Transcript:

– [Zubin] Everybody welcome to the show. The VPZD show episode 16.

– [Vinay] In person, this time.

– [Zubin] We’re doing it in person.

– Might be the second or third time it’s been in person.

– [Zubin] That’s right. Because we don’t believe that COVID is gonna stop us from being us. We’re like “Laverne & Shirley”. That’s how old I am.

– [Vinay] Yeah. We didn’t believe it a while back, but now I think many people don’t believe it.

– [Zubin] You know, what’s funny? Okay. This not believing in a while back stuff. So you and I have been saying this thing like, “Hey, this isn’t, this thing is with us forever. We’ve got deer with COVID unless you wanna murder all the deer, you’re never gonna have zero COVID.

– [Vinay] Well, don’t tell that to China, ’cause they might do it. They’re already going after pets and such, we’ll talk about that. I would love to talk about Shanghai.

– [Zubin] Oh, yeah, Shanghai. They’re doing really great, I understand.

– Yeah.

– But this idea that, Hey, we’ve been saying this and then someone like Leana Wen says it and “Staten News” runs an article saying “Controversial comments from Leana Wen.” I’m like, we’ve been saying this shit from the beginning.

– [Vinay] Yeah. I mean, it’s been obvious, I think, since even 2020, we, I think, where, I think, embracing of sort of a balanced perspective until vaccination, but after vaccination, I think we were, sort of, on the page of, you know, when are you gonna get back to life and what are we gonna, you know, what are we waiting for? And now she’s come along, I think, in 2022, that was when she’s, you know, switched side, so to speak, and you know, getting a lot of heat for it, I guess, ’cause she’s out there on CNN, you know. But she is taking fire because she’s on that channel that is a COVIDian channel.

– [Zubin] Oh yeah.

– And she is putting this message out there. And so I see her on the internet, she’s taking a lot of heat.

– I got to give, I’ll give her props for taking the heat that we’ve been taking for- like infinite years.

– [Vinay] I was like, oh it feels nice and cool now.

– Yes it does.

– Nice and cool.

– [Zubin] She sucks some, she’s like a heat pump. She sucks some of that heat.

– Sucks the anger.

– [Zubin] And the evacuated it into CNN for us.

– But you know what one thing some doctor told me, he messaged me and said, you know, “Look at the response she’s getting. “It’s not about what she’s saying, “cause what she’s saying is actually quite sensible, “which is that, you know, you’ve been vaccinated, “you’ve been boosted, we all have to get back with life, “and this virus is not gonna go anywhere.” Which is what we’ve been saying for about a year. She’s saying something very sensible. And if you look at the response, even from other doctors, people aren’t saying, “Oh actually the virus can be eradicated” or “Actually I disagree with you. “We should just wait for that fifth booster, sixth booster.” They’re not saying sort of what their position is, they’re just making memes about her, you know, they’re targeting her. They’re just sort of general nasty comments about her. And, you know, we’ve gotten a little bit of that, so have a lot of people, but it’s just shows you that, you know, even very well educated people cannot engage on the merits of the argument. They make it about her.

– [Zubin] Yeah. And especially educated people. I feel like they almost weaponize their own petty insecurities and the weird personality quirks in a setting. I mean you look, look, look, look, we both went to medical school. What percentage of your classmates were clinically insane? I mean like, and I put myself in this category. I mean, these are not normal people.

– I mean, to some degree, I think you make a great point, which is that, you know, the thing you’re selecting for is somebody who at a very young age, decided they’re gonna put their nose to the grindstone and give up a lot of, you know, sort of, normal things you do when you’re young in order to pursue this craft. And so by definition, you’re gonna get some people who are a little bit wacky,

– [Zubin] A little wacky.

– [Vinay] But they are acting like high school bullies or middle school, actually not even high school

– No middle school, yeah.

– Middle school, yeah.

– [Zubin] By high school, you figured, okay, I have this fake identity and I’m gonna roll with it, middle school you’re still trying to figure it out. So the bullying and the weirdness and all that at other stuff-

– Just comes out.

– It comes out.

– Maybe social media disinhibits them and makes them, regresses them.

– [Zubin] I think social media is a big piece of it because it does hijack right into our limbic system. It plugs right into the, like the matrix right there.

– [Vinay] It’s right in there.

– [Zubin] And it just rewards all this shitty behavior.

– Yeah. It does.

– [Zubin] And so Twitter’s really good at that. What do you think of Elon Musk trying to hostily-

– Buy Twitter.

– Yeah.

– [Vinay] Buy Twitter. I see, that’s also divided Twitter.

– Of course.

– Should he buy Twitter? Well, you know, I guess I think that, you know, I mean, I don’t know everything about what he actually intends on doing, but my general understanding of it, and tell me if I’m wrong, is that he’s one of these guys that came out of the original internet where they thought the internet would be really sort of unregulated and free and let people, sort of, say whatever the hell they wanna say, and maybe even be whoever they wanna be. Then came along, sort of, Internet 2.0 after the .com bust and Internet 2.0 was about how can we make a lot of money from this thing? And making money means collecting information and selling ads and targeting things, and making money means that somebody will see you’re making tons of money and they may not like the fact that you’re allowing, sort of, all this kind of free for all on your platform, and they’re gonna ask you to regulate it. And so I think right now internet companies are trying to be both like a neutral content, a neutral platform, but also a content regulator. But I think that unfortunately the political left has become a big fan of content regulation. Maybe because we happen to be on the political left, aligned with the people who run the companies. ‘Cause, I think, if the people who ran the companies were on the right, we wouldn’t be so happy about content regulation.

– Right.

– And Elon comes along and he sees the content regulation on Twitter. He doesn’t like it ’cause he’s old school. He wants to buy it and sort of make it what he thinks it should be. I think he’s clever in one respect, which is that if he made his own platform, it would fail. There is a sort of founder effect. They already have the population of people, so you’ve gotta take what’s there and make it better. But I think a lot of people, particularly on the political left, don’t like the idea that we won’t have content regulation.

– [Zubin] Yeah. I think you’re right. And Elon is like a bugaboo on the left now.

– He is.

– Like he’s somebody that they just don’t like. And it’s quite fascinating because he, you know, he’s gonna just, even the threat of this is to enough to like, people are like, “Wait, wait, wait, wait, whoa, what!”

– And what did he do that earned the ire? What did he do that people on the left don’t like?

– [Zubin] I think he’s just honest and says what he thinks, which is never a good thing in today’s day and age, you just can’t do that.

– You know, I was talking to somebody and this person’s like not a fan of these tech billionaires and arguably I’m not a fan-

– I’m not either.

– I’m not either, yeah. But we’re talking about Elon and this person was, you know, saying something critical. And I said, but you’ve got to give him one thing, which is, this is a guy who actually built some real things.

– [Zubin] That’s see, that’s why I often will give Elon a pass. Whereas someone like a Zuckerberg or something like that, it’s like, “Well, he built something “that like is kind of vaporware.” But Elon builds things that move on the road, that do stuff that bring a lot of, you know, tangible benefits to people.

– [Vinay] We’ve both made websites, you know.

– [Zubin] Dude. Exactly.

– [Vinay] And my website, arguably, it’s less entertaining than Facebook, but it’s also less, it’s better for you ’cause it’s not trying to hijack your attention, but Elon made a real thing.

– He made a real thing, a few real things right. Now, the sending people in the space thing. I’m not sure that’s as beneficial in the short run.

– But, I guess, I don’t know.

– [Zubin] The technology that is involved is-

– Maybe it’s kind of cool, he wants to get that rocket to land. You know, I agree with you. I’m not sure going into space isn’t on my bucket list. I got other places I wanna visit-

– Exactly.

– Before I go on the nothingness, the void of space.

– [Zubin] Like the nothingness of inner space.

– Well, I’d rather go on a meditation retreat than outer space.

– Outer space, right.

– And, but, you know, I give him credit, at least that’s like a real thing in this world. You can’t bullshit your way to space, you know, you have to be, you know what I mean?

– Yeah.

– It’s an engineering problem, you can’t bullshit your way to a car, but you can your way to a website.

– [Zubin] Oh, that’s a great way to look at it. I mean, in many ways, all this stuff is kind of bullshit wear, right, except for the tangible stuff. That’s why Elon is a little different. And you listen to Elon on Rogan, which we can talk about, you know, even Bill Maher on Rogan recently.

– Yeas let’s talk about that.

– [Zubin] But, but Elon on Rogan, was a revelation for me, because here you see a guy who like, he starts to open up and I’m like feeling into this guy. He is anxious, he’s neurotic, he’s like every one of our med school classmates, but he’s out there doing crazy multibillion dollar inventing, you know, pushing the envelope of shit. And yeah, he’s gonna come with baggage. If you think that doesn’t come with baggage.

– But what about the current Twitter infrastructure, you think that has no baggage? It’s got a lot of baggage. You’ve got the founder, who’s stepped out, you’ve got this new person appointed. This new person is by all accounts, happy to like stifle things that he doesn’t believe are appropriate. And you just have these tech companies, like they’re less than a year from when they said, “You couldn’t talk about lab leak.” I mean-

– Yeah.

– What a colossal screw up. And now they wanna talk about content moderation. You just screwed that up.

– [Zubin] Yeah. They can’t be trusted to do that.

– [Vinay] Can’t trust them.

– [Zubin] I mean, you know, they’re practically nation state actors now in terms of the size and this influence that they have.

– Wealth and influence.

– [Zubin] Wealth. You know, the Chinese do it with an autocracy, these guys do it with this, you know, ’cause they control conversations. If you’re shadowbanned on one of these platforms, you know, you’re effectively dead. The algorithm pretty much determines your reach and influence and. So Maher on Rogan.

– Yeah.

– I didn’t see it.

– Oh I listened to it on the Spotify app, which by the way is the worst app.

– It’s the worst app.

– The worst app. Stop, like have times and I downloaded the episode. Why is it stopping?

– I don’t know why, we’re on Spotify, but it’s like, I don’t listen to us on Spotify.

– We’re not exclusively on Spotify.

– [Zubin] That’s true, we’re all over.

– [Vinay] Although, listen Spotify for $100 million, we’ll be happy to come on. I don’t know about you, but I’d be sold for 10.

– Yeah, yeah.

– 100, million.

– [Zubin] There’s a company you don’t even know who’s running it. It’s like-

– I don’t even know.

– [Zubin] Who the hell runs Spotify?

– That’s maybe that’s why they couldn’t boycott Rogan ’cause you don’t even know who to send a complaint letter.

– You don’t who’s, right, Bobby Spotify the CEO of the the Spotify dynasty, like.

– I listened to this episode, it was really, I mean they talked about so many things, but he had a little segment about medicine, which I thought was very, a really good point for a layperson. And Bill is, you know, he’s not a doctor. And the point he was making was that, you know, does he believe things that you and I don’t believe about what to eat and how to live, sort of, woo-hoo, holistic kind of stuff, like all Hollywood people.

– [Zubin] You mean Maher or Rogan?

– Maher, well and Rogan, of course, I mean he’s in the supplement business. They had a nice exchange about what, you know, “How do you look like that at 50?” And he’s like, “Oh, I’m taking testosterone.”

– [Zubin] Oh, there you go. Yeah, Yeah.

– But, you know, Maher also has his own health beliefs that I think, you know, you and I wouldn’t agree with because we study, sort of, medical science. But one thing he said that I think is really good is he said that, you know, when doctors tell you, that they know what’s best for you, they have to also acknowledge that they just don’t know a lot, and that biomedicine is its in its infancy, and that the body, to some degree, is like the bottom of the ocean, you just haven’t explored it at all. And I actually think it’s profoundly correct. You know, we look at the successes of medicine, antibiotics, stenting for STEMI, and we think, “Oh they know it all.” But, you know, we have made very modest changes in cancer, even though we’ve had some great drugs, there’s still, you know, so many people who die untimely of cancer. There’s so many things that we just have barely scratched the surface and even understanding how it works in sickness or in health. And so I think like Bill’s point is that if you don’t know a lot, you should come with some humility to say, “Yes, I think, you know, this intervention, “it might be a net benefit to you. “I believe that to be true, here’s the evidence. “I do reserve the fact “that there are some things I don’t know. “And I don’t know about some sort of sequela, for instance. “You know, when we had that adenoviral vector vaccine, “we didn’t know that it’d have VIT “that vaccine induced thrombosis and thrombocytopenia. “That was something that surprised people. “But the way they were talking about when they debuted, “they didn’t say that it could be VIT, you know, “they didn’t know. “So there are things we don’t know.” And I think he was refreshing to point that out.

