56 pages • 1 hour read
Casey MeansA modern alternative to SparkNotes and CliffsNotes, SuperSummary offers high-quality Study Guides with detailed chapter summaries and analysis of major themes, characters, and more.
Means describes her increasingly narrow focus as she advanced through her education and entered her career in medicine. She reflects on a patient, Sarah, who suffered from unexplained migraines. Instead of prescribing Sarah yet another medication, Means decided to investigate further, searching for the cause of Sarah’s symptoms rather than just treating them.
By asking questions and searching for answers, Means discovered that Sarah had excess inflammation—the immune system’s response to “anything foreign, unwanted, or injurious” (6). However, Sarah did not have any injuries or infections to account for her inflammatory response. Upon reflection, Means realized that almost every case she saw in her ENT practice involved inflammation. The medicines and procedures Means used temporarily relieved symptoms but did not address the underlying inflammation. From there, Means questioned whether all of Sarah’s symptoms—not just her ENT symptoms—were caused by inflammation. She found that chronic inflammation is correlated with chronic diseases.
Means asserts that the activity in individual cells combine to make life—”Each cell is a little universe of buzzing work and activity. And the result of all that activity, simply put, is our lives” (8). With this awareness, Means left her residency and began researching, eventually opening a functional medical practice where she provides comprehensive care to her clients, who often see drastic improvements from following Means’s advice.
Through her research and practice, Means has learned that inflammation is rooted in cellular metabolic dysfunction, or what she calls Bad Energy. Means provides foundational discussions on cellular metabolism, which involves the mitochondria, commonly known as “the powerhouse of the cell” (10). Mitochondria synthesize adenosine triphosphate (ATP), which acts as an “energy currency.” Properly functioning cells are important because they make proteins, repair and replicate DNA, signal other cells, transport molecules, maintain homeostasis, clean up waste, and produce energy through metabolism.
Modern lifestyles damage mitochondria, which “trickles up” to create inflammation and disease. Means identifies ten lifestyle factors that contribute to this issue: overnutrition, nutrient deficiencies, an imbalanced microbiome, sedentary behavior, stress, medication and drugs, sleep deprivation, toxins and pollutants, circadian disruption, and “thermoneutrality,” or relatively constant ambient temperatures. These issues lead to high blood sugar levels and insulin resistance, contributing to several chronic diseases, including diabetes. Means also identifies a “dysfunction trifecta”—mitochondrial dysfunction, chronic inflammation, and oxidative stress.
Means asserts that there are several ways to determine whether a person is experiencing such malfunctions. For instance, annual bloodwork can help uncover whether a person has Good or Bad Energy. By using a functional rather than reductionist framework, people can improve their health.
Means describes one of her first patients, Lucy, who experienced acne, bloating, anxiety, and polycystic ovary syndrome (PCOS). Means spent hours speaking with Lucy about her lifestyle and symptoms, discovering that most of her health issues were connected and reversible. Lucy followed Means’s advice to make lifestyle changes, and her health drastically improved. From Lucy and other successful patients, Means became convinced that most symptoms and diseases are connected, that chronic illnesses caused by Bad Energy are on a spectrum of severity, and that mild symptoms are precursors to more serious diseases.
To dig deeper into her findings, Means returns to the story of her mother and herself. Gayle ate the typical diet in the 1980s, consisting largely of simple carbohydrates with minimal vegetables; she also smoked, stayed up late, and rarely exercised. Metabolic abnormalities, like insulin resistance, fat cell size and quantity, and inflammation, can be passed from mother to fetus. Means was born via C-section, meaning she was not exposed to her mother’s microbiome via her vaginal canal, and she was not breastfed due to complications. Means’s childhood diet included a lot of highly processed foods, she experienced numerous infections, and she was overweight, reaching over 200 lbs. by eighth grade. She started focusing on her health as a teenager, losing weight and improving her metabolic health; however, her health declined again when she became a surgical resident, and her lifestyle changed. She developed irritable bowel syndrome (IBS), acne, depression, and chronic neck pain.
Means discusses other conditions that are linked to metabolic health, including sinus infections, migraines, hearing loss, autoimmune conditions, infertility, sexual dysfunction, and chronic fatigue. Bad Energy also impacts children, and diseases that were once rare in children—such as obesity, fatty liver disease, brain disorders, type 2 diabetes, anxiety, and high blood pressure—are becoming increasingly common. Means criticizes Western society for not taking meaningful action and for normalizing Bad Energy practices like processed foods and toxic chemicals. Similarly, rates of severe and terminal diseases, like stroke, dementia, heart and respiratory diseases, and arthritis in individuals over fifty are on the rise. In her research, Means also found a link between metabolic health and contracting COVID-19.
Means identifies several costs of the current medical system, including the idea that suffering from poor health has been normalized. She discusses comorbidities—multiple diseases that occur at the same time—a concept that supports her arguments for a more cohesive approach to medicine. Means believes that Gayle, like many, was let down by the current system, which still uses a reductionist approach. However, she argues that humans can improve their health quickly and drastically with lifestyle adjustments.
Means’s family went against medical advice after Gayle was diagnosed with pancreatic cancer. The doctors had recommended Gayle undergo an invasive procedure which they believed would slightly extend her life but at the cost of keeping her in pain and secluded from family in a hospital during the COVID-19 lockdown. By rejecting the medical advice, Means’s family was able to spend the last few days of Gayle’s life together.
