C (3:23)

Yeah, the fact that we're getting to control it now that, you know, like a rheostat, the more we get at that point where we get, you know, really good control and being able to measure it as, as both you and Harlan know, one of the biggest deficits we have in clinical medicines, we don't have a way to measure the immune system. And we desperately need that because that's really the key.

B (3:43)

So for, for our listeners, like first of all, you know, part of the book, you talk about the fact that your parents died at relatively young ages and, and thankfully you are now explicit in the book, I think you're 71 years old right now. And you even give data that has been acquired about you and how it informs you. What advice would you give our listeners? What are the best pieces of advice you can give our listeners? And as a second part to that, do you find it hard to follow your own best advice? Because I do. I mean, I eat some ultra processed foods that I cannot stop. I do exercise every day. There are some good things I do, there are some things I don't do. Well, what do you do and what do you think are the things that people could reliably change about their behaviors to live longer and live healthier?

C (4:38)

Yeah, well, the problem with the generalized recommendations like an anti inflammatory diet, avoiding ultra processed foods as best you can. But as you point out, Howie, it's hard to just completely get it, get it off of them. You know, attention to not just aerobic but resistance and balance training, exercise and trying to do that as much as you can. I try to do that again hour a day with some combination of that. And most days I do that and then sleep. That was a big thing for me, which was tracking it because I knew I didn't sleep enough or well. And then tracking it and working on that deep sleep component where the glymphatics of the brain do the washout of all your waste products which otherwise will inflame your brain. So I got much better at that. I'm still working. The problem with the general recommendations, as you know, is that most people don't do them. And that's why I think the book is trying to set up a whole different mode, which is we have to partition people's risk and we have to, since it takes 20 years for the major age related diseases, cardiovascular cancers, neurodegenerates, 20 years or more for them to take hold in our body, we got to get ahead of that. And we can do that now. We can never do that before. Once we establish a person's at high risk for one of these diseases, then we have all these ways using lifestyle factors, which are not just these three. There's a long list to help them. But of course we're going to use more than just lifestyle factors in the future. So the point being is we can't just put out general recommendations because they're largely ignored. But we can work with each person through multimodal AI of all their layers of data. So like, for me, a big thing recently, you know, I'm an Apoe 4 carrier, right? And 25% of us are. Right. I don't know if you, either of you have gotten your.

B (6:40)

I've not been tested for it. But just to remind our listeners, that puts you at risk for Alzheimer, right?

C (6:45)

Yeah, yeah. And I don't have a family history of Alzheimer's because as you pointed out, Howie, my, my parents, my family members, they all died in their 60s or younger. So I'm thinking, well, you know, when you forget stuff of name or something, oh man, that must be my amyloid and tau in my brain, whatever. So, you know, this breakthrough, the biggest breakthrough in neuroscience in decade is this P Tau 217. Right. It anticipates whether you're going to have Alzheimer's 10, 15, 20 years in advance. All right. So, you know, I just recently got my P Tau 217 and it was almost zero. And you know how liberating that is. Oh my gosh. So the point is, is that, that I wouldn't be, you know, the one to fixate on the risk factors and, and prevention of Alzheimer's. I'd be much more because my polygenic risk score for heart disease is really high, which people don't get and they should be getting. And also there's a polygenic risk score for each of the common cancers and for Alzheimer's. And there's these markers like P Tau217, there's organ clocks, you know, a brain clock, immune system clock, a heart clock, an artery clock, liver clock. We're not using any of these incredibly important tools to predict the risk, to guide a person about their lifestyle, their prevention plan. That's what we're going to do in the future someday, prevention, real prevention, not this, you know, give somebody a Pneumovax, check their lipid panel. No, real prevention will someday be the norm. And we could do this now, but nobody's doing it.

B (8:27)

So how do you move toward that? Go ahead, Harlan.

A (8:29)

Well, I was just going to say that on the lifestyle side, though, there's a lot of overlap in terms of what represents healthy intervention. So I do wonder whether or not, you know, it's enough to give people, you know, you're off the hook for Alzheimer's as opposed to saying, you know, they're actually behaviors and approaches like good sleep, like exercise, like avoiding ultra processed foods and diet, which we actually have less evidence for than some of the other things, but still seem like the right thing to do based on what we know. You know, that, that crossover that probably helps reduce your risk of cancer, heart disease and neurodegenerative disease altogether. And, and so there does seem to me to be some pluripotent preventive strategies, ones that actually cross all those boundaries. And then there are some things you can do specifically for each of the individuals.