– [Zubin] You know, it’s not something that we teach on the wards actually, humility. It’s in fact, we teach the opposite on the wards. It’s kind of like, “Oh we know we can control all the parameters “of this hospitalized patient course. “Just test this, do this,, turn this dial, turn that,” and actually that was the kind of culture of medicine is “No, you are in control.” What you need to go in is go, “Hey, guess what? “There’s a thing called tincture of time. “There’s a thing called just watch and see what happens.” Understanding the humility and the fact that we really don’t know a lot. Like some of the miracles of medicine are very simple things like epinephrine for anaphylactic shock. Like that’ll save your life. Like we don’t talk about that enough. Like that’ll save your life. And it’s a very, it’s not a complex, actually it is complex.

– Right, right, right.

– [Zubin] But the intervention is quite simple

– Quite simple, yeah.

– [Zubin] Epinephrine, clamp things down, save your life, right. But the things that are much more complex, cancer, heart disease even, like hypertension, diabetes, these chronic diseases, obesity, we don’t understand. There are so many dials and so much unknown and so much mind-body interface and so much mind-environment interface and the biopsychosocial aspect.

– So that’s something he talks about too, which is that, you know, we in Western medicine and, you know, I’m as guilty of this as anyone else, you know, we don’t put a lot of stock in like your state of thinking and your mental awareness on your physical health. But he said, you know, you must acknowledge that you just don’t know everything there. And I was like, I guess to be fair, you know, we don’t know what we don’t know.

– [Zubin] Right.

– We think of the body a very physical thing and that your emotional states are likely secondary to it. But I will also say on a caveat, I also see sometimes these things where it’s like, you know, like among people with cancer, those with more positive thoughts live longer than those without.

– Yeah, Jesus.

– And I’m like, well, one of the confounding variables is if you have a lot of cancer in your body and it’s secreting a ton of, you know, cytokines that might make you feel depressed and lethargic, and it might be the cancer that drives the mood and not the mood that drives the cancer, you know.

– [Zubin] And, going with that, actually, ’cause of this, that correlation, causation, confounding, going with that is this kind of victim shaming that happens in cancer. “Oh, if your attitude wasn’t positive, “you never would’ve, you know, you would’ve never-

– Wouldn’t have lost the battle.

– [Zubin] You wouldn’t have lost the battle the battle with cancer.

– Battle.

– [Zubin] And maybe because your mood is so bad, it’s really harming your healing. And you know, people really don’t like that. You know, like my friend Rachel often talks about chronic pain a lot. And so there is this saying, even in Buddhist Zen circles, that pain is inevitable, but suffering is optional, that it’s your mindset state. But her counter to that, which I think is interesting is that, “Well, so now you’re stigmatizing people who are suffering “because it’s now on them to control the suffering.” The truth is some of these things really are very complicated and you do need to acknowledge that it is that way. It’s a humility, it’s a humility-

– [Vinay] It’s humility thing, you know, and like many people, I also, you know, I bristle at that battle metaphor and I don’t like it, I don’t think it’s very helpful. But there are some people who actually find it helpful. And so who am to say to those people that, you know, if it’s not helpful to, well, if it’s helpful to you, then you do it, but it, we shouldn’t impose that on someone who doesn’t find it helpful. Similarly, I’m always intrigued by, you know, as people have advanced cancer, they often feel the desire to eat less. And we do so, so much to try to get them to eat more, including drug development, that’s pushing, you know, so many compounds to increase appetite, et cetera. And sometimes I wonder if like, you know, are we doing somebody, are we actually like benefiting them? And like we have observational studies that show that like, yes, people who lose more weight are more likely to die in the short term, yes. But that’s different than the claim of, if you take someone who’s losing weight and you spoonfeed them or really, sort of, you know, harp on them to eat more, do you actually extend their life? And do you improve their quality of life? Or, you know, nobody likes somebody telling you what to eat, you know, or to eat more, eat more.

– [Zubin] Oh, this is key man. Because you see this in, not just in cancer but in patients with dementia or elderly patients who just are starting to lose weight and so on. And that weight loss may well be an epiphenomenon of inevitable decline in other things. But the sense of control on the family’s part, in particular, is that, “Oh, if I just,” “You’ve gotta eat, what is wrong with you?”

– [Vinay] It’s like an Indian grandmother when you’re a kid.

– [Zubin] Oh, totally.

– [Vinay] Always trying to get you to eat more.

– [Zubin] If you’re not eat the gulab jamun, have a sweet. You know, anything, anything.

– I don’t think, I don’t have gulab jamun that.

– Exactly come on dude insulin is so expensive right now. But it really is, there’s this kind of idea that we again, gets back to humility, this sense of control, really like, you know, the deepest, and again, I hate to sidetrack it on this, but the deepest spiritual teachings are always that you have no control, like actually accepting this present moment as it is, gives you a weird paradoxical control because you allow life to show you what’s actually supposed to happen. And in medicine you can do medicine, you can practice amazing medicine and still have that philosophy that like, “Wow, no, actually this system that’s so complex “and interacts with everything around it, “actually, is to be respected.” And what we do is we are kind of part of the inevitable unfolding of that, but the humility required to do that.

– [Vinay] You know, where it would’ve been useful, I think, like two things, one the human genome project, you know?

– [Zubin] Oh yeah.

– [Vinay] Francis Collins himself wrote a paper that said by 2015, you’ll go to the doctor and he’ll sequence you, and they’ll tell you which blood pressure medicine is right for you. Well, 2015 came and went and we didn’t do that. Because, of course, the genome wasn’t giving us all the information we thought it might. And the more I think about it now, I feel like the genome is like, you know, in the Plato’s “Allegory of the Cave” the prisoners are chained to the cave and there’s a fire behind them, and they only see their own shadows. And Playto asks, “What would your perception of the world be “if you’ve only seen your shadow and then one day “somebody comes and unshackles you, “and you’re allowed to leave the cave.” Similarly, sometimes in biology, I think, we’re only seeing the shadow, like the sequence of nucleotides when it’s, in reality, a complex three-dimensional thing. And it doesn’t stop us from thinking we know everything.

– [Zubin] Dude, that Plato allegory is like the central heart of a lot of like spiritual traditions too, that this world isn’t illusion to some degree. But what I’d say is this, what you may be pointing at is something that say Donald Hoffman, who I’ve had on my show talks about, what if reality, we just have a amateur error in understanding reality that we think there’s physical stuff that then spins up consciousness and all of that. But what if it was actually consciousness is primary and it spins up icons that within consciousness look like a physical world. So our science, our medicine, and all of this is, it’s like Plato’s “Allegory of the Cave”. You’re moving icons on a desktop, but you’re not seeing the zeros and ones underneath. And so we can get very far with that, like, we’ve gone incredibly far. We have iPhones and all this crazy technology, but there’s gonna come a limit, and, I think, in humans, in the body, that limit is reached faster because this is this oscillating kind of wave form of, you know, quantum mechanics interfacing with consciousness, interfacing with whatever matter is, and we’re like, “Oh, but you can just, “there’s a receptor and a binding protein and a DNA, “you know, code for it.” Doesn’t work that way, you’re just seeing shadows.

– [Vinay] Yah, not always. And then the other example I think about is the idea that, like, all these people are like, “Oh, it’s just more testing. “Like if only we had more testing.” Or, “If only we had a little bit more antivirals,” and I was like, “Well, you know, it will be, I mean, “the antivirals might make a marginal difference, “more testing, you know, I’m not sure “what you’re gonna accomplish, you know, anymore “when it’s just widespread community transmission.” Where do you wanna go there testing or, I wanna go to Shanghai.

– [Zubin] – Yeah, go to Shanghai because now we’re in this like Omicron BA whatever we’re in.

– [Vinay] Oh yeah, yeah.

– [Zubin] And Shanghai is a great example of zero COVID gone mad.

– [Vinay] Or gone to its logical conclusion.

– [Zubin] Yes.

– [Vinay] This is what these people wanted Z. They wanted this. They wouldn’t come out and say it. They said, “Oh, we just need to lock down hard. “and the problem in America was, you know, “those bad people just didn’t do what they’re supposed to, “they didn’t wear their mask, “and they came out and went on unnecessary” what do they call it?

– Thanksgiving visits.

– [Vinay] Thanksgiving visits and their unessential-

– [Zubin] Travel.

– [Vinay] Yeah, unessential travel and unessential social gatherings. While China’s put an end to all that, 27 million people locked in their houses, then they realize that, “Oh, when you lock down, “you might not get enough food on the table. “People going hungry.”

– [Zubin] No medicines.

– [Vinay] No medicines,.

– [Zubin] No insulin.

– [Vinay] No insulin, no food. When you’re sick with a non-COVID, they won’t even take you in the hospital, I hear and read in reports. They have announced that they’re changing their policy of the child separation. You read about-

– [Zubin] Ah-ha!

– [Vinay] But I’ve also read anecdotal accounts that they haven’t, even though they said they would. The policy is, if you’ve got a two-year-old kid, the kid tests positive, you test negative, the kid is being ripped out of your-

– Taken away from you.

– Taken away to central detention agency.

– [Zubin] This is insane.

– [Vinay] Insane. It’s like something out of like an Orwell novel.

– [Zubin] Actually let’s think about this. It’s insane from our perspective.

– [Vinay] Correct.

– [Zubin] From their perspective of, whatever their collectivist perspective is. Okay. Maybe this all makes sense. I don’t know because I’m not in that perspective. But either way, from a standpoint of objectivity, as much as we can muster, that seems unproductive to me.

– [Vinay] You know, I do think, though, like, let’s imagine that like, the reason it feels so bad to us is it just fundamentally clashes with our moral intuition that no matter how bad it gets, you can’t do that, you can’t separate people from their babies.

– From their parents.

– [Vinay] And when you see them crying in the streets and, you know, I heard a grandmother was threatening to commit suicide if they take the child away. You know, all these things that are natural in any time in human history, through war or famine, if anyone tried to do that to someone’s kids, I’m sure they would feel that way, and it clashes with our moral intuition. But from the moral intuition that the good and just thing to do is to minimize COVID-19 spread, so fewer people die and hurt from COVID, the zero COVID philosophy. They may argue, it is the moral thing to do, because if you had the child at home with you, you could get sick and you could spread it to someone else. It would prolong the pandemic. Remember how they kept saying that, you know, this, all those bad actors prolong the pandemic.

– [Zubin] Right, right.

– [Vinay] Ignoring the fact that we will all eventually get the virus. So what does it mean to prolong the pandemic? Once you’re vaccinated, we’re all gonna get the virus, that’s the best you can do.

– And I believe Leana Wen said that.

– [Vinay] Yeah. Recently.

– [Zubin] Yeah. Recently, only recently, right.

– [Vinay] VPZD 2021. Leana Wen 2022. We’re the same person.

– [Zubin] In fact, I think I said it in the summer of 2020-

– [Vinay] You think you were oh, wow, okay.

– [Zubin] Because what I said was, “Listen, I think it’s not a bad idea to, kind of. “bend the curve until we get to a vaccine. “But just so you know, “everybody’s gonna get this eventually.”

– [Vinay] You know, we should do a video where we take all our old videos-

– [Zubin] Oh yeah.

– [Vinay] And do the react to ourselves.

– [Zubin] Yeah. Yeah, yeah, that’s a great video. And you know what? You’ll do much better than I’ll do.

– [Vinay] I don’t know.

– [Zubin] I think you’ll-

– [Vinay] Well, let’s, we should also pick some of the people on CNN and stuff and really get-

– [Zubin] And compare and contrast.

– Oh yeah they’re-

– That’s gotta be a hoot.

– [Vinay] Even Fauci he’ll get decimated.

– [Zubin] Yeah, that’s true.

– [Vinay] I think he won’t do well.

– [Zubin] That, you know what, that’s a viral video waiting to happen, and it’s so much work that we won’t do it.

