WEBVTT - Wellness Check: Dr. Sanjay Gupta on how to build a better brain 0:00:00.240 --> 0:00:03.680 Hi, it's Katie. Welcome to Wellness. Check our series of 0:00:03.720 --> 0:00:07.520 some of our favorite Next Question episodes focused on women's 0:00:07.520 --> 0:00:18.240 health and wellness. Enjoy. Hi everyone, I'm Katie Couric and 0:00:18.320 --> 0:00:22.520 this is Next Question. You know. I've known and admired 0:00:22.560 --> 0:00:26.400 doctor Sanje Gupta for years. He's such a great guy. 0:00:26.840 --> 0:00:31.720 He's also a neuroscientist and the chief medical correspondent for CNN, which, 0:00:31.920 --> 0:00:35.000 as you can imagine, when COVID hit put him at 0:00:35.000 --> 0:00:37.200 the center of the pandemic storm. 0:00:37.280 --> 0:00:39.520 So this may be a new pathogen that circulates around 0:00:39.520 --> 0:00:41.720 the world. You're running into a situation where you just 0:00:41.760 --> 0:00:44.360 don't have beds. If those numbers don't budge, it's going 0:00:44.440 --> 0:00:46.560 to be very hard to get to hurt immunity. I 0:00:46.600 --> 0:00:48.800 think this has added a lot more urgency to an 0:00:48.840 --> 0:00:50.640 already very urgent situation. 0:00:52.040 --> 0:00:54.800 There has been so much to cover. In fact, Sanjay 0:00:54.960 --> 0:00:58.080 also launched a daily podcast on the subject. 0:00:58.200 --> 0:01:02.560 I'm doctor Sanje Gupta's chief medical correspondent, and this is 0:01:02.600 --> 0:01:04.959 coronavirus fact versus fiction. 0:01:06.440 --> 0:01:10.600 Throughout this very long year, Sanche has really acted as 0:01:10.600 --> 0:01:14.680 our guide, helping us understand this thorny virus and what 0:01:14.720 --> 0:01:18.320 it means for our health, our communities, and our country, 0:01:18.760 --> 0:01:21.880 and he admits it's been as all consuming as you 0:01:21.959 --> 0:01:22.520 might think. 0:01:23.000 --> 0:01:25.960 All I think about, Katie is been COVID, you know, 0:01:26.120 --> 0:01:32.800 I viral transmission, how people evaluate risk social behavior. But 0:01:33.040 --> 0:01:35.960 there is some joy in getting so head down in something. 0:01:36.000 --> 0:01:38.880 I feel like we live such distracted lives. You get 0:01:38.920 --> 0:01:41.840 a little bit about a lot of things, like I 0:01:42.000 --> 0:01:44.320 really know so much about this virus. 0:01:46.600 --> 0:01:49.360 I also wanted to talk to sanj because he's got 0:01:49.400 --> 0:01:52.240 a new book out. Yeah, believe it or not, he 0:01:52.360 --> 0:01:55.200 found time to write a book during this crazy year. 0:01:55.840 --> 0:01:59.960 It's called Keep Sharp, Building a Better Brain at any Age, 0:02:00.600 --> 0:02:05.000 and it's fascinating. It's also a practical guide for better 0:02:05.080 --> 0:02:08.799 brain health, something I'm extremely interested in. And don't worry, 0:02:08.960 --> 0:02:11.360 we do get into that, but since I had the 0:02:11.400 --> 0:02:14.760 COVID expert of experts, I couldn't help but start our 0:02:14.800 --> 0:02:19.560 conversation there. You must feel like you have a PhD 0:02:19.680 --> 0:02:22.560 in virology at this point, right, yeah. 0:02:22.400 --> 0:02:25.640 I mean totally and and and the the irony is, Katie, 0:02:25.760 --> 0:02:29.280 is that this is a novel virus, right, So I 0:02:29.320 --> 0:02:33.480 mean novel actually means something, which which that didn't really 0:02:33.480 --> 0:02:35.720 strike me until a few months into this either, like 0:02:35.800 --> 0:02:38.880 I think, because you said the PhD in virology, the 0:02:39.120 --> 0:02:42.160 irony is that that I think people who had a 0:02:42.160 --> 0:02:45.880 lot of knowledge about this in some ways it got 0:02:45.919 --> 0:02:48.320 in their way because it's very hard to think about 0:02:48.320 --> 0:02:51.000 something as novel. You immediately want to put it into 0:02:51.040 --> 0:02:54.760 a box. It's the box of sars, it's the box 0:02:54.840 --> 0:02:57.639 of H one, N one, whatever you come up with. 0:02:58.080 --> 0:03:01.000 But this was novel, which means that if you try 0:03:01.000 --> 0:03:04.000 to put it in a box, you probably got it wrong. 