I know that  when people get to what I call a conceivable cycle, they have a high likelihood of getting pregnant. And so we thought 80 is the score that they would need to have to get to what we called a conceivable cycle. The average score of people who are diagnosed as infertile, who did our program in the pilot was 33. But in 90 days, if they crossed over the threshold of 58, they started getting pregnant with very high velocity and significantly higher in women over 35.

Dr. Pentland: Really? So, these adjustments you found statistically through your data that you've collected have more effect on advanced maternal age?

Kirsten: Yeah, and in fact, they had a 357% increased likelihood of conception. Very significant.

Dr. Pentland: That's so great. My question was, those under 35, I'm just curious as to your thoughts, as to why. To me and my practice, they've always been women that are under 35, typically have been often more difficult patients for me to work with, and that seems backwards at first thought maybe. But I'm not sure exactly what it is but do you have any comment on that trend?

Kirsten: I think you're right. I think that the women over 35 are just having the result of stress in age more than true pathology, and I think that the younger women have like more serious cases of PCOS and endometriosis, and they're just harder cases. They're having elevated FSH at 32, this is bad. I think that truthfully the over 35s, I don't think that we looked at this, but I think that the over 35s are probably the most compliant, because they know, like, now or never.

Dr.Pentland: I believe that. That's also when they start looking at their alternatives such as IVF also showing statistics of less effectiveness as each year passes by, whereas when you're younger you still have the immortality maybe mentality, or you could just come out of your 20s, so you're bright and shiny.

Kirsten: For sure. I mean, we even had women in 42s getting pregnant, which really surprised me because that happen occasionally in the clinic but not that much.

Dr. Pentland: Yeah, awesome. Because in clinic that human element is so huge, sometimes just having that support, maybe what someone needs on a weekly basis or whatever it is to have the strength and really hook into the ‘why they're  doing it every week’, and to keep them going. And that may be the result, but you've removed that piece and still are seeing effect just in a pure algorithmic traditional Chinese medicine model, that’s awesome. Congratulations on that. I am surprised that it only took two years, but it’s ongoing now, right? Where is it headed now?

Kirsten: Well, that was like the first version. We just built, like, they say your first version of your technology, you should be embarrassed by. Because if you're not  embarrassed by it, you built too much.  Well, you took too long, you spent too much money, because you're going to change it a lot, no matter what you'll learn a lot, and then you're going to change a lot. And that was really hard for me because I was going to be like introducing that to my peers, and I didn't want to be like, hey, look at this piece of shit I built. So, we probably spent too much and built too much on the front end. What's been interesting is there's this statement of fact in Chinese medicine like the good doctor treats the patient and the great doctor treats society, and the master makes himself obsolete - we talked about  this yesterday. I felt like I was getting to stage two when I built tech Conceivable, because I took myself out of it to be able to treat on a more societal level. But what we realized was that one, consumers don't understand this. The part that's very hard is like somebody comes into your clinic and has a consultation with you, they're going to be your patient, like probably 95% of people who walk through your door become your patient. And so we were really surprised that when we launched Conceivable that I thought we're going to break the company like on the first day. For 200 bucks a month, you get me, plus herbs, plus whatever, and we hardly sell any. Because people didn't trust us, they're like I've never heard that my menstrual cycle has anything to do with my fertility, I don't  believe that app can help me to get  pregnant, like all these issues. So, then we started reaching out to larger organizations to help us get our technology into more people's hands and help more people. We had a lot of pushback about supplements about the herbs. Insurance companies, hospitals that they're like, this is too scary for us, employers, even that means it has to go through the medical director. And so what our next version will do will be only software,  straight software, but we are exploring the application of using our diagnostic technology and predictive analytics against instead of using herbs as the intervention developing intentional technology delivered placebo.

Dr. Pentland:  Is this proprietary, or do you want to expand on that a little bit? Is it the mindful, like, is it more into that realm of people digging deeper in that piece?

