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[Music] foreign [Music] people of the internet welcome back to another episode of the waveform podcast we're your hosts I'm Marquez I'm Andrew
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and we have a very special guest today yeah Dr Mike is back I stay back because uh you helped us out with the Dyson video we talked about the Dyson Zone
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headphones and I feel like we've had so many conversations at the studio or even in videos about some health feature or
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some feature of a tech product where I have to preface it by saying well I'm not a medical professional but and then
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I'll just get into whatever I think but it was great to have you actually weigh in and give us proper sound technical
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advice from a medical perspective you know it's funny because I'm a clinician meaning I see patients on a daily basis
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so all of my advice and the way that I interpret Tech and gear comes from that standpoint as opposed to a researcher standpoint I think about the real life utility real life usage which
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drastically is different and then intended use or researcher use yeah we we can do all the research we want but
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sometimes you just got to know how real people like interact with things so we uh we decided to put all of it in one
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place today yeah we've had a ton of interesting random things pop up in the tech World from digital well-being to
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like the Apple watch I'm wearing to like all kinds of Fitness question marks and we just wanted to have you weigh in on
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them that would be fun you know what's funny I get in trouble having these conversations all the time from whom
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from The Tech Community mostly because I am sort of a huge skeptic in this space
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because if something's not proven I'm very hesitant to recommend it to people and I'm very protective of my patients time energy money so I don't want them
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spending money their limited health care Budget on things that are not actually going to improve outcomes yeah I feel
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like this is one of my one of the big things in medical professions is like if it's a PR like FDA approved or if it
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gets some stamp of approval by somebody then you know it's good where with me I'm like trying something new that's not approved yet but I'm like logically this seems to work fine and I kind of have to
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blend those two things together um I mean I also think Skeptics is a great thing and maybe us as tech people
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should be more skeptical of some of these because it's really easy for us to go to an event see all these new health
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features coming out on things and being like well they're the ones doing it they probably know more like we don't know anything about health so even you know
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if if this is not your like full-blown expertise on it like getting your opinion on this I think is a good step
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forward and maybe understanding because every single thing we own now tells you something about your health it feels
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exactly so we've just been doing a lot about it recently and have some questions for you yeah I have a little
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widget on my Mac that shows me how much screen time I've gotten today so okay it's like telling me that's that's a
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good widget what apps I'm using and how much and how much I should stop so we do want to dive into all this
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stuff but first I want to zoom out a little bit just to you said you're a clinician and I want to get the like what is the one minute like elevator
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pitch that you give to people on what you do because when I get asked what I do I have to like process like how much
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of a conversation am I ready for right now what do you say I say that uh at heart I'm a human first then I'm a board
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certified Family Medicine physician which means that I take care of people of all ages um I deliver babies we take care of
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women's health Men's Health the one-year-old of 101 year old so that's my day day-to-day job but then it kind of as my side job I've become a YouTuber
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someone that specializes in media production and now I'm a professional boxer as well because there wasn't enough things of variety it's a variety I mean yeah that's like that's a wild
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list first of all becoming a doctor is like more than a full-time job in itself and then a lot of people especially a
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YouTuber with 10 million Subs like that is also a full-time job if anything like I see Marquez working at this and before
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anyone started here he's putting in 60 plus hours a week so how on Earth and now you're saying boxer as well like how
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in the world you know what's happening uh no actually value sleep very very much right you told me this that's very
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important seven to nine hours I have to hit nine has been rare but I put a priority on sleep I just think I'm
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excited about doing all these things it's all like a childhood dream I feel like I'm in fantasy camp half the time
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how do I get a chance to hang out with you guys being on this podcast how do I get to reach 10 million people with
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accurate medical info debunk something that I see happening in medical Media or then get on stage on Showtime baby
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boxing yeah so if given the opportunity why not exactly yeah right well and then the next day go to you're working at a
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hospital or as a private Clinic I also don't want to dox you on anything no no I work at a Community Medical Center it's all googleable so okay it's very
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obvious where I work and I've worked there since residency actually next year despite being pretty young it's my
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10-year anniversary working there as a doctor that's right I think also I am like 90 sure I was born at the hospital
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that you work no which I think is kind of funny that's pretty sick wow but not young enough to yeah I don't know it was
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more than 10 years ago yeah yeah that makes sense okay I think one of the probably easiest places to start with
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like talking about tech is the Apple Watch the watch anytime first of all you see any messaging from Apple about the
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watch there's always something health related in it and it was fascinating the way it started because Apple kind of
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didn't know at the Apple watch was going to be it was an iPhone accessory but then I don't know will you like send a
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digital heartbeat to your friend or will you like answer messages or get notifications and we threw in some Fitness features and then the world kind
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of figured it out and it just turned into fitness and notifications yep and so every single update to the Apple watch adds some Fitness or health thing
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and they have to find a way to sell it to the public and it gets increasingly more and more like if you don't have
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this you might miss that heart irregularity that you have and this has saved X live so far and here's a a
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letter somebody wrote from the hospital about how it saved their life is this uh okay with you it seems like a
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pretty wild uh way to get people to get something they probably don't need I don't wanna
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isolate the Apple watch in this I think as a tech industry I think what's happening is they've seen the value that
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Health Data has and increasingly the healthcare tech industry is and even the healthcare
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industry as a whole is being run as a hedge fund and to me that's where I draw the line because for example if I tell
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you I created uh let's say I'm going to use this water bottle here let's say I created a grip for a water bottle that
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makes it less likely that it'll slip out of my hands but I haven't done the research to prove that that's the case
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are you going to be mad about the fact that I'm saying that it doesn't slip out of your hand not really right who cares but now what
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if I say the water that I've created inside here cures your depression but I haven't yet tested it it's kind of a
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stretch that's the problem with our current Healthcare Tech Healthcare hedge fund industry okay no one is actually going that mile to prove that something works because that's really expensive
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and a lot of times we'll backfire because it proves that it doesn't work and now you've killed your beautiful
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product I see yeah I remember the electrocardiogram coming to the Apple watch and the entire time I'm watching
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this I'm like I'm gonna have to review this watch and I'm going to test it and I have no idea how to tell if the ECG I get from this
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watch is good or bad or if it worked or didn't work but it'll be the first time I ever do an ECG myself so I guess
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that's kind of cool I don't know how to well I just don't know what to do with it to be honest as a doctor and most doctors don't know
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what to do with it because like the most common use example of the features on the Apple watch is that it'll tell you
