0:07

All right, it's Friday, which means

0:09

it's time for another roundtable extravaganza.

0:12

And joining me are two Rubin

0:14

Report veterans, one, a professor of

0:16

health policy at Stanford School of

0:18

Medicine, Dr. Jay Bhattacharya, and the

0:20

other, an addiction medicine specialist and

0:23

host of Ask Dr. Drew, Dr.

0:25

Drew Pinsky. Doctors, gentlemen, welcome

0:27

to the show. Thank you

0:29

as always. Thanks. I feel that

0:31

for a moment I should put on my glasses too,

0:34

otherwise I really look like the dumbest of the three

0:36

of us, which it's true, but people shouldn't know that

0:38

just by the glasses, right? That's like the key to

0:40

the whole operation. I'll take mine off

0:42

and see, no, that's not gonna work. Good. Okay,

0:46

we're gonna just dive into a couple interesting things

0:48

happening this week, not purely political, just a little

0:50

bit of the cultural stuff and some COVID stuff

0:53

and some science stuff and some Ozempic stuff, which

0:55

I don't know that we've talked about Ozempic on

0:57

the show before, but I thought you guys would

0:59

be perfect for what I wanted to dive into

1:02

today. So first I just wanna show you, we're

1:04

gonna show you two videos here. I think there,

1:06

I'm not sure if there's audio on them, so

1:08

we can talk over them, but these are Biden

1:10

at the G7 yesterday. And something

1:12

is going on with this guy, and I'm gonna

1:14

try to do this without being glib since I

1:16

have two serious guests on the show, and just

1:19

take a look at this. And

1:36

then this is the one, really, watch this. Just

1:44

starts wandering off, look at them all, try to,

1:46

McCrone, look at who's gonna get, who's gonna get

1:48

him, who's gonna get him, Oh, Loni, she's in

1:50

charge, it's her country. And... And...

1:58

And... And now the

2:00

slow motion. Something

2:06

is clearly not right here. We all

2:08

can see it. It seemingly is getting

2:10

worse. What should

2:13

we all feel about this? Beyond the

2:15

moments of sort of glibness and humor

2:17

and everything else, Drew, you first. Well,

2:21

it's sad, right? Let's feel bad for

2:23

him as a human being. I

2:25

practice straight internal medicine now, and most of

2:27

what I do, in fact, is geriatrics. And

2:30

so when I look at, again, I don't

2:32

know him. I'm not his doctor, but there

2:34

are certain things that as physicians, we can

2:36

sort of observe and describe like a rash

2:39

or a certain behavior, or in this case,

2:41

what you describe, Dave, as the slow motion.

2:44

He has motoric slowing. He

2:46

has rigidity. He has

2:49

what's called a mask-like facies. The other

2:51

day, we saw him standing with this wild,

2:54

stuck smile on his face while

2:56

everybody else was dancing. So

2:58

when you add up the motoric

3:00

slowing, the rigidity, the mask-like

3:02

facies, those are called, I'm

3:05

describing what we see. Jay, what

3:07

are those called? They're features of? Parkinson's

3:10

disease. Parkinson's, exactly. Or we

3:12

call them Parkinsonian features. And

3:14

in elderly patients, Parkinsonian features

3:17

develop in a variety of neurological conditions,

3:20

even just aging itself. It doesn't mean

3:22

you have Parkinson's disease, per se, but

3:25

it is part of a common

3:27

neurological decline associated with aging. Now,

3:29

the other thing we saw was

3:31

he seems sort of disorganized and

3:34

overwhelmed. That is also a very

3:36

common thing with aging, where people

3:38

feel like they can't process what's

3:40

coming in and take a man

3:43

that age with those constellation of

3:45

symptoms, throw them in an airplane,

3:47

new time zones, multiple stimulations, overwhelmed,

3:49

can't handle it. So this could all

3:52

just be the effect of an aging

3:54

brain. It could be something progressive. It

3:56

could be Parkinson's disease that's also associated

3:58

with cognitive problems. problems like we're seeing.

4:01

But what's interesting is if you remember when

4:03

he was cleared by his doctor, they went,

4:05

oh, his doctor says he's fine. And so

4:07

does his neurologist. And nobody went, hey, why

4:10

does he have a neurologist? Why

4:12

did he need a neurologist? So

4:14

clearly somebody is treating these conditions

4:16

we're seeing. Now add anti-Perkinsonian medication

4:18

in and that can cause all

4:20

kinds of cognitive problems. Jay, do

4:22

you disagree with anything I said?

