WEBVTT - Dr. Sanjay Gupta on how to build a better brain 0:00:00.320 --> 0:00:06.640 Hi everyone. I'm Katie Kuric, and this is next question. 0:00:07.240 --> 0:00:11.920 You know, I've known and admire Dr Sanjay Gupta for years. 0:00:11.920 --> 0:00:15.560 He's such a great guy. He's also a neuroscientist and 0:00:15.600 --> 0:00:19.760 the chief medical correspondent for CNN, which, as you can imagine, 0:00:19.760 --> 0:00:22.720 when COVID hit put him at the center of the 0:00:22.760 --> 0:00:26.120 pandemic storm. This may be a new pathogen that circulates 0:00:26.120 --> 0:00:28.120 around the world. You're running into a situation where you 0:00:28.480 --> 0:00:31.120 just don't have beds. If those numbers don't budge, it's 0:00:31.120 --> 0:00:33.479 gonna be very hard to get to hurt immunity. I 0:00:33.479 --> 0:00:35.680 think this has added a lot more urgency to an 0:00:35.720 --> 0:00:40.520 already very urgent situation. There has been so much to cover. 0:00:40.600 --> 0:00:44.920 In fact, Sanjay also launched a daily podcast on the subject. 0:00:45.080 --> 0:00:49.319 I'm Dr Sanjay Gupta, CNN's chief medical correspondent, and this 0:00:49.360 --> 0:00:55.560 is coronavirus fact versus fiction. Throughout this very long year, 0:00:55.800 --> 0:00:59.800 Sanja has really acted as our guide, helping us understand 0:00:59.840 --> 0:01:02.680 the thorny virus and what it means for our health, 0:01:03.000 --> 0:01:07.119 our communities, and our country. And he admits it's been 0:01:07.160 --> 0:01:10.880 as all consuming as you might think. All I think about, 0:01:11.040 --> 0:01:15.720 Katie has been COVID. You know, I viral transmission, how 0:01:15.760 --> 0:01:20.920 people evaluate risk social behavior. But there is some joy 0:01:20.959 --> 0:01:23.280 in getting so head down in something. I feel like 0:01:23.319 --> 0:01:26.240 we live such distracted lives. You get a little bit 0:01:26.240 --> 0:01:29.520 about a lot of things, like I really know so 0:01:29.640 --> 0:01:34.800 much about this virus. I also wanted to talk to 0:01:34.800 --> 0:01:38.160 Sanjay because he's got a new book out. Yeah, believe 0:01:38.160 --> 0:01:40.680 it or not, he found time to write a book 0:01:40.800 --> 0:01:45.280 during this crazy year. It's called Keep Sharp, Building a 0:01:45.319 --> 0:01:49.400 Better Brain at any Age, and it's fascinating. It's also 0:01:49.560 --> 0:01:53.920 a practical guide for better brain health, something I'm extremely 0:01:53.960 --> 0:01:57.000 interested in. And don't worry, we do get into that, 0:01:57.360 --> 0:02:00.440 but since I have the COVID expert of experts, I 0:02:00.440 --> 0:02:04.760 couldn't help but start our conversation there. You must feel 0:02:04.800 --> 0:02:09.079 like you you have a PhD in virology at this point, right, Yeah, 0:02:09.280 --> 0:02:12.520 I mean totally and and and the the irony is, Katie, 0:02:12.639 --> 0:02:16.160 is that this is a novel virus, right, So I 0:02:16.200 --> 0:02:20.320 mean novel actually means something, which which that didn't really 0:02:20.360 --> 0:02:22.600 strike me until a few months into this either, Like 0:02:22.639 --> 0:02:25.880 I think because you said the PhD in virology. The 0:02:25.880 --> 0:02:28.919 the irony is that that I think people who had 0:02:28.919 --> 0:02:32.400 a lot of knowledge about this. In some ways it 0:02:32.520 --> 0:02:34.920 got in their way because it's very hard to think 0:02:34.960 --> 0:02:37.640 about something as novel. You immediately want to put it 0:02:37.680 --> 0:02:41.280 into a box. It's the box of stars, it's the 0:02:41.320 --> 0:02:44.519 box of H one, N one, whatever you come up with. 0:02:44.960 --> 0:02:47.839 But this was novel, which means that if you try 0:02:47.840 --> 0:02:50.920 to put it in a box, you probably got it wrong. 0:02:51.320 --> 0:02:55.040 So they had to cast aside their preconceived notions completely, 0:02:55.720 --> 0:02:58.880 and that's hard to do, right for a scientist, it's 0:02:59.000 --> 0:03:01.799 really hard to do, and and it goes against sort 0:03:01.800 --> 0:03:04.240 of how you think about things. Let's get the best experts. 