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your mission at the moment to myth bust and call out disinformation as it relates to Health Care let's get into
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that okay Dr Mike verski he's the actively practicing medicine doctor with
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over 25 million followers who's created one of the largest health education Platforms in the world Dr Mike what's
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the key to finding a diet that's going to stick there's two real things that you need to think about one calories in
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and calories out is true second and this is important you need to have what about the prevailing narrative that if you
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want to lose weight you got to get on a running machine nutrition that's where the majority of the change will come from what's the Medical Advantage if I
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go to the gym every day literally everything else is vaping dangerous yes and no one knows this by the way this is
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why I do what I do but the more dangerous part of it is what's your p on supplements they will make you skip on
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doing things that are healthy for you and supplements have side effects you have too many of them we notice that
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they but no one talks about that because you can't really sell that and then considering you care so much about your
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health why would a doctor to choose boxing cuz I unfortunately lost my mom to cancer to ask the doctors to stop
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doing chest compressions on your mom that is not something that I wish on anyone and I got into a very unhealthy
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mental state so boxing chose me instead of me choosing boxing in the
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circumstances that you lost your mother where she was giv the all clear yeah did
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that experience change your perspective of the medical industry in any way
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we've just hit 6 million subscribers on the D Co um so me and my team would like to do something we've never done before as little thank you and we're calling it
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The dire coo subscriber raffle and here is how it works every episode this month we're going to pick three current
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subscribers at random and we'll send one of you a 1,000 voucher one of you tickets to come and watch the D behind
00:01:52
the scenes live with our team and one of you will have a 10-minute phone call with me to discuss whatever you want to talk about if you're a subscriber you're
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in the raffle thank you from the bottom of my heart for allowing me to do something that me and my team love doing
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so much it is the greatest honor of my lifetime and I hope it I hope it continues uh off into the Future Let's
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get to the [Music] episode Dr
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Mike considering everything you do from your podcast to all of the content you produce across your channels to the
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stuff you do in TV everything social media all of it
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how do you summarize the overarching mission that you're on at this in this phase of your life the mission is largely to make sure
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that in the sea of misinformation my patients my viewers are getting the most
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honest transparent and engaging information so that hopefully they can
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make the best decisions Healthcare wise for themselves and their family members why do you care
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when I was a medical student I would go into rooms with patients and they would
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be being seen by some of the top doctors in the world I mean experts upon experts
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credentials published work and the second the doctor would walk out after presenting all this accurate
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evidence-based information the patient would look at me as the med student and say what did he say or what did she say
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and I realized that the message wasn't hitting home and I realized we need to do a better job as communicators in the
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healthcare space and then I said well TV must be the answer media training must
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be the answer and then as I became a practicing physician in my residency program I started seeing people being
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influenced by those TV physicians in the wrong ways they would be promising
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Miracle solutions to any problem they would be having snake oil being sold to
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them they would think that they can skip out on taking their medications or going for treatments or making Lifestyle
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Changes because of a solution proposed to them for three easy payments of 1999 and I said oh man not only are we
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not great communicators but we're being edged by people who are trying to make a
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profit in that in this Health Care space and I viewed it as a mega problem I remember in 2017 I wrote a blog post for
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the American Academy of family physicians and I said the lack of evidence-based Physicians Online is is
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going to create a world of a difference in our patients lives it's going to allow misinformation to come in
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especially in this section I call the gray Zone where modern science doesn't yet have an answer to certain medical
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problems to certain medical conditions and they're going to come in and promise you Solutions and they're going to be
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quite successful at it what happened three years later covid-19 pandemic
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misinformation pandemic people confused not knowing who to seek out for
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information and for some very strange reason a doctor with only 5 years of
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experience uh after a residency was the number one channel on YouTube being watched and giving the answers when
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people were not watching the CDC they weren't listening to True experts in said they were falling for
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misinformation online and I had to be there to set the record straight I couldn't believe that that
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happened for people that might not know who you're referring to when you cite
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that doct doctor that is you you reach a lot of people every month you have 12 million subscribers on
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YouTube now you have other channels with you millions of people following you across the board and that's happened in
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quite a short space of time what is it about you that you think
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has been so resonant with so many people as it relates to sort of medical information and spotting
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disinformation I think it's not one thing much like in healthcare this would
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be a multifactorial situation I think when I first started the reason why I got popularity was because I was an
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early adopter of Instagram and I would share my medical Journey uh of being a med student mostly because I wanted to
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show people that you can have a life a social life a family life a sports life and still go through medical school
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because I felt like there existed this stigma you have to give up everything to study medicine and while I was doing
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that I got some followers on Instagram and at that point having 10,000 followers was a huge win because it was
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so new and being a broke medical student to go to a club and say oh my God I have 10,000 followers let me in without
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paying the admission that was a win then fast forward just a couple years later I'm in my residency program
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BuzzFeed writes an article and they didn't write an article about me being
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the youngest doctor in my hospital they didn't write an article about the fact that I did some medical research they
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didn't write about the fact that I was passionate about putting out accurate info they the title of the article was
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you got check out this sexy doctor and his awesome dog and I'm like oh that's silly no one's going to read this I
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thought it was cute I'd send it to some friends and then boom that was the moment everyone was going viral and it
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seemed like every Outlet in the world was reaching out and when I say in the world I'm not exaggerating like Outlets
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from the UK from Budapest from Asia from the every
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possible Outlet here in the United States was calling for an interview and I very vividly remember all the talk
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show hosts were reaching out and I had no idea about this world that there existed so much competition where I
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remember the Ellen degenerous show folks reached out and they said if you do our show you can't do the Steve Harvey Show
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and Steve Harvey reached out and said you know if you do our show you can't do their show I talked to some friends I'm like all right I'll do the own
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degenerous show I think that'll be a cool opportunity and they do the pre-interviews I meet with the producers
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I tell them about what I'm passionate about and the day before filming they
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call and they say hey we have some news Hillary Clinton is announcing her bid
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for the presidency of the United States and she's doing our daytime talk show as the first talk show and like the other
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guests were like pink and Jimmy Kimmel so you're the one getting kicked off and I said no biggie I'll go on Steve Harvey
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so I called Steve Harvey's people back and they said oh no that was two weeks ago we're not interested anymore and it
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was such a wakeup call where the 15 minutes of fame statement was true you
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were hot for a second people were interested about this unique story and then they move on but I said no way I I
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still have to push this because I viewed it as an opportunity to get people to
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care about the information but drawing their attention to something else first if you look at
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who's successful in media 20 years ago uh in the healthcare space it would be
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unfortunately people who corrupted the health information for the viewership and it feels like you often
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times have to corrupt something to get views and I felt that if I could corrupt
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and have people come for the scandal of sexy doctor but when they come for that I instead give them some accurate
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information or maybe have them come for some comedy and give them some health information that was a way to get people
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interested because if we're being honest Healthcare information textbooks science
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it can be boring if you're not passionate about it but if you can present it in a way like some of the amazing teachers that I've had over the
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years in a way where it's fun it's engaging they make it um almost like a
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journey that you're going on suddenly you pay attention you have a few takeaways and then from those takeaways
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you're better equipped to handle some of the things that could come up with it during life and I really took that to
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heart in the beginning and over the last five years I've really studied what marketers have done so well in the
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commercial space or what those snake oils salesmen have done so well in pitching their misinformation and take
