Inside the Wellness Boom: Separating Scams From Science

Summary

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On with Kara Swisher

Episode: Inside the Wellness Boom: Separating Scams From Science

Date: April 13, 2026
Host: Kara Swisher
Guests: Katie Couric, Dr. Jeffrey Swisher, Amy LaRocca

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Episode Overview

In this rich and candid episode, Kara Swisher sits down with her brother, Dr. Jeffrey Swisher (anesthesiologist and clinical leader), renowned journalist and health advocate Katie Couric, and author/journalist Amy LaRocca, to dissect the booming “wellness” industry. Together, they explore the boundaries between genuine medical science and the fast-growing marketplace of health fads, supplements, scams, and the role of tech and media in shaping public perception. The conversation spans personal investment in health, the erosion of trust in medical authorities, strategies for discerning fact from fiction, and promising advances—while remaining refreshingly self-aware about their own susceptibility to wellness trends.

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Meet the Experts: Personal and Professional Connections to Health

Start – 11:49

• Katie Couric [05:01–07:41]: Driven by deep personal loss (husband and sister to cancer) and her own breast cancer diagnosis, Couric has become a passionate advocate for cancer screening, early detection, and destigmatizing talking about illness.
  • “I became a fierce advocate for colon cancer screening and cancer research in general... sharing what I've learned with the public at large. And it's been really gratifying work for me.”
• Amy LaRocca [07:53–09:31]: Former fashion journalist who shifted focus to the “wellness epidemic” after seeing wellness eclipse fashion as a cultural force. Her book, “How to Be Well,” grew more serious after COVID exposed the health system’s flaws.
  • “Supplements were the new accessories...treating health like a luxury product is actually quite dangerous.”
• Dr. Jeffrey Swisher [09:40–11:49]: Anesthesiologist, liver transplant specialist, and cancer caregiver (his wife’s experience with colon cancer; his own cardiac diagnosis). Brings both clinical and deeply personal lens to modern medicine’s challenges.
  • “Seeing a lot of younger and younger patients with cancer... and recently discovered that I have significant coronary artery disease.”

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The Misinformation Crisis: Why Don’t People Trust Experts?

11:50 – 21:08

• Kara [12:14]: Raises explosion of misinformation and loss of faith in traditional authorities; why is health especially vulnerable?
• Katie Couric [12:49]: Laments the “death of expertise,” and explosion of unqualified influencers.
  • Quote: “There's a whole psychological thing going on with misinformation... people, it seems to me, don't want to know factual information.”
• Dr. Jeff Swisher [14:54]: Emphasizes toxic mix of social media and COVID as amplifiers, vilification of experts like Dr. Fauci.
  • “Everybody has a voice, and not all opinions are valid. You're welcome to your opinion, but you're not welcome to your own facts.”
• Amy LaRocca [15:56–18:28]: Discusses profit motives infiltrating medicine (celebrity doctors shilling supplements), blurring lines between doctor, influencer, and spa–while insurance and healthcare systems destroy genuine doctor-patient bonds.
  • “You're like, am I at the doctor? Or at a spa? Where am I? What's happening?”

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The Wild West of Wellness: Supplements, Scams & Social Media

18:38 – 21:08

• Supplements Debate:

  • Katie Couric [18:38]: Pushes back on “all supplements are bad.” Shares recent multivitamin study; caution but not dogmatic.
  • Amy LaRocca [19:22]: Acknowledges supplement market has “gone berserk;” most people are wasting money.
  • Dr. Jeff Swisher [19:37]: Takes middle ground: “If you have a balanced diet, you're getting mostly more than you need for vitamins and minerals.” Warns of overuse (esp. fat soluble vitamins).
  • Memorable exchange:
    • Katie: “I'm not a big supplement person, but I don't like blanket statements either.” [19:10]

• The Doctor-Influencer Problem: [20:31]

  • Amy: “The disbelief of experts, I find terrifying. I find the anti vax movement terrifying.”
  • Kara: “...they consider Dr. Oz the doctor they know best. So upsetting. Or Gwyneth Paltrow...from Goop.”

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Why Is Real Medical Communication So Hard?

25:25 – 32:37

• Expertise vs. Entertainment:

  • Katie Couric [25:25–27:59]: Critiques TV’s role in giving platforms to 'junk science' (Dr. Oz) vs. her insistence on vetting for accuracy. Calls out doctors for poor public communication.
    • “People in the medical profession are notoriously bad at explaining stuff in an accessible, understandable way.”
  • Amy & Jeff [28:37–31:23]: Systemic reasons: doctors’ lack of time (insurance, hospital consolidation), crowd out trust and create a vacuum for influencers (and scammers).
  • Jeff [29:39]: Sharing examples from anesthesiology (epidural anesthesia misinformation) and the complexity doctors face explaining nuanced science on the internet.
    • “It's very difficult to make it simple.” [31:23]

• Social Media & Magical Thinking:

  • Amy LaRocca [31:27–32:00]: Compares wellness social media to “spin out a narrative thread” from thin air, using collagen as an example.
    • “You will not find a single thing that tells you you're gonna get that collagen to grow again in your face...unless you find a time machine.” [32:00]

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Seeking Truth: How to Make Decisions in a Noisy World

32:37 – 39:00

• Katie Couric [33:28]: Shares her method: seeking out experts, checking credentials, staying evidence-based (“I can trust this person”).

  • Candid about the “magical thinking” and appeal of easy solutions—even for herself.
  • “People want answers, and honestly, they often don't like the answers they get.”

• Case Study: Menopause

  • Amy LaRocca [35:23–37:51]: Details how confusion and missing information about hormone therapy created market openings for over-promising online services.
    • “Now it was suddenly like we went from HRT will give you cancer to HRT is going to do your dishes, wash your car, pay your taxes...”
  • Affirms: suffering is real, but new solutions are rarely miracle cures.

