Richard Isaacson (on Alzheimer’s prevention)

[0] Welcome, welcome, welcome to armchair expert, experts on expert.

[1] I'm Dan Shepard and I'm joined by Lily Padman.

[2] Hi there.

[3] Hi.

[4] This is our first laboratory episode where we do labs real time.

[5] We do.

[6] The beginning of the episode is us getting blood taken and you'll hear a bunch of that.

[7] Enrolling in a study.

[8] I don't think I've ever been a part of a study before this.

[9] That you know of.

[10] Well, that's true.

[11] On our phones, they're probably running all kinds of.

[12] Exactly.

[13] But not to worry if you feel like it's boring at the beginning.

[14] I thought it was interesting.

[15] But it ends.

[16] And then we get into a real interview.

[17] What in the whole episode was that's just getting blood taken?

[18] The reason we're getting our blood taken is because our guest is Dr. Richard Isaacson.

[19] You probably remember if you listen to the Sanjay Gupta episode, he had done a piece on Alzheimer's and interacted a bunch with Richard because he is one of the foremost experts on Alzheimer's.

[20] He's a neurologist with a focus on the treatment and prevention of allsciers.

[21] He's a neurologist with a focus on the treatment and prevention of Alzheimer's.

[22] Alzheimer's disease.

[23] And he is the director of the precision prevention program at Atria.

[24] And the Atria Institute provides coordinated health care and comprehensive predictive testing to enable a highly personalized approach to well -being.

[25] And we are now enrolled in a study.

[26] So cool.

[27] And he's not going to take this unsolicited advice.

[28] But if he changed his name to Dr. Playful, it would work.

[29] He's very playful, but very knowledgeable.

[30] Yes.

[31] Although Dr. Playful sounds a little too sexual.

[32] Sick.

[33] Sick.

[34] Yeah.

[35] Okay.

[36] So we'll stick with Dr. Richard Isaacson.

[37] Please enjoy.

[38] Wondry Plus subscribers can listen to Armchair Expert early and ad free right now.

[39] Join Wondry Plus in the Wondry app or on Apple Podcasts.

[40] Or you can listen for free wherever you get your podcasts.

[41] He's an armchair expert.

[42] Hi.

[43] Nice to meet you.

[44] Nice to meet you, dad.

[45] Right on next.

[46] Now, we probably, because you're going to do glucose.

[47] No, not glucose.

[48] In theory, for the finger pricks, you don't have to fast.

[49] If you ever want to do the actual blood draw, which is the big panel, which is the Boston Heart and all the cholesterol, all the other stuff, metabolism, that's got to be fasted.

[50] Okay.

[51] Thanks for wearing white pants.

[52] I appreciate that.

[53] I know.

[54] Thank you.

[55] I didn't even think about that.

[56] We're wearing white pants.

[57] I've only gotten blood everywhere like once.

[58] Well, you're in a white shirt.

[59] Well, I have, I have this.

[60] Oh, you're gonna put that out.

[61] Oh, yeah.

[62] I can't put a blanket over my legs.

[63] No, it's gonna be okay.

[64] You really don't anticipate gushing?

[65] No, no. I can't believe you have this whole lab setup.

[66] We have people in New York.

[67] that get blood draws and we have a kit now grip strength monitor and wait so we'll start with the blood stuff yeah i'm ready okay yeah let's do it we're gonna need you to turn your head and cough okay wonderful i feel like i'm at a bar like serving i know you can set this up at a bar people would get drunk and do it and do it exactly this is the one if you want to bleed everywhere so i'm going to use the blue ones okay okay why there's just a bigger it's a bigger gauge yeah we're going to do four cards so this is a research study so we're learning This is a research study, it's voluntary.

[68] Basically, we're trying to figure out the colloquial way of saying it is, can we develop like a cholesterol test for the brain?

[69] So just like we know what HDL is, the good cholesterol, even though that may not be true, LDL and APOB and triglycerides and all these things, basically we're trying to do that for the brain.

[70] Right.

[71] So we're making progress.

[72] Boston Heart Labs is the lab we use.

[73] It's a clinical test that, like, you can order clinically, but it looks at all the particle fractions.

[74] It looks at metabolic numbers.

[75] You can check your APOE gene.

[76] But if you do want to do that, it's all included.

[77] in the research and then you would have to like check those boxes but that we would set up a mobile blood draw and we would get that at some point and yeah there is zero identifying information in any way shape or form you guys are going to be somewhere like a hundred and 15th person or so in the study sanjay was the o gs i like that semi -ogees let's do some blood do that first ready to rock and roll ladies first oh sure the goal here is to actually for people to eventually be able to do it by themselves because it's research we're doing four cards at a time hopefully only one or two is necessary but we're we're getting extra because we got to do researchy type things basically it's a little prick shouldn't be painful at all have you ever done this before yeah okay cool you've done this before had a little prick oh god it's just right there it's just can't be You can't be resisted.

[78] It can't be resisted by you.

[79] You could not resist.

[80] Okay.

[81] So I think this is correct.

[82] Here we go.

[83] It's always good when the physician goes to your fingers with a needle and says, I think this is correct.

[84] Yep, exactly.

[85] Do that hurt at all?

[86] No, I don't know.

[87] Could you do this at home, do you think, one day?

[88] Definitely.

[89] Great.

[90] Good to hear.

[91] Because that's the goal.

[92] We're trying to democratize access to bring health care.

[93] I mean, anyone who has diabetes has to do this every day, right?

[94] Exactly.

[95] You got it.

[96] Corey Did some hamburger hanging out Yuck Okay That's it Look at that You were a champ Next victim Okay And three Two One Oh boy How'd that go Wonderful Hurt?

[97] No No no Great Oh there we go Okay You got a bleeder Like when you do a blood draw It's the vein and this is a mixture of capillary blood, which is a mixture of arterial blood like from the arteries and from the veins.

[98] So the reason we have to validate or prove that the test work is because it's a different blood source and that is it.

[99] Wobby -Wong!

[100] Oh, that was easy.

[101] Look at you guys.

[102] You guys are champs.

[103] I'm on mic now, Rob, so I'm going to add some content.

[104] Does this feel like peer pressure or do you have genuine interest in this?

[105] I have genuine interest.

[106] You do, okay.

[107] How old are you?

[108] I'm 36.

[109] Great.

[110] Perfect.

[111] nice getting people from all over the age spectrum is really really helpful oh I'm supposed to ask you guys a couple of questions about age and family history anyone have a family history of Alzheimer's here grandmother on which side fathers paternal grandmother great okay anyone Parkinson's vascular dementia and you have my grandfather had a maternal grandfather I'm sorry about that that's terrible and I don't think so Parkinson's vascular Louie body nothing thing.

[112] Okay.

[113] White privilege.

[114] Okay.

[115] Three, two, one.

[116] And you didn't really feel it either, did you?

[117] Wow.

[118] Love it.

[119] People could definitely do this.

[120] Okay.

[121] We're all pretty high.

[122] I don't know if that was.

[123] That may have something to do with it.

[124] Is it fair for me to guess that you're not normally administering this part of the test?

[125] I am not.

[126] I've probably have a nurse.

[127] I have, well, we have two nurse practitioners and a research coordinator.

[128] I've done this probably a half a dozen times.

[129] Okay, I said five.

[130] It was six.

[131] Well, this is four, five and six.

[132] Here you come.

[133] So you've done it three times.

[134] The Langham Hotel, New York, has blood on the carpet for me. That is for sure.

[135] We've done this in interesting places.

[136] Well, we appreciate that you're doing it.

[137] Absolutely.

[138] I wonder if everyone in the trial, where do you get these people?

[139] It's Bezos.

[140] It's Zuckerberg.

[141] It's us.

[142] He's not saying anything.

[143] It's like the most warped sample size ever.

[144] The vast majority of people are like normal people.

[145] Probably 15 % are exceptionally wealthy.

[146] Yeah, how do people get enrolled in this?

[147] They've emailed the Alzheimer's Prevention Clinic, which we started over a decade ago at Cornell.

[148] A lot of those people came.

[149] A lot of families do it.

[150] For example, we see a person with Alzheimer's and then we do the family members.

[151] Sure.

[152] Which is really the meat of what we've.

[153] Yeah.

[154] Is it time for that?

[155] Yeah, yeah, you guys want to do...

[156] Okay, so, left -handed.

[157] Yes, sir.

[158] You just do a little grip.

[159] But that's not to say that's my strongest hand.

[160] Should I be using my strongest hand?

[161] Your strongest hand, yeah.

[162] No, it's my right.

[163] Oh, really?

[164] You can do both.

[165] Wow, that's pretty good.

[166] Okay, you win again.

[167] Kilgrams!

[168] Did you want it in pounds?

[169] Actually, kilograms, okay.

[170] Okay.

[171] Thank you.

[172] You're supposed to do it as hard as you can.

[173] Yep.

[174] Oh, God.

[175] Definitely broke my wrist, but it was worth it.

[176] That reaction.

[177] I do want to do my left hand after this is to see, because I assume that my right is.

[178] Okay.

[179] Oh, no, it's not great.

[180] No, it's not bad.

[181] That's actually not bad at all.

[182] When do we get to your grip strength is good?

[183] Just hold that to you know.

[184] Oh, 58.

[185] Good job.

[186] That's pretty good.

[187] This is the C. We should have done it.

[188] This is at the end.

[189] This is a depressing.

[190] You're going to meet it.

[191] Oh.

[192] Oh, do you beat me?

[193] What did it get?

[194] What the?

[195] What did you get, right?

[196] Oh, wow.

[197] You're trying to know.

[198] No, you still won, but...

[199] I know, but I just want to see.

[200] This is of my own curiosity.

[201] You were 55 .3?

[202] No, no, you were 58 .6.

[203] Oh, sorry.

[204] Yeah, press that.

[205] Close.

[206] No, you're right.

[207] You're right.

[208] It was stronger.

[209] What's average for a woman and a man?

[210] Uh, there's like, um, percentiles and you have to like look and there's...

[211] We did bad, that's all.

[212] No, no, no. Actually, actually, everyone did really well on, um...

[213] Everyone did well on grip strength.

[214] Okay.

[215] Oh, this is so...

[216] Everyone did well.

[217] We should do more things where we got busted.

[218] Yeah, yeah, this is fun.

[219] Okay, so just depending on how much we use of that, real audio, just want to bring everyone to speed.

[220] We started with a pin prick to the fingers, all three of us.

[221] and we put it on four different cards.

[222] And then we went on to a mobile lo -fi dexas scanner, right?

[223] It's a biometric scale.

[224] And it's going to tell us what?

[225] Percent body fat and muscle mass. What about bone?

[226] Not this version.

[227] This is kind of like a screening test, which is pretty good.

[228] And it's an at -home scale, which is helpful.

[229] But it's not gold standard, but it's helpful.

[230] And then we had a hand grip strength test, which was really fun.

[231] And Rob was very strong.

[232] I was hoping to beat Rob by a lot more than I did.

[233] That was impressive.

[234] Have you done it?

[235] I have.

[236] I've done everything.

[237] What is your hand strength?

[238] Don't fib.

[239] Waiting kilograms?

[240] Yeah.

[241] Oh, I don't remember.

[242] Well, guess what?

[243] You get to take a test now, too.

[244] No, no. We've never put a guest on the spot like this.

[245] Let me show you my blood biomarkers.

[246] I put my best foot forward.

[247] But my hand's sweaty because of the excuses.

[248] It's an athlete who blames his equipment.

[249] Oh, my gosh.

[250] Hold on.

[251] I got this.

[252] No, I had a plastic glove on.

[253] It matters so much to us.

[254] Hold on, I'm starting again.

[255] Oh, it wasn't.

[256] Humans are incredible.

[257] Oh, no, I'm so upset.

[258] My hands are sweaty.

[259] I have your blood.

[260] Yeah, you are blood on your hands.

[261] I can't even, no, this isn't fair.

[262] I can't even forever.

[263] I'm so upset.

[264] No. He's using two hands now.

[265] Oh, my God.

[266] Oh, that's funny.

[267] That's not bad at all.

[268] I don't think.

[269] It's wonderful.

[270] 47 recently.

[271] It was 47 recently.

[272] Oh my God.

[273] Oh, fuck.

[274] That was so funny.

[275] Anyway.

[276] Oh, Sanjay was really fun.

[277] We should add, you're kind of here because we had Sunjay on it.

[278] He did a multi -part series on Alzheimer's, and you were a large part of that investigative work he did.

[279] Sanjay's the man. Yeah.

[280] Isn't he the most love?

[281] Have you hung out with him socially?

[282] I met him briefly like a decade ago, and I haven't told him this.

[283] I met him at like a backstage at Dr. Oz or something, and I'm a fan boy.

[284] Now I know Sanjay, and it's like amazing that I've gotten to know.

[285] I'm mostly during COVID, but I wanted to be Sanjay 20 years ago.

[286] He's a six -year grad.

[287] I'm a six -year medical school grad, like called the baby doc program.

[288] The way he could just communicate science, it's just different.

[289] And that was my career path a little bit when I was in academics.

[290] I used to teach the faculty how to communicate your science.

[291] So that's kind of what I did.

[292] And I looked up to Sanjay.

[293] And now it's so cool.

[294] I don't think of it like that.

[295] I got to like separate it, but 46.

[296] Three years of my junior and you're probably nine years?

[297] Yeah, around there.

[298] Okay.

[299] He's mid -50s.

[300] Looking great.

[301] Then he wrote a great article that I read talking a lot about you.

[302] And yeah, he said he knew you over the years and he would often reach out to you for certain topics.

[303] We were in touch a lot during COVID because the shit was hitting the fan in the world and you have to have a network of specialists that you can rely on.

[304] And Sanjia was always there.

[305] When I had questions and he had questions for me, he's always calling me about interesting people.

[306] I'll just put it that way.

[307] Yeah, I bet.

[308] He's probably a conduit.

[309] I bet when people bump into Sanja, yeah.

[310] This is the same with...

[311] Adam.

[312] Do you know Adam Grant?

[313] I don't.

[314] Well, he'll really connect you with everyone.

[315] Oh, boy.

[316] Yeah, be careful.

[317] You have to do this everywhere.

[318] And then when did you meet atia?

[319] I met Peter in 2014 -ish at the Breakers Hotel.

[320] Oh, down in Florida.

[321] We were speaking at some...

[322] I didn't even know what I was doing.

[323] I don't know.

[324] And didn't know who Peter was, aside from...

[325] He had this blog or micro blog, but it was like a decade.

[326] to go, and he would talk about nutrition.

[327] I knew of him from some nutrition stuff, and it was me, Peter, and Jay Walker, the Priceline guy.

[328] It was 11 p .m. I was exhausted.

[329] Next thing we know, it's like one, two o 'clock in the morning.

[330] We're all talking on a couch, and I'm arguing with Jay Walker.

[331] I enjoy Vegas.

[332] And I thought that you could beat the slot machines because I had a method.

[333] My uncle lived in Vegas.

[334] Because he has like hundreds of patents on slot machine randomization codes or so.

[335] I'm totally probably mangling this because this is a decade ago.

[336] I wouldn't have known that at all.

[337] So he has all this intellectual property.

[338] or whatever.

[339] And I'm like, so did I beat it?

[340] Did I win?

[341] He's like, it's all random.

[342] Oh.

[343] And I'm like, no, no, no, no. Trust me. Trust me. Jacks are better.

[344] High limit.

[345] $5.

[346] Like, I had it all figured out.

[347] And you really believed it.

[348] 100%.

[349] Oh, my gosh.

[350] Wow.

[351] This illustrates a fascinating point about all of us.

[352] No matter how smart you get.

[353] And in fact, a lot of people talk about Dunning Kruger effect.

[354] It almost affects smart people more.

[355] It's more dangerous to be really smart in one area because you can be misled.

[356] But you genuinely thought you had a system for slot machines.

[357] I was certain of it.

[358] And were you shook when he explained you how that was impossible?

[359] I'm still not okay.

[360] I've never gone back to the high limit.

[361] Have you not played?

[362] No, now I play craps, six and eights.

