Inside the Wellness Boom: Separating Scams From Science

What about my fish oil? Yeah, your fish oil is good. Except you get fish breath with fish oil. You burp a lot. You do. Hi everyone from New York Magazine and the Box Media Podcast Network. This is on with Kara Swisher and I'm Kara Swisher. As you might know, my new CNN series debuted this past weekend. It's called Kara Swisher Wants to Live Forever. It's a big look at longevity, anti-aging, and the huge industries popping up around all these topics. I wanted to cut through all the scams and hype and talk about the real science around how to live longer, healthier lives. I do not want to live forever, by the way. Longevity is also the subject of today's show and I've got three experts with me to talk about it. Katie Couric is a journalist. She's also been a long time advocate for people to get cancer screenings after her first husband died of colon cancer and she was diagnosed with breast cancer. Amy Laraca is an award-winning journalist and author of the book How to Be Well, Navigating Our Self-Care Epidemic, One Dubious Cure at a Time. She is in the series and so is my brother, Dr. Jeffrey Swisher. He's the chairman of the Department of Anesthesiology at the California Pacific Medical Center in San Francisco. And he recently caught, before it happened, the possibility of a so-called widowmaker heart attack. His wife has also been diagnosed with stage 3 colon cancer and is actually doing really well. It's a really interesting time to talk to these people because all of them have dealt with health in a very different way. Katie obviously was groundbreaking in bringing really good information to people about colon cancer in a time where people didn't know about it. And what Katie did was saved a lot of people's lives by being a great reporter with facts and science on her side. Amy just blows up in the series, as you'll see, talking about how wellness went from a thing that could make you feel better to a luxury item and how dangerous that could be. And of course, Jeff is my brother and he's really smart about these issues. And I will tell you, he's the first person that told me that Elizabeth Holmes was full of shit when she was peddling that blood machine that never really worked. All right, let's get into my conversation with Katie, Amy and Jeff. Stick around. Support for the show comes from Backmarket. You don't always need the newest tech no matter what your social media algorithm says. Sometimes, newer doesn't exactly mean better. Backmarket is the world's leading premium refurbished tech marketplace. Backmarket offers a range of high quality tech inspected and refurbished by professionals. It's all they do. They have phones, computers, gaming consoles, vacuum cleaners and even iPods. Backmarket is also an emission to reduce the environmental toll that fast tech has on our planet, as refurbished tech is proven to use less raw materials, leave behind less waste, and create fewer carbon emissions than new, making their refurbished tech not only more affordable but more sustainable as well. Shop now at Backmarket.com. Your perspective should be two. The Economist cuts through the noise with the stories that truly shape your world. How can you believe that a new regime won't crush you just like the previous one? Online scams are stranger than they've ever been. When the world's turned upside down, know which way is up. Read, watch, or listen to The Economist. We're here, Shay Rout. Together we talk about the NCAA semifinals, the crazy activity in the transfer portal, and of course the final matchup for the NCAA championship. Check out the latest episode of A Touch More wherever you get your podcasts and on YouTube. Katie, Amy, and Jeffrey, thank you for coming on on. I appreciate it. Thanks for having us. Glad to be here, Kara. Thank you. Good to be here, Kara. And this is going to be fun. All right, I'm excited to get the three of you together in conversation because I find that sometimes these kind of unexpected groupings of people lead to some of the most interesting conversations. And each of you, in your own way, have talked and reported on and discussed, and Jeff practices healthcare. And so let's take a minute, and each of you explain your personal and professional connections to health science and wellness. Let's start with Katie, then Amy, then Jeff. Okay, well, I think many people remember, my husband, Jay, was diagnosed with stage four colon cancer in 1997 and died nine months later. He was just 42 years old when he passed away, and our daughters were six and two. It was really my first experience losing someone close to me and my first experience with cancer in a real way. And so I think because of my position at the time I was co-anchor of the Today Show, I used that as an opportunity to educate the public about colorectal cancer, which is now the number one cancer killer of people under the age of 50, and we can talk in a little bit, care about early-on-set cancers, which are on the rise. But subsequently, I lost my sister Emily to pancreatic cancer just a couple years later when she was 54 and a rising star in the Democratic Party in Virginia. Anyway, as a result of those two losses, I became a fierce advocate for colon cancer screening and cancer research in general. I am one of the co-founders of Stand Up to Cancer, and really advocating for early detection screening and more research dollars committed to finding better treatments and one day, hopefully, a cure has really been my most important life's work. Yeah, and you have also been doing that. You did a colonoscopy on camera. You also were diagnosed with breast cancer and talked about it a lot, which raised the profile in many ways. I hope one of the things that I've been able to accomplish is to destigmatize these diseases. I think even though Ramil Reagan had polyps, and I guess, did he have early-stage colon cancer? I can't remember. There's still this shame and discomfort about talking about that part of our bodies. And like every part of our body, as Amy will tell you, we have to keep that healthy. And I later was diagnosed with early-stage breast cancer just a few years ago. And so I use that as an opportunity to educate women about dense breast and the fact that mammograms alone can't necessarily detect breast cancer, especially in the 42% of women over the age of 40 who have dense breast. So I've really tried to use my personal experiences, Kara, dealing with these various forms of cancer to first educate myself and then share what I've learned with the public at large. And it's been really gratifying work for me. Yeah, it was very groundbreaking when you did that colonoscopy. I think it's shocking to people too, and in a good way. I told them I draw the line at a pap smear. Okay, well, today you do. All right, Amy. So my background is, as a journalist, I was a fashion journalist for many years at New York Magazine, and I switched over when I started realizing that this thing called wellness was really eclipsing fashion in the zeitgeist. And I kept hearing about it, and all the fashion people were talking about it, and they were switching over their fashion careers to juicing or cleansing. And I noticed that wellness and our health was kind of occupying the space that luxury handbags used to, and supplements were the new accessories. And I became really interested in