My Chat with Surgeon Dr. Marty Makary, Author of Blind Spots (The Saad Truth with Dr. Saad_725)
Episode Stats
Words per Minute
164.82898
Summary
Dr. Marty Macri is a New York Times bestselling author and Professor of Surgery and Public Health at Johns Hopkins University. His latest book, Blind Spots: When Medicine Gets It Wrong and What It Means for Our Health, is out now.
Transcript
00:00:00.000
With great excitement, I introduce you to Northwood University, a truly exceptional institution in
00:00:06.400
American higher education. Since 1959, this private, accredited university has been a vibrant
00:00:13.640
bastion of free thought and enterprise, standing out among the thousands of other schools in the
00:00:20.760
U.S. Known as America's free enterprise university, Northwood is dedicated to nurturing the next
00:00:27.760
generation of leaders who drive global, social, and economic progress. At the heart of Northwood
00:00:35.300
lies the Northwood idea, a philosophy that celebrates individual freedom, responsibility,
00:00:42.040
and the importance of moral law and free enterprise. This entrepreneurial spirit is evident in that
00:00:49.020
one-third of Northwood alumni own businesses. Northwood is more than an institution. It's a
00:00:55.520
movement that empowers students to think critically and champion liberty. It is a rare gem in today's
00:01:03.040
academic world. If you're passionate about supporting a university that values intellectual growth and free
00:01:09.620
enterprise, or to learn more about its academic programs, visit northwood.edu.
00:01:15.380
Hi, everybody. This is Ghat Saad. I've hosted many fantastic physicians, and here's a new one to the
00:01:22.820
list. I've got with me Dr. Marty Macri, who is a professor both of surgery and public health at Johns Hopkins
00:01:30.240
University. Let me just read very quickly before I cede the floor to you, Marty. You are a New York Times
00:01:36.660
bestselling author. Your latest book is just out a couple of weeks ago, Blind Spots When Medicine Gets It Wrong
00:01:43.020
and What It Means for Our Health. We're going to definitely drill down there. But your previous
00:01:47.520
books, The Price We Pay, What Broke American Healthcare and How to Fix It, Unaccountable, What
00:01:52.980
Hospitals Won't Tell You and How Transparency Can Revolutionize Healthcare, and maybe a slight departure,
00:01:59.580
Mama Maggie, The Untold Story of One Woman's Mission to Love the Forgotten Children of Egypt's Garbage
00:02:06.960
Slums. Wow. Where do you want to start, Marty? Should we start with the latest book and then work
00:02:11.860
backward to all sorts of other topics? Take it away. Sure. Go ahead. Tell us the central thesis
00:02:16.940
of this latest book. No, it's great to see you, God. And you know, you mentioned people have a tough
00:02:23.160
time pronouncing your last name. Well, I know that letter, the letter A in Arabic, it's actually in my
00:02:30.820
middle name, Adil. And people have such a tough time with that, that I've just learned to go with the
00:02:36.720
flow. Well, you know, before we get going, this may interest you, if only because you're a professor
00:02:43.720
at Johns Hopkins, many, many moons ago, when I was trying to decide what I would pursue my studies
00:02:49.540
at my undergrad was in mathematics and computer science. I thought, do I want to go into the
00:02:54.160
behavioral sciences? Do I want to go into perhaps psychiatry? And at one point, the top program that
00:03:00.820
I was interested in doing an MD PhD in was the one at Johns Hopkins. It used to be at the time,
00:03:08.120
I think maybe the most prestigious one. Does it, is it still the most prestigious of the MDs, PhDs?
00:03:13.760
I mean, I'm going to say yes, even though I don't know.
00:03:17.880
Your employers will be very happy with you. Maybe we could start before we get to the book.
00:03:23.880
As someone who studies psychology of decision-making, I'm always fascinated by,
00:03:28.000
you know, how people make decisions. So how did you, out of all the possible medical specializations
00:03:35.160
that you could have gone into, what were the attributes that you looked at and deciding to
00:03:40.960
go down the pathway that you did? Well, it's interesting you ask because after three years
00:03:45.340
of medical school, I felt disillusioned. I felt like this is not what I expected. We were just really
00:03:52.960
playing whack-a-mole. Sure, the operations and the medications were fascinating and I'd learn about
00:03:59.440
the mechanisms and the technical skills, but there seemed to be something really big missing.
00:04:06.320
And so I quit medical school after three years and I enrolled in public health school. I felt like
00:04:12.760
this is where it's at. We can talk about occupational health and environmental hazards and epidemiology
00:04:20.960
and learn good research methodology. So I enrolled in graduate school in public health
00:04:26.100
and then eventually missed the bedside care. And I love being a surgeon. So I,
00:04:31.020
I missed being in the operating room and I did a surgical residency, but I always had a bookmark
00:04:36.700
to come back to these big questions in medicine that we don't ask that we should be asking. And there's
00:04:44.220
a lot of those. And one thing that I've noticed in medicine is that we just dismiss things really
00:04:49.640
quickly. Good big questions. As we go through medical school, we're taught that the age of puberty is
00:04:57.160
going down every year by about a week and a half. And now it's three to five years earlier than it was just
00:05:04.180
a century ago. And we would just sort of go to the next topic to memorize. And this memorized regurgitation
00:05:10.720
culture to me was so deplete of real intellectual curiosity and the sort of asking of the big
00:05:19.880
questions that was, that was missing that's necessary to really address some of these existential
00:05:25.340
threats, if you will. So that's a little bit of my background, why I've always been interested in
00:05:30.140
public health, how I ended up being a public health researcher and a surgeon specializing in
00:05:35.760
pancreas. And of course it ended up having enough crossover since the pancreas is at the center of
00:05:41.660
so many chronic diseases in physiology. So, uh, I mean, you said that you were intellectually
00:05:47.980
disillusioned at that point. Now your latest book is about blind spots in medicine. So in a sense,
00:05:53.780
have you come around full circle later in your career to that, which originally had served as a
00:06:00.460
warning flag that, you know, they may, they may not be as much intellectual rigor as most people
00:06:05.700
would otherwise think in the practice of medicine. You know, there's a, there's a, a famous book called,
00:06:12.180
um, the popularity of fads and the madness of, uh, crowds. Uh, and it's not fads. I'm getting the name
00:06:21.360
a little bit off, but it's basically about this concept of bandwagon thinking. And what you realize in
00:06:27.420
medicine is that we're all good people. We, we want to do good. These are people who are dedicating
00:06:32.700
their lives and sacrificing much of their lives to be a part of something meaningful and to help
00:06:38.300
others. There's this incredible bond we all have in healthcare around the compassionate calling that
00:06:44.920
all of us, uh, were lured to, but you realize that group think is a powerful force. And when we start
00:06:52.760
surrendering our own independent thinking and just sign up for the program, we can do tremendous damage.
