Salmon Upstream, LLC

Developing and implementing real-world community solutions.

Just like old times...

In those bygone days, I was a force to be reckoned with, provided you were over the age of 40 and lived within the city limits of Lynchburg and preferred long-course to sprint triathlons. Ah, those were the days.


From my new office I can look at my time trial bike hanging on my wall like an exhibit from a past era. In those bygone days, I was a force to be reckoned with, provided you were over the age of 40 and lived within the city limits of Lynchburg and preferred long-course to sprint triathlons. Ah, those were the days. Now I gaze at that outlandish bike with its three-spoke carbon wheels and blade-like frame and can't help but see the cosmic irony: time trial bikes are analogous to healthcare.

I know, here we go again... (Cue the Whitesnake video...) h

I was never much of an athlete, but I have always liked biking, and there have been moments in time where I managed some success in competition against my peers. I hold to the belief that some of this hard-earned success was due to science. I like to research stuff and use it to advantage, and that is exactly what I did when I wanted to get a proverbial leg up in triathlon-ing.

Cyclist are a funny breed. The hardcore will sell a loved-one or spare organ to save weight on a bike, or shamelessly leverage the house to buy components they believe will make them go faster. I am not immune; there was a time when I made spreadsheets comparing dollars spent to increments of 100 grams of saved weight -- roughly ¼ pound. As in a burger. I am not going to tell you what comes next. I recommend against pointing out the fact that the water in 2 large bottles weighs 1360 grams -- over 3 pounds -- if you happen to be riding in a group of men who routinely shave their legs.

When I wanted to go faster on a time trial bike -- a bike designed for a solo rider's absolute speed, ignoring comfort or handling or safety or potential impotence -- I looked at the data. And that data is related to the wind, because wind resistance is the main thing holding you back. Right away I found an interesting stat: 85% of the modifiable drag of a human on a bike is due to the position of the rider's torso. In other words, by far the most important factor is how the rider sits on the bike. Turns out it has nothing to do with what stuff is made of carbon fiber or what pro has signed the frame, the bike just needs to fit right.

So...85% has nothing to do with the bike. Well, as they say in both France and Lithuania: bollocks.

We seem to be failing in the world healthcare. We are certainly performing below the metric I set when I compared myself to other middle-aged triathletes while systematically disregarding anyone I felt had more time to train, more natural talent, or fewer children than me. The WHO regurgitates a lot of data on our travails in this arena, and there seems to be a hauntingly similar stat: 85% of the health of an individual is due to the environment in which they live, not the delivery of healthcare.


You heard that right: it matters more how and where you live than it does what doctors do to you when something goes wrong. And yet, like a cyclist obsessed with bolting on every high-dollar go-fast gadget made by man, we continue to pour money into the healthcare blackhole without taking a few minutes to think about the repercussions of our fruitless efforts, or even consider why -- despite our incredible advances -- we might be failing. Miserably. The cost of healthcare continues to climb: between 2012 and 2017, the per-patient spend for diabetes in the US went up over 25%. Twenty-five percent. Here. In the US.

Every time we create a new treatment, the cost is equitable to outfitting a bike with a comprehensive purple-anodized bolt kit: nothing is going to change except the size of the credit card bill.

What would happen if we devoted the same collective effort and financial leverage to the community that is the source of all that drag? We intend to see.* For sure, solving problems is not a way to make money, which is by far the greatest driving force in modern society. But, as stated here at least a baker's dozen times, there is nothing preventing such a lewd quest for speed. So, as they say in Letterkenny: pitter patter, let's get at 'er.

*This ludicrous project was once just a rumination in my arguably tangential brain, but now there are others. Smart, innovative, motivated, successful others. Read about them here.