[363] The best odds is what I choose, but I'm still upset.

[364] Yeah, they say craps is mathematically the best odds in Vegas.

[365] Yeah, pass line six and eight, Vegas.

[366] That's as good as it's going to get.

[367] Exactly.

[368] I mean, Peter's one of the more influential top tennis or so medical people in my career that's changed the way I think about medicine.

[369] And I was pushed into a little little box because I was always trying to get ahead of things.

[370] And we have a sick care system, but I'm a preventative care kind of guy.

[371] And Peter just saw things the way I saw things.

[372] So it was just really reassuring, motivating.

[373] He mentored me in a way to say, you know, I was in academics and I had to prove what I was doing.

[374] But he really helped.

[375] He kind of told me to stick to it.

[376] Did you participate and outlived at all?

[377] I feel like I saw a version of that book when it was either called The Manifesto or it was very long and very different.

[378] I think I mentioned on some page.

[379] I think I gave feedback, but I didn't see Outlive until I got a copy of it.

[380] So our history is we interviewed Peter.

[381] It was very fun.

[382] We walked out.

[383] Turns out he's a bonkers gearhead like I am.

[384] So then we started doing a lot of motorsports stuff together.

[385] So now we're just pals.

[386] But when I was learning of Sanjay's work vis -a -you, I was like, oh, this is very outlived.

[387] The brain health is a metabolic condition.

[388] This all feels very, very in keeping with what Atia's prevailing theory on all this is.

[389] Yeah.

[390] And we sometimes disagree.

[391] And when I've disagreed with Peter, it's caused me to, like, go down very long time -consuming, complicated and expensive rabbit holes to prove or disprove, like this whole genetic thing.

[392] Him and Bob Kaplan, Nick Stenson is awesome, the guy who does the podcast now, but I was running in Central Park, 2018, and he was talking to Bob Kaplan about how genetics, it doesn't help, and 23 of me is bad, and I'm just like, what do you mean?

[393] I think you can personalize care, and this is more brain health.

[394] And he said something, and I got so pissed off and ran my fastest 10K or whatever around the rest.

[395] reservoir.

[396] And then we did like a half a million dollar research study to try to prove whether or not genetics was whatever.

[397] And we spent a lot of time and a lot of money.

[398] And now we're talking about who.

[399] Well, he's talking about clotho and APOE.

[400] And he's talking about all these things.

[401] So, you know, we were both right because doing whole genome sequencing, for example, is super expensive, super time consuming.

[402] We did it on like a whole bunch of people during COVID spent a whole year on it, spent a lot of money.

[403] And 44 % of the time, we found something that was impactful.

[404] But greater than 50 % of the time we didn't.

[405] So that's the challenge with genetics, but that was fun.

[406] I've been fighting tooth or nail about these blood -based biomarkers trying to develop this cholesterol test for the brain using blood tests for the brain, which we can talk about.

[407] But I'm not sure he's fully convinced yet, but he is talking about him now.

[408] Right.

[409] We're going to earmark cholesterol because he has kind of a provocative take on cholesterol that's very appealing to me because I've always just had high cholesterol regardless of what my diet is.

[410] Are you a LP little A guy or just an LDL guy or APOB high guy?

[411] I have low high density and high.

[412] high loaded.

[413] So the reverse of what you want.

[414] Yes, the absolute opposite of what you would hope for.

[415] Maybe sort of.

[416] H .D .L. is complicated.

[417] Yeah.

[418] And I have since started taking a lot of red yeast.

[419] I have lowered it into a same level.

[420] Isn't it more about the ratio or no?

[421] Let's earmark it, though, because we need to do a full cholesterol deep dive.

[422] But let's start with your story, which you already said.

[423] You had this accelerated medical school plan.

[424] You had a BA at 19.

[425] Does that mean you entered college earlier?

[426] In New York, I made the cutoff, so I was young.

[427] I graduated high school at 17.

[428] I did a lot of AP classes, and I clapped out of stuff and whatever those tests were.

[429] I missed a lot of parties.

[430] Oh, it was terrible.

[431] But I was a substitute teacher for a while because that's how I made money in med school.

[432] And the riverboats, that's gambling.

[433] But I had a lot of college credit.

[434] I did finish my undergrad requirements in the first two years.

[435] Actually, it was a BLA, Bachelor in Liberal Arts.

[436] Oh.

[437] Okay.

[438] I've never heard that differentiate.

[439] I learned how to ask seminal questions in life.

[440] Would you like fries with that?

[441] I don't know what I learned in my BLA.

[442] Will you be eating in or taking out?

[443] Exactly.

[444] Then medical school.

[445] So I was 17 years old.

[446] I remember this vividly.

[447] Got my white coat.

[448] I'm in rounds in the hospital.

[449] On Tuesdays and Thursdays for part of the day.

[450] I'm in medical school.

[451] On Tuesday, my docent is what it's called, like a mentor.

[452] We go around and round the University of Missouri, Kansas City, goroos, fighting kangaroos.

[453] And we basically learned when we were young that medicine can be taught early.

[454] And then the founder of our medical school went over to China and went over all these different places.

[455] and learn that a lot of countries out there, you start med school out of high school.

[456] This was a unique program.

[457] I have regularly wondered why the BAs necessary, because even if you're on the medical path, only 20 % of what you're studying is applicable to that.

[458] Why are we doing all this other stuff?

[459] We know what we're going for.

[460] I can see both sides of that argument, but I think being well -rounded, getting psychology classes, understanding liberal arts, I did take history of rock and roll.

[461] I did take some of those silly but kind of cool classes.

[462] I think it's important.

[463] I don't know if the full four -year degree, but I'm very supportive of the combined.

[464] Well, let me hit you with even more provocative.

[465] People hate this opinion.

[466] I think surgeons should skip a ton of the stuff.

[467] That's a tough opinion because you really need to be medical to be a surgeon.

[468] Critical care, when the stuff's hit in the fan, you've got to know general medicine.

[469] But do you need to know mitosis and meiosis?

[470] And do you need to know organic chemistry?

[471] You're a human mechanic.

[472] This is a very valid point, biochemistry.

[473] I don't know what I remember from it or what I learned in Orgo.

[474] I remember benzene rings, but how that does anything.

[475] And then you're a surgeon.

[476] I think it's even less applicable.

[477] So I don't know.

[478] Some of it's a little gratuitous.

[479] But alas, why were you in such a hurry?

[480] I knew 100 % that I wanted to be a doctor.

[481] Well, you have an older brother, though.

[482] You got it.

[483] I had a picture of Sierra Coupe on my wall, the old Surgeon General.

[484] Oh.

[485] Oh, wow.

[486] Oh, yeah, yeah.

[487] I wanted to be surgeon.

[488] Like, in fifth grade.

[489] So when you say you wanted to be Sanjay, you really did.

[490] Oh, I had these like aspirations.

[491] Do you now have a Vick -Murthy poster in your office?

[492] He's wearing a speedo.

[493] No, I shouldn't have said that.

[494] So my brother is a neurologist, 13 years old than me. He's the smart one in the family.

[495] I'm the better -looking one.

[496] Clearly, this is a podcast, so that works out.

[497] And, you know, I had my neuroanatomy made ridiculously easy and understandable book, and I used to bring in on a camp trip because I was like that dorky kid.

[498] But I wanted to be a neurologist.

[499] I kind of knew it.

[500] I thought the brain was cool, and I went to medical school with a plan, and I just wanted to just do it.

[501] Okay, so there's any number of fields you could have, probably focused on as a neurologist.

[502] How do you get driven into Alzheimer's and dementia as a specialty?

[503] It was a little circuitous because I was fascinated by the brain, thinking skills, memory, cognition.

[504] I always thought it was interesting.

[505] I also kind of enjoyed the fast -paced nature of medicine.

[506] So for a little bit, I thought I was going to be like a vascular neurologist, strokes, and do like what cardiologists do and put piping in and put balloons and stents.

[507] And I kind of went down that phase.

[508] But vascular neurology, cardiovascular medicine, and brain health and cognition were the things I was most drawn to.

[509] You have a family history of Alzheimer's disease.

[510] I have several family members with the disease.

[511] My uncle Bob, amazing guy, I was diagnosed when I was in high school.

[512] Back then, there were no treatments.

[513] And the years going into medical school, there were no treatments.

[514] And I wanted to be a neurologist since I was like eight years old.

[515] You can't do anything.

[516] My uncle Bob introduced my parents.

[517] My uncle Bob saved me when I was, you know, drowning in the pool.

[518] Yep.

[519] Yeah, a very common uncle.

[520] Thing to do.

[521] Yeah, a lot of people get rescued by their uncles.

[522] Oh, my God.

[523] Navy guy.

[524] Still remember.

[525] I don't go near the water anymore, but seriously, I don't go in the pool.

[526] I live in Florida.

[527] It's a whole thing.

[528] Now, really quick, you could have one or two reactions that as you enter a field, nothing's known about it.

[529] So you're like, why am I going to go practice this thing or you have no impact on anyone?

[530] A, you know, if you're kind of defeatist and pessimistic like myself, or you could go, wow, this is a field where I could actually make a real mark on it because no one knows what the fuck they're doing.

[531] It was probably the latter because there's the decade of the brain.

[532] I don't know when they're.

[533] was.

[534] I think it was the 90s or 2000s or something.

[535] And it was supposed to be like when the decade was over, the brain is going to be understood and the decade ended and there really wasn't that much traction.

[536] And was that driven by fMRI?

[537] Was there a technological breakthrough that was supposed to unlock all these secrets?

[538] You know, it was a saying that tried to get people interested and tried to get funding, whatever the saying was.

[539] Because we could say the least understood Oregon at that point.

[540] Yep.

[541] It's kind of like a venture bet.

[542] You know how venture capitalists put a long hedging bets or VC or whatever the term is.

[543] But you put money in and then 10, 20 years down the line, you know that something's going to change.

[544] I kind of thought about that.

[545] I wanted to be challenged in my career.

[546] I wanted to do something that I'm interested in.

[547] Long position.

[548] Yeah, long position.

[549] That's what I'm trying to say.

[550] Exactly.

[551] And I thought or predicted or was hoping that 10, 15, 20 years after I graduate med school, that's when it would hit.

[552] And guess what?

[553] I know.

[554] I know.

[555] You're actually living and realizing your dream.

[556] It's crazy.

[557] So give us a brief history of Alzheimer's as a disease.

[558] When is it first identified?

[559] When do we get that label?

[560] And how are they diagnosing it back then and walk us up to when you enter the scene.

[561] Yeah, so over a hundred years ago, Aloys Alzheimer's is the doctor's name.

[562] And Augusta Dieter, Dieter, was the first person that was given the diagnosis.

[563] And it's a little funny, but she was given this diagnosis of Alzheimer's.

[564] And she had a very uncommon form of Alzheimer's disease.

[565] And she had early onset Alzheimer's in her 50s.

[566] And she was shown to have cognitive changes before she passed.

[567] And then when she passed, they looked at the brain and there was amyloid in the brain.

[568] And there's these pathological features.

[569] And amyloid is a sticky protein.

[570] It builds up in the brains of people with Alzheimer's.

[571] There's also this tau protein, and tau tangles.

[572] And amyloid and tau characterize the disease.

[573] But I'm doing characterized with my carrots or fingers, like in the air, quotes.

[574] Thank you.

[575] So the brain looked like amyloid and tau, and the patient looked like this.

[576] So the disease was characterized that way.

[577] That's something that didn't make sense to me. And it still doesn't make field.

[578] What aspect of it didn't make sense?

[579] They were saying, hey, look at these two proteins.

[580] This brain is riddled with it.

[581] It has an abnormal amount that we don't see often.

[582] This must be the cause of it.

[583] It's probably interrupting neurons from communicating a gummy plaque, like an engine analogy.

[584] The causative part was the problem for me. Yeah, right.

[585] Like, is this the results of a disease or is this the cause of the disease?

[586] Exactly.

[587] And to me, the term biomarker is a biological something that can be a hallmark of a disease or a condition.

[588] Just because there was amyloid and tau there, like it didn't jive with me because I'm a clinician first.

[589] 80, 90 % of the time a neurologist makes a diagnosis.

[590] It should be made based on the clinical history.

[591] And I was seeing patients and also in my own family, like I had a family member.

[592] I was sitting next to her at a wedding and she kept repeating herself.

[593] It took years for conventional medicine that were following this amyloid and tau diagnostic criteria, this framework that was set decades before, to be able to make a diagnosis, but I saw something.

[594] I could feel something with the eye movements and something was different.

[595] Something felt off.

[596] And if something feels off, but the amyloid in town may or may not be there, then there's got to be something else that precedes it.

[597] Right.

[598] And that's what changed things for me. And that's why I went this way.

[599] This is the great universal conundrum in medicine, period.

[600] I have my own example of that, which is people with arthritis.

[601] or psoriotic arthritis like mine often have low vitamin D and the original assumption was low vitamin D leads to inflammation, but then at some point someone finally said, no, low vitamin D is the result.

[602] Understanding the order of these things is imperative and makes a world the difference.

[603] It's very hard to figure out.

[604] If you have a contrarian viewpoint, it's hard to go up against.

[605] And get funding to research it.

[606] Impossible.

[607] And you know, that's something actually that Peter encouraged me to just keep going.

[608] You know, my old chairman, Dr. Cliff Saper at Beth Israel Deacon is Harvard Medical School.

[609] He wrote this email to me. He said, you know, Richard, you're a trailblazer.

[610] You're doing great things.

[611] In 2006, I remember the email.

[612] I printed it.

[613] It was on my wall next to see her for it.

[614] Sanjay never made the wall one day.

[615] But he said, you're a trailblazer.

[616] I said, wow, he's saying this about me, little old me. I'm like 20 -something years old.

[617] But there's not easy funding mechanisms to do this.

[618] So you're going to have problems in your career.

[619] And he was 100 % right.

[620] And I've had to beg and plead and ask and beg again.

[621] And traditional grant writing doesn't really.

[622] work because you write a grant and then you submit it and then it takes six months, nine months, and then no one gets it in the first trend.

[623] And then you get funded two years later.

[624] And that grant was written based on science that you just zoomed past.

[625] And in prevention and reducing risk, the science moves even faster.

[626] And it's contrary and it's controversial.

[627] So I just kept striking out and striking out and striking out.

[628] Most of our funding, 70, 80 percent are donations and philanthropy.

[629] And that's how we did it.

[630] Was your original goal to uncover whether the amyloid was a product of or the cause of, or did you have a more specific, narrower objective?

[631] So in 2006, a paper came out looking at omega -3 fatty acids and its relationship to brain health and cognition and Alzheimer's risk.

[632] It was convincing.

[633] You take omega -3 fatty acids, which to me made intuitive sense.

[634] Good for the brain.

[635] Here we go.

[636] Quotes.

[637] Quotes.

[638] I learned.

[639] I learned.

[640] It's good for the brain.

[641] The outcomes are good.

[642] And everyone in my field shunned it.

[643] So it's not possible.

[644] Omega -3 is not amyloid.

[645] Tau.

[646] But it's the synapse.

[647] It's the brain cell.

[648] It's oxidative stress.

[649] It's mitochondrial.

[650] There's other things that omega -3 fatty acids do.

[651] They would have wanted it to reduce amyloid in tau to be a convincing...

[652] Exactly.

[653] As some of us would say, that really grinds my gears, right?

[654] It just ate at me. So I said, okay, I'm going to start putting people on omega -3 fatty acids.

[655] And I'm going to track stuff.

[656] Basically conducting your own.

[657] in my clinic patients because I was interested in vascular brain health.

[658] Dr. Arthur Agateson, also one of my mentors on the Agateson Calcium Score is the South Beach Diet guy.

[659] But before that, I met him in 2001 when I was a lowly intern at Mount Sinai Medical Center in Miami.

[660] The way he thought about things was just different.

[661] And he believed in nutrition.

[662] He believed in prevention.

[663] I started putting people on omega -3 fatty acids and checking their cholesterol, even though I'm a neurologist, which is kind of okay for stroke doctors, but not really for Alzheimer's specialists.

