Part One: Peter Attia and the Cult of Longevity

0:05 Welcome back to Behind the Bastards, a podcast that tells you everything you don't know about the very worst people in all of history. And this week, I'm one of the laziest people in all of history because I'm getting a week off of researching and writing a script. Thanks to my good friend, Dr. Kaveh Hoda, who has come in and wrote, written, wrote, wrote, wrote, wrote, wrote, Kabe, welcome back to the show. Thank you so much. How are you doing?

0:31 It is so nice to see you both. I miss your faces when I don't get to see them.

0:36 That's right.

0:37 And now I get to see your faces, and that makes me happy. And then I get to talk to you. Now it's my turn. You've done so much. Yes. You've done so much to bother people. It was terrible stories. Really made him unhappy a lot.

0:49 Yeah.

0:49 It's my turn to give back to you.

0:52 Wait, wait.

0:53 I'm going to give you a present first. Have you had fiber today, my friends? You should eat more fiber.

0:59 Yeah, Kavit does always say that.

1:00 Thank you. Fiber zaddy here.

1:01 You're welcome.

1:02 Fiber zaddy. That's what they call me online, Robert. Fiber zaddy.

1:06 Yeah.

1:07 And I looked it up, and it's a good thing, apparently, to be a zaddy. So that's me.

1:11 No, that's good.

1:13 You know, Robert, let me ask you a question. when you envision a doctor, someone trustworthy, someone you feel like you should be listening to, someone with advice you would follow, what do they look like in your mind? What do you envision? Are they handsome? Are they fit? Are they charismatic? And don't lie to me, Robert. I can tell when you're lying.

1:37 Honestly, I picture my old pediatrician, Dr. Sherrod, who was the doctor I had growing up as soon as we moved to the Dallas area. He was a a really good, I had a bunch of like weird health issues around my allergies as a kid. And every other doctor we went to was, or every other pediatrician we went to had a lot of trouble figuring out what to do.

1:57 And Dr. Sherrod did not. He was a really good doctor, like helped me with my allergy problems as a kid, was just always, like my mom worshiped the guy. He was great. That's probably why I have such a positive opinion about doctors, because I grew up with a really, really good one.

2:12 Must be nice.

2:13 Yeah, I think about him.

2:14 And Sophie, what about.

2:17 You?

2:18 You know the details of all my medical history, both of you. A little sour on doctors these days, you know. But I love you and I love my brother and you're both doctors.

2:32 There you go.

2:33 I'm one of the good ones, Robert. I'm one of the good ones. Well, you know, here's the thing. You are both doing, I think, the reasonable thing, which is you are using your own memories, your own relationships with people you know and have met and you know to be good doctors. But I would think, unfortunately, that's not always the case in this country. Yeah. Yeah. Are thinking of a doctor. First of all, they're probably thinking of a male doctor, although most evidence we have would actually suggest you're better off with a female doctor. They've actually looked at that.

3:14 Just in general?

3:16 Well, for particular, the study showed it was, like, in patient hospitalizations, but... It's certainly not worse. It's funny that this had to be done, but at one point there had to be a study that said having a female doctor is not worse. Actually, it's probably better. We'll probably get more of that. We'll probably get more of that in the future, too.

3:39 It's a systemic issue. like most of my doctors in an adult have been women and I usually, I just feel like they pay, have paid more attention.

3:48 To me, I guess. Yeah. I think that's probably it. You know, the study didn't really specify why, but I mean, I, I, I suggest I am, I'm guessing that's probably it, but I think the truth is for a lot of people there, they're going to think of this doctor that's like tall and handsome and stately and well put together. Someone they could imagine wearing like a tailored suit on general hospital.

4:11 or like fitted scrubs on Grey's Anatomy. Of course, of course.

4:14 You got to tailor your scrubs that you're going to throw out.

4:17 It is crazy to me, the tailored scrub thing. I wear the biggest, baggiest, goofiest looking scrubs at work. I mean, here's the thing. My favorite part about my job is that I essentially get to wear pajamas to work. That's fantastic.

4:31 Us too.

4:33 Yeah, I mean, I am wearing pajamas right now.

4:35 That's a good point. I could have skipped a lot of... medical training and just gone straight to podcasting. But hey, live and learn. But I told my brother. So people are thinking like these Dr. Oz's and the Dr. Drew's and these kinds of guys. Tell you something right now. I'm going to tell you right now. I'm going to take a stance here. I think doctors should be schlubby and silly looking. Basically, I should be like the max handsomest doctor that you should envision. It shouldn't get better looking than me.

5:07 Yeah.

5:08 Anything better looking than me, you're going to run into problems. We've seen it time and time again. And I have another question for you. Have you ever heard of a Dr. Dennis Lowe or Dr. Faith Fitzgerald?

5:19 No, but Dr. Faith, I'm already getting like, uh-oh. I'm concerned. That could be a problem. I mean, I know it's a normal name for a lot of people, but just the name Dr. Faith really concerns me.

5:30 Well, I'll tell you this. The reason you don't know of them is because they were amazing doctors. And they dedicated their lives to service and education. And I'm assuming they never had a Q score greater than 20.

5:41 I'm sorry, Dr. Faith. I apologize for judging you.

5:45 And Dr. Dennis Lowe. Dr. Faith Fitzgerald passed, but Dr. Dennis Lowe still kicking. And I was lucky enough to be mentored by both of these terrific and caring doctors. And that's why we're not talking about them today. But we'll be talking about someone you have heard of, one of the most famous most influential, and most widely followed doctors in popular culture, Dr. Peter Attia.

6:08 Oh, boy. I know that name.

6:12 Have you heard? Yeah, I'm curious. What is the thing you've heard? I guess I know what it is. Not much.

6:17 He just shows up. I mean, he's involved in the administration, right? Like, he's been one of those guys who's been— Very peripherally.

6:24 Yeah. Very peripherally. He is someone that the wackier people in the administration— sometimes cite to show that they're not so wacky. He kind of does a little bit of science washing. We'll get into that. But he's the doc who, more than any other modern doctor, has worked to popularize and legitimize the field of longevity medicine. Are you guys familiar with that?

6:50 Yeah, like the Brian Johnson try to live forever. I mean, like the quack end of it is Brian Johnson measuring his sleep erections.

6:58 Obviously.

6:59 There's a good reason to care about longevity. You know, like that's that's there's also definitely a non-quack side of it.

7:06 Oh, yeah.

7:06 We're going to get into that. We're going to get into the good and the bad of it. So like what I.

7:10 Know about him is he exchanged quite a lot of emails with a not so friend of the pod, Jeffrey Epstein.

7:20 Yeah, I have a question about you are correct. And we're going to get to that. Um, but my question for you is Jeffrey Epstein, like, and you've probably made this reference already, but is he like the Forrest Gump of terrible people? Because the fact that he showed up in the story, that wasn't even the reason I wanted to talk about Peter Attia. And then when I was learning more about him and I discovered that I was like, is he involved with every questionable person?