– I know I don’t-

– Yeah. ’cause we’re just, I don’t know, you’re busy and I’m lazy.

– [Vinay] I mean, we’d have to like get the videos, watch them, which would take tens of hours.

– [Zubin] Watching ourselves is so much fun.

– [Vinay] So it to be avoided.

– [Zubin] To our detractors, they think that’s like a paradise for us sitting and watching ourselves.

– [Vinay] I think like a lot of people, I don’t really like to watch myself. It’s awkward.

– Yeah, I don’t like it. We were just talking about, actually, this is a side note, but both of us have changed our style of speaking on video because we’ve gotten more comfortable with being ourselves. So early videos of both of us, like from years ago, for me and, you know, a year or two ago from you.

– [Vinay] You’ve gotten polished under your belt. I’m still a rough gem, I’m still-

– [Zubin] You’re more of a natural than I am-

– More of a natural finish.

– [Zubin] In the old days I was almost playing. I often played to the camera and was more of a character and so on. Like I’m talking about years ago and even, and then, now, I’m just, because I think I’m in my own space and the isolation of the pandemic too, and not having a team here it’s just-

– I feel the same way I listen to like my first podcast, it’s god-awful, like I should pull off the internet-

– Some of my earlier stuff is so embarrassing. And I even had a little, like a couple hairs and I was like, “What the hell is this guy?” I don’t like me now, but that guy, holy.

– [Vinay] It’s amazing. You know, it’s also like if you ever go back and read emails you wrote, like, 10 years ago, you’re like, “Is this loquacious?” Who’s this person talking too much?

– [Zubin] Dude! I used to write so much and eloquently, but it said nothing, it was all double speak. And now my emails are like an emoji.

– [Vinay] Now I’m like, yeah, so short. Somebody’s like, “Oh it’s so, it’s rude “to write such short emails.” I’m like, “But it answered the relevant questions-

– It answered the question.

– [Vinay] And, I didn’t have, like, any more time for that email.

– [Zubin] Exactly.

– Yeah.

– Yeah, yeah, yeah.

– [Vinay] Let’s talk about, well, so to the point on Shanghai. Of course, Shanghai, I think the people who supported stronger restrictions, they are getting what they didn’t know they wanted with Shanghai. And I think what it shows is that we could never have done that. ‘Cause it’s human rights violation.

– It is, it’s as simple as that, from an American’s perspective. Probably from an objective perspective-

– [Vinay] Yeah, it’s a human rights violation.

– [Zubin] And it’s not gonna accomplish, I mean, we’ll see in the end.

– [Vinay] They will lose. I mean, they’ll eventually get completely swept with the virus. And if they don’t, I mean the real question I have is, what the hell have they been doing the last year and a half, vaccinate your population.

– [Zubin] But are they using Sinovac, I mean that’s kind of a-

– Using the crappy vaccine.

– [Zubin] It’s kind of like a wacky, yeah. I mean, you know, I got to give this to Bourla and the gang. mRNA vaccines are pretty high quality-

– [Vinay] Titrate that, as much as the heart can take.

– [Zubin] Titrate it to in inflammation, that’s what you wanna do.

– Titrate it to the tropsin, you’re good.

– [Zubin] As you start leaking troponin. You’ve hit it.

– Listen you’re bad.

– [Zubin] You know what, that’s what we ought to do. Instead of this, like, “Well, how many boosters is good enough?”

– [Vinay] No, no.

– [Zubin] Just like, no wait, when you start leaking troponin, when your troponin becomes super therapeutic-

– [Vinay] Then you’re at the sweet spot.

– [Zubin] Then you’re at the sweet spot.

– [Vinay] It’s all reversible, anyway. I thought that was reversible.

– Yeah exactly, yeah. This is reversible with like five days of hospitalization.

– [Vinay] But, I mean, it’s an effective, I mean, Pfizer, Moderna the first dose, you know, I’m pretty sold on the first dose for most adults and beyond that we got the questions. But yeah, I don’t know what they’re doing in China, but you know, the other thing I learned about China was, the Western world learned about lockdown from China. And it just goes to show you, next time, public health people, like don’t take cues from totalitarian regime.

– [Zubin] Oh yeah, we learned how to do war from Putin.

– Oh, yeah, right.

– You just go in and murder a bunch of civilians, bury the bodies in mass graves and then, yeah.

– [Vinay] Yeah. Don’t learn from bad actors.

– [Zubin] That’s probably a good-

– [Vinay] Probably good.

– [Zubin] That’s a good rule of thumb for Twitter. Like why should the press be taking screenshots of dipshits Twitter, twittering. twatting on Twitter.

– [Vinay] I mean, I guess like a huge chunk of journalism now is just to talk about what people are saying on the social media platform. It’s crazy.

– Yeah. It’s nuts. Yeah. It’s interesting, I’ve actually enjoyed reading some of the Ukraine press just because it’s different. Like they’re not quoting anyone. Oh they actually do. “Well a Russian foreign minister, blah, blah blah, “said on telegram today that all Ukrainians should die.”

– [Vinay] They take, and also since it’s clear that like we, our allegiances are with the Ukraine side, which is, I mean sensible-

– Sensible.

– [Vinay] But it doesn’t mean that we have to accept everything the Ukrainian government says that’s like, ’cause they also need to put out war propaganda too. It’s like sometimes I see our journalist parroting it.

– [Zubin] Yeah. It’s funny my mom was actually, kind of, pissed because the Ukrainians were, I think there were a lot of Indians in Ukraine that were studying medicine at the time of the invasion, and they were treated really badly by the Ukrainians, according to my mother. And so she took umbrage at that, but then later said, “I’m sorry for even taking umbrage at that scene how they’re being treated by the Russians is just like appalling.

– I see.

– [Zubin] So it’s kinda like this weird moral conflict. So speaking of which actually this might be a good segue into a video I did recently about kids and it was based on an “Atlantic” article.

– Ah yes, anxiety.

– [Zubin] Yeah. So kids’ mental health has deteriorated, if you believe the statistics on it.

– [Vinay] If you only believe your eyes and ears, the data. Yeah. I’ll concede to you.

– [Zubin] Any pediatrician, any psychologist and any parent can tell you. So, you know, my own daughters tell me, oh, all their friends are in guidance counselors’ office all the time with anxiety, depression. I have relatives that aren’t that old that are late teens that are on, you know, antidepressants and that kind of thing. And I remember, look, you know, we had, you and I are frame shifted by about 10 years, but we pretty much had very similar upbringings.

– [Vinay] Yeah, similar sort of-

– [Zubin] Rural, you kind of did your thing, parenting was kind of a little hands off. And so the question is, first of all you have to believe that this is really a problem.

– [Vinay] Let’s concede that to be the case. I mean, yeah-

– Lets concede it. Yeah. Let’s concede it. Now, you could say, well, the argument is no, we’ve just destigmatized it so more people talk about it. No, but-

– Yeah, I do think that people have looked at that question and it’s beyond what even-

– [Zubin] That’s right, that’s right. Because you’re seeing actual suicide attempts, you’re seeing actual self-harm, cutting and things like that. It’s worsen in girls, but guys still suffer from it, and so on. It started in about 2009, they started measuring this upstick, which correlates to the development of this. And the fact that now people plug right in.

– Coincidence. Total coincidence.

– Total coincidence. So there are four things postulated in the article. The first is social media, right. Well, so we know we’ve talked about social media as a harmful thing, specially it for young girls, they commit relational aggression, they have FOMO, they stop socializing in person, which has been associated with better outcomes for-

– [Vinay] And I think the reason, like so many people find it palatable is that like, I think most of us, when we finish looking at social media, we are more annoyed than we were when we started.

– [Zubin] Totally.

– Yeah, I mean .

– You know, I’ll be totally transparent like you and I when we just met today, how are you doing Z? “I don’t know, man. “I’m just kind of like whatever.” The truth is, anytime I get sucked into social media, I get less happy.

– [Vinay] And anytime I am so busy that I don’t even have time to look, I get more happy.

– [Zubin] You get more happy. Me too. So whether I go on a retreat or whether I just forget about it or whatever, I’m better, I’m better. Like the other day I decided I’m not gonna, I’m doing nothing today except for the dropping the kids off and I’m gonna meditate. And I meditated for almost six hours. By the end of the day, reality started getting transparent. Like it was just this empty awakeness with like vibrating energy. And I’m like, “Oh, this isn’t so bad.” The next morning I opened some social media, I decided I was gonna make a video. I did this and reality clunks itself back on in a way that’s very dysphoric, it’s very uncomfortable. You don’t have to be that crazy to experience it. But so social media, yeah.

– Okay, social media is one.

– Possible.

– Is one possible thing. Two is the media media.

– Media.

– [Zubin] So this idea, and we were talking about this, like kids are obsessed, they have so much access to news now. News has a negativity bias that all they see is the world, the sky is falling. Climate change, political division, Ukraine, nuclear war, environmental destruction, all this stuff. And they take it very seriously because they don’t have fully formed frontal lobes yet to understand it. Look, I got my own problems, I can’t change the world.

– That’s a good question. So when you were growing up, did you, I’m trying to think about, did I even watch news that much?

– [Zubin] Barely.

– [Vinay] Yeah, we’d sometimes put Tom Brokaw on in the evening, like right around dinner time. But as even a high schooler, even a college kid, I have to admit-

– Hardly.

– [Vinay] I mean the, you know, I mean, I kept up a little bit, but I wasn’t all up to speed.

– [Zubin] These kids are jacked into it now because it’s in their feed and okay, so this is where, so social media and media media interact.

– Intersect. Yeah.

– [Zubin] Because they get their news through social media. So there was a study they did, and I didn’t look at the primary data, so it might be bullshit, but they took people off Facebook for four weeks and found a couple things. One is, their knowledge of world events had plummeted. So they actually knew less about the world. Their subjective sense of wellbeing had skyrocketed. So there’s this inverse curve.

– [Vinay] They paid them to stay off or something like that.

– Something like that.

– Yeah, yeah.

– Yeah.

– [Vinay] I Vaguely recall.

– [Zubin] Yeah.

– [Vinay] Okay, so one social media, two the media, and, of course, the media, if it bleeds, it leads, you know, of course it’s like they go into those kind of dark places ’cause that’s what drives attention economy.

– [Zubin] Yep, that’s exactly right.

– [Vinay] What are the other two?

– [Zubin] Yeah. So the other two who were parenting style. So this accommodative parenting style where we helicopter our kids, if they’re, “Oh little Timmy is afraid of dogs, “keep him away from any dogs. “Don’t let a dog near him.” Instead of exposure therapy was, “Here’s a puppy to me-“

– I see. Or this peanut allergy thing, where they’re all-

– The same thing, same thing. Peanut allergies or bad words that frighten you, or you use the, in other words, you use the wrong pronoun, and now that’s a, like a piece of violence

– Oh, I see I thought that was swear words.

– [Zubin] No, no, but so-

– [Vinay] If you don’t wanna hear swear words, don’t come around me when I’m assembling furniture, ’cause there’s gonna be some swear words, you know. I’m not, these hands are useless. You know, I didn’t become a surgeon for a reason, you know.

– [Zubin] Me too, my hands are truly, they’re like dead appendages. They’re like two appendices, like, you know, like you can just remove them and nothing will-

– Sometimes when I go to scroll, I get a little twitch in my finger, you know, I can’t even do that.

– [Zubin] So physically incompetent with the fingers that even scrolling your feed-

– [Vinay] Even scrolling the feed, I feel like I can’t quite do, sometimes you can’t click on the, you know, I swear to God, maybe it’s just me, but sometimes they make those buttons on the app so small, and I feel like I can just never hit the right spot on the screen, always a little off.

– [Zubin] I’m with you, dude.

– [Vinay] You know, that’s a great way to make somebody feel like they’re going crazy. Make a program that just wherever they tap it always just thinks it’s like slightly off.

– [Zubin] And that’s the fourth reason that kids are crazy. No, that’s really interesting actually, that would drive people insane.

– [Vinay] Okay, so the third reason was parenting styles.

– So social media, media media, parenting style-

– [Vinay] And this has been discussed, I think in Jonathan Haidt’s book,

– [Both] “Coddling the American Mind”.

