Kind: captions
Language: en
there's a quote that I want to read from
one of your tweets that comes from a
book which I just thought was absolutely
brilliant called the Empire of the
summer Moon
about the Comanches uh Native Americans
and so here's the quote you said
Comanches loved eating bison and then
this is the quote from the book children
would rush up to a freshly killed animal
begging for its liver and gallbladder
they would then squirt the salty bile
from the gallbladder onto the liver and
eat it on the spot warm and dripping
blood
and I was like okay so this is a really
different way of living imagine tracking
that animal down your hands are all over
a horse God only knows what's on the
horse you then kill that Buffalo you
then cut it open touching its fur and
all the dirt and feces and God only
knows what is all over it you cut it
open you reach inside you pull this out
uh having done it so many times that the
kids know which organs to beg for
and then you give it to people and I
just thought oh my God the microbes that
people would be ingesting would very
rapidly acclimate your microbiome to
whatever it is that you eat
so
is that part of this or is this going to
be and I know you're guessing but is
this going to be more genome is this
going to be more microbiome which of
those two do you think plays out being
more important
I do think the adaptability point is a
big part of it and I do think the
gastrointestinal tracts of humans but
also of all animals are very adaptable
and there is a lot of debate you know
I've debated with people vegans on
Twitter let's say about what humans
should eat and we we have to Define
should right so should like what is you
know what's healthiest for us what makes
us feel the best which might be two
different things what's the most moral
what's the most sustainable economically
environmentally you know there's many
ways to ask what is the quote-unquote
proper diet for us but I mean I do think
that um that the adaptability of the
gastrointestinal tract is important and
a lot of vegans will point out rightly
that for instance in the large
intestines humans can ferment plant
matter you know cellulose and fiber from
Plants a little bit not to the extent of
cows and other ruminants who have this
initial very large stomach that is a
fermentation vat basically to draw
energy from fibrous material from plants
but we can partially ferment things in
our colon which does suggest we are
quote unquote supposed to eat vegetables
but not only vegetables you know our
gastrointestinal tract does not look
like a pure carnivorous track it also
doesn't look like a pure herbivores
tract so I think we are probably meant
to be omnivorous not to what extent
should meat be only you know used as a
flavoring or eaten occasionally or
should it be 90 of the diet I think
variability is a really important thing
and over Generations I I mean I think
the the mic the microbiome adaptation
over some months or years could play a
role I don't I'm not I don't know a lot
about that that could impact how much
you're able to ferment in your large
intestines but also over Generations
gastrointestinal tracts can adapt in
impressive ways one of the most
impressive is actually the panda bears
gastrointestinal tract where clearly
they were a carnivore in the past almost
like other most other Bears
um but they've adapted to subsist almost
wholly on bamboo alone and their
gasoline tract their gastrointestinal
tract shows that they were a carnivore
or at least a meat Hemi heavy omnivore
who is now a strict herbivore and their
gastrointestinal tract was able to make
that adaptation and I think ours could
adapt similarly whether we're living in
the Arctic and subsisting wholly on
animal meat and fat or in some parts of
the tropics where people do have a very
strictly vegetarian diet you know I
think we can do a little bit of
everything and so the debate will never
end on The Human Side it's not really a
question though right so we do we have
some people right now even in just North
America that are like I'm running a kind
of diet experiment for one reason or the
other and then you obviously have people
usually for moral reasons uh that have
gone strictly vegan but also in the
longevity Community now that debate
rages on in terms of what is it that is
going to give you longevity
I'll lay out my hypothesis you've cut
open a lot more bodies than I have since
my Tally is zero uh and yours is
somewhere far north of that
um that the way that I think this plays
out is from a longevity perspective
I think a vegan diet and and let's first
Define supplement versus non-supplement
because looking at this from an
ancestral perspective I have to believe
that you were in a stressed state if you
were eating a purely vegan diet
um
so from an ancestral perspective
I'm guessing this is a hermetic response
that we're leveraging now in a modern
environment where we can sort of take
the edges off of whatever problems a
purely vegan diet would otherwise create
that's my assumption that there would be
those problems
um
that through supplementation we take the
edge off and so we're getting an
artificial look at why some people think
why the longevity Community seems to
keep circling around a vegan diet for
people that don't know the idea of
hormeses it's saying basically it's a
little bad for you but that gets the
body to respond in a way that's positive
and so and and my guesses here are not
uneducated I've interviewed enough
people around this read so many books on
the topic but I want to be clear that
I'm not an expert
um but that what seems like is happening
is if you're eating a lot of meat you're
going to be in mtor so you're in a
growth phase you're telling your body
grow this is good times the plenty but
if you're always in that to the earlier
comment that you said that variability
is probably one of the keys and so if
you're pegged on eating meat you're
going to be pegging mtor you're going to
speaking from experience you're going to
feel awesome
but because you're pegging that out you
don't get the hormetic effect you're not
shutting down some of those growth
things you're not giving the body hey
you need to conserve calories
effectively so lower your metabolism do
