Doctor Mike
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Wondery Plus subscribers can listen to Armchair Expert early and ad-free right now. Join Wondery Plus in the Wondery app or on Apple Podcasts. Or you can listen for free wherever you get your podcasts. Welcome, welcome, welcome to Armchair Expert, Experts on Expert. I'm Dan Shepard and I'm joined by Monica Padman. Hello there. Hello. We have YouTube's number one doctor, 25 million plus subscribers. Oh, wow.

Sexiest Doctor Alive 2015 People Magazine. Huge accolades. Sexy Doctor Buzzfeed. Doctor Mike. Doctor Mike. I love Doctor Mike, as you'll learn in this episode. I discovered him through my children's obsession with him. He makes the best videos. It's the only YouTube stuff I love when they watch. He also has a podcast called The Checkup with Doctor Mike.

So listen to that. And just, I challenge you, go watch one Dr. Mike video on YouTube and you will just stay and watch them all. He's very charismatic and very interesting. Has a lot of knowledge. Incredibly smart. Yeah. He does these kind of mashups too where it's like the videos you already want to watch, like trampoline injuries. Oh.

And he'll pause and go, ooh, okay, I think that's going to be a femur. Oh, smart. That's funny. Yeah, yeah, yeah. He's lovely. We love Dr. Mike. Please enjoy Dr. Mike.

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No, no, it's good. It's good. As long as you think it's okay. You like it? Yeah. That's comfortable for you. Yeah, I'm the guinea pig guest. I like it. It's a guinea pig, but an expert as well. I know, but you should tell us the problems. Feel free to tell us all the problems. Well, just any problems you see, shine a light on. Okay. Medically or not. I deputize you to be hypercritical of us. Okay, deal. God, you're so cute in real life too. Oh my.

I appreciate that. It's impossible. Did you see how tall he was, Monica? Yeah, I said and tall too. Have you ever added it up? How many hours of content you've created at this point? It's like 800 videos. And they're generally how long? 10 minutes. But then the podcast up to three hours at times. If you and another doctor get geeking out. Geeking out. I like to debate. I'm like you. I love that stuff. I love getting into it and

finding disagreements because I feel like that's a great way to find truth. Yes. I'm a fan. Also, do you find that a great source of fuel is a debate? Yeah. In fact, I had another doctor on and we were arguing about Eastern versus Western medicine. And I was talking about it and I was getting excited and he took it as aggression. And because he's in the psych space, he said, hold on a second. What are you feeling right now? Oh, wow. And I was like, wow, this is like cool. I'm being terrified in the moment. Yeah. I said, I'm excited.

He goes, are you sure you're excited? Not angry. I'm like, no, I'm excited because we're truth seeking together. And when that happens, I get really, really in the zone. Okay. Well, we share this not only now the height, but also that I have been accused many times. My wife will say to me, she'll go, pause. You're very large. Does that ever get told to you? Like, yes, sure. You're arguing with the same veracity as everyone else, but you're very large and you've got to kind of remember that. And I don't always remember that. Yeah.

Are you loud too? That is a factor. How's your volume? Generally not with my dogs, yeah. Like I try and be that stern parent with my dogs. Sure. Yeah. Although that's been a little disproven with animals and such. Ooh, wait. Oh, this could be our first debate. I mean, I'm not an animal expert. I want to hear about it. A lot of this debate comes from definitions and people arguing about what words mean. Vocabulary. Semantics. Yeah, semantics. So the idea of being an alpha in most people's minds is about like dominating an animal. Yeah. Yeah.

Is that you? Well, anytime I use the word alpha. Yeah, but when I use the word alpha, I think for her, we have different definitions of it. And she regularly am I speaking correctly for you that you do interpret that as like almost a bully is an alpha. Sure. Maybe that's fair. But I think when we're normally talking about it, you're talking about a hierarchy and you're saying this person is an alpha person.

Fair.

Fair. And that's different life experiences showing themselves through a definition. Also, just what I studied in college, which is primates and social primates and the hierarchy. And yeah, these roles that intuitive and primitive and evolutionarily came about. They're there. Yeah. In different species. So wolves have a different meaning of hierarchy than primates do. And I'm not an expert. Well, kind of an assumption. Maybe you will. But I will say from a human side of things, especially as it relates to dogs, it's

To me, an alpha is the dog should look for you to guide it because you know more. You know that if it's eating something that's going to make it die, the dog should look for you to be the leader in that situation. That's my understanding of what an alpha is. Yes. And also...

I think you could say like, oh, if there's an alpha there, someone's being subjugated. But I would say like for the dog, it puts them at great ease to know what that is. If you're intermittently an alpha with your dog and then sometimes you're not, I think it's confusing and a source of anxiety. It can be, yeah. It's all about a balance. And I feel like that we're going to get back to that balance all the time throughout this conversation. Because if you overdo the alpha thing, then you're becoming dominating and mean and rude to your dog. And on the other hand, if you're too loose, the dog can develop anxiety. So it's finding that right balance.

Well, isn't that life? It's the nuance between the binary and everything we're presented is binary. Especially on social media. Yes. As shocking as this may be, some people won't know about Dr. Mike. And so I want to bring them up to speed of just how enormous you are. And of course, my own personal journey with discovering you through my daughters, which has been delightful. In general, I can't stand YouTube. I hate when they're on YouTube because it's so quick and it takes you to the next thing. I don't love it. Please subscribe to us on YouTube. Yes. Well,

With the exception of Dr. Mike and now us. But when I walk in and Lincoln's binging you, I'm like, go for it. Keep going. And she'll be policing everyone around the world. Like that's pseudoscience. That's not ever been. Oh, my God. That's a great word. Wow. Oh, yeah. In fact, Kristen got this. Maybe she already told you. She got this neck stretcher. She saw like it was advertised to her on Instagram and it arrived. And Kristen was excited to use it. And Lincoln goes, Dr. Mike says those are not good for your neck. Oh, my God.

And Kristen, listen. Yeah, well, I would too. So tall. The goal of the whole YouTube channel is just to give practical, realistic advice in the age where everything is binary. It's either all good or all bad, or this is the miracle, this is the cure-all. And that's just not the reality, and medicine's so imperfect. So I hope that nuance is translated. Do you know your demographics for your audience? Yeah.

Does it shock you that my daughters are at that young age? No, that's like 15% of my audience. Okay. That age group. What is the breakdown? Actually, a lot of people will make an assumption and say, oh, the good looking doctor guy, you must have a only female audience. It's 50-50. No. It's actually more, I think it might be like 60-40 male. You have such an interesting history.

And I just want to start by saying, do you know anything about Mila Kunis? I know that she's of Ukrainian background. And she came here at roughly six. Same age. And just had to plop into an elementary school and figure it out. I think that's a character builder. I think so. I think anytime you're entering an unfamiliar environment, especially to that degree, where it's like, you don't know the language, your parents have to start from scratch. That's a shocker for most people. And obviously very motivating to see your parents go through something like that.

Yeah, so your dad is Ukrainian, but he went to medical school in Moscow. Near Moscow. But was it called the Third Medical School or something like that?

You can say that. Anytime something is the third, I get nervous. I know! Everyone starts gristling. Keep it out of the title. Don't say that. It is the third. But obviously he was a practicing doctor in Russia where you grew up until five. And mom was a mathematics professor? Yeah, PhD mathematics teacher. Yeah, if you hadn't done well in school,

I had no one to blame but my mom. Oh, my God. Talk about getting set up for being bright. Do you have brothers and sisters? I have an older sister. And was she brilliant, too? She's done the entire world of medicine, it seems. She's a physician assistant.

But then she opened up like a cryotherapy place. She kind of went the opposite world that I'm in more like holistic wellness and I'm medical medical. I want to be at that Thanksgiving dinner when you guys start talking about. We definitely get our fair share of arguments. You just said medical medical on Grey's Anatomy. Yeah. When they write scripts and they just don't know how to write any of the medical terms, they just write medical medical. Do they? Yeah. In the script. And then they are going to have the expert consultant figure out what that is. But the writers just draft that in. They type medical medical.

There's a famous example of that getting on the air. Do you remember that? No. Not that exact thing. Like the Starbucks con? No, it was like an episode of CSI. The Game of Thrones? Yeah.

Wait, there's a Starbucks cup in Game of Thrones. Guess where they left the Starbucks cup in? It was like a CSI or something. And the line was, reveal important new fact of case. Something that nuts. And they just said it. And everyone there was like, year 11. And no one was paying attention. And it made it to air. And I think that's so fantastic. That is great.

Okay, but mom and dad leave when you're five. Your sister's 14? Yeah. You come to Brooklyn, refugee status. What did dad do when he landed here?

Start taking English lessons because he ended up in medical school a year after that really and so he had to recertify himself to practice medical school residency in a new language in his 40s Oh while my mom is basically sweeping floors to make ends meet. Oh what character right? I try to think what would have to happen to me in the next five years and

Then I have to leave America, go to a country where I don't speak the language and redo all my education. Do it all over again. I wouldn't even know. No. What was it? They were sort of predicting what's happening now in Russia. They saw that corruption was at an all time high. They saw religious persecution was terrible. And y'all are Jewish, right? My father's Jewish. My mom is Christian Catholic mix. Because of having Jewish background, people would treat you differently.

That was the reality that my father grew up in. He couldn't be promoted to certain ranks within his jurisdiction of healthcare because of that.

And they were like, we need to get out of here for the sake of our children. Yeah. You were born right when I suppose the wall fell, right? Yeah. You were able to watch your dad practice medicine while you were still a kid, which I think is probably really relevant. Yep. Was he like a superhero? To me, it was so exciting to see the learning process because most kids aren't of age where they see their parents go through school. Yeah.

And I watched it and I watched him study and I saw what he was studying and he would be leaving his textbooks open. And I would say, oh my God, I want to know about that. Why does my muscle cramp up when I'm in Taekwondo or some sport that I'm playing? And

I fell in love. I was like, I have to learn more about this. And I actually got the nickname Dr. Mike when I was in high school. Because all my friends would come to me as if I knew shit. And would say like, hey, I did this to my knee. Like, what do you think I should do? And I'm like, oh, well, my dad always says. I'm sure you weren't short with advice. Definitely given way too much advice. Were you precocious? Problematic. Yeah. So one of my... We got to fast forward so then I can double back up.

- Uh oh, we already have a huge problem. - Look at this, Rob. - That never happens. - Rob, you can come fix it. - I mean, I fixed it. - We just need a new one. - I kind of want Rob in the shot for two seconds. They look alike. - You think so? - Yeah. - That is so flattering. You don't really think so. - Not you. - I'm sorry, I'm sorry, I'm sorry. Oh no. - Yeah, Rob, let's see. - Rob and Dr. Mike look like brothers.

Are you a Russian background? Polish. Oh, so close. And my last name is Polish background. Maybe we should do some genetic testing here and figure this out. I'm sorry. Oh, that was a bummer. I got so excited for half a second. I know. Okay, you also look like him. That's enough. From the back, poorly lit. You guys could have the same silhouette. Yeah.

Okay, so we have to fast forward a little bit. You go to medical school. You have this accelerated program through New York Technical Institute. New York Institute of Technology. Really close. You decide to start documenting it on Instagram. What made you think to do that? I can, after the fact right now, create some really good stories. Yeah, tempting. I thought that it was cool to share a med student's life.

Yeah.

So there was like things I took advantage of and I said, oh, let's keep putting stuff out and see what happens. And then I had one of those viral moments where BuzzFeed writes a story. Check out this sexy doctor, 2015. And then people names you sexiest doctor alive. Oh my God. Which is an interesting distinction because a couple of things. Does that imply that there were much hotter doctors that are now dead?

Who are those? That are no longer alive. Why alive? I think I took Sanjay Gupta was the sexiest doctor alive before me. He is sexy. He is sexy, but also poor Sanjay. Why poor Sanjay? This young buck comes along. Oh, replaces, replaces. Yeah, that is sad. Sanjay has been on the show several times. We love him. We're friends. He's from Michigan. He wasn't a heartthrob in high school. That's all I'm going to say. So he had this great title. I wasn't either. That's what I was saying. I got to set this up so I can go back.

back and just find out, was this a complete revelation to you or were you killing it in high school? No, I was nerdy in high school and didn't get a lot of female attention. That was news to me in that regard. But then in college and medical school, I started coming into myself, getting into fitness, weightlifting. Were you super skinny in high school? Very skinny. What kind of weights were we?

so skinny where i remember going to the beach with a girl that like i like yeah and i was like she's gonna like that i have a six-pack and instead she goes you're all skin and bones and i'm like oh that's the last thing i want in a year so after that i said i'm gonna start working out real hard that's hurt my shoulder and you know the typical thing formative events try to bench press way too much first time out exactly literally i gotta put on some muscle mass tomorrow yep

Okay. So then that's really fun to have not been a stud in high school and then get named all those things. It's messy because then it starts going to your head a little bit. Yeah, yeah, yeah. And you start like, oh, yeah, I'm going to start writing inspirational quotes right now because I actually know stuff. Oh.

So I started doing that. And then I got like 30 likes on those quotes. I would show them to people and be like, look at this. Life's not just fun and games. Oh no. Well, that's the problem is if you haven't had the full experience leading up to that moment, this plagues actors who get on TV and movies. And then overnight, all of a sudden they're very attractive to everyone. They have no practice in dealing with that. And they write inspirational quotes. Wow.

that was also the era of inspirational quotes like twitter what was twitter in its early days people saying they're in the bathroom or writing an inspo quote we're trying to be funny that was a big there was a bit of did you have a favorite inspirational quote that you know they were all i mean you were stealing them from other places i wasn't stealing them i'll give myself credit i did not plagiarize but they were not anything revolutionary they were not anything new there was no innovation i'm gonna pull some up for the

fact check. Stay tuned for the fact check. Do they exist still or did you go clean that up? They're still there. Yeah. God bless you. You gotta leave that stuff. A lot of integrity. Okay. So that's taking off. Did you have any show busy fantasies growing up? Not really. I wanted to do athletics, which is why the whole boxing arc happened. But doing the seven year program that actually precludes you from participating in NCAA sports.

- Why? - Because of the number of credits you're taking. You're not allowed to participate. - What would have been your sport? - Probably soccer. I played soccer well in high school and I really wanted to play that going into college. - Oh yeah, you have nice thighs. I'm checking them out right now. Yeah, they're solid. I've worked so hard to get mine about 70% that size. Your first year of medical school, your mom

Gets cancer or perhaps she had already had a little bit. Yeah leukemia Yep so she what had a phase of it and then went into remission the way that it happened is my parents when they first found out they hid it from us and they kind of kept us in the dark Oh mom sick, but you know, it's no big deal and I'm focused on school Then they told us that she has this cancer that actually people live to old age with and it's not something that actually cuts life short and

And then we started seeing her get sicker and sicker and sicker. And we realized she has a unique variant where in her case, it is problematic. And she needed more extensive treatments, which meant that we had to fly her brother in from Russia, do stem cell transplants, bone marrow, all that. And that's an intense process because you essentially have to destroy one's immune system and replace it with a sibling's. Yes. And that was really what ended up making her lose her life.

How long was that? Let me also say, so my dad died in 2012 of small cell carcinoma. So I had that experience and that was very truncated. That was like diagnosis in August, dead on December 31st.

And then my stepfather had prostate cancer and he died, but he died over the course of, I guess, you know, two or three years. And for me, having gone through both of those experiences, what I learned with my dad, I

that I was able to apply to my stepdad, which is like, first and foremost, it's their thing. They get to decide what they want to do, what treatment they want or don't want. And fighting that at the end is such a waste of time, like regret fighting with him about decisions he was making. But then also dealing with oncologists was an interesting experience. And

I think I walked away thinking, you got to remember they're very myopic. They have almost a single goal, which is to kill cancer cells. And they're not terribly holistic about what it's going to do to every other aspect of your life and your body. Practitioner dependent, right? Sure. The specific example that happened was my dad was so late in this, and there was cancer everywhere. He had it in his bones. He had it in a lot of organs. He had it in his brain. And an oncologist came and said, I'd like to do brain radiation. And I'm like,

I mean, he's going to die of cancer soon here. Is that worse to die of that? Is that the one we should try to arrest? I told my dad, I don't think you should do this. He's like, I want to do it. We did it. It had some pretty major side effects for his cognitive function. You know, ultimately, in retrospect, I'm like, well, that was really a dumb idea. And then three weeks later, he was dead. So maybe in that anecdotal example, I thought, well, yeah, that guy's job is to kill brain cancer. In the correct sequence of events, when a doctor presents a treatment,

it should be presenting treatment A, B, C, and D, no treatment, and discussion of pros and cons, and then allowing you to make that decision or a loved one to make that decision. Healthcare has changed in that regard where now in our education, we talk about the team-based healthcare approach.

where sometimes I'll make an outright recommendation to a patient and then say, how do you feel about it? Do you want to do that? Do you have any concerns? And then we could talk about those concerns. In other instances, I say, look, it's not even clear cut what to do here based on the evidence. So we can do option A and here's the pros and cons of option A and here's option B. And they'll say, what would you do? And I'll say, this isn't about me. Let's talk about this with your family. I can give you more data, but

It shouldn't be me deciding. So I think we're all very curious. When you ask your doctor, what would you do? And they generally do not want to advise you. Is there anything like with HIPAA that they're not supposed to? Well, it's not HIPAA. HIPAA is patient privacy stuff. I think from like a doctor ethics perspective,

You want to respect one of these tenants of our care called bodily autonomy, where we don't tell you what to do if you're a competent adult with your care and you're not a child, you know, those kind of specific situation. When patients ask us that question, it's essentially making us tell them what to do.

