Video URL: https://www.youtube.com/watch?v=ToUpAWW7u4c
your mission at the moment to myth bust and call out disinformation as it relates to Health Care let's get into that okay Dr Mike verski he's the actively practicing medicine doctor with over 25 million followers who's created one of the largest health education Platforms in the world Dr Mike what's the key to finding a diet that's going to stick there's two real things that you need to think about one calories in and calories out is true second and this is important you need to have what about the prevailing narrative that if you want to lose weight you got to get on a running machine nutrition that's where the majority of the change will come from what's the Medical Advantage if I go to the gym every day literally everything else is vaping dangerous yes and no one knows this by the way this is why I do what I do but the more dangerous part of it is what's your p on supplements they will make you skip on doing things that are healthy for you and supplements have side effects you have too many of them we notice that they but no one talks about that because you can't really sell that and then considering you care so much about your health why would a doctor to choose boxing cuz I unfortunately lost my mom to cancer to ask the doctors to stop doing chest compressions on your mom that is not something that I wish on anyone and I got into a very unhealthy mental state so boxing chose me instead of me choosing boxing in the circumstances that you lost your mother where she was giv the all clear yeah did that experience change your perspective of the medical industry in any way we've just hit 6 million subscribers on the D Co um so me and my team would like to do something we've never done before as little thank you and we're calling it The dire coo subscriber raffle and here is how it works every episode this month we're going to pick three current subscribers at random and we'll send one of you a 1,000 voucher one of you tickets to come and watch the D behind the scenes live with our team and one of you will have a 10-minute phone call with me to discuss whatever you want to talk about if you're a subscriber you're in the raffle thank you from the bottom of my heart for allowing me to do something that me and my team love doing so much it is the greatest honor of my
lifetime and I hope it I hope it continues uh off into the Future Let's get to the [Music] episode Dr Mike considering everything you do from your podcast to all of the content you produce across your channels to the stuff you do in TV everything social media all of it how do you summarize the overarching mission that you're on at this in this phase of your life the mission is largely to make sure that in the sea of misinformation my patients my viewers are getting the most honest transparent and engaging information so that hopefully they can make the best decisions Healthcare wise for themselves and their family members why do you care when I was a medical student I would go into rooms with patients and they would be being seen by some of the top doctors in the world I mean experts upon experts credentials published work and the second the doctor would walk out after presenting all this accurate evidence-based information the patient would look at me as the med student and say what did he say or what did she say and I realized that the message wasn't hitting home and I realized we need to do a better job as communicators in the healthcare space and then I said well TV must be the answer media training must be the answer and then as I became a practicing physician in my residency program I started seeing people being influenced by those TV physicians in the wrong ways they would be promising Miracle solutions to any problem they would be having snake oil being sold to them they would think that they can skip out on taking their medications or going for treatments or making Lifestyle Changes because of a solution proposed to them for three easy payments of 1999 and I said oh man not only are we not great communicators but we're being edged by people who are trying to make a profit in that in this Health Care space and I viewed it as a mega problem I remember in 2017 I wrote a blog post for the American Academy of family physicians and I said the lack of evidence-based Physicians Online is is going to create a world of a difference in our patients lives it's going to
allow misinformation to come in especially in this section I call the gray Zone where modern science doesn't yet have an answer to certain medical problems to certain medical conditions and they're going to come in and promise you Solutions and they're going to be quite successful at it what happened three years later covid-19 pandemic misinformation pandemic people confused not knowing who to seek out for information and for some very strange reason a doctor with only 5 years of experience uh after a residency was the number one channel on YouTube being watched and giving the answers when people were not watching the CDC they weren't listening to True experts in said they were falling for misinformation online and I had to be there to set the record straight I couldn't believe that that happened for people that might not know who you're referring to when you cite that doct doctor that is you you reach a lot of people every month you have 12 million subscribers on YouTube now you have other channels with you millions of people following you across the board and that's happened in quite a short space of time what is it about you that you think has been so resonant with so many people as it relates to sort of medical information and spotting disinformation I think it's not one thing much like in healthcare this would be a multifactorial situation I think when I first started the reason why I got popularity was because I was an early adopter of Instagram and I would share my medical Journey uh of being a med student mostly because I wanted to show people that you can have a life a social life a family life a sports life and still go through medical school because I felt like there existed this stigma you have to give up everything to study medicine and while I was doing that I got some followers on Instagram and at that point having 10,000 followers was a huge win because it was so new and being a broke medical student to go to a club and say oh my God I have 10,000 followers let me in without paying the admission that was a win then fast forward just a couple years later I'm in my residency program BuzzFeed writes an article and they didn't write an article about me being
the youngest doctor in my hospital they didn't write an article about the fact that I did some medical research they didn't write about the fact that I was passionate about putting out accurate info they the title of the article was you got check out this sexy doctor and his awesome dog and I'm like oh that's silly no one's going to read this I thought it was cute I'd send it to some friends and then boom that was the moment everyone was going viral and it seemed like every Outlet in the world was reaching out and when I say in the world I'm not exaggerating like Outlets from the UK from Budapest from Asia from the every possible Outlet here in the United States was calling for an interview and I very vividly remember all the talk show hosts were reaching out and I had no idea about this world that there existed so much competition where I remember the Ellen degenerous show folks reached out and they said if you do our show you can't do the Steve Harvey Show and Steve Harvey reached out and said you know if you do our show you can't do their show I talked to some friends I'm like all right I'll do the own degenerous show I think that'll be a cool opportunity and they do the pre-interviews I meet with the producers I tell them about what I'm passionate about and the day before filming they call and they say hey we have some news Hillary Clinton is announcing her bid for the presidency of the United States and she's doing our daytime talk show as the first talk show and like the other guests were like pink and Jimmy Kimmel so you're the one getting kicked off and I said no biggie I'll go on Steve Harvey so I called Steve Harvey's people back and they said oh no that was two weeks ago we're not interested anymore and it was such a wakeup call where the 15 minutes of fame statement was true you were hot for a second people were interested about this unique story and then they move on but I said no way I I still have to push this because I viewed it as an opportunity to get people to care about the information but drawing their attention to something else first if you look at who's successful in media 20 years ago uh in the healthcare space it would be unfortunately people who corrupted the health information for the
viewership and it feels like you often times have to corrupt something to get views and I felt that if I could corrupt and have people come for the scandal of sexy doctor but when they come for that I instead give them some accurate information or maybe have them come for some comedy and give them some health information that was a way to get people interested because if we're being honest Healthcare information textbooks science it can be boring if you're not passionate about it but if you can present it in a way like some of the amazing teachers that I've had over the years in a way where it's fun it's engaging they make it um almost like a journey that you're going on suddenly you pay attention you have a few takeaways and then from those takeaways you're better equipped to handle some of the things that could come up with it during life and I really took that to heart in the beginning and over the last five years I've really studied what marketers have done so well in the commercial space or what those snake oils salesmen have done so well in pitching their misinformation and take those same principles but bring them to evidence-based medicine allow people to have fun while they're learning there's a lot of information out there as it relates to health what is your sort of framework for deciding what you share and how you share it when there's so many a lot of these studies as well the the methodology of the studies is often hard to trust because of the way that that you know certain studies where they look at kind of they don't isolate one variable so you look you look at the study and it could be anything they say you know they you hear these studies about like veganism for example where they say veganism is is healthier but that doesn't remove out all the other factors in that person's lifestyle maybe okay maybe they're they're eating less meat but it's processed meat that they're having with fries and hamburgers Etc so how do you what's your framework for deciding if something is true in a SP in a sea of information every time I look at some new research I treat it differently than most people would in the media space and I also treat it differently than an individual
would treat it so if you're a news outlet and a breakthrough study comes out they treat it like it's the answer to people's problems like it's the new and best I take that research and I apply it to the existing data and knowledge that I've gotten over the years through my medical education and position it in where it belongs so some research comes out it might make me lean in saying we need to move closer to a plant focused diet it doesn't mean that everyone needs to be on it doesn't mean we need to eliminate everything because in medicine extremes are rarely right even when we're talking about optimization you'll hear oftentimes people say oh you can boost your immune system you could hyper optimize this no no no hyper optimization is Extreme whenever you're going to those extremes you start creating problems because that's how the human body works it works in homeostasis it wants to be balanced and the enemy of balance is bad but also perfect so what do you make of this optimization longevity anti-aging live forever culture that's emerged in the last couple years I understand where it's coming from uh We've made a lot of scientific progress we believe that we should have the answers to the one problem that is facing all of us and that's that life is not forever but I feel like the field has been corrupted and it's actually the way that healthc care has been corrupted across the board so when we talk about health insurance the Pharma industry anti-aging industry a lot of it has been corrupted with capitalism and I take and I say that as someone who's actually Pro capitalism but I believe Healthcare is a commodity that cannot be lift I love the idea of being able to call something on demand doesn't quite work for healthcare you demanding what you want for your body when you're not the expert doesn't always yield the best results we've seen that time and time again I see it with my patients when they come in and it's very clear that they have a viral Illness but they demand antibiotics or they demand uh a medication that's going to help them live longer doesn't exist we don't have yet the evidence to sell these things to
