The Danger of Being Disconnected

Our lives are adversely impacted when our interactions are purely transactional. We see this play out in devastating fashion in industry, where certain businesses can cause great harm to society due to their insulation and disconnection from the lives they sell to. But this isn't just for businesses. Our personal and professional lives depend critically on organic, face-to-face interactions with real people. In this episode I argue that a successful life needs to be in direct contact with the effects of what we say and do, and that this is only possible by being in real groups with real people.

Suggested Reading Related to Intro Example
American Cartel: Inside the Battle to Bring Down the Opioid Industry by Scott Higham and Sari Horwitz

Episode Music for Intro Example
Coniferous forest by orangery

Transcript

0:43

More than 1 million people have died since 1999 from a drug overdose. 20, 2100 and 6000 or so drug overdose deaths occurred just in the United States. But 108,000, give or take, in 2022. Most of those deaths were due to fentanyl. Fentanyl is somewhat similar to heroin. Heroin is diacetyl morphine. And so you take the morphine molecule, you add the diacetyl group, it becomes more lipophilic, which means it's soluble in fat, and that allows it to pass the blood brain barrier more effectively. The blood brain barrier is essentially this protective barrier that regulates the passage of substances between the bloodstream and the brain. So you have morphine, then you have diacetyl groups onto morphine, which makes it heroin gets into the brain more quickly, and then the body just metabolizes morphine as usual. So heroin essentially is a kind of faster to the body version of morphine. And again, that's because of the lipophilic aspect of adding the diacetyl group to its chemical structure. Fentanyl, which is causing most of the deaths now from drug overdose, that's another opioid. And it also crosses the blood brain barrier rapidly. And in fact, it does so even more quickly than both morphine and heroin. So obviously, fentanyl is highly lipophilic, right? Fat soluble. It has a high affinity for the opioid receptors in the human brain. And this is what contributes to fentanyl's rapid onset of effect and potent analgesic. Right, pain relieving effects. It's that increased potency of fentanyl compared to morphine and heroin that is a result of its unique chemical structure and pharmacological properties. So it's estimated that fentanyl is anywhere between 50 to 100 times more potent than morphine, and therefore to heroin as well, since even with heroin, you're still just metabolizing morphine in the body. And so fentanyl is at the heart of the current opioid epidemic. It's killing hundreds of thousands of people. And drug overdoses in general have killed over a million since 1999. Now, some argue that the pharmaceutical industry is largely to blame for others, and at first blush, that might sound a little bit od. The pharmaceutical industry is obviously there to provide pharmaceuticals, medicines to people who are in pain, who are trying to alleviate a set of symptoms. But a lot of what the pharmaceutical industry manufactures are painkillers. And those painkillers can become or are addictive. And when people go on to a drug for, let's say, after a surgery, they can become addicted to that drug. And then when the surgery is done and they've healed, the addiction doesn't go away. And because if they can't find regular prescriptions, as they would when they were going through their healing process, then they might look to the black market, they might look for those drugs on the street. And some argue that many of the individuals who are addicted and who are on the streets today started by taking regular medications manufactured by the pharmaceutical industry. So some argue that the pharmaceutical industry actually operates like a drug cartel. You've got manufacturers at the very top, you've got wholesalers that are in the middle, and then at the street level, if you will, you've got the pharmacies. That might sound odd, that pharmacies would be acting as a drug dealer, but there are many cases, particularly concentrated around the South Florida area, but just all across the US, where the pharmacies are writing prescriptions too liberally, and you barely have to show any evidence of a sickness at all in order to get the prescription. And sometimes these drugs can make their way onto the black market and this type of thing. So it's been going on for decades now, and there's been a number of lawsuits kind of thrown at the pharmaceutical industry, and it's become a really big problem. In fact, the DEA has even investigated pharmaceutical companies and manufacturers the way they would a cartel. And that's because companies, pharmaceutical companies, tend to collaborate with each other. They get extremely high powered lawyers, they get lobbyists, and they will actually create legislation that protect their industry and their market share. In fact, the DEA has investigated the pharmaceutical industry on a number of occasions. Now, they would start out by doing kind of what any kind of investigation would do, and they would go to the lowest level of the organization. So you might be assuming, let's say the doctors are the problem. Let's say most doctors are good, but some doctors are bad, and they're giving out pills when they shouldn't. And maybe they're helping them get to the black market. That would be like the lowest level of an organization. And if they're willing to write those prescriptions for drugs, for cash, sometimes for sex, and all kinds of different things, usually for cash, though. And the DA investigations, they soon start to realize that, well, if we just keep arresting the lowest level, the