How much data do we actually want about our bodies?

0:00Thank you so much.

0:30free to get started. Try it for yourself and visit mercury.com to learn more and apply online in minutes. Hello, hello. Hello. We're all home. I feel like this is unusual over the past couple of months. Usually someone is on the road. It is very gloomy. June gloom doing its thing. It's actually pretty gloomy here too. In New York, it's been raining and it's gotten cooler, which is nice. So I'm actually pro the temperature that is coming with this rain, although it's very humid, but I'll take it. All right. So what's going on? Oh man. I feel like we've had a lot of like little, like low stakes controversies on the internet lately, which are like the most fun.

1:11Did you guys see the, the wired dialogue, uh, expose that I think, I think published last week, but I didn't get around to reading it until this weekend. I saw you guys text about it, but I don't know what it is. So I'm excited for the great chat debrief on it. Yeah. So maybe the TLDR is a hacker group got a hold of the member and guest list for this annual event called Dialogue that Peter Thiel is a convener of. It's like a two decades long annual event and wrote kind of like a breathless slash conspiratorial article about who was in attendance and what the topics were. And it was funny because the internet reaction to this piece was very split for a less tech insider audience.

2:09It perfectly fed into the narrative of, oh, there are all these evil fascist tech people who are scheming. And there were politicians there as well. And so it was seen as this underground society, secret society. And then tech people were like, wait, what? Like dialogue? Like I've been to dialogue where like, I know a bunch of people. It's just like another tech conference, invite only tech conference. And so it was kind of wild to see those like two worlds coexist in the timeline, but also to see Wired having fully aligned itself with one of those worlds and catering to one of those worlds despite its tough roots.

2:46So that's my best summary. Yeah, and it was funny. I think Sally made this comment, but it was like, this is such a well-attended thing by journalists that Wired is pretty much just outing itself as having never gotten an invite. Which is funny. Similar to you, I've heard of dialogue for many years. I've worked for two CEOs who were attending. um and so there's like not like crap from a calm standpoint that goes into it but there's there is just sort of like a quick briefing like fyi of attending this thing and this is what it is and this is who will be there and i didn't think it was weird like you know it wasn't like oh secret society you're going no if it's on my if it's on my like pr conferences to track list it's not it's not a secret society in like a very recent group chat i think for the for the dialogue this past year somebody was like hey does anyone have a young founder does anyone have like a young like entrepreneur under 25 who wants to attend dialogue because they want to have more young people and people were like nominating folks whatever so i thought it was like a this is like an out in the open now i want to make the like young blood joke but um no no what angela I got it.

4:05Oh, the Peter Thiel vampire or something. Blood Boy. A new Blood Boy is needed. The funny thing was, to Sally's point around journalists getting invites, one of the names that was listed by Wired was Ezra Klein. And I guess it became a big enough controversy in his world that he felt like he needed to acknowledge it on Twitter. And he wrote this really like sort of long-winded defense slash apology that made it so much worse. By saying it wasn't a big deal, he like made it a bigger deal. It's funny. I tweeted something and now I seem to have made it into some of the conspiracy theorists' pockets of Twitter where my tweet is getting screenshot and with comments like, they don't want us to keep digging, keep digging.

4:55Oh my God, guys. What was your comment, Ashley? I love that you're part of the conspiracy narrative now. I know. No, I just, my comment was just, this is the silliest controversy. Any PR person who has been around for the past couple of decades is familiar with this conference. Helen's point about working with execs who went, like if execs had been invited, I would have told them to go. Yes, there were powerful people there, but that is a draw for conferences. The topics were maybe mildly more interesting than most conferences, but that's a really low bar. Basically, I was just sort of like, this feels like a nothing burger.

5:37Now I have been accused of being part of the teal PR campaign to gaslight. That seems very blue sky. Who are these people on twitter that like that activity sounds very blue sky like but i do think that humans it's like human nature to like want to believe that there are a bunch of secret societies that are like totally you know orchestrating the plans like well and we've we've all seen the epstein files right yes but the illuminati like beyonce and jay-z being a part of this like secret society that's also doing yeah anyway isn't there the actual like the bohemian grove like that's like the actual like secret society of like powerful men that meet in the middle of the forest.

