Waveform: The MKBHD Podcast - Asking Doctor Mike About Health Tech

Episode Date: June 23, 2023

This week, Doctor Mike stopped by to talk about everything from Apple Watches to smart water bottles! There are so many new health features in tech products nowadays that we felt it was about time we asked someone about them. Luckily, Dr. Mike is a practicing physician who knows a thing or two about the human body, so we just asked him! This was a fun and informative sit down that we hope you enjoy!  Doctor Mike on YouTube: https://bit.ly/drmikeyoutube Dyson video: https://bit.ly/mkbhddysonmask Shop products mentioned:  Apple Watch Series 8 at https://geni.us/gSUaiV Shop the merch: https://shop.mkbhd.com Twitters: Waveform: https://twitter.com/wvfrm Marques: https://twitter.com/mkbhd Dr. Mike: https://twitter.com/RealDoctorMike Andrew: https://twitter.com/andymanganelli David Imel: https://twitter.com/DurvidImel Adam: https://twitter.com/adamlukas17 Ellis: https://twitter.com/EllisRovin Instagram: https://www.instagram.com/wvfrmpodcast/ TikTok:  https://www.tiktok.com/@waveformpodcast Join the Discord: https://discord.gg/mkbhd Music by 20syl: https://bit.ly/2S53xlC Waveform is part of the Vox Media Podcast Network. Learn more about your ad choices. Visit podcastchoices.com/adchoices

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Exclusively on Paramount+. A mountain of entertainment. I am so dreading groceries this week. Why? You can skip it. Oh, what? Just like that? Just like that.

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You're on your own there. Could have skipped it. Should have skipped it. Skip to the good part and get groceries, meals, and more delivered right to your door on Skip. What is going on, people of the internet? Welcome back to another episode of the Waveform Podcast. We're your hosts. I'm Marques.

I'm Andrew. And we have a very special guest today. Yeah. Dr. Mike is back. I say back because you helped us out with the Dyson video. We talked about the Dyson Zone headphones. And I feel like we've had so many conversations at the studio or even in videos about some health feature or some feature of a tech product where I have to preface it by saying, well, I'm not a medical professional, but, and then

I'll just get into whatever I think. But it was great to have you actually weigh in and give us proper sound technical advice from a medical perspective. You know, it's funny because I'm a clinician, meaning I see patients on a daily basis. So all of my advice and the way that I interpret tech and gear comes from that standpoint, as opposed to a researcher standpoint. I think about the real life utility, real life usage, which drastically is different than intended use or researcher use. Yeah, we can do all the research we want, but sometimes you just got to know how real

people interact with things. So we decided to put all of it in one place today. We've had a ton of interesting random things pop up in the tech world from digital well-being to like the Apple watch I'm wearing to like all kinds of fitness question marks. And we just wanted to have you weigh in on them. I thought it'd be fun. You know, it's funny. I get in trouble having these conversations all the time.

From who? From the tech community mostly because I am sort of a huge skeptic in this space because if something's not proven, I'm very hesitant to recommend it to people. And I'm very protective of my it to people and i'm very protective of my patients time energy money so i don't want them spending money their limited health care budget on things that are not actually going to improve outcomes yeah i feel like this was one of

my one of the big things in medical professions is like if it's approved like fda approved or if it gets some stamp of approval by somebody then then you know it's good. Where with me, I'm like trying something new that's not approved yet, but I'm like, logically, this seems to work fine. And I kind of have to blend those two things together. I mean, I also think skeptics is a great thing. And maybe us as tech people should be more skeptical of some of these because it's really easy for us to go to an event, see all these new health features coming out on things and being like, well, they're the ones doing it. They probably know more,

like we don't know anything about health. So even if this is not your full blown expertise on it, like getting your opinion on this, I think is a good step forward and maybe understanding because every single thing we own now tells you something about your health, it feels like. So we've just been doing a lot about it recently and have some questions for you. I have a little widget on my Mac that shows me how much screen time I've gotten today so far.

Oh, okay. It's like telling me what apps I'm using and how much and how much I should stop. So we do want to dive into all this stuff. But first, I want to zoom out a little bit just to, you said you're a clinician. And I want to get to, what is the one minute elevator pitch that you give to people on what you do? Because when I get asked what I do, I have to process how much of a conversation am I ready for right now. What do you say? I say that at heart, I'm a human first.

Then I'm a board-certified family medicine physician, which means that I take care of people of all ages. I deliver babies. We take care of people of all ages. I deliver babies. We take care of women's health, men's health, the one-year-old of the 101-year-old. So that's my day-to-day job. But then kind of as my side job, I've become a YouTuber, someone that specializes in media production,

and now I'm a professional boxer as well because there wasn't enough things a variety it's a variety i mean yeah that's like that's a wild list first of all becoming a doctor is like more than a full-time job in itself and then a lot of people especially a youtuber with 10 million subs like that is also a full-time job if anything like i see marquez working at this and before anyone started here he's putting in 60 plus hours a week so how on earth and now you're saying boxer as well like how in the world are you doing what's happening uh no i actually value sleep very very much where you told me this

that's very important seven to nine hours i have to hit nine has been rare but i put a priority on sleep i just think i'm excited about doing all these things. It's all like a childhood dream. I feel like I'm in fantasy camp half the time. How do I get a chance to hang out with you guys being on this podcast? How do I get to reach 10 million people with accurate medical info,

debunk something that I see happening in medical media, or then get on stage on Showtime paper and do boxing? Yeah, if given the opportunity, why not? Exactly. Yeah, right, well, and then the next day, go to, you're working at a hospital or a private clinic? I also don't wanna dox you on anything. No, no, no, I work at a community medical center.

It's all Googleable, so it's very obvious where I work. And I've worked there since residency. Actually, next year, despite being pretty young, it's my 10-year anniversary of working there as a doctor. Wow, that's great. I think also I'm like 90% sure I was born at the hospital that you work at. No way!

Which I think is kind of funny. That's pretty sick. Wow. But not young enough to- Yeah, I don't know. It was more than 10 years ago. Yeah, yeah, yeah. That makes sense.

Okay, I think one of the probably easiest places to start with like talking about tech is the Apple Watch. The Watch, anytime, first of all, you see any messaging from Apple about the Watch, there's always something health related in it. And it was fascinating the way it started because Apple kind of didn't know what the Apple Watch was going to be. It was an iPhone accessory, but then, I don't know, will you like send a digital heartbeat to your friend or will you like answer messages or get notifications? And we threw in some fitness features and then the world kind of figured it out and it just turned into fitness and notifications.

And so every single update to the Apple Watch adds some fitness or health thing, and they have to find a way to sell it to the public. And it gets increasingly more and more like, if you don't have this, you might miss that heart irregularity that you have, and this has saved X lives so far. And here's a letter somebody wrote from the hospital about how it saved their life is this uh okay with you it seems like a pretty wild uh way to get people to get something they probably don't need i don't want to isolate the apple watching this i think as the tech industry i think what's happening is they've

seen the value that health data has and increasingly the healthcare tech industry is and even the healthcare industry as a whole is being run as a hedge fund and to me that's where i draw the line because for example if i tell you i created um let's say i'm going to use this water bottle here let's say i created a grip for a water bottle that makes it less likely that it'll slip out of my hands but i haven't done the research to prove that that's the case are you going to be mad about the fact that i'm saying that it doesn't slip out of your hand not really right who cares but now what if i say the water that i've created inside here cures your depression but i I haven't yet tested it. It's kind of a stretch.