00:07:00.320
So the book blind spots really looks at modern medicine and the group think that is, um, causing so much
00:07:08.520
damage today, uh, putting out the wrong information, issuing bad recommendations and doing the most dangerous
00:07:15.700
thing you can do in medicine, which is recommend something with such absolutism, suggesting that it's backed by
00:07:22.320
solid science when it's not, it's just a gut feeling or an opinion. And, um, so all of it is all coming
00:07:29.100
together. Now, as we look at our chronic disease epidemic surging in the United States and a new
00:07:33.940
found interest as to why, what would be, I mean, I'm sure there are innumerable number of, of examples
00:07:41.220
that speak to the blind spots and the group think that you're talking about, but what might be the top
00:07:46.380
three, you know, top of mind that come to your mind? And, you know, did you start by thinking those
00:07:52.860
things? And then in light of incoming evidence, alter your beliefs on each of those three examples?
00:07:58.540
Well, if we ask the big questions we're supposed to ask, there should be good, uh, clinical wisdom or
00:08:04.500
scientific research to support a lot of the things we do in medicine, but in reality, uh, it's sometimes
00:08:11.480
absent. And so when you look at say the top three things that we have done destructively, um, I would
00:08:18.380
say at the top of that list is putting out the government and medical establishment misinformation
00:08:23.840
that the food pyramid was the way we should be eating. And not only did we get that perfectly
00:08:29.620
backwards, ignoring the role of refined carbohydrates, but it enabled us to put our head in the sand
00:08:35.820
as the entire food supply got poisoned with hundreds of chemicals that are engineered to make food
00:08:42.940
addictive and sometimes to increase your hunger level as you're eating. So then you overeat. And
00:08:49.960
for the first time in history, we saw this mass epidemic of children overeating. And we saw this sort
00:08:56.140
of, um, approach of blaming kids for overeating when in fact the food supply has been rigged. It's been
00:09:03.540
rigged with these engineered chemicals. So I'd say it's the food pyramid. It's ignoring gut health
00:09:09.240
and the microbiome, which is probably one of the most important organ systems in the body. It's the
00:09:14.840
millions of bacteria that line the GI tract. And those bacteria are doing so many things. They're
00:09:21.400
busy. They're involved in training the immune system and digestion, producing serotonin involved in
00:09:28.060
mental health, uh, regulating estrogen, even producing a little bit of, uh, GLP-1, which is
00:09:33.720
the active ingredient in Ozempic naturally. So we've ignored that organ system, not, no time at all in
00:09:40.420
medical school, not a minute that dedicated to gut health and the microbiome. And I would say that the,
00:09:46.860
uh, the third thing that we've overlooked is, um, the role of environmental exposures. We have a food
00:09:54.760
supply coated now with pesticides in a way that's so significant that in one school lunch program, you can
00:10:02.480
detect 38 different pesticides. It's showing up in the urine of kids. It's showing up in the cord blood
00:10:09.140
between the baby and the placenta. So we've got to stop and ask, why are we witnessing all of these
00:10:15.780
chronic disease going up right in front of our noses? Autoimmune disease, mental illnesses, obesity, uh,
00:10:22.020
cancer, diabetes, all of it. Is it really the fault of the public or have we done something to the
00:10:29.900
public? Namely, have we done something to children? Now, the three examples you gave are in one form or
00:10:35.600
another related to, you know, the ingesting of foods. Uh, I suspect though, that the cognitive biases that
00:10:45.220
you're speaking of in medicine, you know, might apply to many different fields. So for example, in
00:10:50.060
psychiatry, it used to be all Freudian and Jungian, it was all due to the environment. And then the
00:10:55.340
fulcrum shifted to the other side where I don't want to hear about what, what your problem is. Here's
00:11:00.400
a pill, get out of my office so I can go to the next. So it became completely pharmacological. And
00:11:05.120
of course, like most things in life, the sweet spot is somewhere in the middle. Do you feel though,
00:11:10.380
that there are some medical specializations by the very nature of what you have to study
00:11:15.400
that are likely to attract people that are more dogmatic, more prone to not altering their
00:11:22.280
opinions in light of new incoming evidence? That's a really good question. I mean, you see
00:11:28.440
it in school, right? You see the type of student that really wants to ask the big questions and
00:11:34.360
isn't satisfied with the quick dismissal of those big questions. And then you see those who just want
00:11:40.580
to memorize and regurgitate, take the exam and collect their paycheck every two weeks until they
00:11:45.420
retire. And I think we've done a terrible thing to doctors in this country. We've told them, put your
00:11:50.980
head down, focus on billing and coding, and here's your prescription pad. That's your hammer. And all of a
00:11:57.140
sudden, everything looks like a nail. And we're going to measure you by your throughput. I think we've
00:12:01.540
done a terrible thing. I think healthcare has been a failure when it comes to the health of the
00:12:06.440
population and addressing the root causes of chronic diseases. Sure, we can do an elaborate,
00:12:11.700
elegant procedure to remove a pancreatic cancer here at Johns Hopkins. But when it comes to addressing
00:12:18.180
why has autism increased 14% every year for 23 consecutive years, it's like we don't even have a
00:12:26.260
clue. So the chapter of the book where I kind of go into this stuff is surprisingly, people are telling
00:12:35.700
me it's their most favorite chapter. And what I did is after talking about group think in the medical
00:12:41.240
establishment, how they got peanut allergy prevention wrong, and hormone therapy for postmenopausal wrong
00:12:47.460
by unfairly demonizing it, and the food pyramid and some other examples, then I take a step back and talk
00:12:53.620
about Leon Festinger and the idea of cognitive dissonance and all the stuff that's right up your alley.
00:12:59.880
And that's the chapter that people are enthralled with, because I think it applies to everybody.
00:13:05.360
It applies to how we see politics and business and relationships. And science is no different. We
00:13:11.660
have a cognitive dissonance, a founder's effect, where we just stick to what we hear first,
00:13:17.420
not because it's more logical or scientific, but just because we heard it first.
00:13:21.920
And that sort of group think. So that's, that's all I was going to say.
00:13:27.200
Yeah, you, I'm glad, of course, you mentioned Leon Festinger. In this book, in the yellow book,
00:13:33.040
in the parasitic mind, towards the end of the book, I have a chapter titled How to Seek Truth.
00:13:39.040
And I offer an epistemological tool for how to construct a nomological network of cumulative
00:13:44.760
evidence to try to convince even your staunchest detractors of your, of the veracity of your position.