Kirsten: We have patents on almost everything, but not on this yet. This is not going to be an easy thing, this is going to take me five years to figure out. I double dog dare somebody try to do this, but, yes, it's pretty hard. And if somebody can do it, that's going to make a huge contribution anyway. The NIH did this really interesting study, they took a group of people and they put them in front of a computer screen in which they showed them a green light or a red light.  They also hooked them up to a machine that would shock them, and so either a very mild shock. When they'd see the green light eight seconds, they’d get the light shock. When they'd see the red light eight seconds, they get a very bad shock. Like as bad as they could shock and get by IRB. In one of the interviews that I read about somebody who had done this, he's like, the shock was bad enough that you like kind of said, Jesus Christ, like bad, and then a few seconds later, you'd have like a foot reflex. It was significant. They administered three sessions within 20 minutes, have 12 shocks. So, they got 36 shocks in 20 minutes. At the end of the thing, they asked the participants what their experience was, and they said, in the first session, they had, one to one, green was easy, red was hard. Second one seemed a little blurry sometimes, green was a little bit worse than what they thought, and in the final one, almost all of them said, I think that I got green every single time, when, in fact, they got red every single time. They conditioned, they used one flash of a red light to condition a person to dump enough dopamine in eight seconds to protect them against a very significant trauma. And I'm going to build technology that does that, but with the paradigm borrowed from Chinese medicine. Instead of just like trying to dump dopamine, can we cause a hormone cascade? There’s lots of different things we can do.

Dr. Pentland: Can we shut down the sympathetic nervous system to a point where they digest better or where their stress level is lower? Awesome.

Kirsten: Yeah, with a wide variety of like prett far-out things. We're in conversations with Apple and Accenture and some pharmaceutical companies. There's a couple pharmaceutical companies that are actually doing really amazing technology R&D to try to really help women. This particular one would give us access to like unlimited resource dollars.

Dr. Pentland: That is so awesome. Under a pharmaceutical point, I grew up as a pharmacist’s son, one thing you can rest assured with pharmaceutical corporations is they're always going to be trying to find something that works. It shouldn't matter if it's a pill that's just easy delivery, and that was effective, cost-effective mostly, but I mean, if you're looking at health and wellness industries and who's higher into the yearly dollar value, I think our wellness industry is quite strong, and for pharmaceutical companies not to be delving into anything or forming partnerships with people like you is inconceivable. Kudos to you for being open. I fear sometimes that you know the kool-aid we talked about at the start, the people in the acupuncture industry and Chinese medicine are largely such amazing folk, rooted in such integrity and deep core values, that they are as health care practitioners supportive, they are all amazing always. But drinking that kool-aid can be a little prohibitive. You don't have to be open or become a naturopath, which I think so many people fall into functional styles or whatever it might be, but just being open to what's going to help your patient, and that being what you're going to recommend or educate yourself on. I think that's way more doable when you are specialized like yourself in infertility or reproductive health. That's awesome. How can people learn more or get involved, or they can obviously use the Conceivable with their patients, but is there any call to action that you have for people, or even inspiration of how to kind of move into just the realm that you're in, because you're clearly in the fast lane. And it's HOV, because you've got a bus of people with you versus being in the slower lane of like that monk like clinical practice, which is important as well. And if that's what you love, that's great, but for those that are aspiring to more, what kick started this fire? I mean, you're awesome, I love you. You're doing such great stuff, and that's important. It's people like you that are pulling Chinese medicine into its new evolution. It's always evolved, it's always kept its core and its foundation, but it's always evolving. In my mind, absolutely everything is right about that. So, what people or mentors or tips or ideas or what gets you going, what fuels you?