0:03:04.480 --> 0:03:08.160 So they had to cast aside their preconceived notions completely, 0:03:08.880 --> 0:03:12.120 and that's hard to do, right for a scientist. 0:03:11.800 --> 0:03:14.959 It's really hard to do, and it goes against sort 0:03:14.960 --> 0:03:17.440 of how you think about things. Let's get the best experts. 0:03:17.560 --> 0:03:21.040 And by the way, I think there's really really value, 0:03:21.120 --> 0:03:24.440 great value and expertise. Don't get me wrong, But what 0:03:24.440 --> 0:03:27.880 you would do is grab the coronavirus experts, grab the 0:03:27.919 --> 0:03:31.120 pandemic experts, and that was all important. But this virus 0:03:31.280 --> 0:03:34.440 was just behaving in a totally novel way. I mean. 0:03:34.440 --> 0:03:37.600 One of the best examples, as you well know, was 0:03:38.000 --> 0:03:41.960 everybody believe that respiratory viruses really only spread when you 0:03:41.960 --> 0:03:45.640 were sick, when you had symptoms that's when you spread. 0:03:45.680 --> 0:03:48.000 And you know, the guidance was well screen people at 0:03:48.040 --> 0:03:50.119 airports will tell people to stay home if they're sick, 0:03:50.160 --> 0:03:53.440 which people should do anyway, regardless of whether in a pandemic, 0:03:54.320 --> 0:03:57.640 and we should be able to quell this thing. No 0:03:57.680 --> 0:04:01.360 one really believed initially that this thing would spread most 0:04:01.400 --> 0:04:06.160 efficiently when people didn't have symptoms. Was that's never really 0:04:06.160 --> 0:04:09.000 happened before, as doctor Faucia said, never in the history 0:04:09.040 --> 0:04:13.680 of respiratory viruses has that happened before. That's novel. I mean, 0:04:13.720 --> 0:04:16.359 you know, you remember the story of typhoid Mary. She 0:04:16.520 --> 0:04:20.520 was a silent carrier of typhoid. It was so dramatic 0:04:20.600 --> 0:04:24.160 because she infected all these people in this single residence 0:04:24.440 --> 0:04:26.880 in this community and all that, and people couldn't figure 0:04:26.880 --> 0:04:30.280 it out. This is like millions of typhoid Mary's in 0:04:30.320 --> 0:04:34.000 a way of a brand new disease, COVID. So it 0:04:34.560 --> 0:04:37.720 was quite extraordinary to sort of see see how that 0:04:37.760 --> 0:04:38.880 all played out. 0:04:39.240 --> 0:04:42.599 Well, before we talk about your new book, keep Sharp, 0:04:42.640 --> 0:04:46.560 because I'm really interested, as someone who's sixty four, in 0:04:46.800 --> 0:04:52.320 maintaining my mental acuity as i age. I just want 0:04:52.360 --> 0:04:55.480 to ask you one last question about COVID and that is, 0:04:56.520 --> 0:04:58.400 are we seeing the light at the end of the tunnel? 0:04:58.520 --> 0:05:02.200 Every time I feel optimist, stick Sanjay, I then read 0:05:02.240 --> 0:05:07.840 something about variants or increase cases, and it's quite nerve racking. 0:05:07.920 --> 0:05:11.359 I think for the average person who doesn't have a 0:05:11.400 --> 0:05:14.839 medical degree or hasn't been deeply, deeply entrenched in the 0:05:14.880 --> 0:05:18.000 science of this, I mean, are we screwed? Are we 0:05:18.720 --> 0:05:20.680 at the tail end of this pandemic? 0:05:21.600 --> 0:05:24.640 I do feel the light on my face, in your face. 0:05:24.680 --> 0:05:28.000 I mean, I do think that the tunnel is the 0:05:28.080 --> 0:05:32.880 end of the tunnels in sight. I mean the can 0:05:32.920 --> 0:05:35.120 I just remind people, and I think this is such 0:05:35.160 --> 0:05:37.920 an important reminder that they were having rave parties in 0:05:37.960 --> 0:05:41.360 Wuhan at the end of last summer, and I bring 0:05:41.440 --> 0:05:43.760 that up only to say that we talk about the vaccines, 0:05:43.800 --> 0:05:46.520 we talk about the fact that science is now rescuing us, 0:05:46.640 --> 0:05:50.919 which is great, fantastic, but