that. And I originally conceived of the book I wound up writing that came out last year called How to Be Well, as a kind of light-hearted thing. And then halfway through my reporting, COVID happened, and it made me realize this wasn't just a light-hearted thing. The way we treat health in this country is really serious, and treating health like a luxury product is actually quite dangerous. So I ended up spending about five years writing and researching a book all about what I call the wellness epidemic in America, which is both the light stuff about boutique fitness classes and colonics and face creams and supplements, and also the kind of deeper stuff about what happens to a culture that does treat healthcare and market healthcare like a luxury good. Right, and you also were looking into a lot of false stuff. Oh my God, the false stuff. We better get to that. We'll get to that. Jeff, you go ahead. Well, as you mentioned, I'm a physician. I have been a doctor now for 35 years. I'm an anesthesiologist, and so a lot of my practice more and more because insurance pays for it is doing anesthesia for colonoscopies and upper endoscopies. So I certainly see tremendous amount of those kind of cases, and I do also, my specialty is liver transplantation and just general surgery as well. So I'm seeing a lot of younger and younger patients with cancer, not just colon cancer, but colon cancer that's metastasized to the liver and to other areas where that is now a problem. Katie, I'm so sorry about your husband. Oh, thanks, Jeff. It's just tragic. I don't know if you know that Kara and I lost our dad when he was 34 years old. He had brain aneurysm. I remember Kara telling me that, and my goodness, so young. It is. It's so, but, you know, Kara asked how we got involved in health issues. You know, we're from a health family because, you know, we've had other, my aunt was a physician as well, and I personally have had issues with, I have muscular dystrophy as well, and I've been dealing with that since age 40, and very recently, unfortunately, in the last year, my wife was diagnosed with stage three colon cancer. Oh my gosh, I'm so sorry. Yeah, so, and she's doing well, but I mean, certainly, I suppose over the course of this we can talk about some of her experiences. I would love to hear about them. And I recently, in the last couple of weeks, I've had a little surprise thing happen to me. I'm 65 years old, you know, Medicare age, thank you. And I recently discovered that I have a fairly significant coronary artery disease, and 10 days ago I had a stent put into my heart. Oh my goodness. I know, so it's been. Wow, God, you look great. Thank you. That was so good. That's so interesting that you just found that out at this point at 65. I'm surprised there weren't any indications previously. Well, that's where we can talk about issues, about screening, et cetera. I mean, this is something that I'm sure this conversation we can discuss about screening and about the values of predictive testing and various things like that. Yeah, because a lot of his signs weren't showing that at all. Exactly, and it's very true with colon cancer. Many people, like my wife, for instance, who had a normal colonoscopy 10 years ago out of the blue developed colon cancer just six months before her next colonoscopy. But every 10 years I would say that's a little long to wait, Jeff. Of course it is. Unfortunately, that's what the guidelines are. Anyway, we'll go into that. Yeah. So let's talk about what's happened, because one of the things that's been significant is there's been so much misinformation around what it means to live a healthy life, because as the explosion of information has happened, the explosion of misinformation has happened, really rather significantly. Katie, as a journalist, you see firsthand how people have lost faith with institutions and experts. Now we have a vaccine skeptic, I would say more than that, running HHS. Unfortunately, again, people accurate information isn't enough. People believe what they want to believe. So talk about why you think healthcare has been particularly vulnerable to misinformation, because one of the things you set out to do was give information and do good reporting on the topic. It is so upsetting. I read a book a while ago called The Death of Expertise, and I guess I don't know really why it's happened, but this idea that experts shouldn't be trusted is so counterintuitive and antithetical to everything I believe. And I mean, I think part of it is what Amy has investigated, which is this plethora of wellness influencers, right, who purport to have a background that would allow them to give medical advice, and they don't know shit from Shinola, basically, while we're on the subject of colonoscopies. And there's just this widespread effort to basically tell people things that have nothing to do with expertise. And I mean, there's a whole psychological thing going on with misinformation. I was talking to David Axelrod earlier today. We're talking, because we're going to be doing a panel on truth and facts, and Andrew Ross Sorkin was there too, and we're all saying some people, they don't, you know how Jack Nicholson said, you can't handle the truth. A lot of people just don't want to know the truth. You know, it's, I think kind of knowledge has been so inextricably linked to identity now, or a view of the world to who you are and what team you're on, that people, it seems to me, don't want to know factual information. And I think they want shortcuts. They don't necessarily want hard truths about what they need to do. I don't know. I'd love to hear what everyone else thinks and why this has happened. But plus you have leaders. You have people in positions of authority, you know, to basically giving factually incorrect medical information. So I can understand why the average person is confused, right? Yeah. So Jeffrey, why do you think people are more inclined to trust a random person online over a doctor? Was it COVID that was pushing over them? Was it social media? Yeah. I think the combination of social media and COVID. COVID was a watershed moment for this country. And it's the first time we actually had a pandemic while we had social media. And of course, everybody becomes an armchair expert. And, you know, in retrospect, some of the ways that things were rolled out could have been done better. But let's just, you know, listen, Dr. Fauci is a national hero. And the fact that he was vilified by the Trump administration was literally one of the most horrific things that happened during that administration. And I think the combination of everybody's got a platform, everybody has a voice. And not all opinions are valid. You know, like it's the old adage that, you know, you're welcome to your opinion, but you're not welcome to your own facts. Well, people felt like their facts were more valid than everything else. And so we have this problem now that, you know, doctors aren't trusted, priests aren't trusted, you know, et cetera. What has the medical profession done that has created that? Is it just that people have new facts that they can use their disposal or is there something that happened? Well, I think there's a few things that are super problematic within the medical profession that have happened. One is the increase in sort of for-profit endeavors inside of the medical community. Right? So