A Different Perspective

One day, about 18 years ago, I was walking along the streets of Kerala, India behind two women strolling side by side—a Catholic nun and a woman in a Muslim chador. From behind, it struck me how similar these outfits were despite the different religions. And then it seemed completely obvious: well, of course they are, they both evolved to deal with oppressive heat and pelting sand in the Middle Eastern desert thousands of years ago.

Although I had been raised Catholic, it had never really occurred to me that these two religions had evolved and existed side by side, just like the two women in the street. The next five months of my around-the-world journey would bring into perspective just how similar they truly were.

Me entering the Ajmer Sharif Dargah Sufi shrine in Rajasthan, India

Changing Your Mind

It’s hard to change your own mind, and I think it gets harder the older you get or the longer you’ve known something to be true. But being able to change your own mind is critical to happiness, success, and yes, I believe, longevity.

This was one of my 101-year-old grandma Betsy’s greatest traits. She did not hold hard and tight to an identity, she was humble and willing to employ critical thinking, and she didn’t take everything handed to her by her tribe as gospel. After nearly eight decades voting as a Republican in deep red central Wisconsin, she said to me in 2016, “This Mr. Trump doesn’t seem like a very nice man, does he now? I won’t be voting for him.”

The ability to change perspectives keeps your thinking nimble and young, childlike, one might say. The ability to zoom out and see a broader perspective keeps you from fixating on negative experiences or seeing small problems as monumental. Being able to change your mind also helps you accept awe and wonder. Those things can’t exist if you insist that you already know and understand everything.

In Carol Dweck’s book Mindset: The New Psychology of Success, she proposes that a growth mindset—a mind that is characterized by believing you can change, evolve, and improve—is critical to being happier and more successful. Having a growth mindset, rather than a fixed mindset that sees skills and abilities as immutable, has been proven to make you a better parent, spouse, colleague, and boss.

A book that will change your mind on changing your mind

Also, keeping an open mind and being open to change keeps you from being a curmudgeon, and nobody likes a curmudgeon.

Changing Your Mind: Drugs

In my last job as the CEO of an interventional psychiatry company, I saw up close the business of industrial-strength mind-changing.

Depression, anxiety, and PTSD are some of the most difficult illnesses to treat. They are characterized by repetitive negative thinking and doom loops, often brought on by a person’s own biology or traumatic experiences.

While anti-depressants and anti-anxiety medication certainly help shift these thinking patterns for some, there are new and emerging drugs that get to the root of the issue in a very different way: creating brain plasticity to rebuild thought patterns.

One day, I was introduced to a patient in one of our clinics. A mother, about my age, who had two teenage daughters. She told me she had been suffering from overwhelming treatment-resistant depression for nearly two decades. With the help of ketamine therapy in our clinic, for the first time in her life, she told me that she could finally feel the veil lifting. She would usually get one or two lucid weeks post-treatment before her old thought patterns would begin to return. But those weeks were life-changing and with regular treatment, her life was indeed changed, as was that of her children.

Ketamine and psilocybin therapy both work by re-plasticizing the brain. Under the right clinical guidance, they can help change thinking paths, lead people out of depressive ruts, and help them look at things from a different perspective.

Changing Your Mind: Children

Children don’t even have to bother changing their minds. Human brains are actually quite plastic until the early twenties, and a child’s lack of experience frees them from preconceived notions and built-in defaults that can keep the rest of us stuck. To them, almost everything is seen with a fresh perspective.

My nine-year-old daughter made me the nametag below after replacing my official nametag at a grand opening event for one of our new longevity clinics.

My next nametag: Meghan, talks on phone all day

I asked her if she even knew what a CEO was.

“Yeah, it’s someone that talks on the phone all day long,” she replied authoritatively.

“Hmm, what do you think daddy does?” I asked, now curious. He manages a few rental properties that we own.

“Oh, dad? He fixes toilets all day.”

If my husband and I had ever been wrapped up in the self-importance of our own work, we were quickly and humbly disabused of that by a grade schooler.

The Marshmallow Challenge is a great example of the benefits of childlike thinking. It’s an 18-minute experiment where teams are told to build the tallest free-standing structure using 20 sticks of spaghetti, tape, string, and a marshmallow, which must sit at the very top.

The Marshmallow Challenge: Apparently, harder than it looks

The experiment tested teams of kindergarteners, MBAs, and CEOs against each other. (Given I fall into the latter two categories, this test doesn’t bode well for me.)

The kindergarteners soundly beat MBA students and CEOs who wasted critical time managing social status and executing a single, flawed plan. Meanwhile, kids excelled because they lacked the fear of failure and thus immediately began to build and test, quickly iterating and fixing mistakes in real time. A child’s natural, play-based mindset inherently values iterative learning and instinctual collaboration over the rigid, theoretical planning common among adult professionals.

In short, an open mind is a more successful mind. A rigid mind keeps you stuck (and getting beat by kindergarteners).

But anyone who spends much time talking to children already knows this. I regularly have illuminating conversations with my nine-year-old daughter, Alice.

Alice: Someone at school told me you can’t have two moms.

Me: Oh, really?

Alice: Yeah, and I told them that wasn’t true. Because you know those three little girls that come to our house to play sometimes?

Me: Yes.

Alice: Well, they have two moms. And it’s fine. So, as long as you love each other, it’s ok. You could also have two dads. Or one dad or one mom. It really doesn’t matter.

A year or so later, I overheard her in the back of the car talking with her friend Gemma.

Gemma: You know, once you get married you have to stay married forever.

Alice: No, you don’t. My auntie got unmarried from my uncle. All you have to do is tell them you want to get unmarried and then you don’t have to be married anymore.

What Alice had seen in the real world had become her reality of what was both possible and acceptable. She was not bogged down by politicians, or laws, or 2,000 years of Catholicism.

For Alice, these were not complicated situations. And honestly, when I look at them from her perspective, they indeed are not.

Changing Your Mind: Travel

The good news is that if you don’t have access to, or don’t particularly like, drugs or children, there is a third way. A different kind of trip.

For me, the medicine that unleashes a new perspective, childlike curiosity, and an open mind is travel.

There are real psychological reasons for this.

When you travel, you are forced to slow down and take things in because everything is new and different. It’s why you can’t remember what you did on a random Tuesday two weeks ago, but you remember days from your vacation last year. In our hurried lives, days blend together as we move through school pickups, Zoom calls, and loads of laundry on autopilot. Travel forces presence and attention because your brain can’t easily anticipate what’s next. To Shake The Sleeping Self is one of the best-named travel memoirs for that reason. It is from this state of mind that you can begin to see things in a new light.

When we are removed from our routine, other things begin to shake loose. Our brains may not actually become more plastic from travel, but freed from routine, our brains are allowed to follow different pathways. You try new foods, you get the courage (or peer pressure) to try new experiences, you experience different religions or political structures. You see that there are many wonderful humans out there just like you, who don’t live just like you. You see countries that seem to do better on many fronts, and you come back demanding more from your life, maybe even your government.

Sometimes it’s good to feel small: Me at Candi Mendut, a 9th Century Buddhist temple in Central Java

Travel also has the ability to make you feel small, in a good way. I once visited a small village in the Czech Republic where eight of my great-great-grandparents emigrated from. I found the town cemetery, retraced my family’s journey, and given the still-rural village life, could almost grasp what it must have felt like in the late 19^th century when they left. I was transported long enough and far enough that suddenly my concerns from the year 2022 felt quite small in the grand arc of history.

Travel also opens us up to awe. A sweeping vista, a thousand-year-old temple, stories of perseverance a century ago. Psychologist Dacher Keltner says of awe that “it quiets the ego so that you’re not thinking about yourself as much.” Awe has been proven to help people feel better mentally and physically. In part because it changes your perspective, moves you and your ego away from the center of the universe.

Sunrise in Central Java at Borobudur Temple, the world’s largest Mahayana Buddhist temple

In a lot of ways, travel does for the mind what ketamine does neurologically: it re-plasticizes calcified thinking.

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Back to Kerala

Which brings me back to those women on the streets of Kerala. On that same trip, I visited mosques in northern India, Catholic cathedrals in Goa, a Sikh temple in Rajasthan, and a Hindu temple in Calcutta. In Indonesia, I watched the sun rise while sitting atop the Buddhist Borobudur temple and made offerings at Hindu temples in Bali. In Japan, I learned about Shintoism.

Me, the day I learned about Shintoism, Itsukushima Shrine, Hiroshima, Japan

If Catholics and Muslims had ever seemed very different from one another, they certainly seemed less so in light of the Eastern religions. And if I had ever thought the world was organized around my own religion (which certainly seemed true growing up in Catholic school), I was quickly disabused of that idea too.

Beyond the religions, I experienced different people, different cultures, and different ways of doing things. I don’t think you can see all of that and continue to think about the world in quite the same way.

For me, at the age of 28, I began to realize that things I’d been told my entire life were just one version of the story—a version heavily influenced by time and place—like a nun’s habit and a chador built for unforgiving heat and sand, not unquestionable truths. Traveling helps you do that. It doesn’t allow you to keep believing everything you think.

I could tell you that I experienced profound changes on that trip, and I did, particularly on the topic of religion. But profound changes are not the only point.

I still travel regularly and do not always experience mind-altering revelations. But on every trip overseas, I see something that doesn’t make sense, something that causes me to question my own beliefs or look differently at my own culture, or something that inspires me.

However minor, there is always something to soften my calcified thinking, something that causes me to stop and question, and something that for a moment can bring me back to a childlike sense of curiosity and wonder.

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Could Grandma Have Lived to 120?

The Power of Hormones: Heart & Metabolic Disease

The Power of Hormones: Cognition & Alzheimer’s Disease

Muscle and Bone Loss As We Age

My grandma fractured her femur in her late nineties while living alone, which prompted her move into assisted living. She degenerated quickly from there. It has always made me wonder, if that hadn’t happened, would she have been healthier for longer?

It’s common knowledge that if an older person breaks a hip in old age, they will often die shortly after. When a hip fracture occurs at 65 or older, roughly 30% face death within a year, and half never return to their prior level of independence.

But aren’t brittle bones just a part of growing old? Isn’t getting weak a natural part of aging?

Yes, But

Yes, but it doesn’t have to be so bad, so fast, or so young. Grandma Betsy was 98 when this happened, but plenty of people — and women especially, who account for 70% of all hip fractures — are dealing with fractures and muscle weakness much earlier than that.

This week I’m covering sarcopenia and osteoporosis — muscle and bone loss — why it happens as we age, and where hormones come into the picture.

Post menopause, women begin to lose both muscle and bone at an accelerating rate. Low bone density can lead to fractures, and paired with weakening muscles, the two can significantly lower the quality of life as we age.

It’s the Estrogen (Again)

According to Dr. Vonda Wright, whom I came across at a women’s health conference, both men and women build bone until roughly age 25 to 30, after which bone loss begins for everyone — but the rate changes dramatically for women at menopause.

• Estrogen directly affects the balance between cells that build bone and cells that break it down — when estrogen drops, bone loss accelerates.

• Women can lose 15 to 20% of bone density during perimenopause from estrogen loss alone.

• 40 to 50% of women will develop low bone density, and during the menopause transition, bone mineral density can fall roughly 2% per year. That adds up to something close to 10% over a decade.

The same hormonal shift affects muscle. Estrogen directly stimulates muscle cell repair and regeneration, so as it drops, muscles don’t rebuild as efficiently. According to UCLA Health, women lose up to 10% of muscle mass per decade after 50, roughly double the rate for women aged 30-50.

Betsy at 98

Betsy clearly prolonged her strong bones and muscle longer than most. Spending nearly her entire life on a dairy farm with a high daily milk intake probably helped. She also exercised daily. In addition to raising six kids and working as an emergency room nurse, she told me she walked four miles every day, as long as it was above -20 degrees outside. I remember her lifting weights while she watched Suzie Orman on TV. And she once told me, “Oh, I only ate red meat about once or twice a day my whole life.” So, clearly, her protein intake was probably adequate.

But What About The Rest Of Us?

You probably don’t live on a dairy farm and if you’re eating that much red meat, I have so many questions.

First, I think it’s important to understand why we’re talking about muscle and bone loss together. They are not separate problems. Muscle pulls on bone — literally — and that mechanical force is what signals bone to stay dense and strong. When you lose muscle, you lose the stimulus that keeps bone healthy. They decline together. They are also both negatively affected by estrogen loss, and so they begin to decline at the same time and at a more rapid rate for women after age 50.

Given this, what should we be paying attention to?

1. Protein

You may not realize it, but you’ve already been pulled into this conversation.

One of the major side effects of GLP-1s is muscle loss (studies show that roughly 25 to 40% of the weight lost on these medications comes from lean mass, meaning muscle and bone, not just fat), and so most patients are being told to eat more protein. As the number of people using GLP-1s increases, we’re seeing the market take notice. Protein now seems like it’s everywhere –from health articles to the McDonalds menu and everything in between.

And while I don’t always believe in the way America likes to go about these things, the focus on protein is real and important not just for GLP-1 users, but for the rest of us as well.

Protein is the raw material your body uses to build and repair muscle tissue. But it also directly supports bone — about a third of bone mass is made up of protein, primarily collagen. Studies consistently show that higher protein intake is associated with greater bone density and lower fracture risk, particularly in older women.

The old recommended daily allowance (0.8 grams per kilogram of body weight) was set to prevent deficiency, not to support an aging body trying to hold onto muscle and bone. Most researchers studying this in midlife women now put the target closer to 1.2 to 1.6 grams per kilogram — roughly double what most of us were taught.

2. Creatine

If protein is having a moment, creatine is quietly having one too. It’s one of the most well-researched supplements out there, and for good reason: it helps your muscles produce energy during exercise, which lets you train harder and recover better.

For women in midlife specifically, research shows creatine combined with resistance training meaningfully improves muscle mass and strength. It’s inexpensive and well-tolerated. And we need all the help we can get.

3. Strength Training

Betsy was onto something with those weights. When muscle contracts, it pulls on bone, and that mechanical stress is what signals bone to stay dense. Lose the muscle, and you lose that signal — which is part of why muscle loss and bone loss tend to happen together.

On the muscle side, a Frontiers in Endocrinology meta-analysis found that resistance training produced an average gain of nearly 1 kg of fat-free mass in postmenopausal women — consistently, across both middle-aged and older participants. You can build muscle after menopause. It just requires actually lifting.

The LIFTMOR trial put postmenopausal women with low bone mass through a high-intensity resistance and impact training program — no hormone therapy — and found significant improvements in bone mineral density at the hip and spine. It didn’t just slow the loss, it helped build it back. Even in women who were already behind. A 2025 network meta-analysis in Scientific Reports analyzed 49 randomized controlled trials involving more than 3,300 postmenopausal women and found resistance training consistently ranked in the top interventions for improving bone density at both the spine and hip.

4. Hormone Therapy

Like heart disease, metabolic disease, and Alzheimer’s, hormones play a key role in bone and muscle loss. And they can play a role in helping us fight it.

