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Speaker 1: Welcome back to Behind the Bastards, a podcast about the

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Speaker 1: very worst people in all of history. And here to

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Speaker 1: talk about, well, here to do a special reverse bastards

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Speaker 1: episode where I don't have to research and write about

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Speaker 1: a terrible person. My guest does is Dr. Kaveh Hoda,

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Speaker 1: who has been very kindly teaching us about Dr.

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Speaker 2: Peter Attia. Yeah. Atiyah? I don't know, actually. It's a

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Speaker 2: good question. Atiyah.

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Speaker 3: Atiyah.

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Speaker 1: Sorry.

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Speaker 2: Peter Atiyah. Peter, I apologize.

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Speaker 4: I know that.

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Speaker 1: You said that correctly. I got it wrong, because my

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Speaker 1: brain does not hold pronunciations well.

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Speaker 2: I might be wrong. Listen, I don't know if I'm

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Speaker 2: saying my own name right, so I can't be certain

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Speaker 2: about anyone else. So sorry, Peter, if that's the case.

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Speaker 1: Who's to say?

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Speaker 2: Okay. You guys ready to get back into this?

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Speaker 4: Yeah, yeah, yeah.

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Speaker 1: Let's do it.

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Speaker 3: Okay.

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Speaker 2: When we left off, our hero, Peter Attia, had left

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Speaker 2: the oppressive groupthink of medical training.

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Speaker 1: Finally.

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Speaker 2: It was finally. It was only a matter of time.

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Speaker 2: He was pretty upset about not being appreciated for attempting

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Speaker 2: to operate outside the Johns Hopkins protocols. Being a maverick.

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Speaker 2: A renegade. Yeah. He doesn't play by the rules, but

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Speaker 2: he gets results. Yeah. You want a rebel doctor.

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Speaker 1: That's what you want. That's right. I love it when

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Speaker 1: my doctors are rebel.

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Speaker 2: That's really outside the box.

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Speaker 5: Yeah.

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Speaker 2: Getting weird with medicine. Yeah.

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Speaker 1: That's what you want. A lot of people say smearing

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Speaker 1: poop into an open wound is bad for you, but

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Speaker 1: they're just sheep. I like to get away from the herd.

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Speaker 1: I like to try new things.

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Speaker 2: Yeah. Get that in there real good. Can we stop this?

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Speaker 5: Yep.

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Speaker 1: Nothing's bolder than sepsis i i don't get.

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Speaker 3: I don't get paid enough for this shit can we that.

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Speaker 2: Yeah well i mean if you didn't stop me i

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Speaker 2: might have gotten stuck in that yeah it is it

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Speaker 2: is disturbing how easily my brain can just like in

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Speaker 2: like get into that role of the manosphere dude and

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Speaker 2: that is it's easy it's funny to work on the

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Speaker 2: joke about yeah Yeah.

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Speaker 1: But back to Petar.

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Speaker 2: So let's get back to him. So he decides to join,

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Speaker 2: leaving the residency, decides to join a consulting firm called

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Speaker 2: McKinsey and Company. Oh, good.

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Speaker 1: Oh, I'm glad they're showing up. That's fun.

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Speaker 2: Yeah. Yeah, I was going to ask. Real peak McKinsey years.

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Speaker 1: Yeah.

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Speaker 2: Yeah. Okay.

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Speaker 1: They're one of those like bloodless consultants. Sorry, you're going

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Speaker 1: to talk about them. Yeah, yeah, yeah. No, no, no.

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Speaker 2: Please, please, please.

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Speaker 1: They're one of those like consulting firms who you bring

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Speaker 1: in to tell like, here's how many people you should

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Speaker 1: fire to maximize shareholder value and the like, right?

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Speaker 2: That is correct. They are a global management consulting firm

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Speaker 2: that advises major corporations, governments, both here and abroad, and

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Speaker 2: institutions on strategy operations some.

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Speaker 1: People call them bloodless ghouls but right no i don't

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Speaker 1: because i i support actually the bloodless ghoul community you

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Speaker 1: are valid you are beautiful and i love you bloodless.

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Speaker 2: You are seen they are one of the most influential

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Speaker 2: oldest and maybe controversial consulting firms in the world let's

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Speaker 2: talk about them because he decided to go work for

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Speaker 2: them and i think that says something about a person

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Speaker 2: good sign So they're firm with the history of being

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Speaker 2: criticized for a lot of things, including involvement with the

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Speaker 2: opioid crisis. Have you heard of the opioid crisis?

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Speaker 3: I have.

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Speaker 1: Oh, man. Yeah. I've had a few myself.

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Speaker 2: Robert.

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Speaker 3: Robert.

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Speaker 4: It's a bit.

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Speaker 1: It's a bit.

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Speaker 2: It's a bit. Please say it's a bit.

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Speaker 1: It's a bit. I'm a medical doctor.

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Speaker 2: I'm a professional.

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Speaker 1: I only do opiates in Mexico. And now I don't

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Speaker 1: do opiates in Mexico anymore because of fucking fentanyl. Man,

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Speaker 1: it ruins so much. You used to be able to

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Speaker 1: just buy opiates off of a pharmacy in Guatemala or

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Speaker 1: something and know that they were just hydrocodone. You could

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Speaker 1: pick it up at the grocery store. It was beautiful. Anyway, whatever.

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Speaker 2: So McKinsey- and company, both of them, were hired by

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Speaker 2: Purdue Pharma to work on strategies to increase opioid sales

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Speaker 2: because they just weren't selling enough.

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Speaker 1: Yeah, 2006 is like peak getting Americans addicted to painkillers years.

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Speaker 2: That's exactly what we're talking about here.

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Speaker 1: Yeah.

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Speaker 2: Oh, cool. They provided them service for over 15 years,

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Speaker 2: specifically advising them on marketing and sales strategies to aggressively

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Speaker 2: increase the revenue of of OxyContin, the opioid painkiller.

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Speaker 1: You want to aggressively increase people using Oxy, yeah.

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Speaker 2: That's what they did. So they advised Purdue, really focusing

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Speaker 2: their sales representative visits on doctors who were already writing

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Speaker 2: high volumes of prescriptions. And according to the New York

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Speaker 2: Times in 2013, McKinsey designed a specific strategy to turbocharge

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Speaker 2: OxyContin sales And they advised the Sackler family, the people

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Speaker 2: who own Purdue, to push the higher dose pills. They

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Speaker 2: did a lot of really fun stuff. Because of this,

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Speaker 2: they faced a lot of legal challenges and some setbacks

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Speaker 2: for the company. They've had to cut back at least 10%

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Speaker 2: of their global workforce. They had to pay nearly $ 600

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Speaker 2: million American dollars to settle investigations.

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Speaker 5: Yeah.

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Speaker 1: A fucking pittance, honestly. But yeah.

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Speaker 2: Probably.

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Speaker 1: Yeah.

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Speaker 2: And by these investigations brought on by 49 different American states.

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Speaker 2: I'm not sure which state didn't, actually. I wish I

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Speaker 2: had looked that up because I'm betting it's Alaska, but

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Speaker 2: I don't know. And the DOJ announced a settlement resolving

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Speaker 2: civil and criminal probes with McKinsey accepting responsibility for a

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Speaker 2: misdemeanor charge of conspiring to aid and abet the misbranding

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Speaker 2: of prescription drugs. So they also had a senior partner,

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Speaker 2: Martin Elling, who faced felony obstruction of justice charges for

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Speaker 2: intentionally deleting Purdue. And they had to pay also 125

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Speaker 2: million into the Purdue Pharmacy bankruptcy estate to fund treatment programs.

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Speaker 2: But what I have here is I printed out, I

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Speaker 2: went to the Department of Justice, the Office of Public Affairs.

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Speaker 2: And I printed out there some interesting stuff that they posted.

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Speaker 2: about these court hearings. So they leveled a couple of

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Speaker 2: complaints against the Perdue family, and they leveled a number

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Speaker 2: against McKinsey.

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Speaker 1: The Sackler family, yeah.

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Speaker 2: Sackler family, sorry. And two of the ones they leveled,

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Speaker 2: two of the charges they leveled were criminal misbranding and

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Speaker 2: false claims to the FDA. So this is fun. So

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Speaker 2: the DOJ, this is a quote from the Office of

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Speaker 2: Public Affairs, the Department of Justice, Quote, the DOJ leveled

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Speaker 2: a criminal misbranding charge against McKinsey for falsely marketing it

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Speaker 2: as less addictive, less subject to abuse and diversion, and

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Speaker 2: less likely to cause dependence and withdrawal than other pain medications.

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Speaker 2: This was specifically their recommendations that McKinsey made to Purdue.

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Speaker 2: They were like, they worked on messaging. They're like, hey,

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Speaker 2: we have to counter these emotional public health warnings. including

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Speaker 2: these complaints that mothers had of teenagers that had overdosed.

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Speaker 2: And so they had this whole marketing campaign to fight that.

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Speaker 2: Among other strategies, intensifying marketing to high-value prescribers, including prescribers

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Speaker 2: who were writing opioid prescriptions for uses that were unsafe, ineffective,

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Speaker 2: and medically unnecessary. So what McKinsey did, basically let me

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Speaker 2: translate some of that, was like, hey. Yeah. These people

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Speaker 2: who are writing the worst prescriptions, the most questionable prescriptions,

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Speaker 2: let's really drill down on them and get them to

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Speaker 2: write even more. Hit them up. That should be number one.

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Speaker 2: Don't go to the person that you have to convince.

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Speaker 2: Go to the person that's just doing it and just

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Speaker 2: work on them the whole time.

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Speaker 1: Makes sense.

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Speaker 2: McKinsey consultants spoke with Purdue about the concerns and increasing

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Speaker 2: reluctance of pharmacists and pharmacy chains to fill prescriptions for

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Speaker 2: OxyContin as abuse of the drug rose. McKinsey consultants also

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Speaker 2: went on several ride-alongs with Purdue sales representatives in the

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Speaker 2: field as these sales representatives called on prescribers and pharmacists.

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Speaker 2: In notes about one of the ride-alongs, a McKinsey consultant wrote, quote,

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Speaker 2: pharmacist had a gun and was shaking abuse is definitely

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Speaker 2: a huge issue they just kept doing it they set

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Speaker 2: them on ride-alongs to convince them to work harder.

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Speaker 1: It's insane that's nuts.

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Speaker 2: And then on top of that they also got uh

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Speaker 2: leveled uh for claims against the fda and McKinsey U.S.

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Speaker 2: knowingly misled the FDA by assigning consultants to concurrently work

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Speaker 2: on both FDA projects and competitively sensitive Purdue projects. So

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Speaker 2: basically what they did was they said to the FDA, hey,

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Speaker 2: we're going to give you some of our consultants. They're

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Speaker 2: going to help you with managing this opioid crisis. And

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Speaker 2: it was the same consultants that were working on Purdue.

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Speaker 2: Who had helped make it worse.

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Speaker 1: Yeah. These guys really know the opioid crisis because they

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Speaker 1: helped cause it. But they're experts.

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Speaker 2: Yeah. Yeah.

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Speaker 1: It would be like bringing in a bunch of former

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Speaker 1: SS guys as experts on denazification.

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Speaker 5: It's like, look, they know who the Nazis were, obviously.

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Speaker 5: They know what they're talking about. They know what they're

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Speaker 5: talking about. There's also criticism of their work with Enron,

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Speaker 5: as well as their work with China and Saudi Arabia

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Speaker 5: and their efforts to enable authoritarian regimes.

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Speaker 2: In those places. I'll leave that for James and Mia

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Speaker 2: to discuss it. that's probably more their wheelhouse. But they've

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Speaker 2: done worse things also in other places as well. Now,

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Speaker 2: Atiyah's work did not seem to be related to anything medical.

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Speaker 2: So I have to say, even though he was there

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Speaker 2: during the opioid crisis, it doesn't seem like he was

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Speaker 2: a part of it. He was focused on corporate risk,

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Speaker 2: and he worked as a management consultant during this time.

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Speaker 2: He considers this his recalibration phase, where he's exposed to

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Speaker 2: systems-level thinking. I don't know who he was working with,

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Speaker 2: but clearly it signals he has an interest in working

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Speaker 2: with affluent, optimization-oriented populations. Right. His core audience is high-income,

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Speaker 2: like high-income health-maxing professionals. People with the ability to pay

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Speaker 2: top dollar for the health. And I'm sure this is

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Speaker 2: a big part of why he ended up there. So

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Speaker 2: he's there for two years. And it kind of correlates

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Speaker 2: when the first major actions are taken against Perdue. So

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Speaker 2: I don't know if that was a part of why

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Speaker 2: he left or not. But he leaves after a couple years.

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Speaker 2: I think that's common for people doing the consultant gigs.

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Speaker 1: Yeah, yeah, yeah.

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Speaker 2: Right? And for reasons I'm not clear about, he's drawn

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Speaker 2: back to medicine. He gets very busy. He starts doing presentations,

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Speaker 2: lots of media stuff, doing TED Talks. He talks about

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Speaker 2: metabolic dysfunction a lot. He co-founds a startup called the

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Speaker 2: Nutrition Science Initiative, or NUSAI.

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Speaker 1: Yeah.

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Speaker 2: Gives him a very public-facing scientific role, and one that

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Speaker 2: he does without needing board certification.

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Speaker 1: Oh, that's handy.

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Speaker 2: That's great, right? His blog helps establish him as a

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Speaker 2: bit of a contrarian and... but one that can actually

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Speaker 2: discuss data. Sophie knows my thoughts about medical contrarians. It's

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Speaker 2: not great. And this is where the Atea content machine

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Speaker 2: really starts. These long form technical pieces framed as this

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Speaker 2: is what your doctor won't tell you. Again, has that real,

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Speaker 2: the one secret your doctors won't tell you energy. And

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Speaker 2: the rise of these doctors, these contrarian doctors, is something

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Speaker 2: that is very much a sore spot for me. Yeah.

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Speaker 2: And not that medicine's perfect, it's not. I'm not going

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Speaker 2: to say that it is. But a lot of these folks,

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Speaker 2: him included, did a lot of what is called, or

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Speaker 2: I call, I don't know if this is a term,

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Speaker 2: I'm sure it is, science washing. Like taking some of

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Speaker 2: the more blatantly crazy quack people, making them seem more legitimate,

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Speaker 2: and making the more blatantly anti-vax doctors seem a little

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Speaker 2: bit more legitimate, really paves the way for for the

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Speaker 2: Maha movement and where we are currently, again, in our

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Speaker 2: golden age of diarrhea. Now, eventually, in 2014, he starts

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Speaker 2: his own private longevity clinic, Early Medicine. And this is

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Speaker 2: really the scaffolding on which his whole shtick is built.

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Speaker 1: On moving forward. Yeah, yeah, yeah, yeah.

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Speaker 2: It allows him to operationalize the Med 3.0 framework that

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Speaker 2: he loves talking about.

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Speaker 1: I feel like you can see a hint of this

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Speaker 1: in the fact that he got so into nutrition, because

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Speaker 1: obviously nutrition is massively important for health, but also when

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Speaker 1: you're in the business of nutrition, because of the way

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Speaker 1: supplements and stuff are regulated, it means that you can,

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Speaker 1: I'm not saying he was, but you can be in

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Speaker 1: the business of just selling people nonsense and claiming it's

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Speaker 1: basically medicine, as long as you avoid certain phrasing, right?

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Speaker 1: That's exactly right. Anytime I hear nutrition, my warning bells

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Speaker 1: start going off, like when it's in the context of

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Speaker 1: a medical professional.

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Speaker 2: Absolutely true. It's really the Wild West, because being a

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Speaker 2: nutritionist could mean you have like two to three PhDs

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Speaker 2: in the matter or can mean you're a wellness influencer online.

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Speaker 2: And there's really a wide breadth of the conversation between

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Speaker 2: the two. So yeah, absolutely true. So during this time,

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Speaker 2: as he's creating this clinic, things he's doing are things

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Speaker 2: like continuous glucose monitors for non-diabetic patients, which you may

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Speaker 2: have already gathered from the way I said it is

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Speaker 2: not appropriate. repeated advanced lipid testing, VO2 max labs, routine

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Speaker 2: MRI scans, DEXA scans, is giving people expensive wearables, using

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Speaker 2: off-label drugs, doing after-hours consults. His clienteles are elite. They

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Speaker 2: want high-touch care. They aren't taking new clients, by the way,

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Speaker 2: I checked. It's a years-long wait list to get in.

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Speaker 2: And although it's not disclosed exactly how much, From the

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Speaker 2: accounts I've seen, he charges anywhere from $ 100, 000 to $ 500, 000

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Speaker 2: annually for this care in this clinic.

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Speaker 1: Nice work if you can get it.

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Speaker 2: Jesus. I mean, if I could find three people to

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Speaker 2: do that. Yeah, yeah.

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Speaker 1: I'll give you nutrition advice for half a million dollars

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Speaker 1: a year. Anyone listening, you know, wire the money ahead

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Speaker 1: of time, and I'll give you all the advice you

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Speaker 1: fucking want.

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Speaker 2: Will you be on call, though? Will you be on

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Speaker 2: call all the time? Sure.

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Speaker 1: You can call me.

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Speaker 2: I may not answer.

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Speaker 1: Eat more fiber. I don't know, man. Fuck it.

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Speaker 2: Hey, you're hired. You're in. Well done, buddy.

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Speaker 1: Could be worse.