doctors, they're just going to have to do that all day long. There's just so many doctors, you're never going to really stop the problem. And historically, this has been the case that every time you take down a doctor, then another one comes up, and you can't really squash the problem. So then the DEA starts to kind of move up the organization, if you will, and they realize what they really need to do is to go after the drug distributors and the manufacturers. So this is what brings us to the pharmaceutical companies themselves. Now, if you read about some of this history here, the lobbying groups that work for Big pharma will actually pass legislation work to pass legislation that limits the DEA's ability to go after the drug distributors. So it used to be the case that you would have to prove that a company's behavior caused what you would say, imminent, what you would call imminent danger to a community. Right. But the industry, the pharmaceutical industry, was able to change the word imminent to immediate. So this is an example of how the lobbying groups and the lawyers can get together and go after the law and actually change the legislation. And when you change the word from imminent to immediate, then that's essentially a bar that the DEA can't meet, because how do you actually prove immediate danger? So it's these kinds of loopholes that people find in legislation. And so you had all these guardrails in place that would have allowed de to do its job and to prevent, arguably, an opioid epidemic from even occurring. But when those guardrails get removed by the lobby groups, pharmaceutical industries, and all of its allies and institutions that kind of work in their favor, and people even within Congress that are allying themselves to that industry, it just becomes impossible to fight something like an opioid epidemic. Now, in 2018, this really came to a head, and there was a big lawsuit filed against big pharma, and it was actually done by a coalition of lawyers and investigators, and it represented just thousands of different counties and cities and native american tribes, people who were adversely affected severely by this opioid epidemic. And arguably because of some of the legislation that had been changed by the lobbyists and the allies in Congress that are working with pharmaceutical companies. And so this big lawsuit was basically filed against big pharma in 2018. And you've got Paul Farrell, this young lawyer. At the time, he was really wanting to go after these drug companies for what they were doing. And again, he had to kind of find his own loopholes to make that possible, because, again, the usual guardrails had kind of been removed because of what the lobbyists and big pharma were doing. And so he found that maybe these companies were in violation of public nuisance statutes, and he was able to kind of take that angle on it, and it would be considered a public nuisance because they were essentially flooding communities with so many drugs. And so he got together. He basically put together this dream team of lawyers and some really hotshot names, and he had to kind of go meet them, go for coffee with them, convince them. Some of them originally said no, and then some of them essentially jumped on board. You've got some really kind of eccentric personalities, but these really high profile lawyers. He assembled this team because that's what you need to do if you're going to go after something like Big Pharma. You need the best of the best, a real hotshot team put together. And so he went to some of the biggest firms all across America, built his team, and built his case, and the whole thing ended up being consolidated basically into a massive piece of litigation called a multi district litigation. So again, you've know, just these thousands of counties and cities and native american tribes, and it just would have been kind of just exhaustive and exhausting to go over all these on an individual basis. So they bring it all under one roof, under this MDL, this multi juristic litigation. And so you've got hundreds of, or if not thousands of these kind of lawsuits that are pending all around the country in all these different courthouses. And what you're doing is you're bringing them all together, consolidate them into essentially one case for the sake of efficiency. Right? Put it to one judge, and one case, this in 2018, went on. And during the procedure, there was talk about whether or not they should allow, basically this DEA database called Arcos, which tracks the paths of every single pill that is manufactured, distributed, and dispensed in America. Because if you release that, you know, it would show, well, here you've got, let's say, this small pharmacy in southern Florida, and you're just sending millions and millions of pills there, but the population there isn't big enough to take all those pills. So something's wrong here. And it would be indicative, if you look at the Arcos database and you see these smaller communities being flooded with pills, it's indicative that the pharmaceutical companies are guilty, either directly or indirectly, of essentially flooding these communities with pills and essentially getting them leaked into the black market. If you're a company and you're manufacturing these pills and revenue is the bottom line, then you're just going to sell wherever the demand is. And so even if you've got these communities that are really small, but the demand is really high for whatever reason, because the pharmacists, the doctors there are prescribing when they shouldn't be. They're giving it to more people than necessary. Could even be this does happen where, let's say, groups, drug distributors, black market drug dealers, essentially will make their way to places like South Florida because the laws are much