7:46 Well, I mean, kind of, yeah, but like Forrest Gump, it was just sort of like coincidental that he kept winding up in all of these historical situations. Jeffrey Epstein like knows and was involved with a lot of powerful people because he was providing them with services, so to speak, or he wanted the cloud associated with them because it, because there were people who didn't do anything awful that Epstein either funded or invited to a lot of things.

8:13 Because he liked to camouflage himself being surrounded by great scientists. And after his arrest, the people who were legitimately just caught up and didn't know anything and were legitimately just caught up in shit, they stopped hanging out with him once he was charged and convicted of child molestation. But yeah, anyway.

8:35 Well, he shows up here. And we're going to get into that. Before we do, there's a lot of other things I want to talk about. That actually wasn't even the main reason I wanted to discuss him. We're going to get into the good and bad of it. We're going to have a little bit of a nuanced, I'm sorry, an advanced discussion. We're going to do the risks and benefits talk, just like you're supposed to with everything in medicine.

8:56 We're going to talk about the potential harms of over-testing and over-medicating. We'll talk about whether it's important to have the VO2 max of a Tour de France cyclist, how important it is to track your blood sugars by the minute if you're not diabetic, and if it's normal for your doctor to be on an email thread with Jeffrey Epstein discussing the nutritional benefits of cunnilingus.

9:17 Yeah, no, that doesn't, that seems questionable.

9:19 Yeah. I don't know if you want to use that as a cold open, but, you know, welcome to Behind the Bastards.

9:25 Yeah, Behind the Bastards, the only podcast that just said cunnilingus. Probably not the only one. One of them, though.

9:37 Okay, so before we get into this episode, I have to clarify a couple things. He's not going to be the worst person you've discussed on the show. He's not even the worst doctor you've discussed. He's not even the worst doctor you've discussed with me on the show. He's obviously not a bastard on the level of Stalin or Saddam Hussein or Mark Zuckerberg. But in my mind, he represents a new kind of danger in medicine, one that doesn't come from direct harm to patients, but from credibility and from charisma and from privilege, from someone whose influence is outsized and ideas are actively reshaping and whose model of care, in my mind, is deepening inequality in this country.

10:23 His whole approach is this sweeping reimagining of healthcare that claims to prevent heart disease, neurodegeneration, and all this stuff. And it sounds great, but it's not all supported by randomized trials. It relies a lot on speculative pharmacology and under-tested and aggressive biomarker manipulation and testing. We'll talk all about that. I obviously take issue with some important aspects of his practice, this whole model of manosphere wellness influencer or Maha adjacent doctor is something I find very troubling.

10:55 History has shown us that if we don't nip these Dr. Oz's in the bud early, they can become real problems for everyone down the road.

11:02 They wind up in charge of everybody's healthcare.

11:04 Yeah. That's right. The people who are now in charge are the people I... We're all internet trolls 10 years ago, and it blows my mind. It's bleak. So about the Manosphere, because I think it's kind of important that we discuss it. Actually, I have to say, one of the first times I was really exposed to it, it was a couple years back.

11:23 You probably don't remember because you see this stuff all the time. But somebody tweeted that Robert Propp and I were part of the quote-unquote leftist Manosphere, and I didn't know what that meant. I still don't know what that means. It's not great, I don't think. I don't think it was a compliment.

11:39 I doubt it. What Manosphere are we a part of?

11:41 Okay.

11:43 As the girly pop on the podcast, fuck no.

11:46 Yeah. No.

11:48 Thank you.

11:48 I don't know what that's supposed to mean, but okay.

11:50 Okay. I think Dr. Atiyah might maybe take issue with being labeled part of the Manosphere, but a large... part of his strongest support comes from there, and his appeal really comes from that same milieu that creates our Joe Rogans or Andrew Hubermans.

12:07 Joe's Rogan, but sure.

12:09 Yeah, right, right.

12:10 It's like Attorney's General.

12:11 Like Johns Hopkins, yeah.

12:13 Right, exactly.

12:15 Atiyah's rise, whether he likes it or not, is inseparable from this podcast industrial complex. They all exist in the same ecosystem. Now, I'm not an expert in this. In fact, most of what I know about the weirder parts of the online world I've learned from you people here on Cool Zone Media.

12:33 Yes, that is kind of our milieu.

12:37 And you don't know, there's been a number of times that I've like texted Garrison to be like, hey, can you explain what this means or this means? And I'm like the old boomer like who needs help with their VCR. But here's what I- No, no, that's good. That's good.

12:55 That's good that Garrison's being a resource. We love that. It's like, hi, I know things.

13:02 It's like the modern equivalent of walking an old person across the street.

13:05 Yeah.

13:07 And I appreciate that.

13:08 But it's the internet, yeah.

13:10 It's the internet. But I think if you think of this online male self-improvement world as a Venn diagram, I think you'd see four circles. And please correct me if I'm wrong and weigh in on this. But one, you have the manosphere, the red pillars, the... looks maxing people, online forum dudes. In another, you have the bro science fitness sphere, the testosterone growth hormone guys, bodybuilders.

13:36 Sure.

13:38 The third is the tech optimization sphere, biohackers. That's, again, where Andrew Huberman comes in. Yeah. Silicon Valley longevity enthusiasts like Brian Johnson. Yeah. Who we'll have to talk about at some point in this. And also then there's also the mainstream wellness sphere people. They're less offensive in general, more standard fitness stuff like your Chris Hemsworth and Hugh Jackman's proponents of the health standard.

14:04 Hugh Jackman, yeah.

14:06 Hugh Jackman.

14:07 Yeah.

14:08 And Peter lives somewhere in between all of these, but probably more three and four. Not that far from the Manosphere, though. And the Manosphere definitely borrows from him, particularly his language on testosterone, metabolic health, VO2 max, protein. His audience definitely shared with Rogan, too. And I will say this, actually, here in San Francisco, so... Silicon Valley tech folk love him.

14:33 And I've met some very reasonable people who listen to him and follow him closely. I've had people with no history of diabetes ask me about getting continuous glucose monitors because of what they've heard on his podcast. That was really eye-opening for me. So what sets him apart from these people is that he doesn't talk about gender politics too much. He has or had... a lot of female followers, especially after Guess Who exposed him, Oprah. And he also had a 60 Minutes profile piece. And more than most of the people in this world, he does actually seem to look for evidence-based medicine. He cherry-picks it a bit when he does. Yeah, sure. But he's... I think he's actually a smart guy. I know a lot of doctors,

15:20 like Dr. Oz and Dr. Ben Carson, all these guys, they're very successful, and I think people consider them smart. But in truth, I don't actually find them that intelligent. They're great at surgery, and they're very hardworking. But, you know, they're surgeons. I'm sorry, surgeons.

15:35 Sorry.