4:25

I'm so glad there's another physician

4:27

here. I don't disagree with

4:29

it. I have to say, it makes me

4:31

uncomfortable, but for a couple of reasons. One

4:33

is I'm a research doctor, not

4:35

a practicing physician. So I shouldn't

4:38

weigh in on that. And I

4:40

also feel uncomfortable when doctors diagnose

4:43

other people. We're not diagnosing it. We're describing.

4:45

That's what I'm saying. You are not doing

4:48

that. What you're doing is you're describing what

4:50

you're seeing. And as a

4:52

citizen, I want to know what

4:57

my leaders, what they're facing. I

4:59

mean, they're human. We're voting for humans,

5:01

right? The leaders are human. And

5:03

it could be forgivable. But if there's real

5:07

things that I should worry about, they should be

5:09

honest about that. Like trying to hide it and

5:11

pretend like it doesn't exist, when people can see

5:13

that it kind of does, is really distressing. And

5:16

then the question is like, are there are the

5:18

decisions that are getting made all made by him?

5:20

Are they really, are they really, is he really

5:22

in charge? There's a lot of like questions I

5:25

think any citizen legitimately could ask. And it

5:27

doesn't matter what party you're in. Doesn't

5:30

it feel to- By the way, Dave, I

5:32

just got to say, I worry more about,

5:34

you know, people are very worried about what

5:36

they're seeing and the slowing and all this

5:38

stuff. But listen, if he is taking medication,

5:40

because sometimes he moves around a little better

5:42

and that's usually medication. And those

5:44

medicines cause very strange cognitive changes. So I almost

5:46

worry about that more than some of the things

5:49

that people are worrying about in their common discourse

5:51

about what's going on with Joe Biden. Right. And

5:53

Drew, you sort of hit this, but we're all

5:55

sort of sympathetic to someone of a certain age

5:57

with all the time zones and flying and pressure.

6:00

and everything else, even if he was cognitively 100%, and

6:03

again, we're not diagnosing him, you'd still accept some level

6:05

of, we've all had jet lag, you fly to Europe,

6:07

you go to- I don't know about you guys, I've

6:10

always wondered how they do that. I've

6:12

gotten older, I really wondered how they

6:15

do it, but if I were advanced

6:17

age with neurological symptomatology, it's like, oh

6:19

man, that's brutal. Well

6:22

then, let me ask you guys one other thing

6:24

on this, not on the medical side, but purely

6:26

on the political side. It strikes me that it's

6:28

fairly obvious, let's say that he's probably on medication

6:30

or that there's a small group of people that

6:32

know what's really going on here. This

6:35

seems not to be hyperbolic, like it could

6:37

be the biggest political scandal in 50 years,

6:41

or something like that, since Watergate, if

6:43

that actually is the case. Does that

6:45

sound totally off the reservation to you,

6:47

Jay? No, I think

6:49

that, okay, so

6:51

like you can go back in American history and look

6:54

at FDR, right? So the press and the White House

6:58

hid his disability from the American

7:00

public. Suppose

7:04

that the American public had known, would they have

7:06

undermined, I mean, the guy obviously was cognitively still

7:08

all there. He was making decisions sharply

7:10

to the end of his life. There

7:15

was also, I think you can go back and look at Ronald

7:18

Reagan, right, toward the end of his

7:21

time as president. There were

7:23

allegations of this, and

7:25

there was some question, this

7:28

strikes me as qualitatively much, much worse

7:30

than either of those two, right?

7:33

FDR wasn't cognitively, there

7:35

was no question about his cognitive capacity. Ronald Reagan,

7:37

by the end, you could start

7:39

to say it's slow, but I didn't, I

7:42

was young then, so maybe I wasn't seeing it, but

7:45

I didn't see anything close to this. Here

7:47

what we have is, in real time, if

7:49

you have elderly parents or grandparents and you've

7:51

seen this, you don't really need to be

7:54

a doctor to say, look, something's not right.