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those same principles but bring them to evidence-based medicine allow people to have fun while they're learning there's
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a lot of information out there as it relates to health what is your sort of framework for deciding what you share
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and how you share it when there's so many a lot of these studies as well the the methodology of the studies is often
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hard to trust because of the way that that you know certain studies where they look at kind of they don't
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isolate one variable so you look you look at the study and it could be anything they say you know they you hear
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these studies about like veganism for example where they say veganism is is healthier but that doesn't remove out
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all the other factors in that person's lifestyle maybe okay maybe they're they're eating less meat but it's processed meat that they're having with
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fries and hamburgers Etc so how do you what's your framework for deciding if something is true in a SP in a sea of
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information every time I look at some new research I
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treat it differently than most people would in the media space and I also treat it differently than an individual
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would treat it so if you're a news outlet and a breakthrough study comes
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out they treat it like it's the answer to people's problems like it's the new and best I take that research and I
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apply it to the existing data and knowledge that I've gotten over the years through my medical education and
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position it in where it belongs so some research comes out it might make me lean
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in saying we need to move closer to a plant focused diet it doesn't mean that
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everyone needs to be on it doesn't mean we need to eliminate everything because in medicine extremes are rarely right
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even when we're talking about optimization you'll hear oftentimes people say oh you can boost your immune
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system you could hyper optimize this no no no hyper optimization is Extreme whenever you're going to those extremes
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you start creating problems because that's how the human body works it works in homeostasis it wants to be balanced
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and the enemy of balance is bad but also perfect so what do you make of this
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optimization longevity anti-aging live forever culture that's emerged in the
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last couple years I understand where it's coming from uh We've made a lot of scientific progress we believe that we
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should have the answers to the one problem that is facing all of us and that's that life is not forever but I
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feel like the field has been corrupted and it's actually the way that healthc care has been corrupted across
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the board so when we talk about health insurance the Pharma
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industry anti-aging industry a lot of it has been corrupted with capitalism and I take and
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I say that as someone who's actually Pro capitalism but I believe Healthcare is a commodity that cannot be
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lift I love the idea of being able to call something on demand doesn't quite work for healthcare you demanding what
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you want for your body when you're not the expert doesn't always yield the best results we've seen that time and time
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again I see it with my patients when they come in and it's very clear that they have a viral Illness but they demand
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antibiotics or they demand uh a medication that's going to help them live
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longer doesn't exist we don't have yet the evidence to sell these things to people to explain them to people but
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there will always be a person who will take some new information some preliminary data data from an animal
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model from a petri dish and sell it as the next great thing this happened with the Fountain of Youth this happened with
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literally snake oil hundreds of years ago and now it's happening but with the power of social media and the fact that
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this misinformation a lot of times is Insidious you don't realize that it's so bad and so problematic because what it's
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doing is it's actually tricking people into not understanding how science Works
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how when we put out a hypothesis an idea of what we think could happen we actually strive to disprove our
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hypothesis so if I say this glass of water here will help you live longer I
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will actually as a scientist want to set out to prove that it doesn't and I will
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think of every way and I would bring on people to disagree with me and find ways that we could test that this doesn't
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work but right now on social media what you see is a lot of people just supporting what agrees with them what
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are some of those ideas that have proliferated across social media that irritate you the most and you think are
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most harmful I think the ones that create certainty in an uncertain world
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and I think that could apply to pretty much any field I talked about the gray Zone earlier and I think the gray Zone
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has changed 30 years ago the gray Zone was weight loss yeah and if you put on any
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TV channel especially late at night there would be a fat burner there'd be some grapefruit diet or some next great
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thing that someone came up with but everyone forgets about all that people used to sell you nonsense to try and
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help you lose weight and all of it didn't work it was not healthy even if it made you lose weight it was in an
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unhealthy way it ended up creating and fueling this almost eating disorder like cycle for most folks and then came out
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some medic s like OIC and people started actually losing weight with an FDA approved medicine
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that had Real Results now you see less of those fat burner ads but you see more
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of a new Gray Zone anti-aging science doesn't have an answer to stop us from aging we don't
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have the answers perfectly to our genetic code but boy there will be a genetic test for sale that will tell you
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exactly what you need to avoid but the reality is we just don't know and it's
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not sexy to say I don't know but I've been passionate about encouraging folks
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to celebrate those experts who come in and say here's what we don't know but
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here's how we're working to get to those answers because that's what gets me excited there's so many breakthroughs
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being made in medicine and we don't talk about those honest breakthroughs because they're not always exciting but if we
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could pair it with something cultural if we could pair it with some comedy with some fun I think we can get in front of
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a lot of eyes one of the first things you said there was was about weight loss in a zmek and it's
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a incredibly relevant and um widely discussed subject at the
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moment as zmek I I listen to the research on a zek and I am someone that
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typically has a bias towards not taking medications if I can and pursuing a natural route and and that is what we do
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too yeah which is understated in most uh circles as doctors yeah yeah so our training for
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example if you look at our we have a reference called let's say up toate it's
00:17:08
a medical platform where we could go and get guidance on any medical condition and it could tell us what the
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epidemiology is who gets sick with it uh what is the diagnosis that we should do to try and make it like what Laboratory
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Testing what Imaging we should do uh What treatments work first line Second Line third line Etc if we look at pretty
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much any crime disease treatment whether it's high blood pressure um sugar management from like
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diabetes all of the first steps is lifestyle modifications that's what we're taught
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is that because of the type of training you had doctor you became or is that all medical doctors that is all medical
00:17:47
doctors but what ends up happening is twofold one patients love a
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shortcut they love having a medication potentially do the work that they may
00:18:02
not be able to or don't want to you know it's difficult to generalize here
00:18:07
because some patients truly have difficult lives they have three jobs they're a single parent they're uh
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having a mental health crisis so they may not be able to do those lifestyle changes but then there's a portion of us
00:18:20
who could do it but prefer to take the shortcut and that's pretty human of us we we would like to get the shortcut we
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would like to take the edge is there such a thing as a shortcut in healthcare no and I heard you actually say it on
00:18:34
your last podcast uh covering OIC that there is no shortcut there are side
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effects and trade-offs to everything and you're absolutely right in that there is no such thing as just something that is
00:18:45
all good hydration you can't live without it over drink you'll throw off your electrolytes
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you could damage your brain you could lose your life carrots healthy food I would say eat enough you'll turn
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orange same thing goes for medications and that's why when people go and villainize treatments
00:19:06
medications supplements it just depends and there needs to be Nuance it's too
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hard to paint medicine with a broad brush but social media makes that really
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tempting that that non aemp path if I'm not going to take the the new sort of
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fat burning magic pills or the appetite I guess I guess they suppress appetite um magic pills
00:19:29
that becomes another a bit of still is a bit of a gray area in many respects because we on the drug side of things
00:19:36
people now have an option that's FDA approved but if they don't want to pursue that path there's still all of this other information around okay I
00:19:43
want to lose weight and there's lots of opportunity for a lot of people to present them with Solutions there's a
00:19:48
there's a roaring debate around calories which seems to just be never ending and um I wanted to get your take on that if
00:19:54
if someone was you know in your training when you've been advised to suggest Lifestyle Changes first and foremost if
00:20:00
I'm trying to lose a bit of weight I'm you know at risk of being diabetic or something what would you say to me as
00:20:05
your patient it would be hard to generalize it because it really depends on what
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pre-existing conditions exist what have you tried thus far what works what do
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you have time for what do you have budget for on that point of tried thus far why is that why does that matter so
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much if I have a patient who's tried dieting and
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failed and I don't ask that question and I recommend
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dieting they may not take the advice they may nod because they want to be a quote unquote good patient and leave and
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say not doing it but if I ask that question they can say they tried and failed then that gives me an opportunity
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to ask what exactly did they try did they try some really restrictive diet