15:36 We could talk about the difference between neutral medicine and surgery at some point, if you guys like. But I never found these two.

15:40 Weird Al wrote a song about that. People are aware.

15:42 Yeah. Did he really?

15:43 Yeah. Like a Surgeon.

15:44 Oh, yeah, that nailed it.

15:46 To the tune of Madonna's Like a Virgin, yeah.

15:47 Yeah, yeah, yeah. Well, as with most things, it was explained early in the 80s by Weird Al Yankovic. Yeah. But I never found them that smart. It's actually kind of wild how far you can go in medicine with some charm and some hard work, and I think those two are examples of that. But I think Atiyah, he's really smart. And I have to tell you, as I prepared for this episode, there were multiple points where I was like, I actually, I like a lot of what he says. More than expected. I agree with some of his recommendations. And there's even some stuff in his history that I empathize with. But there is definitely this pipeline of men who start with guys like Atiyah and Huberman and end up with Peterson and Tate. He's like the

16:30 evidence-based gateway to the manosphere. And that's one of the reasons why I think I want to discuss him here with you folks.

16:36 Right.

16:37 Before we get into him, though, let's talk a little bit about longevity medicine in general and what it actually is. Its proponents would say that for the past century, medicine has been reactive. You've probably seen people talking about this, quote-unquote, sick care, right?

16:54 You get sick— Yeah, shocking that doctors focus most on, like, saving people's lives when they're ill. I mean, like, obviously preventative medicine is important, but it's not weird that that's the way it, you know, goes.

17:05 Yeah, that's kind of what we have to do, because if we don't, then what's going to happen? You have no one else to take care of you. But there's some truth to that. Like, it's always important to think about preventive care. And in longevity medicine, it's meant to be sort of a way to flip the dynamic, that it's preventive, personalized medicine that aims at expanding not just your lifespan, but what they call your healthspan, those years that you're in good health. It's driven by something called the geroscience hypothesis, which is basically aging itself is the shared root of most chronic disease. Right. So instead of playing whack-a-mole with one disease at a time, you could, in theory, delay all of them. And like every system

17:49 that is totally on the up and up, you can consider it like a pyramid. The base is the lifestyle components. The middle is measurement, tons of testing, wearable, biologic age clocks that claim they can tell you how old you are. And at the top level of this pyramid of this particular field of medicine is is the experimental frontier with drugs and supplements aimed at aging pathways like metformin, rapamycin, NAD +. You might have seen that one already. One pattern about all these meds, including the ones that we'll discuss later, there's some impressive effects that are in mice or lab animals, but limited or really non-existent proven effects in humans. the evidence of longevity medicine working in people

18:35 and humans is actually pretty thin. And we're not even sure if we're measuring the right things with these biologic clocks and that sort of thing. So, and of course, there's a question of safety of taking some of these medications long-term. We'll get to that. I think some parts of this field are generally very interesting, and I'm hopeful that some good science will grow out of it. But the more I learn about longevity medicine in general, the less I like it. The thought of these uber-wealthy technocrats learning to expand their lifespans even more than they already have, I find to be kind of terrifying. And as we're going to get into in the second episode, longevity medicine is particularly bad because it disproportionately affects the wealthy, if

19:18 it works at all, allowing them potentially to to extend their influence, consolidate their power, and delay the generational progress of science and cultural, political progress and all that stuff. I don't know, maybe I'm being nihilistic, but my question for you and you both, I'd love to hear what you have to say, is would you even want to live forever? I'm assuming the answer is no, but how long, be honest, how long would you want, what's the longest you would want to live for?

19:47 I don't know, like, I can't imagine It depends. I think the big thing for me, and there's some reasonable people in the longevity space who talk about this, is, like, health span. Like, I would like to stay healthy and mobile and independent forever. you know, the entirety of my life that said, I don't know that I'd want to live longer than like 90 years at kind of the outside, you know, like, I don't think like the kind of max human lifespan, more or less like 90 to 100 or so. I don't feel like that seems great. If I could not like be miserable and decrepit and dealing with like Parkinson's or Alzheimer's or whatever, you know, like at the end of it, right? Like, that's kind of the big thing for me. as opposed to like objective lifespan.

20:32 Cause I do think I'm already, there's already things that I know are like good changes to society that I'm never going to be okay with. Like at some point we'll figure out, you know, some degree of self-driving or we'll finally get our shit together and replace all the cars and with good public transit and whatnot. I like driving.

20:54 I know that's bad. And I support society reforming and getting out of its addiction to cars. That'll just never be something I'm personally ever able to enjoy as much as other people. So I don't want to go on too long, to the point where, hopefully, if things go well, the world will be a lot better in 70 years or however, 50 years, 40 years uh but i don't know that i'll be comfortable in it right you kind of hope that the world evolves beyond you if you're not a shitty person i think you know what i.

21:29 Love after everything you've seen and studied you're still kind of an optimist on the inside i mean i.

21:35 Don't know if i think that's likely i i know.

21:38 You can't say that because you have to be cool and like you know You have to be aloof in whatever podcasts are, but you're kind of an optimist, and I love it.

21:48 The darker thing would be to say, I don't want to live through the complete collapse of the biosphere's ability to support life, which certainly seems likelier than us getting rid of cars and developing good public transit.

21:59 You could have said that first, but you didn't, because you're an optimist.

22:02 I would be nice on the internet to people. I don't want to depress people anymore. I do that too often.

22:07 Sophie, how long would you go for?

22:09 Well, if I could be healthy and Anderson could be healthy- You know, probably the same answer as Robert. I don't want to be, I don't want to be uncomfortable. I don't want to be, like, miserably uncomfortable and a burden to the people around me, one. And, like, you know, if they could, like, health max my dog to live longer and live great and be strong and live long.

22:32 I mean, that would be sick. I don't know if we need to do that for people. But for dogs, dogs don't live long enough as is.

22:40 I agree with both of you about the health span. I think that is very important. I think we should be focused more on living our best lives for as long as we can.

22:49 Yeah.

22:49 Eventually, it will catch up to us all. But, I mean, yeah, I think that's a realistic thing to do.

22:54 There's chia seeds in this shit.

22:56 For you. Look at you. For you.

22:58 Health nut.

22:59 You know, for me, a big part of this is not just the longevity medicine aspect of it. It's that I dislike concierge medicine in general. Yeah.

23:11 It feels bad.

23:13 It feels bad. Well, there's a reason. It shrinks access for everyone that's not wealthy and turns healthcare into this subscription-based privilege rather than a social responsibility to take care of people. And a typical doctor who moves into a concierge practice, and by the way, I understand very well why you would want to do that. And there's like a non-zero percent chance that I will eventually sell out and have my own concierge practice. So I get it.

23:41 But a typical doctor who moves into a concierge practice will reduce their panel from something like 2,000 to 3,000 patients closer to 300. And this is only accelerating the collapse of our healthcare system. And it's also leading to ethical drift in the medical profession. And concierge medicine is, right now, really the only delivery system for longevity medicine for these people. We'll get into that. But let's get into the idea of it all. But first... Oh, but first.