Kirsten: Well, currently placebo fuels me. It's all I can think about. I'm obsessed with the placebo. It's ironic because for so many years, the Western medical community, they're like, oh, acupuncture is just placebo, and I was like, it is not placebo, it's real. I'm like, f****** placebo is even better than any of it!  And how actually even as a clinician, I'm in my clinic just a half a day a week, but how can we as clinicians infuse placebo more of the placebo effect into our treatment, how do we potentiate that. Like who cares! All we want to do, if we really want to help people, then we'll do whatever we have to do to help people. I think that especially maybe younger clinicians, like, there's a lot of ego associated with ‘our way is the right way, the traditional way’, and in my style of teaching around constitutional diagnosis, it's very pared down. I learned that I had to pare it down to be able to teach an algorithm to do it, and then I learned that it worked. I think that just continuing to stay curious is the most important thing, because like when we graduated, I'm sure you had the same thing, Spence, we think we learned a lot in four years. You're like, I know everything. And then like five years, and you're like I know a little bit, and in ten years, you're like, I don't really know anything. And now, I’ve forgotten all the points, so I really don't know anything.

One time Rob was at my office and I was like, I think I have asthma or something, and I was like, what's a good point for asthma, and he said some point, like, kidney 21. And he looked at me, you don't know where that point is, I was like, I have no idea. I think if you're looking to do something different, you have to really step out of your box, you have to step out of your clinic, you have to do things, do different. There's this guy I like, Joe Dispenza, he's got this book, Breaking The Habit of Being Yourself, and he said to have a different outcome, you have to be a different person. So, you wake up in the morning, and you brush your teeth, and  then you put your pants on, and then you go downstairs, and you push the coffee button, and you drink the same kind of coffee and the same kind of cream in your favorite cup, and then you drive the same way to work, and you see 20 patients, and you make $10,000, and then you go to the bank, and then you go to Hawaii, and you repeat and you repeat, and I'm a  quintuple in Virgo so I can really get into that. And as long as you're doing that, you will get the exact same result, the good and the bad. Trying to do things differently, shop at different places, wear different clothes, listen to different music. My partner is an executive at Apple, and one of  the things he does all the time is he listens to like new comedy, and he'll listen to really new music, like, what the young people are listening to, and going to museums and doing things in nature. It seems very obvious, if you don't expose yourself to -- and reading different kinds of books. I'll just ask people, what's the best book you read in the last year, and no matter what they said, I’d go and read it. I don't care if I'm interested or not. Like, oh, this is about the Civil War, who gives a shit. Like I don't care, I don't want to read about a war, but then something clicks, and  magic can happen. For me, that's how it was with the placebo. I read that article about that NIH study, and it was like that same moment with doctor Wu, like the light bulb ‘I know what to do now’. I know how to make myself completely obsolete. I know how to make Chinese medicine obsolete. From this particular application of all the goodness of Chinese medicine, we're still using like it's deeply steeped in Chinese medicine, but the conventional deliveries of herbs and acupuncture in humans are gone.

Dr. Pentland: Awesome. So, getting out being different, if you do want to grow, I am a firm believer that you have to become comfortable with being uncomfortable. You have to ride on that edge where you might fall. The other point you brought up, that is so poetry, I love Tim Ferriss. Something he said in his Titan book was about keeping childhood curiosity or childlike curiosity, and listening to your partner and listening to what the kids are doing. I sit with my children, and I encourage them. Often they ask these questions, and you're just like, shut up. It’s so ridiculous, but now I listen. They ask things that are right in front of our face, that we've looked past as an adult, and it might be revolutionary. My son saying, why can't I just ask Google a question when I'm walking down the sidewalk? I'm like, that is a good question. And that is probably going to be possible in your lifetime.

Kirsten: Yeah, it's really true. I remember the first time when I watched like an adult movie with my kids, my son was a gymnast. He was  like six or seven, and the first  time they had like a show, when they did the cross tumbling, they played Rocky’s music, the Tiger, and he gets in the car, and I was like, how was your  warm-up for your performance, and he's like, it was good, I really liked that  music. And I was like, what music, because I didn't see the warm-up, and he does this, ‘duh-duh-duh’. I was like, oh, Rocky. We watched Rocky. The whole time, he will not stop asking questions, why is Rocky talking that way, why does Rocky look that way, why is Rocky trying so hard, why does he care so much, is he going to lose to Apollo, and I was like, shut up, watch the movie. It was the same thing, their brains are just like, well, why is that, why is that, why is that. I mean, I've even started like trying to dress differently intentionally. Sometimes I wear my son's T-shirts. Because people relate with you differently. I broke my back last year, and I was in this very obnoxious –

Dr. Pentland: I remember, you looked walking so well.