7:57

Well, that changed right before, well, right before we

7:59

started. I mentioned to Jay that

8:01

I spent a lot of time with my grandmother

8:03

who had dementia in her later years and I

8:05

was taking her to geriatric doctors and to the

8:07

cognitive people and all that. And so much of

8:10

what I see in him is the same thing.

8:12

The rigidity in the hands, you mentioned something about

8:14

that, but also the emotional dysregulation, which you see

8:16

with Biden in a lot of these speeches where

8:18

it sounds sort of monotone and then he starts

8:20

screaming out of nowhere. So there's just a whole

8:23

bunch of pieces here. Listen,

8:25

and Jay mentioned two historical antecedents, but

8:27

there's one more egregious one, which was

8:29

Woodrow Wilson, who was in bed, brain

8:31

dead with a stroke, massive stroke, and his

8:34

wife ran the government for three months. So

8:36

what was our takeaway from that? Did we

8:38

learn anything from that experience as a country?

8:40

Or we just went, oh well, moving along,

8:43

move on. I

8:45

don't know, it seems like we've been challenged by this. And

8:47

there's an interesting thing in what Jay was just sort of

8:50

shining a light on, which is we

8:52

are living a lot longer now, a lot

8:54

better. And so we're gonna have older people,

8:56

well, look at our Congress, in positions of

8:58

power and decision-making, and look for JMI's

9:00

profession, there are things in place to

9:02

make sure we don't stay in too

9:04

long for what happens to us when

9:06

we're aging. There should probably be something

9:09

like that in place for our government

9:11

leaders too, given the reality of people

9:13

living so long these days, and reasonably

9:15

so. And as Jay said, it's human

9:18

beings in these positions, no one else.

9:21

And by the way, although it's not about age

9:23

specifically, as you both mentioned, Reagan was younger than

9:25

Biden when he left office, and there is another

9:27

guy running right now who's not that young, that's

9:29

of course Donald Trump. And we wanna just, I

9:31

thought it would be interesting to juxtapose Biden, what

9:34

we just showed you at G7, versus

9:36

what Trump was up to this week. We'd

9:38

like to extend the invite to Joe Biden if he'd like

9:41

to come on this podcast. Yeah, I think he should. You

9:43

know what chance you have of getting a mic? I'd say

9:45

less than 1%, okay? You

9:48

did that, I'd actually watch that one. Oh,

9:52

no way, we got gifts. We're

9:55

gonna talk for a lot of money, just thank

9:57

you. Oh, no way. Thank you, president. split

10:00

it up here. This is a this is your mug shot.

10:04

Yeah, can you. This

10:07

is what we're. No

10:10

way. Should we

10:12

put on now? That's

10:15

crazy. That's amazing. It sells. Well

10:17

Elvis had one. Frank Sinatra had

10:19

one. This shirt. But Weaver clips

10:21

them. A

10:23

long time ago, we've been. He

10:32

does not disappoint. I

10:36

don't know exactly where you guys are on

10:39

on Trump. That's actually

10:41

largely irrelevant. The reason I thought that was

10:43

interesting is if you just look at his

10:45

ability to joke and be a reverend and

10:47

silly and not disappoint and the energy and

10:49

all of that. The movement

10:51

just moving fluidly. Look at the how

10:53

people move their arms when they don't

10:55

have neurological impairment. That's all. Jay,

10:59

I mean, it's just so star. I think

11:01

you're going to vote on that if nothing

11:03

else. I mean, he's he's

11:05

a he's definitely a great entertainer and you

11:07

can see that and Drew, I

11:10

completely grew. He is cognitively just

11:12

what you know, I don't know if you want to say all there

11:14

depending on your opinion of all there for

11:16

Trump, but I'll say

11:18

this is like there's nothing. There's no deficit at all.

11:20

Right. Like you're not worried that you're what you're worried.

11:22

You may be worried about what he what he what

11:25

his policies are or whatever, but you're not worried at

11:27

all about his capacity to say

11:29

and think what he believes. And and and

11:31

so that's that's just a very striking difference

11:33

in the physical movement difference. Again, you're sort

11:36

of you're shining lights on little interesting things

11:38

here. And isn't that what

11:40

leadership is speaking, having

11:42

their thoughts and their decision making

11:44

and their point

11:46

of view. That's what we want. That's what we

11:48

want from. Alita, but Dave, why can't

11:51

you get him on your podcast? I'm I'm

11:53

I'm I'm disappointed. We've had Trump on once

11:55

and I don't want to say too much,

11:57

but okay, good. There's been a little. contact

12:00

recently, stay tuned on that.