Means reflects on a time when her friend, a cancer surgeon, implied that anyone admitted to that department underwent surgery whether they needed it or not, and mentioned being reprimanded by superiors whenever she would recommend non-surgical treatments. Means discusses the “power imbalance” between authoritarian doctors and frightened patients, noting that while, in general, doctors are not trying to take advantage of their patients, the healthcare system profits from bad health.
In contrast to popular medical advice, Means warns readers not to trust the medical system regarding chronic disease prevention and management. She argues that increasing lifespans can be attributed primarily to advancements in sanitation and acute medical treatments. Means criticizes the modern siloed approach to medicine, reasserting that chronic diseases are often interconnected and that the current medical system financially benefits from chronic illnesses. The legal definition of medicine takes an intervention-based approach, which was adopted in 1910, which Means asserts, renders it outdated. However, she acknowledges the current system is acceptable for acute medical issues.
Means also explores other sources of bias, including conflicts of interest, such as pharmaceutical companies funding academic research and judging doctors based on the number of interventions prescribed rather than patient outcomes. Many doctors’ pay is based on the amount of money they bring in, directly correlating their income to the number of prescriptions or treatments they prescribe. The most dangerous feature of the modern medical system, according to Means, is the fact that medical leaders remain silent on the effects of food and lifestyle on health. Means asserts that her message is optimistic and the issues she identifies can be fixed.
Chapters 1 through 3 establish The Link Between Cellular Health and Energy Production as the key to understanding and improving overall well-being. Means uses a blend of rhetorical techniques, engaging language, and pointed critiques to highlight the link between cellular energy production and chronic disease. These chapters use immersive and empowering language that remains critical of modern healthcare systems, maintaining both an optimistic and urgent tone that invites readers to take control of their health and question systemic flaws.
Means roots her discussion of cellular health in mitochondria, the “powerhouse of the cell,” which drive metabolism and energy production. By making the microscopic tangible—” Each cell is a little universe of buzzing work and activity” (8)—she employs imagery that encourages readers to visualize their health at a cellular level. She uses this technique through all three chapters, drawing connections between cellular dysfunction, inflammation, and the progression of chronic diseases. The idea that chronic conditions are interconnected and arise from the same root causes—”branches of the same tree with the same root system” (54)—challenges reductionist medical models and reinforces Means’s holistic approach. Means broadens this theme by emphasizing how modern lifestyles disrupt mitochondrial function, leading to what she terms “Bad Energy.” From diet and environmental toxins to chronic stress and circadian disruption, she identifies a range of factors that damage cellular processes. This holistic perspective deepens the discussion on how lifestyle choices influence health and underscores the urgency of systemic change.
Means’s language is designed to be accessible and empowering, creating a sense of agency for readers while simplifying complex scientific concepts. For instance, she uses clear, actionable statements like, “We can do so much to make our lives and our kids’ lives easier by controlling the controllable” (47). This phrasing encourages focusing on achievable changes rather than potentially overwhelming systemic issues or uncontrollable factors. Similarly, the metaphorical description of cells as a “little universe” transforms an abstract biological concept into something relatable and awe-inspiring—a technique Means continues in Part 2 in her discussion of spiritual health. Means also employes visual text features to place emphasis on key statements, such as when she uses bold text for the statement “Every institution that impacts your health makes more money when you are sick and less when you are healthy” (60). The bolded text amplifies this critical point, ensuring it stands out. This strategic formatting creates moments of emphasis, allowing her key critiques of the healthcare system to resonate more deeply.
Means critiques the healthcare system with a balance of sharp criticism and empathetic understanding. She acknowledges the “power imbalance” in the doctor-patient relationship, where frightened patients are unlikely to challenge authoritative medical advice. However, she also refrains from blaming individual practitioners, instead targeting the structural flaws that incentivize sickness over health. This nuanced critique softens the tone, making her argument more approachable and fostering solidarity with readers who make have felt similarly disempowered by the medical system. The irony in her discussion of healthcare spending is particularly effective: “Never in a million years would that alien say that we should wait for everyone to get sick and then write prescriptions and perform procedures that don’t reverse the underlying reasons they’re sick. But that is what we are doing today” (61). By reframing the issue through an outsider’s perspective, Means highlights the absurdity of current practices, reinforcing her call for systemic reform.
Means’s critique of current healthcare systems lays the groundwork for her argument about The Role of Lifestyle Factors in Overall Health in subsequent chapters. Means employs irony and satire to critique societal norms and the normalization of poor health. Her statement that “Our society has failed to make meaningful preventative moves to counter the exploding epidemics of childhood chronic diseases” (47), exposes a cultural failure to prioritize children’s health over economic gains. The biting tone draws attention to systemic negligence while potentially motivating readers to demand better for future generations. Similarly, Means critiques the normalization of comorbidities, noting that they “should not be normal at all” (54). This observation underscores how language shapes perception, subtly reinforcing her broader argument that chronic diseases are interconnected and preventable. By calling out this normalization, Means challenges readers to rethink what they have been conditioned to accept as inevitable.
Despite her critiques, Means explicitly refers to her discussion as “optimistic,” emphasizing that the issues she identifies are solvable, foreshadowing her Strategies for Fostering “Good Energy.” She imbues her statement, “You now have a powerful understanding of how nearly every common symptom of the Western world is connected” with an empowering tone, validating her readers’ ability to comprehend and address their own health (25). Through this combination of accessible language, critical analysis, and thematic depth, Means uses Part 1 of Good Energy to lay the groundwork for her exploration of metabolic health. The link between cellular health and energy production is positioned as the key to addressing the chronic health crises of the modern world.