As estrogen drops through perimenopause and menopause, the cells that break down bone start to win over the cells that build it. At the same time, lean muscle mass — which had been slowly climbing through a woman’s premenopausal years — begins to reverse course right at the start of the transition.

A 2026 study found that postmenopausal women on hormone therapy were 69% less likely to have low bone mineral density than women who weren’t. A 2025 study found that combining resistance and jump training with hormone therapy produced even greater bone gains than resistance training alone — though resistance training by itself still reliably builds bone, including in women already diagnosed with osteoporosis.

For muscle, the research suggests hormones alone aren’t enough, the benefit seems to show up when you pair them with actually lifting.

5. Get Your Baselines

The women’s health experts I follow tend to recommend getting a good baseline of where you stand with muscle and bone today.

InBody Machine

Based on their advice, I became a regular visitor to one of our clinic’s InBody machines (to get body fat and muscle percentage), and eventually bought a Withings scale that would tell me this daily. As I’ve begun more intentionally introducing creatine, protein, and strength training, I’m interested to see if my muscle percentage budges upward and the fat percentage does the opposite.

DEXA Scan

I also got a DEXA scan this year to understand where I stood on bone density. At 45, I showed strong bones and no concerns yet. (I recognize that it probably helped that I was also made to drink copious amounts of milk by my dairy farm-raised mother). Note, DEXA scans can also give you your fat and muscle percentage, but aren’t as easy (nor recommended) to do regularly, which is why I prefer the scale or InBody.

As a patient of one of our longevity clinics, I also get regular blood work and hormone level checks. That includes check-ins with my provider on symptoms as hormonal issues don’t always show up in bloodwork alone.

Conclusion

I don’t think Betsy set out to optimize anything, though she did live intentionally with her daily four-mile walks, regular strength training, and healthy eating. The dairy farm and red meat intake were the luck of circumstance. But it turns out that she was doing most of it right.

I think about her when I read all of this research. She didn’t have access to any of it, but we do. And the good news is the basics haven’t changed much: eat enough protein, lift something heavy on a regular basis, and if you’re in perimenopause or beyond, it’s worth having a conversation with a doctor who understands what’s happening hormonally. Sprinkle in a bit of creatine and use the benefits of today's technology to get your baselines.

Over the past few weeks, I’ve been talking about Bioidentical Hormone Replacement Therapy (BHRT) and how empowering ourselves with this information can contribute to longevity.

In my role as the CEO of a longevity medicine company, I am exposed to some amazing experts in this space and the latest thinking, and I’m excited to share that with all of you.

Check out my first post on this topic: Could Grandma Have Lived to 120?

In that post, I promised to introduce you to experts in this space and cover longevity and hormones from a few different disease angles, including some of the largest causes of death for Americans, particularly women.

Last week, I covered The Power of Hormones: Heart & Metabolic Disease, an important one since the number one killer of American women is heart disease.

This week I’ll cover another leading cause of death among American women: Alzheimer’s disease. It is the most common form of dementia (60-70% of cases) and it’s important to understand how hormones play a role in the disease development and progression.

This One is Personal

As I already shared, with my grandma Betsy’s genes, one might assume that I’m in this thing called life for the long haul.

However, I had two grandmas. And the other one didn’t pass on the same winning lottery ticket.

My dad’s mother, Alice, was diagnosed with Alzheimer’s in her mid-80s. The disease seemed to come on slowly, and then fast. As anyone who has watched a loved one with this disease can attest to, it is brutal. Watching someone lose their mind – and those times when they can sense that they are losing it – is heart-rending and scary. Several years after being diagnosed, she passed away.

Later, another close family member was diagnosed with the disease. This prompted my dad and me to get genetic testing to see if we were at greater risk. We were.

The APOE Gene

The genetic marker for late onset Alzheimer’s disease is the APOE gene. Each of us has two and they are numbered E2, E3, or E4. An E2 is essentially protective against Alzheimer’s (and fairly rare), an E3 is neutral (and most common), and an E4 puts you at increased risk. My dad and I each had one E3 and one E4.

If you don’t carry the E4 gene, your lifetime risk of Alzheimer’s is around 10%. This risk increases by approximately 2 to 3-fold for individuals with one copy of the E4 variant (about 25% of the population) and by approximately 10 to15-fold for individuals with two copies of this variant E4 genotype (1% of the population).

Interestingly, Alzheimer’s – characterized by protein plaques and tangles in the brain - is the only form of dementia that has this female to male disparity. Vascular dementia – caused by reduced blood flow to the brain, e.g., through a stroke, - doesn’t have the same disparity.

Why More Women Get Alzheimer’s

Why are women more at risk? For years, experts thought it was because women outlived men.

But the latest science suggests it’s something else: Menopause. And specifically the drop in estrogen that comes with it.

The first time I heard this concept was in a Ted Talk by neuroscientist Lisa Mosconi.

She reminds us that many menopausal symptoms – think hot flashes, brain fog, insomnia, and depression – are actually neurological symptoms.

So, what’s happening up there? Estrogen is key for energy production in the brain. If estrogen is high, brain energy is high. Without estrogen, neurons age faster – this aging process can lead to the accumulation of amyloid plaques, a hallmark of Alzheimer’s disease.

Lisa’s work shows that Alzheimer’s starts in the brain in middle age, many years before the onset of clinical symptoms, which generally occur years or decades later.

With the eventual loss of estrogen production post-menopause, the brain experiences a 30-percent drop in brain energy levels.

During menopause, amyloid plaque build-up increases markedly for women, especially when compared to men.

What to Do About It

More recently, in a March 2026 podcast, Lisa Mosconi discusses with Dr. Mary Claire Haver, MD what’s happening and what we can do about it: The Alzheimer’s Prevention Plan for Women: Hormones, Sleep, and Nutrition with Dr. Lisa Mosconi.

First, helpful to state that Alzheimer’s has other risk factors than just being a woman and losing estrogen – over 45% of Alzheimer’s risk is attributable to modifiable factors.

Likewise, many prevention factors revolve around general good health principles, and many that you have likely heard a few (hundred) times at this point:

• Good sleep clears out toxins & plaques

• Good nutrition – i.e., eating real food vs. ultra-processed foods - reduces inflammation and chemicals that our bodies aren’t equipped to handle

• Exercise, which increases blood flow and reduces inflammation in the brain and helps you sleep better. Women with the highest levels of cardiovascular fitness in midlife have a 30% lower risk of dementia.

And Then There’s Hormones

Interestingly, Lisa’s Ted Talk is six years old, and she mentions that hormone therapy is not yet recommended for treating Alzheimer’s. It’s still not, technically. But in 2026, we have far more information and compelling evidence so that women can make more informed decisions.

• What we don’t have: Good clinical trials that have actually tested the effectiveness of bioidentical hormone therapy on the development of Alzheimer’s during the key midlife risk window.

• What we do have: Observational studies that show that estrogen-only therapy is associated with a 30% reduced risk of Alzheimer’s for women who have had a hysterectomy and/ or oophorectomy.

• What this tells us: We haven’t excelled at doing studies that promote women’s health. It’s not a “no, hormone therapy doesn’t protect against Alzheimer’s”, more of a “we don’t know definitively yet”. As is resoundingly true in women’s health, we need more research.

Another expert in this space who I met at a women’s health conference is Louisa Nicola, a neurophysiologist. She shares more detail in her Substack article Menopause is not a reproductive event. She is a great person to follow if brain health, and particularly Alzheimer’s disease, is a topic of interest.

She cites a recent meta-analysis presented at the 2025 American Neurological Association. The study found that HRT initiated within five years of menopause was associated with up to 32% lower Alzheimer’s risk.

She caveats that this is observational and conference-presented, not a completed randomized trial in perimenopausal women. Again, we need more information.

What Else We Know About Hormones & Cognitive Decline

According to Dr. Haver’s book, The New Perimenopause, hormone therapy, particularly transdermal estradiol, has a strong potential to mitigate some of the cognitive decline associated with perimenopause. Specifically, she cites work that shows estrogen therapy can improve executive function and memory.

Starting closer to the onset of menopause has also shown more pronounced cognitive benefits compared with starting treatment later. The higher treatment response to hormone therapy in early perimenopause is likely because it has been introduced before the neuroendocrine system has adapted to prolonged estrogen deficiency.

Where This Leaves Us

Unfortunately, a lot of us don’t have time to wait for the research to catch up. Many of us are going to have to make decisions about hormone therapy without all of the data and before the jury, or randomized clinical trials, are in.

We’re each going to have to do our own risk-reward analysis and use this information to have educated conversations with our providers.

There are certainly risk factors to hormone therapy and everyone is different. But for those of us (including myself) with a low risk for breast cancer and blood clots, who have the opportunity to start hormone therapy prior to menopause, the risks have shown to be incredibly low.

I’m writing this as I hurtle through the air in a metal tube, and it reminds me that there are risks to flying too. The risks are relatively low, but they exist nonetheless. The rewards are obvious: seeing friends and family; exploring new cities, countries, and cultures; being able to do my job. It’s a trade-off I make several times every month.

I feel the same about hormones. My risk profile is low, and I would mitigate it further by working with a knowledgeable provider.

The reward is the potential to stave off cardiovascular disease, brain fog, some hot flashes, and Alzheimer’s.

To me, the trade off feels pretty clear.

Last week I started the discussion on Bioidentical Hormone Replacement Therapy (BHRT) and suggested that it could help all of us, and especially women, live longer, healthier lives.

Check out last week’s post here: Could Grandma Have Lived to 120?

Over the next few weeks, I’m excited to introduce you to some of the most interesting experts that I’ve found in this space and tell you what they can teach us about BHRT and longevity.

I’ve broken these articles into different health categories. This week, we’ll kick off with heart disease & metabolic disease, which are closely linked.

So, if you have a heart and plan to make it past menopause, this article applies to YOU.

I Thought Heart Attacks Were for Men

Here are a few stats that floored me about heart disease:

1. It is the number one killer of American women (kills 1 in 3 of us)

2. Before menopause, a woman’s risk of heart disease is half that of a man

3. After menopause, a woman’s risk of heart disease equals that of a man

4. By around age 70, women start to surpass men in heart attack rates – and have worse outcomes

As Dr. Jayne Morgan, MD, a cardiologist and menopause expert, put it at a January health conference that I attended:

Clearly menopause increases women’s risk of heart disease, but why is that?

In short, because the body stops producing estrogen.

It turns out that estrogen is highly protective against heart disease (and many other things, as I’ll share in the coming weeks).

Estrogen helps keep arteries flexible and protects the inner lining of blood vessels. It helps regulate blood pressure, cholesterol metabolism, and fat distribution. When estrogen declines, those protective pathways collapse, and risk rises rapidly. As estrogen falls, arteries stiffen and visceral fat accumulates around the organs. LDL cholesterol has been seen to rise by roughly 20% and blood pressure creeps up as well.

HRT can replace the lost estrogen and that’s why studies show that HRT is protective for cardiovascular health if started within 10 years of menopause in otherwise healthy women.

Here is Dr. Morgan speaking on How Menopause Impacts Your Risk of Heart Disease.

Here, she breaks down a key gender bias in healthcare—one that is likely keeping a lot of you stuck: Shouldn’t we just allow menopause to proceed uninterrupted since it’s a natural part of aging?

Dr. Mary Claire Haver & The Metabolic Syndrome of Menopause

Another doctor I encountered at the same January health conference was Dr. Mary Claire Haver, MD, FACOG, CMP, an Ob-Gyn and menopause specialist.

I highly recommend subscribing to her Substack for excellent educational content on all things menopause.

I also highly recommend her book The New Perimenopause, which I found to be an excellent starting point to understand the broad array of risk factors associated with perimenopause and menopause.

These span mental health, cognitive function, heart and metabolic disease, osteoporosis, and sarcopenia, among other things. She does an amazing job pulling from her own experience in clinical practice, other experts in the space, and research studies (though, as she notes, we are also pathetically light in this area).

She makes a convincing scientific and clinical case for why hormones, and as she calls it, Menopausal Hormone Therapy (MHT), are critical to treating many of the diseases associated with menopause. (Note, BHRT and MHT are often used interchangeably and are similar, though there are distinctions.)

Dr. Haver has done significant work to promote the message that:

In her book, she clearly lays out how menopause increases the risks for heart and metabolic disease. She specifically calls this constellation of risk factors the Metabolic Syndrome of Menopause.

First, as a level-setting, it’s helpful to understand the medical definition of Metabolic Syndrome. It’s defined as having 3 or more of the following:

• Abdominal obesity (waist circumference more than thirty-five inches)

• Elevated triglycerides (≥150 mg/dL)

• Low HDL cholesterol (<50 mg/dL)

• Elevated fasting glucose (≥100 mg/dL)

• High blood pressure (≥130/85 mmHg)

How does menopause affect these? Let me count the ways.

1. Visceral fat: Estrogen helps keep visceral fat in check. When levels drop during menopause, it can lead to bigger fat cells, especially around the waist. Why is this a problem? Visceral fat pumps out hormones and other substances that create low-grade inflammation, insulin resistance, and muscle loss over time.

2. Cholesterol: Estrogen helps regulate how your body handles fats and works in ways that lower LDL and raise HDL. Estrogen is also an antioxidant, so when it declines, LDL particles can more freely oxidize and become damaging to your arteries.

3. Insulin resistance: Estrogen helps protect women from insulin resistance by supporting glucose metabolism and contributing to keeping inflammation levels low.

4. High blood pressure: Estrogen protects against unhealthy increases in blood pressure. Perimenopause increases the risk for high blood pressure, which in turn raises the risk for heart attacks, strokes, and other serious complications.

My reflection while reading her book was that menopause feels like a game of dominoes, where the loss of estrogen precipitates a cascade of risk factors.

Dr. Haver shares significant evidence and clinical experience showing that replacing that estrogen loss through MHT can help avoid many of the issues above. However, the studies are light and the results nuanced. For example, women on menopause hormone therapy have been shown in research to experience, on average, a 12 percent reduction in LDL. But for some with risk factors, oral estrogen has been shown to increase blood pressure.

I won’t try to get into it here. I’d suggest following her work, reading her book, and using it to educate yourself and to promote better conversations with your own doctor.

So, What Do I Do?

Despite the doom & gloom, this information can be empowering.

Your Heart on Menopause: What Every Woman Needs to Know About Cardiovascular Risk is a great article written by Dr. Haver based on her conversations with Dr. Morgan. It summarizes a lot of the data and risks above but also provides us with a path forward.

A summary of what these experts recommend:

• Get screened early. Start lipid panels, blood pressure checks, and metabolic labs by age 25.

• Know your symptoms. Fatigue, nausea, jaw pain, and dizziness are not “atypical.” They can be cardiac red flags.

• Track your menopause symptoms. Hot flashes, sleep disruption, and mood changes can all reflect underlying vascular shifts.