12:03

Let me just mention one other thing on this

12:05

on the media side, because you guys remember a

12:07

couple of years ago when Donald Trump on a

12:09

rainy day walked down those stairs, no, not stairs,

12:11

he walked down a ramp slowly and

12:13

everyone was on CNN 25th Amendment, we

12:16

gotta get rid of him, versus how the

12:18

media covers Joe Biden. That, I

12:20

think we can connect to a lot of things that

12:22

you guys do specialize in on the COVID side and

12:24

misinformation and all that. That

12:27

to me is the craziest part of this,

12:29

that the media is pretending that we all

12:31

don't see a thing that we all very

12:33

obviously see, Drew. I

12:35

wish this was the only thing, as you said,

12:37

the COVID side, it was the same thing. I

12:40

wish this was the only thing that they were

12:42

obfuscating and distorting around, but you know what? They're

12:45

doing us a favor because people are running

12:47

away screaming from their viewership and they're not

12:49

listening and they're going to sources like you

12:51

and other sources to try to get their

12:54

news because they realize that what is coming

12:56

out of mainstream media is just an abomination

12:58

and it's not a secret. And people that

13:01

stay with it, stay with it for unclear

13:03

reasons, sort of to get their point

13:05

of view massaged maybe, but I'm

13:07

so glad we're with Jay today, by the

13:09

way, you mentioned the COVID misinformation, all that

13:11

nonsense. For me, Jay Bhattacharyya, I've told him

13:13

this before, I'm gonna say it again, is

13:15

the poster child for the excesses of COVID.

13:18

That's the man, this is the man they

13:20

chose to silence and what

13:22

were Fauci's word to- Devastating

13:24

takedown. Devastating, devastating takedown. Jay

13:27

Bhattacharyya needs a devastating takedown.

13:29

And I'm really mad at

13:31

the congressional leadership for not

13:33

bringing in all those emails into

13:36

the hearing on Dr. Fauci because that to me

13:38

is a smoking gun of

13:40

the excess of we're right there. Well,

13:42

we're gonna get to some COVID stuff in a sec, but actually Jay, why

13:45

don't you pick it up there and then I'll give us a nice segue.

13:47

Yeah. Drew, I appreciate

13:50

the kind words and the devastating takedown

13:52

is insane, but actually let me just

13:54

push back just slightly on the media.

13:57

Although I do share your hopeful take, there is

13:59

some aspect that it's just, if

14:01

you have a political leader that

14:03

the media like, they

14:06

don't, you know, the media actually is really important to

14:08

hold political leaders, especially our

14:10

presidents to account. If they, if they

14:12

are allowed to, you know, do

14:15

whatever nonsense they want without being held to account

14:17

by the media, it's very difficult to get the

14:19

American public to pay attention to it. A

14:21

lot of the nonsense during COVID happened because

14:24

especially after Biden got into office, I spent

14:26

with the vaccine mandates and all that normal

14:28

media. If he'd had a president they didn't

14:30

like, they would have, they would have questioned

14:32

a lot of the things that they did.

14:35

Instead, they, they, they were like

14:37

a Praetorian guard for Biden with

14:40

a censorship with all kinds of things that normally I

14:42

think what Americans would just look at, look and say,

14:44

are you kidding me? And I think

14:46

it's very dangerous that the media has, has

14:49

taken sides in this way. It

14:51

would be much, much better for the

14:54

Republic if the media were a reasonable

14:57

constraint on the behavior of Democratic

15:00

presidents and they're not. And

15:02

by the way, that the best argument for what

15:04

you just said there would be that Donald Trump

15:06

for whatever his flaws were during COVID and whatever

15:09

anyone might think about warp speed and everything else,

15:11

he never mandated the Vax. But had he, had

15:13

he mandated the Vax, the very same media that

15:15

was telling you that you had to get vaccinated

15:18

would have said that it would have killed you.

15:20

You're both nodding in agreement on that. So why

15:22

don't we move this to the next COVID topic

15:24

because this is absolutely wild. Dr.