0:03:04.440 --> 0:03:07.960 And by the way, I think there's really really value, 0:03:08.000 --> 0:03:11.280 great value and expertise. Don't get me wrong, But what 0:03:11.320 --> 0:03:14.760 you would do is grab the coronavirus experts, grabbed the 0:03:14.760 --> 0:03:18.000 pandemic experts, and that was all important. But this virus 0:03:18.120 --> 0:03:21.280 was just behaving in a totally novel way. I mean. 0:03:21.320 --> 0:03:24.520 One of the best examples, as you well know, was 0:03:24.840 --> 0:03:28.680 everybody believed that respiratory virus is really only spread when 0:03:28.720 --> 0:03:31.600 you were sick. When you were when you had symptoms, 0:03:31.639 --> 0:03:33.960 that's when you spread. And you know, the guidance was, 0:03:34.000 --> 0:03:36.240 will screen people at airports, will tell people to stay 0:03:36.240 --> 0:03:39.240 home if they're sick, which people should do anyway, regardless 0:03:39.280 --> 0:03:42.440 of whether in a pandemic, and we should be able 0:03:42.480 --> 0:03:46.640 to quell this thing. No one really believed initially that 0:03:46.680 --> 0:03:50.440 this thing would spread most efficiently when people didn't have symptoms. 0:03:50.920 --> 0:03:53.840 That that was that's never really happened before, is it. 0:03:53.920 --> 0:03:55.960 As Dr Fauci has said, never in the history of 0:03:56.000 --> 0:04:00.560 respiratory viruses has that happened before. That's novel. I mean, 0:04:00.600 --> 0:04:03.400 you know, remember the story of typhoid Mary. She was 0:04:03.440 --> 0:04:07.800 a silent carrier of typhoid. It was so dramatic because 0:04:07.800 --> 0:04:11.160 she infected all these people in this single residents in 0:04:11.440 --> 0:04:14.000 this community and all that, and people couldn't figure it out. 0:04:14.960 --> 0:04:17.520 This is like millions of typhoid Mary's in a way 0:04:17.600 --> 0:04:20.919 of a of a brand new disease, COVID, So it 0:04:21.040 --> 0:04:23.360 is it was quite extraordinary to sort of see that, uh, 0:04:23.680 --> 0:04:26.960 see see how that all played out. Well, before we 0:04:27.040 --> 0:04:30.039 talk about your your new book, keep sharp, because I'm 0:04:30.080 --> 0:04:34.840 really interested, as someone who's sixty four, in maintaining my 0:04:34.960 --> 0:04:39.479 mental acuity as i age. I just want to ask 0:04:39.520 --> 0:04:43.520 you one last question about COVID, and that is, are 0:04:43.560 --> 0:04:45.279 we seeing the light at the end of the tunnel. 0:04:45.400 --> 0:04:49.440 Every time I feel optimistic, sang, I then read something 0:04:49.480 --> 0:04:54.680 about variance or increased cases, and it's quite nerve racking, 0:04:54.800 --> 0:04:58.240 I think for the average person who doesn't have a 0:04:58.240 --> 0:05:01.720 medical degree or hasn't been deeply, deeply entrenched in the 0:05:01.760 --> 0:05:04.920 science of this, I mean, are we screwed? Are we 0:05:05.560 --> 0:05:09.200 at the tail end of this pandemic? I do feel 0:05:09.240 --> 0:05:11.760 the light on my face, in your face. I mean, 0:05:11.760 --> 0:05:14.840 I do think that the the tunnel is is the 0:05:14.920 --> 0:05:18.840 end of the tunnels in sight? I mean, the then 0:05:18.960 --> 0:05:21.479 can I just can I just remind people, and I 0:05:21.520 --> 0:05:23.200 think this is such an important reminder that they were 0:05:23.240 --> 0:05:26.640 having rave parties in Wuhan at the end of last summer. 