less cellular divisions I'm definitely
out of my depth here but that's sort of
how I imagine this process and so
while I would categorize certainly from
an evolutionary standpoint that if
you're purely in a vegan situation
you're going to be surviving not
necessarily thriving and if you're going
hardcore on the eating as much meat as
you can get that you're going to be
thriving but you're not necessarily
optimizing for longevity
how does that feel I mean it seems to
make sense I also am not you know an
expert in this area and I think the the
science is still murky but I mean it
seems to make sense to me but I think
going back to sort of lifestyle and
activity level
the the food that we have available
today for anyone in North America let's
say who has disposable income is so
dramatically different from what people
have had available in the past you know
the choice of oils and fats to fry
things in is sort of mind-boggling at
this point when you go to a grocery
store versus 100 years ago when it was
basically animal art and butter you know
with sort of your choices and so now we
can import things from all of growing
parts of the world like olive oil and I
also and our lifestyles are so different
so I think you put you put someone in a
hunter-gatherer Society who has to work
really hard to put food on the table
what's the optimal diet for them
um I feel like you know they're going to
need more meat and fat perhaps than
someone in a modern lifestyle what's
driving that hypothesis the ability to
extract calories
perhaps I guess you know this is all
sort of working on what's theoretically
making sense in my own mind and how our
lifestyles have changed over over the
recent centuries but I do suppose that
in a modern what's optimal for a human
living a modern lifestyle where you
don't actually have to work very hard
for your food physically and you have
all these Foods available from all over
the world not only from your own climate
and your own environment I think it's so
hard to know I feel like what's optimal
for people that don't know your story uh
you're a physician you talk a lot about
two topics which I think are the reason
I want to talk to you about this is they
Collide in this moment we're talking
about right now perfectly which is
understanding all the different systems
of the body the different
um God what do you call them the liquids
the bodily fluids bodily fluids perfect
so all of the different systems of
bodily fluids that they produce all of
that
and then nutrition and you coming at
nutrition from an anatomy eats is the
name of your Twitter feed so
and on that feed it says you are what
you eat so when I look at these two
worlds colliding of okay you've got
operation of the body and then you've
got the things you take in and you are
what you eat
um how do those two worlds come together
and what would you need to know from the
body whether it's urine blood whatever
to know is this diet quote unquote
working the science of nutrition is has
changed a lot in recent decades and I
think I'm in general very skeptical of
what doctors have to say about nutrition
and I think just because they don't
learn about it partially they don't
learn about it when I was in medical
school I went to a public medical school
in New Jersey we had one nutrition
course and it was actually had just been
started and that was in about 2000 2010
and just before so before that there had
been no nutrition course in the medical
school and it had just started and it
was just very basic but I think
nutrition science is just so hard to uh
to to get right and nutrition studies
are so hard to do just because there's
so many variables that have to be
controlled in people's lives and I think
that's one reason that study that
doctors seem to flip-flop on things back
and forth like eggs I feel like in my
you know since I was a teenager I've
seen them flip-flop back and forth and
to add to that I think the way the media
portrays nutrition science or the latest
study or the latest you know perhaps
very low quality study that shows that
eating chocolate is very good for you is
going to be a headline everywhere and
sort of uh disproportionately impacts
the way people understand nutrition sort
of nutritional science through headlines
is a very bad way to understand what's
what's good and what's bad for us I do
think though you know medicine is very
focused on sort of is is someone having
a disease or not and I think when you
get into the finer points of nutrition
about optimizing the human body
optimizing performance
um it's almost beyond the realm of
medicine you know I can say someone's
urine let's say the tests I can do on
the urine are limited I can say
everything looks normal I often say that
to my patients when I get their blood
and urine tests back but
you know I it's hard for to measure or
there is no measurement I'm aware of of
is this diet optimal for you you know I
can show that you are not having any
vitamin deficiency that you're not in a
state of protein malnutrition or you're
not malabsorbing fat in your gut and
failing to absorb it let's say
um but going beyond that and optimizing
you know taking it from you have no
nutritional deficiencies to taking it to
the optimization is sort of a bigger
step that I think medicine is just very
in the very beginning stages of I think
okay so going back to the question if
you were trying to take your best swag
um what would you look at so my gut
instinct is that it's going to be blood
maybe stool would be the ones that I
would really want to see if if to just
speak to your current lifestyle which I
would say is and maybe we disagree about
this but I would say is eighty percent
what you eat 20 activity sure
um loving relationships all that stuff
but man if you want me to impact the
quality of your life give me sleep and
diet I'm over everything and I'm
laughing
um
blood stool or there are better things
to look at in somebody's bodily fluids
do you mean to determine their state of
health yeah like I I so I really care
about the things that I do what impact
do they have and so this is all building
towards me asking when you cut open that
first cadaver and you saw that the lungs
were black you were like this