00:20:54
that's out there carnivore keto what have you and that set them up for fail something that wasn't able to be
00:21:00
sustainable whereas now I can explain that hey the thing you tried actually set you up for failure and here's a more
00:21:07
reasonable recommendation that we can try and now I can actually be a doctor that recommends a dietary modification
00:21:15
that could help them what's the key to finding a diet that is successful from
00:21:20
your experience what are the like the foundational factors of that diet that's going to typically make it stick there's
00:21:26
two real things that you need to think about when it comes to dieting one is its impact on your weight because
00:21:35
calories in and calories out as non-sexy as it sounds as clinical and cold and
00:21:41
heartless as it sounds is true second you also need to think about the nutrients in your food because if we
00:21:49
just take one of those parts and ignore the other we can get into a really bad place I can uh even see those grapefruit
00:21:57
diets that people say like eat three grap fruits a day and you'll lose weight yeah you will because you're underc consuming calories but is that healthy
00:22:02
from a nutrition side absolutely not on the other side is you can get enough protein enough nutrients but if you're
00:22:09
overeating calories you can get into a metabolic problem where now you're carrying excess weight and increasing
00:22:15
your risks of all sorts of conditions so the goal is to get you in a place where it's balanced in both a caloric weight
00:22:23
management standpoint but also an ideally a healthy nutritional balance as
00:22:28
well well and what that means personto person is going to vary it's going to vary based on the medical condition they
00:22:34
have some patients who are anemic may need certain nutrients that someone who's not anemic doesn't need someone
00:22:40
who's prone to kidney stones may need a slightly different diet than someone who is IBS prone so we need to always take
00:22:47
into account that generalized advice isn't great when it comes to Health Care
00:22:52
especially when it's very easy to create Buzzy statements from truth
00:22:59
in healthare like I said on a podcast not too long ago that exercise for
00:23:04
weight loss Almost Doesn't Matter and that's a buzzy statement because on one
00:23:10
hand it's true but you also need to pair it with some nuance and say exercise has
00:23:16
so many benefits outside of weight loss of why it's important to participate in
00:23:22
exercise and the idea of weight loss needs to come from nutrition that's where the majority of
00:23:29
the change will come from Super interesting cuz I've sat here with so many people that have said that to me um
00:23:35
they've said that when you look at a lot of the studies exercise as a if you if
00:23:40
you give prescribe someone exercise to lose weight they probably won't lose weight um but I would definitely say
00:23:46
that in culture people see exercise as the many would see I reckon the primary
00:23:52
way you lose weight they think you have to go for a run to lose weight and and again you've Express the Nuance there
00:23:59
but I've even I've struggled with understanding that because over here people say exercise isn't super useful
00:24:05
for weight loss in the studies but then the the prevailing narrative in society is that if you want to lose weight you
00:24:11
got to get on a running machine that's because they're equating in their
00:24:16
minds Health with a magazine cover and health is not a magazine
00:24:23
cover they think that you need to have big muscles to be considered healthy and while you can have big muscles and be
00:24:29
healthy you could have big muscles and be tremendously unhealthy so just looking at someone's appearance doesn't
00:24:36
give you the full picture just like looking at someone's weight doesn't give you the full picture you need to know
00:24:41
more and when it comes to exercise and weight loss let's just take for a very simple example I used to go to the
00:24:48
movies when I was a kid I loved it I did it all the time it is not unusual to eat a tub of popcorn a little candy bar and
00:24:56
a soda well over over 1,000 calories do you know how hard it is through exercise
00:25:02
to burn off a th000 extra calories most of us are not physically even equipped to burn a th000 calories
00:25:09
during an exercise session so it's just about the science of not being able to
00:25:16
out exercise a bad diet what if I just eat loads of salads I think I've been in
00:25:21
that mindset before where I thought well I it's just really I could have well I've been in periods of my
00:25:27
life where I've just just eaten more and more and more good stuff quotequote good stuff things that I thought were good um
00:25:34
but I also didn't lose weight you are you're a really smart
00:25:39
person you're a person that wants to be as effective as you can in your podcast
00:25:45
in your communication style and you're amazing at it you want to do the same thing with your diet and the hacks and
00:25:52
tricks that you use in your business mind in your communication mind don't work for healthcare you cannot find the
00:25:59
shortcut of the salad that's going to fix everything that bothers you of the
00:26:04
probiotic Miracle supplement it's not going to be there that's why some of the
00:26:10
minds that actually end up falling for the most simplest forms of misinformation are those who are really
00:26:16
good at business because the things that work very well in the business world and the
00:26:21
communication space don't work in healthcare because Healthcare is not a commodity healthare does not work well
00:26:28
with extremes you cannot do something so good all the time without it having
00:26:34
negative repercussions you want to be good not perfect when it comes to
00:26:40
healthare and the more you try and Chase perfect number one you're going to get the negative response but also number
00:26:46
two you're going to create anxieties worries that are also toxic to your
00:26:53
body you have to be very careful so perfect is not only Just an Illusion it's a toxic
00:26:59
illusion I saw someone talking recently about the calories in calories out thing and the first comment was a lady who I
00:27:06
think had a pre-existing condition basically saying because my because of my pre-existing condition the calories in calories out thing does not work for
00:27:13
me I've tried it and then the health influencer responded and said it works for
00:27:19
everybody both statements are true okay dialectics are common in healthcare
00:27:25
we're two opposing ideas can both be true someone can try and do calories in
00:27:33
calories out which through science works but the application of it can fail well
00:27:41
I'm thinking not about the application and like the science of it is it regardless of whether I have a
00:27:46
pre-existing condition not regardless pre-existing conditions is part of the application okay the
00:27:53
individual is part of the application I think she was making the case that because of that existing condition that
00:27:59
the maths of it don't apply to her like it doesn't actually work on her body it shifts versus the applic okay it
00:28:06
absolutely shifts and that's the truth for most medicine like when I try and
00:28:11
get my patients into a healthy blood pressure range because we know that uh having a resting blood pressure above a
00:28:18
certain number predisposes you to having risks of heart attack stroke all these cardiovascular
00:28:24
conditions when I treat them with a medication after lifestyle changes either didn't work or they weren't able
00:28:30
to go down that route we have this really unique knowledge
00:28:38
public healthwise we know that controlling the blood pressure on a large scale will lower deaths
00:28:45
significantly we'll lower heart attacks significantly but by me medicating this one
00:28:50
patient I have no idea if it's going to help this individual exactly but that's
00:28:55
because all we're doing in medicine is doing our best with the limited information that we have on
00:29:02
hand closing off on that point about exercise so if if we shouldn't be thinking about exercise as a way to lose
00:29:07
weight what what is the sort of Medical Advantage the physiological Advantage for me if I go to the gym every day and
00:29:14
I'm I'm active literally everything else if I could bottle the effects of uh
00:29:21
exercise and sell it richest person on Earth happiness
00:29:28
mood social connections strength ability to decrease cancer risk decrease uh
00:29:37
increase ability to fight off cancer increase longevity literally everything else is the benefit of exercise and I
00:29:45
say that as someone who's been very exercise focused but over the last few months I've kind of fallen off I've
00:29:51
gained some weight I haven't been exercising as much as I want because sometimes life gets hard life gets in the way things become problematic mental
00:29:58
health sometimes takes a struggle and we need to be aware that that can happen
00:30:04
the idea that we need to make every person perfect or if they're not perfect they failure that's such a dangerous
00:30:11
Rabbit Hole to go into how much exercise going to vary person to person
00:30:17
General guidelines say 150 minutes of moderate intensity exercise per week
00:30:22
which isn't a lot two and a half hours um moderate intensity meaning that you
00:30:28
shouldn't be able to speak full sentences maybe one sentence at a time until you're out of breath is a simple
00:30:34
way to put it when you you um have such a broad view on medicine well I noticed that in your content I was like this guy
00:30:40
really knows he really has a real much more Broad View than the neuroscientist I spoke to yesterday who's really focused on you know maybe one part of
00:30:47
the body with that broad view what are you concerned about in terms of macro
00:30:52
social trends the direction of travel that we're going in with our health we
00:30:58
talked about misinformation and disinformation but but actual realities of the Western Health Care
00:31:05
condition first of all I think it's important that we have both individuals participating and having a seat at the
00:31:10
table the broad view primary care physician and the single point expert
00:31:17
neuroscientist like you had on your podcast before me we need both in fact where I'm able to gather my information
00:31:23
from is from all those researchers that are putting in those hours at the bench
00:31:29
making sure that they're checking their biases showing the flaws of their own research without them I am nothing right
00:31:36
like where did I get my knowledge from from them so we absolutely need to do this in a teamwork approach I think the
00:31:42
big problem that we face today is two things one the loss of trust in our
00:31:50
health care world that's huge people don't trust healthc care advice they
00:31:56
don't trust our agencies frankly the loss of trust of doctors has been rather shocking over the last decade and then
00:32:03
second is it's more of a philosophical issue that I raise because I don't know
00:32:08
where it's going to go where we've created this world of processed foods
00:32:14
unhealthy Foods foods that it caus us to eat more and more and more and feel not
00:32:20
satiated and then we've come up with a medication to solve that we've created
00:32:25
apps that pull our attention spans that allow us to focus 10 15 seconds at a
00:32:30
time before we swipe to the next thing now a lot of people are requesting prescriptions for ADHD
00:32:37
medications there's people who want to stay out all night and party and still maintain their physical gains they get
00:32:45
on testosterone early when they don't need to how hyperm medicated are we going to
00:32:51
get as a society to a point
00:32:56
of actually harming us and I don't know the answer to it I'm not smart enough to know the answer to that but I think it's
00:33:02
a good philosophical question to ask ourselves are you scared about what
00:33:07
would happen if we had a pandemic that is 10 times more deadly than the previous pandemic break out now are you
00:33:14
scared because of that loss of trust the more deadly the pandemic a lot of times
00:33:20
the less problematic it is isn't that weird oh okay so initial SARS virus was
00:33:26
significantly moread than SARS Cove 2 which is the virus that causes covid-19
00:33:32
so initially when the reports came out about The lethality rate of SARS Cove 2
00:33:37
covid-19 we said oh well it's not as bad as SARS we'll be okay because most people with SARS got really sick they
00:33:43
lost their lives but because asymptomatic spread was a thing with
00:33:48
covid meaning that you could feel fine or maybe just have a sniffles and spread it it killed Millions more
00:33:55
people and that's what that brings me back to that point of when I said Insidious misinformation can be more
00:34:02
problematic than true disinformation because when something doesn't seem so
00:34:08
bad that can we can allow it to go much further and cause much more harm complacency can complacency and feelings
00:34:16
of safety like oh well this one's not as Hill we're good I I feel fine we're good
00:34:22
but when you look at it and you zoom out macro oh my God it's Wrecking Havoc across the world
00:34:28
and I've actually equated this to vaping vaping is not as harmful
00:34:36
as cigarettes on paper but because the odor is not as
00:34:43
offensive it's easier to hide you could do it much quicker and get a bigger dose
00:34:49
because it feels like it's not as harmful many more people can get hooked on it is vaping dangerous yes
00:34:58
why and how so many of my friends VIP I think three three out of my six best friends they're just like they're like
00:35:04
they're just absolutely addicted they never smoked interestingly that's the issue of it that it gets people who
00:35:11
maybe would have been turned off by smoking to try and the chemicals found
00:35:16
inside are really rewarding to the brain nicotine being prime example of it and
00:35:23
the more dangerous part of it is with kids who have a developing frontal lobe meaning that the part of their brain
00:35:29
that is responsible for complex decision- making is not yet fully formed so they're incredibly susceptible to
00:35:35
anything that can build a tolerance a dependence uh an addiction to and it can change the chemistry of their brain
00:35:41
moving forward so we don't want to make it easier for them to start smoking
00:35:46
vaping should be used as a tool as a way of getting you off of cigarettes not as a way of introducing you to cigarettes
00:35:53