so much of this didn't 0:05:50.960 --> 0:05:54.000 need to happen. And I know that's not your question, Katie, 0:05:54.040 --> 0:05:55.480 but I just feel like I can never answer a 0:05:55.560 --> 0:06:00.840 question about about the sort of future or being optimistic 0:06:00.880 --> 0:06:04.440 about this pandemic because I'm so it's just so, it's so, 0:06:05.160 --> 0:06:07.599 I'm so angry in so many ways. I mean, you know, 0:06:07.760 --> 0:06:10.960 six hundred thousand people died and some of them are 0:06:10.960 --> 0:06:14.080 my friends. And I've seen families, I talked to families. Still, 0:06:14.480 --> 0:06:16.800 I just it just this may not have even been 0:06:16.839 --> 0:06:19.400 the Black Swan event, right, we think of this black 0:06:19.440 --> 0:06:22.680 Swan event, this really contagious virus, which this was, but 0:06:22.760 --> 0:06:25.120 something that has a two to three percent mortality that 0:06:25.160 --> 0:06:27.520 would be awful, That would be the Black Swan event. 0:06:27.680 --> 0:06:29.680 This wasn't even that. There were countries around the world 0:06:29.720 --> 0:06:32.640 that immediately quelled this and measure their debts in the 0:06:32.760 --> 0:06:35.840 hundreds instead of the hundreds of thousands. Having said that, 0:06:35.920 --> 0:06:39.880 we are a society. Because we are, we focus on 0:06:39.960 --> 0:06:42.960 touchdowns and home runs and knockouts. We don't care much 0:06:42.960 --> 0:06:46.279 for singles and doubles. Because we're that society. We waited 0:06:46.279 --> 0:06:49.279 for science to rescue us, and the vaccines will. I 0:06:49.279 --> 0:06:53.400 think they're really extraordinary and really effective. They seem to 0:06:53.400 --> 0:06:56.919 be pretty effective against the variant u B one one seven, 0:06:57.080 --> 0:06:59.640 the UK variant, because there's a lot of concern about 0:06:59.640 --> 0:07:02.960 that very but if you have been vaccinated, or if 0:07:03.000 --> 0:07:05.599 you had the infection in the past, the other you know, 0:07:05.680 --> 0:07:09.440 the circulating coronavirus that should also protect you. So it's 0:07:09.480 --> 0:07:11.160 really I think it's really good. And I think with 0:07:11.240 --> 0:07:14.560 the warmer, warmer weather in the summer, viral transmission rates 0:07:14.600 --> 0:07:17.560 will go down. That'll be great. I do think, you know, 0:07:18.600 --> 0:07:21.440 we'll probably get to herd immunity over the summer, but 0:07:22.000 --> 0:07:24.800 it's worth reminding that herd immunity isn't a sort of 0:07:24.800 --> 0:07:28.080 destination necessarily. You can pop in and out of herd immunity. 0:07:28.480 --> 0:07:32.200 So if not enough people get vaccinated over the next 0:07:32.360 --> 0:07:35.480 few months, then going into the colder weather again in 0:07:35.520 --> 0:07:37.400 the fall, we could see resurgences. 0:07:38.000 --> 0:07:41.080 It's quite disturbing when you hear about the people who 0:07:41.160 --> 0:07:45.400 are refusing to get vaccinated. Many of them are white 0:07:45.400 --> 0:07:49.840 men in this country. I think you see the impact 0:07:49.920 --> 0:07:53.400 of politics on that number, not only in terms of 0:07:53.440 --> 0:07:56.880 the response to the pandemic, but now to the response 0:07:57.000 --> 0:08:03.200 to the vaccines. That must be quite disturbing for you too, 0:08:03.320 --> 0:08:04.000 it is for me. 0:08:04.880 --> 0:08:08.800 Yeah. I mean there's been no not a single part 0:08:08.840 --> 0:08:12.360 of this entire pandemic that hasn't been politicized in some way. 0:08:12.760 --> 0:08:14.960 I mean, that's I guess now you say that in 0:08:15.400 --> 0:08:18.880 April of twenty twenty one and it's obvious, right, everyone 0:08:18.960 --> 0:08:22.000 knows that, but it starts starting off covering the story 0:08:23.160 --> 0:08:25.800 and now all the way now to the vaccines, even 0:08:26.000 --> 0:08:28.800 every single component has been politicized in some way. So 0:08:28.840 --> 0:08:32.199 it is disturbing the anti VAXX movement. And you may 0:08:32.200 --> 0:08:34.080 not even remember this, kiddie, but I actually did a 0:08:34.080 --> 0:08:39.679 segment on your show years ago about anti vaccination movement 0:08:39.720 --> 0:08:43.760 at that time, around h one and one. But it's 0:08:43.760 --> 0:08:46.480 been around for a long time, the anti vaccination movement, 0:08:46.840 --> 0:08:49.800 and it's sort of you know, Simmers, we saw measles 0:08:49.800 --> 0:08:54.000 outbreaks in Brooklyn and Disneyland and Minnesota. 