• The Reality of Uncertainty:

  • Dr. Jeff Swisher [39:00]: Acknowledges complexity, emphasizes basics: “Diet, exercise, nutrition, don't smoke, don't overdrink...everything else is very bespoke.”
  • “There is no simple solution to most medical problems.“

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The Longevity Boom: Hope, Snake Oil & Human Nature

40:06 – 44:47

• Kara: Tech’s obsessions with longevity—a $2 trillion industry (per McKinsey), with money pouring in from moguls who “don’t want to die or want to look better.”
• Katie Couric [40:33]: Admits vulnerability even as a skeptical journalist.
  • “I too, because I wanna feel good...you get sucked in. I'm vulnerable and susceptible to scams. We're all vulnerable to stuff that doesn't work or doesn't do anything. Right?”
  • Shares temptation to buy “red light mats”—to which Kara and Jeff respond with healthy skepticism.
• Amy LaRocca [44:01]: Describes “burrito wrap” treatments designed to simulate heart rate on a treadmill while stationary—funny but ultimately “I thought I was gonna die.”
  • “I literally wrote the book. And then I will buy dumb shit all the time.” [42:46]

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Promising Frontiers: GLP-1s, AI, and the Future of Medicine

47:29 – 55:56

• GLP-1s & AI Innovations:
  • Dr. Jeff Swisher [47:57]: Excited by new weight loss/cardiac drugs (“GLP1s and GIPs will have more and more indications...”), AI-led drug discovery (especially monoclonal antibodies), and mRNA cancer vaccines. Outlines the real hope behind medical advances.
  • “Everything is changing. Malignant melanoma is changing. Colon cancer, potentially pancreatic cancer...”
• Katie Couric [50:18]: Sees AI’s “game changer” potential—esp. cancer detection, predictive risk, individualized care. Cautions against over-hype; applauds the promise of liquid biopsies while noting their limits and dangers of premature marketing.
  • “There is something going on in our environment...it's not just obesity or a sedentary lifestyle...it's a confluence of things including ultra processed food, microplastic forever chemicals, over prescription of antibiotics...17 cancers are increasing among people under 50. So what the fuck is going on?” [53:50]
• Amy LaRocca [54:16]: Digital twinning and other AI-powered personalized medicine hold great appeal, even if currently far from reality.
• Dr. Jeff Swisher [55:14]: Stresses complexity; medicine is not as simple as “digital twins,” but the field is moving in exciting directions.

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Lessons from Scandals and Snake Oil: Theranos, Trust, and Critical Thinking

57:02 – 59:26

• Kara & Jeff recall suspecting Elizabeth Holmes (Theranos) long before the scandal broke, illustrating the value of healthy skepticism and science literacy.
  • Jeff: “You can't do that with a blood sample. Physics.” [57:17]
  • Kara: “She lied about a couple of small things, like who she was dating, where she was living... then my brother says there's no math to it...and so I think she's a liar.” [58:43]

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Final Takeaways: The Real Secrets to Health

59:26 – End

Kara: “What's the number one thing each of you would tell people about prioritizing your health, and what's your secret to a longer life?”

• Katie Couric [59:48]:
  • “It's just like the boring stuff, Kara. Eating well, moving your body, getting plenty of sleep. I really believe in the power of community...and laugh. I try to enjoy my life and be positive.”
• Amy LaRocca [60:31]:
  • “It's the basics...getting enough sleep, drinking enough water, not eating junk food, being with your people, loving freely...also, not being poor. The things we're calling basics right now are really not available to a lot of people in this country.”
• Dr. Jeff Swisher [63:10]:
  • “Quality over quantity...floss your teeth, hydrate, eat good food. And most importantly, have connections...help others. That's how we live long and healthy and happy lives.”

Memorable Exchange:

• [63:48] Katie (lightheartedly): “What about my fish oil?”
• [63:49] Dr. Jeff: “Yeah, your fish oil's good. Except you get fish breath with fish oil.”
• [63:55] Kara: “Put that down and go cook yourself a piece of salmon.”
• [64:12] Amy: “It's too much.”

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Standout Quotes

• “There's a whole psychological thing going on with misinformation...people, it seems to me, don't want to know factual information.” – Katie Couric [12:49]
• “Everybody has a voice, and not all opinions are valid.” – Dr. Jeffrey Swisher [14:54]
• “Supplements were the new accessories...treating health like a luxury product is actually quite dangerous.” – Amy LaRocca [07:53]
• “It leaves me scratching my head...there’s so much magical thinking. People want answers, and honestly, they often don't like the answers they get.” – Katie Couric [33:28]
• “If you're talking yoga vs Pilates, like, you're fine.” – Amy LaRocca [61:53]
• “Have connections...help others...that’s how we live long and healthy and happy lives.” – Dr. Jeffrey Swisher [63:10]

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Key Timestamps

• 05:01 Personal stories: cancer, loss, motivation
• 12:49 The “death of expertise” and the trust crisis
• 15:56 Profit motives, broken healthcare, influencers rise
• 18:38 Supplements debate—science vs. hype
• 25:25 From Oprah/Dr. Oz to explaining science plainly
• 29:39 Anesthesia myths and internet misinformation
• 31:27 The storytelling trap of the wellness industry
• 33:28 Navigating scams, finding trustworthy info
• 35:23 Case study: menopause misinformation
• 40:33 Longevity industry—enthusiasm and skepticism
• 47:57 GLP-1s, AI drug discovery, and cancer innovation
• 59:48 The real secrets: basics, community, and privilege

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The Main Message

Take care of the basics—diet, sleep, movement, real connections—and question extravagant promises from the $2 trillion wellness industry. Science is progressing, but so are scams. Maintain skepticism, seek real experts, value community, and understand the social reality that not everyone has access to what’s “basic.” The path to a longer, better life is not glamorous—but it is real.

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Transcript

[Katie Couric]

What about my fish oil?

[Dr. Jeffrey Swisher]

Yeah, your fish oil's good. Yeah, except you get fish breath with fish oil.

[Katie Couric]

You burp a lot.

[Dr. Jeffrey Swisher]

You do.