So we want to not be biased in that regard. We can make recommendations and say, this seems to be the better play. I could say, based on what you told me is important to you, this sounds like it's a better option for reasons A, B, and C. How do you feel about it? And that's the correct way. Does that happen in every single doctor interaction? No, unfortunately not. Also, because then it becomes biased.

personal. If you ask, what would you do? I think it'd be hard to be medical and professional. You then become you as a real person, which is maybe not ideal in that scenario. Because you have different wants and needs for what the patient has. And from the patient point of view...

Of course they want to know that, especially if they trust you. You're someone that they trust and seem to be objective. And so you're looking for some guidance and it's very tempting to seek that advice. We've had Atul Gawande on and I think his take on what do you want this experience to be? What are the goals in this last few months? Do you want to walk around? Do you want to do this? You should know what the goals are before you figure out what the...

strategy is. And that goes for not just end-of-life care in a situation like that. It also goes for something as simple as back pain. When people come in and they say, look, I have back pain to two out of ten, I can introduce various interventions, but some of those interventions have side effects. Then we have to explore, is it worth going and pursuing some of these avenues or

Or are we trying to get to a number that's not realistic, A, B, has way more risk of harm, and C, what's the benefit? Like if you're a pro athlete and going from two to zero is gonna change your livelihood, maybe it's worth it. But if you're a person who's like, it doesn't really stop me from doing anything, it's just kind of annoying, well then the options radically change of what we should do. And I think that's the important pros and cons weighing of patient individuality that we need to take into consideration.

So, okay, now back to mom going through that experience. Did that at all impact how you personally view that process? I think the biggest thing that changed for me in that regard was the moments where she passed. So I remember very vividly, we're in one of the big cancer centers in New York. The alarms start going off. The residents run in to start doing chest compressions, which is something I talk about on my channel a lot. And they're like, I think we should stop.

And I understand why they're saying it because I'm already a med student at that time. I see the medications that she's on. And my dad is in disbelief, even though he's a doctor. Yeah. Totally not rational. That's what I mean. You can't be. She'll be fine. It's okay. Have him keep doing it. I saw that it was too far gone. So I actually was the one who had to tell him to stop. Yeah. And just seeing how that whole process played out, watching my father go home alone and then not know what to do. They had a trip planned a week later. Yeah.

And the nurses laughing at the nursing station after, not about my mom. They're humans. They have stuff going on in their lives. They have death all day in the ICU. They need to laugh, but like hearing it gets you angry. And especially like you're waiting for some paperwork or something. So then when I was a resident, I remember having some of my colleagues laughing about something unrelated. And I'm like, just make sure the parents don't hear you because they're in a bad spot.

Yeah, yeah, yeah. That's a life experience thing that you can share with others. Do you think it was uniquely brutal on your father to have been someone... I mean, look, we all want to solve our loved one's problems. And if you're an expert in some area and even you are powerless, I just feel like it must be compounded so much what he went through. It was compounded, but not for that reason. He had the worst year that I can imagine having as an adult.

He just gave up his whole life to come to another country. He just got on his feet after going through medical school and residency. He opened his own practice. He bought his first home. He's so happy to share this moment with his wife and family. His dad dies. My grandfather dies. That year, his mom dies. My grandmother dies. Three months apart. Within a year, my mom dies.

Fuck me. This is not tenable. And there was other stuff going on too, which makes it even worse. But it was just a lot to witness a person go through all that and still be like, I'm going to work. I'm going to work.

I'm showing up for my patients. This is terrible. I'm going to deal with it, but I need to show up for my family. Well, they're probably the life preserver, the patients to have that. Oh yeah. And I've seen that as well, where people are like, why are you still practicing medicine when you have such success on social media? I'm like, are you kidding me? That's the joy. Right.

That is by far where you get the most refilling of your cup. And meaning. Yeah, exactly. Well, you just stole one of my questions for later, which is like, at what point do we just do the YouTube? Can't do it. Yeah, yeah. And Sanjay, he still practices. Yeah, yeah. You're the heir apparent to Sanjay, I would say. I was just on his podcast. Oh, you were? Yeah, chasing life. He just couldn't be more delightful, right? Yeah, he's lovely. And it's great to see someone in the healthcare space who's so successful in media who hasn't sold out to the bullshit. Yeah. Because, man.

Everyone. So easy. Yeah. So easy to do. Like even some of the big names on YouTube. Well, I was even thinking you have this incredible YouTube channel. There's 25 million followers or maybe there's more at this point. But monetizing it for you is so much trickier than for us. We're not...

trusted medical professionals. It's called armchair experts. Exactly. The armchair is very imperative in this. So yeah, we're free to talk about really anything because it's just two bozos talking about anything, but it must limit. Well, it limits it because I understand my word carries different value to people and I don't want to take advantage of it.

So I stay away from all of that medical promise of solution. When does the Instagram, you start that in 2012? Yeah, right. And then 2017, we start the YouTube channel? Yep. Yep. So how do we transition from documenting your life, getting followers, going to nightclubs, it's a party, to maybe more mission driven? Or at least what I interpret your show to be and why I love it is you're largely focused

doing what my favorite person on Instagram, do you know Lane Norton by chance? Of course. Did you just saw my podcast as well? Yeah. Literally, we were texting two days ago. Oh, yeah. Isn't he the greatest? Yeah. Yeah, I love him. So you're doing that. You're debunking a lot of these popular ideas about diet, medical treatment, supplements. Yeah, there's just like two worlds that exist right now on social media, and I tried to bridge the gap between them, which is world one,

It's complete BS, fear-mongering, scaring people. And then there's this world of hyper-optimization where it's like the promise of getting bigger, faster, stronger, longevity, anti-aging. And I'm like, this is BS, both sides. Here's the reality. The people that are doing the hardcore research that no one knows about, they're nerdy. They're not great on talking on camera. Right.

To be honest, they should be delivering my message because they're the ones that are the experts. Yes. But what I can do well where I found my skill is taking their knowledge-

their confounded, complicated science and translating it to the general public so that we have a chance against the people that are spreading the misinformation to confuse folks. I hate to admit on that spectrum, I'm definitely in the camp on your right hand. I'm like, yes, anything that could possibly make me more fit. I'm going to listen to you. Well, tell me why. Why do you like that? Attack. Attack. Attack him. Out of him. I love muscles. Okay. I fucking love muscles.

Love muscles. Mike, can I call you Mike? Yeah, please. No, please call me Mike. I'm happy to do it either way. Mike, I love muscles. I've loved them since I was a kid. Conan the Barbarian. I'm so much older than you, but had you been my age and you saw Conan the Barbarian, I promise you would have made an indelible mark. Well, I watched Xena and Hercules like when I was growing up. I would try and lift the couch. Yeah, were you inordinately attracted to that? Yeah, of course. Yes, I just love muscles. I am a expert on people's bodies. I can tell you like Pete Dennis Rodman. Okay. Body. Mm.

This is my night scene. Okay, you're a Renatula. I feel like I go toe-to-toe on male physiques with anyone. I'll give you that. What was the best Brad Pitt? Like the Troy, right? Well, so that's one look. Or Fight Club. Fight Club is very, very lean. He's probably like 135. Every time I would go to a personal trainer, I was like, this is it. That's what everyone says and no one realizes he's like 135 in that movie. I think what I like most...

maybe a emotional philosophical thing is you don't pick your face you come out you got this face you got this nose you got whatever you got well these days that's not well that's true and i'm not above pursuing options a lot of items on the menu customization these days is high this room has some of that going on i'll say it this side of the room has a new one

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When I know I can change something, I'm really drawn to it. So the notion that like your body, you have a lot to say and how you look. I have looked so many different ways. My body, my face has been largely the same, but I kind of love that. And I'm like a goal oriented person and I'm kind of a militaristic routine person. And I like the sense of control it gives me. I like to be able to observe results.

I love it. I'm not sure what the finish line is. - But that sounds like a positive thing. - Yeah, yeah. - But it also sounds like you're defending it a bit. - Well, you asked me why am I so obsessed with muscles, didn't you? - No, I said, why are you so much on the camp of the right side of living forever and anti-aging and all that? - Well, first of all, I don't wanna die like everyone else.

Every one of my family's died young. So I think I'm even more incentivized to figure out how to at least add a decade to this. My dad was 62. That's not going to work for me. I have a much different lifestyle. Yeah. If I hear creatine, I will remember where I'm sitting when I hear about creatine, right? I'm in a science class in Santa Monica City College in 95. I'm like, wait, there's an over-the-counter supplement that gives you 11% more body mass or it was promised at the time. And I'm like, fuck yes, I'm going to try that.

And then also I started doing testosterone six years ago and I'm like, oh my God, I fucking love this. This is fantastic. I can't imagine you're super pro testosterone. We'll find out. No, I mean, it depends. It depends.

I'm a 900. I'm not going to 1500. Yes. But also when you're starting, it matters. And for what purpose you're starting, it matters. So there's like a lot of nuance that needs to be had in those situations. But I feel like what happens on social media is bro says he was depressed.

Bro says his gains weren't as strong as they were 10 years ago. Bro's taking TRT. Then comes on my podcast and says, I'm taking TRT. And I'm like, oh, were your levels low before? And he goes, no, they were normal. I'm like, then you're not taking TRT. You're just taking supplemental testosterone, which is not TRT. Yeah. That's the hyper-optimization that I warn people against. For sure. And look, I like to think I'm pretty objective about it, but like there's a cost benefit analysis to look at.

And there is a, do I want to live to this age feeling this way? Or do I want to live, you know, a little bit less than that and feel this way? You know, are you all about longevity? Are you quality over quantity? These are like philosophical questions. Well, those are important questions. My thing that I always like to introduce into these conversations is how much we don't know. Even with testosterone as an example, the idea that if you take it, you will feel a certain way is just not true. I mean, testosterone.

to add you have a very specific look on your face no it's the reality of your personality you're also an addict you're an addict and that side to me leans a little more addictive where you know you do the sauna and you eat this very specific thing and there's a challenge to it

that I think you feel good if you've mastered that challenge. Yeah, I would argue that it's a replacement for what another addiction might be. And this one so far has been largely beneficial. That's what life is. What's healthy to eat? It's like, well, what are you replacing it with? Right? That's the real question. So if you're replacing an unhealthy habit with this habit, maybe that's good for you as a form of risk reduction. When we used to say the only way to prevent STDs is abstinence.

People were like, yeah, we're not going to do that. And then SED rates climbed and they were like, oh, what about condom use? We continued risk reduction and understanding how it works with human biology. So in this case, what works for you, great, could work for you and it could be a totally healthy coping mechanism. The thing that gets complicated is when we talk about it in generalities and on social media and how a lot of podcasters, not you, talk about it. Yeah, yeah, yeah.

They talk about it as like, I have the solution. I'm the health guru. - I'm never promoting it. Mine is, I need to be honest. If you look at me and I'm 49 and I have this muscle mass, I need to include like, yes, I'm eating this way and I'm working out this way, but also I take testosterone. I would feel dishonest to not be owning that.

By no means am I promoting it. I don't think dudes who've not had kids yet, if your numbers aren't low. Yeah, I'm not on a promotion. I will listen to all of it. And then I think I'm pretty skeptical. So I'll run it through a little bit of a... Okay, so we didn't really answer that. When did you feel the exact transition to like it being lifestyle and then turning into kind of a mission driven, I'm going to debunk stuff and educate people? I always wanted to have value from this moment. The viral moment happened and it was all about looks and all that. And I was like...

Well, how do I move that into something meaningful? Because I'm getting this education. Also, your looks are going to go away. That's true, too. And your quotes, you only have so many. That's what I'm saying. You're going to run out. And I would sit there and I would say, like, what can I do with this? And initially, what can I do as a resident? So I auctioned off a date for charity because I was like, oh, that's like a helpful thing. And we gave six figures to charity. Wow, that's so cool. How was that date? Hold on, hold on. It was really awkward. We need all the answers!

Oh my God. We need all the info. I just imagine my dream date doesn't bid a lot of money to date me. It wasn't a sum of money. You had to buy like a lotto ticket. Oh, well then that opens up the door to all kinds of. Yeah. Cool. I just didn't know what I was doing. Right? Like you're starting out with popularity and you're like, I'll do something for charity. That sounds positive. Yeah. Yeah. Did you almost get trapped in that moment? Cause that's a very, I thought it was weird moment.

It was weird. And then being in media in general felt so unnatural. You're used to having your close group of friends or maybe even a wider tribe. You're doing reputation management every time you're at a party. But now it's like millions of people and everyone has an opinion. You don't know what to do with that. I had no training in that. So it was a growing phase of trying to figure out what that meant. You also terribly young. I was pretty young. I was like 24 when all that was going on. Now it's even worse. There's like 16 year olds going viral.

That's worse for them. Oh, no, no. Yeah, that terrifies me for them. At least I had some sort of education, knowledge, some background. Oh, my God. Did you feel like, am I supposed to kiss this person? Because they paid six. No, no, come on. There's been six figures on the line here. No, I would have kissed the shit out of her. I know you would have. That's why. It was a respectful, like. That's why I asked. And I think her mom worked at a hair salon and she heard about it and she brought her a ticket. So I don't even know if she liked me that much. Oh, wow.

A lot was happening during that time. There's a lot of new things coming your way. And to answer your question, basically, I got all these invites to go on television. And I was like, I'll go on under the guise of like they're inviting the sexy doctor. But I'm going to talk about something health related. Substantive. Yeah. And that worked.

for two weeks. Right. And then they're like, we don't care about you anymore. You're too young of a doctor. You're not enough experience. You're a bad doctor. Get out. Take your shirt off or get the fuck out of here. No, no, that happened. I bet. Like one of those entertainment shows invited me and they're like, oh, our reporter wants to go to a gym and work out and you'll talk about the benefits of exercise. I'm like, awesome. Perfect. Show up to the gym. They're like, all right, take off your shirt. The reporter's not coming. We're just going to get B-roll. Stop. Yeah. And I'm like, uh,

Deuces. Yeah. So I just left it because I didn't care. Yeah. The fame wasn't the end goal. You had a real job. Yeah. Luckily. Also, if a woman, this is the opposite of what I normally do, but if that happened to a woman, we'd be like, that's harassment. What are the names? Yeah. They're fired. Yeah.

yeah there's a lot of weird stuff like that you do like rachel ray and she's like oh my god you look like a chippendale stripper or whatever on television and i'm like oh man i didn't rehearse the response to that this may shock you so i'm lucky enough that i was able to push through all that and say okay i won't get the invite so i'll just do it myself on social media right social media removed some gatekeepers and as a result we have this very successful youtube channel yeah and it's

Fantastic. So very little of the content my kids like am I interested in. And I will regularly be in the kitchen. It's on, they're binging it. And I will sit down and I'll do fucking 35 minutes of you. And you're funny and you're irreverent, but the info's dense and it's there. It's so good. The production of it's quite good. Yeah. The way you interact with the clips and the graphics and everything. It's a really great show. It's fun. And I think what we've managed to do is...

make the scandal about like the corniness or the sexy doctor or the silly humor as opposed to corrupting the medical information, which is how people get views on social media. Yeah.

They have those. Here's the pink Himalayan sea salt you're not eating. If you have headaches, this is what you need to. That's an actual video online. Oh, I'm sure. I've seen any product under the sun is the quintessential thing that's killing you. Any object. Or will save you. Yeah. All right. I want to get into some of the medical stuff a little bit here. So we have a big debate here.

about whether farting is holding in your farts holding in your farts one i think it's possible dax thinks it's impossible to do that's actually not my position per design i must be dealing with much more than you if you're able to hold because there's just no way i would so i'm just starting by saying maybe our baseline amount of gas so that's that's issue one because i said no you're just being a

And just entitled. You're entitled and you're just farting all the time. And I've known Monica for 10 years now and she's yet to fart around me, which is insane because we're spending 40 hours. Well, there's like also guy humor. Exactly. That's her argument. But then Dax told me that you said that I'll die if I don't fart in front of him. Lincoln told me, not Dax, but Lincoln told me Dr. Mike said it's not healthy to hold your farts in, which I promptly reported to you.

because I care about your house. And we said we would talk to you in person about it. Fair, fair, fair. Let's talk about sphincters because sphincter control is awesome because if we didn't have sphincter control, we would be defecating ourselves where we sit. So our sphincter is actually quite interesting in that it has a sensor built in to know when it's just a fart or is there matter. Well, his is defunct. So actually, it's under our control. The practical answer of this, it doesn't matter.

Did you hold him or not? I mean, yeah.