0:08:54.040 --> 0:08:57.040 This seems bigger, though, Sancha. You know, that was a 0:08:57.080 --> 0:09:03.559 particular group and it really dealt primarily with childhood vaccinations, 0:09:04.000 --> 0:09:10.520 and now this has expanded to you know, these adults 0:09:10.600 --> 0:09:14.199 who I don't know for one reason or another. I 0:09:14.240 --> 0:09:18.000 think you can understand people of color and the terrible 0:09:18.120 --> 0:09:21.319 history of Tuskegee and some of the ways that people 0:09:21.360 --> 0:09:25.160 of color have been abused in scientific research in the past, 0:09:25.240 --> 0:09:29.839 and this kind of deeply ingrained mistrust of the medical community. 0:09:30.000 --> 0:09:32.520 So I think you can appreciate that. But this is, 0:09:33.080 --> 0:09:36.480 you know, this is a whole other ball of wax, 0:09:36.600 --> 0:09:37.000 isn't it. 0:09:37.200 --> 0:09:40.679 Yes, it really is. And you know we're seeing some 0:09:40.720 --> 0:09:43.040 of this for or really seeing it come to light, 0:09:43.120 --> 0:09:46.319 I should say, you know, in a pretty dramatic way. Now. 0:09:46.320 --> 0:09:48.920 I think I was reading the statistics this morning Katie 0:09:48.960 --> 0:09:52.520 Kaiser Family Foundation, forty to fifty percent of those in 0:09:52.600 --> 0:09:56.559 rural areas who say they absolutely will not take the vaccine. 0:09:56.640 --> 0:09:58.600 It's not a question of hey, I want more information, 0:09:58.679 --> 0:10:00.560 I want to see how this plays out. They're just 0:10:00.600 --> 0:10:02.760 saying out of the gate they absolutely not take it. 0:10:03.360 --> 0:10:05.160 And I said, what is the explanation. 0:10:05.800 --> 0:10:08.720 That's the curious thing, Like you said, with some people 0:10:08.720 --> 0:10:11.560 who are vaccine hesitance, it is concerns about safety or 0:10:11.640 --> 0:10:17.679 mistrust or you know, my grandfather was experimented on as 0:10:17.679 --> 0:10:20.240 part of Tueski, you know, things like that. With this, 0:10:20.440 --> 0:10:24.280 I think it's almost an extension of this pandemic. Isn't 0:10:24.320 --> 0:10:26.160 even real. It's not a hoax. Why would I take 0:10:26.160 --> 0:10:30.680 a vaccine for something that's a hoax. I'm not scared 0:10:30.720 --> 0:10:32.760 for safety of it. I just don't. I think the 0:10:32.800 --> 0:10:35.520 whole thing is sort of, you know, the scamdemic sort 0:10:35.520 --> 0:10:38.280 of thing. So I don't know if that's the case. 0:10:38.320 --> 0:10:40.640 For it's a huge percentage of people we're talking about here, 0:10:40.679 --> 0:10:44.360 So maybe there's some heterogeneity, you know, some variety of 0:10:44.400 --> 0:10:48.760 opinions there, but bottom line, if the numbers stay that high, 0:10:48.920 --> 0:10:51.080 we're not going to get to herd immunity based on 0:10:51.160 --> 0:10:52.520 vaccinating adults. 0:10:52.120 --> 0:10:54.079 Alone, which is really depressing. 0:10:55.040 --> 0:10:57.600 It's so I mean, gosh, we wait for science to 0:10:57.640 --> 0:11:00.000 rescue us. We don't do the basic public health practice, 0:11:00.200 --> 0:11:04.520 and then when this truly extraordinary scientific achievement occurs in 0:11:04.559 --> 0:11:08.079 the form of this vaccine, people don't take it. You know, 0:11:08.440 --> 0:11:10.880 if you are a Martian coming to planet Earth and saying, so, 0:11:12.080 --> 0:11:14.920 let me get this straight. So you didn't do anything 0:11:14.960 --> 0:11:17.880 about the virus, you weighted, created this amazing medicine, and 0:11:17.880 --> 0:11:20.720 then you don't take the medicine. It just it doesn't 0:11:20.760 --> 0:11:21.439 make any sense. 