if you have a doctor who's pushing their own for-profit supplement line, for example, we all know that supplements, they're not great, right? No. They're not going to improve your health. Very few. Well, that's not true. Some are good. I mean, like I'm... All right, let her finish and then I want to hear from you. If you have a diagnosed deficiency in vitamin D, if you have a diagnosed iron deficiency, you need to supplement. But really, the first line of defense should be a healthy diet. You start with, say, dermatologists. I think what you're seeing is because of the merger of the beauty and the health industries in what you call wellness, you get into a position where you don't know, you're like, am I at the doctor? I'm at a spa. Where am I? What's happening? Like, is this medicine? Is this something else? So the kind of world in which healthcare and spa world are merging creates a kind of for-profit industry in which beauty and medicine merge. I mean, Gwyneth Paltrow's Goop was sort of the first avatar. Yeah. And so you start getting into a world in which you get the kind of hybrid influencer person. You also get into a world in which a lot of people don't have relationships with their doctors, right? So because of the way the healthcare system is set up, a lot of people go to the emergency room when they're sick. They don't have a GP who they have a relationship with. So if you're feeling sick, you don't call, you don't have your doctor who you're able to reach easily, right? So, I mean, the idea that Dr. Oz is so-called America's doctor is more true than, I mean, you're getting a lot of your health information on social media, on television, because you don't have that personal relationship with a doctor who you trust, who's someone you know, you have known for years, who's familiar with your health history. Right. So you don't have that relationship. So you're having these online. So you don't have the relationship. So you don't have anyone that you trust. So you're turning to these other sources. These parasocial relationships. That's right. Katie, what were you going to add? Well, I mean, I don't think you can say all supplements are bad, Amy. I think that I think that's accurate. I think that, yes, food should be the first line of recourse, but there are, I think there are supplements that help. And there was a Cosmos study about multivitamins that showed that it actually had a very positive impact on cognitive decline or slowing cognitive decline. So I was just interviewing somebody about longevity actually a couple of days ago and she mentioned it. And I started taking a multivitamin. I was 69 years old and I thought, it's not going to hurt me. I'll just pee out what I don't absorb. Right. Anyway, so I'm not a big supplement person, but I don't like blanket statements either. That's totally fair. I think the supplement market has gone berserk. Yeah. And I think people spend a lot of money on things without great deliverable outcomes. So Dr. Swisher, why don't you jump in here? Well, I mean, I, you know, I'll take a middle road. And I think supplements have shown some benefit like creatin has some benefit. Vitamins have some benefit if for people who are vitamin fission, if you have a balanced diet, you're getting mostly more than you need for vitamins and minerals. And as Katie says, you tend to just pee out stuff. Now the fat soluble vitamins like vitamin D, vitamin E, et cetera, can be problematic if you have an excess. There is something called hypervitaminosis D where that's a problem. It's very rare. I mean, if you want to spend your money on worthless things, go for it. In the manasphere, you know, you just did that really excellent thing with Louis Theroux and about the whole manasphere and the promotion. But the one thing is when you say doctors, I mean, that's a very tiny percentage of physicians. Most of us are literally clinicians. We care about our patients. We want to do the right thing. And you're talking about social media. I'm a doctor. I'm a pro doctor. We're looking at a 0.1% of physicians. Absolutely. The disbelief of experts, I find terrifying. I find the anti-vax movement terrifying. I find the fact that we've gotten ourselves painted in this position where so few Americans have personal relationships with their doctors that they consider Dr. Oz, the doctor they know best. So upsetting. Or Gwyneth Paltrow, they get their medical information from Goop. We'll be back in a minute. 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I don't taste sometimes some of these protein bars taste like protein bars in a way that feels chemical. These are actually quite tasty. I really always like the chocolate chip ones and I also tried the mixes quite good. And right now IQ Bar is offering our special podcast listeners 20% off all IQ Bar products including the ultimate sampler pack, plus free shipping. To get 20% off, text Cara to 64,000. Text Cara, K-A-R-A to 64,000. That's Cara to 64,000. Message and data rates apply. See terms and details. So Katie, you know, a lot of this started with television and with Oprah and things like that. And you obviously deliver good information about colon cancer, right? Really, it's solidly reported information. When you watch that develop, what did that seem like when you saw Oprah sort of platforming some people who had questionable situations? How do you look at that? Listen, whenever I would impart medical information, I would talk to experts. I would talk to doctors, you know, and of course everything that I talked about when it came to colorectal cancer was vetted and, you know, was scientifically proven stuff. You know, I didn't watch a lot of Oprah, to be honest with you. What I got upset with is I think there was a big piece on Dr. Oz and the fact that he was financially benefiting from some of these. And I'm sure Amy, you probably really looked into this in your book, but was financially benefiting from all these different cures and, you know, berries and supplements and pills. Green tea extract, yeah. Yeah, like, and I thought this is so wrong and he was such a well respected. I think he was a cardiac surgeon. Yeah, he's a cardiac surgeon. Cardiothoracic surgeon. And I remember, you know, I know a lot of doctors, I think just because of my cancer advocacy work and he was so highly thought of. He's such a complicated figure because he was such a well respected doctor. And then he became just such a sellout. And I just think it was irresponsible, obviously, in cases when he was giving junk science to have Oprah platform somebody like that. At the same time, I think it's really interesting because I think it does speak to what you were asking earlier of Jeff and Amy, like, what has the medical community done wrong? Why has there been this vacuum? And I think a lot of it is because not only do people not know their doctors, doctors, as Jeff can tell you, have very little time for their patients. You know, they have what 15 minutes to meet with them. And I think the other problem that I've always noticed is people in the medical profession are notoriously bad at explaining stuff in an accessible, understandable way. You know, I know Alan Alda had this whole organization, I think he still does, where he works with scientists helping them explain things in simple terms so people can understand. I had to learn how cancer and cancer therapies