[664] I saw the cholesterol getting better.

[665] And I said, okay, I don't know what that does.

[666] And maybe the cog tests were maybe a little better.

[667] I don't know.

[668] But it wasn't working the same in everybody.

[669] Can I ask you a dumb question now?

[670] I'm always curious about this with blood tests, which is if you find it present in the blood, does that necessarily mean that the body is using it, absorbing it, bringing it into protein synthesis, or is it just mean it's floating around because you dumped it in there?

[671] Does that make any sense?

[672] Like, how do we know that it's being used as opposed to just present?

[673] So the way to check it with omega -3 fatty acids, Dr. Hussain Yassin did some amazing work where they did spinal taps to see how much omega -3 is making it into your...

[674] Basically, and I may be mangling this conceptually a little bit because basic science, I didn't do too well in Orgo.

[675] I got to be an organic chemistry in medical school, but that's not important anyway, right?

[676] Omega -3 is like a perfect thing.

[677] So people with an APOE4 variant, APOE4 is the most common genetic risk factor for Alzheimer's disease.

[678] 25 % of the population have it.

[679] There's four of us in here.

[680] Probably one of us have it.

[681] Rob.

[682] Because he had the grip strength.

[683] I got to get rid of him.

[684] He's my closest competition to grip strength.

[685] So APOE4 increases risk, but omega -3 fatty acids preferentially protect against Alzheimer's and people with the APOE -4 variant.

[686] Now you have this concept of personalized medicine, precision medicine.

[687] We've heard about this in cancer.

[688] We've heard about this in other conditions, and that's kind of what just changed the way I think about Alzheimer's.

[689] Well, we should point out another paradigm you inherited, which I think has pervaded medicine the whole time, which is we have this really weird compartmentalized view of the brain as something completely separate from the rest of the body.

[690] There's this blood brain barrier.

[691] So even though omega -3s, I'm sure people are arguing at that time that's not even making it to the brain.

[692] You know, there's this kind of arbitrary division.

[693] That's its own paradigm you're fighting against.

[694] So I'm going to say something that I don't know if I've said before.

[695] I've said in lectures maybe, but I believe Alzheimer's.

[696] disease, it's a medical condition.

[697] When people have, like, high blood pressure or high cholesterol or diabetes, well, people can have kidney failure.

[698] My buddy Dave, his mom was on dialysis, terrible.

[699] Well, she had diabetes, she had uncontrolled vascular risk factors, and it affected the end organ, the end organ damage.

[700] Downstream.

[701] Exactly, of the kidney.

[702] And this is very controversial, but I absolutely believe it.

[703] I feel it, but I've seen it.

[704] The end organ damage of various medical conditions of the body in certain people, whether they're genetically susceptible or otherwise, is the brain.

[705] While elevated cholesterol, blood pressure, blood sugar, don't really think that causes Alzheimer's disease.

[706] It can fast forward Alzheimer's pathology in a certain person.

[707] So I believe that Alzheimer's is a medical condition most of the time or a lot of the time, and I'm not sure exactly what that is.

[708] It depends on the person's genetics.

[709] It depends on the individual characteristics.

[710] You know, men and women are very different.

[711] women that go through the perimenopause transition with the APOE4 variant, the estrogen drops, the amyloid goes up, you need to intervene then and follow very closely.

[712] Harmon replacement therapy is controversial, but it's the whole thing.

[713] I believe that you can prevent, reduce risk for, delay onset of, whatever word you want to use that you feel comfortable with.

[714] Would I be wrong to say, like a lay version of saying it is the whole system's connected.

[715] Nothing's compartmentalize.

[716] You have an overall metabolic health, and if you have poor metabolic health, it may materialize in any number of downriver symptoms.

[717] It could be a kidney issue.

[718] It could be a brain issue.

[719] Depending on your genetics.

[720] And I remember learning about all these concepts.

[721] Megan Leary, she taught me, you know, trust but verify.

[722] You don't have to always trust the dogma.

[723] Just don't believe blindly.

[724] Dr. Kaplan explained to me, and he was telling me the story about the bedside, C. Miller Fisher, and he was a stroke guy.

[725] And he would tell these stories about intermittent interruption of behavior.

[726] And that was a sign of uremia, which is a kidney problem.

[727] And I'm like, wait a minute.

[728] you can make a diagnosis of a kidney failure based on the way someone's cognition changes?

[729] What?

[730] That's what got me to link that medical conditions, medical disease, is related to the brain and the brain function.

[731] Something called pseudo -dementia of depression.

[732] Someone can be depressed with low serotonin levels and have problems with attention or speed of processing.

[733] If someone's not paying attention, they can't remember things.

[734] That's not dementia.

[735] It's a cognitive problem that is related to low serotonin.

[736] If you're not encoding the memory, then you can't remember it later.

[737] That's a pseudo -dementia of depression.

[738] So all things biological can cause cognitive changes.

[739] Cholesterol, problems with executive function, vitamin D, omega -3s, they're metabolic health.

[740] When I think of metabolism, I think of memory.

[741] People with elevated fasting blood sugar and diabetes, twice the risk of Alzheimer's disease, but there's a correlation.

[742] You hear and you see the high blood sugar and you do the cognitive testing.

[743] and it's usually to little bit correlated.

[744] Stay tuned for more armchair expert if you dare.

[745] What's up guys?

[746] It's your girl Kiki and my podcast is back with a new season and let me tell you it's too good and I'm diving into the brains of entertainment's best and brightest okay?

[747] Every episode I bring on a friend and have a real conversation and I don't mean just friends I mean the likes of Amy Polar Kel Mitchell, Vivica Fox the list goes on So follow, watch, and listen to Baby.

[748] This is Kiki Palmer on the Wondery app, or wherever you get your podcast.

[749] We've all been there.

[750] Turning to the internet to self -diagnose our inexplicable pains, debilitating body aches, sudden fevers, and strange rashes.

[751] Though our minds tend to spiral to worst -case scenarios, it's usually nothing.

[752] But for an unlucky few, these unsuspecting symptoms can start the clock ticking on a terrifying medical mystery.

[753] Like the unexplainable death of a retired firefighter whose body was found at home by his son, except it looked like he had been cremated, or the time when an entire town started jumping from buildings and seeing tigers on their ceilings.

[754] Hey listeners, it's Mr. Ballin here, and I'm here to tell you about my podcast.

[755] It's called Mr. Ballin's Medical Mysteries.

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[757] Follow Mr. Ballin's Medical Mysteries wherever you get your podcasts.

[758] Prime members can listen early and ad -free on Amazon Music.

[759] This is a great opportunity right now.

[760] Sorry, I'm going to fold you into an ongoing argument by proxy with Monica's father, who is so smart.

[761] Ashok, he's one of the smartest guys in the world.

[762] Her maternal grandfather passed of dementia, and he also was diabetic.

[763] He cut out rice from his diet.

[764] Ashok observed that those were pretty correlated with the acceleration of dementia.

[765] No, okay.

[766] You're not representing him properly.

[767] And so his show is decided, even though he is pre -diabic, he's going to start eating rice again because he's made this connection.

[768] Small amount.

[769] Small up.

[770] He's worried.

[771] Wait, wait.

[772] This is maternal.

[773] Right.

[774] They are not related.

[775] Okay.

[776] But he felt that his brain decline started once my grandfather fully took rice out of his diet.

[777] So my dad has stopped eating carbs, basically, because he's trying to be healthy.

[778] And then he's second -guessed that decision because of all this.

[779] thought he might incorporate rice in a little bit more.

[780] And look, the thing is, I don't know what erasing carbs fully from a diet.

[781] It could affect your brain and energy.

[782] Like you said, it's all connected.

[783] And different people with different genes respond differently to different diets, which is why nutrition research is all just completely discombobulated and impossible.

[784] But if someone wants to do a test like that, an experiment on themselves, what we preach and what we suggest is what we call an end of one trial.

[785] An end of one trial is, A person uses themselves as their own control.

[786] You make one change.

[787] You then repeat the blood test before and after.

[788] You check your body fat.

[789] You check your muscle mass. You do some cognitive tests, I'd imagine.

[790] In our program, yes.

[791] But even people out there that don't have access to a preventive neurologist because there's a handful of us, like even less, single digits.

[792] The key here is if he's going to make that change, try to have some objective data.

[793] Because to me, I'm looking at.

[794] Well, I'll say it because I'm not a doctor and I won't get sued.

[795] Granddad had a diet that led to diabetes.

[796] The diabetes had a terrible impact on his brain health.

[797] He cut out the carbs, but it was far past that point.

[798] And Nashok observed this decline because he was observing diabetes at a stage where it required the deduction of all the rice.

[799] To be fair, we don't know his age 100%, unfortunately, but probably around 94 when he died.

[800] This isn't a situation of like a young death or something like that.

[801] Yeah, yeah.

[802] So he was diagnosed with diabetes fairly young.

[803] I mean, he was probably in his 40s or 50s.

[804] Lived with that for a long time before there was a pretty steep decline in cognition.

[805] So that's what my dad's doing.

[806] He's not like, oh.

[807] Dr. Isaacson's not going to give us a full verdict.

[808] That's okay.

[809] I'll ensnare other people.

[810] You did this.

[811] Not me. No, no, I know.

[812] Well, you bring in the age thing because, you know, you got to have sustenance.

[813] You don't want to lose weight and you need to have enough nutrients.

[814] So was part of the decline?

[815] related to nutrition density and mount nourishment.

[816] This is leaning towards a choke now.

[817] There is some plausibility here, but tell a choke to call me later.

[818] He would love to.

[819] That kind of went your way.

[820] I'd want my dad to be right.

[821] Yeah, of course.

[822] Don't we all?

[823] Okay, so at what age do you dedicate your work and focus to prevention?

[824] You adopt this view that this is treating it downriver.

[825] Generally, the outcomes aren't great.

[826] grandma when she got it.

[827] There's nothing.

[828] And it was very much posed to us as a genetic thing.

[829] She just had this.

[830] There's nothing environmental she did.

[831] This is what her genes wanted for her.

[832] Alzheimer's disease and other neurodegenerative disorders, such as Parkinson's disease, Louis -Botid dementia, start in the brain and body, because Parkinson's actually can start peripherally, decades before the first symptom begins.

[833] I knew this, I saw this, I felt this, right?

[834] That's the subjective, the clinical, like you felt something was wrong, but then you couldn't detect it until later.

[835] And in about 2009, I said, if I'm going to see someone with Alzheimer's, a person with Alzheimer's, my patient, and their family member wants to try to do something to reduce their risk, then maybe I should see families.

[836] That was the first concept.

[837] That makes a ton of sense.

[838] When you see a family, and I learn this very quickly, I'm a pattern recognition guy.

[839] This is not rocket science.

[840] I don't understand the biology as well.

[841] I don't get the ortho, you know, the benzene ring.

[842] this is pattern recognition it's not like i'm trying to figure out some scientific milieu of some advanced theory of biochemistry you find out all nine family members swam in this creek no one swamming and they all have glowing fingers you're like okay it's exactly it and i was treating a patient of mine amazing guy retired physician wrote a major textbook and he had two children and one looked more like the dad and the other one didn't and it was my job to deduce what that was that feeling your gut impression what does that mean can you find a biological marker can you find a cognitive testing marker?

[843] Can you find a body composition marker?

[844] Can you find something?

[845] And that's what set it off.

[846] And I talked to the son, who's also a physician in the hallway, that was my first Alzheimer's prevention consult ever for 40 minutes in a hallway.

[847] Talk to the daughter later in the same week.

[848] In medicine, things happen in threes.

[849] Dr. Agotson referred me my first Alzheimer's prevention patient.

[850] Dr. Agatson published on this calcium score in like 1989.

[851] When did it make the diagnostic guidelines for cardiology?

[852] What year do you think?

[853] 2015.

[854] 2018.

[855] Well, I was going to say, I got pitched having one in 2020.

[856] Okay.

[857] And it's the first time I ever heard of it.

[858] So I have to assume it was relatively new in 2020 for me to go get that test.

[859] Over 30 years.

[860] Nuts.

[861] It's okay that you got it.

[862] And that's a good thing.

[863] And I believe in it.

[864] Yeah.

[865] But maybe not for you because we're playing the long game with you.

[866] And 10 year risk can be deduced by the calcium score.

[867] And a younger person in their 40s, maybe the calcium score isn't the perfect measure.

[868] It's a good quick measure.

[869] It's a hundred bucks, whatever it is.

[870] Tiny little bit of radiation.

[871] Oh, no, I'm talking about the one where I went in and they put fluid in.

[872] They looked in my heart and they told me how much calcium I had in every single artery.

[873] A CT angiogram?

[874] I wouldn't remember the name of it.

[875] But they give you a percentage of calcium buildup in every single artery in your heart.

[876] That's what you leave with.

[877] And to my enormous shock and amazement, I was zero.

[878] I was preparing for much worse.

[879] Yeah, okay.

[880] I think that was a calcium squad.

[881] There is more advanced testing now using instead of just a quick cat scan, a little, it's called the CTA, CT angiogram, where they can use artificial intelligence to understand where in the blood vessels there are.

[882] are soft plaques, not just hard plaques, hard plaque is calcium.

[883] That's one degree of risk.

[884] To me, soft plaques is what I want to know for you.

[885] If your calcium score is zero, okay, that means your risk in 10 years is low, but you're in your 40s.

[886] So why is your risk going to be high?

[887] To me, getting soft plaques is something that I'm very interested in.

[888] Is that like the predecessor to a hard plaque?

[889] Exactly.

[890] It would turn into.

[891] Yeah.

[892] And there's things that I believe you can do proactively before there's a problem to maybe even have regression in the plaques.

[893] And that's what we're trying to do now.

[894] And what we do is we use what we find in the heart to try to correlate, what does that mean for the brain?

[895] And how does that mean with cognitive function?

[896] We do know that having a high calcium score increases your risk of vascular dementia two decades later.

[897] So soft plaques has to be the same thing, but we don't fully understand it.

[898] Is it executive function?

[899] Is it memory?

[900] Is it speed of processing?

[901] Is it attention?

[902] Everything that our cardiology friends have been doing and preventive cardiologists have done, now we have to do this for the brain and we have to understand.

[903] People say like what's good for the heart is good for the brain.

[904] That is like so oversimplified.

[905] It's a good saying to kind of get you motivated and get you, you know, okay, I got to pay attention.

[906] There's a lot of nuance there.

[907] That's what we're trying to sort out.

[908] Okay, so Sanjay did all these tests and he wrote a great piece on it.

[909] I recommend everyone read it's on CNN .com.

[910] We went through, okay, when was it label disease?

[911] We got that.

[912] Oh, here's a quick question about Alzheimer's.

[913] Since it's discovery and an accepted diagnostic approach, are we seeing it increase or decrease.

[914] Oh, this is a good question.

[915] And this is one of those incidents prevalence questions.

[916] Explain the difference through that?

[917] I wasn't good at that class either.

[918] That's like a statistics question.

[919] Let me figure this out.

[920] So one is the prevalence is, I don't know how many people have it, but the incidence means how many people have it per group of people or proportion.

[921] I may have mixed that up, but different studies will say different things.

[922] I believe the total number of cases out there are going up because we have an aging population.

[923] We have a lot of things that are charting up over the last 30 years.

[924] We also have obesity charting up.

[925] There's a lot of factors you could correlate probably.

[926] The rates are actually coming down for Alzheimer's.

[927] Oh, they are.

[928] But the number is high.

[929] But the total number is higher because we have an aging population.

[930] I got you.

[931] Depends on what statistics you look at, what study you look at, what the risk factors were.

[932] But because we're getting better control over vascular risk factors like diabetes, high blood pressure, and high cholesterol, if we can slam the brakes on those, we're going to delay cognitive decline in Alzheimer's.

[933] Okay.

[934] That makes sense.