or nicotine at all is it dangerous for adults as well if you're coming off cigarettes no it's
00:35:59
a good choice but if you never all my friends that Vape never smoked yep it's not it's not something that carries
00:36:05
value healthwise and can only potentially harm have they have they done any I guess it's super difficult to
00:36:11
do studies on these kinds of things but have is there any studies that have been done around vaping yeah there's been vaping related lung injury where that's
00:36:18
its own diagnosis code now um there's been children that have been hospitalized with it um there's been
00:36:25
even technical problems of the devices blowing up in people's faces so it's not
00:36:31
the fact that I'm trying to fearmonger here and say vaping is the devil I'm here trying to explain that vaping can
00:36:40
be problematic because on the surface it may not look as harmful by
00:36:45
comparison Everything is trade-offs Everything is trade so interesting it's like when I see all my friends vaping
00:36:50
they're all in we're all in Dubai a couple of about a year ago and I thought Poss me because they will have these little like disposable Vape things now
00:36:56
so let me try I tried it and it was really nice and I thought oh God I could get into this and if it's not unhealthy CU like we all know that smoking is
00:37:03
unhealthy I thought you know your head you think oh what's the harm I could have so easily gotten to it luckily I
00:37:09
just I'm always skeptical when I don't know the side effect I I would rather accept the side
00:37:16
effects yeah and it be super clear than to someone say say to me there's no side effects when someone says there's no
00:37:22
side effects I always well that's like the whole nature fallacy when someone's like oh but this is natural natural
00:37:28
first of all what does that mean because like they say vitamins are natural but they're made in a lab I don't know how
00:37:35
that's considered natural and also just because something natural doesn't mean it's safe arsenic cyanide natural but
00:37:42
deadly the ADHD point you mentioned Y what are you seeing as a doctor you know
00:37:48
over the last couple of years the the term ADHD neurodiversity has seems to have become more and more prevalent
00:37:54
everywhere I look it feels like I'm hearing a conversation around ADHD is that because there's been a social sort
00:38:00
of heightened awareness to the subject and now people are getting diagnosed more are we creating more ADHD somehow
00:38:07
or is it somewhere in between yeah I I assume it's something in between I don't have a clear answer to it uh I do know
00:38:13
that neuro Divergence needs to be talked about more and that's not just from the ADHD perspective it's also from um
00:38:20
autism spectrum disorder uh situation as well where it's folks are going to be
00:38:26
different and some people want treatment for a condition others don't and we have to respect people's autonomy even when
00:38:32
we talk about something like vaping if an adult wants to vape as long as I can
00:38:38
convey to them as their doctor the risks everyone's free to make their own decisions no one lives a life where they
00:38:44
say I'm going to take no risks everyone has a different risk tolerance level everyone is comfortable with a different
00:38:50
level of care in life some people want more care some people want less care even at the end of life I have
00:38:57
discussions with my patients for end of Life Care often and a lot of times they're shocked by it they're like wait
00:39:03
do you think something's wrong with me I'm 30 years old why are you talk this is the time to talk about it when you're
00:39:08
healthy when you you aren't facing a decision that you have to make right now
00:39:14
that's when you're going to be able to spend some time and think about what kind of medical care you want you know
00:39:19
I'm a doctor here that became a professional boxer A couple of years ago that is not healthy I do not recommend
00:39:24
it it increases all sorts of risks for head and injury chronic traumatic incopy all of that is true it's a risk that I
00:39:32
was willing to accept because I studied the risks I accepted the risks I don't doubt the risks but it's something that
00:39:38
I'm passionate about and uh I wanted to go down that route enjoying it very much
00:39:43
so it's a great outlet for me why did you choose boxing despite the risks yeah
00:39:48
I would say that boxing probably chose me instead of uh me choosing boxing I uh
00:39:53
I did Taekwondo growing up so I was in martial arts for8 years and then um when
00:40:00
I was in medical school I unfortunately lost my mom to cancer and that was a a
00:40:06
really strong wakeup call for me being in the medical field knowing what it's like to be in the room to ask the
00:40:12
doctors to stop doing chest compressions on your mom I mean that is not something that I wish on anyone that's that's the
00:40:20
worst thing you can experience especially when my father was there also a doctor who was saying no keep going
00:40:27
but I knew was futile I knew we were causing more harm and in going through that journey I got into a very unhealthy
00:40:34
mental state I didn't leave my house except to go to class I came home I was
00:40:39
socially isolated and after a period of 3 four months where that was going on I said I need to get out of this I need to
00:40:47
take the my own advice that I give to people and take the advice that you need to have action before you get motivation
00:40:56
and the action that I took was to go on guilt City do you remember that app
00:41:01
it's like a group ones app where you can get a coupon to a a class and I got a
00:41:07
coupon for a boxing class and I went and did this boxing session and then I ended
00:41:14
up boxing for 10 years after that session fell in love with the sport and
00:41:19
then a couple years ago I ended up fighting on Showtime pay-per-view in
00:41:25
front of an audience of 15,000 people wow and uh it's it's been a unique Journey so while it's easier to vilify
00:41:34
boxing and say that it's problematic for some people if the trade-off is right it
00:41:39
might be something that uh they could participate in and it could be very healthy for
00:41:45
them losing your mother for anybody I think is just something that is unimaginably
00:41:52
unimaginably painful but in the circumstances that you lost your mother where from what I understood she was
00:41:59
given the all clear at one point with her yeah so um she had this unique form
00:42:05
of cancer called CLL and this is usually a cancer of old age where you get diagnosed with it and
00:42:13
you end up dying of something else other than that cancer but she had a unique more
00:42:19
aggressive form of CLL where they needed to really ramp up treatment and her
00:42:25
treatment took a toll on her body like she did not look the same post treatment she did not feel the same but
00:42:31
it was all in the hopes of curing this cancer and I remember very vividly I was
00:42:38
I was going to Memorial Sloan ketering hospital to pick her up one day and she
00:42:45
actually fell waiting for me at the waiting area so the doctor came down and talked to me and said maybe we should keep her observation for a day or so um
00:42:53
but overall she's doing great she's just very weak from the treatment and he shook my hand in that moment and said
00:42:59
she's cured there's no more cancer in her body now we just got to get her to recover from all these treatments and
00:43:05
that's the greatest news anyone can hear your hopes 10 out of
00:43:10
10 and just a few short days later her weakness got so severe that
00:43:16
she got uh a very unique type of bacteria called gram negative in her blood causing gram negative sepsis
00:43:23
spread throughout her body she required the use of Presser medication to artificially raise her blood pressure to
00:43:30
prevent her organs from dying and it didn't work and unfortunately she lost her life and one of the hardest moments
00:43:37
there was watching my father go through this who with my mom sacrificed their lives to bring us to the United States
00:43:43
as immigrants gave up their lives he went to medical school for a second time in his life she went to University after
00:43:51
having a PhD in Russia to learn English and be able to teach students math here in the states
00:43:57
it it was um it was painful to watch my dad go through it so I think for the first few
00:44:03
months my focus was more on him than it was even on myself did that experience change your
00:44:11
perspective of medicine and the medical industry in any way because in that
00:44:16
moment a doctor a doctor turned to you and said your mother is cured and it wasn't the it sounds like it wasn't the
00:44:23
cancer itself that did the harm it was the treatment for the cancer that did the harm
00:44:29
I never was mad at the doctor for saying that it would have been easy to in a situation like that where you thought
00:44:35
you were good but then it wasn't it taught me a lesson about how life can be cruel and take things away from you very
00:44:40
quickly after just receiving good news I remember sharing a a meme on my
00:44:46
Instagram that it had like you colon I'm actually happy right now and then life
00:44:53
colon hang on a second and that's kind of kind of how life
00:44:58
is so it taught me to be able to bounce back from adversity and realize that you
00:45:04
have to put one foot in front of the other while still being able to feel
00:45:11
because repressing emotions in the short term is a valuable tool you know if
00:45:18
you're unable to function in terms of high stress in the moment you could lose
00:45:23
your life you could make a really bad decision you could harm others you might not be able to successfully
00:45:29
hold down a job but if you do that for a really long period of time even that as a aute coping strategy can become toxic
00:45:37
and I was getting into that point where it was becoming chronic and I was blocking my feelings of not mourning my
00:45:45
mom not having the proper process and for everyone that process will be different you moved in with your father
00:45:51
after that yep if I was a if I was a fly on the wall in that in that household at that time what would
00:45:59
observed two gentlemen trying to raise a dog very
00:46:05
poorly that's probably not what you expected but I um in trying to always
00:46:12
find some kind of way to help um I thought by helping my dad redirect his
00:46:17
feelings towards something else um I got a Siberian Husky for him in that moment
00:46:23
which we always wanted a dog even my mom wanted the dog and uh he took some time
00:46:29
to travel to more in my mother's passing and while he was doing that I
00:46:35
raised a dog a little bit for a few weeks got her at least potty trained and then when he came home she was there he
00:46:41
was typical Soviet father yelling at me and telling me why this is a bad idea crying which I never saw in my father
00:46:49
before obviously until the loss of my mom and
00:46:54
um then he started being happy he started saying what should we call her his Focus shifted his Focus shifted
00:47:03
to going for walks with her which allowed him to think about my mom to not be locked into the house as so many
00:47:10
people are when they're going through a rough time so while I think it was chaotic of us trying to raise this puppy
00:47:16
together it gave us something to bond around in a moment of tough times there will be a lot of people listening right
00:47:22
now that are maybe in the throws of that grief or the throws of Their Own sadness or depression for whatever reason right
00:47:29
and it's um when you're in the midst of the storm when it's it's hard to see any way out and you said something super
00:47:35
interesting which is you said you realize that like action comes before motivation yep if I if I'm someone
00:47:42
that's in that situation right now and I'm listening what would you say to that person put on your
00:47:50
shoes they'll you'll go somewhere doesn't matter where you'll go Chim not
00:47:56
Jim walk dog park you can go to a dog park without a dog it's
00:48:03
therapy the biggest therapy that I think I've ever had and I've gone through traditional therapy was going to a dog
00:48:08
park with my dog after my mom passed away it's such a weird thing but animal
00:48:14
therapy is real and you know who actually gave me
00:48:19
that advice speaking of Dragons Den um Barbara corkran oh really she said that
00:48:25
the way that she gets herself to exercise cuz she doesn't like to she hates it she's very vocal about it but
00:48:30
she says next to her bed are her shoes her athletic shoes that if she puts them on she's like all right well since I
00:48:35
have them on I may as well go exercise and that one little step creates that Cascade look will it work for everybody
00:48:41
is this the Miracle Solution no but it's one step and even if you just do that one step and nothing else the next time
00:48:49
it'll be easier to put on the shoes and maybe try for the second one putting on the shoes is hot as well
00:48:55
when you're in that in showering is hard grooming is hard the basics of all Basics is
00:49:04
hard that's why when I hear advice like go make some friends online when you're
00:49:10
feeling down oh boy that's tough advice that's not easy so the putting on
00:49:17
the shoes thing is simple in the sense of doesn't require others to be around you to judge you doesn't have any steps
00:49:25
after that just to put on the the shoes and if you're at that point seeking help
00:49:31
from a medical professional is of utmost importance because we've put this stigma
00:49:36
where if you go for mental health treatment you're somehow weak but if you
00:49:41
go for treatment for a broken bone you're not weak that stigma doesn't exist for it and that's strange because
00:49:50
both things can have problems arise with it especially from a mental health standpoint especially with the society
00:49:56
we find ourselves in currently Society is the most unnatural that's ever been for
00:50:03
humans how would you describe the journey you've been on with your own mental health I don't know how I would describe
00:50:10
the journey I I would say just like most people it's had ups and
00:50:16
downs I would say the the thing that's really thrown me for a loop is the social media world of it all because of
00:50:24
how unnatural that that is but I feel like a lot of people are working through that without even having a social media
00:50:31
platform because at the end of the day these days everyone's a content
00:50:36
creator right like when you make a video and it gets millions of views you kind
00:50:42
of know what to expect being a content creator you have experience but Johnny