work because I was so desperate to find something for my husband. So I had to know, like, oh, anti-angiogenesis, that's like when you cut off a tumor's blood supply. So imagine a grape and the vine being cut and the grape shriveling up and dying. That's apoptosis. That's what happens to a tumor and cancer. But they're so bad at kind of helping people visualize stuff. I think it's created a lot of confusion. And I think I would say less, I mean, I would say rather than the medical profession, I would say like the problem of how little time doctors have with their patients has to do with the insurance companies, threats of law. The whole way the healthcare industry is set up, as Jeff said, my experience with doctors, my experience with nurses, these are people who have chosen a profession of caring. And they're then sort of hamstrung, right? Totally. They have no time. It's like sort of a main reject. Into the void comes all this very hand-wavy stuff. And there's also hospital consolidation, a shortage of doctors. Let me just say, McKinsey estimates that the wellness industry, which is constrained not the way someone like Jeff is, is estimated to be worth about $2 trillion globally. And it's only growing. Oh, every time I do an interview, I have to check beforehand because it's bigger. So Jeff, when you think about this, like, is it the lack of ability to explain things to people? Is it into the, you know, you must look at Instagram and lose your mind when you see some of this stuff. And I was on Google and I looked, these two young women who are huge and I looked through all their claims and they, all of them were wrong, like very wrong kind of stuff. And I called them and I said, you know, where did you find this out? I didn't even say you're very wrong. And they were like, oh, we Googled it. And I'm like, oh my God, you're very wrong. Like it was really, they were non-constrained, I would say, because they're not clinicians. And then you have AI, which is giving advice non-constrained in the same way you are. Talk a little bit about that. All right. So in the area where I know, obviously, a lot about is anesthesiology. And I'll give you two areas in anesthesia where there is so much misinformation. And one of those is epidural anesthesia for labor. The amount of nonsense that is on the internet about epidurals and, you know, horrible things. I actually wrote a sub-stack piece called You May Get Groceries in my sub-stack about my personal experience as an anesthesiologist when my wife went into labor. And it was a hilarious situation where, you know, a doula went up and put up these crazy things about all these horrible, like, you know, dying of narcotic overdose when the child is 22, things like that. And so I went up to the board and I rode, you know, trip to the grocery store and I rode, you know, tacked by aliens, anal-ly probed, blah, blah, blah. And I wrote down the corner, You May Get Groceries. I mean, because the reality is what it's nonsense, what most of people are posting. The other is spinal anesthesia, for instance. Nonsense. There's so much nonsense about this kind of anesthesia in general. So my area, I can see how easily it is to have misconstrued information on the internet. I can't even imagine how complex somebody like an oncologist, when they're trying to write super complex stuff, how much nonsense there is about. And again, everybody has an opinion, not based on anything but opinion, with no expertise whatsoever. It gets very difficult to explain very complex things and medicine has gotten very complex. I mean, when we look at drugs like rapatha, which is a, you know, PCKS9 inhibitor, you know, what does that even mean, right? When you're throwing all these names around and we do that, we tend to use complex language to describe very complex things. And it's very difficult to make it simple. And I think that's where we could benefit from trying to do that. Yeah, my husband and I had this like game that we play called, I don't know, but if I had to guess, which is like, we're intelligent people. And you take like a tiny shred of information and then you're sort of spin out a narrative thread. And I feel like that is kind of what wellness social media does, right? And I think of it like collagen is my favorite example. Like you will never find anything that tells you collagen products work. Like you can drink it, you can slather it, you can- You will not find it. You will not find a single thing that tells you you're going to get that collagen to grow again in your face. Unless you find a time machine, like that's just it. It's not happening. But you can just picture like all these rooms where people are like collagen. Okay, so it's the thing that makes your skin young again. So maybe if you push it like this, or like, you know, you can find the demos with like these people being like the method is you make it warm and then you smush it or you drink it and then you gargle it or whatever it is. Like you just make up the stories. Look at this Artemis thing. I mean, right now, look at all the nonsense that's on about Flat Earth and about, you know, Apollo hoax. I mean, what seriously? How is this even possible that these things are being propagated on the Internet? You know? Yeah. So Katie, I want to ask you a question about getting to the real stuff and people getting good information. Now, you're a huge advocate for early cancer screenings because of your first husband. Talk about where we are now in this environment. If you were doing that today, how would you get people better information? Because you can imagine how then everyone was like, oh, and listen to you, right? Because besides getting the colonoscopy on screen, they believed you, right? Or they felt like you did your work. So, and especially because of the increase in cancer rates and people under 50. I think they thought I was responsible, right? Yeah. Yeah. So what would you do today? Today, well, I think good old fashioned media literacy is really important. I mean, I know some people don't care about it. I can only operate from like the reality I know because I don't understand Jeff, Amy and Kara, how people can perpetrate all this crazy shit out there. I mean, I just, it leaves me scratching my head. But I think that I would continue doing what I always do. And that is talking about people with deep, deep experience in a certain area. And also whenever I follow someone, you know, I follow a woman named Jessica Nurik, who really disputes a lot of the Mahak claims. They believe in evidence-based medicine. And so I really do trust when they refute something that's being put out there in the ether. And I look at their credentials. I read their reports. I see what they're talking about. And I make a decision. I can trust this person, but I'm somebody who has a basic background in science and medicine. I mean, very basic. Obviously, I'm not a doctor, but I've learned a lot. So how do you get the average person not to fall for these scams? And I think one thing you hit on, Kara, is this parasocial relationship. And Amy, you did an interview for our newsletter with Sarah Levine, our editor. And you talked about, you know, I think people, there's so much magical thinking. People want answers. And honestly, they often don't like the answers that they get. You know, they want to believe, you know, my joints hurt. I want to