6:23I saw tweets bringing that up saying, you know, wait till they hear about Buffington Group. Now, even that is not anymore. And I think even that is like not as interesting as people want to believe. Like I remember when I learned about that like 15 years ago, I was like, what is this? And we're like, it's actually not that big of a deal. So my Ezra Klein comment on that was actually reading his response was like a wake up for me because it was like, oh, who is your core audience? You know what I mean? It's like, oh, okay. I guess we are not your core audience. Right. Because it was so like weirdly apologetic and like making excuses and it was bizarre.

7:03It's like, why did you like something compelled him to write that? I also think some of it was like other journalists who are not in tech. Like there is very much this speaking truth to power. And like I saw some of the discourse among journalists on Twitter, which granted is like a smaller subset of that group than there used to be. Like people were either like, hey guys, this is no big deal. Like in journalists should go to these conferences. Like you should want people there to see like if these all are the halls of power, like you want someone like Ezra Klein there. My reaction was like, oh, this is actually more impressively bipartisan than I would have thought.

7:46That was actually my thought. Like, oh, I'm glad that there are people sort of, you know, on different parts of the spectrum. And then I never thought about it again. And then I think there was also a lot of like pearl clutching and like, how could you, you know, go and endorse that? Basically, the argument that your presence is an endorsement, which is a very interesting dynamic to grapple with. If I were invited to Dialogue, I would go. I'd be fascinated. Although I think I saw somewhere that it cost$16 ,000. So I would not actually go. But if they had scholarships for poor fund managers, I would.

8:27On the topic of events to go to, when you guys get invited by a company or some other sponsor, how do you decide how good an event is that you're willing to go spend time with people you would normally not spend time with? It's sort of like the gift bag. It's, you know, like right now, like I feel like summer is a season of like people are inviting you to World Cup games, to the U.S. Open, to Wimbledon, to F1. Someone was just like, we have a table at Oktoberfest. And I'm just like, but do I want to spend like this event? Maybe I want to spend time with the people that are inviting me. I feel like in my 20s, I would totally go.

9:02But now that I'm older, I'm like. Oh, 100%. Yes, yes, yes. Yeah, yeah, yeah. 20s arc. Yeah. And then your 30s, you're like, there's someone else on my team that can go for me. In New York, it's all the Hamptons parties. Nothing will get me to leave this seat. Yeah. Okay, a couple other Twitter moments from the past week. The Anne Hathaway pregnancy reveal. She is pregnant with her third child at 43. But didn't you just do a press tour for Devil Wears Prada 2 and did not look – was it just an amazing illusion? How did this happen? I think she quopped recently. Yeah. Well, it was funny because people were going back and analyzing those photos and basically how other cast members were putting their arms around her waist.

9:56None of it actually felt like a big aha to me, but we're feeling the aha. It's so funny in these moments because I feel like Anne Hathaway is pregnant. I think Sienna Miller is pregnant. Natalie Portman? Everyone's pregnant right now. Is Natalie Portman pregnant? Yeah. Somebody else is – no, no. Claire Gaines is pregnant. And Natalie Portman, I think. Oh, and Aubrey – Ploset, yes. Whenever these things happen, I'm like, oh, clearly the pronatalists will be so excited. And it's like – Will they know? Do they? Do they want people having kids in their 40s? There are stipulations. Oh, it was split.

10:31It was really like the pronatalist crowd. It was split between people who were like, she's setting a very bad example letting women think that they can have babies at 43 and all the feminists are just going to see this and they're going to wait and fertility will continue to decline. That was like half the proteinitalist feedback. And then the other was like making the case against that, but they're like, no, it's okay because it's her third. And women used to get started at like 18 and they'd have their 12th child at 43. And so this is what fertility – So it was like these two very different response but like both of them if you dig anything you're like oh my god like can we just be happy for the woman like she's excited to be pregnant with her third child but yeah and then I think probably like 99 % of people were like oh that's nice good for her and went about their day yeah I mean separate topic but I think that GLP1s are going to have a more devastating effect to on fertility than some random handful of celebrities getting pregnant in their 40s but what do you mean Am I devastating?

11:37There was a study, speaking of Twitter, that was circulating that are basically showing the differences in men and women's lives post going on GLP-1s. And apparently women's lives change dramatically. They couple up. They break up with their mid-boyfriends and they upgrade. They get job promotions. Okay. Okay. I thought you meant like their health was impacted. Oh, okay. And men's lives like basically just stay the same. And it's so funny because the takeaway is like, let's analyze women, blah, blah, blah. And I was like, let's analyze men. Men's lives are probably pretty good. That even though they were a little chubby, things were going pretty well.