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Speaker 2: If I start a concierge clinic, I am going to

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Speaker 2: hire you in a minute. Anyways, I could see why

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Speaker 2: it's so appealing. I will say this, though, as an aside,

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Speaker 2: I can only imagine as a doctor how annoying it

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Speaker 2: would be to be a regular doctor of one of

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Speaker 2: these patients once they leave this concierge clinic, and you

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Speaker 2: have to see them. Like the stuff they would expect,

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Speaker 2: it would just be wild. And I would not be

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Speaker 2: giving them. But like, they'd be like, my last doctor,

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Speaker 2: he did this and this, and he ordered this and

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Speaker 2: this and this, and he did this for me. And

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Speaker 2: I'd be like, no, I'm sorry. That's just, none of

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Speaker 2: that's appropriate or reasonable to do. And it would be

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Speaker 2: so painful. And of course, none of this is accessible

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Speaker 2: to the average patient, or I'm sure you can guess,

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Speaker 2: covered by insurance.

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Speaker 1: Yeah.

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Speaker 2: People like Atiyah or tech weirdo, Brian Johnson, other longevity enthusiasts.

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Speaker 2: They're famous. That guy, that's the guy with the sons

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Speaker 2: is blood boy for you listeners out there. Yeah.

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Speaker 1: Yeah.

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Speaker 4: Yeah.

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Speaker 1: And tracks his erections. Don't forget about that. Really loves

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Speaker 1: bragging about his four hour erections at night when he's sleeping.

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Speaker 2: Yeah.

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Speaker 3: Yeah.

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Speaker 2: Yeah.

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Speaker 1: Cool, man.

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Speaker 2: Great episode on him. And it was troubling. Um, lots

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Speaker 2: of weird tweets about his, um, girlfriend's vagina um yeah

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Speaker 2: and his and his son's erection just real weird real

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Speaker 2: weird stuff.

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Speaker 3: Really uh tmi my guy.

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Speaker 2: Yeah yeah and i'm not a person who says that

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Speaker 2: like i don't think i've ever said tmi before but

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Speaker 2: i think if i were to use it it would

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Speaker 2: be in this case tmi so uh these people the

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Speaker 2: reason i bring them up both him and natia would

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Speaker 2: would have you believe that this is all proof of

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Speaker 2: concept stuff And that, yeah, only rich people have it

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Speaker 2: for now, but eventually everyone's going to have it. But,

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Speaker 2: I mean, that's just not true. It's not scalable. These

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Speaker 2: longevity wellness people are essentially creating a two-tiered medical system

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Speaker 2: with a different level for the wealthy. I mean, you

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Speaker 2: could argue we already kind of have one, but that

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Speaker 2: gap will only grow. Right. Of course, like all bad people,

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Speaker 2: he starts a podcast. It's called The Drive in 2018.

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Speaker 2: They cover a range of topics built around his practice

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Speaker 2: and early medicine framework. He's really starting to build this

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Speaker 2: parasocial relationship with a high-value audience during this time. He's

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Speaker 2: making appearances on Oprah at least three times on the

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Speaker 2: Joe Rogan Experience. He's hanging out with Bill Ackman, Hugh Jackman. Oh, boy. Yeah.

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Speaker 1: A lot of Ackmans in there.

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Speaker 2: A lot of Ackman and Jackmans.

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Speaker 1: Yeah.

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Speaker 2: And Gwyneth Paltrow and other New York elites. Sure. His book, Outlive,

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Speaker 2: comes out in 2023 and shortly afterwards becomes a number

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Speaker 2: one bestseller.

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Speaker 1: Yeah, they love titles like that. I can see why

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Speaker 1: that one sold.

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Speaker 2: Really a good one, right?

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Speaker 1: Yeah, yeah.

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Speaker 2: Over 3 million copies and spent 131 weeks on the

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Speaker 2: New York Times non-fiction bestseller list. It's crazy.

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Speaker 1: That's bleak.

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Speaker 2: It's not great. He becomes a major figure in the

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Speaker 2: health and wellness scene. Millions of people tuning in to

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Speaker 2: what he has to say or write. And I am

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Speaker 2: a little, I don't want to get too far into

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Speaker 2: the medical minutia here, but I think it's kind of

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Speaker 2: important to do. And your audience is very smart. And

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Speaker 2: I'm not just saying that because I'm pandering, although I'm

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Speaker 2: clearly pandering. They are very intelligent. I think they can

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Speaker 2: hang with this. So I'm going to dig in a

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Speaker 2: little bit to the medical advice he's endorsing and why

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Speaker 2: it matters. Okay. He's moving past the lifespan stuff. He's

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Speaker 2: now about healthspan, the good years. Again, we are mind

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Speaker 2: and body sharp. I'm into that. I like that. And

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Speaker 2: this medicine 3.0, which his clients are paying top dollar for,

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Speaker 2: and he would describe as preventive, personalized, and data-driven approaches

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Speaker 2: to healthcare that focuses on avoiding disease rather than treating it,

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Speaker 2: treating disease. And what's, you know, by the way, um,

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Speaker 2: I get called a shill a lot for being part

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Speaker 2: of big pharma. And it's a lot of the same

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Speaker 2: people who are like, you only want these diseases. to

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Speaker 2: happen so you can be paid by pharma to treat them.

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Speaker 2: And I'm like, what do you think he's doing in

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Speaker 2: these situations? You think that these medicines he's giving you

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Speaker 2: are free? Anyway, sorry. A key part of his justification

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Speaker 2: for aggressive preventative treatments and aggressive pharmacology is this assertion

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Speaker 2: that he has that 90% of the U.S. population has

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Speaker 2: at least one of five markers of metabolic syndrome. Have

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Speaker 2: you guys heard of metabolic syndrome?

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Speaker 3: Yeah.

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Speaker 2: Is that real? It's real.

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Speaker 4: Okay, that's good.

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Speaker 2: It's real, but it is vague, so you are right

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Speaker 2: to be like, yeah, is it real?

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Speaker 1: I hear a lot of things called signs of metabolic

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Speaker 1: syndrome that just sound... Okay, so Cheryl, listen to you.

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Speaker 3: It's like, you know, a number of things that make

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Speaker 3: you at risk for other things. Am I in the

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Speaker 3: right space?

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Speaker 1: It just crops up a lot in grifty kind of

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Speaker 1: medical spaces.

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Speaker 3: Like, all these things means you might have a stroke,

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Speaker 3: or all these things means you might get type 2 diabetes,

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Speaker 3: or all these... Am I in the right... Is that correct,

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Speaker 3: my friend? You guys.

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Speaker 2: You guys are so smart. I'm not just saying that. Honestly.

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Speaker 1: I mean, I had a lot less specifics than she did,

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Speaker 1: but sure.

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Speaker 2: Yeah, that was good. But I meant you guys. I

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Speaker 2: meant her. This is really smart. I just don't want

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Speaker 2: you to feel bad. That is correct. Metabolic syndrome is

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Speaker 2: a real thing, although you're right to be kind of

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Speaker 2: questioning it because it's used by people both professionally who

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Speaker 2: know what they're talking about and by grifters to sell

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00:21:19,260 --> 00:21:23,690
Speaker 2: you an enema made out of coffee. So you're right

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Speaker 2: to be concerned about it. Now, what it is, let's

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Speaker 2: go through it here, okay? Metabolic syndrome is important, and

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Speaker 2: we should touch base on what these five markers of

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Speaker 2: metabolic syndrome are. One, central or abdominal obesity, basically a

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Speaker 2: waist circumference greater than or equal to 102 centimeters in men,

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Speaker 2: 88 centimeters in women, just a big gut. You get

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Speaker 2: adipose tissue in your gut. It changes the way your

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Speaker 2: body acts with insulin. Another marker, elevated triglycerides, greater than

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Speaker 2: or equal to 150. Low HDL, which is quote-unquote good cholesterol. Right.

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Speaker 2: Lower than 40 for men, lower than 50 for women.

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Speaker 2: Hypertension or high blood pressure with a systolic of 130

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Speaker 2: or greater. And a diastolic, that's the bottom number. Systolic

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Speaker 2: is the top number. You see it's like 130 over 85.

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Speaker 2: That's top number systolic, bottom number is diastolic. Probably more

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Speaker 2: information than you need, sorry.

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Speaker 1: Right.

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Speaker 2: And the last of these markers is elevated fasting glucose,

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Speaker 2: if it's over 100. Now, Sophie is 100% right. If

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Speaker 2: you have metabolic syndrome, it puts you at risk for diabetes,

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Speaker 2: coronary artery disease, heart problems, and stroke. And his assertion

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Speaker 2: that 90% of people have at least one of these

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Speaker 2: markers is actually not far off. The CDC runs this

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Speaker 2: research program called the National Health and Nutrition Examination Survey,

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Speaker 2: or NHANES. And there was an NHANES study from 2009

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Speaker 2: to 2016, and it showed that about 12 only, I

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Speaker 2: should say, only 12% of US adults were considered, quote unquote,

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Speaker 2: metabolically healthy, or basically optimal on all five of those

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Speaker 2: markers I mentioned without medication. That implies that roughly 88%

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Speaker 2: of Americans have at least one abnormal test. I'm assuming

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Speaker 2: that's where he gets this 90% number that he talks about.

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Speaker 2: And that part is, I think, true.

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Speaker 4: Hey, everyone, this is Kaveh, you know, from the future

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Speaker 4: after this recording. And I just wanted to jump in

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Speaker 4: here real quick to say that what I said was

435
00:23:27,200 --> 00:23:32,119
Speaker 4: totally correct. No, nothing factually wrong. I just hear Robert

436
00:23:32,180 --> 00:23:34,340
Speaker 4: doing this every now and then. And, you know, it

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Speaker 4: sounded fun to me. So I wanted to give it

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Speaker 4: a try. But yeah, everything I said was right. So anyways,

439
00:23:40,520 --> 00:23:42,120
Speaker 4: back to the podcast.

440
00:23:45,900 --> 00:23:48,770
Speaker 2: But the thing is, That's not how you define metabolic syndrome.

441
00:23:49,790 --> 00:23:52,560
Speaker 2: To have metabolic syndrome, you have to have three or

442
00:23:52,630 --> 00:23:56,280
Speaker 2: more of those markers. Having just one isolated marker is

443
00:23:56,540 --> 00:24:01,520
Speaker 2: probably very, very common, but it's also clinically far less meaningful.

444
00:24:02,060 --> 00:24:04,140
Speaker 2: For metabolic syndrome, you have to have at least three

445
00:24:04,180 --> 00:24:05,879
Speaker 2: of those, and it kind of just drops it to

446
00:24:06,240 --> 00:24:10,760
Speaker 2: one to start treatment. Okay. Does that make sense? Let

447
00:24:10,780 --> 00:24:11,980
Speaker 2: me stop right there. Does that make sense?

448
00:24:12,640 --> 00:24:13,240
Speaker 1: Yeah.

449
00:24:14,340 --> 00:24:14,540
Speaker 3: Sure.

450
00:24:14,560 --> 00:24:14,740
Speaker 2: Yeah.

451
00:24:14,840 --> 00:24:15,020
Speaker 1: Yeah.

452
00:24:15,670 --> 00:24:18,050
Speaker 2: These things are important to note. And I want people

453
00:24:18,090 --> 00:24:21,410
Speaker 2: to be thinking about all these things. But this concept

454
00:24:21,450 --> 00:24:26,260
Speaker 2: of saying, like, he's changing the goalpost here about definitions

455
00:24:26,320 --> 00:24:29,900
Speaker 2: that would justify treating people aggressively. And we'll talk about

456
00:24:29,960 --> 00:24:33,200
Speaker 2: why you don't want to treat everyone aggressively. But I

457
00:24:33,240 --> 00:24:37,560
Speaker 2: don't believe this justifies it. It's certainly not justifying in

458
00:24:37,600 --> 00:24:41,179
Speaker 2: a uniform approach like he applies to his patients. We

459
00:24:41,220 --> 00:24:44,119
Speaker 2: always say lifestyle modification should be the first thing you discuss.

460
00:24:44,640 --> 00:24:47,919
Speaker 2: rather than reflexively treating people with medication. I'm the one

461
00:24:47,940 --> 00:24:50,219
Speaker 2: that gets accused of being a shill for pharma, and

462
00:24:50,300 --> 00:24:52,179
Speaker 2: I'm the one that's usually saying, hey, let's hold off

463
00:24:52,240 --> 00:24:55,600
Speaker 2: on this medicine that's unproven. I don't get it.

464
00:24:55,600 --> 00:24:58,790
Speaker 3: You do say that to me often.

465
00:24:59,190 --> 00:25:00,609
Speaker 2: Yeah, I get it a lot. I'm like, what do

466
00:25:00,650 --> 00:25:01,410
Speaker 2: you think of this thing?

467
00:25:01,450 --> 00:25:05,050
Speaker 3: And you're like, no, no.

468
00:25:05,090 --> 00:25:07,550
Speaker 2: Yeah. And writing medicine is like my bag. I'm an

469
00:25:07,710 --> 00:25:11,280
Speaker 2: internal medicine doctor at heart. That's what we do. Anyways.

470
00:25:12,830 --> 00:25:15,949
Speaker 2: You should think of interventions, I feel, as a staircase

471
00:25:16,270 --> 00:25:18,450
Speaker 2: and not a switch. And the first step should always

472
00:25:18,490 --> 00:25:21,880
Speaker 2: be lifestyle modifications, if you can help it. Now, metabolic

473
00:25:21,890 --> 00:25:24,919
Speaker 2: syndrome is a risk indicator, not an absolute risk. It

474
00:25:24,960 --> 00:25:29,900
Speaker 2: doesn't account for everything, age, sex, smoking, LDL, other factors.

475
00:25:31,140 --> 00:25:34,540
Speaker 2: Aggressive lab testing that he does is a big part

476
00:25:34,580 --> 00:25:38,790
Speaker 2: of his practice and recommendations. But in these cases, it's

477
00:25:38,830 --> 00:25:42,790
Speaker 2: highly questionable about what kind of use that serves. He

478
00:25:42,850 --> 00:25:46,090
Speaker 2: focuses on these aggressive tests for blood markers that could

479
00:25:46,130 --> 00:25:50,590
Speaker 2: potentially represent heart disease. His core panel includes something called APOB,

480
00:25:51,490 --> 00:25:55,360
Speaker 2: LP little a, CRP. And then he also recommends imaging

481
00:25:55,820 --> 00:25:59,420
Speaker 2: the coronary artery calcium or the CAC scoring.

482
00:25:59,500 --> 00:25:59,840
Speaker 1: Okay.

483
00:25:59,940 --> 00:26:01,859
Speaker 2: As well as a coronary CT. I don't think other

484
00:26:01,900 --> 00:26:04,000
Speaker 2: people refer to it as CAC, but I think it's

485
00:26:04,040 --> 00:26:07,379
Speaker 2: funnier to refer to coronary artery calcium as CAC scoring.

486
00:26:08,070 --> 00:26:08,550
Speaker 1: CAC scoring.

487
00:26:09,030 --> 00:26:12,990
Speaker 2: I'm not opposed to... early focused cardiac intervention. Of all

488
00:26:13,010 --> 00:26:15,280
Speaker 2: the stuff he does, I'm the most open to hearing

489
00:26:15,320 --> 00:26:18,280
Speaker 2: about this. But a lot of what he is recommending,

490
00:26:18,440 --> 00:26:21,659
Speaker 2: a lot of this testing outruns the evidence that we

491
00:26:21,700 --> 00:26:25,000
Speaker 2: have to support its use. Some of it hasn't even

492
00:26:25,060 --> 00:26:27,970
Speaker 2: been shown to be something we could change. So for example,

493
00:26:28,350 --> 00:26:31,210
Speaker 2: these CAC scoring tests that he does, they're expensive. They

494
00:26:31,250 --> 00:26:35,490
Speaker 2: expose you to radiation and downstream test events. And there's

495
00:26:35,510 --> 00:26:39,780
Speaker 2: no trial so far that shows that doing that actually

496
00:26:39,820 --> 00:26:43,480
Speaker 2: helps you in any way or decreases cardiac events. And

497
00:26:43,500 --> 00:26:46,679
Speaker 2: whenever you do a test, you should always ask, will

498
00:26:46,800 --> 00:26:50,439
Speaker 2: the results of this test change our management? That should

499
00:26:50,460 --> 00:26:52,619
Speaker 2: always be a question you ask. And if there's nothing

500
00:26:52,680 --> 00:26:55,370
Speaker 2: different you can do, if there's nothing different it will

501
00:26:55,400 --> 00:26:57,720
Speaker 2: give you, then you have to have serious conversations. It

502
00:26:57,740 --> 00:27:00,350
Speaker 2: doesn't mean you can't do it, but it means you

503
00:27:00,410 --> 00:27:05,369
Speaker 2: can't be applying that to everybody. He also is a

504
00:27:05,410 --> 00:27:10,170
Speaker 2: proponent for early screening tests for things like colonoscopy. Which

505
00:27:10,210 --> 00:27:12,850
Speaker 2: he sees as being proactive, but I see, as a

506
00:27:12,990 --> 00:27:16,790
Speaker 2: gastroenterologist who does them, as being a bit reckless. This

507
00:27:16,910 --> 00:27:20,389
Speaker 2: is my wheelhouse, of course. And we could talk at

508
00:27:20,560 --> 00:27:24,440
Speaker 2: length about when to start colonoscopy. But for someone without

509
00:27:24,460 --> 00:27:28,140
Speaker 2: risk factors, it's 45. That's our recommended time for screening

510
00:27:29,060 --> 00:27:31,520
Speaker 2: for colon cancer. And that's lower than 50 where it

511
00:27:31,600 --> 00:27:35,020
Speaker 2: used to be. He pushes for 40.

