Asking Doctor Mike About Health Tech

28:29And even the people who slept and had bad quality of sleep, they performed better when they were told that they had great quality of sleep. And the people who slept great and were told they had bad quality of sleep performed worse. Wow. Yeah. Okay, so I'm just gonna make a werewolf that tells you every day you had great quality of sleep. So you know companies are doing this. And you know which companies are doing this? Dating apps. OkCupid is run, or at least was started by mathematicians. and they said that if we tell people they're at higher match percentage than they really are the odds of them ending up with people is higher and they'll be happier more satisfied and they started doing it and it freaking works that is a really fascinating example because that's such an opaque thing like you don't know no one knows i mean and if it turns into a happy relationship it's also hard to argue against it as well it's weird and it's taking advantage of people but it's yeah But that's the kind of tech thing that kind of gets me scared with AI, because when they start leaning in those directions, I'm like, ah.

29:31I mean, you just segued kind of perfectly into the next segment of things I think we wanted to talk about, which are like generative AI, AI chatbots. Can I make one statement about the final thing about Whoop? Sure, yeah. I just think it's very valuable. Why I also want people to know on their own when they're feeling tired or maybe had worse quality of sleep is because learning about your body and perception, accurate perception, trying to be as objective as possible of how you feel goes a long way to having better health outcomes. Knowing when you're sore versus injured, knowing when there's a true injury or a pain that needs to be addressed, those things are so important when it comes to like long-term health-related outcomes, that if you don't learn that and you trust your phone to do it for you, you're actually missing out on some really good health benefits.

30:25I think what I'm realizing is that, and I'm putting this thought together in real time, that most people go about the data in this wellbeing like kind of backwards. Like you should start with the foundation of how you feel. And then maybe on top of that, you can use this sort of quantifying measures to sort of better understand things where I think some people want to start with, oh, it's a computer, it must know me best, but it doesn't. It doesn't. And then they try to make the balancing on top of the computer's numbers when you should start with really just how you feel. So it's kind of backwards.

30:55Yes, the simple analogy here is we have calculators, but we still learn how to add and subtract. So we still need to learn about our bodies before we start using these apps. Fair. So I'm going to ask ChatGPT. I'm going to ask ChatGPT all the things I don't know. No, this is, okay, so the other version of this, because we talked about, like, okay, a patient comes in, they saw a notification on the Apple Watch. Have you ever had a patient come in with a diagnosis from some, I'm sure not just online, but, like, an AI chatbot or something like that? No, not yet. Or are they sort of wondering? Okay, because this is going to happen, I'm pretty sure.

31:30I feel like that will happen. Or maybe they have, and they just haven't told me. Oh, they didn't tell you. They're not. I mean, I'm sure you have plenty of WebMD people. Like, I know I've been that person before, and I always feel bad being like, I read this online and I don't want to admit it, but that's half the reason I'm here. Some people are like you in that they admit it. Some don't, but I make it a routine question to ask a patient, unless it's very straightforward what's going on, what do you think is going on? Because if they read on WebMD, let's use a basic example, like a cough. A patient comes in with a cough, I'm making the diagnosis, I'm like, it's not bacterial, I think it's viral, they don't need antibiotics.

32:06But the patient went on WebMD and thinks they have cancer, and I go on this long spiel about why it's not bacterial and why it's viral, and then they leave and they're leaving dissatisfied because they don't know if they have lung cancer, I miss the opportunity to actually help the person. I wish every doctor would ask that. You've made me not like most of my doctors. After that, I'm gonna have to start coming to you or something. I just wish, yeah, that's such a simple question to ask that I'd appreciate. Because also sometimes patients won't tell you a little detail or you won't ask the right question.

32:37And then by them saying, I think it's this I would say oh but I don't think it's that because you don't have symptom x they're like actually and I'm like whoa now I know what's going on interesting yeah yeah and I've seen so there's a number of stories of uh you know maybe an ai tool helping to diagnose something faster than a human would where and this goes all the way back to like when I was in school there was a classic business story of you know some dad shares his amazon account with his daughter and he starts getting recommendations for diapers and he's like, why am I getting these? This doesn't make sense.

33:10And like Amazon knows that the daughter's pregnant before the dad does. And it's because these algorithms are really, really good at pattern recognition and finding things often better than humans. And it seems plausible that an AI tool could start to identify patterns, maybe even in the data from the fitness tracker and actually find some diagnosis that's helpful before a doctor could. Is this a future that worries you as a medical professional? Maybe it's taking a job or maybe it's a good thing that it's better and it can help people find things faster. I don't think it's good yet. And I think it's really far away.

33:47I'll explain why. If a problem is that hard to find and does not present itself, treating it will likely yield more negative effects than positive. Okay. Because that means it's not that big of a problem. Right. If you have a legitimate problem, like with your heart rate, you will know. And if you have no symptoms and it's not really affecting you and I had to dig into your data to find a few heartbeats here and there, giving you a medication that has legitimate side effects that I know will have side effects probably won't be beneficial. So that's why I'm down on it. I think the one version of this that is outside of that funnel is like specifically cancer and things that it matters how early you detect them.

34:28So potentially detecting something earlier than a human would, maybe in its absolute beginning, which is ideal. So that is also really tricky because I think that is doable. And I think we need to use our AI tools to improve our screening methods. For example, we have really well-proven screening methods that we use. For example, with a cervical cancer, we do pap smears. When we do pap smears, we've essentially eliminated cervical cancer deaths in women. That's like amazing that we've been able to do that. Obviously, there was the HPV vaccine as well that has helped because the HPV virus actually causes cancer, one of the rare viruses that does that, and the vaccine prevents that.

