Armchair Expert with Dax Shepard - David Fajgenbaum (on repurposing medicine)

Episode Date: November 26, 2025

David Fajgenbaum (Chasing My Cure, Every Cure) is an immunology researcher, professor, and author. David joins the Armchair Expert to discuss being recruited to play football at an assortment of Ivy League schools before ending up at Georgetown, the promise he made to his mother to pursue medicine before she passed away, and starting a foundation in his mom’s honor to help college students with grief. David and Dax talk about the sudden onset of symptoms that meant his liver and kidneys were shutting down, gaining 100 pounds of fluid almost overnight, and nearly dying multiple times amid a diagnosis of Castleman disease. David explains the decision to approach his illness with off-label drugs, putting himself into full remission with a drug used to prevent transplant rejections, and the current mission with non-profit Every Cure to treat other inflammatory diseases with existing medicine.Follow Armchair Expert on the Wondery App or wherever you get your podcasts. Watch new content on YouTube or listen to Armchair Expert early and ad-free by joining Wondery+ in the Wondery App, Apple Podcasts, or Spotify. Start your free trial by visiting wondery.com/links/armchair-expert-with-dax-shepard/ now.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Wondry Plus subscribers can listen to Armchair Expert early and add free right now. Join Wondry Plus in the Wondry app or on Apple Podcasts. Or you can listen for free wherever you get your podcasts. Welcome, welcome, welcome to Armchair Experts on Expert. I'm Dan Shepard. I'm joined by Lily Padman. Hi. Today we have David Faganbaum, who is a physician, scientist, and best-selling author.

His books are chasing my cure, and we get it. Um, this is an incredible story of a guy who cured his own disease that he was dying of, actively dying of. And working hard on curing others. It's, this is wild and so cool. Very cool. And he was a football stud. Not what?

Talk about mixed messages. And he was, went to college with a perfect 10. Charlie as you'll hear. Yes. Also, if you're moved by this episode, which I think you will be, uh, and you want to donate to every cure, please go to www. Cure.org. Please enjoy David Faganbaum. Armchair expert is proud to have Alexa Plus as our presenting sponsor.

The all-new Alexa Plus is your smart, proactive AI assistant. Just chat naturally about anything and watch your to-do list disappear. It learns your style and anticipates what's next across Echo, Fire TV, and more. Learn more at Amazon.com slash new Alexa. We are supported by Pellet. You know how life gets especially chaotic this time of year? Work, kids, trying to remember what day it is. For me, finding time to move can feel impossible, but that's where Peloton comes in. Peloton has completely reimagined cross-training with the new Peloton Cross Training Tread Plus,

powered by Peloton IQ. It's Peloton's most elevated equipment yet, real-time guidance, endless ways to move, and it helps you get more done in less time. I like the time crunch aspect of it because sometimes I only got 20 minutes to squeeze something in. This is perfect. With Peloton IQ, you get personalized plans, form correction, and weight suggestions that help you train smarter and stay consistent no matter how busy life gets. Let yourself run, lift, sculpt, push, and go. Explore the new Peloton cross-training treadplus at one peloton.ca. He's an altruits fun I'm so nice to meet

I was just sharing with Monica that Charlie Yes, it's so exciting I know I just learned this mere minutes to go myself We just FaceTimed him Oh you did! Yeah, we facetimed him said hi Were you recording my home?

Well, we were We're over in the corner. Oh, that's not going to work. So, not really. But, yeah, since we weren't recording, David is good friends with perfect 10. We call him Perfect 10 Charlie on this show. You can't be surprised. I'm not surprised at all.

Georgetown. Georgetown, very good school. Very prestigious. I mean, David's gone to all the good schools. He really has. Too many good schools. It's almost like a sickness. At some point.

Ding, ding, ding. Tell me. Because David had a sickness. Oh. Okay. Hello. I didn't realize we're at the making light of a part. Yeah, but that's great.

We should start there. Welcome, how are you? Doing well. Thank you. How are you doing? Wonderful. So, yeah, as Moni was just saying, I was working out appropriately to receive a text from Charlie. And I was like, oh, Formula One race, yes, expected, expected.

Oh, sure. I think you're interviewing my friend Dave. And I was thinking, how could he possibly know this doctor? Right. And then, of course, you were his quarterback. That's right. We played football at Georgetown. And you guys are a couple of the people who actually know Georgetown as a football team.

A lot of people don't know about our team. I don't know if without Charlie. I would have known. And then also, even if I knew I wouldn't have guessed it was Division 1. Would you? No. I went to Georgia, so different. And you know, we have like a bulldog mascot, but we had to change from being the Georgetown

bulldogs because there's the Georgia Bulldogs. Too close. So were the Georgetown Hoyas. I don't know if you've heard this. Oh, yeah. Go Hoyas. Yeah, go Hoyas. It means what in Greek?

And so apparently, it came about that. Exactly. There were some priests that were streaming Hoyas sax, which means what rocks. Then people would say Georgetown. And all of a sudden were the Hoyas, which means. We were the wets. And so were you guys pails, pales? We were.

Yeah, they're good friends. They're best friends. This is Posim. But Charlie will be the first to admit he ran with a real meathead click within the football program. Were you immersed in that? If you'd open up the book or like I showed Monica a picture, open it up and go to this middle picture. Oh, I've already looked at your body. If that's where we're going with it.

I know your body very well. I don't look anything like I look like now. I mean, I've fully embraced Dad Bob these days. Oh, we're in the middle of the very middle. There's a picture there. I mean, I know this picture by heart, but I love a great body. The point being, that's what I looked like. So, yes, you could have called me a meathead back then.

But I was pre-man. I had intentions to be a doctor. Yeah. And what a catch. Can you believe? I mean, if I'm in college and there's a pre-med... Oh, forget it. My poor wife, she started dating me when I looked like that, and then she's stuck with us.

It's rough. He was a lineman, yeah? He was a defensive plan. Oh, it was a tight end then. So I used to throw a football. Charles, Charlie. Oh, and you could count on them. I always, always.

I would imagine that is a special relationship between the quarterback and the tight end. Tighten, especially, because they're the one position in the field that you both are thrown past the two and they're also blocking for you, right? You have a special relationship with your offensive line because your life is sort of in their hands. Gronk was a tight end.

Gronk was a tight end. Yeah, so, of course, TB12 and Gronk are besties. That makes sense. How are Travis Kelsey and... Oh, and Mahomes? Mahomes are they... They're very good friends. Okay, okay.

Well, let's start in Raleigh, Northe. Carolina. Because your dad was also a physician or a still. That's right. That's right. What kind of physician was it? Orthopedic surgeon. Ironic. Yeah. Because I was going to ask you, how did your physician father feel about you playing football in the first place? But I would imagine even compounded by this being an orthopedic surgeon. Like that he wouldn't want it. Well, he's probably observed a lot of injuries. Well, that's true. But also, he was an orthopedic surgeon for the NC state football team. So he was like taking care of people that were playing football. And that sort of led to why I felt in love with football so much.

Right, because you were hanging. Exactly. Exactly. Okay, and were you a standout in high school? What were the challenges? Did you have a hard time putting on weight? I'm like an okay athlete, but I work really, really hard. But David, I have to tell you something.

Every athlete says that. I finally want one to say, like, I'm a fucking physical phenom. I hit the genetic lottery. Oh, no. He'll tell you he works so hard. No, he says he's the best. He says he's the best. He says he's the best athlete.

One time we were all at a vacation, and the men were playing horseshoes. And my friend, Jess, who is very athletic, but has not done athletics in a long time. And Jess was kind of dominating at horseshoes, and everyone was getting very upset. It was confronting their stereotypes, what is to say, Belize? And I said, Jess is the best athlete here. And Charlie did not like that. Charles' competitive for sure. So to give a sense for how crazy I was about working,

I had posters all over my wall as a 10-year-old. They were like tracking how fast I could run, how far I could throw. I was totally, totally obsessed and just worked like crazy. Your damn was I love this. If I had a little guy and he was taking something this serious and working so hard, it would have just made my heart explode. I think both my parents, they did love it,

but I think they also were like a little concern. He's really, really focused on this thing. Like, is this too much? Well, my concern would be what he's given in his whole life If it doesn't work out in some capacity, he's going to be horrorbroken. Exactly. Yeah. But it worked out.

You did get recruited to play at Georgetown. That's exactly right. Did you have other offers, other schools? I did. I was recruited by Ivy League schools. So Yale and Cornell and Georgetown. And then a couple other smaller schools in the North Carolina, South Carolina region. Did you pick Georgetown for some kind of family tradition?

There were a few things. Georgetown had this pre-health program, which wasn't just a typical pre-med where you're taking basic science, but it actually had where you actually could learn about the human body and learn about health and disease. That was interesting to me at the time. And then I loved the quarterback coach of Georgetown. Joe Moorhead is amazing. He went on to be the head coach, Mississippi State, and no coordinator at Penn State. And it was his first job as at Georgetown.

I was like, oh, my God, this guy's amazing. He's going to be incredible, and he is incredible. And when you went there, you were already going to do medicine, yeah? When I went there, I was really interested in sports medicine. I was really interested in, like, exercise and diet and nutrition and all that sort of stuff. So does mom's glioplastoma change courses here? Changed everything. It was just a couple weeks after I got to Georgetown was when my dad called.

told me that my mom had brain cancer and I immediately went home to be with her and just a couple of days later she had brain surgery. It was a heartbreak. So it was operable? Rarely can you operate on them, yeah? So this was operable. It was in the front left part of her brain

and so it was in a particular location where they opened up your skull and they actually wake you up once they've opened it up. And the reason they do that is because they want to start cutting out tumor but they don't want to cut out too much because then you're like you won't be able to speak. And so they did this surgery. It took four and a half hours.

And my sisters, my dad and I were just terrified. And I remember they said she made it through surgery and we're so happy. We're going to go back to see her. And I remember we're like crying because we're so happy. There's so many emotions. And I told my sisters and dad was like, got to stop crying. Like, let's be strong for mom. And we go back to see her.

And I'll never forget this. She had a wrap around her head and she had this bulb coming out of it. It was basically like draining the fluid. She was sort of sitting up. We just didn't know what to say. And we walked in and my mom pointed to her head. And she looked at us and she said, Chiquita Banana Lady.

And we just like burst in the laughter. She was making this joke for us at like the rap and the bowl, like that she looked like the jikita banana lady. And I loved it so much because she just had a four and a half hour brain surgery. She's brain cancer. But what's the first thing she's thinking about? What can she say to make us laugh? Yeah.

We're crying and we're not crying. And we're like, our mom's still here. First off, she's speaking. We didn't know if she'd be able to. Yeah, yeah. And then she'd make that joke. It was just everything. Do I have Vader Mindhoff?

It feels like I've heard. an inordinate amount of women in the last 10 years get this glioplastoma. Is it asymmetric to women? I haven't heard about it being more common in women, but it does feel like it's just getting more common. We know like three different people in our circle. Related to one person. Well, one person knows three people and we know that person.