00:50:47
Rebecca someone else putting out a video on their social media at 16 years old
00:50:53
that too can get a million views and they're not ready for what comes with a million views in fact so many people
00:50:59
even in the medical community reach out and say how do I go viral I'm like do you want to go
00:51:06
viral that's thrown your your mental heal through a bit of a loop yeah I was obsessed with it checking it all the
00:51:12
time and I wasn't obsessed for it for the reason most people think I was obsessed with it from a place of growth
00:51:20
I was like even if they're 99% BS there's some kind of truth there's a kernel of Truth there that I could take
00:51:27
away and make myself better and you know there is truth to that I did learn a lot
00:51:32
of things I did prevent some mistakes I've improved my content as a result of listening to negative feedback and
00:51:38
criticism but I've had to in working with my therapist carve out moments
00:51:44
where I'm not in a place where that's acceptable for me right now where you just have to say this I'm not in a
00:51:49
healthy mindset to look what was the symptom of the impact it was having on
00:51:57
you um tremendous anxiety where you're just worried at all
00:52:04
times and you're almost addicted to checking it because you want to be ahead
00:52:10
of it you want to be safe you want to be able to think of a response and when you get to that point
00:52:16
you're never letting your mind rest you're always in fight or flight and when you're in fight or flight you're not resting you're not repairing you're
00:52:23
not getting good quality sleep even so I know how important that is I talk about
00:52:29
it all the time but as I said you know we're all not perfect doctors are probably the biggest Hypocrites when it comes to their own health I guarantee
00:52:35
you some of the people that have come on your podcast that talk about sleep or talk about this they struggle with sleep they don't
00:52:42
do those things just like how some advice that I give I don't follow to the tea my job is just to present the
00:52:48
evidence so I know certain things that I should be doing better but just because I know doesn't mean that I'm going to be
00:52:53
100% following it all the time this is interesting thing that I I was just thinking about as you're saying that that um at like a philosophical level I
00:53:01
think we're all kind of just passing our anxiety on to someone else like it's like energy cannot be destroyed and must
00:53:07
be transferred I I noticed this because on my podcast I have multiple guests that often disagree with each other and
00:53:14
if I was to do a map of how those people are feeling they're all suffering well
00:53:19
that's just Humanity as a whole they're all like really suffering and sometimes those people are suffering because of
00:53:25
someone else who suffered and then because of someone else's it's almost like this this chain of suffering because of misunderstanding a variety of
00:53:33
different reasons but I think as you say Humanity as a whole the person that's leaving those messages or you know
00:53:38
attacking you is probably also suffering in their own way of course it's a real shame but I can't see any way out it's
00:53:43
it's a like the circle of anxiety is an artistic way to put it for sure um but I
00:53:48
think there's there's some truth to it you know uh even from trauma the odds
00:53:54
are that if you've experienced a traumatic childhood that you will also potentially cause trauma to others goes
00:54:01
up that risk does go up and that's also pretty Common Sense even if you're not
00:54:07
looking at the medical research you could just say that if you've been hurt ozar you can hurt people what do they
00:54:12
say hurt people hurt people too right um I think that that's like uh that Common Sense logic that does get it right
00:54:19
what's the um did your therapist give you any advice that's proven to be useful well the advice that you put
00:54:26
perfectly in in place of logging off not looking at certain things at certain
00:54:32
times of the day like literally I had to completely shut off my phone at certain
00:54:37
times of the day because otherwise what happens is I would get into the cycle of okay I just finished in the hospital I
00:54:43
just filmed my video for the day now it's sleep time and just before going into bed let's check my phone one last
00:54:49
time and search the social media sites what people are saying and it's like
00:54:54
why that's ultim Ely what I think probably got me healthier like not looking at it was very good in moments
00:55:01
of Despair because during those moments I was just so fragile and it would not be a good time to look but really where
00:55:07
it got me is what got me is don't look unless there's something valuable you're
00:55:14
getting from looking at it so now if I'm in a healthy place and I feel like I'm
00:55:19
looking and I'm doing some kind of preventive task I'm learning from it I'm like okay I'm looking at it but I'm
00:55:25
looking at it with some kind of intention and that's actually true for all of social media I think um he was on
00:55:33
your show as well Dr Robert waldinger who ran the largest uh the longest running study at Harvard of Happiness
00:55:39
talked about the different usages of social media how if you use social media passively and you just look and consume
00:55:46
it can be rather disheartening and make you unhappy but if you use it to form a community to learn from it to better
00:55:52
yourself suddenly the social media may not have as bad of a health impact and can actually have a positive mental
00:55:58
health impact so if I'm looking at the negative comments I'd have to do that check-in with myself of am I doing this
00:56:04
because I'm actually benefiting from it or is it destructive in nature have you ever wondered if there's
00:56:10
something about you that makes you more likely to look at that stuff or
00:56:19
to care about that stuff I've often wondered about that myself yeah I I I feel like I have I think it's a it's a
00:56:25
pretty natural thing I think most people look um I think for me
00:56:32
I derive so much value in the work that I do on social media because this was
00:56:38
never meant to be a financial Venture this was not some Grand ideology that I
00:56:44
had to make myself successful this was solely because of my frustration as a
00:56:49
practicing doctor which the first question ever anyone ever asked me when I got into social media is like now that
00:56:55
you're doing so well you must want to quit medicine right like you're probably out earning it yeah but that's not why I
00:57:01
do medicine I work at a community health center most doctors that do really well on social media either leave medicine or
00:57:08
maybe do concierge practice or you know celebrity practice or something I work at a community health center where 50%
00:57:15
of people don't have insurance so that's been my goal and social media is just a tool to help me
00:57:21
with that goal and when I see negative comments I view it as a threat to that goal have you ever considered quitting
00:57:28
social media seriously I pondered what life would be like um but I just viewed it as
00:57:36
a negative all around not just for me I just VI view as social media such an
00:57:41
opportunity to help people it's like me saying quitting medicine I don't want to quit medicine I I want to be there for
00:57:47
people I want to be valuable and useful I in fact I think about myself as like a
00:57:53
more practical useful person and every strength that everyone has can also be their weakness so sometimes I'm too
00:58:00
practical and that impacts you as a friend as a partner as a family member
00:58:05
so sometimes being too practical is problematic but because of my practical nature I want to be useful to my
00:58:12
patients so let's continue with this um this health related stuff supplements
00:58:18
and vitamins I wanted to get your take on that there's a lot of you've mentioned supplements and a few times in this
00:58:23
conversation is that part of the gray area is that snake oil what's your POV
00:58:28
on supplements I want to say like one sentence that is all-encompassing and
00:58:35
answers all those questions but it's really hard because there's just so much Nuance with it um
00:58:41
vitamins we can't live without them we need them supplements supplemental
00:58:48
vitamins are not necessary the huge majority of the time and are often sold
00:58:54
by people who are praying on Securities promising shortcuts and honestly people trying to
00:59:01
get wealthy the evidence for almost all supplements unless you have a very
00:59:07
specific reason for needing to take them is missing and what I've learned at through
00:59:16
my 10 years of being a physician and the hundreds of years of practice of
00:59:22
medicine unless we're certain of some benefit introducing new things
00:59:29
distracting people from things that work is not a good solution is the harm of
00:59:34
supplements that they don't actually work again with supplements is a broad word so probably have to be is it the
00:59:39
harm that they don't work or is are you saying that we should be getting all of the things that we're supplementing from
00:59:46
our natural diet anyway or are you saying both yes and you can get all of your nutrients
00:59:52
again unless you have a specific medical condition from foods to they will make you skip out on doing
01:00:00
things that are healthy for you because you think you can take a shortcut three
01:00:06
you're spending your limited health care budget that many people have a very limited health care Budget on things
01:00:12
that are very expensive making a lot of promises and the thing that I'm most worried about is when we enter the space
01:00:18
of people saying you need supplements and not true Medical Treatments for
01:00:24
conditions that bother them or that affect them if I'm someone that maybe I'm not talking about myself here but if
01:00:30
I'm someone that has a very very limited diet just because of my lifestyle choices whatever would you recommend that individual to take a multivitamin
01:00:36
supplement I probably wouldn't but if they did I wouldn't discourage them do they work that's what
01:00:43
I'm trying to figure out oh and then the other point that I didn't mention is that there's harm like you said
01:00:48
everything has trade-offs there's no such thing as no side effects so supplements have side effects they have
01:00:53
interactions with medications they can create health conditions uh the term
01:00:59
antioxidants antioxidants are generally healthy uh you know B vitamins are
01:01:05
traditionally labeled as healthy you have too many of them we notice that they become pro-inflammatory but no one
01:01:13
talks about that because you can't really sell that so what instead gets talked about is the promise of what they
01:01:20
could do but there's harms that come from taking supplements especially in our world where you know consumer labs
01:01:26
and Consumer Reports goes and pulls supplements off the shelves to find out that they don't have the ingredients that are listed in them because they're
01:01:33
not regulated by the Food and Drug Administration they have some ingredients at 5 to 10x what's on the
01:01:41
label like vitamin A which is a fat soluble vitamin and can actually be really harmful so they're not regulated
01:01:48
they can cause potential harm their benefit unless very clearly indicated is
01:01:54
in the air and not proven why recommend them why sell
01:01:59
them and I say this as someone who can make a fortune I mean you said to yourself 12
01:02:05
million subscribers you know I take a little boxing selfie fit and say the reason I'm
01:02:12
this fit is because I take whatever thing I bottled up in my house put into
01:02:17
those pills whatever powder I want no one checks it and I could sell it and
01:02:23
become a multi-millionaire is that sure that no one checks it no one checks it no one checks this no one checks it
01:02:29
these supplements no like right now we could bottle up on the table our Miracle formula we can
01:02:35
call it a miracle formula yeah as long as we don't make a claim that it treats a specific medical condition that requires the treatment of a medical
01:02:41
doctor okay and I just put buzzwords on it so instead of saying this helps your depression I just
01:02:48
say depression immunity support just buzzwords feel good feel good happy
01:02:56
happy natural simple from the earth we could sell it how much we don't have to
01:03:01
get anything we don't have to get anything cleared by anybody how much you think we'd make too much money and that's why it's
01:03:09
like man I understand why people do it and there is the notion that they could potentially work there's always like a
01:03:16
little bit of evidence coming out that're just going to cut break for miracle M which is
01:03:23
on it's so tempting I get it and I get there's also I don't want to label
01:03:29
everyone with a broad brush and say they're evil and just trying to make money some people do believe that they work they they want the belief that this
01:03:36
is what alss us as a society and I wish that was true I wish
01:03:42
it was as simple as giving people some supplements or that eating eight almonds a day will extend your life by 10 years
01:03:48
I wish that was the case um the subject around gut microbiome is something that I've talked about a lot on this podcast
01:03:54
because I've just had a lot of experts talking to me about subject and something that I didn't even know existed three years ago I didn't realize
01:03:59
there was loads of bugs in my belly um there are prebiotics probiotics all
01:04:04
of these things coming out now for to enhance the what do they call it it's not gut Flora is it microbiota
01:04:10
encompasses all of it is there truth that prebiotics and probiotics are useful for well there's truth in the
01:04:16
fact that we have all of these living organisms inside of us there's a very strong
01:04:22
interconnectedness between how we feel disease conditions and and what species of those bugs exists in us the counts by
01:04:29
which they exist that people who generally eat specific foods that are rich in them may have better health
01:04:35
outcomes than those who don't but manipulating those bugs has not been
01:04:42
proven or clear in the majority of ways that people promise they do like we know
01:04:49
consuming fiber correlates With Better Health less negative health
01:04:56
outcomes do we know that taking a Prebiotic supplement does the same we don't know do we know that having
01:05:04
specific bacteria in the gut gets destroyed if you have a health condition
01:05:09