[Kara Swisher]

Hi everyone from New York magazine and the Vox Media Podcast Network, this is on with Kara Swisher and I'm Kara Swisher. As you might know, my new CNN series debuted this past weekend. It's called Kara Swish Wants to Live Forever. It's a big look at longevity, anti aging and the huge industries popping up around all these topics. I wanted to cut through all the scams and hype and talk about the real science around how to live longer, healthier lives. I do not want to live forever, by the way. Longevity is also the subject of today's show and I've got three experts with me to talk about it. Katie Couric is a journalist. She's also been a longtime advocate for people to get cancer screenings after her first husband died of colon cancer and she was diagnosed with breast cancer. Amy LaRocca is an award winning journalist and author of the book how to Be Navigating Our Self Care Epidemic One Dubious Cure at a Time. She is in the series and so is my brother, Dr. Jeffrey Swisher. He's the chairman of the department of anesthesiology at the California Pacific Medical center in San Francisco and he recently caught, before it happened, the possibility of a so called widowmaker heart attack. His wife has also been diagnosed with stage three colon cancer and is actually doing really well. It's a really interesting time to talk to these people because all of them have dealt with health in a very different way. Katie obviously was groundbreaking in bringing really good information to people about colon cancer in a time where people didn't know about it. And what Katie did was saved a lot of people's lives by being a great reporter with facts and science on her side. Amy just blows up in this series, as you'll see, talking about how wellness went from a thing to make you feel better to a luxury item and how dangerous that could be. And of course, Jeff is my brother and he's really smart about these issues. And I will tell you, he is the first person that told me that Elizabeth Holmes was full of shit when she was pedaling that blood machine that never really worked. All right, let's get into my conversation with Katie, Amy and Jeff. Stick around. Support for this show comes from back market. You don't always need the newest tech, no matter what your social media algorithm says. Sometimes newer doesn't exactly mean better. Backmarket is the world's leading premium refurbished tech marketplace Backmarket offers a range of high quality tech inspected and refurbished by professionals. It's all they do. They have phones, computers, gaming consoles, vacuum cleaners, and even ipods. Back Market is also on a mission to reduce the environmental toll that FastTech has on our planet. As refurbished tech is proven to use less raw materials, leave behind less waste and create fewer carbon emissions than new, making their refurbished tech not only more affordable but more sustainable. As shop [e-mail]. Support for this show comes from AMC Awards Buzz calls the Audacity a sharply engaging and zany comedic drama. A once buzzy Silicon Valley startup is losing steam thanks to its narcissistic CEO Duncan Park. In his desperation to reclaim his IT factor, he'll take down anything or anyone who gets in his way. Executive produced by Jonathan Glatzer, a writer, producer of Succession and Better Call Saul. Billy Magnuson, Sarah Goldberg and Zach Galifianakis star in this absurd look at 21st century techno royalty. Watch the Audacity Sundays only on AMC and AMC. Learn more at amcplus.com.

[Dr. Jeffrey Swisher]

Adobe Acrobat, your team's home base. Collaborate within a shared PDF space. You've got your docs, your plans, your specs and then invite the crew to build what's next.

[Amy LaRocca]

Talk up the teamwork.

[Dr. Jeffrey Swisher]

They think that this design could be an contender. When somebody wonders what's the next steps,

[Katie Couric]

AI helps you finish the rest.

[Dr. Jeffrey Swisher]

Bolts are tight now. Your plan's refined. Run a smoother business when you're all aligned.

[Kara Swisher]

Do that with Acrobat.

[Amy LaRocca]

Learn [e-mail] do that with Acrobat.

[Kara Swisher]

It is on. Katie, Amy and Jeffrey, thank you for coming on on. I appreciate it.

[Amy LaRocca]

Thanks for having us.

[Dr. Jeffrey Swisher]

Glad to be here, Kara.

[Katie Couric]

Thank you. Good to be here, Kara. And this is going to be fun.

[Kara Swisher]

All right. I'm excited to get the three of you together in convers. I find that sometimes these kind of unexpected groupings of people lead to some of the most interesting conversations. And each of you in your own way have talked and reported on and discussed. And Jeff practices healthcare. And so let's take a minute and each of you explain your personal and professional connections to health, science and wellness. Let's start with Katie, then Amy, then Jeff.

[Katie Couric]

Okay, Well, I think many people remember my husband Jay was diagnosed with stage 4 colon cancer in 1997 and died nine months later. Was just 42 years old when he passed away and our daughters were six and two. It was really my first experience losing someone close to me and my first experience with cancer in A real way. And so I think because of my position at the time, I was co anchor of the Today show. I used that as an opportunity to educate the public about colorectal cancer, which is now the number one cancer killer of people under the age of 50. And we can talking a little bit, Cara, about early onset cancers, which are on the rise. But subsequently, I lost my sister Emily to pancreatic cancer just a couple years later when she was 54 and a rising star in the Democratic party in Virginia. Anyway, as a result of those two losses, I became a fierce advocate for colon cancer screening and cancer research in general. I am one of the co founders of Stand up to Cancer and really advocating for early detection screening and more research dollars, committed to finding better treatments and one day, hopefully a cure, has really been my most important life's work.

[Kara Swisher]

Yeah, and you have also been doing that. You did a colonoscopy on camera. You also were diagnosed with breast cancer and talked about it a lot, which raised the profile in many ways, I hope.

[Katie Couric]

You know, one of the things that I've been able to accomplish is to destigmatize these diseases. You know, I think even though Ronald Reagan had polyp and I guess, did he have early stage colon cancer? I can't remember. There's still this shame and discomfort about talking about that part of our bodies. And like every part of our body, as Amy will tell you, we have to keep that healthy. And I later was diagnosed with early stage breast cancer just a few years ago. And so I use that as an opportunity to educate women about dense breasts and the fact that mammograms alone can't necessarily detect breast cancer, especially in the 42% of women over the age of 40 who have dense breasts. So I've really tried to use my personal experiences, Kara, Dealing with these various forms of cancer, to first educate myself and then share what I've learned with the public at large. And it's been really gratifying work for me.

[Kara Swisher]

Yeah, it was very groundbreaking when you did that colonoscopy, I think shocking to people, too, and in a good way.

[Katie Couric]

I told them I draw the line at a pap smear.

[Kara Swisher]

Okay, well, today you do. All right, Amy.

[Amy LaRocca]

So my background is as a journalist. I was a fashion journalist for many years at New York Magazine. And I switched over when I started realizing that this thing called wellness was really eclipsing fashion in the Zeitgeist. And I kept hearing about it, and all the fashion people were talking about it, and they were switching over their Fashion careers to juicing or cleansing. And I noticed that wellness and our health was kind of occupying the space that luxury handbags used to and supplements were the new accessories. And I became really interested in that. And I originally conceived of the book I wound up writing that came out last year called how to be well as a kind of lighthearted thing. And then halfway through my reporting, Covid happened. And it made me realize this wasn't just a light hearted thing. The way we treat health in this country is really serious. And treating health like a luxury product is actually quite dangerous. So I ended up spending about five years writing and researching a book all about what I call the wellness epidemic in America, which is both the light stuff about boutique fitness classes and colonics and face creams and supplements, and also the kind of deeper stuff about what happens in to a culture that does treat healthcare and market healthcare like a luxury good.