believe that collagen is going to make me less achy when I get up in the morning. I want to believe that I'm going to be more flexible with collagen, you know? So I think that people, you know, are grasping for ways to feel better. And I think there is a lot of suffering out there, you know? There's so much. And I think that's one of the things I've followed this very, with a lot of great interest. I'm 50 years old, so fill into that what you will, where it comes to menopause. So the case of menopause fascinates me because you have a situation where there was some bad information out there, right? Which was that hormone replacement therapy was very dangerous. Don't do it, right? So you have a number of years where women are just like, nope, not doing it. I don't want to get breast cancer. I don't want to get cancer, right? I don't want blood clots. I don't want cancer. They swear it off. So then you have this kind of perfect storm of a number of factors happening, which is that that information is revisited. Actually, it's very safe for a great number of women under a great number of circumstances that collides with the acceleration of women's willingness to be treated online, which was accelerated greatly during COVID when telemedicine. And also with the accessibility of drugs online, all of those things that became very available, I'd say COVID probably accelerated that by, I think, estimates around 10 to 15 years. We're way ahead of where anyone expected we would be, people's willingness to be treated by a doctor or nurse online. And tons of EC Capital just gets dumped into this idea of treating women with menopause online. Now, it was suddenly like we went from HRT will give you cancer to HRT is going to do your dishes, wash your car, pay your taxes, throw away. It won't pay your taxes, but go ahead. But it was like, you know, like throw down your crutches. HRT is here. And what I realized in reporting on these new menopause treatments is like there's this great news, which is that we're treating menopause more seriously. There's drug therapies that can benefit a great number of people with a great number of symptoms, but it is not a cure all. It is not a miracle. It is not going to fix everything. And in so much of the marketing of these new menopause treatment brands, what you were seeing was basically the erasure of menopause. What you weren't being told was you will still go through menopause. You will still age. You might still have some difficulties. What you were being told was menopause done, fixed, over. And that's what I was interested in and what came out of that for me is what you were saying, Katie, is that like nobody wants to suffer and there is so much suffering out there. Menopause is difficult even with HRT. It might still be difficult. You might get some relief. You might get relief from this symptom and not that. It might work for some period of time and then stop. So it's this idea that we can have this certainty. Jeff, as a doctor, how do you work with patients to acknowledge that Void and Unsurgeon? Because like Katie and Amy said, patients, why face complicated? Yeah, but they don't want to hear that. Both of them said that. And I think it's true. One of the things used to complain a lot was Dr. Google. Besides TV medical shows, which you'd call and yell at me about as if I wrote them. Yes. But, but... Well, the pit's actually getting it pretty right except for the fact that... I love the pit. The pit. So how do you, when you deal with the patients who are in a different state of mind, who are like, addled on the Internet, they think everything, like certain things, like, I don't know, whatever it happens to be that I encountered in this series I did, it was like, one thing sort of helped something, but now it's sold as helping everything. So listen, from my perspective as an anesthesiologist, I am very fortunate that I am in a medical profession in which what I do is pretty definitive. I mean, you know, there's not really an illusion of cure and anesthesiology. I mean, I kept people through very dangerous circumstances and operations and things that are routine things as well. But one of the things that an anesthesiologist has to be very good at is the broad range of medicine. So I do talk to patients in their preoperative evaluations about their conditions, et cetera, et cetera. And so I have the ability to discuss, you know, health issues with them and it all goes down to the basics, though, Kara. I mean, the most important things about health are things that we all know already, you know, basically diet, exercise, nutrition, don't smoke, don't over drink, et cetera, et cetera. That's the fundamentals of, you know, good health. Everything else is very bespoke. I mean, everybody comes with individual drug issues. What are they on? What is the side effects? You know, should I change this? Should I change that? Again, it is complex. There is no simple solution to most medical problems. But the fundamentals of health, it is fairly straightforward. And we've talked about that for your show. Yeah, absolutely. So when each of you think about this longevity industry, now I spent a year talking to various people about it. Katie, why don't you start when you think about what it is to you and what it's become? How do you look at it? Because it really is quite a trend. The money is like pouring into it from tech moguls, a lot of them who don't want to die or want to look better. And they don't. They don't, sorry. It's a lot of money to spend to look like that. I mean, listen, I'm interested in it. I'm 69 in January. I'm going to be fucking 70 years old, you guys. You look great. We're just a thank you. You look great. You must be the collagen. The HRT. You know, and so I'm interested, but I also, I think because I'm a journalist care, I'm skeptical and I'm reasonable. So I look at things and I think, well, this might be able to help me. And, you know, like lately I've been thinking and Amy, you can tell me whether this is the waste of money. Kara, you too. Should I buy a red light mat? You know, are our red light mats helpful to, because honestly, I'm achy. I'm achy. You know, my, my joints are achy. Take a hot bath. You probably have a talk. Take a hot bath. I take absence salt baths, but I keep written the magnesium, my guess is good. But I keep reading about this red light therapy. You know, somebody gave me one of those masks that makes you look like Hannibal Lecter and they're so scary. And I was actually thinking, I saw on Instagram some lady who said, this is my single life and I watched the whole damn thing. She came home. She wiped her, what do you call those red, what are those shoes? She cooked herself like scallops in her hair fryer. I love that you're believing randos on IG, but let's, yeah. She looked like she was having a great time. And then she stretched on this red light mat. And I was like, damn, should I stretch on that red light mat? No, no, no. I mean, no. If you want to, I feel like, you know, a big part of my book is like, no shame. Look, like Katie, we're not going to judge you. You want your mat, get your mat. But I don't want to waste money if it's going to do nothing. Take a bath. I mean, look, like, whatever gets you through the night, you know, but like, is it going to change anything? I, Jeff, Jeff is not over here. So I guess the answer to your question, Kara, is