35:08So we have screening methods that we use that work well in catching cancer and addressing it and all these things. But then there's ones that are screening methods that aren't great that actually catch too many false positives. They catch too many cancers that are actually never going to become a problem that we, in order to intervene by doing a biopsy or something we actually create more harm we fuel health anxiety so it's a very thin line of that balance of when do we screen healthy people and when do we not and i think ai tools can improve our screening methods okay but will they be the final answer for everything probably not yeah there's still a human element of like figuring out when to apply certain things that makes a lot of sense i'm sure and i feel like it's in i feel like it'll never i mean and that's coming from someone on the outside i can't imagine it ever taking over even just like general you have to have like general bedside manner and stuff like it's also nice to just be able to talk to a physical human and they're interacting much closer and i know these chatbots they're getting close to like a full-blown conversation but but then you're also you think eventually i'll get there do you see the path to getting there becoming a burden on kind of the medical community for a while maybe not maybe burden's not the right word but like pressures yeah and and not even like influx of more people coming up kind of like the web md problem of i think there's a world where that happens uh i also think that when you look at ai and we see how right now everyone has this fear of ai taking over and then you have people reminding the general public, AI is very narrow focused in what it can do.

36:47It does one task very well, like chat GPT gives you written stuff. Other ones give you AI generated images. Other ones do a voice. And right now they're very set in their tasks. So I think in that narrow space, AI could be really good because we could train it to do some of the more mundane tasks, find patterns, analyze data to help us improve our screening methods, when we should screen, when we should not for that kind of data analysis. I think that will be beneficial. Do I think AI can fully replace a doctor? For now, no, because it would have to, A, be not as narrow. The human mind, what makes it unique is that is the opposite of narrow.

37:24It's so broad and can do so much. And the relatability, the fact that you know - That probably is important. Yes. So it can fake as being a human, but if you don't have that relatability and you don't buy in - Yeah. Yeah. God, that is that is a whole can of worms of like, well, can an AI fake being a human so well that you don't even know that? That's that's that's another that keeps me up at night. Yeah. Do you think there's on the side of rather patients using like chatbots, doctors using chatbots because you see it being a potential tool in the future for and now maybe this is me thinking about like house a little too much where he has to have these full blown conversations of like it might be this, this.

38:02Let's check the symptoms. And maybe that's not what every doctor does essentially. But could you see it being a tool of you trying to think of something and using it as just something to bounce ideas off? Yeah, I just think it needs to be very well validated. And that's going to be really expensive to do. That's that's the tough part about the tools right now, because they just make stuff up. Yeah. Like we were talking about just like if you're an expert in a field and you ask AI tool like a very basic question, then you can vet how good or bad the answers are. And as someone who's an expert in like tech stuff, we'd ask it a basic tech question and get an answer where we're like, oh, that's not great.

38:36That's not a great answer. So I, you know, the other answers and other things I'm not an expert in seem very valid, but I have no idea of knowing if they're actually good. I mean, it reminds me of an instance that I had when I was in my medical school training. I was working at Coney Island Hospital and I was working alongside one of the top cardiologists. We walked into a patient's room. I knew the patient well because I examined them in the mornings before the doctor does their rounds. And the doctor comes in, gives the correct diagnosis, the perfect plan, lays out even like some options if the patient doesn't want to do plan A, there's a plan B.

39:08Perfect. Like everything's awesome. They walk out of the room, the patient looks at me and goes, what did they say? No connection there. But the information was accurate. It was easy enough that I understood it, but not on a level where they connected. So can an AI not only be not as narrow as it currently is, but also be able to absorb patients' body language, the way that they're interpreting data? Can they verify that? Will people have the buy-in to do that? There's so many factors. I feel like we all nuke each other before that happens. I'm just like, I think it's possible. I think these could all be inputs into the system.

39:46Obviously, it's very difficult and it's a long way off. but uh there's there's all these ai tools of like all right you want to be able to summarize a book or a medical paper we train it on that data specifically and then it can give us accurate answers which are verifiable to the thing it's trained on and so if you wanted to create some magical let's say cardiologist ai doctor you would train it on a hand selected by people like you set of medical papers that have good information and then maybe and it's good enough to give answers that are up to par with what a cardiologist would have said and then it also gets all the information of like okay it's got a camera so it can read your body language as it's giving you information this is all very far out but i'm just picturing like tesla bot at the bedside like i can see your heart rate is high here's what i will talk about anxiety the doctor's office of tesla Yeah, maybe don't do Tesla bot.

40:42That's a little far out. Maybe Wally. I see what you're saying, and I see a world where it's possible. I just think that there's so many barriers, and there's so many ways it can go wrong before we even get to that point that I'm super skeptical that we get there. I don't know. Maybe I'm wrong, and there's going to be a lot. I would trust you more than us, for sure. Can I throw out an interesting medical AI story that came out, I think, last week? Yes. there's a scary half and a benevolent half and i'll only share the benevolent half but a lot of pharmaceutical companies are using models right now to predict toxicity in like analogs for drugs so what they'll do is they'll take a drug they know works and then produce 40 000 different variations and have an ai say oh no this one's going to block this receptor and we can't have that and stuff like that the flip side of that is that are the same a team of researchers.