0:05:27.760 --> 0:05:29.520 And I bring that up only to say that we 0:05:29.560 --> 0:05:31.760 talked about the vaccines. We talked about the fact that 0:05:31.800 --> 0:05:36.479 science is now rescuing us, which is great, fantastic, but 0:05:36.839 --> 0:05:38.840 so much of this didn't need to happen. And I 0:05:38.920 --> 0:05:40.880 and I and I know that's not your question, Katie, 0:05:40.880 --> 0:05:42.320 but I just feel like I can never answer a 0:05:42.440 --> 0:05:47.200 question about um, about the sort of future or being 0:05:47.240 --> 0:05:50.640 optimistic about this pandemic because I'm so it's just so, 0:05:50.960 --> 0:05:54.240 it's so, I'm so angry in so many ways. I mean, 0:05:54.279 --> 0:05:57.840 you know, six people died and some of them are 0:05:57.839 --> 0:06:01.000 my friends. And I've seen families, I talk to families still, 0:06:01.360 --> 0:06:03.680 I just it just this may not have even been 0:06:03.720 --> 0:06:06.239 the Black Swan event, right, we think of this black 0:06:06.279 --> 0:06:09.560 Swan event, this really contagious virus, which this was, but 0:06:09.640 --> 0:06:11.960 something that has a two to three percent mortality that 0:06:12.000 --> 0:06:14.360 would be awful, that would be the Black Swan event. 0:06:14.560 --> 0:06:16.560 This wasn't even that. There were countries around the world 0:06:16.600 --> 0:06:19.479 that immediately quelled this and measure their debts in the 0:06:19.600 --> 0:06:22.680 hundreds instead of the hundreds of thousands. Having said that, 0:06:22.760 --> 0:06:26.760 we are a society. Because we are we focus on 0:06:26.800 --> 0:06:29.800 touchdowns and home runs and knockouts. We don't care much 0:06:29.839 --> 0:06:33.120 for singles and doubles. Because we're that society. We waited 0:06:33.160 --> 0:06:36.000 for science to rescue us. And and the vaccines will. 0:06:36.040 --> 0:06:40.120 I think they're really extraordinary and really effective. They seem 0:06:40.160 --> 0:06:43.800 to be pretty effective against the variant B one one seven, 0:06:43.920 --> 0:06:46.600 the UK variant, because there's a lot of concern about 0:06:46.600 --> 0:06:49.839 that variant. But if you have been vaccinated, or if 0:06:49.880 --> 0:06:52.479 you had the infection in the past, the other you know, 0:06:52.560 --> 0:06:56.120 the the circulating coronavirus that should also protect you. So 0:06:56.160 --> 0:06:57.960 it's really I think it's really good. And I think 0:06:57.960 --> 0:07:01.160 with the warmer, warmer weather in the summer, viral transmission 0:07:01.200 --> 0:07:04.080 rates will go down. That would be great. I do think, 0:07:04.200 --> 0:07:07.279 you know, um, we'll probably get to hurt immunity over 0:07:07.279 --> 0:07:10.760 the summer, but but it's worth reminding that her immunity 0:07:10.800 --> 0:07:13.760 isn't a sort of destination. Necessarily. You can pop in 0:07:13.840 --> 0:07:16.320 and out of her immunity. So if not enough people 0:07:16.320 --> 0:07:20.440 get vaccinated over you know, the next few months, then 0:07:20.480 --> 0:07:23.120 going into the colder weather again in the fall, we 0:07:23.120 --> 0:07:26.920 could see resurgences. It's quite disturbing when you hear about 0:07:26.960 --> 0:07:31.400 the people who are refusing to get vaccinated. Many of 0:07:31.440 --> 0:07:35.200 them are white men, Uh, in this country. I think 0:07:35.280 --> 0:07:39.320 you see the impact of politics on that number, not 0:07:39.440 --> 0:07:42.480 only in terms of the response to the pandemic, but 0:07:42.600 --> 0:07:47.200 now to the response to the vaccines. Uh. That must 0:07:47.240 --> 0:07:52.000 be quite disturbing for you too, it is for me. Yeah. 0:07:52.040 --> 0:07:55.800 I mean there's been no not a single part of 0:07:55.800 --> 0:07:59.560 this entire pandemic that hasn't been politicized in some way. 0:07:59.600 --> 0:08:02.080 I mean that I guess now you say that's in 0:08:02.080 --> 0:08:05.720 in April of two one, and it's obvious, right, everyone 0:08:05.800 --> 0:08:09.880 knows that, but started starting off covering the story, um 0:08:10.000 --> 0:08:12.720 and now all the way now to the vaccines, even 0:08:12.880 --> 0:08:15.640 every single component has been politicized in some way. So 0:08:15.720 --> 0:08:18.760 it is it is disturbing the anti vax movement. And 0:08:18.800 --> 0:08:20.720 you may not even remember this, Katie, but I actually 0:08:20.760 --> 0:08:24.560 did a segment on your your show years ago about 0:08:25.240 --> 0:08:29.480 anti vaccination movement at that time around h one and one. 0:08:30.040 --> 0:08:32.240 But it's been around for a long time, the anti 0:08:32.320 --> 0:08:35.520 vaccination movement, and it's sort of you know, it simmers it. 0:08:35.880 --> 0:08:40.800 We saw measles outbreaks in Brooklyn and and Disneyland and Minnesota. 