00:13:50.700
But I start that chapter by arguing, I quote, if I remember correctly, something from Festinger,
00:13:56.060
but I also quote two French psychologists, who stated that our faculty to reason did not evolve
00:14:03.660
to try to get at some objective truth, but rather to win arguments, which is very disheartening,
00:14:10.700
right? Because that might speak about the lack of epistemological humility that some of your
00:14:16.080
colleagues have, right? La la la, I don't want to hear about incoming evidence. I'm vested in the 30
00:14:22.240
years that I've been telling my patients that one thing. I don't care that it's wrong. You can't
00:14:27.940
prove me wrong. So is a lot of it simply the typical failures of our personhoods that cause us to not
00:14:34.960
adjust our thinking? Well, I think you're onto something big there, God. And that's, that is,
00:14:40.920
pride enters into it. A lack of humility magnifies cognitive dissonance and to a point where it can
00:14:49.300
cause tremendous destruction. And it's, I'm not just talking about in medicine, weapons and mass
00:14:56.380
destruction in Iraq. There's just this, the, the sort of pride of not being able to recognize
00:15:04.200
we got that wrong and we got it terribly wrong. And not just in a moment, but held onto it for
00:15:10.760
years. And you see the, the sort of going mental acrobatics to try to make it fit. And that's
00:15:17.540
exactly what Festinger was describing is that the brain subconsciously, not because we're bad people,
00:15:23.560
but because this is part of the human condition, lacks humility. It will reframe new information.
00:15:28.960
It will dismiss new information in order to have the comfort and security of our belief staying
00:15:35.760
nested in the brain. So we don't have to abandon it. And I think we have to recognize that bias in
00:15:41.540
all of us. And the father of modern medicine, Claude Bernard said, we all have our biases. We have to
00:15:47.020
recognize them actively and then knowingly suspend those biases as an active intentional process,
00:15:55.400
as we hear new information. So we can be impeccable.
00:15:59.360
I want to get it because I think it's so in line with what you're saying. So bear with me,
00:16:05.840
it's chapter seven. And I'm almost certain if I remember correctly, it was Festinger because it,
00:16:12.360
I want to read it out because I wonder if you have it in your book, just bear with me a second.
00:16:21.300
I got into where he embeds himself into a cult. That was fascinating.
00:16:26.260
Yeah. So I think this is Festinger. Hold on one second. Yes. Leon Festinger. I remember
00:16:31.560
correctly. Page 142. You're going to love this quote. Let me read it. I'm going to read you the
00:16:35.200
whole thing. A man with a conviction is a hard man to change. Tell him you disagree and he turns away.
00:16:41.460
Show him facts or figures and he questions your sources. Appeal to logic and he fails to see your
00:16:47.120
point. We have all experienced the futility of trying to change a strong conviction, especially
00:16:52.400
if the convinced person has some investment in his belief. I won't read the rest of it, but I mean,
00:16:58.060
it's like, it's basically your book. He's in one pithy quote. He's explaining the inability of most of
00:17:05.220
us to change our opinions. And actually I was on a show maybe about a year ago hosted by a British
00:17:10.300
psychiatrist. And he asked me a question, Marty, which no one had heretofore ever asked me. And he said,
00:17:16.040
in your 30 years as a professor, as a behavioral scientist, what's the single most surprising thing
00:17:22.940
about the human condition that you've discovered that, that, that, that shocked you. And I thought
00:17:27.820
for a minute and I said, the inability for people to change their opinions once they are strongly
00:17:33.700
anchored. So having said all that, how does someone like you, you recognize our frailties.
00:17:40.300
You recognize that we have these big egos that we're not willing to admit to our faults and our
00:17:45.760
wrongdoings. How do we go about changing people's opinions? Well, I think we need number one, a civil
00:17:52.020
discourse. We don't have that right now in medicine. In many areas of medicine, you're not allowed to ask
00:17:57.120
big questions, but the purpose of science has always been to challenge deeply held assumptions.
00:18:02.960
And so one of the things I wanted to do in the book is just show that when we silence dissension
00:18:09.320
and we insist that everybody needs to sign up for the program, show allegiance to a broader
00:18:16.040
institutional guideline or opinion, when there's really no science behind it, it's just kind of the
00:18:23.120
consensus of crowds. It's an illusion of consensus. Then we can, we can do tremendous damage. And it's not
00:18:31.600
like we live in an age of enlightenment where we don't make these groupthink mistakes anymore.
00:18:37.340
We just said opioids were not addictive for 20 years, igniting the opioid crisis. We told
00:18:43.500
parents to avoid peanut butter for kids until they turn three, thinking it would prevent peanut
00:18:49.720
allergies. We got it perfectly backwards. It causes peanut allergies. And that bad medical
00:18:56.260
recommendation in the year 2000, that medical dogma that was just reversed nine years ago, ignited
00:19:03.180
the modern day peanut allergy epidemic. The food pyramid ignited the move to process carbohydrates
00:19:10.520
and ultra processed foods that ignited the modern day obesity epidemic. And all of these, these are
00:19:16.740
self-inflicted wounds, right? The overuse of antibiotics is changing the microbiome of a generation
00:19:24.080
of people. The dogma that, oh, antibiotics won't hurt you. Well, that is doing tremendous damage,
00:19:30.780
not just in creating superbugs, which will be the next pandemic, antimicrobial resistant organisms.
00:19:38.120
It's already here. But the average 10-year-old has taken 11 courses of antibiotics in their lifetime
00:19:47.280
already. It's doing tremendous damage to the microbiome. And we're curious why chronic diseases
00:19:53.020
are going up. Antibiotics are just one of many insults to the microbiome. But a study looking at kids
00:19:59.900
who took antibiotics in the first two years of life compared to kids who did not at the Mayo Clinic
00:20:04.940
found that kids who took antibiotics in the first two years of life had a 20% higher rate of obesity
00:20:10.200
because we're altering the microbiome. They had a 32% higher rate of attention deficit disorder.
00:20:18.360
Remember, some of those microbes produce serotonin, are connected to brain health,
00:20:23.200
and a 90% higher rate of asthma and nearly a 300% higher rate of celiac. Isn't it interesting that
00:20:30.460
all of those diseases are up in the modern era of altering the microbiome? They're not up.
00:20:37.800
They are not higher in the Amish communities where they are still in the subgroup of Amish communities
00:20:46.360
that are avoiding ultra-processed foods and eating good whole foods from good soil and good farming
00:20:51.860
techniques. So I think sometimes we can't see the forest from the trees in medicine.
00:20:59.800
And I think sometimes with good intentions, we can do a tremendous amount of public harm
00:21:05.360
from issuing recommendations when they sound like they're scientifically based when we really know
00:21:12.500
that they're not. And we crush the dissenting opinions. Beautiful. I want to come back in a
00:21:17.900
second to two of your examples, the evolution of the superbug and the peanut exposure, because there
00:21:23.120
are clear evolutionary links there. And as you may or may not know, Marty, my main area of research is
00:21:29.260
in applying evolutionary psychology and evolutionary biology to study human behavior in general and
00:21:34.000
consumer and economic behavior in particular. So let's hold that thought. But I want to read you
00:21:38.040
another quote. This is from, I'm not trying to use my show to promote my own bugs, my own books,
00:21:44.000
but it turns out that this book, 2011, The Consuming Instinct, the last chapter has a quote,
00:21:50.460
arguably my favorite quote of any scientist. And I think it's going to resonate with you. This is JBS
00:21:55.980
Haldane, who was an evolutionary geneticist. And he was basically arguing here that scientists go through
00:22:03.560
four cognitive stages before they accept a new theory. So it's totally in line with it. Now watch,
00:22:10.280
watch the four stages. So I'm going to, I'm going to read the exact quote. I suppose the process of
00:22:15.880
accepting will pass through the usual four stages. Number one, this is worthless nonsense. Number two,
00:22:23.340
this is an interesting but perverse point of view. Number three, this is true, but quite unimportant.