[Kara Swisher]

Right. And you also were looking into a lot of false stuff.

[Amy LaRocca]

Oh my God, the false stuff. We better get to that.

[Kara Swisher]

We'll get to that, Jeff, you go ahead.

[Dr. Jeffrey Swisher]

Well, as you mentioned, I'm a physician. I have been a doctor now for what, more 35 years. I'm an anesthesiologist. And so a lot of my practice more and more because insurance pays for it, is doing anesthesia for colonoscopies and upper end. So I certainly see tremendous amount of those kind of cases. And I do also my specialty is liver transplantation and just general surgery as well. So I'm seeing a lot of younger and younger patients with cancer, not just colon cancer, but colon cancer that's metastasized to the liver and to other areas where that is now a problem. Katie, I'm so sorry about your husband.

[Katie Couric]

Thanks, Jeff.

[Dr. Jeffrey Swisher]

Just tragic. I don't know if you know that Kara and I lost our dad when he was 34 years old. He had a brain aneurysm.

[Katie Couric]

I remember Kara telling me that. And my goodness, so young.

[Dr. Jeffrey Swisher]

It is. It's so. But you know, Kara asked how we got involved in health issues. You know, we're from a health family because, you know, we've had other. My aunt was a physician as well, and I personally have had issues with. I have muscular dystrophy as well. And I've been dealing with that since age 40. And very recently, unfortunately, in the last year, my wife was diagnosed with stage three colon cancer.

[Katie Couric]

Oh my gosh. I'm so sorry.

[Dr. Jeffrey Swisher]

And she's doing well, but I mean, certainly, I suppose over the course of this we can talk about some of her experiences.

[Katie Couric]

I would love to hear about them.

[Dr. Jeffrey Swisher]

And I recently, in the last couple of weeks, have had a little surprise thing happen to me. I'm 65 years old, you know, Medicare age. Thank you. And I recently discovered that I have a fairly significant coronary artery disease. And 10 days ago I had a stent put into my heart.

[Katie Couric]

Oh, my goodness.

[Dr. Jeffrey Swisher]

I know.

[Amy LaRocca]

God, you look great.

[Dr. Jeffrey Swisher]

Thank you.

[Katie Couric]

It's so good.

[Dr. Jeffrey Swisher]

So we can talk about that.

[Katie Couric]

It's interesting that you just found that out at this point at 65. I'm surprised there weren't any indications previously.

[Dr. Jeffrey Swisher]

Well, that's where we can talk about issues about screening, et cetera. This is something that I'm sure this conversation we can discuss about screening and about the values of predictive testing and various things like that.

[Kara Swisher]

Yeah. Cause a lot of his signs weren't showing that at all.

[Dr. Jeffrey Swisher]

Exactly. And it's very true with colon cancer. Many people, like my wife, for instance, who had a normal colonoscopy 10 years ago, out of the blue, developed colon cancer just six months before her next colonoscopy.

[Katie Couric]

But every 10 years. I would say that's a little long to wait, Jeff.

[Dr. Jeffrey Swisher]

Of course it is. Unfortunately, that's what the guidelines are. Anyway, we'll go into that.

[Katie Couric]

Yeah.

[Kara Swisher]

So let's talk about what's happened. Because one of the things that's been significant is there's been so much misinformation around what it means to live a healthy life. Cause as the explosion of information has happened, the explosion of misinformation has happened, really, rather significantly. Katie, as a journalist, you see firsthand how people have lost faith with institutions and experts. Now we have a vaccine skeptic. I would say more than that. Running hhs. Unfortunately, giving people accurate information isn't enough. People believe what they wanna believe. So talk about why you think healthcare have been particularly vulnerable to misinformation. Cause one of the things you set out to do was give information and do good reporting on the top.

[Katie Couric]

It is so upsetting. You know, I read a book a while ago called the Death of Expertise. And I guess it. I don't know really why it's happened, but this idea that experts shouldn't be trusted is so counterintuitive and antithetical to everything I believe. And I mean, I think part of it is what Amy has investigated, which is this plethora of wellness influencers, Right, who purport to have a background that would allow them to give medical advice and they don't know shit from shinola. Basically, while we're on the subject colonoscopies. And there's just this widespread effort to basically tell people things that have nothing to do with expertise. And I mean, there's a whole psychological thing going on with misinformation. I was talking to David Axelrod earlier today. We were talking. Cause we're gonna be doing a panel on truth and facts. And Andrew Ross Sorkin was there too, and we were all saying, some people, they don't. You know how Jack Nicholson said you can't handle the truth? A lot of people just don't wanna know the truth. You know, it's. It's, I think, kind of knowledge has been so inextricably linked to identity now or a view of the world, to who you are and what team you're on. That people, it seems to me they don't want to know factual information. And I think they want shortcuts. They don't necessarily want hard truths about what they need to do. I don't know. I'd love to hear what everyone else thinks and why this has happened, but. Plus, you have leaders, you have people in positions of authority basically giving factually incorrect medical information. So I can understand why the average person is confused. Right?

[Dr. Jeffrey Swisher]

Yeah.

[Kara Swisher]

So, Jeffrey, why do you think people are more inclined to trust a random person online over. Doctor, Was it Covid that was pushing over there? Was it social media?

[Dr. Jeffrey Swisher]

Yeah, I think the combination of social media and Covid. Covid was a watershed moment for this country. And it's the first time we actually had a pandemic while we had social media. And of course, everybody becomes an armchair expert. And, you know, in retrospect, some of the ways that things were rolled out could have been done better. But, but let's just listen. Dr. Fauci is a national hero, and the fact that he was vilified by the Trump administration was literally one of the most horrific things that happened during that administration. And I think the combination of everybody's got a platform, everybody has a voice, and not all opinions are valid. It's the old adage that you're welcome to your opinion, but you're not welcome to your own facts. Well, people felt like their facts were more valid than. Than everything else. And so we have this problem now that, you know, doctors aren't trusted, priests aren't trusted, you know, et cetera.