– [Zubin] So that was referenced even in the article. And I think it absolutely must read if you’re into that, into trying to figure this out. And there was another one and I’ve already forgotten what the third was, but-

– [Vinay] Well, that’s probably why you’re not so anxious. And I was also listening to a podcast and on this podcast, this young, should I say what was, it’s another Bill Maher podcast now. Now I look like I’m a big fan, but I do like him, but, you know, I do think he’s a clever person. I think he’s somebody who just like, didn’t go to a lot, I mean, didn’t he finish college and then he started working in comedy, but like a lot of comedians, you know, some of them are very smart and they’re very astute about, you know, social world and what makes people tick. And he was talking to some young person, this young person, a lot of anxiety about, you know, climate change and things like that. And he was really, I could kind of can feel in his voice that he was like trying to counsel them like, you know, “That’s not on you.” Like, yes, we all can make sort of environmental choices or not, but in the grand scheme of things, that moves the needle like this. Governments have to make big choices, if we’re gonna make some dents in this. But moreover like you shouldn’t feel, I mean, you may feel like it’s a cause worth pursuing. Just like I feel like high cancer drug prices are a cause worth pursuing. And we do have this whole research agenda on it, but I don’t, you know, and I’m sympathetic to people who are paying high out of pocket, I feel bad for them, I get angry about it, but I don’t let that anxiety come back and paralyze me. And I’m certainly not waking up, you know, anxious about this social political issue. I’m trying to think about how to fix the problem.

– [Zubin] That’s right. And this is a part of the distortion of control. Like that my individual choices right now are gonna have this massive impact on the world and it gives you a sense of responsibility. It really, it’s much more nuanced than that. And it actually reminded me of the third thing or the fourth thing, which is, the isolation that we’ve put kids under, whether it’s pandemic or otherwise. And so they say, oh, they’re having alone time, but it’s alone with phone. So they’re not sleeping. They’re spending more time with this and less time in person. So they drink less, they DUI less, they all these things that we would’ve thought, oh, this is, less teen pregnancy, all those things are better, and yet their mental health is suffering, why? Because they’re sacrificing the in-person interaction for a fake interaction. And so this sense of loneliness or isolation, what did we do in the pandemic? We made it 20-fold, worse by closing schools. So you close schools and you put them behind a mask when they are in school and you don’t think that’s gonna have a consequence for developing young people who thrive on social. I mean, the whole idea is during their teens, they get away from their parents and the peer group starts to matter, right. But this has been taken away. Everything’s been shifted later.

– Yeah. I know. I totally agree with you. And that’s a really astute point. I guess this, ah, I didn’t tell you about this before we started, but there’s a new study out of Finland, and they have a really wonderful-

– [Zubin] Oh, you mean a future or NATO partner up ours?

– [Vinay] Oh yeah.

– Yeah. They’re now-

– Yeah. So I hear. I guess of course, maybe I’d be nervous too.

– [Zubin] I would. Sharing a border practically with Russia-

– Sharing a border.

– [Zubin] Yeah.

– [Vinay] But they’ve been invaded before and they pushed, they resisted.

– [Zubin] Yes. During World War II. I think the, when the Germans and started fighting the Russians, the Russians had to give up on the war there.

– The war in Finland.

– [Zubin] Yeah.

– [Vinay] So what I read about Finland was Helsinki and Turku which is apparently, I hope I pronounce that correctly-

– It’s beautiful.

– I’m sure some Fin will say that-

– [Zubin] The Fins are, they can get pissy dude.

– [Vinay] I’ve been to Helsinki and had a lovely time. Helsinki Hematology Day, I think 2018. Thanks all for the visit, but it was actually a lovely time, but, and I took a dip in the Baltic Sea.

– [Zubin] Oh nice.

– [Vinay] And then I went in the sauna and I could barely take that frigid water, but some of these older people were swimming laps. I swear to God.

– Oh, yeah, they’re hardy.

– Oh man!

– Yeah.

– [Vinay] I go, well anyway. Have got to watch, I forgot what I was gonna say. So this is a study Helsinki verse Turku. In Helsinki if you’re under 12, you’re not masking because they follow the WHO to the letter, which is the selective under 12, and they say, there’s no reason to do it. So under 12, no masks, good for Helsinki. Wow, that would be an anathema in this U.S.. And 10 to 12 in Turku they went a little bit more aggressive, and they masked 10 to 12, and they show like a comparison of COVID-19 rates in these two cities, and it has some advantages because culturally Finland is, you know-

– [Zubin] Pretty homogenous.

– [Vinay] Yeah. More comparable than comparing, let’s say for instance, Rando City and in Texas to the Bay Area, where it’s culturally very different. I don’t think masks became as political, you know, they didn’t have the finished version of Donald J. Trump, not wear one, and the anti, you know, DJT’s wear them with vigor and, you know, all this stuff. So they don’t have all that kind of baggage. And in this study, it shows clearly the cases, they were like identical, they rose, they fell, you know, it was all over, but there was, like, no difference between these two cities in this age group, in 10 to 12, even though one had to do it one didn’t. And we also have the Spanish data, that’s a similar kind of thing. Takes advantage of natural experiment, that five year olds didn’t and six year olds did, and there was no regression discontinuity or step in that. So I think the answer is that I really think it probably doesn’t do much to have a cloth mask mandate in kids. It probably doesn’t, well, it certainly doesn’t do much cloth mandate in adults, and most of these, and to this date in this country, everyone talks about like mask mandates, it’s a cloth mask mandate, even to this day on TSA flight. They’re not making you wear a good mask. That’s one. Two: we’ve had vaccines for over a year if you wanna get one, you wanna get one. And then the moment you get off the plane it’s Mardi Gras.

– [Zubin] It’s free, it’s free.

– [Vinay] It’s a free for all. Got 1,000 people here in this party or this club, and there’s no, you know, and so what is this? I’ll come to that, but let’s finish on the kid point. I think it was stupid to mask them. I think at the minimum you do a randomized trial, so you can sort it out, but what’s going on in New York City? Oh my God! This crazy mayor.

– [Zubin] They wanna put masks on only toddlers.

– Only toddlers.

– Only-

– Only, which to me-

– [Zubin] All, because they can’t be vaccinated. And we talked about this.

– [Zubin] But if you’re an unvaccinated six-year-old, you don’t have to wear it. So it’s not based on vaccine status. And two to four have even lower risk than any other age group, and even lower risk than some vaccinated adults. We’re free to go to like, you know, bars, and this mayor’s got the only toddler mask policy, he keeps saying, it’s justified by science, but he must be justified by literally, he must have the dumbest, the dumbest advisors to tell him that this is a good idea. Because one: there’s the science of it, which is bankrupt. But then there’s the politics of it, which I would think would be so bankrupt, you’re gonna look like such an idiot. You think somebody came to you at the beginning of the pandemic, like, “Listen here, look at this, look at this, “this is the age grading a risk. “I show you right here. “It’s got maybe 1,000-fold difference in risk.” ” Older people not doing so good.” “Who do you wanna, who do you wanna mask up in this?” And you’re gonna say, “That two-year-old.”

– [Zubin] Round up that toddler and slap a cloth mask.

– A cloth mask mask. I know . I know.

– On this kid.

– [Vinay] Except when they’re napping, then they take it off-

– [Zubin] Well, that works well, a bunch of like heavily breathing children in an enclosed room.

– Enclosed room .

– [Zubin] For like an hour.

– [Vinay] Yeah, right. Okay. So that’s a stupid, but meanwhile, that Eric Adams went to that Gridiron Dinner, 700 people, you know, and it was a super spreader event, and he got COVID. And I was like, this guy-

– This guy.

– [Vinay] I thought he was a savvy politician.

– [Zubin] Well, who knows, maybe he is. Maybe New Yorkers want that.

– [Vinay] I know, but doesn’t he have some grander ambition than just, I thought that ,it’s always a stepping stone for .

– Yeah, yeah, yeah. Well I don’t know, dude, all I know is that’s just dumb. That’s where science and policy don’t even, they don’t even, I don’t get it.

– [Vinay] Can you imagine debating this person in a political, think, like five years from now when this is all, you know, it’s really cooled down.

– [Zubin] Remember that time you..

– [Vinay] Yeah. I’d be like, “You know, you” he is like, “When you ran the state, “your deficits were little bit higher and blah, blah, blah.” I was like, “Dude, you masked two-year-olds, “while you went to a party.”

– [Zubin] Yeah, and got COVID, everyone got COVID.

– And got COVID.

– [Vinay] I was like, “You want this? “You want the guy who, he masked the, by force of law. “He didn’t even say like, ‘You could, if you want,’ “he forced them by law. “And then he like fired this lawyer who wanted a protest. “And then he kept saying science, “but obviously we all know now that was stupid.” You know, you’re done.

– [Zubin] We are in a world where Senator Dianne Feinstein still is a Senator, despite having, you know, cognitive difficulty. So, I mean, again, we’re in a world that doesn’t fully make sense.

– [Vinay] I see what you’re saying. These politicians, they have such an incumbency that they can-

– Yeah. There’s a momentum.

– [Vinay] Well, you know what? If these people pull off this stunt, I will, a little bet, I will buy you a beer.

– [Zubin] Ooh!

– [Vinay] If, here’s my claim, any politician who is in a photograph that was widely disseminated where they’re unmasked and the kiddos are all masked, the Stacey Abrams photos, you know, these kind of photos, that Kathy from New York State, the governor or any politician that had a totally stupid mandate like this, the toddler mask mandate, I think in 5 to 10 years they have nearly no chance, I’ll say this, in the absence of an absolutely crazy candidate on the other side, they will lose.

– [Zubin] Ah!

– [Vinay] You think they’ll triumph?

– [Zubin] Ah, I hope so. There should be karma for that.

– [Vinay] Oh, you hope they will lose?

– [Zubin] No, I hope they lose. I mean, it’s insane. Did you see how Trump endorsed our boy Dr. Oz?

– [Vinay] Yeah. I see that he’s gone. He’s gone for Oz.

– [Zubin] He said, “People, middle-aged housewives “really trust this guy.” Like that was like-

– [Vinay] I thought he said something like, “He’d been on TV for 10 years-

– He’d been on TV-

– [Vinay] And he had the top ratings.

– [Zubin] Yeah, yeah, yeah, yeah. I mean, it was, how’s he doing? I heard he was not doing so well.

– [Vinay] I haven’t kept up on that. I thought he would do well because I thought the name recognition would be a lot.

– [Zubin] Yeah. But I think people, Pennsylvanians see through the charlatan in that.

– [Vinay] Maybe the thing that irritates the most is that he’s like a New Jersey carpetbaggers, you know-

– [Zubin] Yeah. Yeah. I mean that’s, I mean, I’m a New Jersey carpetbagger I mean, I was born in Morristown, New Jersey.

– [Vinay] I see. But then you have Central Valley cred.

– [Zubin] That’s right. So you can carpetbag from shithole to a shithole.

– That’s an equal exchange.

– It’s an equal, yeah. It’s okay, yeah.

– Equal exchange.

– [Vinay] So, okay, we talked about, oh, the airplane travel mask. Do you wanna go into that a bit- I mean, I think it’s stupid.

– Oh yeah, yeah. So they were going to get rid of travel mask requirements on public transport, but then they decided not to.

– [Vinay] Yeah, and then somebody was like, somebody put this, well, they were like, they were like, “Oh, you know, “this is to protect IC people.” And there’s an equity issue here, like the people have to use public transport have no choice. And then they’re like, “It’s actually the other way around that rich people “get to go in a way that they don’t have to wear “the mask all the time. “And poor people have to travel on like buses “and trains and planes.”

– That’s right.

– [Vinay] And they have to. I mean the simple point is that like what, what is, I mean, what is their logic? You have a situation right now where you’re getting like pre-omicron seroprevalence with 140 million Americans, plus like 200 million Americans have been vaccinated, 250 million of Americans have been vaccinated. So you combine like vaccinated, plus people who’ve had COVID, plus people who have vaccinated and had COVID and then you look at what people, what’s going on, and it’s like Mardi Gras all over the place.

– Yeah. All over.

– It’s just like parties all the time. And then you think to yourself, I wanna slow spread by putting a mask mandate only in one tiny place with a mask that doesn’t work. What is the, and they’re gonna get it eventually. We’re all gonna get the breakthrough.