0:11:21.600 --> 0:11:23.240 It's a head scratcher for sure. 0:11:23.800 --> 0:11:24.280 Yeah. 0:11:24.320 --> 0:11:27.120 When do you think Sancha will be able to go 0:11:27.200 --> 0:11:30.320 about our daily lives without mass I. 0:11:30.559 --> 0:11:33.640 Think it'll be the summer, Katie, I really do. I mean, 0:11:33.679 --> 0:11:35.400 I know that there's people who are painting a more 0:11:35.440 --> 0:11:39.200 dire prediction around that, but you know, we for no 0:11:39.280 --> 0:11:41.839 other reason alone with the warmer weather, and then you're 0:11:41.880 --> 0:11:45.400 going to really see the blunting despite the vaccine hesitancy 0:11:45.400 --> 0:11:46.599 that we're talking about. You are going to see a 0:11:46.600 --> 0:11:49.840 significant blunting of people who are getting very sick, people 0:11:49.880 --> 0:11:52.160 who are dying. And we know that the virus the 0:11:52.240 --> 0:11:54.720 vaccine does seem to have good evidence that it stops 0:11:54.840 --> 0:11:57.599 or decreases transmission. So I think we're really going to 0:11:57.640 --> 0:11:59.640 get to a pretty good point. I think you'll still 0:11:59.640 --> 0:12:04.480 seeks around, you know, in Hong Kong after Hong Kong 0:12:04.520 --> 0:12:07.480 really wasn't a mask wearing country until after SARS, and 0:12:07.520 --> 0:12:11.240 then there was this huge psychological impact. That's why they 0:12:11.280 --> 0:12:13.280 went to mass so early in Hong Kong, but they 0:12:13.320 --> 0:12:16.319 became a mask wearing culture. I think you will see 0:12:16.320 --> 0:12:18.800 people who are just frightened still want to wear masks 0:12:18.800 --> 0:12:21.640 in public places. I think in flu season, you know, 0:12:21.679 --> 0:12:24.320 the colder months, I think you'll see more masks. I 0:12:24.320 --> 0:12:27.480 think that may become a larger part of our culture. 0:12:27.520 --> 0:12:29.599 Not a dominant, but I think a larger part of 0:12:29.640 --> 0:12:30.240 our culture. 0:12:30.440 --> 0:12:35.120 That's interesting because I remember being in Tokyo maybe gosh, gosh, 0:12:35.160 --> 0:12:38.720 maybe ten ten or twelve years ago and going on 0:12:38.760 --> 0:12:42.240 the train to Kyoto and seeing everyone wearing masks and 0:12:42.320 --> 0:12:45.840 thinking this is so weird. Why are they wearing masks? 0:12:46.000 --> 0:12:49.400 And now, of course I understand, and you're right. I 0:12:49.400 --> 0:12:52.800 think when people are on places like public transportation, if 0:12:52.800 --> 0:12:57.400 they're in a closed spaces with lots of strangers, it 0:12:57.520 --> 0:12:59.280 actually makes sense, doesn't it. 0:13:00.000 --> 0:13:01.720 I mean, you know, one thing we saw, as you 0:13:01.760 --> 0:13:04.800 may remember, is that the flu numbers were way down 0:13:05.440 --> 0:13:08.080 this is past season, and that you know that that 0:13:08.160 --> 0:13:11.320 wasn't because of any increase in vaccination or anything. That 0:13:11.400 --> 0:13:14.080 was because of just public health behavior. It's always worked, 0:13:14.480 --> 0:13:17.320 you know. I don't know there's a metaphor for this, Katie, right, 0:13:17.400 --> 0:13:19.839 I mean we I don't know. I guess it's true 0:13:19.880 --> 0:13:21.840 in our lives, like we'd rather just take a pill 0:13:21.880 --> 0:13:25.199 for weight loss rather than go exercise, and we always 0:13:25.240 --> 0:13:28.959 want the convenience. And and this is this is another 0:13:29.000 --> 0:13:32.760 example of that. We I was struck. And again, we 0:13:32.760 --> 0:13:34.760 can talk about COVID all day long, but the but 0:13:34.840 --> 0:13:38.640 the I'll never forget these these mask researchers from Harvard, 0:13:38.679 --> 0:13:41.640 a guy named Aarbara Kuran. He basically was doing all 0:13:41.640 --> 0:13:44.080 this modeling all along. We were talking to him. He 0:13:44.200 --> 0:13:46.600 told me that if for four weeks and this is back, 0:13:46.760 --> 0:13:49.400 you know, October November of last year. If for four 0:13:49.440 --> 0:13:53.520 weeks everybody just wore a high filtration mask when they 0:13:53.520 --> 0:13:56.160 went out in public, that's it. For four weeks. If 0:13:56.160 --> 0:13:58.880 everybody did that, it would have ended the pandemic. 