I'm interested. I try to be a educated consumer, but I too, because I want to feel good and I want to get sucked in. I'm vulnerable and susceptible to scams. We're all vulnerable. And to stuff that doesn't work or doesn't do anything. Right. I don't know. I literally wrote the book. I actually wrote the book. And then I will buy a gun of shit all the time. Yeah, that's exactly. So one of the things with red lights, no, the science is very thin. Really? And if you have, if you're a plant in space, you'll do great. If you're, yes, the science is very skinny on it. And if you have some, it may have some inflammatory health. It may have some comfort. Well, isn't being anti-inflammatory, wouldn't that be helpful to me, Dr. Swisher? Yes, but you could do it in a lot of different ways that don't cost $3,000. That would be a very minimal way of being an anti-inflammatory. There's probably, you know, I mean, unfortunately, inflammation is a very comp, again, a very complex science. And there's no simple solutions to, you know, anti-inflammatory stuff. And don't you think you guys that so many people like, they don't want to exercise for 30 minutes, three times a week. So they're like, tell me something else I can do. Give me a pill I can take. Give me a cream I can use because honestly, I'm just lazy. And by the way, I'm speaking for myself too. I'm lazy. And sometimes I'm like, wow, if I didn't have to do that, I don't want, I really don't want to do that. What else can I do? Show me. Fair, but nothing, nothing. I went to a place, it was, it's since closed, but where they would wrap you up like in a burrito wrapper and then make you so hot that your heart went like you were on the treadmill. But you were just watching Netflix and your burrito wrapper and they were like, but we've got your heart at like the same rate that it would be on the treadmill. Oh no. Yeah, but you're not increasing your cellular oxygenation. But I thought I was going to die. I thought I was going to, I was hitting the like help button. I was like, yes. No, not good. Not good. A lot of people, it's fine. If you X or anyway, get it if you want to, it makes you feel better. No, I'm not going to now. You kind of yucked my yam, I feel sick. I'm going to get my stomachs. I feel sick. I don't. It's sorry. I'm sorry. These real people are going to be after you now, Kara. I know they are. Wait all the peptides people come from it. Yeah, that's a nice touch. Oh God. The best thing, if I had to take away two things from this series I did is don't be poor and have a lot of friends and GLP ones and AI detection is really interesting. As so is CRISPR. Like, wow, the scientific stuff is really fascinating. We'll be back in a minute. Support for this show comes from HIMS. There's an endless amount of weight loss advice out there, but if you want to reliably reach your goals this year, you can take out the guesswork with weight loss by HIMS. Now offering access to FDA approved GLP one medications, including Wagovie. With Wagovie at HIMS, you can lose up to 20% or more of your body weight when combined with diet and exercise. It helps you regulate your appetite and eat less so success is within reach. And now Wagovie is available in a pill so there's no needles needed. Ready to reach your goals? Visit HIMS.com slash Kara to get a personalized affordable plan that gets you. That's H-I-M-S dot com slash Kara K-A-R-A HIMS dot com slash Kara. Weight loss by HIMS is not available in all 50 states. Wagovie is a registered trademark of NoVote Nordisk, A-S. To get started and learn more, including important safety information, Wagovie clinical study information and restrictions, visit HIMS.com. And it's all about helping you trust yourself, level up your mindset and actually make the changes you've been thinking about. Robin is Peloton's vice president of fitness programming and head instructor. She's also a 27-time marathon and ultra marathon runner, founder of Swagger Society Media Company, and a two-time New York Times bestselling author. In under 30 minutes, Robin shares the rituals, routines and mental shifts that fuel her hustle and show you how to apply them in your own life. In the very first episode, she opens up about the moment that forced her to transform her inner voice and the strategies that helped her become what she calls a self-talk ninja. You can find Project Swagger with Robin Arazon on YouTube or wherever you get your podcasts. New episodes drop every Tuesday. So, I want to finish up talking about two more things. Prevention broadly, one of the things I think I really do say in this series is GLP-1 is really interesting. And so is this AI cancer, and it's a very important topic for people who are not getting a lot of attention. And I think it's a very important topic for people who are not getting a lot of attention. And one of the things I think I really do say in this series is GLP-1 is really interesting. And so is this AI cancer detection, and not just cancer detection, drug discovery and things like that. And of course, the AI people oversell it as always that it's going to solve every problem. Jeff, first you and then Katie and then Amy, talk about what you're seeing that you think is really promising in whatever area you're in. Well, okay, so let me just very briefly. GLP-1's NGIP medicines are very promising. And I think that we're going to find more and more indications for them aside from diabetes management, weight loss, etc., anti-inflammatory effects of these drugs, but cardiac beneficial effects. Especially now they're going to transition to more oral forms of it that will allow more people to kind of overcome that resistance to injecting themselves. As far as AI medications go, I had the pleasure this past weekend of being at a party with Mark Tessier-Levin, who was the president of Stanford for many years and... Until Peter Baker's son got him fired, but go ahead. I know, I know. Yeah, I know. That was such a really sad. He's a charming, charming man. And anyway, his company is looking at what he calls the high-hanging fruit of the AI drug market. There's a lot of low-hanging fruit associated with AI drug discovery, but there is a lot of other medications which will be very specific towards cancer therapies, monoclonal antibodies, etc. I mean, look at colon cancer. Recently, there was a large study, I think it's called a CAST study that just finished in January, that benefited my wife because the standard chemotherapy protocol, which was called FALF-Ox, oxaloplatin, lary-uricil, 5FU. That's what my husband had. Right. And that's what my wife had too. But the five-year mortality of just that is still pretty high in stage three and stage four, but now the addition of an antibody called the tzilizumab has radically changed that, and this is due to these drug companies which are now using novel drugs to develop monoclonal antibodies. And it's changing everything. It's changing malignant melanoma. It's changing colon cancer. It potentially will change pancreatic cancer. The third area, Kara, and you've mentioned it before, is the use of mRNA vaccines and the ability to potentially develop vaccines against cancer. There's very promising things with a very fatal cancer called glioblastoma, which is brain cancer, and some of these potential vaccines may actually cure this once completely fatal, almost completely fatal type