more lax, and they will end up getting just a ton of pills that they will then go distribute on the streets. Right. So this demand is higher than it should be in any of these kind of pharmacies. And the Arcos database would showcase. So during the procedure, the judge decided to allow the parties and the plaintiffs of the defendants and the defendants to get access to Arcos. That's that internal de database that shows where all the pills are going and by how much. But the judge actually sealed that Arcos database from the public. But then a legal motion was later brought to the forefront to intervene, and that was filed to make Arcos public. And so, all in all, this legal attack on big pharma has resulted in nearly $40 billion in settlements. And these are all companies. Johnson and Johnson and McKesson and Cardinal Health and Amerisaurus Bergen, and two of them, Malin Crocked and Purdue, have actually settled and are now in bankruptcy court. So it definitely had an impact. It definitely had an effect. And the reason why I brought up the pharmaceutical lawsuit example is because I want to talk about this notion that how our lives are adversely impacted when our interactions are purely transactional. In other words, if you look at the pharmaceutical companies, it's easy to kind of point your finger and say, oh, these are a bunch of bad people, and they were just revenue hungry, profit hungry, and they don't care about lives. And who knows? Maybe for some individuals in pharmaceutical companies, that's true. But I think, by and large, people don't go to work for companies to be bad people. I don't think it's about pointing your fingers and saying it's evil. I think kind of like any white collar crime, it usually starts off pretty innocent. But what ends up happening is that individuals get and groups and companies get disconnected from the effects of their decisions on real people. And they get disconnected, disconnected because of things like scale. So if you're going to go build a pharmaceutical company and you're going to build this organization that serves millions and millions of people, there's obviously no way for you to get to know an individual customer. And so everything becomes very transactional. And business in general is like this. But, of course, smaller businesses are able to still keep communication with a lot of customers. If you're a hairdresser and you run your own little salon, you probably know most, if not all your customers, and you're able to have conversations with them and get to know them. But if you're going to do something that scales to a big company, that's obviously not possible. So as part of doing business, as part of scaling, and as part of having quarterly revenue goals, targets, and all this kind of stuff, everything you do is essentially transactional. And we can see in the case of the pharmaceutical companies, it's not about pointing and saying these people are bad. It's about saying that when everything becomes transactional, particularly with something that affects an individual's health, in this case, bad things are going to happen. People's lives are going to be adversely affected. If all you see is revenue and all you see is profit, and you have those quarterly target meetings, and everything is inputs and outputs, and you're treating individuals as though they're just a number and not real, organic, deep individuals who have real lives and families and connections. If you're going to do that, then there's going to be a lot of collateral damage, if you will, because things become transactional. And you could do this with war, right? You can become disconnected through technology. For example, you might be a drone operator who essentially guides drones almost like it's a video game, and is disconnected from the real lives at the other end. We can do this with social media. We can maybe start getting into arguments and say things that we might not say face to face with individuals. When we communicate only for the sake of finishing a transaction, we are disconnected from the system that would otherwise kind of correct or guide or encourage us to maybe more human behavior. So transactional interactions obviously prioritize the exchange of information needed for a particular task, right? Without delving into the deeper, more personal elements of communication. So the Internet has absolutely supercharged transactional exchanges between humans, that type of exchange, because we're separated from almost everybody that we talk to, right? It's just a text on a screen. And even if it's something like a Zoom call, you can see a face that's obviously still a lot better, but it's still very kind of transactional. I'm not in the same room with you. We kind of say what we say and then we jump off the call. If you look at social media, especially, it doesn't lead to deeper connections or meaning in conversations. If you can even call them conversations. Think about buying a coffee or renting a car or buying a pair of jeans. It's easy to just walk into these places that are actually supposed to be face to face. I guess they are. And sometimes face to face. You got to buy that coffee. You look at the person, but we can still kind of treat it as a purely transactional thing. I'm giving you the money. Give me my coffee. Let me fill out the form. Now give me the car. I rented the car. I just need a pair of jeans. Let's get out of here. I'm not here to be your friend. I'm not here to talk to you. I just want the transaction. And we don't really think that this necessarily affects us, but I think it does, because at the end of the day, humans are meant for organic, messy, nonlinear, deep conversations. That's how we evolve to communicate. So I use that example at the beginning of kind of an extreme example. We've got