guy smoked right and so I just dude I
again I understand that to some extent
I'm just ignorant enough that I have so
much confidence in what I think
it's very dangerous but it also allows
me to move forward in my life so I am
convinced that at some point we're going
to realize oh when you cut open the
arteries and you see this that tells me
that they ate this and I think it is
only a lack of being able to draw a
direct correlation between the two
because the two worlds are so divorced
so the guy cutting open your heart and
looking at your arteries and you know
being in charge of repairing that he's
not studying nutrition and the guy's
setting nutrition is not cutting open
your heart right but I have a feeling
that the second that those two things
are married and you've got a guy who
just knows nutrition forwards and
backwards or this is probably going to
get solved by AI but whatever entity
that is both cutting open the person and
looking at what people eat is going to
be like oh this is easy when you're
eating a bunch of Highly processed food
and this is my punch line if you're
eating a bunch of Highly processed food
your arteries are going to look like
trash and you're going to be storing fat
everywhere and it's going to glom on to
your organs and that's just going to
literally choke the ability for the
fluids to move through the body in the
way that they should choke it off and
you die and that's like the end of the
story and again because I'm like on this
side of ignorance that just seems so
clear to me but I am hoping you will
either
say yes that all makes sense or slap the
ignorance out of me either way I'll take
it gotcha
um let me say I certainly make it I
certainly think it makes sense I
certainly think the point at which the
cardiothoracic surgeon who's cutting
open your chest let's say to look at
your arteries versus the nutritionist
uh we're such a long way from those two
sort of meeting and marrying each other
and knowing for sure I guess the trick
is that it takes these large population
studies to know what what is optimal uh
for people and that doesn't always tell
you what's optimal for the individual
honestly and studies in the past have
been very
poor quality and not controlled well for
all the variables that exist like for
instance some of the recent
multinational studies on let's say salt
intake they're done on much larger scale
they're done with more powerful
computers to compute the statistics and
do the statistical analysis in a more
efficient and better way and there's
more money behind it and and they're
discovering that perhaps the salt
cutoffs let's say are not as low as we
thought so I think every you know
everyone who sort of agrees that eating
huge amounts of salt is not good for you
but where's the cut off between assault
that's in an okay amount and salt that's
too much and it turns out that we've
been being much too strict you know and
it seems like people could eat more salt
without the effects that we've been
warning about for a while
um so for instance so those sorts of
bigger better run studies are
overturning a lot of what we have
thought in the past but I do think you
know when you cut open a person let's
say you could look at their arteries and
see that they're there's more plaque
built up on the walls or they're stiffer
when with more calcium because of injury
you could look at their liver and see
there's more fat accumulated there you
know in a fatty liver disease which
could be either from alcohol or could
could be from the modern lifestyle and
diet which causes non-alcoholic fatty
liver disease which is very young give
me what you think is actually going on
there so the alcohol one is pretty
simple right but when you say modern
lifestyle right that's an abstraction
get into the specifics what in the
modern lifestyle sitting around yeah so
I think you know again it's complicated
since there's so so many things happened
at once to change human life and human
diet over the last let's say century and
a half in the developed world that it's
hard to pinpoint but doctors refer to
something called the metabolic syndrome
which is a constellation of conditions
that include type 2 diabetes high blood
pressure high cholesterol chronic kidney
disease and fatty deliver disease and
that whole constellation which can
appear to different extents in different
people someone might have all those
someone might have a few or one
um that seems to that constellation of
of diseases that syndrome seems to be
much more common these days and is that
due to some probably due to the change
in our lifestyle less physical activity
a change in diet but you know what is it
exactly that's doing it perhaps a
combination of the two but you you see a
lot of people you know obesity obviously
plays a role in there as well but I see
a lot of patients who are not obese at
all and still have some version or some
portion of the metabolic syndrome and I
think it seems like something about
Modern Life has caused that or at least
has made that much more common these
days but what exactly is it I think is
really hard to know I think doctors when
they've tried to show causality of
eating this causes that we've gotten
into so much trouble and ended up
looking like idiots so many times and
continuously we still do that I'm so
hesitant to draw conclusions you know
until the platonic ideal of the large
population nutrition studies are
complete to show it's like what really
is is causing
um us to be less healthy I find if you
want to know what somebody really
believes you need only ask what they do
with their kids what do you do with your
kids
um so I I encourage my kids to eat as
wide a variety as possible I feed them
Oreos
um you know occasionally I mean so for
instance in my mind I feel like you know
processed food seems to be not the
optimal choice of what you should eat or
what your kids should eat
um some a lot of studies seem to suggest
that what I bet my life on it no do I
think if you went back to a
hunter-gatherer people who uh do an
Olympic athletes amount of physical work
each day and gave them lots of Doritos
like would it really make them less
healthy I kind of don't think so because
they're living such a Physically Active
