Behind the Bastards - Part One: Peter Attia and the Cult of Longevity

Episode Date: October 13, 2026

Dr. Peter Attia is not the worst doctor we've covered, but he may be one of the most influential. This week, Robert is joined by Dr. Kaveh Hoda to learn about the rise of a longevity medicine supersta...r who would influence the manosphere, the biohacker set, and the "healthspan" crowd.  Covering what longevity medicine actually is and why concierge care is a problem for the country. Check out Kaveh's new podcast here: https://podcasts.apple.com/us/podcast/persian-of-interest/id6814679153?i=1000791027349  Sources: Attia, Peter. Outlive: The Science and Art of Longevity. March 28, 2023. Johansson, Minna, et al. "Continuous Glucose Monitoring for Persons With and Without Diabetes." JAMA, August 3, 2026. Khullar, Dhruv. "How to Die in Good Health." The New Yorker, April 15, 2024. Mann, Brian. "McKinsey & Company to Pay $650 Million for Role in Opioid Crisis." NPR, December 13, 2024. Martin, Kristen. "The Problem With Peter Attia: The Longevity Guru Turned Up in the Epstein Files. Should We Have Taken His Health Advice So Seriously in the First Place?" Slate, February 26, 2026. Ruetenik, Daniel, and Arden, Farhi. "Dr. Peter Attia, Longevity Expert, Apologizes for 'Indefensible' Emails to Jeffrey Epstein." CBS News, February 2, 2026. Tyrangiel, Josh. "The Epstein Spectrum." The Atlantic, April 3, 2026. Walker, Graham. "A Skeptic's Review of Peter Attia's Outlive." LinkedIn, January 13, 2024. https://www.linkedin.com/pulse/skeptics-review-peter-attias-outlive-graham-walker-md-z6rsc Blum, Dani "Peter Attia's Ties to Epstein Spark Backlash From Doctors." The New York Times, February 10, 2026 Kaufman, Maya and Gardner, Laura . "I Think She Will Be Loyal: Jeffrey Epstein's Role in Peter Attia's Rise." Politico, March 16, 2026. Pollack, Neal. "The Plight of Peter Attia." The Spectator, July 15, 2025. Greene, Jenna. Epstein files up in lawsuit, over stock options by longevity expert, Peter Attia. March 20, 2026 Podcasts:The Peter Attia Drive. Episode 168, August 2021.The Peter Attia Drive. Episode 172, August 2021.The Peter Attia Drive. Episode 190, January 10, 2022.The Peter Attia Drive. Episode 298, April 15, 2024.The Joe Rogan Experience. Episode 1735, 1961 Jocko Podcast. Episodes 55, 56, and 392.The Tim Ferriss Show. Episode 398, "Peter Attia, MD: Fasting, Metformin, Athletic Performance, and More," November 27, 2019.See omnystudio.com/listener for privacy information.

Transcript
Discussion (0)
Starting point is 00:00:01 Welcome back to Behind the Bastards, a podcast that tells you everything you don't know about the very worst people in all of history. And this week, I'm one of the laziest people in all of history because I'm getting a week off of researching and writing a script. Thanks to my good friend, Dr. Kave Hoda, who has come in and wrote, wrote, wrote, writing a script for us. Kabe, welcome back to the show. Thank you so much. How are we, how are you doing? It is so nice to see you both. I miss your faces when I don't get to see them.
Starting point is 00:00:36 That's right. And now I get to see your faces and that makes me happy. And then I get to talk to you. This is, now it's my turn. You've done so much. Yes. You've done so much to bother people with terrible stories. Really made them unhappy a lot.
Starting point is 00:00:49 Yeah. It's my turn to give back to you. And I want to. Wait, wait. I'm going to give you a present first. Have you had fiber today, my friends? You should eat more fiber. Yeah, Kavit does always say that.
Starting point is 00:01:00 Fibersaddy here. You're welcome. Fiberzaddy. That's what they call me online, Robert, Fiberzaddy. Yeah. And I looked it up, and it's a good thing, apparently, to be a zaddy. So that's me. Yeah, no, that's good. You know, Robert, let me ask you a question. When you envision a doctor, someone trustworthy, someone you feel like you should be listening to, someone with advice you would follow. What do they look like in your mind? What do you envision? Are they, are they handsome? Are they fit? Are they charismatic? And don't, don't lie to me, Robert. I can tell
Starting point is 00:01:36 when you're lying. Honestly, I picture my old pediatrician, Dr. Sherrod, who was the doctor I had growing up as soon as we moved to the Dallas area. He was a really good, I had a bunch of, like, weird health issues around my allergies as a kid. And every other doctor we went to was, or every other pediatrician we went to, had a lot of trouble figuring out what to do. And Dr. Sherrod did not. He was a really good doctor, like help me with my allergy problems as a kid, was just always, like my mom worshiped the guy. He was great. It's probably why I have such a positive opinion about doctors because I grew up with a really, really good one. Must be nice. Yeah, I think about him. And Sophie, what about you? You know, you know the details about all my medical history, both of you. A little sour on doctors these days. You know, but I love.
Starting point is 00:02:29 you and I love my brother and you're both doctors. There you go. I'm one of the good ones, Robert. I'm one of the good ones. Well, you know, here's the thing. You are both doing, I think, the reasonable thing, which is you are using your own memories, your own relationships with people you know and have met and you know to be good doctors. But I would think, unfortunately, that's not always the case in this country.
Starting point is 00:03:00 I think when a lot of people in this country are thinking of a doctor, first of all, they're probably thinking of a male doctor, although most evidence we have would actually suggest you're better off with a female doctor. They've actually looked at that. Just in general? Well, for a particular, the study showed it was like in patient hospitalizations. but it's certainly not worse. So that was like actually kind of,
Starting point is 00:03:26 it's funny that this had to be done, but at one point there had to be a study that said having a female doctor is not worse. Right. And actually, it's probably better. So yeah, we'll probably get more of that.
Starting point is 00:03:38 We'll probably get more of that in the future too. But I usually prefer, like most of my doctors and an adult have been women. And I usually prefer, I just feel like they have paid more attention to me, I guess. Yeah. I think that's probably, it. You know, the study didn't really specify why. I mean, I suggest, I'm guessing that's probably
Starting point is 00:03:57 it. But I think the truth is, for a lot of people, they're going to think of this doctor that's like tall and handsome and stately and well put together. Someone they could imagine wearing like a tailored suit on general hospital or like fitted scrubs on Grey's Anatomy. Of course, of course. You got to tailor your scrubs that you're going to throw out. It is crazy to me, the tailored scrub thing. I wear the biggest baggiest, goofiest looking scrubs at work. I mean, here's the thing. Like, my favorite part about my job is that I essentially get to wear pajamas, you know, to work. That's fantastic. Us too. Yeah. I mean, I am wearing pajamas right now. It's a good point. I could have skipped a lot of medical training and just gone straight to
Starting point is 00:04:40 podcasting. But hey, live and learn. We all could. What I tell my brother. So people are thinking like these Dr. Oz's and the Dr. Drew's and and these kinds of guys. I'll tell you something right now. I'm going to tell you right now. I'm going to take a stance here. I think doctors should be schlubby and silly looking.
Starting point is 00:04:58 Basically, I should be like the max handsomest doctor that you should envision. Like it shouldn't get better looking to me. A convenient rule to suggest? Yeah. Anything better looking to me, you're going to run into problems. We've seen it time and time again. And I have another question for you. Have you ever heard of a Dr. Dennis Lowe or Dr. Faith Fitzgerald?
Starting point is 00:05:19 No, but Dr. Faith, I'm already getting like, oh, that could be a problem. I mean, I know it's a normal name for a lot of people, but just the name Dr. Faith really concerns me. Well, I'll tell you this. The reason you don't know of them is because they were amazing doctors and they dedicated their lives to service and education. And I'm assuming they never had a cue score greater than 20. I'm sorry, Dr. Faith. I apologize for judging you. And Dr. Dennis Lowe, Dr. Faith, that Cheryl passed, but Dr. Dennis Lowe still kicking, and I was lucky enough to be mentored by both of these terrific and caring doctors. And that's why we're not talking about them today.
Starting point is 00:05:57 But we'll be talking about someone you have heard of, one of the most famous, most influential and most widely followed doctors in popular culture, Dr. Peter Atia. Oh, boy. I know that name. Have you heard? Yeah, I'm curious. What is the thing you've heard? I guess I know what it is. But not much he just shows up.
Starting point is 00:06:18 I mean, he's involved in the administration, right? Like, he's been one of those guys. Very peripherally. Very peripherally. He is someone that the wackier people in the administration sometimes cite to show that they're not so wacky. He kind of does a little bit of science washing. We'll get into that. But he's the doc who, more than any other modern doctor, has worked to popularize and legitimize the field.