41:37Bioterrorism. Yeah, a team of researchers, like, to see if it was possible, flipped a few line of code and just had it make different poisons for six hours. Yeah. And that's actually so much less worrying to me than what I thought he was going to say, as funny as that is. Poison's whatever. You got to ingest the poison. That's true. But now, what about a virus that uses your own body to replicate that we can now program using AI to be the most infectious to be the most lethal that only affects certain genetic types yeah holy yeah that's like yeah we were talking about these hypotheticals talk about bioterrorism on full display there was a headline recently actually today that uh neural link yeah it's going there first approval to do human testing and it's really funny reading the comments because half the comments are like i would do it yeah it seems like a great idea like this elon guy is pretty smart i think i want a computer in my brain and then the other half are like i would never be first in line for human testing like we've seen first gen tech products for so long like if you've seen like the first gen iphone the first gen folding phone do you want the first gen iphone version of a human brain implant not really uh but i'm curious where you where you see this i think a lot of times when it comes to these really borderline ethical medical experiments because when we do medical research, they have to go through a process known as an ERB, which is an ethics review board.

43:06And I actually was a member of one of these when I was a student. And they have all sorts of people on them, teachers, doctors, non-medical people, business people, so that we get the general gist of, is this project ethical to go? And using CRISPR as an example, it's pretty uniformly country to country agreed upon that this is an unethical thing to test on humans unless they have an illness that is lethal and they will not survive. So that is why when it came out that, I believe it was in China, they were doing some CRISPR gene editing on an individual to see if they can cure HIV. We found that in the international medical community to be really unethical because HIV is no longer a life-threatening virus.

43:53We have medications for it. So the fact that they were testing it on that virus, we found to be very unethical and when it comes to neural link unless you're implanting this in someone who desperately needs whatever i don't even know what the hell this thing is yeah i have no idea then i don't know who would be first in line to get this thing yeah i don't know enough about what neural link is designed to be but it seems from what i've read to be more of a uh add-on than a solution it's and they've to be fair they've said like oh we've had lots of like examples of it like helping a paralyzed mouse to be able to walk again.

44:26And like, there's really cool possible examples of it being a solution, but clearly not everyone needs it. So it's kind of weird for just like regular healthy people to volunteer for a brain implant they probably don't need. So that's kind of how I see it. And I just wonder like why would anyone do it? There's so many cool experiments like that going on. I remember I was in Israel learning about their biotech stuff and they had four people I believe that had strokes or traumatic brain injuries where they needed to regrow neurons and they were literally using electron fields or magnets or something to try and regrow these fields in order to create pathways for neurons to fire and i was like this is so above my understanding that this could potentially work but at the same time could this kill someone could this girl like i don't know anything about it and we need to be really careful about again there's promise and a lot of stuff but then we got to talk about the negatives because if you don't we can really get in trouble in the world sector of things causing more harm when trying to cause good yeah there's that classic line when good intentions cause bad outcomes i think we need to be more cognizant of that these days because we're very good at being pr people for our stuff yeah like look at all the good that i'm trying to do but could there be bad outcomes for the jurassic park your scientists were so preoccupied with whether or not that they could that they forgot to think about whether or not they should yeah That's a pretty powerful line.

45:56We've been throwing a lot of products at you that we review a lot. Is there anything in the tech slash medical or just healthy lifestyle aspects that you're excited about these days? I am excited about improving things that require calculations. Because we as doctors, A, we don't have time. And B, we're really bad at doing these calculations. Or we forget to do them in a lot of cases. and if I could know right away which patient would benefit from starting a statin, which is a cholesterol-lowering medication, when I should start it on them based on the calculations that are already given to me from analyzed data of millions of patients, that's gonna lead me to give better medical advice.

46:37Genetic testing is still not there yet. For general use for us at home, I'm really negative on people taking genetic tests at home. You're talking about 23andMe, stuff like that. Yeah, like I don't even want to individualize companies. But yeah, I think it's problematic for so many reasons. We could even get into it later. But in the future, I'm really excited about finding out which patients of mine, based on their DNA, would benefit from one antidepressant versus another, instead of having me experiment with them and get a subjective answer when they may have just had a shitty week and they're actually not getting the best medication.

47:12It gets really messy that way. You said we could get into it later. Do you mind saying why you're generally against at-home genetics? Yeah. So A, they're incomplete. Okay. So when you go to see a proper geneticist and you go to a genetic counselor, what they do is they do the most validated tests, the tests that are testing for all different variables of a specific illness, and then they give you guidance based on what we know off the data and what we don't know. And off of that, you could make some decisions for your health. But when you get these at-home tests, you're like, oh, check if you have high or low risk for developing diabetes later in life.

47:51What do you do with that data? What do you do when you find out you have low risk for developing diabetes? Do you eat sugar more? Tons of it. But like, that's bad. That's not good advice. Because your body, your life is not just about diabetes. It's unhealthy to eat a ton of sugar, not just for diabetes. Or the more like a pronounced one with Chris Hemsworth situation, people are getting tested to find out if they're gonna develop neurologic diseases early in life, like Alzheimer's. What is the use of finding that out? There's no intervention in the future, maybe. And when I say no intervention, like yes, eating a healthy, living a healthy lifestyle, all that can mitigate that risk.

48:32But do that anyway. Yeah, you can just do it yourself. Not for Alzheimer's, but for literally every other disease. That's a new startup. It just tells you every time, I'm like, if you don't develop a healthy lifestyle quickly, it's gonna go downhill for you. And it just tells that to everyone. To everyone. Everyone starts developing a healthy lifestyle and everyone's happy. This is the argument that I have with some of my friends. They're like, I should get preventive MRIs to catch things early because then we could prevent certain problems. And I'm like, but all you end up hearing in most of these cases, just like live a healthy lifestyle.