people to explain them to people but there will always be a person who will take some new information some preliminary data data from an animal model from a petri dish and sell it as the next great thing this happened with the Fountain of Youth this happened with literally snake oil hundreds of years ago and now it's happening but with the power of social media and the fact that this misinformation a lot of times is Insidious you don't realize that it's so bad and so problematic because what it's doing is it's actually tricking people into not understanding how science Works how when we put out a hypothesis an idea of what we think could happen we actually strive to disprove our hypothesis so if I say this glass of water here will help you live longer I will actually as a scientist want to set out to prove that it doesn't and I will think of every way and I would bring on people to disagree with me and find ways that we could test that this doesn't work but right now on social media what you see is a lot of people just supporting what agrees with them what are some of those ideas that have proliferated across social media that irritate you the most and you think are most harmful I think the ones that create certainty in an uncertain world and I think that could apply to pretty much any field I talked about the gray Zone earlier and I think the gray Zone has changed 30 years ago the gray Zone was weight loss yeah and if you put on any TV channel especially late at night there would be a fat burner there'd be some grapefruit diet or some next great thing that someone came up with but everyone forgets about all that people used to sell you nonsense to try and help you lose weight and all of it didn't work it was not healthy even if it made you lose weight it was in an unhealthy way it ended up creating and fueling this almost eating disorder like cycle for most folks and then came out some medic s like OIC and people started actually losing weight with an FDA approved medicine that had Real Results now you see less of those fat burner ads but you see more of a new Gray Zone anti-aging science doesn't have an answer to stop us from aging we don't have the answers perfectly to our
genetic code but boy there will be a genetic test for sale that will tell you exactly what you need to avoid but the reality is we just don't know and it's not sexy to say I don't know but I've been passionate about encouraging folks to celebrate those experts who come in and say here's what we don't know but here's how we're working to get to those answers because that's what gets me excited there's so many breakthroughs being made in medicine and we don't talk about those honest breakthroughs because they're not always exciting but if we could pair it with something cultural if we could pair it with some comedy with some fun I think we can get in front of a lot of eyes one of the first things you said there was was about weight loss in a zmek and it's a incredibly relevant and um widely discussed subject at the moment as zmek I I listen to the research on a zek and I am someone that typically has a bias towards not taking medications if I can and pursuing a natural route and and that is what we do too yeah which is understated in most uh circles as doctors yeah yeah so our training for example if you look at our we have a reference called let's say up toate it's a medical platform where we could go and get guidance on any medical condition and it could tell us what the epidemiology is who gets sick with it uh what is the diagnosis that we should do to try and make it like what Laboratory Testing what Imaging we should do uh What treatments work first line Second Line third line Etc if we look at pretty much any crime disease treatment whether it's high blood pressure um sugar management from like diabetes all of the first steps is lifestyle modifications that's what we're taught is that because of the type of training you had doctor you became or is that all medical doctors that is all medical doctors but what ends up happening is twofold one patients love a shortcut they love having a medication potentially do the work that they may not be able to or don't want to you know it's difficult to generalize here because some patients truly have difficult lives they have three jobs they're a single parent they're uh
having a mental health crisis so they may not be able to do those lifestyle changes but then there's a portion of us who could do it but prefer to take the shortcut and that's pretty human of us we we would like to get the shortcut we would like to take the edge is there such a thing as a shortcut in healthcare no and I heard you actually say it on your last podcast uh covering OIC that there is no shortcut there are side effects and trade-offs to everything and you're absolutely right in that there is no such thing as just something that is all good hydration you can't live without it over drink you'll throw off your electrolytes you could damage your brain you could lose your life carrots healthy food I would say eat enough you'll turn orange same thing goes for medications and that's why when people go and villainize treatments medications supplements it just depends and there needs to be Nuance it's too hard to paint medicine with a broad brush but social media makes that really tempting that that non aemp path if I'm not going to take the the new sort of fat burning magic pills or the appetite I guess I guess they suppress appetite um magic pills that becomes another a bit of still is a bit of a gray area in many respects because we on the drug side of things people now have an option that's FDA approved but if they don't want to pursue that path there's still all of this other information around okay I want to lose weight and there's lots of opportunity for a lot of people to present them with Solutions there's a there's a roaring debate around calories which seems to just be never ending and um I wanted to get your take on that if if someone was you know in your training when you've been advised to suggest Lifestyle Changes first and foremost if I'm trying to lose a bit of weight I'm you know at risk of being diabetic or something what would you say to me as your patient it would be hard to generalize it because it really depends on what pre-existing conditions exist what have you tried thus far what works what do you have time for what do you have budget for on that point of tried thus far why is that why does that matter so much if I have a patient who's tried
dieting and failed and I don't ask that question and I recommend dieting they may not take the advice they may nod because they want to be a quote unquote good patient and leave and say not doing it but if I ask that question they can say they tried and failed then that gives me an opportunity to ask what exactly did they try did they try some really restrictive diet that's out there carnivore keto what have you and that set them up for fail something that wasn't able to be sustainable whereas now I can explain that hey the thing you tried actually set you up for failure and here's a more reasonable recommendation that we can try and now I can actually be a doctor that recommends a dietary modification that could help them what's the key to finding a diet that is successful from your experience what are the like the foundational factors of that diet that's going to typically make it stick there's two real things that you need to think about when it comes to dieting one is its impact on your weight because calories in and calories out as non-sexy as it sounds as clinical and cold and heartless as it sounds is true second you also need to think about the nutrients in your food because if we just take one of those parts and ignore the other we can get into a really bad place I can uh even see those grapefruit diets that people say like eat three grap fruits a day and you'll lose weight yeah you will because you're underc consuming calories but is that healthy from a nutrition side absolutely not on the other side is you can get enough protein enough nutrients but if you're overeating calories you can get into a metabolic problem where now you're carrying excess weight and increasing your risks of all sorts of conditions so the goal is to get you in a place where it's balanced in both a caloric weight management standpoint but also an ideally a healthy nutritional balance as well well and what that means personto person is going to vary it's going to vary based on the medical condition they have some patients who are anemic may need certain nutrients that someone who's not anemic doesn't need someone who's prone to kidney stones may need a slightly different diet than someone who
is IBS prone so we need to always take into account that generalized advice isn't great when it comes to Health Care especially when it's very easy to create Buzzy statements from truth in healthare like I said on a podcast not too long ago that exercise for weight loss Almost Doesn't Matter and that's a buzzy statement because on one hand it's true but you also need to pair it with some nuance and say exercise has so many benefits outside of weight loss of why it's important to participate in exercise and the idea of weight loss needs to come from nutrition that's where the majority of the change will come from Super interesting cuz I've sat here with so many people that have said that to me um they've said that when you look at a lot of the studies exercise as a if you if you give prescribe someone exercise to lose weight they probably won't lose weight um but I would definitely say that in culture people see exercise as the many would see I reckon the primary way you lose weight they think you have to go for a run to lose weight and and again you've Express the Nuance there but I've even I've struggled with understanding that because over here people say exercise isn't super useful for weight loss in the studies but then the the prevailing narrative in society is that if you want to lose weight you got to get on a running machine that's because they're equating in their minds Health with a magazine cover and health is not a magazine cover they think that you need to have big muscles to be considered healthy and while you can have big muscles and be healthy you could have big muscles and be tremendously unhealthy so just looking at someone's appearance doesn't give you the full picture just like looking at someone's weight doesn't give you the full picture you need to know more and when it comes to exercise and weight loss let's just take for a very simple example I used to go to the movies when I was a kid I loved it I did it all the time it is not unusual to eat a tub of popcorn a little candy bar and a soda well over over 1,000 calories do you know how hard it is through exercise to burn off a th000 extra calories most of us are not physically even equipped to burn a th000 calories during an exercise session so it's just
about the science of not being able to out exercise a bad diet what if I just eat loads of salads I think I've been in that mindset before where I thought well I it's just really I could have well I've been in periods of my life where I've just just eaten more and more and more good stuff quotequote good stuff things that I thought were good um but I also didn't lose weight you are you're a really smart person you're a person that wants to be as effective as you can in your podcast in your communication style and you're amazing at it you want to do the same thing with your diet and the hacks and tricks that you use in your business mind in your communication mind don't work for healthcare you cannot find the shortcut of the salad that's going to fix everything that bothers you of the probiotic Miracle supplement it's not going to be there that's why some of the minds that actually end up falling for the most simplest forms of misinformation are those who are really good at business because the things that work very well in the business world and the communication space don't work in healthcare because Healthcare is not a commodity healthare does not work well with extremes you cannot do something so good all the time without it having negative repercussions you want to be good not perfect when it comes to healthare and the more you try and Chase perfect number one you're going to get the negative response but also number two you're going to create anxieties worries that are also toxic to your body you have to be very careful so perfect is not only Just an Illusion it's a toxic illusion I saw someone talking recently about the calories in calories out thing and the first comment was a lady who I think had a pre-existing condition basically saying because my because of my pre-existing condition the calories in calories out thing does not work for me I've tried it and then the health influencer responded and said it works for everybody both statements are true okay dialectics are common in healthcare we're two opposing ideas can both be true someone can try and do calories in calories out which through science works but the application of it can fail well