512
00:27:35,020 --> 00:27:37,939
Speaker 1: I mean, there's a lot more younger colon cancer cases, right?

513
00:27:38,040 --> 00:27:39,520
Speaker 1: So I don't know.

514
00:27:39,660 --> 00:27:42,060
Speaker 2: Is that wrong? I could talk to you about that.

515
00:27:42,080 --> 00:27:43,830
Speaker 2: This is a fascinating topic to me. In fact, I

516
00:27:43,900 --> 00:27:47,270
Speaker 2: just released an episode about early-onset colorectal cancer, and you

517
00:27:47,369 --> 00:27:50,870
Speaker 2: are correct. There are increasing rates. Overall, the absolute risk

518
00:27:50,910 --> 00:27:53,830
Speaker 2: is still low, but there is increasing rates of why

519
00:27:53,850 --> 00:27:57,210
Speaker 2: that is. But that's why we drop it to 45. Now,

520
00:27:57,970 --> 00:28:01,620
Speaker 2: people online constantly get mad when I talk about this.

521
00:28:02,030 --> 00:28:04,330
Speaker 2: Because they'll be like, hey, I want a colonoscopy and

522
00:28:04,369 --> 00:28:05,770
Speaker 2: you doctors are not giving it to me. And I'll

523
00:28:05,790 --> 00:28:07,750
Speaker 2: be like, how old are you? And they'll be like, 30.

524
00:28:07,730 --> 00:28:10,130
Speaker 2: And I'll be like, do you have any risk factors

525
00:28:10,170 --> 00:28:14,490
Speaker 2: like family with colon cancer or family with advanced polyps

526
00:28:14,970 --> 00:28:18,780
Speaker 2: or history of inflammatory bowel disease? Or do you have any?

527
00:28:19,260 --> 00:28:21,160
Speaker 2: signs or symptoms that are concerning? And the answer is no,

528
00:28:21,180 --> 00:28:23,760
Speaker 2: they just want it. I'm like, that's not what we

529
00:28:23,820 --> 00:28:26,160
Speaker 2: want you to do. I don't want you getting colonoscopies.

530
00:28:26,280 --> 00:28:28,540
Speaker 2: I'm a guy who does colonoscopy. I get paid to

531
00:28:28,560 --> 00:28:30,619
Speaker 2: do colonoscopies, but I don't want you to get it

532
00:28:31,040 --> 00:28:31,800
Speaker 2: unless you need it.

533
00:28:31,800 --> 00:28:35,060
Speaker 1: Yeah, it's not like free for everyone, not just out

534
00:28:35,080 --> 00:28:38,780
Speaker 1: of money standpoint, but like doctors don't have unlimited time. Yeah,

535
00:28:38,880 --> 00:28:39,320
Speaker 1: I get that.

536
00:28:39,340 --> 00:28:41,290
Speaker 2: Yes, that's a big part of it. And there's more.

537
00:28:41,310 --> 00:28:43,730
Speaker 2: We'll discuss that a little more. We'll come back to it.

538
00:28:43,750 --> 00:28:46,290
Speaker 2: But what I think he is tapping into here is

539
00:28:47,170 --> 00:28:54,030
Speaker 2: is a very real dissatisfaction, disillusionment with mainstream medicine. And

540
00:28:54,070 --> 00:28:57,490
Speaker 2: I feel that. People feel like doctors, for one reason

541
00:28:57,570 --> 00:29:02,630
Speaker 2: or another, are always gatekeeping healthcare. And to be clear,

542
00:29:02,710 --> 00:29:06,800
Speaker 2: I am 100% for preventative care. This idea is not new.

543
00:29:06,840 --> 00:29:10,010
Speaker 2: We've had primary cares for this exact reason. Why he

544
00:29:10,050 --> 00:29:11,770
Speaker 2: went into surgery, I don't know. He would have been

545
00:29:11,830 --> 00:29:14,310
Speaker 2: better off had he gone to endocrinology, but, you know,

546
00:29:14,370 --> 00:29:16,070
Speaker 2: not a lot of money there. So maybe that's, I

547
00:29:16,090 --> 00:29:18,630
Speaker 2: don't want to assume that's why he did it. But

548
00:29:19,740 --> 00:29:24,160
Speaker 2: there are other things you can do to get preventative care.

549
00:29:24,200 --> 00:29:27,360
Speaker 2: And I'm, as I said, I'm a simple country doctor.

550
00:29:28,620 --> 00:29:32,060
Speaker 2: Four years of medical school, three years of internal medicine training,

551
00:29:32,080 --> 00:29:35,560
Speaker 2: a year of chief residency, three years of gastroenterology, and

552
00:29:35,600 --> 00:29:38,820
Speaker 2: a year of liver transplant fellowship under my belt. simple

553
00:29:39,380 --> 00:29:43,270
Speaker 2: country doc stuff. And I feel so much less confident

554
00:29:43,330 --> 00:29:47,510
Speaker 2: taking the giant swings he does on all these medical issues.

555
00:29:48,690 --> 00:29:53,250
Speaker 2: He has no formal training in cardiovascular disease, neurodegenerative disease, endocrinology,

556
00:29:53,730 --> 00:29:56,870
Speaker 2: or even nutritional science, yet these are the pillars of

557
00:29:56,910 --> 00:30:01,000
Speaker 2: his practice. Again, Very smart, incredible potential as a doctor.

558
00:30:01,420 --> 00:30:04,600
Speaker 2: But what he's describing as research into these fields seems

559
00:30:04,660 --> 00:30:07,720
Speaker 2: more like maybe read a couple studies and having relationships

560
00:30:07,760 --> 00:30:10,400
Speaker 2: with people that are his friends that do know more

561
00:30:10,440 --> 00:30:13,960
Speaker 2: about than him. There's something you have to consider when

562
00:30:13,980 --> 00:30:16,680
Speaker 2: you're doing all these tests, all these advanced genetic testing,

563
00:30:16,740 --> 00:30:22,580
Speaker 2: CT angiograms, these colonoscopies. There's real harms, real risks associated

564
00:30:22,620 --> 00:30:25,030
Speaker 2: with them. And we have to weigh the benefits of them.

565
00:30:26,860 --> 00:30:29,180
Speaker 2: I'm assuming you probably want to take a commercial break

566
00:30:29,220 --> 00:30:30,280
Speaker 2: before we do that.

567
00:30:30,770 --> 00:30:31,640
Speaker 1: Yeah, why not?

568
00:30:31,680 --> 00:30:32,290
Speaker 2: Yeah.

569
00:30:32,370 --> 00:30:34,390
Speaker 1: Speaking of that, ads?

570
00:30:35,290 --> 00:30:35,630
Speaker 2: Why not?

571
00:30:35,650 --> 00:30:44,330
Speaker 1: Ads. And we're back.

572
00:30:45,670 --> 00:30:49,620
Speaker 2: Yes, we are back. Now, there was a JAMA study

573
00:30:49,660 --> 00:30:50,920
Speaker 2: I want to talk about because I think this is

574
00:30:50,940 --> 00:30:53,630
Speaker 2: really funny. And funny may not be the right word.

575
00:30:54,010 --> 00:30:56,330
Speaker 2: It came out of UC Davis in 2012. It's an

576
00:30:56,750 --> 00:30:59,780
Speaker 2: old study. And what it did was this. It showed

577
00:30:59,840 --> 00:31:02,940
Speaker 2: how happy a patient was with the care they received

578
00:31:03,460 --> 00:31:07,820
Speaker 2: and how that related to their outcomes. That study showed

579
00:31:07,840 --> 00:31:12,360
Speaker 2: that the most satisfied patients had not only higher healthcare spending,

580
00:31:12,980 --> 00:31:18,240
Speaker 2: but more hospital admissions, and most strikingly, a 26% higher

581
00:31:18,300 --> 00:31:24,270
Speaker 2: risk of death compared to the least satisfied patients cool

582
00:31:24,310 --> 00:31:29,750
Speaker 2: the satisfied patients were doing worse yeah what what thoughts

583
00:31:29,790 --> 00:31:31,770
Speaker 2: do you have about why why may that be we

584
00:31:31,790 --> 00:31:33,930
Speaker 2: don't know for sure by the way the test this

585
00:31:33,950 --> 00:31:35,070
Speaker 2: study was empowered.

586
00:31:35,410 --> 00:31:40,500
Speaker 1: I guess because people like are are satisfied because they

587
00:31:40,540 --> 00:31:43,100
Speaker 1: like their doctor and they feel listened to but that

588
00:31:43,120 --> 00:31:46,660
Speaker 1: doesn't necessarily correlate to actually improving their health care outcomes

589
00:31:46,720 --> 00:31:49,630
Speaker 1: at all it's just like how people can be really

590
00:31:49,950 --> 00:31:52,830
Speaker 1: satisfied with a doctor who's selling them like snake oil

591
00:31:52,870 --> 00:31:55,430
Speaker 1: that doesn't actually cure their cancer until they fucking die.

592
00:31:55,490 --> 00:31:58,070
Speaker 1: They don't notice something's wrong. I don't know. That would

593
00:31:58,090 --> 00:31:58,630
Speaker 1: be my guess.

594
00:31:58,950 --> 00:32:02,450
Speaker 2: No, that's right. So the more satisfied patients are probably

595
00:32:02,470 --> 00:32:06,730
Speaker 2: getting more than they asked for. More tests, more side effects,

596
00:32:06,950 --> 00:32:12,240
Speaker 2: more complications. Doctors who always say yes score very well.

597
00:32:13,520 --> 00:32:18,270
Speaker 2: And sometimes saying no in medicine is really hard. But sometimes,

598
00:32:18,290 --> 00:32:22,050
Speaker 2: and not always, declining a test or medicine or antibiotic

599
00:32:22,150 --> 00:32:25,010
Speaker 2: or refusing to do a low-value scan or imaging study

600
00:32:25,690 --> 00:32:29,810
Speaker 2: may actually serve patients better. Now, this is a big, nuanced,

601
00:32:30,070 --> 00:32:33,510
Speaker 2: and difficult conversation because you have to weigh those considerations

602
00:32:33,610 --> 00:32:36,469
Speaker 2: with listening to your patients and advocating for them. And

603
00:32:36,530 --> 00:32:38,410
Speaker 2: it is not an excuse to not listen to your

604
00:32:38,450 --> 00:32:42,360
Speaker 2: patients and take their complaints seriously. I'm fully aware that

605
00:32:42,410 --> 00:32:45,710
Speaker 2: our country has a very serious problem taking patients seriously,

606
00:32:45,790 --> 00:32:48,880
Speaker 2: particularly if they are Black and or female. This is

607
00:32:48,990 --> 00:32:52,800
Speaker 2: a real problem that we have in this country. But

608
00:32:53,440 --> 00:32:56,680
Speaker 2: it's always important to keep in mind that sometimes do

609
00:32:56,740 --> 00:32:59,800
Speaker 2: no harm is the right step. Not doing the thing

610
00:33:00,080 --> 00:33:04,800
Speaker 2: is the better approach. To be totally transparent also, there

611
00:33:04,840 --> 00:33:08,620
Speaker 2: have been follow-up studies to that 2012 studies. Some have supported,

612
00:33:08,740 --> 00:33:12,190
Speaker 2: some have detracted. I feel the weight of time has

613
00:33:12,230 --> 00:33:14,640
Speaker 2: sort of borne this out, though, and it does seem

614
00:33:14,700 --> 00:33:19,080
Speaker 2: to be true. There was a 2019 Cochrane meta-analysis that

615
00:33:19,160 --> 00:33:23,000
Speaker 2: showed real dangers to over-diagnosis and treatment. It can lead

616
00:33:23,040 --> 00:33:27,070
Speaker 2: to unnecessary interventions. One test leads to another test leads

617
00:33:27,110 --> 00:33:30,510
Speaker 2: to another test, and these things have risks. Sometimes they're necessary,

618
00:33:30,550 --> 00:33:33,150
Speaker 2: sometimes they are not. And these things carry not only

619
00:33:33,270 --> 00:33:35,990
Speaker 2: real harm, but also psychological burden as well.

620
00:33:36,710 --> 00:33:36,820
Speaker 3: So.

621
00:33:37,750 --> 00:33:40,890
Speaker 2: I think largely his reason for doing this is not

622
00:33:40,950 --> 00:33:43,330
Speaker 2: bad or malicious. I think he does want to help

623
00:33:43,450 --> 00:33:46,750
Speaker 2: before a problem exists. And like I said, a lot

624
00:33:46,770 --> 00:33:49,170
Speaker 2: of his advice is reasonable stuff. And I actually kind

625
00:33:49,210 --> 00:33:52,060
Speaker 2: of like some of it. Eat less processed food, exercise,

626
00:33:52,100 --> 00:33:52,540
Speaker 2: sleep well.

627
00:33:52,880 --> 00:33:53,080
Speaker 1: Great.

628
00:33:54,040 --> 00:33:58,240
Speaker 2: But it's also paired with this really over-the-top monitoring with

629
00:33:58,300 --> 00:34:03,200
Speaker 2: intense and very pricey strategies that lack evidence. And some

630
00:34:03,240 --> 00:34:05,480
Speaker 2: of the relationships he has to these things are not

631
00:34:05,780 --> 00:34:10,330
Speaker 2: ideal at For example, he, as I mentioned, promotes continuous

632
00:34:10,390 --> 00:34:14,480
Speaker 2: glucose monitoring for people without diabetes or signs of insulin resistance.

633
00:34:15,200 --> 00:34:16,560
Speaker 1: Yeah.

634
00:34:16,980 --> 00:34:21,299
Speaker 2: Not necessary. Yes. In your medical professional experience, you would

635
00:34:21,380 --> 00:34:24,180
Speaker 2: also agree with me, and you are correct. But it's

636
00:34:24,200 --> 00:34:27,540
Speaker 2: become a big hit with the MAHA crowd, these tests.

637
00:34:29,060 --> 00:34:32,340
Speaker 2: And there's no evidence that's of any use to non-diabetic patients.

638
00:34:32,460 --> 00:34:36,700
Speaker 2: And it can lead to unnecessary dietary restrictions, anxiety, even

639
00:34:36,760 --> 00:34:41,980
Speaker 2: disordered eating. And the information, the data you get from

640
00:34:42,040 --> 00:34:46,219
Speaker 2: these continuous glucose monitorings, it's often difficult to interpret. And

641
00:34:46,510 --> 00:34:49,770
Speaker 2: getting one with an ongoing data plan is hundreds of

642
00:34:49,810 --> 00:34:50,969
Speaker 2: dollars per month.

643
00:34:51,230 --> 00:34:52,069
Speaker 3: It's expensive.

644
00:34:52,090 --> 00:34:53,109
Speaker 2: A lot of.

645
00:34:53,070 --> 00:34:57,770
Speaker 3: People that have diabetes that need these sorts of devices-

646
00:34:58,550 --> 00:35:03,360
Speaker 3: are either unable to get it or the prices are

647
00:35:03,390 --> 00:35:07,320
Speaker 3: increasing because of things like this. And I know a

648
00:35:07,440 --> 00:35:08,720
Speaker 3: specific device that you're going.

649
00:35:08,620 --> 00:35:09,380
Speaker 2: To talk about.

650
00:35:09,400 --> 00:35:15,980
Speaker 3: And I know that it is extremely difficult to at

651
00:35:16,040 --> 00:35:19,920
Speaker 3: times get that device. And I can't imagine this helps.

652
00:35:20,820 --> 00:35:24,520
Speaker 2: No, you're exactly right. That's what happens. You, the resources

653
00:35:24,860 --> 00:35:27,140
Speaker 2: are limited. Our problem in this country is not so

654
00:35:27,180 --> 00:35:30,540
Speaker 2: much that we don't have the things to help patients.

655
00:35:30,560 --> 00:35:32,520
Speaker 2: It's that we don't have access for them to get

656
00:35:32,580 --> 00:35:32,900
Speaker 2: to it.

657
00:35:33,620 --> 00:35:33,900
Speaker 1: Yeah.

658
00:35:34,260 --> 00:35:37,620
Speaker 2: And also grounding out what Sophie was alluding to there.

659
00:35:38,250 --> 00:35:41,670
Speaker 2: He was a paid advertiser for a company called Dexcom

660
00:35:42,170 --> 00:35:47,400
Speaker 2: that sells these devices. That's not ideal. It's not ideal. Um,

661
00:35:47,880 --> 00:35:50,940
Speaker 2: He has been criticized for not disclosing that very well.

662
00:35:51,040 --> 00:35:53,390
Speaker 2: I have seen him mention it, but I don't think

663
00:35:53,430 --> 00:35:55,330
Speaker 2: he did it every time. So I think it's a

664
00:35:55,370 --> 00:35:56,770
Speaker 2: valid criticism.

665
00:35:57,469 --> 00:35:57,689
Speaker 4: Sure.