24:12 You know what will make you live forever? The sponsors of this podcast. I guarantee it. And if you don't live forever, you can sue iHeartMedia. You know?

24:21 No, no, no, no, no.

24:23 Sophie, Sophie, it's perfect. They can't look. If they don't live forever, how are they going to sue us? If they die, what are they going to do? No, no, no, no, no, no. It's the perfect scam.

24:30 No, no, no, no, no, no.

24:31 It's the perfect scam. We'll be way out of the podcast game by the time they figure it out.

24:36 Yeah, we'll be in El Salvador by then.

24:38 Robert, don't tell them where we're going.

24:41 It's okay. Honduras is what we meant.

24:43 We're really going to North Korea, Sophie, but we're not going to tell them that.

24:46 Robert, no.

24:56 And we're back. Sophie and I aren't moving to North Korea to avoid extradition laws. We didn't spend years working out a plan with Kim Jong-un or whichever Kim we've got in there right now. I think it's Jong-un, right? I forget.

25:10 Anyway, Kava, let's continue.

25:11 You should probably learn that before, you know.

25:15 Kim Jong-un. Yeah, his dad was Kim Jong-il. Look, whoever I've.

25:17 Been emailing is in charge of North Korea according to the guy I've been emailing and sending money to.

25:22 You just call him Kim. It's fine.

25:24 Exactly.

25:25 I get it. Let's talk about Peter Attia. Let's start with the early years. He's talked a lot about his childhood, but it's usually in these controlled, self-narrated ways through podcast monologues or interviews or his book, Outlive, The Science and Art of Longevity. There's been a couple of very useful pieces written about him, but not any real investigative biography.

25:49 So we have to reconstruct his early life with what's been revealed in his podcast. I listen to a lot of podcasts, both his and others that he's been on and what I can gather from online sources. So he was born in Toronto in 1973 to Egyptian parents who had immigrated to Canada. I don't think a lot of people know that he's Egyptian. I didn't actually until we started this. And it's a little bit of a personal bummer for me whenever you see a famous Middle Eastern type doctor that's not rad. He described his parents as highly educated, intellectual, not sure what they did for work.

26:22 From some interviews, I got the sense that It was white-collar work, but in his book, Outlive, he actually refers at one point to his father working in a limestone quarry. So I'm not sure. I'm assuming there's not a lot of white-collar jobs in a limestone quarry, but I could be wrong.

26:36 No, I mean, I guess the limestone could turn your collar white because it's limestone. So maybe, like, literally, yeah.

26:43 Yeah, that's right. That's what I was thinking. And I'm sure this is not surprising to anyone, but his family was very achievement-oriented. He described them as emotionally restrained and demanding in subtle, culturally specific ways. And then that last aspect is probably pretty similar to Dr. Oz and his backstory, and it's something I actually know a little bit about myself.

27:06 I could probably dedicate four whole episodes to this particular topic, but I'll just keep it short here, that being a physician of Middle Eastern descent myself, My family and my father in particular were also very clearly achievement-oriented, but it's also a large part of how and why I became a doctor and why I've had any success. That being said, one major difference between me and him, as I was reading about him and thinking about him, I don't think anyone would ever mistake my family for being emotionally restrained.

27:39 Like a lot of Persian households, we felt things out loud, you know, very loudly. And his family situation felt like a more high-pressure immigrant household with love being expressed only through achievements and not as much through affection. And I think that is fertile soil from which an optimization-obsessed man can grow. I'm assuming this is a recurring theme you've seen in some of the people you've covered. You did Dr. Oz, right? Yeah, yeah.

28:07 We've talked about Dr.

28:08 Oz.

28:08 We've talked about most of the Oprah industrial complex bastards.

28:13 Yeah.

28:13 That's great. So he described himself as a very anxious child who was obsessed with being perfect and was terrified of disappointing people. I think a lot of doctors can understand that and relate to that. Doctors are people pleasers. And sometimes this is helpful, sometimes it's not.

28:29 Well, not always, but yeah.

28:30 Dr.

28:30 House, of course.

28:32 Yeah, right. He was not a people pleaser.

28:33 Being an exception, no.

28:34 The most, actually, interestingly enough, this is a small aside. Remember I mentioned Dr. Faith Fitzgerald? She was this brilliant internal medicine doctor at UC Davis. And the rumor is that she was the basis for that character. Not because she was crotchety or mean. She was actually super sweet and nice. But just because she was one of these brilliant, like, diagnosticians.

28:55 She was so good at her job, yeah.

28:56 Yeah, right. So he excelled at school academically from a young age. Top of his class. I have no doubt about that. He also said that being smart was the only thing I had. And quote... If I was not exceptional, I was nothing, which I think is like the Middle Eastern equivalent of Ricky Bobby's, if you're not first, you're last.

29:18 Yeah, yeah. Being normal is the greatest shame there is. Sure, if that makes sense.

29:23 Yeah, a lot of pretty textbook gifted kid identity formation stuff happening here. And there's also some overlaps with Andrew Huberman and Dr. Oz in that they all have this sort of early athleticism and these signs of obsession with being physical and physical fitness. He reports that he was always pushing himself physically and was drawn to endurance sports that tested his limits. And this is a seed for things that come up later for him. Ironman races, swimming the Catalina Channel, the VO2 max focus he's big on.

29:53 He was also a boxer, which is, you know, actually surprises and surprise people, but... It's one of my favorite things to watch in terms of sports is boxing. My dad was not only a doctor, but he was a boxer when he was younger. So I kind of grew up watching it. And although the doctor in me does not love what boxing does to your brain, I do enjoy watching the boxing. And that is a dirty little secret.

30:17 that I've never shared on air before. So there you go, a little Behind the Bastards exclusive there. Who doesn't?

30:23 I mean, especially just from a medical standpoint, I love watching CTE as it happens, you know?

30:29 I mean, just in real time, yeah. I mean, I will watch it and just be like, God, I don't feel good about this, but I'll watch it nonetheless.

30:36 I love it, I love it.

30:38 Something that is not a very bastard-like trait about him is that he has been open about dealing with anxiety issues perfectionism, and fear of failure, and even anger issues. It's usually in the context of how he overcame it, but that's just stuff we have to be talking about. We have to be talking about moral injury in doctors.