I thought there was a story about- Barring extreme, I know someone's going to be like, this person had some gangrenous bowel situation. Barring extreme, please hold your farts. Please fart. Do whatever makes you feel happy. I feel victorious. You should. And now I got to find the video that Lincoln claims to be referencing in her bibliography of your show. This may interest you. Maybe you've already thought of this. We had an astronaut on and he had been in space for a year. I think he spent the longest amount of time in space. A couple of things that shocked me. I was like,

Does it feel so great to sleep in space? Because you're like weightless. You're always trying to get comfortable on the pillow. It seems like it. And he said, it's nearly impossible to sleep in space because...

gamma rays, which are blocked by the atmosphere, are coming through your eyelids. They penetrate your eyelids. So you're laying in bed with your eyes closed and you're getting huge flashes of light that are the gamma rays. What? Isn't that fucking crazy? That's wild. So that was one thing that was nuts. And then another thing was you can't shit.

because your digestive system is gravity driven. And he said that the Russian cosmonauts gave him the advice, want to take shit, eat more food. Or maybe like a gastric massage, not gastric, an intestinal motility. Yeah. So I was like, oh, I would have never thought about. Oh. And then the other thing he said, which would make total sense to you is, well,

Well, your body is designed to live at one ATM, right? So it's a pressurized system driving blood up to the top of your head. Well, without that atmospheric pressure, it pushes way too much blood to your brain. So they have headaches. They're getting flashes of light and they can't shit. I wonder what the adaptation process for that is. Because the human body does adapt quite well. It's a master of homeostasis. You know, there's these astronauts stuck up there right now. Yeah, I heard that. It's so weird. It's so weird. Space scares me. Oh, no, I have no desire to you. That's my anxiety. Anytime I look up, I get...

I get nervous. I get vertigo. I just start thinking the world's ending. Yeah, anytime you look up. Yeah, like anytime open spaces, I'm like, we're all going to die. Oh, wow. Yeah, I'm not going to be on any of those ships. No, you won't. Blue origin or whatever. The only thing that seems very enviable is many of the astronauts describe looking out the window. They say like,

When they're not doing the things they're mandated to do, most of them will spend their free time just laying in the bed, staring at earth, watching it go around. And they all say there's something so surreal about being on the outside of it and how beautiful it is. I believe that. I'm envious of that. Have you ever flown in a fighter jet since you like speed? No, I've been invited a couple of times. I know that you throw up. I know that's what they do to you. They try. Yeah. Yeah. And I did the Thunderbirds. You did it. Yeah.

And you didn't throw up? No. And I did 9.3 Gs. 9.3 Gs? What was that experience like? I mean, I'm afraid of heights and scared of all this stuff. Yeah, well, you totally black out. You have to do the G-straining maneuver where you're breathing in a specific way because you can't take a full deep breath. So you have to do these concentrated puffs of air. It's very weird. And you have the G-suit squeezing you. It's like a whole experience. Yeah, but you didn't get nauseous. Oh, I got nauseous. Oh, you got nauseous. Yeah, I just didn't throw up.

Okay. I fought it and we did all the maneuvers. I have a side issue, which is I've done a couple of USO tours. I was in a Blackhawk at one point and the guy said, do you want us to do combat simulation flight? And I was like, yeah, I'm a fucking daredevil. Let's party. And about 20 seconds into it, I was like,

I've gotten myself into a situation where someone's potentially trying to impress me and I don't want someone in impress mode when they're operating something. So I was just like, I never signing up for that again. I had that with Mario Andretti. I did one of those ride-alongs with him. Oh, you did. And I was like, oh my God, he's old. He's going to try and impress me right now. He's going to say the doctor. I'm like,

Please don't have a stroke right now. What if you were like, yes, I'm in. Can I take your blood pressure really quick? I just want to do a couple quick. Oh, I talked to him before because I was like, let me like chat with you. Make sure you're all there. Cognitively. He's a bad motherfucker behind the wheel. 90, he'll still be a monster behind the wheel. And I love cars. Was it in a two-seater IndyCar? At what track? Poconos. Oh, fun. Do you like F1? Yeah.

I think we should be bros. I'm so much older than you. You're a car guy, right? Or motorcycle guy? I live for car. Well, both. I have a lot of cars. I'm a big car guy. All I know is you had a Urus that was stolen by a, was it a doorman or something? Garage attendant, yeah. Garage attendant took his Lamborghini Urus and went for a five-hour zip through New York City. And then when he came back, the cops came. He's like, I went for a family emergency. Oh.

That was the best answer ever. They were really bored and I had to blow their mind by fucking... No, but then the cops scanned the license plate and it was like all over New York. Oh my God. So like who knows where... I would imagine too the nav was recording where it had all been too. Oh yeah, probably could have done that. Do you want to do your game and guess his car? Oh yeah, can you? Well, I can tell you what car you should be in. Oh, okay. And we'll see if you have it. I probably have it. Yeah.

I mean, you must have a GT3. I thought that's what you would say, but I have a 911 Turbo S. That's great. Very close. No GT3? No GT3. I have another car that's fun like a GT3. Okay, what is that? An F8 Spyder. Okay, okay.

We can cut it out. Yeah, we can if you want. That's very conservative. But I like to play with them and swap them out. And I just started collecting within like the year. Okay. Nice. I have a sickness. Yeah. There's a disease. I actually just bought my dad a Roma for his retirement. A what? A Ferrari Roma. Oh, I don't know what the Roma is. It's like a GT like relaxed car. Front engine. Yeah, front engine. Oh, okay. Oh, that's nice.

And I surprised them with it. It was like really cute. Okay. We're going to debunk some stuff. Yep. I guess my first question is, it would seem like the most audacious exaggeration of science is in nutritional space and the diet space. Do you think that's the number one place where you see disinformation? Yeah.

It's probably the most common on social media. Yeah. Or like vaccine hesitancy. What is your theory behind why that? Well, first of all, let's just talk about why our nutritional science is so fucked up. It's like every time you hear a different study, it's just so variable. It seems like we can't learn anything concrete. I actually think media messed it up for all of us because they're really terrible with their science literacy. And I'm going back like 40 years.

Where like one epidemiological study showed that people who ate nuts lived on average 12 years longer. They didn't account for like wealth. They didn't account for exercise or any of these things. Yeah, exactly. And then they write an article like nuts make you live 12 years longer. That's not what the study said. Yes. Even now it's still bad where they'll see the word significant.

And they're actually saying that a study is statistically significant, which does not mean the same as practically significant. So this is actually really fun. And I kind of geek out over this stuff where if something is statistically significant, that means odds are whatever the result happened is true. That's all it means. Whether that result is good, bad or something, the other, it doesn't mean anything. Clinically significant or practically significant means that it actually makes a valid difference. So it's just saying that

the test was done correctly? That means by chance the results didn't happen. Like 95% chance that this is the truth. And that to us is the barometer that we set in science. Got it. 95%. Well, also the way the data is reported is so significant. So this was my personal experience with it. I got curious. I was like, well, Sweden ran the experiment for us. They didn't social distance and they didn't mask and they took a very specific approach.

the results are in. Like one day I'm like, oh, I want to see what that was. So I searched, you know, what was the outcome of Sweden's policy? In the articles, all of them are like 50% rate fatality rate increase.

And I'm like, well, that's pretty heavy. Then I actually look at the data in the article as compared to their neighbors. Well, their neighbors had a death rate of two per 10,000 people in Sweden had a death rate of three per 10,000. And that is 50%. Well, there's like that absolute or relative. So everything gets reported. That seems enormous. And like, you've almost halved your chances of survival, but three out of 10,000 or two out of 10,000, that's negligible. But boy, when you read it positioned that way, that's mind-blowing.

my main issue with these studies being reported in the media all the time, it's like, what is the incident rate really? That's important. Cause when we even say, Oh, those who eat red meats have higher rates of colon cancer by like 20% or processed meats have a higher rate of colon cancer by 20%. And then you have to like then figure out that the natural incidence is 4% and 20% increase goes up to five. Right. Yeah.

So it is 20, but it's one. Right. Interesting. Yeah. It's really, really misleading. You can really. You can twist it basically to make it say whatever you want. And because of that on social media, how are you going to get viewership by twisting it as much as possible? Right.

Sweden up there. Even in regular media at this point. Yeah, exactly. But at least with regular media, why it's a little harder to do it is they have more to lose. Yeah. They have investors, they have reputation management, like all that stuff. Versus if you're like a dude-

reading stuff in front of a camera. You're like, yeah, cancel me. If you're canceling me, it's because you're silencing me now. And there's that playbook that's used all the time. Oh God. Yes. But what are the most alarming trends that you're seeing in the diet space that you've been spending time on? I think it's changed before it used to be like intermittent fasting, keto, then like carnivore popped up for a while and you started getting all these tribal camps and

And the reality, as Lee Norton always points out, it's like whatever you can do to lower your calories, that's going to help you lower your weight. No one really wants to hear that, though, do they? That's not fun. Yeah, he's got a great thing. It's like, yeah, intermittent fasting works, but not because of some magic of intermittent fasting, but because your caloric intake ends up being reduced. We're not going to get away from calories in, calories out. Well, notice if we look at the misinformation space 25 years ago, all the...

Nighttime commercials were like, here's how you could lose five pounds with our new formula. Here's the grapefruit diet of how to lose five pounds. Notice those went away. Do you know why they went away? No. Ozempic. We have a proven way to lose weight. We don't need the BS stuff. And I'm not saying that everyone should be on Ozempic, but they lost market share because their stuff didn't work. Versus this stuff is proven and has side effects, obviously, and shouldn't be used by everyone, but actually it's proof that it works.

That has to be a topic people really want you to talk about. I know even in here it comes up a lot. I am very pro-Ozempic. I have had friends, I've watched them try to lose weight forever, and they had gotten themselves into an actuary line that's pretty dangerous. Yeah.

And lo and behold, now they're significantly thinner and people are mad about that. And I'm just confused why someone would be mad about that. People like the natural thing and they view this as unnatural and they view it as pharma getting rich and weaponizing it. And look, a lot of these arguments that people have with these situations are all what I call truth wrapped in a lie.

There is a kernel of truth that this is a natural, that pharma is getting rich. But what the ultimate answer is a grand conspiracy. Exactly. What I see is happening is society creates problems. We created through capitalism all these foods that are hyper palatable. We want to eat more and more. They're not satiated. Designed by scientists. Yeah, exactly. And then we started gaining so much weight that we couldn't stop eating these foods. So now we created another problem.

which was what capitalism does. It creates a problem. Before we had poop on the streets of horses. And then we're like, how do we create the solution? We created cars. Now we have pollution. We're going to create a solution. So it's like constantly playing catch up. But because this medication breaks it in a fundamental way where it changes your relationship to culture, because food is culture. I think that strikes a chord with people.

Yeah. And there's this sense that, yeah, people have cheated or they didn't put in. I had to work hard. Yeah. Like I put a lot of effort into my fitness and my diet, but I don't care if someone. But also people that are on Ozempic, they're also might be putting in effort. They probably are. They should be really. That's the correct way to use that medication. I think the only thing about Ozempic that people aren't shining maybe the best light on or could be doing better with is it is great. But also you do tend to lose muscle mass on it.

If you consume less calories, you'll lose both. And if you do it in a way where you're not resistance training, you're not consuming the proper amount of protein. Yeah. You will lose muscle. Are you in the Atea camp? Do you believe in the overall metabolic health improvements through muscle mass? Oh yeah, for sure.

Where we disagree from like the Peter Atiyah camp versus what I do is the worlds in which we practice medicine are radically different. I work at a community health center. You don't have Bezos as a patient? Allegedly. Allegedly. I don't know whose patients are. I'm just throwing out a rich person. It's very consumer oriented. People that are going there are already pre-motivated. They already have a bias that this is going to work, which means that it will work just because they believe that it will work.

And then also some of the things are not evidence-based. Some, not all. Okay. Where it's a protocol that he's created. And I am scared of that.

Because science can go wrong in so many different ways. So whether we're talking about full body scans to catch things early, just preventatively, or... Are you pro or anti those? Generally speaking, anti those. Really? I did it. I did it. And I know which brand you did, so I don't want to say... Oh, you do. I mean, I... You assume. I presume. I presume.

I'll tell you. Okay, go ahead. Yeah, we got to hear why. Why not? As of now, and remember, science evolves. And this is important to say because we messed this up bad during COVID. And we were like, this is the answer and this will never change. Science evolves. As of right now, the only group of people that really should be getting vaccinated

These scans are people who have extremely high risks of cancer because they have a genetic condition. There are specific ones that create higher risks of familial cancers. Besides that, what we've seen on a population level is that the benefit is outweighed by the harm.

The harm being the radiation? Well, a lot of those tests are now MRI driven, so the radiation is not a concern. I guess the old previous iteration- Was the CAT scan model. Yeah, yeah, yeah. But now it's MRI, so that's a little bit better. But the human body has lumps, bumps, masses, things that don't have clinical significance.

Okay, I'm going to guess what the problem is. I'm in lockstep with you, which is they did a study. I'll get the numbers wrong, but in general, you'll get what I'm saying. They did a random MRIs on a thousand people's backs that did not have back pain.

And something outrageous, like 40% of them. 67, yeah. Yeah, had like ruptured discs or they had something that would have- Some finding. Yes. And so if you go in with your back hurts, 70% of people you give an MRI to, you're going to find something. It doesn't mean that that's the thing. So is that maybe the concern is that you'll start treating something that didn't need treatment? Yes. Or maybe you're more conservative that you say, well, get treatment.

but you need to investigate. Investigations, biopsies, needles inside the body, they're side effects to procedures. They're side effects to the anxiety that comes with knowing you have something. And some will say, well, maybe it'll motivate you. Yeah, maybe. Or maybe it'll give you such bad anxiety that you'll have more problems. Right.

So right now we don't have the data to support it. And I think that it's easy to sell it in a sexy, fear-mongering way. And I really dislike that because right now the science isn't clear cut saying that's a good recommendation. Okay. Now we're going to click into patient doctor mode. So I am an ex-smoker of, I quit when I was 30 and I started at 15. So I smoked for 15 years. I haven't for almost 20. One pack a day?

Pack, pack and a half. I was hammered and doing coke. So around 20. Three packs. Okay, so it's 20 plus pack years. Yeah. Okay. Snorted a copious amounts of coke. Drank like a motherfucker for a decade or more. I wanted the peace of mind that they looked in my lungs. There were a lot of question marks that I thought with my history, I would just feel a lot better taking a peek inside there and seeing what was going on.

So with someone with my history, would you say still probably don't need to do it? There is an age where we do for people who have an extensive smoking history, preventive screening with a low dose CAT scan. So we do do screenings for that, for lung cancer. You'll be relieved to know I was out of the woods or so we think from that result. You have the opposite. It relieved some anxiety. A thousand percent. Which then is helpful. But what if you found a nodule that then you needed to follow? I would follow it. Yeah. And how would your anxiety feel then?

You have a growing nodule. Oh, no. Okay. Because literally I go into those. I'm like, I definitely have lung cancer. You know, when I got the CT scan of the heart, I'm like, this is going to be a mess. Oh, you got a calcium score? Yeah. Yeah. I go in thinking it's going to be like 70%. I eat meat nonstop. It was zero. Shocked. I'm not. You're not what? Shocked? Yeah. Because of the exercise? No. Because that's normal. That's why I don't scan you. Yeah. Yeah.

Oh, this is a perfect timing because of my heart explosion. You had a heart explosion? Any day now. You would probably know him. Do you know Dr. Richard Isaacson that does the Alzheimer's work down in Florida? He's a friend of a neurologist. He worked with Sanjay and he has a whole... Sanjay did a four-part story on him. Yeah, he has a whole...

thing going that we are participating in. Yeah, we're in a study. Yeah, we're in a study, which is very cool. We give a shit ton of our blood, all of our blood. And then he's called us with some results. And there's some unnerving stuff about my cholesterol, which I already know. I have high cholesterol. I've had it since I was a kid. He's basically asking for that. And I said, yeah, I've always had high cholesterol. So sue me.

Doesn't seem to be related to anything I eat or not. It's the way it goes. And he was like, okay, but now I'm going to go to a preventative cardiologist and there's going to be more tests.

It's like good to maybe clear that and see. But it is funny because to me, I've always just been like, well, yeah, I just have it. I've always had it. You're in acceptance mode. Yeah. But now I am nervous. Well, that would have flagged on any checkup for you. They do. It's like, just keep an eye on it. Keep an eye on it. And he's surprised that that's been the response. And it hasn't been. Do you know what the numbers are? I don't currently. I didn't ask very much. I was kind of overwhelmed. Yeah.

Well, no, look, because I'm not here saying, oh, just throw your hands up and you'll be fine. Wellness and screening and getting in front of problems is what I preach. That's what family medicine is. But it's knowing when screening is beneficial and knowing when screening can actually cause more of a problem. Right.

And we've had instances with that. We've changed our guidance on prostate cancer screening. We've changed recommendations on breast cancer screening when we should cut off certain screenings because we found over-testing was a problem. And over-testing is a real problem, especially, this is pretty unique. It makes sense, shitty that the world exists this way, that those who have less money get worse healthcare. They can't afford medications. They don't have good health insurance. They don't go for preventive stuff.

