#73 - AMA #9： NAD & metformin, fat-burning zone, creatine, estrogenization of men, emergency kit for cold & flu, and more
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Summary
In this episode, we talk about my history with Bob Karpelos, why we don t run ads on this podcast, and why we rely entirely on listener support to sustain the show. In this episode I'm joined by the incredibly handsome Bob Kaplan.
Transcript
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Hey everyone, welcome to the Peter Atiyah Drive. I'm your host, Peter Atiyah.
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The drive is a result of my hunger for optimizing performance, health, longevity, critical thinking,
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along with a few other obsessions along the way. I've spent the last several years working with
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some of the most successful top performing individuals in the world. And this podcast
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is my attempt to synthesize what I've learned along the way to help you live a higher quality,
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more fulfilling life. If you enjoy this podcast, you can find more information on today's episode
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Hey everyone, I'd like to take a couple of minutes to talk about why we don't run ads on this podcast
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and why instead we've chosen to rely entirely on listener support. If you're listening to this,
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you probably already know, but the two things I care most about professionally are how to live
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longer and how to live better. I have a complete fascination and obsession with this topic.
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I practice it professionally and I've seen firsthand how access to information is basically
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all people need to make better decisions and improve the quality of their lives.
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Curating and sharing this knowledge is not easy. And even before starting the podcast,
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that became clear to me. The sheer volume of material published in this space is overwhelming.
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I'm fortunate to have a great team that helps me continue learning and sharing this information
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with you. To take one example, our show notes are in a league of their own. In fact, we now have a
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full-time person that is dedicated to producing those and their feedback has mirrored this. So all of
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this raises a natural question. How will we continue to fund the work necessary to support this? As you
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probably know, the tried and true way to do this is to sell ads. But after a lot of contemplation,
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that model just doesn't feel right to me for a few reasons. Now, the first and most important of these
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is trust. I'm not sure how you could trust me if I'm telling you about something when you know I'm
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being paid by the company that makes it to tell you about it. Another reason selling ads doesn't
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feel right to me is because I just know myself. I have a really hard time advocating for something
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that I'm not absolutely nuts for. So if I don't feel that way about something, I don't know how I
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can talk about it enthusiastically. So instead of selling ads, I've chosen to do what a handful of
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others have proved can work over time. And that is to create a subscriber support model for my
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audience. This keeps my relationship with you both simple and honest. If you value what I'm doing,
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you can become a member and support us at whatever level works for you. In exchange, you'll get the
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benefits above and beyond what's available for free. It's that simple. It's my goal to ensure that
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no matter what level you choose to support us at, you will get back more than you give.
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So for example, members will receive full access to the exclusive show notes, including other things
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that we plan to build upon, such as the downloadable transcripts for each episode. These are useful
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beyond just the podcast, especially given the technical nature of many of our shows. Members also get
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exclusive access to listen to and participate in the regular ask me anything episodes. That means
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asking questions directly into the AMA portal and also getting to hear these podcasts when they come
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out. Lastly, and this is something I'm really excited about. I want my supporters to get the best deals
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possible on the products that I love. And as I said, we're not taking ad dollars from anyone, but instead
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what I'd like to do is work with companies who make the products that I already love and would already
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talk about for free and have them pass savings on to you. Again, the podcast will remain free to all,
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but my hope is that many of you will find enough value in one, the podcast itself, and two, the
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additional content exclusive for members to support us at a level that makes sense for you. I want to
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thank you for taking a moment to listen to this. If you learn from and find value in the content I
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produce, please consider supporting us directly by signing up for a monthly subscription. Another
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month, another AMA. Welcome to AMA number nine. I am again joined by the incredibly handsome Bob
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Kaplan. In this episode, we talk about my history with Theranos. This is kind of a funny sort of sad
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story. The estrogenation of men, a conversation around plastics and glass containers, takeaways from my
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recent hunting trips, what books I'm reading and listening to at the moment, what advice I would
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give my 25 year old self relating to mental health, my emergency protocol for when I get sick as a dog,
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things that I used to be bearish about that I'm now bullish about or vice versa. Bob and I talk about
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exercise in the quote unquote fat burning zone. Hint, that's a term I can't stand. And we end with a
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little creatine supplementation conversation. As a reminder, AMAs are for subscribers only. If you're
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not a subscriber, you'll only be able to hear a preview of the AMA here. If you are a subscriber
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and hearing this, it means you have yet to download our members only podcast feed. With this members
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only feed, you'll be able to subscribe to the drive in your podcast player to get every episode of the
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drive without the subscriber call out plus full episodes of the AMA podcast directly along with other
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exclusive content. You can learn more about it at peteratiamd.com forward slash members to become
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a subscriber, to have access to the members only podcast feed, as well as other benefits, such as
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detailed show notes and member only discount codes and the products I believe in. You can visit
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peteratiamd.com forward slash subscribe. We'll continue to pull these questions from the AMA forum,
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and we encourage all subscribers to participate, ask questions as we hope to get to all of your
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questions in time through future AMAs. So without further delay, welcome to AMA number nine.