lifestyle and their diet is so well
balanced with everything else they eat
like maybe they could eat a lot of junk
food and be fine I don't know and that
study is probably impossible to do but I
do find it silly for instance I hear
pediatricians sometimes recommending
that a child's diet have more olive oil
and less butter
and there is no study on children that
shows olive oils better their study on
probably unhealthy American 60 year olds
maybe that show olive oil might be
better than butter even those I'm
skeptical of those studies but to then
take that nutrition that nutritional
data or evidence from adults and apply
it to otherwise healthy children I think
is very silly and I think there's no
reason to think olive oil is is more
healthy in a healthy child than uh than
but what's the difference between uh the
way that a kid will respond and an adult
um I think it has to do with at least in
the doctor's mind has to do with sort of
risk factors you know we there's some
evidence that uh unsaturated fat is
better than saturated fat for things
like coronary artery disease although
that evidence also I think is I'm a
little skeptical of it or at least the I
don't believe the full picture has has
totally been drawn yet so I think for
the the adult with five out of the six
conditions of the metabolic syndrome
who's already had three heart attacks
and has eight stents in their heart yes
probably nitpicking their source of fat
uh is more worthwhile than in a healthy
child who almost no matter what they eat
is not going to have coronary artery
disease for decades to come
um so I think there's a lot of applying
uh nutritional information from one
population to another for instance from
adults to children or for instance from
let's say white Europeans to other
people when the variability is just too
great especially between adults and
children
um
so interesting to me so
um
I want to go back to the the Primal way
of living so you had another tweet that
was like you should embrace the Primal
side of life as readily as you embrace
the intellectual side of life
do you mean that spiritually or do you
mean like that's just gonna be better
for you at a cellular level
well that's a good question I guess that
plays into uh the psychology uh and how
psychology and emotion our emotional
lives affect the cellular level you know
clearly there's some some correlation
there between our emotional and
psychological lives and how well our
guts work you know there's a lot of
conditions that we deal with IBS and
others that where there's some seems to
be some connection with
um you know mental duress or psychiatric
disease and and gastrointestinal
function let's say or sleep and
psychiatric illness and health there's a
lot of connections there between the
body and the mind that that we really
haven't figured out yet and I think
doctors sort of poo poo a lot of those
things but the causality is not clear
but it's clear there's some tie-in with
psychology and I think being
um embracing the Primal side of life I
guess by that I sort of meant
um you know realizing where we came from
understanding where a food comes from
that for 99.9 of human history we've
lived by
uh lived and eaten and survived by
killing other things whether it's
ripping mushrooms out of the ground uh
felling trees killing uprooting plants
or killing other animals you know that's
sort of where we come from that's where
everything we put into our mouth comes
from from the Flesh of another organism
not all of them have to die for us to
eat yes fruit do fall from a tree that
continues to live but
um I think even just recognizing where
things come from and I do try to instill
that in my kids you know meat doesn't
come from the store it comes from the
body of another animal and you are made
of exactly the same stuff and if we
zoomed in with a microscope on that
pizza meat or the muscle in your leg no
one would be able to tell the difference
because we're made of the same stuff and
I think that is
I understand why people are sometimes
grossed out by that but there's
certainly a beauty there and I often
tell my kids about the circle of life I
say and that's one of them you know that
everything that dies becomes food or do
you want them to understand that
um perhaps because I find it so
beautiful and intellectually satisfying
and stimulating and fascinating
and I think those are important lessons
you know to understand where things come
from I think that's something I've
always been interested in
um not in childhood but actually in
adulthood I got interested in where do
these things from the store come from or
how did how how is technology made from
how metals are extracted from the ground
and how uh all the way back to the
beginning of how we take from the
natural world and turn it into the
things around us that seem so artificial
and seem to have no connection to the
natural world of course they have their
Source in the natural world I was
similarly fascinated with a lot of the
medications that we use in in modern
medicine many of them come from the
natural world from fungi from plants
from the bodies of other animals even
from the bodies of other humans we make
medicines out of everything just like we
make sort of useful devices for our own
life out of out of everything and I
think there's a beauty in that and it
helps you understand the world and why
the world is the way it is why things
are shaped the way and act the way they
are and do to why people lust after the
things they lost after you know the the
circle of life of food and death is also
the circle of life of how feces becomes
fertilizer for plants to grow more food
you know there's all these sort of
intertwining circles and I think I don't
understand I guess having my kids
understand the way the world works is
part of my job as a parent one of the
things that I was drawn to reading your
book and this may be a misread on you
but one of the things I took away which
may be projection uh is that you take a
very dispassionate look at the way that
the Body Works there's a story that you
tell in the book the note I took was
like is this guy Hannibal Lecter you
were driving down the road you saw a
deer on the side of the road
you pulled over drug the deer into the