this pharmaceutical industry. Everything is transactional. They're dealing in something that has to do with human health, which is, like, obviously a very big deal and sometimes personal to everybody. But they've scaled it, and it's just purely transactional. And it's about revenue targets. And you can take what are probably a perfectly fine group of people. I don't think people who go work for pharmaceutical companies are evil people, but they get caught up in this system, and then they can start being part of what is essentially like a cartel, at least according to some. And arguably, that's a good argument, because they will be shipping pills wherever the demand is. And if you don't look into the demand to see why the demand is high, you're just going to keep doing it. That's business. Go for revenue, go for profit. Everything's a transaction. And before you know it, 2021, 106,000 people die. 2022, 108,000 people. Right? A million since 1999. Now, that's not all because of the pharmaceutical industry, but there's a strong argument there that when we flood the streets, which is obviously happening when you send too many pills to these pharmacies that don't really have the population to have that demand, right? So obviously something's getting taken advantage of in the system, and you don't investigate that. And you put the lobbying and laws in place to prevent the DEA from going after, well, from just having the guardrails that are meant to be there, right? And even the lobbying and finding allies within Congress, you can say, oh, well, this is obviously bad. This is evil. I don't really think that's necessarily what it is. I think companies are doing what companies do. They have lobbyists for a reason. They want the government to be favorable to their business. That's what they do. They do that business. And I don't think they're there to necessarily cause a bunch of harm. But you're going to fight to do things that are of benefit to the transactional side of business, not to the human side of business. Right. And when you are insulated and disconnected from the people who are on the other end of that transaction, then it's pretty easy to do that lobbying and to find those allies in Congress and to put things in place or to remove guardrails that were in place that end up causing a lot of harm. It's easy to turn a blind eye. And I think we can do this in our own lives. I'm using the pharmaceutical industry as an extreme example. But anytime we insulate ourselves from the effect that our words or our decisions have, it can cause harm to others. It can also cause a lot of harm to ourselves. And so what does this mean for our everyday individual lives? I mean, it's easy to understand that if people are in positions of power, that the more they insulate themselves from the effect of their decisions and their words, that that's going to cause a lot of harm because they're influential and they affect a lot of people. But I think this can be a bad thing in our own lives, just as our own individuals. The more we get transactional about things, the more we insulate ourselves from what our words, actions, and decisions actually mean to other people. And because of that, I'm arguing in this episode that we need to be in direct contact with the effects of what we say and do, or at least work towards being in more direct contact. Because, again, that is how we evolve. Millions of years of hominid evolution. I mean, organic, messy, nonlinear, deep conversations is really what we're about. There's way more information content in that. So if you think about a group of people getting together as a system, that system provides a ton of feedback. There's error correction, there's judgment, right? If I say something in a group, I can't necessarily just get away with it. I'm going to get people looking at me. Some people might say something based on what I said. There's all kinds of body language. There's eye movements, right? The whites of our eyes have apparently evolved because we can see the way people look in different directions. And that's a huge social cue. Again, I talk a lot about just how the intelligence of humanity is really about social intelligence. It's really operating at the group level. So the way we communicate the information that we get in situations really comes from looking at people, looking them in the face, looking at their hand gestures, looking at the body language, and just having the person in the room. Right. The environment, everything plays such a big role. When you strip all that away and do things on a purely transactional basis, you're no longer in direct contact with the effects of what you do and say. You don't get the feedback, you don't get the error correction, you don't get people judging you. And you might think, well, I don't want people judging me. Well, you do, actually. I mean, obviously there's too much of that. There could be too much of that, but being judged is definitely not all bad. You even need to be offended sometimes. These are critical social cues, critical aspects of the information that we use in communication. Regular social interactions within a group contribute to improved mood, cognitive function, overall psychological and physical well being. This has been well studied, and this just makes sense. There's no way that would not be the case, because, again, we've evolved to work in groups. And so if you think about just kind of group membership and the positive effects that has, and this group membership is essentially the opposite of what's going on. In the extreme case of that example I gave with the pharmaceutical industry, where they're completely insulated from the effects of their decisions and all that lobbying and all those laws that they pass through Congress and the pills that they