49:01I'll tell you that for free. Yeah. And even that is a little bit more complicated because it needs to be individualized, what that means for you based on your values, your culture, your government, what access you have. I mean, so many different variables. But it's the same thing for everybody. Yeah, I agree. Do you see any current consumer-based tech that you could see helping potentially a more healthy lifestyle becoming more active? One thing I kind of think about is VR and kind of video games that are incorporating more activity rather than sitting at a chair all the time. do you think that there's some minor benefits there of getting someone up and moving around a little more than, I mean, as someone who's - Theoretically, yes.

49:44Okay. And while I'm usually very evidence-based by looking at the collective randomized controlled studies, that's the gold standard, I'm gonna give you anecdotal research that I've done. Sure. Everyone that I've ever met in my life that got a VR product, used it four and a half times, and discontinued. Same, so it's like 10 more people. Yeah, I can't argue with that. So it is more about developing habits than it is finding a quick gadget to help you do something. I think that's the ultimate takeaway when it comes to health. Because there's such a homeostasis between acid base, hot and cold. That thin line exists and it needs to be balanced so carefully that there's no quick fix.

50:25Because any quick fix is going to come with a quick downside also. I guess it kind of goes into what you were saying before about getting things that feel like a motivator. VR is just turning into another one of those like I'm gonna get a two weeks 10. I mean like listen I played Beat Saber non-stop for like two weeks and then that thing hasn't been plugged in. The caveat is if inside of Beat Saber there's some sort of gamification that makes you want to come back every day like closing my rings on the watch like if there's something like that. Yeah like if it creates a community around it where you go to tournaments and it's well thought out.

50:55It could exist. It's the same with relationships. I mean I'm sure you've seen in your personal lives whether for yourself or others any relationship that starts super hot and they're in love day one. I'm going to let it sit there. Yeah, exactly. That's usually lust. And if you're lusting after your VR, odds are you're not going to be continuing it or you're down the line.

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53:02Promoted jobs get three times more qualifying applicants. At the end of the day, the most important thing to your small business is the quality of candidates. And with LinkedIn, you can feel confident that you're getting the best. Based on LinkedIn data, 72 % of SMBs using LinkedIn say that it helps them find high quality candidates. Find out why more than 2.5 million small businesses use LinkedIn for hiring today right now as we speak find your next great hire on linkedin post your job for free at linkedin.com slash mkbhd that's linkedin.com slash mkbhd to post your job for free terms and conditions apply all right i got a little lightning round for you i want to throw a bunch of small tech related medical concepts or maybe just medical concepts tech or like uh people in the tech world their lifestyle choices maybe unhealthy habits stuff i'm wondering about uh first one is david has a water bottle that like tracks how much he drinks every day literally like the battery can die on his water bottle it's hilarious how much water should we actually drink every day it's individually dang it decided first of all i'll can i judge the water bottle uh i wish we had it no no i mean judge it like like oh yeah tell you what i think about it yes yeah yeah i think you've evolved as a species for millions of years and no one's ever been like, I mean, not no one, I should be careful here.

54:3099.99 % of individuals know when they're thirsty and you could just use that as a gauge. If you fall into this rare specific population that maybe you're taking a medication that makes you more thirsty, maybe you have ADHD and you're taking Adderall and that causes you to forget to drink or whatever it is then maybe it's a tool that works but the huge majority of people gimmick it's not eight like eight glasses or whatever every day no that's just made up 10 gallons every time if you were trying to be i guess like medically sound about it you would look at your urine and you would aim to have a straw colored urine okay so like pale yellow fair and whatever that because again if you go outside and you run and it's hot you're gonna need more water than if you sat all day inside and if you have a higher body mass and more muscle Again, there's different variables.

55:17Eight glasses is so random. We have healthy water drinking habits at the studio. Well, we can't say that one last time we came here. We had no water bottles and 12 cases of Red Bull in the kitchen. Somewhat, somewhat. Okay, this might have a similar answer, but how many hours of sleep should I actually aim for? Yeah, adults, seven to nine. Seven to nine. And it's not just the number of hours. It's consistency of those hours, and even more so the consistency of which hours. Would you value a sleep score that can just like do the calculations for how consistent you're being and how often you're hitting those targets?

55:53I feel like most of them do that. Why? Well, I don't necessarily know if I am hitting the same fall asleep time every day. Are you tired when you wake up in the morning? Am I tired when I wake up? I feel like we're getting to the point where I can answer for you because I know how you're gonna answer half of these questions. Sort of? You kind of know that already. You know. It doesn't make your life better to know is my question. No, not really. Can I ask a question on the consistency part of that? Sure. So when you say consistent, you mean it is seven to nine hours every day, every week, not I'm doing six hours this night and then nine hours the next night.

56:30There's no making up for that sleep. Ideally, you find the number of hours that works for you. And it's, by the way, different for everybody. Sure, sure. Matthew Walker, who's a sleep expert, like he's kind of the sleep diplomat. I think that's his Twitter handle. He was on my podcast. And we talked about, he has a book called Why We Sleep. Really interesting book, highly recommend it. He not only talks about that the hours need to be consistent, that if you're sleeping from like 11 to eight, sleep 11 to eight every night. So the number of hours and which hours is very important. Weekends, sleep the same.

57:02And if you don't, it's gonna get messy. but then there's individuals who some people are night owls some people are morning people but then there's also people in between so not everyone is actually designed by nature to sleep at the same time and our society kind of makes that unfortunate distinction that everyone needs to sleep at the same time yeah and that's not the way nature intended it because nature was meant to keep some people up at night maybe to watch over us while we slept so there's like that's the theory of what's going on. And what has happened, I was just reading a great book on the way here called Sapiens through Audible, not reading and driving.