00:22:30.520
Number four, I always said so, right? So, so you start off by huffing and puffing. This is pure
00:22:37.280
bullshit. What are you talking about applying evolutionary psychology to study human behavior?
00:22:41.840
That's quack science. Well, the same person who sent me that email 20 years ago, 20 years later
00:22:47.400
saying, oh, I'm a big fan of your work, Professor Saad. So it's the auto-corrective. So if you're,
00:22:52.960
if you're dogged enough, people will come around. Do you agree with hopefully that optimistic bent?
00:22:59.580
Well, we just went through this. We just went through this with prolonged school closures during
00:23:04.500
COVID, right? We, a bunch of us, Jay Bhattacharya, who I know you're friends with and
00:23:08.880
Vinay Prasad and Zubin Damani, so many of us, we were yelling until we're blue in the face that the
00:23:16.040
schools need to be reopened in the fall of 2020. The data were clear from Europe. And for the next year,
00:23:24.820
many parts of the country continue to shut out kids out of school, which is not bad if you're
00:23:30.420
wealthy and you're part of the ruling class with private tutors and the kids are hanging out at
00:23:34.620
the country club, come here to inner city East Baltimore. And it was brutal. What we did to poor
00:23:40.760
and minority communities was brutal and it was a human rights violation. And so we just had this sort
00:23:48.860
of discussion at Stanford about school closure policies and a bunch of doctors and, you know,
00:23:54.820
I wouldn't call them journalists, but writers said, how dare they question public health officials?
00:24:01.860
And then of course, we all know that schools were open too long or closed too long. And it's like,
00:24:08.540
you know what? A little bit of support at the time would have been, a little bit of humility
00:24:15.040
would go a long way. We just had a study come out in JAMA and network trust in doctors and hospitals
00:24:22.140
is down from 71% to 40% in four years. Largely because of the COVID stuff.
00:24:29.400
I presume so. I mean, they didn't get into it with the respondents, but a 31 point drop in trust
00:24:36.600
over just four years. Have you, I've not heard a single apology from anyone in the public health
00:24:43.640
community? I mean, we were fighting against so many of these cruel policies, not allowing a family
00:24:50.340
member to visit their loving, dying loved one for two years. I mean, I get it for maybe a week or two
00:24:57.180
in the beginning. We didn't know what was going on for two years. But you could go to the BLM protest
00:25:02.280
with a hundred thousand people there. The virus won't spread. Correct. Doesn't spread at those
00:25:07.740
protests. It cannot spread. If you're progressive, you have natural immunity in your, in your, right?
00:25:14.440
It can't spread there. It can't spread at restaurants. Right. It can spread at bowling
00:25:22.280
alleys or bars. And of course it cannot spread when two-year-olds are napping in daycare for the
00:25:30.300
two hours that they're allowed to take off their cloth mask while napping. Unbelievable. Do you think,
00:25:35.740
I've asked this before you mentioned Jay, I've asked Jay, I've asked Scott Atlas, I've asked other
00:25:40.980
people who, you know, who were courageous enough to speak out against some of those policies. Do you
00:25:46.020
think that a lot of the now in retrospect, incorrect policies were due to just, you know, the fog of war,
00:25:55.160
or do you think that there was, you know, willful intent? So if you have to allocate a hundred points
00:26:01.360
to either, you know, willful intent or just fog of war, how many points would you allocate to each?
00:26:08.680
Well, I think the fog of war argument may have been applicable for the first few weeks or months,
00:26:15.920
but when you're talking about three years in running of ignoring natural immunity, when natural
00:26:23.740
immunity, you know, I wrote a lot about it and people came up to me and somebody said,
00:26:27.740
how did you discover natural immunity? And I said, it's been known since the Athenian plague of 430 BC
00:26:35.520
and it applies to every other virus practically. So yeah, I don't, you know, it was ironic to me.
00:26:44.960
I was starting to write the book blind spots and we were in the middle of COVID. I didn't want to
00:26:49.940
talk about COVID because it's so tribal and people are sick of it, but I was watching all of this
00:26:55.920
cognitive dissonance play out. Everything Leon Festinger described, it's almost like, you know,
00:27:03.220
the doctor, one of the cult members of the cult that Festinger embedded himself in was a physician,
00:27:10.100
presumably a smart guy. And when the prophecy did not come true that the spaceship was going to pick
00:27:16.080
him up and Dr. Festinger was there, he asked the doctor about his belief after the prophecy failed.
00:27:23.220
And then the doctor in sort of, in a very psychologically naked way said, well, you have
00:27:30.880
to understand, I still believe, and I believe even stronger because I have so much invested in this,
00:27:37.520
my family, my friends, my reputation, my job, my community. And you saw this unbelievable display
00:27:47.860
of cognitive dissonance in the real world of how he had so much invested. He just cannot stop believing
00:27:54.680
in it, even if the evidence is clear. And I think we saw that during COVID.
00:27:59.140
Yeah, indeed. Okay. So I, as promised, I want to come back to this evolutionary angle. So let's,
00:28:04.340
let's take, say the, the peanut example that you gave. So as you know, this, but many of our
00:28:11.420
listeners and viewers may not. So in the field of evolutionary medicine, which regrettably remains
00:28:18.580
greatly under taught in medical school would look at the Darwinian why of why our, you know,
00:28:28.580
bodily systems have evolved to be of that form. So rather than simply asking the proximate questions,
00:28:34.240
the how and the what, right? If you're an orthopedic surgeon, you don't necessarily care about the
00:28:38.500
ultimate Darwinian why there's an Achilles tendon that's ruptured and I have to fix it.
00:28:42.880
So that's the mechanics of fixing it, but understanding the Darwinian why can lead to
00:28:48.740
insights. Like for example, the peanut example, we know that kids who've been raised in allergen rich
00:28:58.020
environments are less likely to develop autoimmune diseases like asthma, precisely because the,
00:29:06.120
the, your immune system expects to be triggered in order for it to work maximally. So had the folks
00:29:15.280
who were offering those original wrong peanut prescriptions, maybe studied a bit more in
00:29:20.760
evolutionary medicine, then the correct prescription would have been blatantly obvious to them. So this
00:29:26.260
is a long winded way of saying, do you think there is value? I mean, I think there is value, but do you
00:29:33.040
think there is a growing appreciation of at least incorporating a single close course, a single
00:29:40.080
module within the training of medical students on evolutionary medicine? Gosh, I love what you're
00:29:46.760
saying because it, it doesn't just apply to the absurdity of the peanut abstinence dogma that the
00:29:53.700
American Academy of Pediatrics put out that ignited the peanut allergy epidemic today. It applies to so
00:30:00.200
many areas. So we blow off, for example, sleep in medicine, never talk about it, not a single moment.