woods so that passersby would not see
what you were about to do and you
skinned the deer
now you've been trained how to do this
so it wasn't like oh the first roadkill
I see I just want to cut it open and see
what's inside but uh so when I was
reading all of that I was like so I if I
were going to have an Epitaph put on my
Tombstone I would want it to say you're
having a biological experience
now to me there's something deeply
spiritual in that but I'm trying to get
people to understand there's a very
grounded real way your body works in a
certain way your mind works in a certain
way the things you eat will react in a
certain way that may be too complex for
today's technology for us to track what
that is but there is a way and
ultimately I think through Ai and better
Technologies we'll actually be able to
track all that stuff and it will really
become day regard to say okay on a
lifespan you're working out this much
sleeping this much getting this much
sunlight eating these things with that
microbiome this is going to be the
outcome of plaque in your arteries
and that will really be able to to build
some
terrifyingly predictive models which
right now for anybody who wants to cut
through the BS look at the insurance
industry they're literally betting that
they know what are the things that are
going to kill you and keep you living
longer and so I think they're the the
people to beat but I think that
ultimately we'll be able to beat that so
anyway that's how I think people ought
and I use that word on purpose people
ought to look at the world if they want
to have a better life
is that have I misinterpreted you that
you have a similarly like you just need
to understand what's going on at a
cellular level and that's why you say
you are what you eat and that's why
you're fascinated by skinning an animal
uh or
is there something more spiritual to
what you were just walking through with
the circle of life and understanding
where we fit
I think that it's a little bit of a
combination I got interested in the Life
ways of ancient peoples uh in my early
20s and like I said I wanted to know
just where everything came from how
everything was made how people figured
out everything that we know these days
and so um one of the things I did in
that journey of exploration was take a
Wilderness survival course where I
learned how to make stone tools in the
the way that people did for most of our
history certainly much longer than we've
dealt with any of the technology
surrounding us today uh how you know
everything from tracking an animal to
making rope from the bark of a tree to
uh
um setting traps you know kind of
everything that a person in their
natural state let's say in nature with
no artifice around them except their own
body their own flesh how would they
survive or how would they manipulate the
world around them in order to make
themselves more comfortable and more
able to survive so the the use of skins
to make clothing not even to make paper
let's say you know parchment
um America's founding documents are
basically written on animal skin and so
the the use of skins I guess just really
fascinated me and this was before I went
into medical school
I certainly do think there's something
spiritual there I I think but uh for me
the the spirituality is in understanding
how people have lived throughout history
and what our bodies are kind of designed
to do whoever whoever or whatever you
think the designer is clearly our bodies
have a design in a particular way you
know every body part and every bodily
fluid has a purpose that seems
particularly designed for a specific
problem of everyday life with the human
body everything uh everything that we're
made of and everything the way it's
shaped the way it flows makes perfect
sense from the human mind perspective of
problem solving and kind of getting the
job done and keeping the human organism
alive
so I think I like understanding the
world around me there's a pleasure in in
that Fascination and that understanding
I sort of just have always wanted to
know more and how everything works and I
think there is for me at least a
spiritual side to that knowledge to
understand why our bodies are the way
they are why we act the way they do why
human history preceded the way it did so
do you think that you're naturally
unsquemish or is it this sort of loop of
wanting to understand where it's from
that bringing both a biological and a
spiritual connection to everything
that gives you an intellectual framework
to not be freaked out
I think I'm definitely not squeamish to
start with though I do think something I
learned in medical school when we
started dissecting our cadavers on the
first day of school we met our cadavers
those four students for each body and I
think everyone was surprised by how
quickly we got used to it even people
who were let's say not uh more squeamish
than I am let's say like I have a friend
who ended up being a psychiatrist who I
write about in the book and the sight of
blood made him faint for most of his
life and here he was in front of a dead
human body he was now tasked with
cutting open and is there blood though
in a cadaver there isn't blood but he's
sort of just a squeamish person sort of
blood was not the only thing that
freaked him out but no there's no blood
it's actually all been drained out and
replaced with a preservative sort of
similar to formaldehyde though not
exactly formaldehyde but even he
throughout medical school got less and
less squeamish you know he would be on
let's say his surgery rotation where he
was cutting open a lot of bodies seeing
a lot of blood and blood didn't phase
him anymore but then for the next six
weeks he was on a Psychiatry rotation
and that screen Mission has crept back
in and he sort of lost that um
interesting lost what he had gotten used
to I think I started from a less
squeamish Baseline
um and then I think just the
intellectual understanding or the desire
to understand how things work uh sort of
helped me not be squeamish even further
you know being fascinated with the
process of turning animal skin into
Buckskin or clothing or leather I just
find so fascinating there's no room for
squeamishness why do you have to rub