30:56 We have to be talking about how doctors have psychological and psychiatric issues, just like anyone else, and how to get past that. So kudos for him for discussing it. He's actually even talked on air about going to a recovery center in Kentucky called Bridge to Recovery, not for alcohol, but for what sounds like anger management. So Actually, I feel like if he focused all his work on just like that, how his background created issues for him and how to address that, I think he'd be a pretty cool dude. But, you know, regardless, it seems like he didn't get unconditional love growing up. And whether that left an emotional wound that shaped his relationships or need for mastery or later why he fell prey to the gravitational

31:38 pull of powerful people like Jeffrey Epstein, I think is something to discuss. And I'll be upfront, I am not a psychologist, I am not a psychiatrist. I am a simple gastroenterologist, which is essentially an ass dentist. But I think it's important to touch on the psychological components of his drive. And actually, I think from listening to him talk, I think he would agree that that's an important thing to discuss as well in his credit. Yeah. In his book, he briefly mentions kind of obliquely experiencing trauma. But he never really explains it. I didn't see what that meant, what he was referring to. Did he just mean the upbringing that we've already discussed, or was there something else?

32:20 I couldn't find that. But he does great. He gets into Stanford Medical School after completing a Bachelor of Science in Mechanical Engineering and Applied Mathematics at Queens University. Not the typical humanities, biologic science-leaning approach a lot of medical students do. Nothing wrong with that. I mean, I studied biology and music in college, and it was always cool to me when someone came from a different mindset, like engineering or some systems-minded thinker. I think there should absolutely be room for that. I think it's cool. He loves math.

32:53 It actually makes me wonder if being a doctor didn't come with this sense of accomplishment or achievement that he could show his family. I wonder what he would have done. Probably could have been very useful to the world in that sense as well. And I'll say this. I know Stanford pretty well. I did rotations there. did research there as well. And they do great research. A lot of very important bench-to-bedside translational science happens there. And this is going to be a hot take and one that I will certainly regret. But since I do have some familiarity with what I speak, I will say this. It's not the best place to go for clinical training if you really want to take care of patients.

33:33 Strong stance, Andy Stanford, coming out here.

33:36 I know. And I'm going to Absolutely going to regret that and probably ask you to cut it. But no, you know what? We're going to do it. We're going with it. The best rotations you get when you're there are when their students and their residents get to do time at the Santa Clara Valley Medical Center, which is this terrific county hospital that Stanford works with and that I spent most of my training in. Fantastic place. And, you know, I'll give an excuse. I mean, I don't need an excuse to give them a shout out, but I'll take any time I can. Santa Clara Valley Medical Center is rad. Yeah.

34:06 If you get, go hurt yourself now and go there. You know what?

34:09 Ideally, ideally.

34:10 And shoot a nail gun into your hand and head right over.

34:13 Yeah.

34:13 You know?

34:13 Yeah. Yeah. No, great people, great doctors, really great mission there for the doctors there. So, and I know people that went to Stanford around this time, and it's clear that even then he was standing out. People knew he was going to be kind of something at an early age. He was athletic. He already had this shaved head look that we kind of see now. What was that? Okay.

34:37 Shaved head. Sure.

34:38 Right.

34:39 Yeah, yeah.

34:39 I mean, there's some guys that lean into that early. Easier.

34:43 He's got the Mr. Clean.

34:44 And it looks good on him.

34:48 It's a good look for some people.

34:49 He has the right head shape.

34:51 It won't work for me. I hate to say it. I will tell you that right now. It's going to be bad news. I'm going to Turkey when things get real bad here.

34:57 I am.

34:58 I can't. It's not going to be good for me if I don't. I'm going to need to do something when I get bald, because my head's not this well-shaped as his. So he graduates, and he matches at general surgery residency at Johns Hopkins. It sounds like he was going to go into a surgical oncology field after that.

35:19 But as we'll discuss, he didn't actually finish his surgical residency. A general surgery residency, and stop me any time if I'm going into the weeds here about this, but I think it's kind of important to note, they're usually about five years long. It can be longer based on if you do research, and if you do a fellowship or extra training on top of that, like surgical oncology, it can be even longer. He did some time at the NIH as well, which, you know, Johns Hopkins was great for getting funded research, at least then. I mean, who knows now with the country being the way it is, but it's still a very prestigious place, Johns Hopkins, great place to go. In year five, what ostensibly could have

35:57 been his last year, he quits residency. It's not clear if he was counting the extra year of surgical oncology and that, but he's towards the end of his training and he quits. Now, I think this is something to discuss. I have no evidence that he was forced out, but I do have to say it's always a little unusual for residency programs when someone leaves. In the rare cases I've seen it, there's usually a reason. There's usually someone's being forced to leave. In this case, I don't see that, but it is always something good to note. Even people who doubt whether or not they want to be practicing physicians and they hate residency still finish it to at least give them the option of being a doctor afterwards

36:41 if they want. I actually loved residency, but I would never, ever do it again. It is by far the most challenging time of a young doctor's life, particularly in the beginning. I mean, you don't sleep. Him and I were both around the same time, him before me, but we both experienced what life was like before the 80-hour work restriction.

37:02 There is a restriction now, so you don't work more than 80 hours, and that was considered soft.

37:08 Just a nice, mild 80 hours, yeah.

37:11 And we were... I was like the first class to really experience how, to see how different that was. So I was a lucky one. But anyways, so generally the last year of residency isn't necessarily easy, but it tends to be easier. You have more specialty rotations. You're usually not on call as much. But it is interesting because we've seen this now a couple times in people that are related to the manosphere or related to the current administration.

37:40 For example, Casey Means, I don't know if you're familiar with her. She was President Trump's, Donald Trump's earlier surgeon. Right.

37:48 Yes.

37:49 Sophie doesn't like it.

37:50 We talked about this.

37:51 Yeah.

37:51 Yes. Yes.

37:53 She was like very like wellness guru-y type content and had very questionable opinions on scientifically proven things.

38:03 You're exactly right. She's really a co-architect of that Maha messaging that's pushed and still being pushed. And she dropped out of her OHSU head and neck surgery residency six months before completing her five-year program. Now, as opposed to with Peter, there are some different accounts. No one's ever...

38:24 I haven't heard anything from anyone, even people who knew him, that there was a reason he left other than what he says. But with her... Her account is, you know, basically she got sick of the stick care and etc. But her colleagues have a slightly different account of why she left. But I have no reason to doubt him.

38:44 To be honest, people should be able to quit, leave what's not right for them. Actually, more doctors probably should do it. I know too many doctors that are unhappy and stuck in that sunken cost fallacy where they feel like they can't quit or leave. You could actually even question why Abdul Saeed didn't even go to residency in the first place. I think in his case, it makes sense.

39:05 He never bills himself as a clinical doctor. He doesn't seem to have any interest in providing direct patient care. He's more interested in the broader strokes of public health. Now, for Peter, when he was asked about why he left residency without finishing or becoming a board-certified MD, he reports that he left on his own accord because he became disillusioned with the medical system, what he called Medicine 2.0, which the fact that he's already referring... Okay.

39:35 Yeah.

39:35 2.0, huh? Yeah. Okay. You're getting a vibe already that it's being referred to as.