00:30:07.240
Never talk about it. Guess what? It drives high blood pressure, drives mental illness, chronic poor
00:30:12.180
sleep. We just did a study showing that it's associated with the development of Alzheimer's and early
00:30:19.520
Always lack of sleep leads to those. Is there ever, is there a disease of too much sleep leads to diseases?
00:30:26.240
I haven't seen that, but I'm sure that it goes in both directions, but the, if you don't sleep,
00:30:33.340
let's say you don't sleep well for three days. If, if, if you had four hours of sleep for three
00:30:41.320
consecutive nights, what is your behavior going to look like? You were going to look like you've got
00:30:48.340
many Alzheimer's. You're going to forget things. You're going to talk slower. You're going to,
00:30:52.640
it's going to take longer to process things. And what we found is that chronic poor sleep
00:30:59.280
does not, it's in the deep sleep that the glial lymphatic system in the brain engorges to sort of
00:31:07.120
vacuum out a lot of the amyloid plaques. And it's actually a circulation. Stress produces more plaques
00:31:14.200
and good sleep can help remove them. And so we can go through all the technical biology, but you
00:31:22.040
nailed it. When you said, if we think about the sort of evolutionary basis for this stuff,
00:31:28.880
it makes sense that we were designed to rest and you can't, you know, change that strategy
00:31:36.560
and assume you're going to perform better or else it would have been done in nature.
00:31:40.600
Sure. Exactly. Beautiful. So I usually give an example, the following one, when I'm trying to
00:31:46.140
explain to people, and it's a medical one, when I'm trying to explain to people the difference
00:31:49.840
between proximate explanations in science and ultimate ones. So take, for example, pregnancy
00:31:55.300
sickness, Marty. So from a proximate perspective, you, pregnancy sickness, you know, you could study
00:32:01.000
how does the fluctuating hormonal levels of a woman affect the severity of her pregnancy sickness? Okay,
00:32:07.500
fine. Great. The Darwinian why it asks, why have women evolved that physiological reality? And it
00:32:14.800
turns out that pregnancy sickness happens during the first trimester during organogenesis, precisely
00:32:21.980
because during that very important developmental period, a woman should not be exposed to certain
00:32:28.040
teratogens, food pathogens that could wreak havoc to the development of the organs in utero. Therefore,
00:32:34.840
she evolves an attraction to certain foods with pregnant women are attracted to pickles because
00:32:41.640
pickling serves as an antimicrobial property. They're repulsed by other foods that have high
00:32:46.880
pathogenic load. They will oftentimes throw up because it's the ultimate insurance policy. Hey,
00:32:52.900
if something did get by, at least I get rid of it. And it turns out that when you study
00:32:57.360
the severity of a woman's pregnancy sickness to her, to the ultimate outcome of her childbearing,
00:33:04.160
the more pregnancy sickness she's had, the more likely that she will have a successful pregnancy.
00:33:11.340
So when you go see your OBGYN and he or she gives you a pill to shut off your pregnancy sickness
00:33:18.440
symptoms, they are doing the perfectly evolutionarily wrong thing. So I lecture about this,
00:33:24.060
Marty, in front of, say, MBA students who come from a medical background. They're surgeons,
00:33:29.980
they're physicians, they're OBGYN. And then they come up to me and say, Dr. Saad, you're a consumer
00:33:35.560
and evolutionary psychologist. I'm a physician. How come I have to learn this from you? How come
00:33:40.320
I didn't study this in medical school? But that shows you that there's a whole slew of light that we
00:33:47.480
can understand by studying the ultimate causation. So, you know, when you mentioned that amazing
00:33:55.140
example, I thought of a little section of the book I wrote about Tylenol for fevers. It's a reflex.
00:34:01.160
It's a dogma. Oh, the kid has a fever. We gave a Tylenol. What else would you like to do, doctor?
00:34:07.200
What are we doing with this medication? We are stopping the body from its natural mechanism of
00:34:13.740
heating up to try to rid it of a pathogen. Now, if a kid is visibly uncomfortable and we're in pain,
00:34:20.920
then maybe it's just compassionate to give them the medication to help alleviate the discomfort. But
00:34:26.900
that's not why people give it. They give it because they believe, oh, we're treating the fever. Why?
00:34:32.760
What are you doing? You're messing with mother nature. And a new study out of Johns Hopkins found that
00:34:38.100
when you treat an illness with a Tylenol, you prolong the illness. Exactly.
00:34:45.160
And so they did this study with chickenpox, but it's true of other illnesses. And we're introducing
00:34:49.900
a medication. So where can we teach common sense? You know, the NIH doesn't fund research
00:34:59.360
that is based on common sense. It funds research on whatever the esoteric, and there's some good
00:35:07.260
work coming out of the NIH, but most of it is just dinosaur research on chemical pathways at the end
00:35:13.700
stage to develop medications or therapeutics, not asking why we are getting so sick as a country.
00:35:19.700
When the Pima Indians in Arizona and New Mexico had their water diverted from the Gila River by
00:35:29.020
settlers and ranchers, the soil was destroyed. And the American government, recognizing this
00:35:34.100
tremendous injustice, decided to address their new famine by sending them free government food.
00:35:40.860
But it wasn't organic kale and healthy foods. It was spam and potato chips and other whatever
00:35:46.080
junk food. Well, guess what? Their obesity diabetes rate went from 1% to 90%.
00:35:54.020
It's amazing. And the Indians in the same group that were just living south of the border in Mexico,
00:36:01.700
they continue to have 1% rates of obesity and diabetes. So they remained healthy, having a different
00:36:09.480
soil and water supply. Now, the US government sent all this junk food, and their obesity rates and
00:36:17.500
diabetes rates went to 90%. So what did the NIH do? They dispatched their genetic scientists to go down
00:36:24.840
there and draw the blood of the Indians to look at their genes to see if they could find a gene that
00:36:31.200
explained their high rates of obesity and diabetes. No joke. No joke. What were they doing just before
00:36:38.000
COVID? Were they studying food as medicine or general body inflammation or the harms of pesticides?
00:36:43.740
They were giving money to a laboratory in China to study coronaviruses that they captured from bats
00:36:50.560
200 miles away in caves. What are we doing? And so we've got to redirect our priorities and start
00:36:57.140
focusing on common sense. Beautiful. What do you think? I mean, I suspect you're going to be for it.