• Ask your doctor about Lp(a). A blood marker with strong genetic ties that increases heart disease risk, especially in Black and South Asian women.

• Move every day. Exercise remains the single best intervention for heart and brain health.

See, that doesn’t feel too hard, does it?

The BHRT Angle

Lastly, these doctors share why hormone therapy is a critical part of the puzzle:

Imaging data shows estrogen users have stable, healthier arterial walls compared to non-users. It’s most helpful when started early—when vascular tissue is still responsive to estrogen. Once plaque calcifies, estrogen can no longer help.

For those interested, our longevity medicine practices recommend a Cardio CT Angiography (CCTA)—a test that shows plaque build up in the arteries, to know where you stand here. The test is usually around $500 (insurance will cover for some folks depending on age and risk factors) and relatively easy and non-invasive.

I did one of these at age 44, and it luckily showed no plaque build-up (I’ll thank grandma Betsy for that). It felt good to have a baseline. I plan to get another test in the next 5-10 years to see if and how things have changed. But I also plan to do everything I can in the meantime, including estrogen therapy, to ensure they don’t.

The Takeaway

When I saw Dr. Morgan speak in January, she shared an interesting concept. Until the late 1700s, the average human lifespan was 35 and only 50% of people who survived childhood would surpass age 60. With the advent of antibiotics and Medicine 2.0, the average American now lives to age 79, and the vast majority of adults live past 60. Thus, aging is a relatively new problem—but also one we can treat.

Those of us from the 1900s have an entirely new set of risks to contend with

If you take nothing else away from this article and from these experts, remember this:

The loss of estrogen precipitated by menopause has a cascade of dangerous risk factors associated with it—but we don’t have to let aging take its course “naturally”. (Unless you want to die young, which is technically the most “natural” way to go about this).

There are very real things we can do now—from exercise, to regular testing, to estrogen therapy—to live longer, healthier lives.

Yesterday, on August 1^st, my grandma Betsy turned 101. I wrote about Betsy in an earlier Substack article (The Secrets to Longevity) because I work in the longevity medicine space, write about topics related to longevity, and, well, Betsy is pretty much the poster child for longevity.

Betsy was born in 1925, so she hasn’t exactly had access to the latest technologies. That includes cars (when she was born, her family had a horse and buggy), electricity (until she was in her teens), epidurals (and still, 6 kids!), computers (until she was retired), and—the one I want to talk about today—bioidentical hormone replacement therapy.

Bioidentical Hormone Replacement Therapy (BHRT) is Having a Moment

Clearly, BHRT is having a moment. So is perimenopause and so is menopause, and of course that’s related. At first, I thought this ever-presence was just because I was turning 45 right as I became the CEO of a longevity medicine company.

But no, as it turns out, they’re actually everywhere.

My podiatrist mentioned them the other day when I came in with an injured foot. She told me she’s seeing more women “my age” with injuries that wouldn’t heal and unexplainable pain. (Mine was explainable, I fell off of a block at the gym). But she was right that it was taking forever to heal. She claimed these issues were correlated with a drop in certain hormone levels. “Have you thought of getting on hormones?” the foot doctor inquired.

At around the same time as I was starting my new job, The Women’s Health Initiative (WHI)—the study that had scared women away from using hormones since 2002—was debunked. Suddenly, after more than two decades of telling women hormones weren’t safe, in November 2025, they were.

The 2002 WHI study had looked at an older age group and, importantly, synthetic rather than bioidentical hormones when they made their claims that caused the FDA to put a black box warning on hormones for women (but not men). In November 2025, the FDA formally announced the removal of those black box labels and officially removed them in February 2026.

All of this was preceded by the FDA convening an expert panel on menopause and HRT in July 2025 which led to the eventual reversal.

A Foray Into Hormones

In January 2026, I heard from several of the experts from that FDA panel, and many others, at a women’s health conference organized by YPO.

The panel of speakers from the women’s health conference

That included Kelly Casperson, MD, a Board Certified Urologist who spoke about the importance of hormones and sexuality, and Vonda Wright, MD, MS, an Orthopedic Surgeon who spoke about the importance of hormones in sustaining muscle and bone through menopause.

While the topic of the conference was women’s health generally, hormones took center stage (after Jane Fonda’s appearance). I heard (all female) experts across a number of other specialties, including obstetrics & gynecology, cardiology, sleep medicine, neuroscience, endocrinology, and pelvic floor health.

Conference kicked off with Jane Fonda - who went hilariously off script

Some of the talks that most stuck with me the most were from Dr Mary Claire Haver (an OB-GYN), Dr Jayne Morgan (a cardiologist), and Louisa Nicola (a neurophysiologist).

The totality of them completely changed my perspective on hormones.

First, after years of hearing hormones weren’t safe, I found out that just wasn’t true, and it wasn’t supported by data.

Second, I stopped seeing hormones as something unnatural to add to your body—a thing I generally avoid. On that point, Dr Casperson’s words stuck with me: “Menopause is just outliving the useful life of your ovaries. Bioidentical hormone replacement therapy is just putting back what your body has stopped creating naturally.”

Lastly, and probably most importantly, I stopped seeing hormones as “nice to have” or just a way to manage symptoms, like hot flashes and low libido. Women are taught to suffer (see exhibit A: breastfeeding), and so I figured I would just deal with any pesky symptoms as they came. Instead, I began to see hormones as a necessity to avoid some of the most detrimental effects of aging, namely cardiovascular disease, dementia, and muscle and bone loss.

A powerful talk from Dr Jayne Morgan

After that conference, I began quickly coming up the learning curve with my role in the corporate trenches of longevity medicine. I was developing go-to-market plans for new services, writing marketing copy and editing the website, and supporting due diligence on potential acquisitions, among other things, all of which forced me to deepen my understanding in this area—conveniently right around the time I had my first hot flash.

Grandma at 120

This deluge of knowledge, and a burgeoning personal interest, led me to realize a few critical things about hormones.

Which brings me back to Betsy. She lived alone until her late 90s, when two health events precipitated moving her from her apartment into an assisted living facility, where she experienced a rapid decline both physically and mentally.

The first was a fall that broke her femur—likely a result of weakening bones. The second was a heart attack followed by a series of small strokes.

Betsy avoided osteoporosis and cardiovascular disease for far longer than average. (I’m convinced that living on a dairy farm for 60+ years and her daily 3+ mile walks kept her bones healthy). But these diseases of aging eventually got to her, too.

So here was my thought: What if she could have staved off osteoporosis and cardiovascular disease for another decade, or two? Could she have continued her high quality of life until age 110, or 120?

What’s Next

The science suggests that the answer might be yes—and the implications for the rest of us are significant.

In my next few Substacks, I’ll introduce you to some of the medical experts I’ve encountered who are leading the conversation on hormones—along with their books, YouTube videos, and Substacks—and share what they are telling us about hormones and their effects on things like heart disease, metabolic disease, and Alzheimer’s.

I don’t think anyone’s goal is to make it to 120, or at least not if they don’t feel good doing it. I think hormones may offer a way for us to not only live longer, but also live better. And that is the entire point of longevity medicine.

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One of the upsides to being the CEO of a small longevity medicine company is that I get first-hand access to the latest and most intriguing longevity treatments. I’ve gotten the chance to jump into a hyperbaric oxygen chamber (more on that in a future post), I have access to Therapeutic Plasma Exchange (TPE), I’ve gotten my lab and blood work done about six times in the last six months and I now know what things like homocysteine are, I’ve done genetic testing for Alzheimer’s, I get access to high-quality supplements and peptides (at a discount), and I always have someone to call to discuss new treatments and symptoms.

One of the downsides is that I often wear a number of hats, and a lot of them aren’t glamorous. This week, that included trying to take delivery of a new red light therapy bed for our new Cherry Creek location, which meant watching two guys spend three hours figuring out how to get a 350-pound tanning bed-like apparatus through a door and up a stairwell.

For the record, they failed. After several frantic calls to the manufacturer, several more days of delay, another delivery company, and another two hours (including watching the poor delivery guys disassemble the bed on the sidewalk in 96-degree heat), we had our bed.

At some point in the sidewalk disassembly process

Luckily as customers we rarely see behind the scenes (and sometimes I wish I didn’t have to either!). And as much as the grunt work is not my favorite part of the job, I do love seeing what comes out the other side. In this case, we’ve now got a red light therapy bed to complement our longevity services and a new location in Cherry Creek. And I got to be the first to try it out!

In preparation for getting the bed, I ended up doing a lot of research on red light therapy and what I found was pretty interesting and exciting, so I wanted to share it here.

Huberman on Red Light Therapy

A few years ago, I listened to an episode by Andrew Huberman on red light therapy and that was when I first got interested in the technology, the therapy, and the wellness applications. In preparation for our bed, I went back to that episode this week and relistened to it.

Check out the Huberman episode for yourself: Using Light (Sunlight, Blue Light & Red Light) to Optimize Health

In true Huberman fashion, he goes significantly deeper into the paint than any human should. He even provides additional studies, in case you’re the type of person that wants to go even deeper than that. For the rest of us, I’ve summed up some of the most interesting things he shared about red light therapy in that episode.

According to Huberman, low level light therapies (LLLT) – which include the use of red light and infrared light - have been shown to be effective for a large number of biological phenomena and medical treatments.

The way the therapy works – whether you’re applying it to skin, muscles, vision or something else - is basically the same. It works by targeting cells so that they remain youthful and continue to function well, and it helps prevent or reverse aging in cells.

Red and near-infrared light can penetrate deep enough into our tissue to reach the organelles inside individual cells – specifically the mitochondria, which are responsible for producing ATP (our cellular energy). The process of producing ATP also creates a byproduct – reactive oxygen species, or ROS. Think of ROS as the exhaust fumes of your cells’ energy production. They’re not just useless waste – they actually change which genes get expressed in a cell, essentially reprogramming how it functions. And as cells age, ROS tend to pile up while ATP production slows down.

Red light therapy disrupts the normal cycle of aging by simultaneously boosting ATP production and reducing the ROS that accumulate as a result. Less cellular exhaust, more cellular energy – and a cell that keeps functioning the way it did when it was younger.

For skin specifically, a similar process is at play. By going into deeper layers of skin, the light changes the metabolic function of certain cells. The light has sufficient intensity to trigger cell activity – the upper-level cells will ‘burn’ off and the deeper level cells become activated to churn out new cells which then come to the surface. That’s why, as Huberman cites, red light studies are showing promise for things like treating acne and other skin lesions, treating wounds and helping diminish scars, and eliminating pigmentation like red or dark blotchiness.

Other Red Light Therapy Benefits

Understanding the mechanisms above helps make sense of the applications and benefits of red light therapy. Here are a few that I’ve found through my research:

• Faster Muscle Recovery by reducing inflammation & accelerating tissue repair after exercise or physical stress.

• Relief for Pain & Inflammation through the cellular rejuvenation explained above, helping to improve comfort and mobility.

• Increased Energy by boosting ATP production in cells which can help sharpen focus & reduce fatigue throughout the day.

• Improved Skin Health from cellular stimulation that helps heal skin and stimulate collagen production, improving skin tone, texture, and cellular regeneration.

• Improved Sleep Quality by supporting your natural circadian rhythm, creating deeper & more restorative sleep cycles.

• Longevity & Anti-Aging benefits that come from supporting mitochondrial function to slow cellular aging.

We’ve also added a nice perk to our bed – a Pulsed Electromagnetic Field (PEMF) and Vibration mat. The silicone mat laid on the bed amplifies the therapeutic benefit. PEMF emits low-frequency electromagnetic waves and the vibration component provides a massage-like treatment experience. Here’s what I found on benefits of this technology:

• Enhanced Microcirculation by delivering a massive boost to local blood flow and cellular oxygenation.

• Deep Relaxation & Stress Relief through calming of the nervous system and sleep support.

• Lymphatic Drainage comes from the vibration which encourages lymphatic flow, helping to reduce mild swelling and support waste removal.

Getting Started

About six months ago, my first foray into the technology, was an investment in a red light therapy face mask. This one to be exact: Current Body RLT Mask. Red light masks were the talk of my friends and people were claiming great results, so I dove in. I’ve been impressed with how well it works. After wearing it, I notice less redness and my skin looks brighter for a few days. However, the effects don’t appear to be long-lasting and so you have to wear the mask a few times per week to see continued results. This makes sense given how Huberman explains red light impacts on skin – basically it’s ‘burning’ off the old cells and cultivating new ones to rise to the top.

While the picture is sort of frightening, the results are good!

Obviously, something that covers your face and decolletage isn’t going to give the full benefits of red light therapy. For that, you need a fully-body machine and that’s what we’ve invested in at our clinic. Our machine looks a bit like a tanning bed (yes, I’m old enough to have used those), is equipped with 12,000 LEDs, and delivers targeted red (633 nm, 660 nm) and near-infrared (850 nm, 940 nm) wavelengths. It’s also 350-pounds and apparently doesn’t fit into a standard sized door without being disassembled.

Our new bed – worth the wait

To maximize therapeutic benefits, you need to expose as much skin as possible when you’re in the bed. Our clinic provides disposable bathing suits for this purpose. Eye protection is also required and provided. While there are some vision protocols, these require special settings and doctor oversight – otherwise, you should never look directly at the light.

Our bed has several pre-set treatment protocols including Recovery, Inflammation, Cognitive, and Stress/ Sleep so that you can aim to customize for what you need. General recommendation is to use the bed 3-5 times per week with each session lasting 15 minutes.

Customizable Settings

Worth the Wait

While getting the bed was decidedly not relaxing, the bed itself is a much different story. I got to take an inaugural run on Friday and can report that it works great!

The bright side (literally) of my job - someone had to do a test run!

It was, as expected, much like climbing into a tanning bed, goggles and all. I chose my setting (Recovery) and the bed gave me 15 seconds to lay down and get situated before it turned on. The red light felt pretty soothing and a little warm, but not hot. I didn’t experience anything dramatic during the session itself, but afterward I felt genuinely relaxed and energized. Perhaps that was the increased ATP, or it could just be the fact that I wasn’t able to look at my cell phone nor was I dealing with the chaos of the delivery.

Red light therapy isn’t magic, and like most things worth doing – exercise, sleep, eating well – it requires consistency to see real results. But the science is solid and the experience is easy and non-invasive.

If you’re curious about what it can do for you and if you live in Colorado, shoot me a DM for a complimentary session. More info here: ThriveMD Red Light Therapy.

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To me, reading is another form of travel. I love to read books when I’m stuck in place. Immersing myself in other people’s lives, other cultures, and other centuries can be the next best thing to going abroad.

When I do travel, I love to go deeper into a country by reading local books. I like books that talk about the present day and those that span history, as both can tell me more about the place I’m visiting, its deeper cultural undertone, and how it got that way.

I generally can’t handle dry historical books and stick to memoirs, historical fiction, or non-fiction books written by journalists – for the record, journalists write far more palatable history books than history professors.