Yeah. And one of the people is a man who was affected by her awful. But yeah. So there's no weird gender thing happening with that, but it's heartbreaking. It's just one of the worst out there. So the surgery, what did that buy her? It bought her about a year of clean scans. Was it followed by radiation?

Radiation and chemotherapy. And this was back in 2003, 2004. She either came up to Georgetown every weekend, or I went home every weekend to North Carolina to see them. So got a really special time with them. And I remember about nine months in when they did the first big scan after it's been a while and it was clean. That was one of the first times where I just saw the most intense tears of joy of my life.

It was just sort of like, oh my gosh, a clean scan. This is amazing, but then it was just a few months later was when it started to grow back. And she passed away 15 months after she got sick. Oh, man. So, yeah, that's fucking rough. So you were in your sophomore year? Over a sophomore year.

You're in college. Yeah, do you see a dip in performance in all categories for a minute? Or do you get psychotype A and work even harder to ignore it all? More the latter. Part of it was the moment my mom got sick with brain cancer. All those posters I had about football and all the thoughts, that was out of my mind.

and it was like, I want to dedicate my life to finding treatments for people like her. I'm not interested in sports medicine. I'm not even really interested in football right now. I just want to be a doctor because I want to dedicate my life to helping patients like her. If I'm going to be at school while my mom's going through this, like I'm going to lock in and I'm going to become a doctor and help people like her. And a couple weeks before she passed away, I promised her that. That was the last thing I ever told her.

Yeah. I said, Mom, I'm going to be okay. And I'm going to dedicate my life to trying to find treatments for patients like you. Yeah. What did she say? So I have kids, you have kids. If one of my little girls says to me, I go, oh, honey, do not burden yourself with me at all. You go have whatever life you want, you don't know.

Because of the brain tumor and the part that was in, she didn't have too many words left, but it still hits me today. One of the things that she could say and the thing that she said was unconditional love. Again, she didn't have too many words. And it's like, that was something she could say. She started crying. And I cried. Yeah. Wow, how special.

Well, dude, you gave her the ultimate gift, which is I only hope for one thing in my life. And if I get me looking at my little girls when I die, I'm going to be like stoke. That's as good as it gets. It is. Okay, so you get hardcore about medicine. You graduate from Georgetown. You go to Oxford. What's this D-Tor?

You get your master's in Oxford? Yeah, during my time of Georgetown, I now became obsessed with medicine and cancer and cancer treatment, cancer prevention. And I learned that there was a program at Oxford focused on health promotion and disease prevention. And they were particularly focused on heart disease prevention, but there was data coming out around that time that diet, physical, and activity and smoking can actually all contribute to cancer risk. And so it was this idea that, like, well, maybe I could go study with these people

who are focused on heart disease prevention. We could apply it to cancer prevention. Did you like it? I did. I love the academic part of it. I have to admit, I didn't mesh as well with Oxford as Oxford as maybe I did with my buddies from Georgetown or from Penn. Whatever cultural gap. It's funny. I played football at Oxford. They have an American football team. Were you ridiculously good compared to everyone? It was really fun. It was really fun. It was fun. But what was cool is that it was a joint program between Oxford University and Oxford Brooks.

Oxford Brooks is the local state school that's right next to Oxford. And I just got along so much better with the guys from the Brooks side of things. Oh, interesting. Can you be objective enough to answer if you were exceptional at Georgetown or if everyone at Georgetown is like you?

In terms of... Achievement. The biggest thing that I would say is that Georgetown has this really special focus on helping other people. Like the motto is men and women for others. And I think that that was the perfect place for me to be at that moment in my life, to be in an environment where literally the wall say like men and women for others,

take what's gone on to you and help other people. That was the perfect environment because I shared one part of the promise to my mom with you all. And that was that I would become a doctor. The other promise is I told her I was going to create an organization in her memory. Her name was Anne-Marie Faganbaum. Her initials were AMF. And I was like, I'm going to call it AMF. I don't know what's going to stand for.

But it's going to be for grieving college students because I was really struggling with this anticipatory grief. And so we started AMF and then ended up spreading that to other college. campuses. I think if I was at any other college campus, I don't know if that immediate, I'm going through a lot of pain. I'm going to now create something to help other people. I don't know if I would have done that anywhere else. I think Georgetown was the right environment for that. Now, David, I'm on teeny bit suspicious, though, that I don't know if you were, were you dealing with it? Do you think you were dealing with that? Dealing with my grief. With your grief? No, I think that the way that I decided to start dealing with my grief was,

it's called instrumental grieving where, like, you create something and you pour it into that thing. And this is actually something that a lot of men do when they deal with grief. They channel it to something. I created AMF and now I'm like sitting in support group meetings, other people are dealing with grief. And they're talking about AMF. And that for me was how I tried to deal with it. Yeah, yeah. Yeah. It sounds a bit like you tried to treat it with action. Yes, exactly. Sitting with it. Yes. For sure. In discomfort. Absolutely. I was like, if you start feeling some discomfort, I'm like, I'm going to go work on this nonprofit. Yeah. Yeah. Yeah. Okay, good. That was kind of my hunch.

And then, of course, that just waits there. At some point, it does start just kind of seeping out. How delayed was it for you? I lost my dad when he was 62, and I just had all these waves. First was just getting him through the whole thing. There's a lot of action there. Then there's action in the aftermath. And it's just honestly years and it continues to be waves of like, oh, right. Wow, I have a sadness now that I didn't allow myself to have then.

And that's 13 years ago. Sorry that you lost your dad. I've had those waves. And I think that you're right. If I sat with it more when I was 19, and I probably would have had maybe fewer waves. Also, who knows? Yeah, who knows? Exactly.

I've gotten a drinking problem and got nowhere. I will say that the one thing is that because my thing that I was channeling my time into was like schoolwork and this grief support group in that grief support group,

I'm talking. I think I got maybe some of that out. But when I went on to get sick, that brought back a lot because all of a sudden I'm now laying in the hospital bed and my dad, my sister's around me. And I was with them before.

I was on that side. Yes, and you can't get into action because you are strapped to this thing. So let's get to there. So we leave Oxford. we go to Penn. That's right, for med school. And you're in your third year of med school?

And what's the first symptom? You're like, everything's great. You're humming along. You're your third college for many years. That's right. I was very healthy still. I actually won a bench pressing contest a couple months before that. How much did you put up?

I think it was like 325. Jesus Christ, wonderful. So very healthy. I am on an OBJO and rotation. I'm now on the OB part of it. So I delivered my first couple babies into the world, which in med school, that's this major highlight as incredible it gets.

Actually, I'll share a quick story about the second patient I delivered. The parents were both older than me, as you can imagine, because I'm 25. And they're sort of really concerned, like, why is this like 25-year-old in here? It's not what I want. Not what I want you. The husband comes here. He's like, this isn't your first time, right? I was like, well, no, because it was my second time.

And I was like, no, it was not my first time. I'm a med student. I'm just learning. I remember delivering the baby and baby's healthy and everything was all good. But then I remember turning her, I'm like, It was my second time. But like, your baby's really healthy. Everything's all good.

We got lucky. We all got lucky today. We're two for two. Oh, my God. So yes, maybe I got sick as payback for that. But within the next couple weeks, I started feeling more tired than I ever felt before. I'd been in school forever and I just never felt fatigue like that. And I started noticing lumps and bumps in my neck, which turned out to be in large lymph nodes and had abdominal pain.

And then what was so weird, but I noticed like fluid pulling around my ankles. And I was like, but I'm like this healthy 25-year-old. What's going on? Also, can we add, and I love the irony of this, you're also a dude. You're in medical school, and you probably ignored three or four red flags, right? Oh, for sure. Yes, isn't this insane? Like, you would think you'd be inoculated from this because you know about it?

You're not. No, exactly. I'm literally feeling lumps in my neck. I'm like, oh, these feel like lymph nodes, like that patient I felt on lymphoma two months ago. I'm like, that's weird. Head on to something else. Yeah, don't keep reading. Why am I not paying attention to any of this?

Probably a lot of reasons for it. But so the fatigue got so bad. I would see a patient and then I would go find an empty room and I would take an eight minute nap. I'd set my alarm for nine minutes. I'd wake up eight minutes later. I'd go see another patient. I'd just keep doing that over and over again. I was taking caffeine pills.

I was doing anything I could to stay awake. So I took a medical school exam and then I'm sure I got like the worst grade ever. I never got my score back. And I went down to the hall to the emergency department and they did blood work. Really quick. From feeling the inflamed lymph nodes. Two weeks. Two weeks.

Okay. So walking down the hall. I even remember when I was taking this med school exam, I was like, is it the answer A or B? And then I remember in my brain, I thought to myself, I'm like, it doesn't matter because I'm about to die. And I'm like, soon I'm like, why did I think that? I'm about to die, what? And so, like, I finished the exam. I walked down the hall to the yard.

Can we take one second right there? That is a gift to have those moments a few times in your life to experience a right-sizing of what's important. Just a few times in your life and hopefully it doesn't kill you. But I've had a couple of those, right? Where it's like, oh, right, I don't give a flying fuck about all the stuff I thought I thought I cared about. It's a unique feeling. Like, for you to say you don't give a shit how you did on the test is really profound. And I think it's an important.

feeling for us to share with other people because the important thing is to start putting your mind in that place before you have to experience it yourself. Like don't wait until you're 80 years old and then you're like, oh crap, I wish I had thought this. But I don't know that you can get. But yeah, I used to have to be there. I don't know if you could borrow it. I think you just have to experience it, unfortunately. Maybe do a medically supervised overdose. Yeah, hopefully not. Hopefully don't have to experience. I'm open up a clinic that's like medically supervised. It is normally death related though. It's moments where either someone around you is sick,

or has died or you yourself are dealing with some health issue. So, yeah, it does suck, but you have to experience it like that. The main thing has to be in threat. So bad. Yeah, yeah, yeah. Okay, so sorry, we go down the hall. Yeah, they go down the hall. They do some blood work.

I'm a med student, so I'm used to, like, being on the other side. It usually takes a while to come back and see the patient, unless there's something really serious, and then they come back really quickly. Yeah. The doctor comes back like 10 minutes later, or maybe it was 15 minutes, but it was quick. He said, David, your liver, your kidneys, and your bones. and your bone marrow are shutting down. We have to hospitalize you right away.