– [Zubin] All gonna get it. And in fact, what do you think is really the case rate right now for this BA2 variant? Because nobody’s reporting their home antigen test. Nobody’s even testing.

– It’s much higher than what it is.

– [Zubin] It’s way higher. And yet our hospitalizations are flat, declining, deaths are declining. So the actual outcome that we want is there.

– [Vinay] You know, and I wanna go back to that, like, ’cause I think that this is something that people have said. And I guess, like, it’s the idea of flatten the curve, which is like, we should implement these things so we prevent the hospitals from being overcrowded, et cetera. I guess, I wanna say like we’re in year three of the pandemic, like one, you need to build a hospital, that you can kind of handle a little excess in a time. You might get that surges.

– Surge.

– [Vinay] You might get them in the winter. Two: how much can you suppress normal life because you’re worried about hospital capacity? And then three: the reality is, like, most of the places that were like totally shut down in 2020, it wasn’t about hospital capacity, like, their hospitals were mostly empty. That’s why we had a bailout for hospitals because there wasn’t a surge everywhere, just a few cities that were really hit.

– [Zubin] I would even say this. You wanna help hospital capacity? Try to help unload the mental health crisis in the ER, by opening up. Because the pandemic made all of that worse by creating social isolation, anxiety, and all that.

– [Vinay] And firing all these doctors and nurses for vaccine mandates.

– [Zubin] They didn’t get a booster, they get fired.

– What about the-

– I mean, you had to hold your nose and get a booster.

– [Vinay] I did, have to do it.

– [Zubin] By the way.

– Don’t remind me.

– So Paul Offit just wrote-

– [Vinay] I saw that in the New England Journal commentary.

– [Zubin] New England Journal thing.

– [Vinay] It’s good.

– [Zubin] It’s really good, he basically-

– [Vinay] You think if I had printed that off and sent it to them, I could have gotten out of my booster?

– “Yeah, look, Paul Offit says, “We’d love to see compelling data “for severe disease prevention in young healthy people “that you’re compelling a booster for.”

– [Vinay] Yep. I think this goes to show you the age old truth, which is you can’t let stupid people make mandates. No, you can’t let, you can’t let, I mean, mandates are, you need to be very cautious and booster mandates for 20-year-olds is a mistake.

– It’s a mistake.

– It’ a mistake made all over the place.

– [Zubin] Just wasting your juice, you’re wasting your public health juice and you’re creating mistrust.

– You’re wasting it. Gain mistrust.

– [Zubin] Yeah. That’s all it is. So guess what’s coming up though, 5 to 11 year olds, FDA is weighing in on a booster for them.

– Based on antibody data?

– Yeah.

– And I thought the first two-

– Based on a tiny study with antibody data.

– [Vinay] And the first two is not even working so good for them, their breakthroughs are going through the roof. The first two are like vaccine effectiveness in a new New York state study of like 11% or something like that.

– [Zubin] You know, I think, and Offit was right in the article to say, you know, “Why are we even calling these breakthroughs? “This is what this vaccine is designed to do “is prevent severe disease.

– Yeah, that’s it. Well, you know, to push back on Offit a little bit. Well, one, I agree with him, I think he’s right, that’s what it was. That’s what it ought to have been designed to do. But if its goal was always severe disease, they should have made the primary endpoint of the original randomized control trial, severe disease.

– Ah, severe disease, but they made it infections.

– [Vinay] They made it symptomatic infection.

– [Zubin] Yeah, symptomatic infections.

– [Vinay] So it wasn’t asymptomatic infection.

– [Zubin] That’s right.

– [Vinay] And also they purposely, I don’t say purposely, let me take that back, I take back the word purposely. They happen to not do asymptomatic swabbing on everyone at random.

– That’s right. I remember that.

– [Vinay] Because that would’ve provided a lot of information about transmission.

– That’s right. That’s right. So we couldn’t say in those early days, “Oh, does this vaccine actually implement “transmission declines?”

– [Vinay] We had like a subset analysis from Moderna. They found very low swab positivity, but we didn’t have like a gold standard.

– [Zubin] Right. That was with Wuhan strain.

– [Vinay] Yeah. Wuhan strain. And by the way, this is the same old mRNA, huh, they never wanna change that.

– [Zubin] So, okay. That brings me up to another thing that Paul mentioned in his piece, which is original antigenic sin. And what that is for people who don’t know, now this is, now, by the way, this has been co-opted by the, sort of, fringe anti-vaccine community-

– Correct, right.

– [Zubin] So let’s just put that out there, that listen, it’s not what they say.

– [Vinay] But just because some crazy person said it doesn’t mean it’s not true’s-

– That’s right.

– I mean, there’s a kernel of truth in it.

– [Zubin] Cause there’s gonna be crazy people who are like “The asteroids coming.” But then there may actually be an asteroid coming, right.

– Yeah, right, of course.

– [Zubin] So, the original antigen sin is where the immune system, kind of, imprints on the first version of the viral antigen that it sees. And so we’ve given it that in the form of either natural infection with Wuhan strain or with the vaccine. Now, when you keep showing it the same strain it’s gonna imprint, so, and they actually did some data on this, they updated the strain to be an omicron antigen. And when they tested it, versus the original AI thing, they both developed the same number of antibodies. And it might be because system is already imprinted on the original and you’re not gonna do better, now.

– [Vinay] Yeah, and I think like when I think I listened to Paul say this on your podcast, which was, you know, they learned with HPV, they originally had the quadrivalent and they went to the nonavalent, from, like, four to nine.

– That’s right.

– [Vinay] And if a girl had never gotten the nine and got the nine, she’s got antibodies to all nine. But if the girl had gotten the four, quadrivalent HPV antigen, and then the nine, she would make very robust, again, to the four and not as good for the five.

– Not as good to the nine.

– The other five.

– That’s antigen sin, or imprinting.

– Imprinting.

– [Zubin] And so the question then becomes, why would we keep flogging? Well, it actually becomes a couple questions. One is, would an updated vaccine then be helpful for people who’ve already had the original?

– [Vinay] Correct. With a different structure.

– [Zubin] With a different structure, because it may not be because original antigenic, you know, you might as well just use the same one. And the second question is, why even use the same one if it’s not gonna do anything for severe disease?

– [Vinay] So like, oh right, there’s two questions, right. What is the goal? And then two: like what is the immunological response? And then the other point to make is that like, I mean, like, the spike protein is slightly different with omicron. And what happens if you give an omicron only mRNA, it’s possible you have a rev up of the antibodies that hit the epitopes that are preserved between the two, but not sort of all the novel epitopes?

– [Zubin] That’s right, the new stuff, yeah.

– [Vinay] The new stuff. And these are all good questions.

– [Zubin] They’re good questions.

– [Vinay] You know, let me tell you something. You ever get to that point where you’re like, you know, I don’t wanna go grocery shopping, I just gotta use up whatever’s in my freezer?

– [Zubin] Oh, yes.

– [Vinay] I think Pfizer’s, at that point. “We’ve gotta use up all this vaccine and all this. “Give them four, maybe five doses, I don’t know, “but they use up that shit.”

– [Zubin] You may be onto something there-

– [Vinay] I don’t know why they’re doing this stupid.

– [Zubin] How bad does Pfizer feel that they thought Paxlovid’s gonna be this big blockbuster and no one wants to use it, though.

– [Vinay] I think. Well, no, people wanna use it.

– [Zubin] I, no, no, sorry. People want to use it, but it’s actually not being used that much.

– [Vinay] Oh, well I say, but I think that they’ve already sold it and they got the cash.

– Ah! I forgot that.

– Didn’t they sell it to the federal government? I heard that-

– [Zubin] I know federal government bought a ton of it. Yeah, yeah, yeah.

– Yeah. But I saw this graph of like Pfizer’s earnings this year.

– Oh my God.

– They’ll top at 100 billion.

– [Zubin] Oh my God.

– [Vinay] You know, I’ll just make out my tax check straight to Albert Bourla.

– [Zubin] Might as, might as well.

– Dear Al.

– Just write it “Dear Al.”

– [Vinay] I was like, and then in the notes it says, I say, “Thanks for dose number eight.”

– [Zubin] Yeah. That’s in the notes, right? Dose eight. You’re hoping you can write it off your HSA, which you have because you don’t have universal coverage for healthcare.

– [Vinay] And then I had to put my trope, 10.0 .

– [Zubin] My troponin just bumped ever so slightly, I might be reaching asymptote of that last booster that I need. “Am I fully vaccinated?” “Well, what’s your troponin?

– [Vinay] Fully vaccinated is always, how many many you’ve had plus one plus one.

– [Zubin] Plus one.

– [Vinay] How’s the time?

– [Zubin] Is it? No, no, no, you’re good. It’s an asymptote that you never reach.

– [Vinay] So we did the Eric Adams. We did the travel mask. We talked about, ah, Ashish Jha on TV.

– [Zubin] Yes. I just read an article where Ashish, they were talking about Ashish and they were saying, he’s received very warmly by the administration because he’s so congenial and such a good communicator and so on. And he’s now telling people he’s very optimistic and he’s saying, “Listen, guys, “what we care about are hospitalizations, “and it’s not about cases. “So let’s not panic about cases.” So that’s the last I understood about Ashish.

– [Vinay] Well, I’ll say a few things that I think won’t get me in trouble.

– [Zubin] Than don’t say them, say stuff that’s gonna get controlled. It’s the VPZD show.

– [Vinay] Well, I guess the first thing I would say is that, like, you know, some people were like, it said, like, “TV, pundit becomes “White House council.” And they’re like, “Oh, that’s unfair, “he’s the dean of a public health school.” So I wanna say, like, he has like real credentials, he has published many, many papers in top journals. He was a professor at Harvard. He ran the global health sort of group. And then he became the dean of Brown’s School of Public Health. And that was all before the pandemic.

– [Zubin] That’s right, and I also a nice guy.

– [Vinay] And by all accounts, well, I don’t know. I’ve never met him.

– [Zubin] Yeah. I know a lot of people who know him very well. We’re connected on LinkedIn, but I haven’t met him.

– [Vinay] You connect on LinkedIn.

– [Zubin] Yeah, well, you know, back when I did LinkedIn, now, LinkedIn just sits there and I have all these messages from people, “Do you even check your LinkedIn?” I’m like, why would I, I’m not a douchebag.

– [Vinay] I always get people who like, it’s like, they want to connect with you on LinkedIn. I was like, “Dude, “I don’t even know how to log into LinkedIn.” I get the email, I know how to, well, anyway.

– [Zubin] LinkedIn is like, you know how each social media, and, again, we won’t get too distracted. Each social media has its own flavor. Like TikTok is like dancey stupidity. Twitter is whatever it is. And Facebook is like, you know, middle-aged women and me and, but LinkedIn is something special. It is you pure business, drivily-

– [Vinay] I see, business speak.

– [Zubin] I hate it. And I tried to do it for a while when I was a business, when I was ZDoggMD LLC, and I was having sponsors and all this. And then I was like, you know, the minute I stopped doing that, I felt so much happier.

– Yeah. I can understand.

– It’s just not me. It’s not me. But anyways.

– So, every time-

– Ashish, Ashish.

– [Vinay] Ashish, okay. So he’s got like the credentials, like to be a Dean of Public Health. And I think he had the job at Brown before he, COVID even came. Like, I think he had already like, agreed he would take the job. If I recall correctly, somebody can correct me if I’m wrong. But like, I don’t think it was COVID that helped him become the dean, I think he was-

– No. I don’t think so. Yeah. I don’t think so.

– [Vinay] Then though, I think we have to separate if he had just, if he had never opened the Twitter app, he would still be the Dean of the Brown School Public Health, and he wouldn’t be the COVID czar. So I think that’s a separate thing people don’t follow. Like, yes, he has qualifications, but he wouldn’t be the COVID czar if he didn’t tweet a lot. And he tweeted a lot and he tweets in a certain way, you know, he has puts a lot of spaces in the..

– [Zubin] Oh, I haven’t seen his tweets.

– [Vinay] Oh, he’s got, like a, his tweet is like, it’s always this long, because he puts lots of-

– Ah, space in there.