[Kara Swisher]

What is the medical profession done that has created that? Is it just that people have new facts that they can use at their disposal, or is there something that happened?

[Amy LaRocca]

Well, I think there's a few things that are super problematic within the medical profession that have happened. One is the increase in sort of for profit endeavors inside of the medical community. Right. So if you have a doctor who's pushing their own for profit supplement line, for example, we all know that supplements, they're not great, right? No, they're not going to improve your heart.

[Dr. Jeffrey Swisher]

Very few are great.

[Kara Swisher]

Very few.

[Katie Couric]

That's not true. Some are good. I mean, like.

[Kara Swisher]

All right, let her finish and then I want to hear from you.

[Katie Couric]

I will.

[Amy LaRocca]

If you have a diagnosed deficiency in vitamin D, if you have a diagnosed iron deficiency, you need to supplement. But really the first line of defense should be a healthy diet. You start with, say, dermatologists. I think what you're seeing is because of the merger of the beauty and the health industries in what you call wellness. You get into a position where you don't know. You're like, am I at the doctor? I'm at a spa. Where am I? What's happening? Like, is this medicine? Is this something else? So the kind of world in which healthcare and spa world are emerging creates a kind of for profit industry in which beauty and medicine merge.

[Kara Swisher]

I mean, Gwyneth Paltrow's goop was sort of the first avatar.

[Amy LaRocca]

And so you start getting into a world in which you get the kind of hybrid influencer person. You also get into a world in which a lot of people don't have relationships with their doctors, right? So because of the way the healthcare system is set up, a lot of people go to the emergency room when they're sick, they don't have a GP who they have a relationship with. So if you're feeling sick, you don't call, you don't have your doctor who you're able to reach easily, Right? So I mean, the idea that Dr. Oz is so called America's doctor is more true than. I mean, you're getting a lot of your health information on social media, on television, because you don't have that personal relationship with a doctor who you trust, who's someone, you know, you have known for years, who's familiar with your health history, right?

[Kara Swisher]

So you don't have that relationship. So you're having these online, these.

[Amy LaRocca]

So you don't have that relationship. So you don't have anyone that you trust. So you're turning to these other sources, these parasocial relationships. That's right.

[Kara Swisher]

Katie, what were you gonna ask?

[Katie Couric]

Well, I mean, I don't think you can say all supplements are bad, Amy. I think that. I don't think that's accurate. I think that, yes, food should be the first line of recourse, but there are, I think there are supplements that help. And there was a Cosmos study about multivitamins that showed that it actually had a very positive impact on cognitive decline or slowing cognitive decline. So I was just interviewing somebody about longevity actually a couple of days ago, and she mentioned it. And I started taking a multivitamin. You know, I'm 69 years old and I thought, it's not gonna hurt me. I'll just pee out what I don't absorb. Right. Anyway, so I'm not a big supplement person, but I don't like blanket statements either.

[Amy LaRocca]

That's totally fair. I think the supplement market has gone berserk.

[Katie Couric]

Yeah.

[Amy LaRocca]

And I think people spend a lot of money on things without great deliverable outcomes.

[Kara Swisher]

So, Dr. Swisher, why don't you jump in here?

[Dr. Jeffrey Swisher]

Well, I mean, I'll take a middle road. Some supplements have shown some benefit, like creatinine has some benefit. Vitamins have some benefit for people who are vitamin deficient. If you have a balanced diet, you're getting mostly more than you need for vitamins and minerals. And as Katie says, you tend to just pee out stuff. Now, the fat soluble vitamins like vitamin D, vitamin E, et cetera can be problematic if you have an excess. There is something called hypervitaminosis D where that's a problem. It's very rare. I mean, if you want to spend your money on worthless things, go for it in the manosphere. You know, you just did that really excellent thing with Louis Theroux and about the whole manosphere and the promotion. But the one thing is when you say doctors, I mean, that's a very tiny percentage of physicians. Most of us are literally clinicians. We care about our patients. We want to do the right thing and.

[Amy LaRocca]

Oh, absolutely.

[Dr. Jeffrey Swisher]

You're talking about social Media.

[Amy LaRocca]

I'm pro doctor.

[Dr. Jeffrey Swisher]

We're looking at a 0.1% of physicians.

[Amy LaRocca]

Absolutely. The disbelief of experts, I find terrifying. I find the anti vax movement terrifying, I find. And the fact that we've gotten ourselves painted in this position where so few Americans have personal relationships with their doctors that they consider Dr. Oz the doctor they know best. So upsetting. Or Gwyneth Paltrow they get their medical information from Goop.

[Kara Swisher]

We'll be back in a minute. Support for this show comes from Rippling. Nowadays, every business app claims to be all in one, but for some reason, you're still bouncing between a handful of platforms to run things smoothly. With Rippling, you can finally downsize to one platform that actually does it all. Rippling is the unified platform for global hr, payroll, IT and finance. Workflows that normally bounce across several different tools and departments all just happen in one place automatically. Here's an example. You have an employee getting promoted. Rippling can update their payroll taxes, manage any new app permissions, ship them any new devices, issue a new corporate card, and assign trainings all in one platform without the fuss of dealing with 10 different logins to accomplish a short list of tasks. With Rippling, you can run your entire hr, IT and finance operations as one, or pick and choose the products that best fill the gaps in your software stack. So if you and your company want to run the backbone of your business on one unified platform with people at the center, head to rippling.com Kara and sign up today. That's R-I-P-P-L-I-N-G.com Karakara to sign up. Support for the show comes from Shopify. Starting a business is never easy, but what's worse is living with all those what ifs in your mind and never knowing what might have been. Thankfully, Shopify is a partner that can help you take that first step. Shopify is the commerce platform behind millions of businesses around the world and 10% of all E commerce in the United States. From household names like Rare Beauty and skims to brands just getting started, Shopify can help you build a beautiful online store that matches your brand style with hundreds of ready to use templates. And whether you're uploading new products or trying to improve existing ones, Shopify can help accelerate your efficiency. Their AI tools can help write product descriptions, page headlines and even help enhance your product photography. Best yet, Shopify is your commerce expert. With world class expertise in everything from managing inventory to international shipping to processing returns and beyond. Shopify can even help you find your customers with easy to run email and social media campaigns. It's time to turn those what ifs into with Shopify today. Sign up for your $1 per month trial today at shopify.com karaswisher go to shopify.com karASwisher that's shopify.com Karaswisher. This episode is brought to you by IQ Bar IQ Protein Bars, IQ Mix Hydration Mixes and IQ Joe Mushroom Coffee are delicious low sugar, brain and body fuel you need to win your day no matter your age or fitness level. We all need a good snack break now and then. And when you're really hungry and low energy, it's tempting to reach for those high fat, high Sugar goodies you'll regret 20 minutes later. You can do better with IQ Bar. Their ultimate Sampler pack is a great way to try all IQ Bar products and flavors. You get nine IQ Bars, eight IQ Mix sticks and four IQ Joe Sticks. I've tried them all and I actually really love the bars. They don't taste. Sometimes some of these protein bars taste like protein bars in a way that feels chemical. These are actually quite tasty. I really always like the chocolate chip ones and I also tried the mixes quite good. And right now, IQ Bar is offering our special podcast listeners 20% off all IQ Bar products, including the Ultimate Sampler pack, plus free shipping. To get 20% off, text Kara to 64,000. Text Kara K A R A to 64,000. That's Kara to 64,000. Message and data rate. Apply See terms and details. So Katie, you, you know, a lot of this started with television and with Oprah and things like that. And you obviously delivered good information about colon cancer, right? Really, it's solidly reported information. When you watch that develop, what did that seem like when you saw Oprah sort of platforming some people who had questionable situations? How do you look at that?