That's the problem with our current healthcare tech, healthcare hedge fund industry. No one is actually going that mile to prove that something works because that's really expensive. And a lot of times will backfire because it proves that it doesn't work. And now you've killed your beautiful product. I see. Yeah. I remember the electrocardiogram coming to the apple watch and the entire time i'm watching this i'm like

i'm gonna have to review this watch and i'm gonna test it and i have no idea how to tell if the ecg i get from this watch is good or bad or if it worked or didn't work but it'll be the first time i ever do an ecg myself so i guess that's kind of cool i don't know how to well i just don't know what to do with it to be honest as a doctor and most doctors don't know what to do with it because like the most common use example of the features on the apple watch is that it'll tell you your heart rate's high uh there's a potential risk that you have atrial fibrillation right which is when your heart beats irregularly at an irregular rate i meant to show you this oh did you have some i got well i started getting

these pvcs these a couple nights ago yeah low heart rate and it just tells you this is marquez that's because you're a fitness hype beast so i guess it's weird though because it's notifying me of some health thing and i'm like is this good bad i don't know sometimes you get a high heart rate notification there's all kinds of things do people ever go to you saying my watch told me something is it ever useful no joke what's today today is friday yesterday i was in the office a gentleman comes in who has a history of svt which is a type of fast heart rhythm that exists and he said that after that happened to him once he got an apple watch to start tracking when this happens but here's the interesting part he knows when it's happening he can feel it he can feel the palpitations he has the skills and the techniques necessary how to shut it down and

it happens very rarely but he still got the apple watch now the apple watch started warning him after he played squash that he would have high heart rates and he started getting anxious and then he started getting worse outcomes with his heart rhythms so you see how the tech is fire it works it tracks things but what we do with that information is really problematic because until we get some guidance and we gather enough data to actually make use of it, more data just means more health anxiety, more weird interventions that we don't even know if they work or not. Yeah. The magic really is in when the watch notifies you and specifically how it sort of gives

you and displays the information in a way that's useful. Yeah. Because it can measure all it wants, but it's not necessarily, like if you go through the health app and scroll for a while there's tons of stuff your breath rate your like heart rate over time and all these different things vo2 max somehow it knows and i just don't know what to do with that i think it's entertainment purposes only for now the the one feature on the apple watch that i think is really exciting is the fall notification feature yes and you have a story of it going on a roller coaster. No, no, not a roller.

That's one that's happened to a lot of people. Actually, car crash detection is the one on the roller coaster. But I'll be running around during a frizzy practice and chasing somebody around a field long enough, you'll stumble and you'll get a little vibration that says, are you okay? Did you fall?

Did you need me to call SOS? See, that's the cool feature. It's kind of a flex though. Cause if you made someone fall hard enough that they get the Apple watch notification, that's pretty fine. I've never thought of it. You break someone's ankles hard enough that they, their watch is like, are you good? Bro?

Yeah, I'm good. Yeah. Yeah. There's a lot. I feel like the, we keep saying Apple watch cause it's the one that seems to plug it in the most, but like, obviously. Pixel Garmin, Samsung, they're all doing it and it feels like they all started focusing on like health and fitness activity tracking first um and now they

seem to have gone into more of these like afib vo2 max like uh fall detection more things that feel like past i'm trying to live an active health style and more like I'm warning you about your regular health style. I kind of wanted to go over, like can we split that into two? Maybe from what you said already, it seems like a lot of it seems kind of nonsensical, but if we can, not nonsensical, but- I think it's less useful.

And every time we weigh any kind of medical intervention, we weigh risk benefit, right? So if I prescribe a surgery, a medication, everything has risk benefits. In fact, if something doesn't have a risk, that means it probably doesn't even work anyway because it has to have the opposite effect if it does something.

So with this Apple Watch, what I feel like is happening, we're getting data, very limited benefit of what we can do with said data, but definite harms that I'm seeing as a result of health-related anxiety that's being fueled by all these alarms. So that's how I make my decisions. It's very simplified.

Yeah. Do you use any type of trackers yourself? So for example, I used to wear an Apple Watch myself, and I remember watching a UFC fight, and I guess because I've been in the ring, yeah, I got an alert for the first time that your heart rate's been elevated for an extended period of time while sedentary. While watching it. Yeah, while watching it. That happened to me in hockey playoffs this year.

I was like, just so you know you're anxious. That I guess makes sense. Yes, exactly. You know that's happening though, so it's easy to dismiss that. I guess like for abnormal heart rate and stuff, it's more of the times where you're not quite feeling it and you get that. You said you've already had it. Do you think it's stuff like that? How much is that affecting you guys in the medical field

of just getting calls and patients who are, like you said, anxiety? Specifically, my watch told me this. Okay, so now we're kind of talking about the anxiety and the non-health important, I guess, vital disease notifications, like random, like fast heart rate, all that. But now let's talk about the atrial fibrillation notification, because that's the one that could actually

have healthcare implications. We have no idea what to do with it in the healthcare setting when you get a random alert like that. Yes, we can put on a halter monitor, monitor you for seven days, which is a little thing you wear on your chest. It monitors it. If you have symptoms like palpitations, you could notify it. So when we read it back, we can go back to the time where you press it, you had symptoms. Because a lot of times patients will have some sort of electrical irregularity in their heart, feel it, but then we didn't do the EKG when that was going on. So we don't know what's going on. So the halter allows us to do that. But in general, when we have atrial fibrillation, we have rules of how we decide to treat it. How often is it happening? We have scoring systems that we use

based on the patient's age. There are other medical history, like little factors. But if it happens very, very rarely and the person's otherwise healthy with no medical history, which is most of the time what happens when we get these calls,

what we do with it, we don't have good evidence to decide. Maybe we put the halter monitor on but then it doesn't catch anything then the apple watch two weeks later catches something again we still don't know what to do yeah i feel like there's the in the keynote there's a classic example of like i got this notification i thought it was kind of weird i went to a doctor the doctor confirmed it this thing saved my life yeah and the the the fitness things that we wear have such scale there's so many of them

out there that inevitably there's a couple of those stories that are real. And then when those stories are the display for like whether or not you should get the thing, it makes it feel like this is something everyone should be looking out for. Yeah. It's a very manipulative marketing tool because look, I can say right now, let me give you a CAT scan every day for the next 20 years. And I might be able to catch a cancer. And we might be able to intervene. But what I'm not telling you is that I'm also going to be radiating your body probably producing all sorts of cancers at the same time. So there's a healthy balance that has to exist when it comes to healthcare tech where it's like we tell people what it's possible to accomplish but then we

have to be honest with the drawbacks otherwise it gets into shady territory yeah do you think there's any type of and if like the doctor community has discussed this before but there's some people who say like obviously all these numbers aren't very accurate, but if you follow trends based on numbers that you're getting on things, is there a best practice of potentially using these to actually not just increase healthy lifestyle, but also potentially see some sort of health?

The health app does show trends. Trends, but even just you reading things yourself. I mean, I get a heart rate variance every morning when I wake up, and that's something when I first saw it, I research it, and then I'm scared. Like you said, I'm exactly who you're talking about with health anxiety, looking stuff up online. Sometimes I think this really helps me. Sometimes I think this sends me into a bit of a spiral, and I don't love it.

So, like, for example, resting heart rate it like for example resting heart rate the lower the resting heart rate generally speaking the healthier person is right because that usually means they're in great shape this is why this guy over here sits at a 40 heart rate going to sleep um but if you are at a resting heart rate of 75 that's considered normal you're healthy and let's say you start exercising and you start lowering that. The Apple Watch will show that trend over the course of the month. But you tracking that number is purely for entertainment. Because if I, as a doctor, encourage you to work out and you start working out, I don't need the Apple Watch to tell me that your resting heart rate's going to go down. The only time that's really important is if you're an athlete professionally

and you're trying to go from 99th percentile of success to 99.5 which the huge majority of the general public is not needing these tools but again for entertainment for motivation fine i'm with it especially this tech can evolve and really will become good i think the future is bright i don't want to like poo-poo the whole industry. I just think the way that they're selling it now is premature. Yeah. It kind of reminds me of like,

we were talking to the CEO of Rivian where a lot of people will get like this $100,000 truck and will never use anywhere near the capabilities of the truck. But the tech and the capabilities are so good that it's like once in a while when someone maximizes its use, it's kind of amazing. Kind of reminds me of like, yeah, most people aren't trying to get from the 99 to 99.5 percentile, but the people who are

might find this watch amazing. Exactly. The new Ultra's got this like trail climbing mode and all these other things that are like super, super useful. But generally for most of us, we're just kind of like, oh, neat, I should probably be okay. And I just did that. Well, it's the same thing with like protein, creatine supplements.