brains on it so there's many weird right
so skin you know when you uh take skin
off a living animal human or otherwise
it will either rot and it will stay wet
and rot or it will dry and be really
hard almost like cardboard neither of
which is good for clothing let's say or
any other material that we'd want to use
in our daily life so you have to find a
way to to make it dry so it doesn't rot
but have it solved and so humans
throughout the world have figured out
many different ways of doing that but
one of the common ways in uh North
America
um the tribes a lot of them used brains
and there's something about brains it
could be these molecules called
glycolipids where half the molecules
sugar and dissolves in water and half
the molecules lipid and dissolves in fat
it could be those two-sided molecules
sort of like an emulsifier that attaches
to the collagen fibers and skin and the
you know the wavy the way I picture on
the molecular level these wavy fatty
acid Tails between the fibers are
keeping things lubricated perhaps I
don't know that anyone knows no one's
committing a lot of money to researching
why brain tanning a hide works so well
but I think that people have also used
eggs people which have emulsifiers that
are used like in the yolk especially are
used in food products like called
lecithins or lecithins people have
rubbed liver into hides soap into hides
and all kinds of other things um so I
don't know that it's known why it works
but the product is really amazing and
the transformation too which I had seen
before I dragged that deer into the
woods I had seen the transformation from
this stinky wet gross sloppy hide into
this luxurious material that's almost
finer than the highest quality suede
that I've seen and just got so
fascinated with that transformation so I
think in this gross uh raw thing in
front of me I see that finished product
perhaps because I've been through the
process before and you use your own
muscles and sweat to soften the hide
once the brain's been applied I just
love the physicality of it and the
Hands-On nature of it and the
transformation so I perhaps seeing that
transformation in my mind help me be
even less squeamish about the initial
product which can be quite unpleasant
all right so there's certainly moral
implications to killing animals and
things like that but before we get to
that part of the carnivore vegan debate
I would love to get a better
understanding of when you say that we
are what we eat that's one the things
where I think about vegetable matter and
I'm like I get why there's going to be
things in that that are going to be
useful to us at a cellular level but
also seems impossible to get all the
muscle built up and everything that we
would need without eating meat now I
know it's not true because I know that
people can certainly with
supplementation eat a vegan diet forever
and certainly live
uh so
you you make a point of saying that we
are what we eat what what is my take
away from that
all right so on the most basic
biochemical or physiologic level to me
it means that you know nothing in our
body stays the way it is for very long
even the longest lived cells which might
be in the muscles of the heart or in the
brain even those have a turnover there's
this constant churn in everything that
we're made of where nothing no
individual specific molecule is going to
stay there for long everything is
constantly being broken down and rebuilt
from new materials uh and you could you
could think of that constant churn as
metabolism and we're constantly
replacing everything in us right just
like you can never put your foot in the
same river twice because it constantly
changes our bodies are kind constantly
changing from minute to minute and the
new material for rebuilding uh
everything comes from food you know
there's also obviously the the oxygen in
the air is a big part of it too that
gets incorporated into a lot of what
becomes human flesh but uh most and
water of course but everything else is
food from other organisms that goes in
our mouth we break it down in our
intestines and absorb it and use it as
the building material to refashion
ourselves and we're constantly
refashioning ourselves
uh nothing is ever staying the same for
long and that's part of staying healthy
you know if you're if you're not
changing you're stagnating so in many
other ways you know perhaps in a
business environment too you have to
sort of constantly innovate constantly
change constantly renew yourself and so
the same is true in the human body and
so it's all food that becomes us I mean
every bit of Flesh came from food or
from the air that we breathe and do you
is it
um at a cellular level completely
um it just doesn't matter whether it
comes from meat or from Plants I've
heard people say that plants vegetable
matter does not have a complete amino
acid profile
um true false
so I'm not a nutritional expert but I do
think you know there's many vegan diets
that if you're not careful and don't pay
attention to certain nutrients you can
become deficient uh you know B12 is a
common vitamin that's found in all sorts
of meat products and much less in Plants
uh and if you're not careful you can be
deficient in that same with protein you
know there are many plant sources of
protein and if you're careful it's not
hard to get enough protein but it's
perhaps much easier to get protein if
you're eating animals I do think with
the way the food supply is these days
the way that you know nutritional
supplements Supply the nutritional
understanding of what the human body
needs and our lifestyles where we don't
have to uh jump out of a tree branch
onto the back of a deer and strangle it
to put food on you did that what's that
I I have never heard of that as a method
for killing a deer well if you don't
have any weapons let's say if you're
found found yourself in the wilderness
with no weapons uh perhaps that's always
an option do they teach that in survival
no I mean now giveth and you take it
away for a second there I thought this
was like a thing and there was like a
known tribe that they would just choke
them out yeah well there is there's a
actually one of the first Wilderness
survival courses I took was in New
Jersey there's this guy named Tom Brown
