{"id":1976,"date":"2026-01-29T08:28:52","date_gmt":"2026-01-29T13:28:52","guid":{"rendered":"https:\/\/foreverwell.com\/blog\/?p=1976"},"modified":"2026-01-29T08:28:56","modified_gmt":"2026-01-29T13:28:56","slug":"precision-medicine-homeostasis-safety-system","status":"publish","type":"post","link":"https:\/\/foreverwell.com\/blog\/precision-medicine-homeostasis-safety-system\/","title":{"rendered":"What a Homeostasis-Centered Safety System Would Look Like Part 3"},"content":{"rendered":"\n<h4 class=\"wp-block-heading\">From Population Averages to Biological Resilience<\/h4>\n\n\n\n<p>Modern oncology wouldn&#8217;t dream of treating every cancer patient the same way. So why do we still treat every child&#8217;s immune system as identical?<\/p>\n\n\n\n<p>The <a href=\"https:\/\/foreverwell.com\/blog\/category\/the-vaccine-series\/\" target=\"_blank\" rel=\"noreferrer noopener\">first two essays<\/a> in this series were critical by design. This one is constructive.&nbsp;<\/p>\n\n\n<style>.kb-row-layout-id1976_f8525e-9c > .kt-row-column-wrap{align-content:start;}:where(.kb-row-layout-id1976_f8525e-9c > .kt-row-column-wrap) > .wp-block-kadence-column{justify-content:start;}.kb-row-layout-id1976_f8525e-9c > .kt-row-column-wrap{column-gap:var(--global-kb-gap-md, 2rem);row-gap:var(--global-kb-gap-md, 2rem);padding-top:var(--global-kb-spacing-sm, 1.5rem);padding-bottom:var(--global-kb-spacing-sm, 1.5rem);grid-template-columns:repeat(2, minmax(0, 1fr));}.kb-row-layout-id1976_f8525e-9c > .kt-row-layout-overlay{opacity:0.30;}@media all and (max-width: 1024px){.kb-row-layout-id1976_f8525e-9c > .kt-row-column-wrap{grid-template-columns:repeat(2, minmax(0, 1fr));}}@media all and (max-width: 767px){.kb-row-layout-id1976_f8525e-9c > .kt-row-column-wrap{grid-template-columns:minmax(0, 1fr);}}<\/style><div class=\"kb-row-layout-wrap kb-row-layout-id1976_f8525e-9c alignnone wp-block-kadence-rowlayout\"><div class=\"kt-row-column-wrap kt-has-2-columns kt-row-layout-equal kt-tab-layout-inherit kt-mobile-layout-row kt-row-valign-top\">\n<style>.kadence-column1976_80ce3a-b8 > .kt-inside-inner-col,.kadence-column1976_80ce3a-b8 > .kt-inside-inner-col:before{border-top-left-radius:0px;border-top-right-radius:0px;border-bottom-right-radius:0px;border-bottom-left-radius:0px;}.kadence-column1976_80ce3a-b8 > .kt-inside-inner-col{column-gap:var(--global-kb-gap-sm, 1rem);}.kadence-column1976_80ce3a-b8 > .kt-inside-inner-col{flex-direction:column;}.kadence-column1976_80ce3a-b8 > .kt-inside-inner-col > .aligncenter{width:100%;}.kadence-column1976_80ce3a-b8 > .kt-inside-inner-col:before{opacity:0.3;}.kadence-column1976_80ce3a-b8{position:relative;}@media all and (max-width: 1024px){.kadence-column1976_80ce3a-b8 > .kt-inside-inner-col{flex-direction:column;justify-content:center;}}@media all and (max-width: 767px){.kadence-column1976_80ce3a-b8 > .kt-inside-inner-col{flex-direction:column;justify-content:center;}}<\/style>\n<div class=\"wp-block-kadence-column kadence-column1976_80ce3a-b8\"><div class=\"kt-inside-inner-col\">\n<figure class=\"wp-block-image size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"979\" height=\"681\" src=\"https:\/\/foreverwell.com\/blog\/wp-content\/uploads\/2026\/01\/Two-men-debating-about-vaccine-safety.png\" alt=\"Two men debating about vaccine safety\" class=\"wp-image-1950\" srcset=\"https:\/\/foreverwell.com\/blog\/wp-content\/uploads\/2026\/01\/Two-men-debating-about-vaccine-safety.png 979w, https:\/\/foreverwell.com\/blog\/wp-content\/uploads\/2026\/01\/Two-men-debating-about-vaccine-safety-300x209.png 