12:18Like they lost the weight and it's like dramatic changes didn't happen. It's like, does anyone else read from this that the way women look is like extremely important? It's like, no one's taking that away? Yeah. I don't know. I feel like you could also read that as like more empowering for, like, I mean, it's, it's both very upsetting that weight is so much more important for women, but also like, all right, maybe this is a more of a lever for women in their lives than for them at home. I thought you were going to say something else because I do some investing in the healthcare space. And so I see a lot of like companies in the fertility world and GLP ones are completely changing the fertility industry.

13:03And especially when we talk about things like IVF, which of course, all the pernatalists love, the number one reason people get turned away from doing IVF is their BMI. And historically, they've been told, oh, go off and you need to lose like 40 pounds and then come back. And like, you know, that was that used to be like a really hard mandate to fulfill. And now IVF clinics and like all these digital health startups are just prescribing GLP-1s and it's working. And so the market for fertility is like exploding. And so I actually do think obesity is one of the biggest hurdles to fertility and GLP-1s are adjusting that.

13:43So we're coming at it from like a bunch of different angles. And I think we could see like a massive increase in NIVF, but also hopefully maybe an increase in people who are able to get pregnant naturally as well. Yeah. I know that some people take it when they're going through infertility who are not obese because it helps with inflammation. And blood sugar regulation, which is, I guess, tied to that and helpful as well. So maybe we're going to have a GLP-1 baby boom. That would be a surprise twist, but maybe it's just women doing on their own because the guys are just sticking with the status quo.

14:24My coworker just came back from his HBS reunion. And I don't know, it was like the 20th or 25th reunion. And his only takeaway was everyone is on a GLP one. It's so rampant. So it'll be interesting to see if that becomes the new expectation of what you weigh and how you look because everyone's on GLP one, that that just like sets a different bar for appearances. Women's health Twitter had like a big week. I think we shared in the group chat, the Grimes discovering menopause tweet, which got like the tech bros all excited. Like Brian Johnson was in our replies and it actually got kind of weird where he's like, oh, actually maybe it wasn't Brian Johnson.

15:13Maybe it was some other, anyways, the idea that maybe you would like remove part of an ovary and then like, and then surgically reattach it later to extend ovarian life. And there was some pretty wacky, wacky ideas. But, but anyways, the TLDR is Grimes sort of just learned about like how awful menopause is. She's, I worked it up. She's 38 years old. So she's still like a ways off, but of course there's perimenopause. So she gets to find out about that next. And was like, why aren't we doing anything about this? Which is funny because I feel like if you're in tech and you're sort of in like the longevity or just you just follow any longevity conversation like there are companies like midi like there's a whole industry around this but i think um she sort of kicked off this like broader mainstream awareness and now all of the all of the twitter bros are rallying to solve menopause so very good guys how apt that if the story arc were that the Twitter bros solved women's health.

16:17It was interesting. I went to a talk by Dr. Lori Green for any like local SF people. She's an OB-GYN that is very sought after, especially for complex pregnancies. And her take actually was, she feels like it's overkill to have these labels of like perimenopause and menopause. And she was like, it just gives women like one additional thing to stress out about in terms of like what I need to do and like how do I label something and what's happening. And it was kind of an interesting perspective as a, you know, women's health practitioner. She was much more focused on just understanding the underlying symptoms versus like being our age and worrying about perimenopause, maybe causing unnecessary stress or seeking unnecessary treatment before you need to.

17:06So it was kind of like an interesting counterbalance too. It's good to drive awareness and it's good to start to drive towards solutions, but the unintended consequences of defining and categorizing and creating these additional stages to go through. Angela, maybe to that doctor's point, it's felt like a useful bucket to throw a bunch of like, you know, things start to change in your 30s. Maybe you're not sleeping as well. Like maybe like, you know, some women put on weight that's harder to take off. And now it's like there's this nice, simple label for it, which can either be comforting or it can like spin you up in terms of like, oh my gosh, what should I be doing about perimenopause?