0:13:59.240 --> 0:14:01.280 Are you kidding? That's incredible. 0:14:01.600 --> 0:14:05.000 The virus would have nowhere to go. It couldn't find 0:14:05.040 --> 0:14:09.480 a willing host. I mean, you know, sort of that 0:14:09.559 --> 0:14:12.040 sort of concept is something that's more than one hundred 0:14:12.160 --> 0:14:16.520 years old. I just don't quite you know, I don't know. 0:14:16.600 --> 0:14:19.000 Maybe I'm just being naive. But you hear that and 0:14:19.040 --> 0:14:21.800 you think it's amazing, right, I think it's amazing. And 0:14:21.920 --> 0:14:24.760 yet we also know both of us that in the 0:14:24.840 --> 0:14:28.560 United States that couldn't happen. It just wouldn't happen. I mean, 0:14:28.960 --> 0:14:32.120 a human being survived and thrived as a species because 0:14:32.120 --> 0:14:35.800 we're reciprocally altruistic. There's a reason that it feels good 0:14:35.880 --> 0:14:38.400 to do good. Why should it feel good when I 0:14:38.440 --> 0:14:40.360 do something nice for you? I mean, what purpose does 0:14:40.400 --> 0:14:43.040 that serve my evolutionary tree? I don't know, But the 0:14:43.080 --> 0:14:45.000 reality is that it does feel good to do good. 0:14:45.360 --> 0:14:48.320 We encoded that in some way in our DNA, and 0:14:48.360 --> 0:14:50.480 then people can't be bothered to wear a mask to 0:14:50.520 --> 0:14:54.560 save tens of thousands of lives. I just I'll that 0:14:54.600 --> 0:14:56.840 may be one of the greatest mysteries of all out 0:14:56.840 --> 0:14:57.480 of this whole thing. 0:14:58.360 --> 0:15:01.160 Well, I just want to say, on behalf of the 0:15:01.200 --> 0:15:05.840 American public, thank you for your coverage of this. I 0:15:05.880 --> 0:15:13.560 think you're so measured and so eloquent and honestly calming 0:15:13.840 --> 0:15:17.360 in a way. And I just really appreciate all the 0:15:17.520 --> 0:15:22.760 fantastic reporting you've done throughout this pandemic. So on, behalf 0:15:22.800 --> 0:15:26.000 of a grateful America, I would like to say, thank you, 0:15:26.120 --> 0:15:27.280 Sancha Gufta. 0:15:27.200 --> 0:15:31.040 Well, Katie, thank you, thank you, And that obviously means 0:15:31.800 --> 0:15:34.320 a great deal in particular coming from you, So I 0:15:34.600 --> 0:15:37.160 appreciate that. You know, you get it. You know, I 0:15:37.160 --> 0:15:40.680 mean you are the standard obviously by whom we all 0:15:40.720 --> 0:15:43.600 measure ourselves. But also you know, we're all in these 0:15:43.800 --> 0:15:46.400 black holes, right I mean, I don't know where you 0:15:46.440 --> 0:15:48.160 are right now. As I said, I'm in this tiny 0:15:48.240 --> 0:15:51.640 little closet. You don't get any feedback. Sometimes it's been 0:15:51.640 --> 0:15:55.920 really dispiriting because you think, Okay, I'm a medical reporter 0:15:56.280 --> 0:15:58.400 in the middle of a pandemic. That is my you know, 0:15:58.680 --> 0:16:01.960 that's a job, and at the same time, the country 0:16:02.000 --> 0:16:05.160 in which I'm reporting arguably did the worst in the world. 