Starting point is 00:06:47 of longevity medicine. Are you guys familiar with that? Yeah, like the Brian Johnson try to live forever. I mean, like the quack end of it is Brian Johnson measuring his sleep erections. Obviously, there's a good reason to care about longevity, you know?
Starting point is 00:07:02 Like, there's also definitely a non-quack side of it. Oh, yeah, we're going to get into that. We're going to get into the good and the bad of it. What I know about him is he exchanged quite a lot of emails with a not so front of the pod Jeffrey Epstein
Starting point is 00:07:19 Yeah I have a question about You are correct And we're going to get to that But my question for you Is Jeffrey Epstein Like, and you've probably made this reference already But is he like the Forrest Gump
Starting point is 00:07:31 Of terrible people Because the fact that he showed up in the story That wasn't even the reason I wanted to talk about Peter Atia And then when I was learning more about him And I discovered that I was like Is he involved with every questionable person?
Starting point is 00:07:44 person? Well, I mean, kind of yeah. In modern times somewhat. Forrest Gump, it was just sort of like coincidental that he kept winding up in all of these historical situations. Jeffrey Epstein like knows and was involved with a lot of powerful people because he was providing them with services, so to speak. Or he wanted the cloud associated with them because it, because there were people who didn't do anything awful that Epstein either funded or invited to a lot of things, because he liked to camouflage himself being surrounded by great scientists. And after his arrest, the people who were legitimately, like, just caught up and, like, didn't know anything and were legitimately just caught up and shit, they stopped hanging
Starting point is 00:08:27 out with him once he was, like, charged and convicted of, you know, child molestation. But, yeah, anyway. So, yeah. Well, he shows up here. And we're going to get into that. Before we do, there's a lot of other things I want to talk about. That actually wasn't even the main reason I wanted to discuss. Awesome. We're going to get into the bin of it. We're going to have a little bit of a nuanced, I'm sorry, in advanced discussion.
Starting point is 00:08:51 We're going to do the risks and benefits talk, just like you're supposed to with anything in medicine. We're going to talk about the potential harms of over-testing and over-medicating. We'll talk about whether it's important to have the VO2 max of a tour de France cyclist, how important it is to track your blood sugars by the minute if you're not diabetic. and if it's normal for your doctor to be on an email thread with Jeffrey Epstein discussing the nutritional benefits of conalinguish. Yeah, no, that doesn't. That seems questionable. Yeah. I don't know if you want to use that as a cold open, but, you know, welcome to Behind the Bastards. Yeah, behind the bastards. The only podcast that just said, Conalingis, probably not the only one.
Starting point is 00:09:30 One of them, though. This is an I-Heart podcast. Guaranteed Human. Detective said he had stalked her before she died. Years later, they said he remained the person they continued to focus on. This is Hunter Gilmore, host of Hunting for Answers A True Crime Podcast, shedding light on the silent epidemic of missing and murdered black women and girls, bringing attention to stories that equally deserve to be told and to the questions that still remain. Listen to Hunting for Answers a True Crime podcast from the Black Effect Podcast Network on the IHeart Radio app, Apple Podcasts, or wherever you get your podcast. You broke me.
Starting point is 00:10:09 You do not deserve happiness. I'm Andrea Gunning. On this season of betrayal, Carl thought he was living a normal, drama-free life until the messages started. Someone's not going to make it out of this alive. Every piece of evidence pointed to the wrong guy. He was not going to stop unless we stopped him. Listen to Betrayal Season 6 on the IHeart Radio app, Apple Podcasts, or wherever you get your podcasts. In 1986, a man named Scott Macklam was killed in broad daylight.
Starting point is 00:10:43 Police quickly found their suspect. Prosecutors convicted him. But now, almost 40 years later, I'm re-examining this case. I really didn't believe any of it was real. And I was like, well, they're going to figure out this is not me. They're going to do their police job. Has the wrong man been in prison this whole time? Listen to examined the backfire effect on the I-Heart Radio.
Starting point is 00:11:08 app, Apple Podcasts, or wherever you get your podcasts. Is there an epidemic against literature? More specifically, Black Literature. I'm Jack Quist-Peace Thomas, and on this season of the Black-Lit's podcast, we're outside asking why. They don't want a whole bunch of little Ella Bakers, Malcolm Waxes and Martin Luther Kings running around. And when you look at a lot of different cultures, they're like, we need to know where you
Starting point is 00:11:34 came from. And considering this is Black Reading Month, the only real question is, what are you reading next. Listen to Black Lit from the Black Effect Podcast Network on our iHeartRadio app, Apple Podcasts, or wherever you get your podcast. If anyone wanted to commit a murder, up here would be the greatest place in the world to hide the body. But no one will find it. He acted friendly. He talked friendly. He sounded friendly. They all knew that I did the scary boogie stuff and I said maybe she'll find out where this girl is. I saw him violent. backhand their, pow!
Starting point is 00:12:16 Listen to the devil's quarry season two in the Bone Valley Feed on the IHeart Radio app, Apple Podcasts, or wherever you get your podcasts. Okay, so before we get into this episode, I have to clarify a couple things. He's not going to be the worst person you've discussed on the show. He's not even the worst doctor you've discussed. He's not even the worst doctor you've discussed with me on the show. He's obviously not a bastard on the level of a Stalin or. Saddam Hussein or Mark Zuckerberg. But in my mind, he represents a new kind of danger in medicine, one that doesn't come from direct harm to patients, but from credibility and from charisma and
Starting point is 00:13:07 from privilege, from someone whose influence is outsized and ideas are actively reshaping medicine and whose model of care in my mind is deepening inequality in this country. It's this, his whole approach is this sweeping reimagining of health care that claims to prevent heart disease, neurodegeneration, and all this stuff, and it sounds great, but it's not all supported by randomized trials. It relies a lot on speculative pharmacology and under-tested and aggressive biomarker manipulation and testing. We'll talk all about that. I obviously take issue with some important aspects of his practice. This whole model of Manosphere wellness influencer or or Maha adjacent doctor is something I find very troubling. History has shown us that if we don't
Starting point is 00:13:55 nip these Dr. Oz's in the bud early, they can become real problems for everyone down the road. They wind up in charge of everybody's health care. Yeah. That's right. The people who are now in charge are the people I were all internet trolls 10 years ago. And it blows my mind. It's bleak. So about the Manisphere, because I think it's kind of important that we discuss it. Actually, I have to say one of the first times I was really exposed to it. It was a couple years back. You probably don't remember because you see this stuff all the time. But somebody tweeted
Starting point is 00:14:24 that Robert Prop and I were part of the quote unquote leftist manosphere and I didn't know what that meant and I still don't know what that means. It's not great I don't think. I don't think it was a compliment. I doubt it. What manosphere are we up? Okay. As the girly pop on the podcast,
Starting point is 00:14:42 fuck no. Yeah. I don't know. Thank you. I don't know what. what that's supposed to mean, but okay. Okay. I think Dr. Atia might maybe take issue with being labeled
Starting point is 00:14:54 part of the Manosphere, but a large part of his strongest support comes from there, and his appeal really comes from that same milieu that creates our Joe Rogans or Andrew Ruben's, but sure. Joe's, yeah, right, right. It's like attorneys general.
Starting point is 00:15:09 Like Johns Hopkins, yeah. Right, exactly. Atea's rise, whether he likes it or not, is inseparable from this. podcast industrial complex. They all exist the same ecosystem. Now, I'm not an expert in this. In fact, most of what I know about the weirder parts of the online world I've learned from you people here on Cool Zone Media. Yes, that is kind of our milieu. And you don't know, there's been a number of times that I've like texted Garrison to be like, hey, can you explain what this means or this
Starting point is 00:15:43 me. I'm like the old boomer who needs help with their VCR. No, no, that's good. That's good. That's good. That's good that Gerson's being a resource. We love that. It's like, hi, I know things. It's like the modern equivalent of walking an old person across the street. Yeah. Yeah. That's, and I appreciate that. So it's the internet. Yeah. It's the internet. And so, but I think if you think of this online male self-improvement world, as a Venn diagram. I think you'd see four circles. And please correct me if I'm wrong
Starting point is 00:16:19 and weigh in on this. But one, you have like the manosphere, the red pillars, the looks maxing people, online forum dudes. And another, you have the bro science fitness sphere, the testosterone growth hormone guys,
Starting point is 00:16:34 bodybuilders. In the third is the tech optimization sphere, biohackers. That's again where Andrew Huberman comes in. Silicon Valley longevity enthusiasts like Brian Johnson, who will have to talk about some point in this. And also then there's also the mainstream wellness sphere people.
Starting point is 00:16:55 There are less offensive in general, more standard fitness stuff like your Chris Hemsworth and Hugh Jackman's proponents of the health standard. Huge Jackman, yeah. Hugh's Jackman. And Peter lives somewhere in between all these, but probably more three and four. Not that far from the Manosphere, though.