C (9:22)

I'm with you totally. The lifestyle factors, they extend to a lot of other things. Air pollution, alcohol, plastics, alcoholics, alcohol forever chemicals, social engagement. I mean, there's a long list of. That's why I call it lifestyle, Lifestyle plus. You're absolutely right. They, they cut across all three. The point is, though, we're not doing well right now. 75% of Americans don't even meet the minimal standards for physical activity. All right, so what I'm saying is if you can tell a person this is the disease you're going to get in 16 years, you'll start having symptoms. Because we can even give time now, not yes or no, we can give temporal link, then the chance of them doing these things might be increased. I mean, for example, in Finland, they did a polygenic risk score for heart disease. A prospective study, what they found when people were given their polygenic risk score was very high for heart disease. Those people made radical changes in their lifestyle. They stopped smoking, they lost weight, they had physical activity. But who gets a polygenic risk score today about anything? You know, and so I'm just trying to suggest that we will do better when we give people specific individualized or when personalized recommendations, because we're not doing too well with these generalized things, which I couldn't agree with you more. These are things, by the way, in the book I review, if you do all these things that you and Howie were reviewing, you get seven to 10 years of healthy aging, added years. If you start at age 50. If you start at age 50, you start younger, you get even more. So if you start older, you'll still get something. So, yeah, they would help everybody, but everybody's not doing these things.

B (11:13)

How does one get access to a polygenic risk score in today's day and age in society? Is it something accessible to the average person?

C (11:22)

Well, there's 10 companies at least that are offering them. I mentioned many of them in the book in that section. We're working with one of those called Haplotype to get them cheap because some of these are like $200. This is the cheapest thing to do, is we could do it, but not at scale. At Scripps Research, we were doing it now for $20 is a cost for us to do. It is a snip chip, 1 million snips variant. So it's very easy. The work here has been done over, you know, 15 years to define what are the letters SNPs that are associated with the polygenic risk for each of these common diseases. So we're working with Haplotype because the guy that did all these for 23andMe, he branched off or left 23andMe and their turbulence and set up this company. And we're trying to get that hopefully in the months ahead. So It'll be like $25 for everyone. Anyway, at Mass General Brigham, they launched all clinicians can get polygenic risk scores. Pradeep Natarajan put out post now that they're. I don't know how much it costs, but they can do it. Add it to the companies. So academic labs know how to keep the variants updated, because for heart disease, there's hundreds of variants that are used to give the most accurate ancestry specific, ethnic specific risk score. Because in the beginning of all this, you know, we didn't have this millions and millions of people of diverse backgrounds with this kind of data. But we do now for all these polygenic risk scores. And I can't believe this. You know, here it is, 20, 25. This data has been available for almost 10 years, keeps getting better every month, and no one's using it. I mean, it's just amazing. As a cardiologist, every patient I see, I asked them. Now, it used to be easy when they could get their 23me data before the company imploded. I would sit in the clinic with them and say, just upload it. Go to our My Gene Rank, our app that we made for free and get us your polygenic risk score. And they would do it in like two minutes for free. Once they had 23andMe. But now, you know, they can't do that, unfortunately.

A (13:47)

Well, Eric, do you want to. I mean, I believe that everybody will have this, you know, sometime in the future. I don't know when, but do you want to explain to people listening? Because not everyone's going to know the concept behind the polygenic risk. I might as well let your master teacher. So instead of me saying it, why don't you go ahead and explain?

C (14:03)

Well, to simplify, you're going to find out risks that you didn't think were in your family or you knew weren't in your family. And the reason for that is polygenic. These common diseases, there are hundreds of gene variants that contribute to their risk. And you're going to get something from your mother's side of the genome and your father's side. And that admixture comes up with unpredictable things. Okay. You don't just get a pure paternal or pure maternal inheritance. Okay. We get a recombination. So the point about the polygenic risk score is for each of these conditions. Could be colon cancer, could be atrial fibrillation validated to the health. There's hundreds of variants that are linked to that condition. Now, the only problem is they don't, they don't tell you when. Right. So let's see, you have a high risk polygenic risk score for Alzheimer's, it's yes, no. So it only would tell. Maybe you could be age 99. For Alzheimer's, it could be 69. Right, 59. So now we have much more or never.