15:26

Mike Yeeden, who is the former, one of

15:28

the former vice presidents of Pfizer is now

15:31

saying that the COVID vaccines were

15:33

actually designed to reduce

15:35

fertility. Take a look at this. If

15:37

you followed me, you'll know I, over

15:39

30 years in research

15:43

in the pharmaceutical industry and biotech.

15:47

I trained in toxicology and I

15:49

worked with colleagues designing experimental

15:51

molecules that would hope to

15:53

become medicines. That

15:56

gives me the credentials

15:59

to stand as it were, in the

16:01

shoes of the designers

16:03

of these vaccines and

16:05

answer the question, what were you

16:08

thinking when you made these

16:11

design decisions? Now,

16:13

you can go and watch any of my interviews or cut

16:15

to the chase. And

16:17

you may not believe it, but I am

16:20

sure, not slightly

16:22

but sure, these

16:25

materials were designed intentionally

16:30

to harm, maim,

16:33

and kill, and to

16:35

reduce human fertility. That

16:38

is my verdict. And

16:40

I can stand it up. I will be in court. It's

16:43

pretty important, Costa Rica, very shortly. And

16:46

I'll be using exactly this argument

16:48

that I will give the detail.

16:51

That's the first point. So don't

16:53

take these injectables. Don't take the

16:55

next lot either. They will also

16:57

be designed to harm you. Earl,

16:59

mRNA-based materials are dangerous.

17:02

Don't take them. All

17:05

right, that is a former VP advisor.

17:07

Obviously, I can't speak to

17:09

the claim there specifically. Jay, this is a

17:11

little more your department. I mean, we've heard

17:13

all sorts of stuff about mRNA technology now,

17:16

even from Robert Malone, who owns more patents

17:18

on it than anyone else. What do you

17:20

make of this stuff at this point? OK,

17:23

so first, I don't think he's right. I

17:25

don't think that specifically in

17:27

one point, he's not. In

17:30

my experience with drug developers and others, I

17:33

don't see that any of them

17:36

would intentionally design a molecule

17:39

in order to create

17:41

infertility. And that

17:44

just doesn't ring true with me. I

17:46

don't see anything in the makeup of

17:48

the vaccine that

17:51

just from this molecular sequence or whatever that

17:53

screens out this is going to cause infertility.

17:57

That particular thing doesn't make sense. But

18:01

it may, like the question of does

18:03

it cause infertility? Right, does

18:05

it cause birth defects? Those

18:07

are empirical questions that are actually weird,

18:10

often answered after you've rolled the vaccine

18:12

out because the randomized trials don't have

18:15

pregnant women in them, they generally don't have, they

18:17

don't ask that kind of question. They

18:19

don't have the sample sizes to address it. Those

18:22

are not enough time, right? I mean, there's just

18:24

so many other times. So that's why I don't,

18:26

I think he's being hyperbolic in ways that I

18:28

don't agree with. I do

18:30

agree with one part of this, and maybe the sum

18:32

of the spirit of it, in the sense that

18:35

I think that the regulatory agencies have

18:37

been very, very slow to look

18:40

at these kinds of side effects

18:42

from this vaccine. And

18:44

they were motivated in large part because they thought

18:46

that if people thought that there were

18:48

these kinds of side effects, or if they actually identified

18:50

these kind of side effects, no one would take the

18:52

vaccine. I don't

18:54

understand why that would be a bad thing. If

18:57

one were to find that there

18:59

was fertility defects caused by

19:01

the vaccine, then you should not be recommending

19:04

it to pregnant women, to women that are

19:06

trying to get pregnant, or just generally to

19:08

younger people. It

19:12

would make no sense to do that, right? So that would

19:14

not be a bad outcome. And yet

19:16

the regulatory agencies, because they were afraid

19:18

that it would cause vaccine hesitancy, I

19:21

believe that's the motivation, did not act

19:24

as rapidly as they should have and as

19:26

rigorously as they should have to identify

19:28

the side effect profiles of this vaccine

19:30

like they would normally for other drugs

19:33

and products. True, can

19:35

we stick with the intent part for a minute? Because

19:37

Jay, I totally hear you, we have no way of

19:39

knowing the intent. But I think what a lot of

19:41

people are probably thinking while they're watching this is, the

19:44

intent is actually irrelevant at this point.