Starting point is 00:17:13 The Manosphere definitely borrows from him, particularly his language on testosterone, metabolic health, V-O-2 Max, protein. His audience definitely shared with Rogan, too. And I will say this actually here in San Francisco, Silicon Valley tech folk love him. And I've met some very reasonable people who listen to him and follow him closely. I've had people with no history of diabetes ask me about getting continuous glucose monitors because of what they've heard on him. his podcast. That was really eye-opening for me. Yeah. So what sets him apart from these people is that he doesn't talk about gender politics too much. He has or had a lot of female followers, especially after Guess Who exposed him, Oprah, and he also had a 60 Minutes profile piece.
Starting point is 00:18:05 And more like, and more than most of the people in this world, he does actually seem to look for evidence-based medicine. He cherry picks it a bit. Yeah. does. But he's, I think he's actually a smart guy. I know a lot of doctors, like Dr. Oz and Dr. Ben Carson, all these guys, they're very successful. And I think people consider them smart. But in truth, I don't actually find them that intelligent. Their greatest surgery and they're very hardworking. But, you know, they're surgeons. I'm sorry, surgeons. Sorry. We could talk about the difference between neutral medicine and surgery at some point if you guys like. But I never found these two. He wrote a song about that. People are aware. Yeah. Did he really? Yeah, like a surgeon.
Starting point is 00:18:42 Yeah. Oh, yeah. To the tune of Madonna's like a virgin, yeah. Yeah, yeah, yeah. Well, as with most things, it was explained early in the 80s by Weird Al Yankvic. Yeah. But I never found them that smart. It's actually kind of wild how far you can go in medicine with some charm and some hard work.
Starting point is 00:18:57 And I think those two are examples of that. But I think Atia, he's really smart. And I have to tell you, as I prepared for this episode, there were multiple points where I was like, I actually, I like a lot of what he says. more than expected. I agree with some of his recommendations. And there's even some stuff in this history that I empathize with. But there is definitely this pipeline of men
Starting point is 00:19:22 who start with guys like Atia and Huberman and end up with Peterson and Tate. He's like the evidence-based gateway to the atmosphere. And that's one of the reasons why I think I want to discuss him here with you folks. Right. Before we get into him, though,
Starting point is 00:19:37 let's talk a little bit about longevity medicine in general and what it actually is. Its proponents would say that for the past century, medicine has been reactive. You've probably seen people talking about this, quote-unquote, sick care, right? Right. You get sick. Yeah, shocking that doctors focus most on, like, saving people's lives when they're ill. I mean, like, obviously preventative medicine is important, but it's not weird that that's the way it, you know, goes.
Starting point is 00:20:04 Yeah. That's kind of what we have to do, because if we don't, what's going to happen? You have no one else to care of you. But there's some truth to that. It's always important to think about preventive care. And in longevity medicine, it's meant to be sort of a way to flip the dynamic that it's preventive, personalized medicine that aims at expanding not just your lifespan, but what they call your health span, those years that you're in good health. It's driven by something called the geroscience hypothesis, which is basically aging itself is the shared root of most chronic disease. So instead of playing whack-a-mole with one disease at a time, you could, in theory, delay all of them.
Starting point is 00:20:45 And like every system that is totally on the up-and-up, you can consider it like a pyramid. The base is the lifestyle components. The middle is measurement, tons of testing, wearable, biologic age clocks that claim they can tell you how old you are. And at the top level of this pyramid of this particular field of medicine is the experimental frontier with drugs and supplements aimed at aging pathways like metformin, rapamycin, NED plus. You might have seen that one already. One pattern about all these meds, including the ones that we'll discuss later, there's some impressive effects that are in mice or lab animals, but limited or really non-existence proven effects in humans. The evidence of longevity medicine working in people and humans is actually pretty thin. And we're not even sure if we're measuring the right things with these biologic clocks and that sort of thing.
Starting point is 00:21:40 And of course, there's a question of safety of taking some of these medications long term. We'll get to that. I think some parts of this field are generally very interesting, and I'm hopeful that some good science will grow out of it. But the more I learn about longevity medicine in general, the less I like it. The thought of these uber wealthy technocrats learning to expand their lifespans even more than they already have,
Starting point is 00:22:05 I find it to be kind of terrifying. And as we're going to get into in the second episode, longevity medicine is particularly bad because it disproportionately affects the wealthy, if it works at all, allowing them potentially to extend their influence, consolidate their power,
Starting point is 00:22:22 and delay the generational progress of science and, cultural, political progress and all that stuff. Maybe I'm being nihilistic. But my question for you and you both, I love to hear what you have to say, is would you even want to live forever? I'm assuming the answer is no. But how long?
Starting point is 00:22:40 Be honest. How long would you want? What's the longest you would want to live for? I don't know. Like, I can't imagine. It depends. I think the big thing for me, and this is, there's some reasonable people in the longevity space who talk about this is like health span.
Starting point is 00:22:55 Like, I would like to stay. healthy and mobile and independent, you know, the entirety of my life that said, I don't know that I'd want to live longer than like 90 years at kind of the outside, you know? Like, I don't think, like the kind of max human lifespan, more or less, like 90 to 100 or so, uh, I don't feel like that seems great. Uh, if I could not like be miserable and decrepit and dealing with like Parkinson's or Alzheimer's or whatever, you know, like at the end of it, right? Like, that's kind of the big thing for me, as opposed to, like, objective lifespan. Because I do think I'm already, there's already things that I know are, like,
Starting point is 00:23:33 good changes to society that I'm never going to be okay with. Like, at some point, we'll figure out, you know, some degree of self-driving or we'll finally get our shit together and replace all the cars with, like, good public transit and whatnot. I like driving, you know? I know that's bad. And I, I don't, you know, I support society reforming. out and getting out of its addiction to cars, that'll just never be something I'm personally ever
Starting point is 00:24:03 able to enjoy as much as other people. So I don't want to go on too long, like to the point where hopefully if things go well, the world would be a lot better, you know, in 70 years or however, 50 years, 40 years. But I don't know that I'll be comfortable in it, right? You kind of hope that the world evolves beyond you if you're not a shitty person, I think.
Starting point is 00:24:26 You know what I love? After everything you've seen and studied, you're still kind of an optimist on the inside. I mean, I don't know. He is. I think that's likely. I know you can't really say that because you have to be cool and like, you know, you have to be a loof and whatever podcast are.
Starting point is 00:24:43 But you're kind of an optimist, and I love it. The darker thing would be to say, I don't want to live through the complete collapse of the biosphere's ability to support life, which certainly seems likelier than us getting rid of cars. developing good public transit. You could have said that first, but you didn't. Because you're an optimist. On the internet to people.
Starting point is 00:25:02 I don't want to depress people anymore. I do that too often. Sophie, how long would you go for? Well, if I could be healthy and Anderson could be healthy, you know, probably the same answer as Robert. I don't want to be, I don't want to be, I don't want to be, like, miserably uncomfortable and a burden to the people around me, one. And, like, you know, if they could, like, health max my dog,
Starting point is 00:25:26 to live longer and be, and live great and be strong and live long. I mean, that would be sick. I don't know if we need to do that for people, but for dogs, dogs don't live long enough as is. I agree with both of you about the health span. I think that is very important. I think we should be focused more on living our best lives for as long as we can. Eventually, it will catch up to us all.
Starting point is 00:25:49 But, I mean, yeah, I think that's a realistic thing to do. There's T. There's T. There's T. There's T. For you. For you. For you, for me, a big part of this is not just the longevity medicine aspect of it.
Starting point is 00:26:03 It's that I dislike concierge medicine in general. It shrinks access for everyone. It feels bad. Well, the reason. It shrinks access for everyone that's not wealthy and turns health care into this subscription-based privilege rather than a social responsibility to take care of people. And a typical doctor who moves into a concierge practice, and by the way, I understand very well why you would want to do that. And there's like a non-zero percent chance that I will eventually sell out and have my own concierge practice. So I get it.
Starting point is 00:26:38 But a typical doctor who moves into a concierge practice will reduce their panel from something like 2 to 3,000 patients closer to 300. And this is only accelerating the collapse of our health care system. And it's also leading to ethical drift in the medical profession. And concierge medicine is right now really the only delivery system for longevity medicine for these people. We'll get into it. But let's get into the Atea of it all. But first. Oh, but first.
Starting point is 00:27:10 You know what will make you live forever, the sponsors of this podcast, I guarantee it. And if you don't live forever, you can sue I-Heart Media, you know? No, no, no, no. Sophie, Sophie, it's perfect. They can't look. They don't live forever. How are they going to sue us? If they die, what are they going to do?