A (15:11)

It's just about risk.

C (15:13)

Yeah, it gives you a gradient of risk. And so if you're in the 90th percentile, then you're 95th percentile. You know, that's probably something you want to be preventing, but you don't know when. Now, we can take that much further.

A (15:28)

But let me just to follow up on that, you're also the guy who did the Wellerbee study and said part of what this taught me was that genes aren't as important as everything else I can do. So how do you reconcile this idea that I can get an assay of my genes? And the way I explain it to people is it's a super duper family history. This has taken all of the stuff that's happened with all your ancestors, how you've inherited that, and telling you based on a whole bunch of different genes, what your risk is. And so it's kind of a super duper family history rather than just asking.

C (16:03)

It's additive and independent of the clinical family history. Yes.

A (16:07)

Of what people will report. But how do you reconcile? Because you also are the guy who's saying, hey, double. Let me put it like this. I think you're saying, which I think, and I definitely agree with you if this is what you're saying, you can control your destiny to a large extent.

C (16:22)

Yes, absolutely.

A (16:24)

You're not trapped in what you've inherited because you have a lot of latitude to modify that risk, whatever it is, wherever it starts.

C (16:32)

Yeah. So here's the. Let me get to this. Because the welderly were the 1400 people that we did whole genome sequences, they were over age 85, range up to 102. And we didn't find any real differences in their polygenic risk. The welderly, it took seven years to find. These people they know are no medicines, never had a disease, cognitively intact. And I present my lady patient, Mrs. Russell, the first thing in the book, 98. I mean, she's incredible, right? And I've even had her at grand rounds here, you know, to present her, because she's just like, wow. And she'd never stood up before anybody in her life. And here she is, she's joking with the crowd. They're all laughing their heads off because she's so amazing. Oil painter, a jigsaw puzzle, thousands of pieces, you know. So these people, their polygenic risk scores are essentially similar to the elderly. The elderly are Americans over age 60 who have at least one chronic disease, typically two or more, right? So we say, wait a minute, how did these elderly get to age 90, 89, and they have the same polygenic risk score? Well, you look at their lifestyle and as you say, Harlan, it's not deterministic. These people are relatively thin, they very, very physically active, they're socially engaged, they have a sunny disposition, all sorts of. They have hobbies. And these people are different the way they have approach life and taking care of themselves. It was very rare we would find somebody in the elderly who was obese or smoked. Still very rare. Most of them really took good care of themselves and they have a lot to show for it.

A (18:28)

I was just going to weigh in and just say, eric, look, this book, there's so many wackadoodles out there who want to ride a wave and depart from conventional science in their recommendations to people. The one thing about you that people should know is in addition to everything Else being an extraordinary thinker, great communicator, so creative is you're an outstanding scientist. I mean, you know, your roots are in science and you're evidence based. You can evaluate studies and people should know if they go to this book. Unlike many other books, it's replete with references. It analyzes the science in ways that are accessible to the lay public but are also rigorous. And that's what's really distinctive about it. I wanted to ask you, sometimes by going off on these tangents and suggesting sort of wild things to people, it's easier to get attention. Did you think as you did this book, like, gosh, it's like, I don't know if I can get people excited about real evidence. I mean, how did you approach it like that when you thought about this book?

C (19:32)

Well, thanks so much for your comments, Harlan. It means a lot to me. This is a really tough mission because we have books out there like Peter Attia's Outlive and Casey Means Good Energy. And both those books have some good parts to them, but they also have a lot of things that are completely off the rails and they are extremely popular, having sold to over 2 million 1 million copies respectively, and still going strong. So the problem is, you know, they tell things to people that they want to hear, like there's these secrets and that the medical establishment has got it all wrong. But we know, you know, take rapamycin or, you know, get a total body MRI or take these peptides and on and on and on. And so I don't know, over time when you try to tell stuff that is representing the medical establishment with evidence, I don't know if it will compare with the giving the messages that people want to hear, which is basically from people who are challenging their medical establishment, which, as you know, is kind of the rage right now.