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your heart rate's High uh there's a potential risk that you have atrial fibrillation right which is when your heart beats are regularly at an
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irregular rate I meant to show you this oh did you have some I got well I started getting these PVCs these a
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couple nights ago yeah low heart rate and it just tells us is an athletic Flex right here that's because you're a
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fitness hypebeast so I guess it's weird though because it's notifying me of some health thing
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and I'm like is this good bad I don't know sometimes you get a high heart rate notification there's all kinds of things
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do people ever go to you saying yeah my watch told me something is it ever used no joke what's today today is Friday
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yesterday I was in the office uh gentleman comes in who has a history of SVT which is a type of fast heart rhythm
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that exists and he said that after that happened to him once he got an Apple Watch to start tracking when this
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happens but here's the interesting part he knows when it's happening he can feel it he can feel the palpitations he has
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the skills and the techniques necessary how to shut it down and it happens very rarely but he's still got the Apple
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watch now the Apple watch started warning him after he played squash that he would have high heart rates and he
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started getting anxious and then he started getting worse outcomes with his heart rhythms so you see how the tech is
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fire it works it tracks things but what we do with that information is really problematic because until we get some guidance and we gather enough data to actually make use of it more data just
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means more health anxiety more weird interventions that we don't even know if they work or not yeah the magic really
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is in when the watch notifies you and specifically how it sort of gives you and displays the information in a way that's useful yeah because it can it can measure all at once but it's not
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necessarily like if you go through the health app and scroll for a while there's tons of stuff your breath rate your like heart rate over time and all
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these different things VO2 max somehow knows and I just don't know what to do with that information I think it's entertainment purposes only for now the
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the one feature on the Apple watch that I think is really exciting is the fall notification feature yes and you have a
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story of it going off on a roller coaster that's one that's happened to a lot of people
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um but I'll be running around during a frizzy practice and chasing somebody around a field long enough you'll like stumble and you'll get a little
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vibration says are you okay did you follow did you need me to call see that's the cool feature it's kind of a flex though because if you made someone
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fall hard enough I never thought of it you break someone's ankles hard enough that they
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their watch is like are you good bro yeah I'm good yeah I feel like the we keep saying Apple watch because it's the one that it seems to plug it in the most but like obviously pixel Garmin Samsung
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they're all doing it and it feels like they all started focusing on like health and fitness activity tracking first
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um and now they seem to have gone into more of these like afib VO2 max like uh fall detection more things that feel like past I'm trying to live in Active Health style and more like I'm warning
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you about your regular Health style um I kind of wanted to go over like can we split that into two maybe from what
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you said already it seems like a lot of it seems kind of nonsensical but if we can uh not nonsensical I think it's but
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less useful okay and every time we weigh any kind of medical intervention we weigh risk benefit right so if I
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prescribe a surgery a medication everything has risk benefits in fact if something doesn't have a risk that means
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it probably doesn't even work anyway because it has to have the opposite effect if it does something yeah so with
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this Apple watch what I feel like is happening we're getting data very limited benefit of what we can do with
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said data but definite harms that I'm seeing as a result of health related anxiety that's being fueled by all these
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alarms so that's how I make my decisions it's very simplified yeah do you use any type of trackers yourself so for example
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I used to wear an Apple Watch myself and I remember watching a UFC fight and I guess because I've been in the ring yeah I got an alert for the first time that your heart rate's been elevated for an
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extended period of time well sedentary so while watching it yeah that happened to me in hockey playoffs this year I was
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like getting it was just like just so you know you're anxious that I guess makes sense yes exactly you know that's happening though so it's easy to dismiss
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that I guess like for abnormal heart rate and stuff it's more of the times where you're not quite feeling it and
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you get that um you said you've already had it do you think it's stuff like that how much is that affecting you guys in
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the medical field of just getting calls and patients who are like you said anxiety specifically my watch told me
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okay so now we're kind of talking about the anxiety and the non on health important I guess vital disease
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notifications like random like fast heart rate all that but now let's talk about the atrial fibrillation notification because that's the one that
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could actually have Healthcare implications we have no idea what to do with it in the healthcare setting when you get a random alert like that yes we
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can put on a halter monitor monitor you for seven days which is a little thing you wear on your chest it monitors it if
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you have symptoms like palpitations you could notify it so when we re read it back we can go back to the time where
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you press it you had symptoms because a lot of times patients will have some sort of electrical irregularity in their
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heart feel it but then we didn't do the EKG when that was going on so we don't know what's going on so the halter allows us
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to do that but in general when we have atrial fibrillation we have rules of how we decide to treat it how often is it happening we have scoring systems that we use based on the patient's age there
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are other medical history like little factors but if it happens very very rarely and the person's otherwise
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healthy with no medical history which is most of the time what happens when we get these calls yeah what we do with it
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we don't have good evidence to decide maybe we put the halter monitor on but then it doesn't catch anything then the
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Apple watch Two Weeks Later catches something again we still don't know what to do yeah I feel like there's the in
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the keynote there's a classic example of like I got this notification I thought it was kind of weird I went to a doctor the doctor confirmed it this thing saved
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my life yeah and the the the fitness things that we wear have such scale there's so many of them out there that
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inevitably there's a couple of those stories that are real and then when those stories are the display for like
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whether or not you should get the thing it makes it feel like this is something everyone should be looking for it's it's
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a very manipulative marketing tool because look I can say right now let me give you a
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CAT scan every day for the next 20 years and I might be able to catch a Cancer and we might be able to intervene but what I'm not telling you is that I'm also going to be radiating your body
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probably producing all sorts of cancers at the same time yeah so there's there's a healthy balance that has to exist when
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it comes to healthcare Tech where it's like we tell people what it's possible to accomplish but then we have to be
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honest with the drawbacks otherwise it gets into Shady territory yeah do you think there's any type of and if like the doctor Community has discussed this before but
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there's some people who say like obviously all these numbers aren't very accurate but if you follow Trends based
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on numbers that you're getting on things is there like a a best practice of potentially using these to actually not
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just increase healthy lifestyle but also potentially see some sort of Health the health app does
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show Trends Trends but even just like you reading things yourself like I mean I get a heart rate variance every
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morning when I wake up and like that's something when I first saw it I research it and then I'm scared like you said I
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I'm exactly who you're talking about with health anxiety looking stuff up online sometimes I think this really