57:41And there was a part that just played that is very applicable here. Back in the day, the shoemaker would make the entire shoe. So if the shoemaker came late to work, no one cared because they could keep making their shoes and they'll be fine. But now in the assembly line in the industrial age, if one person does not show up exactly on time, the whole system falls apart. So it made everyone have to come to work at the same exact time. It created public transportation that needed to bring people at the exact same time to work. But humans are not all the same. And as a result, it kind of has some negative implications on us.

58:15What's the word for, you know this word. Normalization? No, we have like a, when humans used to have a tail, but now it's just like a tailbone. Yeah, like a remnant. Vestigial. Vestigial remnant. Remnant of old, yeah, we don't need to all wake up at the same time. Okay, I like that. uh blue light glasses dumb or actually smart uh for what uh i guess it's mostly for like style definitely dumb 100 percent no i agree but i think most of them there's a whole bunch of all this research that i read and that i keep hearing in these tech presentations about how oh the longer you see blue light into the afternoon hours the more your brain is tricked into thinking it's the daytime and it makes it harder to go to sleep that's sure there's either blue light glasses or your phone will have some mode where it stops showing you blue light after a certain hour Or does this actually make a meaningful difference?

59:02Most blue light glasses are not blocking enough blue light to make the difference between impacting melatonin, which is your sleepiness hormone that your brain produces throughout the day. So closer to the night rather. And they're not really as effective. But traditionally blocking blue light or less exposure to blue light close to bedtime is ideal because you want maximal melatonin to get sleepy at night. So that's true. Most blue light glasses are not even great at doing that. That's number one. Number two, the thing that pisses me off about blue light glasses, they lie. When you go on their websites, they say that they help with eye strain.

59:38Yeah, they do say that. They do not do anything. Blue light is not why you have eye strain. You have eye strain because you stare at a computer without blinking and your muscles are tired. Yes. And you need to, every 20 seconds, look 20 feet away. Every 20 minutes. 20 minutes. I was going to say 20 seconds is all right. Every 20 minutes, look 20 feet away for 20 seconds. Yes, that's the rule. That's going to help your eyes straight, not the blue light glasses. So you're saying the$240 Razor blue light glasses I just got are not worth it? It depends what's worth it to you. If you want to block some blue light at night before you go to sleep, maybe.

1:00:09They make me look really dumb. If you're editing, I'll say that sucks because then you can't get a good color perception of what you're looking at. I fully agree. I will not wear them while editing. We talk about that with the phones or computers because there's a lot of screens that will then reduce blue light. But then I talk about how mine at 10 o 'clock and you're like, how am I going to edit a Instagram picture at 10 o 'clock? My Instagram picture is going to look blue when I post it. It's crazy. When will people stop talking about cold plunging? I don't know. This is like a, I don't want to say it's Andrew Huberman.

1:00:40He definitely got people hyped on the cold water immersion thing. Yeah. I will just say like, again, like lose the quick fixes. They don't exist. This is hilarious because we're in an industry, right, where we can sell things. and all the things in my industry that I can sell, I'm poo-pooing. Supplements, health tech, every sponsorship I can get right now. It's what we want to, that's what we would like to hear though. By the way, this doesn't work. It just like, if you love it, enjoy it. Like do it as a hobby. You know what I'm saying? I'm not going to go out and say like soccer is so much more healthy than tennis or something.

1:01:16Like it's whatever you want. That's kind of what it feels like. Yeah, that's what's happening. It's like, if some doctor comes to you and is like, yo, you're lifting, you need to be cross-fitting because it's so much healthier. Leave that guy. I mean, like, there's, no, here's why. Maybe their research will tell you something that's true. But here's my take on it. Life has so many variables. There's so many things that can go wrong that are outside of our control. Thinking that you now have the grasp of control by doing one sport or another, going to this water temperature versus this, it's ridiculous.

1:01:48It's really, it's a fake version of reality thinking that you have that much control that if you go five minutes into 65 degrees versus 63 degrees come on yeah you're allowed to do it without posting about it by the way it's possible um i have one that's uh i wish had a quick fix but like you said probably there isn't one and a lot of us nerds deal with you can probably tell me right now poor posture okay and do you have any tips on how to improve that or like how much is this how am i destroying my back over the years of playing games and sitting at a computer one never buy a posture corrector those straps that you see on tiktok i've had it in my cart multiple times and i just stopped it's like the thing that you just put on your shoulders no no it has like a it's like a back brace thing that like straightens out your back but it's actually terrible because the purpose of having good posture is that your muscles naturally keep you in a healthy posture but by wearing this thing you actively weaken the muscles that you're supposed to be training for good posture oh i I had this exact, I had a mini version of this with my feet because if you have plantar fasciitis, that's kind of like the arch was fatigued.

1:02:54So I felt the need to wear arches that would support it, but then that weakens the muscles. And I was like conflicted on whether or not I should do it. Plantar fascia is not necessarily muscle, but maybe there was some other mechanical thing happening. I watched a lot of YouTube videos. I got some misinformation, but yes, yes, you're probably right. Yeah. So I ended up designing my own shoe for two years and now that helps a lot. That's what everyone should just do when they've got that problem. Yeah, it worked out. Yeah. So I will say, being in an unhealthy posture for a long period of time, which is what we do at work, is not ideal.