I'm thinking not about the application and like the science of it is it regardless of whether I have a pre-existing condition not regardless pre-existing conditions is part of the application okay the individual is part of the application I think she was making the case that because of that existing condition that the maths of it don't apply to her like it doesn't actually work on her body it shifts versus the applic okay it absolutely shifts and that's the truth for most medicine like when I try and get my patients into a healthy blood pressure range because we know that uh having a resting blood pressure above a certain number predisposes you to having risks of heart attack stroke all these cardiovascular conditions when I treat them with a medication after lifestyle changes either didn't work or they weren't able to go down that route we have this really unique knowledge public healthwise we know that controlling the blood pressure on a large scale will lower deaths significantly we'll lower heart attacks significantly but by me medicating this one patient I have no idea if it's going to help this individual exactly but that's because all we're doing in medicine is doing our best with the limited information that we have on hand closing off on that point about exercise so if if we shouldn't be thinking about exercise as a way to lose weight what what is the sort of Medical Advantage the physiological Advantage for me if I go to the gym every day and I'm I'm active literally everything else if I could bottle the effects of uh exercise and sell it richest person on Earth happiness mood social connections strength ability to decrease cancer risk decrease uh increase ability to fight off cancer increase longevity literally everything else is the benefit of exercise and I say that as someone who's been very exercise focused but over the last few months I've kind of fallen off I've gained some weight I haven't been exercising as much as I want because sometimes life gets hard life gets in the way things become problematic mental health sometimes takes a struggle and we need to be aware that that can happen
the idea that we need to make every person perfect or if they're not perfect they failure that's such a dangerous Rabbit Hole to go into how much exercise going to vary person to person General guidelines say 150 minutes of moderate intensity exercise per week which isn't a lot two and a half hours um moderate intensity meaning that you shouldn't be able to speak full sentences maybe one sentence at a time until you're out of breath is a simple way to put it when you you um have such a broad view on medicine well I noticed that in your content I was like this guy really knows he really has a real much more Broad View than the neuroscientist I spoke to yesterday who's really focused on you know maybe one part of the body with that broad view what are you concerned about in terms of macro social trends the direction of travel that we're going in with our health we talked about misinformation and disinformation but but actual realities of the Western Health Care condition first of all I think it's important that we have both individuals participating and having a seat at the table the broad view primary care physician and the single point expert neuroscientist like you had on your podcast before me we need both in fact where I'm able to gather my information from is from all those researchers that are putting in those hours at the bench making sure that they're checking their biases showing the flaws of their own research without them I am nothing right like where did I get my knowledge from from them so we absolutely need to do this in a teamwork approach I think the big problem that we face today is two things one the loss of trust in our health care world that's huge people don't trust healthc care advice they don't trust our agencies frankly the loss of trust of doctors has been rather shocking over the last decade and then second is it's more of a philosophical issue that I raise because I don't know where it's going to go where we've created this world of processed foods unhealthy Foods foods that it caus us to eat more and more and more and feel not satiated and then we've come up with a medication to solve that we've created apps that pull our attention spans that allow us to focus 10 15 seconds at a time before we swipe to the next
thing now a lot of people are requesting prescriptions for ADHD medications there's people who want to stay out all night and party and still maintain their physical gains they get on testosterone early when they don't need to how hyperm medicated are we going to get as a society to a point of actually harming us and I don't know the answer to it I'm not smart enough to know the answer to that but I think it's a good philosophical question to ask ourselves are you scared about what would happen if we had a pandemic that is 10 times more deadly than the previous pandemic break out now are you scared because of that loss of trust the more deadly the pandemic a lot of times the less problematic it is isn't that weird oh okay so initial SARS virus was significantly moread than SARS Cove 2 which is the virus that causes covid-19 so initially when the reports came out about The lethality rate of SARS Cove 2 covid-19 we said oh well it's not as bad as SARS we'll be okay because most people with SARS got really sick they lost their lives but because asymptomatic spread was a thing with covid meaning that you could feel fine or maybe just have a sniffles and spread it it killed Millions more people and that's what that brings me back to that point of when I said Insidious misinformation can be more problematic than true disinformation because when something doesn't seem so bad that can we can allow it to go much further and cause much more harm complacency can complacency and feelings of safety like oh well this one's not as Hill we're good I I feel fine we're good but when you look at it and you zoom out macro oh my God it's Wrecking Havoc across the world and I've actually equated this to vaping vaping is not as harmful as cigarettes on paper but because the odor is not as offensive it's easier to hide you could do it much quicker and get a bigger dose because it feels like it's not as harmful many more people can get hooked on it is vaping dangerous yes why and how so many of my friends VIP I think three three out of my six best
friends they're just like they're like they're just absolutely addicted they never smoked interestingly that's the issue of it that it gets people who maybe would have been turned off by smoking to try and the chemicals found inside are really rewarding to the brain nicotine being prime example of it and the more dangerous part of it is with kids who have a developing frontal lobe meaning that the part of their brain that is responsible for complex decision- making is not yet fully formed so they're incredibly susceptible to anything that can build a tolerance a dependence uh an addiction to and it can change the chemistry of their brain moving forward so we don't want to make it easier for them to start smoking vaping should be used as a tool as a way of getting you off of cigarettes not as a way of introducing you to cigarettes or nicotine at all is it dangerous for adults as well if you're coming off cigarettes no it's a good choice but if you never all my friends that Vape never smoked yep it's not it's not something that carries value healthwise and can only potentially harm have they have they done any I guess it's super difficult to do studies on these kinds of things but have is there any studies that have been done around vaping yeah there's been vaping related lung injury where that's its own diagnosis code now um there's been children that have been hospitalized with it um there's been even technical problems of the devices blowing up in people's faces so it's not the fact that I'm trying to fearmonger here and say vaping is the devil I'm here trying to explain that vaping can be problematic because on the surface it may not look as harmful by comparison Everything is trade-offs Everything is trade so interesting it's like when I see all my friends vaping they're all in we're all in Dubai a couple of about a year ago and I thought Poss me because they will have these little like disposable Vape things now so let me try I tried it and it was really nice and I thought oh God I could get into this and if it's not unhealthy CU like we all know that smoking is unhealthy I thought you know your head you think oh what's the harm I could have so easily gotten to it luckily I just I'm always
skeptical when I don't know the side effect I I would rather accept the side effects yeah and it be super clear than to someone say say to me there's no side effects when someone says there's no side effects I always well that's like the whole nature fallacy when someone's like oh but this is natural natural first of all what does that mean because like they say vitamins are natural but they're made in a lab I don't know how that's considered natural and also just because something natural doesn't mean it's safe arsenic cyanide natural but deadly the ADHD point you mentioned Y what are you seeing as a doctor you know over the last couple of years the the term ADHD neurodiversity has seems to have become more and more prevalent everywhere I look it feels like I'm hearing a conversation around ADHD is that because there's been a social sort of heightened awareness to the subject and now people are getting diagnosed more are we creating more ADHD somehow or is it somewhere in between yeah I I assume it's something in between I don't have a clear answer to it uh I do know that neuro Divergence needs to be talked about more and that's not just from the ADHD perspective it's also from um autism spectrum disorder uh situation as well where it's folks are going to be different and some people want treatment for a condition others don't and we have to respect people's autonomy even when we talk about something like vaping if an adult wants to vape as long as I can convey to them as their doctor the risks everyone's free to make their own decisions no one lives a life where they say I'm going to take no risks everyone has a different risk tolerance level everyone is comfortable with a different level of care in life some people want more care some people want less care even at the end of life I have discussions with my patients for end of Life Care often and a lot of times they're shocked by it they're like wait do you think something's wrong with me I'm 30 years old why are you talk this is the time to talk about it when you're healthy when you you aren't facing a decision that you have to make right now that's when you're going to be able to spend some time and think about what kind of medical care you want you know I'm a doctor here that became a professional boxer A couple of years ago