of cancer. So those are the three areas I'm really interested in. Katie, what are you when you're looking into this stuff right now? Well, I'm excited. I think you're right. It's probably been overhyped, but there's so much to be frightened about when it comes to artificial intelligence. I think people are like, ah, but look what it will do for healthcare. And obviously, for my area of interest, early detection, AI is going to be a game changer, because I think what it can do is, and Jeff, you can help me explain this, but the large data sets that they can compare scans to are going to be really helpful to recognize very, very early stage, for example, breast cancer. And there's a woman who I read about. I want to interview her. Kara, you should talk to her. She is both a scientist and a breast cancer patient, and she worked on AI early detection. And it will not only be able to detect early, but it's going to be predictive. It's going to be able to say you are at high risk for getting breast cancer in the next five years, and then you can monitor it accordingly. It's called organ clocks. I just interviewed Eric Topol. He's like, that's the real move. Like detection of individual organs, and that's to me was his first. Yeah, so I'm super excited about that. The other thing I am really excited about, but I think they're not ready for prime time, and I get very distraught when I see them advertised on these various cable news networks, are so-called liquid biopsies. Being able to determine if there is early stage cancer or cells kind of floating around your bloodstream that can kind of indicate early on, oh, this is a problem. We talked a little bit about colon cancer, and the screening protocol is now starting at age 45. Only one in five people between the ages 45 and 50 get screened, so we've got to get the word out about that. But when Jay got diagnosed, you guys, I was like, oh, are people under 45, or in this case, it was 50 back in 1998, are these just expendable individuals? Because there was no screening for them. And I am hearing more and more about people in their early 40s, 30s, even 20s being diagnosed with this disease at an advanced stage, often metastatic colorectal cancer. It is so upsetting to me, so I'm hoping that there can be some tests that's less invasive and more accessible, not as expensive, not as disruptive for your daily activities like a colonoscopy might be, and that these blood tests can be used to everyone who's going to get a physical. I don't know. I can't even tell you guys how crushing it is. I had coffee with an oncology fellow about two months ago, and she said, I had a very rough day. I just had to tell a 21-year-old college student with no family history, not Lynch syndrome, no familial apolloposis, no kind of high risk, that he had stage 4 colorectal cancer. And it just crushes me. And I hear these stories. I'm interviewing a 31-year-old, I think, next week who is dealing with it. And of course, I'm excited about trying to figure out why this is happening. Epidemiological studies are so hard to conduct, but there is something going on in our environment. It's not just obesity or sedentary lifestyle. It's a confluence of things that include ultra-processed food, maybe microplastic, forever chemicals, overprescription of antibiotics. I don't know what is happening, but something is going on. And there are 17 cancers. 17 cancers are increasing among people under 50. So what the fuck is going on? Yeah, it would be great to have a government who studies these things. Amy, what about you? Well, I was excited to hear you both talk about some of the AI things, because again, I'm typically around writers, and it's like AI is the devil. And then I was at the Aspen conference last summer, I was speaking at the Aspen conference, and I sat next to this woman who was talking about digital twinning. What is digital twinning? Well, Katie, it's when you can replicate your biological self through AI, and then you can kind of run the tests. I have an interview with Reed Jobs talking about this, who's the son of Steve Jobs. Beautiful. So it's basically like you can test, there's all these very specific cures for very specific cancers, but to test them is so expensive and so time consuming. So you might have lung cancer, but you might have this 1% of lung cancer that they know how to treat, but to know if you have it is so complicated to know. Anyway, Jeff, you made a sigh there. Well, I think it is very simplistic. I am not a physician. No, the degrees, unfortunately, it's a very interesting concept. I mean, especially it's more interesting from a morphologic standpoint than an actual physiologic biochemical standpoint, because the degrees of freedom involved in the human body, it's enormous. You're talking 10 to the trillions kind of complexity. And so some of these things are in their nascent area, and they are exciting. And I think Reed Jobs is a perfect example of somebody who really will be the future of what medicine could be. But just keep in mind, we're very, very... Very early. In the last assist stage, if you know developmental biology. Well, that idea is so exciting, because I used to feel like when it came to cancer therapeutics, and I don't know, Jeff, if you feel like this, and I'm sure going through what you're going through with your wife, but they would just kind of throw it against the wall and see what sticks. And I remember there was one doctor when Jay was sick who could take a tissue sample and put it in a petri dish and then see how it interacted with various therapies. And when he was sick, it was 5FU and leukivore, and that was it. And that had been around since the 50s. So they hadn't even added the oxyloplatin yet when Jay was sick. But this idea that cancer is like a million different diseases and a million different biologies, how it interacts with your body just varies from patient to patient. But the idea, I think, is so exciting that instead of using people as human guinea pigs and just trying these therapies and checking their CEA levels, that you could run all these possibilities. That to me is thrilling if it could happen. It is actually. The problem is when they overpromise. Jeff was the first person who told me Elizabeth Holmes was full of shit. Oh my God. I wasn't going to cover her anyway, but she was around the tech sector quite a bit. She tried to look like Steve Jobs. And you just said no. No, Jeff was like, you can't do that with a blood sample. You can't. No, it's just math. It's math. A vial that you'd find in a dollhouse. I went to see her when I dropped my daughter off at Stanford. And I called her and I was like, can I just come and say hi? And this was when she was such the it girl on the cover of every magazine. And it was, it was fascinating, but she seemed so sincere. Of course she was. Did you smell her at? Did you think, no? Oh, 100%. Well, Jeff did. I, I'm like so trusting and think the best of people. And I was like, wow, this is so exciting. No, he definitely was like, you can't do that. When she wouldn't do an interview. And I remember she did an interview at Vanity Fair. I don't know care if you were there at one of these summits. Yes, I was there. And, and do you remember Maria Shriver interviewed her and I raised my hand and I said, can you explain how you can take a minuscule, a tiny drop of blood and determine so many different