I also happen to read and travel a lot, so finding good books on other countries is something I do frequently. Probably not a truly marketable skillset, but I have it.

Below are some of my favorite international travel inspiration books, including many from places I’ve traveled to. These are books I couldn’t put down, books that helped transport me to another time or place, or books that better helped me understand the place I was in.

Book #1 - We Will be Jaguars: A Memoir of My People

Author: Nemonte Nenquimo and Mitch Anderson

Genre: Memoir

Geography: Ecuador

Description: A Reese’s Book Club pick, and Reese does not disappoint with this selection. Nemonte, an indigenous woman native to the remote Waorani tribe in the Ecuadorian Amazon, tells her story and the story of her family and her people. This is a current book, as Nemonte was born in 1985.

From her primitive upbringing in the Amazon rainforest, to the missionaries who come to “save” her people, to the push and pull of development and globalization that force her and her family to reckon with new ways of living – it’s a fascinating read that makes you think differently about the costs of “development”. A successful environmental activist, she and her American husband (who co-wrote the book) are also doing something about it.

A page-turner and an incredible story. Couldn’t put it down.

Link: https://a.co/d/03m9FJwR

Book #2 - Kuleana: A Story of Family, Land, and Legacy in Old Hawai’i

Author: Sara Kehaulani Goo

Genre: Memoir, Investigative Journalism, History

Geography: Hawaii

Description: Ok, full disclosure: I’ve never liked Hawaii. I’ve only been twice, both on work trips, and true to American-visits-Hawaii form, I stayed at fancy hotel resorts which led me to believe the place lacked culture and character, beyond some natural beauty. I’m a person that lives for culture, history, and the stories of people, so staying at the Four Seasons Kauai is not exactly my thing. If I wanted to see the inside of an American hotel, I’d head into downtown Denver and skip the long flight and time zone change. (Sorry, I’m kind of a brat.)

This book completely changed how I thought about Hawaii. Which is pathetic on my part, but here we are. An American journalist of Hawaiian descent traces her family’s history on the island and tells a story rich in culture and heritage. She talks about modern-day issues, including the massive diaspora of Native Hawaiians out of Hawaii due to the exorbitant rise in costs that have come with tourism, development, and billionaire land acquisitions. She covers her own family’s quest to preserve their culture and lands, originally inherited from King Kamehameha III in 1848.

This is an approachable read to better understand the cultural heritage of the island —and one that takes your far beyond the superficial tourist layer.

Link: https://a.co/d/0gRfL19T

Book #3 - Stolen

Author: Ann-Helén Laestadius

Genre: Contemporary Literary Fiction

Geography: Sweden

Description: This one became a #1 International Bestseller and a movie recently, so apparently I’m not alone here. Based in the northern Scandinavian tundra, the story follows a young girl and her family of Sámi reindeer herders affected by the killing and stealing of reindeer. In a broader context, this is a book about a native people reckoning with the effects of climate change, xenophobia, and other challenges in this modern era.

The deep dive into an indigenous culture that most of us know very little about is a must-read and particularly helpful to check out if you visit Scandinavia.

Link: https://a.co/d/0057w5h9

Related Honorable Mention: The End of Drum-Time, a historical fiction novel by Hanna Pylväinen that also covers the Sámi people of northern Scandinavia. Based in the mid-1800s in a remote village, a family of reindeer herders is challenged by declining herds and proselytizing missionaries.

Link: https://a.co/d/0bBHHynr

Book #4 - The Bosnia List

Author: Kenan Trebinčević and Susan Shapiro

Genre: Memoir

Geography: Bosnia

Description: Hardly any wars have pulled me in and horrified me quite as much as the wars in the former Yugoslavia, and the Bosnian War in particular. Maybe because it happened in my lifetime, maybe because my dad was deployed there with NATO post-war to give a first-hand account, or maybe because I visited shortly after the war ended – encountering the reality of bombed-out buildings and bullet holes in building facades.

Though perhaps it’s also because the war was just so horrific and unfathomable. Maybe a civil war always is. This story gives the human side of that war. The author, a young boy growing up in Bosnia during the war, tells what he and his family saw and went through. He tells the story of neighbors turning on neighbors and, in his case, a coach turning on his former students. He tells the story of his brother and father being brought to a death camp and miraculously saved. Eventually, the family was able to immigrate to the United States and twenty years later the author returns to his homeland to face what happened.

I read this while in Bosnia in the summer of 2025. And while the war scars are more healed than during my 2006 visit, that makes this book even more important. It’s something none of us should forget.

Link: https://a.co/d/0997vUZk

Book #5 - The Great Divide

Author: Cristina Henriquez

Genre: Historical Fiction

Geography: Panama

Description: A story that tells the human side of building the Panama Canal. From the immigrant workers who came to build it to the locals who were displaced by it, journalists, activists, doctors, and many others.

We visited the canal last April, and it is truly a phenomenal feat of engineering. Most of the tourism focuses on just that, and so it could be easy to miss the stories of the people that got us there. It’s also surprisingly hard to find good Panamanian historical fiction, so if you’re heading to Panama and want a deeper read on the place – this is a good place to start.

Link: https://a.co/d/06IGvdqw

Book #6 - Behind the Beautiful Forevers: Life, death, and hope in a Mumbai undercity

Author: Katherine Boo

Genre: Narrative Non-Fiction

Geography: India

Description: Full disclosure, I was embarrassingly far through this book when I realized it was a true story. And I had to fact check that in several places, because it was frankly so unbelievable.

The author embeds herself in a makeshift settlement on the outskirts of Mumbai, near the international airport, for several years. She follows a number of families and individuals, telling their often heartbreaking stories. From a trash collector, to an aspiring city council woman, to orphans, and the single college-bound student. This is a story of poverty and those in the lowest rungs of society trying to make a life in any way they can. No happy endings here.

My dad and I traveled to India and visited the enterprising Dharavi slum on the outskirts of Mumbai in 2008. This book reminded me of that area, but with a far more human component than what we could have ever picked up on a tour.

Link: https://a.co/d/0cnEShum

Book #7 - Whiskey Tender: A Memoir

Author: Deborah Taffa

Genre: Memoir

Geography: US, Native American

Description: A National Book Award Finalist, this is a contemporary book written by a Native American woman who is a descendant of the Quechan Nation and Laguna Pueblo tribes. She weaves the history of her ancestors with the realities and challenges of present times.

She tells the human side of the news stories of what the American government did to assimilate Native Americans – from her grandparents being sent to Indian boarding schools run by white missionaries, to her parents being put through government job trainings off the reservation. She examines what that assimilation did to her people and culture.

A great read to better understand a culture and history very close to home. The book won more awards than I can name here, so suffice to say, her story is compellingly told.

Link: https://a.co/d/0efhBlvn

Book #8 - A Woman of No Importance: The Untold Story of the American Spy Who Helped Win World War II

Author: Sonia Purnell

Geography: France

Genre: Biography, Historical Non-Fiction

Description: True to my rule, this non-fiction history book was written by a journalist and so it reads more like a thriller. The main character, Virginia Hall, was an American who worked for the OSS (precursor to the CIA) and embarked on a number of daring missions into France during WWII in support of the French Resistance.

She was based in Lyon for part of the story, and since I was living in Lyon when I read this, I found the story particularly fascinating. (Historical sidenote: Lyon was the heart of the French Resistance and the museum there on this topic is incredible). It was hard to reconcile the airy French culture devoted to food and lifestyle that I was living in with the brutality and misery presented in this book when Lyon was under Nazi control only eighty years prior.

A must read, especially if you’re in Lyon. Also, this became a New York Times Bestseller and a movie, so I’m not alone here.

Link: https://a.co/d/0dOaVrRS

Book #9 - The Fall of Heaven: The Pahlavis and the Final Days of Imperial Iran

Author: Andrew Scott Cooper

Genre: History

Geography: Iran

Description: Ok, obviously didn’t travel here, but I believe all of us can benefit from a deeper understanding of Iran. This book was recommended to me by an Iranian-American friend to better understand the current state of Iran through the eyes of history. (Yes, I’m a hit at parties). I know how to suffer, so I can slog through some tough books, but I was delighted to find that this wasn’t one of them. It was written by a journalist-turned-history-professor, so it only somewhat breaks my rule of not reading pure history books.

The book tells the story of the Pahlavi dynasty, the imperial family that ruled Iran for two generations in the 20^th century before being overthrown in the Islamic Revolution, led by Ayatollah Ruhollah Khomeini. What probably makes this so interesting is that it’s more of a biography of the family, who they were, and what they were like, rather than just a boring play-by-play of historical events (although those are in there too). To make history truly page-turning, you’ve got to throw in some “People magazine” vibes, and this book does that.

Link: https://a.co/d/00VY6rdw

Book #10 (a 4-part series) - (1) The Emigrants, (2) Unto a Good Land, (3) The Settlers, (4) The Last Letter Home

Author: Vilhelm Moberg

Genre: Historical Fiction

Geography: Sweden & the US

Description: A four-book historical fiction series written by one of Sweden’s greatest 20^th century writers. It begins during the great waves of Scandinavian immigration to America in the middle of the 19^th century and follows the lives of two Swedish pioneers through their lifetimes over the course of the four books.

The book covers their lives in Sweden and why they left. It speaks in vivid detail about their harrowing voyage across the Atlantic. You follow them across a young America and into the lightly inhabited and frigid lands of Minnesota, where they build a life with other pioneers and encounter Native Americans. You live the challenges of pioneer life.

For Midwesterners of Scandinavian descent, or really any of us who descend from immigrant pioneers to America, if you’ve ever wondered how you got here, this is that story.

The story is captivating, and while I have convinced very few people (none?) to dive in, I will maintain that this series represents some of my all-time favorite books.

Link: https://a.co/d/0aDulyXB

I get asked a lot about how we managed to move overseas for a year. The short answer is that it was a lot of work and stress:

• I had to quit my job and go unpaid for a year (felt super responsible for the 40-year-old breadwinner in the family).

• We had to rent our house out to complete strangers (they were great, but their kids did overflow the bathtub one day and our first-floor ceiling caved in—super fun).

• We had to procure year-long French visas (oh my god, the paperwork) which included a flight to Chicago for fingerprints (two flights for Andy, because they lost his).

• We had to find housing for our family and schooling for our daughter in France, usually in French (which we didn’t speak).

• Once we got there, we had to figure out cell phone plans, metro cards, and other life necessities (I generally let my husband do all of this, and it looked SUPER stressful. Thanks, hon!).

There was more, but you get the point. And while totally doable, it is not for the faint of heart. Nor for people whose parents taught them to be responsible with things like finances and careers. Which is why most people don’t do it.

It was also completely worth it, and we feel incredibly fortunate that this was possible. But it’s still not something that even we can do every year, or even every five years.

At the same time, I hear more and more people say that they don’t want to wait to travel—to really travel, to sink into a place, and to explore—until they are retired. As our parents age, I think many people my age realize that those later retirement years are also not promised.

A couple of years ago at a birthday party, I was essentially telling a woman all of this—how hard it had been to move to France, how I wanted to do it again but on a smaller scale, but how it seemed nearly impossible with a job and a social only child who required constant playmates.

“You know, I have some friends that just spent the summer in Bali,” she replied. “The parents had a co-working space, there was summer camp for the kids, and it was basically a big group of families to hang out with.”

“That sounds like Study Abroad for families,” I told her.

“I think it was called Boundless Life,” she replied.

I immediately began my research. A year later we were on our way to Kotor, Montenegro, as part of Boundless Life’s July cohort.

A Boundless Life Overview

I think that Boundless Life offers one of the most seamless ways for families to explore the world—which is why I want to tell more people about it.

The program allows families to go abroad and truly sink into a new place, while solving for so many of the problems most of us encounter when we think about a trip like this. That includes things like work, housing, friends, and childcare, not to mention figuring it all out in a foreign language and culture.

First, a bit of background on Boundless Life. They truly are a turnkey travel abroad program for families. They have a handful of locations around the globe and in each location they provide housing, a coworking space, schooling or summer camp, and organized activities for families that are staying anywhere from a few weeks to a few months. They generally choose smaller or mid-size towns for their bases, and they have a number of wonderful countries to choose from. When we began our research in 2024, our options included Portugal, Spain, Italy, Greece, Montenegro, and Indonesia. Since then, they’ve added Uruguay & Japan.

Learn more about Boundless Life here

We settled on Montenegro and joined the July 2025 cohort, a 4-week program based in the beautiful, walled city of Kotor, nestled at the end of a fjord.

Getting There & Back – A Travel Adventure

Before I dive into the basics around Boundless Life, it’s helpful to know that the chance to be overseas with the program introduces a lot of other adventures. For us, this included the trip to get to and from Montenegro.

For our trip, we decided that we could be gone for approximately six weeks. I took two weeks of vacation time—the first and last weeks of our trip—and spent the middle four weeks working from Kotor since that’s when we were settled into one place for our program (and I had daily childcare and playmates).

Kotor is not the easiest place to get to, and so we made a bit of an adventure out of getting there. We first flew into Vienna, Austria (easy access from Denver with cheap rental car options) and rented a car traversing the Balkan coast on our way to Montenegro. We stopped along the way in Graz, Austria; Maribor, Slovenia; and Zagreb, Plitvicka Lake National Park, and Dubrovnik in Croatia. From there, we made our way to Kotor. According to the spreadsheet I kept, this was something like 12 hours of driving but split across six days.

Views in Graz, Austria

Plitvicka Lake National Park, Croatia

While I highly recommend this route—it allowed us to see so much of this part of the world up close and visit small towns that are very off the beaten path—I do recommend checking rental car agreements in advance. We were at the Croatian-Montenegro border crossing (a guy sitting in a kiosk) when my boredom in the passenger seat led me to peruse said rental car agreement. Apparently, we lost all liability coverage once we took the car out of the EU (which, the rental agreement stated, was also 100% in violation of the agreement). That is also the approximate time when we learned that Montenegro is NOT in the EU. And pretty quickly after that, we learned that a 4-door Opel Corsa costs approximately $11,000. We crossed our fingers—we would be out of the EU with our Corsa for a little over four weeks.

On the way back, we also took a week to travel from Kotor to Vienna. We travelled through Bosnia, stopping in Sarajevo for several days and some other small towns. We then made our way to Budapest (finally back in the EU—we breathed a huge sigh of relief!), Bratislava, and then on to Vienna where we returned the car (and didn’t mention anything about our journey).

Of course, most of the normal people in our group flew into Tivat, Montenegro or into nearby Dubrovnik. They rented local (legal) rental cars, generally in Kotor, and Boundless helped with both transport to and from the airport and procuring the rental cars.

Boundless Life Basics: Housing, Coworking, Schooling, Community

The real beauty of Boundless Life is that it is turnkey. We showed up in Montenegro, with our illegal rental car, and were immediately provided parking and shown to our new apartment by the staff. Our apartment was in a brand-new building, near the city center, and fully furnished with two bedrooms. The other units in the building were also filled with other Boundless Life families. Our then 8-year-old daughter Alice basically got to experience living in the dorms with all of her friends for the next month.