666
00:35:57,770 --> 00:36:00,110
Speaker 2: By the way, that company has since said his advisory

667
00:36:00,130 --> 00:36:04,950
Speaker 2: role ended in 2021. But when this topic comes up

668
00:36:05,570 --> 00:36:09,960
Speaker 2: of concerns, hey, aren't we just creating a new tier

669
00:36:10,000 --> 00:36:13,569
Speaker 2: of medical care for just those with extreme wealth? And

670
00:36:13,590 --> 00:36:17,110
Speaker 2: that it's preventative medicine for people who are already privileged

671
00:36:17,200 --> 00:36:21,100
Speaker 2: and probably doing better. He'll downplay the cost of these

672
00:36:21,140 --> 00:36:24,879
Speaker 2: things he's ordering by correctly pointing out that the end-of-life

673
00:36:25,000 --> 00:36:29,100
Speaker 2: care is also very expensive. And that is true. A

674
00:36:29,180 --> 00:36:33,540
Speaker 2: disproportionate amount of healthcare in this country spending is at

675
00:36:33,580 --> 00:36:36,279
Speaker 2: the end of a patient's life. The cost of all

676
00:36:36,340 --> 00:36:39,340
Speaker 2: the machines and the labor and medicine in those critically

677
00:36:39,480 --> 00:36:43,410
Speaker 2: ill hospitalized patients, that adds up quickly. But both things

678
00:36:43,590 --> 00:36:46,610
Speaker 2: can be true. And nobody's saying we shouldn't practice preventative care.

679
00:36:47,310 --> 00:36:49,950
Speaker 2: But the thing is this, even if his measures do work,

680
00:36:50,150 --> 00:36:52,850
Speaker 2: which is a big if, it's still just pushing the

681
00:36:52,910 --> 00:36:55,200
Speaker 2: end-of-life care and all the money that goes into it

682
00:36:55,320 --> 00:36:59,779
Speaker 2: further down the road. So you're not saving money this way.

683
00:37:00,140 --> 00:37:03,270
Speaker 2: You're spending money on both ends. A lot of it,

684
00:37:03,280 --> 00:37:05,440
Speaker 2: a lot of health care dollars are going to go

685
00:37:05,460 --> 00:37:09,440
Speaker 2: into this on both ends. And for that reason, actually,

686
00:37:09,820 --> 00:37:13,210
Speaker 2: real quick before we move on from end-of-life care– It's

687
00:37:13,230 --> 00:37:17,210
Speaker 2: an important reason that doctors recommend having those goals of

688
00:37:17,250 --> 00:37:20,310
Speaker 2: care discussion and what you would want done if you

689
00:37:20,330 --> 00:37:22,870
Speaker 2: were to become critically ill and not be able to

690
00:37:23,250 --> 00:37:27,580
Speaker 2: weigh in. Unfortunately, when this is reasonably discussed, Republicans refer

691
00:37:27,620 --> 00:37:30,080
Speaker 2: to it as death panels, and we never get to

692
00:37:30,120 --> 00:37:30,500
Speaker 2: have this.

693
00:37:30,520 --> 00:37:30,640
Speaker 3: Right.

694
00:37:30,940 --> 00:37:32,340
Speaker 1: I remember the death panel days.

695
00:37:32,380 --> 00:37:32,680
Speaker 3: Yeah.

696
00:37:33,340 --> 00:37:36,720
Speaker 1: And then we had real death panels under a Republican. Anyway, whatever.

697
00:37:37,100 --> 00:37:41,029
Speaker 2: We've had real death panels. But having end-of-life care discussions is,

698
00:37:41,690 --> 00:37:45,850
Speaker 2: is not only important for saving money, it's also just

699
00:37:45,950 --> 00:37:49,570
Speaker 2: really important for knowing really what your loved ones want.

700
00:37:50,390 --> 00:37:54,390
Speaker 2: So I think it's... Anyways, have that discussion, folks, even

701
00:37:54,450 --> 00:37:56,109
Speaker 2: if you are healthy. You should at least be having

702
00:37:56,130 --> 00:37:58,879
Speaker 2: those discussions along the way. Now, all this, I think,

703
00:37:58,930 --> 00:38:01,620
Speaker 2: are things that you kind of learn in the actual

704
00:38:01,680 --> 00:38:04,780
Speaker 2: practice of medicine, something he missed, this do no harm.

705
00:38:05,340 --> 00:38:06,860
Speaker 3: Yeah.

706
00:38:06,980 --> 00:38:10,510
Speaker 2: The colonoscopy part, I think, is... A great example of this.

707
00:38:11,110 --> 00:38:13,649
Speaker 2: So our current guidelines have dropped to 45. He wants

708
00:38:13,690 --> 00:38:15,589
Speaker 2: it to go down even further to 40. And again,

709
00:38:17,110 --> 00:38:18,839
Speaker 2: despite how strange it might seem to some people, there

710
00:38:18,880 --> 00:38:21,600
Speaker 2: are people who want these tests done as early as possible.

711
00:38:22,080 --> 00:38:26,960
Speaker 2: But as Robert said, one part of it is we

712
00:38:26,980 --> 00:38:28,950
Speaker 2: just don't have the people to do it. I mean,

713
00:38:29,010 --> 00:38:32,390
Speaker 2: I could... do colonoscopies every day, all day for the

714
00:38:32,410 --> 00:38:34,940
Speaker 2: end of time, and I will not have scratched the

715
00:38:34,980 --> 00:38:38,100
Speaker 2: surface of the colonoscopies that need to get done. So

716
00:38:38,120 --> 00:38:40,600
Speaker 2: we're taking it away from people who need it. But

717
00:38:41,440 --> 00:38:44,250
Speaker 2: on top of that, there's risk to doing these tests.

718
00:38:44,770 --> 00:38:48,610
Speaker 2: There's actual physical risks. Bad things can happen. It's rare, thankfully.

719
00:38:49,070 --> 00:38:52,950
Speaker 2: You should get colon cancer screening. But colonoscopy does have

720
00:38:53,010 --> 00:38:55,930
Speaker 2: some risk, and it's not cheap. And again, I'm telling

721
00:38:55,950 --> 00:38:58,410
Speaker 2: you this as someone who stands to make a lot

722
00:38:58,430 --> 00:39:01,310
Speaker 2: of money off of you getting colonoscopies.

723
00:39:01,330 --> 00:39:02,450
Speaker 1: Yeah.

724
00:39:02,770 --> 00:39:05,410
Speaker 2: So take my word for this one. You're like, it's

725
00:39:05,450 --> 00:39:07,250
Speaker 2: something we have to be more mindful about.

726
00:39:07,670 --> 00:39:09,069
Speaker 1: Yeah, for sure.

727
00:39:10,700 --> 00:39:12,910
Speaker 2: He talks about some other stuff with his patients that's

728
00:39:13,030 --> 00:39:16,060
Speaker 2: overall less fun for me. He emphasizes zone two training

729
00:39:16,760 --> 00:39:21,540
Speaker 2: as optimal for mitochondrial capacity and longevity. This does contradict

730
00:39:21,640 --> 00:39:26,820
Speaker 2: some substantial evidence behind higher intensity training. Again, kind of

731
00:39:26,860 --> 00:39:29,350
Speaker 2: what he's doing here is he's cherry-picking studies that look

732
00:39:29,730 --> 00:39:33,660
Speaker 2: at observational data in elite endurance athletes. I'm not sure

733
00:39:33,700 --> 00:39:37,500
Speaker 2: how that translates. But that cherry-picking study stuff is something

734
00:39:37,520 --> 00:39:40,200
Speaker 2: that RFK Jr. does as well. And what they all

735
00:39:40,239 --> 00:39:41,420
Speaker 2: do in this sort of world.

736
00:39:41,440 --> 00:39:43,759
Speaker 1: It's a vote these days, yeah.

737
00:39:43,960 --> 00:39:47,680
Speaker 2: It's the modus operandi of our current administration. So RFK Jr.

738
00:39:48,390 --> 00:39:51,050
Speaker 2: One thing that they will all do is they will

739
00:39:51,489 --> 00:39:54,290
Speaker 2: take a little bit of data and then extrapolate it

740
00:39:54,730 --> 00:39:58,850
Speaker 2: far beyond what that data was meant to do. Something

741
00:39:58,910 --> 00:40:01,820
Speaker 2: he does this with is one of his quote-unquote horsemen.

742
00:40:01,840 --> 00:40:04,020
Speaker 2: He talks about the four horsemen of the apocalypse, and

743
00:40:04,060 --> 00:40:08,400
Speaker 2: one of them is cancer. Sorry.

744
00:40:08,880 --> 00:40:11,640
Speaker 3: That was like an audible groan.

745
00:40:14,300 --> 00:40:14,700
Speaker 4: Okay.

746
00:40:15,020 --> 00:40:18,200
Speaker 2: Sorry, I'm back. I felt that way. Again, I actually

747
00:40:18,239 --> 00:40:20,969
Speaker 2: liked parts of his book. Parts of it were, I thought,

748
00:40:21,050 --> 00:40:27,370
Speaker 2: very reasonable. But, for example, when he talks about cancer,

749
00:40:27,870 --> 00:40:30,270
Speaker 2: he points out that cancer cells require more glucose than

750
00:40:30,330 --> 00:40:35,089
Speaker 2: normal human cells. And that is true. And you'll hear

751
00:40:35,110 --> 00:40:37,550
Speaker 2: a lot of wellness people take that little bit of information.

752
00:40:37,570 --> 00:40:41,600
Speaker 1: Yeah, starve your cancer by avoiding sugar or whatever. I've

753
00:40:41,660 --> 00:40:42,940
Speaker 1: seen that a lot.

754
00:40:43,020 --> 00:40:45,180
Speaker 2: Right. They take a little bit of truth and they

755
00:40:45,200 --> 00:40:48,520
Speaker 2: make giant leaps from there regarding the nature of cancer's

756
00:40:48,560 --> 00:40:52,200
Speaker 2: formation and sugar's role in it. And it's honestly, it's

757
00:40:52,219 --> 00:40:54,860
Speaker 2: still not clear what that means, you know. Is it

758
00:40:54,930 --> 00:40:57,090
Speaker 2: the cause of the cancer, the sugar, or is it

759
00:40:57,150 --> 00:40:59,770
Speaker 2: just some interesting feature of the cancer?

760
00:40:59,790 --> 00:40:59,870
Speaker 5: Yeah.

761
00:41:00,460 --> 00:41:03,989
Speaker 2: To make jumps from a simple lab-tested fact to saying

762
00:41:04,070 --> 00:41:07,630
Speaker 2: dietary manipulations could help the growth of cancer is shaky

763
00:41:07,790 --> 00:41:12,050
Speaker 2: at best. And diet is important. I'm a huge proponent

764
00:41:12,219 --> 00:41:14,919
Speaker 2: of a healthy diet that is high in fiber. Again, fiber, folks.

765
00:41:15,700 --> 00:41:19,839
Speaker 2: I'm deep in the pocket of big fiber. But while

766
00:41:19,860 --> 00:41:22,530
Speaker 2: there is solid evidence that healthy dietary patterns can lower

767
00:41:22,550 --> 00:41:25,959
Speaker 2: your risk for things, right now... There isn't the risk

768
00:41:26,000 --> 00:41:29,920
Speaker 2: of these things he's recommending, like ketogenic diets, prolonged fasts,

769
00:41:30,140 --> 00:41:34,880
Speaker 2: caloric restrictions. There's no evidence that those things work. When

770
00:41:34,920 --> 00:41:38,859
Speaker 2: we want people to learn, when I want people to

771
00:41:38,969 --> 00:41:40,620
Speaker 2: learn about what they're eating and how it affects them,

772
00:41:40,730 --> 00:41:44,670
Speaker 2: I want it to be broad and sustainable patterns. Mostly plants,

773
00:41:45,230 --> 00:41:49,530
Speaker 2: limited red meat, limited processed meats. And I don't disagree

774
00:41:49,570 --> 00:41:52,049
Speaker 2: with limiting sugar either. I agree. For the purpose of

775
00:41:52,150 --> 00:41:56,730
Speaker 2: maximizing your cardio metabolic risks, That's well proven. I don't

776
00:41:56,770 --> 00:41:58,290
Speaker 2: find it to be a good argument in the case

777
00:41:58,430 --> 00:42:00,710
Speaker 2: of cancer. The data just isn't there yet. Or if

778
00:42:00,750 --> 00:42:04,310
Speaker 2: you're cool, you call it data. Let's talk a little

779
00:42:04,330 --> 00:42:07,569
Speaker 2: bit more about the medications. Because, again, I'm the one

780
00:42:07,590 --> 00:42:10,060
Speaker 2: that gets accused of being a pharma shill. But if

781
00:42:10,100 --> 00:42:12,720
Speaker 2: a right-wing doctor tells you to buy a year's supply

782
00:42:12,760 --> 00:42:16,719
Speaker 2: of ivermectin, you do it out there. So I'll never

783
00:42:16,760 --> 00:42:19,540
Speaker 2: understand that. Not that he's recommended ivermectin.

784
00:42:19,600 --> 00:42:25,010
Speaker 3: For the non-pharmacist. Netflix watchers, I just rolled my eyes very, very, very, very,

785
00:42:25,090 --> 00:42:26,190
Speaker 3: very dramatically.

786
00:42:26,210 --> 00:42:28,290
Speaker 2: Yeah, you're going to strain something. You got to be careful.

787
00:42:28,969 --> 00:42:34,910
Speaker 2: So he's a big fan of aggressive pharmacologic intervention using medications.

788
00:42:34,930 --> 00:42:35,390
Speaker 4: Sure he is.

789
00:42:35,950 --> 00:42:39,710
Speaker 2: Off-label. Now, I'll give one example. I could give a lot,

790
00:42:39,750 --> 00:42:41,739
Speaker 2: but there's one, and I think it's a fun one.

791
00:42:42,200 --> 00:42:43,719
Speaker 2: And there's a little nerd in me that wants to

792
00:42:43,760 --> 00:42:46,779
Speaker 2: share this story with you guys. And I think your

793
00:42:46,820 --> 00:42:49,779
Speaker 2: listeners will enjoy it. It's about a medicine that he prescribes.

794
00:42:50,330 --> 00:42:55,069
Speaker 2: for his patients called rapamycin. You might have seen it, serolimus.

795
00:42:55,760 --> 00:43:01,700
Speaker 2: And he prescribes it for longevity-enhancing purposes. And, yeah, there

796
00:43:01,840 --> 00:43:06,380
Speaker 2: is a little bit of promising preclinical data to suggest

797
00:43:06,540 --> 00:43:10,940
Speaker 2: some longevity benefits. It's still very much a hypothesis, and

798
00:43:10,980 --> 00:43:14,219
Speaker 2: there's no phase three trials to prove it. As an

799
00:43:14,520 --> 00:43:18,489
Speaker 2: interesting aside, this rapamycin is actually an antifungal And this

800
00:43:18,550 --> 00:43:21,090
Speaker 2: is fun, how it was discovered. It was discovered in

801
00:43:21,130 --> 00:43:24,840
Speaker 2: the dirt of an Easter Island volcanic crater in the

802
00:43:24,900 --> 00:43:26,500
Speaker 2: 60s in Rapa Nui. Okay.

803
00:43:26,520 --> 00:43:29,160
Speaker 1: Which I hope I'm saying right. How did they find it?

804
00:43:29,440 --> 00:43:30,940
Speaker 2: Great question. What in the world is going on here?

805
00:43:30,960 --> 00:43:33,860
Speaker 1: Were they just looking at random, just sucking up different

806
00:43:34,430 --> 00:43:36,830
Speaker 1: things that they found on the island? Does this have medical?

807
00:43:36,910 --> 00:43:38,220
Speaker 1: I don't know. How did they find it?

808
00:43:38,690 --> 00:43:42,029
Speaker 2: Great, great question. So there was this microbiologist. who was

809
00:43:42,090 --> 00:43:45,469
Speaker 2: collecting soil because they wanted to take samples, and they

810
00:43:45,510 --> 00:43:48,560
Speaker 2: wanted to figure out why the islanders who lived there

811
00:43:49,020 --> 00:43:52,800
Speaker 2: never got tetanus despite walking around with no shoes.

812
00:43:54,060 --> 00:43:56,879
Speaker 1: Cool as that. Actually, that's a really cool thing to do. Yeah,

813
00:43:56,900 --> 00:43:57,680
Speaker 1: that makes sense.

814
00:43:58,400 --> 00:44:02,239
Speaker 2: But you can imagine some Republican talking about this in

815
00:44:02,260 --> 00:44:06,129
Speaker 2: the day being like, hey, we're wasting money testing the

816
00:44:06,330 --> 00:44:07,890
Speaker 2: dirt in Rapa Nui.

817
00:44:08,030 --> 00:44:08,150
Speaker 5: Yeah.

818
00:44:08,800 --> 00:44:10,960
Speaker 2: You know, that's how it is. Yeah, that makes sense.

819
00:44:10,980 --> 00:44:13,460
Speaker 2: You never know where research is going to lead you.

820
00:44:13,500 --> 00:44:15,940
Speaker 2: And it leads you to some really amazing places. Anyways,

821
00:44:16,739 --> 00:44:19,719
Speaker 2: since discovering it, people have studied its use for all

822
00:44:19,780 --> 00:44:22,419
Speaker 2: kinds of different things. It was actually found to have

823
00:44:22,620 --> 00:44:27,380
Speaker 2: some immunosuppressive effects. So because of that, it's used for

824
00:44:27,460 --> 00:44:30,339
Speaker 2: transplant patients to alter their immune system. So if you

825
00:44:30,360 --> 00:44:35,180
Speaker 2: get a transplanted kidney, you take this medication usually to

826
00:44:35,239 --> 00:44:39,400
Speaker 2: help prevent your body from rejecting it. Now, as I mentioned,

827
00:44:39,420 --> 00:44:42,740
Speaker 2: there is some early data that suggests it can affect

828
00:44:42,980 --> 00:44:48,839
Speaker 2: lifespan of mice. Human trials have been very limited, though.