19:46

These people, they didn't maybe intend to

19:48

lie about six feet social distancing, but

19:50

they did. They didn't intend to lie

19:52

about masks, but they did. So in

19:54

a weird way, I fully

19:57

understand the argument, but I

19:59

don't think it even. the

24:01

vaccine was entirely safe, when they had no way

24:03

of knowing that was entirely safe, even after the

24:05

randomized trial was done. Drew,

24:07

you mentioned Joe Freiman, who's

24:09

a fantastic scientist. He reanalyzed

24:11

the COVID vaccine trials

24:15

for the mRNA to see what

24:17

the rate of adverse events were. He found a

24:19

one in 800 measure of

24:21

serious adverse events in the randomized trial.

24:24

That doesn't mean no one should take the vaccine. What

24:26

it does mean is that you wanna be very careful

24:29

about who you recommend it to. Older people, the

24:31

balance of benefits and harms, do

24:33

they make sense to recommend it? Wait, Jay, can you explain

24:35

that? That is way higher. Now, I'm sorry, for a moment,

24:37

I couldn't remember who he was. I was actually at the

24:39

panel that you were at that DeSantis put together, Jay, here

24:41

in Florida, and Jay Freiman was there and mentioned that. The

24:43

one in 800 is way, way higher than

24:47

a normal vaccine, right, for injury. Oh,

24:50

ridiculous. Yeah. Yeah, I mean, what's

24:52

one of these things where like, okay, you're in

24:54

the middle, it's December, 2020, everyone's scared to death

24:56

about COVID. You have this product that all of

24:58

a sudden has promises to

25:01

reduce the symptomatic

25:03

infection rate by 95% for a couple of months.

25:05

The question is, how do you use it? 1-800

25:08

is a big number. Now,

25:10

serious adverse events doesn't mean necessarily

25:12

killing you. In fact, what

25:14

it means is like, you know, severe reactions,

25:18

rarely it'll get you in the hospital, but it's

25:20

not something you wanna ignore, right? But it's much higher,

25:22

as Drew said, than most vaccines that are on the market.

25:25

So the question is, how do you use

25:27

that thing? How do you use that product?

25:29

The reasonable way to use it is to

25:31

say, look, let's look at the high-risk people

25:33

for whom this product might, the benefits might

25:35

outweigh the harms and recommend it for them

25:37

carefully, you know, making

25:39

sure it's not like, you know, too

25:41

aggressively and with informed consent. And for

25:43

younger people for whom the benefit almost

25:45

certainly does not outweigh the harms, don't

25:47

recommend it and certainly don't mandate it.

25:49

Yeah, oh yeah, for sure. But

25:52

I would, to follow what you're asking, look,

25:54

look no further than your food sources to

25:56

look for things that have been covered by

25:58

lobby groups and scientists. Now,

28:00

Jillian Michaels went on Sage Steele's

28:03

podcast and talked a bit about

28:05

that. You will plateau on this drug.

28:08

Not an opinion, fact. Fact,

28:12

Google that. I'm encouraging

28:14

to Google. Don't trust me. Google

28:17

it for yourself. You will

28:19

plateau on the drug. Your

28:22

body is homeostatic, which

28:24

means over time it's seeking

28:27

a balance. GLP-1

28:32

is a hormone, incretin. It's a hormone.

28:34

So when you are giving the body

28:36

a hormone exogenously, over

28:39

time the body is like, oh, I'm gonna

28:41

stop making this on my own. Oh,

28:43

I'm gonna develop a tolerance to

28:45

this. Tolerance, yep. And you will

28:48

plateau on the drugs. Google

28:51

it. Now then, what

28:53

are you going to do when

28:56

they stop working physiologically?

28:59

Do you think you're going to get off of it because

29:02

you will gain all of the

29:04

weight back? All of the meta-analyses

29:07

show us this. Google

29:09

it. It's not my f***ing opinion, okay?

29:13

So here's the bigger problem.

29:15

Now when the drug stops working, if

29:19

you choose to get off of it, because

29:21

it's also very expensive, you're handcuffed to this

29:23

drug for the rest of your life, Google

29:25

it, okay? So

29:27

we get off of it. You've

29:30

got a couple of issues. Fact,

29:33

there is, quote, let me quote Peter

29:35

Atia. Hopefully he's more credible than Dr.