And I'm like, wait, what? I was just like, I delivered baby a couple weeks ago. What do you mean? My organs are shutting down. They hospitalized me. And then over the next couple weeks, I go from my organ shutting down to being unconscious,

gaining 100 pounds of fluid all over my body. You see the picture? 100 pounds of fluid all over my body because my liver and my kidneys weren't working. So everything's just backing up. You're not urinating at all. So the fluid is going everywhere. I had a retinal hemorrhage,

which made me temporarily blind left eye, so I couldn't see anything out of my left eye. Couldn't have thrown any passes. Depth perception's gone. That's exactly. That's all I can think about it, actually. I was like, darn it. This is going to really hurt my leg. You're going to throw 10 feet or 25 feet away. Exactly. And so I was getting so sick because of all the organs shutting down, I was on dialysis because the kidneys weren't working. I was getting daily transfusions of red blood cells and platelets. They were just trying to keep me alive, and no one knew what the diagnosis was. In that state, is your white blood cell count

just like off the charts? So white blood cell count was pretty normal at that time. I don't have a good explanation for why. White blood cells were normal, but the platelets and the red blood cells were just collapsed. And you need platelets in order to prevent basically from you bleeding out at all times. Because you have these little microbleeds that happen all over your body, including your brain. And your platelets just sort of stop it up always. It's like fix a lot all over your body all day every day. And so when you get as low as mine where you're in this critical state where you can have a little bleed in your brain and then you die from it. Let's take a second for your poor fucking father.

Oh, my wife. And now he's visiting his. Yeah. He spent every night in the hospital room by my side. So, like, you know how to just, like, pull out couch things? Horrified. Every night with me. My sisters were amazing. Stay tuned for more armchair expert. If you dare.

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and get into the real heart of basketball watch mind the game now on YouTube, prime video or listen wherever you get your podcast Also you told your mom you were going to be okay and then that was another promise I made sure because I was like I promised her I was going to help people

and I've just been like working working working to help people and I'm in there I was thinking about that Now you say I'm like, darn. You know what? I was thinking I'm not going to help. I did all this training. I'm not going to help anyone I told her I would. So with Francisco, he came in to see me.

He, like, leaned in to give me a hug. And he's a med student also, so he has a stethoscope around his neck. And I remember it was like slow motion because he comes to give me a hug. And I see the stethoscope coming because any sort of trauma to my body could create one of these bleeds. And I see the stethoscope coming. And it just like hits me like right between the eyes. And we're just like looking at one another. And for a split second, we're like, oh my gosh, did he just kill me?

They're like, my best friend just like hit me in the head with his death. of this stethoscope. Oh, my God. And then we, like, we're sort of still for a second. And then I didn't black out because of an internal hemorrhage. And then we were okay. And then we laughed about it. But it's crazy.

That was what things were like back then when I was in the hospital. Yeah. Oh. Okay. So they end up giving you a crazy cocktail of chemotherapy. That's right. It was a last ditch effort. At this point, how long were you in the hospital?

So I was in the hospital for seven weeks before they gave me, this first they actually gave me high dose steroids because we didn't have a diagnosis. So first they gave me high dose steroids, things start to improve. and then four weeks later, it's roaring again. And this time is when I had my last rights read to me. This was now 11 weeks into my illness right when we finally had the diagnosis. So diagnosed with Castleman disease, this rare disease where your immune system attacks your vital organs.

Right around the time of diagnosis, they give me first one chemotherapy. And thankfully, that's enough to sort of hold things at bay. But then four weeks later, I'm back in the ICU again. And that's when they give me seven chemotherapies. So, yeah, your own immune system's killing you. And so they need to carbid bombing our immune system so that's non-functional. And that works. It does.

The time they gave me now, it's the third time that I'm on death's doorstep. And they tell me before, you know, we're out of option. So we're going to carpet bomb you with every chemotherapy we can think of at the highest dose possible. You know, remember closing my eyes and being like, well, this is it. It's not going to happen. Hugged my family goodbye. Was there any peace at any point during this? You know, I have to admit, during that six-month period, there was never a moment.

Oh, actually, no, there was one moment apiece. But for the most part, it was the fight. Like, I can't believe this, like, such sadness. With the diagnosis of Castleman, that doesn't get you shit, right? Because there's no real treatment for Castleman. Do they even know, I got quite curious whether we think this is a genetic condition or environmental? Do we have any sense of how Castleman comes about? Yeah, so my step-type's called idiopathic.

Moldysenter Castleman's idiopathic means we don't have the cause. You don't everyone have a disease that's called idiopathic. But we do know that even within idiopathic, that about 5% of patients will have a family member with Castleman's as well. And so those people, we feel pretty confident. There's some sort of genetic heritability. But in the rest of us, we don't know what triggers this. I run a lab. And our lab does spend time trying to figure this out.

And we have found some what are called somatic mutations. So they're basically not mutations you're born with, but mutations you acquire over the course of your life. It's in the same way that cancer occurs because you acquire mutations in your life in those cells. We're observing somatic mutations in Castleman's patients. And where is that centered? Generally in the lymph node.

And part of the reason that makes sense is that the lymph node is sort of the home-based for your immune system. So, like, if you're fighting an infection, you'll notice your lymph nodes get enlarged. And that's because your immune cells are fighting something and they go back to the lymph node and they talk to one or they communicate and they go back and they fight. They come back and they go out and fight. And so the lymph node is like the home base for your immune system. And so we think these are occurring in the lymph node.

Therefore, all these immune cells are going out and wreaking havoc. So they're leaving mutated. And so they're not good at reading its own DNA. The big thing is that in both of your immune systems, you want your immune system to be in surveillance mode, which means it's turned off looking for bad things. And when it's a bad thing, you want it to kill that bad thing, then you want to turn itself back off and go back into surveillance mode. What we find in Castleman's is that our immune system turns on and then it doesn't turn off. And when your immune system's on and it's releasing

all these bad things, it starts attacking healthy, good things like your heart, your lungs, your kidneys. That's autoimmune disorders in general, right? And autoimmune disorders typically are focused on one particular organ or one tissue type. So it might be the joints or it might be the heart. I have psoriotic arthritis. Yes. And so that's your skin and it's also your joints. Yes, yes, yes. Castleman's is like that, but it seems to be more nonspecific. It's not directed at the skin or the joints, like in Surdic or the rights, but it's more general.

Okay, so this intense carpet bombing works, but it works for how long? For about a year. So now I'm out of the hospital for a year. I'm back in med school. And by the way, my girlfriend, Caitlin and I were dating and somehow she, like, wants to stay with me during all this. You look rough. You did a 180. I do it.

Yeah, yeah. Well, yeah. You had a very distended. fluid. And that kind of distended stomach you get when you, I forget what condition that's called, but yeah, there's a lot happening. A lot's happening, yes. When do we put the NBA in the mix? So the NBA comes two years after I get sick with Castleman's because I spend the next two years, certainly bad on my disease, but also when I have this relapse after I get the carpet bomb chemo, I decided I'm going to dedicate my life to trying to find a cure for Castleman's. But it took,

getting the carpet bombing, and then I was actually put on an experimental drug that I would hope would keep me in remission. And it was after it didn't work, that then I was like, I got dedicate my life to this. And then it was in the course of trying to figure out a cure for Castleman's that I realized that the barriers in the way of a cure for Castleman's were not science and technology. They were like, can you get people to work together? And can you collect enough blood samples for research? And can you come up with the right strategy and can you raise money? And like, these are organizational business problems. And I was like, oh, the science is clear. The administrator stuff is going to prevent me from solving this disease. And actually, I mentioned

that experimental drug is called psiltoxamab. And it's hard for me to put into words what it meant when I got started on this drug because Casam is a rare disease. So there's 18,000 human diseases and more than half of them are very rare. And so you probably never heard of literally 10,000 plus diseases ever. Casim's is one of those, super rare. And it's very rare for them to have a clinical trial of a drug that might work. Like 95% don't have any treatments.

Mine actually had a trial. And I was like, oh my gosh, I know there's no solutions, but maybe this drug's going to work. I was so hopeful. And I got put on it after the carpet bombing chemo. and I really believed in hope that it would keep me in remission. And then a little bit over a year later is when I had that relapse. And it all came back.

And I'm back in the ICU with all my organs shutting down. And that was so difficult emotionally to go from like, I think we got it. Like this is the thing. And I think it's going to keep me in remission. And I actually met other patients who were in remission. I like saw them. They told me how they were in the ICU for months. One person had part of his bowel resected.

He had all these strokes. And he was walking around on this drug. And I was like, oh my gosh, I can be like him. and then when it came back, it just wrecked me. True vulnerability hits when you relapse like that. You had three relapses in five years? The total of four relapses of five episodes of this disease. And each one was so difficult for the emotional parts.

I mean, obviously there was the physical part. I'm in the ICU because for each of them, I had gotten really hopeful. And I was like, we did it. And then it just all came back. Okay, so when do you get the kind of breakthrough thought that maybe I should approach this in an off-label way? And let's just talk about off-labeling and medicine and how that works. It was during that big relapse, and now this is flare number four, so the third relapse. And my doctors explained to me, okay, you've now failed to respond to the only drug in development.

Like, Styl toxinab is it. There's nothing else. It didn't work for you. He said, all of your organs are shutting down. I'm going to try the same seven chemotherapies again. There's just a few problems. One is that, who knows if they're going to work again? You know, you've gotten them multiple times.

They tend to lose their affection as the time goes on. Two, you're approaching the lifetime maximum of a drug called atriumycin. There's only so much of these chemos that you can actually get before they cause cancer and organ, and organ dysfunction on their own. So you're approaching your lifetime max. I don't know how many more times we can do this. And the third thing he said was we've tried everything. There's nothing more we can do.

And my sisters and my dad and my girlfriend, Caitlin, were sitting in the hospital room. And I remember we were just heartbroken because he's telling us, end of the road. Yeah. This is it. Like, this is it. And we're crying and it's horrible.

And around maybe a minute or two of just like us all crying and bawling, I just remember thinking to myself. I'm like, wait a minute. You just gave me seven chemotherapies. And none of them were made for Castleman. They were all made for lymphoma and myeloma, and they worked. I know I keep relapsing, but how do we know there's not like an eighth drug out there?

Did we try all the other drugs? There's 4,000 drugs. 4,000 FDA-approved prescriptions one could be given. Exactly. And so I've gotten 10 of them now between the different drugs, they've been like, there's nothing. There's nothing. Still like a lot left. And not to say every drug is possible, but how can you tell me that we've tried everything?

Or at the end of the road. If I hadn't benefited from those seven, I wouldn't have thought that. They'd be like, oh, nothing else's going to work. I'm like, okay, they're probably right nothing else to work. But they gave me drugs that were working. So that became really clear. I'm going to dedicate my life to trying to find a drug for this disease. They sort of were like, all right, Dave,

weren't particularly optimistic at that moment. As someone who loves someone going through that stuff, you're always really having a hard time debating whether or not you're going to snuff out their hope or help them get to the part where we have closure. That's what you're trying to navigate. Like, no, my love, it's time for us to take stock of all the good stuff and have as much gratitude as we can have on the way out. It's hard.

It's really hard because I also think back with my mom, probably two of the most important months of my life or the two months after the cancer was coming back where we just were like present with one another. We were like looking at old home videos together. Not fighting. Exactly. And then I like look at how I handle this.