39:41 Excited for Medicine 2. Medicine 1 did too much, like, you know, vaccines, stopping the spread of horrible plagues... making it so that you don't stub your toe and then die of an infection. I'm excited to see what Medicine 2.0 brings us. Yeah, and it just really has— 70-hour erections? The sky's the limit.

39:59 Well, he calls what we're experiencing now Medicine 2.0. What he wants to offer you is Medicine 3.0.

40:06 Was medicine 1.0 like arsenic and telling you to go to the sea when you're sick?

40:11 I don't know. But he calls it medicine 2.0, and it really just strikes me as odd because it has this real sort of like Silicon Valley bro vibe to it just off the bat, you know, doing that. And he explains that he did this because he had essentially a crisis of faith. Again, he sells this frustration as the symptom, saying that it's built to react to disease instead of preventing it. And whenever I hear that, it has a real, like, pick-me energy. I'm a different kind of doctor, you know? I'm not like the other doctors, you know? I'm a cool doctor.

40:47 Yeah, yeah, yeah.

40:49 That's a bit of a red flag. Keep that in mind. And when this topic comes up, he explains why he left by telling a story about his last year in residency. when he was treating a patient in the ICU with an antibiotic called gentamicin. Now, gentamicin is a type of antibiotic called an immunoglycoside. This is gonna be on the test.

41:10 And it's used for bad infections sometimes, and it gives you really powerful activity against gram-negative bacteria. But here's the issue with it. There is a narrow therapeutic window that you kind of have to hit when you use it. The effective dose is actually pretty close to the toxic dose. Ah, okay.

41:30 Yeah, I can see how that could be a problem.

41:31 You can see why this is a problem. And small errors can cause real harm, permanent harm to either your kidneys or giving you what's called ototoxicity. You can lose your hearing from it. It's terrible. It's a board's question when you're young. And it's one thing you always keep in mind. You rarely see it. I don't think I've ever seen it. But there's systems in place to help prevent this from ever happening. It is something that has to be monitored carefully because if you give too much, you can cause permanent damage. But if you give too little, well, then you're not stopping this bacteria that may be trying actively to kill you. So it is an interesting antibiotic in that sense. And it's tightly controlled with weight-based dosing

42:13 And checking kidney functions to make sure you're getting rid of it.

42:15 Okay.

42:16 And checking peak and trough levels. So you check the blood when it's at its highest point. You check the blood when it's at its lowest point. So you're getting a sense of where you need to give the dosing. It's not the kind of drug that a resident should be casually fucking around with. Right. There's generally protocols for its use.

42:38 Really, it's a measure-twice-cut-once kind of drug. Exactly.

42:42 Or they die. And this is why pharmacists are so amazing. Because the amount of deaths pharmacists have you know, prevented by double checking doctor's orders, mine included, you know, cannot be underplayed. It is, it is huge. And there, that's why at most hospitals and Johns Hopkins, Johns, it's not, by the way, it's Johns Hopkins. It's not John. It's like Ruth, Ruth's Chris's steakhouse. It's a, I never understood that, but at Johns Hopkins, it's attending approved and pharmacy driven.

43:19 It's like the pharmacists are really the ones that, that you rely on for these sorts of things. So while he's caring for this patient, receiving the antibiotics, he starts considering there has to be a better way to optimize the timing of this drug. He wanted to disrupt the way it's delivered. He didn't say those words disrupt, I don't think, but that is how I feel. I feel like he said it in that Silicon Valley sense of the word to disrupt. He's a disruptor. So he stays up.

43:49 He stays up late while he's on call. He presumably studies up on the drug's half-life and other factors, and he creates an Excel spreadsheet that would change the timing to more accurately predict when the drug would hit trough levels, and that's the best time to give it. It's not entirely clear to me if this was a problem that was in need of solving. I mean, the current method may not be that efficient. There's a lot of moving parts to it. It's hard to know. Whenever he brings this up on podcast, it's usually with like some, you know, dude bro who doesn't, like, have follow-up medical questions for him, but.

44:24 Yeah, yeah, yeah.

44:26 So it's hard to know. I mean, I would actually, if I had a chance to talk to him, that's actually probably the first thing we'd start with is talking about this story. And he apparently ran it by an infectious disease fellow, and they recommended against doing it, but he does it anyways, right? He enacts this new dosing protocol without his attending's approval, or without any communication with the pharmacy. And when he tells his attending this the next morning, when everyone's doing rounding, and they're all standing around, you stand around a group, do you guys know what rounding is? Do you know what attending is? Stop me if I'm using medical jargon.

45:01 Yeah, like doing your rounds, you mean?

45:03 That's right.

45:04 Like in-house. Scrubs actually shows that a lot more. Yeah, yeah, yeah.

45:11 But for the audience... If you haven't seen House, you haven't seen Grey's Anatomy, it's when a bunch of doctors discuss a case and go around and discuss all the cases they're assigned to.

45:22 You lead the doctors who are doing their residency around, and a more experienced doctor is talking them through as they look at different patients and stuff to learn.

45:33 That's exactly right. Every time, though, just to be clear, listener, Robert knows what he's doing. Every time he says, yeah, it's like house, he knows that a little part of my soul dies, and that's why he does it.

45:43 No, I mean, my last direct experience with rounds was when my dad was dying. His oncologist took a bunch of students around, and they were doing their rounds, and I overheard them talking about my dad's case, where he was just like, yeah, this one really is a very surprising case. We didn't expect it to go. It was not a great thing to hear after his... because it didn't, like, the case did not proceed the way he had expected.

46:11 It was not, like, expected to be a very serious situation. He wound up dying. So I got to overhear him, like, talking to students about that. But yeah, I know what rounds are.

46:20 Yeah, you know, it is a, it's never fun to be the interesting case.

46:25 No.

46:25 Or the family of the interesting.

46:26 No, you really don't want to be interesting. No. Yeah.

46:29 God, now I feel like an asshole for making fun of you.

46:31 No, I mean, I didn't blame him. Like, he's an oncologist, right? Yeah. That's the job. Okay.

46:36 Okay. So he enacts this new dosing protocol, and he's telling the team about it. And the attending is the head of the team, the person that's out of training. They kind of run the team. They're at the top of the ladder. They spend the least time there. You know, the interns, residents, they're the ones that are there all the time. And the attendant kind of comes in for a period of time, but not as long. And he thinks he's going to get lauded for being a very special boy here. Instead, he gets chewed out. his attending considers it a serious breach of safety and hierarchy. And I have to tell you, things, I think, have overall gotten better, but there are few things worse than having attending totally dress you down in rounds around other people.

47:23 And in some places, particularly, I think, Johns Hopkins, that's the kind of place where that sort of thing is going to happen. Less so here on the West Coast, where we are. People tend to be more chill, but... Man, there are attendings that kind of get a little kick out of seeing their intern, their medical student, their resident cry. Like, it is terrible. So I actually, even though I agree with the attending, I do feel for him in this case.