0:08:40.880 --> 0:08:46.360 This seems bigger though you know that was a particular group, uh, 0:08:46.400 --> 0:08:51.520 and it really dealt primarily with childhood vaccinations and now 0:08:52.040 --> 0:08:58.040 this has expanded to um, you know, these adults who 0:08:59.240 --> 0:09:01.240 I don't know for one reason or another. I think 0:09:01.280 --> 0:09:05.280 you can understand people of color and the terrible history 0:09:05.320 --> 0:09:08.320 of Tuskegee and some of the ways that people of 0:09:08.360 --> 0:09:12.000 color have been abused in scientific research in the past, 0:09:12.080 --> 0:09:16.679 and this kind of deeply ingrained mistrust of the medical community. 0:09:16.840 --> 0:09:19.360 So I think you can appreciate that. But this is, 0:09:19.960 --> 0:09:23.319 you know, this is a whole other ball of wax, 0:09:23.440 --> 0:09:26.360 isn't it? Yes, it really is. And and you know 0:09:26.400 --> 0:09:29.240 we're we're seeing some of this for or really seeing 0:09:29.280 --> 0:09:31.560 it come to light, I should say, you know, in 0:09:31.600 --> 0:09:33.720 a in a pretty dramatic way. Now. I think I 0:09:33.720 --> 0:09:36.200 think I was reading the statistics this morning, Katie Kaiser 0:09:36.240 --> 0:09:40.920 Family Foundation, forty of those in rural areas who say 0:09:40.960 --> 0:09:43.920 they absolutely will not take the vaccine. It's not any 0:09:44.000 --> 0:09:45.839 question of hey, I want more information, I want to 0:09:45.840 --> 0:09:48.000 see how this plays out. They're just saying, out of 0:09:48.000 --> 0:09:50.840 the gate they absolutely not take it. And what said, 0:09:50.920 --> 0:09:54.320 what is the explanation? That's the curious thing, Like you said, 0:09:54.360 --> 0:09:57.520 with some people who are vaccine hesitants, it is concerns 0:09:57.520 --> 0:10:01.920 about safety or mistrust or you know, uh my my 0:10:02.040 --> 0:10:05.560 grandfather was experimented on as part of Tuskegee, you know, 0:10:05.640 --> 0:10:08.559 things like that. With this, I think it's almost an 0:10:08.559 --> 0:10:12.400 extension of this pandemic. Isn't even real. It's not a hoax. 0:10:12.400 --> 0:10:15.840 Why would I take a vaccine for something that's a hoax. 0:10:16.160 --> 0:10:19.240 I'm not scared for safety of it. I just don't. 0:10:19.280 --> 0:10:21.080 I think the whole thing is sort of you know, 0:10:21.120 --> 0:10:24.120 the scam demic sort of thing. So I don't know 0:10:24.200 --> 0:10:26.439 if that's the case. For it's a huge percentage of 0:10:26.440 --> 0:10:29.760 people were talking about here, so maybe there's a some heterogeneity, 0:10:29.840 --> 0:10:33.480 you know, some variety of opinions there. But bottom line, 0:10:33.640 --> 0:10:36.120 if if, if the numbers stay that high, we're not 0:10:36.240 --> 0:10:39.360 going to get to hurt immunity based on vaccinating adults alone, 0:10:39.600 --> 0:10:43.560 which is it's it's it's so. I mean, gosh, we 0:10:43.600 --> 0:10:45.559 wait for science to rescue us. We don't do the 0:10:45.600 --> 0:10:48.440 basic public health practices, and then when when this truly 0:10:48.480 --> 0:10:52.559 extraordinary scientific achievement occurs in the form of this vaccine, 0:10:53.240 --> 0:10:55.679 people don't take it. You know, if you are a 0:10:55.760 --> 0:10:59.160 Martian coming to planet Earth and saying, so, let me 0:10:59.160 --> 0:11:02.600 get this straight. So you didn't do anything about the virus. 0:11:02.679 --> 0:11:05.120 You waited, created this amazing medicine, and then you don't 0:11:05.160 --> 0:11:08.280 take the medicine to it. Just it doesn't make any sense. 