1:03:24So you want an ergonomic good position. But the idea that posture is to blame for all our problems is overstated. Okay. I like, I've found myself attempting to fix it. I've found myself noticing it more often. I've been attempting. Physical therapy. Yeah. Doing the exercises. Strengthening certain support muscles. Finding out where you're weak. All that's very important. Like incredibly. way more important than any quick fix than anything you can do yeah i hope one day one day i will be like i think i spent the whole day in a nice posture that'll be my crowning you know that by the way my number one prescription physical therapy pt oh yeah yeah yeah i can vouch for pt for sure uh which is a this doesn't have a real answer but i just want to see what you say which is a worse vice oh oh i like these it's like a would you rather or sugar this is from someone who in excess in uh i guess in that can we talk about habitual caffeine versus habitual sugar but like i can eat 10 grams of sugar i can eat five down like you know what i'm saying right like overeating sugar or over drinking caffeine can we can we how about let's go can we know that cup of coffee yeah because it's coffee is 400 milligrams day that we say that you should have?

1:04:46Versus... Sugar, I don't know what the exact numbers are. Versus a tall glass of fruit juice with every meal. Wait, wait. Say the first one again. What's the coffee number? A cup of coffee every morning. Okay, or? Or a full glass of fruit juice with every meal. So that's maybe 20 grams. No, it's more than that. Way more than that. 40 grams? Orange juice has a ton of sugar in it. It's basically soda without the carbonation. yeah what i'm what i'm asking is is my vice of sugar going to kill me faster or slower than the one i'm avoiding which is caffeine um you for you i'll give you this is not individualized advice because i'm not your doctor i'm going to say all the medical legal things but what i will say is none of those matter to your health long-standing especially because you participate so actively in sports you have a higher glucose requirement than most okay sound fine and also you can drink coffee I mean, again, I don't know your lab values.

1:05:42That's why I can't give you advice as a doctor. But like, if everything's fine and you're an athlete and you drink orange juice for all your meals, you're fine. But now, if your BMI is 40 and you have heart disease and you're drinking orange juice and your triglycerides are through the roof and all this stuff, yeah, maybe that's not ideal. Maybe the coffee's a healthier choice. Is there a similar thing, like caffeine, I feel like. I know you don't drink much of it, but like there are a lot of people, especially in this tech and gamer world who are they drink a lot of coffee or worse a lot of energy drinks yeah is there any difference to that and obviously this is individualized but you're an active person you're drinking a lot of caffeine or you are i am sitting down and playing games and i'm just pounding red bulls or energy drinks i don't think that one is as important lifestyle wise i think that one is more uniform the recommendation that if you're going over the recommended amount consistently, you're going to create long-term harm.

1:06:38And 400's a pretty solid number. It's not a solid number. There's one blonde, like the big size blonde roast at Starbucks is 400. Really? And people put espressos into that bad boy. Well, yeah. Starbucks drinks are an anomaly, it feels like. Does that also numb you to it? Because I always wondered like - Tolerance builds up. Yeah. Like there's a Gatorade, fast twitch Gatorade or something that has, they have like a bunch of different Gatorades now. This one's for like in the moment performance. and I think there's caffeine in it. And so I wonder, as someone who never drinks caffeine, would that be more effective for me if I always had coffee every day?

1:07:11It's more, if you've never had caffeine, you're caffeine naive, we call it, you're gonna get a better result from drinking the caffeine. Sick. What we've also seen in research, you can become caffeine naive quite quickly. So if you take only a few days off drinking caffeine, you can already start seeing improved benefits. Something that I was gonna say about caffeine, Caffeine's the number one studied performance enhancing drug. Definitely. And it actually has proven benefits. It's like the most well studied, the most evidence behind it, that it truly improves performance. It goes caffeine, creatine, protein.

1:07:47Those are the three most proven supplements. And again, remember I said 90 % of us don't eat supplements. Yeah. Okay. I love that. And I guess the last one for me is our phones now have these digital well-being sections in the settings where they will try to limit how much you use certain apps during the day, but it's incredibly easy to override them is the other thing. So they'll go, all right, you need one hour of Instagram or less per day, one hour or less of YouTube per day. Is a social media detox worth considering for anybody who's maybe spending too much time on social media? You asked me a different question than I thought you were going to ask me.

1:08:25A social media detox is wise. It's good to take it every now and then, especially for us who are so involved in this space. But the apps themselves are good for getting a grasp on what's going on. But if you are thinking that's going to be a solution, you're probably mistaken in most cases. Given the fact that they work in the same way the posture correctors work. You need to figure out what a healthy balance is and be aware of when you've reached your limit. But when you start relying on this thing to be your posture corrector, that's where you're going to get into trouble. I love that analogy.

1:08:58Life's hard. is the bottom line. And anyone that's promising you a shortcut is probably trying to make some money and not really helping you in many cases. Bang. Clip that. Clip that. That's a short TikTok right before the appalachian. And I lost all my sponsors. No, that's awesome. Well, I think we have one last thing we want to do, which is a little bit of trivia. I wanted to have you explain, do you know what this is? Yes, I do know what this is. Where have you seen this? This is in one of my videos. My 10 million subscriber video. I was like, wait, why does that look familiar? We'll put it on the screen for those who haven't seen it.

1:09:37Were you happy with how my animator designed you? I was going to ask. Is this how I look to people? Is this how I really look, Mom? I mean, we did do a round of reviews, and we felt like these were the closest that they did. You and Casey, they're hanging out. Look at all the money on the table, though. There is a lot of money on the table. Were you ever signed with an MCN? Not, no. Not a traditional one. No. What do you mean not a traditional one? Meaning I started working with a company that wasn't an MCN until they started selling ads for me, and I was the first channel they ever started selling ads for.