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Hi, and hello again, podcasters, subscribers. Bob Kaplan here.
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I know, I know. It's hard. It's hard to see me in this getup.
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I can see you. You're soiling green. All right, let's jump right into it. Two-minute drill.
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Should I even say two-minute drill? It's a two-minute drill that might take longer. Not exactly Tom Brady
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on these drives, but who's counting? Will you talk about your history with Theranos?
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Yeah. So in 2006, I was working in Palo Alto at a consulting firm, and a good friend of mine,
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he had a connection to Theranos. And at the time, both he and I were considering jobs there in the
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role of chief financial officer and me in the role of chief medical officer. This was very early days.
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I don't recall what year Theranos was founded. I want to say 03, but it was still very small. And
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I remember their office was next to ours. I think we were actually both on California Avenue in Palo
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Alto. So the first time I went over there to meet with Elizabeth Holmes, I remember it was just a tiny
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place. I think there were maybe 20 or 30 employees. And we sat down and looked at this black box that
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they had and talked about a bunch of things that had to do with the business and the technology.
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And we met again. And ultimately, I decided not to take the job for several reasons. One of the reasons
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was when I did my due diligence on their investors, something came up on one of the investors that
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someone I knew and trusted a lot, didn't have a lot of great things to say about one of their
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investors. And when you're thinking about joining a startup company, that kind of stuff matters.
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The other thing is I really loved what I was actually doing. So the hurdle rate for me to kind
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of leave what I was doing had to be very high because I was super happy at McKinsey and really,
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really loving the work I was doing. And then the third thing was I wasn't convinced that what you
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could test in a box that size was interesting. So although Elizabeth was incredibly secretive about
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what they were doing, and I was not allowed to look in the box, which of course, I and I'm sure
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every other person that showed up would ask that question. Okay, let's actually see what's in the
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box. That was a no go, even under an NDA. If people want a primer on Theranos, there's a
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documentary right on HBO if they don't know the story behind it. That's right. Nothing I'm saying
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now will be even remotely interesting if you don't understand why in the end, this is an interesting
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story. I knew enough about diagnostics and I knew enough about the chemistry of it that I knew that
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there was pretty much not going to be anything you could do on a drop of blood in a box that size
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that was clinically interesting. And so in the end, the reason I did not go forward was I just didn't
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think it was medically interesting enough. I thought, look, yeah, you'll figure out a way to do
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a Chem 20 and a CBC and a few other things, but I don't care. Like you're not moving the needle in
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terms of clinical medicine. So that was the end of that. So that was 2006. Now fast forward to 2014.
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That's eight years later. Elizabeth is on the cover of Forbes. The most recent valuation of Theranos is
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$9 billion. And I remember coming home and saying to my wife, remember that company I almost joined
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eight years ago and she didn't remember. And I told her the whole story and she's like, oh yeah, yeah,
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yeah. And I said, this is how much money we'd be worth today if I had taken that job based on my
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estimation of how much dilution would have occurred in the cap table, et cetera, et cetera. And it was a
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big number, like a life-changing number. And she was just like, oh, wow. You win some, you lose some,
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huh? I was like, yeah. So I kind of never really thought about it again. And then fast forward to the
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beginning of October, 2015, there was an event in San Francisco called the Vanity Fair or something.