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helps me sometimes I think this sends me into a bit of a spiral and I don't love it like for example resting heart rate
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the lower the resting heart rate generally speaking the healthier a person is right because that usually
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means they're in great shape this is why this guy over here sits at a 40 heart rate going to sleep um but
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if you are at a resting heart rate of 75 that's considered normal you're healthy and let's say you start exercising and
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you start lowering that the Apple watch will show that Trend over the course of the month yeah but you tracking that
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number is purely foreign purely for entertainment okay because if I as a doctor encourage you to work out and you start working out I don't need the Apple watch to tell me that your resting heart rate's going to go down yeah
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that that's the only time that's really important is if you're an athlete professionally and you're trying to go
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from 99th percentile of success to 99.5 which the huge majority of the general public is not needing these tools but again for entertainment for motivation fine I'm with it especially this Tech
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can evolve and really will become good I think the future is bright I don't want to like poo poo the whole industry I
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just think the way that they're selling it now is premature yeah it kind of reminds me of uh like we were talking to
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the CEO of Ravine where a lot of people will get like this hundred thousand dollar truck and will never use anywhere
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near the capabilities of the truck but the tech and the capabilities are so good that it's like once in a while when
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someone maximizes its use it's kind of amazing uh kind of reminds me of like yeah and most people aren't trying to
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get from the 99 to 99 and a half percentile but the people who are might find this watch Amazing exactly the new
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Ultra has got this like Trail climbing mode and all these other things that like super super useful but generally
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for most of us we're just kind of like oh neat I should probably be okay well it's the same thing with like protein
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creatine supplements like you could take these but if you're an average person and I I mean average even to like a
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higher degree yeah if you fall within 90 of people who exercise if you just focus
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on a healthy diet and focus on the routines you're doing the supplements are going to maybe add
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five percent of improvement and again that's for people who are competing the average person people who go to GNC and
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Vitamin Shoppe and all these and get these things you're doing it for fun yeah you're not really changing much
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that's fair yeah that's super fair I do like I I like how you use the term entertainment I guess it's not something
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we've thought about much but like entertainment doesn't necessarily mean bad thing like no entertainment is a
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motivator as well and like I I pers I used to play Frisbee with Marquez I had four knee surgeries and then had to quit
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that eventually and found my activities like way way down like some minor things and then I borrowed an Apple Watch here
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once and those competitions they do are like one of the most things ever identifying
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Fitness yes it's like that has super helped me get into like a way way more active lifestyle and and that is amazing
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but yes on the other hand like what you're saying like if you're not in that potentially professional athlete aspect
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of things like these things are just like you can look and be like okay cool I did it today I knew that already but
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it's nice to just see it on my wrist there's the same way I'm like addicted to like checking the checkbox like
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closing the ring is like yes that's a satisfying thing look that's the strong part of this app and these tools and the
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motivation of it is exciting and I want people to make use of it in fact when I made like one of my first videos on
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YouTube it was about how to get fit for summer it was like get some new workout gear as a Kickstarter to your motivation
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the one thing that I'll say is because I'm again very research based when you look at research and you see these
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initial boosts of Motivation by getting new gear by getting a Tracker long term they don't make a difference right you
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gotta have a routine and get into something it's a lifestyle change or you just need to keep buying things which is
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I've fallen into that whole way too many times yeah new hobby new shoes new everything yeah
00:19:41
thank you thank you support for today's episode comes from Shopify selling things can be complicated even if it's just a pair of shoes and I say that from personal
00:19:53
experience since I just released my own line of the sneakers the two five ones I mean they're just sneakers right but
00:19:58
athletes come out with new ones every year no it's tough sizing durability materials I never expected that creating
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a quality shoe would take as long as it did but it did take a long time and I'm glad the final result shows the effort
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00:20:54
to quickly touch on like obviously covet changed the world and there was a lot of uh attempts at responses from tech
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companies to try to make something that's for this sort of new covid world and this sort of exact example came up
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there's a recent leak and this happens a lot of a new pixel phone okay they get leaked all the time pixel 8 and the leak
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was that they would have a new uh sensor on the back that's just a thermometer oh
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just a thermometer and there's this glyph that was just like a person holding it up to their forehead like
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this and like moving it around their Temple to take their temperature and like hitting the button and reading
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what do you think of this is this is this too little too late should people actually use this for anything I mean it's cool because I know a lot of times
00:21:36
there's like events we'll hold up the thermometer to your forehead and just like beep uh it says 94. okay that seems fine you're good I mean 94 is a little
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weird it's the surface though I've never had it say 98.6 oh really because it's just
00:21:50
like that the ones that we use in the hospital are really good do they say exact because isn't that your core temperature not your like surface
00:21:56
temperature these like I don't know how they work they're really accurate maybe they're calibrated differently I don't know interesting they're really really
00:22:01
accurate okay I kind of we're scared do you think a phone has any shot yeah or is that like a step too far inside of my
00:22:08
expertise I mean like where my clinicians yeah yeah there's probably some questions we're going to ask where
00:22:13
we think like you know literally everything about everything related memes I have a wide of wide
00:22:20
understanding and we're trying to like dig deep on some random things like this reminds me of I was with
00:22:26
um I had the same thing David Blaine did this insane project where he was gonna hold on to these balloons and Ascend up
00:22:33
to 10 000 feet or something crazy maybe it was more than that just holding onto the balloons which of course means the
00:22:39
atmosphere gets thinner there's lots of oxygen in the air it's colder and he did this whole thing where he like floated
00:22:45
up the top and then was gonna parachute down to the ground and I was sort of helping him with the behind the scenes
00:22:51
and the broadcast of it and at one point he asked me like so Marquez the Apple watch has
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um it has like a heart rate thing in it it's got like your VO2 max and it seems to be able to understand if you're hypoxic like if your blood oxygen goes too low do you think I should use my
00:23:07
Apple watch to know if I'm going hypoxic or if I should get a dedicated like reader and my first gut reaction was
00:23:13
like do not trust the Apple watch just get the thing that's supposed to do just blood oxygen and that's probably that's
00:23:18
good advice um but it was just just curious I like the watch totally has a tool that'll
00:23:24
tell you oh yeah you're at 9 000 feet and your blood oxygen is at 95 instead of 100 and you might be going hypoxic
00:23:29
right now so probably grab some oxygen and that's just a thing that it can do wow so there's a variety of things I
00:23:36
would still go with the safer if it's in a life or death situation it seemed like that was life or death it didn't seem
00:23:42
like watching the broadcast that he could buy possibly die but in that moment of recommending the tool I was
00:23:48
like I also don't even know like this is why it's very dangerous to give advice in
00:23:53
situations like that yeah for example the way that these tools work is they work through a sensor of seeing color of
00:24:00
uh your blood flow going in and in and out that's even how the iPhone sensor Works who knows if you're when you're
00:24:06
that high are those sensors calibrated for that height I don't even like do they work the same way on ground level as they do up there I don't know I don't know if the color changes when you go
00:24:17
higher like that's crazy I think we assume that like Apple has infinite money and can probably test
00:24:25
in infinite scenarios like hopefully they've done enough of this and like this is very much benefit of the doubt
00:24:31
for like this one particular company but like hopefully they've tested it and hopefully it'll work in all the scenarios we think it should yeah but we
00:24:36
just don't know or they can provide anecdotal evidence in an event that shows one person having their life saved