0:16:05.720 --> 0:16:08.040 I mean, I know I keep taking this in that direction, 0:16:08.080 --> 0:16:11.280 but it's just so dispiriting. Did anyone listen to me? 0:16:11.880 --> 0:16:15.720 I mean, if you're the medical reporter and presumably people 0:16:16.000 --> 0:16:19.720 are counting on you to provide knowledge hopefully that will 0:16:19.720 --> 0:16:22.320 inform how they behave, and then we do the worst 0:16:22.360 --> 0:16:25.160 in the world. That's you know, I'm going to need 0:16:25.240 --> 0:16:28.320 to reflect on that. I think, you know, in the 0:16:28.400 --> 0:16:30.920 years to come, Like what is the real impact here? 0:16:31.160 --> 0:16:32.920 One could argue that maybe it would have been worse, 0:16:33.080 --> 0:16:35.360 who knows, you know, but it's pretty bad. 0:16:35.760 --> 0:16:39.080 Well, don't get too dispirited, because I think a lot 0:16:39.080 --> 0:16:43.800 of people listened, relied on you, and actually acted. So 0:16:44.280 --> 0:16:48.200 even though the track record was bad, your information was 0:16:48.320 --> 0:16:50.280 good and important. So thank you. 0:16:50.920 --> 0:16:51.840 I appreciate that. 0:16:58.920 --> 0:17:04.040 Let's talk about sharp because moving forward, I think many 0:17:04.080 --> 0:17:08.080 people like me really are interested in how to keep 0:17:08.240 --> 0:17:13.919 our cognitive and mental health at the top. And I think, 0:17:14.560 --> 0:17:18.639 you know, certainly one big change in medicine is that 0:17:20.000 --> 0:17:25.560 we as patients are not passive. It turns out, Sanjay, 0:17:25.640 --> 0:17:28.080 that there is a lot of things that we can 0:17:28.119 --> 0:17:31.239 do to keep our brains in shape, just like we 0:17:31.320 --> 0:17:34.600 can do to keep our bodies and our organs and 0:17:34.720 --> 0:17:38.560 other things in shape. And that's why you broke keep sharp. 0:17:38.680 --> 0:17:43.280 But you have a very very personal connection to this, 0:17:43.600 --> 0:17:48.119 I guess well, obviously because of your specialty, but particularly 0:17:48.600 --> 0:17:54.640 about Alzheimer's dementia and our failing brain power that happens 0:17:54.680 --> 0:17:57.000 as we age. Tell me about that. 0:17:57.800 --> 0:18:02.399 Well, when I was twelve or thirteen years old, my grandfather, 0:18:03.080 --> 0:18:08.240 my mother's dad, who I was very close to, developed, 0:18:08.640 --> 0:18:13.080 you know, signs of dementia. He had had a stroke 0:18:13.119 --> 0:18:17.480 earlier in his life that had recovered and was now developing. 0:18:17.760 --> 0:18:22.000 You know, just these these periods of time where he 0:18:22.320 --> 0:18:24.960 really wasn't aware of what was going on. He would 0:18:24.960 --> 0:18:28.760 sometimes make a joke that no one else was in on, 0:18:28.880 --> 0:18:30.320 you know, and it was all these things that I 0:18:30.960 --> 0:18:32.919 remember really being struck by as a kid, because you 0:18:32.960 --> 0:18:35.800 look at adults and you're not used to seeing brain 0:18:35.880 --> 0:18:37.840 power start to diminish. And it was the first time 0:18:37.880 --> 0:18:41.040 I saw really specific things like he could he could 0:18:41.119 --> 0:18:45.159 still write, but he couldn't really read. It was it 0:18:45.200 --> 0:18:48.280 was all these things that became really fascinating in a 0:18:48.320 --> 0:18:50.000 way for me in terms of just how does the 0:18:50.000 --> 0:18:52.560 brain work like that? But also to see it in 0:18:52.600 --> 0:18:56.280 a loved one to wonder, is that, how genetic? Is that? That? 0:18:56.720 --> 0:18:58.760 Is my mom going to develop those symptoms? Will I 0:18:58.840 --> 0:19:01.800 one day all of that? And then you know, fast forward, 0:19:01.840 --> 0:19:06.119 you know, thirty forty years later, and we're still worrying 0:19:06.119 --> 0:19:09.639 about the exact same things and haven't really made a 0:19:09.680 --> 0:19:11.760 lot of progress in terms of being able to deal 0:19:11.800 --> 0:19:14.760 with that. So that was a large part of what 0:19:14.880 --> 0:19:18.680 I think inspired me to write the book What has 0:19:18.720 --> 0:19:21.960 Happened over the Last forty years, both from a, you know, 0:19:22.359 --> 0:19:26.520 a pharmaceutical standpoint, but also more importantly, I think from 0:19:26.560 --> 0:19:29.160 a lifestyle behavioral standpoint in terms of what we. 0:19:29.080 --> 0:19:32.840 Know and how does that influence you to go into neurology? 