Like you could take these, but if you're an average person, and I mean average even to like a higher degree. If you fall within 90% of people who exercise, if you just focus on a healthy diet and focus on the routines you're doing the supplements are going to maybe add five percent of improvement and again that's for people who are competing the average person and people who go to gnc and vitamin shop and all these and get these things you're doing it for fun yeah you're not really changing much that's fair yeah that's super fair i do like i i like i use the term entertainment i guess it's not something we've thought about much but like entertainment doesn't necessarily

mean bad thing like no entertainment is a motivator as well and like i i personally i used to play frisbee with marquez i had four knee surgeries and then had to quit that eventually and found my activity like way way down like some minor things and then i borrowed an apple watch here once and those competitions they do are like one of the most things ever gamifying fitness yes it's like that has super helped me get into like a way way more active lifestyle and and that is amazing but yes on the other hand like what you're saying like if you're not in that potentially professional athlete aspect of things like these things are just like you can look and be like okay cool i did it today i knew that already but it's nice

to just see it off my wrist just like there's the same way i'm like addicted to like checking the checkbox like closing the ring is like yes that's satisfying thing look that's the strong part of this app and these tools and the motivation of it is exciting and i want people to make use of it in fact when i made like one of my first videos on youtube it was about how to get fit for summer it was like get some new workout gear as a kickstarter to your motivation the one thing that i'll say is because i'm again very research based when you look at research and you see these initial boosts of motivation by getting new gear by getting a tracker long term they don't make a difference right you got to have a routine and get into something it's a lifestyle change before you initial boosts of motivation by getting new gear, by getting a tracker, long-term, they don't make a difference.

You got to have a routine and get into something repeatable. It's a lifestyle change. Or you just need to keep buying things, which I've fallen into that hole way too many times. New hobby, new shoes, new everything. Yeah. Breaking news coming in from Bet365, where every nail-biting overtime win, breakaway, pick six, three-point shot,

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Get more everything with FanDuel Sportsbook and Casino. Gambling problem? Call 1-866-531-2600. Visit connectsontario.ca. I also wanted to quickly touch on, like, obviously COVID changed the world, and there was a lot of attempts at responses from tech companies to try to make something that's for this sort of new COVID world, and this sort of exact example came up.

There was a recent leak, and this happens a lot, of a new Pixel phone. They get leaked all the time. Pixel 8, and the leak was that they would have a new uh sensor on the back that's just a thermometer oh just a thermometer and there was this glyph that was just like a person holding it up to their forehead like this and like moving it around their temple to take their temperature and like hitting the button and reading what do you think of this is this is this too little too late should people actually use this for anything usable? I mean, it's cool. Because I know a lot of times there's like events

where they'll hold up the thermometer to your forehead and just like beep, it says 94. Okay, that seems fine. You're good. I mean, 94 is a little weird. You're running 90. It's the surface though. I've never had it say 98.6.

It's always lower because it's just like that. The ones that we use in the hospital are really good. They say exact. Because isn't that your core temperature, not your like surface temperature? These, like, I don't know how they work. They're really good. Did I say exact? Because isn't that your core temperature, not your surface temperature? These, I don't know how they work. They're really accurate. Maybe they're calibrated differently.

I don't know. Interesting. They're really, really accurate. Okay. I kind of want one. They're scary. Do you think a phone has any shot? Yeah. Or is that a step too far?

Outside of my expertise. I mean, we're my clinician side. Yeah, fair. There's probably some questions we're going to ask where we think, like, you know literally everything about everything i react to memes you have a wide of wide understanding and we're trying to like dig deep on some random things like this reminds me of i was with um i had the same thing david blaine did this insane project where he was gonna hold on to these balloons and ascend up to

10 000 feet or something crazy maybe it was more than that just holding onto these balloons and ascend up to 10,000 feet or something crazy. Maybe it was more than that, just holding onto the balloons, which of course means the atmosphere gets thinner. There's lots of oxygen in the air. It's colder. And he did this whole thing where he like floated up the top and then was going to parachute down to the ground. And I was sort of helping him with the behind the scenes and the broadcast of it. And at point he asked me like so marquez the apple watch has um it has like a heart rate thing in it it's got like your vo2 max and it seems to be able to understand if you're hypoxic like if your blood oxygen goes too low do you think i should use my apple watch to know if i'm going hypoxic or if i should get a dedicated like reader and my first gut reaction was like do not trust the Watch. Just get the thing that's

supposed to do just blood oxygen and that's probably going to be super accurate. But it was just curious that the watch totally has a tool that'll tell you, oh yeah, you're at 9,000 feet and your blood oxygen is at 95 instead of 100 and you might be going hypoxic right now so probably grab some oxygen.

And that's just a thing that it can do. So there's a variety of things. I would still go with the safer choice. If it's just a thing that it can do wow so there's a variety of i would still go with the safer if it's in a life or death situation it seemed like that was life or death it didn't seem like watching the broadcast that he could buy possibly die but in that moment of recommending the tool i was like try to just get the i also don't even know like this is why it's very dangerous to give advice in situations like that yeah for example the way that these tools work is they work through a sensor of seeing color of uh your blood flow going in and out that's even how the iphone sensor works who knows if you're when you're that high are those sensors calibrated for that height i don't even like do they work the

same way on ground level as they do up there i don't know i don't know if the color changes when you go higher like that's crazy i think we assume that like apple has infinite money and can probably test in infinite scenarios and like hopefully they've done enough of this and like this is very much benefit of the doubt for like this one particular company but like hopefully they've tested it and hopefully it'll work in all the scenarios we think it should yeah but we just don't know or they can provide anecdotal evidence in an event that shows one person having their life saved and that's way cheaper and we'll sell way more fair yeah have you heard of a whoop yeah do you do you think it's

good or better than i watch in most cases recommend against it. Interesting. I'll tell you why. You know, it gives you like this score of how well rested you are and all that stuff. And the score is probably reliable. But you know what's even better to learn and is equally as reliable? How you feel. And you know why that's better than the phone and the score? I mean, the app on the phone and the Whoop itself? Because if the Whoop tells you you are not well rested even if you are well rested you're gonna have worse outcomes yes isn't that sick i can attest to so my watch has body battery on it

and i was gonna ask you about this as well it's similar to that and i found it i started using i finally started sleep tracking and like i would have days where i'm at 100 body battery and i found it i started using i finally started sleep tracking and like i would have days where i'm at 100 body battery and i'm like i'm going climbing tonight like i'm gonna have a great session and i had a great session then the next week it's like you didn't sleep that well your body battery is like 40 percent now i get there and i do terrible i was like was that me or was that actually was it close to it like doing well? Or did I just totally psych myself out? This has been tested. So the way that they tested this is they had people sleep and they fake track their sleep.

And they would tell them that they had really bad quality of sleep or really good quality of sleep. And even the people who slept and had bad quality of sleep, they performed better when they were told that they had great quality of sleep. And the people who slept great and were told they had bad quality of sleep perform worse wow okay so i'm just gonna make a werewolf that tells you every day you had great quality so you know companies are doing this and you know which companies are doing this dating apps uh okay cupid is run or at least was started by mathematicians and they said that if we tell people they're at higher match percentage than they really are the odds of them ending up with people is higher and they'll be happier more satisfied and they started doing it and it

freaking works that is a really fascinating example because that's such an opaque thing like you don't know no one knows i mean and if it turns into a happy relationship it's also hard to argue against it as well it's weird and it's taking advantage of people but it's yeah but that's the kind of tech thing that kind of gets me scared with ai because when they start leaning in those directions i'm like i mean you just segued kind of perfectly into the next segment of things i think we wanted to talk about which are like generative generative ai ai chat bots i know you can i can i make one statement about the final thing about whoop sure yeah i just think it's it's very valuable why i also want

people to uh know on their own when they're feeling tired or maybe had a worse quality of sleep is because learning about your body and perception, accurate perception, trying to be as objective as possible of how you feel goes a long way to having better health outcomes. Knowing when you're sore versus injured, knowing when there's a true injury or a pain that needs to be addressed, those things are so important

when it comes to like long-term health related outcomes that if you don't learn that and you trust your phone to do it for you, you're actually missing out on some really good health benefits. I think what I'm realizing is that, and I'm putting this thought together in real time, that most people go about the data in this wellbeing, like kind of backwards. Like you should start with a foundation of how you feel. then maybe on top of that you can use this sort of quantifying measures to sort of better understand things where I think some people want to start with oh it's a computer it must know me best but it

doesn't it doesn't and then they try to make the balancing on top of the computers numbers when you should start with really just how you feel so it's kind of backwards yes the simple analogy here is we have calculators but we still learn how to add and subtract so we still need to learn about our bodies before we start using these apps fair that's so great i'm gonna ask chat gpt i'm gonna ask chat gpt all the things i don't know no this is okay so the other version of this because we talked about like okay a patient comes in they saw a notification on the apple watch have you ever had a patient come in with a diagnosis from some i'm sure not just online but like an ai chat bot or something like that

where they're sort of wondering okay because this is gonna happen i'm pretty sure like that will happen i mean maybe they have and they just haven't told they didn't tell you yeah they're not i mean i'm sure you have plenty of webmd people like i know i've been that person before and i always feel bad being like i read this online and i'm i don't want to admit it but that's half the reason some people are like you in that they admit it some don't but i make it a routine question to ask a patient unless it's very straightforward what's going on, what do you think is going on? Because if they read on WebMD, let's use a basic example like a cough.