ship, because that's what the demand is. There's nothing wrong with that from a purely business perspective, just on the surface, that looks like doing business. Why wouldn't you do that? But it's because they're insulated from the effects of those decisions that it causes so much harm. So group membership provides all kinds of things, right? There's emotional support during challenging times. There's stress reduction, promotion of mental well being. There's a sense of belonging when you're in a group. We know that groups foster a feeling of inclusion and connectedness, and that's going to obviously contribute to your mental health and physical as well. Sometimes we just think it's mental, but also physical, right. Think about just joining groups and getting more physically active. And obviously, there's a strong mind body connection. When you reduce your isolation, you can combat feelings of loneliness and isolation. It's good to have companionship, a sense of community. A lot of healthy habits can come from being in groups. There's group activities, obviously, sports and fitness classes. Anything that encourages a level of physical activity you want to kind of keep up with your friends, right? Everybody knows it's a lot easier to stick to a workout regimen when you have a group to go to and they hold you accountable compared to when you try to do that yourself. There's collective knowledge and wisdom, which is just huge. And again, goes back to what I'm saying about the social intelligence, which is really all intelligence as far as I'm concerned, when it comes to human beings. It's not something that's locked up in an individual's head. It's absolutely interconnected to a group. Groups, they provide diverse pools of knowledge and experiences, and all individuals can benefit greatly from the shared insights and perspectives that come from being in a group. Coping mechanisms, right? Discussions and shared experiences really help with coping strategies and enhancing one's mental resilience and just social skills in general. Now, I'm an introvert, so I'm not super big on constantly getting involved in groups and being super social. But I also know that it's critical to have a good level of social interaction for physical and mental health. And no matter how introverted you are, you don't want to be completely isolated. You got to be part of a system where there's that feedback, there's a bit of judgment. The information content is so much richer, scientifically speaking, and it should just be obvious when there is body language, when there are people there, it makes me think of salespeople. Sometimes they kind of annoy me. If you work with salespeople because they always want to jump on a call, they always want to jump on a call. It doesn't matter what you want to do, they don't want to read an email, they don't want to send a text. It can be the most mundane, simplest thing. Jump on a call. Jump on a call and kind of get annoyed. Maybe that's just because I'm a bit of an introvert, but I don't mind sending a text or an email. But I get what they're doing and they're right. It's because when you jump on a call, even though it's still not face to face, it's more real, it's more organic. You get the ums and ods in there. It's nonlinear, it's just real, and it's a far more efficient way to communicate. And if you can go for coffee or maybe jump on that Zoom call and actually see the face, the order of magnitude of quality of information just takes a step up again. So look, I said at the beginning, I use this example of the pharmaceutical industry. Because to me, it's a good example of, look, everyday normal people going into business and thinking in terms of transactions, just on transactional terms. How do we get the revenue, how do we build profit, how do we meet targets, how do we meet the demand? And all it would take is a little bit of good investigation and allowing the DEA, let's say, to do its job, to look at a database like Arcos and see that the amount of pills being shipped to these communities is way more than should be. There's no way that demand is there unless those pills are getting onto the black market. And then you tie in the whole narrative with people getting addicted to these drugs to begin with. And then if they can't get them through regular means, they're going to now find them through the black market. Why are so many people addicted? Why is it more people than there are, let's say, the surgeries or people that would really need the drugs? And on and on. I don't think it's about people being bad. I think it's about people being insulated and disconnected from the impact of their decisions. And I think that does affect our lives as well. That same pattern, our lives are adversely affected when our interactions are purely transactional. And I think it's easy to do that in this day and age. Social media, the Internet, even going into a store, everything we do is very, very, most of what we do is very, very transactional. And think of people just looking on their smartphones as opposed to talking to each other. You even see a couple across the room, they'll be on a date, and they're both looking at their phone. They're not even talking to each other. I think we really got to be careful about avoiding a purely transactional lifestyle. It will adversely affect our mental and our physical health. There's all kinds of benefits that come from group membership. The social support, the sense of belonging, reduced isolation, collective knowledge and wisdom. And these are really big deals. This isn't just about feeling better about yourself or isn't that nice? This directly impacts your ability to make money. This impacts your ability to network, to build your career, to build your physical health. Everything, it all comes down to