0:11:08.440 --> 0:11:11.760 It's a head scratcher for sure. When do you think 0:11:11.800 --> 0:11:15.480 Sanjay will be able to go about our daily lives 0:11:15.559 --> 0:11:19.199 without mass I think it'll be this summer, Katie, I 0:11:19.559 --> 0:11:21.320 I really do. I mean, I know that there's people 0:11:21.360 --> 0:11:24.480 who are painting a more dire prediction around that, but 0:11:24.960 --> 0:11:27.200 you know, we for no other reason alone with the 0:11:27.200 --> 0:11:30.240 warmer weather, and then you're gonna really see the blunting 0:11:30.880 --> 0:11:33.040 despite the vaccine hesitancy that we're talking about. You are 0:11:33.040 --> 0:11:35.720 going to see a significant blunting of people who are 0:11:35.720 --> 0:11:38.280 getting very sick, people who are dying. And we know 0:11:38.320 --> 0:11:40.800 that the the vaccine does seem to have good evidence 0:11:40.840 --> 0:11:44.000 that it stops or decreases transmission. So I think we're 0:11:44.000 --> 0:11:45.920 really going to get to a pretty good point. I 0:11:46.000 --> 0:11:49.360 think you'll still see masks around, you know, in in 0:11:49.480 --> 0:11:52.520 Hong Kong after Hong Kong really wasn't a mask wearing 0:11:52.559 --> 0:11:55.280 country until after Stars and then there was this huge 0:11:55.320 --> 0:11:59.120 psychological impact. That's why they went to mass so early 0:11:59.160 --> 0:12:01.720 in Hong Kong, but they became a mask wearing culture. 0:12:02.160 --> 0:12:04.320 I think you will see people who are just frightened 0:12:04.600 --> 0:12:07.280 still want to wear masks in public places. I think 0:12:07.280 --> 0:12:09.880 in flu season, you know, the colder months, I think 0:12:09.880 --> 0:12:13.160 you'll see more masks. I think that may become a 0:12:13.160 --> 0:12:15.560 a larger part of our culture. Not a dominant, but 0:12:15.600 --> 0:12:18.040 I think a larger part of our culture. That's interesting 0:12:18.080 --> 0:12:22.480 because I remember being in Tokyo maybe gosh, gosh, maybe 0:12:22.480 --> 0:12:25.720 ten ten or twelve years ago and going on the 0:12:25.760 --> 0:12:29.559 train to Kyoto and seeing everyone wearing masks and thinking 0:12:29.960 --> 0:12:33.880 this is so weird. Why are they wearing masks? And now, 0:12:33.960 --> 0:12:36.680 of course I understand, and you're right. I think when 0:12:36.679 --> 0:12:40.040 people are on places like public transportation, if they're in 0:12:40.040 --> 0:12:44.840 a closed spaces with lots of strangers, Um, it actually 0:12:44.880 --> 0:12:47.719 makes sense, doesn't it. I mean, you know, one thing 0:12:47.760 --> 0:12:49.839 we saw, as you may remember, is that the flu 0:12:50.040 --> 0:12:54.520 numbers were way down this past season, and that you 0:12:54.559 --> 0:12:56.800 know that that wasn't because of any increase in in 0:12:57.000 --> 0:12:59.920 vaccination or anything. That was because of just public health behavior. 0:13:00.080 --> 0:13:02.680 It's always worked, you know. I don't know there's a 0:13:02.679 --> 0:13:05.560 metaphor for this, Katie, right, I mean we I don't know. 0:13:05.960 --> 0:13:07.920 I guess it's true in our lives, like we'd rather 0:13:08.000 --> 0:13:10.959 just take a pill for weight loss rather than go exercise, 0:13:11.480 --> 0:13:15.160 and we always want the convenience. And and this is 0:13:15.240 --> 0:13:18.880 this is another example of that. We I I was struck. 0:13:19.000 --> 0:13:21.000 And again, we can talk about COVID all day long, 0:13:21.080 --> 0:13:24.320 but the but the I'll never forget these these mask 0:13:24.360 --> 0:13:28.040 researchers from Harvard, a guy named Abera Kuran. He basically 0:13:28.080 --> 0:13:30.280 was doing all this modeling all along. We were talking 0:13:30.280 --> 0:13:32.760 to him. He told me that if for four weeks, 0:13:32.760 --> 0:13:35.320 and this is back, you know, October November of last year, 0:13:35.640 --> 0:13:39.640 if for four weeks everybody just wore a high filtration 0:13:39.679 --> 0:13:42.200 mask when they went out in public, that's it. For 0:13:42.240 --> 0:13:45.160 four weeks, if everybody did that, it would have ended 0:13:45.160 --> 0:13:49.800 the pandemic. Are you kidding? That's incredible. The virus would 0:13:49.800 --> 0:13:52.760 have nowhere to go. It couldn't find a willing host. 0:13:53.640 --> 0:13:56.319 I mean, you know that that that sort of that 0:13:56.400 --> 0:13:58.920 sort