29:37

Terry DeBrow. He will tell

29:39

you that in his practice, according

29:42

to the DEXA scans he does with his

29:44

patients, he sees muscle loss

29:46

at a, quote, alarming rate. He

29:49

uses these drugs as a

29:51

last resort and he won't even put patients

29:54

on them until he does a

29:56

DEXA scan to make sure that they're not older and in

29:59

a dangerous position in

32:00

our profession, it's the weirdest thing. We've

32:03

gone backwards on it for sure, Drew. And during the, I

32:05

mean, I was just, if you've

32:07

mentioned cost-benefit analysis or benefit-harm analysis,

32:09

you were a fringe epidemiologist back

32:12

during the COVID era. It

32:15

strikes me that this is, obesity

32:17

is a particularly dangerous area for drug

32:20

intervention because of the fact that it's

32:22

so common, I think, what

32:24

is it, like 40% of the American population or more

32:26

are obese, or adult population are obese.

32:30

And because people so desperately want to fix it. And

32:33

so it's really easy to take advantage

32:35

of people. And so this drug, Ozempic,

32:37

it was first used in diabetics. There

32:39

were good reasons to use it in

32:41

diabetics, and it kind of worked for

32:43

diabetics. The expansion of

32:45

it to use for the entire

32:48

population wide is not

32:50

at all surprising that you're gonna see portions

32:53

of the population that take it have these side

32:55

effects, have some side effects that we didn't anticipate,

32:58

and some of which we did anticipate. I'm

33:00

reminded of an earlier weight

33:02

loss drug, this FenFen, yup. And

33:05

that, same exact, like it was very, very popular for

33:08

a while until there was a major

33:10

side effect identified with lung, such, yeah. Much

33:15

of a valve deterioration. That too, and all

33:17

of a sudden, it was like, okay, this

33:19

was just poison that was put

33:22

on the population. I just, it looks

33:24

to me like the same kind of trajectory.

33:26

All right, so again, as

33:28

the layman here, I mean, this just to me

33:30

is just like another one where you're both exactly

33:32

right. They are going to end up saying that

33:34

there's all of this side effect, nobody should be

33:36

on this. But Drew, can you talk a little

33:38

bit about how does this stuff go from being

33:40

a niche medication for something

33:43

to then, what then happens

33:45

in the system after that, that it

33:47

then just gets commercialized to everybody as

33:49

Jay's talking about? It's a great question,

33:51

it's a great question. And I'm sure

33:53

everyone wants to blame the drug company,

33:55

but the drug company is duplicitous. They

33:57

blow wind into the sail of what.

38:00

because he's like monopolized, but

38:02

then he turns into this philanthropist and finds

38:04

success in the public eye as being the

38:06

good guy. What

38:09

you have is this like weird scientific,

38:12

the scientific isn't the weird thing,

38:14

but this mindset of engineering solutions

38:17

to problems that are complex

38:19

social problems that require

38:22

careful understanding of

38:24

all the trade-offs. And his instinct

38:27

is always seems to be in

38:29

both his philanthropy and his capitalist

38:31

work before, is to like a

38:33

very, very simple technological

38:36

solution which runs roughshod

38:38

over all of the subtleties and often ends

38:40

up causing more harm than good. I mean,

38:42

I think in this case, I don't know,

38:44

maybe his technological breakthrough is a good one,

38:46

I have no idea, but I don't think

38:49

that, I'm not gonna be eating any of those cows if

38:51

I can avoid it until I understand a little more about

38:53

them. But isn't that the

38:55

point? So he's going to invent something, or I

38:57

guess he has already, or is investing in this

38:59

company that's going to do something to cows so

39:01

they don't burp as far as much. And that

39:03

will be either the meat wheat or it will

39:05

be the artificially engineered meat that he

39:07

will also somehow profit from. By the way,

39:09

this is the same guy who created Microsoft's

39:11

Windows, which as you're right, he got into

39:13

a major antitrust lawsuit over it, but that

39:15

was the thing that put viruses on computers.

39:18

And now he's supposed to be in charge

39:20

of our viruses of our bodies, Drew, help

39:22

me. It's a corollary to what

39:24

I was saying before. By the way, did he

39:26

say get beef without cows? How exactly- Well,

39:29

I think he means artificial. He means artificial.