that is not healthy I do not recommend it it increases all sorts of risks for head and injury chronic traumatic incopy all of that is true it's a risk that I was willing to accept because I studied the risks I accepted the risks I don't doubt the risks but it's something that I'm passionate about and uh I wanted to go down that route enjoying it very much so it's a great outlet for me why did you choose boxing despite the risks yeah I would say that boxing probably chose me instead of uh me choosing boxing I uh I did Taekwondo growing up so I was in martial arts for8 years and then um when I was in medical school I unfortunately lost my mom to cancer and that was a a really strong wakeup call for me being in the medical field knowing what it's like to be in the room to ask the doctors to stop doing chest compressions on your mom I mean that is not something that I wish on anyone that's that's the worst thing you can experience especially when my father was there also a doctor who was saying no keep going but I knew was futile I knew we were causing more harm and in going through that journey I got into a very unhealthy mental state I didn't leave my house except to go to class I came home I was socially isolated and after a period of 3 four months where that was going on I said I need to get out of this I need to take the my own advice that I give to people and take the advice that you need to have action before you get motivation and the action that I took was to go on guilt City do you remember that app it's like a group ones app where you can get a coupon to a a class and I got a coupon for a boxing class and I went and did this boxing session and then I ended up boxing for 10 years after that session fell in love with the sport and then a couple years ago I ended up fighting on Showtime pay-per-view in front of an audience of 15,000 people wow and uh it's it's been a unique Journey so while it's easier to vilify boxing and say that it's problematic for some people if the trade-off is right it might be something that uh they could participate in and it could be very healthy for them losing your mother for anybody I think is just something that is unimaginably unimaginably painful but in the circumstances that you lost your mother
where from what I understood she was given the all clear at one point with her yeah so um she had this unique form of cancer called CLL and this is usually a cancer of old age where you get diagnosed with it and you end up dying of something else other than that cancer but she had a unique more aggressive form of CLL where they needed to really ramp up treatment and her treatment took a toll on her body like she did not look the same post treatment she did not feel the same but it was all in the hopes of curing this cancer and I remember very vividly I was I was going to Memorial Sloan ketering hospital to pick her up one day and she actually fell waiting for me at the waiting area so the doctor came down and talked to me and said maybe we should keep her observation for a day or so um but overall she's doing great she's just very weak from the treatment and he shook my hand in that moment and said she's cured there's no more cancer in her body now we just got to get her to recover from all these treatments and that's the greatest news anyone can hear your hopes 10 out of 10 and just a few short days later her weakness got so severe that she got uh a very unique type of bacteria called gram negative in her blood causing gram negative sepsis spread throughout her body she required the use of Presser medication to artificially raise her blood pressure to prevent her organs from dying and it didn't work and unfortunately she lost her life and one of the hardest moments there was watching my father go through this who with my mom sacrificed their lives to bring us to the United States as immigrants gave up their lives he went to medical school for a second time in his life she went to University after having a PhD in Russia to learn English and be able to teach students math here in the states it it was um it was painful to watch my dad go through it so I think for the first few months my focus was more on him than it was even on myself did that experience change your perspective of medicine and the medical industry in any way because in that moment a doctor a doctor turned to you and said your mother is cured and it
wasn't the it sounds like it wasn't the cancer itself that did the harm it was the treatment for the cancer that did the harm I never was mad at the doctor for saying that it would have been easy to in a situation like that where you thought you were good but then it wasn't it taught me a lesson about how life can be cruel and take things away from you very quickly after just receiving good news I remember sharing a a meme on my Instagram that it had like you colon I'm actually happy right now and then life colon hang on a second and that's kind of kind of how life is so it taught me to be able to bounce back from adversity and realize that you have to put one foot in front of the other while still being able to feel because repressing emotions in the short term is a valuable tool you know if you're unable to function in terms of high stress in the moment you could lose your life you could make a really bad decision you could harm others you might not be able to successfully hold down a job but if you do that for a really long period of time even that as a aute coping strategy can become toxic and I was getting into that point where it was becoming chronic and I was blocking my feelings of not mourning my mom not having the proper process and for everyone that process will be different you moved in with your father after that yep if I was a if I was a fly on the wall in that in that household at that time what would observed two gentlemen trying to raise a dog very poorly that's probably not what you expected but I um in trying to always find some kind of way to help um I thought by helping my dad redirect his feelings towards something else um I got a Siberian Husky for him in that moment which we always wanted a dog even my mom wanted the dog and uh he took some time to travel to more in my mother's passing and while he was doing that I raised a dog a little bit for a few weeks got her at least potty trained and then when he came home she was there he was typical Soviet father yelling at me and telling me why this is a bad idea crying which I never saw in my father before obviously until the loss of my mom and
um then he started being happy he started saying what should we call her his Focus shifted his Focus shifted to going for walks with her which allowed him to think about my mom to not be locked into the house as so many people are when they're going through a rough time so while I think it was chaotic of us trying to raise this puppy together it gave us something to bond around in a moment of tough times there will be a lot of people listening right now that are maybe in the throws of that grief or the throws of Their Own sadness or depression for whatever reason right and it's um when you're in the midst of the storm when it's it's hard to see any way out and you said something super interesting which is you said you realize that like action comes before motivation yep if I if I'm someone that's in that situation right now and I'm listening what would you say to that person put on your shoes they'll you'll go somewhere doesn't matter where you'll go Chim not Jim walk dog park you can go to a dog park without a dog it's therapy the biggest therapy that I think I've ever had and I've gone through traditional therapy was going to a dog park with my dog after my mom passed away it's such a weird thing but animal therapy is real and you know who actually gave me that advice speaking of Dragons Den um Barbara corkran oh really she said that the way that she gets herself to exercise cuz she doesn't like to she hates it she's very vocal about it but she says next to her bed are her shoes her athletic shoes that if she puts them on she's like all right well since I have them on I may as well go exercise and that one little step creates that Cascade look will it work for everybody is this the Miracle Solution no but it's one step and even if you just do that one step and nothing else the next time it'll be easier to put on the shoes and maybe try for the second one putting on the shoes is hot as well when you're in that in showering is hard grooming is hard the basics of all Basics is hard that's why when I hear advice like go make some friends online when you're feeling down oh boy that's tough advice that's not easy so the putting on
the shoes thing is simple in the sense of doesn't require others to be around you to judge you doesn't have any steps after that just to put on the the shoes and if you're at that point seeking help from a medical professional is of utmost importance because we've put this stigma where if you go for mental health treatment you're somehow weak but if you go for treatment for a broken bone you're not weak that stigma doesn't exist for it and that's strange because both things can have problems arise with it especially from a mental health standpoint especially with the society we find ourselves in currently Society is the most unnatural that's ever been for humans how would you describe the journey you've been on with your own mental health I don't know how I would describe the journey I I would say just like most people it's had ups and downs I would say the the thing that's really thrown me for a loop is the social media world of it all because of how unnatural that that is but I feel like a lot of people are working through that without even having a social media platform because at the end of the day these days everyone's a content creator right like when you make a video and it gets millions of views you kind of know what to expect being a content creator you have experience but Johnny Rebecca someone else putting out a video on their social media at 16 years old that too can get a million views and they're not ready for what comes with a million views in fact so many people even in the medical community reach out and say how do I go viral I'm like do you want to go viral that's thrown your your mental heal through a bit of a loop yeah I was obsessed with it checking it all the time and I wasn't obsessed for it for the reason most people think I was obsessed with it from a place of growth I was like even if they're 99% BS there's some kind of truth there's a kernel of Truth there that I could take away and make myself better and you know there is truth to that I did learn a lot of things I did prevent some mistakes I've improved my content as a result of listening to negative feedback and criticism but I've had to in working with my therapist carve out moments
where I'm not in a place where that's acceptable for me right now where you just have to say this I'm not in a healthy mindset to look what was the symptom of the impact it was having on you um tremendous anxiety where you're just worried at all times and you're almost addicted to checking it because you want to be ahead of it you want to be safe you want to be able to think of a response and when you get to that point you're never letting your mind rest you're always in fight or flight and when you're in fight or flight you're not resting you're not repairing you're not getting good quality sleep even so I know how important that is I talk about it all the time but as I said you know we're all not perfect doctors are probably the biggest Hypocrites when it comes to their own health I guarantee you some of the people that have come on your podcast that talk about sleep or talk about this they struggle with sleep they don't do those things just like how some advice that I give I don't follow to the tea my job is just to present the evidence so I know certain things that I should be doing better but just because I know doesn't mean that I'm going to be 100% following it all the time this is interesting thing that I I was just thinking about as you're saying that that um at like a philosophical level I think we're all kind of just passing our anxiety on to someone else like it's like energy cannot be destroyed and must be transferred I I noticed this because on my podcast I have multiple guests that often disagree with each other and if I was to do a map of how those people are feeling they're all suffering well that's just Humanity as a whole they're all like really suffering and sometimes those people are suffering because of someone else who suffered and then because of someone else's it's almost like this this chain of suffering because of misunderstanding a variety of different reasons but I think as you say Humanity as a whole the person that's leaving those messages or you know attacking you is probably also suffering in their own way of course it's a real shame but I can't see any way out it's it's a like the circle of anxiety is an artistic way to put it for sure um but I