00:24:41
and that's way cheaper and it will sell way more fair yeah have you heard of a whoop yeah do you do you think it's good or better than I in most cases recommend
00:24:52
against it interesting I'll tell you why you know it gives you like this score of how well you're rested you are and all
00:24:59
that stuff and the score is probably reliable but you know what's even better to learn and is equally as reliable how
00:25:06
you feel and you know why that's better than the the phone and the score I mean the the app on the phone and the whoop itself because if the whoop tells you you are not well rested
00:25:19
even if you are well rested you're going to have worse outcomes yes isn't that sick I can attest to so
00:25:25
my watch has body battery on it and I was going to ask you about this as well it's similar to that and I found it I
00:25:32
started using I finally started sleep tracking and like I would have days where I'm at 100 body battery and I'm
00:25:37
like I'm going climbing tonight like I'm gonna have a great session and I had a great session then the next week it's
00:25:42
like you didn't sleep that well your body battery is like 40 you know I get there and I do terrible I was like was
00:25:49
that me or was that actually was it close to it like doing well or did I just totally this has been tested so the
00:25:56
way that they tested this is they had people sleep um and they fake tracked their sleep and
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they would tell them that they had really bad quality of sleep or really good quality of sleep and even the
00:26:08
people who slept and had bad quality of sleep they performed better when they were told that they had great quality of
00:26:14
sleep and the people who slept great and we're told they had bad quality of sleep perform worse wow yeah okay so I'm just
00:26:22
gonna make a wearable that tells you every day you had great qualities so you know companies are doing this and you know which companies are doing this
00:26:28
dating apps uh okay Cupid is run or at least was started by mathematicians and they said that if we tell people they're at higher match percentage then they really are
00:26:40
the odds of them ending up with people is higher and they'll be happier more satisfied and they started doing it and
00:26:46
it freaking works that is a really fascinating example because that's such an opinion like you
00:26:51
don't know no one knows I mean and if it turns into a happy relationship it's also hard to argue against it as well
00:26:58
yeah it's weird and it's taking advantage of people but it's yeah it's insane but that's the kind of
00:27:04
tech thing that kind of gets me scared with AI because when they start leading in those directions I'm like ah I mean
00:27:10
you just segued kind of perfectly into the next segment of things I think we wanted to talk about which are like
00:27:16
generative generative ai ai chat Bots I know you can I can I make one statement about the final thing about it sure yeah I just think it's it's very valuable why I also want people to uh
00:27:28
know on their own when they're feeling tired or maybe had worse quality of sleep is because learning about your body and perception accurate perception
00:27:39
trying to be as objective as possible of how you feel goes a long way to having Better Health outcomes knowing when
00:27:46
you're sore versus injured knowing when there's a true injury or pain that needs
00:27:51
to be addressed those things are so important when it comes to like long-term health related outcomes that
00:27:58
if you don't learn that and you trust your phone to do it for you you're actually missing out on some really good health benefits I think what I'm
00:28:04
realizing is that and I'm putting this thought together in real time that most people go about the data in this
00:28:10
well-being like kind of backwards like you should start with the foundation of how you feel and then maybe on top of
00:28:17
that you can use this sort of quantifying measures to sort of better understand things where I think some
00:28:23
people want to start with oh it's a computer it must know me best but it doesn't it doesn't and then they try to
00:28:28
make make the balancing on top of the computer's numbers when you should start with really just how you feel so it's kind of backwards yes the simple analogy
00:28:35
here is we have calculators but we still learn how to add and subtract so yeah we
00:28:40
still need to learn about our bodies before we start using these apps Fair that's so great GPT
00:28:47
I'm gonna ask chat gbt all the things I don't know no this is okay so the other version of this because we talked about
00:28:53
like okay a patient comes in and they saw a notification on the Apple watch have you ever had a patient come in with
00:28:58
a diagnosis from some I'm sure not just online but like an AI chat bot or something like that you're sort of wondering okay because this is gonna happen I'm pretty I feel like that will happen I mean maybe they have and they
00:29:11
just haven't told they didn't tell you yeah they're not I mean I'm sure you have plenty of WebMD people like I know
00:29:16
I've been that person before and I always feel bad being like I read this online and I'm I don't want to admit it
00:29:22
but that's half the reason some people are like you and that they admit it some don't but I make it a routine question to ask a patient unless it's very straightforward what's going on what do
00:29:33
you think is going on because if they read on WebMD let's use a basic example like a cough a patient
00:29:39
comes in with a cough I'm making the diagnosis I'm like it's not bacterial I think it's viral they don't need antibiotics but the patient went on
00:29:46
WebMD and thinks they have cancer and I go on this long spiel about why it's not bacterial and why it's viral and then
00:29:51
they leave and they're leaving dissatisfied because they don't know if they're not they have lung cancer I missed the opportunity to actually help
00:29:57
the person I wish every doctor would ask that I I've you've made me like not like
00:30:03
most of my doctors after that I'm gonna have to start coming together or something like I just wish yes that's such a simple question to ask that I'd
00:30:10
appreciate because it also sometimes patients won't tell you a little detail or you won't ask the right question and
00:30:15
then by them saying I think it's this I would say oh but I don't think it's that because you don't have symptom X they're
00:30:22
like actually and I'm like whoa now I know what's going on interesting yeah yeah and I've seen so there's a number of stories of uh you know maybe an AI tool helping to diagnose something
00:30:33
faster than a human would where here and this goes all the way back to like when I was in school there was a classic
00:30:39
business story of you know some dad shares his Amazon account with his daughter and he starts getting
00:30:45
recommendations for diapers and he's like why am I getting these this doesn't make sense and like Amazon knows that
00:30:50
the daughter's pregnant before the dad does and it's because these algorithms are really really good at pattern recognition and finding things often
00:30:56
better than humans and it seems plausible that an AI tool could start to identify patterns maybe even in the data from the Fitness tracker and actually find some diagnosis that's helpful
00:31:09
before a doctor could is this a future that worries you as a medical professional maybe it's taking a job or maybe it's a good thing that it's better and it can help people find things
00:31:20
faster I don't think it's good yet and I think it's really far away and I'll explain why if a problem is that hard to find and does not present itself
00:31:31
treating it will likely yield more negative effects acts than positive okay because that means it's not that big of a problem right if you have a legitimate problem like with your heart rate you
00:31:43
will know and if you have no symptoms and it's not really affecting you and I to dig into your data to find a few
00:31:49
heartbeats here and there giving you a medication that has legitimate side effects that I know will have side effects yeah probably won't be
00:31:55
beneficial yeah so that's why I'm down on it I think the the one version of this that is outside of that funnel is
00:32:02
like specifically cancer and things that it matters how early you detect them sure so potentially detecting something earlier than a human would yeah maybe in its absolute beginning which is ideal so
00:32:13
that is also really tricky because I I think that is doable but and I think we need to use our AI tools to improve our
00:32:21
screening methods for example we have really well proven screening methods that we use for example with a cervical
00:32:28
cancer we do pap smears when we do pap smears we've essentially eliminated uh cervical cancer deaths in women that's like amazing that we've been able to do that obviously there was the HPV vaccine
00:32:39
as well that has helped because the HPV virus actually causes cancer one of the rare viruses that does that and the
00:32:45
vaccine prevents that so we have screening methods that we use that work well in Catching cancer and addressing it and all these things but then there's ones that are screening
00:32:57
methods that aren't great that actually catch too many false positives they catch too many cancers that are actually
00:33:02
never going to become a problem that we in order to intervene by doing a biopsy or something we actually create more
00:33:08
harm we fuel health anxiety so it's a very thin line of that balance of when do we screen healthy people and when do we not and I think AI tools can improve
00:33:19
our screening methods okay but will they be the final answer for everything probably not yeah there's still a human
00:33:25
element of like figuring out when to apply certain things that makes a lot of sense I'm sure and I feel like it's in I
00:33:31
feel like it'll never I mean and that's coming from someone on the outside I can't imagine it ever taking over even
00:33:36
just like General you have to have like General bedside Manner and stuff like it's also nice to just be able to talk
00:33:41
to a physical human and they're interacting much closer and I know these chat Bots they're getting close to like
00:33:47
a full-blown conversation but but then you're also you think eventually it'll get there do you see the path to getting
00:33:55
there becoming a burden on kind of the medical community for a while Maybe not maybe burden's not the right word but
00:34:02
like pressure or something right yeah and not even like influx of more people coming up kind of like the WebMD problem
00:34:08
of I think there's a world where that happens uh I also think that when you look at Ai and we see how right now everyone has this fear of AI taking
00:34:19
over and then you have people reminding the general public AI is very narrow focused and what it can do it does one
00:34:26
task very well like chat GPT gives you written stuff other ones give you AI generated images other ones do a voice
00:34:33
and right now they're very set in their tasks so I think in that narrow space AI
00:34:38
could be really good because we could train it to do some of the more mundane tasks find patterns analyze data to help
00:34:45
us improve our screening methods when we should screen when we should not for that kind of data analysis I think that
00:34:50
will be beneficial do I think AI can fully replace a doctor for now no because it would have to a be not as narrow the human mind what makes it unique is that is the opposite of narrow
00:35:02
it's so Broad and can do so much yeah and the relatability you know the fact that you know is important yes yeah so
00:35:09