39:31

He doesn't mean beef, he means something else.

39:33

He means something made out of molds. But

39:36

I like the fact that he's at

39:38

least thinking more broadly about the problem

39:40

of burping primarily, cows burping.

39:43

Maybe we can make cows not burp.

39:45

I like the idea that he's at

39:47

least doing that than just saying in

39:49

the ideology of beef bad, cows bad,

39:51

which was crazy. But it's the same thing

39:53

I was complaining about with my physician

39:55

colleagues. Now there's a corollary which has

39:57

infected all of us. It was irrational.

40:00

irrational certitude, irrational

40:02

certitude, when it comes, like Jay

40:04

said, to very complex problems. We

40:06

should have a rational uncertainty. We

40:08

have a, the current pandemic is

40:10

hubris. We need humility. Yeah,

40:13

so Jay, can you talk to that for a

40:15

moment? Cause I really, since Drew credited you, I'll

40:17

do the same thing. That one of the reasons

40:19

I did not go crazy on COVID on this

40:21

show was that you were either the first or

40:24

second expert that I had on, and you were

40:26

kind of sobering. So I was like, let me

40:28

just pace this thing out a little bit. But

40:30

it seems to me that to your point, guys

40:32

like Bill Gates are looking for problems all the

40:35

time and they will do things not knowing, well,

40:37

okay, the cow can't burp anymore. Maybe we've now

40:39

somehow changed its molecular structure and the meat that

40:41

you're gonna be eating is going to do God

40:43

knows what to you. Yeah,

40:45

I think Drew hit

40:47

it right on the head. This is hubris,

40:50

right? This is scientific hubris. Like somehow, I

40:53

mean, when I say science, I don't mean

40:55

actual science, which I love, which I

40:57

think is like a fantastic way to learn

41:00

about the world and improve the world.

41:02

I mean, capital T, capital S, science,

41:04

with a trademark sign, that's the problem.

41:07

Like you have this like something

41:10

that's, where's the skin suit of science

41:12

and promises, it's like these hucksters promising

41:14

you just, let's build a monorail, it'll solve

41:17

all our problems. I mean,

41:19

it just comes across that

41:21

way. It's like someone who's

41:23

like wants to sell you something rather than really

41:26

grappling, like these are real problems.

41:29

These are not things that we can just ignore, but whatever

41:32

we choose to do is gonna come with

41:34

trade-offs. It's not gonna be magic

41:36

and he's promising magic. And I think

41:39

that that is what makes me uncomfortable

41:41

watching him. It made

41:43

me uncomfortable watching him during the pandemic and it makes me

41:45

uncomfortable watching him talk about cows and

41:47

methane. There's

41:50

no magic here. Yeah, I wanna

41:52

just highlight that again, is also say that

41:54

science is a procedure, it's a process. It's

41:57

a way of trying to uncover the truth

41:59

in the world. And my friend

42:01

Harvey Reish distilled it down to one phrase that

42:03

I thought was so exactly right on. He

42:06

goes, look, it's just a scientific process.

42:08

It is an instrument that tells us

42:10

the null hypothesis is either informative or

42:12

not informative. That's science. That's it.

42:14

The null hypothesis either told us something or

42:16

didn't tell us something and we build from

42:18

there. And I want to say one other

42:20

thing about Jay being so measured at the

42:22

beginning. I had the same experience, Dave, early

42:24

on. Although I noticed his Twitter feed has

42:27

become a little more lively lately. He's got

42:29

a little more unspoken. I have noticed

42:31

it. I like seeing it. I got to tell you. Yeah.

42:34

It might be time to go back to being an anonymous again. I

42:36

don't know how to watch it. By

42:38

the way, Jay, I got the Monorail reference. He

42:40

went all the way to Ogdenville. I'm pretty sure

42:42

it was the best episode of, I almost said

42:44

Seinfeld, of The Simpsons ever written by Conan O'Brien,

42:47

believe it or not, around 1994. All

42:50

right, guys. Well, it's always a pleasure having you on. I feel a

42:52

little smarter. I think the audience did here. I'll put

42:54

on my glasses so it looks like three stars. Oh, look at

42:56

you. There you go. Have a great weekend and

42:59

I'll talk to you guys soon. All right, guys. Thanks.