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It's like a Vanity Fair event. And this was back in the day when I was, a lot of my life revolved
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around fundraising and having to be at events like this. So I was at this event and Elizabeth was the
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main attraction of the event actually. So much so that Mark Zuckerberg also spoke, but he was at one
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of the smaller breakouts. So Elizabeth was really the main attraction. And the night either of or
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before her big, big talk, there was a cocktail party. And I actually wasn't invited to the cocktail
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party because it was really only for the important people. But I was there with Tim Ferriss and he was
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invited to it. So I got to be Tim's date. So Tim and I went to the cocktail party together and we're
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just sort of playing patty cakes and in walks Elizabeth. And of course she's just swarmed by people,
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but somehow over the course of the next 20 or 30 minutes, she ends up standing kind of right next
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to me. And I'm thinking to myself, there's no way she's going to remember me because of course by this
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point it's been nine years. But anyway, I said to her, I said, hey Elizabeth, you're probably not going
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to remember me, but we met. And she goes, oh no, no, I remember you. Your name's Peter. She didn't
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remember my last name. I barely remember my last name. So she's like, yeah, your name's Peter. And we met
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in 2006 and you're a friend of so-and-so who was the person. And she knew everything. I was really,
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really surprised. And I said, Elizabeth, that's unfreaking believable. How could you possibly
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remember that? And she's like, oh no, no, I totally remember and blah, blah, blah. And I was like,
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hey, well, congratulations on all of your success. It's just amazing. And she gave me her card and
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she's like, look, let's stay in touch. I'd love to talk with you again, blah, blah, blah, blah, blah.
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So this was like the first week of October in 2015. And I want to say that was like a Thursday night.
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I think it was like a couple days later, early in the next week when the John Cario story in the
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Wall Street Journal hit. And in retrospect now, of course, you realize that all of that stuff had
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been brewing long before. And obviously Elizabeth knew this was coming in. You know, I got to say,
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like, I think you don't come away from that documentary with a lot of empathy for Elizabeth.
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I don't think that's the purpose of the documentary at all. But in retrospect, if you're going to try to
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just, if do nothing else, but practice the art of having empathy for people who you don't think
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deserve any, it's hard for me to imagine the cognitive dissonance she would have been
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experiencing when on the one hand, she is at this event, which is a huge event, by the way,
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the sort of people who were there. I mean, it was the who's who of everything. I remember walking
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out of one of the sessions and literally almost bumping into Bradley Cooper, who, by the way,
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is incredibly good looking. It's worth pointing this out, by the way, in real life, how good looking
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Bradley Cooper is. I just want to state that for the record. It's almost upsetting how good looking he is
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because you sort of think person's not supposed to be that good looking. But anyway,
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and here she was as the headliner of this event. And yet in her mind, she has to know her world is
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about to get really messy. Now, the flip side of that from a psychology standpoint is I don't believe
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that Elizabeth ever thought she was doing anything wrong, which is not for a moment to say she shouldn't
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be held accountable for what happened. I think you can be so delusional that, I mean, I don't think
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Hitler believed he was doing anything wrong either. So the fact that you don't believe you're doing
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something wrong doesn't in any way absolve you of the responsibility of what you've done.
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But it's a very important distinction, I think, which is you are so delusional that you really
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believe that the lies you're telling are for the better good. And therefore, I think Elizabeth felt
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that this was just a temporary speed bump along the way. But anyway, it's sort of interesting.
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We stayed in touch over email a couple of times in the ensuing months and obviously lost track.
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But that's my little history of almost having gone to work at Theranos.
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I think another thing that I thought about with that, watching the documentary is the people that
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were on board. How could these people be so foolish and be duped and everything? I think
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hindsight bias really plays a role there that after the fact, when everybody's looking at where all the
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chips have fallen, people think. And to be clear, I want to make sure that nobody ever assumes I'm
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trying to take credit for knowing the whole thing was a fraud. That I never suspected. Not for a second
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did that ever cross my mind either at the time or in the years that followed. I just thought it was the
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world's most uninteresting business in the history of civilization. Like point of care testing in a
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drugstore for Chem 7 and CBC. I mean, I would have more interest in a business that specialized in
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removing hangnails and nose hairs. That to me is more interesting than just being able to get a CBC
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and Chem 7 at Rite Aid. My opposition to it was, I never suspected there was fraud going on.
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And opportunity costs. It sounded like you had a good gig going too.
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Yeah. I mean, in the end, our paths are our paths.
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You have referenced to the estrogenation of man as one of the most important
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yet largely uncovered trends. What is this? What causes it? And what can be done to fix it?
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You can find all of this information and more at peteratiamd.com forward slash podcast.
00:14:47.560
There you'll find the show notes, readings, and links related to this episode.
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You can also find my blog at peteratiamd.com. Maybe the simplest thing to do is to
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00:15:01.280
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all with the ID, peteratiamd. But usually Twitter is the best way to reach me to share your questions
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