I'm like, wait a minute, I didn't do that at all. We watched no home videos. I was like in the lab trying to figure out, is there a drug to get saved me? And I was fighting, fighting, right? It really was like, let's go. So yeah, it's hard to put those two things together. So once you have this idea, where do you start?

There's 4,000 drugs. You start doing classes. of drugs? How do you start weeding out? Great question. So the first thing I did was to try to start to understand what does the world know about this disease. And so there were 2,000 papers. I read those 2,000 papers to try to understand what do we know about Castleman disease. Second, I connected with all those doctors for all the papers that were written to try to start connecting them through an organization called the Castlem Disease Collaborative Network. So I created this nonprofit just basically let's centralize all the doctors, the patients, the loved ones. Let's get an understanding

for what do we know? Because I even heard there was a doctor in Japan that was trying this one drug. I'm like, well, I want to try that drug. How are you doing all this? Weren't you so tired? I mean, your organs are in flux. How are you doing this? I did none of this for the month that I was in the ICU. So like I made the promise to my family and then I'm out for the next four weeks, fighting for my life. But it's then once I started to make it through that, then it's like, all right, let's get to work. And so started reading papers, started reaching out to doctors. So coming up with sort of this network. And then the second thing was, let me look at all the related diseases. These that are kind of like

Castleman's that are weird immune disorders, like psoriotic. What's out there? What are all these drugs that exist for other conditions. Because we would agree. These labels are arbitrary. They are very arbitrary. There's a doctor dealing with six patients over here that calls it this thing. It could be the same thing, right? Exactly.

And the drug companies, when they pick a disease to pursue, they've got a lot to pick from. Like, they pick the aisle 17 drug for psorotic arthritis, but they could have picked a lung disease with the same drug. And they pick for a lot of reasons that have nothing to do with biology and nothing to do with whether it's going to work. It's like they have to figure out the most profitable opportunities. Yeah, kind of market. Just because it's not a proof for it doesn't mean it's not going to work.

So my mindset was, okay, let's figure out what we know by Castleman's. let's start looking at related diseases that are like Castleman's. And then the last bucket, which was probably the scariest, or at least the most challenging, was I'm going to start collecting blood samples on myself and start trying to do research on my own samples. And the reason that was scary is because I didn't really know all that much about laboratory research. I found this amazing colleague at Penn who gave me some space in her lab. But I could do the first two. Like I could build a network and I built that organization to AMF.

I could understand what other diseases there were, but like starting to do experiments, that was certainly the most challenging. And so, yeah, over the next year, built out the network and started identifying, you know, potential related drugs, was storing my blood samples every couple of weeks in the lab. And so as opposed to you taking one of the medicines and monitoring your symptoms, you were actually able to apply the medicine to your blood in some kind of a petri dish and observe it? So what I was doing was actually trying to understand in my blood samples, which of my immune cells were turned on, what were the proteins that were elevated in my blood versus healthy people?

And see if that could give me a fingerprint for what was wrong in my disease. My idea was that if I could figure out what was wrong, I could then see, is there a drug that can reverse the thing that's wrong? Like, if something's too high here, find a drug that can maybe make it go down. Yes. That was that third bucket in my mind that I wanted to do. How hard was just to figuring out which of these T cells or immune cells were the ones that were problematic.

That feels hard enough right there. It is hard. I didn't even get to the third bucket before I then had my fifth relapse. I was just storing these samples. So by that stage, I started business school because I'd finished med school and I had this relapse and I had this long spreadsheet and I remember now I had a couple drugs at the top that I thought maybe we should try because they were used in related diseases. I hadn't yet done the experiments of my own blood to figure out what could be maybe useful for me. And I remember I talked

to my doctors about trying this one drug called psychosporin. We tried it. We were so hopeful and then it didn't work at all. My disease was just roaring through it. Organs were shutting down. All the markers were bad. I was getting like worse and worse every day. And then I asked my doctors to try the number two drug on my list. This drug called IVIG. It requires an infusion. I remember I'm going to get that infusion. And my doctor who I asked to this, she asked me, she was like, do you want some fries with that order, David? Because I'm like asking for this IVIG. Yeah. That was going to be one of my question was like, were you able to prescribe yourself this stuff? Because you had your medical degree, or were you reliant and how hard is it to get other doctors to sign on to this approach? I was reliant

on the other doctors. And it's appropriately hard to get these medicines, right? Like, it should be hard. You know, it shouldn't just be the drugs get thrown all over the place. But while it was appropriately hard and I needed to show them evidence and reasoning, I was dying. They already told me they tried everything. Right. They told me they didn't have anything else for me. So I'm telling them things that maybe we could try. It was a lot at risk. Exactly. And I was willing to take on all the risks. I was like, I know that the drug could kill me, but I'm not going to live much longer. And so the IVIG, they give me the infusion. Everything stopped. All the things that were getting worse halted. In like what time frame? Within a couple days. So like, it's halting and I'm

with Caitlin and we're engaged. Are you scared to trust it as well, though? Yeah. I sort of wish I was. You're just so hopeful. It's so nice. I was like, Ivy IG. I remember literally saying the words, we did it, Caitlin.

We did it. And so a couple more days go by and then all of a sudden, things start getting worse again. No. I'm like, this can't be. We're going for blood work. It's getting horrible. Within a couple weeks, now I'm back in ICU with everything shutting down. And I just tried the two things.

that were like the top of our list. I gave it my best. I wasn't ready to like fully accept it, but at least we tried it. And I had the feeling like we tried and we failed. And then my doctors gave me the same seven chemotherapies. This time they gave me the highest dose they'd ever given a human of this one like called the Tobicide.

And I remember saying goodbye to my family again and saying about it. I was just heartbroken about it. And Caitlin and I were supposed to get married five months later. And I felt like I'd failed her. She wasted all this time. Yeah. She'd been with me for all this time. And she was just amazing.

I remember sort of starting to close my eyes and let go. I remember falling asleep and realizing that this was it. And a couple days passed, and that crazy intense chemo worked just enough. Like, I squeaked by. I remember starting to wake up and just being shocked. It was a lot of feelings. Like, one was shocked.

Another was, oh, my gosh, it's so exciting. Like, I'm, ah. The amount of times you said it worked. But this time I didn't say it worked. It was like, because of what happened just a couple weeks before. But then it was immediate. the sense of urgency was like, okay, I've got a window. I don't know how long it's going to be.

I turned to my sister, Gina was on my left side, and Caitlin was on my right side. And I remember turning to Gina, and I was like, hey, G. And they were like, oh, my God, Dave. Hey, G, can you go downstairs and see if you can get that lymph node? They just cut out and send it to Philadelphia. And I was like, and Caitlin, will you call UNC and send those blood samples to Philly? Can you get the records to go down to? And they're both like, what?

And I was like, because I'm getting out of here. I was like, and we got to find a drug for this thing. And so it was about three weeks of me recovering, dislovering. just like, I got to get to Philly, I got to get to Philly. So I got to Philly, and I thought the blood samples and started doing experiments. This is when I was now in that third bucket, which is what are those immune cells doing, what proteins are too high? I spent about three weeks doing experiments, and by the end of it, I was pretty convinced

that this one part of my immune system called M-Tor, so your immune cells are all over your body, literally billions of cells, they have to communicate with one another and be able to let cells in different parts know what's going on. One of the key communication lines of your immune system is called M-Tor. The research I had done on my own samples suggested it was turned into overdrive. There's like too much mTOR on. You can imagine like if your fire alarm is mTOR and it's saying like there's a fire here and it's stuck in overdrive, your immune system's going to go berserk. In my opinion, the data suggested it's a false alarm. Like the alarm is going off.

It's going berserk, but there's nothing to fight. So when I saw this result, I got so excited because there are drugs that are called mTOR inhibitors. They've been around for decades. They actually were made for organ transplant rejection. Because if you get a kidney, your immune system will attack that organ and it'll turn mTOR on. But if you turn mTOR off, the alarm goes off and don't attack that kidney. So I was like, oh my gosh, we can try an mTOR inhibitor. And so I took the data to my doctors, and they prescribed me this mTOR inhibitor called serilimus. It was like a 10-year-old drug at the time. Been on the market 15 years. Yeah. Sort of known for a few decades. And yeah, now it's been over 11 and a half years that I've been doing great on this medicine.

Wow. No relapses, full health. Yes, let's start knocking out all the way. The question I don't want to ask what I got to ask is how many of these drugs your body kind of adapts? How long is it going to work for yet. It's the right question. I mean, I think that what's so crazy is how long it's been. Well, to me, 11's like, you've definitely passed that window where stuff stops. But you can imagine that every day that went by afterwards, I used to measure someone to be like, how long have you been in remission for it? And I'd be like 37.29 months. And they're like, what? You're like someone in sobriety. Yeah, I'm like, I can't round up. You don't know what's going to happen tomorrow when you're going through these sorts of things. But I know it's

been like 28.29. And so the months added up. I made it to Kaylee's Wednesday, May 24, 2014. My hair grew back just in time for the wedding. Nice. It looked like a bus cut. It was like back in time. And yeah, the months have just sort of stacked and stacked. Okay, so you come out of this and I don't know in order, but you get a job as a professor at Penn in the medical school. That's right.

And you have a lab. Yep. And you decide to really dedicate yourself to exploring these other 18,000 diseases with these 4,000 medicines that exist to see what off-label stuff could exist. Are you immediately employing AI? When does AI enter the picture? Because it's got to be almost impossible without AI. Yes, that's right. So the moment that Sir Lima started helping me,

I just remember having these flashbacks to walking past the CVS and being like, wait a minute, it was in there. All those three years that I was dying from this thing and all those five times that's to goodbye to my family, like it was in that CVS. And I just never knew it. Like, no one knew it. Stay tuned for more armchair expert.

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Listen to Tis the Grinch holiday podcast wherever you get your podcasts. Are you kind of like, why didn't all these doctors figure, I'd be mad. You would. I'm just in here doing my own blood and testing. Why aren't these other doctors doing that? I think you have to acknowledge how myopic the field of medicine is. You are an oncologist. His father's a surgeon.

You're not in the synthesizing generalist business. You're in the specializing business. And generalizing and synthesizing is so hard. This is why people were freaked out. that Homeland Security was tapping everyone's phones. And so it's like, it's a fucking joke. Nothing can synthesize all this information. You can gather information all you want.

But to actually find patterns within information is so time consuming and nearly impossible for a human to do. I completely agree. And then also the incentives are the other problem for why this doesn't happen. Yeah, you're not going to launch a new drug. Hopefully you're going to pick up another few patients, but it's going to be a few. So the pharma company is not incentivized to figure this out. That's exactly right.