think there's there's some truth to it you know uh even from trauma the odds are that if you've experienced a traumatic childhood that you will also potentially cause trauma to others goes up that risk does go up and that's also pretty Common Sense even if you're not looking at the medical research you could just say that if you've been hurt ozar you can hurt people what do they say hurt people hurt people too right um I think that that's like uh that Common Sense logic that does get it right what's the um did your therapist give you any advice that's proven to be useful well the advice that you put perfectly in in place of logging off not looking at certain things at certain times of the day like literally I had to completely shut off my phone at certain times of the day because otherwise what happens is I would get into the cycle of okay I just finished in the hospital I just filmed my video for the day now it's sleep time and just before going into bed let's check my phone one last time and search the social media sites what people are saying and it's like why that's ultim Ely what I think probably got me healthier like not looking at it was very good in moments of Despair because during those moments I was just so fragile and it would not be a good time to look but really where it got me is what got me is don't look unless there's something valuable you're getting from looking at it so now if I'm in a healthy place and I feel like I'm looking and I'm doing some kind of preventive task I'm learning from it I'm like okay I'm looking at it but I'm looking at it with some kind of intention and that's actually true for all of social media I think um he was on your show as well Dr Robert waldinger who ran the largest uh the longest running study at Harvard of Happiness talked about the different usages of social media how if you use social media passively and you just look and consume it can be rather disheartening and make you unhappy but if you use it to form a community to learn from it to better yourself suddenly the social media may not have as bad of a health impact and can actually have a positive mental health impact so if I'm looking at the negative comments I'd have to do that check-in with myself of am I doing this because I'm actually benefiting from it
or is it destructive in nature have you ever wondered if there's something about you that makes you more likely to look at that stuff or to care about that stuff I've often wondered about that myself yeah I I I feel like I have I think it's a it's a pretty natural thing I think most people look um I think for me I derive so much value in the work that I do on social media because this was never meant to be a financial Venture this was not some Grand ideology that I had to make myself successful this was solely because of my frustration as a practicing doctor which the first question ever anyone ever asked me when I got into social media is like now that you're doing so well you must want to quit medicine right like you're probably out earning it yeah but that's not why I do medicine I work at a community health center most doctors that do really well on social media either leave medicine or maybe do concierge practice or you know celebrity practice or something I work at a community health center where 50% of people don't have insurance so that's been my goal and social media is just a tool to help me with that goal and when I see negative comments I view it as a threat to that goal have you ever considered quitting social media seriously I pondered what life would be like um but I just viewed it as a negative all around not just for me I just VI view as social media such an opportunity to help people it's like me saying quitting medicine I don't want to quit medicine I I want to be there for people I want to be valuable and useful I in fact I think about myself as like a more practical useful person and every strength that everyone has can also be their weakness so sometimes I'm too practical and that impacts you as a friend as a partner as a family member so sometimes being too practical is problematic but because of my practical nature I want to be useful to my patients so let's continue with this um this health related stuff supplements and vitamins I wanted to get your take on that there's a lot of you've mentioned supplements and a few times in this conversation is that part of the gray area is that snake oil what's your POV on
supplements I want to say like one sentence that is all-encompassing and answers all those questions but it's really hard because there's just so much Nuance with it um vitamins we can't live without them we need them supplements supplemental vitamins are not necessary the huge majority of the time and are often sold by people who are praying on Securities promising shortcuts and honestly people trying to get wealthy the evidence for almost all supplements unless you have a very specific reason for needing to take them is missing and what I've learned at through my 10 years of being a physician and the hundreds of years of practice of medicine unless we're certain of some benefit introducing new things distracting people from things that work is not a good solution is the harm of supplements that they don't actually work again with supplements is a broad word so probably have to be is it the harm that they don't work or is are you saying that we should be getting all of the things that we're supplementing from our natural diet anyway or are you saying both yes and you can get all of your nutrients again unless you have a specific medical condition from foods to they will make you skip out on doing things that are healthy for you because you think you can take a shortcut three you're spending your limited health care budget that many people have a very limited health care Budget on things that are very expensive making a lot of promises and the thing that I'm most worried about is when we enter the space of people saying you need supplements and not true Medical Treatments for conditions that bother them or that affect them if I'm someone that maybe I'm not talking about myself here but if I'm someone that has a very very limited diet just because of my lifestyle choices whatever would you recommend that individual to take a multivitamin supplement I probably wouldn't but if they did I wouldn't discourage them do they work that's what I'm trying to figure out oh and then the other point that I didn't mention is that there's harm like you said everything has trade-offs there's no
such thing as no side effects so supplements have side effects they have interactions with medications they can create health conditions uh the term antioxidants antioxidants are generally healthy uh you know B vitamins are traditionally labeled as healthy you have too many of them we notice that they become pro-inflammatory but no one talks about that because you can't really sell that so what instead gets talked about is the promise of what they could do but there's harms that come from taking supplements especially in our world where you know consumer labs and Consumer Reports goes and pulls supplements off the shelves to find out that they don't have the ingredients that are listed in them because they're not regulated by the Food and Drug Administration they have some ingredients at 5 to 10x what's on the label like vitamin A which is a fat soluble vitamin and can actually be really harmful so they're not regulated they can cause potential harm their benefit unless very clearly indicated is in the air and not proven why recommend them why sell them and I say this as someone who can make a fortune I mean you said to yourself 12 million subscribers you know I take a little boxing selfie fit and say the reason I'm this fit is because I take whatever thing I bottled up in my house put into those pills whatever powder I want no one checks it and I could sell it and become a multi-millionaire is that sure that no one checks it no one checks it no one checks this no one checks it these supplements no like right now we could bottle up on the table our Miracle formula we can call it a miracle formula yeah as long as we don't make a claim that it treats a specific medical condition that requires the treatment of a medical doctor okay and I just put buzzwords on it so instead of saying this helps your depression I just say depression immunity support just buzzwords feel good feel good happy happy natural simple from the earth we could sell it how much we don't have to get anything we don't have to get anything cleared by anybody how much you think we'd make too much money and that's why it's
like man I understand why people do it and there is the notion that they could potentially work there's always like a little bit of evidence coming out that're just going to cut break for miracle M which is on it's so tempting I get it and I get there's also I don't want to label everyone with a broad brush and say they're evil and just trying to make money some people do believe that they work they they want the belief that this is what alss us as a society and I wish that was true I wish it was as simple as giving people some supplements or that eating eight almonds a day will extend your life by 10 years I wish that was the case um the subject around gut microbiome is something that I've talked about a lot on this podcast because I've just had a lot of experts talking to me about subject and something that I didn't even know existed three years ago I didn't realize there was loads of bugs in my belly um there are prebiotics probiotics all of these things coming out now for to enhance the what do they call it it's not gut Flora is it microbiota encompasses all of it is there truth that prebiotics and probiotics are useful for well there's truth in the fact that we have all of these living organisms inside of us there's a very strong interconnectedness between how we feel disease conditions and and what species of those bugs exists in us the counts by which they exist that people who generally eat specific foods that are rich in them may have better health outcomes than those who don't but manipulating those bugs has not been proven or clear in the majority of ways that people promise they do like we know consuming fiber correlates With Better Health less negative health outcomes do we know that taking a Prebiotic supplement does the same we don't know do we know that having specific bacteria in the gut gets destroyed if you have a health condition we do know that but does that mean reestablishing it by taking it in a pill will fix that condition we don't know that but people will make that jump and say no big deal we're trying to help but to me it's a big deal because we're promising something that we're uncertain
of without even some good evidence for it there's very few conditions that probiotics can actually help with well what advice would you give someone that comes into your practice and you identify that they have some kind of gut related gut microbiome related issue is there anything that you would recommend that they do to improve that got micro micro well it would be focusing on foods that are considered healthy for uh the microbiome so foods that are rich in fiber plants essentially um avoiding bad habits poor quality sleep over drinking alcohol smoking all those things are unhealthy um the the the thing that makes Health advice so boring is that the things that grandma told us still is what I say in my office and it's not sexy and it puts people to sleep but it's true that's what we know works we don't have a perfect answer as to why and right now there's like tests on the market to check your microbiome to know what food too preliminary to recommend we don't know what to do with the information the promises that they make don't hold up when we look at it long term genetic tests potential is there for a lot of value most of them are very preliminary unless you're working with a geneticist on a very specific condition so I think the hype often times speeds up the selling of the products before the evidence is there it outpaces the evidence and in some instances medicine does that too like traditional medicine but it does that with some thought in mind for example if we create an emergency use authorization or if we allow someone to have a treatment exemption for something that is not proven for a disease that's already lethal that they're going to lose their life anyway or if we don't act now we're going to lose so many lives in the moment then yeah there might be instances where we can speed up the process of certain things we can uh create some shortcuts because we're taking that trade-off that's thought about but with a lot of these products they come and go and there's just so much misinformation around them you know like one of the uh big individuals that does this in this space and hate to single out but it's just been such a um a a voice in this community is Gary Brea you know I I talked about him on my show have you spoke to him no