[935] Ozzympic is going to like this is what we look at we have multiple people in our study where we do the blood biomarkers and Sanjay outed me by the way yeah yeah I think on this show yeah yeah thanks well he was the patient so he was allowed to say whatever you said to him hipah hello yeah so for science I took three doses of terseptide mound jar and I got a blood test before and then I got a blood test afterward you did an end of one you could too you're higher you're hired so we did an end of one I don't have the results back yet, but we'll get those back very soon.

[936] And then I'll just come clean.

[937] I then did another experiment.

[938] By the way, when I went on this terseptide, the GLP1, and I have nothing to disclose, I don't have any relationships with pharmaceutical companies or supplement companies or anything like that.

[939] I try to keep it clean.

[940] I wish I did have relationships.

[941] I would have paid off my student loans earlier.

[942] It took me 22 years to pay up my student loans.

[943] But when I did this, my LDL dropped from 109, which was like, borderline.

[944] My APOB was 72, which I'm like, eh, when do I need something?

[945] my LDL jar from 109 to 60.

[946] What?

[947] On the...

[948] The three doses of tears appetite.

[949] Wow.

[950] My body fat went down from 20 .5 to 17.

[951] How long is three doses?

[952] I spaced it out.

[953] I was experimenting on myself.

[954] I did dose one.

[955] Then I did eight days for the second dose.

[956] And I felt like a little sick.

[957] And I waited 13 days for the third one.

[958] You know, 2 .5 milligrams is the lowest that you could get with the injections.

[959] And it just floored me. I didn't leave my couch for three, four days.

[960] No kidding.

[961] I was so sick because I didn't need it.

[962] I was doing like an experiment.

[963] I guess what I was asking is, how long was the window you were on it?

[964] A month.

[965] So in a month, you drop 3%.

[966] You know, interestingly, I lost a little muscle mass, but I gained it back.

[967] I have more muscle mass now than I did six months ago because I did a second end of one.

[968] I felt the 2 .5 milligrams of Tresepotide was too much for me. So I did the unthinkable, thanks to my niece.

[969] She was the guinea pig first, but we got compounded Tersepotide, which I shouldn't be talking about.

[970] But whatever, it's all good.

[971] And I injected one milligram, and then 1 .1 and 1 .2.

[972] And then after three doses...

[973] I got terrible heartburn, and I'm like, I'm done.

[974] And then I got another blood draw.

[975] So I used myself as an N of one study with the real Tersepitide and then the compounded Tersepitide.

[976] And we're going to look at amyloid and tau before and after.

[977] So Tresepetitide is the active ingredient in all these different brands.

[978] It's Manjaro and Zepound are Tersepetite.

[979] Ozempic and Wagovi are semaglutide.

[980] Okay.

[981] So semaglutide is a GLP1.

[982] It's been out for.

[983] By the way, these GLP1 drugs have been out for decades.

[984] Yes.

[985] When I argue with people about these, I go, this isn't brand new.

[986] Yeah, 20 years oral.

[987] The semaglutide injections have been out for like five, six years.

[988] And the terzepotide injections, just like a year or two.

[989] And the ones you're running on the block market, just a few weeks old.

[990] Exactly, yeah.

[991] I don't know that I'm going to do that again.

[992] That was very bad.

[993] So has your cholesterol stayed down?

[994] It went back up to 90.

[995] Okay, but still much better than 109.

[996] You know what?

[997] And my APOB was 68.

[998] I didn't check my APOB the second time.

[999] but my APOB is lower and my LDL's lower.

[1000] With GLP -1s, there's vast amounts of data that suggest the people that take GLP -1s, so semaglutide, tersephotide, all the brand names, absolutely have lower risk of dementia and Alzheimer's.

[1001] There's actually a study being funded by the semaglutide company.

[1002] It's called Evoke, I believe, and it should report out in a year or so, where semaglutide, the oral, is being used in a preventative trial to see if it can delay mild cognitive impairment, the first symptomatic stage of Alzheimer's from progressing to the dementia phase.

[1003] So there are randomized double -blind placebo -controlled trials ongoing now using GLP -1s to try to reduce the risk and try to look at the effects.

[1004] We have patients.

[1005] Our study is a biorepository study.

[1006] So you donate your plasma, get your bloodsum.

[1007] And when people are in our study, they are treated by their own doctors.

[1008] So Dr. Agateson actually treats one of the patients that was in the CNN documentary, Simon, amazing, amazing guy.

[1009] And Dr. Agateson prescribed terse appetite.

[1010] And Simon took terseptide.

[1011] He went an hour and a half of strength training three times a week, so it was not to reduce muscle mass. Because the critics of it will point out that it's very common to lose muscle mass. There's a lot of micromanaging and nuance here, but I don't exactly agree with that if the person sticks to the plan.

[1012] Like, I won't allow one of my patients to continue on Tures Epitite if they are not doing strength training.

[1013] Not happening and no refills, like forget it.

[1014] I want the inbody, I want taking pictures.

[1015] I want to see what your body fat is, what your muscle mass is.

[1016] Yeah.

[1017] So what we do in our research study is we look at the change over time in blood -based biomarkers, amyloid, tau, all these other markers, and we're trying to figure out when people are seeing their doctors to reduce their risk of Alzheimer's disease based on modifiable risk factors, does that have a downstream positive or negative or neutral effect on the brain markers?

[1018] We've only presented 15 patients, you know, at the American Academy Neurology meeting, and we're presenting some new data at the Alzheimer's Association International Conference.

[1019] We have little bits of data, but the data looks amazing.

[1020] The GLP ones are working.

[1021] Anti -Amaloid drugs just had a new FDA approval for a new anti -amloid drug.

[1022] We have lachanamab and dinanamab.

[1023] People go on the anti -amloid drugs and the amyloid and tau improve.

[1024] People go on g -lp -1s, amyloid and tau improved.

[1025] Okay, but really quick, so back to your original question decades ago of whether the amyloid and tau was a result or the cause, when people are seen a reduction in the amyloid and tau?

[1026] What are you to do seen from that?

[1027] Great question.

[1028] It's a biomarker of disease.

[1029] That's what I believe amyloid and tau are.

[1030] I don't know what causes Alzheimer's disease.

[1031] If anyone can tell me that they are definitively certain that they know what causes Alzheimer's disease, I'll respectfully disagree because there's a lot of smart people.

[1032] So I guess, yeah, it doesn't answer the question because even if you're seeing a reduction in the amyloid and then an improvement in the cognitive function, you can't really then conclude, oh, it was the amyloid that caused it, you could say, well, whatever this treatment is, it's reducing the production of the amyloid and tau.

[1033] So anti -ameloid drugs reduce amyloid and reduce tau.

[1034] Okay, that's easy.

[1035] Right.

[1036] But if you were only reducing the symptoms.

[1037] Non -amloid targeting drugs are still lower.

[1038] This guy, Kevin, he just exercised, he changed his diet, and he reduced alcohol by 30%.

[1039] No anti -amloid drugs, no GLP -1s, nothing, and his amyloid in town normalized.

[1040] Someone just told me last night was having dinner with a woman whose father's got Alzheimer's, and she was saying that, yeah, alcohol is really powerful in this.

[1041] Specifically in people with the APOE4 variant, especially two copies of the APOE4 variant.

[1042] One percent of the population has two copies of APOE4.

[1043] Smoking, alcohol, poor diet, poor exercise, much worse effect on people with one or more copies of E4.

[1044] We are going to find out if we have these.

[1045] So today, all we did was just the finger prick test.

[1046] That would require a fasting blood draw.

[1047] Yeah, I got to find out if I have that.

[1048] I do too.

[1049] I'm nervous.

[1050] You more than me. I don't smoke or drink.

[1051] Yeah, I do drink.

[1052] Okay.

[1053] So it would be helpful to know.

[1054] Genes are not your destiny.

[1055] You can win the tug of war against your genes.

[1056] And I really believe if someone has the 8 .4 -4 variant, great.

[1057] I know what to do about it.

[1058] One copy, no big deal.

[1059] I believe you can neutralize the negative impact of that gene, probably 80, 90 % of it by living the right lifestyle and modifying risk factors.

[1060] Let's talk about if you have that gene, what factor are you going up in your odds of getting it?

[1061] Because a lot of these things, like when we did a 23ME thing and you get these results back, Can you actually start looking at the uptick that the gene predicts?

[1062] It's like 30 % more likely.

[1063] Well, 30 % more likely is not that big.

[1064] Have you guys both done 23M?

[1065] Yeah, a while ago.

[1066] So you have 8.

[1067] Oh, we know.

[1068] Oh, it's there.

[1069] If you log into 23 of me, you scroll down, you have to take some health quizzes and just verify that you understand the limitations.

[1070] You'll see a very dapper -looking neurologist.

[1071] Pop -up.

[1072] He's very good -looking dapper.

[1073] Dapper guy.

[1074] Sure.

[1075] Pretty low hand strength, though.

[1076] Very low hand strength.

[1077] Oh, you got me. That was in better shape than.

[1078] there will be a video in education materials that is personalized based on your genotype.

[1079] Oh, really?

[1080] It's already there?

[1081] It's there.

[1082] Oh, my God, I want to go look.

[1083] That wasn't one that they were flagging.

[1084] Yeah.

[1085] Yeah, we did that like six years ago.

[1086] Those videos were recorded in like 2017, 2018.

[1087] Oh, wow.

[1088] So we already know.

[1089] Again, if you have the APOE marker, what percentage are you more likely to get Alzheimer's?

[1090] I'm glad we're talking about this because the answer to this question is impossible to figure out.

[1091] And every media story out there was say, two copies of APOE4 equals an 8 to 10 to 12 fold risk or you have a 90 % chance of getting Alzheimer's if you have two fours.

[1092] That is such bullshit.

[1093] Different people with different genes respond differently.

[1094] I have so many APOE44 patients.

[1095] And this is clinical observation.

[1096] Taller, lighter eyes, lighter skin, thin, the impact of 4 -4.

[1097] I don't see it.

[1098] Clotho, for example, can neutralize it.

[1099] The gene right upstream and right downstream, ApoC1, which is a cholesterol gene, Tom 40, which is a mitochondrial metabolism gene.

[1100] It's the total picture.

[1101] It's called polygenic risk.

[1102] If there's one four, was it from mom or dad?

[1103] Because maternal history is worse than paternal.

[1104] Men with 4 -4?

[1105] Eh, not that big of a deal.

[1106] Women with an E4, higher risk.

[1107] Why?

[1108] Perimenopause transition.

[1109] So what is the APOE4 risk in a woman who goes on hormone replacement therapy during the perimenopause transition?

[1110] Well, it's not the same as a woman that has the gene that doesn't go on H .R. T and has a rapid withdrawal of estrogen and then amylate starts.

[1111] Oh my God.

[1112] I need to find out right now.

[1113] You're going to start shooting up some...

[1114] Parymenopause is on its way.

[1115] Well, hold on, you're...

[1116] I mean, you know, it can happen in your 30s.

[1117] It's not going to happen in your late 30s.

[1118] The roof could also cave in, honest.

[1119] That could happen.

[1120] Liz thought she had it.

[1121] Yeah, Kristen's, I think, been convincing herself.

[1122] I think y 'all are going to have a rude awakening, really.

[1123] Well, whatever.

[1124] Still good to know as early as possible.

[1125] I agree, and there's something you can do about it.

[1126] Fearing genes means.

[1127] that there's a misconception or misunderstanding of what the genetic information is telling you.

[1128] Knowing your numbers, knowing your genes, there are things that you can do about it.

[1129] You can grab the bull by the horns, and same with cancer.

[1130] This is the future of medicine.

[1131] Yeah, your genes are interacting with the environment.

[1132] Robert Sapolsky's book had just a great section about, we had this Lamarckian fear of how evolution worked, and lo and behold, it kind of works in both directions.

[1133] We have a full chemistry set that can be turned on and off as needed more than we previously thought.

[1134] They're a little more variable than we've thought.

[1135] I agree.

[1136] Sanjay brought this up, but we have a sick care system, not a preventative health care system.

[1137] Our entire health care system is built the wrong way.

[1138] We're treating disease, whether it's cardiovascular disease or Alzheimer's, decades after, it's too late in so many cases.

[1139] And to get ahead of things, to have these conversations, Alzheimer's shouldn't be talked about in your 60s, 70s and 80s.

[1140] It should be talked about in your 30s, 40s and 50s.

[1141] When I was in academic, medicine, aside from struggling getting grants and trying to see patients and not getting reimbursements, you know, you see a patient, there's no code that is a reimbursable code for an insurance company to reduce risk for Alzheimer's.

[1142] Yeah, it's like they need to go back to the drawing board and they got to go, all right, what's our total output for these insured people?

[1143] It's $2 trillion a year.

[1144] What if we divert 35 % of that and we take this other approach?

[1145] It's like looking at it like vaccines.

[1146] But they need to be proved that they're going to win financially, but they're going to win financially.

[1147] It's just, I think, shifting that, what a heavy, slow -moving ship it is.

[1148] Rebuilding medicine from the ground up with a preventative mindset, I think, is really the only way to do it.

[1149] I do a lot of research now at the Institute for Nerdy Genitive Diseases in Florida.

[1150] It's amazing.

[1151] We get to do fun things and fancy things.

[1152] And outside of academia, when you get a donation or you get something, you get to use it right away.

[1153] In academia, there's all this red tape.

[1154] I practice now in a place called Atria, and Atria is both in New York and Palm Beach, and this is a different way to practice medicine.

[1155] I don't have to worry about insurance, because it's set up in a different way.

[1156] It's trying to engage the science, the cutting -edge science, with the medical practice immediately, and it's preventative health care first.

[1157] You have the sick care, you have the preventative health care, and it's just a different way to practice medicine, and that's just not prime time right now.

[1158] I can't wait until it is.

[1159] You can feel, I'd imagine, that you're approaching a tipping point.

[1160] I think, like, the enormous popularity of Atia's book, I think people actually feel empowered by this mindset and approach, which is you're not just waiting for the knock on the door to tell you you have this disease, you're going, you're going to be largely in control of who knocks on the door.

[1161] That's comforting.

[1162] It's daunting.

[1163] Lifestyle changes scare people.

[1164] It's hard to create habits.

[1165] But for me, that's just very empowering.

[1166] It's the future.

[1167] How do we get there sooner?

[1168] You know, it takes 17 years on average for something proven in medical science today to get translated into medical practice.

[1169] Commercial insurers now, if they're going to do something to prevent a disease, you 20 years from now.

[1170] You know what they're doing?

[1171] They're saving money for their competitors because people don't stay in the same insurance companies.

[1172] They just flip around.

[1173] I've had three different insurance companies in the last like four or five years.

[1174] And that's a problem.

[1175] Medicare and Medicaid, okay, at 65, they pay for a bunch of stuff.

[1176] Yeah, because they're kind of the only system set up that could enact some kind of system, but you're joining it way too late.

[1177] This is just an opinion question.

[1178] I want to preface it by saying this.

[1179] Do you think Alzheimer's existed in the Paleolithic era?

[1180] Well, did people live long enough?

[1181] What was the average lifespan?

[1182] But that's very misleading.

[1183] People love to say that people only live to 40.

[1184] That's bullshit.

[1185] People live to 80 and 90.

[1186] Infants died at a rate of 35%, which drives down the overall mean age.

[1187] Oh, I didn't know that.

[1188] Even look at our scientists.

[1189] Gale Lillian living to 89.

[1190] You know, like if you made it to 20, you could make it pretty far.

[1191] They had to have manifested symptoms of cognitive decline.

[1192] How to diagnose Alzheimer's back then, I'm not sure.

[1193] We just have a lot of modern diseases.

[1194] A lot of people would agree on that.

[1195] Our diet was very specific.

[1196] You didn't have probably type 2 diabetes.

[1197] That's an evolution result of our diet.

[1198] The level of coronary disease we have certainly wasn't existing in a hunting and gathering population.

[1199] It's hard for me to guess, and there's just so many differences.

[1200] I don't know.

[1201] I could speculate either way.

[1202] Yeah.

[1203] Let's just say this.

[1204] Do you think that the treatment that would be widely recommended would involve physical activity, community, a diet that's probably.

[1205] fruits, nuts, vegetables, and protein.