– [Vinay] He’s a space bar man. Enter, enter man, he’s an enter man.

– [Zubin] He’s a spaceman, he’s a spacheman. spaceman.

– [Vinay] So he has his own tweets and he has his threads about everything, you know. And then from the threads he got, and, of course, he’s got the title. Then he got invited to all these shows and he goes on the shows and he does his circuit, and he’s on the shows like all the time. And I read an article saying that he was, like, literally, like, on the shows for like tons of like, you know, quarter of the days doing the shows. All the shows, CNN, MSNBC, all the shows that like real people don’t watch, but like elites watch.

– You’re right.

– [Vinay] Or you’re forced to watch in the airport lobby.

– Or a 70-year-olds watch. Like Marty was saying when, when they watch him on Fox it’s like.

– You’re right. He’s like a rager in like West Palm Beach .

– Yeah. He gets recognized in West Palm Beach all the time, right exactly.

– Palm Beach or something, yeah, some retirement community. Like, “Marty, Marty!” You know, hear it like. So, all right, Twitter got him on TV, and TV got him in the eye of Biden. And then the other thing that I find is a little problematic is that he was a bunch, he’s one of many doctors who received quote, “updates and announcements from the administration “that were private” of like what might be coming down the pike. And then one instance, he wrote an oped like minutes after there was a policy change that was very supportive.

– [Zubin] He’s all ready to go, yeah.

– [Vinay] But I think there’s already something problematic happening, which is that he was on Twitter, he likely had a lot of stuff in praise of the administration, some stuff critical of the administration. It seems like the administration reached out to him privately. They have private meetings, he start getting private updates. And the moment you do that, you’re starting to be captured. Because it’s like, “You wanna please me “’cause I’m the presidency, “and this is the Office of the White House, “and I’m telling you some of what you’re saying is we like, “and some of what you say, we don’t like, that’s fine. “You know, you do you, “but just remember some of what you’re saying we like. “So what do you wanna say next? I mean, it’s, you know, I don’t have to pressure you, you will start to say what I like, because you know I’m gonna be in touch with you. “You like those updates and announcements, “it helps you, doesn’t it? “So what are you gonna say now? “What are you gonna say about my policies?” So I think naturally his policies were more and more praiseworthy of the administration. Why do I think that’s problem? When people turn on the TV, they need to know that the person on that TV is not in cahoots with the person making the calls. I want the TV person, who’s a critical of it, at least to be totally independent. I don’t want somebody who’s like auditioning for Trump or Biden.

– [Zubin] Right. Which, of course, it’s not how it works. They are all doing that.

– [Vinay] Yeah, they’re all playing this bullshit game.

– If they’re all playing this game.

– [Vinay] Well, this is the bullshit game.

– [Zubin] It is. No, but that’s actually, this is a point and you actually made that same point. I don’t know what you have against Indian physicians working in the administration. But, Vivek Murthy I mean, VEC Murphy, you were saying-

– [Vinay] I’m an equal opportunity critic.

– [Zubin] You are. No one will ever accuse you of racial nepotism.

– [Vinay] No, I’m equal, equal opportunity.

– [Zubin] In fact, let’s see who did we talk about today? We talked about Ashish, I just said Vivek, Leanna Wen who is a woman of color, so we’re just basically racist. We’re just attacking people.

– [Vinay] President Trump.

– [Zubin] Trump, he’s pretty white.

– [Vinay] Yeah, he’s white, so we attack white people too.

– [Zubin] Okay, good, good, good. So we’re equal opportunity.

– No sorry, yeah, right.

– [Zubin] Right. Good, good, good, all right. I was getting nervous.

– [Vinay] No, I don’t see race when I see problems. I see the specific problem. The problem is, the problem is it doesn’t matter who this person is, the problem is that-

– [Zubin] There’s a problem here.

– [Vinay] That it it’ll lead to the auditioning. It will lead to the audition.

– [Zubin] Well, so let me ask a question then I’ll play devil’s advocate. Do you think doctors who care about stuff and you would fall in this, shouldn’t do their thing on Twitter?

– [Vinay] No, you should. But you can’t let yourself be captured. And you have to be careful you’re not auditioning for somebody. I mean, I don’t know. I don’t know who I would be auditioning for ’cause I don’t have.

– Well for, you’d be-

– Much aspirations.

– [Zubin] Basically auditioning for anti-vaxers ’cause we know who you are, you’re a hater. I mean that-

– [Zubin] Well, I think that’s different. I mean, well, not that I, I say is different in disrespect. Well, first of all, I’m not auditioning for anti-vaxers.

– [Zubin] Let’s just put that out there.

– [Vinay] I’m as provax as they come, but I’m a smart person who understands numbers. So that’s why I think about safety and risk and uncertainty. And that’s why some of these anti anti-vaxers, these zealots don’t understand ’cause they’ve lost their minds, and they’re not really sort of scientists. But like auditioning for an audience, like they might say, like, “You’re auditioning for the Z-pac.” And it’s like, “Well, the Z-pac is, “who is the Z-pac? “It’s like thousand of people that randomly like you for, “I don’t know your views on meditation “or views on vaccine or your views on this “or your views on that, or for just the way you talk “and the way you present yourself. They like you for whatever reason, you don’t even know.

– [Zubin] It’s the shape of my head.

– [Vinay] I’ll tell you what it isn’t. It’s not those early videos. No just kidding. Not those early videos.

– [Zubin] Oh! You know how to hurt me. That’s it, that’s it. My daughter grabbed my head, my 10-year-old, this morning and she said, “Your head looks like to me, like a potato.”

– [Zubin] I was like, that’s pretty accurate. Anyways, you’re right. So the Z-pac yeah, yeah, yeah.

– I mean., you know.

– Capture, you know. I don’t know, is it capture, I mean, it would be capture if you were like really, I don’t know, maybe, maybe if you were known for some perspective or issue and if you feel like compelled to talk about that issue to grow your brand or audience, as, maybe, some people are. But I don’t think you fit that bill. But also I think it’s different than people who are trying to please a specific political party or political person. ‘Cause if you’re on TV, you wanna please the White House because they’ll give you a job. Z-pac can give you no job.

– [Zubin] No way. I mean, they, actually, they support our show to a degree, so I could be captured by them.

– [Vinay] But it’s like supported by like the way Bernie is supported by $5 payments.

– [Zubin] That right, that’s right. The $5 payments.

– [Vinay] You’re not, it’s not like one person giving you $100 million.

– That’s right.

– I mean-

– Actually, this is worth really diving in.

– Yeah. No.

– [Zubin] Because this idea of capture is actually a huge problem, social media and beyond. So what you’re talking, we’re not, no one’s saying Ashish is captured or anything like that, you’re just saying that-

– [Vinay] Except, well no, I was hinting at. No, I don’t think he’s captured, but I do think he was in a bad cycle.

– [Zubin] That’s right That’s right. And it certainly can give the appearance of that. And the truth about capture is, this is something that no one talks about except for my friend David Fuller on his podcast, “Rebel Wisdom”. The truth about capture is, you don’t know you’re captured.

– [Vinay] You don’t know you’re captured.

– [Zubin] It’s an unconscious bias in many ways. Some people make it conscious. Like I’ve talked to some people who are on Twitter and stuff and they say, “Oh no, no, I say these things “because, you know, I’m really angling for a job “in the White House or something like that.” You know, I’ve heard people say this. But that’s overt, they are aware of it, they know exactly what they’re doing.

– Wow, shameless.

– The only people they’re are misleading is the public, but they’re not misleading themselves. The people I worry about more are the people who also mislead themselves. Like, if you look at, and I’m gonna name-

– Interesting.

– I’ll name, a name. So somebody like a very smart guy, like Brett Weinstein, right, like he has grown a brand during COVID, he’s done all this stuff during COVID by saying certain, very contrarian things about vaccines. And his audience absolutely loves that. Now whether you know it or not, that capture of validation and views and money because there is there’s Patreon, there’s all the other stuff. It does, can capture you.

– [Vinay] Now, let’s think about like, okay, so there’s like three things, three tiers of capture, our three tiers we’re talking about. One tier is a speaker or actor is speaking or acting in a way for a very small but powerful audience, okay. So that’s why I’m saying that job might be falling into, or at least we should be cognizant that what our media, Twitter ecosystem is doing is creating such a potential. Like there’ll be a future person who will be working for whatever future president we have a Republican president, and they’ll be going on TV saying things that they hope they like. And, in fact, a lot of people, they accuse that like, that’s how Trump found them. They’re like, watch them on TV, right.

– [Zubin] And Dr. Oz’s been accused of that. He’s shifted a lot on his things that he said, based on-

– [Vinay] Now that he got the endorsement.

– [Zubin] Now he got an endorsement.

– [Vinay] He got the big, the letterhead.

– The big T.

– The big T. And there’s doctors who will like take money from Celgene and then say good things about Celgene products, and take money from Celgene. These are like very small entities with a strong, like, interest and they can capture this person with like a lot of money. Okay, so that’s one type of capture. That’s a capture like really most worried about. The next capture is the capture you’re talking about, like, this Brett Weinstein, this capture where somebody’s views may be pulled by, not just like, not by one rope, but by lots of rope, like thousands of people who happen to hold kind of view. And I guess the question I have would be like, one: you should always ask yourself, like, “Are you taking that stand because you feel like “the audience is pulling you there?” Two: if you took the stand that you really want to, might there be a different audience? Like, you know, you don’t have to keep saying the same shit you said yesterday to have an audience, you might find there’ll be different people who are drawn to you. And then the third thing is what I’m talking about, which is where I think, you know, you and I fall, is that we do talk about a range of different things. You know, like my show’s got all that boring bullshit that you don’t listen to.

– Hell, yeah. Yeah, and the boring I say is like, “Hey, let’s all meditate ourselves into oblivion, yeah.”

– [Vinay] And you have a range of different topics. And it’s shifted over your 10 years too.

– [Zubin] That’s right, it sure has.

– ‘Cause you weren’t into meditation that much back then?

– No, no, no.

– [Vinay] The audience has gone with you because in part what you are-

– [Zubin] At least some of them, yeah.

– [Vinay] At least some, right, and there’s different people. And so I think that’s very different. And it’s the same thing with like political donations. Wouldn’t it be more problematic if if it turns out that, like, I don’t know, Bill Clinton was entirely supported by big agriculture, he signed an agriculture bill, versus Bernie is supported by, you know, 1.5 million people who hold certain views, some of which you agree with, some of which you don’t agree with.

– [Zubin] Well it’s like Cory Booker, when they were talking about importing drugs from, reimporting from Canada or whatever.

– [Vinay] Oh, he took all that pharma money.

– [Zubin] He took all that pharma money because he’s in New Jersey, which is the big pharma central.

– Pharma capital. So I don’t like that.

– Everybody was like “What?” I mean, that’s direct capture.

– [Vinay] That’s captured.

– [Zubin] Whereas we’re talking about subtle levels of capture. Yeah. I mean, you know, I think that this is something that requires introspection to even think that it’s possible for you if it’s unconscious, Sam Harris is a good example of someone who does not get easily captured.

– [Vinay] Oh, it’s interesting, yeah, right. ‘Cause he keeps changing up his topics.

– [Zubin] Yeah. He changes topics, but he’s also quite consistent. His audience, because he’s a bit of an intellectual dark web guy, so he is a contrarian on a lot of stuff. When his audience, his audience then starts to enrich in these folks. “like what he found like this was a good example. He found that a bunch of real strong Trump supporters were starting to be in his audience because he was saying things like, very negative about Hillary Clinton, you know, he really doesn’t like the Clintons and he’s quite authentic about it. But then like his audience started being, filling with like these pro-Trump people.

– [Vinay] Oh, then he said something against them.

– [Zubin] Then basically said, “Listen, you guys, “you guys are idiots. “Like if you think this guy’s a good president.” And he just chokes that aspect of the audience and just tries to guide it to wherever he thinks it ought to be. Now that requires a degree of-

– [Vinay] Wait, and then let’s flip the whole coin because we’re talking about people who are in, sort of, the public space. But this is true even if people who are in totally in private space. Like I know like a doctor, who’s a researcher, they know if they say certain things or have certain views on certain issues, they’re gonna get more grant funding, that’s the hot, those are the hot topics.