it can fake as being a human but if you don't have that relatability and you don't buy in yeah yeah God that is that
00:35:16
is a whole can of worms of like well can an AI fake being a human so well that you don't even know that that's that's a
00:35:22
that's another that keeps me up at night yeah do you think there's on this side of rather patience using like chat Bots
00:35:29
doctors using tripods because you see it being a potential tool in the future for and now maybe this is me thinking about
00:35:36
like house a little too much where he has to have these full-blown conversations of like it might be this this let's check the symptoms and maybe
00:35:42
that's not what every doctor does essentially but could you see it being a tool of you trying to think of something
00:35:48
and using it as just something to bounce ideas off yeah I just think it needs to be very well validated and that's going
00:35:53
to be really expensive to do that's that's the tough part about the AI tools right now because they just make stuff up yeah like we were talking about just
00:36:00
like if you're an expert in a field and you ask AI tool like a very basic question then you can vet how good or
00:36:06
bad the answers are yeah and as someone who's an expert in like Tech stuff we'd ask it a basic Tech question and get an
00:36:12
answer where we're like oh that's not great that's not a great answer so I you know the other answers
00:36:18
and other things I'm not an expert in seem very valid but I have no idea of knowing if they're actually good I mean
00:36:23
it reminds me of an instance that I had when I was in my medical school training I was working at Coney Island Hospital
00:36:29
and I was working alongside one of the top cardiologists we walked into a patient's room I knew the patient well
00:36:35
because I examined them in the mornings before the doctor does their rounds and the doctor comes in gives the correct
00:36:41
diagnosis the perfect plan lays out even like some options if the patient doesn't want to do plan a there's a plan B
00:36:46
perfect like everything's awesome they walk out of the room the patient looks at me and goes what do they say
00:36:53
no no connection there but the information was accurate yeah it was easy enough that I understood it but not
00:36:59
on a level where they connected right so Cad and AI not only be not as narrow as
00:37:04
it currently is but also be able to absorb patients body language the way that they're interpreting data can they verify that will people have the buy-in to do that there's so many factors I
00:37:18
feel like we all knew nuke each other before that happens I'm just like I think it's possible I think these could
00:37:23
all be inputs into the system obviously it's very difficult and it's a long way off yeah but uh there's there's all
00:37:30
these AI tools of like all right you want to be able to summarize a book or a medical paper we train it on that data specifically and then it can give us accurate answers which are verifiable to
00:37:42
the thing it's trained on and so if you wanted to create some magical let's say cardiologist AI doctor you would train
00:37:49
it on a hand selected by people like you set of medical papers that have good information and then maybe and it's good enough to give answers that are up to
00:38:02
par with what a cardiologist would have said and then it also gets all the information of like okay it's got a
00:38:07
camera so it can read your body language as it's giving you information this is all very far out but I'm just picturing like Tesla POD at the bedside like I can
00:38:14
see your heart rate is high here's what I will talk about anxiety at the doctor's office of Tesla yeah maybe you
00:38:19
don't do maybe I don't do Tesla bot that's a little that's a little far out maybe Wally I see what you're saying and I see a world where it's possible I just
00:38:26
think that there's so many barriers and there's so many ways it can go wrong before we even get to that point that
00:38:32
I'm super skeptical that we get there I don't know maybe I'm wrong and there's can I throw out an interesting medical AI story that came out I think last week
00:38:46
yes um there's a scary half and a benevolent half and I'll only share the benevolent
00:38:52
um but a lot of pharmaceutical companies are using models right now to uh predict
00:38:58
toxicity in uh like analogues for drugs so if what they'll do is they'll take a drug they know works and then produce 40
00:39:05
000 different variations and have an AI say oh no this one's going to block this receptor and we can't have that and
00:39:12
stuff like that the flip side of that is that the same a team of researchers terrorism yeah a team of researchers
00:39:18
like to see if it was possible flipped a few line of code and just had it make different poisons for six hours yeah
00:39:27
and that that's actually so much less worrying to me than what I thought he was going to say as funny as that is
00:39:33
poisons whatever you got to ingest the poison that's true but now what about a virus that uses your own body to
00:39:39
replicate that we can now program using AI to be the most infectious to be the most lethal that only affects certain
00:39:46
genetic types yeah holy yeah that's like yeah we're talking about these hypothesis talk about bioterrorism unfold display there was a headline
00:39:56
recently actually today that uh neuralink yeah the first approval to do human testing and it's really funny reading the comments because half the comments are like I would do it yeah it
00:40:09
seems like a great idea like this Elon guy is pretty smart I feel like I want a computer in my brain and then the other half were like I would never be first in
00:40:16
line yeah for human testing like we've seen first gen Tech products for so long like if you've seen like the first gen
00:40:22
iPhone the first gen folding phone do you want the first gen iPhone version of a human brain implant not really uh but
00:40:29
I'm curious where you where you see this I think a lot of times when it comes to these really
00:40:36
borderline ethical medical experiments because when we do medical research they have to go through a process known as an Erb which is an ethical ethics review board and I actually was a member of one
00:40:46
of these when I was a student and they have all sorts of people on them teachers doctors non-medical people
00:40:52
business people so that we get the general gist of is this project ethical to go and using crispr as an example
00:41:00
it's pretty uniformly country to Country agreed upon that this is an unethical thing to test on humans unless they have an illness that is lethal and they will
00:41:13
not survive so that is why when it came out that I believe it was in China they were doing
00:41:19
some crispr Gene editing yeah on um an individual to see if they can cure HIV we found that in the International Medical Community to be really unethical because HIV is no longer a
00:41:30
life-threatening virus we have medications for it so the fact that they were testing it on that virus we found
00:41:35
to be very unethical and when it comes to neuralink unless you're implanting this in someone who desperately needs
00:41:42
whatever I don't even know what the hell this thing is I have no idea then I don't know who would be first in line to
00:41:48
get this thing yeah I don't know enough about what neurolink is designed to be but it seems from what I've read to be
00:41:54
more of a add-on than a solution it's and they've to be fair they've said like lots of like examples of it like helping a paralyzed Mouse to be able to walk again and like there's really cool
00:42:06
possible examples of it being a solution but clearly not everyone needs it so it's kind of weird for just like regular
00:42:12
healthy people to volunteer for a brain implant they probably don't need need so that's kind of how I see it and I just
00:42:18
wonder like why there's so many cool experiments like that going on I remember I was in Israel learning about their biotech stuff and they had for people I believe that had Strokes or
00:42:30
traumatic brain injuries where they needed to regrow neurons and they were literally using
00:42:36
electron fields or magnets or something to try and regrow these fields in order to create Pathways for neurons to Fire and I was like this is so above my understanding that this could
00:42:49
potentially work but at the same time could this kill someone because this girl like I don't know anything about it and we need to be really careful about
00:42:56
again there's promise and a lot of stuff but then we've got to talk about the negatives because if we don't we can
00:43:03
really get in trouble in the world sector of things and causing more harm when trying to cause good yeah there's
00:43:08
that classic line when good intentions cause bad outcomes I think we need to be more cognizant of that these days
00:43:14
because we're very good at being PR people for our stuff yeah like look at all the good that I'm trying to do but
00:43:20
could there be bad outcomes from the Jurassic Park your scientists were so preoccupied with whether or not that
00:43:26
they could that they forgot to think about whether or not they should yeah it's a pretty with high power comes
00:43:32
great responsibility powerful line we've been throwing a lot of products that you that we that we review a lot is there
00:43:39
anything in the tech slash medical or just healthy lifestyle aspects that you're excited about these days I am
00:43:46
excited about improving things that require calculations because we as doctors hey we don't have
00:43:52
time and B we're really bad at doing these calculations or we forget to do them in a lot of cases and if I could
00:43:58
know right away which patient would benefit from starting a Statin which is a cholesterol lowering medication uh when I should start it on them based on the calculations that already given to
00:44:09
me from analyze data of you know millions of patients that's going to lead me to give better medical advice
00:44:15
genetic testing is still not there yet for for like General use for us at home I'm like really negative on people taking genetic tests at home you're talking about like 23andMe stuff like
00:44:27
that yeah like I don't even want to individualize companies yeah I think it's problematic for so many reasons we
00:44:32
could even get into it later but in the future I'm really excited about finding out which patients of mine based on
00:44:39
their DNA would benefit from one antidepressant versus another instead of having me experiment with them and get a
00:44:46
subjective answer when they may have just had a week and they're actually not getting the best medication it gets
00:44:51
really messy that way well uh you said we could get into it later do you mind saying like what why you're generally
00:44:58
against at home genetics yeah so a they're incomplete okay so when you go to see uh a proper geneticist and you go to a genetic counselor what they do is they do the the most validated tests the
00:45:12
tests that are testing for all different variables of a specific illness and then they give you guidance based on what we
00:45:18
know of the data and what we don't know and off of that you could make some decisions for your health but when you
00:45:23
get these at-home tests they're like oh check if you have high or low risk for developing diabetes later in life
00:45:29
what do you do with that data what do you do when you find out you have low risk for developing diabetes do you eat
00:45:35
sugar more tons of it but like that's bad that's not good advice because your body your life is not just about
00:45:41
diabetes there's it's unhealthy to eat a ton of sugar not just for diabetes yes yeah or the more like a pronounced one with Crimson Chris Hemsworth situation people are getting tested to find out if