A (20:43)

You know, just want to follow up one thing, Howie, because, I mean, we're so excited to talk to you. We're like colliding. That's why it's like I wanted people to know who are listening because they may have heard about superagers, but you've really created a body of work that actually I see coming together there was starting with the creative destruction of medicine with a big idea about digitization of everything would fundamentally disrupt medicine. Of course, you were right about that. And then the Patient will see you. Now is such an important book. Of course, as you know, I'm very. I resonate a lot with the idea of how do you empower patients? How do you put them in in this position. And your idea there about smartphones and digital tools putting patients really in the middle. And I just love that Flip the patient will see you now. It's a fantastic title. You know, you go into deep medicine where you start talking about, you know, the promise of AI and then you get into the longevity stuff and wellness with, with super agers. I really see this as a connected group. And if people haven't had a chance to dig into these, even though some of these are a little bit older now and the world's changed, you actually did them in a way that I think they have enduring wisdom associated with them, that you're providing insights that are still relevant. Even if people go back to these, they'll see lessons that we're still applying even as the sciences move forward. Did you ever conceptualize these together or did these just come out one by one as you did it? How did you approach the idea of books? Because earlier in your career you weren't writing books like that.

C (22:16)

No, no, I actually I got started much later than I probably should have because I didn't ever think I would write a book for the public rather than just these medical book textbooks.

A (22:28)

And of course you wrote the major interventional cardiology and edited the major interventional cardiology textbook for many years. I think through four editions it was.

C (22:37)

Oh, now it's on. It's soon going to be at the ninth edition. You haven't given up on it. It's kind of amazing. But you know, I think what I've learned is our audience has to be the public because we live in this microcosm, whether it's radiology or cardiology, whatever specialty, even internal medicine, it's just not the right audience. It's fine to talk to your colleagues and peers, but it's much bigger than that. So I finally learned later, now every book, including superagers, I tried to forecast the future and I've always been wrong. Not by what it was going to happen, but when, you know, because it takes much longer for medicine to, you know, reset and change. And here the thing that I tried to put forth in superagers was we have an opportunity to prevent the big three age related diseases like never before. That's really the big idea here. But are we going to do it? Are all the gutting of our medical research support resources going to prevent it or suppress it or slow it down? But that's what's so, to me, so exciting. So each of these is kind of an optimistic forecast which has been off by years. I mean the first one in creative destruction. I kept talking a chapter on telemedicine. It took a pandemic so that we would have telemedicine. But fortunately, I think so far, AI, as you mentioned, Harlan, is deep medicine. We're starting finally to get into the AI use of AI. And the whole. The gender of AI wasn't even known then, but we knew it was coming. And I had spoken to the leaders in the field and we knew that this whole ability to read text and images and everything was going to change. And it did. And now we're in a new era. But it's the very early era of medicine. And as you know, both of you know so well, there's lots of fear, lots of reluctance, and some of that's justified, of course. So it'll take time, but we will get into AI being, you know, kind of incorporated into daily medicine eventually.

B (24:51)

I wanted to briefly just touch on something. You had your mo. Your second to most recent substack was on protein. And that is one of the biggest fads right now. Everybody's trying to figure out how they can get like all their calories and protein. And I fall prey to this all the time. I have protein bars in the office, but my protein bars are almost passe right now compared to the new super protein bars that everybody has. I'm curious though, another topic in superagers is about this issue about rapamycin and its interaction with immunology. And on your most recent one on the protein, you talk about leucine and how so many of these sort of health oriented individuals are taking leucine and they're also taking rapamycin. You just talk about like what the evidence is about this and why it's so crazy.

C (25:44)

This is incredible to me. You know it all. I mean, I was on this topic, but then when the daily New York Times podcast last week had one on David Bars. Yeah, Peter Attia and Andrew Uberman being the number one and two influencers pushing the protein, one gram per pound, which obviously is a lot of protein to ingest every day. And of course they're selling these bars that have the most protein ever with the lowest calorie in bars and they've sold so much that they can't even make them fast enough. Hundreds of millions of dollars. Anyway, I started getting into this because in the book I even mention about how all the work from Washington University, St. Louis, which hasn't gotten enough regard, shows that high protein intake, and this is shown both in mice and in people, will add to Inflammation of the body and at least in the mice models, promote atherosclerosis. And in fact, you know, the leucine as you mentioned, Howie, that's the essential amino acid we can't get. The body can't make it, but we get it through eating food or bars. Most of it comes from animal sources. Well, it turns out leucine is the culprit. That's the big thing. And this is a real problem because these people that advocate taking rapamycin with no data to know that your immune system is not knocked out because we can't measure it, that inactivates mTor, the molecular target of rapamycin and leucine activates it. So what they're doing is they're getting the yin and yang opposing effects. They're knocking out whatever the rapamycin was supposed to do with the leucine. It's just crazy. And there's no data. There's no data. And I just reviewed every meta analysis, every paper out there, every randomized trial. There's hundreds of them that support this 1 gram per pound, you know, which is 2.2. And people are on it. You know, all these TikTok videos that take 200 grams of protein a day. This is a sick with no basis. It's kind of reckless. And some people, especially if they take this big protein intake through animal sources, they're going to get a lot of leucine and if they had a risk for heart disease, it's not going to make it any better.