we do know that but does that mean reestablishing it by taking it in a pill will fix that condition we don't know
01:05:15
that but people will make that jump and say no big deal we're trying to help but
01:05:21
to me it's a big deal because we're promising something that we're uncertain of without even some good evidence for
01:05:28
it there's very few conditions that probiotics can actually help with well what advice would you give someone that
01:05:35
comes into your practice and you identify that they have some kind of gut related gut microbiome related issue is
01:05:40
there anything that you would recommend that they do to improve that got micro micro well it would be focusing on foods
01:05:45
that are considered healthy for uh the microbiome so foods that are rich in fiber plants essentially um avoiding bad
01:05:53
habits poor quality sleep over drinking alcohol smoking all those things are
01:05:58
unhealthy um the the the thing that makes Health advice so boring is that
01:06:04
the things that grandma told us still is what I say in my office and it's not
01:06:09
sexy and it puts people to sleep but it's true that's what we know works we
01:06:14
don't have a perfect answer as to why and right now there's like tests on the market to check your microbiome to know
01:06:21
what food too preliminary to recommend we don't know what to do with the information the promises that they make
01:06:28
don't hold up when we look at it long term genetic tests potential is there
01:06:34
for a lot of value most of them are very preliminary unless you're working with a
01:06:39
geneticist on a very specific condition so I think the hype often times speeds
01:06:47
up the selling of the products before the evidence is there it outpaces the
01:06:52
evidence and in some instances medicine does that too like traditional medicine but it does that with some thought in
01:06:59
mind for example if we create an emergency use authorization or if we
01:07:05
allow someone to have a treatment exemption for something that is not proven for a disease that's already
01:07:11
lethal that they're going to lose their life anyway or if we don't act now we're going to lose so many lives in the
01:07:17
moment then yeah there might be instances where we can speed up the process of certain things we can uh
01:07:24
create some shortcuts because we're taking that trade-off that's thought about but with a lot of these products
01:07:30
they come and go and there's just so much misinformation around them you know like one of the uh big individuals that
01:07:37
does this in this space and hate to single out but it's just been such a um
01:07:43
a a voice in this community is Gary Brea you know I I talked about him on my show
01:07:49
have you spoke to him no and seems like a really good person seems very passionate about what he's
01:07:55
talking about but the the promises that are
01:08:01
being made are not proven and the intention may be good and
01:08:08
good intentions can have bad outcomes but if the information is not accurate No matter how passionate you are about
01:08:14
the subject long term it's going to have negative outcomes when you use the word proven there do you mean that there's
01:08:21
not a significant or a a a reliable sort of basis of research that's been done
01:08:29
yet to validate the hypotheses or the statements or you're not saying that
01:08:34
it's been disproven it just hasn't been proven yeah so that's a good point to bring up the things that I say that are
01:08:42
inaccurate largely have not been disproven because if I say the juice
01:08:47
inside this cup will help you live forever would you say that's true or
01:08:54
not I Theory would be that that's not true right but can you disprove it no you would have to run a study to
01:09:00
disprove it yeah and that's how I function as a doctor so I can't disprove what he's saying because then I would
01:09:07
have to run my own study but based on what we do know based on remember how I said at the beginning when a new study
01:09:13
comes out I try and bring it to the already the established information that we have it doesn't Vibe with what we
01:09:19
know to be true if you want to go against public health standards from what we've established as science you
01:09:26
better have a good reason for doing it and if you do I'm all ears I'm excited
01:09:31
for that kind of stuff if you have some breakthrough of why you disagree with the CDC with the wh with uh Harvard
01:09:38
Health please tell me why you disagree but if you disagree because you said so
01:09:45
that's where things get problematic like I'll give you the simplest of examples there's a very famous clip that I
01:09:50
reacted to on my podcast where Gary Brea says if you have headaches it's because
01:09:55
you're low on pink Himalayan sea salt how many reasons do you think
01:10:02
people get headaches many reasons you're not even you're not even a doctor right my
01:10:08
brother has my brother has had chronic headaches since he was since he was a kid just you got a concussion you have
01:10:14
stress you have a hormone issue you have a tumor there's so many you have migraines you have a neck cramp what the
01:10:23
possibilities are endless right to have the confidence to say this is
01:10:30
what you're missing everything else Almost Doesn't Matter the confidence is the
01:10:37
misinformation like notice every time you asked me a question today it was either I don't know it depends Nuance
01:10:44
for who it's almost annoying because I can never give a clear answer but that's
01:10:49
what science is and that's actually why people have lost trust in science because we're not as confident as Gary
01:10:56
Brea when he talks about salt for headaches sometimes you've been wrong
01:11:02
right of course sometimes you've I remember reading um something where you said I admit that I I change I've
01:11:08
changed my mindset when presented with new information and I've explained why I think when we we think about
01:11:15
doctors this is the part I think that some people struggle with is if you look over the course of sort 10 20 30 40
01:11:20
years some of the things we were told were healthy back then are no longer healthy and new information about I'm
01:11:25
well aware that this is a scientific model but I'm I'm trying to the coun trying to present the counter argument put yourself in that shoe in that seat
01:11:31
yeah how do we know who to trust when doctors say that they've been wrong and they've changed their mind on really
01:11:36
critical things before and even you know when we think about vaccine disinformation right a lot of the
01:11:42
arguments you'll get from the right are that you said this and now look what happened so we'll never trust you again
01:11:49
how do we navigate and know who to believe even doctors when doctors will say information I gave you in the past
01:11:55
was actually no longer true you have to take the hard route and do the work to
01:12:01
find out why they said what they said then and why they're changing their mind
01:12:06
now so I'll give you an example y actually maybe this isn't a doctor this is um studies I remember having a guest
01:12:12
on my podcast that talked about I think there was a bit of a crisis with um depression drugs in the early years
01:12:18
where they had because of the way that the tests had been done by the big pharmaceutical companies the CEO of the pharmaceutical
01:12:25
company knew that the depression drug did not work and had all these side effects but they pushed it through even
01:12:31
though the vast majority of the studies had hadn't shown that the drug worked they found one study that had they pushed it through got to Market loads of
01:12:38
kids used it and then I think a decade later I again I'm paraphrasing here I link what I'm talking about below it was
01:12:44
discovered that the CEO of that company knew it it didn't work but there was a study and research that got it to Market and people started using it I think
01:12:50
Johan hary who's been on my podcast before he was the zmek episode we released um he was one of the people as
01:12:55
a young man that started taking that depression drug only to find out that five six years seven eight years later
01:13:01
it didn't work and the CEO knew that it wasn't really working so that was the that was trust in the medical system it
01:13:07
that was trust in research that was trust in big farmer much of the counter
01:13:13
movement we're seeing now is we think big farmer is corrupt and we think they're meddling with doctors to get
01:13:19
drugs into Market that maybe don't work
01:13:25
there's a lot of drugs on the market agree yeah if science is so problematic and we
01:13:33
shouldn't trust for all those reasons why is it the one example that we're stretching to find of the mistake that
01:13:40
was happened or the fraud that happened with this one drug we're talking about something that happened decades ago it
01:13:46
does happen fraud happens it happens in healthcare it happens with policing it
01:13:51
happens politicians there is fraud but pointing to that one episode and saying
01:13:58
we should throw the whole field away is going to cause a loss for us and there
01:14:04
are issues with Pharma there's huge issues with Pharma I frequently talk
01:14:10
about even from like the pricing standpoint of Pharma how problematic they are we've seen the issues with the
01:14:16
opioid epidemic how that was driven largely by Pharma but we're calling them out the
01:14:23
beauty of Western medicine of what we do here is that we are the best at calling
01:14:29
ourselves out on our failures but actually the more we call ourselves out on our failures the more trust we've
01:14:37
lost and in fact when someone owes up to their failures and seeks to learn from
01:14:44
them and seeks to make change that's the person you want to follow the person who is not confident
01:14:52
who is open to be transparent who explains why these things are happening without 100% confidence that's the
01:14:59
people that are giving you advice that's true the same way that we said uh earlier that everything is all natural
01:15:05
does not mean it's all good everything for profit is not necessarily evil my YouTube channel is
01:15:11
for profit I make a very healthy living doing what I'm doing doesn't mean it's evil so while it's easy to make
01:15:19
shortcuts and overgeneralize we have to talk about specific instances and call
01:15:25
balls and Strikes as they are umpires make mistakes healthcare industry has
01:15:30
made mistakes there's been vaccine incidents in the past that have hurt people we've learned from them we called
01:15:36
it out we've studied it we are con there are doctors constantly studying where we need to do better this
01:15:44
is ongoing at all times and the ironic part is most people have no idea that
01:15:50
it's happening because we only find out about it on issues we're passionate about I recently did a video or I was on
01:15:56
a podcast where I was asked about birth control I gave a very simple answer it was
01:16:02
non motivated in any way it was just kind of presenting the information as it was there were a lot of very mean
01:16:08
comments in that information about how birth control can potentially be harming people that I don't believe the negative
01:16:15
side effects that can come with it all these statements that were being made and I found them to not be true I had to
01:16:22
do like a little soul searching to see if they were true because I do that with all the negative comments and I said no
01:16:27
birth control can have side effects just like with any medication the reason why
01:16:33
birth control maybe is being brought up is because this is a topic people are very passionate about this is a topic
01:16:40
where doctors have discriminated in the past about so it's a bit more triggering to the emotional part of our brains but
01:16:47
if we look at what's leading hospitalizations from a drug in the United States Tylenol you don't see
01:16:55
anyone uproar making YouTube videos that Tylenol is problematic what is Tylenol acetamin paracetamol for you a
01:17:02
paracetamol yeah the amount of hospitalizations for Tylenol induced liver failure is skyh
01:17:08
high I'm sure we could pop up the statistics on screen but no one gets upset about Tylenol because it's not
01:17:13
emotionally triggering and that is true for all of healthcare there's side effects to taking
01:17:19
medications so it's easy to only focus on one part of that equation say well
01:17:25
doctors used to say this what about this why did doctors say it what got them to
01:17:31
say it there and the idea of us getting it perfect never going to be true we're
01:17:37
always working with incomplete information all of medicine is just our best
01:17:42
guess how many of you started thinking about your long-term Health when you hit 30 for me this was a wake up moment of
01:17:49
me thinking to myself okay I probably need to start paying a little bit more attention now I already felt a change
01:17:55
myself when I hit 30 with things like my metabolism my energy levels so this year
01:18:00
is no different Zoe which is a company I've invested in but also a company that are a sponsor of this podcast helps me
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up enjoy and let me know how you get on what about these animal studies a lot of the research that's presented from
01:18:45
experts is from animal studies rats and things like that yes so that's where people like to skip steps the amount so
01:18:52
Pharma is out for money right that's fair say that's their job they're trying to create a return for their
01:18:58
stockholders they try and pick research to do that hopefully will drive the best profits 99% of the stuff that they start
01:19:06
researching on from the initial promise of animal studies 99% of it fails and
01:19:12
they're only picking the top then you go one step further once it works in animal studies and Petri dishes and then it
01:19:18
goes into human trials another 99% of it fails so the idea that something has
01:19:24
mechanistic value then Works in an in a Petri dish then it works in an animal model for it to make all those steps is
01:19:32
so astronomically rare that it ends up working for the general population the fact is that we shouldn't
01:19:39
jump to from animal model to human because 99% of that is going to
01:19:46
fail so what are we saying then do we have to you know go back to just living like our ancestors lived and because you
01:19:52
said earlier on that the world we live in is been more unnatural yeah so is the is the antidote for all of this stuff
01:19:59
we're talking about is it to go back to being human and like we always say our
01:20:04
ancestors were well I think what we need to look at is the evolution of humans and the anthropology aspect of it