00:45:53
they're going to develop neurologic diseases early in life like Alzheimer's what is the use of finding that out yeah
00:46:01
there's no intervention in the future maybe and when I say no intervention like yes eating a healthy
00:46:07
living a healthy lifestyle all that can mitigate that risk but do that anyway you can just do it yourself timers but
00:46:14
for literally every other disease it just tells you every time like if you if you don't develop a healthy lifestyle
00:46:21
quickly it's going to go downhill for you and it tells that to everyone everyone starts developing a healthy lifestyle and everyone's happy this is
00:46:27
the argument that I have with some of my friends they're like I should get preventive MRIs to catch things early
00:46:32
because then we could prevent certain problems and I'm like but all you end up Hearing in most these cases just like
00:46:38
live a healthy lifestyle I'll tell you that for free yeah and even that is a little bit more complicated because it needs to be individualized what that means for you based on your values your culture your government what access you
00:46:50
have I mean so many different variables but it's the same thing for everybody yeah I agree do you see any um current
00:46:59
consumer-based Tech that you could see so like you could see helping potentially like a more healthy
00:47:05
lifestyle becoming more active like one thing I kind of think about is VR and kind of video games that are
00:47:10
incorporating more activity rather than sitting at a chair all the time like do you think that there's some minor
00:47:17
benefits there of getting someone up and moving around a little more than I mean theoretically yes okay and while I'm
00:47:25
usually very evidence-based by looking at the collective randomized controlled studies that's the gold standard I'm going to give you anecdotal research
00:47:31
that I've done sure everyone that I've ever met in my life that got a VR product used it four and a half times
00:47:39
and discontinued Samsung it's like yeah I can't argue with that I mean so it's it is more
00:47:46
about developing habits than it is finding a quick like uh Gadget to help you do something I think that's the ultimate takeaway when it comes to health because there's such a homeostasis between
00:47:57
acid base hot and cold like that thin line exists and it needs to be balanced so carefully that there's no quick fix
00:48:03
because any Quick Fix is going to come with a quick downside also yeah I guess it kind of goes into what you were
00:48:09
saying before about getting things that feel like a motivator VR is just turning into another one of those like I'm gonna
00:48:15
get a two-week stand I mean like listen I played beat saber non-stop for like two weeks and then that thing hasn't been plugged in the caveat is inside of
00:48:22
beat saber there's some sort of gamification that makes you want to come back every day like closing my rings on the watch like if there's something like
00:48:28
that yeah like if it creates a community around it where you go to tournaments it's well thought out it could exist it
00:48:35
absolutely it's the same with relationships I mean I'm sure you've seen in your personal lives whether for yourself or others any relationship that
00:48:42
starts super hot and they're in love day one yeah that's you need I'm gonna I'm gonna let it the gimmick at the beginning yeah exactly that's fair that's usually lust and if you're lusting after your VR odds are you're
00:48:53
not going to be continuing it or you're down the line this episode of waveform is supported by Factor if you're trying to say money on takeout this summer factors got you
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Wave like Surf and search all right I got all the lightning round for you okay I want to throw a bunch of
00:50:19
small Tech related medical Concepts or maybe just Medical Services Tech or like uh people in the tech World their
00:50:25
lifestyle choices maybe unhealthy habits stuff I'm wondering about uh first one is David has a water bottle that like tracks how much he drinks every day literally like the battery can die on his water bottle it's hilarious how much
00:50:37
water should we actually drink every day it's individually dang it decided first of all I'll can I
00:50:44
judge the water bottle uh uh I wish we had it no you're not meaning judge it like like oh yeah tell you what I think
00:50:50
about it yes yes please I think you've evolved as a species for millions of years and no one's ever been like uh I mean not no one I should be careful here
00:51:02
99.99 of individuals know when they're thirsty and you could just use that as a gauge okay
00:51:07
um if you fall into this rare specific population that maybe you're taking a medication that makes you more
00:51:14
thirsty maybe you're uh have ADHD and you're taking Adderall and that causes you to forget to drink or whatever it is
00:51:19
then maybe it's a tool that works but the huge majority of people gimmick it's not eight eight glasses or
00:51:26
whatever every day no that's just made up 10 gallons every time if you're trying to be I guess like medically
00:51:32
sound about it you would look at your urine and you would aim to have a straw colored urine okay so like pale yellow
00:51:37
there and whatever that because again if you go outside and you run and it's hot you're gonna need more water than if you
00:51:44
sat all day inside and if you have a higher body mass and more muscle again there's different variables eight glasses is so Random we have yeah we
00:51:52
have healthy water drinking habits at the studio well we can't say that one last time it came here we had no water bottles and like 12 cases of Red Bull in
00:51:59
the kitchen somewhat somewhat okay this might have a similar answer but how many hours of sleep should I actually aim for
00:52:06
yeah adults seven to nine seven to nine and it's not just the number of hours it's consistency of those hours and even
00:52:14
more so the consistency of which hours would you value a sleep score that can just like do the calculations for how consistent you're being and how often you're hitting those targets I feel like
00:52:25
most of them like that why well I don't necessarily know if I if I am hitting the same yeah you
00:52:32
do fall asleep yeah are you are you tired when you wake up in the morning am I tired when I wake up I feel like we're getting to the point where I can answer
00:52:39
for you because it like I know how you're gonna answer half of these questions you know like yeah it doesn't make your
00:52:46
life better to know is my question no yeah not really can I ask a question on the consistency part of that sure So
00:52:52
when you say consistent you mean it is seven to nine hours every day every week not
00:52:58
I'm doing six hours this night and then correct nine hours there's no like making up for that sleeping ideally you find the number of hours that works for you and it's by the way different for everybody sure sure
00:53:09
um Matthew Walker uh who's a sleep expert like he's kind of the Sleep Diplomat I think that's his Twitter
00:53:15
handle he was on my podcast and uh we talked about he has a book called why we sleep really interesting book highly
00:53:21
recommend it he not only talks about that the hours need to be consistent that if you're sleeping from like 11 to 8 sleep 11 to 8 every night okay so the
00:53:29
number of hours and which hours is very important weekends sleep the same and if you don't it's gonna get messy
00:53:36
but then there's individuals who some people are night owls some people are mourning people but then there's also
00:53:42
people in between so not everyone is actually designed by nature to sleep at the same time and our society kind of
00:53:50
makes that unfortunate distinction that everyone needs to sleep at the same time yeah and that's not the way nature
00:53:56
intended it because nature was meant to keep some people up at night maybe to watch over us while we slept so there's
00:54:02
like that's the theory of what's going on and what has happened I was just reading a great book on the way here called sapiens through audible not reading and driving
00:54:13
um and there was a part that just played that is very applicable here back in the day the Shoemaker would make
00:54:20
the entire shoe so if the Shoemaker came late to work no one cared because they could keep making their shoes and
00:54:25
they'll be fine but now in the assembly line in the Industrial Age if one person does not show up exactly on time the
00:54:32
whole system falls apart so it made everyone have to come to work at the same exact time it created public
00:54:38
transportation that needed to bring people at the exact same time to work but humans are not all the same and as a
00:54:44
result it kind of has some negative implications on us what's the word for email this word when normalization no we
00:54:51
have like a when humans used to have a tail but now it's just like oh yeah yeah we don't need to all wake up at the same time okay I like that uh blue light glasses dumb or actually smart uh for
00:55:06
what 100 but I think most of them there's a whole bunch of all this research that I read that I keep hearing in these type
00:55:18
presentations about how oh the longer you see blue light into the afternoon hours the more your brain is tricked
00:55:23
into thinking it's the daytime and it makes it harder to go to sleep that's true there's either blue light glasses or your phone will have some mode where
00:55:29
it stops showing you blue light after a certain hour does this actually make a meaningful difference yeah most blue
00:55:34
light glasses are not blocking enough blue light to make the the difference between
00:55:40
impacting melatonin which is your sleepiness hormone that your brain produces throughout the day so
00:55:46
um closer to the night rather and they're not really as effective but traditionally blocking blue light or less exposure or blue light close to bedtime is ideal because you want
00:55:57
maximal melatonin to get sleepy at night so that's that's true most blue light glasses are not even great at doing that
00:56:02
that's number one number two the thing that pisses me off about blue light glasses they lie when you go on their
00:56:07
websites they say that they help with eye strain yeah they do say they do not do anything blue light is not why you
00:56:14
have eye strain you have eye strain because you stare at a computer without blinking and your muscles are tired yes
00:56:19
and you need to every 20 seconds look 20 feet away every 20 20 minutes I was gonna say 20
00:56:25
seconds every 20 minutes look 20 feet away for 20 seconds that's the rule up your eye straight not the blue light glasses so you're saying the 240 razor blue light glasses I just got are not worth it depends what's worth it too if
00:56:38
you want to block some blue light at night before you go to sleep maybe they make me look really dumb if you're
00:56:43
editing I'll say that that sucks because then you can't get a good color perception of what you're looking at I fully agree I will not wear them all
00:56:50
editing we talk about that with like the phones or computers because there's a lot of just like screens that will then like reduce blue light but then yeah I
00:56:56
talk about how mine at ten o'clock and you're like how am I gonna edit a Instagram picture my Instagram picture's
00:57:02
gonna look blue when I post it it's crazy um when will people stop talking about cold plunging
00:57:09
I don't know this is like a I've always I don't want to say it's Andrew huberman he definitely got people hyped on the
00:57:14
cold water immersion thing yeah I I will just say like again like lose the Quick Fix as they don't exist it's this is