829
00:44:49,450 --> 00:44:52,210
Speaker 2: Maybe it might help improve the flu vaccine response. It's

830
00:44:52,250 --> 00:44:55,529
Speaker 2: not quite clear. People thought it could be potentially used

831
00:44:55,550 --> 00:44:59,730
Speaker 2: for weight loss, but that really didn't pan out. And

832
00:45:00,350 --> 00:45:02,989
Speaker 2: it's not shown the metabolic stuff that they expect it to,

833
00:45:03,150 --> 00:45:06,509
Speaker 2: but it's a really small example of of something that

834
00:45:06,590 --> 00:45:11,510
Speaker 2: the anti-vaccine community and something that RFK Jr. do. Extrapolating

835
00:45:11,560 --> 00:45:14,420
Speaker 2: a small truth in a small study or an animal

836
00:45:14,480 --> 00:45:19,640
Speaker 2: study to a large truth in humans, something it's not powered, meant,

837
00:45:19,700 --> 00:45:20,120
Speaker 2: or designed to do.

838
00:45:20,120 --> 00:45:21,660
Speaker 1: Right, yeah, I see a lot of this.

839
00:45:22,460 --> 00:45:23,840
Speaker 2: Yeah, it's a big stretch.

840
00:45:24,489 --> 00:45:24,790
Speaker 1: Yeah.

841
00:45:26,010 --> 00:45:28,350
Speaker 2: And I mean, it's great clickbait stuff, right? You see

842
00:45:28,370 --> 00:45:32,989
Speaker 2: an article that says like, this secret medicine discovered in

843
00:45:33,010 --> 00:45:36,080
Speaker 2: the Easter Island crater is, will expand your life. And

844
00:45:36,100 --> 00:45:39,400
Speaker 2: you're like, that's awesome. And you read it. And sometimes

845
00:45:39,440 --> 00:45:42,200
Speaker 2: if you're lucky, they'll explain that it's not that, but

846
00:45:42,260 --> 00:45:45,719
Speaker 2: it's really fun. Clickbaity stuff. It's really, it sits with

847
00:45:45,739 --> 00:45:48,720
Speaker 2: people and it's exciting. So yeah, he's.

848
00:45:48,580 --> 00:45:51,819
Speaker 3: Also a guy that like is a soundbite guy. So you're,

849
00:45:51,840 --> 00:45:53,819
Speaker 3: you know, you're going to get, you know, two minutes

850
00:45:53,880 --> 00:45:56,739
Speaker 3: of him talking on some other guy. We hates podcast

851
00:45:57,300 --> 00:45:59,680
Speaker 3: talking about how great said thing is. And it just

852
00:45:59,719 --> 00:46:05,870
Speaker 3: spreads like wildfire and, and is actually just not scientifically sound,

853
00:46:06,350 --> 00:46:10,730
Speaker 3: and you're just spreading scientific misinformation and causing harm.

854
00:46:11,390 --> 00:46:15,110
Speaker 2: That's exactly right. Yeah. Thank you. Now, because it's off-label,

855
00:46:16,090 --> 00:46:20,340
Speaker 2: there's no regulating the dose. There's no guidelines on dosing

856
00:46:20,380 --> 00:46:24,940
Speaker 2: or monitoring. Maybe there's some protective effects against aging, but

857
00:46:24,980 --> 00:46:29,460
Speaker 2: these same exact pathways... drive immunosuppression. So you can't take

858
00:46:29,500 --> 00:46:32,640
Speaker 2: these things lightly. You don't want to be immunosuppressed if

859
00:46:32,680 --> 00:46:37,080
Speaker 2: you don't need to. No. Because as the title suggests,

860
00:46:37,480 --> 00:46:40,910
Speaker 2: your immune system is being suppressed. And your immune system

861
00:46:40,930 --> 00:46:41,239
Speaker 2: is a good thing.

862
00:46:41,260 --> 00:46:43,989
Speaker 1: Yeah, I wouldn't want to take immunosuppressants as a longevity

863
00:46:44,310 --> 00:46:47,950
Speaker 1: treatment because your immune system sometimes helps you stop dying.

864
00:46:47,989 --> 00:46:49,890
Speaker 1: Like I get why it helps your longevity if you've

865
00:46:49,930 --> 00:46:51,569
Speaker 1: got like a transplant. That makes sense.

866
00:46:51,590 --> 00:46:51,770
Speaker 5: Right.

867
00:46:52,290 --> 00:46:55,480
Speaker 2: And people haven't studied its use in situations like this.

868
00:46:56,050 --> 00:46:59,200
Speaker 2: It's long-term risk of use for people who don't have

869
00:46:59,640 --> 00:47:03,439
Speaker 2: a transplant, for example. And, you know, there's some real

870
00:47:03,500 --> 00:47:05,980
Speaker 2: risk with it that we do know about. There's some

871
00:47:06,060 --> 00:47:10,360
Speaker 2: increased risk to infection, as I mentioned, the development of lymphoma,

872
00:47:11,140 --> 00:47:14,710
Speaker 2: and some metabolic problems that the whole field of longevity

873
00:47:14,730 --> 00:47:20,330
Speaker 2: is really supposedly aimed to prevent. So it's this kind

874
00:47:20,370 --> 00:47:23,250
Speaker 2: of fast and loose relationship to science and medicine that's

875
00:47:23,290 --> 00:47:26,450
Speaker 2: made him a pop culture scientist and star. He sounds

876
00:47:26,510 --> 00:47:29,570
Speaker 2: really convincing, intelligent when he talks about the stuff, especially

877
00:47:29,610 --> 00:47:32,230
Speaker 2: if it's in these short bursts. He knows how to

878
00:47:32,290 --> 00:47:34,690
Speaker 2: talk about data in a way that's even more convincing,

879
00:47:34,750 --> 00:47:36,840
Speaker 2: I feel, than Andrew Huberman. He's good at it.

880
00:47:37,070 --> 00:47:37,630
Speaker 1: Yeah.

881
00:47:37,890 --> 00:47:38,150
Speaker 3: Yeah.

882
00:47:38,190 --> 00:47:41,130
Speaker 2: And he's influencing people. He's getting the attention of everyone

883
00:47:41,150 --> 00:47:44,540
Speaker 2: in the manosphere. His approach to medicine is great for

884
00:47:44,560 --> 00:47:48,420
Speaker 2: people like RFK Jr. and anti-vaxxers. He can speak intelligently

885
00:47:48,480 --> 00:47:51,040
Speaker 2: about the data and sound authoritative, but And it can

886
00:47:51,080 --> 00:47:53,440
Speaker 2: help science wash them a little bit. He's got a

887
00:47:53,500 --> 00:47:57,299
Speaker 2: real credibility behind him. It's like when Brian Cox shows

888
00:47:57,380 --> 00:48:01,339
Speaker 2: up in Super Troopers. He gives them this whole sense

889
00:48:01,380 --> 00:48:02,300
Speaker 2: of gravitas.

890
00:48:02,510 --> 00:48:02,700
Speaker 3: Great.

891
00:48:02,719 --> 00:48:05,390
Speaker 1: I often think about Super Troopers when I'm considering the

892
00:48:05,430 --> 00:48:08,670
Speaker 1: validity of different medical opinions. Yeah.

893
00:48:08,969 --> 00:48:11,810
Speaker 2: He doesn't even need to vocally support RFK Jr. He

894
00:48:11,890 --> 00:48:14,430
Speaker 2: doesn't vocally support him. He's pretty careful about what he

895
00:48:14,469 --> 00:48:16,469
Speaker 2: says about him. But all he has to do is

896
00:48:16,530 --> 00:48:20,359
Speaker 2: give them the plausibility by not refuting them And coexisting

897
00:48:20,380 --> 00:48:22,460
Speaker 2: in the same world with them and going out of

898
00:48:22,480 --> 00:48:26,899
Speaker 2: his way to not trouble them. For example, when he's

899
00:48:27,000 --> 00:48:31,000
Speaker 2: asked about RFK Jr. 's accusation that Tylenol causes autism,

900
00:48:32,070 --> 00:48:35,770
Speaker 2: something that every doctor I know of, even ones who

901
00:48:35,790 --> 00:48:38,270
Speaker 2: don't have the same political links as me, they look

902
00:48:38,290 --> 00:48:40,049
Speaker 2: at that, they've seen it, they know anything about it,

903
00:48:40,050 --> 00:48:41,610
Speaker 2: they're like, that's kind of nonsense.

904
00:48:42,170 --> 00:48:42,330
Speaker 3: Yeah.

905
00:48:42,350 --> 00:48:44,430
Speaker 2: When he's asked about it, he describes it sort of

906
00:48:44,750 --> 00:48:47,270
Speaker 2: as a low probability event and kind of tries to

907
00:48:47,290 --> 00:48:48,330
Speaker 2: move on from that discussion.

908
00:48:48,350 --> 00:48:48,989
Speaker 3: Okay.

909
00:48:49,489 --> 00:48:52,710
Speaker 2: A low probability. Is it Pete? From all the available data,

910
00:48:52,810 --> 00:48:55,650
Speaker 2: it's a no probability event. That's the kind of thing

911
00:48:55,890 --> 00:48:57,569
Speaker 2: you have to be able to stand up. You have

912
00:48:57,610 --> 00:48:59,069
Speaker 2: to be able to take a side. And I know

913
00:48:59,110 --> 00:49:02,160
Speaker 2: people will say doctors shouldn't be political, but this isn't

914
00:49:02,180 --> 00:49:04,620
Speaker 2: even political. This is not political.

915
00:49:04,660 --> 00:49:06,520
Speaker 3: This is just due diligence.

916
00:49:06,540 --> 00:49:07,080
Speaker 1: This is just.

917
00:49:08,020 --> 00:49:10,840
Speaker 2: Yeah. Say the truth. Say the medical truth. Say the

918
00:49:10,890 --> 00:49:11,680
Speaker 2: scientific truth.

919
00:49:12,550 --> 00:49:14,810
Speaker 3: This is just the sky is blue bullshit. Yeah.

920
00:49:15,610 --> 00:49:19,969
Speaker 2: It absolutely is. So when it comes to his bastard-ish, bastardocity,

921
00:49:21,400 --> 00:49:23,880
Speaker 2: is he a medical bastard? Obviously not on the level

922
00:49:24,600 --> 00:49:26,960
Speaker 2: of Marion Sims, who we discussed before.

923
00:49:26,980 --> 00:49:29,850
Speaker 1: Right, or on RFK Jr. even. Or Dr.

924
00:49:29,870 --> 00:49:32,450
Speaker 2: Oz either, who I really don't like either.

925
00:49:32,469 --> 00:49:32,549
Speaker 5: Sure.

926
00:49:33,100 --> 00:49:35,880
Speaker 2: He's not as creepy. He's not as creepy as some

927
00:49:35,940 --> 00:49:38,279
Speaker 2: of the other longevity gurus.

928
00:49:38,400 --> 00:49:40,420
Speaker 3: I pre-laughed at that. Sorry.

929
00:49:40,460 --> 00:49:41,020
Speaker 1: No, no.

930
00:49:41,320 --> 00:49:42,560
Speaker 2: He's not as creepy.

931
00:49:42,820 --> 00:49:45,800
Speaker 3: You're not wrong.

932
00:49:46,180 --> 00:49:49,250
Speaker 1: He's not as creepy.

933
00:49:49,489 --> 00:49:52,069
Speaker 2: He's not as creepy as some of the other longevity

934
00:49:52,390 --> 00:49:56,810
Speaker 2: guys like Brian Johnson who deserves his own episode. Have

935
00:49:56,830 --> 00:49:58,569
Speaker 2: you done Brian Johnson? No. No.

936
00:49:59,450 --> 00:50:01,010
Speaker 3: I mean, he comes up every now and again.

937
00:50:01,030 --> 00:50:03,410
Speaker 1: Nah, he's not, because he's not really a bad, he's a,

938
00:50:03,410 --> 00:50:07,260
Speaker 1: we might do him because he's funny. Yeah. But he's not, like,

939
00:50:07,280 --> 00:50:09,500
Speaker 1: the thing about him that I actually do respect a

940
00:50:09,520 --> 00:50:11,540
Speaker 1: little bit is that, like, of all of the super

941
00:50:11,660 --> 00:50:14,400
Speaker 1: crazy rich maniacs out there, most of them are spending

942
00:50:14,440 --> 00:50:18,630
Speaker 1: all of their money on, like, horrible shit or really boring,

943
00:50:18,750 --> 00:50:20,730
Speaker 1: bland shit, like, I've got a bigger yacht, no, I've

944
00:50:20,750 --> 00:50:22,950
Speaker 1: got a bigger yacht, he's spending a lot of his

945
00:50:23,010 --> 00:50:27,280
Speaker 1: money on, like, dangerous self-experimentation. And that kind of mania

946
00:50:27,300 --> 00:50:29,600
Speaker 1: that I actually do respect a little bit, like, well,

947
00:50:29,640 --> 00:50:35,880
Speaker 1: you're genuinely kind of unhinged, but you're committed to being unhinged. And, like,

948
00:50:36,060 --> 00:50:38,239
Speaker 1: I kind of respect that more than, like, the way

949
00:50:38,320 --> 00:50:39,820
Speaker 1: Bezos spends his fucking money.

950
00:50:39,840 --> 00:50:42,170
Speaker 2: Yeah, no, he walks the walk. Yeah, that's a very

951
00:50:42,190 --> 00:50:42,589
Speaker 2: good point.

952
00:50:43,030 --> 00:50:43,190
Speaker 3: Yeah.

953
00:50:43,230 --> 00:50:45,670
Speaker 2: Very good point. It's the same way that, like, I mean...

954
00:50:46,280 --> 00:50:49,680
Speaker 2: I'll never totally understand deeply religious people because it's just not,

955
00:50:49,960 --> 00:50:52,760
Speaker 2: I don't have that part of me. But when somebody

956
00:50:52,860 --> 00:50:57,460
Speaker 2: believes it enough to proselytize, as annoying as that is

957
00:50:57,500 --> 00:50:58,960
Speaker 2: and how little I want to see it, there's a

958
00:50:59,000 --> 00:51:01,040
Speaker 2: part of me that's like, okay, well, they seem to

959
00:51:01,140 --> 00:51:04,420
Speaker 2: really believe it or they wouldn't care to proselytize. Like

960
00:51:04,440 --> 00:51:07,890
Speaker 2: the proselytizing, they really believe these people are going to hell,

961
00:51:07,910 --> 00:51:10,169
Speaker 2: so they want to change their minds about it because

962
00:51:10,190 --> 00:51:13,569
Speaker 2: they really believe it. So I kind of see that. Anyways,

963
00:51:14,750 --> 00:51:18,440
Speaker 2: so he's not that bad. And actually, compared to ghouls

964
00:51:18,480 --> 00:51:21,080
Speaker 2: like that, he actually kind of seems reasonable. He did

965
00:51:21,140 --> 00:51:23,680
Speaker 2: go to medical school. He didn't finish his residency, but

966
00:51:23,700 --> 00:51:26,219
Speaker 2: he did some of it. If you saw him profiled

967
00:51:26,280 --> 00:51:28,680
Speaker 2: on 60 Minutes last fall or read some of his

968
00:51:28,700 --> 00:51:31,700
Speaker 2: stuff in Scientific American, he actually comes across as a

969
00:51:31,739 --> 00:51:36,219
Speaker 2: pretty sound thinker. But this whole shtick is based on

970
00:51:36,260 --> 00:51:39,670
Speaker 2: critiques of what he calls Medicine 2.0. And all of

971
00:51:39,710 --> 00:51:45,239
Speaker 2: this is based on limited experience actually practicing Medicine 2.0.

972
00:51:45,239 --> 00:51:48,020
Speaker 2: A key point he makes in his book, which he illustrates,

973
00:51:48,520 --> 00:51:53,719
Speaker 2: is that the mortality rate per 100,000 people declined relatively

974
00:51:53,840 --> 00:51:56,759
Speaker 2: little over the course of the 20th century, if you

975
00:51:56,800 --> 00:52:00,210
Speaker 2: subtract out the deaths from the eight top infectious diseases,

976
00:52:01,510 --> 00:52:06,650
Speaker 2: implying that contemporary medicine has made scant progress against the

977
00:52:06,710 --> 00:52:12,940
Speaker 2: horsemen of things like cancer and neurodegenerative diseases. Yeah, very frustrating. Well,

978
00:52:12,980 --> 00:52:15,359
Speaker 2: first of all, yeah, one, if you take out all

979
00:52:15,420 --> 00:52:18,000
Speaker 2: these deaths that we're avoiding with, you know, treating these

980
00:52:18,040 --> 00:52:20,560
Speaker 2: infectious diseases, which is like, come on, that's pretty good.

981
00:52:20,680 --> 00:52:21,020
Speaker 2: Let's be.

982
00:52:21,120 --> 00:52:24,520
Speaker 1: Yeah, the problem is that, like, there are individual cancers, like,

983
00:52:24,580 --> 00:52:26,970
Speaker 1: up until recently, because there have been, there do seem

984
00:52:26,989 --> 00:52:30,390
Speaker 1: to be some, like, breakthroughs maybe occurring in pancreatic treatment, but, like,

985
00:52:30,930 --> 00:52:33,630
Speaker 1: there wasn't a massive amount of progress made on pancreatic

986
00:52:33,670 --> 00:52:36,750
Speaker 1: cancer compared to some other cancers up until fairly recently, but, like,

987
00:52:36,790 --> 00:52:39,649
Speaker 1: lung cancer, we've gotten... way better at dealing with.