Logically shitty, but makes sense. The wealthiest demographic also gets bad healthcare. Really? Because they're not- Overtesting. They think they can buy good healthcare. They get great hormonal treatments that they may not need. I feel singled out. Attacks, attacks. I'm saying this generally speaking, and it happens. And it happens. That's interesting. That's what my hope is on the YouTube channel, just to say, here's what actually we know

And then there's people doing stuff that we don't know about because they want to be on the forefront of it and they want to be the leaders and they believe in it. And this is, again, where studies get so hard to isolate what variable you're actually testing, which is that also correlates perfectly with what we know about happiness and financial, right? So when you're very poor, it's miserable. And when you're above...

You know, it was kind of low. At that time. At that time, yeah, they've upped it. But you plateau after 170 to 3.1 million. Beyond that, you have a reduction in happiness. So it's like, okay, now our health reflects that. And also the happiness is in the mix. It's life homeostasis. Right. Our acid-base balance in our body, like our pH is so...

Narrow and what's considered a good range for your body the body keeps your pH within like a decimal point and then you have people are like drink alkaline water and I'm like, okay. Hold on a second pause You're gonna have alkaline water slightly more basic water that's gonna go into your stomach. That's full of gastric acid and

which is one of the most potent acids, your water is no longer alkaline, A. B, it's going to get absorbed into your gut. Your body will do whatever it wants to do with it because it's controlling your acid-base balance. It'll dump it or use it, right, if it needs it or not. Yeah, so it's like the idea that you're controlling something with your alkaline water is illusion. People just want to feel in control. That's really what it is. I'm so glad you're debunking alkaline water. I've been pitched it many times. I love it. You love it?

If you like the taste of it or you like that it's fun, great. Just the health claims are not true. No, I know. This is the example I give when you're talking about homeostasis. To me, opiate addiction is the finest example of it, which is you give yourself an opiate. It blocks the receptors. The body grows more receptors and now you need more and then you take more. There's no end to that. Your body will fucking win. It's why it's the most terrible addiction you can have. To clarify, it lowers the receptors because it doesn't want to have as much of a reaction.

So it down-regulates. Oh, I thought the opiate blocked the receptors from uptake of the pain. For the opioid example, yes. Let's say for mental health of serotonin, right? Right, yeah, yeah, yeah. There's instances where it happens in both ways, where you could up-regulate or down-regulate. I just want to point that out. Yeah, yeah, okay, great. But just you're in an arms race with your body with opiates and you actually can't get the upper hand. You can OD, I guess. But yeah, it's like the body is insanely good at reaching homeostasis. So good.

Did you read them? They're both good and bad. Stay tuned for more Armchair Expert, if you dare.

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They also offer 12-hour protection against leaks, which is a game changer. Get your baby's butt into the best-fitting diaper. Huggies Little Movers. We got you, baby. Did you read Dopamine Nation by Anna Lemke? Oh, God, it was good. I think you would really like it. You're not an optimized guy, but I do feel like you would recognize... No, there's benefits to a lot of these things. So her position is, okay...

We like dopamine. It's a great chemical. There are ways to spike it, cigarettes, caffeine, all these things. But in all these studies, if you spike it, the bad chemicals that re-regulate you last far longer than the spike did, right? It's an investment with a return. And

But conversely, if you cold plunge for eight minutes, you get two hours of elevated dopamine as it tries to re stabilize you or reach homeostasis. So go ahead and chase dopamine. But what one has the good odds? Yeah. And so I read that. I was like, oh, that makes total sense. And I'm a dopamine junkie. So, yeah, let's suffer three times a day.

And I dig it. Are you in any of that cold plunging or no? I like saunas. Yeah, me too. I'm not a cold punch person because I don't like the feeling of being cold. Nobody does, Mike. Yeah, but like, I don't even enjoy the challenge of it. I'd rather challenge myself in the gym or boxing or something, getting my ass kicked. I'd rather do that for some reason. But even that whole protocol thing has been blown out of proportion.

The very limited studies that people are referencing. Well, it's just like my protocol is better than your protocol. And if you're not doing it this way, or if you're not breathing this way, or if you're not meditating this way, it's like...

Nah. Yeah. I'm with you, but I do try them all. And one, we just learned that. But you can have fun with it. Like if you're doing it for fun, that's like the same thing with all those fitness trackers, right? Like everyone loves their fitness tracker. If you just love it for the fun of it, great. But the health aspect of the fitness trackers is really questionable. Okay. So I wonder if we have the same position on this because I fight with my wife about this all the time. She's had every kind of tracker. She was wearing a glucose monitor for a while there. And I'm like,

The results of which you will know, okay, I got to sleep eight hours. I got to eat this way and I got to exercise this way. Like we already know what the prescription will be if you don't like the results. So just live by the prescription. If you wake up and

and you feel well-rested after a night of sleep, and you slept the correct number of hours for your age group, why do you need an app to tell you you slept well? Because if that app tells you you didn't sleep well, your performance is going to suffer. That's been proven. It's exactly what I say to our friend Charlie, who's a fitness trainer and has got a donus of a body. But yeah, he'll wake up and it'll tell him, don't train today. And it's like, well, what are you going to do with that? In the upper echelon of performance, like for the LeBron James of the world, maybe it's different. But again, I work at a community health center.

So like I have like real people, like the averages of the world, they don't need the health tracker to change their life. They need the information and they need guidance as to what is the biggest bang for their buck.

in terms of effort, not money, in order to change their world, their numbers, all that. The fitness tracker, the cold plunges, that's not in medicine. Never in a real medical encounter in like a legitimate medical institution, tertiary care center, is anyone being like, did you cold plunge today? How much are you cold plunging a week? Are you in here 11 minutes? Like that's not happening. And it's not because we don't care about wellness. It's just because like, that's not really wellness. It also makes everyone a victim. It's like, oh, I only slept two hours. Yeah.

I hate that. And again, that's not saying sleep isn't important. It's so important. It's the most important. Maybe the most important. But yeah, you know if you've slept well or not for the most part. And if you're not, like searching for the reason why you're not is very important too. And that's what we talk about on the channel, ways to improve that, sleep hygiene, all that good stuff. Okay. So I want to talk about gut health because I find it very intuitive. I'm very interested in every time they start talking about just how much it's regulating your overall health.

What is your position on gut biome? And what do we know about it? And what can we actually augment about it? That's a good point. So like what we know versus what we can augment is pretty limited. There's certain medical conditions that we've seen evidence of messing with the gut microbiome is valuable. Far and few between like a C. diff, we do fecal transplants and it works. Antibiotic associated diarrhea, in some cases, traveler's diarrhea. There's like some childhood things. But in general, there's no good data for probiotic use right now. Right.

Really? And they're sold for every condition. And that's not to say that in the future we won't find one. Yeah. But saying it prematurely is doing a disservice because then people who have an issue where they need to go get a checkup and get a colonoscopy to check for colon cancer are not getting it because they're wasting time trying a probiotic for a condition that probiotic doesn't help with. Okay, but what about this rationale, which is like, yeah, we might not know

I think a lot of people live under this approach, which is like, yeah, we're not sure. It can't hurt. Maybe it will be proven. Well, here we go. There's been issues with probiotics causing problems with people, infections in the gut. A lot of the probiotics that are sold on the shelf, and this actually goes to the larger picture of supplements, what's written on the label is not what's actually in the product.

- How bad? Like, what are we looking at? - Like I've seen consumer labs who do these off the shelf testing be as high as 70% for some of the supplements. - Meaning they actually contain 70% of what they say they do? - No, 70% of the supplements on the shelves have an inaccurate label of what's in them. Some ones that sell herbs, the presence of the herb isn't even there 'cause they're not regulated.

And people are saying, well, that's because pharma is a problem. Natural is better. It's like both are businesses. Both are for profit. One is at least somewhat regulated. And if something happens with a pharma drug, you can sue. There's someone to hold accountable for that. There's no one to hold an LLC that you'll sue. They'll open up a new one. It parallels nicely the kind of Bitcoin thing.

debate of like, they love it because there's no regulation. And then when it gets stolen, there's like, there's no one to call. There's no one to punish. They're like, wait a minute. Maybe...

Accountability is kind of rad in a monetary system. Balance. We're back to balance. Some regulation is better than none. More regulation is better than some. So are there chronic conditions that you do think are originating from poor gut microbiome? I'll just own that. I think the future of it seems very promising that you would be able to regulate the microbiome and have pretty positive

powerful impacts on like some autoimmune stuff and different things. It seems very promising of all the different things that really we don't know a ton about. We've seen a pattern of people who have poorer health have disruptions in their microbiome. What that means, we don't yet know. Is it chicken or the egg? Can we alter that chicken or the egg phenomenon? We don't know.

And anyone that's saying they do know is jumping too far ahead because we don't yet know. Right. So just to articulate specifically, you're saying like, yeah, does the poor health cause the bad microbiome or does the bad microbiome cause the poor health? We don't know yet. Yeah. What I'm excited about is AI, but not in the way most people think. So-

When I give patients blood pressure medications because their blood pressure is elevated, I gave them a diagnosis of hypertension after checking it correctly, which most people don't do. After multiple visits, we tried lifestyle modifications, didn't work. For whatever reason, their blood pressure is still high. We want to lower that blood pressure. Why? Because over the population of people who have high blood pressure, by controlling it to a certain number, we see a decrease in risk of heart attack and stroke. Forgetting the number. We see a decrease. Yeah.

But now if I gave you the medicine, that same percentage doesn't hold true for you. In fact, in most instances, that medicine is going to do nothing for you. But I don't know which one of my patients that has the high blood pressure, it will prevent the heart attack and stroke. AI can use a lot of data points and then further reduce the number of patients that I need to treat to actually get the benefit of said treatment. And am I right in understanding this? I've heard a couple of people talk on it, but-

Yeah, the amount of data they're going to be able to put into this evaluation, knowing your genetics, knowing 65 different markers, they're going to be able to point to a much more probabilistic treatment. Correct. That doctor would have to spend three weeks.

sifting through to try to figure out. Sifting through and there's experimentation. Sometimes even with psych meds, we're experimenting with patients. We're giving them this one. How are you doing? That's subjective, right? That doesn't always work really well. And I'm excited for the day where AI genetics can all come together and guide this. But you know who's the biggest opponent of that notion? You have to guess what industry. Big pharma. Yeah.

And I'm not like someone that's like anti-pharma because they're also making the greatest changes for humanity and saving us from problems. But why Big Pharma would not be a fan of this problem?

Yeah, less medication. Yeah, because I would need to treat a lot less patients. You're not prescribing 70% of it that is ineffective. I would be lowering the number. Well, that's interesting. Back to Ozempic, that was an issue they were in, right? They were a company that was manufacturing insulin, and they had created this thing that would potentially cannibalize their insulin business. And you're just hoping that that company...

that, you know, they'll make more money. You're just praying. Yeah. And it does make you wonder how many. I'm not a big pharma conspiracy. Again, it's not binary. They're not good or bad. They're both. You know what their incentives are. Yeah. Yeah. It's not a mystery. When the incentives align, it's really nice. Sometimes they don't always align. And that sucks. Ideally, they want it to be good and work for everyone so that they can sell stuff.

But if it cannibalizes their existing... Yeah, and there's been evidence of some pharma companies being like, oh, this one's coming off patent. We need to create a new one to protect it, even if it's not that much. That happens. Yeah. Absolutely. And it's like a financial game for them. Oh, I've always wondered this, and you're someone who prescribes a lot of medicine. How the fuck are you staying on top of it? I feel like half of your job would have to be evaluating the...

numerous medications that are constantly coming out. I watch 60 Minutes every episode. I find out about three new medications. There are new medications. Being a primary care doctor, I have like a common arsenal of medications and we have really good resources these days. One that I use often is called Up to Date where you can

I can literally punch in a condition. It'll give me some information about the epidemiology of it, how it presents in patients, what the first line, second line treatments are. Here's the evidence behind why, like you can click into it. And then the dosages are all there, the length of days. That's what we use. And I use that quite often. I use that with the patients in the exam room. We look at it together. - Oh, that's great. And that's a service you're subscribing to? - Yeah, the hospital. - The hospital does. What's your take on autoimmune diseases?

Do you believe in them? I guess I'm trying to back you into... Do I believe in them? Yes. Okay. Well, some... Wait, people don't believe in autoimmune diseases? No, no, no. I think I potentially have a fringe opinion about it based on the fact that I have one. I'd love to hear it. I'll try to do the four second version. Seven years of pain, a joint locks up, get surgery on my toe, my knee locks up, about to get surgery on a dermatologist, looks at my fingernails and he says, I think you have psoriatic arthritis. You should go to a rheumatologist. I go, I get tested, psoriatic arthritis.

I get put on Humira right away. After eight years of trying to figure out why the fuck all this is happening, it's like a light switch. I have a year of no pain in my joints anymore. I'm like, oh my God, this is heaven.

It stops working as good as it did. They wanted to up my dose. I didn't want to go that route of continuing to carpet bomb my immune system. So I was like, I'm not going to pursue this. I got to get off it. It was miserable. Through three or four years of trial and error, I've really fine tuned my diet. I have a prescription for Zaljans.

I almost never have to use it. If I cheat and I'm on a vacation and I eat a bunch of hamburger buns, I will have to use it. So for me, anecdotally. So it's like gluten related for you? Gluten, peanuts, garlic, a couple other things I'll forget while we're talking. But yeah, I have a very, very sugar. If I were to go eat four pieces of bread tomorrow morning, my forehead would be flaky, my eyebrows would flake and my wrist would hurt. My conclusion, and then talking to other people with different autoimmune diseases. Here's again, I have no business saying this theory, but

I think we're all allergic to stuff. And I think these allergies can manifest in a lot of different ways, whether that's a Crohn autoimmune disease or it's a psoriatic arthritis thing. Or I feel like a lot of the autoimmunes maybe originate in just allergies. Well, if you really think about what an allergy and an autoimmune condition is,

is an allergy is an overreaction of your immune system, but which line of the immune system is important? 'Cause the immune system takes various forms. There's different cell lines of the immune system. So when you have an allergic reaction, that's very specific. Sometimes a patient will tell me, "Oh, I don't like this antibiotic 'cause I'm allergic." I say, "Well, what symptoms do you have?" They say, "My tummy hurts."

That's not an allergic reaction. That's an adverse reaction, not allergic. Allergic is a very specific reaction. What's it defined by? Swelling, itchiness, hive. Histamine release. Correct. Mass cell histamine. Yes. That's an allergic reaction. When you have autoimmune reactions, now you're having cell lines damaging your existing tissue.

For whatever reason, if I understand it correctly, they've identified your tissue as a pathogen. Correct. Not a pathogen, as an antigen that is bad. Okay, great. Maybe I get pathogens. I'm really stuck on a patient saying my tummy hurts. It's kind of cute. Maybe they were flirting with you. I don't trust that person. I wonder how many people fake illnesses to come to see mine. No. Most people don't even know I have a social media presence. It doesn't matter. They meet you and they're like, fuck, I wouldn't mind going to see him again. I hope he smiles. I had an allergic reaction.

Oh, no. How many of your patients show up like they're going to a formal event? No, they don't know. They don't know. They don't know they're going to see you. Yeah. Oh, no.

Well, you have recurring patients now. Yeah, I do. But there are patients that I built up through residency. I know their families. I delivered some of their babies. I bet your tummy would hurt a lot if you... Once you deliver someone's baby, your relationship changes. Have you delivered babies? Yeah, family medicine. Well, but you're not an OBGYN. It's not like you're doing that. I do pap smears. I deliver babies. Not anymore because I did that during my residency, but I still perform basic GYN. Great. But when's the last time you delivered a baby? 2017. Okay. Sorry.

It's pretty good. That was seven years ago. I delivered 38 babies because I had to get those. I had to like document it for my residency. Yeah. I feel like I would have interest in keeping in touch with them. Is that a weird? Well, they're my patients.

They then went on to be your patients, the ones you delivered. That must be so rewarding. That's what I'm saying. Family medicine is so awesome. Yeah, you bring them into the world and then you keep them healthy. And some of them write to me on social media and I'm like, this is crazy. That's why they're not abnormally attracted to him because that thing happens with a family member. Sure, sure. Like when it's your sibling, you're not attracted to your sibling. Yes, yes, yes, yes, yes. Because you imprint their pheromones. Okay, okay.

We figured it out. We should fight about something. This was the explanation I learned in Anthro, which was, I think I learned in Anthro. I shouldn't say that. Yeah, that you imprint the pheromones of your family members, which turns off your sexual attraction to them. Wow. This is 100%. You could look this up. There's this really creepy phenomenon. I shouldn't say creepy. I shouldn't be judgmental. Where parent and child get reunited. There's an inordinate amount of

Or they start dating. No. Yes. Inordinate. In the general population of daughters dating. I cannot confirm or deny this is outside of my expertise. The general population rate of daughters dating dads is very minuscule. And in this population of people that have been reunited, there was an article. I talked about it on the show. I read it. I probably white noised it. It sounds like you need an expert on that. We'll do it in the fact check. We'll talk about this phenomena. Moving on.

Back to autoimmune, though. Okay. So your thought is that it's an allergy. It kind of is because an allergy is sort of autoimmune and that it's an overreaction. It's just not attacking your tissue. It's creating that inflammation, that histamine response, as you said. Yeah, I guess my intuition is that it's either through what you're putting into your body orally by eating it.

