Rethinking Health from First Principles
Why I Started this Substack
There’s a moment I’ve seen over and over, in practitioners and in serious “patients” alike.
You’ve already done the trainings. You’ve tried several protocols. Your bookshelf is full of cleverly titled programs that all promised to be “root cause.”
You sign up for one more course anyway.
The material isn’t bad. The instructor is sincere. The model more or less makes sense.
But a quiet thought lands halfway through:
“If I fully adopt this system, will I be right back where I started—only now with different language and a bigger to-do list?”
At that point the issue isn’t the content. The issue is the relationship you’re being asked to have with health itself.
That’s what this essay is about.
The moment another course becomes the problem
For me, this realization came after years of moving through three worlds:
I started in gyms and clinical psychiatric behavioral work.
I spent 25 years in technology leadership.
Somewhere in the middle, I was diagnosed with Crohn’s disease and eventually reversed it.
Across all of that, I learned to do what conscientious people do when something matters: read widely, find experts, stack best practices.
In the health space, that strategy worked… until it didn’t.
I watched the pattern:
A new symptom or stuck case triggers urgency.
You look for “the” model that finally explains everything.
You learn the system, adopt the language, buy the tools.
For a while it helps. Then it starts to generate more questions than it answers.
Instead of stepping back, you look for an even more advanced system.
The more sophisticated you become, the harder it is to admit that the method of searching may now be part of the interference.
At some point, “doing everything right” quietly becomes your new problem.
The health attention economy in the background
This isn’t just a personal quirk. It’s the predictable outcome of the environment we’re all working inside.
Health information no longer arrives mainly through textbooks and quiet clinics. It comes through:
search engines tuned to show what is safe and popular
social feeds, podcasts, and influencers
pharma marketing and wellness brands
and, increasingly, AI systems trained on all of the above
The result is a health attention economy.
Every part of that stack is rewarded for keeping you engaged, hopeful, and in motion. Almost none of it is rewarded for helping you settle into a durable sense of “I understand what’s happening now, and I know my next small move.”
If you feel oddly restless and underpowered despite consuming more health information than ever, you are not imagining it. The environment is set up to keep you rotating through models, not resting in understanding.
Once you see that, a natural question follows:
“What would it look like to rebuild health from the ground up, in a way that doesn’t depend on the next protocol or personality?”
That question is the origin of Health Under Control.
First principles as explanations you can understand and trust
“First principles” sounds abstract, but the idea is simple.
A first-principles approach to health asks:
What are the things about human physiology that do not change?
What constraints will be true no matter which diet, device, or era we are in?
What patterns can a person test in their own life without needing to believe anyone?
From there, everything else has to line up.
In practice, that means preferring mechanistic explanations that you can understand and trust over stories that require belief or brand loyalty.
For example:
“Your nervous system is stuck in fight-or-flight. Here is how breathing, posture, and schedule are keeping it there. Here is a concrete way to test that for a week and notice the change.”
makes a different kind of demand on you than:
“Your energy field is depleted. You need this specific sequence of supplements and sessions to recharge it.”
The first invites you into a chain of cause and effect you can track. The second asks you to outsource your judgment and hope the story is true.
First principles, in this project, means we refuse the second. Not because it is “unspiritual” or “unscientific,” but because it is not testable enough to build a life on.
Why your doctor can’t do this job (and shouldn’t be asked to)
There’s another layer to this.
As health has been pulled into the attention economy, we’ve quietly reassigned expectations onto physicians.
We still need them to:
rule out danger
treat acute crises
manage clear disease
use drugs and procedures to keep people alive
At the same time, we’ve started to expect them to:
unpack long histories of fatigue, anxiety, and gut disruption
interpret half a dozen functional lab panels
rebuild someone’s relationship with food, rest, movement, and stress
act as long-term guides and investigators
That is not what medical training, scheduling, or liability structures are built for.
So patients leave ten-minute appointments feeling dismissed. Doctors leave full days in clinic feeling falsely accused of not caring.
The system is not failing because individual physicians are lazy or uncaring. It is failing because we are asking it to play a role it was never designed to play.
Naming that clearly matters, because it makes the real gap visible:
between acute medical care on one side
and the chaotic swirl of health courses, protocols, influencers, and devices on the other
The work here sits in that gap.
The missing seat and What I’m actually doing here
The missing role is not:
a mini-doctor operating without a license
a charismatic influencer with a favorite protocol
a motivational “accountability coach” who keeps you compliant with someone else’s system
The missing seat is a guide who:
stays strictly within non-medical scope
has time to look at nutrition, breath, sleep, pacing, and meaning together
works under explicit principles that keep your judgment central
To make that concrete, I use two internal maps:
Five Stages of Health – a map of how people actually move through the modern health landscape: from managing symptoms, to chasing diagnoses, to stacking protocols, to realizing that control and optimization have quietly become a new stressor, and finally toward letting health re-emerge as interference is removed.
Seven Principles – a set of rules for how I agree to work. They filter out any method that requires belief, hides its mechanism, or increases your dependence over time.
You don’t need to memorize those maps to read this Substack. You just need the underlying promise:
Anything that lives here must have a clear rationale, a mechanism you can follow, and a way for you to test it yourself.
That applies to functional labs, breathing techniques, nutrition, and emotional processing techniques.
It even applies to AI. Large language models are not here to tell you who you are or what to do. Used well, they are thinking partners that help you externalize patterns, stress-test ideas, and see what you already suspect is true. They are held to the same first-principles standard as everything else.
How to Understand this Substack
You don’t have to move through the site in any strict order, but there is a logical progression:
Start with About.
That’s it. Figure out where you want to go from there. Follow what feels alive.