00:57:21
hilarious because we're in an industry right where we can sell things and all the things in my industry that I can sell I'm poo pooing supplements Health
00:57:32
Tech every sponsorship I can get what we want to eat that's what we would like to hear though about them by the way this
00:57:38
doesn't work um it just like if you love it enjoy it like do it as a hobby you know what I'm saying I'm not gonna go out and say like soccer is so much more healthy than uh tennis or something like it's whatever you want to do yeah that's
00:57:50
what's happening it's like if some doctor comes to you and is like yo you're lifting you need to be crossfitting because it's
00:57:57
so much healthier it's like leave that guy I mean like there's no here's why maybe their research will tell you
00:58:03
something that's true but here's my take on it life has so many variables there's
00:58:08
so many things that can go wrong that are outside of our control thinking that you now have the grasp of control by
00:58:15
doing one sport or another going to this water temperature versus it's ridiculous yeah it's really it's it's a fake
00:58:23
version of reality thinking that you have that much control that if you go five minutes into 65 degrees versus 63
00:58:30
degrees come on yeah you're allowed to do it without posting about it by the way that's possible
00:58:35
um I have one that's uh I wish I had a quick fix but like you said probably there isn't one and a lot of us nerds
00:58:42
deal that you can probably tell me right now poor posture okay and do you have any
00:58:48
tips on how to improve that or like how much is this how am I destroying my back over the years of playing games yeah one
00:58:55
never buy a posture corrector those straps that you see on tickets I've had in my car multiple times and I just
00:59:00
stopped it's like the thing that you drink no no it has like a it's like a back brace thing that like strains out your back but it's actually terrible because the purpose of having good
00:59:11
posture is that your muscles naturally keep you in a healthy posture but by wearing this thing you actively weaken the muscles that you're supposed to be
00:59:17
training for good posture oh I had this exact I had a mini version of this with my feet because if you have plantar
00:59:23
fasciitis that's kind of like the arch yep was fatigued so I felt the need to wear arches that would support it but
00:59:29
then that weakens the muscles and I was like conflicted on whether or not I should do it plants are fascia is not necessarily a muscle but maybe there's
00:59:35
some other mechanical thing happening I watched a lot of YouTube videos but yes yes you're probably right yeah
00:59:42
so I ended up uh designing my own shoe for two years and now that helps okay well that's that's what everyone should
00:59:48
yeah it worked out yeah so I will say being in an unhealthy posture for a long period of time which is what we do at work is not ideal so you want an ergonomic good position but the idea that posture is to blame for all our
01:00:01
problems is overstated okay I like I've I've found myself attempting to fix it I
01:00:06
found myself noticing it more often I've yeah doing the exercises strengthening certain support muscles finding out where you're weak all that's very important like incredibly way more important than any Quick Fix than
01:00:20
anything you can do yeah I hope one day one day I will be like I think I spent the whole day in a nice posture that'll
01:00:27
be my crown scripture you know that by the way my number one prescription to physical therapy yeah yeah
01:00:35
for sure uh which is a this doesn't have a real answer but I just want to see what you say which is a worse Vice oh oh
01:00:42
I like these would you rather or sugar this is from someone who in excess in uh I guess in that can we talk about
01:00:54
habitual caffeine versus habitual sugar but like I can eat 10 grams of sugar I can eat five dollars like you know what I'm saying right like overeating sugar or over drinking caffeine
01:01:07
can we can we how about let's go can we know that cup of coffee yeah because coffee is 400 milligrams per a day that we say that you should have versus sugar
01:01:18
I don't know what the exactly versus a tall glass of orange of fruit juice with every meal wait wait say the first one again what's the coffee number cup of coffee every
01:01:29
morning okay or or a full glass of fruit juice with every meal so that's maybe 20
01:01:35
grams no it's more than that way more than that 40 grams orange juice has a ton of sugar in it yeah it's basically
01:01:41
soda without the carbonation yeah what I'm asking is is my advice of sugar going to kill me faster or slower than the one I'm avoiding which is caffeine um you for you I'll give you this is not
01:01:53
individualized advice because I'm not your doctor I'm going to say all the medical legal things but what I will say is none of those matter to your health
01:01:59
long-standing especially because you participate so actively in sports you have a higher glucose requirement than most okay so I'm fine
01:02:11
and also you can drink coffee I mean again I don't know your lab values that's why I can't give you the advice as you're a doctor but like if you're
01:02:17
everything's fine and you're an athlete and you drink orange juice for all your meals you're fine
01:02:23
but now if your BMI is 40 and you have heart disease and you're drinking orange juice and your triglycerides are through the roof and all this stuff yeah maybe that's not ideal maybe the coffee is a
01:02:34
healthier choice is there a similar thing like caffeine I feel like I know you don't drink much of it but like
01:02:40
there are a lot of people especially in this Tech and gamer world who are they drink a lot of coffee or wears a lot of
01:02:46
energy drinks yep is there any difference to that and obviously this is individualized but
01:02:51
you're an active person you're drinking a lot of caffeine or you are I am sitting down and playing games and I'm
01:02:57
just pounding Red Bulls or energy drinks I don't think that one is as important lifestyle wise I think that one is more
01:03:04
uniform the recommendation that if you're going over the recommended amount consistently you're going to create
01:03:09
long-term harm okay and 400 is a pretty solid numbers it's not a solid number one there's one uh blonde like the big
01:03:17
size blonde roast that Starbucks is 400 really and people put espressos into that bad boy well yeah Starbucks drinks
01:03:23
are an enough so that's like feels like does that also numb you to it because I I always wondered like tolerance builds
01:03:28
up yeah like there's a Gatorade fast twitch Gatorade or something that has it's they have like a bunch of different Gatorades now this one's for like in the
01:03:35
moment performance and I think there's caffeine in it yeah and so I wonder as someone who never drinks caffeine would that be more effective for me if it was
01:03:41
then if I always had coffee every day it's more if you've never had caffeine your
01:03:47
caffeine naive we call it you're going to get a better result from drinking the caffeine well we've also seen in
01:03:53
research you can become caffeine naive quite quickly so if you take only a few days off drinking caffeine you can
01:04:00
already start seeing improved benefits um something that I was going to say about caffeine caffeine is the number
01:04:06
one studied performance enhancing drug definitely and it actually has proven benefits it's like the most well studied the most evidence behind it that it truly improves performance
01:04:17
it goes caffeine creatine protein those are the three most proven supplements and again remember I said
01:04:23
90 percent of Australian supplements yeah no okay I love that and I guess the last
01:04:30
one for me is uh our phones now have these digital well-being sections in the settings where they will try to limit
01:04:36
how much you use certain apps during the day but it's incredibly easy to override
01:04:42
them is the other thing so they'll go all right you need one hour of Instagram or less per day one hour or less of
01:04:47
YouTube per day is is a social media detox worth considering for anybody yeah maybe spending too much time on social media you asked me a different question I thought you were gonna ask me a social
01:04:58
media detox is Wise It's good to take it every now and then especially for us who are so involved in this space
01:05:04
um but the apps themselves are good for getting a grasp on what's going on but if you are thinking that's going to be a solution you're probably mistaken in most cases given the fact that they work
01:05:17
in the same way the posture correctors work you need to figure out what a healthy balance is and be aware of when you've
01:05:24
reached your limit but when you start relying on this thing to be your posture corrector I love that analogy yeah
01:05:30
life's hard yeah yeah and anyone that promising you a shortcut is probably trying to make some money and not really
01:05:36
helping you in many cases bang that's a short ticket and I lost all my sponsorships no that's awesome well I think we have uh one last
01:05:48
thing we want to do which is a little bit of trivia I wanted to have you uh okay explain do you know what this is you yes I do know where have you seen
01:06:00
this this is in one of my videos about 10 million subscriber video I'll say quick why does that look familiar we'll put it on the screen for those who haven't seen it I just wanted were you happy with how my uh animator designed
01:06:13
you I was gonna ask is this how I look to you and how I really look Mom I mean we did do a round of reviews and we felt like
01:06:25
these were the closest that they they did you and Casey they're hanging out look at all the money on the table
01:06:30
though there's a lot of money with an MCN uh not no not a traditional one no what do you mean I I started working with a company that wasn't an
01:06:41
MCN until they started selling ads for me and I was the first channel that ever started selling ads so yeah so not a
01:06:48
traditional one but that was what that segment was about oh mcns yeah got it it was printed out and left in the
01:06:55
studio I love it okay trivia time [Music] I missed it the first time so today's trivia question it bothers me yeah I'm going to give you three medical
01:07:10
devices okay you need to tell me the order in which they were invented and I'm looking at not just I'm looking not
01:07:17
for like theoretical someone wrote down this idea I'm talking about they use them on a human being in that year okay
01:07:24
interesting and it goes from earliest well I'm going to give you the three devices and you need to tell me from
01:07:29
earliest yeah so if I say number one that's the earliest exactly okay yes all right number one the implantable
01:07:37
pacemaker not an external Pacemaker and not a wearable pacemaker but a pacemaker
01:07:43
that goes inside the human body number two the medical laser and again I'm not looking for when someone invented the laser I'm looking for the first time someone shot a laser at a human to heal
01:07:55
them number three computerized medical records hmm [Music] I'm definitely just gonna do a slow zoom on Dr Mike's thinking face
01:08:19
it's one of those things where you know too much and then it's potential yeah for sure they're good at getting questions that
01:08:26
are anyone as well I'm fairly confident that I fact check all of this correctly but I will welcome Dr Mike I welcome your um actually as a
01:08:38
uh as a medical person yeah no way again I I watch memes this is It's not what I
01:08:45
do all right this is uh we flip our boards uh Mike what did you have I was gonna go
01:08:50