Or there's something obviously environmental that's coming into the system that's triggering this response. It's all. And it's hard to know in each case which one it is. What was the conventional explanation for these? Why would it body start? You said like what you're putting into your body. It's also what you're not putting into your body.

So like for example, parents that withhold peanut products from their children actually raise rates of peanut allergy. That was a statement made by the American Academy of Pediatrics back in the day. Like withhold peanut products, allergen foods, and then we saw that it caused a huge spike. - Yes. - So we actually now recommend introduction through like Bomba and all these snacks. - It's like growing up with a pet. You're drastically less likely to have a pet allergy. - So it's interesting how putting things into your body, not putting things into your body, environmental exposures,

Mental health has a component. Well, I was going to say, we look at the correlation between autoimmune disorders and ACE scores is kind of really hard to deny. Talking about adverse childhood experiences, I'm sure you're familiar with the book, The Body Keeps the Score. Oh, I love it. There's so much value in talking about that and...

There's people who are anti some of the messages in that book. - 'Cause they sound what, woo? - Yes, but also I've had experts on in the psychiatric space that say like, well, there's no actual part of the body that keeps the score. I'm like, it's a metaphor. - Yeah. - We can make a metaphor without actually having to think. - Don't get hung up on the title of a book. - On the semantics, yeah. The statement was the body doesn't keep the score, the body's like the scoreboard. I'm like, all right. - Oh great. - Yeah. - You won. - So I think that's true and there's truth in that

The mind is so much more powerful than we give credit to. That's why the placebo effect is true. That's why if you're able to have a positive mindset through your cancer journey, you're more likely to have better outcomes. All these things, even like the Wim Hof and that whole world of it, which is not super evidence-based, there's like proof that they can modulate their immune system, that they can change the heat that's within their hands in a given moment. They can survive in extreme temperatures. There's truth in how powerful the mind is.

What we do with that knowledge remains to be seen and we need to use it responsibly, but it's cool. Well, it's not a far walk to the area we all agree on, which is under moments of great stress, your body's immune system amps itself up, preparing. Yeah.

So, okay, great. We agree on that. Now, what could stress you out? What can't stress you out? Yeah. But if you're an extreme ACE score person who's in a constant state of fight or flight, yeah, your immune system's likely to be probably overactive. Overactive or underactive? Remember, some of the steroids that the body creates are also immunomodulating downregulating. Explain that. Like when you take prednisone, which is a corticosteroid, part of the side effect is that you can have higher rates of infection. It immunocompromises you.

Right. And that's a corticosteroid. That's like what it is. That's how it works. And the body naturally produces those steroids during moments of stress. Are you aware of the uptick in emergency room visits for pickleballs? Have you seen the data on this? I keep reading headlines and they seem impossible to be true. Have you in your own practice? I've had a few, but isn't that because just pickleballs becoming more popular? Yeah. But there was some, I'm not even going to attempt to say the statistic. Eric sent us all the article. Okay.

But it was a double digit percentage of emergency room visits last year were pickleball related. Well, I can actually see why that's happening is because the population that plays pickleball is usually older. Yes, exactly. People who can't play tennis because it's a little bit too physically demanding. So they try out this sport. They think it's low impact.

No, but that's just the population trend that I've seen. 49 or above. Yeah, I would probably say my patient population is like 60 plus usually. Yeah, I think that's right. And that's like when rates of tears and arthritis are already high. You know who also has an uptick in injuries? People who use testosterone treatments.

Because they're overexerting in the gym or? Yeah. Especially if they go into the supra physiological levels that you were talking about, like the 1500s and all that, because they have really high levels. They're sometimes of older age. Their muscles can't take that and they tear a bicep. Okay. So you deal a lot.

in studies. And I imagine you do your best to do maybe more of the meta analysis of many, many studies. I have grown and I've read some things recently that I've just grown more and more skeptical of studies in general. A, let's just discuss how hard it is to study a human being and a single variable within a human being. You're going to stay with this subject the entire day and the entire week and month. There's so much going on.

If you had to rate studies across the board, especially all these ones that are making it into the news cycle, what grade do you give it? It's just very broad because nutritional studies aren't great notoriously because...

most are not so controlled. There have been new ones where they actually had people in locked wards and they controlled what they ate. That's like the gold standard. - That's all we would really care to hear about, really. - But when we're testing like medications and such, you can control a lot of the variables to get a sense of what's happening. And because in these studies, what you're doing is you're controlling one variable. And if you start seeing a statistically significant and clinically significant result,

That's pretty good as long as it's replicatable. So hopefully that you're able to do another study and say, oh yeah, look, these results hold up. Right. I guess what level of skepticism do you start? A hundred percent. And in fact, one study is rarely enough to change everything.

our general way of practicing. That's not because we're slow to adapt. It's because one study in comparison to many studies doesn't hold that amount of value. So we need to see in general, okay, studies are starting to move in this direction. Okay, let's see how it's moving. And we're very patient with

it. Whereas people want to like, I saw that one study, let's change everything. Yeah. And if you hear something on the news about red meat, I think your next question should be like, how many other studies also have said that? Because boy, these make the headlines. That's the biggest headlines and why people are so confused. I mean, how often did we hear that coffee's terrible for us? Coffee's good for us. Coffee causes cancer. It prevents cancer. Same with eggs. Yeah, eggs. Oh my God. I was on a fat-free diet when I was 20. I mean, that was a popular sticker.

on labels. Fat free. Fat free. But triple the sugar. Yes. To make it taste a little bit better. You're a big fan of lifestyle changes. That's the most powerful thing we can do for our health. Yeah. That's under our control. Probably the biggest thing. The one I like to think about

is surgery versus physical therapy. - Oh, okay, for musculoskeletal stuff. - Yeah, tell us about it. - That's my world, I'm a DO. - Yeah, so tell me in general, like what kind of outcomes you expect with physical therapy versus surgery? - Well, again, very dependent on condition, but in general, what I see people,

knee-jerk reaction when they have pain or they want better performance is fix it. And really what we need to focus on is the body's own ability to heal itself. That's the magical thing. So we either have to intervene when necessary or stay out of its way. So intervention when it comes to like surgery,

should be like the small minority of the time or in like traumas. Whereas people think that's the treatment for all problems. Step one. Step one is not surgery. Minus the extremes. Sure, sure, sure. People say, oh my God, you're finding that I have a torn meniscus. I mean, surgery right away.

No, my labrum is torn in two places right now. I have a torn rotator cuff. My shoulder works great. Just because you have that injury doesn't mean you're doomed for surgery. And that's why we don't jump to the MRI. And sometimes patients get upset. Like you don't want to get imaging. Well, I say, number one, your insurance probably won't pay for it. Are you cool paying for it out of pocket? Most people say no. If they say yes, I say, just realize that we might find something.

that we didn't care about finding in the first place. - Yes. - If people are okay with that, I get them the MRI and they can continue on their way. But unless I'm planning for surgery or I'm really confused or we tried conservative management through physical therapy, activity modification,

I'm not really getting imaging. Admittedly, I've had so many surgeries. I have no business saying this, but do you think we are in generally speaking an over surgery option? I would say we're more, we're over intervention. We don't have enough faith in the body. Needs to be a little bit more patience and understanding of how the human body heals itself. And when it comes to musculoskeletal stuff, we have like so few modalities to actually help.

Like if you really think if someone comes in with, let's say knee pain, we have some medications over the counter, the acetaminophen, ibuprofens of the world. And there's different classes within there. I like NSAIDs. Yeah. Well, ibuprofen is a good example that people use those a lot. Maybe overuse them, create gastric ulcers, kidney issues. That happens. Also, those who have high cardiovascular risk.

should be talking to their doctor if they should be using NSAIDs regularly important. Wink, wink, wink. I love Advil. I love Believe. Then there's physical therapy, which is like the gold standard. I love physical therapy. That's good even if it doesn't help your initial problem. It's going to be valuable. Right. You're going to end up strengthening something along the way. You're going to decrease fall risk. You'll get better balance. You'll have better flexibility, better performance, all that good stuff.

Then we have like some injectables, which have really bad evidence. This would be getting the steroid shot? Well, steroid shot, we know what it does, but it usually is not a long lasting intervention. So it's like a temporary relief of a situation. There's injections that we do for arthritis where...

It mimics the synovial fluid in hopes of decreasing arthritic pain. And the evidence for that is really low quality. What's synovial fluid? It's the fluid that's within the joint that allows it to be lubricated. Okay, great. So there's some prescription products that you come in for every few months, these injections multiple times, and the evidence for them is not great, but the placebo effect is wonderful. So people like them. What about PRP and stem cell? That was the next step. So-

PRP is interesting because we found some evidence in some body parts and then we said, put it everywhere. Right. Put it on the scalp, put it in the vampire facials, put it in penises, put it everywhere. Carpet bomb. Yeah, it's like a little preliminary. How does PRP work? They take some blood, they spin it, they get out the plasma, they re-inject that somewhere? Correct. So basically there's growth factors within the blood. It's called platelet-rich prolotherapy and...

And we take those growth factors, we spin them down because they're heavier, so they'll sit lower. You inject them into a joint and you hope that they create inflammation and healing. So it's funny, we used to like decrease inflammation to help healing happen. Now we're increasing inflammation because initially prolotherapy started with injecting just sugar.

into joints, dextrose. Oh, really? And they would create massive inflammation. We thought that stimulated healing because it brought growth factors. But then they created platelet-rich prolotherapy. They're skipping a step. Well, they're not skipping a step. They're trying to create like the better new science version. And there's been some evidence for medial epicondylitis. You're so embarrassed that I got that wrong. Not for Dr. Mike. Don't interrupt Mike again. Oh.

Well, whatever. So anyway, PRP. And what about stem cell? There was a great... I think it was the second season of Dr. Death. Maybe it was about these crazy stem cells. People were getting massive infections. I'm not well-versed in the stem cell world because it's not mainstream enough to be in my purview. But from what I've seen, there's a lot of people taking advantage of folks...

with these stem cell clinics abroad. - Yeah, like they might have some promising future, but again, it's almost like probiotics. - Yeah, literally haven't seen enough, haven't documented enough. - I would urge people that when they're taking advice from people,

They should minimally ask themselves, are they an expert in this? I want it to be that. And I wish it was that simple. But then there's even experts in some fields that bias that we sometimes have. Yeah. We're like, I'm a doctor, so I know. In its most extreme case, we see it with the tech entrepreneurs. They have demonstrated a genius in this category. And now we listen to them on biohacking. And it's very curious. But you're like, well,

He's one of the smartest people in the world. So surely I should probably translate. It doesn't, right? Well, it's what Lane Norton said on my podcast about Nobel prize syndrome. So like those who win Nobel prizes have also believed in some like incredibly wild and accurate theory as well. Cause they were so smart that they convinced themselves they were right. Well, they're like Linus Pauling believe like vitamin C can cure anything and

cure cancer and then Linus Pauling died of cancer. It's like the classic example. You're like Steve Jobs. Yeah, that one. You're like, wow, you're so smart. I mean, well, that's like the example of the rich people getting bad outcomes. You have the Steve Jobs example or like the Michael Jackson example where they say, give me that medicine because I'm a celebrity. Or now we're kind of seeing it with Matthew Perry. You're a celebrity. You can demand it. And that's why I've never really been successful in

Allowing celebrities into the practice where I practice. They ask for things and I'm like, but this isn't ideal. And then when they don't get it, they get mad and they seek the care elsewhere. I'm like, great. They can go doctor shopping. Yeah. Stay tuned for more armchair expert. If you dare. And we're back with camera presents secret sounds work edition. Caller guess this sound.

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Now, to talk about the Matthew Perry thing for one second, I will say one thing that's aggravating me about the stuff that's coming out. And again, I'm coming from a very specific place. I'm an addict. I think it's OK if I now say I was...

around him in his pursuit of sobriety. Trying to hold this assistant accountable. I agree. We're hurt. We're sad. It's a tragedy. We just can't resist wanting to blame somebody. But unfortunately, the addict is to blame. I'm to blame. I had a great fucking doctor do a surgery. I haven't told him everything I call for more. I've ran out of my, you know, like...

That's too much for someone to manage someone's entire personal life or know what's going on. Now, when you're a doctor and your only patient is Michael Jackson, you're putting them to sleep every night with propofol. That line for me is really clear. That's criminal, no? Well, that's criminal negligence. You know what you're doing at that point.

Yes. You know, you're also not disenfranchised like an assistant who's working paycheck to paycheck. Yeah. I mean, there's a difference between ethical, moral lines and then legal lines, because even if someone did something by accident and then a life was lost, maybe legally there is some kind of rule that they're crossing. But legal doesn't always mean moral and moral doesn't always mean legal. Those lines are always crossing. It's just.

They're fucking slippery. You don't know what he said to her, even if she did think... Oh yeah, I'll say addicts are tricky. Yeah, it's very tricky. People who, one, haven't been around an addict don't know that. And two, who haven't been an assistant don't know what that's like either, where you're just like...

I guess I have to do all these things. It's a weird position. Well, your livelihood's on the line. In your career, you feel like if I don't do this, then I'll never get hired again. For sure, yeah. I mean, it's very tricky. That's scary. There's the power dynamics. Yes. But speaking of addicts, I listened to Day 7 on my way here. Oh, you did? Your episode. That's a little bit heavy for a ride here. I want to, like, you guys are doing great work. I got to say thank you for that. Oh, thank you. For being open and sharing that journey. It's awesome for me as even a doctor to hear that perspective.

Because a lot of times what's said in an exam room is not as honest and open as how you guys talk about it. Thank you for like the openness of that conversation. Cause I think it does a lot of good

from a humanistic standpoint for people to understand what happens behind the scenes in these scenarios. They're not often talked about because embarrassment, shame, fear, all the things that you guys discussed on the episode, that leading by example there is powerful. It's hard for me to take a compliment about that episode, but thank you. It's weird to now feel like it's always tricky for me, but I really appreciate that. Okay. We've come to the

a new segment on our first episode of video, which is questions my daughter was dying to ask you. I told her a few days ago, you have a couple of days to write down. So I'm going to allow you five questions. Oh, P.S. Dad, ask him if he can do a Russian accent. Oh, my God. I can do the Borat thing.

P.S. Dad. P.S. Dad. So that's not one of her questions. She wants the Russian accent. That's the weirdest request. Well, because she knows you're from Russia. Is that like a Russian villain thing? Who knows what she's thinking of? Yeah, presumably she saw it in some teenage caper where there was a Russian villain. I'll answer one of the questions in a row. Oh, wow. Okay. Oh, my God. This is great. This is great. Who is the better snuggler, rib or bear? Maybe we should first say who rib and bear are. I have two Newfoundlands, two giant dogs. Newfoundlands.

I had one as a kid. Oh, really? Yeah, yeah, yeah. Bear is 130 and Rib is already like 110 and he's six months. Oh my God. So he's going to be a monster. Yeah, maybe 160 we'll get to. They suck at cuddling. They do. They get too hot. They do and they start foaming. They start foaming and he can't breathe and panting so they go on the floor and they go on the tile. So I get very limited cuddles. Cold plunge.

We're back. Do you know the origin of their breed? You know they're in the pool all the time? Of course. I can't get them out of the pool. You know the origin of the Newfoundland? Yeah, of course. They're like the rescue swimming dogs. Yeah, they're the St. Bernard of the water. Have you seen the videos? In Italy, they throw them out of helicopters. No. Yeah, there's like videos on YouTube. Awesome. And they go and they rescue people.

Wait, they save drowners? I should get one. I'm not sure about my swimming skills, so it'd be good to have one around. I think this is right. St. Bernard's would rescue people in avalanches and Arctic conditions. Like Bernese Mountain Dogs, like the Swiss. And so the Newfoundlands are that version, but of the water. And sailors would shipwreck out and they would release these dogs and the people hang on to them. They fucking swim in.

pull heavy loads. We had a book growing up and it was all the championship dogs. In fact, ours was from like, it's great. Grandfather had, there's a picture of it, like 70 enormous trees on a sleigh pulling it through the, yeah, they can pull thousands of pounds. They're very cool. But the slobbering is rough. So they don't shed really, but the slobbering is wow. It is. On the ceiling. Cause they do. Oh, it gets on the ceiling. In the food when you're eating. Oh,

It's everywhere. Okay. Number two, forgive me. Have you ever farted in front of a patient?

Is it? It's pretty great. Because I have farted not only in front of a guest, on a guest, and it became... On a guest? Because I did not feel this coming. We stepped outside to take our picture. And as I put my arm around her, I farted. And it was audible. I go, oh my God, I'm so sorry. She now does a show with Monica. Yeah, now we're all very good friends. Now it's in the family. I think it was a great icebreaker. I mean, that happens. It's a human body. Yes. So that's a yes? The answer is yes.

Yes. And I believe it was during like an eight hour surgery when I was a med student. You had plausible deniability because there's eight people in the room. Yeah, there's people in the room. And then maybe the patient. And the body smells. Maybe the patient. The person's alive still. It's not a body. It wasn't an autopsy. I don't know. I don't know.