01:20:11
because we can then better understand ourselves now and why we're having problems with this unnatural world right
01:20:18
so if you look at why anxiety was a a survival benefit to us back then versus
01:20:26
how it could be very problematic to us now in a safer World studying
01:20:31
prehistoric cavemen humans would be beneficial but drawing conclusions from
01:20:37
their diets and potentially what they ate all men you're going to get into so many fallacies and biases that the
01:20:43
information is not going to be great and not very applicable if you um if you could redesign Society in such a way
01:20:49
that it would be in your mind more healthier more healthier for the for the
01:20:55
average human you had to start from zero so you're president of the United States Trump doesn't get it Biden doesn't get it Dr Mike gets it and you could really
01:21:03
rewire Society what are the some of the sort of macro Topline changes you would make okay I'm
01:21:08
taking I'm going to keep everything on the table the first thing that I would do and this is uh echoing one of the
01:21:15
authors and experts I I really enjoy listening to and he's actually coming on my podcast soon Jonathan height I would
01:21:21
get phones out of schools I think that that much in the same way that we uh regulate addictive
01:21:29
substances like cigarettes like vaping like um alcohol to those of age we need
01:21:36
to start thinking about that for social media and that's an unpopular thing to
01:21:42
say but I think if you really look at it there's a lot of problems that can come
01:21:48
from it very limited benefit for someone who's 13 to be looking at those images
01:21:55
so I think some major changes need to be made uh in schools you were voted in
01:22:02
2015 you know that's a long time ago 10 years ago in 2015 you were named people
01:22:07
Magazine's sexiest doctor alive I don't think I was voted I think
01:22:13
they just nominated me well it's it is something right yeah it is what it is um
01:22:18
your relationships mhm what's your relationship status if you're able to share it relationship ship have been
01:22:25
really tricky um as a medical provider
01:22:31
you have to carry yourself with an air of professionalism you have to make
01:22:38
people feel comfortable in talking to you uh about very sensitive subjects so
01:22:44
I've been very careful to balance the world of showing my personal life to
01:22:49
some degree and showing people and reminding them that I'm human I too have relationships I to play sports I have a
01:22:55
family I have dogs but also not do it so much that it actually can cause harm in
01:23:01
my clinical interactions so initially when I started social media I was very open about my relationships who I was
01:23:08
dating what my relationship status was and I thought that I was under the firm
01:23:13
belief that there is no way this could be detrimental and much in the same way that I thought that reading every
01:23:19
negative comment can only be helpful boy was I proven wrong not only does it cause harm to potentially the clinical
01:23:26
interactions it can cause harm with my audience online not dating patients that's not
01:23:31
what I mean no no just a clinical interactions piece I mean well like you know if a patient is wondering who
01:23:37
you're dating or what you're dating that that's going to derail the conversation away from Health okay um the same way
01:23:43
that it would derail the conversation from social media from people listening to Medical talking points to then
01:23:48
talking about personal life um so before while I was being very open with it now
01:23:54
I've kind of said my personal life to some degree is my personal life when I begin sharing everyone will know about
01:24:00
it it'll be everywhere but now I tend to become a little bit more I have some
01:24:05
things for my personal life but the majority of it is an open book that's I was curious about your relationship status because as someone who's so busy
01:24:12
and a content creator and going through all of the things we described earlier with your mental health and the feedback
01:24:17
and all of that sure how you manag to be successful in that realm as well yeah so
01:24:24
like in in doing what I do I I feel like I'm very busy because I'm involved in so
01:24:30
many different things but I feel like everyone's busy you know you you make time for what you're passionate about so
01:24:37
there was a period of time I was single for a few years then I got into relationships I got out of relationships
01:24:43
and it it really is if you meet the right person and you want to dedicate your time to them you'll sacrifice something you know before I used to be
01:24:49
all about watching sports like that was my nighttime routine now I can't even
01:24:55
tell you the last time I watched the sporting event I've just been so busy like maybe the Ryan Garcia fight boxing
01:25:00
match but um I don't I don't have the time for it because I've made sacrifices to do other things I'm passionate about
01:25:06
and I think if your partner consistently I think this something I said before that if your partner consistently says
01:25:12
they don't have time no matter how busy they are you need to do a little evaluation and see is is that something
01:25:18
that they truly want or at least bring up that conversation you're someone that strik
01:25:24
me as being quite philosophical and deep thinking in their downtime M and probably spends a
01:25:31
lot of time thinking about bigger questions about life meaning purpose and all of those things is that a accurate
01:25:38
and B what are those big things that you're
01:25:43
considering in your mind um it's accurate but not big picture big
01:25:48
philosophical questions it's more I'm deep thinking from an introspective standpoint point
01:25:55
of running back every day what could I have done
01:26:01
better what can I improve on uh what should I think about for the future how
01:26:06
can I grow from today so I spend a lot of time doing that and that's not something I taught myself to do when I
01:26:12
was a kid I remember this very vividly in high school age 13 being very awkward
01:26:18
freshman year of high school um talking to girls at my class and then coming home and sleeping in my bed and as I'm
01:26:24
going to sleep thinking oh my God what should I have said to look cool maybe I should have just stayed quiet like those
01:26:30
cool guys in the movies and playing back those scenarios throughout the day and
01:26:37
while that was silly when I was 13 now as a doctor I play back my patient
01:26:42
encounters and think about what I could do better in that communication sense I play back my podcast interviews in my
01:26:48
head and think about what I could do better so I'm constantly thinking about that and again not by choice it just
01:26:54
kind of happening in my mind and that's where the anxiety stems from I guess um the anxiety can creep up there if you
01:27:00
feel like you're not improving or your progress is stagnating like um the idea
01:27:06
that I told you I wasn't exercising a lot I start ruminating and thinking oh my God you haven't been exercising in so
01:27:12
long now you're going to not be healthy what if people online start thinking that oh that's not a healthy thing to do
01:27:18
and you could start catastrophizing very easy this is what our human Minds do and that's why C BT cognitive behavioral
01:27:25
therapy one of the more popular forms of evidence-based therapy is taking those cognitive distortions those
01:27:32
catastrophized black or white labeling thoughts and just talking back to them
01:27:37
saying how true is that that if you had all A's on your tests and then you got one C that you're a failure how true is
01:27:44
it that if you don't exercise for three months that means you're an out of shape slob and you have to talk back to them
01:27:50
so doctors are not immune to cognitive distortions I always wonder with doctors when you're dealing with like People's
01:27:56
Health and their outcomes which sometimes are positive and sometimes not positive how that can sit on your
01:28:03
shoulders and how you can take that home with you because you must deal with a lot of people that are no longer here
01:28:09
yeah for sure um especially when I would be a resident working in the ICU where
01:28:14
an intensive care unit patients are the sickest so mo more likely for them to lose their lives you're having
01:28:21
conversations with family members about discontinuing CPR about signing certain
01:28:26
papers to say that we're not going to give more medical care we're only going to focus on comfort as opposed to
01:28:31
treatment and those conversations are not easy conversations and the way that I've approached them is with unbiased
01:28:39
truth just here's what I know I want you to know what I know I'm explaining to
01:28:44
you why I think what I think now you tell me what you'd like to do and ultimately it gives
01:28:51
patients a sense of responsibility in a good way where it empowers them or empowers their family members to make
01:28:57
the right choice and the right choice is not clear two people can make different
01:29:03
choices and they both be right choices same thing with Healthcare like art uh um Healthcare is as much art as it is a
01:29:09
science so so two doctors can see the same patient and recommend two different treatments and not be wrong is there was
01:29:16
there a hardest day when you think back over your medical career was there a hardest day in your practice
01:29:24
no nothing that specifically jumps out I think it's it's how it wears on you from
01:29:30
a perspective of just length of the amount of administrative work you
01:29:36
have to do the amount of time you want to spend with the patient versus what you're given um the ability of
01:29:44
helplessness where you can't fully help a patient no matter how much you want to when you know if a patient does a
01:29:51
specific treatment you know they'll get better but they're not interested in it or are being deceived or influenced in a
01:29:57
way where they're not going down the right path those really really drain me because I I think about those at night
01:30:04
of how can I be more effective so I can help my patient come to the right conclusion or at least help them make a
01:30:10
decision that is actively not detrimental to their health your mission
01:30:16
at the moment to really help to myth bust and um call out disinformation as
01:30:21
it relates to health care and advice is that driven in part because as a doctor you're seeing the consequences firsthand
01:30:28
of information your patients are bringing to you that is patently false or untrue or doesn't isn't quote unquote
01:30:35
proven um and then you're basically arguing with them about that or or something is that where it comes from yeah that's why I started social media
01:30:42
because I was having a very similar conversation with the 30 patients that I saw in a day and I was like wow I got to
01:30:48
tell the world this so they can all know this information so that they all don't fall VI them to these scams where they
01:30:55
think doctor I had $100 this month to spend on my health and I bought this thing I bought these two smoothies and I
01:31:01
thought this is the answer this is going to help me right this says it helps with cancer and it's that's not the answer and in having
01:31:09
those conversations over and over again it's what drove the passion to being on social media and now I think about
01:31:15
medicine differently than I did when I first started I used to think medicine is doctor and patient now I view it more
01:31:21
in a public health sense where my impact on social media goes so much further
01:31:26
than patient interactions or viewer interactions where now I can influence policy had a medical emergency on a
01:31:32
flight and they made that call is there a doctor on board and I was faced with a moment like okay do I volunteer do I
01:31:39
just stay quiet I don't know what to do but I volunteered and it turned out after some investigation that a young
01:31:45
gentleman was going into anaphylactic shock his throat was closing up to it an allergy and I wasn't worried I said
01:31:51
where where's your EpiPen he said I don't have one I didn't even know I had this allergy so I asked the pilot can we
01:31:57
land pilot says well it's an hour and a half back to Canada and an hour to Portugal some Island in Portugal that's
01:32:04
not enough time his throat's closing he's going to die in five minutes so I'm like what can I do so I
01:32:09
opened the plan's emergency kit thinking there's going to be some epinephrine in there or an EpiPen and there's no
01:32:15
EpiPen and I'm like okay what do I do now there's no internet when you're over the Atlantic Ocean so there's nothing to
01:32:22
Google but um finding that there is epinephrine which is the same medicine that is found in an EpiPen in a
01:32:28
different formulation in a different dosage for a cardiac arrest so when someone's heart stops we also give the
01:32:34
same medicine if they're Flatline if they have a specific Rhythm to try and restart the heart so it's a much thicker
01:32:40
needle much longer not those cute little EpiPen needles that just go into the side of your thigh and I said okay well
01:32:46
I need to do some rough calculations here and just uh guesstimate here because otherwise he's going to lose his
01:32:51
life and right there in the first class cabin we take off his pants we uh inject
01:32:56
them with this huge needle he's screaming there's like a little bit of blood coming out I inject the medicine
01:33:01
I'm praying that it's working and fast forward that story uh I stayed with him
01:33:07
for eight hours for the rest of that flight until he landed we didn't need to divert I checked his blood pressure and pulse every 15 to 30 minutes and uh we
01:33:16
saved his life and you think that would be the end of it you're like look at that I did my doctor job and that's it but I went and
01:33:23
told that St Story on YouTube got almost 10 million views if not more now I don't know what it's at and um the Senate
01:33:30
Majority Leader Chuck Schumer calls from his office or his office calls and says hey uh I'd like to get epipens on planes
01:33:37
can you stand with us and tell us your story to the media yes we tell the story we call on
01:33:44
the FAA to make these changes and now 70% of planes I don't know what the
01:33:50
exact number is but something like 70% of planes have epip pens on board that will never have to happen again that's
01:33:55
incredible and that's the power of social media that people don't talk about that's Public Health that's
01:34:01