who
um sort of grew up in the Pine Barrens
the sort of Wilderness Area in Southern
New Jersey it was supposedly taught by
this older Indian Native American from
the southwest who had uh migrated there
and that was something in one of his
stories he actually does do that jumps
out of a tree with a huge knife and
kills a deer that is against all hunting
laws
um I am not advocating do not try this
at home I've never done that and
probably would never I mean weapons are
not hard to find these days so um it's
rare to find yourself uh Naked and
Afraid perhaps in the wilderness
somewhere where you have to resort to
that but I guess I just meant that we
don't have to you don't have to
physically exert yourself almost at all
even nowadays more than 10 years ago you
can do everything without leaving your
house you know my kid gets piano lessons
we don't have to take more than 10 steps
over the piano and it's through the
computer everything we do these days
requires less and less physical activity
almost approaching you know the
singularity of never having to move uh
so I think that but with all the
supplements available with the food
supply where we can get anything from
any part of the world at any time uh
winter or summer and with our
understanding of nutrition I think that
you probably can be uh healthy as a
vegan as where in a hunter-gatherer
Society you didn't really have a choice
as much in the past as you do today all
right so then let me ask the obvious
question
why do you eat liver like if you could
eat strawberries and be fine what are
you doing right me personally yeah yeah
well
one I like it I did not like it as a kid
it was a chop liver was a tradition in
my family it was on the table at every
holiday I thought it was totally gross I
thought it tasted like rotten iron
pretty much whatever that is delicious
um but then after as I talk about in the
book learning about the liver and just
understanding this incredibly complex
organ that does a million and one things
on a daily basis to keep our our bodies
alive and healthy
realizing that that complicated uh
amazing thing inside each of our
abdomens is that pretty much the exact
same thing of although from an animal
that is chopped up in that bowl on the
table at the Holiday uh it's sort of
similar to that you know perhaps that
transformation of the the gross wet raw
hide of an animal into that beautiful
Buckskin that has a million and one uses
in daily life it's sort of like uh oh
these two things are connected that's
exactly where this things come from this
thing comes from I never considered that
the chopped liver was actually coming
from this internal organ that is so
complex inside the abdomen of these
animals and now it's mixed with fried
onions you know on the holiday table so
I think that Fascination alone probably
helped me similarly get over my
squeamishness and get over my childhood
disgust for the dish and like many
things how does it get you over it
tasting like rotten iron you know the
humans can get used to a lot of things
not only let's say the site of their
cadaver and the smell of the cadaver lab
as a medical student which people do get
used to but also I mean the taste of
alcohol let's just say when I first
tried hard liquor as a teenager I wasn't
impressed with the taste and now I love
it I don't even know if that do I
actually like the taste or do I just
more like the effect and I know that's
the you know that's the beautiful
Buckskin at the end of the dealing with
this gross hide or do I actually like
the taste I think I actually like the
taste even though it still sort of burns
your mouth
pretty gross but it's still this amazing
thing and so I think humans we can get
used to a lot and there's a lot in the
food world too that takes some getting
used to and that is an acquired taste
and I think liver is one of those and
now that I've tried it so many times I
love it and if it was a holiday without
it on the table I'd probably be outraged
that's so interesting okay so why do so
many animals go straight for the liver
it's a good question I I just read about
some orcas off South Africa that have
been killing sharks and eating only
their liver and leaving the rest of it
which I find very interesting
um I guess they have good taste probably
as part of it but um they you know I'm
not really sure why perhaps there's a
are they going because of a nutritional
deficiency I it's possible you know
there's a lot of nutrients in liver it's
one of the most nutrient packed thing
you can put into your mouth not only
iron which contributes to The Taste but
a variety of other things as well
uh I don't know why animals go for that
but that's a fascinating topic like
which body parts do animals go for first
often it's the internal organs uh
sometimes it's the bone marrow which is
very fatty and a great source of fat I
mean polar bears will often eat all the
fat off uh seals as the first thing but
in the Arctic it's a particular matter
of kind of calculating nutrients and fat
is clearly the source of nutrients that
everybody needs just because it's so
nutrient dense and calorie dense so I
think that's an interesting fact but
what is the process there of the Hume of
the animals are they considering oh am I
in the mood for the meat today am I in
the mood for the liver do I does my
tummy hurt so I'm going to avoid the fat
today I'm not sure that that kind of
processing happens but I do wonder I
also wonder for instance how do
adolescent Lions know to bite the
animal's neck like how do they know
that's going to kill them is it just
because they saw their parents do it is
it because they understand something
about the physiology and that's where
the big blood vessel Czar I'm not really
sure maybe it's just what their parents
taught them to do that's interesting
again not afraid to have a hypothesis
I'm perfectly willing to to find out
that I'm wrong trust me I'm not dogmatic
but
um
interesting right turn here into other
elements of your book which get into all
of our organs including our sexual
organs if I had to guess the biting the
neck is very akin to as a guy thrusting
deeper when you orgasm which I always
found super weird like all of a sudden
this one thing feels so it it is the