[Katie Couric]

Listen, whenever I would impart medical information, I would talk to experts, I would talk to doct, and of course everything that I talked about when it came to colorectal cancer was vetted and was scientifically proven stuff. I didn't watch a lot of Oprah, to be honest with you. What I got upset with is I think there was a big piece on Dr. Oz and the fact that he was financially benefiting from some of these. And I'm sure, Amy, you probably really looked into this in your book, but was financially benefiting from all these different cures and you know, berries and supplements and green tea. Yeah, like, and I thought this is so wrong. And he was such a well respected. I think he was a cardiac surgeon.

[Amy LaRocca]

Yeah, he was a cardiac surgeon, cardiothoracic surgeon.

[Katie Couric]

And I remember, you know, I know a lot of doctors, I think just because of my cancer advocacy work. And he was so highly thought of.

[Amy LaRocca]

He's such a complicated figure because he was, was such a well respected doctor.

[Katie Couric]

And then he became just such a sellout. And I just think it was irresponsible, obviously in cases when he was giving junk science to have Oprah platform, somebody like that. At the same time, I think it's really interesting because I think it does speak to what you were asking earlier of Jeff and Amy, like, what has the medical community done wrong? Why has there been this vacuum? And I think a lot of it is because not only do people not know their doctors, doctors, as Jeff can tell you, have very little time for their patients. You know, they have, what, 15 minutes to meet with them. And I think the other problem that I've always noticed is people in the medical profession are notoriously bad at explaining stuff in an accessible, understandable way. You know, I know Alan Alda had this whole organization, I think he still does, where he works with scientists, helping them explain things in simple terms so people can understand. I had to learn how cancer and cancer therapies work. Cause I was so desperate to find something for my husband. So I had to know, like, oh, antiangiogenesis, that's like when you cut off a tumor's blood supply. So imagine a grape and the vine being cut and the grape shriveling up and dying. That's apoptosis. That's what happens to a tumor and cancer. But they're so bad at kind of of helping people visualize stuff. I think it's created a lot of confusion.

[Amy LaRocca]

And I think, I would say less. I mean, I, I would say rather than the medical profession, I would say, like the, the problem of how little time doctors have with their patients has to do with the insurance companies, threats of loss. Like, I would just the whole way the healthcare industry is set up, as Jeff said, my experience with doctors, my experience with nurses is like, these are people who have chosen a profession of caring and they're then sort of hamstrung, right?

[Katie Couric]

Totally.

[Amy LaRocca]

They have no time.

[Kara Swisher]

It's like, let me interject, into the void comes all this very hand wavy stuff. So, you know, and there's also hospital consolidation, a shortage of doctors. Let me just say McKinsey estimates the wellness industry, which is constrained not the way someone like Jeff is, is estimated it's worth about $2 trillion globally and it's only growing.

[Amy LaRocca]

Oh, every time I do an interview, I have to check beforehand because it's bigger.

[Kara Swisher]

So, Jeff, when you think about this, like, is it the lack of ability to explain things to people? Is it into the, you know, you must look at Instagram and lose your mind when you see some of this stuff. And I was on Google and I looked these two young women who are huge, and I looked through all their claims and they, all of them were wrong, like, very wrong kind of stuff. And I called them and I said, you know, where did you find this out? I didn't even say, you're very wrong. And they were like, oh, we Googled it. And I'm like, oh, my God, you're very wrong. Like, it was really. They were non constrained, I would say, because they're not clinicians. And then you have AI, which is giving advice non constrained in the same way you are. Talk a little bit about that.

[Dr. Jeffrey Swisher]

All right. So in the area where I know obviously a lot about is anesthesiology, and I'll give you two areas in anesthesia where there is so much misinformation, and one of those is epidural anesthesia for labor. The amount of nonsense that is on the Internet about epidurals and horrible things. I actually wrote a substack piece called you may get groceries in my substack about my personal experience as an anesthesiologist when my wife went into labor. And it was a hilarious situation where a doula went up and put up these crazy things about these horrible dying of narcotic overdose when the child is 22. Things like. And so I went up to the board and I wrote trip to the grocery store. And I wrote attacked by aliens, anally probed, blah, blah, blah. And I wrote down the corner, you might get groceries. I mean, because the reality is it's nonsense. What most of people are posting. The other is spinal anesthesia, for instance. Nonsense. There's so much nonsense about this kind of anesthesia in general. So my area, I can see how easily it is to have misconstrued information on the Internet. I can't even imagine how complex somebody like an oncologist when they're trying to write super complex stuff, how much nonsense there is about. And again, everybody has an opinion not based on anything, but opinion with no expertise whatsoever, it gets very difficult to explain very complex things. And medicine has gotten very complex. I mean, when we look at drugs like Repatha, which is a PCKS9 inhibitor, what does that even mean? Right. When you're throwing all these names around and we do that, we tend to use complex language to describe very complex things. And it's very difficult to make it simple.