Patient comes in with a cough, I'm making the diagnosis, I'm like, it's not bacterial, I think it's viral, they don't need antibiotics. But the patient went on WebMD and thinks they have cancer, and I go on this long spiel about why it's not bacterial and why it's viral, and then they leave and they're leaving dissatisfied because they don't know if they have lung cancer cancer i miss the opportunity to actually help the person i wish

every doctor would ask that i i've you've made me like not like most of my doctors after that i'm gonna have to start coming to you or something like i just wish yeah that's such a simple question to ask that i appreciate because it also sometimes patients won't tell you a little detail or you won't ask the right question. And then by them saying, I think it's this, I would say, oh, but I don't think it's that because you don't have symptom X. They're like, actually. And I'm like, whoa, now I know what's going on. Interesting.

Yeah. Yeah. And I've seen, so there's a number of stories of, you know, maybe an AI tool helping to diagnose something faster than a human would. of maybe an AI tool helping to diagnose something faster than a human would. And this goes all the way back to when I was in school, there was a classic business story of some dad shares his Amazon account with his daughter and he starts getting recommendations for diapers and he's like, why am I getting these? This doesn't make sense. And Amazon knows that the daughter's pregnant before the dad does.

And it's because these algorithms are really, really good at pattern recognition and finding things often better than humans. And it seems plausible that an AI tool could start to identify patterns, maybe even in the data from the fitness tracker, and actually find some diagnosis that's helpful before a doctor could. Is this a future that worries you as a medical professional? Maybe it's taking a job, or maybe it's a good thing that it's better and it can help people find things faster. I don't think it's good yet.

And I think it's really far away. I'll explain why. If a problem is that hard to find and does not present itself, treating it will likely yield more negative effects than positive. Okay. Because that means it's not that big of a problem.

Right. If you have a legitimate problem, like with your heart rate, you will know. And if you have no symptoms and it's not really affecting you, and I had to dig into your data to find a few heartbeats here and there,

giving you a medication that has legitimate side effects that I know will have side effects, probably won't be beneficial. So that's why I'm down on it i think the the one version of this that is outside of that funnel is like specifically cancer and things that it matters how early you detect them sure so potentially detecting something earlier than a human would yeah maybe in its absolute beginning which is. So that is also really tricky because I think that is doable. And I think we need to use our AI tools to improve our screening methods.

For example, we have really well-proven screening methods that we use. For example, with a cervical cancer, we do pap smears. When we do pap smears, we've essentially eliminated cervical cancer deaths in women. That's amazing that we've been able to do that. Obviously, there was the HPV vaccine as well that has helped because the HPV virus actually causes cancer, one of the rare viruses that does that, and the vaccine prevents that. So we have screening methods that we use that work well in catching cancer and addressing it and all these things.

But then there's ones that are screening methods that aren't great, that actually catch too many false positives. They catch too many cancers that are actually never going to become a problem that we, in order to intervene by doing a biopsy or something, we actually create more harm. We fuel health anxiety. So it's a very thin line of that balance of when do we screen healthy people and when do we not and i think ai tools can improve our screening methods okay but will they be the final answer for everything probably not yeah there's still a human element of like figuring out when to apply certain things that makes a lot of sense i'm sure i've and i feel like it's in i feel like it'll

never i mean and that's coming from someone on the outside. I can't imagine it ever taking over, even just like general, you have to have like general bedside manner and stuff. Like it's also nice to just be able to talk to a physical human and they're interacting much closer. And I know these chatbots, they're getting close to like a full-blown conversation,

but then you're also, you think eventually it'll get there. Do you see the path to getting there becoming a burden on kind of the medical community for a while? Maybe burden's not the right word, but like... Pressures. Yeah, and not even like influx of more people coming up, kind of like the WebMD problem of... I think there's a world where that happens. I also think that when you look at AI, and we see how right now everyone

has this fear of AI taking over, and then you have people reminding the general public, AI is very narrow focused in what it can do. It does one task very well, like chat GPT gives you written stuff, other ones give you AI generated images, other ones do a voice. And right now, they're very set in their tasks. So I think in that narrow space, AI-generated images, other ones do a voice. And right now, they're very set in their tasks. So I think in that narrow space, AI could be really good because we could train it to do some of the more mundane tasks, find patterns, analyze data to help us improve our screening methods, when we should screen, when we should not, for that kind of data analysis. I think that will be beneficial. Do I think AI can fully replace a doctor?

For now, no, because it would have to, A, be not as narrow. The human mind, what makes it unique is that is the opposite of narrow. It's so broad and can do so much. And the relatability, the fact that you know- That part I think is important. Yes, so it can fake as being a human, but if you don't have that relatability

and you don't buy in- Yeah, yeah, God, that is a whole can of worms of like, well, can an AI fake being a human but if you don't have that relatability and you don't buy in yeah yeah god that is that is a whole can of worms of like well can an ai fake being a human so well that you don't even know that that's that's that's another that keeps me up at night yeah do you think there's on this side of rather patients using like chatbots doctors using chatbots because you see it being a potential tool in the future for and now maybe this is me thinking about like house a little too much where he has to have these full-blown conversations of like it might be this this let's check the symptoms and maybe that's not what every doctor does essentially

but could you see it being a tool of you trying to think of something and using it as just something to bounce ideas off yeah i just think it needs to be very well validated and that's going to be really expensive to do that's That's the tough part about the AI tools right now because they just make stuff up. Yeah. We were talking about just like if you're an expert in a field and you ask AI tool like a very basic question, then you can vet how good

or bad the answers are. And as someone who's an expert in like tech stuff, we'd ask it a basic tech question and get an answer where we're like, oh, that's not great. That's not a great answer. So the other answers and other things I'm not an expert in seem very valid, but I have no idea of knowing if they're actually good. I mean, it reminds me of an instance that I had when I was in my medical school training. I was working at Coney Island Hospital, and I was working alongside one of the top cardiologists.

We walked into a patient's room. I knew the patient well because I examined them in the mornings before the doctor does their rounds. And the doctor comes in, gives the correct diagnosis, the perfect plan, lays out even like some options. If the patient doesn't want to do plan A, there's a plan B. Perfect. Like everything's awesome. They walk out of the room, the patient looks at me and goes, what did they say? No connection there. But the information was accurate. It was easy enough that I understood it, but not on a level where they connected.

So can an AI not only be not as narrow as it currently is, but also be able to absorb patients' body language, the way that they're interpreting data? Can they verify that? Will people have the buy-in to do that there's so many factors i feel like we all nuke each other before that happens i'm just like i think it's possible i think these could all be inputs into the system obviously it's it's very difficult and it's a long way off yeah but uh there's there's all these ai tools of like all right you want to be able to summarize a book or a medical paper, we train it on that data specifically. And then it can give us accurate answers,

which are verifiable to the thing it's trained on. And so if you wanted to create some magical, let's say, cardiologist AI doctor, you would train it on a hand selected by people like you set of medical papers that have good information and then maybe, and it's good enough to give answers that are up to par with what a cardiologist would have said. And then it also gets all the information of like, okay,

it's got a camera so it can read your body language as it's giving you information. This is all very far out, but I'm just picturing like Tesla pot at the bedside. Like I can see your heart rate is high. Here what i will talk about anxiety the doctor's office of tesla yeah maybe don't do maybe don't do tesla bot that's a little that's a little far out maybe wally i see what you're saying and i see a world where it's possible i just think that there's so many barriers and there's so many ways it can go wrong before we even get to that point that i'm

super skeptical that we get there i don don't know, maybe I'm wrong. And there's- I would trust you more than us, for sure. Can I throw out an interesting medical AI story that came out, I think, last week? Yes. There's a scary half and a benevolent half, and I'll only share the benevolent half.

But a lot of pharmaceutical companies are using models right now to predict toxicity in analogs for drugs. So what they'll do is they'll take a drug they know works and then produce 40,000 different variations and have an AI say, oh no, this one's going to block this receptor and we can't have that and stuff like that.

The flip side of that is that the same team of researchers- side of that is that are the same a team of researchers terrorism yeah a team of researchers like to see if it was possible flipped a few line of code and just had it make different poisons for six hours yeah yeah and that that's actually so much less worrying to me than what i thought he was gonna say as funny as that is poisons whatever You got to ingest the poison. That's true. But now what about a virus that uses your own body to replicate that we can now program using AI

to be the most infectious, to be the most lethal that only affects certain genetic types? Yeah. Holy shit. Yeah. That's like, yeah, we were talking about these hypotheticals.