1:10:14So, yeah. So not a traditional one. But that was what that segment was about. Oh, MCNs? Yeah. Got it. That's amazing. It was printed out and left in the studio, I have to ask. I love it. Okay. Trivia time. I missed it the first time. So today's trivia question. It bothers me. Yeah. I'm going to give you three medical devices. Okay. You need to tell me the order in which they were invented. And I'm looking not for like theoretical, someone wrote down this idea. I'm talking about they use them on a human being in that year. Okay. Interesting. And it goes from earliest. Well, I'm going to give you the three devices and you need to tell me.

1:10:57From earliest. So if I say number one, that's the earliest. Exactly. Yes. All right. Number one, the implantable pacemaker. Not an external pacemaker and not a wearable pacemaker, but a pacemaker that goes inside the human body. Number two, the medical laser. And again, I'm not looking for when someone invented the laser. I'm looking for the first time someone shot a laser at a human to heal them. Number three, computerized medical records

1:11:40I'm definitely just going to do a slow zoom on Dr. Mike's thinking face It's just one of those things where you know too much and then it's potentially Yeah, for sure they're good at getting questions that are anyone has well hold on a second i'm fairly confident that i fact check all of this correctly but i welcome you're wrong dr mike i welcome your um actuallys as a as a medical professional yeah no way again i i watch memes this is not what i do all right this is uh we flip our boards uh mike what did you have i was gonna go with what you did but i i went computer medical records ehr pacemaker laser and that is earliest to latest yes so unfortunately mike oh on all of them so sorry oh did you all put the same thing no no oh no sorry okay i went oh what did you do did i did computerized medical records one medical laser two which i'm starting to think is earlier than we think and then implantable pacemaker three oh so i do have a different i have laser

1:12:49no the correct answer is implantable pacemaker 1958 wow that was the first time someone stuck one of those in somebody um fun fact before that there were these wearable pacemakers that you had to plug into the wall so you just had full wall voltage running through your chest Tope. Number two is the optical laser in 1961. Just a year after the laser was invented, someone had the idea to shoot it at a guy, specifically a guy's eyeball, to remove a tumor. And it worked. And then computer medical records? Computer medical records. There were several, specifically four attempts to set them up. The earliest one was in 1968.

1:13:30And the latest one I have here was 1972. I don't believe that there was a pacemaker, but they didn't have a record electronically. I thought of shooting lasers at eyes and then like punching a paper. What's even crazier is the idea of shooting electricity at someone's heart goes back all the way to the 19th century. Wow. Yeah. Weird. Yo, computers are young. I had a feeling the records was the trick part of that question. Kind of. That's why I knew records either came first or last. That's what I should have thought I put in the middle. I thought the laser would be for sure the trick one. Interesting.

1:14:03Wow. Wow. laser was in the middle huh that was a good question thank you yeah there's that the only one i have another one oh yeah let's do it you want to do it let's do it yeah see all right according to a 2020 survey by cisco what percent song uh what you alice might be too young who did the thong song uh no cisco the uh networking giant oh that's what i meant sorry All right. According to a 2020 survey by Cisco, what percent of medical devices are currently running unsupported software? That means the software they're running has no patches or updates available. 2020. And this is closest wins?

1:14:48Oh, yes. Here we do price is right rules. So closest without going over.

1:14:59Is it Steve Penancey?

1:15:10I don't want to go first this time. Before, I just want to say, this question was inspired by an episode of the podcast Darknet Diaries. So if you're interested in this, go check them out. Wow, that's a high number, Marcus. So I said 91%. I said 42%. All right, that is under. so mike you have to shoot the tube i'm so sorry the correct answer 3.13 it's uh 60 percent of of medical devices that actually surprises me surprises you because it that it's low or high i figured very few medical devices get software patches i guess it depends what you consider a medical device so it's an issue people talk about in cyber security a lot because things like a medical laser typically is actually running a version of windows 2000 which i thought it was 3.1 which wouldn't be that big of an issue except now these medical laser devices are hooked up to wi-fi's oh hospitals wi-fi networks yeah and so there are actually points of attack now for a lot of cyber security threats um so hospitals aren't sure whether to you know get new medical device like get new lasers that run up-to-date OSs and then retrain everybody or leave this sort of point of vulnerability in their system.

1:16:31That's why you guys are worried about AI. We have lasers that are about to be worried. Wi-Fi connected lasers in hospitals. That's crazy. Good to know. I'm glad to, most cars aren't software updatable. So that's pretty impressive. One last question, Mike. Okay. How fast can you type the alphabet? What's like the average speed? I don't even know. I feel like it's hard to do an average. Do you have to do mistakes aloud? Just A through Z. You can make mistakes, but as long as you hit every letter in order. We're going to test it, if that's what you're wondering. We can just find out. I'm going to say, if I'm going to aim to try and do no mistakes, I would do it 10 seconds.

1:17:16I don't think anyone's ever guessed their time beforehand, so I'm excited about this. I almost guarantee you're going to be faster than you think. Just so you know, it's something we do with all of our guests on here. Similar to if you've watched Top Gear. Do I look? Am I allowed to? Yeah, you're allowed to do however makes you the fastest possible. The way this works is. Oh, you have an app? Yeah. You made this? No, my friend made it. So you type A through Z. If you miss one, you have to hit that letter to go on. And we'll give you three shots. Don't hit enter at the end because it resets the counter.

1:17:46Oh, okay. So the timer shows up when you hit Z. And we do have a leaderboard. I was going to say that at the end but now there's a little pressure sometimes pressure gets to go now I need the caffeine I also like how you take your watch off I always take my watch off specifically with the metal yeah okay I'm going to type it like my also do you like the laptop keyboard or we have other keyboard choices if there's something you would prefer I like the old school is 10 seconds even on the leaderboard what I predicted? I'll tell you as soon as you finish your first rep and I have three reps yes okay ready should I just go?