helping people that aren't even needing the help yet so that's the kind of medicine I like to think about now well
01:34:07
you have a half a body lying over there in the corner so in the in the sake of helping people using social media um I
01:34:14
asked you if you could bring a I don't even know what to call that it looks like a half a mannequin or something a mannequin it's a mannequin um because
01:34:22
early in my life I got told that learning learning the skill of CPR is one of the sort of simplest potentially
01:34:28
life-saving things that I could learn because you never know and I've got people in my family that died of various
01:34:33
cardiovascular related um conditions heart attacks and things like that and so I would love to learn again again
01:34:41
this is probably not an official certification to learn the basics of CPR and how to keep someone alive in such a
01:34:47
situation um could jack could you bring the the what should we call him we'll call him off Mike yeah we we'll call him
01:34:55
uh baby Mike so I'm curious before we do any
01:35:02
kind of instruction on it what do you know thus far about CPR and all wrong answers are acceptable here um you push
01:35:08
on the chest roughly around the top of the rib cage and then you blow into the
01:35:14
mouth and you just do that over and over again until they come back to life okay do you know what the reason of doing CPR
01:35:21
is H that's a very good and it's not a trick question I'm just genuinely curious because I like to know where
01:35:26
we're starting from and no one knows this by the way this is why I do what I do so this is not it's something to do
01:35:33
with keeping oxygen flowing around the body through the blood you're right on target okay so the purpose of CPR is if
01:35:41
you find someone who's unconscious not breathing is pulseless that means their heart's not beating that means
01:35:46
clinically they're dead so anything you do here can only potentially hurt help
01:35:52
can't hurt right cuz the person is already dead so by doing proper CPR what
01:35:57
you're doing is you're compressing the chest chest compressions to squeeze the heart which has some blood in it to
01:36:05
circulate the blood throughout the body that still has some residual oxygen in it to deliver oxygen to the vital organs
01:36:12
so you're not actually saving someone's life by doing CPR you're buying them
01:36:18
time the purpose of doing CPR is to allow time for First Response ERS to
01:36:24
arrive to then give Advanced cardiac life support oh okay and that's why the
01:36:31
first step of doing CPR has nothing to do with the person and has everything to
01:36:36
do with calling for help okay so I call the First Responders or because that
01:36:43
would so ideally you never want to do anything that will distract you from starting chest compressions because the
01:36:49
faster you can get to doing chest compressions the better are your outcomes so tell someone else to call ideally if you're alone obviously that's
01:36:56
not happening but you can't just say out into the open hey someone call 911
01:37:01
because what happens everyone assumes the other person calls no one calls this happened with many medical emergencies
01:37:08
and it's terrible when it happens there's actually criminal cases about that someone screaming for help and
01:37:13
everyone assuming the other neighbor would call and then no one ends up calling so you have to say Hey you in the blue shirt you and the pink hat you
01:37:20
call 911 and they will call 911 and you immediately start pushing hard and fast
01:37:26
in the center of the chest one hand on top of the other when you say center of the chest you mean in between the pecs
01:37:32
correct okay so right in between the pecs one hand on top of the other on top of the other what if I break whole body
01:37:38
doesn't person's dead so I can go as hard as I want to go you want to go two inches deep which means pretty hard
01:37:45
because in order to compress the heart you need to go 2 in deep and two inch deep is pretty 5 cm deep so one hand on
01:37:52
top of the other push hard and fast in the center of the chest in between the pecs and you're doing that until help
01:37:58
arrives okay so you see how you're uh much like most people who are in really
01:38:04
good shape you're using your triceps yeah try doing that for more than two
01:38:09
minutes you will fade no matter what good shape you're in in fact when we're in the hospitals the way that we do this
01:38:16
is maximum two minutes at a time and then we tap out and get the next person in because it's so tiring the way to Max
01:38:24
full body weight correct and you hear the click that means you're doing it to the correct depth and that way you will
01:38:30
get less tired and you'll be able to do that for longer periods of time so that click means I'm hitting the heart for
01:38:36
this little device yes I had to go down a long way away I had to go down so far that I would never have naturally done
01:38:42
that to somebody I would have thought that I was going to do more damage correct and because of that fear that people have we unfortunately have worse
01:38:50
outcomes with people who have cardiac arrest in the field and in fact most cardiac arrests meaning heart stopping
01:38:57
happen not in hospital settings they happen in community settings they happen on the street at dinners with our loved
01:39:04
ones and the important point to remember here this isn't what you do for someone who's talking and is having a heart
01:39:10
attack this is for cardiac arrest they're not talking they're not moving
01:39:15
they're not breathing because if they're talking that means they have a pulse because I've seen in some videos
01:39:21
online like someone's trying to talk or moving around are doing chest I'm like no stop he's doing chest compression but
01:39:26
if they're pulseless if they're not breathing they're unconscious start hands only CPR after calling for help I
01:39:32
can't I really want to emphasize how hard I had to push down then it wasn't just like pushing on the surface I had
01:39:37
to put all my weight and shove down on the chest and you know that insecurity about the amount of pressure that you were talking about there's even worse
01:39:45
outcomes for women who have a cardiac arrest because people are afraid of pushing in between breasts ah if the
01:39:53
person's life can be saved when First Responders ared because you bought them time do it it's not fair that women are
01:40:02
less likely to receive CPR from bystandard because of their bodies I
01:40:07
thought because I think again because I've watched so many movies that when you start doing the CPR the person comes back to life it can happen Okay CU I
01:40:14
thought that's what you were doing I thought you were like bringing them back to life that's what if that's the notion that some people have and that's why I
01:40:20
want them to make sure that you're not actually bringing them back to life you're buying them time and circulating
01:40:26
the residual oxygen so that help can arrive to try and restart the heart how long do you have to do what's the
01:40:32
longest you've had to do CPR on someone for and then they've ended up Surviving I've been in um double digits
01:40:39
before for young patients um because young patients we will like if you have
01:40:46
a patient who's elderly who's in the ICU who's already very sick when they're
01:40:52
hard stop the odds are that you'll bring them back are obviously very low but even if you
01:40:57
will bring them back to life they're going to be in a worse quality of life than they already were so many times we
01:41:05
actually have a conversation as the CPR is ongoing with the families explaining that and saying that this is not
01:41:12
beneficial that even if we bring them back they might be in a worse State and that we don't recommend it we actually
01:41:18
have scores and guidelines that we can discuss with patients about statistics on this but when someone's very young
01:41:24
let's say you have a 20-year-old who has an unusual Cardiac Arrest we would fight much longer because they have an
01:41:31
opportunity to heal once we bring them back so it's very dependent on a on a
01:41:36
specific situation and you had to have that exact same conversation when someone was operate when treating your
01:41:42
mother of yep I that was the conversation that was my first interaction with that kind of environment I actually remember um when
01:41:50
I was in the the room and the alarms were going off and the residents or the
01:41:55
doctors were doing CPR and I called it off I remember the next time I heard those alarms was during my training in a
01:42:02
patient simulation lab and that was like the first moment I ever had a
01:42:08
flashback where a sound brought back a feeling where that sound of those alarms
01:42:13
brought me back to how I felt and how uncomfortable I felt I've never felt that before
01:42:24
you must have had that sound a lot since then oh yeah and I've had some difficult
01:42:30
conversations with my fellow colleagues because of it I remember very vividly
01:42:35
when my mom passed away we were in the waiting room waiting for documentation forms to sign and I came out to check
01:42:43
and see if they're finishing up and some of the nurses and doctors I don't even
01:42:48
know what medical professionals they were they were kind of laughing in their little work area in the back now where they were patient facing but hearing
01:42:55
those laughs got me so angry how could anyone laugh during a time like this but then I had to remind myself these are
01:43:01
people too these are people who are losing patients every day and if they
01:43:06
took the loss the way that I'm taking this loss they wouldn't last they wouldn't be able to help my mom or other
01:43:12
moms so I had to remind myself about that but what my take away from it was
01:43:18
when I saw co-residents of mine maybe writing their notes after someone's family passed away and I see the family
01:43:25
in earshot and they're talking about their day or they're laughing or they're giggling or saying some kind of joke not
01:43:30
related to the situation I I just I don't correct them that's not my place to do I just share my story of how I
01:43:36
felt and I thought it created a really good learning
01:43:41
opportunity Dr Mike we have a closing tradition on this podcast where the last guest leaves a question for the next guest not knowing who they leaving it
01:43:48
for if you could go back to a pivotal moment in your life
01:43:54
and make a different decision what would that moment be and
01:43:59
why I think about the social isolation and loneliness that you described that I
01:44:06
felt when I lost my mom and how I isolated myself from my
01:44:12
classmates to this day out of 300 students in my class or
01:44:19
so I didn't make a lot of friends in fact any friends and I was not
01:44:26
involved um I was fully disconnected from my class and I I think it's because
01:44:32
of what I was going through at that time and I wish that um I either reached out for support from
01:44:39
the school or created conversations amongst my
01:44:45
classmates because the friendships that they've created have lasted to now this
01:44:52
is over a DEC decade um people got married in those classes they've created
01:44:58
lifelong friends and I feel like because I moved away and I was two hours away
01:45:03
from the school I wasn't a part of it and I feel like that has significantly
01:45:10
impacted the number of friendships I carry to this day that the friends that I do have are my close friends from high
01:45:16
school maybe some from college but almost none from medical school and I feel like that's a really really big
01:45:22
missed opportunity do you feel lonely yeah sometimes for
01:45:28
sure but I think that's a byproduct of society these days and my work adds to
01:45:36
that as well Dr Mike thank you so much thank you for all of the work you do and the way you do it um you're the one of
01:45:44
the most accessible voices on the internet as it relates to medical information and I say accessible intently because um sometimes doctors
01:45:51
can be a little bit um exclusive they're too smart and they don't really let us in but I think
01:45:57
you're both confronting disinformation in a really honest fair balanced way but at the same time you're providing
01:46:03
information in such an accessible way and um you've drawn a tremendous audience to you across YouTube and your
01:46:09
podcast and across your socials and everywhere else and it's there's no doubt in my mind that you've not just
01:46:15
saving the lives in your practice every day but you're saving hundreds of thousands of lives you'll never meet but
01:46:20
also you're improving so many lives because your health helping us to navigate towards um better information
01:46:26
or a better way to think about the information we receive and I'm on that Journey too I'm doing my very best to try and navigate that and as someone
01:46:32
that sits here with a lot of experts which is your lowest criteria of like acceptable evidence experts and medical
01:46:37
practitioners and I'm doing this two three times a week sometimes there's often conflicting information um I'm I
01:46:44
always struggle with how to present that information because on one hand you don't want to censor people because that
01:46:49
assumes that I know what's right but on the other hand you feel a sense responsibility that the the platform you're creating is is not doing any harm
01:46:57
and I think that's the first kind of principle of anyone that's trying to produce content is doing no harm so Mike you're a prime example of someone that I
01:47:03
see doing no harm and a lot of good in the world so thank you so much for your very much appreciate you saying that it means a lot you know a lot of days uh me
01:47:10
and my team my small team will sit in front of the camera and talk and forget the implications and the outcomes that
01:47:16
uh we can make in the world with the content that we make so that's what continually drives Us by reminders like
01:47:21
what you just said so I appreciate you saying please keep going I know it's difficult some sometimes and I know people do are very vicious I've been on
01:47:27
the receiving end of that for much of my life but I think um you know that I don't have to tell you this but you know
01:47:33
that the net impact of your mission is so unbelievable it's so you'll never see
01:47:40
it you'll never meet the people the families the father the mother the grandfather but I just wish you could
01:47:45
because I because I think if you could see the the net impact it would put all
01:47:50
of that stuff um in in perspective where it should be so Mike thank you thank you
01:47:55
appreciate you having me on [Music]