– Equity.

– And they may be, that might be one. And I think there’s a lot of important things to do there, but I also think there are ways in which it can be cliched and repetitive.

– Sure, sure, sure.

– And not very productive. And, but even like stupid things, like, I don’t know, intercellular kinase, some bullshit that we don’t even, you know, they have like a strong point of view about it. Or genomics, that was a hot topic. And so they can become trapped in that. And then they very quickly can come to say things, that they’re like, “Oh yeah, I don’t really think it’s that promising, “but that’s where the grant money is.” And it’s a type of authenticity, they’re not an authentic scientist, they’re authentic, you know-

– [Zubin] Oh, so capture in academics and in research, absolutely.

– [Vinay] By what the journal likes. They’re like, “Oh, the journals like this, I’ve got to go “into that space.”

– Totally.

– [Vinay] Where the grant money is; certain tumor types or certain, even pathways or certain ideas. When Varmus was famously in charge of the HIH he discovered RAS, some oncogene. And he really wanted to drug RAS and there was like disproportionate funding to drug RAS than there was other targets, of course.

– I remember RAS.

– RAS.

– [Zubin] Yeah. Those tumor suppressor genes. Is that what RAS is?

– [Vinay] RAS is an oncogene.

– [Zubin] Oncogene that’s right.

– [Vinay] But they are also tumor suppressors.

– [Zubin] Yes, that’s right, it’s an oncogene, PP3 is a tumor suppressor.

– Correct.

– [Zubin] See, I remember nothing from oncology.

– [Vinay] And now you 50% the way there.

– [Zubin] You think I can get a grant?

– [Vinay] Those are very important.

– [Zubin] Oh, good, good, good.

– [Vinay] Well, here’s how you get a grant. You’d say like, “Our novel and innovative,” and put all this-

– That’s right.

– [Vinay] You’ve gotta put that LinkedIn word, vocabulary in there.

– That’s right.

– [Vinay] Get that LinkedIn vocabulary.

– [Zubin] That’s right. Actually what I studied in college for my honors thesis in genetics was integrin-mediated cell cell adhesion pathways, which were important in cancer. It was felt to be, yes. And so what we did was we mutated Drosophila fruit flies so that they developed blisters in their wings, which I would screen for. And then we’d run the gels on them to see if there were any integrin-associated pathway mutations.

– [Vinay] Hence your college nickname, Lord of the Flies.

– [Zubin] That’s right. I’ve got the conch piggy, I’m the one who speaks- “Lord of the Flies”.

– Where my glasses piggy?

– Where are my glasses?

– Oh!

– [Zubin] Oh, I’ve got the conch. Gosh!

– [Vinay] If you were a kid growing up today, you wouldn’t get that reference, ’cause you’d never a book.

– [Zubin] You know, it’s true. My daughter read “Lord of the Flies” twice actually, because she just thought it was so powerful.

– [Vinay] It’s a powerful book.

– [Zubin] Yeah. She’s a dark child.

– [Vinay] I don’t wanna read 1984 again, ’cause I’m afraid. I will see it in the mirror.

– [Zubin] Dude, it is bad news.

– [Vinay] Going back to the Ashish Jha, back to the story. So close this out. Close out the, so I guess the lesson is the first thing is, like, you’ve gotta be authentic. Two, you have to avoid like real capture. I think Ashish was in this problematic thing. I don’t know how he’s gonna do, but so far extending airplane mask mandate, I vetoed that decision. He was on Fox news yesterday, they asked point blank. “Dr. Jha, what do you think about masking young children?” And he said, “Oh, I trust the AAP and CDC “’cause they’re the experts here.”

– Oh dear.

– I said strike two. It’s not good because the WHO disagrees and the data is crappy. And I think he is smart enough to know how crappy the data is. So then it smells to me too political. We’ll see how he does. But I’ll be on him. If he does good, you know what, if he says the things I like to hear and that, by like to hear, I mean, like scientifically based and factual.

– Right, I was gonna say yeah, yeah.

– [Vinay] ‘Cause that’s what I like. Not like my point of view, which happens to be that. But if he says what I like, ’cause it’s factual and accurate, then he’ll earn my blessing.

– [Zubin] I like the word you said, which is authenticity. That’s what I like to see, I like to see authenticity. You can feel it in people. It’s funny, I think that’s part of the reason Trump for all his pluses and minuses.

– [Vinay] For all his pluses and minuses.

– [Zubin] He was Trump. You knew what you were getting there.

– [Vinay] Sometimes when he like says something, that’s like, it’s just what he was thinking.

– [Zubin] Yeah. And you’re like, you know, Americans actually do respond to authenticity.

– [Vinay] Especially when the, like the opposite candidate is like feels very inauthentic.

– [Zubin] Feels inauthentic. I remember when I was watching the debate, Trump and Biden and I was watching them both and Biden looked like a mask of a politician, you know, kind of reciting the stuff, and Trump was just there just being an asshole. And I’m like, “That’s authentically who he is, “he’s an asshole, “whereas Biden’s being this character.”

– [Vinay] And I honestly think that, like, I think Biden is worried that like in his youth he was more himself and he said things and then he like the quote unquote “gaffs,” and so he doesn’t wanna be there again. But I actually think that if he was really more himself people might even like him better.

– Like him more, yeah. Like him more. I think you’re right. There is an authenticity thing. And, you know, that word authenticity can become cliche too. But the truth is, you know, one of the things that, you know, my friend Angelo Dilullo says, a physician who, we do some meditation videos and stuff awakening videos, he says, something that happens as you go down the path is that you become more and more authentic actually. “You become who you are without filters more.” And it doesn’t mean you go hurting people by insulting them and saying exactly what you think and on, it’s just, you’re more true to what you are without all the obfuscation. And I think there’s something there.

– [Vinay] But I wonder if you think this, like, you know, that being able to be authentic in America in 2022 is a luxury that very few people get.

– [Zubin] Oh yeah, you’re right.

– [Vinay] ‘Cause like, let’s say you work in some regular job, you’ll not be able to have a podcast where you actually say what you think about anything. Remember that woman from Levis, they fired her, she was, did you see this article?

– [Zubin] No, I didn’t.

– [Vinay] She was like in line to be the next president of the Levi’s Corporation, and then she tweeted, it was originally covered in Barri Stack, “Substack”, and then it moved over to the “New York Times”.

– [Zubin] Barry Weiss.

– [Vinay] Sorry, Barri Weiss’s “Substack”. And she worked for Levi’s and she started tweeting that school closures was a bad idea. And Levi’s gradually put the squeeze on her, squeeze on her, squeeze on her and then fired her.

– [Zubin] Wow!

– [Vinay] And then she made, okay, a excellent point, which was that her colleagues were also tweeting on political issues, including George Floyd and things like that, but it was for the other side, presumably.

– [Zubin] Right, and they had no problem.

– [Vinay] And they had no problem with that. And then also I think school closure, really, the sides got flipped. It was the progressive of who forgot what their goals were and the philosophy is. Okay, so that’s another issue. And I think she identifies as a progressive too. And, but she was fired and I think like so many people, you know, ’cause I’m always, like, I always criticized social media. I’m like, “Look at all these anonymous, “these anonymous accounts.

– [Zubin] Like acc, yeah.

– [Vinay] Anonymous accounts. And then somebody was like, “Well, you know, you have to be anonymous, “if you work in my job. “If anyone saw any of these posts, like, you know.” So I do feel bad.

– [Zubin] Oh, that’s a, so this is a good point. Now this is talking about expressing your opinions on things and your views in a public space. But like even like the person working in that job, what if they’re authentically them in the job, meaning, “Okay, this is my aptitude and I am me in my most honest “expression in this space.” That’s probably 90% of the battle, that other 10% of like, “Well there are other beliefs and so on.” So it is interesting. ‘Cause in medicine, I think many of us are inauthentic.

– [Vinay] Of course.

– [Zubin] I mean, it’s just conditioned into us. “Don’t be who you are, be who they, “you think the patients want or who the administrators want “or who your boss wants.”

– [Vinay] Who the graders want. I mean, most of it, like the first 10 years are grading.

– [Zubin] Right, it’s all attendings. You’re just kissing the ring, right. And then the goal is like, “One day you’ll be the ring that’s kissed, so it’s okay, “just to kind of suck it up “and then you can inflict it on others.”

– [Vinay] Yeah, but then what happened was the culture changed and now that-

– [Zubin] Now you can’t even do that.

– [Vinay] No, no, no. Now that like people come up they I’ll question you so hard. “Hey listen, easy.”

– [Zubin] That’s true. That’s true. It has shifted. Now it’s like the attendings are targets, it’s like-

– [Vinay] Our generation, we like paid up and then we paid down.

– [Zubin] Yeah! It’s really true. I think that’s right.

– Paid a whole lot.

– [Zubin] We could probably get some understandable criticism for being a little hard in that way because we did have to pay up.

– [Zubin] We did.

– [Zubin] We had to kiss the ring, kiss the ring, kiss the ring. Now it’s less the case.

– [Vinay] I had to listen to say, seeple say, like things are really just factually an error. And I was like, “Oh, you know,” I have to think like, I say, like, you know, maybe you think about it like as polite, as I possibly could. They’re like, “No.” And I was like, “All right.”

– [Zubin] I’ll suck it up. Now that kid would like, they’d have a blog about how their attending’s a dipshit and, you know, and they’d get social credit for doing that. “Oh, you knock down, no, you’re speaking truth to. Power.”

– [Vinay] You know, I do think that they’re in for a rude awakening because everybody will eventually get older and then they’ll be knocked down by the newer. And, I think, we’ve already seen in some organizations that live on tearing down, they just get torn down themselves.

– [Zubin] Yeah. It’s a, you know, even the Facebooks and stuff like, their employees run the show in some way, you know.

– [Vinay] They’re all upset about Elon and Twitter and-

– [Zubin] Right. It’s like, dude, dude.

– [Vinay] Yeah. But back to, I guess, how does it connect to the Ashish? I mean, I guess I’d say that, you know, he shouldn’t have said that thing about the masking kids. I don’t know why he did.

– [Zubin] What we’d like to see is just honesty. You know, it’s funny if like whatever Leana Wen just said, if our public officials would have been saying that.

– [Vinay] I’d love to interview, I’d love to interview her because if you’re listening because she did a really a 180, in my opinion, on these policy issues. She was very, in December of 2021, she said, “We may,” I think she wrote an oped, “we may need to proactively shut down schools for omicron.”

– [Zubin] I remember that.

– [Vinay] And now she’s the other way around.

– [Zubin] Right. It’d be interesting to talk to her because I’d love to get also, and we’re connected actually, we’ve met before and we’re connected, but I don’t know her well, but I’d say that, I’d like to ask her about Planned Parenthood. What happened there?

– What happened there?

– [Zubin] I mean, I would love, but, you know, the thing is, again, like how much authenticity can a public figure actually show about these kind of things publicly?

– [Vinay] That’s always a thing. And especially if like there’s ongoing legal, I don’t know-

– I don’t know either. Yeah. Then you can’t say anything. So see this, and this is the thing you and I have talked about this, this idea of authenticity when you’re interviewing someone. Like I’ve had people on the show that will not be themselves, will not be the person they are before the show starts. They put on a mask and I effing hate that. I hate it so much that I will, it’s almost stopped me from an interviewing people to a degree, like how many interviews do I do? There’s a rotating cast of characters that I have.

– [Vinay] You find who you like.

– [Zubin] I find who’s authentic. Like, it’s you, like if Jay Bhatt wanted to come back on? I know who Jay Bhatt is. You may disagree with what he’s saying, but he is Jay Bhatt.

– [Vinay] And old man, Marty.

– [Zubin] Old man, Marty. Is this soup fresh? What’s going on?

– [Vinay] And where’d you get you juice? And the oranges come from?

– [Zubin] Are they free range, oranges?

– [Vinay] Florida.

– [Zubin] Marty, Monica, you Jay, these are people that I know are gonna be authentic-

– [Vinay] This is something that no one in the audience, unless you’ve actually done an interview show will be sympathetic to, but it’s really-

– [Zubin] It’s really powerful.

– [Vinay] It’s really powerful how true it is that like you, of somebody who doesn’t wanna talk and it’s so painful.