Kirsten: I'm good now, but I had to wear this brace. It was like from my chest all the way to below my pelvis. And it was white, it was like a Jason mask for your body. Full of straps, and it was really interesting wearing it because people were flipped out, like, you'd be walking to someone, they'd be like, oh, you must have just gotten out of mental hospital, or something is really wrong with you. You know what I mean. It's the same thing, and you show up differently. Even just tiny things, like, go buy some new socks.

Dr. Pentland: I'll speak for myself. I just moved from Vancouver where I've been for over 20 years, and uprooted my family of five, and moved to the Okanagan Valley in British Columbia, it's absolutely beautiful.

Kirsten: I’ve been there, it is beautiful.

Dr. Pentland: I hope to see you soon next year, but what I had to be most careful of I believe is not transplanting my microcosm from the old to the new, and being open to what is supposed to be here. I’m in the new space. That's been  challenging though to undo programming, to not dress the same way, but those little tips you gave are brilliant. It just started with wearing a weird shirt.

Kirsten: Or like if you're a girl, buy a new lipstick. I always wear brown lipstick. Get a new haircut or don't wear makeup for a week. I mean, I can speak of the girl things.

Dr. Pentland: I think that's great. I'm giving a talk tonight at a fertility clinic with some people, and thank you for that piece. Actionable items, go home. I love the quote about if you have a goal, it’s as much about the goal as it is about the person you need to become to achieve that goal. I love that. When people come to my clinic I'm like I can't, no one can guarantee you that you'll get pregnant and have a baby, but I can guarantee you that if we connect and you take the steps and we work together and you persevere, that personal transformation is a guarantee. Again, we talked about how big that can be and how scary that can be, but boiling it down, the bottom line is what we want to see is a change. Even if we've worked together for a cycle and that next cycle maybe feels like a step back, that's feedback we're looking for change, that's good, we're seeing that your body moves and is ready to be guided. We want change, and change can happen that trajectory thing with just something as simple as going-- I'm going to recommend them all get a different haircut tonight.

Kirsten: Yeah, or go start eating a kind of foreign food that you never ate before,  go eat Ethiopian food, or start eating on the floor, or change your bed cover, or I like it on your body, because it's all day long, and you're just experiencing something different. If you always wear pants, buy a dress.

Dr. Pentland: Yeah. You know what is funny, because I teach people this mindful hand washing technique that I have. It's like add four seconds to washing your hands, be in that moment, feel the water, smile, think of something you're grateful for and then take a deep breath. It's that simple. Or I bought this thumb ring, a thumb ring I don't know if you've ever worn one, but they're kind of awkward. It’s simply just a commitment to myself to remind myself to breathe. And something as simple as breathing I think that's the best stress relieving technique on earth, besides sleeping. That's great, thank you for the reminder of the small things. Because sometimes I think maybe even young practitioners in the clinic think, oh,  I've got to produce and create this big plan and make sure things have big shifts, and because I'm supposed to be a master that fixes people. I think those are fantastic places to start.