[1206] Those are the tenants.

[1207] People come to me in New York.

[1208] People were on the wait list for four and a half years.

[1209] We have thousands of people that have reached out based on the CNN documentary.

[1210] We have had hundreds and hundreds of people on a waiting list for years.

[1211] And it's like, I don't even know how to do this.

[1212] This is why we're trying to scale care using low -cost finger -prick tests.

[1213] Hopefully bring costs down.

[1214] We could do a test through the mail and screen positive.

[1215] You're working on an app too that can administer the cognitive portion of the test.

[1216] The cognitive assessments, retain your brain.

[1217] and it's a NIH -funded study that people can go on.

[1218] We had a 1 ,500 -person study fill in 48 hours.

[1219] Wow.

[1220] Then we had another NIH study filled 1 ,000 people.

[1221] There's so much demand.

[1222] We have to figure out a way to scale this, and we're just scratching the surface.

[1223] One day we'll fix these things.

[1224] Because the things I'm reading about, so a lot of the, let's just put it this way, you couldn't have lived almost any other way 6 ,000 years ago.

[1225] It wasn't an option.

[1226] All the things you're prescribing, you had to live that way.

[1227] you had to eat that way.

[1228] You had to do physical exercise all day long because you had to forage and you had to do these things.

[1229] The medicines that are there now and even thinking about vitamins and supplements, those are a drop in the bucket or something in an ocean or something in a swimming pool, whatever that's saying is, if you don't have the basic tendons down of regular physical activity between strength trading and cardiovascular, do you neglect sleep?

[1230] Fast forward amyloid.

[1231] That's when the trash gets taken out and you need to sleep.

[1232] You need to prioritize sleep.

[1233] You need to prioritize mental health and stress mitigation.

[1234] Well, as you said, depression, lead to decline in pseudo.

[1235] Not only can it cause a pseudo dementia, but it's actually a risk factor for dementia due to Alzheimer's disease also.

[1236] So the core tenets of brain health are the things we have control over.

[1237] The micromanaging, all the fancy GLP -1s and the inject this and that, it's just not going to do anything for you if you don't have the other things right.

[1238] That's, I think, a concept that people don't fully understand.

[1239] Yeah, that's like moving in from 80 % prevention, pushing yourself up to 100 % prevention will involve all those other things.

[1240] But I guess I think that's what's wonderful and empowering about a Tia's book, which is the bulk of the important stuff is very doable.

[1241] I don't need to have access to you.

[1242] I agree.

[1243] What we try to do is get free educational resources online because people do have a lot of nuanced questions related to APOE.

[1244] What is the difference between a brain healthy diet and a heart healthy diet and a brain healthy exercise and heart healthy exercise?

[1245] There is nuance there.

[1246] And we try to just push that out there.

[1247] I'm not on social media, but we put videos.

[1248] We have a free mastering brain health course on IND .org.

[1249] It's a totally free two hours of me just blab in front of a camera and IND .org?

[1250] It's our foundation.

[1251] Can we talk about a couple of the fun ones?

[1252] I wouldn't mind giving people a few pointers while we're here.

[1253] Please.

[1254] This is from Sanjay's article.

[1255] He said, Loading the spine with additional weight helps activate core muscles such as abdominal and obliques as well as stimulating the growth of new bone cells.

[1256] This could lead to a critical redistribution of the fat muscle and bone in the body and help drive down in any insulin resistance that I may be genetically predisposed to and eventually lower my risk of developing amyloid in the brain.

[1257] So, yeah, just how you work out.

[1258] Well said.

[1259] I don't recall telling him that, so he learned that on his own.

[1260] So that's pretty amazing.

[1261] But osteoporosis and osteopenia, when a bone is not very dense, it's one of the leading causes of death.

[1262] You think of women that have osteoporosis and they fall and break a hip.

[1263] Well, men get it too.

[1264] So it's men and women, calcium intake, vitamin D. Okay, there's lots of things.

[1265] But just staying physically active and weight training, doing strength training, is absolutely critical for building and maintaining muscle mass as we age.

[1266] You know, interesting with Sanjay, when I was talking to Sanjay about what he does and his exercise and like he's so fit, he does everything right.

[1267] He's so on it.

[1268] But conceptually, when we did the scale and the this and everything, what happened was is he's been doing the same activities over the last two decades.

[1269] And as you get older, you need to personalize or modify some things because your body is different 20 years later.

[1270] You're the same person on the inside in some ways, but you're different.

[1271] Your bones are different.

[1272] Your muscles are different.

[1273] Your nutrition's different.

[1274] Your sleep is different.

[1275] Aging causes specific changes.

[1276] So doing things passive.

[1277] So if you're going to go for a walk anyway, try a weighted vest or a rucksack.

[1278] Just add a little bit of load.

[1279] If you're going to exercise and you want to lose body fat, well, work smarter, not harder.

[1280] Zone 2 exercise.

[1281] Keeping a pulse rate of 60, 65 % of your max heart rate, that's the body fat burning mode.

[1282] As a peloton enthusiast or in the You can go all out and do your hit, but it's not as efficient to burn body fat.

[1283] You keep your pulse lower.

[1284] Good for your max VO, not great for your body fat burning.

[1285] So you want to do all the stuff.

[1286] You want to have a comprehensive.

[1287] And you personalize it based on your numbers.

[1288] So if you have APOE4, if you have low body fat, high body fat, high muscle mass, low muscle mass, you can personalize an exercise routine that targets these individual numbers.

[1289] And then you track the numbers.

[1290] That's the core of precision medicine, precision exercise.

[1291] Who you will?

[1292] Who's going to help us?

[1293] he's going to tell us exactly what to do based on these numbers i don't know how to do that myself and if i don't no one does clear of course where's a show where's a show i wish medicine could move at a faster pace and it's not doctors fault doctors try the best they can how do you get 15 minutes per patient how is that even fair and reimbursement from like our healthcare system is broken but preventative health care in the united states that's the disaster and the remedy that we need to fix these problems long term how do you learn them?

[1294] well, there's a preventative medicine subspecialty of medicine.

[1295] You can be board certified in preventive medicine and lifestyle medicine.

[1296] That's an actual subspecialty.

[1297] You can go see a preventive cardiologist that's different from a treatment cardiologist, although oftentimes they do both.

[1298] I'm a preventive neurologist.

[1299] There are places out there that do this.

[1300] I'm a preventative health doctor.

[1301] I'm a preventative medicine.

[1302] Not certified in preventive medicine, but I work with a preventive medicine special.

[1303] I work with a family practice nurse practitioner.

[1304] I work with a team of physicians and a team of allied healthcare professionals, PAs, NPs, physical therapists.

[1305] We have a whole comprehensive team.

[1306] If you don't have access to that kind of care, A, try to seek it out.

[1307] Just try to find someone that's preventive mind.

[1308] If you can't, talk to your doctor and see what they can do for you.

[1309] And if 15 minutes isn't enough, you've got to be a citizen scientist.

[1310] And this is terrible until our healthcare system is fixed.

[1311] But we're trying.

[1312] We're putting educational resources.

[1313] It's all free.

[1314] We're trying.

[1315] But I wish I had better answers.

[1316] I want to introduce a concept that I think about often, and maybe you'll agree with it, maybe you'll disagree with it.

[1317] But I think for me, kind of a light bulb moment was your body is the ultimate responsive machine.

[1318] So this stuff that's kind of counterintuitive, but as you say, bone density health, you lift heavy, your body has to respond.

[1319] It has to make the bones thicker.

[1320] It makes the bones thicker.

[1321] You have more blood production.

[1322] It has to make the tendon attachment.

[1323] stronger.

[1324] It has to make the tendons more flexible.

[1325] As you load it, it responds.

[1326] And just as a mindset knowing that the body will respond to what you throw at it.

[1327] So if you want it to be a certain way, there's a paradigm there that I don't think people generally think about their body.

[1328] They think their body like, well, I should eat good and put good stuff in my body and that will magically make everything good downriver.

[1329] No, it's kind of the opposite.

[1330] You stress the fuck out of it and it reinforces itself.

[1331] I think when it comes to the concept of food is fuel.

[1332] I eat to live, not live to eat.

[1333] Maybe I'm lucky.

[1334] Like I don't enjoy food.

[1335] I like chocolate milkshakes.

[1336] And actually, since using these GLP ones, I almost can't even eat a cheeseburger anymore.

[1337] And my chocolate intake has come down.

[1338] I feel like it's reset my brain.

[1339] It's been really interesting.

[1340] But I believe food is fuel.

[1341] I eat different levels of protein and different amounts of protein at different time based on did I do strength training that day.

[1342] That's how Dax lives too.

[1343] Yeah.

[1344] And conceptually, was I taught that in health class?

[1345] Like three meals a day.

[1346] By the way, do we really need three meals a day?

[1347] That's a whole different concept.

[1348] Is that pyramid correct?

[1349] Oh, definitely, I mean, my God.

[1350] Oh, my God.

[1351] The food pyramid is like so broken.

[1352] And our whole system of education in America between food and exercise, your body, kind of like you said, it's like a sports car.

[1353] It's even better than a sports car.

[1354] Your body is a sports car you drove at 180 and the next day it went 185.

[1355] And then you drove it at 185 and it retrofitted itself to go 190.

[1356] It's actually even better.

[1357] The body's incredible.

[1358] Treat it that way.

[1359] Yeah, yeah, yeah.

[1360] Give it the fuel that it needs.

[1361] It's a machine and you need to nourish.

[1362] it and you need to make it change its tires and you need to stretch and you need to build muscle and maintain muscle.

[1363] So conceptually, I think we're looking at medicine the wrong way and it affects the brain in a negative way.

[1364] Stay tuned for more armchair expert if you dare.

[1365] Last thing I want you to talk about because it's so stupid that I want to talk about it, which is toe spacers.

[1366] This is preposterous.

[1367] This is the one that hit me. I was like, well, I'm certainly not doing that.

[1368] So yeah, I mean, I guess it makes sense with the way I just described the body, which is it responds and it keeps things healthy that are being used.

[1369] So, yeah, talk about your toes.

[1370] When you use different parts of your body that haven't been used, you learn how to use them and you can refine.

[1371] I am far from the expert here.

[1372] Beth Lewis has taught me a ton and I've listened to her podcast and watched her videos, but use it or lose it.

[1373] And movement and motor rehabilitation, When you pay attention to your toes, you activate pathways and signals and preventing movement disorders.

[1374] We talked a lot about Alzheimer's disease and vascular.

[1375] Parkinson's disease, Louis body dementia.

[1376] What about movement rehab and maintaining or focusing on movement as a way to prevent a movement disorder?

[1377] These are biological diseases, but they're also motor conditions and motor diseases.

[1378] So I think conceptually, toe spacers, learning something new, a new language, a new skill, these are things that it sounds out of the box, but it makes a lot of sense.

[1379] Yes, the longest nerve in the body, obviously, from your brain to your toes.

[1380] And if that then fatigues and atrophies, then things now further up, reverse, start.

[1381] Yeah, the whole thing, it's like a gray scale on Game of Thrones, starts moving through your body.

[1382] All right, I have one self -serving question, then I'll let you go.

[1383] I tell myself that this is a really great job for myself, because I have to, six times a week, learn a lot about somebody, learn a lot about their discipline, hold it for several hours while I talk to the person.

[1384] Is this good?

[1385] And I also look at some of my heroes, right?

[1386] Like, Letterman just so fucking sharp.

[1387] Stern is so sharp.

[1388] And again, how you say, you know, you just recognize patterns, you can't help but ignore it.

[1389] And I go, yeah, there's something to having to engage in a very intense way, what part of your brain has to be activated to do that.

[1390] socialization and communication and learning new things, staying intellectually active is critical for maintenance.

[1391] It's called the Katzmann theory of cognitive reserve.

[1392] So building a backup system, building backup pathways.

[1393] If something goes wrong, you're going to have a backup there.

[1394] So basically reinforcements are coming through all the different neurons and brain pathways.

[1395] I think the other thing here is having a sense of purpose.

[1396] What you guys do is you spread the message far and wide on topics that are really important.

[1397] I appreciate this.

[1398] Thank you for allowing me to talk about our research.

[1399] our work, trying to democratize access to care, you're doing a service and you have a sense of purpose.

[1400] You come to work X days a week, X podcasts a day, whatever it is, and you're giving back.

[1401] And the countries that have the earliest retirement years, like the younger, the people retire, have the earliest onset of cognitive decline in dimension.

[1402] Yeah, that makes sense.

[1403] There's like robust data about that.

[1404] Oh, yeah.

[1405] Directly correlates.

[1406] Well, that's not promising for a future in which AI has replaced everyone's jobs.

[1407] And people have fucking.

[1408] Alzheimer's at 30.

[1409] We're going to need to define purpose or figure out our purpose in a different way outside of work.

[1410] That sweet, sweet green.

[1411] Whatever it takes.

[1412] Well, Dr. Isaacson, this has been a blast.

[1413] I can't wait for our results.

[1414] We'll be very public.

[1415] And we definitely want the follow -up stuff, right?

[1416] We want full.

[1417] We want to go all the way.

[1418] Yeah, especially, and I've heard some stuff about cholesterol.

[1419] We earmark that.

[1420] Should we do?

[1421] A little bit.

[1422] Yeah, let's do a few seconds on cholesterol.

[1423] Yeah.

[1424] You know, the test that we do is a regular cardiovascular disease, panel.

[1425] That's what the company does.

[1426] We use it for brain health.

[1427] We have the cholesterol test for the brain.

[1428] That's the research.

[1429] That's the stuff we're doing here.

[1430] And then we have the usual blood tests.

[1431] So different cholesterol particles, different risk factors.

[1432] Is someone an over -absorber or over -producer of cholesterol?

[1433] There is a precision way, a personalized way that I believe that people need to be treated for cholesterol in a brain -friendly manner.

[1434] This is a controversial, complicated whole thing.

[1435] But I'm pro -statins.

[1436] I think statins do amazing things and meta -analysis.

[1437] And they're and they reduce all these bad things from happening.

[1438] But in the wrong person at the wrong dose versus the right person at the right dose, we can personalize and individualize cholesterol management in a more brain -healthy, targeted way.

[1439] And this is what we do.

[1440] So one of the benefits of the testing, it's in a research study that you're getting access to it.

[1441] It's all free and people can participate and all that kind of stuff.

[1442] But the challenge here is how do we interpret the cardiovascular test for the brain?

[1443] So in the panels that we'll get, we're going to understand why you have high cholesterol, and then you treat it accordingly.

[1444] And that's the future of medicine.

[1445] We're going to look at your blood sugar.

[1446] For example, hemoglobin A1C, you've heard about this.

[1447] It's like the diabetes test.

[1448] It's like a really bad test in a lot of people.

[1449] Depends on how long your red blood cells live.

[1450] They're going to get a false up or down, whatever.

[1451] What's your fasting blood sugar and what's your fasting insulin levels?

[1452] Those are really important.

[1453] Do you have inflammatory markers?

[1454] So if you have high cholesterol, but your inflammatory markers are flat, like your blood vessel inflammation marker is flat, well, that probably means that you don't have problems in your vessels yet.

[1455] But if your blood vessel inflammation comes up and your cholesterol is high, then we better do something.

[1456] It's like if this, then, and if that, and if this, and we have all these paradigms, and then we personalize it for brain health.

[1457] We're going to check your omega -3 fatty acid levels.

[1458] We're going to look at testosterone and hormones, estrogen, for example, which is complicated for men easier in women to understand.

[1459] Thankfully, we finally understand this now after years.

[1460] And we're going to look at other things like B -12 level and homocysteine.

[1461] And if you want to slam the brakes on brain shrinkage and possibly even improve memory a little bit, you can use a certain type of B -complex vitamins to lower homocysteine.

[1462] But if you have one gene versus another, then we need to use a different type of B vitamin.

[1463] So basically, there's dozens of blood tests that we'll do to try to give you a personalized plan.

[1464] And I understand that this is in a research study, and I understand this is like still early days, but this is not rocket science.