and seems like a really good person seems very passionate about what he's talking about but the the promises that are being made are not proven and the intention may be good and good intentions can have bad outcomes but if the information is not accurate No matter how passionate you are about the subject long term it's going to have negative outcomes when you use the word proven there do you mean that there's not a significant or a a a reliable sort of basis of research that's been done yet to validate the hypotheses or the statements or you're not saying that it's been disproven it just hasn't been proven yeah so that's a good point to bring up the things that I say that are inaccurate largely have not been disproven because if I say the juice inside this cup will help you live forever would you say that's true or not I Theory would be that that's not true right but can you disprove it no you would have to run a study to disprove it yeah and that's how I function as a doctor so I can't disprove what he's saying because then I would have to run my own study but based on what we do know based on remember how I said at the beginning when a new study comes out I try and bring it to the already the established information that we have it doesn't Vibe with what we know to be true if you want to go against public health standards from what we've established as science you better have a good reason for doing it and if you do I'm all ears I'm excited for that kind of stuff if you have some breakthrough of why you disagree with the CDC with the wh with uh Harvard Health please tell me why you disagree but if you disagree because you said so that's where things get problematic like I'll give you the simplest of examples there's a very famous clip that I reacted to on my podcast where Gary Brea says if you have headaches it's because you're low on pink Himalayan sea salt how many reasons do you think people get headaches many reasons you're not even you're not even a doctor right my brother has my brother has had chronic headaches since he was since he was a kid just you got a concussion you have stress you have a hormone issue you have a tumor there's so many you have
migraines you have a neck cramp what the possibilities are endless right to have the confidence to say this is what you're missing everything else Almost Doesn't Matter the confidence is the misinformation like notice every time you asked me a question today it was either I don't know it depends Nuance for who it's almost annoying because I can never give a clear answer but that's what science is and that's actually why people have lost trust in science because we're not as confident as Gary Brea when he talks about salt for headaches sometimes you've been wrong right of course sometimes you've I remember reading um something where you said I admit that I I change I've changed my mindset when presented with new information and I've explained why I think when we we think about doctors this is the part I think that some people struggle with is if you look over the course of sort 10 20 30 40 years some of the things we were told were healthy back then are no longer healthy and new information about I'm well aware that this is a scientific model but I'm I'm trying to the coun trying to present the counter argument put yourself in that shoe in that seat yeah how do we know who to trust when doctors say that they've been wrong and they've changed their mind on really critical things before and even you know when we think about vaccine disinformation right a lot of the arguments you'll get from the right are that you said this and now look what happened so we'll never trust you again how do we navigate and know who to believe even doctors when doctors will say information I gave you in the past was actually no longer true you have to take the hard route and do the work to find out why they said what they said then and why they're changing their mind now so I'll give you an example y actually maybe this isn't a doctor this is um studies I remember having a guest on my podcast that talked about I think there was a bit of a crisis with um depression drugs in the early years where they had because of the way that the tests had been done by the big pharmaceutical companies the CEO of the pharmaceutical company knew that the depression drug did not work and had all these side
effects but they pushed it through even though the vast majority of the studies had hadn't shown that the drug worked they found one study that had they pushed it through got to Market loads of kids used it and then I think a decade later I again I'm paraphrasing here I link what I'm talking about below it was discovered that the CEO of that company knew it it didn't work but there was a study and research that got it to Market and people started using it I think Johan hary who's been on my podcast before he was the zmek episode we released um he was one of the people as a young man that started taking that depression drug only to find out that five six years seven eight years later it didn't work and the CEO knew that it wasn't really working so that was the that was trust in the medical system it that was trust in research that was trust in big farmer much of the counter movement we're seeing now is we think big farmer is corrupt and we think they're meddling with doctors to get drugs into Market that maybe don't work there's a lot of drugs on the market agree yeah if science is so problematic and we shouldn't trust for all those reasons why is it the one example that we're stretching to find of the mistake that was happened or the fraud that happened with this one drug we're talking about something that happened decades ago it does happen fraud happens it happens in healthcare it happens with policing it happens politicians there is fraud but pointing to that one episode and saying we should throw the whole field away is going to cause a loss for us and there are issues with Pharma there's huge issues with Pharma I frequently talk about even from like the pricing standpoint of Pharma how problematic they are we've seen the issues with the opioid epidemic how that was driven largely by Pharma but we're calling them out the beauty of Western medicine of what we do here is that we are the best at calling ourselves out on our failures but actually the more we call ourselves out on our failures the more trust we've lost and in fact when someone owes up to their failures and seeks to learn from them and seeks to make change that's the person you want to follow the person who is not confident
who is open to be transparent who explains why these things are happening without 100% confidence that's the people that are giving you advice that's true the same way that we said uh earlier that everything is all natural does not mean it's all good everything for profit is not necessarily evil my YouTube channel is for profit I make a very healthy living doing what I'm doing doesn't mean it's evil so while it's easy to make shortcuts and overgeneralize we have to talk about specific instances and call balls and Strikes as they are umpires make mistakes healthcare industry has made mistakes there's been vaccine incidents in the past that have hurt people we've learned from them we called it out we've studied it we are con there are doctors constantly studying where we need to do better this is ongoing at all times and the ironic part is most people have no idea that it's happening because we only find out about it on issues we're passionate about I recently did a video or I was on a podcast where I was asked about birth control I gave a very simple answer it was non motivated in any way it was just kind of presenting the information as it was there were a lot of very mean comments in that information about how birth control can potentially be harming people that I don't believe the negative side effects that can come with it all these statements that were being made and I found them to not be true I had to do like a little soul searching to see if they were true because I do that with all the negative comments and I said no birth control can have side effects just like with any medication the reason why birth control maybe is being brought up is because this is a topic people are very passionate about this is a topic where doctors have discriminated in the past about so it's a bit more triggering to the emotional part of our brains but if we look at what's leading hospitalizations from a drug in the United States Tylenol you don't see anyone uproar making YouTube videos that Tylenol is problematic what is Tylenol acetamin paracetamol for you a paracetamol yeah the amount of hospitalizations for Tylenol induced liver failure is skyh high I'm sure we could pop up the
statistics on screen but no one gets upset about Tylenol because it's not emotionally triggering and that is true for all of healthcare there's side effects to taking medications so it's easy to only focus on one part of that equation say well doctors used to say this what about this why did doctors say it what got them to say it there and the idea of us getting it perfect never going to be true we're always working with incomplete information all of medicine is just our best guess how many of you started thinking about your long-term Health when you hit 30 for me this was a wake up moment of me thinking to myself okay I probably need to start paying a little bit more attention now I already felt a change myself when I hit 30 with things like my metabolism my energy levels so this year is no different Zoe which is a company I've invested in but also a company that are a sponsor of this podcast helps me to make smarter food choices all based on their world leading science and my own test results if I'm ordering food I know how to make my takeaway so much smarter by adding things like a side of vegetables to eat first or choosing the option with the most fiber Zoe helps me to make that choice it guides me and coaches me it's my personalized nutrition coach that I have on me 24/7 and to help you start your Zoe journey and start making smarter food choices I'm giving you guys 10% off when you join Zoe now all you've got to do is use code ce10 at the checkout when you sign up enjoy and let me know how you get on what about these animal studies a lot of the research that's presented from experts is from animal studies rats and things like that yes so that's where people like to skip steps the amount so Pharma is out for money right that's fair say that's their job they're trying to create a return for their stockholders they try and pick research to do that hopefully will drive the best profits 99% of the stuff that they start researching on from the initial promise of animal studies 99% of it fails and they're only picking the top then you go one step further once it works in animal studies and Petri dishes and then it goes into human trials another 99% of it fails so the idea that something has
mechanistic value then Works in an in a Petri dish then it works in an animal model for it to make all those steps is so astronomically rare that it ends up working for the general population the fact is that we shouldn't jump to from animal model to human because 99% of that is going to fail so what are we saying then do we have to you know go back to just living like our ancestors lived and because you said earlier on that the world we live in is been more unnatural yeah so is the is the antidote for all of this stuff we're talking about is it to go back to being human and like we always say our ancestors were well I think what we need to look at is the evolution of humans and the anthropology aspect of it because we can then better understand ourselves now and why we're having problems with this unnatural world right so if you look at why anxiety was a a survival benefit to us back then versus how it could be very problematic to us now in a safer World studying prehistoric cavemen humans would be beneficial but drawing conclusions from their diets and potentially what they ate all men you're going to get into so many fallacies and biases that the information is not going to be great and not very applicable if you um if you could redesign Society in such a way that it would be in your mind more healthier more healthier for the for the average human you had to start from zero so you're president of the United States Trump doesn't get it Biden doesn't get it Dr Mike gets it and you could really rewire Society what are the some of the sort of macro Topline changes you would make okay I'm taking I'm going to keep everything on the table the first thing that I would do and this is uh echoing one of the authors and experts I I really enjoy listening to and he's actually coming on my podcast soon Jonathan height I would get phones out of schools I think that that much in the same way that we uh regulate addictive substances like cigarettes like vaping like um alcohol to those of age we need to start thinking about that for social media and that's an unpopular thing to say but I think if you really look at it there's a lot of problems that can come from it very limited benefit for someone who's 13 to be looking at those images