So once I started just like, oh my gosh, how many drugs are out? there. It's like, okay, this worked for me. Are there other drugs out there for other people? And I'm just thinking about the patients that I took care of in med school, where we said, this is it, we're out of office. It's like, well, maybe we weren't. Maybe there was something else. I think about my mom. Maybe there was something that could have helped her. I'm going to add, too. It's not a sexy idea. No, not

at all. It's like recycling old drugs. We like inventions and breakthroughs. We don't like hearing the fucking answer was sitting next to us the whole time. Well, unless you have the ailment, then it's really sexy. Like, it's already here. Yeah, yeah. Of course. It's just our nature is to want the breakthrough in the next

thing in the next clinical trial and not, hey, we already had it. That's exactly right. The people who are doing the work are not incentivized as the patients. Like, we are incentivized to do it. We can benefit from it. But the people actually doing the work are not going to benefit from it the same way that they would a new drug. So decide that, okay, this is what I want to do with my life.

I want to find new uses for the medicines we have. I want to save people with treatments that already exist just in the same way that I was able to be saved. And so join the faculty at Penn. And of course, we started focusing on Castleman's and other related rare inflammatory diseases, rare cancers, rare immune conditions. Because there's some weird overlap. That's exactly right.

So Castleman's is very similar to Multimiloma, it's similar to Poem's Syndrome. There are these weird inflammatory conditions and cancers that overlap. And so start studying them and we start finding more repurposed drugs. I'm like, wait a minute. There's more for Castleman's and there's more for Poem syndrome. Sadly, you had recommended to another guy suffering from Castleman to take what just worked for you and you were so excited to share it with them. And then it worked for a minute, but it didn't work.

It worked in some Castleman's patients, not another. I remember the first Castleman's patient that I got to see because we treated patients in various parts of the world, but that I actually got to see in person a young boy named Joey who responded incredibly well to it. So, of course, Monica, you're going to laugh with me. Here I am again. We're like, we figured it out. Like, Castleman's just taking care of.

Look at Joey. Like, it's working for everyone. We're done with Castleman. I was directing the sitcom version of this. Like, he would always pop champagne. And it was like, by the 20th time we saw him pop champagne, we were laughing so hard. I know. But you need that spirit, actually.

It takes that. It's essential. It's a type of mentality. That's right. So we start helping these other people, and then it's other diseases. And so angiosarcoma, this horrible cancer, we find that there was research that was done three years earlier about a potential drug that could be useful for it,

but it was done in the lab and it was never given to a patient. And we treat a patient with it, and it works for him. And, like, he has this uniformly fatal cancer and actually this person is actually my uncle. And so that's even why I was thinking about it, my uncle, Michael. He got this horrible diagnosis. Everyone dies within a year. I hate to be.

No. This is too much stuff in your family. You guys all in a well. Like, at some point I get suspicious of your environment. So much is like, definitely this proportionate amount. We've had a lot of suffering. Yes. So figure out that basically this work had been done three years earlier, but no one

ever tried it in a patient. So we get Michael on this drug. It works incredibly well. Last month, he walked his daughter down the aisle on her wedding eight nine years later. Wow. This is crazy, incredible. So start giving it to other patients. It turns out it works in about 18% of patients.

So it's not everyone, but 18% it works in, it's everything. You're living years instead of weeks. And so that for me was this major eye opener. The other drugs we discovered, the repurposed drugs, we did a lot of hard lab work to figure it out, doing experiments in my blood and other people's samples. But we didn't have to do anything for Michael. We said to find a paper that someone else had published and everyone had disregarded because, like, you can't read millions of papers a year and stay on top of everything.

And so here I was like, wait a minute, maybe there's actually breadcrumbs that are already out there. So we don't even have to do all the crazy hard lab work. And so that was a really important moment for me. And fast forward over these 11 years, we've now advanced 14 repurpose drugs for a number of diseases. We saved thousands of lives, including angiosarcoma patients. But about three years ago was when artificial intelligence was really coming on the scene. And to your point, we could do 14 drugs for rare diseases, saving a few thousand lives. But AI actually would allow us to say, like, instead of looking at these few diseases,

we actually can look at all 4,000 drugs and all 18,000 diseases and let AI actually give us to score globally, every drug, every disease in a way that one lab never could. Right. never could. And so that was the big unlock. The whole school, if you dedicated the school, no, couldn't do that. It would spend years. It would be impossible for humans to do. So three years ago, my best friend from Medical School, Grant, and I and Tracy Secorra, we co-founded every cure of this nonprofit, with the idea being that we want a nonprofit that's on a mission to save lives with the drugs we already have. It's here to unlock the potential of the treatments we have

to treat the diseases at ALS. And we use AI to actually quantify every drug to treat every disease. So there's 4,000 drugs, 18,000 diseases. That's 75 million possibilities. If you tried every drug in every disease. You do it 75 million times. We get a score from zero to one for every one of them for how likely it is to work. Yeah, so what's the max out of that zero to one range? I read that and I was just curious. What do you see normally or what's outrageous? Like a point seven is like, well, we got some. It's a good question. It's a fairly linear scoring system. So there's actually a lot of point nine, nine, nine. The idea being that we want to look at the point nine nine. The whole point of the scores, you always say like, what are the things at the top? Because if you start with Castleman's

only, it's like, well, you might find the best drug for Castleman's, but is that the best drug for humanity to use? Is that the best match between a drug and a disease? Probably not. But if you do this all versus all, to your point, like, you can look at the things that are the point nine-nines, and you come across things where like, really? But then you dig into it deeper and you figure out how might work. And you've discovered, had an impact on nonverbal autistic kids.

Yes. It seems impossible. Yeah. So a portion of kids that are nonverbal and or have other nerd about mental challenges, often in speech delays, they actually can have a antibody against the folate receptor. So folate is important for brain development. And in order to get folate into your brain, you need this receptor be functioning. But if you have an antibody against it, basically the vitamin doesn't cross into the brain. These kids can have what's called a cerebral folate deficiency. And so interestingly, there's a derivative of folate called

folinic acid. It was made for people that are on methotrexate chemotherapy. And it's been around for decades. But that derivative of folate can actually bypass this blockage at the receptor and can get into the brain. can leapfrog this whole. Yeah, there's something called the RFC, which is a channel right next to the folate receptor. And so if the follow receptor is blocked, but if you give the derivative of folate, it can go through this channel.

So basically leapfrog, get into the brain. And that was a really important discovery that humans made. Let me do really quick. So that makes total sense. There's this thing inhibiting this vitamin required for this part of the brain to function. But in the absence of that, wouldn't that portion have already been so atrophied?

It couldn't be brought back? Or it's just there and it needs that as fuel? It's a good question. We don't know the answer to it. All we know. is that work's been done to show that some of these kids have too little folate. We know that the reason they have too little folate is because the antibiotic receptor. And then the really interesting thing is that there have been multiple clinical trials now,

all relatively small, that have shown that giving this derivative folonic acid can improve verbal communication to these kids. Wow. Is it just a pill? It's just a pill. You give the example. One kid was nonverbal for five years. That's Ryan. Ryan was basically nonverbal for five years.

He could do something called echolokia, where if someone said something to him, he could repeat it back to them, but he could never actually share his own. He never made yet an executive communication. where he made the decision, he had receptive communication. So he had a lot of things in his mind that he wanted to say, but he couldn't say them. Within two weeks starting Luke Givoran, he told his dad for the first time ever a statement. And he said, Daddy, I love you. Oh, honey.

You can't even right now. That would have killed Dad. I was like, I cried for the next 15 minutes. Like, I couldn't do anything. Can you imagine? He couldn't even leave the house. Yeah, my kid's first sentence would be like, I want to go to Target, I think. Oh.

Because he's been stuck. Why's to say that? And also, like, should Ryan have had behavior? behavioral issues over the years. Of course, if you had all your thoughts and you couldn't fucking get them out to you. I would rage. Could you imagine? But there's been multiple success stories.

There's multiple success stories. Next day, there's another patient, Mason, who within three days of starting it, he said his first word and just thinking about what my kids would say, his first word was more. And I feel like that's all my kids is asking me for more. And I was like, that's exactly all my kids. My kids are more, more, more, more, more. It's very human.

Yes, me too. Oh, my gosh. That's so incredible. Yeah. And so, like, this is why we wanted to. to start every cure because there's things that are out there. And I love that every cure and AI can help us discover new treatments. And I can share about some that we've discovered.

Literally, it's like, oh, wow, this is never been used. That's amazing. But sometimes it just uncovers what us humans know about, but we just don't put into practice. Yeah, I want to hear those two things. I want some more examples. And I also want to know, I keep reading, you guys train this model to do this. But how the fuck do you take this tool we have and actually get it to go through every single medical journal ever written?

How do you construct that? That's its own break. through. It is. So we utilize something called biomedical knowledge graph. So knowledge graph is a way to basically construct and bring together lots and lots of information from disparate places. So imagine a knowledge graph would be if we had on the wall, every drug, every disease, every gene, everything we know about medicine, all is one node each. And then you've got lines connecting all of them based on the relationship between them. So we use every paper that's ever been written, all data we can find online. Anything that we can find will fill out this graph. So every concept plus all the relationships

between them. So it's like, so toxinab treats Castleman disease. I-L-6 elevated in Castleman's, but imagine that for everything on this graph. So now this serves as the perfect ingredients to then train machine learning algorithms because we can say, you know this whole graph here? This drug works for this disease. This drug works for that disease. And we train it on the known treatments. And what it'll learn is that there was a paper that was published three years earlier, like an angiosarcoma showing that this drug might work in that disease. And it did. And so understand these patterns. And then we ask the exact same algorithm now that we've shown it, this drug works for this disease. now give us a score from zero to one for how likely every other drug is to treat every other disease based on these pattern of connections.

And do we owe the Scandinavians the biggest debt of gratitude? I don't think the ones that have kept the best medical data and made it. It's not public, but it's public. It's obscured, but it's all there. Yes. Northern Europeans have done a great job with electronic medical record data. You need these like epidemiological studies in five seconds. Absolutely. Yes. Everyone's in the same database, which a lot of other countries, we don't have that. I know we all have privacy concerns, but there's got to be a way.

Everything I've gone through with this whole psoriotic arthritis thing. Like, I could save someone years if you could access my thing and just not know my name. I feel like we need to move towards that. Yeah. Why is this not happening on its own? Like, what's broken about our system? And I think there's a couple of things that have just completely shocked me. So first of all, those 4,000 drugs we have, 80% of them are generic, which means that once a drug comes generic, anyone can make a copy of that drug.