988
00:52:39,750 --> 00:52:39,969
Speaker 2: Right.

989
00:52:40,070 --> 00:52:42,549
Speaker 1: And like, yeah, there's still some sorts of, there's still

990
00:52:42,590 --> 00:52:45,200
Speaker 1: varying sorts of like, you know, heart disease or whatever

991
00:52:45,239 --> 00:52:46,779
Speaker 1: that we don't have, but we've gotten better at like

992
00:52:46,820 --> 00:52:50,040
Speaker 1: a lot of other kinds. Like it's, it's just people are,

993
00:52:50,200 --> 00:52:51,460
Speaker 1: I think a lot of it is like, yeah, you

994
00:52:51,480 --> 00:52:53,839
Speaker 1: lose a loved one to like a disease that we

995
00:52:53,880 --> 00:52:56,969
Speaker 1: just haven't gotten a good handle on. And it's easier to,

996
00:52:57,370 --> 00:53:00,180
Speaker 1: for people in that situation to be like, Medical science

997
00:53:00,260 --> 00:53:02,960
Speaker 1: still hasn't made any progress. And it's, well, I'm sorry

998
00:53:03,000 --> 00:53:05,739
Speaker 1: you got hit by that fucking bullet, but that's not

999
00:53:05,780 --> 00:53:07,919
Speaker 1: the only thing going on, you know?

1000
00:53:08,440 --> 00:53:11,469
Speaker 2: No, you're exactly right. And it is medicine 2.0, as

1001
00:53:11,489 --> 00:53:14,150
Speaker 2: he would call it, that is providing those advances in

1002
00:53:14,170 --> 00:53:18,410
Speaker 2: things like pancreatic cancer, which, I mean, agreed, not as

1003
00:53:18,450 --> 00:53:21,930
Speaker 2: fast as it should be. And we should be pushing

1004
00:53:21,969 --> 00:53:24,120
Speaker 2: this forward. But I don't think that's what medicine 3.0

1005
00:53:24,120 --> 00:53:29,100
Speaker 2: really is. this, this whole thing is really not only

1006
00:53:29,160 --> 00:53:33,200
Speaker 2: downplaying the role of antibiotics and vaccines, but these horsemen

1007
00:53:33,239 --> 00:53:37,080
Speaker 2: he's talking about in particular cancer and Alzheimer's are diseases

1008
00:53:37,120 --> 00:53:40,219
Speaker 2: of older people. The fact that he gets to write

1009
00:53:40,460 --> 00:53:44,279
Speaker 2: books about how we're not treating them aggressively enough is

1010
00:53:44,340 --> 00:53:47,500
Speaker 2: because our public health system had improved enough to keep

1011
00:53:47,580 --> 00:53:51,460
Speaker 2: us alive long enough to get these diseases, these diseases

1012
00:53:51,820 --> 00:53:54,989
Speaker 2: that are largely of older people, not completely, but largely. Um,

1013
00:53:56,910 --> 00:53:59,710
Speaker 2: And this whole 3.0 thing doesn't even make sense internally.

1014
00:54:00,270 --> 00:54:03,700
Speaker 2: In his book, Outlive, he discusses how immunotherapy is amazing,

1015
00:54:04,020 --> 00:54:07,520
Speaker 2: and it is, but that's very much 2.0 medicine. That's

1016
00:54:07,560 --> 00:54:12,919
Speaker 2: conventional medicine and research working. At the end of the day,

1017
00:54:13,940 --> 00:54:16,430
Speaker 2: who has the time and the money to do these things?

1018
00:54:17,320 --> 00:54:20,870
Speaker 2: We have a real problem in this country with access.

1019
00:54:21,010 --> 00:54:23,530
Speaker 2: It's not enough tests, as I said. It's enough access.

1020
00:54:24,330 --> 00:54:27,259
Speaker 2: And he's clearly chosen on purpose to surround himself with

1021
00:54:27,430 --> 00:54:30,660
Speaker 2: only the wealthiest Americans who have the time and the

1022
00:54:30,800 --> 00:54:34,440
Speaker 2: money for all the exercise he recommends, the ability to

1023
00:54:34,500 --> 00:54:37,779
Speaker 2: pay for all the things, the testing, the wearable devices,

1024
00:54:38,280 --> 00:54:41,580
Speaker 2: and the desire to live forever. And that's what brings

1025
00:54:41,660 --> 00:54:44,060
Speaker 2: us to the last part of our conversation. But first.

1026
00:54:44,080 --> 00:54:46,740
Speaker 1: Speaking of the last.

1027
00:54:46,800 --> 00:54:47,100
Speaker 2: Oh, yeah.

1028
00:54:47,320 --> 00:54:49,040
Speaker 1: Toby's got it. But first.

1029
00:54:56,580 --> 00:55:01,000
Speaker 3: And now, Jeffrey Epstein. There we go. I know it's here.

1030
00:55:01,460 --> 00:55:03,620
Speaker 3: I know it's here. I brought it up in the beginning.

1031
00:55:03,719 --> 00:55:07,960
Speaker 2: Carly Rae Jepstein himself. So that's right. Where does all

1032
00:55:07,980 --> 00:55:13,089
Speaker 2: this lead us to? All this Medicine 3.0, all the costs.

1033
00:55:13,190 --> 00:55:17,130
Speaker 2: Who can do it? Only the wealthiest people. And that

1034
00:55:17,489 --> 00:55:22,410
Speaker 2: is how our hero, Dr. Peter Attia, gets connected with

1035
00:55:22,770 --> 00:55:26,520
Speaker 2: one person. Jeffrey Birmingham Epstein. I'm just kidding. I don't

1036
00:55:26,540 --> 00:55:27,379
Speaker 2: think that's his middle name.

1037
00:55:28,280 --> 00:55:28,779
Speaker 1: No, that was it.

1038
00:55:29,660 --> 00:55:33,040
Speaker 2: Earlier this year, you might have heard CBS News announced

1039
00:55:33,100 --> 00:55:36,590
Speaker 2: a whole new slate of 19 contributors as part of

1040
00:55:36,610 --> 00:55:40,070
Speaker 2: the efforts. They are trying to go with Barry Weiss

1041
00:55:40,330 --> 00:55:44,670
Speaker 2: to revamp the network's public image. One of the contributors

1042
00:55:44,770 --> 00:55:47,969
Speaker 2: that they had hired, along with, again, Andrew Huberman, which

1043
00:55:48,110 --> 00:55:53,660
Speaker 2: we could do another two-parter on, conservative Mel Ferguson- was Dr.

1044
00:55:53,820 --> 00:55:59,250
Speaker 2: Peter Attia. Three days after that, the DOJ released a

1045
00:55:59,330 --> 00:56:04,469
Speaker 2: chunk of Epstein files, which included over 1,700 mentions of

1046
00:56:04,489 --> 00:56:09,069
Speaker 2: the name Peter Attia, and a lot of very embarrassing

1047
00:56:09,110 --> 00:56:16,450
Speaker 2: and very douche-chill-inducing emails between Attia and J.E., as he

1048
00:56:16,489 --> 00:56:20,810
Speaker 2: calls him, J.E., And also with Epstein's handlers, live emails

1049
00:56:20,850 --> 00:56:26,410
Speaker 2: with Atiyah Epstein's handlers. Because of this, Atiyah was forced

1050
00:56:26,430 --> 00:56:29,450
Speaker 2: to step down from his role at CBS. Because it

1051
00:56:29,489 --> 00:56:33,580
Speaker 2: turns out, before he became this wellness influencer that he

1052
00:56:33,600 --> 00:56:36,959
Speaker 2: was destined to become, with millions of followers, a very

1053
00:56:37,560 --> 00:56:41,899
Speaker 2: influential book, he relied on Jeffrey Epstein's advice to help

1054
00:56:41,960 --> 00:56:46,899
Speaker 2: get his concierge medical practice going. So let's get into

1055
00:56:46,940 --> 00:56:48,299
Speaker 2: the Epstein files here.

1056
00:56:48,320 --> 00:56:49,100
Speaker 3: Yeah.

1057
00:56:49,940 --> 00:56:50,319
Speaker 2: Here we go.

1058
00:56:51,180 --> 00:56:51,680
Speaker 1: Okay.

1059
00:56:52,280 --> 00:56:58,319
Speaker 2: Yeah. So from Atiyah's own report, he met J.E. in 2014.

1060
00:56:58,320 --> 00:56:59,799
Speaker 3: I hate every time you say that.

1061
00:57:00,719 --> 00:57:01,000
Speaker 4: I know.

1062
00:57:01,440 --> 00:57:04,819
Speaker 2: But like, it's just, well, it gets worse. Wait, hold on.

1063
00:57:05,010 --> 00:57:05,280
Speaker 3: Yeah.

1064
00:57:05,800 --> 00:57:11,489
Speaker 2: So he met Joffrey while he was raising funds for

1065
00:57:11,550 --> 00:57:15,830
Speaker 2: scientific research. And interestingly, he makes a point to note

1066
00:57:15,890 --> 00:57:20,550
Speaker 2: that it was facilitated, the meeting, by a female healthcare leader, Dr.

1067
00:57:20,710 --> 00:57:25,070
Speaker 2: Eva Anderson Dubin. Interesting person. She was a former model,

1068
00:57:25,140 --> 00:57:29,900
Speaker 2: became a doctor and philanthropist. That makes sense. Epstein clearly

1069
00:57:30,000 --> 00:57:34,400
Speaker 2: kept ties across academia. They remained in contact over the years,

1070
00:57:34,440 --> 00:57:40,770
Speaker 2: exchanging emails. They exchanged advice. Eventually, Atiyah lets Epstein know

1071
00:57:40,910 --> 00:57:42,790
Speaker 2: that he's looking for someone to help run his office.

1072
00:57:42,810 --> 00:57:45,570
Speaker 2: I have this office, it's concierge practice, but I need

1073
00:57:45,630 --> 00:57:48,689
Speaker 2: a patient care coordinator, someone to like walk them through

1074
00:57:48,710 --> 00:57:51,830
Speaker 2: the whole thing, someone that's going to make the experience

1075
00:57:51,850 --> 00:57:54,900
Speaker 2: really enjoyable for them. And he's asking for his help

1076
00:57:54,980 --> 00:57:59,400
Speaker 2: in finding him or her. Epstein invited Atiyah to his

1077
00:57:59,520 --> 00:58:03,360
Speaker 2: Upper East Side mansion and introduced him to a foreign-born

1078
00:58:03,500 --> 00:58:08,280
Speaker 2: model Okay. Yeah. You might see where this is starting

1079
00:58:08,300 --> 00:58:08,920
Speaker 2: to head.

1080
00:58:08,940 --> 00:58:11,960
Speaker 1: Oh, this is 2014, right?

1081
00:58:12,040 --> 00:58:12,900
Speaker 2: Yes, 2014.

1082
00:58:12,900 --> 00:58:15,640
Speaker 1: Okay, so he had been convicted and everybody knew.

1083
00:58:15,860 --> 00:58:18,460
Speaker 2: Oh, yeah. That was 2008, if I remember correctly.

1084
00:58:18,480 --> 00:58:22,020
Speaker 1: Just always really want to highlight when somebody befriends Jeffrey

1085
00:58:22,140 --> 00:58:23,340
Speaker 1: after that. Yeah.

1086
00:58:23,420 --> 00:58:25,720
Speaker 2: Yes. Oh, yeah. We're going to get to whether or

1087
00:58:25,780 --> 00:58:28,500
Speaker 2: not he had a sense of what was going on

1088
00:58:28,640 --> 00:58:31,020
Speaker 2: or not here, too. I think there's some telltale signs

1089
00:58:31,140 --> 00:58:38,200
Speaker 2: in his emails. So, Atiyah, is introduced to this foreign-born model.

1090
00:58:38,720 --> 00:58:42,390
Speaker 2: They exchange emails. And in other emails, it's clear that

1091
00:58:42,530 --> 00:58:46,590
Speaker 2: Atiyah has invited her to a hangout with some other

1092
00:58:46,670 --> 00:58:51,210
Speaker 2: potential candidates, other people at Swanky Bar in Midtown. I

1093
00:58:51,310 --> 00:58:55,050
Speaker 2: think she will be loyal, Epstein writes to Atiyah in

1094
00:58:55,090 --> 00:58:58,580
Speaker 2: an email. Turns out this woman was also a victim.

1095
00:58:58,780 --> 00:59:02,480
Speaker 2: Her name is redacted, but she was one of Epstein's victims.

1096
00:59:03,450 --> 00:59:07,460
Speaker 2: And from Atiyah's spokesperson, they say that this person never

1097
00:59:07,500 --> 00:59:10,280
Speaker 2: ended up working for them. After all, they said... that

1098
00:59:10,500 --> 00:59:13,340
Speaker 2: for some other reason, they went with somebody else. That

1099
00:59:13,390 --> 00:59:16,810
Speaker 2: wasn't even the reason he was at Jeffrey Epstein's apartment.

1100
00:59:17,230 --> 00:59:20,190
Speaker 2: But Politico reports that it was visa issues that were

1101
00:59:20,210 --> 00:59:22,390
Speaker 2: the problem. And you can see this in the emails.

1102
00:59:22,890 --> 00:59:26,010
Speaker 2: The emails are like, hey, she's great, but there's this

1103
00:59:26,090 --> 00:59:28,050
Speaker 2: visa issue, and I don't think we can be able

1104
00:59:28,070 --> 00:59:30,620
Speaker 2: to get past that. And this is the kind of

1105
00:59:30,640 --> 00:59:33,100
Speaker 2: thing you see a lot in these emails, Atiyah relying

1106
00:59:33,340 --> 00:59:37,590
Speaker 2: on Epstein for referrals and providing him with health advice

1107
00:59:37,710 --> 00:59:40,890
Speaker 2: and testing. He downplays their relationship. He admits to hanging

1108
00:59:40,910 --> 00:59:45,870
Speaker 2: out about 10 times after that until Jeffrey Epstein's arrest.

1109
00:59:46,370 --> 00:59:49,340
Speaker 2: He says the hangouts happened at Jeffrey Epstein's home, although

1110
00:59:49,380 --> 00:59:52,160
Speaker 2: from emails, he did have interest in going to the island.

1111
00:59:52,760 --> 00:59:54,220
Speaker 2: And there was even a plan to go to the

1112
00:59:54,280 --> 00:59:57,220
Speaker 2: New Mexico ranch that Epstein owned, but there was no

1113
00:59:57,260 --> 00:59:58,260
Speaker 2: evidence that actually proves that.

1114
00:59:58,200 --> 00:59:59,980
Speaker 1: He actually did that. The Zorro Ranch.

1115
01:00:00,000 --> 01:00:00,600
Speaker 2: Is that what it's called?

1116
01:00:01,200 --> 01:00:02,060
Speaker 1: Yeah, the Zorro Ranch.

1117
01:00:02,100 --> 01:00:02,280
Speaker 2: Yeah.

1118
01:00:02,360 --> 01:00:02,740
Speaker 1: Oh, my God.

1119
01:00:04,260 --> 01:00:06,840
Speaker 2: So he definitely did stay at one of Epstein's apartments

1120
01:00:06,910 --> 01:00:09,890
Speaker 2: in New York for some time period. Cool.

1121
01:00:09,970 --> 01:00:10,270
Speaker 3: Yeah.

1122
01:00:10,930 --> 01:00:14,330
Speaker 2: He used Epstein to help fill out his clientele as well.

1123
01:00:14,370 --> 01:00:16,530
Speaker 2: That's really where I think Epstein came on big.

1124
01:00:17,310 --> 01:00:17,530
Speaker 4: Great.

1125
01:00:18,150 --> 01:00:19,970
Speaker 1: Yeah, because he can connect him to other rich guys

1126
01:00:19,990 --> 01:00:21,370
Speaker 1: who are interested in longevity stuff.

1127
01:00:21,530 --> 01:00:24,350
Speaker 2: That's exactly right. And it looks like he's giving him medication.

1128
01:00:24,390 --> 01:00:27,450
Speaker 2: He's probably giving him metformin, which is another diabetes medication,

1129
01:00:27,470 --> 01:00:27,970
Speaker 2: which I don't.

1130
01:00:27,850 --> 01:00:31,280
Speaker 1: Think Epstein had. It's very popular for life extension folks.

1131
01:00:31,400 --> 01:00:35,880
Speaker 2: Right, yeah. In return, he provides medical care and advice.

1132
01:00:36,700 --> 01:00:39,420
Speaker 2: And to quote Atiyah later, he says, to be clear,

1133
01:00:39,440 --> 01:00:43,040
Speaker 2: I never witnessed illegal behavior and never saw anyone who

1134
01:00:43,100 --> 01:00:47,680
Speaker 2: appeared underage in his presence. But, To also be clear.

1135
01:00:47,740 --> 01:00:51,040
Speaker 1: Appeared doing a lot of work. That is a very,

1136
01:00:51,180 --> 01:00:56,280
Speaker 1: very strong piece of verbiage there. There's a lot weighted

1137
01:00:56,420 --> 01:00:56,840
Speaker 1: on that.

1138
01:00:57,540 --> 01:00:58,860
Speaker 2: Yes, exactly right.

1139
01:00:58,900 --> 01:00:59,620
Speaker 1: Disgusting.