00:37:03.380
So interdisciplinarity is something that every university puts on the top of its mission
00:37:11.080
statement. We support. But then I know from my own personal experience for many decades as a professor
00:37:17.000
that the second that I introduce some new program that is supposed to, by definition,
00:37:23.340
be an exemplar of interdisciplinarity, then everybody becomes super clanship. They all become
00:37:29.820
very territorial. So let's say I wanted to create a university-wide evolutionary program. The idea
00:37:35.260
being that whether you're studying politics or medicine or consumer psychology, there is value in
00:37:42.240
infusing it with evolutionary theory. So it really would have been the perfect interdisciplinary program.
00:37:47.460
But then each dean to whom I pitched this idea would suddenly become very territorial over their
00:37:54.600
their little fiefdom, their little silo. Now, before I turn the floor to you, the latest two Nobel
00:38:02.460
Prizes have just been announced. The one in physics went to AI researchers. The one in chemistry went to AI
00:38:10.040
researchers. Now, to me, that was cause for celebration because it speaks to the value of
00:38:15.900
interdisciplinarity. It was computer scientists who were winning the Nobel Prizes in physics and chemistry
00:38:23.620
for some of the tools that they were applying those fields. So what's your view on interdisciplinarity?
00:38:28.980
Can we become better physicians if we increase our commitment to interdisciplinarity and so on and so
00:38:34.620
forth? Take it away. Well, I'm devastated. I just learned I did not get the Nobel Prize.
00:38:39.280
Next year, next year. I'll recover quickly. I've been doing a study on the average size of stones
00:38:48.380
on Wolf Street. And I guess that did not put it over the top. No, you're so right. We've got to focus
00:38:56.380
on these. So what we are missing in medicine, in our little busy churning hamster wheels that we're on
00:39:05.440
is the big picture. How do we watch the public get sicker and more medicated right in front of our
00:39:15.200
noses and nobody is asking why? How is it that nobody is doing an analysis between autoimmune
00:39:21.340
diseases in the general population and in the Amish community subgroup that eats well and lives off the
00:39:29.500
land? How is it that we're not doing comparisons across parts of Europe and the United States where
00:39:35.520
there are radically different rates of things? How is it we're not studying food as medicine? How is
00:39:39.300
it we're not talking about environmental exposures? Maybe we need to talk about school lunch programs,
00:39:44.280
not just studying Ozempic. And we need to talk about environmental exposures that cause cancer,
00:39:49.780
not just the chemo to treat it. And so we get this tunnel vision. And what's happened is we have these
00:39:55.440
giant medical institutions that are so siloed with their own accounting streams. They've got their own
00:40:01.360
profit and loss sheets. And so they can talk broadly about we want everyone to play in the same
00:40:07.420
sandbox. But as long as you've got your doctors on this treadmill, where they've got to produce
00:40:13.620
their in their own accounting line, a profit, then guess what, they're going to do what they're
00:40:20.720
conditioned to do. And that is do what they need to do to survive. That means small, incremental,
00:40:27.060
little scientific studies within their specialty that are not big ideas. And guess where we are now
00:40:33.400
today. One in six NIH grants goes to health equity or diversity. We've got basically no progress in
00:40:42.520
many areas of cancer research, despite a return on investment that's astronomically high in terms of
00:40:49.320
the investment. And the return is pathetic. If you go to the ASCO, the cancer meeting, and you look at
00:40:55.100
the top papers presented every year, and you think that's what we got for $300 billion. And from the
00:41:02.700
government, maybe a fraction of that. So we need big ideas. We don't promote Ben Franklin thinkers
00:41:08.560
anymore. If you show up in a university and you say, hey, I got a big idea. I want to do cross
00:41:13.500
this point of research. They tell you, put your head down, focus on getting your NIH grants.
00:41:19.560
By the way, if I'm, forgive me for interrupting you, Marty. At one point, there was a university in
00:41:25.120
Southern California that was very keen on hiring me. And when they were going through my CV,
00:41:31.380
one of the things that they told me is, well, we were, we're a bit concerned as to how all over
00:41:39.200
the place you are, because precisely my career is built on the fact that I've used evolutionary theory
00:41:44.860
in, in studying human mating, in studying gift giving. I've, I've looked at studies use, you know,
00:41:51.240
using testosterone to study conspicuous consumption. I've looked at how the menstrual cycle
00:41:56.020
affects women's beautification practices. So, I mean, in that sense, I'm all over the place. But
00:42:02.780
what unifies all of my work is that there's always a commitment to apply the evolutionary lens. But to
00:42:08.120
them, to your point, I was all over the place. So rather than viewing the fact that I could publish
00:42:13.900
in medicine and in psychology and in consumer behavior and in economics as a laudable thing,
00:42:19.840
it was basically, I'm too distracted. I'm not a hyper specialist. And so they view that as somewhat
00:42:26.100
with, with, with derision. Is there a way for us to change the PERC system so that people are
00:42:33.380
more appreciative of the big Ben Franklin thinkers?
00:42:37.880
Well, I think the NIH should identify people who have bold, big ideas, just give them the money,
00:42:44.980
give them five or $10 million and give them the time they need to go and do whatever they feel
00:42:51.300
they need to do. Don't burden them with all of these forms and grants and fonts and submission
00:42:57.940
deadlines. And then they have to stick to whatever they said they were going to do. Well, what if the
00:43:03.560
purpose of science is to chase big ideas as they become evident in the process of doing research,
00:43:09.960
right? So I think we were not promoting Ben Franklin. Ben Franklin invented an amazing
00:43:16.720
stove called the Pennsylvania stove. He invented the lightning rod. He was doing experiments in
00:43:23.740
electricity. He was a pioneer in sanitation, in government, in the structure of government,
00:43:29.480
one of the signers of the Declaration of Independence, a statesman. We don't encourage that anymore. So what we
00:43:35.920
get are these bright, creative minds in college and med school. And then we beat them down and tell them,
00:43:43.340
you need to focus on one tiny area and look who we glorify. Look who we worship. Look who gets the job
00:43:50.080
of the dean of the medical school. Someone whose focus is so tiny, you don't even understand it.
00:43:56.780
You don't even know what they're doing. And look, I'm all for sub, sub, sub specialization.