Yeah, because if you're in the room with just a patient and start smelling, there's only two. Then you would have to apologize. Yeah, that would be rough. Would you ignore it? You would ignore it. I mean, it depends. It'd have to be really pungent. If it was pungent, I would apologize. Yeah, you'd have to go. You could pick it up on the patient's face. And you got to go straight to an excuse. You go, holy smokes, I'm so sorry. I tried a new restaurant today. I'm definitely never going back. Like you'd have to. I would try not to put a lot of story into it because that makes it more memorable. Yeah. What happens if there's a

going back to that word, tummy incident during surgery. From the patient or the doctor? No, the doctor. Oh, like if they have to leave to help? Yeah. Has that happened? I'm not sure it happens. Yeah. You can take a bathroom break. Yeah. You just have to re-scrub. Well, you do have to re-scrub. Well, yeah. What if you didn't re-scrub? I didn't think you didn't have to. I just said, yeah, you have to re-scrub. Oh, fecal batter is excused. Well, if it's- Fecal transplant. Exactly. It might save their life. That's not a surgical thing, though.

Where did you go to middle school? She just started middle school. Oh, PS 104 in Brooklyn. Have you been delighted to see Brooklyn come up in the way it has? I haven't realized Brooklyn was coming up. Oh, it's very cool. What are you talking about? I always thought it was cool. That's why I don't know. People only lived in Manhattan and now everyone wants to live in Brooklyn. Oh, is that true? That's a change. I loved Brooklyn growing up. And I had to move to Staten Island for high school, which I wasn't like,

It wasn't a choice. A lot of guidos out there. What was the vibe? You know what's funny? I had the Pauly D hairstyle when I was in high school. You did? I had pictures on my phone. Good for you. Really bad. I had to fit in. You got no choice. You had to survive. They simulate you're a Russian Jew. You had to get that hair as high as you could. I had to figure it out. Oh, good.

Do you want a third Newfie? I was very close to getting a third dog this week. Someone clearly knows me very well. Well, she, way too many. And I didn't even say anything. She probably knows more of your episodes than you do. Oh my God. Are you her Matt Damon? Oh, big time. Oh.

She's not old enough to know she's in love with you, but she's in love with you. It's kind of adorable. Oh, no, he's my Dr. Mike to me is Dr. Mike to Lincoln. So before I got ribbed,

I was talking to a friend of mine that recently got a Bernese Mountain Dog. I love those. And they were like, it's amazing. You have to talk to this breeder, put a deposit down. I was like, okay, let's just put it down because who knows when they'll come. It's like whenever my dog gets pregnant, you'll be like the first to know. And she messaged me this week and she's like, you ready? And I'm like, left her on read for now. So I haven't decided yet. Ooh.

raising a puppy's heart oh my god and like i take it seriously i do the whole crate training thing every two hours out wow it disrupts your life yeah my wife is the ultimate dog person but she has a rule no puppies not a chance she's like let someone else deal with all that we'll take them they're fucking broken we've got a three-legged one inside my husky's three-legged right oh really oh i know this this is kind of sad had a band-aid that was on too tight and caused gangrene that's what we suspect yeah oh my god are you impressed with the research that's

Great. Thank you so much. I mean, the fact that you knew the dates when things happened was impressive earlier. Okay, great. How was it moving from the city? I think she means away from the city. I still have my apartment in the city, but I find myself spending less and less time there. I'm realizing that I'm a nature person. Growing up in Brooklyn, you never thought that's something that you would identify with. You're not even aware that it exists. And now I'm just like, I like sitting with the tree. You're in upstate New York? Yeah.

Dr. Mike, this has been a blast. I had fun. Yeah, did you have fun? It's surreal. Like, it's awesome. Yeah, so for me too. Watching you guys from afar. You really threw me for a loop with that height. I mean, you really, I'm still kind of recovering from that first introduction. Do you do any boxing? I don't. Oh, I was going to say we could spar or something. You fought an influencer. I fought an influencer. Then I fought on Showtime pay-per-view boxing. You were the undercard for...

Anderson Silva and Jake Paul. Yeah, yeah, yeah. Were you shocked that he beat Silva? I was. Very. Yeah. I was also more shocked that I lost right before that, so I was a little not myself. She was a man that crossed the board. Because, you know, I gave up a lot of time training for that. A lot of surprises that evening. Do you watch Couples Therapy? No, it's not. Couldn't recommend it enough. It's a great show. Orna's a therapist in Brooklyn. Mm-hmm.

I think Brooklyn. It is intoxicatingly great. Okay, couple therapy. Yeah, it's working on all the levels. It's like you're rubbernecking and then there's enormous breakthroughs that are incredibly empowering. It's the best show. So what's the favorite show right now? Is it couple therapy? We burned through that. I love Only Murders in the Building. Okay. I love that show. Where is that? You guys are talking about show. I just finished Presumed Innocent. Oh, me too. That's so good. It was good.

The ending? I know. We're not going to spoil it. Dax hasn't seen it yet. Although I saw the movie. It has to be the same ending. We don't know. We're not going to say. There's twists. Okay. I'm not going to say. But I did really like it. Did you watch Fallout? No. I played the game, though. Oh, then you would even be more incentivized to watch it. It's fantastic.

What else do we love? Chimp Crazy. What's that? I've never even heard of it. By the makers of Tiger King. It's on Netflix? It's on Max. Okay. Same director. Chimp Crazy? And of course, now we're exploring people who own chimpanzees, which as you and I would both- Oh, Chimp Crazy. Yeah. Terrible idea to own a male sexually active chimp. What about a spider monkey? Those look like fun.

You're not going to have your face eaten off by it. Yeah, I heard that happening. Oh, here's I'll quiz you. And don't give me a real answer because, you know, I'm giving you fake. Yes. And I'll tell you what, we have a bias to not be made a fool of, basically. So if I ask you how many times you think blank, you already know it's going to be higher than I would think or lower. Right. The fact that I'm asking you a question, there's a hint in there that it's a shocking number. Right. So then you try to adjust. OK, so don't what I'm asking you is to give me the answer you would have really given me without any prep.

How many times do you think a male chimpanzee has sex in the wild in a day? What would be your real guess? One. I probably would have went five. I kind of know their mating strategy. Oh, really? Yeah. Well, because I was an anthro major and I love primates, right? And they have enormous testicles, which is the giveaway of their mating strategy, which is just spread it everywhere. 50 times a day.

Yikes. Interesting. Times. They're only awake 12 hours, Mike. So what does that mean for proportion of the day? Forget the times. Because how long? What is the proportion to eating, sleeping, and sex? That's a great question. There should be a pie chart. I'd give my hands on that. But the sex, let's be honest. It's not for her pleasure. They're in and out. That's what I'm saying. Yeah, yeah, yeah. Have you seen a lion mate? No.

No. Oh, I have millions of feelings. Clearly I need to get on with it. Female chimps. It just sucks. Unless you're a bonobo chimp. Then you're having female on female. They're very inclusive. It's just when we say the male chimps are having sex 50 times a day, that means the female chimps are also having sex 50 times a day. But...

- It's split up. - No excitement. - The male chimp's not having sex with the same female 50 times a day. He's having sex with multiple females in a day. - Is the whole rabbit thing a fallacy? - What's the rabbit thing? - Well, like they say rabbits- - Oh yeah. - Crump all the time or whatever. - Oh, hyphocondy rate. - Like fuck like rabbit. - That's a great word, isn't it? - One more time. - Hyphocondy rate. - Hyphocondy rate. - That's how quickly they reproduce. - Use that. - Yeah. - Hyphocondy rate. - Oh my God, I knew one word you didn't know. - That's a great word. - I'm gonna write that on. - Hyphocondy. - I might get a painting made that says phocondy.

But my point being is if you have this animal that in its natural state should be fucking 50 times a day and it's in your household with all that crazy venom. Well, I've seen like people like aggressive dogs are like, oh yeah, you got to relieve them. I've seen that. I don't know if that's good. Well, we know that if you castrate them, they're infinitely less aggressive. But the relieving component of it. Well.

Well, then we get into this. We're very obsessed with dolphins and people who have had sex with dolphins. Oh, yeah. Didn't you say like dolphins always do it consensually or something? No. What we were hypothesizing is now morally, clearly, legally, no, no. Let's be very clear about this. We'll say it on camera for the first time. Yes. Having sex with animals is amoral. Is this happening? Yes. Many people and some scientists have had sex with dolphins. Like anatomically, what does that mean? Blowhole?

No, no, no. It's a male dolphin. It's always male dolphins having sex. See, I'm learning so much today. So when you go through, okay, it's bad, it's no good, but we can establish a hierarchy of what would be the most evil thing

And what would be the least evil to cross that line with? Because a sheep doesn't want to have sex with a human being. The dolphin wants to have sex with a human. They've shown it time and time again. There's so much footage of these people swimming with dolphins for their fun thing. And the dolphin male gets on top of some poor swimmer and starts pumping away.

They want to have sex with human females. We should stop allowing children at these like dolphin parks. Well, we shouldn't have these things to begin with. They know about like 18 and consent. Oh, they do? Yeah, they know about all of that. They have dolphin school. Yeah. Did you see this viral video? They're so perverted. It's insane. This one dolphin got an anaconda in its mouth and it was swimming up the Amazon and it was fucking.

only to say there was this documentary in the 80s and it was about this team of researchers and this female scientist just says very matter-of-factly she said

You just couldn't study them unless when you got in the pool with them, you quickly relieve them. And then you could study them because until then, the only thing they're trying to do is have sex with you. So you got to kind of do that to even get into this. So is this the same for anthropology and ape research? I've not heard.

heard the tales like these dolphin situations. There was also famously a female dolphin that was in love with her male scientist. And when he left, she killed herself. Remember that? How does the dolphin do that? She suffocated herself somehow. She didn't come up for air. We also had an Armchair Anonymous story where we talked to listeners and there was a man who had a small, short love affair with

Not sexual, but real love affair with this dolphin. And they're very smart and there's some human-like stuff. And then obviously the sexual component. It's very interesting. So we've told everyone if they listen and they are attracted to dolphins that they can always just... That a safe way to say it would just be to write...

hashtag dolphin asparagus. And you're not really admitting to anything, but we will know what you mean. Oh, got it. Like if you're in love with dolphins. Like if you want to comment, you want to tell us that actually it's me, I'm in love with dolphins. That's how you can do it. Dolphin asparagus, wow. They have a really impressive mastoneal cortex ratio, which is relevant here, I think. Because that makes them good decision makers. You should only be dating people that are meant to be.

They can stand by their decisions. They can't be ruled incompetent in a courtroom. They're very with it. That was awesome. Yeah, that was maybe the funnest part. The gutter is always a fun place to splash around for a little bit. A little dolphin humor. Well, thank you so much for being our first video guest. This was so awesome. That's so cool. We picked you because you're so handsome. If you guys make your way to New York, I'd love to reciprocate and I can ask you all the questions about

I'd love to know we're actually going to be there in a minute, funny enough. So yeah, anytime you would want to have us. We're in Midtown Manhattan, so it's easy enough. Have you guys been to Peak or The Edge? No.

No. Oh, I gotta take you there. Peak or the edge? So the edge is the highest point observatory deck in New York where you can go outside and overlook the city. But what's cool is there's a little triangle. I can't stand on it, but you could see all the way down to the floor. And people like lay on it. It's a whole adventure. And then you could eat there. It's like a really good quality restaurant. And the burger's great.

everything they make is great okay what's your favorite burger in the city though you know it's funny i like garbage burgers i like five guys i like shake shack yeah but that's like not sexy there's not a man it's fine there's hardly a bad burger yeah it's like it's hard to like mixed messages i grew up in brooklyn so you can imagine which was always great apparently brooklyn was always awesome i don't know like i treasure my childhood in brooklyn well

Dr. Mike, this has been incredible. You're going to have to oblige me because now I'm going to introduce you to my daughter. Let's do it. All right. I'm excited. Thank you. Thanks for coming. Hi there. This is Hermium Hermium. If you like that, you're going to love the fact check with Miss Monica. Fui. I take fui. I take fu. I take fui.

I'm so lonely. I took four Advils. Oh, to have you with your friends? So I won't wake up for a while and feel alone. No, that's so sad. It's too dark out. Don't look in my Advil collection. They're all gone. Are we rolling, Robbie? That is a ding, ding, ding.

Because this is for Dr. Mike and we talk about inseds. We don't talk about Elmer Fudd, but we talk about inseds. We talk about Advil. Oh, inseds. Yeah. I thought you were saying incest. I'm like, I do not recall talking about inseds with Dr. Mike. We could have. We could have. He was very playful. Playful doc. A rare thing happened. He stayed the whole evening. Oh.

He even got his agent who was down the street waiting for him. And they had a flight at like 10 something. And fully for me, because I liked him so much. But also Lincoln loves him. Yeah.

So I was like, you know, chatting by the gate and I was like, if you guys want to hang, we're going to order dinner. And so, and Kristen's dad and stepmom were visiting. So they joined. So it ended up being all of us around a table. And it was really cute because both Tom and Kelly, the father and stepmother must have said 30 times.

Those were really nice people. Really, really nice people. Really interesting people. It's kind of cherry picking. If I just invite the people that were on the show, they're generally going to be pretty interesting for dinner. That's true. Yeah, it's kind of a stocked pond. It is. To pull dinner guests. And he sent me

What do you think, Jay? This is for us. Dolphin accused of sexual assault at beach. A sexually frustrated dolphin in Osaka Bay, Japan, is accused of assaulting 45 people, biting and rubbing its genitals on beachgoers. Researchers suspect it's the same dolphin due to similar tail fin wounds. So, boy, he said, oh, my gosh, you guys weren't kidding. Yeah. Yeah.

They're out there. You got to be careful. You really got to be careful. Yeah. Look from afar. They're adorable. I know they're cute. They're cute until they're biting you and rubbing their genitals on you. Not so cute. Yeah. Although I would. And there's no dolphin. I wouldn't want the bites. But if he rubbed his genitals on me, I could survive that. No one can take these dolphins to court. Right. There's no dolphin jail. Well, I guess. Are they a sponsor?

Do you want me to tell you about my evening? I mean, I already told you about my evening, but can I recap my evening for you? Yes, please. It was really something else. Okay, let's hear it. Just, we've been busy. Yeah. So when we got off work, which was pretty late, I was tired. I was ready to go to bed. But...

Delta has shown this great passion and interest for basketball recently. How did that happen? I don't know. As I just told you a minute ago, we were at a barbecue for Lincoln School. I took her to the bathroom. As we were walking back from the bathroom, there was a basketball court. And so I said, let's shoot hoops or whatever. And she was immediately very...

very good at dribbling and she was immediately very good at shooting. Wow. And I said, have you been practicing at school? And she's like, no. And I'm like, Delta, you're very naturally good at this. Like really? So maybe that's like in the stew, you know, like encouraging people. Yeah. And it was so genuine. I then went on to fall on her. Yeah. Which was the, maybe the worst moment I've had with her. As a parent? Yes. Other than when I shaved my beard. Yeah, that was rough. You've had a few. Look, you rack them up over time. Yeah.

But in this situation, she got under my legs at some point, like, cause the, I was looking up to grab the ball and then all of a sudden I was tripping over her. And then I made this really dramatic move to step out of the way so I wouldn't fall on her. And I rolled my ankle in that exact moment. And so then I just collapsed. I had no control over my fall and she was already on the ground laying on her back.

And I fell full. I couldn't do anything to stop it. It was the worst feeling ever, falling and knowing she's under me. And I landed directly across her rib cage. And her body let out a gasp. Like it was, she didn't, it was involuntary. I was like, oh my God. I turned, I felt so bad. I was very worried I had broke her ribs. 200 pounds fell on her. That's too much for her little body. Yeah.

She's a baby. She got up and ran to go find mom. All the parents that were in that gymnasium only saw me lying on my daughter and her screaming and crying and running away from me. Yeah, not a great first look. I was very embarrassed. Oh, you were? I was. And in fact, like an hour later, when she was long over it, she cried, cried, cried. She was fine. She even told me she felt better after it, which was very kind and codependent of her.

And then an hour later, I took her back to the bathroom and some of the parents that had been in there. And one of the moms goes, is she OK? And I was like, yep, she's doing good. And then what I love about Delta, this is that she's so weirdly mature in this way.

We got to the bathroom. Someone was in there. So now we're sitting there waiting for the bathroom. And she goes, if I were you, I would have felt very judged by the way that woman just said, am I okay? And I go, I do. I'm thinking that. And she goes, yes. And then she picked the word, the word. She came up, lilted her voice, and she really had caught the whole thing. Wow. Yeah. So.

Oh, I'm sorry you were embarrassed. That was just something that happened. I know. It's just embarrassing to hurt a little girl. Well, on accident. Because my fear was they thought I was being overly competitive with her or something. Yeah, but that's not what was happening. That's not what was happening. But then that was Saturday. And then so Sunday, we got our basketball. And then we went to Titi's house and shot a round. Nice. And her and I played pig, many rounds of pig. Love pig. She's doing great again.