300w, https:\/\/foreverwell.com\/blog\/wp-content\/uploads\/2026\/01\/Two-men-debating-about-vaccine-safety-768x534.png 768w, https:\/\/foreverwell.com\/blog\/wp-content\/uploads\/2026\/01\/Two-men-debating-about-vaccine-safety-150x104.png 150w\" sizes=\"auto, (max-width: 979px) 100vw, 979px\" \/><figcaption class=\"wp-element-caption\"><a href=\"https:\/\/foreverwell.com\/blog\/vaccine-debate-better-questions\/\" target=\"_blank\" rel=\"noreferrer noopener\"><strong>The Vaccine Debate: Finding Honest Answers and Better Questions Part 1<\/strong><\/a><\/figcaption><\/figure>\n<\/div><\/div>\n\n\n<style>.kadence-column1976_2b9774-09 > .kt-inside-inner-col,.kadence-column1976_2b9774-09 > .kt-inside-inner-col:before{border-top-left-radius:0px;border-top-right-radius:0px;border-bottom-right-radius:0px;border-bottom-left-radius:0px;}.kadence-column1976_2b9774-09 > .kt-inside-inner-col{column-gap:var(--global-kb-gap-sm, 1rem);}.kadence-column1976_2b9774-09 > .kt-inside-inner-col{flex-direction:column;}.kadence-column1976_2b9774-09 > .kt-inside-inner-col > .aligncenter{width:100%;}.kadence-column1976_2b9774-09 > .kt-inside-inner-col:before{opacity:0.3;}.kadence-column1976_2b9774-09{position:relative;}@media all and (max-width: 1024px){.kadence-column1976_2b9774-09 > .kt-inside-inner-col{flex-direction:column;justify-content:center;}}@media all and (max-width: 767px){.kadence-column1976_2b9774-09 > .kt-inside-inner-col{flex-direction:column;justify-content:center;}}<\/style>\n<div class=\"wp-block-kadence-column kadence-column1976_2b9774-09\"><div class=\"kt-inside-inner-col\">\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"717\" src=\"https:\/\/foreverwell.com\/blog\/wp-content\/uploads\/2026\/01\/RFK-MARTY-How-I-Found-Hope-and-Healing-in-Holistic-Healing-Methods-1024x717.png\" alt=\"Silhouetted figures surrounded by red question marks in front of vaccine-related imagery, highlighting unanswered questions in pharmaceutical transparency.\" class=\"wp-image-1973\" srcset=\"https:\/\/foreverwell.com\/blog\/wp-content\/uploads\/2026\/01\/RFK-MARTY-How-I-Found-Hope-and-Healing-in-Holistic-Healing-Methods-1024x717.png 1024w, https:\/\/foreverwell.com\/blog\/wp-content\/uploads\/2026\/01\/RFK-MARTY-How-I-Found-Hope-and-Healing-in-Holistic-Healing-Methods-300x210.png 300w, https:\/\/foreverwell.com\/blog\/wp-content\/uploads\/2026\/01\/RFK-MARTY-How-I-Found-Hope-and-Healing-in-Holistic-Healing-Methods-768x538.png 768w, https:\/\/foreverwell.com\/blog\/wp-content\/uploads\/2026\/01\/RFK-MARTY-How-I-Found-Hope-and-Healing-in-Holistic-Healing-Methods-1536x1075.png 1536w, https:\/\/foreverwell.com\/blog\/wp-content\/uploads\/2026\/01\/RFK-MARTY-How-I-Found-Hope-and-Healing-in-Holistic-Healing-Methods-150x105.png 150w, https:\/\/foreverwell.com\/blog\/wp-content\/uploads\/2026\/01\/RFK-MARTY-How-I-Found-Hope-and-Healing-in-Holistic-Healing-Methods.png 1800w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><figcaption class=\"wp-element-caption\"><strong><a href=\"https:\/\/foreverwell.com\/blog\/who-benefited-from-not-knowing-vaccine-safety-monitoring\/\" target=\"_blank\" rel=\"noreferrer noopener\">Who Benefited from Not Knowing? The Unasked Questions of Vaccine Safety Monitoring Part 2<\/a><\/strong><\/figcaption><\/figure>\n<\/div><\/div>\n\n<\/div><\/div>\n\n\n<p>Because critique without a credible alternative invites dismissal, and because modern biology already points toward a better path.<\/p>\n\n\n\n<p>Also, please recall from my <a href=\"https:\/\/foreverwell.com\/blog\/homeostasis-and-natural-healing\/\" target=\"_blank\" rel=\"noreferrer noopener\">First Five #2<\/a> on homeostasis that the body is driven by a balancing energy that scientists call homeostasis.