Within our first few days, there were several orientations to ensure we understood how the school worked, where the coworking space was, what activities we should plan for, and other important information about staying in Kotor for a month. This was also a chance to meet the 30 or so other families that had made the same decision to spend July in Kotor. This was a group we became close to over the next several weeks.

The other beautiful part of our apartment was that the school was on the first floor of the building. That meant that each morning we sent Alice downstairs with a cadre of other hollering children to be kept occupied and amused for most of the day. I don’t fully remember the hours, but it was something like 9am to 3pm and included some late pick-up options and after-school activities. They went to school Monday through Friday, though there were quite a few days off for local holidays.

The childcare hours were a tad challenging with my work schedule since I didn’t get Montenegrin holidays off and the time difference meant that I was generally getting online around 3pm and working until midnight (my company at that time was based primarily on the West Coast). Boundless does provide a pretty nice coworking space, including private booths for those of us who spend too much of our lives in meetings.

Kotor, Montenegro

Adult Summer Camp

While my hours were a challenge, I was lucky to have a spouse who doesn’t work and he took up much of the childcare after 3pm. Lest you think he’s a martyr, his childcare responsibilities generally meant he was heading to a plaza for happy hour and having long, leisurely dinners with other parents as they let the kids run wild, unsupervised through the medieval streets of Kotor with dozens of stray cats (something the city is known for).

A surprisingly large number of parents on this trip didn’t have to work while we were there—stay-at-home spouses, people who did contract work and had taken the summer off, people who were using their vacation time, etc. I’m going to venture that it was roughly 50% of the adults. The rest of us schleps could usually be found most weekday nights hanging out in the Boundless coworking space. It was great—but not as nice as the patios in Old Town.

The upside to this schedule was that after Alice went to school, Andy and I would generally have the entire day free to explore. There were quite a few group activities planned on various days either by Boundless or some of the parents—this included a group boat trip, a trip to a floating restaurant that stored their wine bottles under water (and dove for them), and a wine tasting and lunch. Many of us also organized smaller ad hoc activities, including trips to nearby towns, a tour to the nearby Ostrog Monastery built into a cliff, and hikes in the surrounding area.

Floating restaurant, Montenegro

Winery visit

My absolute favorite was a 30-minute walk up the steep hill behind our building which led to a local “cheese shop.” Quotations used because that’s what Google called it, but it appeared to be a guy and his daughter who had put a patio outside of their house and started serving homemade bread, goat cheese, and wine. The goats freely roamed the property. There were no roads leading there, so they got their necessities delivered by donkey. The food and the views were spectacular.

Goat cheese with a view

The donkey that made it all possible

The only downside to all of this was that as I played all day and worked all evening, I had little time for sleep. I’m not sure how sustainable that would have been for more than a month, but in service of travel and exploration, it felt worth it.

An 8-Year-Old’s Review

Alice loved the freedom she had in Kotor. Roaming the apartment building searching for kids was exciting. We also started giving her a longer leash to go further afield. Since it was a pretty small and safe town, she was allowed to go to the nearby bakery by herself and buy bread and morning pastries. It involved crossing one small street and a huge feeling of responsibility. In the Old Town, which was car-free, we let her run rampant with her friends as we hung out on patios.

The structured summer camp itself was not Alice’s favorite. She was on the older side of kids in her group and she said it was kind of boring. They did spend a lot of time indoors—in part because it got really hot during the day—and I think Alice wanted more freedom. That said, every time we peeked in on her with her friends, she looked like she was having fun.

And, when I asked Alice where she would like to live or go on vacation, she always says Montenegro. Though, honestly, that could be because of the stray cats.

Never enough stray cats

Activities & Other Travel

One of the best parts of setting down roots somewhere for a few weeks is what I call the “concentric circles”—all of the places that are near enough to travel to on day trips or weekend trips that allow you to see so much more than a normal vacation.

For us, this included a trip into the Montenegrin Highlands (a trip organized by Boundless) where we took a tour on four-wheelers and got to see how life was lived in a less touristed part of the country.

4-wheeling in the Montenegrin Highlands

A dip in the lake

On our way back from the highlands, I forced the family to take the long way home and drop into Serbia for a few hours (another non-EU country for the rental car). We had lunch along a river in a small town near the border and visited a local monastery.

Greetings from Serbia

For another long weekend, we spent four days in Albania (also not in the EU). The road trip allowed us to stop in the winery region where we dropped into a local winery that seemed a tad surprised to see us (I don’t think many Americans made it out this way), but was generously accommodating nonetheless.

Our unsuspecting wine tour hosts

We also visited the old Ottoman town of Krujë, a small town north of Tirana built into a rocky mountain slope and one of the last holdouts against the Ottomans in the 15^th century. It’s now known for its fortress and Old Bazaar.

Old Bazaar in Krujë, Albania

In Tirana we had a chance to learn more about Albania. We realized we knew so little about it because it had been the equivalent of North Korea until the early nineties, a hermetic and little-understood country under the rule of dictator Enver Hoxha.

To me, a bit of an experience junkie and someone who can never get enough foreign exploration, these side quests were my favorite part.

The Verdict & The Recommendation

We liked it and we would go back. Many of the friends we met on this trip went on to experience other countries and cohorts around the world. I recently read that something like 75% of families return to do it again, which speaks for itself. We are definitely planning on doing it again. Current plans are to hit up Uruguay over the December break (3-week options available, and it’s Uruguayan summer!) or next summer.

Andy, Alice, and I all got something different and needed from the program. Andy and Alice had built-in friends—which is critical for my little social butterflies. I had an unending list of places, cultures, and histories to explore and the time to sink in and do it.

The infrastructure of housing and school took a ton of the stress out of figuring out where to go and how to manage the logistics, which allowed us to spend our time elsewhere—preferably on patios with lots of stray cats around.

Patio life, Kotor, Montenegro

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DON’T THROW THE BEBE OUT WITH THE BATHWATER

This week a friend sent me an article on French parenting from the New York Times Magazine. Specifically, Did American-Style ‘Gentle Parenting’ Spoil French Children. I was a little bit sad reading it. Were French parents losing their edge? I thought.

The article speaks of detractors of the traditionally strict French parenting style that includes strong boundaries, discipline (including time outs), higher expectations, and generally not making children the center of the universe. It puts it in contrast to the kid-centric American system where kids receive more leeway and a softer approach to discipline (hugs vs. time out).

To be clear, I am not a parenting expert. I don’t even have a large-scale experiment running. I have a sample size of exactly one, and my experiment has been running for slightly more than nine years. Her name is Alice.

What I do have in terms of experience is a child who was raised in both France and the US. And in fact, this very week, she is at a week-long summer sleepaway camp, in large part inspired by, and because of, what we learned from living in France for a year.

Alice heading off to a week of summer camp.

We all want our kids to be happy, healthy, independent, resilient, and well-adjusted members of society. But how do we build that? This is where I believe tearing a few pages—but not all of them—out of the French parenting playbook makes sense.

OUR FRENCH EXPERIMENT

In October 2021, my husband Andy and I packed up our bags and moved to France. At the time, Alice was four and didn’t have much say in the matter. She was a typical American preschooler who also, typically, only spoke English.

On a cool fall day, approximately 48 hours after we’d landed in Lyon, we dropped her off at her new school. A new location, new teachers, new students, and taught wholly in French. I still remember giving her a hug and then watching her bravely walking into the classroom with her little backpack. She never looked back.

Over the course of the next year, Alice experienced life as a French child. Yes, her parents were still American and so this wasn’t full immersion. But the cultural infrastructure we were surrounded by influenced our approach too.

Here are a few places we saw the parenting styles show up differently.

Playgrounds

Our first taste of French parenting showed up during our first weekend living in Lyon, on the playground. In stark difference to an American playground, there were no parents hovering around their children or climbing on any of the equipment. There were very few (no?) toys that would have required adult involvement, e.g., swings. Parents sat around the perimeter, largely ignoring their children.

“Mom, will you come play with me on the slide,” Alice asked.

Thinking fast, I replied, “I can’t. No parents allowed on the playground.” She looked at me suspiciously and then looked around the playground. “It’s a rule in France,” I clarified.

She gazed around at the playground, the French parents around the perimeter unwittingly supporting my lie. “Oh, ok,” she said slowly. “Then, can you teach me how to say will you play with me in French?”

I did, and soon she was off and playing with some little French kids in the universal languages of childhood and hand gestures.

Strollers vs Scooters & Striders

For the first week or so of school, I walked the mile to school each day pushing Alice in her stroller. After a few days of struggling to push thirty pounds of inert weight over bumpy sidewalks, I had a realization: I was the only one doing this. The only other children I saw in strollers were children who were not old enough to walk, actual babies.

One day after school, I ran into one of our new French friends, Baptiste, at the grocery store. I asked him about what I was seeing, “Is it just me, or does no one push their kids in a stroller after they know how to walk?”

He glanced at Alice in her stroller, “It’s highly unusual to see a kid that old in a stroller,” he said politely. That evening, I went to the store and bought Alice a strider bike.

Alice had actively protested her strider bike in Denver, opting instead for the ease of being pushed in a stroller. She was not stupid. But now, inspired by peer pressure, she agreed to start riding a bike to school. As it turned out, she loved the new freedom and independence it gave her. As for us, instead of uncomfortably hunching over Alice’s stroller on the way to and from school every day, now we just had to race behind her yelling désolé! at every fellow pedestrian she nearly ran over.

With playgrounds and strollers as only two examples, the French seemed to have a more laissez-faire approach to parenting in general. They didn’t feel the need to make themselves martyrs at the altars of their children. I have to admit, it was a far less stressful way to parent that I quite enjoyed. The approach also granted kids more independence and agency without as much dependence on parents. I noticed the change in Alice—she ate up the opportunities and became more independent and confident as a result.

Food

For the first several weeks of school, every day that I picked Alice up, she was famished.

“Why didn’t you eat lunch?” I would ask her each day.

“It was gross,” she would complain, with some new complaint about the food they had served her in the school’s cantine.

The school menu read like an adult fine-dining menu. A sample lunch menu pulled from her school’s website one week was grilled hake, an egg omelet, hazelnut potatoes, fried vegetables, and a peach milkshake. On another day, it was sauteed pork with olive sauce, spring vegetables, rice pilaf, peas, organic camembert, and applesauce.

Naturally, Alice was pissed. There was no pizza, no mac and cheese, no chicken nuggets, no fish crackers. Lunch was also the only meal Alice was served during her 8:30am-4pm school day, since the French generally treated snacking as a cultural no-no. The lunches were nutritious and sufficient so that snacking really shouldn’t be necessary, but that was only if you actually ate the lunch.

“It often takes the foreign kids a month or so to adapt to our food,” Alice’s teacher had told us. “Americans generally take the longest.”

Alice’s hunger strike lasted about that long. Through our encouragement or downright hunger, Alice eventually began to begrudgingly ingest the school lunch.

“What did you have for lunch today?” I asked her one day at pickup.

“Something purple, about this big,” she said, holding up her hands to indicate the size. “It had a sauce, and it was gross,” she said, making a gagging noise for effect, “But I ate it anyway.”

Little by little, week by week and month by month, she stopped complaining. Soon, her palate had a massive expansion. She wasn’t eating chicken when we arrived in France (except in nugget form as a ketchup vehicle) and she had never tried lentilles, which she now loved. She was also eating other things like fish, pork, couscous, and hamburger, all of which she had refused to eat back home.

In America, we assume kids won’t like certain foods and we cater to that. In France, they assume kids won’t like certain foods unless they are fed them repeatedly and given no other options. They set their expectations higher, and they were met.

Parent-Teacher Conferences

The starkest difference between American and French approaches to child-rearing came at Alice’s first parent-teacher conference. Alice was four at the time, so I didn’t expect this would be a very in-depth conversation. I was wrong.

“A few questions for you,” the first teacher began, “does Alice move a lot at home? She moves quite a bit at school. She really doesn’t sit still well. It can be distracting to others.”

“Yes, that sounds like her…” Andy began, as I made a concerted effort to stop bouncing my leg.

“Also, does Alice take ‘no’ for an answer very well at home, or does she constantly try to negotiate everything that you tell her to do?”

I wanted to laugh, but the woman looked serious. I began to consider ways I could try to blame this on Andy, but I faltered. “She has a tendency to push the limits,” I said cautiously.

“She is very smart,” the woman began, “And thus a very good negotiator, but this is not a good trait to have for a child. Children need to learn how to listen and follow instructions and do what they are told. She needs to learn to accept and follow the rules like the other children, no exceptions. If she does not, this behavior will persist as she gets older, and just imagine where that would lead a child!” she finished, exasperated at the future possibilities.

When it came to expectations for children’s behavior, there were clearly differences. The French are trying to mint future adult members of society, people that abide by the group rules and fit in. The French think we are raising sociopaths.

This made me confront a lot of my own cultural biases. As I thought about Alice’s behavior, I had to agree that, yes, Alice moved a lot, always questioned the rules, and was readily willing to negotiate and advocate for herself. I just didn’t think it was that big of a deal. Or, if I’m going to lay all my cultural cards on the table, a part of me thought that these traits were actually a good thing.

While France seemed to focus on molding the child’s behavior to meet the needs of the group, that wasn’t exactly how a nation that glorified tech entrepreneurs and cowboys looked at success. Wasn’t questioning the system and negotiating proof of critical thinking and logical reasoning? Wasn’t the ability to stand up to someone (even an adult) a necessary demonstration of self-confidence?

Though I was also willing to concede that our American reverence for limit-pushers and rule-breakers and our focus on the individual had its downsides. Silicon Valley and The White House demonstrate most of them.

A French friend of ours, who had raised her daughters in the U.S. before moving home to Lyon when the girls were in second and fourth grade, explained the difference she saw. “In America, I was shocked at the confidence young children displayed. They would get up and speak in front of a crowd and expect people to listen. You would never see that in French children. To some degree, that’s great. That’s the confidence I want for my daughters, but…,” she continued, “I feel like it doesn’t set them up to deal with failure later in life. French kids, on the other hand, aren’t given so much attention and praise. And no one is really concerned about their self-esteem if they fail. So, they learn disappointment early, and then when they don’t get into the university they want or get let go from a job, it’s not earth-shattering, it’s just the cruel world that they have already been exposed to for their entire lives.”

On one hand, that’s not really selling the place.

On the other, they were probably raising more resilient children and fewer whiny narcissists who couldn’t deal with failure.

In French schools, I noticed that expectations were higher, and it was fine if that led to some failure. In American schools and parenting, there is a focus on building confidence by praising children, perhaps to the point of coddling them or not setting expectations high enough in order to avoid failure. Though, as our friend demonstrated, this can also give them room to learn and grow in a safe environment.

After the parent-teacher conference, Andy and I discussed what we had heard from the teachers. “I mean, I don’t want to raise a criminal or a politician, but I don’t want to raise someone who blindly submits to authority, either,” I said.