Talk about bioterrorism on full display. There was a headline recently, actually today, that Neuralink got FDA approval to do human testing. And it's really funny reading the comments because half the comments are like, I would do it, yeah, seems like a great idea. Like this Elon guy is pretty smart. I think I want a computer in my brain.

And then the other half are like, I would never be first in line for human testing. Like we've seen first gen tech products for so long. Like if you've seen like the first gen iPhone, the first gen folding phone, do you want the first gen iPhone version of a human brain implant? Not really. Uh, but I'm curious where you, where you see this. I think a lot of times when it comes to these really borderline ethical medical experiments, because when we do medical research, they have to go through a process known as an ERB, which is an Ethics Review Board. And I actually was a member of one of these when I was a student. And they have all sorts of people on them, teachers, doctors, non-medical people,

business people, so that we get the general gist of, is this project ethical to go? And using CRISPR as an example, it's pretty uniformly country to country agreed upon that this is an unethical thing to test on humans unless they have an illness that is lethal and they will not survive. So that is why when it came out that, I believe it was in China, they were doing some CRISPR gene editing on an individual to see if they can cure HIV. We found that in the international medical community to be really unethical

because HIV is no longer a life-threatening virus. We have medications for it. So the fact that they were testing it on that virus, we found to be very unethical. And when it comes to Neuralink, unless you're implanting this in someone who desperately needs whatever, I don't even know what the hell this thing is.

Yeah, I have no idea. Then I don't know who would be first in line to get this thing. Yeah, I don't know enough about what Neuralink is designed to be, but it seems from what I've read to be more of a add-on than a solution. And to be fair, they've said like,

oh, we've had lots of examples of it like helping a paralyzed mouse to be able to walk again. And there's really cool possible examples of it being a solution, but clearly not everyone needs it. So it's kind of weird for just regular healthy people to volunteer for a brain implant they probably don't need. So that's kind of how I see it. So it's kind of weird for just like regular healthy people to volunteer for a brain implant they probably don't need. So that's kind of how I see it. And I just wonder like why? There's so many cool experiments like that going on. I remember I was in Israel learning about their biotech stuff and they had four people, I believe that had strokes or traumatic brain

injuries where they needed to regrow neurons and they were literally using electron fields or magnets or something to try and regrow these fields in order to create pathways for neurons to fire and i was like this is so above my understanding that this could potentially work but at the same time could this kill someone because this girl like i don't know anything about it and we need to be really careful about, again, there's promise in a lot of stuff, but then we got to talk about the negatives because if we don't,

we can really get in trouble in the world sector of things. And causing more harm when trying to cause good, yeah. There's that classic line when good intentions cause bad outcomes. I think we need to be more cognizant of that these days. Because we're very good at being PR people for our stuff. Like, look at all the good that I'm trying to do. But could there be bad outcomes?

What's the Jurassic Park? Your scientists were so preoccupied with whether or not that they could that they forgot to think about whether or not they should. Yeah, there you go. That's a pretty powerful- With great power comes great responsibility. Powerful line.

We've been throwing a lot of products at you that we review a lot. Is there anything in the tech slash medical or just healthy lifestyle aspects that you're excited about these days? I am excited about improving things that require calculations because we as doctors, A, we don't have time and B, we're really bad at doing these calculations or we forget to do them in a lot of cases. And if I could know right away which patient would benefit from starting a statin, which is a cholesterol-lowering medication, when I should start it on them

based on the calculations that are already given to me from analyzed data of millions of patients, that's gonna lead me to give better medical advice. Genetic testing is still not there yet for for like general use for us at home i'm like really negative on people taking genetic tests at home you're talking about like 23andme stuff like that yeah like i don't even want to individualize companies but yeah i think it's problematic for so many reasons we could even get into it later. But in the future, I'm really excited about finding out which patients of mine, based on their DNA, would benefit from one antidepressant versus another, instead of having me experiment with them and get a subjective answer when they may have just had a sh**ty week and they're

actually not getting the best medication. It gets really messy that way. You said we could get into it later. Do you mind saying why you're generally against at-home genetics? Yeah. So A, they're incomplete. Okay. So when you go to see a proper geneticist and you go to a genetic counselor, what they

do is they do the most validated tests, the tests that are testing for all different variables of a specific illness. And then they give you guidance based on what we know off the data and what we don't know. And off of that, you could make some decisions for your health.

But when you get these at-home tests, you're like, oh, check if you have high or low risk for developing diabetes later in life. What do you do with that data? What do you do when you find out you have low risk for developing diabetes? Do you eat sugar more? Tons of it. of it but like that's bad that's not good advice because your body

your life is not just about diabetes there's it's unhealthy to eat a ton of sugar not just for diabetes yeah yeah or the more like a pronounced one with chris chris hemsworth situation people are getting tested to find out if they're going to develop neurologic diseases early in life like alzheimer's what is the use of finding that out yeah yeah there's no intervention in the future maybe and when i say no intervention like yes eating a healthy living a healthy lifestyle all that can mitigate that risk yeah but do that anyway not for alz Alzheimer's but for literally every other disease it just tells you every time

if you don't develop a healthy lifestyle quickly it's going to go downhill for you and it just tells that to everyone everyone starts developing a healthy lifestyle and everyone's happy this is the argument that I have with some of my friends they're like I should get preventive MRIs to catch things early because then we could prevent certain problems

and I'm like but all you end up hearing in most of these cases is just like live a healthy lifestyle to get preventive MRIs to catch things early because then we could prevent certain problems. And I'm like, but all you end up hearing in most of these cases, just like live a healthy lifestyle. I'll tell you that for free. Yeah. And even that is a little bit more complicated because it needs to be individualized. What that means for you based on your values, your culture, your government, what access you have. I mean, so many different variables, but it's the same thing for everybody.

Yeah, I agree. Do you see any current consumer-based tech that you could see? So like you could see helping potentially like a more healthy lifestyle, becoming more active. Like one thing I kind of think about is VR and kind of video games that are incorporating more activity rather than sitting at a chair all the time? Do you think that there's some minor benefits there of getting someone up and moving around a little more than, I mean, as someone who's- Theoretically, yes. Okay.

And while I'm usually very evidence-based by looking at the collective randomized controlled studies, that's the gold standard, I'm going to give you anecdotal research that I've done. Sure. Everyone that I've ever met in my life that got a vr product used it four and a half times and discontinued same so it's like yeah i can't argue with that i mean so it's it is more about developing habits than it is finding a quick like uh gadget to help

you do something i think that's the ultimate takeaway when it comes to health because there's such a homeostasis between acid base hot and cold like that thin line exists and it needs to be balanced so carefully that there's no quick fix because any quick fix is going to come with a quick downside also yeah i guess it kind of goes into what you were saying before about getting things that feel like a motivator v VR is just turning into another one of those, like, I'm going to get a two-week stint. I mean, like, listen, I played Beat Saber nonstop for, like, two weeks, and then that thing hasn't been plugged in.

The caveat is if inside of Beat Saber there's some sort of gamification that makes you want to come back every day, like closing my rings on the watch, like, if there's something like that, then... Yeah, like, if it creates a community around it where you go to tournaments... That, too, yeah.

It's well thought out. It could exist. It absolutely... It's the It could exist. It absolutely, it's the same with relationships. I mean, I'm sure you've seen in your personal lives, whether for yourself or others, any relationship that starts super hot and they're in love day one.

Yeah. That's, you need, I'm going to, I'm going to let it sit there. The gimmick at the beginning. Yeah, exactly.

That's fair. That's usually lust. And if you're lusting after your VR, odds are you're not going to be continuing it a year down the line. plans and having your unused data roll over to the following month. Every month at Fizz, you always get more for your money. Terms and conditions for our different programs and policies apply. Details at Fizz.ca. Support for the show today comes from NetSuite. Anxious about where the economy is headed? You're not alone. If you ask nine experts, you're likely to get 10 different answers. So unless you're a fortune teller and it's perfectly okay that you're not, nobody can

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All right, I got a little lightning round for you. I want to throw a bunch of small tech-related medical concepts or maybe just medical concepts. Tech or like people in the tech world, their lifestyle choices, maybe unhealthy habits. Stuff I'm wondering about. First one is David has a water bottle that like tracks how much he drinks every day.