[1465] The goal of our work is to try to figure out, what is the minimal amount of tests in the cheapest, most accessible way?

[1466] Could we do this alter finger prick?

[1467] Then people don't have to go get a blood draw.

[1468] Comes in the mail, you send it away in the mail.

[1469] You get marching orders.

[1470] Yep, you stick it into a computer, and it pops out.

[1471] We are mission driven and we want to democratize access.

[1472] Let's just get people that care they deserve.

[1473] Create online resources.

[1474] Videos are like easy to make, a little graphic design, a little whatever.

[1475] You mail in your thing, you get the result back, and you get a personalized plan.

[1476] The other thing that I always want to say is we also have to promise not to over promise.

[1477] This is like super exciting stuff.

[1478] I love it.

[1479] And the results that our team has seen, and you can watch the CNN documentary.

[1480] Like Simon's brain got big.

[1481] I have multiple people whose brains are getting bigger.

[1482] And their amyloid and tau is improved.

[1483] What is happening here?

[1484] All this stuff I was talking about is real.

[1485] But there's a lot of people that could do everything right and still get Alzheimer's disease.

[1486] And those are different people with different genes and different risk factors.

[1487] You have figured out some subset of the pool.

[1488] Yes.

[1489] And there'll be many others that need a more bespoke approach.

[1490] That's exactly it.

[1491] And all we need is a little more funding and a little more time.

[1492] Okay, this was great.

[1493] I'm so glad Sanjay turned us on to you.

[1494] Good luck with all of this.

[1495] I hope to God you get massive funding and we figure out how to fix all this stuff up river personalized care let's do it all right be well appreciate it next off is the fact check i don't even care about facts i just want to get in their pants i was for reason last night oh in the oh yeah like jethra had it at 67 uh not his money i was acting like he's at a hotel what a prick oh he's a nice Nice guy.

[1496] He is.

[1497] He's lovely.

[1498] He might actually not have touched it.

[1499] They were there fixing.

[1500] Do you remember when you would turn on the air in there, it'd go pump, bump, bump, if the bathroom fan was also on?

[1501] It would make that clicking noise?

[1502] They finally fixed that and they were there monkeying with it.

[1503] And when I went in there last time, I turned it off and it was on 66.

[1504] I should have adjusted it, but maybe he just turned it on and left.

[1505] Maybe he's not a prick.

[1506] Maybe.

[1507] Maybe.

[1508] Also, it could still be a prick.

[1509] No, he is not.

[1510] No, we'd love Jethro Bovington.

[1511] The way the TV folds out, I laid my head where my feet would be normally to watch TV.

[1512] And so I wasn't under the blanket.

[1513] So I was just in my underpants.

[1514] Yeah.

[1515] And I started shivering.

[1516] Oh, my God.

[1517] I'm so jealous.

[1518] And then before I knew it, I grabbed the thing, put it on 72, and hit under the covers.

[1519] My number one complaint about our house, even though I love it, is the upstairs, you really can't cool it down.

[1520] You can keep it from getting hot.

[1521] But you can't really get it.

[1522] You don't have an extra air conditioning up there?

[1523] No, it's totally inadequate.

[1524] And then this maddens me. So when the girls, it's not cold enough in the room, they, in the temperature set at 72, right?

[1525] But it's 75 in there or whatever.

[1526] So they put it down to like 60, right?

[1527] Sure, sure.

[1528] And I try to explain.

[1529] Would you do that too, Monica?

[1530] to lower it though it is going to register at a lower temp even if it's not 75 if it's if it's 75 in there and they have it on 74 74 and it never gets the 74 it's working as hard as it can already to get there so if you put it on 60 it doesn't it's 75 is just like the lowest is going to be well it just the point is it's not variable It's on or it's off.

[1531] And so if you have it set to a lower temp than it is in the room, it's on as hard as it can work.

[1532] Right.

[1533] To try to get it down.

[1534] And all that happens when you get frustrated and you put it at 62.

[1535] In the middle of the night, once it has cooled down enough and it can, then they wake up freezing.

[1536] And they got to wake up in the middle night and adjust it up.

[1537] And I'm just always, I've many times tried to explain like, it's on or it's off.

[1538] It's not going to blow.

[1539] Colder air or get there quicker because you have it lower.

[1540] Maybe you should get an ice block and a fan.

[1541] Maybe.

[1542] And a big bucket to keep capture the.

[1543] the caps are the water melting.

[1544] That sounds good.

[1545] I did get given this crazy portable cooler from Benpack, and I haven't used it yet, but I think somehow it's an air conditioner that you don't have to have an exhaust fan for.

[1546] Have you seen these?

[1547] Yes, I want, yeah.

[1548] I think maybe I should just put that in the girls' room and blast it.

[1549] Wait, I need that.

[1550] Is it similar to a, so it, is it something you plug in or no?

[1551] Yes, you plug it in, but I don't think it's a swamp cooler, because that's another thing.

[1552] thing you can have right yeah like the home depot bucket yeah and water's running through it yeah and you cut a hole in it oh wow i don't even know all those steps you got to buy a bucket with the thing you buy and then cut a hole yeah a whole yeah a whole cutter and then uh then you had a size a little camping fan to fit in there oh wow i don't know about this one oh so money why do you have a headache do you suppose did you under hydrate yesterday well we gave a lot of blood this morning.

[1553] Oh, it started post blood giving?

[1554] Yeah.

[1555] So maybe it is that.

[1556] We did give a lot of blood.

[1557] It is a ding, ding, ding, because this is for Richard Isaacson, so this is perfect.

[1558] I can't believe it timed out that way.

[1559] Yes.

[1560] We did a follow -up test today.

[1561] A lovely lady came and took...

[1562] Her name was Holly.

[1563] Shout out.

[1564] She came and took a lot of our blood and then did more finger pricks.

[1565] Now we're going to get like full real results.

[1566] I'm very excited about.

[1567] Yeah.

[1568] And I have to give blood every few months.

[1569] I do a blood panel because I'm on hormones.

[1570] And so I'm used to that.

[1571] But we gave, she filled 11 vials.

[1572] I've never outside of when you donate blood to the Red Cross, if I given that much blood.

[1573] I did have the thought.

[1574] I was like, I'm technically when I'm at my regular weight, which I am right now.

[1575] Not anymore after losing that blood.

[1576] Well, exactly.

[1577] Two pounds of blood.

[1578] I'm not allowed to give blood.

[1579] Normally.

[1580] Yes.

[1581] And so I did have the.

[1582] thought when she was taking so much, like, huh, I don't think I'm actually allowed to do this.

[1583] Give this much blood.

[1584] But I did.

[1585] And it was fine, but I do have a headache.

[1586] And she told me, Rob, she broke your patient confidentiality.

[1587] You got a little well, right?

[1588] I got nauseous immediately after.

[1589] It was like, is it something I'm I supposed to be?

[1590] I'm supposed to pass out.

[1591] Oh, you got woozy.

[1592] No, it was like I wanted to throw up.

[1593] It wasn't even a woozy.

[1594] Oh, that sounds the same.

[1595] Woozy.

[1596] A woozy pass out, I guess.

[1597] And whatever.

[1598] I think those both.

[1599] Yeah, that's the same.

[1600] A lot of overlap.

[1601] But I gave blood a lot for egg retrieval.

[1602] You had to go every other day and they took blood.

[1603] Not 11 vials.

[1604] Yeah, what a vial?

[1605] A couple vials.

[1606] Yeah, I normally don't have any problems.

[1607] I didn't really.

[1608] I just, I have a headache.

[1609] But it also could be that yesterday I made pork chops.

[1610] Made eight pork chops?

[1611] I made four pork chops.

[1612] Wow.

[1613] And they were so good.

[1614] They were.

[1615] Yes.

[1616] I think pork chops is a hard thing to make at home.

[1617] It is.

[1618] I was scared.

[1619] They dry out easy, right?

[1620] So I dry brined for over a day in the fridge.

[1621] Tell me about a dry brine.

[1622] Okay.

[1623] So it's a brine, not a brine.

[1624] Well, it's also pork chops, not chop.

[1625] What did I say?

[1626] You said I made a pork chops yesterday.

[1627] Oh, oh.

[1628] Okay, well, you put a ton of salt and pepper.

[1629] First, you have to get really good pork chop.

[1630] Okay.

[1631] And you get it at McCall's.

[1632] I get it at McCall.

[1633] You went to the new location?

[1634] Had it delivered.

[1635] They have a delivery service.

[1636] Oh, wonderful.

[1637] Because they moved out of our neighborhood.

[1638] I know.

[1639] So they're, you know, the thick pork chops.

[1640] Even harder to cook.

[1641] And then you put, like, you know, you salt and pepper it very liberally.

[1642] And then Max, who's a very good cook, gave me the idea.

[1643] And I said, oh, do I just, like, put it in the fridge on a plate?

[1644] And he said, don't worry back.

[1645] Terea doesn't jump, so that's fine, but put it on a drying rack on a baking sheet.

[1646] Yeah, so that it can have airflow.

[1647] Oh, yeah.

[1648] And so I did that, and it was over 24 hours.

[1649] This is Allison Roman's recipe, by the way, and I had decided at the beginning of the summer when she first posted the video that I was going to make it during the summer.

[1650] It was a summer goal.

[1651] Okay, one of your summer goals.

[1652] Yeah.

[1653] And summer's.

[1654] Fastly.

[1655] I don't want to talk about it, but it's leaving.

[1656] It's leaving.

[1657] It's on its way out.

[1658] And so I had to do it, and I did it.

[1659] And it was so good.

[1660] You bake them?

[1661] No, skill it.

[1662] Pan fry.

[1663] Oh, yeah.

[1664] Seven minutes on one side, five on the other.

[1665] It's very crisp.

[1666] And it was delicious.

[1667] Do you wrap it and let it sit for any moment?

[1668] Not wrap, but rest, yeah.

[1669] Just a rest.

[1670] It rested for a while.

[1671] Okay.

[1672] And I had a caper, thyme, garlic.

[1673] sauce on top.

[1674] I made a polenta with corn, paprika, and parmesan, and then cabbage, and you cook it in the pork fat, and a tomato salad.

[1675] And did you eat all four by yourself?

[1676] Yeah.

[1677] No, I didn't.

[1678] I had friends over.

[1679] Okay, wonderful.

[1680] And the reception, I'm sure, was?

[1681] It was very positive.

[1682] Oh, good.

[1683] I was happy.

[1684] I was scared.

[1685] It was a big, scary thing I did.

[1686] Well, I applaud your valiance.

[1687] Yeah, and we watched Olympics, we ate it.

[1688] Okay, Olympic.

[1689] Oof, oom.

[1690] This will be a few days late, but we got to talk about it.

[1691] A lot of the things happened.

[1692] Big stuff happened.

[1693] Heartbreak and...

[1694] Victory.

[1695] Well, what's really funny is we've already, you and I've chatted a little bit about it, and we already had two different takeaways from both very big events.

[1696] Well, also, we haven't even all, Simone, like, we've missed a lot.

[1697] Okay, Simone, yeah.

[1698] just eviscerating the comp, which is great.

[1699] She's won everything she's competed in.

[1700] She's so good.

[1701] I love her so much.

[1702] I love her so much.

[1703] I learned a lot about her on the podcast I did, Blind Landing.

[1704] Oh, the one that you did right after the all -around competition.

[1705] I learned a lot.

[1706] She's extremely generous.

[1707] She has her own gym and she invites a lot of people to come train there, a lot of international people to come train there.

[1708] Competitors.

[1709] Yeah.

[1710] And I wanted to talk to you about this.

[1711] Okay.

[1712] I felt that the gymnast really proved my theory that the big brand commercial that we brought up before, that that message is incorrect.

[1713] I wanted to text you about it, but I thought I'd wait and do this in person.

[1714] I mean, this will be a circular debate.

[1715] Did you watch?

[1716] You can't wish well for the person you're trying to beat or you're wishing that you don't win.

[1717] No. This is a oxymoron or paradox let me tell you about winning okay let me teach you something about winning okay great you want to beat someone at their best sure that's fine so you want them to do the very best they can and then and you want to do the best you can and you want to win but you want to win I mean that's the end this you know what this you know what this debate is identical to oh god net versus global or no worldwide versus yeah international versus domestic yeah no it's the debate i i endlessly am in and shouldn't be in anymore about selfishness you can act selflessly out of selfishness but you know i don't think an animal can do anything but be selfish and in their selfish pursuit they can be quite selfless so just you you believe that you can be motivated yeah i want ever i when a lot of people do i i i i recognize a lot of of people think that well they're cheering for each other yeah they're being very supportive but they want to win and they don't want the other person to win that's all it's about for me is like they don't wish that the person win yeah that's not the argument the argument is that you have to be insanely cut throat you have to be like colby or jordan you have to yeah and you don't you can want to win and not want somebody else to feel bad or lose or do their work worst or i agree with you i don't think you have to want the person to feel bad or suffer but you have to want them to not win minimally that's it and i think that's all the commercial says i don't you want me to play i can't play no but people should let go and yeah a lot of people agreed with you a lot of people don't like that commercial they're in the comments people agreed also not everyone me is talking about it so it obviously worked it got people to talk yeah although i have not seen that commercials since I said it.

[1718] Oh.

[1719] You think they really.

[1720] They pulled it.

[1721] Well, it's also interesting because they have Shikari on so many of those.

[1722] And it says winning.

[1723] And she didn't win.

[1724] And I'm like, what happens then?

[1725] They film those commercials.

[1726] Pull it.

[1727] It's like, get it out of there.

[1728] Get it out.

[1729] I don't want everyone to see it again.

[1730] Pull it.

[1731] Did you have that thought too?

[1732] Yeah.

[1733] Well, I had the thought of, God, this fucking, the pressure again.

[1734] It's like, you're on all these commercials.

[1735] commercials and then you have to deliver.

[1736] Oh, it's also the result is the difference in tens of millions of dollars.

[1737] It's like the rest of your life.

[1738] She better still get that money.

[1739] Listen, I love her so much.

[1740] So we had different reactions to Shikari getting silver.

[1741] I was like completely devastated and crestfallen and heartbroken.

[1742] Yeah.

[1743] And I wanted to appeal and start a campaign.

[1744] Well, ding ding ding, we'll circle back.

[1745] Back to that.

[1746] Okay, because there was a bunch of weirdness that happened before her race.

[1747] Yes, we found this out after.

[1748] But didn't it happen to the only thing that gives me. So you did tell me that and that's really interesting.

[1749] You should tell everyone about that.

[1750] But also, the same woman did beat her in the semis.

[1751] So that's at least comforting.

[1752] It's not like she blew that woman away and then she was in this weird bus situation and then lost.

[1753] That would be unacceptable.

[1754] Like that would be really hard.

[1755] But you don't know what's going to happen on any individual race.

[1756] And if you just locked an hour.

[1757] Hugh Noah Liles.

[1758] He lost.

[1759] He did not win.

[1760] either the quarters of the semis and he won the final.

[1761] Yeah.

[1762] Okay, so your reaction was like you were really happy for her.

[1763] No, I was like, I was sad for her, but I was also happy for the person who won.

[1764] Oh, sure.

[1765] I was like, oh, man, that sucks.

[1766] And also because I felt that the pressure was insane on her.

[1767] Yeah.

[1768] And that didn't feel fair.

[1769] But I was happy for this woman who won.

[1770] That's so happy.

[1771] St. Lucia.

[1772] 300 ,000 people.

[1773] Or two or 300 ,000.

[1774] Whatever Aaron said.

[1775] A few hundred thousand people to draw from and they have the fastest woman on the planet.

[1776] I love that.

[1777] That's awesome.

[1778] See, that's happy.

[1779] Yeah.

[1780] And I was also happy that Shikari, she was such a good sport.

[1781] She was.

[1782] She looked happy.

[1783] Yep.

[1784] She did.

[1785] She probably was upset, but she also, I think, was like, yeah, fuck yeah.

[1786] I got a silver medal in the Olympics.

[1787] Like, that's damn good.

[1788] It's nuts.

[1789] She's his second fastest.