And then I'm like, I'm going to get a basketball hoop. Obviously, this is great. Maybe we should get good at it. And that could be her sport. So I ordered one. And so last night we finish and I see the box sitting there. It's arrived. And I've told her Wednesday, your basketball hoop's coming. And so there were a lot of parts, but I looked at it. And also Kristen was like,

Do you want to get in the sauna? Because it had been a long day. And I go, I'm going to get in. I'm just going to put this basketball hoop together really quick. And this is like a full. 10 foot high with adjustable, whatever. In my mind, whatever. I even said, turn it on. I'll be done in 20 and then I'll get in. Yeah. And that'll be the time it heats up. An hour and a half into the project, I'm not even close to being done. And all of a sudden I'm like, oh my God, I'm going to have experience.

Explosive Hannes. Oh, no. Okay. I run into the house. I go to the bathroom right next to the front door. I Hannes. It's epic. It's serious? Yes. I flush the toilet. Yeah. And it doesn't flush.

And what I know is it's not the harness. That's not clogging the toilet. The toilet's already been clogged. Yeah, you harnessed on top of a clogged toilet. Oh. And now I'm like, oh, fuck. I'm going to deal with this. So then I go get a plunger. Okay. And I'm working the plunger and I'm trying to get the balls. You know, it's ugly work. Yeah, sure. And it needs to be done.

And then that plunger is not getting it done. And I plunge a lot. I'm pretty good at plunging. So I'm like, fuck, I'm going to have to go get that crazy plunger I have out in the guest house. That's got a real long accordion neck on it because this other one's not working. I go get that one. I'm plunging. I'm playing. I eventually lose my temper. Right.

Now, something's going down and I'm reflushing. So it's not great and it's not at its worst point. Okay. But now I'm fucking trying to plunge this thing and fucking water's getting on my legs.

Water? You mean hottest. On the floor and I'm getting mad. Oh, no. And it's on my arms. And now I'm like, no, I'm just like, I feel like I'm like, I'm field dressing an animal. Like, no, I just got to get it over with. Oh, my God. Kill this thing and make it stop squirming. Like, I felt life or death all of a sudden. Why won't this fucking thing unplug? I've been down this road. It won't unplug. I went to battle with this toilet. So now I got to call a plumber. So it never, it wasn't. It wouldn't go down. I'm like, this thing has to be snaked. That's where we're at.

So now I call a plumber and then I go back outside and I resume building this basketball hoop. Yeah. They're busy. They arrive in like 40 minutes. Oh. No problem. I'm still working on the basketball hoop. But they came that day. That's good. They had to come that night. Yeah. I couldn't have slept knowing this was happening. Is there such a... I didn't know that. I thought like, are there emergency plumbers? Oh, yeah. Oh, yeah.

Oh. Well, even Roto-Rooter, which is a franchise, you know. They can come at any moment? Yeah, yeah. Because people have, they have plumbing disasters. I know. I was having one. So they arrive and the first thing they do is they snake the toilet. Well, that doesn't help. It doesn't go down.

So then they go to the outside of the house where you have a clean out, right? And you take the cap off and then you can snake the pipe beyond that wall. Okay. So then they snake from the clean out, still not going down. Now we have a problem that's not in the toilet and it's not in minimally the first 40 feet of sewer main. Okay. They go to the next clean out, which is like at the wall of the property. Okay. Okay.

And I don't even know if I should describe what happened. Mind you, I'm right. That's exactly where I'm building this basketball hoop is like six feet from the final clean out. Okay. They take the cap off the cleanup. What? Mostly tons of water starts billowing out and duty into the yard. No. And I'm like. Human duty. I'm like, oh my God, I can see it's starting to get, we're not dark yet, but it's definitely the sun has set.

Oh, I thought you meant the car. And I'm like, oh my God, they shouldn't have taken that fucking cap off. And when will it stop? Is it coming from the street? Like, is this Los Felices? Ew. And I'm like, oh my God, is it going to, like, it looked for a minute. I actually thought, is my yard going to flood with the city's waste? It would be so ironic.

Kind of warranted, I guess. I guess you've asked for it. I'm also still building this basketball hoop because now I'm going to fucking finish this thing. I thought it was going to take me 20 minutes. I'm like, this is now two and a half hours I've been building this thing. Yeah. And it's now gotten dark. So then I go get some lights. I put some lights up to finish. These guys are six feet away. It smells horrendous. You know, the kids are coming out. Then they're going in. Oh, daddy farted. I'm like, I didn't fart. It's the fucking city sewage is in our yard. You know.

I think Kristen's checking in, like, is he going to blow kind of, you know, like how, how in the red is he on this? And, and they weren't being very optimistic. Right. Cause then when they came in, there's toilets, it's not, it's not, you know, then the second one, they're like, it's not, I'm just, I'm starting to sense from them that they're not going to be able to fix this situation. So they're working on that for a while and they got it. So,

When we built through all this renovation, we did a whole new sewer line out to the wall. But I don't think from the wall to the street was replaced. So, roots. Roots.

When they finally pulled out what it was, they pulled out this mass of roots that had backed everything up from the street. Oh, my God. Oh, my God. So it was. I saved this part of the story for you. Yeah. You knew about the basketball hoop. All I heard was you were in the middle of building a basketball hoop. Yeah, yeah, yeah. All that to say, they wrapped up roughly the same time I finally finished this fucking basketball hoop. And it was three hours long.

that I was doing that. It was my entire night. I finished that and I went upstairs and put my jammies on. Took a shower and put my jammies on. - Did she play?

So this morning they got up before school and they both played the whole time before school. Oh, cute. Yeah. And I do think people should see their dad in this state as long as it's not directed at them. But it was definitely like Christmas story, right? Where I'm in the bathroom, they can hear plunging. And I'm just in there like fucking what the fuck? I'm just like, I'm just mumbling swear words. Yes. Yeah. I

I know. I know. And then they'll peek their head outside and then I'm like this fucking, you know, I'm putting this thing together. I'm swearing at the tools and stuff. So it was like a good three hours of me just murmuring all kinds of muttering, muttering. I was just muttering. Yeah. Dad's mutter. Yeah. Well, it got settled. Jeez. So it was a hell of an evening. Yeah. So what did you do with the poop in the yard?

Do you spray that? Hose the hell out of it. And then? Into this little outcropping of new bushes that were planted. Okay. So part of me was like, that's fertilizer. I mean, sure. Good for them. Yeah. Wow. Are you afraid that they have hepatitis now? I just think. Those plants? I just think your whole yard is covered in poop. By the end, after the wash down happened. I know, but the wash down is really just like diluting it.

Fair. Because it's not going anywhere. Seeping into the soil and nurturing the plants. Okay. That's interesting because we don't mind often. I mean, I do think, and I'm not just saying this to be like a prissy girl. I don't, I'm not someone who loves the smell of my farts. I know that's like a thing that everyone says that like people like the smell of their farts. It's fine. It's one of the few things that.

I take you at face value. You think I'm lying, but I'm not. I believe you. It's so hard for me to imagine. I mean, why would I lie about it? I know. I've said a lot of stuff on here. Yeah, you have. And in that way, I should take it. But it's hard to imagine. You don't like them, but you don't hate them, do you? Sometimes, yeah. Sometimes I hate them. I know what you guys are saying, but I really don't have it.

Right. And that's fine. I think most people do like the smell of their farts. But all to say, they don't like their poop, I guess, because you love the smell of your farts and you did not like having poop on you. Your own poop. I do not want to have my poop on me. Yeah. That's an interesting distinction. Yeah. Yeah. Well, it's not healthy to have your poop on you because then you spread it around. It's not good. It just, for me, there's not that...

Yeah, if you like it, then you should like it. You should marry it. Yeah. If you like it so much, I don't even marry it. No, I would rather, hmm. I like this. Something big's coming. I think I would rather have poop on me, my own, my own, than smell my own fart. Oh.

I think. I mean, obviously, if I can wash it off immediately. Wow. And in this scenario, obviously you can't smell it because that would defeat the purpose. Exactly. Right. Correct.

No smell, but if it's on me and then I know I can wash it, I'm not, I have no. You're fine. But I think it's because of that. It's like farts. You don't know how long they're going to last. That's part of the fun. That's where you get the dopamine because it's unpredictable. And that's where kind of the fun of it is. Happy for you. Happy that you have that. So anyway, that was my evening. What was your night?

No, nothing. Just worked. Plumbing worked great. My plumbing. Didn't assemble anything. Has worked great. Yeah. The blessing of all this, if I'm being honest, again, all these, there's blessings in all this. Yeah. The whole house was clogged. Yeah.

So we could have been discovering this at 3 a.m. True. We could be discovering it at 6 a.m. when we're all trying to get ready for school and I gotta go to work. Yeah. So in a weird way, what a blessing because all the toilets would have started backing up. Blessing in disguise. Ding, ding, ding. Armchair Anonymous coming up. Check it out. Coming up. All right. So Dr. Mike, I looked for his inspirational quotes. Oh, yes. But the Twitter, the X app,

I can only go to 2020. Really? Yeah. Because you're in pain or something? When I scroll, like when I, uh-oh. By the way, it takes probably a very long time for you just to scroll to 2020. It took so long and then now like it's off. It's off. Okay. So I can't get his inspirational quotes. He's probably glad about that. What do you think, what variety do you think they were?

Like stay positive kind or work, probably work hard kind. Nose to the grindstone. Because he's a hard worker. Yeah, but he liked, but part of his videos were like, you can still have fun. Still go to clubs. Yeah. Yeah. I'm going to go ahead and assume that they were work oriented. Okay. Do you want to, do you want to make one up that you think he would have made up? Yeah. Nothing tastes as good. No, that's a.

what's that nothing tastes as good as skinny feels i say that to myself all the time out loud it's kind of like remember our trip to the sand dunes when i said no calories on your birthday yeah yeah it's been a long time since we told that story yeah tell it that was fun yeah it's not even it's only good at the very end but how does it even originate it was someone's birthday

It wasn't yours because we weren't in the Sand Dunes in August. We were there for Thanksgiving. We were there for Thanksgiving. Okay. And we were eating Thanksgiving food and it was all delicious and it was rich and it was, there were a lot of calories involved. For some reason, I just said, past the such and such, no calories on your birthday. So then the next day I did it again.

And then I started this thing where I would tell a story that was unrelated to calories and I would end it with no calories on your birthday. But it was it was incorporated well, like you would tell us about this woman. And then by the end, it was like and then it was a totally made up story, but it sounded real. And then the punchline would be and she said, no calories on your birthday.

It worked pretty good. And then it was starting to get a little long in the tooth. Like I was doing it too much for sure. But then we left the sand dunes and we all checked into this hotel in Palm Springs for a night. Yeah. And everyone was in a panic of have we ordered food for the kids?

And so I claimed I had ordered the food for the kids. And everyone's like really paying attention because it's like it has to happen. I'm like, don't worry. I ordered. I got so-and-so something, something, something. And then they I don't know how you guys feel about this, but they you get a free milkshake with the kids meal. And I was a little bit nervous. But then I said, no calories on your birthday. And it had been days. Yeah.

And all of it was fake. Yeah, everything you said was fake. That was also, it was just like, you've wasted so many minutes of our lives telling us these stories that are fully made up. Oh, man. Funny. Anyway. You found some. You found it? Oh, wonderful. Oh, my God. Does your ex go past 2020? Maybe being on a computer is helpful. No, I was on my phone. It was...

2015, yeah. What I like about this is we already, now we guessed. So it's a real time find out if we are right. Choose a job that you love and you will never have to work a day in your life. Now, I am going to have to call bullshit on him because I said you were stealing quotes. He said Noah was making those up and that's definitely existed before he used that. Well, this one,

But by the way, that was hard work related. It is. Okay, but that one, to be fair to him, is printed on a piece of paper and it's obviously in his office. And there's a hanging stethoscope next. That's how we know it's a doctor's office. No, no, no. But okay, now you have to look at his caption. His caption is probably the quote he's probably... It says, step one, know thyself. He's using biblical terms. That's a big swing. Step two, find a passion. Step three, enjoy the ride.

Found mine. Have you? Classic. He's a natural at... He knew about social media long before anyone else you ask a question so people feel it. Yeah, engagement. Prompting them. Wow. Next one. Okay, so you're right. So he's...

The post is fall for their strengths and you have something. Fall for their weaknesses and you have something extraordinary. I'm going to have to think on that one. I don't understand that one, but let's read this caption and maybe we'll. Human vulnerability is a beautiful thing. Oh, we love that, Dr. Mike. Yeah, we love that. Focus on the whole package and appreciate the faults. Enjoy exploring how they got there. The flaws tell a story, a story that's...

We can't see the rest of it. Great message. I get it. I think he wrote this after he screwed a girlfriend over. Oh, and he wanted forgiveness. I'm teasing, I'm teasing. I love Dr. Mike. Okay. Now another one is also one that's not his. Correct. And it's very, very long. And then he just wrote, yes. So we're going to probably not do that one. Okay. The next one is. Although let's see what message he wanted out in the world. You want to read this one? Sure. Life will break you. Nobody can protect you from that.

and living alone won't either, for solitude will also break you with its yearning. You have to love. You have to feel. It is the reason you are here on earth. You are here to risk your heart. You are here to be swallowed up, and when it happens that you are broken or betrayed or left or hurt or death brushes near, let yourself sit by an apple tree and listen to the apples falling all around you in heaps, wasting their sweetness. Tell yourself...

You tasted as many as you could. What if midway through you got like... Started crying. A huge lump in your throat. You know, I'm not very sappy. Hey! People could never see you. I couldn't kick you in the act. I know. This is a huge improvement. This is what I said. I want to sit over there. I like more distance. If you'll...

Yeah, a little bit. Well, and I just want to say for the record, we are not making fun of Dr. Mike. He made fun of himself. Exactly. He had a very good sense of humor about this. This is all very in keeping with Dr. Mike's playful, sexy energy. Sexy tiger. He's also like probably 25 in these. Yeah, it was a long time ago. Okay. The last one is very cheeky. Oh, you have another one? Yeah. Oh, okay. I do too. Yeah.

You want to read it? An apple a day keeps anyone away if you throw it hard enough. That's just good. That's just hilarious. Yeah. But he likes apples. These last two are apple related. Also biblical. Interesting. Very interesting. Ligon's learning the Old Testament right now at school. Oh, wow. Does she have questions or she has thoughts that are interesting to share here?

Of course, of course. Let's hear. Well, she learned that God said, you know, this place is for you. It's an Eden. Don't eat the apples. She said the apple symbolizes wisdom. That's probably an atheist point of view, but I don't know where she got that. Interesting. I was like, oh, that's interesting. Don't eat the apples. Why wouldn't you want to consume wisdom? Well, he didn't say that apple represents wisdom. She

She's saying the apple represents wisdom. I don't know that we have a great explanation for why you're not allowed to eat the apple. It was a test from God. It's a test from God. Yeah. And so the serpent gets Eve.

that betraying, conniving bitch. Yeah, big old bitch. To tempt Adam. Yeah, this mean bitch. Yeah, he was so good and pure. He would have never eaten that apple. No, he was such a good boy. He was a good boy. He was a best boy. He would listen to his dad. Cool guy, sexy man. Yeah. And he always listened to his dad. His daddy. And this mean, evil.

Evil bitch comes along. Temptress Siren. Yeah, and then she fast forward and she said, and then, you know, we learned about Noah and he had to, God had to kill everyone because something was raining on earth.

Evil, for lack of a better word. I said, well, hold on, hold on. Are we to believe that Noah and his wife populated the entire planet? That's a lot of inbreeding. And she said, no, he brought his three sons and their wives. And apparently God told them, you cannot have sex on this boat.

I mean, I don't know why. Because like it'll tip. There's a lot going on in that boat. So many animals. Motion of the ocean. Yeah. For whatever reason, they were not supposed to fuck on the board of the ark. One of the sons did. People that are really biblically inclined are like screaming at their dashboards right now. But he and his wife did. And they had kids. And then those kids then brought back the same evil that

God had just rid the planet of. And now he said, I'm not going to meddle anymore.

Oh, he's sick of it. That was his declaration. He was tired of it. And I said to her, and I'm like, so he really fucked that up, God. Basically. And she's like, yeah, he just can't seem to make a plan that works. Do you think this is where the term rock the boat comes from? Don't rock the boat? Don't rock the boat, maybe, Wob? Wobby? Hello? It's Robert. Wobby.

Well, Delta just chimed in. She's not learning about the Old Testament, but she said, that's your Adam's apple. Yeah, it is. I said, that's why dad has so much wisdom in his voice. Oh, God. Did you teach her about the clitoris and that's where we keep our wisdom? I don't see nothing wrong. It's time for the Doughty Datter Dance.

With a little bum and grime. So what I have decided about that daddy-daughter dance is if it ever comes across my desk, and I'm expected to do it, even though I will not pay for a wedding. I'm just, they got to figure that out. Really? Yeah, because I didn't have one. I think it's absurd to spend that much amount of money. You're starting your life. You are so all over the place. Okay. Say more.

Sometimes I worry I don't know you anymore. Yeah. That's probably what it is. That is what it is. This isn't new. Obviously, I didn't have a wedding, so I think it's crazy to spend a bunch of money on a party. I get it. When people are starting their life and you could buy them a freaking starter home for what these weddings cost. Yes. So I think it's a dumb use of money. I get that. Invite some friends over, whatever. So that's not inconsistent. No, it's not. Very consistent. Yeah.