Literally like the battery can die on his water bottle. It's hilarious. How much water should we actually drink every day? It's individually. Dang it. Decided. First of all, I'll, can I judge the water bottle? I wish we had it.

No, no, no. I mean, judge it like, like, oh yeah. Tell you what I think about it. Yes. Yeah. I think you've evolved as a species for millions of years and no one's ever been like i mean not no one i should be careful here that 99.99 of individuals know when they're thirsty and you could just use that as a gauge okay um if you fall into this rare specific population that maybe you're taking a medication that makes you more thirsty, maybe you have ADHD and you're taking Adderall and that causes you to forget to drink or whatever it is, then maybe it's a tool that works.

But the huge majority of people, gimmick. It's not eight glasses or whatever every day? No, that's just made up. Ten gallons every time. If you were trying to be i guess like medically sound about it you would look at your urine and you would aim to have a straw colored urine okay so like pale yellow there and whatever that because again if you go outside and you run and it's hot you're gonna need more water than if you sat all day inside and if you have a higher body mass and

more muscle again there's different variables eight glasses is so random we have yeah we have healthy water drinking habits at the studio. Well, we can't say that one last time at Gamer. We had no water bottles and 12 cases of Red Bull in the kitchen. Somewhat. Somewhat. Okay, this might have a similar answer, but how many hours of sleep should I actually aim for? Yeah, adults, seven to nine.

Seven to nine. And it's not just the number of hours. It's consistency of those hours and even more so the consistency of which hours would you value a sleep score that can just like do the calculations for how consistent you're being and how often you're hitting those targets i feel like most of them why well i don't necessarily know if i if i am hitting the same fall asleep time every day. Are you tired when you wake up in the morning? Am I tired when I wake up?

I feel like we're getting to the point where I can answer for you. Because I know how you're going to answer half of these questions. You kind of know that already. You know. Does it make your life better to know is my question. No, not really. Can I ask a question on the consistency part of that? Sure. is my question no yeah not really can i ask a question on the consistency part of that sure

so when you say consistent you mean it is seven to nine hours every day every week not i'm doing six hours this night and then correct nine hours it's not there's no like making up for that sleep ideally you find the number of hours that works for you and it's by the way different for everybody sure sure um matthew walk Walker, who's a sleep expert, like he's kind of the sleep diplomat. I think that's his Twitter handle. He was on my podcast. And we talked about, he has a book called Why We Sleep.

Really interesting book, highly recommend it. He not only talks about that the hours need to be consistent, that if you're sleeping from like 11 to eight, sleep 11 to eight every night. Okay, yeah. So the number of hours and which hours is very important. Weekends, sleep the same. And if you don't, it's going to get messy.

But then there's individuals who, some people are night owls, some people are morning people, but then there's also people in between. So not everyone is actually designed by nature to sleep at the same time. And our society kind of makes that unfortunate distinction that everyone needs to sleep at the same time yeah and that's not the way nature intended it because nature was meant to keep

some people up at night maybe to watch over us while we slept so there's like that's the theory of what's going on and what has happened i was just reading a great book on the way here called sapiens through audible not reading and driving. And there was a part that just played that is very applicable here. Back in the day, the shoemaker would make the entire shoe. So if the shoemaker came late to work, no one cared because they could keep making their shoes and they'd be fine. But now in the assembly line in the industrial age, if one person does not show up exactly on time the whole system falls apart so it made everyone have to come to work at the same exact time it created public transportation that needed to bring people at the exact same time to work but humans are not all the same and as a

result it kind of has some negative implications on us what's the word for you know this word when normalization no we have like a when humans used to have a tail, but now it's just like a tailbone. Yeah, like a remnant. Vestigial. Vestigial remnant. Remnant of old, yeah. Yeah. We don't need to all wake up at the same time.

Okay, I like that. Blue light glasses, dumb or actually smart? For what? I guess it's mostly for like eye health. Style, definitely dumb. 100%. Fair, 100%. No, I agree with you. I guess it's mostly for like style definitely done but I think most of them there's a whole bunch of all this research that I read and I keep hearing in these tech presentations about how oh the longer you see blue light into the afternoon

hours the more your brain is tricking to thinking it's the daytime and it makes it harder to go to sleep that's sure there's either blue light glasses or your phone will have some mode where it stops showing you blue light after a certain hour, does this actually make a meaningful difference? Yeah. Most blue light glasses are not blocking enough blue light to make the difference between impacting melatonin, which is your sleepiness hormone that your brain produces throughout the day.

So closer to the night rather. And they're not really as effective. But traditionally blocking blue light or less exposure to blue light close to bedtime is ideal because you want maximal melatonin to get sleepy at night. So that's true. Most blue light glasses are not even great at doing that. That's number one.

Number two, the thing that pisses me off about blue light glasses, they lie. When you go on their websites, they say that they help with eye strain. Yeah, they do say that. They do not do anything. Blue light is not why you have eye strain. You have eye strain because you stare at a computer without blinking

and your muscles are tired. Yes. And you need to, every 20 seconds, look 20 feet away. Every 20 minutes. 20 minutes. I was going to say 20 seconds. Every 20 minutes, look 20 feet away for 20 seconds. Yes, that's the rule.

That's going to help your eye strain, not the blue light glasses. So you're saying the $240 razor blue light glasses I just got are not worth it? It depends what's worth it to you. If you want to block some blue light at night before you go to sleep, maybe. They make me look really dumb. If you're editing, I'll say that sucks because then you can't get a good color perception of what you're looking at. I fully agree. I will not wear them while editing.

We talk about that with the phones or computers because there's a lot of just screens that will then reduce blue light. But then I talk about how mine at 10 o'clock and you're like, how am I going to edit an Instagram picture at 10 o'clock? My Instagram picture is going to look blue when I post it. It's crazy. When will people stop talking about cold plunging?

I don't know. This is like a, I don't want to say it's Andrew Huberman he definitely got people hyped on the cold water immersion thing I will just say again like lose the quick fixes they don't exist this is hilarious

because we're in an industry right where we can sell things and all the things in my industry that I can sell I'm pooing supplements, health tech every sponsorship i can get what we want that's what we would like to hear though about by the way this doesn't work um it just like if you love it enjoy it like do it as a hobby you know i'm saying i'm not going to go out and say like soccer is so much more healthy than uh tennis or something like it's whatever you

want it feels like yeah that's what's happening it's like if some doctor comes to you and is like yo you're lifting you need to be cross-fitting because it's so much healthier it's like leave that guy i mean like there's no here's why maybe their research will tell you something that's true but here's my take on it life has so many variables there's so many things that can go wrong that are outside of our control thinking that you now have the grasp of control by doing one sport or another going to this water temperature versus it's ridiculous yeah it's really it's it's a fake version of reality thinking that you have that much control that if you go five minutes into 65 degrees versus 63 degrees come on yeah you're allowed to do it without posting about it by the way it's possible um i have one that's uh i wish had a quick fix but like you said

probably there isn't one and a lot of us nerds deal with it you can probably tell me right now poor posture okay and do you have any tips on how to improve that or like how much is this how am i destroying my back over the years of playing games and yeah um one never buy a posture corrector those straps that you see on tiktok i've had it in my cart multiple times and i just stopped it's like the thing that you no no it has like a it's like a back brace thing that like strains out your back but it's actually terrible because the purpose of having good posture is that your muscles naturally keep you in a healthy posture but by wearing this thing you actively weaken the muscles that you're supposed to be training for good posture oh

i had this exact i had a mini version of this with my feet because if you have plantar fasciitis that's kind of like the arch yep was fatigued so i felt the need to wear arches that would support it but then that weakens the muscles and i was like conflicted on whether or not I should do it. Plants are fascist, not necessarily muscle, but maybe there was some other mechanical thing happening. I watch a lot of YouTube videos, so I got some misinformation, but yes, yes, you're probably right.

Yeah, so I ended up designing my own shoe for two years and now that helps a lot. Okay, well, that's what everyone should just do when they've got that problem. Yeah, it worked out. So I will say being in an unhealthy posture for a long period of time which is what we do at work is not ideal so you want an ergonomic good position but the idea that posture is to blame for all our problems is overstated

okay i like i've i've found myself attempting to fix it i've found myself noticing it more often i've been physical therapy yeah doing the exercises strengthening certain support muscles finding out where you're weak all that's very important like incredibly way more important than any quick fix than anything you can do yeah i hope one day one day i will be like i think i spent the whole day in a nice posture that'll be my crowning achievement you know that by the way my number one prescription to physical therapy. PT? Oh, yeah. I can vouch for PT for sure.