B (28:08)

Not to mention that this, these David bars and most of these high protein products are ultra processed foods.

C (28:15)

Yeah, that's right. On top of that, they're all ultra processed. But especially these David bars with the epg. I mean this stuff is just, you could never make this up. I mean it's just amazing. And of course the peptides, you know, is another ground truth. I wrote a couple of weeks before that that's the same. You got RFK Jr advocating everyone should take BPC157 peptide. And people are taking stacks of peptides, each a few hundred dollars or more every month and they're self injecting themselves with these peptides. It's the same issue. There's no data for any of this stuff.

A (28:51)

We can't get people to control their blood pressure. But there's all these people following all this other stuff.

C (28:56)

Yeah, but you know, try to dissuade from the influencers who have massive following and they are trying to tell you the secrets that the medical establishment won't tell you that, you know, this is what we're up against. It's a real challenge right now. I mean, you saw it. Even the hearing with RFK Jr. You know, it's crazy. They got truth and evidence versus stuff that's made up and you can't tell the difference out there.

B (29:24)

I'd be remiss to not reflect on the fact that the moment that we're in right now, we had the RFK hearing and you did a podcast with Dr. Mike Osterholm, which I thought was great, where you talked about sort of the challenges that we're in, in the public health space right now. Do you want to just say a couple of words? You are incredibly careful about not going out too far with, you know, running around with your head cut off. You do, you do judge bad behaviors out there. But it's not like this is the thing you do. You don't sit there and say, look how crazy everybody is. Tell us how you feel about the current moment though, because it does make a lot of us feel like it's crazy.

C (30:08)

Yeah, I mean, you could go crazy by doing that. So I try to stay sane and you know, I obviously we're in a dark time. We have all this dis and misinformation and made up stuff and politicization of everything. And I'm just. The way I keep my sanity is I get my head into other topics. I don't fixate on it, knowing that someday this will get righted. It may be too long from now and it may take too much to get back on our footing. But this can't go on forever how bad it is. So I try to just stay optimistic. I know it's bad, but, you know, like I'm on blue sky and blue sky, you know, if you want to get anyone to pay attention to your post, it's got to be something about how crazy everything is and, you know, how the world is ending. And I just post stuff about some interesting science stuff to try to titrate that because, you know, the science isn't going to go away. And as much as the funding might get cut, people who do good science, they're just going to keep on going and eventually great discoveries will be made. Maybe not at the same velocity. Right. And so I, I always been optimistic and I'm not losing it. I refuse to have a derangement syndrome. You know, I just can't, I can't handle it. You know, I just, I rather try to find whatever positive out there that are, that are Fascinating discoveries that tell us that, you know, the world is not going to, you know, the sky isn't falling. It kind of is falling, but you know what I mean. Yeah.

B (31:48)

One last thing. This comes from Tobias, our research assistant and undergrad at Yale. He raises a point that a number of years ago you thought Level five autonomy was not achievable with AI, and more recently you seem to indicate that you think it is. Do you want to just say a quick word on. I know you say you get the timing wrong, and I agree you get the timing wrong a little bit. AI dissemination. But I'd love to hear you say what you think is going to happen in the future with health care, medicine and AI.

C (32:22)

Yeah. So I was borrowing from the car, auto industry, and level 5 autonomous driving means that under any condition, fog, ice, that the AI can navigate. And I'm just trying to say, in medicine, we will never get there. There will always be conditions that the AI. You have a new cancer diagnosis. Do you want the AI to tell you that and to what treatments? No, no. So we're not going to ever get to Level five. We may not even get really to Level four. So it's just about how deep, how far, how the breadth that AI can take us. I do think the biggest thing of AI in the future is going to be this remarkably precise and accurate forecasting of conditions long before they ever start to show up. People haven't centered on that, but that to me is the big thing that we haven't yet even started talking about. So. But we're not going to get to Level five. I maintain that. And if I ever intimated that I would retract it or say it isn't true.