The exact same drug, it's the same name. And when you have 10 people making the exact same drug, the price plummets, which is good for our health care system. It's not a cheap drug. But now it's like a penny a pill of profit per sale. And there's 10 different companies all selling what one company used to sell. So you might find that that drug could work for a million people with another disease and no one will make any money off of that. The depressing thing is that that shouldn't matter. But it does matter. It's not that people are hiding. It's just that if you can't make any money off this thing, you can't spend millions of dollars doing clinical trials and then actually raising awareness about it. Somehow,

80% of the drugs we have, there's no incentive to find a new use for them at all. Even though they're there and they're safe and we know how they work and we know everything about them and they're the things that are perfect for a knowledge graph because we've got a lot of knowledge about them. Of course, everyone's using AI to find new uses for medicines, but no one's using AI to find new uses for old medicines. And so that financial problem is huge. So really before you move on to the next one, what's the solution for that one? We feel that the solution is to create a non-profit that doesn't have to be driven by profit. So we've got this financial problem, which is that it's not profitable to find a new use for an old medicine. And then on top of that, we have an issue that somehow no entity has taken responsibility to be like,

I know that there's this market problem over here, but we're the NIH or the FDA or we're some entity. We're just going to do this. Like, we're just going to find new uses for medicines. And so there's just been this huge gap. And then to your point earlier, there's also never really been the technological capability to really do this at scale. Maybe we can't blame the system too much because it's only reason that the system could even address this. Yes. But when you bring those three things together, we have this horrible situation where there's all these drugs that could help people,

all these people that are suffering and no one doing the work to bring together. But you're here now. Thank God. Yeah, so give us a couple more. I read an article maybe in the New Yorker about Joseph Coates. Joseph was diagnosed with a rare cancer called Poemm Syndrome. He actually was initially thought to have Castleman disease. And so that's how we initially got connected.

He came to a conference and I got a chance to meet him. His diagnosis was changed correctly to poems. And a few months went by and I hadn't heard anything about how Joseph was doing or what was going on. And then his girlfriend, Tara, reached out. He said, David, since I saw you guys last, Joseph got really, really bad. He's in the ICU right now, and he's on life support. This was a Friday, and by Monday, the doctors are going to take him off of life support and put him in end-of-life hospital care.

And I remember just being so shocked. I was like, oh, my gosh, I saw him just a few months ago. He has so much life and energy and love and just heartbroken for it. And home syndrome is a condition that I mentioned is in the sort of same family as Castleman's and myeloman. So I knew enough about it to where I felt comfortable really digging into Like, are there drugs we could recommend for Joseph? I know that his doctors are ready to give up, but can we just try something?

And so I was able to get in touch with this doctor on that Saturday. And his doctor graciously called me back on a Saturday. I recommended three drugs that are typically used for multiple myeloma, which, again, is a similar cancer to poem syndrome. That doctor hadn't considered. In hindsight, it's like, let's be creative here. Yes, there's nothing for poems, but like, let's look to the side of poems. Thankfully, he listened to me and he's like, well, I'll talk to the family and I'll talk to my colleagues.

Maybe we'll try them. But he was actually very worried about the fact. fact that the chemotherapy that we were recommending was going to kill Joseph. And I talked to him, said, but you're going to take him off life support on Monday. He's going to die from his disease. Let's give him a shot. Let's try this. He made the decision to try these three drugs.

And we just sort of waited for the next few days, like, what are we going to find out? And then within a few days, heard that things started to improve. And I can't tell you. You got that bottle of champagne out. Oh, no. Exactly. Exactly. Cut the cigar tips.

He responded. He got out of the hospital. And then what's so amazing is that Poem syndrome is a condition where if you can get into remission like we got him into, we did a stem cell transplant for him. And so he's potentially even cured right now. So like I saw him just a few weeks ago and he's got the most incredible energy and he's so positive and he's got his life back. So I should also mention this is an example. And at every cure, the way that we work is so we scan every drug against every disease or our ad platform. Our med team finds the best matches and then we move them for it.

We do lab studies. We do clinical trials with this whole systematic approach to fix the. this system problem. And then also in parallel, we get contacted by patients like Joseph and Tara. I struggle so much because I want to help them. I want to throw the Hail Mary in the same way that we did a Hail Mary for me. And at the same time, we have this systematic process where we've got a 50-member team where we're using AI.

We have to focus on that. Like we've got this responsibility from a systems level because there's people at the other end of these drugs that we're working on that are waiting for solutions. But then there's also people who are reaching out to us like Tara and Joseph. And that's probably the biggest struggle that I have is how do I balance the two? because we've got an amazing team, but our team can't actually pursue every disease that we're contacted. I need to be crude, but you could be penny-wise and pound foolish.

I think that's the right analogy here. So what we have to do is we have to say, okay, if you match every drug to every disease, what are the best opportunities? We've nine programs already. We launched this nonprofit. Three years ago, we built our platform over the first couple years. We've only been using the pipeline for 12 months.

And we already have nine drug disease matches that we're advancing forward from breast cancer. And there's this lytocane thing, which is bizarre. tell Monica about this. Yeah. So amazingly, there's really interesting both laboratory and clinical data on the potential role that lydicane injection could play in individuals with breast cancer. So lydicane is the numbing medicine you get when you go to the dentist, right? So injecting it around a breast cancer tumor before surgery, there was a large trial that was done in India of 1,600 patients. And those patients who had it injected around their tumor before surgery

had a 29% reduction in mortality at five years versus people who didn't. Wow. society came, like this simple substance. And it was published in a major journal called The Journal of Clinical Oncology, one of the best cancer journals in the world. We're looking at it in our platform. It comes through our pipeline and we're like, people must be using this, right?

It's like super cheap and it's widely available. But then we learned that no one is using this. The paper's out there, the study's done. And the general consensus from a lot of folks is like, well, you guys should do another study, another seven-year study and see how people are doing. The question is, do we need to do another study? Why? This is already proven.

A randomized control of trial. It's already going to be used in the surgery. And so we are doing more lab work now. because the other thing that doctors like is to understand why something might work. Because like, oh, we injected lytocaine and people died less. Like, well, why? So we are doing lab work to try to figure out the mechanism. We've got some hypotheses.

One is there's a lot of evidence to suggest that during the actual active surgery to cut out a tumor, whether it's breast cancer or you name the tumor, that that's apparently a moment when a number of cancer cells become very migratory. They basically try to escape from the region. It's partly because there's decreased blood flow because there's trauma that's occurring in the area. So the thought is that there's actually metastases that occur while you're operating. It's actually migration. And, of course, this is a hypothesis, but it's something we're studying.

So the idea for how lydicane may work is that lydicane is very good at making cells non-migratory. It freezes it, like it stops it from moving. The thought is that maybe we prevent what would have been a future metastasis to your liver or you name it from being able to get out of the space before the surgery happens. You're like kind of paralyzing. And you actually do the injection eight to ten minutes before surgery. So you're like paralyzing it, then you cut it out. And at least in these patients in India, it was a game changer. We trust India.

Yeah, we like that. So these are the kinds of things that we would have never thought to look for. One that blew my mind is Botox in the frowning because that is a cycle, as we know, the people that were famously documenting all the face shapes were giving themselves emotions. And this is a two-way street. And just numbing the ability to frown can have an impact on depression, maybe. Crazy. Yeah, so this idea with Botox is there's actually been clinical studies that for about three or four months after a Botox injection right here between your eyebrows,

there's improvement in mood. I mean, shit's getting wild, right? And so we got to figure the stuff out. I mean, we actually just talked through two of our nine programs, but one of my favorite ones is this rare condition called Bachman Buff. So kids are born on feeding tubes. They are unable to move. It's a horrible condition.

And it's because they have two high levels of an enzyme called OCE1. And so what's so interesting is that African sleeping sickness is a condition that involves elevated levels of OCE1. So there's a drug called DFMO that blocks OCE1 for African sleeping sickness. Well, it turns out. that OC1 is also too high in these poor kids that are bedbound on feeding tubes, if you give that drug DFMO to these kids, and there's now been about 10 kids treated, the earlier you give it to them in life, the more likely they might have their feeding tube taken out.

They might sit up. They can even walk. I keep saying this is why we started every cure. Every one of these is why we start every cure. But this is it, right? It's like this super rare disease, this super cheap drug that's been around for decades. No one's ever going to do the work to get it to every patient possible. But we had every cure, we can do that.

We can get involved in trying to diagnose more kids to make sure that more kids get DFMO. This is for us why we did this. Well, okay, so if people want to support every cure, what should they do? Go to EveryCure.org slash donate to donate to us. Also, a big part of this is awareness raising. So thinking about some of the drugs we've talked about and even others that we're working on, part of it is doing really good science, great lab work, great clinical trials. But another part is actually just getting the word out.

If you know someone who might be able to have this blood test, it might be helpful for someone in their family, so going to our website, learn about our organization, help to spread the word. I did a TED talk that came out about a month ago, spread the word about that. These are the kinds of things that actually, you know, patients will benefit because we tweeted something. The work's already been done. The drugs are there. So just get in the word off.

Is your wife come home? It's like, we got to eat kale now. And you're like, how did you find that out? My whole diet is based on whatever someone's told my wife that's good for us now. Exactly. And then, of course, people should read your book chasing my cure. It's wonderful. It's rare that I can say this to somebody, but I'm so happy you didn't make it in the NFL.

Oh, my God. Congratulations on not going to the NFL. We needed you way more. And not getting CTE. I knew we would have. I mean, we're just lucky that you didn't get it because you wouldn't be able to do all this. Very true. Maybe there's a drug to repurpose.

Exactly. David, this has been a delight, and I hope everyone does check out your book and checks out the website and totally grateful this is the work you're doing. And every time we're getting really negative and pessimistic about AI, it's also doing this. It's like doing this shit humans could never do. Can't calm through all that stuff. Thank you so much. Good luck with everything. Well, thanks that for having.

This has been so special. Thanks, guys. Stay tuned for the fact check. It's where the party's at. Okay, so I have huge Aaron updates. Okay. Okay. So Aaron was there for, I think, five days.

He already went? He flew home this morning. Oh, wow. So he didn't fall down? Well, listen. In order, you know, each evening, I would FaceTime him. Okay.

Even before he started. And I said, look, and what's the game plan for this, like, the second story, Eve on the roof, you know? I said, do you need to rent, like, a bucket? If you want to rent a bucket, you know, let me know, I'll figure that out. And he said, no, I think I'm going harness and ropes. Okay, I like that. But what's that mean? You put yourself in kind of a diaper.

Yeah. You put yourself in a leather diaper. or a nylon dip. You use a carabiner. Yeah, and then you hook off onto the roof. What, to what? Exactly. So the issue with the house in Nashville is it has a metal roof.

So you can't do what he would have done when he was a roofer, which is like anchor to the top, just screw into the wood. Oh. So he had to lassoe the chimneys. What? Yes. But this plan wasn't he, I think wisely like I would have done. And he just kept putting off the height, the really tall work. The hard part.

He just kept, like, working in the yard and doing trees and doing, like, fences and stuff and just, I think, eyeing all week. And so each night, but he's up and down a ladder. You know, he's doing a lot of ladder stuff. Oh, my God. And then I would look at the cameras at the house just to see if he was lying anywhere on the ground, you know. And then I would FaceTime them every night, which was so fun, A, just to have an excuse to have to FaceTime every single night. It's a good, I want to make up a reason why I have to do that.

I think you can just, friendship can be the reason. I know, but there's something more organic about it. It was like, okay, good, you're alive. And then I'd hear about everything he did that day. And, all right, so did you look at the pictures? Okay. I see him on top. Wow.