00:44:01.720
I'm one of those guys. But at some point, you need to look at the entire system and say,
00:44:08.100
what are we doing? All of these chronic diseases are going up. As we prescribe more antidepressants,
00:44:16.020
more people are depressed. As we prescribe more pain medication, more people have pain. As we prescribe
00:44:22.380
more diabetes medications, more people have diabetes. As we prescribe more anti-hypertensives,
00:44:27.300
more people have hypertension. As we prescribe more obesity drugs, the population becomes more
00:44:33.820
obese. It's not causal. It's not from the prescribing, but we are missing something big
00:44:38.660
and no one is talking about it. We need big thinkers. Yeah. Beautiful. I'll just say one more
00:44:43.000
point about this. Then I want to ask you maybe a few personal questions. I mean, personal within a
00:44:47.580
professional context. Yeah. My favorite, I often played a game of, you know, if you can invite 10
00:44:54.480
people, historical people to your dream dinner, who would they be? And number one on my list always
00:45:00.140
is Leonardo da Vinci for reasons exactly what we're talking about, right? He's an anatomist and a painter
00:45:06.440
and a sculptor and a futurist and an engineer. He's everywhere, right? I mean, he literally is bridging
00:45:11.700
the natural sciences and art and so on. So I hear you. Okay. A personal question. Maybe it's more to
00:45:20.260
address my own paranoia. I have massive health anxiety. So when it comes to my yearly checkup,
00:45:30.540
even though knock on wood, everything is good, probably two weeks before I have to go for my
00:45:35.620
physical, I'm a complete nervous wreck because I think that I'm going to do the blood test and every
00:45:41.180
single disease that anyone has ever studied, I'm going to find out that I have it. So I want to
00:45:48.960
stay as far away with all due respect, Dr. Macri, as far away from guys that look like you and that
00:45:55.740
are wearing that white lab coat. If I could go on my whole life without ever seeing any of you guys,
00:46:01.020
I'm very happy. How do you... Well, thank you. You're very kind. Look at you. I want to be approachable.
00:46:08.060
Yeah. That's right. Of course, you know, the fact that just wearing that damn lab coat makes the
00:46:14.220
blood pressure go up. What is it? Like 10 points, I think. Is that about right? Yeah. That we have
00:46:18.320
more reasons to medicate. Exactly. So how is it that someone like you, and I mean, you're a surgeon
00:46:24.180
dealing with the pancreas, pancreatic cancer, arguably one of the worst diagnoses you can have.
00:46:28.720
How is it that you can operate, I mean, literally and figuratively in that world and never turn it
00:46:36.600
inward in the sense of, oh God, I see so much horrible things. Yes, of course I help tons of
00:46:41.880
people, but I know more than most people what could be waiting around the corner. If I were in your
00:46:48.380
shoes, I would have jumped off the ledge already because I simply don't have the ability to... And
00:46:53.440
maybe that's one of the reasons why I decided medicine is not for me. I'm going to go into
00:46:57.020
academia, behavioral sciences. How do you do it? Are you able to completely compartmentalize
00:47:02.600
and go about your business without ever caring and turning it inward?
00:47:06.960
Well, you know, we doctors are the worst patients. And when we see a doctor who's coming in to see us,
00:47:14.840
we immediately think, we look at each other and just kind of realize, okay, this could be
00:47:20.120
challenging. They're going to ask about all sorts of options that we normally don't talk about.
00:47:24.800
They may not listen to our advice. They may say, well, can I get an MRI instead of a CAT scan because
00:47:31.760
of the radiation? It's almost like they know too much. And then sometimes they just decline
00:47:36.780
what other people would normally agree to. And other times they have too much medical care because
00:47:43.680
they perceive that there's, they have a belief system that more care is better. But I would say
00:47:50.660
as I've progressed and look, I've spent so much time with people at the very last hours of life,
00:47:57.500
and it's, I, I see it as a privilege. I've gained so much wisdom on life from people reflecting back.
00:48:05.300
I've seen families come together. I've thought in times of my life, you know, I don't, I don't need to
00:48:12.660
go to church. I have some disagreements with church, with what they believe. And then you see
00:48:18.900
this church community rally around and nest around somebody who is dying in their community. And you
00:48:26.900
look at it, you say, that is, that is a beautiful thing to see community like that. And it changed my
00:48:33.080
perspective. I thought, you know what? Maybe I don't agree with everything they say, but I want to be a
00:48:37.360
part of something beautiful like that. So it does, it affects you a lot. And I would say
00:48:42.440
it goes both ways. We, we do operations and then people have complications and we think, gosh,
00:48:49.940
you know, if looking back, I wish we never offered them surgery. They begged for surgery. They had it
00:48:56.640
in their brain that they wanted some, some cyst removed because it could be precancerous. They were
00:49:02.960
in the borderline area of whether or not it needs to be removed based on our guidelines. They begged
00:49:09.400
for it. We decided to offer it. And then they had a bad complication. What am I doing? What are we doing
00:49:15.500
as a profession? And so the next time I'd consent somebody for the same procedure, I would give them a
00:49:23.280
more full picture of what could happen and maybe encourage it less or be more neutral or discourage it and
00:49:32.520
see if they, you know, how motivated they are. And so one thing that I observed is after doing pancreatic
00:49:38.920
surgery for years, at five years, most of my patients were no longer alive. And that was after doing the
00:49:46.900
surgery and oftentimes after they get chemo. And so I started doing something I just felt was ethical, wasn't
00:49:54.520
part of our custom, but it's just something I felt a moral duty to do. I would let people know,
00:50:02.500
when I'm going to do surgery for pancreatic cancer, when we discuss the option that even with the
00:50:08.080
surgery and doing chemo afterwards, most people do not make it out to five years, only 20% make it out
00:50:14.900
to five years. And guess what? A bunch of people were like, what? Well then, no, thank you. And I
00:50:23.580
realized that when you give people all the information, they think differently. It's how you present things.
00:50:28.380
In the past it was, hey, you got a tumor. We're going to take this out. Yeah, let's go for it.
00:50:32.700
We got an opening in two weeks. Can we get it in sooner? They would ask and we'd be like, we'll try.
00:50:38.260
And we'd high five each other and encourage them. They'd leave the hospital. And then I realized it's
00:50:43.680
not about getting the cancers out. It's about treating the whole person. And that's what's
00:50:50.340
missing in medicine. We are not treating the whole person. We all have our little subspecialties and you get
00:50:56.240
15 referrals and you get bopped around and no one's really in charge of your care. And you need to
00:51:01.860
stop and say, what are we doing in healthcare here? Who's in charge? Who's looking after and
00:51:07.540
treating the whole person? Wow. You were mentioning earlier that you often are with people at their
00:51:14.580
last moments. And in my latest book where I'm talking about how to live a good life and happiness
00:51:21.460
and so on. I quote a palliative nurse. Undoubtedly, you probably have heard of her where she tallied
00:51:28.480
up the five greatest or most frequent regrets that people had on their deathbeds. Do you know
00:51:35.640
what I'm talking about, Marty? No, I've heard of this, but I'm eager to hear.
00:51:39.080
Yeah. So I basically quote those five regrets, but I want to put it in an academic framework.
00:51:46.700
Actually, one of my former professors in my PhD, a psychologist by the name of Thomas Gilovich,
00:51:53.520
he pioneered the empirical study of the psychology of regret. And he basically looked at two sources
00:52:01.240
of regret, regret due to action versus regret due to inaction. Regret due to action, I regret that I
00:52:08.420
cheated on my wife and now I'm divorced. I regret that I cheated on her. Regret due to inaction,
00:52:14.040
I regret that I became a surgeon because my dad was a surgeon. He expected this of me,
00:52:19.660
but I always wanted to be an artist. I always wanted to be an architect. And so it's the path
00:52:24.280
not taken. Well, it may or may not surprise you, Marty, that over the long haul, when people are
00:52:30.360
sitting on the proverbial porch or on their deathbeds, the most looming regret is one due to
00:52:36.340
inaction, the road not taken. So having set that whole thing up, if I were to ask you, you're still a
00:52:43.020
relatively young man. So hopefully God willing, you have many more years left. What would you be
00:52:48.880
willing to share to us right now would be your greatest regret thus far in your life?