Which is a... This doesn't have a real answer, but I just want to see what you say. Which is a worse vice? Ooh, ooh, I like these. Caffeine or sugar? This is from someone who... In excess? In... I guess in that, can we talk about habitual caffeine versus

habitual sugar but like i can eat 10 grams of sugar i can eat five doubt like you know what i'm saying right like overeating sugar or over drinking caffeine can we can we how about let's go can we know that cup of coffee yeah because coffee is 400 milligrams per day that we say that you should have versus sugar i don't know what the exact um versus a tall glass of orange of fruit juice with every meal wait wait say the first one again what's the coffee number cup of coffee every morning okay or or a full glass of fruit juice with every meal so that's maybe 20 grams no it's more than that way more than that 40 orange juice has a ton of sugar in it yeah here we go it's basically soda without the carbonation

yeah what i'm what i'm asking is is my vice of sugar going to kill me faster or slower than the one i'm avoiding which is caffeine um For you, I'll give you, this is not individualized advice because I'm not your doctor. I'm going to say all the medical legal things. But what I will say is none of those matter to your health longstanding, especially because you participate so actively in sports, you have a higher glucose requirement than most.

Okay, so I'm fine. And also you can drink coffee. I mean, again, I don't know your lab values, that's why I can't give you advice as your doctor, but like if you're, everything's fine, and you're an athlete and you drink orange juice for all your meals, you're fine. But now if your BMI is 40 and you have heart disease

and you're drinking orange juice and your triglycerides are through the roof and all this stuff, yeah, maybe that's's not ideal maybe the coffee is a healthier choice is there a similar thing like caffeine i feel like i know you don't drink much of it but like there are a lot of people especially in this tech and gamer world who are they drink a lot of coffee or worse a lot of energy drinks yeah is there any difference to that and obviously this is individualized but you're an active person you're drinking a lot of caffeine or you are i am sitting down and playing games and i am just

pounding red bulls or energy drinks i don't think that one is as important lifestyle wise i think that one is more uniform the recommendation that if you're going over the recommended amount consistently you're going to create long-term harm okay and 400 is a pretty solid number it's not a solid number one there's one uh blonde like the big size blonde roast at starbucks is 400 really and people put espressos into that bad boy well yeah starbucks drinks are an anomaly it feels like does that also numb you to it because i i always wondered like tolerance builds up yeah like there's a gatorade fast twitch gatorade or something that has it's they have like a bunch of different gatorades now this one's for like in the up. Yeah. Like there's a Gatorade fast Twitch Gatorade or something that has, it's, they have like a bunch of different Gatorades now.

This one's for like in the moment performance. And I think there's caffeine in it. Yeah. And so I wonder as someone who never drinks caffeine, would that be more effective for me if it was then if I always had coffee every day? It's more, if you've never had caffeine, you're caffeine naive, we call it, you're going to get a better result from drinking the caffeine. Sick.

What we've also seen in research, you can become caffeine naive, we call it, you're going to get a better result from drinking the caffeine. Sick. What we've also seen in research, you can become caffeine naive quite quickly. So if you take only a few days off drinking caffeine, you can already start seeing improved benefits. Something that I was going to say about caffeine, caffeine is the number one studied performance enhancing drug. Definitely. And it actually has proven benefits.

It's like the most well-studied, the most evidence behind it that it truly improves performance. It goes caffeine, creatine, protein. Those are the three most proven supplements. And again, remember I said, 90% of us don't need supplements. Yeah.

Okay, I love that. And I guess the last one for me is our phones now have these digital well-being sections in the settings where they will try to limit how much you use certain apps during the day. But it's incredibly easy to override them as the other thing. So they'll go, all right, you need one hour of Instagram or less per day, one hour or less of YouTube per day. Is a social media detox worth considering for anybody who's maybe spending too much time on social media? You asked me a different question than I thought you were going to ask me. A social media detox is wise. It's good to take every now and then, especially for us who are so involved in this space. But the apps themselves are good for getting a grasp on what's going on.

But if you are thinking that's going to be a solution, you're probably mistaken in most cases, given the fact that they work in the same way the posture correctors work. You need to figure out what a healthy balance is and be aware of when you've reached your limit. But when you start relying on this thing to be your posture corrector,

that's where you're going to get into trouble. I love that analogy. Life's hard is the bottom line. And anyone not promising you a shortcut is probably trying to make some money and not really helping you in many cases. Bang. Clip that.

Clip that. That's a short TikTok right before the Apple ad. And I lost all my sponsorship. No, that's awesome. Well, I think we have one last thing we want to do, which is a little bit of trivia. I wanted to have one last thing we want to do, which is a little bit of trivia. I wanted to have you explain. Do you know what this is?

Yes, I do know what this is. Where have you seen this? This is in one of my videos. My 10 million subscriber video. I was like, wait, why does that look familiar? We'll put it on the screen for those who haven't seen it. Were you happy with how my animator designed you? I i was gonna ask what is this how i look to you this is how i really look mom i mean we did do uh a round of reviews and we felt like these were

the closest that they they did you and casey they're hanging out look at all the money on the table though there's a lot of money on the table. Were you ever signed with an MCN? No, not a traditional one, no. What do you mean not a traditional one? Meaning I started working with a company that wasn't an MCN until they started selling ads for me, and I was the first channel they ever started selling ads for. So not a traditional one.

But that was what that segment was about. Oh, MCNs? Yeah. Got it. It was printed out and MCNs? Yeah. Got it. It was printed out and left in the studio on my desk. I love it. Okay, trivia time. I missed it the first time.

So today's trivia question. It bothers me. I'm going to give you three medical devices. Okay. You need to tell me the order in which they were invented and i'm looking at not just i'm looking not for like theoretical someone wrote down this idea i'm talking about they use them on a human being in that year okay interesting and it goes from earliest well i'm going to give you the three devices and you need to tell me

from earliest so if i say number one, that's the earliest. Exactly. Yes. All right. Number one, the implantable pacemaker. Not an external pacemaker and not a wearable pacemaker, but a pacemaker that goes inside the human body. Number two, the medical laser. And again, I'm not looking for when someone invented the laser.

I'm looking for the first time someone shot a laser at a human to heal them. Number three, computerized medical records. I'm definitely just going to do a slow zoom on Dr. Mike's thinking face. It's just one of those things where you know too much and then it's potentially... Yeah, for sure. They're good at getting questions that anyone has the chance of. Hold on a second. I'm fairly confident that I fact check all of this correctly but i welcome you're wrong dr mike i welcome your um actuallys as a uh as a medical professional yeah no way again i i watch memes this is not this is not what i do all right this is uh we flip our

boards uh mike what did you have i was gonna go with what you did but i i went computer medical records ehr pacemaker laser and that is earliest to latest yes so unfortunately mike oh and all of them so sorry oh did you all put the same thing no no oh no sorry okay i went what did you do did you i did computerized medical records one medical laser two which i'm starting to think is earlier than we think and then implantable pacemaker three oh i do have a different i have laser no the correct answer is implantable pacemaker 1958 wow that was the first time someone stuck one of those in somebody um fun fact before that there were these wearable pacemakers that you had to plug into the wall so you just had full wall voltage running through your chest dope uh number two is the optical laser in 1961 just a year after the laser was invented someone

had the idea to shoot it at a guy specifically a guy's eyeball to remove a tumor and it worked and then computer medical records computer medical records there were several specifically four attempts to set them up the earliest one was in 1968 and the i don't believe that there was a pacemaker but they didn't have a record electronically shooting lasers at eyes and then like punching a paper what's even crazier is the idea of shooting electricity at someone's heart goes back all the way to the 19th century wow yeah weird yo computers are young i had a feeling the records was the trick part of that question kind of that's why i knew records either came first or last i've yeah that's what i should have thought i put in

the middle i thought the laser would be for sure the trick one interesting wow wow laser was in the middle huh that was a good question thank you there's that's the only one i have another one oh yeah you want to do it let's do it yeah see all right according to a 2020 survey by cisco what percent song uh what you alice might be too young who did the thong song uh no cisco the networking giant oh that's what i meant sorry all right according to a 2020 survey by cisco what percent of medical devices are currently running unsupported software? That means the software they're running has no

patches or updates available. 2020. And this is closest wins? Oh, yes. Here we do Price is Right rules, so closest without going over. Is it Steve Bonanzi? is it steep and antsy i don't want to go first this time before i just want to say uh this question was inspired by an

episode of the podcast darknet diaries so So if you're interested in this, go check them out. Wow, that's a high number, Marcus. So I said 91%. I said 42%. All right, that is under. So Mike, you have to shoot the tube. I'm so sorry. Was it 3.13?