[1790] He went on the plan.

[1791] Do we know if she was faster three years ago or now?

[1792] I don't know what her age is doing or she's gotten faster or slower, but what would be heartbreaking as if that she could have got gold in Tokyo, but.

[1793] I think she's gotten faster.

[1794] I think she's become more of a front world.

[1795] World is that what was called?

[1796] Oh, yeah, not nationals.

[1797] That would be domestic, not international box office.

[1798] Okay, then Noah Lyle was like the Riles.

[1799] Liles.

[1800] as I said pork chop is now the opposite scenario which is like he was finishing second second and I was like oh no I'm losing face Shakari I was like oh yeah she's gonna do it no I was like what's going on although low expectations 200s his event exactly yeah and even it was spoiled for me that he won before I could see it so sorry that happened and there was a there's a weird bullshit thing with the programming like all the stuff's available for me once it airs it records but for some reason the final was You couldn't view it until the 7 o 'clock re -airing, and then not until 11 in that block.

[1801] Exactly.

[1802] It didn't record.

[1803] I'm recording every Olympic event, and that one was unavailable.

[1804] They did this with the Formula One race one time.

[1805] I've got a phone to pick.

[1806] Yeah, I think something happens where it bumps up against local program.

[1807] I don't know what happened.

[1808] Oh, my God.

[1809] Well, I saw it.

[1810] Oh, how exciting was that because it did not look like he won.

[1811] I know.

[1812] Even when I saw the replay, knowing he won.

[1813] first reaction was oh well the jamaican must have disqualified himself and come out of the blocks early like that jamaican won how's now he gonna win but boy buy oh god buy oh boy boy boy they show that freeze frame and he was he's that four inches ahead four inches ahead four inches not four inches like one centimeter one centimeter ahead fuck he really wanted it was crazy it was really It was, that was really heartwarming.

[1814] I, okay, then I felt really bad for that silver.

[1815] See?

[1816] Yeah.

[1817] You were happy when Shikari lost for the, yeah.

[1818] Because I want, you're very underdoggy.

[1819] I get it.

[1820] I want my friends to be happy, and I want underdogs to be happy.

[1821] Yeah.

[1822] I want everyone to be happy.

[1823] See, this is why the commercial doesn't work for you.

[1824] You wanted everyone to win.

[1825] It's like our guy we've been rooting for one, and you feel bad, and that's great.

[1826] Right.

[1827] There's a group of folks.

[1828] Listen, listen.

[1829] I'll cut this.

[1830] I love bread.

[1831] Okay.

[1832] I don't love Noah.

[1833] I like him.

[1834] I like him.

[1835] But he's on the verge for me of being too cocky.

[1836] And I can buy it to a certain extent, but sometimes it's too much.

[1837] So, you know, there's a little bit of like.

[1838] I think you can leave that in there.

[1839] A lot of people are wrestling with that.

[1840] I don't want to say anything disparaging because I do really like.

[1841] him he's a nice fucking boy like he is nice forget like all the whatever bragging he's doing he's with his whole family he's got no group of like bloody he's with his mom and dad all the time it's he's a sweet sweet boy also on the dock he's encouraging other people to be cocky which i like right like that's what made me like him it's like he's he told the english guy yeah it's like don't be so modest yeah you're gonna fucking break that what are you talking yes so i like him a lot for that wasn't you same bolt telling him to be cocky to that the sport needs it well that's the whole thing that's interesting i think it also it depends what you loved growing up so mohammed ali's the number one braggard he started this whole thing this genre of athlete that's exuding confidence in braggadocia and trying to intimidate his opponents through this mental battle so while it was happening people hated that about mohamma ali right But then he becomes a legend and he occupies such a place in history.

[1842] And obviously he's such a, an incredible role model.

[1843] Yes.

[1844] Historically and he stood up for the right stuff and he, you know, all this stuff.

[1845] Now you watch it and you find it quite charming and you also go like, yeah, it was very effective.

[1846] And because that's the example I grew up loving, I look at Noah Liles with an S and I go, yeah, man, he's falling right in the footsteps of Muhammad.

[1847] And it's actually so brave because, man, if you don't do it, the fucking embarrassment of having bragged so much.

[1848] Like, I couldn't be that way because I don't believe in myself all that much.

[1849] But the risk that he's taking on by doing this and trying to transcend the sport, make it bigger than just running all that stuff, you know, I'm for it.

[1850] I'm for it too.

[1851] But I just personally, I like quiet luxury.

[1852] Sure, sure.

[1853] I like a quiet.

[1854] Not a purple Lamborghini with a Gucci symbol.

[1855] I don't.

[1856] I just like, I like you to be quiet and win.

[1857] Talk with your actions.

[1858] Exactly.

[1859] Okay, but it makes it so much more fun.

[1860] It's fun.

[1861] He's great.

[1862] I'll also say, the one interview afterwards I love so much as he's like, I'm going to be honest with you.

[1863] I didn't think I got it.

[1864] I said to the Jamaican, I think you got this one.

[1865] He goes, then I saw that photo and I said, my lord, I'm incredible.

[1866] I thought that was the greatest 180.

[1867] He's like, my lord, I'm incredible.

[1868] But he had the cutest little wink.

[1869] Like, he's letting you know he knows it's people.

[1870] No, it's great.

[1871] Look, look, it's great.

[1872] I love it.

[1873] I love it.

[1874] And then I didn't feel like bad for the Jamaica.

[1875] That was his very first Olympics.

[1876] That margin, the five millionths of a second or whatever it was.

[1877] Ten millionths of a minute.

[1878] I cannot.

[1879] I would die.

[1880] That's really hard to process.

[1881] But even look at Freddie.

[1882] I love Fred.

[1883] Fred's only 0 .2 or he's like 0 .02.

[1884] I know.

[1885] It's all so close.

[1886] I said it last time, but I got to say it again.

[1887] What's insane is that these guys in Formula One are getting the same time down to the 1 ,000 sometime.

[1888] That's like when you see it in a 10 second race and it happens, it's mind -blowing.

[1889] But then you think about a minute and 12 -second lap.

[1890] I know.

[1891] That one for me is less because it's a machine.

[1892] and it's not a body.

[1893] But there's so many variables.

[1894] It's like a different manufacturer, a different driver, all this stuff.

[1895] And somehow they get this, those are the same margins in Formula One.

[1896] Yeah.

[1897] Speaking of cocky athletes.

[1898] Yeah.

[1899] I rewatched air this weekend.

[1900] You did.

[1901] I love that movie.

[1902] Who's cocky in that?

[1903] Jordan.

[1904] Oh, he's not very cocky.

[1905] Ah, yeah.

[1906] And I like it on him.

[1907] Yeah, that's the thing a little, we are all full of contradictions, but he's the number one hate your opponent guy.

[1908] He is the embodiment of that commercial.

[1909] He had to find something he hated about each team he played, and he wanted to, but he actually wanted ill will to fall upon that.

[1910] You know, he went even a step further than I'm comfy with.

[1911] Yeah, but he, um.

[1912] He's handsome.

[1913] No, he's the best.

[1914] No, he's the best.

[1915] Probably.

[1916] But I think he was that way at North Carolina.

[1917] He was?

[1918] Yeah, if you watched Last Dance, I think he.

[1919] had some weird rivalry he gave himself they're all fake but he also has chips on it he has a lot of chips on his shoulder yeah yeah and chips in his bank account oh hell yeah yeah yeah and at the end of that movie oh god the numbers yeah at the end of that movie are fucking mind blowing air yeah yeah why what's it say he makes 400 million dollars and passive income a year on the shoes a year a year so he's made like five billion dollars Yes, he should.

[1920] Yeah.

[1921] Don't get me started.

[1922] I love it.

[1923] And I watched that speech a few times, two speeches.

[1924] I watched this math speech.

[1925] Well, okay.

[1926] Are we going to talk about it?

[1927] Are we going to talk about the elephant in the room?

[1928] Oh, I know about this.

[1929] There's a reason I did a little marathon.

[1930] I watched air and then I watched Goodwill Hunting.

[1931] Oh, you were in a real.

[1932] I was in a mood.

[1933] This is post -bork chops?

[1934] I was taken him back.

[1935] Oh, wow.

[1936] This is Friday.

[1937] I wonder you have a headache.

[1938] Oh, this is Friday.

[1939] No, yeah.

[1940] This was Friday.

[1941] By the way, you're waiting from all the salt you put on the fork.

[1942] Saturday night.

[1943] Saturday night.

[1944] I was going to go to sleep to Goodwill hunting, but then I kept watching.

[1945] You know what's weird?

[1946] I applaud you.

[1947] Thank you.

[1948] It was weird because it's been a minute since I've watched it.

[1949] Okay.

[1950] Other than watching it in my head, you know?

[1951] And they're so young in that movie.

[1952] Probably way younger than I think they are.

[1953] Yeah, they're like probably 24.

[1954] Well, sure, I was, Bree and I went on one of our first dates, and I was 20 and she was 19 or 21 and 20.

[1955] Yeah, I think, I think they won the Oscar when Matt was like 25.

[1956] Oh, wow.

[1957] So they must have shot it when they were 24 or three or something.

[1958] I want to rewatch.

[1959] Oh, God, is it a good movie.

[1960] But also, it was weird because now they're way too young for me. To be horny for?

[1961] Don't you allow yourself?

[1962] I do.

[1963] I do, but I really had to jump some mental hurdles because I was like, oh, my God, they look so boyish.

[1964] Right.

[1965] I mean, and for my whole life, they were always old.

[1966] Old and hot.

[1967] Yeah, yeah, mature.

[1968] And now they're young and hot.

[1969] And that's uncommon.

[1970] Don't fight that.

[1971] You know, there's no ethical issue there.

[1972] First of all, they're 20, you could fuck a 24 -year -old and be fine.

[1973] I did think about that.

[1974] I was like, you know, legally this is fine anyway.

[1975] Yeah, yeah, yeah.

[1976] Who did I just find out dating someone like, oh, yeah.

[1977] We have a friend I just found out is.

[1978] Oh, yeah, yeah.

[1979] She's our age and she's dating like 20, yeah, 24, maybe.

[1980] And I was like, good work, man. Fuck yeah, it's about time.

[1981] Well, I have the script, ladies.

[1982] I have heard from Liz that male sex drive goes down as they age and women's goes up until menopause.

[1983] And so there is a period of time Where it actually makes sense For an older woman to be with a young guy It always makes sense, yeah I mean, I'm not sure if it's real Because I'm not a young guy anymore, but Me too Yeah Do you think your sex drive has gone down?

[1984] Oh God, yeah See, yeah, it's real I think she's right about that Oh, what happens, yeah Anyway Okay, so the reason I watched air Oh yeah, the speech She made such a good speech I watch it twice.

[1985] And then...

[1986] Wait, what speech did you watch?

[1987] Is Oscar speech?

[1988] No, no, no, no. In air.

[1989] Oh, Matt makes an impassioned speech.

[1990] Yes.

[1991] Yeah, yeah, yeah.

[1992] Well, listen, he's, I mean, I'm reticent to declare someone the best actor, but what I'll say is there's nobody better than Matt Damon.

[1993] He's so fucking good.

[1994] And for all the reasons when we interviewed him, I said to him, he's not flashy.

[1995] It's so natural.

[1996] He's so not an attention.

[1997] He's just, like, so fucking consistent.

[1998] And the variety of characters he's played are when you contrast them against each other.

[1999] It is a flashy career.

[2000] He's as good as it gets.

[2001] He's as good as it gets.

[2002] He's so good that movie.

[2003] Anyway, he makes a great speech, but then Viola Davis makes an incredible, yeah, an even better speech on the phone about value and worth, and it's so good.

[2004] So I love that movie.

[2005] I had a BMI bonnet to get some Matt back in my life.

[2006] For me to reclaim him as mine as he is.

[2007] Yes, of course.

[2008] Because you have, don't, you've done your, you've done the worst thing imaginable.

[2009] Got huge.

[2010] Aaron's referring to my muscles.

[2011] I told him the story and I explain, like the only thing I can explain why Matt's interested to me is that my muscles.

[2012] That's what I've concluded.

[2013] I think that's why he was willing to like start chatting.

[2014] You hung out with him this summer a little bit and.

[2015] And we're falling in love.

[2016] what do you i'm trying to i need people need to know why you're mad is it worth losing me as a friend to gain him as one are you gonna make it that way wondering what you're willing to what you're willing to lose i'm i'm kidding and i have to say i'm kidding no i have to make clear that i'm kidding because one of the mean comments is like why does monica care who dachs his friend with it's like go fuck yourself you have no idea who we're talking about um but anyway i was walking down the street leaving Deadpool, as I discussed, great film.

[2017] Great film.

[2018] And I happened to walk right over his star.

[2019] Yes.

[2020] So I was like, what a prime opportunity.

[2021] I'm always looking for an excuse to contact him.

[2022] So I took a picture of myself in front of his star and I wrote in all caps, rock hard.

[2023] Yeah.

[2024] And then he wrote something back very lovely.

[2025] I will not, I will not dishonor it by saying what he said.

[2026] But he sent a very beautiful text back, which put a real spring in my stuff.

[2027] And I was coming directly from there to meet you at Reefer Madness.

[2028] So it had just happened.

[2029] Yeah.

[2030] And again, we were back to the thing.

[2031] There's no way I can keep that from you.

[2032] It would have felt weirdly unethical to keep that from you.

[2033] I appreciate that.

[2034] And I showed you and you left your body.

[2035] Your skeleton left your body and marched around the room.

[2036] It did take flight.

[2037] And then you reentered your body.

[2038] The text was so beautiful and kind and like.

[2039] Loving.

[2040] Everything I could ever dream of to hear from him.

[2041] I get it Delivered at you That's a That's whoa I mean look by the way I agree with him Do you Some days I agree with what he said Obviously I know The perfect comp is like You and Pitt I said I am going to become best friends with him I have fully declared that Yep And then you got to show me the text I'll show you You'll see that there have been others, but you don't get to see those.

[2042] Okay, just prepare yourself now for how that will feel.

[2043] I hope both those men are flattered by this and don't feel exploited by this.

[2044] Let me just say that.

[2045] I hope so, too.

[2046] It's only flattering.

[2047] Yeah, if I lose this new friendship because I put it up.

[2048] This is like, who was it?

[2049] Someone was dating Hallie Berry.

[2050] There's an infamous story.

[2051] And then they were on stage and she had called and he answered on something.

[2052] stage and that there is a bit of showing off and then they broke up and I guess this is identical that although you brought it up does that make me yeah I brought it out does that get me out of jail well I hope I hope you're not in jail because he's just a great person he is I'm learning that yeah you were you are on to the right path I guess that's really what this all circles back to is you have an eye for talent I do yeah my instincts are just always correct and I wish you would remember that he's impossibly sweet Yeah, yeah, yeah.

[2053] How does this make you feel, Aaron?

[2054] Oh, yeah, you're, you, this is great.

[2055] Yeah, this is great.

[2056] What an opportunity.

[2057] I was, I was very excited for Dex.

[2058] And, um, and immediately said, oh, oh, oh, oh, oh.

[2059] Oh, for me, for me. Yeah, for you, yeah.

[2060] Oh, uh -oh.

[2061] No, I'm happy.

[2062] I want more love in this world The more people who love him And the more people who love you That is what I was asking Oh God, no, I didn't even know That's what you're asking Don't be crazy That's right Well, that's the right answer There's nothing to be threatened But It is very truthful, I believe I'm mad I'm Maddie My number is 313 300 What if I gave you his number then you went out to the Hollywood bullfart shot a picture of yourself and read that just cold text in that photo got your number from to X I'm his original best friend thought we should meet I did think when I was watching the movies I think it's great and I think it's very sweet what he said but and there is there's a one hold on I am being honest I just got to ask one question okay did anybody be honest Any part of year?

[2063] Yeah, PQs?

[2064] No, no, no, no. I mean, always.

[2065] Anytime he's involved.

[2066] No, no. Did you go?

[2067] And just wait until you get to know him better.

[2068] Did any hint of a voice say that?