Starting point is 00:27:26 No, no, no, no. It's the perfect. It's the perfect scam. It's the perfect scam. We'll be way out of the podcast game by the time they figure it out. Yeah, we'll be in El Salvador by then. Robert, don't tell them where we're going. It's okay.
Starting point is 00:27:40 Honduras is what we meant. We're really going to North Korea, Sophie, but we're not going to tell them that. Robert, no. This episode is sponsored by Better Help. Your mental health does not know it's World Mental Health Day. Stress does not politely wait until October 10th. Burnout does not RSVP, and your brain definitely doesn't check the calendar
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Starting point is 00:29:18 Everywhere you go. Always free. Download the free. Free IR Radio app today. I'm Hamza. And I'm Martin. And we're the hosts of Out of Character. It's a podcast.
Starting point is 00:29:28 I know. There's a lot of them to listen to these days. How are you going to get to us? Well, there's a specific reason why you should listen to us. We are the best podcast in the entire world. I swear. I know, bold. But why don't we list some of the things we might talk about on a regular episode?
Starting point is 00:29:43 So sometimes we'll talk about, I don't know, the Uber driver we just had. And how nice they were, or if we tip them or not, come and find out. Sometimes we'll talk about that weird news story from last week. It's the one you're thinking about. Trust me. Or maybe we'll talk about music and what's happening in the underground or drama and music or TV shows or the Met Gala and what the actors wore. What we're saying is we're not afraid to talk about everything under the sun. And if you want to see what that's like, come join us.
Starting point is 00:30:11 It's a place where everyone can hang out, anyone. Wherever you're from, whatever you're like, you're welcome. Listen to out of character from Will Ferrell's Big Money Players Network. Heart Radio app, Apple Pods, or wherever you get your podcasts. I'm Melissa Jeltson, and in my new podcast, what happened to her, I'm bringing you new stories and conversations every week. Stories about women whose deaths were too quickly ruled as suicide. She was starting to get worried and get scared for her safety.
Starting point is 00:30:43 Stories of survival. The only difference between me and her, frankly, was a little bit of luck, because by all rights, I should be dead. Cases that everyone else called closed. They can't convict her, right? Like, she has so much evidence. These stories all start in the same place, with a woman failed by a system that didn't believe her,
Starting point is 00:31:04 that didn't protect her, that didn't see her. No child should ever experience that. And we were babies. She did all of these brave things and came out and spoke about it, and he got a year. You never know who that devil is because he's wearing the disguise. Sometimes it's a police uniform. Listen to what happened to her on the IHeart radio app, Apple Podcasts, or wherever you get your podcasts.
Starting point is 00:31:29 Lisa, we should tell them about our new show. Oh my God, Lexi, we have a new podcast. It's called Don't Lie to Me. I'm Lexi Iwano. We're two best friends, 22 years apart, but so close at heart. And I'm Lisa Di Giulio, the old one, which means we have wildly different references, occasionally different opinions. And at this point in my 50s, I've lived it all. I'm not going to get anyone fighting.
Starting point is 00:31:54 That is wild. I learned that about you today. Now in my 30s, being the founder of new shoes, good taste is my business. And I've always got something to say. If men were just honest about this, there would be so much more peace in the world. We're going to talk about dating, relationships, beauty,
Starting point is 00:32:12 getting older, and a little wiser. We're best friends, but we don't always agree. Because you told us how much. accommodating you are. Obviously, I would do what I think I could do to fight the fight, but there's only so much fight I can fight. Don't lie to me. Don't lie to me. Don't lie to me. Don't lie to me. Don't lie to me. Don't lie to me. Liar. Listen on the IHeart Radio app, Apple Podcasts, or wherever you get your podcast. I don't really care. And we're back. Sophie and I aren't moving to North Korea to avoid extradition laws. We didn't spend years working out a plan with the Kim Jong-on.
Starting point is 00:32:53 or whichever, whichever, Kim, we've got in there right now. I think it's Jong Un, right?
Starting point is 00:32:57 I forget. Anyway, Ka-ah. Let's continue. Should probably learn that before, you know. Kim Jong-un. Yeah,
Starting point is 00:33:03 his dad was Kim Jong-I. Look, whoever I've been emailing is in charge of North Korea according to the guy I've been emailing and sending money to. You just call him Kim.
Starting point is 00:33:12 I get it. Yeah. Let's talk about Peter Atia. Let's start with the early years. He's talked a lot about his childhood. But it's usually in these controlled, self-narrated ways through podcast monologues or interviews. Sure. Or his book, Outlive, the Science and Art of Longevity.
Starting point is 00:33:31 There's been a couple of very useful pieces written about him, but not any real investigative biography. So we have to reconstruct his early life with what's been revealed in his podcast. I listen to a lot of podcasts, both his and others, that he's been on and what I can gather from online sources. So he was born in Toronto, 1973, to Egyptian parents who had immigrated to Canada. I don't think a lot of people know that he's Egyptian. I didn't actually until we started this. It's a little bit of a personal bummer for me whenever you see a famous Middle Eastern type doctor that's not rad. He described his parents as highly educated, intellectual, not sure what they did for work.
Starting point is 00:34:10 From some interviews, I got the sense it was white collar work, but in his book, Outlive, he actually refers at one point to his father working in a limestone quarry. So I'm not sure. I'm assuming there's not a lot of white collar jobs in a limestone. Limestone core, but not, not, no. I mean, I guess the limestone could turn your collar white because it's limestone. So maybe like literally, yeah. Yeah, that's right.
Starting point is 00:34:32 That's what I was thinking. And I'm sure this is not surprising to anyone, but his family was very achievement-oriented. He described them as emotionally restrained and demanding in subtle, culturally specific ways. And in that last aspect, it's probably pretty similar to Dr. Oz and his backstory. And it's something I actually know a little bit of. about myself. I could probably dedicate four whole episodes to this particular topic, but I'll just keep it short here, and that being a physician of Middle Eastern descent myself, my family, and my father in particular, were also very clearly achievement-oriented, but it's also a large part of how
Starting point is 00:35:13 and why I became a doctor and why I've had any success. That being said, one major difference between me and him as I was reading about him and thinking about him. I don't think anyone would ever mistake my family for being emotionally restrained. Like a lot of Persian households, we felt things out loud, you know, very loud. And his family's situation felt like a more high-pressure immigrant household with love being expressed only through achievements and not as much through affection. And I think that is fertile soil from which an optimization obsessed man can grow. I'm assuming this is a recurrent theme you've seen in some of the people you've covered. You did Dr. Oz, right? Yeah, yeah. We've talked about Dr. Oz. We've talked about most of the Oprah
Starting point is 00:35:58 industrial complex bastards. Yeah. That's great. So he described himself as a very anxious child who was obsessed with being perfect and was terrified and disappointing people. I think a lot of doctors can understand that and relate to that. Doctors are people pleasers. And sometimes this is helpful. Sometimes it's not. Well, not always, but yeah. Doctor, how? of course. Yeah, right. He was not a people pleaser. Being an exception. No. The most actually, interestingly enough, this is a small aside. Remember I mentioned Dr. Faith Fitzgerald. She was this brilliant internal medicine doctor at UC Davis. And the rumor is that she was the basis for that character. Not because she was crotchety or mean, she was actually super sweet and nice, but just because she was one of these brilliant, like, diagnostician to come up with.
Starting point is 00:36:43 She was so good at her job, yeah. Yeah, right. So he excelled his at school. academically from a young age, top of his class. I have no doubt about that. He also said that being smart was the only thing I had. And quote, if I was not exceptional, I was nothing, which I think is like the Middle Eastern equivalent of Ricky Bobby's, if you're not first, your last. Yeah, yeah. Being normal is the greatest shame there is. Sure. That makes sense. Yeah, a lot of pretty textbook, gifted kid identity formation stuff happening here. And there's also some overlaps with Andrew Huberman and Dr. Oz
Starting point is 00:37:21 in that they all have this sort of early athleticism and these signs of obsession with being physical and physical fitness. He reports that he was always pushing himself physically and was drawn to endurance sports that tested his limits. And this is a seed for things that come up later for him. Iron Man races
Starting point is 00:37:37 swimming the Catalina channel and the VO2 Max focus he's big on. He was also a boxer, which is actually surprised. It's going to surprise people, but it's one of my favorite things to watch in terms of sports is boxing. My dad was not only a doctor, but he was a boxer when he was younger. So I kind of grew up watching it. And although the doctor to me does not love what boxing does to your brain, I do enjoy watching the boxing. And that is a dirty little secret that I've never shared on air before. So there you go, a little behind the
Starting point is 00:38:09 bastards exclusive there. Who doesn't? I mean, especially just from a medical standpoint, I love watching C-T-E as it happens, you know? I mean, just in real-time, yeah. I mean, I will watch it and just be like, God, I don't feel good about this, but I'll watch it nonetheless. I love it. Something that is not a very bastard-like trait about him is that he has been open about dealing with anxiety, perfectionism, and fear or failure, and even anger issues.