This is so dangerous. Aaron looks, he looks like an ant on top of the roof. Who's taking these picks? Chris, the content. contractor happened to stop by for something else and he sees Aaron way on the top look at the one of Aaron crawling up I know that's so scary dags I want him to almost be a decoration like wouldn't it be funny if there's a person we had a person like a dummy up there putting it on yeah um okay now if you go to the last picture in that group do you see Aaron lying on the yeah on the roof okay so he did fall no no no no no no No, no. Aaron, and by the way, he's not wearing the helmet, so he does not get $500 for me. Okay, but look how happy is zoom in on his face. This is his textbook, Aaron.

So Aaron, he had this long rope, but the problem was, is the chimney is not centered to where he needs to be on the high point. So he's using this rope kind of diagonally. And he's in his mind, he's like, oh, yeah, I map this out perfectly. Like, if I fall, it's going to catch me on the second story. Well, no, the rope was longer than he anticipated. And he fell down to the first story. But he did land right before he would have gone off the edge. He has taught.

I said, are you hurt? I was talking on my ride to my meeting last night. I said, you get hurt. And he goes, oh, my God, no, I feel great. No problem. Then he sent me this picture about an hour later from the shower. I'm going to send it to you. And this is from his harness.

No, it's not. That's from his fall. Well, yeah, the harness. tightening when he fell. That looks horrible. He's hurt. I know what he just doesn't care. But I also know what it's like to be him,

which is like this stuff just doesn't even register. It's like I wanted to get those lights up there. I got them up there. I don't really care about the thing. Okay, now watch the video coming into the house. And I'm going to watch it with you. That's in fast forward. He's not really driving 100 in my neighbor.

He just wanted you to see what the neighbors have going before you saw what we have going. They do. Wait, that's yours? Yes. The yellow and the blue? Look at this place. It's like Descanso Gardens. Oh, my God. It's truly Clark Griswold. Wow, Aaron.

Can you believe this? He did such an amazing job. It's like an amusement park. Chris is like, you should charge $20 for people to walk through your yard this Christmas. Can you believe I'm like, Aaron, no one has ever over-delivered this much. my expectations versus what he did that looks so good it looks stylized like he like he didn't just throw a bunch of shit everywhere right he put some real thought and yeah wow good job aaron um so for people who don't remember our custom for thanksgiving with our friendship group yeah we do something called secret turkey yes i presume you've been assigned somebody yes and have you been working on it

yet? Yes. You have. I have. I finalized my idea yesterday and I put it a little bit into action, but there's a lot more steps than I'm nervous about running out of time. Because is it, it's next week? Yeah, it's a week from Thursday. Okay. I got to get cooking on mine too. I have the base of mine, but then I need to get artistic on top of it. I, you know, the rule is you have to make it. Okay. Right? Like that's a rule. Yeah, yeah, yeah. And I, I feel like- Or customize something about it. So I feel like I'm blurring the line a little bit this year on that. Me too.

A little. Okay, you too, too. Okay. Yeah. I want to know who you have it. I don't want to know. Yeah, I don't want to know either. You like spoilers or not?

Lincoln loves spoilers. Yeah, she loves that. I don't like it. I don't either. And she'll ask me like, we're watching a movie I've already seen. She's like, well, what happens about it? And I'm like, I don't want to tell you. I know.

You really want to know. Yeah. And she really wants to know. It must be anxiety in a movie or something, maybe. Yeah, or just impatience. I think more impatient. That's interesting. Yeah, I mean, that's a quality of mine impatience that I definitely think I passed on.

But you don't, you don't want to know. I don't. And that might be a product of getting older, which is there's so few surprises anymore in life. You've got to really kind of protect them. So, like, I never want to know. I mean, I virtually don't even want to ever open presents on Christmas. What I love is the anticipation of presence. It is exciting.

Yeah. Post presence is... Sad. It's sad. Yeah. It's time to make up an excuse for why... You're going to Staples. Why you got to go to Staples.

Yeah, because yesterday I walked in the house and Lincoln was there and she was working on something. She was like, oh, I want to show you. She showed me and it was her secret turkey. Yeah. And she was like, I have. And she said, and she said, who do you have? with no like I know we're not supposed to say like she just feels like we're going to say it that's

right I did tell her because I felt kind of weird being like no I'm not I'm not telling you yeah she cornered you I told her and I told her my whole idea oh you did yeah okay well I'll make sure to not ask her I'll make sure to not find out from her yeah don't let her tell you about mine was it no it couldn't have been done because when I got home last night for my meeting she was just kind of finishing and it was mind-blowing like i don't know what career exists in making diaramas but boy her that is her her crazy superpower she makes so many dioramas she's very artsy and it has the tree has lighting in it and stuff beautiful yeah yeah i mean her and Aaron they could get together and really start a business she could make a model of your house what it'll look like when it's done

and then Aaron could execute it and then you get the model afterwards then you have a small version of And it's like 55,000 instead of... Is that a five? Because of the model. Oh, the... Do you guys take down everything the day after Christmas? Oh, God, no. Okay, yeah.

Some people are like, it's over and we're done. Those... Good for those people. No, you got to go after New Year's, man. That's how I feel. You're going to be entertaining and having people over. Okay, so I have a correction to make. Okay.

And this is, I'll take responsibility, even though I think we were on the same page with what the lyrics were. Dax, I was screaming in my car. The ne'er lyrics are, Oh. Who wears short shorts? We wear short shorts. If you dare wear short shorts,

ne'er for short shorts. Neer for. And they're using nears a verb there. Even though it is a noun, because it's a proper noun in the name of a product, they are using as a verb. Nair for short shorts, near yourself.

Or, sure. Yeah, it could still be the product. So it's not Nairwear shorts. Okay, well, I guess I'm happy because that didn't make any sense to us. I'm sad. I liked it more when it was Nairwear short shorts as if Nairwear shorts. Yeah, I mean, I do think it's cute if those little shorts on the bottle. Big time.

That's adorable. But I do, I do appreciate Taryn Graydell correcting us. I like that. Do we think Nair is still on the market? Rob? Checking. Still the website. Yeah, it looks like it.

Okay. Oh, great. I kind of feel like, allegedly, it had some, you know, some stuff in it that was, like, not so great. Well, if it's interesting, it burns your hair off your body, but it doesn't hurt your skin. What a product. You got to give your, you got to tip your hat to the folks. sitting there that they figure out how to burn hair off your body without hurting your skin? I guess the question is, but does it hurt your skin?

I remember using it once and it hurt my skin. Do you know what's so interesting about my unibrow? Oh, yeah, what? I think it started coming in when I was like in high school unibrow. What do you say? I mean, it is. You and eyebrow? No, you're right, but it's just, it sounds cute the way you're saying.

I think I'm like, oh, she has, have you seen her? She has a unibrow. Unibrow. I say unibrow. But that doesn't make sense. right, because there's no A and uni. That's how I say it too. You say Unabrow?

Yeah, Unabrow. Okay. And I want you guys to continue to say it that way, but I do think in this rare case, I'm saying it correctly and you guys are saying it incorrectly. Okay, the point is... But I think it's funny. Okay, go. Okay, my unah or e-brow started coming in probably ninth grade or something.

I started getting insecure about it. Yeah. And I started shaving it. Oh. Which is dicing. And a lot of boys shaved it in my school. And you can see them to be stubble. And it looks, it's terrible.

So I was like, this doesn't work Because you see it grow in Yeah, yeah And then I used Nair, I think You did? Yeah, I think I did And I remember in between my brows Being very red and irritated

And me thinking, oh, Jesus, do I have a burn now between That's not better. You got a chemical burn Because this skin is so sensitive Base skin is extremely sensitive It's like silk, they say Is that what they say? They say, and you don't want to be pouring chemicals on silk

Never, never Almost never. I never put nair on my silk, even if I have a tough, stubborn stain on my self. Yeah, you don't want to. Now, you never, I guess like the boys in ninth grade weren't even thinking about plucking. No, so then I switched to plucking in my probably by the time I'm a senior or 20s or whatever. All this to say, Monica, I don't do anything to it now. And it's gone.

It's fucking gone. Yeah. And it's been gone for a while. Yeah. And I'm so confused because hair is just proliferating all over my body in the most offensive way. Right. I told you, it's like when I work out, half my workout has seen different hairs because the light's coming from behind me and I'm in front of a mirror. Sure.

I'm like, my God, I'm turning into a werewolf. Yeah. But for whatever reason, the uniture, the middle part of the unibrow. Yeah. Went away in an era of great, great hair growth. So I agree, though, even for me, like... Have you had that experience? Yeah, I mean, every now and then I'll, like, have to, like, pluck a little bit, especially

on the sides, but the middle is... It's free. Done. Yeah. And it used to have some action? Yeah. Yes. I think there is something to when you pluck a lot...

They give up. In area... Yeah. They give up. They give up. That's why people were so worried, you know, girls of my gen would overpluck our eyes. eyebrows like crazy and it was just this like teeny tiny thin line that was what was in yeah and then there was a lot of fear once bushy eyebrows were back in they would never come back right but they

did they kind of did yeah for me anyway but yeah the the uni is retired it'll retire it retire i wonder why it thinks you needed in your youth and not in your old age must have been a very attractive thing at some point maybe it showed your virility or something well testosterone sure tea very virile yeah interesting but mine's gone do you think yeah at one point like the female unibrow was considered hot yeah i guess frida frida she was hot yeah yeah may almost had it and she looked great like she would she would on parenthood she had bushy eyebrows and she would comb them towards each other oh yeah yeah yeah it looks so cute yeah yeah you just just i mean you You really, the power to decide you're cute and it's infectious is really one of the miracles on earth.

What if they start doing like implants? Mercans. Yeah, Merkins. Stay tuned for more armchair expert if you dare. Okay, we got to talk about it. Skims has a Merkin. Yeah, tell me more. Tell me all about it.

Skims has a thong. The front is covered in hair. Okay. And then there's different colors and there's different textures. There it is. Interesting. So blue is an option? Well, I think that's black.

Okay. Yeah. Photographed a little blue, but that's okay. It did. And the other one looks like camel hair. Yeah, one's red. I don't really understand that. Well, that's red on the head, firing the hole.

Oh, that's a red hat. Do the curtains match the, match? See how they're different textures, like one's curly, one's straight, one's like fuzzies. Yes. By the way, you can't get any of these. Oh, you can't? No, they're all sold out, which I find, I have to be, I love skims. And I want them to send this to me.

Yeah, send it to Monica. I was going to say, I want to see someone in them, obviously not you. That would be in the realm of, what was the, what were you going to have to put your thumb in my butt to save my life? As a co-worker. The things we talk about. So, yeah, I want to see someone in this. Maybe Rob. Okay.

You can see Rob in this. I think you should see Kristen in it. Yeah. Because that's the best case to know if, like, it actually is erotic. Yeah. Yeah. It says it's an actual pair of underwear. I mean.