“I think we’re beyond the part where she blindly submits to authority,” said Andy. “I think she really needs to learn to follow the rules. And at the very least, she can’t just walk away from the teacher when they speak to her in French.”

“You just want her to be a well-behaved French child, don’t you?” I said, eyeing him.

A few days later, Alice threw a massive tantrum on a street corner on the way home from school. She screamed and threw her bike to the ground. She called me a “stupid head” at the top of her lungs. People stared. I don’t think they were used to seeing this from children around here. I certainly hadn’t seen it from any French children.

“So, are you saying you don’t want a well-behaved French child?” Andy asked.

A THIRD WAY

The New York Times article paints the two methods in contrast, but I think a middle way is actually the key. One that is less coddling than the American way and less disciplinarian than the French way. Authoritarianism doesn’t work, but nor does anarchy.

The cumulative effect of a year of French parenting for Alice was that she gained a sense of self-confidence from the independence she was being granted—or forced—into.

Compared to her friends, I find we have more tolerance and higher expectations on her independence. In France, sleepovers started at age four. So, before Alice had much time to wonder if these were scary, she’d probably done a half dozen of them.

When I told most of her friends’ parents that she was heading away to a week of sleepaway camp this year, I generally heard “my kid could never do that.” I’m positive I would never hear that from a French parent.

After Alice’s initial French hunger strike, she’s also far more open to new foods and has a far better palate than most American kids her age. We have less tolerance for “I won’t eat that,” and more tolerance for her hunger strikes—we know they never last.

I will not claim that we have a better-behaved child or one that’s better disciplined. Through genetics or environmental failure, we still rank relatively low here.

A year of French parenting can’t fix everything, apparently.

One Scandinavian Summer

In the summer of 2022, our family took a six-week road trip from our then-home in Lyon, France through Luxembourg, Belgium, the Netherlands, Germany, Denmark, Sweden, and Norway. We followed an aggressive itinerary that was all mine—more than a dozen cities and towns, full daily agendas.

About a year prior, I had left my job due to burnout and was living in France to recollect myself and decide what I wanted to do next. Not working meant I had far too much time on my hands and applied a lot of that to travel planning. Instead of running a company, I was running my nuclear family through European travel bootcamp.

Along the way, we were tormented by an epic European heat wave (and the realization that most of northern Europe doesn’t have air conditioning). Our five-year-old was pissed at being in a car all the time and away from playmates. Her meltdowns were becoming next-level. My husband threatened to leave us and head home on a train, several times.

Admittedly, I was having a lovely time. My family, not so much. While they sulked, I studied up on Northern European culture, read books, and sought to understand more about this part of the world.

The Happiest Women on Earth

One of the earliest things I learned on our trip was that we were traveling through some of the happiest countries in the world.

The 2022 World Happiness Report rated five of the countries on our itinerary in their top ten. This included the Scandinavian countries we would visit—Denmark, Sweden, and Norway—in addition to the Netherlands and Luxembourg.

The Happiness Report asks respondents in over one-hundred-fifty countries to rate their current lives on a scale of zero to ten, with ten being the best possible life for them and zero being the worst. In 2022, the United States ranked 16th, mostly because Western Europe ran out of countries at that point. These rankings remained pretty consistent over time as did the factors that drove them.

The Happiness Report showed that a country’s performance on GDP per capita, social support, healthy life expectancy, freedom to make life choices, perception of corruption, and generosity were the primary factors leading to greater happiness.

In other words, in the happiest countries people did well and chipped in to ensure their fellow citizens were healthier, freer, and less screwed if something went wrong. Strong social safety nets—from universal health care to subsidized childcare to parental leave—and laws that protected group freedoms—from female reproductive rights to LGBTQ rights—were the norm.

Strong social welfare states were generally funded with some of the highest incomes and taxes globally, which did not appear to dampen the mood but did decrease wealth inequality. Norway, the Netherlands, Denmark, and Sweden were in the top fifteen percent of most equal countries globally, while America fell in the bottom quartile.

But aren’t they able to do that because they’re so homogeneous? Aren’t people more likely to help people that are like themselves? You may ask.

Unfortunately, no. That’s something Americans like to tell themselves to feel better.

The happiest countries have a higher percentage of foreigners than most other countries, including the U.S. As it turned out, in the last few years, immigrants made up seventeen percent of the population in the ten happiest countries while in America it was fourteen percent.

Perhaps it’s religion?

Definitely not, and maybe the opposite. Despite the Scandinavian’s near-biblical “love your neighbor as yourself” social policies, fewer than ten percent of Danes and Swedes and fewer than nineteen percent of Norwegians rated religion as “very important,” compared to fifty-three percent of Americans, whose social policies paled in comparison.

The Scandinavian support system, already lifting its entire populace to an elevated state, is also particularly beneficial for women. Though I suppose you can’t win happiness awards if half of your population is pissed off and making everyone else miserable.

Sweden, Denmark, and Norway were rated the top three best countries for women based on women’s perception of things like gender and income equality, progress on women’s rights, and safety, according to U.S. News and World Report. Scrolling a few pages, I found America at number eighteen.

Sweden and Norway also ranked at the top for the role and influence of women in the workforce, according to The Economist. America came in at number nineteen, below the OECD average and a few notches above Turkey (go us!). America fared poorly because it lacked legal paid maternity or paternity leave, had high childcare costs, and had one of the highest gender wage gaps in the group.

In a Nordic country, you can choose whether or not to have a child and then be legally assured of a generous paid maternity leave to recover. Fathers there can also take paid leave, which has been proven to equalize future home and childcare responsibilities (i.e., the stuff that becomes the proverbial “mental load”) while also changing societal perceptions of gender roles. When it’s time to go back to work, a Scandi couple can drop little Sven at a free or highly subsidized childcare center, while they go back to being paid nearly equally for the same job and with enough legally assured vacation days to rest in the coming months.

By law, American women can count on none of this.

Our options are to leave the workforce (which far more of us do when compared to Nordic women), pay a lot of money to make the problems go away, or get pissed off and make the rest of you miserable. My personal preference was for all three.

American women are killing themselves to make things work. We’re leaning in so hard we’re falling over, wondering what we’re doing wrong, asking ourselves why we can’t cut it.

Instead, it turns out, we should be demanding a lot more from our society and our government. Especially if they’re asking us to have more children. Speaking of that, someone needs to tell JD Vance that it’s him, not us.

The Independent American

It’s no secret that America doesn’t have the social safety nets and support of the Nordic countries or the rest of Europe. To a large degree, our cultural heritage is to wear this like a badge of honor.

We are strong, independent, and don’t need any help from the government! (except road infrastructure, a functioning legal system, a regulated stock market, Medicare & Medicaid, safety & protection from our police/fire/military, public schooling & universities, etc.). Nope, we’ve completely pulled ourselves up by our bootstraps.

Why is individualism and independence such an ingrained part of our culture? How did we get here?

And this is where the Nordics provided another fascinating answer.

I came across some research by an economist named Anne Sofie Beck Knudsen, who studied migration from Scandinavia to America in the 19^th century. In her research paper she showed that people with more collectivist cultural traits were less likely to emigrate than those who exhibited more individualism. She identified collectivist vs. independent cultural traits by using first names—those with more unique first names, even in cultures today, have been proven to be more independent.

As a result, and as proof of this phenomenon, while the waves of independent Scandinavian emigrants sailed west, the towns they left behind became increasingly more collectivist, with rising shares of left-wing voters and growing trade union membership.

The new trends persisted for generations. Her findings were supported by other immigration scholars and the “voluntary settlement hypothesis,” which asserts that self-selection tends to produce groups of immigrants who are more independent than the neighbors they leave behind.

These are people who don’t want to bend to the government or societal norms around religion, education, or taxation—and perhaps just have a bit of a wild streak in general.

People with more collectivist traits might be willing, for example, to pay higher taxes so that their neighbors can have health insurance. While individualists might, say, vote against keeping millions of other people’s children out of poverty by refusing to extend a child tax credit (something America did just a few years ago).

Said another way, the welfare state that made Scandinavia one of the happiest places on earth might exist because the region had dumped all its rugged individualists on America.

People like my great-great grandparents. In 1878 at the age of twenty, my dad’s great-grandfather William Ryan secreted out of his house while his mother was at church, taking money from the sugar bowl to help finance his journey from Ireland to America. Once in America, he paid back the money before traveling west in search of opportunity. Eventually, he settled on the American frontier in a small mining town in the Arizona Territory, more than three decades before the area became a state and at a time when shootouts were still a legitimate way to solve grievances. He married Anna Mary Moloney, who also left her entire family in Ireland to travel alone to America at the age of sixteen, eventually landing in the same Arizona mining town. William was a mail carrier and then a miner, a dairy owner and involved in cattle ranching, and eventually started a general store and pharmacy that expanded statewide. Anna and William had six children, including my dad’s grandfather Bill Ryan who was involved in cattle ranching. Family lore has it that on cattle drives Bill used to sleep with his boots on and his horse’s reins in his hands, lest he need to bolt after the cattle without much notice in the middle of the night.

During our road trip, I tore through Swedish author Vilhelm Moberg’s The Emigrant series about a 19th century Swedish family that emigrates to Minnesota. One of his lines about American immigrants struck me:

“They had left Germany because of revolution, Ireland because of a potato blight, Sweden because of religious persecution. The immigrants were the disobedient sons and daughters of their homelands, who now settled down on a land that as yet had little or no government.”

While the American frontiers populated by William, Anna, and Bill Ryans are technically long gone, the rugged individualism of the people who settled them is not. People in former American frontier regions to this day still demonstrate more individualism, including a stronger dislike of taxes and more opposition to wealth redistribution and regulation. In other words, guess who doesn’t want to go halfsies with you on the cost of health insurance?

Though one does not need to travel to the old frontiers to find the spirit of individualism alive and well in America. It has become a key part of our identity and continues to attract more of the same. I read about it daily in the form of Silicon Valley startups, often led by immigrants. I heard about it regularly when I volunteered with refugees and asylum seekers who had chosen America for a better life. I see it when I ask Alice to pick up her shoes that she has strewn in the entryway and she tells me, “No thanks, I am not your servant.”

So if you’re following, Scandinavia sent America a bunch of religious zealots and people who didn’t play nicely with others and then they were left with a collectivist society that supported strong investments in public welfare which made them a beacon for women’s rights with some of the happiest people on earth.

Ok, but what did America get?

From what I can tell, the Religious Right, Elon Musk, and a higher propensity for disobedient children.

We will not be sending a thank you note.

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Several days ago, my husband and I spent the morning at a Turkish hammam in the ancient city of Istanbul. I was lying on a raised, hot slab of marble in a disposable bathing suit with a woman dousing me in warm water. She had just given me a loofah exfoliation so intense that I came out a different color. My husband was getting a similar treatment on the other side of the slab. After a good shampoo, a massage, and a dry down, we were left to luxuriate with tea and Turkish delights on a small, raised bed.

As I lay there in a trancelike state, I thought about how many other cultures had their own version of the bathhouse and how many I’d encountered on my travels. I’ve visited a Japanese onsen outside of Kyoto, a sauna in Scandinavia, and hammams in France, often run by the large population of North African immigrants. I once spent a weekend in Vichy France enjoying the thermal waters, something people have been doing there since Roman times, but popularized by Emperor Louis Napoleon III in the middle of the 19th century. In America, I’ve visited their imports in the form of Korean spas and Russian banyas.

America, always adept at adopting the old and making it new, is now awash in so-called recovery studios—usually some mix of saunas, steam rooms, and cold plunges. And I’m not knocking these—I go regularly.

Popularized of late by health influencers like Andrew Huberman and Mark Hyman, among others, the benefits of hot and cold therapy are gaining traction. They are talked about in longevity circles, and the benefits are truly compelling.

Our Ancestors Were Onto Something – The Benefits of Heat

A recent Finnish study shows that regular sauna usage can improve lifespan. Specifically, people who do two or three sauna sessions per week versus one can lower risk of death by 24 percent. Spending 20 minutes versus 10 minutes in the sauna lowers your risk of cardiac death by 52 percent. The study was done in Finland, so there wasn’t a control study for those doing no sauna. For most of us, we’re starting from zero and thus the benefits are likely even greater.

How does this work? Heat therapy increases production of heat shock proteins (HSPs). Altered and damaged proteins are a hallmark of aging—but HSPs help the proteins reform (fix themselves) or get eliminated so that they don’t accumulate. Heat also activates our internal antioxidant and repair systems, protecting cells and reducing systemic inflammation, among other benefits.

And it’s not just sauna: hot baths, hot yoga, infrared saunas, and steam rooms all work too.

Heat therapy has also proven it can improve cardiovascular fitness, increase HRV, support insulin sensitivity, and regulate blood sugar & blood pressure. For those who have spent time in the sauna, particularly after a cold plunge, you will not be surprised to know that heat therapy can also increase endorphins for a natural high, reducing stress hormones, and improving sleep.

There is strong scientific evidence that heat therapy offers real longevity benefits. But without a doubt, generations of people have not trekked to bathhouses with the hopes of lowering their blood pressure and optimizing the production of their HSPs, or at least not knowingly.

There is clearly more at play, which I believe has made bathhouses such a universal component of so many cultures across the world.

Understanding the Hammam

In early 2006, through an unforeseen chain of events, I ended up stranded in the Moroccan town of Fez at around 10pm in the evening. I was traveling with a friend, Meredith, and through our inability to speak the local language we had inadvertently missed a train. Missing the train meant we also missed curfew at the hostel in Fez where we had a reservation.

“We cannot let you in,” a woman told us over the intercom. “It’s too late.”

We were joined at the hostel door by a man we had met on the train. He tried to talk the hostel into letting us in and, when he failed, offered to let us stay with him and his family at his nearby apartment. Through the blind trust and stupidity of youth, and a bit of desperation, we accepted.

Soon, a taxi was dropping Tariq (our host), Meredith, and I off on the outskirts of a cluster of concrete housing blocks. We snaked our way through the trash-strewn alleys, and then up onto the top floor of one of the buildings. Tariq’s home was a one-room unit. There was almost no furniture, save a bench around the perimeter of the room with pillows and blankets. We got ready for bed. Meredith and I made eye contact, questioning the sanity of our joint decision.

The next morning, we awoke, jubilant to be alive, and even more excited to see Tariq’s mother Fatima walking in the door with her daughter and granddaughter. If Fatima found it odd to see two Americans awakening in her living room, she didn’t show it.

We ended up staying with Fatima and her family for several days. (The hostel had not exactly earned our loyalty, and we were young enough to prioritize free housing and a good adventure).

This is how I ended up having my first real hammam experience.

The family apartment didn’t have its own bathroom, but rather shared one at the end of the hall with all of the other units on the floor. The bathroom was only a small room with a hole in the ground for a toilet. There was no shower, no bathtub. I quickly saw the logic, or rather the necessity, of a local bathhouse.