Starting point is 00:38:36 It's usually in the context of how he overcame it, but that's just stuff we have to be talking about. We have to be talking about moral injury and doctors. to be talking about how doctors have psychological and psychiatric issues just like anyone else and how to get past that. So kudos for him for discussing it. He's actually even talked on air about going to a recovery center in Kentucky called Bridge to Recovery, not for alcohol, but for what sounds like anger management. So actually, I feel like if he focused all his work on just like that, how his background created issues for him and how to address that, I think he'd be a
Starting point is 00:39:09 pretty cool dude, but, you know, regardless, it seems like he didn't get. unconditional love growing up. And whether that left an emotional wound that shaped his relationships or need for mastery or later why he felt prey to the gravitational pool of powerful people like Jeffrey Epstein, I think is something to discuss. And I'll be upfront. I am not a psychologist. I'm not a psychiatrist. I am a simple gastroenterologist, which is essentially an ass dentist. But I think it's important to touch on the psychological components of his drive. And actually, I think from listening to him talk,
Starting point is 00:39:48 I think he would agree that that's an important thing to discuss as well in his credit. Yeah. In his book, he briefly mentions kind of obliquely experiencing trauma, but it doesn't really, he never really explains it. I didn't see what that meant, what he was referring to. Did he just mean the upbringing that we've already discussed, or was there something else? I couldn't find that.
Starting point is 00:40:09 But he does great. He gets into Stanford Medical School. after completing a Bachelor of Science in Mechanical Engineering and Applied Mathematics at Queen's University. Not the typical humanities, biologic science-leading approach. A lot of medical students do. Nothing wrong with that. I mean, I studied biology and music in college, and it was always cool to me when someone came from a different mindset, like engineering or some systems-minded thinker.
Starting point is 00:40:36 I think there should absolutely be room for that. I think it's cool. He loves math. It actually makes me wonder if being a doctor didn't come with this sense of of accomplishment or achievement that he could show his family. I wonder what he would have done. Probably could have been very useful to the world in that sense as well. And I'll say this.
Starting point is 00:40:53 I know Stanford pretty well. I did rotations there. Did research there as well. And they do great research. A lot of very important bench-to-bedside translational science happens there. And this is going to be a hot take and one that I will certainly regret. But since I do have some familiarity with what I speak, I will say this. it's not the best place to go for clinical training
Starting point is 00:41:18 if you really want to take care of patients. Strong stance anti-Stanford coming out of here. I know. I'm going to, I'm going to, absolutely going to regret that and probably ask you to cut it. But no, you know what? We're going to do it. We're going with it.
Starting point is 00:41:32 The best rotations you get when you're there are when their students and their residents get to due time at the Santa Clara Valley Medical Center, which is this terrific county hospital that Stanford works with and that I spent most of my training in fantastic place. And, you know, I'll give an excuse. I mean, I don't need an excuse to give them a shout out,
Starting point is 00:41:51 but I'll take any time I can. Santa Clara Valley Medical Center's rat. Yeah, if you get, go, go hurt yourself now and go there. You know what? Ideally, I ideally make it bad. And you shoot an a gun in your hand and head right over. Yeah, yeah. Yeah.
Starting point is 00:42:02 No, great people, great doctors, really great mission there for the doctors there. So, and I know people that went to Stanford around this time, and it's clear that even then he was standing out. people knew he was going to be kind of something at an early age. He was athletic. He already had this shaved head look that we kind of see in now. What was that? Okay.
Starting point is 00:42:25 Shaved head, sure. Right. Yeah, yeah. I mean, there's some guys that lean into that early. Easier. He's got the Mr. Clean. It's, and it looks, I mean, it looks good on him. It's good luck for some people.
Starting point is 00:42:36 He has the right head shape. It won't work for me. I don't tell you that right now. It's going to be bad news. I'm going to Turkey when things get real bad here. I can't. It's not going to be good for me if I don't. I'm going to need to do something when I get bald because my head's not this well-shaped as his.
Starting point is 00:42:55 So he graduates and he matches at general surgery residency at Johns Hopkins. It sounds like he was going to go into a surgical oncology field after that. But as we'll discuss, he didn't actually finish his surgical residency. A general surgery residency. and stop me any time if I'm going into the weeds here about this. But I think it's kind of important to note they're usually about five years long. It can be longer based on if you do research. And if you do a fellowship or extra training on top of that, like surgical oncology, it can be even longer.
Starting point is 00:43:26 He did some time at the NIH as well, which, you know, Johns Hopkins was great for getting funded research, at least then. I mean, who knows now with the country being the way it is, but it's still a very prestigious place, Johns Hopkins. Great place to go. In year five, what ostensibly could have been his last year, he quits residency. It's not clear if he was counting the extra year of surgical oncology and that, but he's towards the end of his training and he quits. Now, I think this is something to discuss. I have no evidence that he was forced out, but I do have to say it's always a little unusual
Starting point is 00:44:03 for residency programs when someone leaves. In the rare cases, I've seen it, there's usually a reason. there's usually someone's being forced to leave. In this case, I don't see that, but it is always something good to note. Even people who doubt whether or not they want to be practicing physicians and they hate residency, still finish it to at least give them the option of being a doctor afterwards if they want. I actually loved residency, but I would never ever do it again. It is by far the most challenging time of a young doctor's life, particularly in the beginning. I mean, you don't sleep.
Starting point is 00:44:42 Him and I were both around the same time, him before me, but we both experienced what life was like before the 80-hour work restriction. There is a restriction now so you don't work more than 80 hours, and that was considered soft. Just a nice mild 80 hours, yeah. And we were, I was like the first class to really experience how, to see how different that was. So I was a lucky one. But anyways, so generally the last year of residency isn't necessarily easy, but it tends to be easier. You have more specialty rotations. You're usually not on call as much.
Starting point is 00:45:20 But it is interesting because we've seen this now a couple times in people that are related to the manosphere or related to the current administration. For example, Casey Means, I don't know if you're familiar with her. she was President Trump's Donald Trump's earlier surgeon Right yes Sophie doesn't like it Yeah Yes yes
Starting point is 00:45:40 She was like very like wellness guruy Type content And had very questionable opinions On scientifically proven things You're exactly right She's really a co-architect of that Maha messaging that was That's pushed and still being pushed
Starting point is 00:45:57 And she dropped out of her OHSU head and neck surgery residency six months before completing her five-year program. Now, as opposed to with Peter, there are some different accounts. No one's ever, I haven't heard anything from anyone, even people who knew him that there was a reason he left other than what he says. But with her account is, you know, basically she got sick of the stick care and etc. But her colleagues have a slightly different account of why she left.
Starting point is 00:46:29 But I have no reason to doubt him, you know. to be honest, people should be able to quit, leave what's not right for them. Actually, more doctors probably should do it. I know too many doctors that are unhappy and stuck in that sunken cost fallacy where they feel like they can't quit or leave. You could actually even question why, you know, Abdul-Said wouldn't, didn't even go to residency in the first place. I think in his case, it makes sense. He never bills himself as a clinical doctor. He doesn't seem to have any interest in providing direct patient care.
Starting point is 00:46:59 he's more interested in the broader strokes of public health. Now, for Peter, when he was asked about why he left residency without finishing or becoming a board certified MD, he reports that he left on his own accord because he became disillusioned with the medical system, what he calls Medicine 2.0, which the fact that he's already referring, you're getting a vibe. Yeah. You're getting a vibe already that it's being referred to. I'm excited for medicine two.
Starting point is 00:47:30 Medicine 1 did too much like, you know, vaccines, stopping the spread of horrible plagues, making it's that you don't stub your toe and then die of an infection. I'm excited to see what Medicine 2.0 brings us. Yeah, and it just really has. Seventy hour erections? The sky's the limit. Well, he calls what we're experiencing now, medicine 2.0. What he wants to offer you is medicine 3.0.
Starting point is 00:47:53 Was medicine 1.0 like arsenic and telling you to go to the sea when you're sick? I don't know. But he calls it medicine 2.0 and it really just strikes me as odd because it has this real sort of like Silicon Valley bro vibe to it just off the bat, you know, doing that. And he explains that he did this because he had essentially a crisis of faith. Again, he sells this frustration as the symptom saying that it's built to react to disease instead of preventing it. And whenever I hear that, it has a real like, pick me energy. I'm a different kind of doctor, you know. I'm not like the other doctors.
Starting point is 00:48:32 I'm, you know, I'm a cool doctor. Yeah, yeah, yeah. That's a bit of a red flag. Keep that mind. And when this topic comes up, he explains why he left by telling a story about his last year in residency when he was treating a patient in the ICU with an antibiotic called Gentimicin. Now, gentomycin is a type of antibiotic called an amino glycoside. This is going to be on the test. And it's used for bad infection sometimes, and it gives you really powerful activity against gram-negative bacteria.