thing I must do it feels so right I'm
like this is just making it better
nobody told me to try it just every
impulse that I had was like do this the
same with lordosis I don't know if
you've heard about that and who knows if
this research is actually true but I
heard something and I was like oh my God
that makes so much sense that women
actually like the feeling of that
posture where you're arching your lower
back a little bit I was like that would
make sense because in certain positions
it's going to allow you the ability to
penetrate more deeply which is going to
increase the likelihood that you get
them pregnant so you put together the
woman wanting to Arch her back and the
guy wanting to thrust deeper right at
the moment of climax it's like okay like
that makes sense so for a juvenile lion
to just have the the Instinct I don't
know what better word to use for it
where it just that's the most attractive
part so when you're going for it every
Instinct you have has like honed you in
on the neck because from an evolutionary
perspective those that did that got more
kills and thusly live longer I mean
that's obviously a guess but from an
evolutionary perspective that makes a
lot of sense to me yeah that makes sense
you know the lions that were had the
instinct to bite the tail didn't survive
as much because they didn't get as much
food to the ones that
um you know went for the neck and maybe
going for the leg it makes you more
likely to get kicked in the face or
something so that doesn't make sense but
but yeah I think you know that that uh
that desire to thrust is kind of part of
the sexual desire
um you know just the feeling you have
when let's say when when you're turned
on it's almost like nothing can stop you
from completing the act and clearly
that's part of the the intelligence of
the human organism is that like nothing
will get in your way from completing
that act because that's sort of what the
species has has to have to survive
um and then you know it's soon as the
orgasm is over everything is different
and that desire just like completely
disappears it's almost one of the few
ways or instances in which physiology
really turns on a dime and goes from
this unquenchable urge to this
completely different state in all these
hormones and other things are released
at that time as well but yeah I think
you know there's an intelligence to what
we do even if we don't understand it and
some of that is Instinct what is
instinct is it stuff we unconsciously
picked up from our parents is it stuff
that's just uh you know in our genetics
I don't think anyone knows but maybe
we'll know more in the future yeah
almost certainly true as we look at ai's
ability to track so many data points and
just the you know when you think about
we're good at large language models
right now but we will for sure I mean
this is again I don't know for sure but
it seems inevitable that we'll start
being able to put other data into AI it
will be able to go through find these
crazy patterns and begin linking them
all AI is super fascinating have you
thought about where AI is going from a
medical standpoint definitely quite a
bit and I do think the processing power
and I of computers in general has help
been helping with epidemiologic studies
such as nutrition and I would love to
see AI play a bigger role in in these
sort of large multinational studies on
things like nutrition and salt and
saturated fat and other things I think
they could probably do a lot more
hopefully in an unbiased way to help us
understand things and I think more
processing power is needed and better
statistical methodology can help so I'd
love to see AI be applied in that area
you know I think AI it's been uh I mean
it's been getting better and better some
of my colleagues have I one of my
colleagues in fact uses chat GPT uh for
has it open on his computer while he's
working beside me in the ER and uses it
uses it to help him you know does he
need it I mean he's been at this job for
years without it but he just started
using it recently and actually finds
that it helps him write some of his
notes or at least some of the things
that we have to put in our note is uh we
write a note on every patient we see of
course otherwise nobody gets no one can
Bill no one gets paid and we get angry
letters from our employers but in that
note you have to put your differential
diagnosis meaning what could this be the
patient came in with XYZ I found ABC on
the exam the labs show you know EFG uh
what could it be and you give a list of
things traditionally in order of
decreasing likelihood like it's most
likely this but could also be these
other five things chat gpt4 is really
good at giving you those differential
diagnoses and I've done it with him just
for fun and it came up with just exactly
right like exactly what I would have
written
the other thing is even Google for years
you know a lot of doctors poo poo doctor
Google but Google is great at making
diagnoses
um especially of rare syndromes you know
you could put in for instance blood in
the urine and coughing up blood and it
will one of the first two hits will be
something called good pasture syndrome
which is something all medical students
learn about a rare autoimmune condition
where where you uh you know there's
blood in your urine and blood in your
sputum or uh I the other day I looked up
uh swollen joints rash blood in stool
and the first hit is something called
hennox online purpura which is a not too
rare condition in kids and it gets it
exactly right and a lot of things are
like that have you compared Google to AI
I I have seen it done on AI and it does
it better I mean the same if not better
but it's definitely good at those uh
those rant those rare diseases that have
a very particular constellation of
symptoms like that Google's been good at
for a while decades since it's been
around basically
um I think it's harder for instance to
say let's say this person with a fever
and a cough did they have just a viral
respiratory tract infection or do they
have a pneumonia that needs antibiotics
that's a bit of a finer uh a finer point
that I'm sure AI will get much better
and be better than humans you need to
interact with the patient in some way
yeah so s