<\/p>\n\n\n\n<p>The body does not know individual diseases; it only knows balance and imbalance. It is constantly striving to maintain balance within the system.<\/p>\n\n\n\n<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_83 counter-hierarchy ez-toc-counter ez-toc-grey ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">Table of Contents<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 ' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/foreverwell.com\/blog\/precision-medicine-homeostasis-safety-system\/#The_Core_Failure_of_the_Current_Model\" >The Core Failure of the Current Model&nbsp;&nbsp;<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/foreverwell.com\/blog\/precision-medicine-homeostasis-safety-system\/#Why_Precision_Medicine_Already_Accepts_This_Logic\" >Why Precision Medicine Already Accepts This Logic<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/foreverwell.com\/blog\/precision-medicine-homeostasis-safety-system\/#From_Averages_to_Vulnerability\" >From Averages to Vulnerability<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/foreverwell.com\/blog\/precision-medicine-homeostasis-safety-system\/#Longitudinal_Tracking_Not_Passive_Reporting\" >Longitudinal Tracking, Not Passive Reporting<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/foreverwell.com\/blog\/precision-medicine-homeostasis-safety-system\/#Honest_Informed_Consent\" >Honest Informed Consent<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/foreverwell.com\/blog\/precision-medicine-homeostasis-safety-system\/#Protecting_the_Vulnerable_Strengthens_Public_Health\" >Protecting the Vulnerable Strengthens Public Health<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/foreverwell.com\/blog\/precision-medicine-homeostasis-safety-system\/#Closing_the_Trilogy\" >Closing the Trilogy<\/a><\/li><\/ul><\/nav><\/div>\n<h2 class=\"wp-block-heading has-text-align-center\"><span class=\"ez-toc-section\" id=\"The_Core_Failure_of_the_Current_Model\"><\/span><strong>The Core Failure of the Current Model&nbsp;&nbsp;<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>Today\u2019s safety architecture asks primarily:<\/p>\n\n\n\n<p>Does this intervention increase adverse outcomes at the population level? That question is necessary, but insufficient.<\/p>\n\n\n\n<p>A homeostasis-centered system asks:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>For whom does this intervention disrupt balance?<\/strong><\/li>\n\n\n\n<li><strong>Under what conditions?<\/strong><\/li>\n\n\n\n<li><strong>At what developmental stage?<\/strong><\/li>\n\n\n\n<li><strong>In interaction with which other exposures?<\/strong><\/li>\n<\/ul>\n\n\n\n<p>The immune system is not uniform. It is developmental, adaptive, and deeply individualized, especially in early life.<\/p>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-full is-resized\"><img loading=\"lazy\" decoding=\"async\" width=\"1000\" height=\"481\" src=\"https:\/\/foreverwell.com\/blog\/wp-content\/uploads\/2026\/01\/Depositphotos_374448886_S-1.jpg\" alt=\"Digital illustration of a human figure blocking virus particles, symbolizing immune defense and holistic health protection.\" class=\"wp-image-1983\" style=\"aspect-ratio:2.0790316838732643;width:622px;height:auto\" srcset=\"https:\/\/foreverwell.com\/blog\/wp-content\/uploads\/2026\/01\/Depositphotos_374448886_S-1.jpg 1000w, https:\/\/foreverwell.com\/blog\/wp-content\/uploads\/2026\/01\/Depositphotos_374448886_S-1-300x144.jpg 300w, https:\/\/foreverwell.com\/blog\/wp-content\/uploads\/2026\/01\/Depositphotos_374448886_S-1-768x369.jpg 768w, https:\/\/foreverwell.com\/blog\/wp-content\/uploads\/2026\/01\/Depositphotos_374448886_S-1-150x72.jpg 150w\" sizes=\"auto, (max-width: 1000px) 100vw, 1000px\" \/><\/figure>\n<\/div>\n\n\n<p>The fact that the immune system is deeply individualized is the key to realizing that small subgroups can be susceptible to any intervention in ways that defy population-based conclusions.