Starting point is 00:49:05 But here's the issue with it. There is a narrow therapeutic window that you kind of have to hit when you use it. The effective dose is actually pretty close to the toxic dose. Ah, okay. Yeah, I can say that could be a problem. You can see what's a problem. And small errors can cause real harm, permanent harm, to either your kidneys or giving you what's called autotoxic. you can lose your hearing from it.
Starting point is 00:49:30 It's terrible. It's like it's a board's question when you're young. And it's one thing you always keep in mind. You rarely see, I don't think I've ever seen it, but there's systems in place to help prevent this from ever happening. It is something that has to be monitored carefully because if you give too much, you can cause permanent damage. But if you give too little, well, then you're not stopping this bacteria that may be
Starting point is 00:49:52 trying actively to kill you. So it is an interesting antibiotic in that sense. And it's tightly controlled with weight-based dosing and checking kidney functions, make sure you're getting rid of it. Okay. And checking peak and trough level. So you check the blood when it's at the highest point. You check the blood when it's at lowest point.
Starting point is 00:50:11 So you're getting a sense of where you need to give the dosing. It's not the kind of drug that a resident should be casually fucking around with. And there's generally protocols for its use. And at least- Really, it's a measure twice, cut one- kind of drug. Exactly. Exactly. Or they die. And this is why pharmacists are so
Starting point is 00:50:34 amazing. Because the pharmacists have the amount of deaths pharmacists have prevented by double-checking doctor's orders, mine included, cannot be underplayed. It is
Starting point is 00:50:49 huge. And that's why at most hospitals in John Hopkins John's, it's not, by the way, it's Johns Hopkins. It's not, by the way, it's Johns Hopkins. It's not John. It's like Ruth's Chris's Steakhouse. I never understood that, but at Johns Hopkins, it's attending, approved, and pharmacy driven. It's like the pharmacist are really the ones that you rely on for these sorts of things. So, okay. While he's caring for this patient,
Starting point is 00:51:13 receiving the antibiotics, he starts considering there has to be a better way to optimize the timing of this drug. He wanted to disrupt the waste delivered. He didn't say those words disrupt, I don't think. But that is how I feel. I feel like he said it in that Silicon Valley's sense of the word to disrupt. Yeah. Yeah. He's a disruptor. Um, so he stays up. He stays up late while he's on call. He presumably studies up on the drug's half-life and other factors. And he creates an Excel spreadsheet that would change the timing to more accurately predict when the drug would hit trough levels. And that's the best time to give it. It's not entirely clear to me if this was a problem. that was in need of solving. I mean, the current method may not be that efficient. You're a lot of moving parts to it. It's hard to know. Whenever he brings this up on podcast,
Starting point is 00:52:05 it's usually with like some, you know, dude bro who doesn't like have follow-up medical questions for him. Yeah, yeah, yeah. So it's hard to know. I mean, I would actually, if I had a chance to talk to him, that's actually probably the first thing we'd start with is talking about the story. And he's, he apparently ran it by an infection.
Starting point is 00:52:25 disease fellow, and they recommend it against doing it, but he does it anyways, right? He enacts this new dosing protocol without his attending's approval or without any communication with the pharmacy. And when he tells his attending this the next morning, when everyone's like doing rounding, and they're all standing around, you stand around a group, do you guys know what rounding is? You know what attending is? Do you have to stop me if I'm like using medical jargon. Yeah, like doing your rounds, you mean? Like in house? Yeah, so scrubs actually. shows that a lot more. Yeah.
Starting point is 00:52:57 Yeah, yeah, yeah. But for the audience, if you haven't seen House, you haven't seen Grey's Anatomy, it's when a bunch of doctors discuss a case and go around and discuss all the cases that are assigned to. You lead the doctors who are like doing their residency around and a more experienced doctor is like talking about what's going on with a certain patient. Look at different patients and stuff to learn. Yeah.
Starting point is 00:53:20 Yeah. That's exactly right. Every time, though, just to be clear, listener, Robert knows what he's doing. Every time he says, yeah, it's like house, he knows that a little part of my soul dies. And that's why he does it. No, I mean, my last experience, my last direct experience with rounds was when my dad was dying. His oncologist took, like, a bunch of students around and they were doing, like, their rounds.
Starting point is 00:53:41 And I overheard them talking about my dad's case where he was just like, yeah, this one really, like, you know, it's a very surprising case. We didn't expect it to go. that, like, it was, it was not a great thing to hear after his, you know, because it didn't, like, the case did not proceed the way he had expected. It was not, like, expected to be a very serious situation and he wound up dying. So I got to overhear him, like, talking to students about that. But, yeah, I know what rounds are. Yeah, you know, it is a, it's never fun to be the interesting case or the family. No, no, you really don't want to be interesting. No. Yeah. Okay, now I feel like an asshole for making fun of you. No, I mean, it's, I didn't.
Starting point is 00:54:20 name him like he's an oncologist, right? Yeah, that's the job. Okay, so he enacts this new dosing protocol and he's telling the team about it. And the attending is the head of the team, the person that's out of training, they kind of run the team. They're at the top of the ladder. They spend the least time there, you know, the interns, residents, they're the ones there all the time. And the attendant kind of comes in for a period of time, but not as long. And he thinks he's going to get lauded for being a very special boy here. Instead, he gets chewed out. His attending considers it a serious breach of safety and hierarchy.
Starting point is 00:54:57 And I have to tell you, things I think have overall gotten better, but there are a few things worse than having the tending totally dress you down in rounds around other people. And in some places, particularly, I think, Johns Hopkins, that's the kind of place where that sort of thing is going to happen, less so here on the West Coast, where we are. people tend to be more chill but man there are attendings with like that I need to get a little kick out of seeing their intern
Starting point is 00:55:29 their medical student their resident cry like it is it is terrible so I actually even though I agree with the attending I do feel I do feel for him in this case I don't know what happened to the patient there's never any discussion of that
Starting point is 00:55:45 if it hurt the patient or if it didn't I'm assuming it didn't I'm hoping but I don't know. I assume the attending was worried that changing the testing and dosing could have either invalidated the levels or caused the next level to be uninterpretable or maybe even wind up delaying the patient's care even more. So I'm not sure why the attending was so mad. I never found anything from their perspective.
Starting point is 00:56:10 But at the end of the day, it's their, it's totally their responsibility. It comes down to them. So if anything happens to that patient, I can understand why they'd be so pissed. Right. Now, that response pisses off Atia, who feels his brilliance is being stifled. And he feels that this is an example of medicine punishing out-of-the-box thinkers. But before I tell you more about what happens next, I want to tell you that coming up soon, you're going to hear some in-the-box thinkers.
Starting point is 00:56:46 That's right. That's right. Maybe. The box of money that you need to give to them. Or I was thinking Blue Apron, if they're still sponsors. If not Screw. Blue Apron does send boxes. I think they may have gone out of business because of all of the deaths, but I'm not sure.
Starting point is 00:56:59 The island? You know, no, no, we don't joke about the island anymore. We just joke about the deaths. Ah, that's funny. Anyway. Yeah. All right. Well, let's just take a little break.
Starting point is 00:57:08 I'm ticking over the podcast now, folks. That's right. I'm calling the ad breaks. We'll be right back. Yeah. You've heard the chaos. Now you can see it. Do we want to jump right in?
Starting point is 00:57:23 Watch all your favorite podcasts from start to finish right inside the free IHard Radio app. Make some noise. Wooee! Catch every laugh and eye roll on shows like Bestie Listen. Hey Jonas and Las Culturistas. Now with full video. I'll just leave that there. It's the same hosts and the same chemistry with all the hilarious moments you've been missing right on your screen.
Starting point is 00:57:43 Open the free IHR radio app. Search video podcasts and tap watch. I'm Hamza. And I'm Martin. we're the host of out of character. It's a podcast. I know there's a lot of them going around, but why should you listen to ours? Well, we're only the best podcast in the entire world. And we talk about pretty much everything under the sun. For example, music we're listening to, underground music, trending music, drama in music worlds. Yes, sometimes we even talk about
Starting point is 00:58:10 just everyday mundane situations in our lives, like the cool Uber driver we just had. Or the food we just say, that is surprisingly delicious. Or we'll talk. Or we'll talk about, talk about the med gala and the looks that they wore. Are they awesome? Are they trendy? Come find out. Because our opinion matters. And so does yours. And this is a place where all of our minds can come together and connect. So what are you waiting for? Come connect with us. Listen out of character from Will Ferrell's Big Money Players Network on the Iheart Radio app, Apple Pods, or wherever you get your podcasts. I'm Melissa Jeltson and in my new podcast, what happened to her. I'm bringing you new stories and conversations every week. Stories about women whose death
Starting point is 00:58:49 were too quickly ruled a suicide. She was starting to get worried and get scared for her safety. Stories of survival. The only difference between me and her, frankly, was a little bit of luck, because by all rights, I should be dead. Cases that everyone else called closed. They can't convict her, right? Like, she has so much evidence.