of concept is something that's more than a hundred 0:13:59.000 --> 0:14:02.800 years old. I just I just don't quite you know, 0:14:02.960 --> 0:14:05.040 I don't know. Maybe I'm just being naive, But but 0:14:05.240 --> 0:14:07.080 you hear that and you think it's amazing, right, I 0:14:07.120 --> 0:14:10.680 think it's amazing. And yet we also know both of 0:14:10.760 --> 0:14:13.599 us that in the United States that couldn't happen. It 0:14:13.720 --> 0:14:17.840 just wouldn't happen. I mean, human being survived and thrived 0:14:17.840 --> 0:14:21.680 as a species because we're reciprocally altruistic. There's a reason 0:14:21.680 --> 0:14:24.120 that it feels good to do good. Why should it 0:14:24.120 --> 0:14:26.520 feel good when I do something nice for you? I mean, 0:14:26.560 --> 0:14:29.520 what purposes that serve my evolutionary tree? I don't know, 0:14:29.680 --> 0:14:31.480 But the reality is that it does feel good to 0:14:31.520 --> 0:14:34.040 do good. We encoded that in some way in our 0:14:34.120 --> 0:14:36.840 DNA and then people can't be bothered to wear a 0:14:36.920 --> 0:14:39.680 mask to save tens of thousands of lives. I just 0:14:40.360 --> 0:14:42.800 I'll that may be one of the greatest mysteries of 0:14:42.800 --> 0:14:46.080 all out of this whole thing. Well, I just want 0:14:46.120 --> 0:14:49.480 to say, on on behalf of the American public, thank 0:14:49.520 --> 0:14:53.160 you for your coverage of this UM. I think you're 0:14:53.200 --> 0:15:00.440 so measured and uh so eloquent and and honestly calming 0:15:00.680 --> 0:15:04.240 in a way, and I just really appreciate all the 0:15:04.400 --> 0:15:09.600 fantastic reporting you've done throughout this pandemic. So on behalf 0:15:09.640 --> 0:15:12.880 of a grateful America, I would like to say thank you, 0:15:12.960 --> 0:15:17.120 Sancho Gupta, Well, Katie, thank you, thank you, And that 0:15:17.200 --> 0:15:20.800 obviously means a great deal in particular coming from you, 0:15:20.920 --> 0:15:23.720 So I appreciate that you know, you get it. You know, 0:15:23.920 --> 0:15:27.280 I mean, you're you are the standard obviously by whom 0:15:27.280 --> 0:15:30.000 we all measure ourselves. But also you know you were 0:15:30.000 --> 0:15:32.920 all in these black holes, right I mean, I don't 0:15:32.920 --> 0:15:34.560 know where you are right now. As I said, I'm 0:15:34.560 --> 0:15:36.680 in this tiny little closet. I don't you don't get 0:15:36.720 --> 0:15:41.680 any feedback. Sometimes it's been really dispiriting because you think, Okay, 0:15:41.720 --> 0:15:44.320 I'm a medical reporter in the middle of a pandemic, 0:15:44.400 --> 0:15:47.400 that that is my you know, that's a job. And 0:15:47.520 --> 0:15:49.800 at the same time, the country in which I'm reporting 0:15:50.120 --> 0:15:53.240 arguably did the worst in the world. I mean, I 0:15:53.280 --> 0:15:55.200 know I keep taking this in that direction, but it's 0:15:55.240 --> 0:15:58.280 just so dispiriting. Did I did anyone listen to me? 0:15:58.720 --> 0:16:01.360 I mean, if if, if you're the medical reporter and 0:16:01.720 --> 0:16:04.680 presumably people are are counting on you to provide knowledge 0:16:04.760 --> 0:16:08.600 hopefully that will inform how they behave and then we 0:16:08.680 --> 0:16:11.160 do the worst in the world. That's that's you know, 0:16:11.480 --> 0:16:13.640 I'm going to need to reflect on that. I think, 0:16:14.240 --> 0:16:16.720 you know, in the years to come, like what is 0:16:16.760 --> 0:16:19.120 the real impact here? One could argue that maybe it 0:16:19.120 --> 0:16:21.640 would have been worse, who knows, you know, but it's 0:16:21.640 --> 0:16:25.640 pretty bad. Well, don't get too dispirited, because I think 0:16:25.680 --> 0:16:29.360 a lot of people listen, relied on you, and actually acted. 