[Kara Swisher]

Yeah.

[Dr. Jeffrey Swisher]

And I think that's where we could benefit from trying to do that.

[Kara Swisher]

Yeah.

[Amy LaRocca]

My husband and I have this game that we play called I don't know, but if I had to guess, which is like, we're intelligent people and you take like a tiny shred of information and then you sort of spin out a narrative thread. And I feel like that is kind of what wellness social media does.

[Katie Couric]

Right.

[Amy LaRocca]

And I think of it like collagen is my favorite example. Like, you will never find anything that tells you collagen products work. Like, you can drink it, you can slather it, you can.

[Kara Swisher]

You will not find it.

[Amy LaRocca]

You will not find a single thing that tells you you're gonna get that collagen to grow again in your face. Like, unless you find a time machine. Like, that's just it, it's not happening. But you can just picture like all these rooms where people are like collagen, okay? So it's the thing that makes your skin young again. So maybe if you push it like this or like, you know, you can find the demos with like these people being like. The method is you make it warm and then you smush it or you drink it and then you gargle it or whatever it is. Like, you just make up the stories.

[Dr. Jeffrey Swisher]

Look at this, Artemis. I mean, right now, look at all the nonsense that's on about flat earth and about, you know, Apollo hoax. I mean, what? Seriously, how is this even possible? That these things are being propagated on the Internet, you know?

[Kara Swisher]

Yeah. So Katie, I wanna ask you a question about getting to the real stuff and people getting good information. Now, you're a huge advocate for early cancer screenings. Cause of your first husband. Talk about where we are now in this environment. If you were doing that today, how would you get people better information? Cause you can imagine how. Then everyone was like, oh, and listen, right, because besides getting the colonoscopy on screen, they believed you, right? Or they felt like you did your work. So. And especially because of the increase in cancer rates in people under 50, I

[Katie Couric]

think they thought I was responsible. Right. You know?

[Kara Swisher]

Yeah, yeah. So what would you do today?

[Katie Couric]

Today? Well, I think good old fashioned media literacy is really important. I mean, I know some people don't care about it. I can only operate from like the reality. I know. Cause I don't understand Jeff, Amy and Kara, how people can perpetrate all this crazy shit out there. I mean, I just. It leaves me scratching my head. But I think that I would continue doing what I always do. And that is talking about people with deep, deep experience in a certain area. And also, whenever I follow someone, you know, I follow a woman named Jessica Nurek who really disputes a lot of the Maha claims. They believe in evidence based medicine. And so I really do trust when they refute something that's being put out there in the ether. And I look at their credentials, I read their reports, I see what they're talking about and I make a decision. I can trust this person, but I'm somebody who has a basic Background in science and medicine. I mean, very basic. Obviously, I'm not a doctor, but I've learned a lot. So how do you get the average person not to fall for these scams? And I think one thing you hit on, Kara, is this parasocial relationship. And Amy, you did an interview for our newsletter with Sarah Levine, our editor, and you talked about, you know, I think people. There's so much magical thinking. People want answers, and honestly, they often don't like the answers that they get. You know, they want to believe, you know, my joints hurt. I want to believe that collagen is going to make me less. Less achy when I get up in the morning. I wanna believe that I'm gonna be more flexible with collagen, you know. And so I think that people, you know, are grasping for ways to feel better. And I think there is a lot of suffering out there.

[Kara Swisher]

You know, there's so much.

[Amy LaRocca]

And I think that's one of the things I've followed this very with a lot of great interest. I'm 50 years old, so fill into that what you will where it comes to menopause. So. So the case of menopause fascinates me because you have a situation where there was some bad information out there, right, which was that hormone replacement therapy was very dangerous. Don't do it. Right? So you have a number of years where women are just like, nope, not doing it.

[Katie Couric]

I don't wanna get breast cancer.

[Amy LaRocca]

I don't wanna get cancer, right? I don't want blood clots. I don't want cancer. They swear it off. Then you have this kind of perfect storm of a number of factors happening, which is that that information is revisited. Actually, it's very safe for a great number of women under a great number of circumstances. That collides with the acceleration of women's willingness to be treated online, which was accelerated greatly during COVID when telemedicine and also with the accessibility of drugs online, all of those things that became very available. I'd say Covid probably accelerated that by, I think, estimates around 10 to 15 years. We're way ahead of where anyone expected we would be. People's willingness to be treated by a doctor or nurse online and tons of EC capital just gets dumped into this idea of treating women with menopause online. Now it was suddenly like we went from HRT will give you cancer to HRT is going to do your dishes, wash your car, pay your taxes, throw

[Kara Swisher]

away it won't pay your taxes, but go ahead.

[Amy LaRocca]

But it was like, you know, like Throw down your crutches. HRT is here. And what I realized in reporting on these new menopause treatments is like, there's this great news, which is that we're treating menopause more seriously. There's drug therapies that can benefit a great number of people with a great number of symptoms, but it is not, not a cure all, it is not a miracle, it is not going to fix everything. And in so much of the marketing of these new menopause treatment brands, what you were seeing was basically the erasure of menopause. What you weren't being told was you will still go through menopause, you will still age, you might still have some difficulties.

[Kara Swisher]

Right.

[Amy LaRocca]

What you were being told was menopause done, fixed, over. Right, Right. And that's what I was interested in. And what came out of that for me is what you were saying, Katie, is that like, nobody wants to suffer and there is so much suffering out there. Menopause is difficult. Even with hrt, it might still be difficult. You might get some relief. You might get relief from this symptom and not that it might work for some period of time and then stop.

[Kara Swisher]

So it's this idea that we can have this certainty. Jeff, as a doctor, how do you work with patients to acknowledge. Is it void and uncertainty? Because like Katie and Amy said, patients want to.

[Amy LaRocca]

Life is complicated.

[Kara Swisher]

Yeah, but they don't want to hear that. Both of them said that. And I think it's true. One of the things you used to complain a lot was Dr. Google. Besides TV medical shows, which you'd call and yell at me about as if I wrote them.

[Dr. Jeffrey Swisher]

Well, the Pitt's actually getting it pretty right. Except for the fact that I love

[Katie Couric]

the Pitt, the pit.