0:19:33.600 --> 0:19:37.040 No, you know, it's funny, it didn't. I Actually when 0:19:37.080 --> 0:19:39.040 I started medical school, I thought I was going to 0:19:39.040 --> 0:19:42.360 go into pediatrics, and then I did a neurosurgery rotation 0:19:43.520 --> 0:19:44.960 during my third year of med school and I just 0:19:44.960 --> 0:19:46.439 sort of fell in love. So I came to it 0:19:46.520 --> 0:19:50.160 quite late, but I was always interested in the brain 0:19:50.359 --> 0:19:52.480 because of my grandfather, and so it felt like a 0:19:52.560 --> 0:19:53.360 very natural fit. 0:19:54.240 --> 0:19:59.200 Let's talk about the numbers. Because forty seven million Americans 0:19:59.280 --> 0:20:02.680 have some of and so a pre clinical Alzheimer's disease, 0:20:02.720 --> 0:20:06.160 and by twenty sixty one new case of dementia will 0:20:06.200 --> 0:20:11.320 be diagnosed every four seconds. Sonjay, what the heck is 0:20:11.359 --> 0:20:12.240 going on here? 0:20:12.760 --> 0:20:18.000 Well, this will become the most dominant neurodegenerative disease of 0:20:18.040 --> 0:20:23.200 our time. I think that part, I think is pretty 0:20:23.200 --> 0:20:26.119 well established at this point. But there was two things 0:20:26.160 --> 0:20:28.560 about the statement that you just made that I thought 0:20:28.600 --> 0:20:31.800 were really important in terms of what we could potentially 0:20:31.800 --> 0:20:33.960 do about it. As you point out, there's probably about 0:20:33.960 --> 0:20:35.679 forty seven million people who if you were to look 0:20:35.720 --> 0:20:39.520 at their brains, they would have objective evidence of plaques 0:20:39.640 --> 0:20:43.440 and tangles and things like that, but also have no symptoms. 0:20:43.800 --> 0:20:45.760 That's the pre clinical time, right. 0:20:46.480 --> 0:20:48.600 So, Okay, you're breaking me out a little. 0:20:49.040 --> 0:20:51.720 Well, it's you know, but I think this is ultimately 0:20:51.760 --> 0:20:54.000 good news, and I'll tell you why. If you look 0:20:54.040 --> 0:20:59.000 at patients with Alzheimer's disease and able to retrospectively look 0:20:59.000 --> 0:21:01.439 at their lives and their skins in their brains, you 0:21:01.560 --> 0:21:05.040 find we now know that Alzheimer's starts in the brain 0:21:05.680 --> 0:21:09.639 decades before people develop symptoms decades so you're starting to 0:21:09.640 --> 0:21:13.080 see the kindling and then even plaques and tangles. But 0:21:13.119 --> 0:21:16.320 the fundamental point that neuroscientists really started to focus on 0:21:17.080 --> 0:21:21.400 was almost the the the analog of that meaning, Okay, 0:21:21.520 --> 0:21:23.520 so now you've established it, you can have a brain 0:21:23.600 --> 0:21:27.439 that has plaques and tangles but still functions normally. So 0:21:27.480 --> 0:21:30.200 why don't we focus on that side of things instead 0:21:30.200 --> 0:21:32.600 of saying, hey, look, let's get rid of the plaques 0:21:32.640 --> 0:21:35.800 and tangles. And we have spent billions of dollars testing 0:21:35.880 --> 0:21:38.800 drugs to do that that haven't really worked. What if 0:21:38.800 --> 0:21:41.560 we say, instead, we have established that a brain with 0:21:41.680 --> 0:21:44.520 plaques and tangles can function normally. Let's figure out why 0:21:45.119 --> 0:21:48.840 and see if we can basically make that an aspiration. 0:21:49.560 --> 0:21:53.800 Do you still have objective evidence of Alzheimer's in your brain? Yes? 0:21:54.280 --> 0:21:58.320 Is it consequential no? Because you know you are able 0:21:58.359 --> 0:22:02.159 to still have normal cognitive function, memory, judgment, all the 0:22:02.200 --> 0:22:05.800 things that you associate with a healthy functioning brain. The metaphor, 0:22:05.800 --> 0:22:07.399 in some ways, Katie would kind of be like a 0:22:07.440 --> 0:22:11.800 heart bypass surgery. You got a block blood vessel. Now 0:22:12.080 --> 0:22:15.119 you go in there and you bypass that area of 0:22:15.160 --> 0:22:17.600 the blockage with a new blood vessel, Do you still 0:22:17.600 --> 0:22:23.240