47:54 I don't know what happened to the patient. There's never any discussion of that, if it hurt the patient or if it didn't. I'm assuming it didn't. I'm hoping, but I don't know. I assume the attending was worried that changing the testing and dosing could have either invalidated the levels or caused the next level to be uninterpretable, or maybe even wind up delaying the patient's care even more.

48:16 So I'm not sure why the attending was so mad. I never found anything from their perspective. But at the end of the day, it's their, it's totally their responsibility. It comes down to them. So if anything happens to that patient, I can understand why they'd be so pissed. Right. Now, That response pisses off Atiyah, who feels his brilliance is being stifled. And he feels that this is an example of medicine punishing out-of-the-box thinkers. But before I tell you more about what happens next, I want to tell you that coming up soon, you're going to hear some in-the-box thinkers.

48:58 That's right.

48:58 Maybe. That's right. Maybe. The box of money that you need to give to them.

49:03 Or I was thinking Blue Apron, if they're still sponsors. If not, screw them.

49:06 Blue Apron does send boxes. I think they may have gone out of business because of all of the deaths, but I'm not sure. You know?

49:13 No, no.

49:13 We don't joke about the island anymore. We just joke about the deaths.

49:16 Ah, that's funnier anyway. Because they didn't kill a lot of people. Yeah. All right. Well, let's... take a little break. I'm taking over the podcast now, folks. I'm calling the ad breaks. We'll be right back.

49:26 Yeah. And we're back. Kava, you really should explore at some point accidentally creating a conspiracy theory about a company that people really do believe and then you have to backtrack it because you didn't realize that it was going to actually be taken seriously it's always.

49:48 A good time that is um is that is that real that happened people actually believe you're very clear obvious jokes.

49:55 For sure for sure that's why we stopped making the blue acorn jokes yeah people someone was like is there really an island Yeah. More than one person took it seriously.

50:04 I will say this after my first or second appearance on this podcast many years ago, um, you, you did do an ad break and you bleeped out the name of the, the, the company. And I got a number of messages from people begging for me to tell them who it was, who it was. And I was like, no, I signed an NDA. I can't say that. Um, But yeah, I guess I'm not surprised that people took it seriously.

50:34 But speaking of taking things seriously, last we left off, Peter Attia felt his brilliance was being stifled, and he took that seriously, and he was very upset. I listened to a couple of podcast interviews he did about this, and this is something he said. It struck me as anti-intellectual. Maybe my model wasn't perfect. We'll never know. But the fact that nobody even cared to see if there was a better way to do this drove me batshit crazy. Now, here's the thing. Let me say something here. Let me say something here. Let's take a little quick aside here.

51:10 I think this is very emblematic of my broader thoughts on Peter Ortia. Maybe he had a good idea. And we should always be trying to push science forward and deliver things better, deliver better care. But you know when he says, we'll never know because nobody cared to see if there's a better way to do it. There is a better way to do it. You can make a study out of it. Why not do that? He's right.

51:35 We'll never know if it works because he didn't study it. He had the idea and he didn't study it. This could have very easily been done at a place like Johns Hopkins. And you could do this and prove that it works. If it's not unethical, an IRB will review it as such and you can prove it.

51:53 Yeah.

51:54 I just want to add that I'm really enjoying the way that you pronounce Johns Hopkins every time. Yeah.

52:02 Johns Hopkins. I really have to really stress the plurality of Johns. There's more than one John involved in the Hopkins of this situation, and I don't understand it. So this will probably bum out the doctors on my little group chat, you know, my little doctor group chat that I run some of this stuff by. But as I'm researching this guy for this episode, and I use the term research lightly, Actually, there's a lot of things I like about him. If he was more inherently a physician and less a business-y sort of like accountant engineer guy, I think he could have been a great doctor. And like Peter. Pete, I don't know if you're listening.

52:47 Yeah.

52:48 My Middle Eastern brother. I don't think it's too late for you to have an amazing redemption arc. I think it's still possible. Yeah. But that mentality has to change. I mean, be just a doctor. Do the doctor thing, says the medical podcaster.

53:07 Says the doctor. Yeah, I mean, like, yeah. You don't have to, yeah. You don't have to make bedfellows with the worst people in the world to do medicine.

53:18 We'll get to that in the next episode. So basically what he was doing here is an unauthorized experiment. And I know this sounds like a... sort of small potatoes issue to a lot of the Behind the Bastards listeners. It's not mass murder. And again, he's not as bad as RFK Jr., who I really, really, really don't like.

53:38 You probably know that. I don't enjoy him very much. I don't like the man. But this laissez-faire approach to medicine and science is just not how science works. Science is supposed to be a little boring. Yep. Honestly, 10 years ago, I probably wouldn't be bothered by this at all. But what has happened over that time is that a lot of the little stuff in medicine that we just let slide has added up. And it's led us to where we are now in this country. 20 years ago, if I heard about Gwyneth Paltrow putting a jade egg, you know, up her hoo-ha, or somebody using essential oils to cure their diabetes— It's the medical term. Sure. It's the medical term. We would laugh and move on. That would be it. But— All these things add up over time.

54:25 The more nonsense we let go by without saying anything because it's easier to ignore it, the more coffee enemas we let slide now because we don't want to have to explain to you that you don't need to detox outside of your liver and kidneys and that it's bad for you. The more of this we let go, the easier it is to eventually have confusion around important public health care issues, like vaccines, for example. It creates this murkiness around science where people can be like, yeah, there's lots of different ways to interpret science. Like, it's religion. And, like, that's not how science works.

55:03 Yeah, you're reading tea leaves as opposed to just trying to figure out, like, what works and doesn't empirically.

55:09 Yeah.

55:09 Because now we have, like, this thing where people are like, hey, you have your interpretation of science, I have mine. And sure, to some degree, that is true. People can have different interpretations of the study. But there are basic tenets of science that need to be met before you can do that. Anyways, in listening to Atiyah talk about this particular experience in his podcast, sometimes he acknowledges, yeah, it was kind of a bit reckless what I did. In his book, he kind of comes across as much more like contrite, and he seems to understand that maybe he was just trying to prove himself. But I actually feel like in the more truthful moments when he's talking about this on the Manosphere podcast, He interprets this as less of being a

55:55 misguided intern to being more of a misunderstood iconoclast. Okay. Yeah. He uses the story to justify leaving surgery and setting him up as this maverick thinker ready to tell you the one trick your doctors don't want you to know. And there's a telling quote that I heard him talk about in an interview about why he really left. Okay.

56:21 He didn't feel residency was a meritocracy. So on an interview with a guy named Jocko, are you familiar with Jocko?

56:29 Oh, Jocko Willick. Yes, yes. The former SEAL team guy who was the officer in charge of the American snipers unit. We talked about them in our SEAL episodes because their unit killed a lot of civilians or was alleged by another Navy SEAL of having killed a lot of civilians.

56:45 That checks out. That checks out. I have to tell you, in preparation for this episode, I exposed myself to some real Manus Fury stuff.