&nbsp;&nbsp;<\/p>\n\n\n\n<h2 class=\"wp-block-heading has-text-align-center\"><span class=\"ez-toc-section\" id=\"Why_Precision_Medicine_Already_Accepts_This_Logic\"><\/span><strong>Why Precision Medicine Already Accepts This Logic<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>Modern oncology has already abandoned the idea that uniform treatment is acceptable. Two patients with the same cancer diagnosis may receive entirely different therapies based on genetics, metabolism, and immune markers\u2014this is the power of precision medicine.<\/p>\n\n\n\n<p>No oncologist argues that a treatment is <strong>\u201csafe\u201d<\/strong> simply because most patients tolerate it. Instead, medicine asks:<\/p>\n\n\n\n<p><strong>For whom does this work? For whom does it fail? And why?<\/strong><\/p>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"1000\" height=\"652\" src=\"https:\/\/foreverwell.com\/blog\/wp-content\/uploads\/2026\/01\/Depositphotos_18062409_S-1-1.jpg\" alt=\"Healthcare professional with stethoscope analyzing digital population data, symbolizing public health diagnostics and medical technology.\" class=\"wp-image-1985\" srcset=\"https:\/\/foreverwell.com\/blog\/wp-content\/uploads\/2026\/01\/Depositphotos_18062409_S-1-1.jpg 1000w, https:\/\/foreverwell.com\/blog\/wp-content\/uploads\/2026\/01\/Depositphotos_18062409_S-1-1-300x196.jpg 300w, https:\/\/foreverwell.com\/blog\/wp-content\/uploads\/2026\/01\/Depositphotos_18062409_S-1-1-768x501.jpg 768w, https:\/\/foreverwell.com\/blog\/wp-content\/uploads\/2026\/01\/Depositphotos_18062409_S-1-1-150x98.jpg 150w\" sizes=\"auto, (max-width: 1000px) 100vw, 1000px\" \/><\/figure>\n<\/div>\n\n\n<p>There is no scientific reason this same logic cannot be applied to immune development.<\/p>\n\n\n\n<h2 class=\"wp-block-heading has-text-align-center\"><span class=\"ez-toc-section\" id=\"From_Averages_to_Vulnerability\"><\/span><strong>From Averages to Vulnerability<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>A modern safety system would:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Stratify outcomes by biological vulnerability<\/strong><\/li>\n\n\n\n<li><strong>Identify metabolic or immune profiles associated with adverse responses<\/strong><\/li>\n\n\n\n<li><strong>Treat so-called \u201crare\u201d outcomes as signals, not noise<\/strong><\/li>\n<\/ul>\n\n\n\n<p>If even 1\u20133% of children are vulnerable, population-level studies may show no signal, while thousands of families are profoundly affected.<\/p>\n\n\n\n<p>Averages protect the majority. They erase the vulnerable.&nbsp;&nbsp;<\/p>\n\n\n\n<h2 class=\"wp-block-heading has-text-align-center\"><span class=\"ez-toc-section\" id=\"Longitudinal_Tracking_Not_Passive_Reporting\"><\/span><strong>Longitudinal Tracking, Not Passive Reporting<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>A homeostasis-centered system would:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Establish longitudinal birth cohorts<\/strong><\/li>\n\n\n\n<li><strong>Track immune, neurological, metabolic, and developmental markers over time<\/strong><\/li>\n\n\n\n<li><strong>Study cumulative exposure rather than isolated products<\/strong><\/li>\n<\/ul>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-full is-resized\"><img loading=\"lazy\" decoding=\"async\" width=\"692\" height=\"442\" src=\"https:\/\/foreverwell.com\/blog\/wp-content\/uploads\/2026\/01\/Screenshot-2026-01-27-125923.png\" alt=\"Illustration of human development from genetics to environment, highlighting childhood growth and biological influences.