If my daughters want a daddy-daughter dance, by God, I'm going to give them one. I know, as you should. That's consistent. Yeah. Now, if it comes across my desk, I'm going to do the thing where I'm going to learn like the jitterbug with her or something. I'm going to put a month into it being the greatest daddy-daughter dance you ever saw. That's fun. Props, chairs, aerial stuff.

And then that would be awesome because that would just be me and one of the two daughters performing together. Yeah, that's great. No, that's – but then – but you have a stance about asking the dad's permission, which that to me feels very old. But this – it's like we're in the same world. We're in wedding world. We're in marriage world. Yet there's a lot of inconsistencies in thinking about –

Well, and that one thing is like steeped in tradition that I'm honoring. But again, I'm just going to put a really fine point on it. I don't believe in the permission part. Yeah. Good. I don't. That's not really what I'm doing. Yeah. In the same way that I'm not celebrating Jesus' birthday on Christmas. I know. Yeah. So I just want to be clear about that. Yeah. I'm saying to him, I'm humble enough to come acknowledge this is the most important thing in your life, your daughter. Yeah.

And I want to show you my character and that I can bend the knee and honor you right now. Yeah. I mean, I know what you mean. It's just is an antique. It's an old school tradition. Yeah. And it is, it's based in things that are old, just like...

paying for a wedding is based on things that are old. Like a lot of these things are based on old foundational structures that are gone. And like, and, and it's just, and look, we all do this. We all pick and choose what works for us and what doesn't work for us. And it's just, it's all a car, but it is, it, it, it's hard to predict. It can be hard to predict. And it's scary when you can't predict people. Yeah. But also it's why we like people.

a lot of people we like. Max Maxis? Well, novelty is burbling up and it keeps everything interesting and exciting. It's like we want total predictability and we hate total predictability. It's another great dichotomy and paradox of just what even what we want.

It's like we want safety and predictability. And then you have it. And then people are bored and disimpassioned. Yeah. So then you're trying to like, you're trying to infuse novelty and excitement and keep the, you know, it's all like trade-offs. But it's, I think that's different for everyone. Everyone has a different level of novelty seeking. We all want some, but there's definitely a spectrum. And we talked about this on next week's Faction. You can't say that. Yeah.

I have to say it's sort of because it's what's happening. And then it's going to sound weird when they hear it. But I like safety. Yeah. I really, really like safety a lot. And I seek it out. And I seek predictability out. You don't think so? I mean, there are things. I know you like safety, but I don't think you're attracted to safety. Like you could have gobbled up at any moment.

A ton of safe options that are on the table for you. And you're not attracted to those people. You mean, oh, you mean partners? Yeah. Well, I mean, I still- This is the tension we live in. No, no, no, no, no. You mean safety like a personality wise? No. That's, oh, what do you mean? Highly predictable. Yeah. Highly trustworthy. I mean- I don't think-

Do I? I don't know if I've had those options. If that's what you wanted, you could have had that so easily so many times. Yeah. I mean, yes, you're right. Those aren't things at the top of my list of what I want. They don't wake up your attraction. Yeah. But they're probably what I need. Totally. But again, this is pretty universal. I think it's like that is the tension everyone's trying to get whatever the peak amount you can handle. Yeah.

So you're getting the most amount of excitement and then whatever, you know, whatever the minimum requirements you have for safety and all that. But you're not just like running towards super safe. You're not like, oh yeah, this person, they don't even leave their apartment. They're never going to talk to anyone else. You know, like you're not. No, but that's not what, that's not what I mean. We're look, that's looking at it in such a. Monogamy way. Or no, it's just such like a black and white. Like to me, safety just means like, I basically know.

for the most part, what this person's gonna say or do or think. Like I know them, I know what's. Yeah, yeah, and I got you. So you're saying even if it's on the outrageous end of the spectrum, there's a zone in which their outrageousness should be predictable. Consistency, or so I think it's more consistency than it is,

I guess it's the same thing as predictability. But like Eric's not safe. At all. But he's very safe to me. That's what I'm saying. That's exactly what I'm saying. He is not safe. He's outrageous. He'll say the craziest stuff. You don't know what can happen. And we both are so attracted to him. It's a live wire. But he. You do know. He's not going to hurt you physically. Right. Exactly. That's about all we can say. He's not going to hurt you.

you, but you know you're probably going to get something absolutely outrageous. But yeah, he's consistent. I just mean in life, not just with people. Yeah. Again, next respect.

I like routine. You like to know your toilet's going to flush when you flush it. I do. Then it won't be backed up. I appreciate that. And I like seeing the people I like to see. And I like, you know, yeah. Yeah. I just think it's a fascinating paradox of people. It is. We all struggle with this. We still want to be surprised a lot, too. Well, it's why social media works.

We're playing a slot machine every time we go on there. We like that. We obviously like that as a human. Then you're back in Vegas with a handle in your hand. I know that song. Yeah. Yeah. Back. It's a good song. Do it again. You claim you don't like gambling, but then you're back in Vegas with a handle in your hand. That's a ding, ding, ding to what we're talking about. That's right. I thought of the purpose. Oh, yeah.

Thanks you to the people in the comments. Remember the other day you wouldn't remember, but I was saying, I was like, and I can't go for that. It led to the witch song. I don't give a about, but the original song I was trying to sing is actually a Weezer song. I don't care about that. Ah,

They were like, you were thinking of the Weezer song. Oh, that's funny. And that is what I was thinking of. People are on top of it. I do too. Buddy Holly. Buddy Holly. Just like Buddy Holly. Oh, that's funny.

That was such a huge song. Okay. So he said he does pap smears. Yeah. Or did pap smears or whatever. Yeah. I don't know what I would do if my doctor came in and he looked like Dr. Mike and he was going to perform a pap smear. First of all, this is why like absolutely no to – For you. For a male – kind of any doctor. Not any. But I do prefer women because –

Yeah, I'm never going to try to impress them. This episode should be called Paradoxes because I honor that and you're totally right. But can you imagine if a man said only male doctors? I mean, I think a lot of men will say only male like testicular doctors or whatever. You have a woman. I wish. See? I'd way rather have a woman.

I think mostly the women are like, I won't have male patients. Like it's more, it's always a protect the woman because the women are the ones mainly getting assaulted. I accept it. I'm supportive of it. I'm just pointing out the paradox. It'd be crazy if I said like, I would never have a woman doctor. Yeah. Women are stupid. No, they're just often, women are not often hurting men.

physically. They have and they do and they will. I'm watching a great Netflix stock right now. If you watch the Love Stalker or whatever one, I know you've seen it pop up. I haven't seen it. It says like lover stalker or something and it is wozers. And it's a woman doing some nuts. Yeah. Yeah. Look, we are all capable. We're all capable of all things we are. I am

I'm for sure not saying otherwise. Yeah, but proportionally, get real. Yeah, let's look at Larry Nassar. I mean, come on. It's quite lopsided. Yeah. But anyway, whatever. I mean, I had a male, I guess he was a student or something. It was during the egg freezing. Okay. And so he was in there with my doctor. Uh-huh.

And they asked and it was fine. You let him stay. I did. I do remember being on edge in a different way when he was in there. And he was also attractive. So I want to ask some follow-up questions. Oh, he was attractive. Yeah, he was. And so with Dr. Mike, I mean. That's what I need to get really specific here. Are you saying you wouldn't want Dr. Mike because he's just a man or he's so hot

A, now I'm insecure, self-conscious, or B, I don't want to be aroused during this. Okay. So there's so much to answer there. If a man's not attractive, I don't want him there either. Okay, great. So you just don't want a man. I don't. Yeah. But with Dr. Mike, if he walked in, I would feel very self-conscious and worried. Okay.

I hope he likes what he sees. Yeah. And that is not what you want to be thinking about when you're getting a pap smear. But what if you were now, let's. And the, okay. I know you want to hear about the arousal. Also, what if you were feeling very confident? Like, I can't wait for him to see. But you never know. You never know what people's cups. I can't wait for him to see this. What if he walked in and I was already undressed?

I was like, ready. Check it out. I'm ready for you, Dr. Mike. You never know what people's cups of tea are. That's true. So as confident as I could be, you don't know. You don't know. And you don't know what people like. You get what you get and you don't complain. Yeah.

And so I would feel nervous. Yeah. And excited. Do you think, what if I like had my top off and he was like, you don't need to, for a pap smear. He's like, you don't need to take your shirt off. No, no, I know. But I just, I feel better. I feel more comfortable this way. I'm so bound up and it's a vulnerable situation. I feel much better with my breasts out. I'm much more comfortable this way.

And then what would I do? Because I also would, because I like him and he's nice and he's a great doctor. I wouldn't, I would feel codependent and nervous to say I would really prefer if a female conducted the pap smear. Yeah. Or you put on like an ugly mask. No, because by then I already know it's too late. It's too late. And then yes, I would be

I'm a little nervous, a little. I mean, look, I don't think, pap smears are horrible. They're terrible. It sucks. Speculum in? No. Yes. Okay. Yes. It's not fun. So I don't think I would get aroused.

But what if? And then you're in your head and then you can't be natural if you're in your head. You know, lots, lots at play. Yeah. And I'm in a much different scenario. As the aforementioned assaults on women, I'm not ever nervous I'm going to get assaulted. Yeah, exactly. So I'm in a different headspace. Yeah, you're in a different headspace across the board. Yeah. My computer did just die. Okay.

Do we have a situation for this? We do have... Let's see here. Oh, great. I have a charger, actually. Perfect. Thank you. Poipums. I'm going to... I've been meaning to tell you guys both this. You can go on the other side. It's broken. No, no. I mean your other shoulder. Oh. So you're not like...

No, no, no. You repped. Oh, my God. It's like watching. I would love to watch you build that basketball. I never have ever claimed to be good at spatial stuff. Yeah. It's not your thing. It's not my thing. But I have wanted to tell both of you. I wanted to admit something to both of you. I bought a new laptop like. Finally. Like months ago. You did. And remember, Rob, you set it up for me. Yeah. Yeah. Yeah.

- She's never refused it. - I'm like refusing to use it. - You are such. - I don't know what's going on mentally. - Yeah, this is the bathroom door and the. - Yeah, I do know what's going on mentally. I'm like clinging on. - Yeah, what we just talked about, predictability. - I'm clinging on for dear life. - You know how this thing's fucked up. - That thing doesn't have any space on it either. - It's not functional really. - Yesterday, when you tried to put something on it and you were like, oh, there's no space. I was like, fuck, I am gonna have to move over.

Yeah, the hard drive has no memory on it. It has no memory, but it has all my memories. Right. You can still keep it. So that's important. It's taking a long time to boot up. Yeah, the other one probably would. The battery would probably. It was really expensive, too. Like, I bought, like, the nicest laptop. With a ton of memory and stuff. Yeah, and it's just sitting. You should leave the price tag on it for when you take it out to do in public.

You're doing your editing at these bars and restaurants you frequent. Does anyone ever complain to you? Any patrons? Cause no, cause you're, you're drinking the whole time you're there. Yeah. I make sure to have something in front of me, not drinking necessarily. Sometimes I'll just order food. Just throw it in the trash. I do try to really milk whatever drink. Yeah. Like drink it so slow.

So that I can be there for a long time. Yeah, yeah, without it raising any red flags. Do you ever buy people's meals that you don't know? Yeah. Yeah. I've done it. It's fun, right? I like doing it. It's really nice. It's really fun. Yeah, it feels good. Sometimes it gets complicated. Yeah. I tried to buy, so this is not someone I don't know. Bill, my dad and contractor and- I hate to bring this up, but I'm meaning to.

I haven't seen anyone working over there in so long. Okay. Have they stopped? No, they haven't stopped. They're like wiring the house. So maybe. Are they doing that remotely? Well, I don't think wiring is that big of a, maybe you just don't see it. Yeah. Have you been over there in a minute? Well, we took a walk on Sunday or something and we walked by it.

It just looks the same as it's looked for a very long time. And I'm not seeing any cars parked in front. I'm around. On the weekend. Well, no, even during the week, I'm not seeing them. Well, I have because I can't park there. Every time I try to park, I'm back on Hobart. I'm not even trying to...

this is something that has happened between us. You reminded me, you've mentioned a few times, like why don't you park in the neighborhood? - Yeah. - And that's a fair question. And I said, well, it's hard to park in the neighborhood.

And that's because there are cars all over the place. There are cars like outside your house and then there are cars outside my house because of construction. And I said that and then you asked me again and I said it again. Yeah.

You tried it. It got in my head a little bit. I was like, oh, okay, maybe I am wrong. Maybe it is fine to park inside and there's plenty of space and I'm crazy. And two days in a row, there was- The wires were there. There's no place to park and I had to drive back out and it took long. And then I was panicked because then I'm late and I could have just parked on Hobart to begin with.

And I should have listened to my own intuition. Yeah, you always should. Okay. Now, oh, you mentioned our astronaut that we had on a long time ago. Yeah. And you said you thought he was the longest guy in space. American. American. Yeah. The longest U.S. astronaut.

Space flight? Yeah. Frank Rubio, he spent 371 days in space. Oh. So that's not who we had on. Nope. No, we had the twin. Scott Kelly. Scott Kelly. Scott Kelly. Well, anyway, Frank Rubio. Good job, Frank. Blue Origin is the Bezos Aerospace Company. Okay. Blue Origin. Oh, the new number for happiness is.

For the money? For money is $500,000. Okay.

Seems like they keep fixing it a lot. Yeah. I mean, I think that's correct. Indicative of the original 75,000. No, I thought it was 170 was the one. I don't know why that number is in my head. But, you know, 500 is a substantial living. Well, originally it was Kahneman. Oh, it was? Yeah. And it says here, and it was in 2010, and it said found that money could only boost happiness up to about 75,000. Wow. Yeah. Yeah.

But new studies say 500,000. Okay, great. So keep pushing until you hit 500 and then put it in neutral. Yeah. Plateau. That number...

resonates for sure that's right but it's also so different around the country exactly okay genetic sexual attraction we talked about that a lot most people say is pseudoscience what is what what genetic sexual attraction the attraction basically between like an adopted mom or dad reuniting with their kid but there is there's a there's like science around it that

that has to do with like smell and reuniting. Well, that's what I was saying is that the smell hadn't imprinted. Well, this is the opposite of that. What article? I wonder if it's the same article I read. It's from Cumbria County Council. Nope. This...

Dax. No disrespect to Cumbria. I'm telling you that most things I found normal were like, no. Like that's the only thing that's saying it's a possibility. There is a Wikipedia on genetic sexual attraction, a hypothesis that attraction may be a product of genetic similarities. While there's scientific evidence for this position, some commentators regard the hypothesis as pseudoscience. And then I, the more I looked around,

Everyone was saying that. God, I'm going to find it. I would like that. I would like to. It was from a very legitimate news source. And it was just, now, the explanation, I have no dog in that fight. Yeah. But my claim that it's an inordinate amount that that happens to, I stand by. I'll find the article. Find the article. Report back. Weird phenomena. Yes, if you grow up with a pet, you are significantly, your chances are reduced of developing a pet allergy later in life. That is true.

The second season of Dr. Death was, you said maybe it was about stem cells. - It was about the cancer guy in Michigan. - Cancer guy, yeah. - Yeah, maybe third was stem cells. - Cancer guy. - Surgeon guy, cancer guy. - Miracle man is the third and that is about, oh, smart and handsome surgeon. - We trust good looking people more. - I know, then bad magic, maybe that, ooh, that one sounds good.

When a young charismatic doctor. Watch out. Get ready for your pap smear. Get your bra off. I'm not seeing stem cell. But we did. I think we had someone on who did a podcast on that. And then The Dolphin Who Loved the Woman. That was a NASA funded project. The woman's name was Margaret Lovett. You can read up about that if you'd like. Okay.

But we've talked a lot about it so it can be done. Brad Pitt, according to the internet, was 155 pounds during Fight Club. 155. That's thin. Because he's six foot tall. Yeah. Tall boy.

The stem cell thing, I think. So Laura Beal, when she came on, she was talking about her new podcast, Bad Batch, which was about stem cells. There we go. Thank you, Rob. That makes a lot of sense. So the original reporter from the first season of Dr. Death's second project was called Bad Batch. That was not connected to Dr. Death. It wasn't under the Dr. Death umbrella. That makes sense, yeah. But I think it's still Wondery.

Still Wondery. Oh, cool. Ding, ding, ding. Under the mega umbrella. What would you call above an umbrella? Oh, the sky. Okay. The atmosphere. A canopy. It's in the, oh, yeah, that's good. Wondery canopy. Oh, nice. That's nice. Very nice. Very nice. Oh, well, that was fun. That's it for Dr. Mike. Yeah. I love you. Love you.

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What's up, guys? It's your girl Kiki, and my podcast is back with a new season. And let me tell you, it's too good. And I'm diving into the brains of entertainment's best and brightest, okay? Every episode, I bring on a friend and have a real conversation. And I don't mean just friends. I mean the likes of Amy Poehler, Kel Mitchell, Vivica Fox. The list goes on. And now I have my own YouTube channel.

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