A (33:29)

Well, I'll just say, how about this? You might get to Level five for selected things. What about. Oh, yeah, people have a rash, they take their phone, they take a picture of it, it tells them what it is and they. And for. For 80% of them, they're telling, put a little steroid cream on and take care of it. I'm just joking. But, you know.

C (33:47)

Yeah, but that's Level three. Level three is under specific conditions where the, the roads are clear and the maps are good. So, yeah, specific things. That doesn't get you out to the five. Total autonomy. I don't think total autonomy. I don't think medicine can ever go there. I hope it doesn't go there. Because the human touch and the, you know, knowing that the doctor has your back, that, I mean, if there isn't anything more essential in Medical.

A (34:13)

What about on the Mars. Mars trip? Don't they have to bring a hologram? That.

C (34:18)

This is ridiculous. No human being is fit to go to Mars. Okay? You're not. You can't even live up in the International Space Station for a while. I mean, I just got to know the twins and the one that stayed up there and the one that was up there, the one that. On ground. And you know, we're talking about real suffering of the brain and everything from. You can't. People aren't going to Mars here. You know, maybe they could find a gene that's Mars selective that could get you there. Six months trip. This is ridiculous stuff.

B (34:49)

I'm willing to send Elon Musk to Mars if that's what it takes.

C (34:53)

So. I'm with you. I'm with you. I think he should go and start the. Start the colony. Colony, exactly. Yeah. I think it'd be good. I think it'd be really good.

B (35:04)

I am so grateful that you joined.

A (35:06)

We're so happy to have had you on. It's so great to see you.

B (35:09)

Hopefully we'll get you back again and again. The book is Super Agers in Evidence Based Approach to Longevity.

A (35:16)

Buy it, it's worth it.

B (35:17)

And the substack is Ground Truths, which is so fantastic. It is free. You can subscribe for additional content, but it is free and it is fantastic.

A (35:28)

It comes out the podcast substack. Fantastic. I'll tell you that it's so easy to get behind this book because it really looks at the science. It's something people can rely on and, you know, for that. We thank you, Eric, for all you do and it's really great to see you.

C (35:42)

Oh, thanks to both of you. This was so much fun. I really thank you, enjoyed it and really appreciate all your feedback and keep up your great work because. Thank you. It's changing the medical world for sure. Yeah.

B (35:55)

Not like you, but we're gonna try. We're gonna keep following you. Let us know if we can do anything and if you ever are willing to come out to Yale and do a series of events like we did with Mandy, I am all in.

C (36:07)

No, I would love to do. Thank you.

A (36:09)

We'll even try to sell some books if you do.

C (36:12)

All right, you guys take care. Thank you.

B (36:15)

Bye Bye.

A (36:16)

All right, bye. What a way to kick off season five, baby.

B (36:19)

Absolutely. I'm so grateful for him. He is such a good guy. He's such a nice man.

C (36:23)

Yeah.

A (36:23)

And kudos to Tobias for putting together a great notes for us to enable us to do a good interview. Anyway, everyone, you've been listening to Health and Veritas with Harlan Krumholtz and Howie Forman. We're back for season five.

B (36:34)

Back, baby, back. How did we do? To give us your feedback or to keep the conversation going, email us@health.veritasale.edu or follow us on LinkedIn threads or Twitter or whatever social media you want to try.

A (36:48)

Yeah, I'll plus one on that. We always enjoy hearing from you. Rate us. It helps people find us. And you know we're off to the races this this season.

B (36:55)

Absolutely. If you have questions about the MBA for Executives program at the Yale School of Management, reach out via email for more information or check out our website at som yale.edu.

A (37:05)

Emba Health and Veritas is sponsored by the Yale School of Management and the Yale School of Public Health. We are fortunate to have superstar students at Howie's recruited from his class, Tobias Liu and Gloria Beck. We have a remarkable producer who somehow makes us sound okay every week, Miranda Schaefer. And I've got the best co host in the world, Howie Forman.

B (37:25)

I am so grateful for all of you and we just are excited for the new season and happy to have started with Eric Topol.

A (37:32)

So talk to you soon. Howie.

B (37:34)

Thanks very much, Harlem. Talk to you soon.