56:51 Yeah, yeah, yeah.

56:53 And that felt real Manus Fury up in there. Yes, I felt like discipline, self-improvement type stuff. Yeah. So he's having this discussion with Jacko. And in regards to residency, he said, quote, we all get paid the same. We all take the same number of years to get through. First of all, If I said that exact quote, I would mean it in the 100% different way he does.

57:19 But he said, okay, we all get paid the same. We all take the same number of years to get through. It seems crazy to me. There's no other system where that would be the case. Like, I couldn't think of another system where they just had this complete, total lack of meritocracy. And I'm like, bro, what are you talking about?

57:36 That is the point of residency. We all have to do the work. You all have to do it. We're all in this shit together.

57:44 That's the whole thing, right? Is that, like, everybody has this same basic kind of, like, not the same, but, like, yeah, there's a standardized procedure for getting prepared to go be an independent doctor, right?

57:55 And that's why, like, Even if you're on a flight and there's nobody around to help you, if there's a psychiatrist there, you're still better off with the psychiatrist helping you through an emergency than somebody who has no experience. Because they've been through a lot of this shit. You get a lot of training during this time. And it's not about the prestige or the paycheck. That can come later.

58:17 And I'm trying to think of an analogy here. It's a bit hard to do, but it'd be like, say somebody... Somebody shows up to boot camp, and they're already able to do like 50 pull-ups. And they're expecting because of that they can like skip rifle training. Right, right.

58:35 The pull-ups will be enough. Yeah.

58:37 Yeah, because they're ahead of the curve. It's like, great, congratulations on the pull-up, but you still don't know how to be like a Marine, dude.

58:43 Yeah.

58:45 Being smart and hardworking doesn't mean you know how to practice medicine.

58:49 No, no. Being able to answer all of the questions on a test doesn't mean that you know how to practice medicine because there's like a lot more. It's just like you could have someone who knows intellectually and can explain how to deal with like a gunshot wound or like a fucking horrible broken leg with the bones protruding from the skin. But then if they actually sit down in front of a person, they have like a panic attack because they can't handle blood that person may have all of the knowledge but they still can't be a doctor because you can't be scared of blood and be a doctor.

59:18 That's it's exactly it's exactly right it takes actually i think years of being an actual attendee to get past, to get to where you need to be. You know, even after years, I think you still should have some imposter syndrome. Like, I don't think the imposter syndrome should go away anytime soon. I think that's just something that we always need to be humble about. But something, I mean, speaking of humble, there is a little bit of a prestige of a sort. If you really wanted to, if you're really good at You do get asked to be a chief resident, like I was. That is a little bit of prestige. Stop, you were chief resident?

59:58 Humblebrag.

59:59 Humblebrag. I was chief resident. That is correct.

1:00:03 Oh, my God, honey. I did not know you were that good.

1:00:07 I didn't realize we had a chief resident on the pod.

1:00:09 No, no, no.

1:00:10 If I'm being honest, they're like, hey, we need some schmuck to stick around one year. And not take a paying job and just do some teaching. So it's, you know, they were much smarter people. And you were like, I volunteer as tribute.

1:00:26 Yeah.

1:00:28 They had a sucker in me. I was a target.

1:00:29 I've always thought of you as the Jennifer Lawrence of medicine. Yeah.

1:00:32 That's always been what I've called myself. Cave from the block.

1:00:35 Yeah.

1:00:36 Absolutely.

1:00:37 So.

1:00:38 Anyways, after this.

1:00:39 I think you're thinking of a different Jennifer, but okay.

1:00:41 Yeah, I don't know. I didn't catch the reference, but I just wanted Jennifer Lopez.

1:00:44 Let's talk about Jennifer Lawrence from Hunger Games.

1:00:46 I explained the whole thing.

1:00:47 Yes, yes, yes. That's all good. That's all good.

1:00:50 Yeah, yeah. Yeah, I didn't understand the Jennifer Lopez of it at all, but I thought it was still good. So he makes this decision. He's going to leave residency. And after a chance encounter with a radiologist who worked previously at a consultant firm named McKinsey and Company in Palo Alto, that name might be familiar to some of you, He leaves medical training to try his hand at consulting.

1:01:13 And I think I'll probably pick up there for the second part and the conclusion of this topic, I guess, when we get into... some more of the real bastardy parts of this. But let's maybe end there for now. Does that sound like a good plan? It's your podcast. I don't want to be running your podcast. You tell me what you want to do.

1:01:34 I appreciate it. Thank you for, again, doing the episodes this week. That's going to be part one. We'll be back on Thursday for part two. Until then, Kavit, you want to tell the people where they can find former chief resident Dr. Kavahota?

1:01:47 That is how I think I should be referred to. At all times. Okay. So thank you again very much for letting me come on and do this. It's fun. It's a lot of this conversation I think is really important. I'm really glad that we get to have it. There's a lot that's going to go into this conversation, particularly the second part that says a lot about our state of medicine, where we're heading, why I find it troubling.

1:02:11 And I appreciate you guys having me. So thank you so much. Okay. So some of your listeners may already know that they can find me on my podcast, The House of Pod. It's a relatively fun, informal look at medicine and science. And we take a look at wellness and health grifters and talk about RFK Jr., all the terrible things he's doing to usher in this golden age of diarrhea that we are in. And you can find that anywhere you look for podcasts. And both of these fine people I'm talking to today have been on that podcast in the past, so you'll hear people you'll know and love. But starting later this month, there's also something very exciting for me that I'm very excited about and I want to tell you all about. It is my

1:02:53 new podcast about Persian history. It's going to be a fun look at Persian contributions to the world of art, medicine, science, philosophy, taking a look at a lot of things that we've sort of been either written out of or at least minimized in, in terms of telling the history of it. It's going to be with my co-host, my friend Shaheen Daivari.

1:03:14 If you guys watch Survivor Season 48, he was on that. I'm really enjoying preparing this and recording these episodes. I think it's going to be a ton of fun for you all as well, even if you're not Persian. It's just if you like anything about history and fun storytelling, we're going to be doing that. It is called Persian of Interest. So keep your eye out for that, please.

1:03:35 I like that.

1:03:36 Awesome.

1:03:36 Thank you. Thank you. I feel pretty proud about that one.

1:03:39 Check it out, everybody. Check out Persian of Interest and check out part two of this on Thursday.

1:03:45 Bye, everybody.

1:03:46 Bye. Behind the Bastards is a production of Cool Zone Media. For more from Cool Zone Media, visit our website, coolzonemedia.com. Or check us out on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. Full video episodes of Behind the Bastards are now streaming on Netflix, dropping every Tuesday and Thursday. Hit Remind Me on Netflix so you don't miss an episode. For clips and our older episode catalog, continue to subscribe to our YouTube channel, youtube.com slash at Behind the Bastards. We love about 40% of you, statistically speaking.