[2069] No. Okay.

[2070] I mean, I did think he doesn't know him that well.

[2071] It's early.

[2072] It's early to be saying stuff like this.

[2073] So it's adjacent.

[2074] I'm kidding.

[2075] I'm kidding.

[2076] I did not.

[2077] I did not think that.

[2078] I did think there's a small percentage, very small, like 3%, that feels uncomfortable.

[2079] I have a guess at a potential thing, which is I think you might be feeling some weird tension of your fantasy world and your real world overlapping and intersecting.

[2080] Yes, that's like he, he's another entity.

[2081] He represents something else for me. And he lives on another planet almost.

[2082] Does it demystify him a bit that he's friends?

[2083] with me. It's not that it demystifies him, but he's falling off of Mount Olympus.

[2084] No, no, no, no. There's something like when he, when he came here, that moment is an indicator that dreams can come true.

[2085] Like, that's a weird thing to say, but that is.

[2086] It's like, oh, my God, I used to sit in my bedroom and dream of an interaction like this.

[2087] Yeah.

[2088] It's just like life is long, but things kind of come full circle and that's a beautiful, like life is.

[2089] Like, life is.

[2090] magical that's sort of like for me what what he and my interactions with him represent yeah so yeah when you're like hanging out with him and you're my best friend it's like wait this is fucking up my thing and it's very compartmentalized he's the Ben and Matt are the only people left really yes yes that remain magic special to me yeah yeah everyone else is real like they're just humans and humans can be difficult and tricky.

[2091] I get it.

[2092] But those two, like, have remained.

[2093] I've kept them in a very precious little box in my head.

[2094] And you are like prying open that box.

[2095] Yes, I understand.

[2096] With your little grubby, mechanical hand, greedy hand.

[2097] Grease, there's grease on my chicken grease.

[2098] Fried chicken grease on my porcelain box.

[2099] So anyway, I just, I just want to.

[2100] be honest about that, but that's only 3%.

[2101] No, I understand.

[2102] 97 % is very happy.

[2103] Yeah, it's interesting.

[2104] Yeah.

[2105] Oh, blood.

[2106] I just wanted to say that Aaron and I tried moo barbecue.

[2107] Oh, yeah.

[2108] Have you been now?

[2109] Yeah, that's good.

[2110] It's not as far.

[2111] I thought it was downtown, but it's not.

[2112] It's Lincoln Heights or something, which...

[2113] Got it delivered.

[2114] Oh, you did.

[2115] I think.

[2116] Oh, I've tried it.

[2117] Maybe I didn't check it right at.

[2118] It's a nice experience.

[2119] You should go.

[2120] Oh, it's really cool in person, yeah.

[2121] I felt like we were in Texas.

[2122] Yeah.

[2123] Like when we went to Shmitties.

[2124] Yes, exactly.

[2125] That's the one, yeah.

[2126] Yeah, where you walk up to that counter.

[2127] You're not huge into barbecue, are you, Monica?

[2128] I like it.

[2129] You should go.

[2130] Yeah.

[2131] It's outrageous.

[2132] We had a brontosaurus rib.

[2133] That was as big as a picnic table.

[2134] It was ridiculous.

[2135] It had a full brisket on it.

[2136] Like, we had ordered brisket.

[2137] It's a beef rib.

[2138] And then there was brisket attached to a bone.

[2139] And we got the burger And we got the sausage And we got a sausage potlick Coal potatoes Yeah Did you see the French pole vaulter Okay I've only Guys I've only I've seen in the comments that I miss it And it's filling me with panic You guys saw it?

[2140] No you took a lot for five seconds Yeah Oh yeah it's just a clip It's everywhere What happens?

[2141] His dick gets stuck on the...

[2142] His dick and balls get stuck on the...

[2143] He's over, and then his penis just knocks it off.

[2144] I did see it.

[2145] Kristen showed it to me. I guess I assumed that was...

[2146] I was like, is that from this Olympics?

[2147] Because I would have...

[2148] Okay.

[2149] It's wonderful.

[2150] It's fantastic.

[2151] Because it gets completely stuck, and his body keeps going down, and then it slingshots out.

[2152] It's a nice package.

[2153] Yeah, great dick and balls.

[2154] You have been waiting, and you got a really good one.

[2155] Yes.

[2156] Yes, and soon as track and field started, I was like, here we go.

[2157] Here's the dicks.

[2158] They're out and about.

[2159] Yep.

[2160] Oh, this is great because Aaron's here.

[2161] Can we ask him?

[2162] So we were talking about how much I like the penises and the Olympics.

[2163] Yeah.

[2164] And then I said, I'm a 10 that I like looking at penises.

[2165] Yes.

[2166] And then I asked Rob what he was and he thought he was a six.

[2167] And what are you?

[2168] At looking at penises?

[2169] Yeah, like them bouncing in the outfits and anytime you can see him.

[2170] Being amused by it.

[2171] Yeah, it's more, it's more than looking at them.

[2172] Sure, so sure, sure.

[2173] I'm, um, year by year, I like them more.

[2174] Okay.

[2175] So I like them a lot right now.

[2176] Okay, great.

[2177] Like, I watched that video 50 times this morning.

[2178] And, um, there you go.

[2179] Oh, it's so wrapped around.

[2180] Like, like the balls and I was trying to see where the balls met the dick and the, what was happening.

[2181] And then I was picturing mine.

[2182] And if it was like a, you know, some nights, it's real acorned up and small.

[2183] And sometimes when it's really warm, like it is in France, it might look like that.

[2184] Oh.

[2185] Oh, yeah.

[2186] So you were looking at more of like a climateological look.

[2187] I'm always thinking of a climate control because I always have to make an excuse before anything happens.

[2188] Did I tell you that was my idea?

[2189] I wanted to do a contest where it's a small penis contest.

[2190] Like, you have to go on the cold plunge for three minutes naked and then get out and then we measure everything.

[2191] That would be great.

[2192] And they're like 10 men compete.

[2193] I would love that contest.

[2194] I would run away with the gold on the small penis.

[2195] Yeah, presumably some men's penises would disappear entirely.

[2196] Yeah.

[2197] Like just go inside the body.

[2198] Okay.

[2199] But are you willing to quantify it with a number?

[2200] Eight.

[2201] Eight.

[2202] Great.

[2203] Room to grow.

[2204] Pun intended.

[2205] There you go.

[2206] Well, yeah.

[2207] I don't think I ever could be.

[2208] You've been a 10 for a lot.

[2209] long time from the jump right yeah yeah yeah yeah yeah you were you came out with it before anyone was willing to look at a penis thank you yeah the trailblazer yeah you were so i think what he's saying is he agrees with me that you over index sure and you always have yeah i was more making i was assuming men like it well let me ask you this when you're watching righteous gemstones and there's that great scene and it's like um our lead character is making a speech and behind him's playing on a big movie screen this guy's penis walking around his head and the whole speech is his penis moving back and forth like that's as funny as it gets for me but everyone laughed it that wasn't gender that was just funny like that's like a funny clever thing to do in a show yeah it's my favorite kind of joke is when you get one of those penises yeah he looks ridiculous I mean a lot of people have been catching on over the ears.

[2210] Yeah.

[2211] The small, small penis.

[2212] Oh, in the Patriot.

[2213] Yes, we have a child.

[2214] Oh.

[2215] Hello.

[2216] Hi.

[2217] Oh, my God.

[2218] Oh, my Lord, honey.

[2219] It's a beautiful.

[2220] Wow, it's a work of art. Oh, my gosh.

[2221] That's really good, Linky.

[2222] Say what?

[2223] I had a blue eye on him.

[2224] Oh, as you should.

[2225] Did your dad have blue eyes?

[2226] He did not.

[2227] He absolutely did not.

[2228] Oh, wow.

[2229] But Aaron's are...

[2230] I have a empty socket, so I had to throw her in.

[2231] Oh, I love it, honey.

[2232] Tell people what happen.

[2233] Oh, Lincoln has done a painting of a can of Ted Seegers.

[2234] Yeah, it looks good.

[2235] It's really, really, really good.

[2236] You want us to keep it up here?

[2237] Very good artist.

[2238] Maybe this will go in the new filming space.

[2239] We can put it here for now on top of the thing.

[2240] Oh, yeah, lean it under the tap.

[2241] Oh, I love it.

[2242] I love it.

[2243] Leaning it under?

[2244] Yeah, like lean it against the tap.

[2245] We can put this, yeah.

[2246] Yeah, let's stay.

[2247] Good job, Linky.

[2248] Cute.

[2249] Thank you.

[2250] Really good.

[2251] I love you.

[2252] Bye, buddy.

[2253] Bye.

[2254] Okay.

[2255] That's a Delta's nailed that.

[2256] She always said by that way.

[2257] Bye.

[2258] Wait.

[2259] Penises.

[2260] Vagina.

[2261] Buds.

[2262] But back to some facts.

[2263] Okay.

[2264] great because i do have some because Alzheimer's episode it's important so we should give it some whatever the opposite of levity is some gravity some gravity okay the calcium test so there's two carotid ultrasound for neck arteries yeah i've done that okay and then there's a ct angiogram it's called a cta it's a medical imaging test that uses a CT scan and a contrast dye to create detailed pictures of blood vessels and tissues in the body.

[2265] And you said you had that, right?

[2266] Yeah, and they tell you before they inject you with the contrast, that it's going to feel like you peed your pants, which I was so excited about.

[2267] Of course, yeah.

[2268] Wouldn't you look forward to that feeling?

[2269] Did it?

[2270] Not as much as I wanted to.

[2271] It made my whole chest cold in a fun way.

[2272] Yeah, but I did want to feel like I had wet myself, like a baby.

[2273] And I'd say, oopsie.

[2274] Ooh, gaga.

[2275] I did a boo -pooh.

[2276] Okay, so most CTAs take about 15 minutes, but the actual scanning only taking a few minutes.

[2277] Patients typically don't need to be admitted to the hospital for a CTA.

[2278] I was not admitted in and out.

[2279] Okay, great.

[2280] There's also a coronary artery calcium score.

[2281] That's C .A .S. That's a non -invasive imaging test that can help detect early signs of heart disease.

[2282] Mine, with the contrast, gave me a calcium score.

[2283] They would tell you what percentage calcium.

[2284] Yeah, it's just more intense.

[2285] Okay.

[2286] Prevalence versus incidents.

[2287] Prevalence.

[2288] The proportion of a population that has a specific characteristic at a given time, regardless of when they developed it.

[2289] Prevalence is usually expressed as a percentage of the population.

[2290] For example, in a one -year study of diabetes, prevalence would include anyone who had diabetes during that year, whether they had it at the beginning or developed it later.

[2291] Prevalence can be a useful tool for planning health services.

[2292] Incidents, the number of new cases of of a characteristic that develop in a population during a specific time period.

[2293] Incidents can also be a measure of the risk of getting a disease during a given period.

[2294] For example, in a one -year study of diabetes, incidents would only include people who develop diabetes during that year.

[2295] Incidents is often reported for infectious diseases, and researchers may study it to help identify causes and prevent future cases.

[2296] Even with that explanation, yeah, it's not the most obvious difference.

[2297] well new cases versus all cases yeah I guess it is which makes sense yeah because it's saying is it increasing is the incidence increasing all right well I thought maybe we would look into the 23 and me and see if we could find our APO remember he says we it was on it but I can't find that that's from years ago I know I cared a lot when he said it and I was like I'm going to do that and then I just never thought about it again yeah do it for me i think like if you're already doing everything that's prescribed for it what's the point of knowing like it'd be one thing if you're like i don't want to make these life changes so i'm only going to do it if i find out i'm an increased risk but if i'm already doing all the stuff doesn't really matter i need to know right yes because you could do much more heavyweight training i know you're not looking forward to that no who's got the time what part of it just the Thought of the exertion.

[2298] No, because I like cardio.

[2299] Right.

[2300] I just, it is time.

[2301] It is that.

[2302] It's like, I don't add that in.

[2303] Like, there's no time.

[2304] Just no time.

[2305] Only time for brining.

[2306] Paleolithic.

[2307] I know you don't like this.

[2308] You don't like this.

[2309] And I know, and you already said it in here that it's bullshit and people did live, live to be very old.

[2310] Yeah.

[2311] But.

[2312] Well, what I, yeah.

[2313] It includes infant mortality.

[2314] Yeah, but life expectancy in the Paleolithic stage was 33.

[2315] But again, because of an infant mortality rate at like 60%.

[2316] Although it says 75 % of deaths were caused by infection, including diarrheal diseases, to honest, that resulted in dehydration and starvation.

[2317] Thanks for putting it into our knowing nature.

[2318] Yeah, I didn't think you'd know what that meant.

[2319] Yeah, yeah, yeah.

[2320] So, yeah, I'm, I'm, I know what you mean.

[2321] You do.

[2322] Yeah, and if you look up Italy, 1600s life expectancy, it's probably in the 40s, and yet we had Galileo at 80, like, we know all these people documented that lived into their 80s and 90s from the, these eras.

[2323] But not Paleolithic.

[2324] But there's, if you believe Yuval Harari, we were actually much healthier in the Paleolithic era because we weren't keeping animals.

[2325] So we weren't getting all the animal transference pathogens, which we, most of our diseases have come from living with animals.

[2326] Tell me about it.

[2327] How are your dogs?

[2328] I love them.

[2329] I know.

[2330] I'm obsessed.

[2331] He loves them like crazy.

[2332] You should have met.

[2333] They had a little tiny guy here last week.

[2334] They had a, just stopped in for a week.

[2335] Yeah, they thought, you guys fostered a little puppy.

[2336] Yeah.

[2337] And he was really cute.

[2338] He was outragesly.

[2339] He just bounced around the backyard.

[2340] He hopped like a bunny.

[2341] His name was cowboy.

[2342] Not the most suited name.

[2343] He was also the runt of the litter, which is weird to name the runch cowboy.

[2344] He was really cute, though.

[2345] You would have liked him because he was a little doodleish.

[2346] Mm -hmm.

[2347] Yeah, who knows what he was.

[2348] I got to get snuggle with him.

[2349] Yeah, you could have.

[2350] I've told you right, every time Aaron's walking his dogs, people are yelling out the window.

[2351] What kind of doodle is that?

[2352] Yeah.

[2353] Yeah, people love.

[2354] They love a doodle.

[2355] Oh, man. They love a dudes.

[2356] Hey, man. What kind of doodle you got there?

[2357] Hey, look at this.

[2358] Well, that's it.

[2359] We'll tell everyone our results.

[2360] Oh, yes, from this.

[2361] Our blood results.

[2362] I don't even know what results are in the car.

[2363] I'm not even sure what we're going to learn, but I guess we'll learn.

[2364] Hopefully a lot from 11 vials.

[2365] No, right?

[2366] I want to know the exact day I'm going to die.

[2367] What if they're like, you're going to die at 9.

[2368] 30 on March 29th, 265.

[2369] No, 2090.

[2370] Yeah, it's nice.

[2371] That'd be 115.

[2372] Yeah.

[2373] That's a great age to die.

[2374] Good year.

[2375] All right.

[2376] Well, I love you.

[2377] Love you, Beau.

[2378] Well, Aaron will still be around for Monday's fact check.

[2379] Okay.

[2380] But we are going to invite people to go meet Aaron at the Avitt Show in Detroit.

[2381] Oh.

[2382] Yeah, yeah.

[2383] Okay.

[2384] Get your deeds.

[2385] But Aaron's going to be at the Avitt Show.

[2386] with a Ted Seeger's tasting station.

[2387] Mm -hmm.

[2388] Party.

[2389] Talk about a marriage of things we love.

[2390] Yeah, I like that.

[2391] All right, how's your headache feel?

[2392] Are you getting any better during this?

[2393] Yeah, my Advil kicked in.

[2394] Okay, wonderful.

[2395] I mean, my pain reliever kicked in.

[2396] Yeah.

[2397] I don't know who's a spouse.

[2398] I don't know who's a spouse.

[2399] I don't know who's a lot.

[2400] Okay.

[2401] Okay, love you.

[2402] Love you.

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