Anything's erotic. It's called faux hair micro string thong. It's totally sold out. Yeah. I would like Skims to send me one. Now, I do have a question. Like, I've never seen a red-headed pub. Uh-huh.

Would it possibly be that red? No. It wouldn't, right? Well, I've had some red-headed lovers. Yeah. And I've had the great pleasure and joy of seeing red pubis. Uh-huh. They're lovely.

But aren't they more orange? Yeah. Okay. That would be my guess. Even red hair isn't that color. No, unless it's been augmented. Okay, the one I would be, I think I should try is, um. Well, blonde though, that's kind of mixed messages.

It's like fun mixed messages. Yeah, yeah. They have like a white blonde one. They also have, let me look at, let me see what I want. Okay. I want two. I want, I want three. Okay, great.

I want the cocoa blonde straight. Mm-hmm. That's this. Oh, yeah, great, exciting. Okay, then I want cocoa ginger curly. Oh, sure. Okay. Okay.

Then I'm interested in cocoa brown straight. That's the bottom one there. Yeah. That one looks a little coarse, doesn't it though? It does, but to me that looks the most real. But it's not my coloring, so I think that would be interesting. Yeah, that could be fun for people. We'll keep them guessing.

And I, this one is closest to me, that middle one, Cocoa Black Curly. Uh-huh. So that's what you want. Oh, wow, Rob. We have a real extra close-up of the. The brown hair. It looks beautiful. It looks itchy.

Yeah. It looks like, hey. It looks, stabby. It really looks like pointing. Well, you all do send those to Monica and then we'll get a full update on how they worked out. Yes, Kim's, please send me these. Cocoa, Curly, I would like, because I want to see how realistic it is.

Well, there's got little hints of gray hair in there. I know. That's fun. No. That will depress me. That will depress me. People's pubic hair does turn gray. I know.

I've heard that. Mine hasn't. Yeah, luckily. Still look youthful. Wow. Will you let us know when yours starts to turn? Turn gray? Yeah.

Be a sad day I'll report it. There's that old allegory. There's a very famous story right about a king with one gray hair. As soon as you get a gray hair, you can no longer be king. Do you know this is a very famous story? I don't know. I don't know it. What happens? He's either, well, you can't be king anymore, and he might even have to die.

I don't know. Or turns it over to his son immediately when there's a gray hair. So he's living in this great fear of one gray hair. Oh. Yeah, and it teaches you some kind of lesson, but I don't know what it is. It feels like you should be afraid if you're going to get killed or dethroned. Yeah, it's a legitimate fear. Yeah.

But it's supposed to teach you an important lesson. It's the messenger of death sent by the god of death and the king immediately understands the implication is youth, middle age, and old age are coming to an end and death is imminent. I still don't understand the lesson. The core moral story is that

even a long life is too short to waste on mere worldly pleasures and power. One must recognize the signs of aging and mortality and dedicate oneself to a life of wisdom and righteousness. Interesting. Okay, wow, this is a ding, ding, this is really ringing a bell.

Oh, okay. Okay, so my weekend, now I'm going to violate it, but I'm not really violating it. You might think I'm violating it, but I swear I'm not. Okay. Because I'm not telling any of the people involved, and that's the key. Okay.

And no one involved in this will listen to this, nor will it get to them. So my weekend was 100% of service. Great. We had a thing on Friday night. I had to drive to sit through. I had a volleyball game. Then I had a birthday party.

had to drive someone out there and then I just sit in my car for an hour and a half while someone was at a birthday party then there was a show of thing and the thing I mean just it was the whole weekend and I found myself wanting to call attention to what a sacrifice I had been making that was my instinct and that I I wanted it to be known that I hadn't done anything I wanted to do this weekend right and I remembered my great therapist Mark telling me um listen as a man you can think this but you shan't say this You shan't ever say, what about me? Mm-hmm. And that's solid advice for a man.

I like that. Yeah. It's the path we need to walk, us men. And it should be walked. And I just kept hearing the voice in my head all weekend. Like, you're not going to mention at all that you haven't done anything but drive people around your limited two days off. Yeah. And I achieved that goal.

And then on the flip side of the coin was I had done something. abnormally generous for me for virtually a stranger okay and then I was like and you can't tell anyone and I was like I'm gonna call my mom and tell her that's what I wanted to do great like I'm not gonna tell you my friends I did this great I don't want my children to know Kristen had to know because we share finances um and I had to talk myself out of telling your mom telling my mom and I decided it's your old man it's time to stop doing anything looking for and so that you'll be observed doing it applause validation yeah we love you you're so good when is it just going to be for you why don't you just do things that you know give you a steam and leave it at that that's a hard challenge for me

i'm embarrassed to admit yeah like to do things secretly that only fill me up and only i know we're good right is is the i think the last chapter you should i should hope to achieve yeah that's great on my evolution on this planet but that that reading just made me think of that entirely like it's time for wisdom it's time for other things oh that can and for me in my life it's time to just do things yeah with quietly for me yeah and it's almost it feels pointless which is crazy. That's how deep the exhibitionism of my soul is. It feels pointless to help. If I only know. Oh, wow. I mean, it doesn't feel pointless to the person that I helped. Right. Of course. Yeah, exactly. That should be enough. But opening my imagination to a world where no one

ever knows if I did something good is shockingly absent of the normal reward I'm, seeking used to giving or just the operation yeah um i don't know it's really tripping me out yeah that's a great goal yeah and it's harder than i want it to be yeah this kind of circles back to something we talked about a few weeks ago the give for fun and for free uh-huh that's what it is about i know i know i guess like i don't feel very judgmental of myself because like look again we're we're like this super social animal and our reputation is everything in a group. Yeah. Are you benevolent?

Are you selfish? Like these are key things we need to know about each other if we're going to trust each other. So naturally, we want people to see when we're benevolent. I know. And we pray they don't see when we're selfish and shitty. Yes. Because we have to keep our standing in our group. I know.

But I guess the... It's like life or death. The catch 22 of it, though, and this isn't fair, but this is true. is displaying your benevolent or generous, like stating it has the opposite effect. It makes people think, like, no, you're not because you had to do that. Like, it takes away from the act itself. I think people, I think, well, there's some artistry to it. There is a way for people, for you to let people find out stuff you've done.

That's good. That isn't overtly braggy. Like, if someone's overtly bragging, yeah, it's immediately. tasteful. But if you find out that Eric put a kid through college, you're like super proud Eric. That's amazing. Yeah. And you would want to say to him like that was rad, dude. I'm glad you did that. Yeah. And so there's a way for Eric to get that out. That's not gross. But I don't think so. Like I think if he has a hand in saying it, it does take away. I think though I think people do find out whether you say it or not people will find out other people's

level of generosity whether they are affected or not or told or not it's I don't know I think it's clear yeah and it way more clear when the person is keeping it to themselves yeah it's just it's a really powerful force yeah to do things secret Yeah. It's a good goal. It is. I like it. And it's just, but again, so me saying that there seems to be no reward on the other side of it is also me saying like, oh, this is interesting. Because I know there is a reward, but I can't even imagine it.

Yeah. Which is interesting and fun. Because I'm so locked into this architecture of like people approve of you. Yeah. The reward. That's how you know you're doing the right thing. It's like, yeah. people approve of you. Yeah, the reward is that you know you're good. Right. And that's where

I think the growth is, is that why don't I value at all if I think I'm good? Yeah, exactly. Right. Why do you need other people to know, to think it if you know it's true? Yes. Why doesn't my opinion about myself matter at all? Unless it's negative, then I think it's very important. Right. Like when I'm self-flagellating, I think. I'm the most astute observer of me in the world. Right. And so, yeah, I think I am going into it with a blind faith that one day I'll wake up and go, oh, this is the reward. And I love it.

But it is a bit of a blind faith pivot. Yeah, I like that. I think I've been slowly moving in that direction. But for whatever this weekend just was like compounded, two things I would have normally done. I was like, called my mom. Yeah. Yeah. Mommy, I was a good boy.

I mean, I think it's cute to be good like you hoped I would be. I think of all the people to tell your mom is safest. Yeah. Which is why it was hard to talk myself out of. Right. Yeah. Yeah, I think you would, you could have done that. No, I'm not going to.

Well, that's great. All right. Let's do some facts. Okay. David Faganbaum, I only have one fact. He was extremely factual. He sure was. The only thing I did look up was, does glioblastoma affect women more than men?

Yeah. It's more common in men than women. Oh, my God. Well, this is why anecdotal info is misleading. That's true. It just so happens in my life. I've known a lot of women. Yeah.

And none men. Men are about 60% more likely to develop the tumor. While the exact reasons are still being researched, this disparity is not believed to be solely due to sex hormones. Anyway, it's very, it's not fully understood. It's horrific. I know that part. I know. It's because, so, unfortunately, one of our very good friends has had multiple people affected by this, died of it.

She once taught me that, like, it's like the shape of the tumor. It has, like, kind of spikies. V. Um, which make it hard to remove. Oh. What are those kind of, they look like call flowers, but they're pointing at the end, you know? They're beautiful. Yeah.

Um, they're green normally. Yeah. Uh-huh. They're beautiful. Romanesco. Yes, Romanoesco what? Caulflower. Caulflower.

God, is that impossibly gorgeous. Nature, let's all give it up. Round of applause for nature. Isn't that impossibly beautiful? It looks like tiny Christmas trees. Tiny Christmas trees, also coral, see coral. It is wild that nature made that. Yeah.

And like nature makes pineapples. Like, that's crazy. Oh, in the symmetry you see and crystals and all these things, like the shapes it can make. Yeah. It's pretty cool. I'm really grateful for you, nature. I hope you're a listener. Oh, one other thing I did look up because he talked about folic.

acid for nonverbal autism. So when I got diagnosed with epilepsy, he told me, so I got put on the Kepra, my doctor, my neurologist, great man, Dr. Stephen Sykes, love him. Beautiful man. He said if I'm thinking about getting pregnant ever, that I should take folic acid being on this medication and having epilepsy. Okay. I didn't really know why. He probably told me, but my brain was a little fucked up. So then I just looked. Should you take folic acid if you have epilepsy? Yes, people with epilepsy, especially women of childbearing age, should take folic acid. Uh, but the appropriate dose must be determined with a doctor, prevents neural tube defects and other birth defects in children and can also be deficient in those taking certain anti-epileptic drugs. I take it and I

don't have epilepsy. Oh, you do? Yeah. It's part of my regime. You like the taste? No. I don't I don't like any of it. I constantly am complaining at night. It takes me like 30 minutes extra to go to bed because of all the stuff I'm doing to try to stay alive longer. And I lament it. I'm like, God, it's a lot of work to stay. And you're actually taking time out of your life. What if we added up the amount of time? It was a push. I would rather have the TV time. Oh, I love you. All right, love you. Follow Armchair Expert on the Wondry app, Amazon Music, or wherever you get your podcasts.

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