0:16:30.560 --> 0:16:34.680 So even though the track record was bad, your information 0:16:34.920 --> 0:16:38.720 was good and important. So thank you. I appreciate that. 0:16:40.760 --> 0:16:44.240 When we come back Sanja and I find some optimism 0:16:44.280 --> 0:16:47.360 and believe it or not, brain health, that's right after this, 0:16:58.320 --> 0:17:02.560 let's talk about keep sharp because moving forward, I think 0:17:03.120 --> 0:17:06.960 many people like me really are interested in how to 0:17:07.119 --> 0:17:12.719 keep our cognitive and mental health at the top. And 0:17:12.800 --> 0:17:17.439 I think you know, certainly, one big change in medicine 0:17:17.560 --> 0:17:24.760 is that we as patients are not passive. It turns out, Sang, 0:17:25.040 --> 0:17:27.440 that there is a lot of things that we can 0:17:27.480 --> 0:17:30.639 do to keep our brains in shape, just like we 0:17:30.680 --> 0:17:33.919 can do to keep our bodies and our organs and 0:17:34.080 --> 0:17:37.919 other things in shape. And that's why you broke keep Sharp. 0:17:38.040 --> 0:17:42.680 But you have a very very personal connection to this, 0:17:42.960 --> 0:17:47.880 I guess, well, obviously because of your specialty, but particularly 0:17:47.960 --> 0:17:54.000 about Alzheimer's dementia and are failing brain power that happens 0:17:54.040 --> 0:17:58.040 as we age. Tell me about that. Well, when I 0:17:58.119 --> 0:18:01.760 was when I was twelve thirteen years old, my grandfather, 0:18:02.440 --> 0:18:05.480 my my mother's dad, who I was very close to, 0:18:06.400 --> 0:18:11.360 um developed, you know, signs of dementia. He had had 0:18:11.400 --> 0:18:14.320 a a stroke earlier in his life that had recovered 0:18:15.240 --> 0:18:20.320 and was now developing. You know, just these these um 0:18:20.359 --> 0:18:22.720 periods of time where he he really wasn't aware of 0:18:22.760 --> 0:18:26.440 what was going on. He would sometimes, uh make a 0:18:26.560 --> 0:18:28.399 joke that no one else was in on, you know, 0:18:28.440 --> 0:18:30.600 and it was all these things that that I remember 0:18:30.640 --> 0:18:32.480 really being struck by as a kid, because you look 0:18:32.480 --> 0:18:35.480 at adults and you're not used to seeing brain power 0:18:35.520 --> 0:18:37.320 start to diminish. And it was the first time I 0:18:37.359 --> 0:18:40.840 saw really specific things like he could he could still 0:18:41.640 --> 0:18:44.520 um right, but he couldn't really read. It was it 0:18:44.560 --> 0:18:47.679 was all these things that became really fascinating in a 0:18:47.680 --> 0:18:49.359 way for me in terms of just how does the 0:18:49.400 --> 0:18:51.919 brain work like that? But also to see it in 0:18:51.960 --> 0:18:55.600 a loved one to wonder, is that how genetic is that? Is? That? 0:18:56.080 --> 0:18:58.119 Is my mom going to develop those symptoms? While I 0:18:58.200 --> 0:19:01.159 one day all of that and then you know, fast forward, 0:19:01.200 --> 0:19:05.119 you know, thirty forty years later, and and we're still 0:19:05.160 --> 0:19:08.560 worrying about the exact same things, and and I haven't 0:19:08.600 --> 0:19:10.600 really made a lot of progress in terms of being 0:19:10.600 --> 0:19:12.840 able to deal with that. So that was that was 0:19:12.880 --> 0:19:15.800 a large part of what I think inspired me to 0:19:15.800 --> 0:19:18.919 to to write the book What has Happened over the 0:19:19.000 --> 0:19:23.879 last forty years? Both from a, you know, a pharmaceutical standpoint, 0:19:23.920 --> 0:19:26.000 but also more importantly, I think from a from a 0:19:26.040 --> 0:19:29.440 lifestyle behavioral standpoint in terms of what we know and 0:19:29.480 --> 0:19:33.000 how did that influence you to go into neurology? No, 0:19:33.280 --> 0:19:36.399 you know it's funny, Um, it didn't. I actually when 0:19:36.440 --> 0:19:38.240 I started medical medical school, I thought I was going 0:19:38.280 --> 0:19:41.840 to go into pediatrics, and then I did a neurosurgery rotation, 0:19:42.600 --> 0:19:44.240 uh during my third year of med school, and I 0:19:44.240 --> 0:19:45.679 just sort of fell in love. So I came to 0:19:45.720 --> 0:19:49.200 it quite late. But I was always interested in the 0:19:49.280 --> 0:19:51.760 brain because of my grandfather, and so it felt like 0:19:51.760 --> 0:19:56.480 a very natural fit. Let's