Kirsten: Seriously, I recommend every person who takes care of people to read that book, One Small Step Will Change Your Life, because the guy talks about like when you're asking people to make behavior change, if it's too big and it  scares them, you turn on the amygdale, which is the flight or fright part of the brain. And when someone is afraid, they don't have access to willpower or creativity or all the things that are necessary for behavior change. He goes through these clinical examples, where like this woman was super overweight, high cholesterol blah, blah, blah, blah, single mom, and the guy's a psychologist,  he's following doctors around to look at the interactions around behavior change,  and the doctor says to the patient, you're so overweight, you've got to lose  weight, you've got to stop eating so much, you got to go to the gym, you're going to have a heart attack and orphan your children. You can see the woman's is like, okay, okay, and he's like, you know she's a single mom, she does not have time to be in the gym four times a week, she's  poor. And the guy steps in front of her and he says, hey, do you have a TV, and she says, yeah. He goes, could you do something for me, and she said yeah, and he goes, just on one commercial per night, could you stand up next to your chair and march as fast as you can. And she laughed, and he says, if they laugh, you know that the amygdala is not on, because there's nothing funny about dying. So, she comes back next week, and he goes, how did it go, and she goes, I marched for two. And he said, what you gave her, and this is my favorite part of this book and one of beautiful clinical moments, he's like, what you gave her was the confidence that she can do something different. And every time you give her something that she can achieve, it's like one more brick in her confidence, like, I can do this, I can do this. As opposed to giving them, like, I used to give my patients a huge book of all kinds of shit that. Well, I'm just like get all the plastic out and blah, blah, blah, blah, blah, blah, and then be like apologizing all the time.

So, then you're reinforcing the story called you don't have time to do everything to take care of yourself. You're never going to get that.

Dr. Pentland: That's powerful, and that's a good advice. I’m always, like, I’m going to send you a bit of a Cadillac plan or recommendations, but I want you to come back to me next week, and we will discuss what you feel you can do and is sustainable for you. But I like that explanation of it, turning on a portion of brain that causes stress, and then of course they're going to have an aversion to doing anything probably. Because it’s like, oh, that's stressful. Wow, good tips. We boiled it back down to some good clinical stuff. Okay, so, conceivable.com is there on a Facebook page probably that they could send people to or YouTube or whatever.

Kirsten: Yeah, just go to the conceivable.com, that's where the blog is. The blog is super useful stuff to share. We do have a Facebook page, it's not that active really. Mostly, people are interested in the shop.conceivable.com page. If they go to the resources, there’s a ton of my courses for free that they can watch. If you send me an email -- I forgot to make a code for this webinar, but if somebody's watching and they want to order a starter pack and try our herbs, they get a box that has each of our 12 formulas. Eight ounces with a hundred bottles for dispensing, they get me for an hour of training, and all for 799 bucks. But they will do a 100$ off for your podcast listeners, and all they have to do is  email me at kirsten@conceivable.com and say, hey, I saw you on Spencer's podcast, and I'll discount you back. What they get though is for 799$, they get $2,500 worth of herbs. It’s practically a cost for us. We know that 70% of people who start using our herb system, continue to use it right, because it's got a five-year shelf life, it's completely hypoallergenic, it's about five times stronger than anything else on the market, it tastes good, it's very portable. People typically love it.

Dr. Pentland: Okay, I'll get that information from you, put it succinctly in the show notes as well, and we promote on the social world.  I will for sure be giving links wherever I go, just straight to Conceivable. I would continue chatting, but we should just maybe come up with another topic.

Kirsten: We can do a part two.

Dr. Pentland: And beingfertileprogram.com. As soon as that is up, I will be podcasting on there too, so, that will be very similar but different. I'm so excited for that because I think what you've developed is so awesome. Anyway, I will let you get back to creating, and I will get editing down this video so it can get out to the world, thank you so much.  

Kirsten: Just one other thing, while Conceivable is the name of our company and we launched it as a women's health herb company, we do have a sister brand called Viv wellness. That's our line of herbs that are for practitioners who are not focused on fertility. The truth is they're the exact same formulas because they are constitutional formulas, they're not fertility formulas. But people don't want to use women’s health called Conceivable, and so, if you go to the Conceivable shop.conceivable.com, you will still get access to Viv wellness. If you order either one, you're still going to get the same formulas. And I also do consulting, so, practice consulting and personal consulting, so, people can email me too for that.

Dr. Pentland: It’s so awesome. You would be a valuable resource for so many. Thanks again. Thank you so much. I will let you know as soon as this is ready, and thank you all for watching. Get a hold of Kirsten. If you've got any further questions, you can also post them online, and we'll see you again soon.

Kirsten: Okay, happy holidays, everybody!