so I think some major changes need to be made uh in schools you were voted in 2015 you know that's a long time ago 10 years ago in 2015 you were named people Magazine's sexiest doctor alive I don't think I was voted I think they just nominated me well it's it is something right yeah it is what it is um your relationships mhm what's your relationship status if you're able to share it relationship ship have been really tricky um as a medical provider you have to carry yourself with an air of professionalism you have to make people feel comfortable in talking to you uh about very sensitive subjects so I've been very careful to balance the world of showing my personal life to some degree and showing people and reminding them that I'm human I too have relationships I to play sports I have a family I have dogs but also not do it so much that it actually can cause harm in my clinical interactions so initially when I started social media I was very open about my relationships who I was dating what my relationship status was and I thought that I was under the firm belief that there is no way this could be detrimental and much in the same way that I thought that reading every negative comment can only be helpful boy was I proven wrong not only does it cause harm to potentially the clinical interactions it can cause harm with my audience online not dating patients that's not what I mean no no just a clinical interactions piece I mean well like you know if a patient is wondering who you're dating or what you're dating that that's going to derail the conversation away from Health okay um the same way that it would derail the conversation from social media from people listening to Medical talking points to then talking about personal life um so before while I was being very open with it now I've kind of said my personal life to some degree is my personal life when I begin sharing everyone will know about it it'll be everywhere but now I tend to become a little bit more I have some things for my personal life but the majority of it is an open book that's I was curious about your relationship status because as someone who's so busy
and a content creator and going through all of the things we described earlier with your mental health and the feedback and all of that sure how you manag to be successful in that realm as well yeah so like in in doing what I do I I feel like I'm very busy because I'm involved in so many different things but I feel like everyone's busy you know you you make time for what you're passionate about so there was a period of time I was single for a few years then I got into relationships I got out of relationships and it it really is if you meet the right person and you want to dedicate your time to them you'll sacrifice something you know before I used to be all about watching sports like that was my nighttime routine now I can't even tell you the last time I watched the sporting event I've just been so busy like maybe the Ryan Garcia fight boxing match but um I don't I don't have the time for it because I've made sacrifices to do other things I'm passionate about and I think if your partner consistently I think this something I said before that if your partner consistently says they don't have time no matter how busy they are you need to do a little evaluation and see is is that something that they truly want or at least bring up that conversation you're someone that strik me as being quite philosophical and deep thinking in their downtime M and probably spends a lot of time thinking about bigger questions about life meaning purpose and all of those things is that a accurate and B what are those big things that you're considering in your mind um it's accurate but not big picture big philosophical questions it's more I'm deep thinking from an introspective standpoint point of running back every day what could I have done better what can I improve on uh what should I think about for the future how can I grow from today so I spend a lot of time doing that and that's not something I taught myself to do when I was a kid I remember this very vividly in high school age 13 being very awkward freshman year of high school um talking to girls at my class and then coming home and sleeping in my bed and as I'm going to sleep thinking oh my God what
should I have said to look cool maybe I should have just stayed quiet like those cool guys in the movies and playing back those scenarios throughout the day and while that was silly when I was 13 now as a doctor I play back my patient encounters and think about what I could do better in that communication sense I play back my podcast interviews in my head and think about what I could do better so I'm constantly thinking about that and again not by choice it just kind of happening in my mind and that's where the anxiety stems from I guess um the anxiety can creep up there if you feel like you're not improving or your progress is stagnating like um the idea that I told you I wasn't exercising a lot I start ruminating and thinking oh my God you haven't been exercising in so long now you're going to not be healthy what if people online start thinking that oh that's not a healthy thing to do and you could start catastrophizing very easy this is what our human Minds do and that's why C BT cognitive behavioral therapy one of the more popular forms of evidence-based therapy is taking those cognitive distortions those catastrophized black or white labeling thoughts and just talking back to them saying how true is that that if you had all A's on your tests and then you got one C that you're a failure how true is it that if you don't exercise for three months that means you're an out of shape slob and you have to talk back to them so doctors are not immune to cognitive distortions I always wonder with doctors when you're dealing with like People's Health and their outcomes which sometimes are positive and sometimes not positive how that can sit on your shoulders and how you can take that home with you because you must deal with a lot of people that are no longer here yeah for sure um especially when I would be a resident working in the ICU where an intensive care unit patients are the sickest so mo more likely for them to lose their lives you're having conversations with family members about discontinuing CPR about signing certain papers to say that we're not going to give more medical care we're only going to focus on comfort as opposed to treatment and those conversations are not easy conversations and the way that I've approached them is with unbiased truth just here's what I know I want you
to know what I know I'm explaining to you why I think what I think now you tell me what you'd like to do and ultimately it gives patients a sense of responsibility in a good way where it empowers them or empowers their family members to make the right choice and the right choice is not clear two people can make different choices and they both be right choices same thing with Healthcare like art uh um Healthcare is as much art as it is a science so so two doctors can see the same patient and recommend two different treatments and not be wrong is there was there a hardest day when you think back over your medical career was there a hardest day in your practice no nothing that specifically jumps out I think it's it's how it wears on you from a perspective of just length of the amount of administrative work you have to do the amount of time you want to spend with the patient versus what you're given um the ability of helplessness where you can't fully help a patient no matter how much you want to when you know if a patient does a specific treatment you know they'll get better but they're not interested in it or are being deceived or influenced in a way where they're not going down the right path those really really drain me because I I think about those at night of how can I be more effective so I can help my patient come to the right conclusion or at least help them make a decision that is actively not detrimental to their health your mission at the moment to really help to myth bust and um call out disinformation as it relates to health care and advice is that driven in part because as a doctor you're seeing the consequences firsthand of information your patients are bringing to you that is patently false or untrue or doesn't isn't quote unquote proven um and then you're basically arguing with them about that or or something is that where it comes from yeah that's why I started social media because I was having a very similar conversation with the 30 patients that I saw in a day and I was like wow I got to tell the world this so they can all know this information so that they all don't fall VI them to these scams where they think doctor I had $100 this month to spend on my health and I bought this thing I bought these two smoothies and I
thought this is the answer this is going to help me right this says it helps with cancer and it's that's not the answer and in having those conversations over and over again it's what drove the passion to being on social media and now I think about medicine differently than I did when I first started I used to think medicine is doctor and patient now I view it more in a public health sense where my impact on social media goes so much further than patient interactions or viewer interactions where now I can influence policy had a medical emergency on a flight and they made that call is there a doctor on board and I was faced with a moment like okay do I volunteer do I just stay quiet I don't know what to do but I volunteered and it turned out after some investigation that a young gentleman was going into anaphylactic shock his throat was closing up to it an allergy and I wasn't worried I said where where's your EpiPen he said I don't have one I didn't even know I had this allergy so I asked the pilot can we land pilot says well it's an hour and a half back to Canada and an hour to Portugal some Island in Portugal that's not enough time his throat's closing he's going to die in five minutes so I'm like what can I do so I opened the plan's emergency kit thinking there's going to be some epinephrine in there or an EpiPen and there's no EpiPen and I'm like okay what do I do now there's no internet when you're over the Atlantic Ocean so there's nothing to Google but um finding that there is epinephrine which is the same medicine that is found in an EpiPen in a different formulation in a different dosage for a cardiac arrest so when someone's heart stops we also give the same medicine if they're Flatline if they have a specific Rhythm to try and restart the heart so it's a much thicker needle much longer not those cute little EpiPen needles that just go into the side of your thigh and I said okay well I need to do some rough calculations here and just uh guesstimate here because otherwise he's going to lose his life and right there in the first class cabin we take off his pants we uh inject them with this huge needle he's screaming there's like a little bit of blood coming out I inject the medicine I'm praying that it's working and fast
forward that story uh I stayed with him for eight hours for the rest of that flight until he landed we didn't need to divert I checked his blood pressure and pulse every 15 to 30 minutes and uh we saved his life and you think that would be the end of it you're like look at that I did my doctor job and that's it but I went and told that St Story on YouTube got almost 10 million views if not more now I don't know what it's at and um the Senate Majority Leader Chuck Schumer calls from his office or his office calls and says hey uh I'd like to get epipens on planes can you stand with us and tell us your story to the media yes we tell the story we call on the FAA to make these changes and now 70% of planes I don't know what the exact number is but something like 70% of planes have epip pens on board that will never have to happen again that's incredible and that's the power of social media that people don't talk about that's Public Health that's helping people that aren't even needing the help yet so that's the kind of medicine I like to think about now well you have a half a body lying over there in the corner so in the in the sake of helping people using social media um I asked you if you could bring a I don't even know what to call that it looks like a half a mannequin or something a mannequin it's a mannequin um because early in my life I got told that learning learning the skill of CPR is one of the sort of simplest potentially life-saving things that I could learn because you never know and I've got people in my family that died of various cardiovascular related um conditions heart attacks and things like that and so I would love to learn again again this is probably not an official certification to learn the basics of CPR and how to keep someone alive in such a situation um could jack could you bring the the what should we call him we'll call him off Mike yeah we we'll call him uh baby Mike so I'm curious before we do any kind of instruction on it what do you know thus far about CPR and all wrong answers are acceptable here um you push on the chest roughly around the top of the rib cage and then you blow into the mouth and you just do that over and over again until they come back to life okay