Starting point is 00:59:14 These stories all start in the same place, with a woman failed by a system that, didn't believe her, that didn't protect her, that didn't see her. No child should ever experience that. And we were babies. She did all of these brave things and came out and spoke about it, and he got a year. You never know who that devil is because he's wearing in disguise. Sometimes it's a police uniform.
Starting point is 00:59:38 Listen to what happened to her on the IHeart Radio app, Apple Podcasts, or wherever you get your podcasts. Lisa, we should tell them about our new show. Oh my God, Lexi. We have a new podcast. It's called Don't Lie to Me. I'm Lexi Youanu. We're two best friends, 22 years apart, but so close at heart. And I'm Lisa Di Giulio, the old one, which means we have wildly different references, occasionally different opinions.
Starting point is 01:00:04 And at this point in my 50s, I've lived it all. I'm not going to get anywhere fighting. That is wild. I learned that about you today. Now in my 30s, being the founder of new shoes, good taste is. is my business, and I've always got something to say. If men were just honest about this, there would be so much more peace in the world.
Starting point is 01:00:25 We're gonna talk about dating, relationships, beauty, getting older, and a little wiser. We're best friends, but we don't always agree. Because you told us how accommodating you are. Obviously, I would do what I think I could do to fight the fight, but there's only so much fight I can fight. Don't lie to me. Don't lie to me.
Starting point is 01:00:43 Don't lie to me. Don't lie to me. Don't lie to me. Don't lie to me. Liar. Listen on the Iheart radio app, Apple Podcasts, or wherever you get your podcast, I don't really care. Shortly before 6 o'clock a.m. on November 13th, 1991, Annette's mother and her two young sons found her unresponsive inside their apartment. Investigators ruled the case a homicide. Over the years,
Starting point is 01:01:09 detectives continued searching for answers, but the case eventually went cold. This is Hunter Gilmore, host of Hunting for Answers, a True Crime podcast. shedding light on the silent epidemic of missing and murdered black women and girls, bringing attention to stories that equally deserve to be told and to the questions that still remain. As the years passed, detectives continued working the case. But more than three decades after Annette's death, no one has been held accountable. Annette's mother, Freda Scott, spent years hoping to see her daughter's case solved. She never saw that day come.
Starting point is 01:01:43 Annette Jones' case remains unsolved. Listen to Hunting for Answers a true crime podcast from the Black Effect Podcast Network on the IHeart Radio app, Apple Podcasts, or wherever you get your podcast. And we're back. Kava, you really should explore at some point accidentally creating a conspiracy theory about a company that people really do believe. And then you have to backtrack it because you didn't realize that it was going to actually be taken seriously. It's always a good time. That is. Is that real?
Starting point is 01:02:17 That happened? people actually believe you're very clear obvious jokes. For sure, for sure. That's why we stopped making the blue acre jokes. Yeah, someone was like, is there really an island? Yeah, more than one person. Seriously. I will say this.
Starting point is 01:02:31 After my first or second appearance on this podcast many years ago, you did do an ad break and you bleeped out the name of the company. And I got a number of messages from people begging. for me to tell them who it was. Yeah, of course. And I was like, no, I signed an NDA. I can't say that. But, yeah, I guess I'm not surprised
Starting point is 01:02:58 that people took it seriously. But speaking of taking things seriously, last we left off, Peter Atia felt his brilliance was being stifled, and he took that seriously, and he was very upset. I listened to a couple of podcast interviews. He did about this,
Starting point is 01:03:15 and this is something he said, it struck me as anti-intellectual. Maybe my model wasn't perfect. We'll never know. But the fact that nobody even cared to see if there was a better way to do this drove me bat-shit crazy. Now, here's the thing. Let me say something here.
Starting point is 01:03:32 Let me say something here. Let's take a little quick aside here. I think this is very emblematic of my broader thoughts on Peter Rattia. Maybe he had a good idea. And we should always be trying to push science forward and deliver things better, deliver better care. But you know, when he says, we'll never know, because nobody cared to see if there's a better way to do it.
Starting point is 01:03:55 There is a better way to do it. You can make a study out of it. Why not do that? He's right. We'll never know if it works because he didn't study it. He had the idea, and he didn't study it. This could have very easily been done at a place like Johns Hopkins, and you could do this and prove that it works.
Starting point is 01:04:13 If it's not unethical, an IRB. will review it as such and you can prove it. Yeah. I just want to add that I'm really, I'm really enjoying the way that you pronounce Johns Hopkins every time. John's Hopkins. I really have to really stress the plurality of Johns. There's more than one John involved in the Hopkins of this situation. And I don't understand it. So this will probably bum out the doctors on my little group chat, you know, my little, doctor group chat that I run some of the stuff by. But as I'm researching this guy for this episode, and I use the term research lightly,
Starting point is 01:04:55 I actually, there's a lot of things I like about him. If he was more inherently a physician and less a businessy sort of like accountant engineer guy, I think he could have been a great doctor. And like Peter. Right. Pete, I don't know if you're listening. Yeah. my Middle Eastern brother, I don't think it's too late for you to have an amazing redemption arc.
Starting point is 01:05:21 I think it's still possible. But that mentality has to change. I mean, be just a doctor. Do the doctor thing, says the medical podcast, you're right? Says the doctor. Yeah, I mean, like, yeah, you don't have to, yeah, you don't have to make bedfellows with the worst people in the world to do medicine. listen. We'll get to that in the next episode. So basically
Starting point is 01:05:47 what he was doing here is an unauthorized experiment. And I know this sounds like a sort of small potatoes issue to a lot of the behind the bastards listeners. It's not mass murder. And again, he's not as bad as RFK Jr. Who I really, really, really don't like.
Starting point is 01:06:03 You probably know that. I don't enjoy him very much. I don't like the man. But this laissez-faire approach to medicine and science is just not how science or science is supposed to be a little boring. Yep. Honestly, 10 years ago, I probably wouldn't be bothered by this at all.
Starting point is 01:06:21 But what has happened over that time is that a lot of the little stuff in medicine that we just let slide has added up. And it's led us to where we are now in this country. 20 years ago, if I heard about Gwyneth Paltrow putting a jade egg, you know, a per hoo-ha, or somebody using essential oils to cure their diabetes. It's the medical term. We would laugh and move on. That would be it. But all these things add up over time. The more nonsense we let go by without saying anything because it's easier to ignore it.
Starting point is 01:06:56 The more coffee enemas we let slide now because we don't want to have to explain to you that you don't need to detox outside of your liver and kidneys and that it's bad for you. The more of this we let go, the easier it is to eventually. have confusion around important public health care issues, like vaccines, for example. It creates this murkiness around science where people can be like, yeah, there's lots of different ways to interpret science, like it's religion. And like, you should, that's not how, that's not how science works. You're reading tea leaves as opposed to just trying to figure out like what works and doesn't empirically. Yeah. Yeah. Because now we have like this thing where people are like, hey, you have your interpretation of science. I have mine. And sure, just.
Starting point is 01:07:42 some degree that is true. People can have different interpretations of the study, but there are basic tenets of science that need to be met before you can do that. Anyways, in listening to Atia talk about this particular experience in his podcast, sometimes he acknowledges, it was kind of a bit reckless what I did. In his book, he kind of comes across as much more like contrite, and he seems to understand that maybe he was just trying to prove himself. But I actually feel like In the more truthful moments when he's talking about this on like the Manusphere podcast, he interprets this as less of being a misguided intern to being more of a misunderstood iconoclast. Okay.
Starting point is 01:08:27 Yeah. He uses the story to justify leaving surgery and setting him up as this maverick thinker ready to tell you the one trick. Your doctors don't want you to know. And there's a telling quote that I heard him. talk about in an interview about why he really left. Okay. He didn't feel residency was a meritocracy. So, on an interview with a guy named Jocko, are you familiar with Jock?
Starting point is 01:08:54 Oh, Jock Willick, yes, yes, the former SEAL team guy who was the officer in charge of the American Sniper's Unit. We talked about them in our SEAL episodes because their unit killed a lot of civilians. Or was alleged by another Navy SEAL if having killed a lot of civilians? That checks out. That checks out. I have to tell you, in preparation of this episode, I exposed myself to some real manistphiri stuff.
Starting point is 01:09:17 Yeah, yeah, yeah. And that felt real manisphiri up in there. Yes, I felt like discipline, self-improvement type stuff. Yeah. So he's having this discussion with Jock. And in regards to residency, he said, quote, we all get paid the same. We all take the same number of years to get through.