On the day of our group bath, Fatima dressed us each in a full body-covering djellaba (head scarf and all), and proudly paraded us through the streets to her local hammam.

At the hammam, we were handed a bucket and some soap and told to undress. We then entered to a steamy room with naked women of all ages. We filled our buckets with water and sat down to await our exfoliating rubdown from a woman making her way through the steam.

Fatima didn’t speak English and we didn’t speak Arabic, and so we managed all of the instructions through a series of hand gestures.

We were lucky to have a teenage translator who seemed to know both languages better than most and she helped as best she could. At one point the women all looked at us and began to laugh.

“No babies?” the teenage translator said, pointing at our chests. Apparently, our lanky Northern European bodies were a bit of a novelty around here.

More laughing.

“I’m glad these women are having such a good time with us,” I laughed to Meredith, despite being the target of the joke.

The hammam was clearly a place for socialization. It was a chance for connection and laughter. In a world where women covered nearly everything in public, this was a place where they could let their hair down quite literally. In a world of modesty and discretion, this was a place where everything could be out in the open.

I left with an increased appreciation for the hammams and their purpose, their place in this culture. Not only were they a hygienic necessity in a crowded neighborhood without bathing facilities, but they were also a chance for women to connect with one another and be free.

My body, freed of at least 30% of my skin cells after that loofah experience, also felt liberated.

So What for Longevity

So much of what I have learned about longevity—be it from grandma Betsy or Blue Zones—circles back to the fact that community is key. Mental health is a key component of physical health, and mental health is driven in large part by connection with others and purpose—the feeling that you are needed and part of a group.

I think this social element is in large part why bathhouses in their various forms have grown across cultures and persisted throughout time.

There is also an element of true self-care in bath culture. Who doesn’t feel better after a good sweat or a warm bath or shower? Who doesn’t feel better when you add a full loofah rub down, Turkish delights, and a nap?

It’s a luxury that our hustle culture has strayed from. But it’s coming back.

Bathhouse Resurgence

Today, we are seeing a resurgence in these things in the western world. A recent New York Times article, The Smoking Hot Return of Bathing Culture, highlights how people are once again finding the joy in the ancient rituals of heat, sauna, and bathhouse culture. It’s one of the buzziest topics and fastest-growing sectors in wellness and I’ve seen more than a handful of these places pop up in my own neighborhood.

I recently visited a local recovery studio in Denver with my friend Riley. On a Friday late afternoon, it was packed.

“This is the new happy hour,” he told me. “This is what everyone does instead of drink now.”

I looked around at the young, urban crowd and had to admit he might have a point. This latest generation drinks less than previous ones and is more wellness-focused in general. In a world heavy with technology and screens, people are also looking for that IRL connection.

I also have found myself increasingly hanging out with friends at places like this, rather than our standard coffee shop or happy hour haunts.

Bathhouses started to fall out of favor as indoor plumbing took over and they became less of a necessity. But it seems we may have thrown the baby out with the bathwater, as the benefits clearly go so far beyond basic hygiene.

As people come back to realizing the importance of slowing down, self-care, heat therapy, and community, I applaud the comeback.

Maybe Riley is right—maybe this is the new happy hour. And honestly, after thousands of years of evidence, it might just be the best one we’ve ever had.

References

https://www.nytimes.com/2025/08/27/style/bathing-culture-trend.html

“The real voyage of discovery consists not in seeking new landscapes, but in having new eyes.” – Marcel Proust

Writing from the Greek Islands & a Longevity Hot Spot

I’m sitting poolside on the Greek island of Paros, eating French fries, and thinking about longevity. Yes, I have my laptop open and admittedly spent most of the afternoon working instead of relaxing, so between that and the fries, while I’m thinking of longevity, I’m not exactly the poster child for it.

But per the map, I’m a quick ferry away from the nearby island of Ikaria, which I first heard about in Dan Buettner’s book Blue Zones: 9 Lessons for Living Longer From the People Who’ve Lived the Longest. The book popularizes the concepts of Blue Zones, regions of the world where people regularly live to age 100 and tend to have some of the lowest rates of chronic disease worldwide.

In my last article, I wrote about my Grandma Betsy who is closing in on 101 and has never been on a chronic disease medication. I noted that some of this was attributable to luck, and the rest was lifestyle. Specifically, her diet focused on real food, daily movement and exercise, and a sense of community and purpose paired with an ability to not pick up life’s proverbial baggage.

It turns out, that’s not too far off from what Dan Buettner and National Geographic found when they started studying Blue Zones.

What are Blue Zones?

The Danish Twin Study confirmed that about 20% of longevity is based on the luck of genetics, while the other 80% is dictated by lifestyle. Buettner and his team set out to understand the secrets to this 80%. What he found were five regions in the world with the highest percentage of centenarians and some of the lowest rates of chronic disease, now called the Blue Zones:

• Sardinia, Italy

• Okinawa, Japan

• Nicoya Peninsula, Costa Rica

• Loma Linda, California

• Ikaria, Greece

Interestingly, three of these locations are physical islands – Ikaria, Sardinia, and Okinawa. Another, the Nicoya Peninsula, has been historically cut off from mainland Costa Rica, and primarily reachable by boat. I happened to visit there last Fall and can confirm that the roads leading there are still terrible. Loma Linda is an island of sorts – it’s an enclave of Seventh Day Adventists, many of whom strictly follow their religious protocols – such as being vegetarian, honoring the sabbath by not working, and spending time with a tightly-knit community.

This tells me not so much that there are five Blue Zones, but that there are five Blue Zones left. These islands – whether protected from outsiders and an encroaching western society by water or religious rules, have preserved traditional lifestyles, social structures, and food and agricultural systems longer.

Nine Lessons & Three Big Ideas for Longevity

Buettner and his team studied these regions and landed on nine key lifestyle lessons for longevity. Of course, these could be easily bucketed into three main categories (again!): Eat real food & not too much; move regularly; and have a healthy purpose, mindset & sense of community. Here they are:

1. Move naturally. The world’s longest-lived people live in environments with built in movement, movement that happens without thinking about it. It’s not marathons and heavy weights. They grow gardens, walk (often tending their animals), and often do not have mechanical conveniences for house and yard work.

2. Purpose. Having purpose has proven to add up to seven years of extra life expectancy. The Okinawans call it Ikigai, the Nicoyans call it plan de vida, and for the Adventists it is built into their religious faith.

3. Downshift. Stress leads to chronic inflammation, associated with every major age-related disease. People in Blue Zones are unique in that their cultures embed routines that shed stress. Okinawans take a few moments each day to remember their ancestors, Adventists pray, Ikarians take a nap, and Sardinians do happy hour.

4. 80% Rule. The centenarians studied did not have a tendency to overeat, and much of this was historical and cultural. The Okinawans spoke of food shortages during WWII and the 2500-year old Confucian mantra Hara hachi bu, which they say before meals. It reminds them to stop eating when their stomachs are 80% full. People in the Blue Zones eat their smallest meal in the late afternoon or early evening, and then, they do not eat any more the rest of the day. Also, it has been proven that when bodies ingest real (not processed foods) one’s natural satiety kicks in more readily.

5. Plant slant. These cultures are not heavy on meat. Adventists are generally vegetarians. Many Blue Zone diets have high concentrations of beans. Meat—mostly pork—was eaten on average only 5 times per month and in small servings. Given the location of these communities, their meat was likely from free-range animals and free from antibiotics and hormones.

6. Wine @ 5. Blue Zone cultures (except Adventists) tend to drink alcohol moderately and regularly. This means 1 to 2 glasses per day, generally with friends and/or with food.

7. Belong. Of the 263 centenarians interviewed, all but 5 belonged to a faith-based community. The denomination doesn’t matter, but the data does: Research shows that attending faith-based services 4 times per month will add 4 to 14 years of life expectancy.

8. Loved ones first. There is a strong sense of family connectedness among centenarians in the Blue Zones. Aging parents and grandparents live nearby or in the home (where it is found to lower disease and mortality rates for both generations), they commit to a life partner (which adds up to 3 years of life expectancy), and they invest in their children with time and love.

9. Right tribe. The Blue Zone cultures stress community and it’s woven into their daily fabric. These groups can tend to have a positive influence – a good peer pressure so to speak – on their members. In Okinawa, there are moais – groups of 5 friends that are committed to each other for life. Adventists have a tight-knit religious community. Research shows that smoking, obesity, happiness, and even loneliness are contagious. The social networks of long-lived people have favorably shaped their health behaviors.

Reading this list, it’s clear that these rules exhibit what our modern age would call a “traditional” lifestyle. Grandma Betsy, who was born in 1925 and lived most of her life on Wisconsin dairy farms, had a life that had far more in common with Blue Zones and far less in common with mine. Her lifestyle was on the move; I sit at a desk for eight hours a day. Church attendance in her era was 65%, in mine it’s closer to 32%. She ate off the farm; I was raised on Frosted Flakes. She didn’t drink regularly; I went to a state school that introduced me to beer bongs. Times have changed.

Luckily, with most of my time in Paros I was far more in tune with the Greek island lifestyle. My husband and I were here for our 10^th wedding anniversary, and we had over 30 friends (or in some cases, friends of friends) in attendance with us to celebrate. There were half a dozen kids and my parents also came. We spent a lot of time walking and swimming. We spent a lot of time sitting around plates of food and liters of wine. I cannot say sleep was always prioritized, but people were full of community, laughter, and sunlight. I can see how even in our situation, this place made it easier to adopt a slower, more traditional lifestyle.

And sometimes that’s exactly what travel is meant to teach you. It is not just about seeing new parts of the world, but about seeing your world with new eyes.

Our Paros Community

Want to Learn More on Blue Zones?

Want to learn more about the Blue Zones? The book and documentary are both truly fascinating and entertaining:

Book: Blue Zones: 9 Lessons for Living Longer From the People Who’ve Lived the Longest, by Dan Buettner - https://a.co/d/0dNtGv5Y

Documentary: Live to 100: Secrets of the Blue Zones (found on Netflix)

“If I do have any advice for anybody, any final thought, if I’m an advocate for anything, it’s to move. As far as you can, as much as you can. Across the ocean, or simply across the river. The extent to which you can walk in somebody else’s shoes—or at least eat their food—it’s a plus for everybody. Open your mind. Get up off the couch. Move.” – Anthony Bourdain

Several years ago, while living in France and taking French lessons, I came across a word that finally explained everything.

It explained a feeling that I had had for years, a lifetime perhaps—the need to move, the need to travel, the need to pull up roots and go somewhere else when I felt stuck, uninspired, sad, bored, or confused. I always euphemistically explained this as a thirst for adventure; but I secretly worried it was just a way for me to justify running away from my problems.

But the thing is, running away always worked. And now, I had a beautiful French word to explain it: Dépaysement.

A word that, thanks to my French lessons, I could also pronounce.

In 2022, it explained why I had uprooted myself and my family, quit my corporate career with no path to return, and moved to France on a seemingly mid-life-crisis-esque whim.

In the depths of the Covid pandemic, like everyone else, my life was laid bare. No friends, no yoga, no kids’ playdates, no happy hours, no vacations, no distractions, no joy to mask what at its core was a pretty mundane existence. A lifelong workaholic, I was now test-driving a life that revolved wholly around work and a screaming preschooler, but was devoid of everything else. After years of overwork and the stress of the previous months, I was completely burned out. I turned forty and had a reckoning: I didn’t like what I was doing, and I didn’t like my life.

Sometimes you have to “un-country” yourself

Dépaysement (pronounced: day-pay-EE-smahn) is a uniquely French concept that has no direct English equivalent. It describes the disorienting, unsettling feeling of being somewhere foreign or out of your natural element—a mix of displacement, disorientation, and estrangement. Literally, it comes from dépayser (”to change country”), or “to be removed from one’s country”.

It is quite literally to “un-country” yourself. It is the act of unmooring yourself from everything familiar, safe, and known. It takes your life off autopilot, demands your full attention, and makes you live in the present tense. It forces you to see a world that doesn’t always make sense and live in a culture you don’t always understand. It naturally awakens curiosity and interesting, often uncomfortable, questions. It makes you question things that your culture has handed you as gospel, often quite literally.

Sometimes these are minor fascinations. When I was in the Peace Corps, living in northern Peru in my early twenties, someone in my village once asked if they could touch my eyeballs—they had never seen blue eyes before. People asked me if my family was dead, because why else would a single young woman leave her country and live in this village all alone? While we’re at it, they wondered how I had made it to the ripe age of 22 with no husband and no children. Was I defective? Probably. I didn’t know how to cook with firewood and I’d never skinned a sheep before. They were fascinated by me. I learned more from them.

My travel has also induced lifelong changes to my operating system. After business school, I piled onto my grad school loans and spent several months traveling through India, Southeast Asia, Japan, and southeastern Africa. On that trip, I visited mosques in northern India, Catholic cathedrals in Goa, a Sikh temple in Rajasthan, and a Hindu temple in Calcutta. A lifelong and disillusioned Catholic, the exposure to other religions was eye-opening. I began to realize that things I’d been told my entire life were just one version of the story—a version heavily influenced by time and place—not unquestionable truths.

Travelling helps you do that. It doesn’t allow you to keep believing everything you think.

Do you need a bit of dépaysement?

Travel, particularly overseas, is humbling. To be an outsider, a stranger in a foreign land, is often to be a full-grown adult communicating like a toddler. It creates empathy and awareness for another’s journey. Seeing the world run on a different set of rules makes you question how you, or your own country and culture, have always approached things. It makes you realize how much you don’t actually know. I often think travel helps all of us move along the Dunning-Kruger line.

Only a foray into the big wide world can teach you how much you truly do not know.

It changes how you solve problems, your ability to think outside the box. The hardships of many travels build courage and confidence.

Netflix founder Reed Hastings was, like me, a former Peace Corps Volunteer. He served in Swaziland and has credited that experience with helping him see the world from a different perspective and think more creatively. He also credits it with giving him courage: “Once you have hitch-hiked across Africa with ten bucks in your pocket, starting a business doesn’t seem too intimidating.”

And it is not just changed perspective. Ever notice that you can’t remember the exact details of your daily routines last week, but have a full memory of your last out-of-town vacation?

Novel environments genuinely increase new neuron growth; boost dopamine and norepinephrine, which enhance attention, learning, and memory encoding; and activate the brain’s exploratory circuitry, making it more receptive and plastic.

That’s dépaysement. It doesn’t just change your perspective, it literally changes your brain.

Internationally Induced Shock Therapy

In 2022, after my husband and I decided to make the move to France, I handed off my house, my car, my job, and my Peloton. In the beginning, “freedom” felt a lot like a panic attack. It was frightening to let go of so many things that made me feel comfortable, secure, and anchored. It was like shedding an identity.

My career had always been the largest part of my identity, and I had just quit, with no plan for a return and no idea how it might impact my career (poorly, I assumed).