17:48And you know, you could imagine that this is a way to create a market where maybe there wasn't one before. But maybe we should just segue into our bigger topic because it's kind of on this like broader sort of longevity crossover within tech, our longevity maxing era. Life maxing. I like life maxing because that implies more than just let's try to live as long as possible and, you know, like sort of the more Brian Johnson model of the world. That the sort of big news from last week was mid-journey. the AI image generation company that's fully bootstrapped, introducing Mid Journey Medical. So there are spas in San Francisco, but then also a full body ultrasound scanner that doesn't use any radiation.

18:45And there's this big story around how much better it is than existing technology and it's less expensive and less harmful. I think they mostly positioned against the MRI. And so it was like this funny, again, like two different, very different reactions in at least my feed, which was a lot of people in tech and venture just like applauding this and a lot of excitement, like understandably so. and then from like the medical community a lot of people being like wait wait wait wait let's hit pause and like actually look at this for a second do you guys know anyone who was invited to go and and try it out i saw some people saw ashley vance posting about it i saw ben parr post i like saw a lot of people who were i guess like influencers invited to their invited to their demo day.

19:41No, but I did see people who were like, this seems obviously good. And I'm kind of in that camp. MidJourney is famous for not taking VC funding, right? Yeah. They've got money. They're probably like... Gen AI was, I think, kind of like one of the shallower, exciting AI use cases. And I think that they saw an opportunity to do something pretty meaningful and cool, and they went for it. And I don't know why anybody would hate on that. So that was sort of like my like, what? This is great. This is cool. And I do think very smart because, you know, why this is our main topic for today, like a lot of people are using function health and, you know, learning more about their biometrics and sort of like their genetic background.

20:29I mean, I feel like there was a prior wave of this in which we talked about, which was like 23andMe and forward. And that was kind of the first time where like a lot of people opted in to like, let me learn more about, you know, myself, my ancestral history and my diseases that I might be genetically predisposed to. I was an early adopter of both. So I think I actually held out on the second wave for a while because I didn't see any interesting results from the first two, which was great. You want to not see interesting results. But now I'm doing some of these things. Yeah, it is pretty cool. I think the 1.0 was more like, here is information and insights about yourself.

21:15And then 2.0 feels like, here are insights, here are some actionable things you could do. P.S., buy these 1 ,000 supplements from us. That feels very 2.0 to me. It definitely feels like for those investing in healthcare, Ashley, I don't know if I know you're more of a generalist, but I think I hear a lot about the consumerization of healthcare as a big trend and especially driven by AI. And I think that is probably also symptomatic of some of the dysfunction of our current healthcare system, especially in the US. And now people have tools that can help them take more control of it. But I think that when I speak to my doctors about even the existing Pronovo or I forget the Spotify founders.

22:06It's less that they have any particular gripes against the technology and more that our healthcare system is already like not functioning. And then this introduces so much more, I don't know, like backlog into the system. Because one of the outcomes of doing the screenings is there's no protocol. There's no sort of what you should. there's no set standard of like what you should follow up on. So you have a bunch of people who have a bunch of things that have been identified and then they reach out to get referrals to specialists and they get additional scans and screens. And, you know, we already don't have enough technicians and people to run the screens on just the set basis.

22:40And now you're introducing a whole new volume into the system. So in some ways it actually makes an inefficient, expensive system even more inexpensive and inefficient. So a lot of the dialogue I've seen from the medical community is less. We don't like the technology, but more before we just like toss this technology into the hands of the masses, we need to figure out some way of coordinating next steps. And just from personal experience, I think I told you guys last year when I was in Taiwan, I did like a full body scan and, you know, they had identified all of these things that I needed to follow up on.

23:14And like a year later, I'm still like scheduling follow-up appointments. And for all of them, it's sort of been like a nothing burger, which is a good thing. And of course, like I want to follow up on it. But like, I think about that, then multiply by every other person who's doing that versus like the people who have actual needs. And I'm like, it is, it is, it is easy to see how this can be a huge tax on our healthcare system. And we do need to figure out some way of actually setting up like the right protocol for people to, to follow up on. So that that's maybe like more of a technical, but it was just like a, it's a, I think maybe more nuanced.

23:46I think it's like, I mean, that, that was actually like, there were two main pushbacks from people in healthcare on the mid-journey medical announcement. One was more focused on how it was positioned against MRIs and just a sort of more technical analysis of the difference in ultrasound and MRI technologies and like the limitations of both. And like, it doesn't really make sense to say this is better because they can do different things and they're better for different types of scans and different types of like organs and body parts. And so there was a more sort of technical backlash, which largely to me felt like more of a positioning critique than anything else.