do you know what the reason of doing CPR is H that's a very good and it's not a trick question I'm just genuinely curious because I like to know where we're starting from and no one knows this by the way this is why I do what I do so this is not it's something to do with keeping oxygen flowing around the body through the blood you're right on target okay so the purpose of CPR is if you find someone who's unconscious not breathing is pulseless that means their heart's not beating that means clinically they're dead so anything you do here can only potentially hurt help can't hurt right cuz the person is already dead so by doing proper CPR what you're doing is you're compressing the chest chest compressions to squeeze the heart which has some blood in it to circulate the blood throughout the body that still has some residual oxygen in it to deliver oxygen to the vital organs so you're not actually saving someone's life by doing CPR you're buying them time the purpose of doing CPR is to allow time for First Response ERS to arrive to then give Advanced cardiac life support oh okay and that's why the first step of doing CPR has nothing to do with the person and has everything to do with calling for help okay so I call the First Responders or because that would so ideally you never want to do anything that will distract you from starting chest compressions because the faster you can get to doing chest compressions the better are your outcomes so tell someone else to call ideally if you're alone obviously that's not happening but you can't just say out into the open hey someone call 911 because what happens everyone assumes the other person calls no one calls this happened with many medical emergencies and it's terrible when it happens there's actually criminal cases about that someone screaming for help and everyone assuming the other neighbor would call and then no one ends up calling so you have to say Hey you in the blue shirt you and the pink hat you call 911 and they will call 911 and you immediately start pushing hard and fast in the center of the chest one hand on top of the other when you say center of the chest you mean in between the pecs correct okay so right in between the pecs one hand on top of the other on top of the other what if I break whole body
doesn't person's dead so I can go as hard as I want to go you want to go two inches deep which means pretty hard because in order to compress the heart you need to go 2 in deep and two inch deep is pretty 5 cm deep so one hand on top of the other push hard and fast in the center of the chest in between the pecs and you're doing that until help arrives okay so you see how you're uh much like most people who are in really good shape you're using your triceps yeah try doing that for more than two minutes you will fade no matter what good shape you're in in fact when we're in the hospitals the way that we do this is maximum two minutes at a time and then we tap out and get the next person in because it's so tiring the way to Max full body weight correct and you hear the click that means you're doing it to the correct depth and that way you will get less tired and you'll be able to do that for longer periods of time so that click means I'm hitting the heart for this little device yes I had to go down a long way away I had to go down so far that I would never have naturally done that to somebody I would have thought that I was going to do more damage correct and because of that fear that people have we unfortunately have worse outcomes with people who have cardiac arrest in the field and in fact most cardiac arrests meaning heart stopping happen not in hospital settings they happen in community settings they happen on the street at dinners with our loved ones and the important point to remember here this isn't what you do for someone who's talking and is having a heart attack this is for cardiac arrest they're not talking they're not moving they're not breathing because if they're talking that means they have a pulse because I've seen in some videos online like someone's trying to talk or moving around are doing chest I'm like no stop he's doing chest compression but if they're pulseless if they're not breathing they're unconscious start hands only CPR after calling for help I can't I really want to emphasize how hard I had to push down then it wasn't just like pushing on the surface I had to put all my weight and shove down on the chest and you know that insecurity about the amount of pressure that you were talking about there's even worse outcomes for women who have a cardiac
arrest because people are afraid of pushing in between breasts ah if the person's life can be saved when First Responders ared because you bought them time do it it's not fair that women are less likely to receive CPR from bystandard because of their bodies I thought because I think again because I've watched so many movies that when you start doing the CPR the person comes back to life it can happen Okay CU I thought that's what you were doing I thought you were like bringing them back to life that's what if that's the notion that some people have and that's why I want them to make sure that you're not actually bringing them back to life you're buying them time and circulating the residual oxygen so that help can arrive to try and restart the heart how long do you have to do what's the longest you've had to do CPR on someone for and then they've ended up Surviving I've been in um double digits before for young patients um because young patients we will like if you have a patient who's elderly who's in the ICU who's already very sick when they're hard stop the odds are that you'll bring them back are obviously very low but even if you will bring them back to life they're going to be in a worse quality of life than they already were so many times we actually have a conversation as the CPR is ongoing with the families explaining that and saying that this is not beneficial that even if we bring them back they might be in a worse State and that we don't recommend it we actually have scores and guidelines that we can discuss with patients about statistics on this but when someone's very young let's say you have a 20-year-old who has an unusual Cardiac Arrest we would fight much longer because they have an opportunity to heal once we bring them back so it's very dependent on a on a specific situation and you had to have that exact same conversation when someone was operate when treating your mother of yep I that was the conversation that was my first interaction with that kind of environment I actually remember um when I was in the the room and the alarms were going off and the residents or the doctors were doing CPR and I called it off I remember the next time I heard
those alarms was during my training in a patient simulation lab and that was like the first moment I ever had a flashback where a sound brought back a feeling where that sound of those alarms brought me back to how I felt and how uncomfortable I felt I've never felt that before you must have had that sound a lot since then oh yeah and I've had some difficult conversations with my fellow colleagues because of it I remember very vividly when my mom passed away we were in the waiting room waiting for documentation forms to sign and I came out to check and see if they're finishing up and some of the nurses and doctors I don't even know what medical professionals they were they were kind of laughing in their little work area in the back now where they were patient facing but hearing those laughs got me so angry how could anyone laugh during a time like this but then I had to remind myself these are people too these are people who are losing patients every day and if they took the loss the way that I'm taking this loss they wouldn't last they wouldn't be able to help my mom or other moms so I had to remind myself about that but what my take away from it was when I saw co-residents of mine maybe writing their notes after someone's family passed away and I see the family in earshot and they're talking about their day or they're laughing or they're giggling or saying some kind of joke not related to the situation I I just I don't correct them that's not my place to do I just share my story of how I felt and I thought it created a really good learning opportunity Dr Mike we have a closing tradition on this podcast where the last guest leaves a question for the next guest not knowing who they leaving it for if you could go back to a pivotal moment in your life and make a different decision what would that moment be and why I think about the social isolation and loneliness that you described that I felt when I lost my mom and how I isolated myself from my classmates to this day out of 300 students in my class or so I didn't make a lot of friends in fact any
friends and I was not involved um I was fully disconnected from my class and I I think it's because of what I was going through at that time and I wish that um I either reached out for support from the school or created conversations amongst my classmates because the friendships that they've created have lasted to now this is over a DEC decade um people got married in those classes they've created lifelong friends and I feel like because I moved away and I was two hours away from the school I wasn't a part of it and I feel like that has significantly impacted the number of friendships I carry to this day that the friends that I do have are my close friends from high school maybe some from college but almost none from medical school and I feel like that's a really really big missed opportunity do you feel lonely yeah sometimes for sure but I think that's a byproduct of society these days and my work adds to that as well Dr Mike thank you so much thank you for all of the work you do and the way you do it um you're the one of the most accessible voices on the internet as it relates to medical information and I say accessible intently because um sometimes doctors can be a little bit um exclusive they're too smart and they don't really let us in but I think you're both confronting disinformation in a really honest fair balanced way but at the same time you're providing information in such an accessible way and um you've drawn a tremendous audience to you across YouTube and your podcast and across your socials and everywhere else and it's there's no doubt in my mind that you've not just saving the lives in your practice every day but you're saving hundreds of thousands of lives you'll never meet but also you're improving so many lives because your health helping us to navigate towards um better information or a better way to think about the information we receive and I'm on that Journey too I'm doing my very best to try and navigate that and as someone that sits here with a lot of experts which is your lowest criteria of like acceptable evidence experts and medical practitioners and I'm doing this two three times a week sometimes there's
often conflicting information um I'm I always struggle with how to present that information because on one hand you don't want to censor people because that assumes that I know what's right but on the other hand you feel a sense responsibility that the the platform you're creating is is not doing any harm and I think that's the first kind of principle of anyone that's trying to produce content is doing no harm so Mike you're a prime example of someone that I see doing no harm and a lot of good in the world so thank you so much for your very much appreciate you saying that it means a lot you know a lot of days uh me and my team my small team will sit in front of the camera and talk and forget the implications and the outcomes that uh we can make in the world with the content that we make so that's what continually drives Us by reminders like what you just said so I appreciate you saying please keep going I know it's difficult some sometimes and I know people do are very vicious I've been on the receiving end of that for much of my life but I think um you know that I don't have to tell you this but you know that the net impact of your mission is so unbelievable it's so you'll never see it you'll never meet the people the families the father the mother the grandfather but I just wish you could because I because I think if you could see the the net impact it would put all of that stuff um in in perspective where it should be so Mike thank you thank you appreciate you having me on [Music]