1140
01:01:00,620 --> 01:01:04,190
Speaker 2: It's not ideal. No, no, no. No, men are terrible.

1141
01:01:04,350 --> 01:01:05,850
Speaker 2: I don't think you're going to find Robert and I

1142
01:01:05,870 --> 01:01:08,170
Speaker 2: defending men in general. No.

1143
01:01:08,290 --> 01:01:13,230
Speaker 1: I'm being very specific about who I'm attacking here.

1144
01:01:13,810 --> 01:01:18,260
Speaker 2: Okay. Also... To be clear, it was not a mystery

1145
01:01:18,440 --> 01:01:21,470
Speaker 2: at this point who Epstein was. As you mentioned, he

1146
01:01:21,550 --> 01:01:25,470
Speaker 2: already had a record and a reputation well known, and

1147
01:01:25,750 --> 01:01:28,870
Speaker 2: you can even tell from these emails that Atiyah knows

1148
01:01:28,910 --> 01:01:32,370
Speaker 2: his friend is infamous. I reviewed as many of these

1149
01:01:32,430 --> 01:01:34,840
Speaker 2: emails as I could tolerate, and there's a couple lines

1150
01:01:34,890 --> 01:01:36,540
Speaker 2: I want to read through some of these for you

1151
01:01:36,560 --> 01:01:40,700
Speaker 2: guys that I think stand out. 2015, an email thread

1152
01:01:40,740 --> 01:01:45,590
Speaker 2: from Atiyah with a redacted photo. and the subject line,

1153
01:01:45,870 --> 01:01:49,240
Speaker 2: got a fresh shipment. Not clear what Atiyah was referring

1154
01:01:49,280 --> 01:01:53,500
Speaker 2: to there. Hold on. It's not clear what Atiyah's referring

1155
01:01:53,520 --> 01:01:56,360
Speaker 2: to there. He said later it was the medication metformin,

1156
01:01:56,400 --> 01:02:00,100
Speaker 2: but that kind of weird. But Epstein responds with an

1157
01:02:00,180 --> 01:02:04,450
Speaker 2: email that says, me too, with an attached photo, but

1158
01:02:04,490 --> 01:02:06,090
Speaker 2: the attached photo is redacted.

1159
01:02:07,390 --> 01:02:08,530
Speaker 1: I got some theories.

1160
01:02:08,910 --> 01:02:11,310
Speaker 2: Well, Atiyah's response, let me tell you first before you

1161
01:02:11,330 --> 01:02:15,780
Speaker 2: tell me your theories, Atiyah's response was, Please tell me

1162
01:02:15,820 --> 01:02:22,940
Speaker 2: you found that picture online. Dot, dot, dot. Bastard. Cool. Yeah. Yeah. Fuckers.

1163
01:02:23,880 --> 01:02:27,740
Speaker 1: Not a lot. We're not exactly. We're not exactly connecting. Like,

1164
01:02:27,760 --> 01:02:30,900
Speaker 1: this isn't like a crazy board situation where we have to, like,

1165
01:02:30,980 --> 01:02:38,610
Speaker 1: draw pictures with, like, twine. It's pretty obvious what's happening here. Yeah.

1166
01:02:38,850 --> 01:02:44,030
Speaker 2: Epstein's response was, afraid not. He just. He's so ghoulish,

1167
01:02:44,190 --> 01:02:45,450
Speaker 2: even in his emails.

1168
01:02:46,110 --> 01:02:50,810
Speaker 1: What always takes me is not Epstein's ghoulishness, because he's Epstein.

1169
01:02:50,830 --> 01:02:53,550
Speaker 1: It's the degree to which you can tell there's so

1170
01:02:53,570 --> 01:02:56,530
Speaker 1: many of these guys that all cool is to them

1171
01:02:56,650 --> 01:03:01,010
Speaker 1: is having access to frighteningly young women. Like, that's cool.

1172
01:03:01,110 --> 01:03:03,590
Speaker 1: That's what makes you have, like, an enviable life is

1173
01:03:03,650 --> 01:03:05,760
Speaker 1: the young girls around you.

1174
01:03:07,530 --> 01:03:11,160
Speaker 2: Cool. And to be clear, Atiyah's not the only doctor

1175
01:03:11,740 --> 01:03:17,930
Speaker 2: in these files. providing medical care or doing something for, for,

1176
01:03:18,030 --> 01:03:22,490
Speaker 2: for Epstein. And that bums me out so much. There's

1177
01:03:22,530 --> 01:03:27,620
Speaker 2: like one normal Norman Finkelstein to every like 20 other

1178
01:03:27,780 --> 01:03:32,120
Speaker 2: dudes trying to like get in on Epstein in Epstein's world.

1179
01:03:32,380 --> 01:03:35,430
Speaker 2: You know, Norman Finkelstein was invited to go to his, uh,

1180
01:03:35,490 --> 01:03:37,310
Speaker 2: he's the Columbia professor. I don't know if you know

1181
01:03:37,350 --> 01:03:40,930
Speaker 2: who he is. Cool dude. Um, Anyways, he was invited

1182
01:03:41,070 --> 01:03:44,250
Speaker 2: by another academic colleague, and he was like, no, and

1183
01:03:44,490 --> 01:03:47,590
Speaker 2: if I ever see you bringing your daughter to hang

1184
01:03:47,650 --> 01:03:50,970
Speaker 2: out with Epstein, I'll throttle you. There are some cool

1185
01:03:51,010 --> 01:03:54,570
Speaker 2: dudes out there. But for the most part, it's just

1186
01:03:54,650 --> 01:03:57,930
Speaker 2: dudes like this who just want to be close to power.

1187
01:03:58,250 --> 01:03:59,590
Speaker 2: They want to be close to it. They want to

1188
01:03:59,770 --> 01:04:03,150
Speaker 2: suckle at the teat of these rich and powerful people.

1189
01:04:03,530 --> 01:04:07,910
Speaker 2: And doctors are no exception, and that really... bums me out.

1190
01:04:08,010 --> 01:04:10,660
Speaker 2: And not just because we took a stupid oath, but because, like,

1191
01:04:10,680 --> 01:04:15,300
Speaker 2: it's not our job. And it leads to more... We'll

1192
01:04:15,320 --> 01:04:17,540
Speaker 2: get to that. I got something to deal with. Anyways, okay.

1193
01:04:18,820 --> 01:04:24,090
Speaker 2: So anyways, Epstein said, afraid not. So, you know, in

1194
01:04:24,530 --> 01:04:28,210
Speaker 2: defense of Etia, he said it was a picture of

1195
01:04:28,270 --> 01:04:31,810
Speaker 2: an adult woman. Now, I don't think that makes a

1196
01:04:31,830 --> 01:04:33,710
Speaker 2: lot of sense, because if it was a picture of

1197
01:04:33,750 --> 01:04:36,690
Speaker 2: an adult woman... why would he say, please tell me

1198
01:04:36,710 --> 01:04:40,110
Speaker 2: you found that picture online, dot, dot, dot, bastard? Yeah.

1199
01:04:40,280 --> 01:04:43,160
Speaker 1: I mean, I guess because he's like, theoretically, maybe just

1200
01:04:43,180 --> 01:04:45,860
Speaker 1: some hot adult lady that he's like, oh, please tell

1201
01:04:45,900 --> 01:04:48,120
Speaker 1: me that's not someone you're in front of right now

1202
01:04:48,140 --> 01:04:50,360
Speaker 1: because it's so cool that you get to fuck her, right? Like,

1203
01:04:51,100 --> 01:04:53,480
Speaker 1: that would be the defensive thing, knowing what we know

1204
01:04:53,540 --> 01:04:56,080
Speaker 1: about Jeffrey. My assumption isn't that she's of age.

1205
01:04:56,300 --> 01:04:59,400
Speaker 2: I don't think so either. And I also doesn't, I mean,

1206
01:04:59,420 --> 01:05:01,380
Speaker 2: if my buddy was like, hey, this is this hot

1207
01:05:01,860 --> 01:05:05,000
Speaker 2: chick that I'm hooking up with, and she's of age,

1208
01:05:05,080 --> 01:05:07,820
Speaker 2: and it seems like normal. I don't think I'd be.

1209
01:05:07,910 --> 01:05:10,370
Speaker 1: If he just sends me a picture of her sight unseen,

1210
01:05:10,410 --> 01:05:11,430
Speaker 1: that's also upsetting.

1211
01:05:11,450 --> 01:05:11,990
Speaker 2: That's pretty weird.

1212
01:05:12,010 --> 01:05:15,470
Speaker 1: But also, I mean, here's what I'll say. There were guys,

1213
01:05:16,010 --> 01:05:17,670
Speaker 1: and I kind of suspect Bill Clinton was one of them,

1214
01:05:17,910 --> 01:05:20,410
Speaker 1: who Jeffrey would have played them with women, but would

1215
01:05:20,430 --> 01:05:22,190
Speaker 1: have played them with adult women, because he didn't just

1216
01:05:22,310 --> 01:05:26,620
Speaker 1: automatically send someone underage. That's not what every creepy guy prefers.

1217
01:05:26,660 --> 01:05:29,680
Speaker 1: There's some creepy men who prefer to have sex with, like, 20-year-olds, right?

1218
01:05:29,700 --> 01:05:30,680
Speaker 2: Right. Like.

1219
01:05:31,060 --> 01:05:33,720
Speaker 1: that are provided to them by a service or whatever.

1220
01:05:33,740 --> 01:05:36,980
Speaker 1: So that's not impossible. But even if, even if the,

1221
01:05:37,560 --> 01:05:40,250
Speaker 1: he's playing you with adult women, you know what Jeffrey,

1222
01:05:40,270 --> 01:05:44,030
Speaker 1: you know, he got arrested for trafficking children. You know

1223
01:05:44,050 --> 01:05:47,010
Speaker 1: what he's doing to other guys, just because your taste

1224
01:05:47,210 --> 01:05:50,290
Speaker 1: is like not a felony. Doesn't mean that you're not

1225
01:05:50,470 --> 01:05:54,920
Speaker 1: enabling and supporting a guy who's trafficking children as a pen, right?

1226
01:05:55,320 --> 01:05:59,500
Speaker 2: Even if you never saw it, You know what was happening.

1227
01:05:59,520 --> 01:06:00,480
Speaker 2: You know.

1228
01:06:00,660 --> 01:06:02,520
Speaker 1: And I don't believe that never saw it.

1229
01:06:03,310 --> 01:06:04,190
Speaker 2: Right.

1230
01:06:04,270 --> 01:06:07,230
Speaker 1: I think I think Jeffrey brought out a smorgasbord, you know,

1231
01:06:07,250 --> 01:06:09,950
Speaker 1: for the rich, powerful men. And some of them were adults.

1232
01:06:09,970 --> 01:06:12,630
Speaker 1: Some of them weren't. But the guys, they know what's

1233
01:06:12,710 --> 01:06:16,180
Speaker 1: happening and they often see what's happening, even if their

1234
01:06:16,220 --> 01:06:18,140
Speaker 1: tastes are not in that direction.

1235
01:06:18,340 --> 01:06:18,540
Speaker 2: Yeah.

1236
01:06:18,900 --> 01:06:19,080
Speaker 3: Yeah.

1237
01:06:20,310 --> 01:06:24,780
Speaker 2: So another email from 2016, Atiyah tells Epstein that he would, quote,

1238
01:06:25,360 --> 01:06:27,600
Speaker 2: love to add five years or more to your life,

1239
01:06:27,980 --> 01:06:30,000
Speaker 2: even if the only reason to do so is to

1240
01:06:30,060 --> 01:06:33,060
Speaker 2: have more sex. It's so gross.

1241
01:06:33,100 --> 01:06:34,140
Speaker 1: Cool stuff, Peter.

1242
01:06:35,450 --> 01:06:36,630
Speaker 2: It's so gross. Nice.

1243
01:06:36,670 --> 01:06:38,070
Speaker 1: Yeah, disgusting.

1244
01:06:38,930 --> 01:06:40,970
Speaker 2: I'm going to read this next one also, but I

1245
01:06:41,010 --> 01:06:42,870
Speaker 2: want you to take a drink of your water while

1246
01:06:42,890 --> 01:06:43,750
Speaker 2: you do it.

1247
01:06:44,430 --> 01:06:44,730
Speaker 1: Okay.

1248
01:06:44,930 --> 01:06:48,050
Speaker 2: Okay. In a related exchange, he asked J.E., have you

1249
01:06:48,090 --> 01:06:51,510
Speaker 2: decided if you're interested in living longer? Solely for the ladies,

1250
01:06:51,570 --> 01:06:53,490
Speaker 2: of course. Spit take.

1251
01:06:53,510 --> 01:06:54,730
Speaker 1: I was going to do a spit take, but I

1252
01:06:54,730 --> 01:06:55,490
Speaker 1: don't want to actually like.

1253
01:06:55,550 --> 01:06:57,630
Speaker 2: I don't want to have to then clean up after that.

1254
01:06:58,010 --> 01:07:01,050
Speaker 1: I've got like vegetable powder in my water.

1255
01:07:01,070 --> 01:07:03,740
Speaker 2: I don't want you to ask me about eating vegetable powder. Okay,

1256
01:07:03,880 --> 01:07:07,820
Speaker 2: another email. And this one's a big one. The biggest

1257
01:07:07,880 --> 01:07:10,980
Speaker 2: problem with becoming friends with you, the life you lead

1258
01:07:11,040 --> 01:07:13,560
Speaker 2: is so outrageous, and yet I can't tell a soul.

1259
01:07:14,470 --> 01:07:16,770
Speaker 2: Why not, Pete? Why can't you tell a soul, Pete?

1260
01:07:16,910 --> 01:07:20,490
Speaker 1: Yeah, because of the felonies. Because of the felonies.

1261
01:07:20,690 --> 01:07:23,490
Speaker 2: Listen, he knew the guy was a dirtbag, but I'll

1262
01:07:23,530 --> 01:07:26,220
Speaker 2: say this. I've become friends from doing this podcast with

1263
01:07:26,240 --> 01:07:30,080
Speaker 2: a couple of famous people. I tell everyone about it

1264
01:07:30,800 --> 01:07:34,820
Speaker 2: because they're not ghouls, Pete. They're not ghouls. If you

1265
01:07:34,920 --> 01:07:38,240
Speaker 2: hang out with people that aren't terrible, you can tell people.

1266
01:07:39,210 --> 01:07:42,060
Speaker 1: Yeah. It's this idea that like what cool is and

1267
01:07:42,100 --> 01:07:44,400
Speaker 1: like the real, like the only kind of life that's

1268
01:07:44,420 --> 01:07:46,440
Speaker 1: really worth bragging about is one in which you just

1269
01:07:46,480 --> 01:07:49,380
Speaker 1: have constant, very young women or girls around you all

1270
01:07:49,400 --> 01:07:51,820
Speaker 1: the time. And it's all about like, it's, it's a very,

1271
01:07:52,180 --> 01:07:54,450
Speaker 1: wasn't cool enough in a high school and never got

1272
01:07:54,530 --> 01:07:57,570
Speaker 1: over it attitude as opposed to like, I don't know.

1273
01:07:57,690 --> 01:08:00,450
Speaker 1: Like when I think of the people I know who

1274
01:08:00,490 --> 01:08:02,930
Speaker 1: are like really cool and who I like tell people about,

1275
01:08:02,990 --> 01:08:05,200
Speaker 1: cause their lifestyle is so amazing. It's folks who like,

1276
01:08:06,140 --> 01:08:09,220
Speaker 1: have hobbies and do stuff like, you know, they participate

1277
01:08:09,240 --> 01:08:12,460
Speaker 1: in like fucking incredible races or they like build things.

1278
01:08:12,480 --> 01:08:16,450
Speaker 1: They make like weird custom cars or motorcycles, uh, or they,

1279
01:08:16,570 --> 01:08:20,030
Speaker 1: they engage in like incredible feats of athleticism. You know,

1280
01:08:20,330 --> 01:08:23,330
Speaker 1: they build things, they into 3d printing or like they

1281
01:08:23,350 --> 01:08:26,410
Speaker 1: have skills and they make stuff and they, I don't know,

1282
01:08:26,530 --> 01:08:29,530
Speaker 1: that all takes money, but it's, it's actually impressive as

1283
01:08:29,590 --> 01:08:31,309
Speaker 1: opposed to just like, Oh yeah, you're just hanging out

1284
01:08:31,330 --> 01:08:33,090
Speaker 1: a bunch of around a bunch of like really young

1285
01:08:33,150 --> 01:08:34,590
Speaker 1: women who you're probably applying with money.

1286
01:08:35,120 --> 01:08:39,620
Speaker 2: Cool yeah okay um another email that struck me it

1287
01:08:39,660 --> 01:08:43,170
Speaker 2: was him pleading with epstein's handlers to basically help arrange

1288
01:08:43,210 --> 01:08:45,250
Speaker 2: a play date with him i go into je withdrawals

1289
01:08:45,270 --> 01:08:48,550
Speaker 2: when i don't see him uh famously there is the

1290
01:08:48,610 --> 01:08:51,090
Speaker 2: email from a tia to epstein discussing the issue of

1291
01:08:51,130 --> 01:08:53,690
Speaker 2: cunnilingus that i brought up in the very beginning of

1292
01:08:53,729 --> 01:08:59,809
Speaker 2: the first podcast and i apologize i'm sorry Pussy is

1293
01:08:59,890 --> 01:09:04,210
Speaker 2: indeed low carb. Still awaiting results on gluten, though. Okay.