After we landed in Lyon, France, I opened my work email on my phone, and it didn’t load. I’d been cut off. I assumed I would get many texts and many phone calls from former colleagues asking for my help. I didn’t. They didn’t really need me. That was an important lesson.

We enrolled our daughter in a French Montessori school, enrolled ourselves in French lessons, found an apartment, and began exploring. We encountered many, many challenges (like French paperwork and the French language) and I devoted myself to the exploration of local history, culture, and food like it was my job. Which it now was. We built a travel schedule around the school schedule and explored 11 other countries during our year abroad.

I studied the French social safety net, Nordic parental leave policies, cultures that didn’t devote themselves to work, and governments that supported their populace so that they didn’t have to. I came across a hypothesis that explained the root of the American workaholism culture (which I’ll write about in a future post). I realized there was a different way to live than what I had been told my entire life. My perspective was changed.

My time overseas was a shot in the arm for a bruised soul. For someone experiencing burnout, quite logically the answer turned out to be a culture that mandated Sunday closures, a 35-hour workweek, and five weeks of annual vacation.

It also gave me distance and perspective to miss some things about my old life. One of those things was work. I missed the purpose it provided, the teamwork, the sense of building something unique. I did not miss the unending stress, the non-stop hours, the unquestioned devotion to it. I committed myself to going back reformed. And I largely have.

It changed my sense of identity. I’m no longer just a business executive, and rarely even mention that to most people I meet. But I am a world traveler, a curious learner, a history buff, and someone who really likes eating, sleeping, and reading. My year of being “un-countried” was like rediscovering myself amidst the layers of years of sedimentary life buildup.

Dépaysement is the concept that travel is medicine. If you need a life reset, travel can be a lifesaver, as it was for me.

Go Forth, Uproot Yourself

The French have a cultural tendency to embrace this concept. Partir en dépaysement—going somewhere for the sake of being uprooted. It is seen as restorative, even necessary. A total change of scenery, not just a vacation.

My year living in France was a radical dépaysement from a life that had depleted me. I wrote about it in my book Everything Looks Different From Here (coming out in February 2027). In fact, you could say it was the main point.

I’m a big fan of running away from your problems, because I think it actually works. The key, it turns out, is to apply a fancy-sounding French word to it.

So, I’ll end by asking you this: What is one area of your life where dépaysement would help, and what are you going to do about it?

Here is what Betsy’s life has taught me about longevity.

Grandma Betsy’s Secrets to Longevity:

1. Eat Real Food.

About 15 years ago, fresh off reading The China Study, and positive that a vegan diet was the secret to a long and healthy life, I asked Betsy about her eating habits. I already knew she drank fresh milk growing up (unpasteurized, whole, from their own cows) and as an adult (daily, with every meal). She also ate cheese daily. But what about red meat? According to health literature at the time, it was the devil.

“How frequently did you eat red meat growing up?” I remember asking her.

“Oh…,” she replied, “I only ate red meat about once or twice a day my whole life.”

The dairy and meat that Betsy lived on was generally from their own cows until much later in life. From talking to grandpa Matt, I knew that the cows were raised without growth hormones and without preventative antibiotics. I could see with my own eyes that they were raised in an open pasture, brought in only for milking. Today we might call that “free range” or “regenerative farming” (i.e., the cows poop, grass grows, they eat the grass, rinse & repeat). This was not some sort of hippie farming method; my lifelong Republican grandfather was about the farthest thing from a hippie.

Growing up, Betsy told me her fruit came from their apple and apricot trees in their yard—fresh in the summer, dried for the winter. Vegetables came from the backyard garden—fresh in the summer, canned and pickled for the winter.

She baked and ate sweets, though sparingly. She didn’t drink a lot of alcohol, but she did drink a lot of coffee (yay!). She didn’t eat too much.

It reminds me of the Michael Pollan quote: “Eat real food. Not too much. Mostly plants.” Minus the whole “mostly plants” part.

Here’s the punchline: She ate real food. That’s it. It wasn’t processed, there weren’t ingredient names she couldn’t pronounce, the animal products were unadulterated.

It’s a far cry from today’s Standard American Diet (fittingly known as SAD).

2. Exercise & Move Daily.

When I lived in Chicago in the 2010’s, I often called my grandma on Fridays on my way to work. I lived close enough to my office to walk, but more often than I’m proud to admit, the cold Chicago winters would scare me into a taxi for my two-mile commute. One day I called grandma from the taxi.

“I just got in from a walk,” she told me, “What are you doing?”

“I’m taking a taxi to work because it’s too cold to go outside.” (I was about 300 miles directly south of her and it was probably 10 degrees outside).

“Really? It didn’t seem that cold out today. I always get out for a walk as long as it’s above negative twenty.”

Until her late 90’s, Betsy walked 3-4 miles every day. It was a non-negotiable for her. Rain or shine, negative 20 and above. While Betsy topped out at 5 feet tall, I struggled to keep up with her pace despite being 8 inches taller.

She often watched her talk shows (she loved Dr Oz and Suze Orman) as she lifted her weights from the kitchen table. She told me she loved getting out to go skiing. That was the extra stuff she did.

Betsy spent her adult life as an emergency room nurse, raised a family on a farm (including cooking for all the farm hands), and had to chase six children around. These were the days before many of the modern appliances that make our lives easier (e.g., dishwashers) existed.

Betsy was always on the move. Even in her later years when I knew her, I called her a hummingbird, because I rarely remember her resting or sitting down.

Today’s science says, “sitting is the new smoking.” If the opposite is true, it may be Betsy’s other secret to success: Always be moving.

3. Manage Stress & Create Purpose.

My family often jokes that we can’t recall Grandma Betsy ever holding a single grudge against someone…except for Ernie Becker. To go 100 years and only truly be mad at one person tells you something profound.

First, Ernie must have really screwed up.

Second, it is a choice to pick up emotional baggage.

Grandma, like any human, could have chosen all sorts of emotional baggage to hold onto. But it wasn’t her nature.

Once, when I was asking her to tell me more about her family and their history, she responded:

“Why do you care so much about old things and dead people?” She was genuinely curious why someone would harp so much on the past.

Another time, I asked her if she was sad that she had been discouraged from learning German (after WWI German was outlawed in dozens of states) and thus could never truly communicate with her grandparents.

“Why would I care about that?” she said, without an ounce of regret.

She carried the same lightness into the harder parts of her life.

She was born at a time when birth control wasn’t a thing (at least not for Catholics) and women had very few paths available to them.

She once told me she never wanted children, that she never really liked them. “Then why did you have six!?!” I asked her incredulously.

“Well, the first one I wanted, and the next five came on the rhythm method.” (The rhythm method is the Catholic church’s answer to birth control. Needless to say, it doesn’t work). “But it was fine. Luckily your mom came second, and she took care of the rest,” she said smiling.

When I knew her, there was not a whiff of mom guilt. She once told me she loved skiing.

When I asked how she managed to get out to ski with six kids, she responded, “Oh, I never took them.”

Women didn’t have a lot of control in decision-making back then. My conservative grandfather’s household was no exception. She was expected to raise the kids, get dinner on the table, and keep the house clean. She did all of this while holding down a part-time job as a nurse.

On that topic, she once told me conspiratorially, “The secret to a happy marriage is letting the man think he’s in charge, even when you actually are.”

While the Catholic church professionalized loading people up with guilt and baggage, Betsy—a lifelong and devout Catholic—avoided that too.

On the Catholic sacrament of Reconciliation, she once told me, “I think that whole rule about having to confess your sins to the priest is dumb. So, I don’t do it. I just go directly to God and tell him myself.”

She also had stress-relieving hobbies: going to church, quilting, sewing, playing cards, walking, gardening.

She always had purpose—she worked as an emergency room nurse, managed estate sales, and worked on the school board. She had community—her friends in her breakfast club, the people she played cards with, women she worked with. I knew her long after she had raised her kids, but I always felt her purpose wasn’t really tied to being a mother or grandmother.

She created the life she wanted, not just from what she was given. And she made the best of it within the confines she had, without complaint (except for Ernie).

The main lessons? You control what you worry about and what you don’t—don’t pick up the baggage. You create your own purpose.

4. Everything else.

Helpfully, Betsy never smoked and she drank very little. I’m sure that contributed to her longevity.

On sleep, I remember grandma prioritizing naps, though I can’t imagine her life as an emergency room nurse, farm wife, and mother of six enabled lots of restorative sleep. My mom remembers grandma being exhausted growing up.

Yes, she brushed and flossed her teeth, but I guarantee the horse & buggy wasn’t heading into town for regular dental visits. She didn’t text and drive because, well, she never learned how to text and could barely use her cellphone. She actually did enjoy Facebook, but sparingly from her desktop computer. She was careful about sun exposure, admittedly a relatively easy endeavor in Wisconsin, but also spent a lot of time outside. These things all likely played only minor roles in her longevity.

5. Luck

Last but not least, let’s not forget the role of luck. You can do only some of the most important things right, and still be OK. You can do all of the things right, and still get hit by a bus. Genes are a form of longevity lottery, constituting an important part of your lifespan and healthspan.

I’m all too aware of this as my husband’s family carries a genetic cancer gene, and my father’s carries the Alzheimer’s gene.

Grandma Betsy’s gene pool could probably survive the apocalypse.

You play the best you can with the cards you’re dealt.

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The main subject of my fascination was usually my Grandma Betsy. Betsy was born in 1925, raised on a dairy farm in central Wisconsin, has never been on chronic disease medication, lived independently until she was 99, and once told me she ate red meat “only once or twice a day” her entire life. She’ll turn 101 in August of this year.

Through work, I also regularly encounter the latest trends, studies, doctors, and influencers on this topic. One of those influencers is Bryan Johnson. For those who don’t know him, a quick synopsis: He’s a guy who has spent millions trying to unlock the secrets to longevity—supplements, prescription drugs, skin care routines, stem cell injections, gene therapy, blood plasma exchanges, hyperbaric oxygen, blood panels… You get the point.

Below is what he has learned in his own words:

I get a little twitchy looking at a list of 42 items that are not properly bucketed (and who could follow that?!), so I fixed it for him. Let’s summarize what millions of dollars taught Bryan.

Bryan Johnson’s “Secrets” to Longevity:

1. Get good sleep (about a quarter of this list relates to this single item)

2. Consume a good diet (e.g., eat real food and drink water; avoid sugar, fried foods, processed foods, alcohol)

3. Exercise (incorporate cardio, heavy weights, stretching, and walking; don’t sit too much)

4. Manage stress & create real human connection (connect with friends, avoid social media & notifications)

Honorable mentions:

• Take care of your teeth (brush & floss, go to the dentist) & protect your ears

• Get sunlight & also protect your skin

• Don’t text & drive

• Don’t smoke (duh)

I appreciate everyone’s contributions to this space. We need the Bryans of the world willing to invest millions to explore the space; but likewise, we need the Betsys of the world who have actually lived it.

Below is a picture of grandma Betsy at age 94 with her great-granddaughter.

As a bit of context, Grandma Betsy was born in 1925 on a dairy farm in Central Wisconsin. The family lived off the land. This wasn’t unusual for the time. In America in 1930, about 30% of the population was living on farms where they could raise and grow their own food. When she was born, her family had a horse and buggy, but no car. Not that it mattered, as there were no grocery stores for miles (still aren’t).

Betsy married in her twenties, moved to the nearby dairy farm that my grandpa Matt was raised on, and there they raised six children and ran the farm until they retired in the late 1980s. (For the record, Matt lived a similar lifestyle and made it to 93, not bad for a man).

While living in Europe in 2022, I spent a lot of time studying my grandparents’ ancestry, including going back to the village in the present-day Czech Republic where all eight of their grandparents originated.

Betsy & Matt are both descended from Austria-Hungarian peasants. Their grandparents left the small German-speaking village for Wisconsin in the early 1880s. The primary reason for leaving was that, as peasants, they couldn’t own land. They were recruited to clear trees for the expanding railroad, and then they founded the dairy farms that my grandparents were raised on. Their grandparents were recruited because the village was known for being cold and full of Catholics—they could survive in the Wisconsin tundra and populate it with lots of children. They were also hard workers (as peasants often are) and skilled woodsmen. The village was known for glassblowing, and the locals were skilled at tree-cutting to fuel the glass furnaces.

I mention all of this to explain their starting point. This is a hardy group, from a culture that values hard work, and survives a lot of childbirth. They also live long lives. Betsy’s father lived until age 90 and her mother lived until age 98. I’m aware we are starting from a place of genetic advantage.

And yet, the more I talked with grandma Betsy, the more I realized that it wasn’t just genetics. Her lifestyle was fundamentally different from most current-day Americans. As America has “evolved” over the last half century, that gap has continued to widen.

Next, I’ll post about Grandma Betsy’s Secrets to Longevity. Spoiler alert: It didn’t cost millions.

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First off, a quick introduction. In 2021, I quit my job and moved my family to France. After nearly two decades building a business career—ironically in the health and wellness space—I was completely burnt out.

So, I walked into my boss’s office, and I quit. He was surprised (so was I!), and I was pretty sure I had just dropped a bomb on my career that I would never recover from.

My family and I then spent an unforgettable year living in Lyon, France and traveling through Europe. I wrote about that experience—the work-life conflict and breaking point that drove me there, the international move, living and travelling in Europe, and coming home with new perspectives on life & work—in my book Everything Looks Different From Here, out in February 2027.

So where am I now? Ironically, after swearing off of the evils of corporate American burnout, and spending a year overseas learning how many (most?) countries have a better approach to work & life than the U.S., I returned to corporate America and became a CEO. A strange career arc. Possibly.

But what brought me back blends the two. A well-balanced life requires some purpose—as my husband and I learned as we aimlessly wandered around France eating croissants. Purpose requires taking your unique skills and interests and applying them to something you care about. I wanted to invest my time & talents towards projects that hopefully make the world a slightly better place. I threw myself into companies & industries that I believed in—things like mental health and longevity medicine.

A wise advisor once told me, “every strength taken to an extreme becomes a weakness”. So, while I have now returned to something that I feel gives me purpose, I also recognize I cannot live in its extreme.

There is also some irony here. As a CEO in the longevity medicine space, I’m very cognizant of what longevity medicine actually teaches us about wellbeing: The importance of sleep, of managing stress, and of managing mental wellbeing (including work burnout).

So now I spend my time balancing the two—work & life. I pull from lessons learned during my year off, when I devoted all of my time to family, travel, eating, and studying how other cultures approach work and life. And I pull from lessons as someone who has climbed the career ladder—failed miserably at my own mental wellbeing along the way—and is now managing herself and others through those same challenges daily.

What you’ll find here is perspectives from a CEO in the longevity space on health & wellness, balancing work with personal wellbeing, and why balance sometimes means quitting your job to move to France. (Because I’m still not ruling that solution out for a second time).

If you’re curious about career sabbaticals, the Sabbatical Project wrote about my family’s year abroad—you can read it here: Meghan’s Gap Year - The Antidote to Burnout.