\" class=\"wp-image-1986\" style=\"width:534px;height:auto\" srcset=\"https:\/\/foreverwell.com\/blog\/wp-content\/uploads\/2026\/01\/Screenshot-2026-01-27-125923.png 692w, https:\/\/foreverwell.com\/blog\/wp-content\/uploads\/2026\/01\/Screenshot-2026-01-27-125923-300x192.png 300w, https:\/\/foreverwell.com\/blog\/wp-content\/uploads\/2026\/01\/Screenshot-2026-01-27-125923-150x96.png 150w\" sizes=\"auto, (max-width: 692px) 100vw, 692px\" \/><\/figure>\n<\/div>\n\n\n<p>This is how child development is studied elsewhere. It should not be controversial here.<\/p>\n\n\n\n<h2 class=\"wp-block-heading has-text-align-center\"><span class=\"ez-toc-section\" id=\"Honest_Informed_Consent\"><\/span><strong>Honest Informed Consent<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>Parents deserve transparency about:&nbsp;&nbsp;<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>What is known?<\/strong><\/li>\n\n\n\n<li><strong>What is not known?<\/strong><\/li>\n\n\n\n<li><strong>Where uncertainty exists?<\/strong><\/li>\n<\/ul>\n\n\n\n<p>Trust is built through honesty, not slogans.<\/p>\n\n\n\n<h2 class=\"wp-block-heading has-text-align-center\"><span class=\"ez-toc-section\" id=\"Protecting_the_Vulnerable_Strengthens_Public_Health\"><\/span><strong>Protecting the Vulnerable Strengthens Public Health<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>Uniformity is not equity.<br>Protecting the majority does not require sacrificing the minority.<\/p>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-full is-resized\"><img decoding=\"async\" src=\"https:\/\/foreverwell.com\/blog\/wp-content\/uploads\/2026\/01\/Depositphotos_752303456_S-1.jpg\" alt=\"Business professional holding umbrella over paper-cut family, symbolizing financial protection and insurance coverage.\" class=\"wp-image-1988\" style=\"width:578px;height:auto\"\/><\/figure>\n<\/div>\n\n\n<p>A system that identifies vulnerability early:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Reduces harm<\/strong><\/li>\n\n\n\n<li><strong>Builds trust<\/strong><\/li>\n\n\n\n<li><strong>Improves outcomes<\/strong><\/li>\n\n\n\n<li><strong>Strengthens public health credibility<\/strong><\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading has-text-align-center\"><span class=\"ez-toc-section\" id=\"Closing_the_Trilogy\"><\/span><strong>Closing the Trilogy<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>Together, these three essays make a single argument:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>We lack critical long-term safety data<\/strong><\/li>\n\n\n\n<li><strong>That absence reflects incentives and paradigm failure, not inevitability<\/strong><\/li>\n\n\n\n<li><strong>And a better public health care system, grounded in biology and ethics, is both possible and overdue<\/strong><\/li>\n<\/ul>\n\n\n\n<p>This is not a rejection of medicine.<\/p>\n\n\n\n<p>It is an invitation to inspire medicine to evolve, to mature beyond averages, toward resilience, humility, and genuine protection of children\u2019s health.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>From Population Averages to Biological Resilience Modern oncology wouldn&#8217;t dream of treating every cancer patient the same way. So why do 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