1:18:28when you press A it will start the timer

1:18:417.9 that was close I was going to say that sounded really close to your guess I wrote down 8.2 but that's a great first rep feel free to go two more you might improve your time i see detailed results though what is that if you want to look it's the time between each letter and you can see where potentially you uh 7.93 okay okay

1:19:116.9 that's a that big improvement nice really good improvement okay do you think you can shave another second off yes that's a whole nother second trajectory would be incredible if you did it again but yeah that's a that's a really solid spot already okay okay i have to hit reset right or enter

1:19:34shake it out okay so you i'm gonna go really fast

1:19:44it's 5.9 wait you got 5.9 5.9 we have to 5.97 I feel like pretty good about that so where do you think so right now we've got about 20 something names on the leaderboard where do you think 5.97 would rank you 8th you're exactly right wait what the hell these are some weird 1 ,2 ,3 ,4 ,5 ,6 ,7 no you're 9th sorry The current eighth is 5.9. It's Doug DeMuro. He got 5.900. He got 5.97. So you're right behind him at number nine between Doug DeMuro and So Crispy Media. Wow. Well played. I'd be interested to see. Way faster than what it thought. 10 seconds. 10 seconds is not on the leaderboard. Everybody's under 10.

1:20:24Everyone's under 10. Well, I didn't know how long this takes. I got over 10 seconds and it was so bad. I just decided to stop. I need to know what Tom did. Tom Scott did a... blistering 3.55 What? Followed by Quinn from Snazzy Labs and my original time from when we first started the test. Mark is good at everything. It's really annoying around here. Someone's gonna get me off the podium but that's 1, 2, and 3. Oh. And then 4. That was your first time? Yeah, we all did three tries at the studio just to set a leaderboard just to have context and so I set a 4.5 and I'm gonna get knocked off eventually sooner or later.

1:21:06but welcome to the leaderboard if you give him two more tries shaving a second off each one i think he'd knock you off there welcome to the top 10 mike that was an impressive showing okay thank you for joining us of course for the wayform podcast we appreciate all the medical advice and all the expertise that you bring and of course uh you should go watch mike's videos if you haven't already he watches memes yes he beats people up and he's uh incredibly informative so we appreciate that thank you it was really fun all right well that was it with dr mike that i think that was a lot of fun this is a conversation we've been meaning to have so i'm glad we got all the facts and figures and pros and cons and all the stuff from an actual expert but now we're back with andrew and david because you haven't done the trivia that's from that episode that's true so let's let's read david the questions and see if he gets them right there's a lot of pressure here yeah because you guys have already heard this yeah i have not and we'll just be judging you as we totally already know the answer i think i might remember the answers all right let's see trivia time anxiety time oh god this marker needs new markers yeah and i got signed out google docs nice you could use this one yeah trivia question what is ellis's password password you wish you wish i should not i should not say something like that on the internet and everyone's gonna try and get okay don't get me question number one that'll do it on that day ellis got yeah on that day ellis signed up for bit warden question number one according to a 2020 survey by cisco what percent of medical devices are currently running unsupported software meaning no patches or updates will ever be available and it's uh it's it's price is right rules oh as per usual oh so that means whoever we think could be right may be wrong.

1:22:58Right. David could get closer than anybody. David could get closer. All right. I got one. Oh. Well, I mean, you know. It's totally a random guess. Let's see it. And you put 68%. Wow. Is that over? Barely over. It's 60%. No, I was going to put 60%. Bryce is right. Unfortunately, that one cannot win. Really? But you're pretty close. Yeah. You're pretty close. You're in the ballpark. Yeah. What did you guys put? I have no recollection of what I did. I don't either. The winning guess was Andrew with 42%. Wow. I think both Marquez and I can't remember. Wow. I'm so smart. I almost put. Anyway, whatever.

1:23:44Question number two? Almost doesn't win trivia. Question number two. Almost doesn't win trivia. All right, David. Yeah. I'm going to give you three medical devices. You are? And you are going to tell me the order in which they were invented from earliest to most recent. Oh, my goodness. Okay. The first device, the implantable pacemaker. This is a pacemaker that goes completely inside your body and you get sewn up. Okay. Number two, the optical laser for medical purposes. What? Does that mean for like healing wounds with vibrating things? Healing wounds, yeah, doing like laser surgery. Number three, computerized medical records.

1:24:31Oh, yeah, that's... Okay, wait, wait, wait, can you give me the... No, no, wait, stop it. Number one, implantable pacemaker. Number two, optical medical laser. And number three, computerized medical records. And I'm looking for the order first invented, most recently invented. Wait, first? Yeah, okay.

1:25:03From oldest to newest. You're welcome. Okay. Oh man, this is probably... Alright, I'm doing... One is pacemaker. Okay, that's correct. Two is laser. That is correct. Three is? Computer. Oh my god! Yes!

1:25:24No one else got that. Yeah, we're the only one. Heck yeah. I remember this because my grandpa used to have heart attacks from when he was like 20 on. And he got a pacemaker like really early. Really? Yeah, in like the 60s or something. Wait, so do I get one point for each one? No, just one point in total. So I just won the round, basically. Okay, whatever. I guess I won one of them. That's fine. Well played. Thanks, guys. Well played. Appreciate you. Well, I think that wraps it up. Yep. Shout out to you for getting the question right. Thanks again to Dr. Mike for coming on and answering all of our questions.

1:26:03And thanks again to you for watching and listening. Catch you in the next one. Peace. We're produced by Adam Molina and Ellis Roven. We're partnered with Vox Media Podcast Network, and our intro outro music was created by Vane Sill. Thank you.

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