Alone we are ignored,together, we make a difference.
No one is ever turned away because of cost. We ask for something more valuable
than money — your participation.
Welcome.
Tell me briefly what brought you here, and how I can help.
However it comes out is fine — there is nothing to choose from, and no wrong
way to say it.
What brought you here tonight?
Some people see their own situation in the list below.
Others would rather skip it and just say what is going on. Both are the right
way round here — take whichever is less work tonight.
Something is wrong and you do not know how serious it is.You do not have to guess. There is a lot of ground between
“wait and see” and the emergency room, and someone will help you
work out which part of it you are in.
Start with a phone call. Your doctor’s
office has a and a
nurse will talk it through with you. They are genuinely good at this, they
do it all day, and it costs nothing.Most practices have
a phone line where a nurse takes calls about whether something needs to be
seen, and how soon. It is often not advertised — you ring the main
number and ask to speak to the triage nurse. There is no charge and you do
not need an appointment to use it.If it feels more serious than that, go to urgent
care. You will usually be seen faster than at a hospital, and the care
is good.If it feels life-threatening, call 911 or go to the
emergency room. Do not wait until you are sure.Which one is yours to decide, not ours. But our
advice is to assume it is worse than it looks and take the more cautious
road. And trust your body — if it is telling you something is wrong, it
is probably right.The best possible outcome of a trip to the emergency room
is walking out saying well, that was a waste of an evening — but I
feel a lot better knowing it is nothing serious.
You cannot get it out straight.Every time you try to explain what has been happening it
comes out jumbled, or you remember the important part afterwards. Talk it
through in Your Health Story below, in whatever shape it arrives. You
end up with it set down plainly and in order, in your own words: something you
can read back, or hand to somebody.
You have an appointment and you know you will forget half of it.Everybody does. Preparing for the Visit gets it all
onto a single sheet beforehand — your first question, what is different
since last time, and the one point that has to be raised even if nothing else
is.
None of these is quite it.That is the ordinary case, not the odd one. Three examples
cannot cover why anyone is awake at two in the morning, and you should not
have to squeeze yours into one of them to be taken seriously. Your Health
Story below starts with a blank page and nothing to choose from —
you say what is going on, in whatever words arrive, and it takes it from
there.
Each one opens on this page. Close it and you are back exactly where
you were.
What you can do right now
Your Health Story — Say what is happening the way you would say it to a person. Nothing to fill in, no forms — it asks, you answer.
Preparing for the Visit — The face time with your doctor is short and under pressure, so you need to come prepared — with a little knowledge, and a list of the concerns that matter most to you.
Where conditions overlap — Two diagnoses, and the part in the middle that neither specialist owns. For when you are ready to look at how it all connects.
Nothing here is a diagnosis, and none of
it replaces your doctor.
Why this exists
Most people who look something up at two in the morning are not doing research.
They have a worry, they do not know how serious it is, and they do not know what to
do next.
Nobody here will tell you what you have. What we can do is help you understand
what is being said about you, and help you walk in able to use
.
A complicated problem does not fit into a
seven-minute appointment. That is the clock, not the doctor being careless. But it
means people routinely leave with the question they came in with, because the words
they needed were never said in a language either side could use.
What we actually do
Take research that is real but written in a vocabulary that locks most people
out, and say it plainly without changing what it means. Every claim carries
,
and the grade travels with the claim.
A through F, plus U for “the evidence genuinely
does not resolve this.” Not a permanent label — the current reading, which
changes when the evidence changes. What it must never do is get stripped off
somewhere between the study and you. The one people find strangest is
.
Most grading stops at F and treats
“we don’t know” as the bottom of the scale. It is not on the
scale at all. F means we looked and the evidence says no. U means
we looked and the evidence does not settle it either way — and
those are completely different things to be told about your own body. Collapsing
them is how a genuinely open question comes back to you as a closed one, which is
.
Anne was given closed answers for years about
a condition nobody had actually settled. Each one was delivered with the
confidence of a finding. The evidence underneath was U the whole time, and
saying so out loud would have changed what was looked at next.
And the harder half: noticing when something already known in one field would
answer a question in another, where
.
has been standard in quality improvement for decades and is
almost absent from the exam room — not because anyone rejected it, but because
it came in through a door that owns institutional processes and never crossed into
clinical ones. The barrier is the finding.
Watching how a number moves over time,
rather than asking whether today’s number is inside the normal range. One
reading tells you where you are. A run of them tells you which way you are going
and how fast — and the direction is usually the thing that matters. Factories
have used this since the 1920s to tell an ordinary wobble from something actually
changing. It is the same question a doctor is asking, with better arithmetic
behind it. Which is why
.
A value can sit inside the reference range for
years while travelling steadily across it — low end to high end, one
direction, never once flagged. Nobody is being careless. Each result is compared
to the population it came from, not to your own previous results, so the
comparison that would show the movement is not the one being made.
Three questions people actually ask
Each one opens here and answers in
full. They run in order — the second only makes sense once the first is
settled.
Questions people ask
Am I smart enough for this? — The short answer is yes, and it is a finding rather than encouragement. What looked like genius from outside was mostly method — and method can be picked up.
I found something. What do I do with it? — One observation is an anecdote. Four hundred of the same observation is a signal nobody has ever collected. How to write yours down so it still counts in a year.
Where the arguing happens — The room where disagreement is the point, and where every claim can be contested in public. Not open yet — this is exactly what it will be.
Where this is going — What comes next, segment by segment, with an honest label on each — and the open questions where your answer changes what we build.
What does eGFR mean on my blood test — The number your doctor glanced at, what it is actually measuring, and why a result inside the normal range can still be telling you something.
Intellectual Democracy — how I work with AI — The method, written out. What it looks like when one person and a machine work a problem properly, and why the method is the transferable part.
Vermont Common Sense — Consumer protection worked the same way as the medicine: claims sorted by where the evidence came from, and graded.
My doctor never answered my message — What to send so it can be answered, the five steps to take when nothing comes back, and the one column in a message log that nothing else in medicine records.
Who is doing this
A retired chemical engineer in Bondville, Vermont, whose wife has a rare kidney
disease that took years to name — working with people who have been through the
same thing, and with AI as a research partner rather than an oracle.
What the marks mean
Every room has the lights on. Nothing here says “under
construction” and nothing is hidden for being unfinished — the mark tells
you what you are walking into. The states are worked out from what is actually on
disk rather than decided by us.