00:52:55.580
Not getting off the hamster wheel sooner. I was, I came out of residency and subspecialty training
00:53:03.100
in gastrointestinal surgery and surgical oncology. And I was off to the races. I was a busy surgeon
00:53:10.220
and about 15 years into it, I realized I don't want to keep doing this until I die. I want to
00:53:17.000
ask the big questions in healthcare that we need to ask that we are not asking. And it took,
00:53:25.040
it took a while. And, you know, I missed out a lot when you sacrifice your twenties and your thirties
00:53:31.800
and even some of your forties. And you were just incredibly singularly focused on working in the
00:53:40.920
hospital and operating and treating disease and rounding and seeing patients and taking calls.
00:53:47.080
We were always on call. There was no idea of, you know, someone's covering for me. We would still
00:53:53.560
take the calls no matter where in the world we'd be. And it's so consuming that you don't get to ask
00:54:01.240
the big question. And in my field, that big question is why has the number of pancreatic
00:54:07.100
cancer cases nearly doubled in the 20, in the 20 years I'm in practice? No one's asking that
00:54:13.940
question. And so now I'm doing exactly what I want to be doing. I love every aspect of my job or jobs
00:54:22.180
in the sense that I do a lot of different things. I speak, I write, I get to teach, we do a lot of
00:54:28.960
research and I see patients. So right now I'm, I'm happy as a clam doing exactly what I want to be
00:54:35.440
doing. Well, that speaks to one of the prescriptions in my happiness book is seeking variety, whether it
00:54:41.840
be food variety or intellectual variety. So I think by you wearing all of these different hats as part of
00:54:48.700
your greater profession, it is tickling your pension for variety, right? Yeah. It's, and I want to tell
00:54:57.460
other students as they come through and they see my life and they, they, they tell me, I want to do what
00:55:02.660
you're doing, but there's no shortcut. You sort of, you have to get through the system. You have to get
00:55:09.220
the degree. You have to get the credentials, whatever, in whatever field you need to be respected in that
00:55:15.660
field. And then you can have the authority to speak out about the broken system. But there's a
00:55:20.980
lot of us now doing it. You may have seen Casey Means is out there now. She also has a book, a book
00:55:26.380
came out just before my book, Blind Spots. And for a while, her book was number one and mine was number
00:55:32.840
two on Amazon. And I thought, gosh, this is amazing. I'm a big fan of Dr. Means. So many doctors
00:55:40.620
like her, Jay Bhattacharya, Vinaya Prasad, a whole bunch of docs, yourself, who are willing to be
00:55:46.740
honest with the public. And they're, we're not going to let the medical establishment control
00:55:51.720
the narrative. We're going to speak up if we perceive that people are getting bad information
00:55:58.120
or they should hear about a different point of view. Now, some people think that's, that should be
00:56:02.840
illegal. But if, you know, if they think that, then they may want to look at the opioid crisis and
00:56:10.380
how the medical establishment did, you know, putting out information on that or any one of
00:56:16.240
the many topics I go through in the book, Blind Spots. Blind Spots is not meant to be a history book,
00:56:22.020
although I have a chapter on sort of a short history of groupthink in medicine over the centuries,
00:56:28.120
which is, I think, the funniest chapter from what people tell me. But it's really meant to,
00:56:33.460
sorry, go ahead, go ahead. It's really meant to educate people about health by telling them the
00:56:37.900
backstory of how we ended up with the dogma today that still prevails. Yeah, beautiful. In my forthcoming
00:56:44.920
book, it's titled Suicidal Empathy, how dysregulated empathy can result in all sorts of, you know,
00:56:50.980
bad policy, whether it be immigration or homeless crisis or so on. I have a section where I talk
00:56:57.840
about so-called hate speech and misinformation and disinformation and settled science. And I say
00:57:03.400
that the second that you say something like settled science, settled science, you're actually
00:57:08.900
advertising that you're not a scientist. Because, I mean, truth, scientific truths are provisional.
00:57:15.480
That which we thought was true 300 years ago, we eventually updated, right? So you should never say
00:57:22.240
that something is settled. And I actually give several examples that might interest you that are from
00:57:26.360
the medical field. What is the gentleman's name? Is it Michael, the gentleman who ingested the virus
00:57:33.700
to demonstrate that that's what caused the ulcers? He eventually won the Nobel Prize for it.
00:57:40.420
Yeah. People were laughing at him. Semmelweis, the guy who childhood bed fever. Is it all in your book?
00:57:48.820
Yeah, I love it. Keep going. It's all in there. I love it.
00:57:51.420
Yeah. The gentleman, the ophthalmologist who came up with cataract surgery. Oh, he's a bullshitter.
00:57:58.920
This is nonsense. Now everybody loves him. So the idea that it's settled science. And if you say
00:58:05.080
anything contrary to that, we're going to shut you down. We're going to take your medical license.
00:58:09.440
We're going to close your YouTube channel. It amazes me, Marty, that in the 21st year,
00:58:14.520
that reflex is still something that we see in the Western world. It's breathtaking. So I'm so
00:58:21.480
thankful that there are guys like you, guys like Jay Bhattacharya that exist because otherwise I'd be
00:58:26.460
losing my mind. Well, I don't know if you saw Bill Gates said, or I don't know if you saw him
00:58:36.460
personally, since you live out there. You're in the West Coast, right?
00:58:39.940
No, I often go to the West Coast, but currently I'm in Montreal, Canada.
00:58:46.220
Yeah. So what were you going to say about Bill Gates?
00:58:48.900
Well, I was going to say also my school of public health professor said a Canadian is essentially an
00:58:59.700
Right, right. Although it's not such a good thing to be unarmed in that I was threatened in person while
00:59:06.580
walking with my son. And when I went to the police, they said, well, next time that you're
00:59:12.360
threatened, just make sure to call 911 because the guy who wants to behead me is going to have the
00:59:18.600
courtesy to say, oh, okay, I'll wait until the police responds before I behead you. So I think I must, I
00:59:26.380
prefer the second amendment to our castrated system.
00:59:31.000
Marty, stay on the line. I'd like to say goodbye to you offline.
00:59:35.520
Let me just remind people the full title of the book, Blind Spots, When Medicine Gets It Wrong
00:59:41.120
and What It Means for Our Health. You need to read that book. Thank you so much for coming on.
00:59:46.240
Such a pleasure having you. I'm a big fan of your work. Come back anytime you'd like,
00:59:50.980
and hopefully we'll get a chance to see each other in person soon.
01:00:12.780
To the advance of his replied to human beings Wit