– [Zubin] It’s so painful. It’s like, you can’t get the time back for yourself. You can’t get the brain cells back, and you missed an opportunity, you feel to really-

– [Vinay] It’s like a woodworker and you get the delivery for the wrong product. You get the, you can’t even start, you can’t even do, you can’t even build a table. That’s not the right wood, instead of the-

– [Zubin] Ah, yeah, yeah, yeah. So why even bother. You know, ’cause I’ve had people tell me, “Z, why don’t you interview some more mainstream, “COVIDian voices and so on.” And I go, “Cause I know who they are. “They are not gonna tell you what they really think.”

– [Vinay] And that’s the other problem. And then I also think that a lot of people are like, this is another cultural thing where it’s like, “I don’t want to go on and be challenged about my views.”

– [Zubin] Yeah, right, yeah. Well then next.

– Yeah.

– Yeah, yeah.

– [Vinay] They’ll be like, “I don’t want any tough questions or right. I don’t wanna talk for more than 10 minutes.

– [Zubin] And the, yeah. And the truth is like, you know, I have all kinds of PR companies reaching out to me. “We have a perfect guest for your show. “They’ve written this in “New York Times” selling book.” And I look at it and I go look and I watch some of their videos. I’m like, “This is the most inauthentic piece of shit “I’ve ever seen.” And some of them are in, in spiritual circles too like big heads of like things-

– Really?

– [Zubin] Yeah. You know. And you’re just like, “No.”

– [Vinay] So then I guess the question I have is, like, what do you think motivates them? Like, I mean, I understand somebody who like, you can tell, they like, they have a point of view, they wanna get their point of view across. And, you know, and they are willing to be open about their point of view, that’s why they’re doing it. But what motivates somebody to want to be an influencer then not want to be themself?

– [Zubin] Yeah. I really think it’s a narcissism. It’s like a fake mask they put on to protect their own insecurity that they’re not good enough, you know. I mean, and look as somebody who continually suffers from general imposter syndrome-

– You do.

– [Zubin] Ah, I do. But, you know, and I’ve talked about this on the show, but I’d say that, I do and I don’t. I know who I am. So when I suffer imposter syndrome, it’s a feeling that I’m not doing what I, I’m not doing as good as I really should. Like, I know I can do better.

– [Vinay] I don’t think, that’s not imposter syndrome.

– [Zubin] It’s not true imposter syndrome. The true, sometimes I get real imposter syndrome where I’m like, “Dude, I have no business. “I can’t believe I’m asked to weigh in on this.

– [Vinay] Well, you know, I wanna push on this. I feel like a lot of people are talking to me about imposter syndrome. And like, some of them, I’m like, you know, you have imposter syndrome ’cause I was like, you got some stuff to to work on. I was like, ’cause you don’t know all the-

– [Zubin] The you’re actually an imposter.

– [Vinay] Well, yeah. I mean like.

– [Zubin] Oh, that’s a good point.

– [Vinay] I mean, I think people like, you know-

– [Zubin] I think it’s definitely the case.

– [Vinay] Yeah. Like I don’t know what to tell you, “it’s like kindly, but like we all, when anyone starts any field or any craft, you are not that good at it. You’re not as good as you could be. because you haven’t started it, from medical knowledge, you don’t know a lot to, I don’t know, even the art of the gab, you know. I think we do better than we did when the first time I came here.

– [Zubin] Yeah, yeah, yeah. It’s actually, we should link to our first interview.

– [Vinay] No, God, I’m terrible.

– [Zubin] No let’s not, let’s not, let’s not.

– [Vinay] You could link to it, I’m curious.

– [Vinay] But, whoever you talked to, one of them had a lot of hair.

– [Zubin] Yeah. You look like Bigfoot, it was great. It was pandemic

– I didn’t get a haircut like-

– [Zubin] Yeah, actually we did a Zoom interview even before that, didn’t we, about oncology.

– [Vinay] That was even, that was worse because-

– [Zubin] Well, we didn’t even know each other and we’d never met in person.

– [Vinay] And we should never have a Zoom talk.

– [Zubin] Zoom is the worst.

– [Vinay] I know, I’ve done. I mean, I do a lot of Zoom interviews, but it’s-

– [Zubin] You have to.

– Very technical-

– Technical stuff.

– [Vinay] Like on my, like we can have this but, Well, you and I of course, a rapport now, so we can do a lot better.

– [Zubin] But anybody in a physical space, the rapport goes up exponentially. It just goes up exponentially. Plus you get to hang out a little before, a little after in person.

– [Vinay] And the way the words fall on, you know.

– [Zubin] Absolutely. Like, you know, Offit is one of the only people I interview by Zoom now. And the reason I do it is we had an in-person back in the day and we developed that connection and rapport. If I didn’t have that and it was only Zoom, I don’t know that we’d have the same interaction.

– [Vinay] Well, I’ve interviewed a bunch of people because, like, to talk about their publication or something, which is more kind of structured. Now, what were we saying a second ago? Oh, on this imposter syndrome.

– [Zubin] Ah, yeah, yeah, yeah.

– [Vinay] So I guess the one thing I wanna tell people is like, who are suffering from imposter syndrome, like, yes, part of it could be like a misplaced feeling, but the other part is like, you could be potentially there’s room for you to improve and so you’ll feel more confidence. I think that’s true in medicine a lot because like a lot of people feel imposter when they just don’t know what to do next, you know? Or they think they know but they don’t really feel that confidence that they know because they may not, you know. And I think that’s part of, like, medical training. But then the other part is a misplaced.

– [Zubin] Yeah. Misplaced, yeah. There is a valley in sort of the Dunning-Kruger where, you know a little, you overestimate what you know, but then as you learn more, you reach that valley where imposter syndrome becomes real because you realize how much there is to know and how impossible it is to know it all. But then as your confidence improves, the imposter syndrome maybe, it’s made, there’s a component of it because you still know there’s more to learn. But you actually, you’re confident, but you overestimate what other people know? So this is something that’s been looked at, it’s like, they tend to go, “Well, you know, we don’t need to talk about “because everybody knows that.” It’s like, “No, they don’t.”

– [Vinay] I feel like I make that mistake sometimes in my videos and stuff.

– I do it, yeah.

– [Vinay] Assume. But you know, one thing I think about is like, especially with these papers on like vaccine safety and stuff, and I interviewed this woman who like, is like a specialist in it. And I was just like, “I see these people on Twitter, “and they’re like, you know, so critical of the stuff “that I’ve said about myocarditis and others. “And I just wanna say, you’re totally wrong.” I was like, “You’re totally wrong. “You should have imposter syndrome, “’cause you’re in over your head. “You dunno what you’re talking about. “You don’t analyze data like this for a living. “I don’t think, I think you have, “you you’re turning science into this like “popularity contest based on what “like your political friends think.” And I was like, “You’re doing such a disservice to science.” I was like, “Shut up.”

– Yeah dude.

– Is that bad?

– [Zubin] No, this is why that’s authenticity. That’s exactly how you feel about it because you do this for a living.

– [Vinay] I know, and I’m like-

– [Zubin] Yeah. You know, it’s like, okay. Okay, what do I do for a living now? I do this, right. So here’s when people tell me, “You ought do this on social media,” or you know, “you should do this or that.” I’m like, you have no effing clue what you need to do on social media because you’re just, you’re trying to move these icons and play this game, it’s not a game. The game is be your authentic self, deliver something people really want, and the rest of it just clicks.

– [Vinay] Well, like, at every academic, like medical conference, they always have a panel on like how to use social media.

– [Zubin] Yeah, those are the best.

– [Vinay] And they find people who like have no competence.

– [Zubin] Just the worst. Or these social media consultants.

– [Vinay] I know, it’s like, they can’t even get their own accounts to do it.

– [Zubin] I know it’s like PR companies, like what do you do exactly?

– [Vinay] I don’t even get it.

– [Zubin] Are you kidding? Like you cold reach out to random podcast host and try to get your dipshit guest with a terrible book.

– [Vinay] So sad.

– [Zubin] On a show that not even gonna reach the audience that matters to them.

– [Vinay] So sad.

– [Zubin] Yeah, it’s just, it’s really depressing.

– [Vinay] 10 Lessons for social media. And you’re like, “Who is writing this?”

– [Zubin] “Four reasons children are mentally ill.” Oh wait, I just did that.

– [Vinay] Oh yeah, no.

– [Zubin] No, it’s true, it’s true. And, I don’t know, again, it cuts to just get good at something that you know is authentically what you care about and then talk about it and be you.

– [Vinay] And talk, be you. And then, and also, and don’t have anxiety about things that are like so far outside of your ability-

– [Zubin] The world.

– [Vinay] The world, you can’t be, I mean, I’m anxious about those like four to-do list items I have for today, and the 4,000 I have for this week-

– [Zubin] There’s something to be said for proximal busyness-

– Proximal?

– Yeah.

– [Zubin] You know, just get busy on something that you care about. Oh, that reminds me of the kids’ mental health thing. The kids are so overscheduled, and overstructured, they’re doing a bunch of activities, that was the other piece, to get into college that it’s this arms race, mostly among affluent people, like Bay Area, it’s exactly like this. They’re all hyper scheduled, they have the soccer and they have violin, and then they have a Spanish tutoring and they have this. And so the kids are like in this weird bubble where they actually quite lonely and overworked and underslept, but they’re not actually doing anything that’s of value at like free play or going out and socializing with kids in the neighborhood until the street lights come on, where they learn like real skills, like how to deal with a bully or how to, how to properly bully others. Vin, I like, I learned that early on. Like, “I don’t care if I’m short, “I’ll bully the crap out of you. “I’ll find what’s weak about you “and I’ll just power a drill on it.”

– [Vinay] It’s a gift honed with time.

– [Zubin] It is, it is.

– [Vinay] All right, I gotta run because, and I hate when people say that at the end of the show.

– [Zubin] No, but it’s true.

– [Vinay] But I do have to run because this person wants to have a phone call later.

– [Zubin] Ah, I think we actually did a thing though.

– [Vinay] That’s good.

– [Zubin] Yeah. This was fun.

– [Vinay] We hit all the things on my little list.

– [Zubin] Yeah. Look at that little thing. See, ever since I got this little pad, the show has gotten structured-

– [Vinay] Went up a notch.

– [Zubin] It went up three notches and my imposter syndrome just plummeted through the bottom.

– Plummeted.

– [Zubin] Now I’m full Dunning-Kruger.

– [Vinay] We should talk more about this imposter syndrome, anxiety.

– [Zubin] Yeah. We’ll do another show on this.

– [Vinay] Another show on these kids. ‘Cause I always think, I was also thinking like all these activities I see young people do. I was like, you know, the moment you turn like 22, you’re never gonna do any of those things again.

– None of it.

– [Vinay] I love soccer, but it’s been 15 years since I even played-

– [Zubin] I played clarinet in middle school. Don’t do you think I’m gonna play a clarinet now?

– [Vinay] You’ve got to cut that out. You gonna admit to, clarinet!

– [Zubin] I do.

– [Vinay] Why you play clarinet?

– [Zubin] This one time in band camp, dude, it was bad, I was a huge nerd man. But anyway, I continue to be. Guys, you know what to do? This is the VPZD show, I’ll put it out on the channel, but you’re gonna put it out on Facebook. I’m gonna put-

– [Vinay] No, no, maybe you put it, well we’ll see, we’ll see, we’ll see.

– A well we’ll both do it we’ll both do it, we’ll both put it out, and it’s gonna be on the podcast. Subscribe on your favorite platform. Leave a review, it helps us, you know, beat out “Hidden Brain” with what’s his name?

– Shankar.

– Shankar Enjeti. Is that his name?

– [Vinay] No, Shankar Vedantam.

– [Zubin] That’s right.

– Saagar Enjeti.

– Saagar Enjeti.

– [Vinay] Well, I’m the biggest Saagar fan.

– I love that dude.

– Met too, I love Saagar.

– [Vinay] I love “Breaking Point”.

– [Zubin] “Breaking Point” is great.

– [Vinay] “Hidden Brain,” no comment.

– [Zubin] Yeah. I don’t know. I just don’t listen to it. We love you-ish, and we’re out. Peace.