talk about the numbers. Because 0:19:57.280 --> 0:20:02.040 seven million Americans have some evidence of pre clinical Alzheimer's disease, 0:20:02.080 --> 0:20:05.560 and by two sixty one new case of dementia will 0:20:05.560 --> 0:20:10.680 be diagnosed every four seconds. SANJ, what the heck is 0:20:10.720 --> 0:20:14.119 going on here? Well, this is this will become the 0:20:14.600 --> 0:20:19.760 most dominant neurodegenerative disease of our time. I think that 0:20:19.760 --> 0:20:23.479 that part, I think is is pretty well established at 0:20:23.480 --> 0:20:26.320 this point. But there was two things about the statement 0:20:26.359 --> 0:20:29.520 that you just made that I thought were really important 0:20:29.560 --> 0:20:31.639 in terms of what we can potentially do about it. 0:20:32.000 --> 0:20:34.080 As you point out, there's probably about forty seven million 0:20:34.080 --> 0:20:35.960 people who if you were to look at their brains, 0:20:36.720 --> 0:20:40.040 they would have objective evidence of plaques and tangles and 0:20:40.080 --> 0:20:43.520 things like that, but also have no symptoms. That's the 0:20:43.600 --> 0:20:49.000 pre clinical time, right, so out a little well, it's 0:20:49.160 --> 0:20:51.480 you know, but I think this is ultimately good news, 0:20:51.520 --> 0:20:54.040 and I'll tell you why. If you look at patients 0:20:54.040 --> 0:20:58.360 with Alzheimer's disease and and and able to retrospectively look 0:20:58.400 --> 0:21:00.880 at their lives and their scans and their brains, you 0:21:00.920 --> 0:21:04.119 find we now know that that Alzheimer's starts in the 0:21:04.160 --> 0:21:08.919 brain decades before people develop symptoms. Decades so you're starting 0:21:08.920 --> 0:21:12.000 to see the kindling and then even plaques and tangles. 0:21:12.400 --> 0:21:15.520 But the fundamental point that neuroscientists really started to focus 0:21:15.560 --> 0:21:20.800 on was almost the the the analog of that, meaning, Okay, 0:21:20.880 --> 0:21:22.879 so now you've established that you can have a brain 0:21:23.000 --> 0:21:26.800 that has plaques and tangles but still functions normally. So 0:21:26.840 --> 0:21:29.560 why don't we focus on that side of things instead 0:21:29.600 --> 0:21:31.960 of saying, hey, look, let's get rid of the plaques 0:21:31.960 --> 0:21:35.160 and tangles, and we have spent billions of dollars testing 0:21:35.240 --> 0:21:38.159 drugs to do that that haven't really worked. What if 0:21:38.200 --> 0:21:40.960 we say, instead, we have established that a brain with 0:21:41.040 --> 0:21:44.359 plaques and tangles can function normally. Let's figure out why 0:21:44.480 --> 0:21:48.280 and see if we can basically make that an aspiration. 0:21:48.920 --> 0:21:53.240 Do you still have objective evidence of Alzheimer's in your brain. Yes? 0:21:53.680 --> 0:21:57.440 Is it consequential? No, because you know you you are 0:21:57.480 --> 0:22:01.440 able to still have normal cognitive function, memory, judgment, all 0:22:01.440 --> 0:22:03.840 the things that you associate with a healthy functioning brain. 0:22:04.560 --> 0:22:06.440 The metaphor, in some ways, Katie would kind of be 0:22:06.520 --> 0:22:10.119 like a heart bypass surgery. You've got a block blood vessel. 0:22:10.840 --> 0:22:13.840 Now you you go in there and you bypass that 0:22:14.000 --> 0:22:16.439 area of the blockage with a new blood vessel. Do 0:22:16.520 --> 0:22:20.880 you still have heart disease? Yes? Is it? Is it? 0:22:20.960 --> 0:22:23.480 Is it causing you some dysfunction? No, because you're getting 0:22:23.560 --> 0:22:25.600 enough blood flow now to the heart. If you can 0:22:25.600 --> 0:22:29.399 think about that same metaphor for the brain, Yes, you 0:22:29.440 --> 0:22:32.120 have plaques, but there's so many ways to build all 0:22:32.160 --> 0:22:35.560 these new pathways in the brain to your destination, that 0:22:35.880 --> 0:22:40.600 little blockages due to the plaques becoming consequential. So is 0:22:40.640 --> 0:22:43.119 there a tipping point? You know you talk about these 0:22:43.200 --> 0:22:47.080