the information that you're accessing, the help that you can get from others, the communities that you can leverage. Everybody needs people to take you there. I get people who call upon me because I have skills that they don't have and they really, really want what I have. But it's vice versa. They're able to bring me into the fold. They might be part of a community or an infrastructure or some kind of network that I don't have the parlance, I don't have the language to move in, I don't have the connections, but they do. There's this mutual benefit and career opportunity, happiness, money making. Any kind of definition of success you want to use is just massively, massively improved through social interaction. I am an introvert. I definitely recharge my batteries, if you will, by going for long walks by myself. I definitely like my alone time. I need my alone time. But I would never want only that. It would be absolutely detrimental to career, to happiness, to personal and professional life. So if it's true that our lives are adversely impacted when our interactions are purely transactional, when we're disconnected from the effect of what we say and do, then obviously we should look for ways to join groups. And maybe some of you are already part of a lot of groups and do this already, but for maybe some more of the introverted people like myself, maybe it's a little bit harder. You got to really think about how to get interacting. Obviously, there's a number of things we can do. There's hobbies and interests. We can join clubs and groups centered around those hobbies and those interests that we enjoy. And you probably hear that a lot, but have you done it recently? Have you really taken a look and just joined a group and get that organic, nonlinear conversation going? It could be a book club, could be a hiking group, something to do with gaming. There's all kinds of local community groups, right? Events and meetings and workshops usually centered around common interests. Volunteering, I think, is a great one. Always kind of told to volunteer, and I bet you a lot of people think of volunteering again, just on a transactional level. They probably think, well, if I volunteer, then my little contribution might help a little bit. Maybe I'll work for something with a food bank and somebody gets a little bit of food, and that's that. And of course, that transaction is true, and that's good, but it's so much more in that when you engage in the volunteer activities, you're talking to like minded individuals, you build networks, you build connections. I talked to an accountant a while back who said most of his business comes from just this one kind of musical group that he joins, that he ends up talking to all kinds of people, and it's word of mouth and it spreads and it builds his business. It's not why he does it, and it's not why you should do it. But it just shows that there are so many second order, third order effects that come from integrating yourself into a group. It's what we are meant to be doing. So go and volunteer for something. It's not just about helping, which itself, of course, is great. It can lead to all kinds of opportunities in your life, and we all know it'll definitely improve your mental health because helping others always feels great for a good reason. Right? We're meant to collaborate. Fitness classes, online communities. Even though online is still a bit transactional, try to make it face to face if you can. But there are ones online where at least you can kind of get on zoom or something and look at people's faces and just get real conversations going. Most of social media is not about having real organic conversations. It's usually a fight or just people kind of putting a statement out there, and it's kind of just screaming in the void. It's kind of just screaming in the void how many people are really seeing or hearing what you have to say. Right. You have to have the two way actual deep conversation. Professional associations, religious or spiritual groups, support groups. The list goes on and on. Okay, so that's what I wanted to talk about in this episode. Again, I use the pharmaceutical industry as an example. There's a ton of harm that can be caused, and we can say, oh, maybe the business isn't right, or maybe the DEA didn't do enough, and maybe this and the legal system isn't good. We can kind of keep pointing the fingers, and some of that is correct. But at the end of the day, I think it comes from being so disconnected from the people at the other end of the transaction. Companies can obviously improve what they do to kind of make that more human, but it also adversely affects our own personal lives. When we disconnect ourselves from the transactions that we make, from the communications that we have disconnected, from the lives that are affected. We're missing out on so much for ourselves. Yes, we can harm others too, but we really can harm ourselves as well. You got to think about how systems feed off of feedback and error correction and judgment. You need all those things. You make connections, you get the wisdom of the crowd. People leverage you, you leverage them. It's absolutely critical to any definition of success. Okay? And there's all kinds of ways that you can work to find ways to join groups in your own lives. Okay? So get connected, seek out. You don't have to join a ton of groups. I'm not going to either, but I'm going to join some. I want to join some. I do join some. It's important to think about volunteering or think about meeting people that have a common interest. See them face to face, go for coffee, have real conversations. Your mental and physical health will definitely thank you. Okay, that's it for this episode. Thank you so much for listening. Until the next one. Take care. Bye. I. I.