24:30I don't think anyone was saying like, this is junk, we shouldn't use it. It was more like you shouldn't have picked MRI as your enemy. And then the other bucket of response, Angela, sort of like along the lines of what you're saying, and I learned a new term last week, incidentalomas. It's not just that you're going to come out of this scan and there are going to be a bunch of things flagged and the health system isn't prepared to guide you through that from a capacity standpoint. It's also that everybody has so many anomalies. Are consumers of technology like this prepared to have a bunch of stuff flagged that could be scary but is probably not?

25:10so like you know we all could have things that are maybe are like tumor-like but are probably benign and it's like a one percent chance and the only way to find out is to go in there and have like an invasive surgery so it's it's it's almost um there's the there's the capacity side but then there's like are people actually prepared to know all of that like you know i think we're used to oh, I got this diagnosis and now here's the plan. And there's just going to be a lot of things, a lot of things that come up where maybe you should just let it be. But that's going to be really hard for people.

25:50And so I think there's a lot of conversation around people should be able to be entrusted with... They can figure out how to handle the ambiguity of this. And we shouldn't gatekeep technology because we don't trust patients to be able to understand. And on the other side, you might assume that like, oh, if A, then B, and actually like there are just so many things that are unknown and no one person is equipped to sort of grapple with that ambiguity. There's also a lot of legal implications from this. One of these sort of scanning technology companies that is in legal trouble because it didn't flag something that should have been flagged.

26:34That complicates what do you do with ambiguity and who is responsible for deciding what is worth acting on. So it's a whole gray area. But of course, tech is on the side of we want as much data as possible and ChatGPT and I will figure this out. I would say that for anybody who has tried to get an MRI. I had frozen shoulder on both of my shoulders and it was perplexing. No one could figure out what it was. What's frozen shoulder? Oh, well, in the conversation of perimenopause, it typically comes around closer to when you actually go through menopause. So I just got it really, really early. Basically, it's what it sounds like.

27:18Your shoulder just locks up and there's shooting pain going down your arm and back and it's awful. And it's crazy. After I got treated for it, which is usually like a combination of physical therapy and chorizo injections, I started talking about it. And literally every woman in my family was like, oh yeah, I had that. We just don't talk about stuff and stuff or in silence. That's cool. But anyways, my point is, if you've ever tried to get an MRI, which that was recommended for me as a step, it's very hard. There's a lot of gatekeeping. talk about gatekeeping it's like the entire medical system is basically like are you sure you need one can we get like four more notes you know and and so i wonder how much overlap there is uh of people who would have who would have otherwise successfully so easily gotten an mri who would now go get this thing and it's like no i don't think there's much of my hypothesis there's people who would have never gone that path who are gonna like because you know it's tech so So people make the UI so easy.

28:17They think about how to sell and market this thing as something easy that they can do. And they've got data, and that's so interesting. And who now have information at their fingertips that they wouldn't have otherwise gotten. So I think of it very differently. I think we also hear so many stories, or at least people that I know who have shared, like, oh, this was not something that we would have caught had we not gotten some free whatever thing. And so I'm like, I don't know. It feels very weird to me that people would be like anti more information. The woman who leads go to market for OpenAI in their healthcare division, Maggie Haught, has been open about.

28:59She went for a biograph scan and found a tumor where if she had waited a couple of years, she had no symptoms, she waited a couple of years, it probably would have been too late. And instead, she was able to get that surgically removed and she's totally fine. So, I mean, there are these like incredible stories. And I think she then told like every friend and a bunch of people found critical stuff. So it's really, I think it's a really nuanced and challenging and challenging thing. I haven't done any of these. Like everything, this is like longevity. One, two point oh, three point oh, I guess if there was like the 23andMe and the forwards, I guess that's one point oh.

29:44And then the function health, the prenovo. So this is like the 2.0 version. Although maybe like the aura rings or something where like the in-between. I haven't dipped my toe in there, although I do get lots of blood tests just for kicks. I think you're right. I think it's probably so individually driven for people who have found something. You know, they probably would preach. But on the other side of that, and like knock on wood, but you know, one of the outputs that came from my scan was like a potentially like tumorous thing that was probably most likely benign, but like they flagged it. And like once they flag it, the doctors sort of like my position was like, well, I didn't, I didn't do the scan.