with what you did but I I went computer medical records EHR pacemaker laser and that is earliest to
01:08:57
latest yes so unfortunately Mike oh I'm also sorry oh did you all put the same thing no no oh no sorry okay I went oh what'd you do I did computerized medical
01:09:07
records one medical laser two which I'm starting to think is earlier than we think and then implantable pacemaker
01:09:13
three [Music] I do have a different one I have laser now the correct answer is implantable pacemaker 1958. wow that was the first
01:09:27
time someone stuck one of those in somebody um fun fact before that there were these wearable pacemakers that you had to plug
01:09:33
into the wall so you just had full wall voltage running through your chest taupe
01:09:38
uh number two is the optical laser in 1961 just a year after the laser was invented someone had the idea to shoot it at a guy specifically a guy's eyeball to remove a tumor
01:09:52
and then computer medical records computer medical records there were several specifically four attempts to
01:09:58
set them up the earliest one was in 1968 and the uh I don't believe that there was a pacemaker but they didn't have a record Electronics shooting lasers
01:10:09
what's even crazier is the idea of shooting electricity at someone's heart goes back all the way to the 19th
01:10:16
century wow yeah weird yo computers are young I had a feeling the records was the trick part of that question I know that's why I knew records either came
01:10:27
first or last I've yeah that's what I should have thought I put in the middle I thought the laser would be for sure
01:10:33
the trick one interesting wow wow laser was in the middle huh that was a good question thank you yeah
01:10:39
there's there's that the only one I have another one oh yeah you want to do it yeah see all right according to a 2020
01:10:48
survey by Cisco what percentage [Laughter] uh no Cisco the networking giant oh that's what I bet said
01:11:05
all right according to a 2020 survey by Cisco what percent of medical devices are currently running unsupported software that means the software they're running has no patches or updates
01:11:16
available 2020. and this is closest wins oh yes uh here we do prices right rules so closest without going over
01:11:31
is it a stupid answer thank you [Music] I don't want to go first this time before I just want to say uh this question was inspired by an episode of the podcast Dark Net Diaries so if
01:11:51
you're interested in this go check them out wow that's a high number Marcus so I
01:11:57
said 91 percent I said 42 all right that is under so Mike you have to shoot the tube I'm so sorry
01:12:08
3.13 it's uh 60 of medical devices surprises me surprises you because it that it's low or high I figured very few medical devices get software patches I
01:12:21
guess it depends what you consider a medical device so it's an issue people talk about in cyber security a lot
01:12:27
because things like a medical laser typically is actually running a version of Windows 2000 which I thought it was 3.1 which wouldn't be that big of an
01:12:39
issue except now these medical laser devices are hooked up to Wi-Fi's a Hospital's Wi-Fi networks yeah and so they're actually points of attack now for a lot of cyber security threats
01:12:51
um so hospitals aren't sure whether to you know get new medical device like get new lasers that run up-to-date os's and then retrain everybody or leave this sort of point of vulnerability in their
01:13:02
system that's why you guys are worried about AI we have lasers Wi-Fi connected lasers and hospitals that's crazy good to know I'm glad to
01:13:13
most cars aren't software updatable so that's that's pretty weird one last question Mike okay how fast can
01:13:20
you type the alphabet what's like the average speed I don't even know it's I feel like it's hard to
01:13:27
do an average mistakes allowed uh just a through z you can make mistakes but as long as you hit
01:13:33
every letter in order if I'm going to aim to try and do no mistakes I would do it
01:13:47
10 seconds I don't think anyone's ever guessed their time so I'm excited about this I almost guarantee you're going to
01:13:53
be faster than you think because you've just so you know it's something we do with all of our guests on here um similar to if you've watched top two
01:13:59
yeah you're allowed to do however makes you the fastest possible yeah the way this works is oh you have an app yeah
01:14:05
yes you made this no my friend made it so you type A through Z if you miss one you have to keep you have you have to hit that letter to go on and uh we'll give you three shots don't
01:14:16
hit enter at the end because it resets the counter oh okay so the timer shows up when you hit Z and we do have a leaderboard
01:14:23
I was gonna say that at the end but now there's a little pressure sometimes pressure gets to go now I need the
01:14:28
caffeine true yeah true performance that's like how you take your watch off I always take my watch off when I like
01:14:33
this really with um with well metal yeah yeah okay I'm gonna type it like my also Father do you like the um do you like the laptop
01:14:45
keyboard or we have other keyboard choices if there's something I like that you like this I like the old school
01:14:51
is 10 seconds even on the leaderboard what I predicted I'll tell you as soon as you finish your first trip and I have three reps yes yes okay ready
01:14:59
yeah yeah should I just go yeah when you press a and we'll start that okay okay [Music] 7.9 I was close wow I was gonna say that
01:15:16
sounded really close to you I wrote down 8.2 but that's a great first rep feel free to go two more you might
01:15:22
improve your time I see detailed results though what is that about if you want to look it's the
01:15:28
time between each letter and you can see where potentially you uh 7.93 okay okay [Music]
01:15:41
[Music] 6.9 that's a that big Improvement nice really good Improvement okay do you think we have another second off yes that's like a whole nother second
01:15:53
trajectory would be incredible if you did it again but yeah that's a that's a really solid spot already okay okay I have to hit reset right or enter
01:16:06
Shake It Out okay so I'm gonna go really fast [Music] it's 5.9 too wait you got 5.9 5.9 we have to
01:16:22
5.97 I feel like pretty good about that so where do you think so right now we've got about 20 something names on the
01:16:27
leaderboard where do you think 5.97 would rank you eighth you're exactly right no way
01:16:34
these are some weird one two three four five six seven no you're not sorry the current eighth is 5.9 it's Doug demiro he got 5.900 okay you got 5.97 so you're
01:16:45
right behind him at number nine between Doug dimiro and so crispy media wow well played I'd be interested way faster
01:16:53
10 seconds is not on the leaderboard everybody's under 10. well I didn't know uh how long this takes I I got over 10
01:17:01
seconds and it was so bad we just decided yeah what followed by Quinn from snazzy labs and my original time for when we first started Mark as good at everything
01:17:20
really annoying around someone's gonna get me off the podium but that's one two and three oh and then four that was your
01:17:27
first time yeah we all did three tries at the studio just to set a leaderboards to have context and so I've said a 4.5
01:17:34
and I'm I'm I'm gonna get knocked off eventually sooner or later if you give him two more tries shaving a
01:17:42
second off each one I think he'd knock you off there welcome to the top ten Mike that was wow okay thank you for
01:17:48
joining us of course for the waveform podcast we appreciate all the medical advice and all the expertise that you bring and of course uh you should go
01:17:54
watch Mike's videos if you haven't already he watches memes yes he beats people up yeah and he's uh incredibly
01:18:01
informative so we appreciate that thank you it was really fun all right well that was it with Dr Mike that I think
01:18:07
that was a lot of fun this is a conversation we've been meaning to have so I'm glad we got all the facts and figures and pros and cons and all the
01:18:13
stuff from an actual expert but now we're back with Andrew and David because you haven't done the trivia that's from
01:18:20
that episode that's true so let's let's read David the questions and see if he gets them right there's a lot of pressure here yeah because you guys have
01:18:27
already heard this yeah I have not and well I'll just be judging you because we totally you already know the exactly
01:18:32
what it is I think I might remember the answers all right let's see trivia time anxiety times oh God this Market
01:18:39
and there's two new markers yeah and I got signed out of Google docs nice you could use this one yeah trivia question what is Ellis's password password
01:18:49
you wish you wish I should not I should not say something like that on the internet and everyone's gonna try to get okay don't get me question number one that'll do it
01:19:01
on that day Ellis yeah on that day Ella signed up for bit Warden question number one according to a 2020 survey by Cisco what
01:19:12
percent of medical devices are currently running unsupported software meaning no
01:19:17
patches or updates will ever be available and it's uh it's CL it's Price is Right rules
01:19:23
as per usual oh so that means whoever we could be right may be wrong right David can get closer than anybody David could get closer all right I got one
01:19:37
oh well I mean you know let's see it and you put 68 percent wow is it over barely over it's 60 no I was gonna put 60.
01:19:52
Price is Right unfortunately that one cannot win really but you're pretty sorry yeah
01:19:58
you're pretty close you're in the ballpark yeah what did you guys put I have no recollection of what I don't
01:20:04
either the winning guess was Andrew with 42 I think both Marquez and I can't remember wow I'm so smart I almost put anyway whatever question
01:20:16
number two almost doesn't win question number two almost doesn't win trivia all right David yeah I'm gonna give you
01:20:22
three medical devices you are and you were gonna tell me the order in which they were invented from earliest to most recent oh my
01:20:33
goodness okay the first device the implantable pacemaker this is a pacemaker that goes completely inside your body and then you get Sona
01:20:45
okay number two the optical laser for medical purposes what does that mean for like healing wounds with healing wounds doing
01:20:58
laser surgery number three computerized medical records oh yeah that's okay wait wait can you give me the no no wait stop number one okay
01:21:10
implantable pacemaker number two Optical medical laser at number three computerized medical records and I'm looking for the order first
01:21:22
invented most recently invented first yeah okay [Music] from oldest to newest you're welcome okay oh man this is probably
01:21:41
all right I'm doing one is pacemaker okay that's correct two is laser that is correct there is computer oh my God
01:21:56
no one else got there we're the only one heck yeah I remember this because uh my
01:22:03
grandpa used to have heart attacks from when he was like 20 on and he got a pacemaker like really early
01:22:09
like yeah in like the 60s or something wait so do I get one point for each one no just one point in total uh so I just won the round basically yes okay
01:22:20
whatever I guess I won one of them that's fine well played thanks guys well played appreciate you well I think that
01:22:27
wraps it up shout out to you for getting a question right uh thanks again to Dr Mike for
01:22:33
coming on and answering all of our questions and thanks again to you for watching and listening catch you in the
01:22:38
next one media podcast Network and our inter outro music was created by vayne still [Music]