1294
01:09:04,729 --> 01:09:07,400
Speaker 2: Now I'm going to say something that's very, very controversial here.

1295
01:09:07,410 --> 01:09:08,180
Speaker 1: Okay?

1296
01:09:08,689 --> 01:09:11,920
Speaker 2: And I apologize in advance. Feel free to cut. But

1297
01:09:12,400 --> 01:09:16,540
Speaker 2: in a vacuum, this conversation I don't think is completely

1298
01:09:16,939 --> 01:09:19,970
Speaker 2: terrible for a couple reasons. One, It would at least

1299
01:09:20,010 --> 01:09:24,010
Speaker 2: suggest they're attempting to provide some pleasure. But that is

1300
01:09:24,050 --> 01:09:26,590
Speaker 2: something that I encourage men to do in general with

1301
01:09:26,610 --> 01:09:29,870
Speaker 2: their partners because I think there's a potential health benefit

1302
01:09:30,070 --> 01:09:32,700
Speaker 2: in terms of probiotics for men to get. And more

1303
01:09:32,720 --> 01:09:34,290
Speaker 2: men should be doing it if their partners want it.

1304
01:09:35,420 --> 01:09:36,900
Speaker 2: But I don't know if there are benefits because nobody

1305
01:09:36,920 --> 01:09:39,540
Speaker 2: will ever fund that study. But the point is, if

1306
01:09:39,640 --> 01:09:41,500
Speaker 2: one of the two people in this conversation weren't the

1307
01:09:41,520 --> 01:09:46,280
Speaker 2: worst people in history, this could be a genuinely interesting

1308
01:09:46,350 --> 01:09:49,150
Speaker 2: scientific question. The nerd in me has curiosity.

1309
01:09:50,120 --> 01:09:52,960
Speaker 1: If, if Jeffrey, if someone's talking about like giving a

1310
01:09:52,979 --> 01:09:56,200
Speaker 1: massage to like a partner, that's perfectly fine. If it's

1311
01:09:56,240 --> 01:09:58,820
Speaker 1: Jeffrey Epstein, it's not because that partner is probably not

1312
01:09:58,840 --> 01:10:01,320
Speaker 1: an adult, right? Like that's the thing.

1313
01:10:01,360 --> 01:10:01,519
Speaker 2: Yes.

1314
01:10:01,660 --> 01:10:04,309
Speaker 1: That's the issue. I think is that you just have

1315
01:10:04,350 --> 01:10:04,910
Speaker 1: no idea.

1316
01:10:05,030 --> 01:10:07,530
Speaker 2: It's very gross. I agree. It's very, but I mean,

1317
01:10:07,750 --> 01:10:11,350
Speaker 2: as a scientist, there's a part of me that has,

1318
01:10:11,450 --> 01:10:15,780
Speaker 2: has questions. Um, but let's, let's move past that. Um,

1319
01:10:16,330 --> 01:10:19,350
Speaker 2: There's one other thing that his emails shed light on.

1320
01:10:19,430 --> 01:10:21,590
Speaker 2: It's something that was dug up afterwards. I'm not sure

1321
01:10:21,610 --> 01:10:25,190
Speaker 2: if it got enough attention. In his book, he shares

1322
01:10:25,229 --> 01:10:27,710
Speaker 2: that in July of 2017, while he was in New York,

1323
01:10:28,310 --> 01:10:32,670
Speaker 2: his one-month-old son back in California almost died. Has to

1324
01:10:32,710 --> 01:10:35,610
Speaker 2: be resuscitated by his wife, who's a nurse. And for

1325
01:10:35,670 --> 01:10:38,530
Speaker 2: four days, his wife is begging him to come back home.

1326
01:10:39,110 --> 01:10:41,660
Speaker 2: She had to perform the resuscitation herself. The child is

1327
01:10:41,680 --> 01:10:45,400
Speaker 2: in the ICU. She needs him back home. And he

1328
01:10:45,460 --> 01:10:48,310
Speaker 2: didn't because he felt his work was too important. That's

1329
01:10:48,350 --> 01:10:51,650
Speaker 2: his own admission. Now, he will say that this was

1330
01:10:51,670 --> 01:10:54,430
Speaker 2: a mistake. He frames it as having deep disgust with

1331
01:10:54,450 --> 01:10:57,210
Speaker 2: himself for doing that. He's like, I thought my work

1332
01:10:57,250 --> 01:10:59,490
Speaker 2: was so important, I had to stay to do my work.

1333
01:11:00,320 --> 01:11:03,140
Speaker 2: But here's the thing. In his book, he shares the

1334
01:11:03,180 --> 01:11:05,760
Speaker 2: date being July 11th. And when you go through the files,

1335
01:11:05,780 --> 01:11:08,340
Speaker 2: the Epstein files, he has an email exchange on July

1336
01:11:08,439 --> 01:11:11,939
Speaker 2: 13th to Epstein, where basically he's planning to meet him.

1337
01:11:12,010 --> 01:11:15,059
Speaker 2: And he's like, yeah, I'll meet you wherever you want. Like,

1338
01:11:15,950 --> 01:11:18,349
Speaker 2: so during this time while this kid is in the ICU,

1339
01:11:19,270 --> 01:11:22,610
Speaker 2: he is still there doing important work, quote unquote, but

1340
01:11:22,689 --> 01:11:25,070
Speaker 2: really it's to try and hang out with Epstein. And

1341
01:11:25,130 --> 01:11:28,930
Speaker 2: that is rough out of all the things. That's a really,

1342
01:11:28,950 --> 01:11:32,080
Speaker 2: that's a tough one. And I will say this. I

1343
01:11:32,120 --> 01:11:36,020
Speaker 2: think if anything gives him shame, it is that. That's

1344
01:11:36,040 --> 01:11:38,700
Speaker 2: the only good news is that he probably does feel

1345
01:11:38,780 --> 01:11:39,540
Speaker 2: terrible about that.

1346
01:11:39,700 --> 01:11:39,769
Speaker 5: No.

1347
01:11:40,370 --> 01:11:40,970
Speaker 1: Yeah.

1348
01:11:41,410 --> 01:11:44,430
Speaker 2: Along with the CBS fallout, he also parted ways with

1349
01:11:44,470 --> 01:11:48,170
Speaker 2: protein bar company David and powdered supplement maker AG1 or

1350
01:11:48,310 --> 01:11:51,650
Speaker 2: Athletic Greens. And he's currently in a lawsuit with wearable

1351
01:11:51,750 --> 01:11:55,509
Speaker 2: medical tracker Aura, the Aura ring, after they distanced themselves

1352
01:11:55,570 --> 01:11:58,270
Speaker 2: from him. They sound kind of like a sketchy company themselves.

1353
01:11:58,330 --> 01:11:59,930
Speaker 1: But I don't know.

1354
01:12:00,530 --> 01:12:02,950
Speaker 2: The thing about this, this is really a cautionary tale,

1355
01:12:03,010 --> 01:12:06,480
Speaker 2: I think, for all doctors. It's the cautions of interacting

1356
01:12:06,490 --> 01:12:09,910
Speaker 2: with people with fame and power. Doctors, as I mentioned,

1357
01:12:10,189 --> 01:12:12,750
Speaker 2: are people pleasers at heart. And just like anyone else,

1358
01:12:12,970 --> 01:12:15,470
Speaker 2: we can be drawn to the appeals of the rich

1359
01:12:15,510 --> 01:12:18,990
Speaker 2: and famous. And doctors can find themselves doing things to

1360
01:12:19,070 --> 01:12:21,640
Speaker 2: and for these people that they wouldn't do for other patients.

1361
01:12:22,340 --> 01:12:25,400
Speaker 2: And like that 2012 study, this is not always a

1362
01:12:25,479 --> 01:12:30,060
Speaker 2: service to people. Nope. Patient satisfaction doesn't always correlate with

1363
01:12:30,100 --> 01:12:32,940
Speaker 2: good outcomes. They want to be liked by these individuals.

1364
01:12:32,960 --> 01:12:34,930
Speaker 2: They want to be seen as useful patients. And that

1365
01:12:34,950 --> 01:12:38,460
Speaker 2: can land the doctor, and more importantly, the patient, in

1366
01:12:38,540 --> 01:12:43,120
Speaker 2: serious trouble. Look at Michael Jackson's doctor, Matthew Perry's, Joan Rivers.

1367
01:12:43,180 --> 01:12:46,550
Speaker 2: These are all examples of when doctors probably overstepped the

1368
01:12:46,600 --> 01:12:49,430
Speaker 2: bounds of what they should have done, in part at

1369
01:12:49,470 --> 01:12:52,970
Speaker 2: least because they were dealing with a famous and rich person. So,

1370
01:12:53,670 --> 01:12:57,599
Speaker 2: my closing thoughts. Again, there's a lot of what he

1371
01:12:57,680 --> 01:12:59,660
Speaker 2: does that is not bad.

1372
01:12:59,680 --> 01:13:00,800
Speaker 1: Uh-uh.

1373
01:13:01,200 --> 01:13:03,290
Speaker 2: I'm well aware, as I said, that he is not

1374
01:13:03,650 --> 01:13:05,910
Speaker 2: the worst person, one of the least bad people we've

1375
01:13:05,950 --> 01:13:07,809
Speaker 2: ever done on the show. And I still hold out.

1376
01:13:07,830 --> 01:13:08,229
Speaker 1: I don't know.

1377
01:13:08,270 --> 01:13:09,350
Speaker 3: Hung out with Epstein.

1378
01:13:09,680 --> 01:13:12,519
Speaker 1: The Epstein stuff really changes my opinion on that a bit.

1379
01:13:12,540 --> 01:13:15,559
Speaker 2: Yeah. I still hold out hope for redemption arc as

1380
01:13:15,600 --> 01:13:17,740
Speaker 2: I do for everyone. I don't know why I do that,

1381
01:13:17,810 --> 01:13:21,400
Speaker 2: but I can't help but do that. But. What it does,

1382
01:13:21,420 --> 01:13:24,140
Speaker 2: it says a lot about the practice of medicine in

1383
01:13:24,160 --> 01:13:26,900
Speaker 2: this country and how it is moving towards becoming something

1384
01:13:27,050 --> 01:13:30,910
Speaker 2: even more economically inaccessible and unequal. It says something about

1385
01:13:30,950 --> 01:13:34,950
Speaker 2: the common pitfalls doctors make once they become public figures

1386
01:13:35,610 --> 01:13:41,129
Speaker 2: and what can happen when influence outweighs the actual science,

1387
01:13:41,250 --> 01:13:44,110
Speaker 2: becomes more important than the actual science. I think he's

1388
01:13:44,150 --> 01:13:48,230
Speaker 2: sort of the missing link between the dangerous maha pseudoscience

1389
01:13:48,990 --> 01:13:52,689
Speaker 2: practitioners and the more mainstream, but kind of also problematic

1390
01:13:52,729 --> 01:13:56,929
Speaker 2: healthcare leaders like recent FDA commissioner, Marty Macari, who he

1391
01:13:57,070 --> 01:14:00,590
Speaker 2: claims is his close personal friend. He's not a bastard

1392
01:14:00,630 --> 01:14:04,990
Speaker 2: because he's malicious. He's because it's consequential. He's part of

1393
01:14:05,030 --> 01:14:08,309
Speaker 2: this push that's making medicine. I think he's a bastard.

1394
01:14:09,110 --> 01:14:10,140
Speaker 3: I'm just going to.

1395
01:14:11,360 --> 01:14:14,940
Speaker 2: Say it. I will say this. Like, I feel comfortable

1396
01:14:14,960 --> 01:14:17,860
Speaker 2: when he talks about certain things. He talks about strength training. Fine.

1397
01:14:18,220 --> 01:14:22,320
Speaker 2: Do it. Um, And I do want people listening to

1398
01:14:22,340 --> 01:14:24,920
Speaker 2: these things and learning about metabolic syndrome and learning what

1399
01:14:24,960 --> 01:14:27,520
Speaker 2: it is. I also don't want them being so hyper-focused

1400
01:14:27,620 --> 01:14:30,809
Speaker 2: on it. I think... We face bigger problems when he

1401
01:14:30,870 --> 01:14:33,540
Speaker 2: faces into areas where he doesn't have expertise. For example,

1402
01:14:33,580 --> 01:14:36,720
Speaker 2: we talked about colon cancer and I know what's right there.

1403
01:14:36,740 --> 01:14:38,700
Speaker 2: Then it sounds really silly to me. And I'm like,

1404
01:14:38,820 --> 01:14:41,099
Speaker 2: you just can't be an expert in all things, which

1405
01:14:41,160 --> 01:14:43,840
Speaker 2: is something that we have to address and grapple with

1406
01:14:44,000 --> 01:14:46,720
Speaker 2: as medical podcasters. And this is something I have to

1407
01:14:46,820 --> 01:14:49,810
Speaker 2: wrestle with all the time, which is how do we

1408
01:14:50,390 --> 01:14:54,410
Speaker 2: do what we do and not fall into these common mistakes?

1409
01:14:54,590 --> 01:14:56,310
Speaker 2: And I try hard, but I don't know, maybe I'm

1410
01:14:56,330 --> 01:14:58,850
Speaker 2: not perfect either about this. I don't consider myself a

1411
01:14:58,930 --> 01:15:03,830
Speaker 2: medical influencer like he is, but it's always concerning to

1412
01:15:03,870 --> 01:15:07,070
Speaker 2: me if I'm overstepping my expertise or my bounds. So

1413
01:15:07,610 --> 01:15:11,100
Speaker 2: having the air of authority but without the same responsibility

1414
01:15:11,189 --> 01:15:15,300
Speaker 2: and guardrails of real medical practice is a concern for

1415
01:15:15,479 --> 01:15:18,940
Speaker 2: all physician podcasters, myself included, and is a concern here

1416
01:15:19,000 --> 01:15:20,950
Speaker 2: with him. It's something we should all be aware of.

1417
01:15:20,960 --> 01:15:21,880
Speaker 3: Yeah.

1418
01:15:22,630 --> 01:15:24,330
Speaker 2: But the long and short of it is I think

1419
01:15:24,370 --> 01:15:26,269
Speaker 2: he is a part of this push that is making

1420
01:15:26,370 --> 01:15:30,750
Speaker 2: medicine less scientific and it's making medicine less accessible. And

1421
01:15:30,790 --> 01:15:33,370
Speaker 2: it really worries me and concerns me. And that is

1422
01:15:33,450 --> 01:15:37,570
Speaker 2: my shtick on Dr. Peter Attia.

1423
01:15:38,510 --> 01:15:39,150
Speaker 1: Well, thank you.

1424
01:15:39,170 --> 01:15:40,830
Speaker 2: Thanks, Kaveh.

1425
01:15:40,850 --> 01:15:43,759
Speaker 1: Yeah, bastard ends of things. You want to plug things

1426
01:15:43,800 --> 01:15:44,620
Speaker 1: before we roll out here?

1427
01:15:45,060 --> 01:15:47,280
Speaker 2: I certainly do. I want to plug my podcast, The

1428
01:15:47,320 --> 01:15:51,430
Speaker 2: House of Pod. It is a fun-ish medical podcast. We

1429
01:15:51,450 --> 01:15:53,390
Speaker 2: look at science. We look at wellness grifters and make

1430
01:15:53,410 --> 01:15:55,750
Speaker 2: fun of them. And we talk about what RFK Jr.

1431
01:15:55,830 --> 01:15:57,870
Speaker 2: is doing to our terrible country. But even more than that,

1432
01:15:57,890 --> 01:15:59,750
Speaker 2: I want you to listen to my brand new podcast

1433
01:16:00,090 --> 01:16:03,670
Speaker 2: that I'm very excited about called Persian of Interest. It's

1434
01:16:03,710 --> 01:16:08,229
Speaker 2: about Persian contributions to art, music, philosophy, science, a lot

1435
01:16:08,250 --> 01:16:10,880
Speaker 2: of the fun stories that we've been written out of

1436
01:16:11,030 --> 01:16:13,880
Speaker 2: or minimized in. And we're going to cover a lot

1437
01:16:13,920 --> 01:16:15,780
Speaker 2: of great topics with a lot of great guests. It's

1438
01:16:15,820 --> 01:16:20,589
Speaker 2: going to be a really fun time. Please check it out. Bye. Bye.

1439
01:16:20,650 --> 01:16:21,439
Speaker 1: Bye.

1440
01:16:24,710 --> 01:16:27,229
Speaker 3: Behind the Bastards is a production of Cool Zone Media.

1441
01:16:27,410 --> 01:16:31,130
Speaker 3: For more from Cool Zone Media, visit our website, coolzonemedia.com.

1442
01:16:31,530 --> 01:16:34,170
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1443
01:16:34,330 --> 01:16:37,850
Speaker 3: or wherever you get your podcasts. Full video episodes of

1444
01:16:37,870 --> 01:16:40,610
Speaker 3: Behind the Bastards are now streaming on Netflix, dropping every

1445
01:16:40,689 --> 01:16:43,340
Speaker 3: Tuesday and Thursday. Hit Remind Me on Netflix so you

1446
01:16:43,360 --> 01:16:46,809
Speaker 3: don't miss an episode. For clips and our older episode catalog,

1447
01:16:46,870 --> 01:16:50,770
Speaker 3: continue to subscribe to our YouTube channel, youtube.com slash at

1448
01:16:50,840 --> 01:16:55,520
Speaker 3: Behind the Bastards. We love about 40% of you, statistically speaking.