diseases from such a small sample of blood? I just don't understand it. Well, she, you know, she said there, a chemistry happens was her direct quote. Yes. A chemistry does in fact happen. Chemistry happens. The math is not math. Yeah, Jeff kept yelling math. Math is not math. And I'm like, you know what? And this is where statistics and knowledge of basic science is a fundamental thing in looking at all of these things. Yes. I was sitting at a table of all people with Bob Iger and he goes, huh, you're always looking for women in an interview. You should interview her. I said, I think she's a liar. And he goes, why? And I said, she lied about a couple of small things like who she was dating, where she was living, because I knew where she lived. You know what I mean? And she told all these lies and stories. And I said, then there's too much press. And then my brother says there's no math to it. And so I think she's a liar. And he said, you think everyone's a liar? And I go, I think you're not a liar. And it was like, and it was, it was a, it was a really interesting moment. Then a week later, it all got out and he goes, how did you know? And I said, I, I didn't, she just lied about her home. I look, it sounds dumb. We're good yin and yang, Kara. I believe everyone and you believe no one. But you asked the killer question. You didn't believe her. So let me finish up. After all we've discussed, what's the number one thing each of you would tell people about prioritizing about your health? And what's your secret to a longer life? Katie, then Amy, then Jeffrey, who I hope lives the longest of all, because he's my beloved brother. Oh, thanks. Well, I hope we all live along. All right, Katie. I guess for me, I mean, I think it's just like the boring stuff, Kara. It's like eating well and moving your body, getting plenty of sleep. And I also really believe in the power of community. You know, I interviewed Vivek Murthy a lot when he was search in general about the loneliness epidemic and how isolation and loneliness can be so detrimental to your health. So, and laugh. I try to enjoy my life and be positive. I mean, it's sort of boring and obvious, but that's what I do. And by the way, there's more science to community, much more by far than there is red light. But go ahead, Amy. That's true. I agree with everything Katie said. It is the basics. Everyone is like, oh, come on. You did all this research like, come on, you can tell me. I don't like God, I wish I'd be doing it. But it's the really boring stuff. It's getting enough sleep. It's drinking enough water. It's not eating junk food. It's being with your people. It's loving freely and all of those things. And as you said, it's also not being poor because the things that we're calling basics right now are really not available to a lot of people in this country. That's so true. And I think it's really important to acknowledge that. And I think when I said I had a really important moment when I was researching this book, when COVID happened, look who got sick and who died in America. It was not subtle. It was like a flashing neon sign. When you look at who got sick and who died in America of COVID. You're 100%. It should have been the wake up call about how our healthcare is handled in this country. The racial and the socioeconomic divide was stark as could be. So the things we're calling basics are not basic for a lot of people. That is so important. I'm so glad you both called that out. So when people say to me like yoga or Pilates, I'm like, look, if you're talking yoga versus Pilates, like you're fine. I think about this all the time. I helped a friend of mine's dad who has a rare cancer get into a well known institution and talk to a really experienced smart doctor where I think his clinician had no expertise in his specific kind of cancer. And I was like, this just sucks. Like if you're not educated and informed about a certain situation or you don't have contacts or connections, even if you aren't necessarily poor, you're kind of screwed. And I wish we could fix the whole healthcare system. And it shouldn't rely on your zip code, whether you can not only eat healthy, but whether you live or die and the social determinants of health. If you want to get really depressed about healthcare in America, just look at who lives and who dies with certain diseases. It's asthma, diabetes. It's terrible. Yeah, exactly right. Zip code makes a huge difference. Jeff, finish this up. Quality over quantity. I'm a very strong believer that life without quality, you don't need to have quantity. It's just not worth it. So the basics, floss your teeth, hydrate, eat good food. And most importantly, as Kara is going to point out in her series, have connections, have social connections with your friends and family. Be present and help others. And I think when you help others, you form a network that expands like ripples in a pond. And that's where we can do the most good for everybody and for ourselves. And that's how we live long and healthy and happy lives. What about my fish oil? Yeah, your fish oil is good. You accept to get fish breath with fish oil. You burp a lot. You put yourself a piece of salmon. I'm having salmon. My husband's making me salmon right now. Have that instead of the fish oil. Put the fish oil down. It's too much. It's fine. Fish oil is not going to hurt you. Just don't take the whole bottle. Thank you, Jeff. And I read your Kalanik chapter in your book, Amy. Holy moly. How did you agree to do that? I was like, I'm never going to do it again. It was horrible. Oh my God, that subway ride home to Brooklyn. All right. We'll end on that. You can see what happens to me when I take ketamine in the first episode of the show. Anyway, oh, never again. It's a great drug. I use it on people every single day. It's a fantastic medication. It's a medication that shouldn't be taken by Elon Musk who's then running our country. I'll tell you. Anyway, thank you all so much. I really appreciate it. We could talk for a long time and maybe I'll have you back to talk more. I wish you all a long and happy life. I really do. A health span and not just a lifespan, which is the way you say it these days. Anyway, thank you so much, Katie, Amy and Jeffrey. Thanks, Kara. Thank you. Thank you. One small thing before we go. Want career advice from Kara Swisher? Now's your chance. Send a video to on at voxmedia.com and you might be featured. I can't wait to see what you've got. Ask any question. I'll try to answer it. Today's show was produced by Christian Castor-Rosell, Michelle Aloy, Katherine Millsop, Megan Burney and Kailin Lynch. Nishat Kuruwa is VoxMedia's executive producer of podcasts. Special thanks to Bradley Sylvester. Our engineers are Fernando Arruda and Rick Kwan. And our theme music is by Trackademics. If you're already following the show, you're living a long and happy life. If not, put the red light mask down. If you're already following the show, you're living a long and happy life. If not, put the red light mask down. If you're already following the show, you're living a long and happy life. If not, put the red light mask down. Go wherever you listen to podcasts. Search for On with Kara Swisher and hit follow. Thanks for listening to On with Kara Swisher from Podium Media, New York Magazine, the VoxMedia Podcast Network and us. We'll be back on Thursday with more.