It's 60% of medical devices. That actually surprises me. Surprises you that it's low or high? I figured very few medical devices get software patches. I guess it depends what you consider a medical device. So it's an issue people talk about in cybersecurity a lot. Oh, it's huge. Because things like a medical laser

typically is actually running a version of Windows 2000, which- I thought it was 3.1. Which wouldn't be that big of an issue, except now these medical laser devices are hooked up to hospitals' Wi-Fi networks. And so there are actually points of attack now for a lot of cybersecurity threats.

So hospitals aren't sure whether to get new medical device, like get new lasers that run up-to-date OSs and then retrain everybody or leave this sort of point of vulnerability in their system. That's why you guys are worried about AI. We have lasers. Wi-Fi connected lasers in hospitals. That's crazy.

Good to know. I'm glad to... Most cars aren't software updatable, so that's pretty impressive. One last question, Mike. Okay. How fast can you type the alphabet? What's like the average speed?

I don't even know. I feel like it's hard to do an average. Do you have to do... Are mistakes allowed? Just A through Z. You can make mistakes but as long as you hit every letter in order we can we're gonna test it if that's what you're wondering i'm gonna say if i'm gonna aim to try and do no mistakes i would do it

10 seconds i don't think anyone's ever guessed their time no one's ever so i'm excited about this i almost guarantee you're gonna be faster than you think because you've just so you know it's something we do with all of our guests on here um similar to if you've watched top tier they have look am i allowed to yeah you're allowed to do however makes you the fastest possible yeah the way this works is oh you have an app yeah you made this no we my friend made it so you type a through z if you miss one you have to keep yeah you have to hit that letter to go on and uh we'll give you three shots don't hit enter at the end because it resets the counter oh okay so the timer shows up when you hit z and we do have a leaderboard

i was gonna say that at the end but now there's a little pressure sometimes pressure gets to go now i need the caffeine true yeah true performance like was like how you take your watch off i always take my watch off when i like it's really annoying with um with well metal yeah yeah yeah okay i'm gonna type it like my also father do you like the um do you like the laptop keyboard or we have other keyboard choices if there's something you would prefer i like this i like the old school is 10 seconds even on the leaderboard what I predicted? I'll tell you as soon as you finish your first rep. And I have three reps. Yes.

Yes. Okay, ready? Yeah. Should I just go? Yeah, when you press A, it will start the timer. Oh, okay. Okay. 7.9. I was close.9.

I was close. I was going to say, that sounded really close to your guess. I wrote down 8.2, but that's a great first rep. Feel free to go two more. You might improve your time. I see detailed results, though. What is that about? If you want to look, it's the time between each letter. You can see where potentially you...

7.93 okay okay 6.9 that's a that big improvement nice really good improvement okay do you think you can shave another second off yes that's a whole other second. That trajectory would be incredible if you did it again. But yeah, that's a really solid spot already. Okay. Okay. I have to hit reset, right? Or enter. Shake it out.

Okay. So you got... I'm going to go really fast. okay so you i'm gonna go really fast it's 5.9 wait you got 5.9 5.9 we have to 5.97 i feel like pretty good about that so where do you think so right now we've got about 20 something names on the leaderboard where do you think 5.97 would rank you names on the leaderboard where do you think 5.97 would rank you eighth you're exactly right wait no way this is these are some weird one two three four five six seven no you're nine sorry the current eighth is 5.9 it's doug demuro he got 5.900 okay you got 5.97 so you're right behind him at number nine between doug demuro and so crispy media wow well played i'd be interested

to see faster see what it... 10 seconds is not on the leaderboard. Everybody's under 10. Well, I didn't know how long this takes. I got over 10 seconds and it was so bad. I just decided not to. I need to know what Tom did.

Tom Scott did a blistering 3.55 seconds. What? Followed by Quinn from Snazzy Labs and my original time from when we first started the test. Mark has good at everything. It's really annoying around here.

Someone's going to get me off the podium, but that's one, two, and three. Oh. And then four. That was your first time? Yeah, we all did three tries at the studio just to set a leaderboard to have context. And so I set a 4.5 and

I'm going to get knocked off eventually, sooner or later. But welcome to the leaderboard. If you give him two more tries shaving a second off each one, I think he'd knock you off there. Welcome to the top 10, Mike. That was an impressive showing. Thank you for joining us, of course, for the Waveform Podcast. We appreciate all the medical advice

and all the expertise that you bring. And, of course, you should go watch Mike's videos if you haven't already. He watches memes. Yes. He beats people up. I beat people up. And he's incredibly informative. So we appreciate that.

Thank you. It was really fun. Thank you very much. All right. Well, that was it with Dr. Mike. I think that was a lot of fun. This is a conversation we've been meaning to have. So I'm glad we got all the facts and figures and pros and cons

and all the stuff from an actual expert. But now we're back with Andrew and David because you haven't done the trivia from that episode. That's true. So let's read David the questions and see if he gets them right. There's a lot of pressure here because you guys have already heard this and I have not.

And we'll all just be judging you. Because we totally remember exactly what it is. I think I might remember the answers all right let's see trivia time anxiety time oh god this marker needs new markers yeah and I got signed out of google docs nice could use this one yeah trivia question what is Ellis's password password one two three wish you wish sound I should not I should not say something like that on the internet and everyone's Ellis' password. Password. One, two, three, four. You wish. Sound. I should not say something like that on the internet. Everyone's going to try and get... Okay.

Don't get me. Question number one. That'll do it. On that day, Ellis got good. Yeah, on that day, Ellis signed up for Bitwarden. Question number one. According to a 2020 survey by Cisco, what percent of medical devices are currently running unsupported software,

meaning no patches or updates will ever be available? And it's Price is Right rules, as per usual. Oh, so that means whoever we think could be right may be wrong. Right. David could get closer than Right. David could get closer than anybody. David could get closer. All right.

I got one. Oh. Well, I mean, you know. It's totally a random guess. Let's see it. And you put 68%.

Wow. Is that over? Barely over. It's 60%. No, I was going to put 60. Price is right. Unfortunately, that one cannot win.

Really? But you're pretty close. Yeah. You're pretty close. You're in the ballpark. Yeah. What did you guys put? I have no recollection of what.

I don't either. The winning guess was Andrew with 42%. Wow. I think both Marquez and I can't remember. Wow. I'm so smart. I almost put.quez and... I can't remember. Wow. I'm so smart. I almost put... Anyway, whatever.

Question number two? Almost doesn't win trivia. Question number two. Almost doesn't win trivia. All right, David. Yeah. I'm going to give you three medical devices. You are?

And you are going to tell me the order in which they were invented from earliest to most recent. Oh my goodness. Okay. The first device, the implantable pacemaker. This is a pacemaker that goes completely inside your body and you get sewn up. Number two, the optical laser for medical purposes. What? Does that mean for like healing wounds with healing wound doing laser surgery?

Number three, computerized medical records. Oh yeah, that's okay. Wait, wait, wait, can you give me the,

no, no, wait, stop. Number one. Okay. Implantable pacemaker. Number two, optical medical laser.

And number three, computerized medical records. And I'm looking for the order first invented, most recently invented. Wait, first? Yeah, okay. From oldest to newest. You're welcome. Okay. Oh, man, this is probably...

All right. I'm doing... One is pacemaker. Okay, that's correct. Two is laser. That is correct. Three is... Computer!

Oh, my God! Oh, my god! Yay! No one else got that. We're the only one. Heck yeah. I remember this because my grandpa used to have heart attacks from when he was like 20 on. And he got a pacemaker like really early. Really?

Yeah, in like the 60s or something. Wait, so do I get one point for each one? No, just one point in total. So I just won the round, basically. Okay, whatever. I guess I won one of them. That's fine. Well played.

Thanks, guys. Well played. Appreciate you. Well, I think that wraps it up. Yep. Shout out to you for getting the question right. Thanks again to Dr. Mike for coming on and answering all of our questions. And thanks out to you for getting the question right uh thanks again to dr mike for coming on and answering all of our questions and thanks again to you for watching and listening

catch you in the next one peace waveform is produced by adam melina and ellis rovan we're partner with vox media podcast network and our intro outro music was created by vane sill still.