Starting point is 01:09:36 First of all, if I said that exact quote, I would mean it in the 100% different way he does. But he said, okay, we all get paid the same. We all take the same number of years to get through. It seems crazy to me. Like, there's no other system where that would be the case. Like, I couldn't think of another system where they just had this complete, total lack of meritocracy.
Starting point is 01:10:00 And I'm like, bro, what are you talking about? That is the point of residency. We all have to do the work. You all have to do it. We're all in the shit together. That's the whole thing, right? Is that like everybody has this same basic kind of like, not the same, but like, yeah, there's a standardized procedure for getting prepared to go be an independent doctor, right?
Starting point is 01:10:21 That's, and that's why, like, even if you're on a flight and there's nobody around to help you, if there's a psychiatrist there, you're still better off with a psychiatrist helping you through an emergency than somebody who has no experience because they've been through a lot of the shit. You get a lot of training during this time. and it's not about the prestige or the paycheck. That can come later. And I'm trying to think of an analogy here. It's a bit hard to do, but it'd be like, say somebody shows up to boot camp,
Starting point is 01:10:52 and they're already able to do like 50 pull-ups. And they're expecting because of that they can skip rifle training. Right, right. The pull-ups will be enough, yeah. Yeah, because they're ahead of the curve. It's like, great. Congratulations on the pull-up, but you still don't know how to be like a- Like being smart and hardworking doesn't mean you know how to practice medicine.
Starting point is 01:11:14 No, no. Being able to answer all of the questions on a test doesn't mean that you know how to practice medicine because there's like a lot more. It's just like you could have someone who knows intellectually and can explain how to deal with like a gunshot wound or like a fucking horrible broken leg with the bones protruding from the skin. But then if they actually sit down in front of a person, they have like a panic attack because they can't handle blood. that person may have all of the knowledge, but they still can't be a doctor because she can't be scared of blood and be a doctor. That's exactly, it's exactly right. It takes actually, I think, years of being an actual attending to get past, to get to where you need to be. You know, even after years, I think you still should have some imposter syndrome. Like, I don't think the imposter syndrome should go away anytime soon. I think like, I think that's just a, uh, something. that we always need to be humble about, but something, I mean, speaking of humble, there is a
Starting point is 01:12:12 little bit of a prestige of a sort. If you really wanted to, if you're really good, you do get asked to be a chief residence like I was. That is a little bit of prestige. Stop, you were chief resident. Humblebreg. I was chief resident. That is correct. So, sure. Oh, my God. Honey, I did not know you were that. I did. Realize we had a chief residence on the pub. No, no, no, no. If I'm being honest, they're like, hey, we need some schmuck to stick around one year and not take a paying job and just do some teaching. So it's, you know, they were much smarter people. You were like, I volunteer a tribute.
Starting point is 01:12:51 Yeah, they had a sucker in me. I was a... I've always thought of the Jennifer Lawrence of medicine, yeah. That's always been what I've called myself, Kave from the block. Yeah, absolutely. So, anyways, after this... I think of a different Jennifer, but okay. Yeah, I don't know. I didn't catch a reference, but I just wanted to Jennifer Lopez.
Starting point is 01:13:09 I was talking about Jennifer Lawrence from Hunger Games. Yeah. I explained the whole thing. Yes, yes, yes. That's all good. That's all good. Yeah, yeah. Yeah, I didn't understand the Jennifer Lopez of it at all, but I thought it was still good. So he makes this decision. He's going to leave residency. And after a chance encounter with a radiologist who worked previously at a consultant firm named McKinsey and company in Palo Alto, that name might be familiar to some of you. He leaves medical training to try. his hand at consulting. And I think I'll probably pick up there for the second part and the conclusion of this topic, I guess, when we get into some more of the real bastardy parts of this.
Starting point is 01:13:51 But let's maybe end there for now. Does that sound like a good plan? It's your podcast. I don't want to be running your podcast. You tell me what you want to do. I appreciate it. Thank you for again doing the episodes this week. That's going to be part one.
Starting point is 01:14:04 We'll be back on Thursday. for part two. Until then, COVID, you want to tell the people where they can find former chief resident, Dr. Cava Hoda? That is how I think I should be referred to at all times. Okay, so thank you again very much for letting me come on and do this. It's fun. It's a lot of this conversation, I think, is really important. I'm really glad that we get to have it. There's a lot that's going to go into this conversation, particularly the second part that says a lot about our state of medicine, where we're heading. Why I find it troubling? And I appreciate you guys having me. So thank you so much. Okay. So some of your listeners may already know that they can find me on my podcast, The House of Pod. It's a relatively fun, informal look at medicine and science.
Starting point is 01:14:49 And we take a look at wellness and health grifters and talk about RFK Jr. All the terrible things he's doing to usher in this golden age of diarrhea that we are in. And you can find that anywhere you look for podcasts. And both of these fine people, why I'm talking about, to today have been on that podcast in the past, so you'll hear people you'll know and love. But starting later this month, there's also something very exciting for me that I'm very excited about and I want to tell you all about. It is my new podcast about Persian history. It's going to be a fun look at Persian contributions to the world of art, medicine, science,
Starting point is 01:15:27 philosophy, taking a look at a lot of things that we've sort of been either written out of or at least minimized in in terms of telling the history of it. It's going to be with my co-host, my friend, Shaheen DeVari. If you guys watch Survivor Season 48, he was on that. I'm really enjoying, preparing this and recording these episodes. I think it's going to be a ton of fun for you all as well.
Starting point is 01:15:50 Even if you're not Persian, it's just if you like anything about history and fun storytelling, we're going to be doing that. It is called Persian of interest. So keep your eye out for that, please. I like that. Awesome. Thank you.
Starting point is 01:16:02 Thank you. I feel pretty proud about that one. Check it out, everybody. Check out Persian of interest. And check out part two of this on Thursday. Bye, everybody. Bye. Behind the Bastards is a production of Cool Zone Media. For more from Cool Zone Media, visit our website,
Starting point is 01:16:20 coolzonemedia.com or check us out on the IHeartRadio app, Apple Podcasts, or wherever you get your podcast. Full video episodes of Behind the Bastards are now streaming on Netflix, dropping every Tuesday and Thursday. Hit Remind me on Netflix so you don't miss an episode. For clips in our older episode catalog, continue to subscribe to our YouTube channel, YouTube.com slash at Behind the Bastards. We love about 40% of you, statistically speaking.
Starting point is 01:16:49 Detective said he had stalked her before she died. Years later, they said he remained the person they continued to focus on. This is Hunter Gilmore, host of Hunting for Answers, a True Crime podcast, shedding light on the silent epidemic of missing and murdered black women and girls, bringing attention to stories that equally deserve to be told and to the questions that still remain. Listen to Hunting for Answers a true crime podcast from the Black Effect Podcast Network on the IHeart Radio app, Apple Podcasts, or wherever you get your podcast. Is there an epidemic against literature? More specifically, black literature. I'm Jack Quist-Pice Thomas, and on this season of the Black Lit podcast, we're outside asking why.
Starting point is 01:17:30 They don't want a whole bunch of little elevators, Michael Maxes and Martin Luther King running around. And when you look at a lot of different cultures, they're like, we need to know where you came from. And considering this is Black Reading Month, the only real question is, what are you reading next? Listen to Black Lit from the Black Effect Podcast Network on our iHeartRadio app, Apple Podcasts, or wherever you get your podcast. You broke me. You do not deserve happiness. I'm Andrea Gunning. On this season of betrayal, Carl thought he was living a normal, drama-free life until the messages started.
Starting point is 01:18:04 Someone's not going to make it out of this alive. Every piece of evidence pointed to the wrong guy. He was not going to stop unless we stopped him. Listen to Betrayal Season 6 on the IHeart Radio app, Apple Podcasts, or wherever you get your podcasts. If anyone wanted to commit a murder, up here would be the greatest place in the world to hide the body. But no one will find it. He acted friendly. He talked friendly.
Starting point is 01:18:35 He sounded friendly. They all knew that I did the scary boogie stuff, and I said, maybe she'll find out where this girl is. I saw him violent, backhanded her, pow! Listen to the Devil's Quarry Season 2 in the Bone Valley Feed on the IHeart Radio app, Apple Podcasts, or wherever you get your podcasts. In 1986, a man named Scott Macklem was killed in broad daylight. Police quickly found their suspect.
Starting point is 01:19:13 prosecutors convicted him. But now, almost 40 years later, I'm re-examining this case. I really didn't believe any of it was real. And I was like, well, they're going to figure out this is not me. They're going to do their police job. Has the wrong man been in prison this whole time? Listen to examined the backfire effect on the IHeart Radio app, Apple Podcasts, or wherever you get your podcasts. This is an IHeart podcast. Guaranteed Human.

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