[Kara Swisher]

So how do you, when you deal with the patients who are in a different state of mind, who are like addled on the Internet, they think everything, like certain things, like, I don't know, whatever it happens to be that I encountered in the series I did, it was like one thing sort of helped something, but now it's sold as helping everything.

[Dr. Jeffrey Swisher]

So listen, from my perspective as an anesthesiologist, I am very fortunate that I'm in a medical profession in which what I do is pretty definitive. I mean, you know, there's not really an illusion of cure in anesthesiology. I mean, I kept people through very dangerous circumstances and operations and things that are, you know, routine things as well. But one of the things that an anesthesiologist has to be very good at is the broad range of medicine. And so I do talk to patients in their preoperative evaluations about their conditions, et cetera, et cetera. And so I have the ability to discuss health issues with them. And it all goes down to the basics, though, Kara. I mean, the most important things about health are things that we all know already, basically. Diet, exercise, nutrition, don't smoke, don't overdrink, et cetera, et cetera. That's the fundamentals of good health. Everything else is very bespoke. I mean, everybody comes with individual drug issues. What are they on? What is the side effects? You know, should I change this? Should I change that? Again, it is complex. There is no simple solution to most medical problems. But the fundamentals of health, it is fairly straightforward. And we've talked about that for your show.

[Kara Swisher]

Yeah, absolutely. So when each of you think about this longevity industry, now, I spent a year talking to various people about it. Katie, why don't you start? When you think about what it is to you and what it's become, how do you look at it? Because it really is quite a trend. And the money is, like, pouring into it from tech moguls, a lot of them, who don't want to die or want to look better, and they don't. They don't. Sorry. It's a lot of money to spend to look like that.

[Katie Couric]

I mean, listen, I'm interested in it. I'm 69 in January. I'm going to be fucking 70 years old, you guys. Thank you.

[Kara Swisher]

You look great. Must be the college of.

[Katie Couric]

In the hrt, you know, and so I'm interested. But I also, I think because I'm a journalist, Kara, I'm skeptical and I'm reasonable. So I look at things and I think, well, this might be able to help me. And, you know, like, lately I've been thinking and Amy, you can tell me whether this is a waste of money. Cara, you too. Should I buy a red light mat? Our red light Matt. That's helpful to. Cause honestly, I'm achy. I'm achy, you know, my joints are achy.

[Amy LaRocca]

Take a hot bath. You probably have a. Todd.

[Kara Swisher]

Take a hot bath.

[Katie Couric]

I take Epsom salt baths, but I keep. And the magnesium, I guess, is good. But I keep reading about this red light therapy. You know, somebody gave me one of those masks that makes you look like Hannibal Lecter, and they're so scary. And I was actually thinking, I saw on Instagram some lady who said, this is my single life, and I watched the whole damn thing. She came home, she wiped her Her. What do you call those red. Oh my God, what are those shoes? She cooked herself like scallops in her.

[Kara Swisher]

I love that you're believing randos on ig, but let's.

[Katie Couric]

She looked like she's having a great time and then she stretched on this red light mat and I was like, damn, should I stretch on that red light mat?

[Kara Swisher]

No, no, no. I mean, no.

[Amy LaRocca]

If you want to. I feel like, you know, a big part of my book is like no shame. Look like Katie, we're not gonna judge you. You want your mat, get your mat.

[Katie Couric]

But I don't wanna waste money if it's gonna do nothing.

[Amy LaRocca]

Take it back. I mean, look like whatever gets you through the night, you know, but like, is it going to change anything? Jeff is not.

[Katie Couric]

So I guess the answer to your question, Kara, is I'm interested. I try to be a educated consumer, but I too, because I wanna feel good and I wanna get in. You get sucked in.

[Amy LaRocca]

We really all get sucked in.

[Katie Couric]

I'm vulnerable and susceptible to scams. Look, we're all vulnerable and to stuff that doesn't work or doesn't do anything. Right? I don't know.

[Amy LaRocca]

I literally wrote the book. I actually wrote the book. And then I will buy dumb shit all the time.

[Kara Swisher]

Yeah, that's exactly. So one of the things with red lights. No, the science is very. And if you're a plant in space, you'll do great. If you're. Yes, the science is very skinny on it. And if you have some. It may have some inflammatory help. It may have some.

[Katie Couric]

Isn't being anti inflammatory? Wouldn't that be helpful to me, Dr. Swisher?

[Kara Swisher]

Yes, but you could do it in a lot of different ways that don't cost $3,000.

[Dr. Jeffrey Swisher]

That would be a very minimal way of being an anti inflammatory. There's probably. I mean, unfortunately, inflammation is a very comp. Again, a very complex science and there's no simple solutions to anti inflammatory stuff.

[Katie Couric]

And don't you think, you guys that so many people, they don't want to exercise for 30 minutes three times a week. So they're like, tell me something else I can do. Give me a pill I can take, give me a cream I can use. Because honestly, I'm just lazy. And by the way, I'm speaking for myself too. I'm lazy. And sometimes I'm like, wow, if I didn't have to do that, I don't want. I really don't wanna do that. What else can I do?

[Kara Swisher]

Show me fair. But nothing. Nothing.

[Amy LaRocca]

I went to a place it's since closed, but where they would wrap you up like in a burrito wrapper and then make you so hot that your heart went like. You were on the treadmill, but you were just watching Netflix in your burrito wrapper and they were like, but we've got your heart at like the same rate that it would be on the treadmill.

[Kara Swisher]

Oh, no.

[Dr. Jeffrey Swisher]

Yeah, but you're not increasing your cellular oxygenation, so.

[Amy LaRocca]

But I thought I was gonna die. I thought I was gonna. I was hitting the like, help button. I was like, yes.

[Kara Swisher]

No, not good. Not good. A lot of people, it's fine if you exercise anyway. Get it if you want to. It makes you feel better. Just like a lot of people.

[Katie Couric]

No, I'm not going to now. You kind of yucked my yum. As the kids don't.

[Kara Swisher]

Sorry. I'm sorry.

[Dr. Jeffrey Swisher]

These red light people are gonna be after you now, Kara.

[Kara Swisher]

I know they are. Wait till the Peptides people come for me.

[Dr. Jeffrey Swisher]

Yeah, that's the next one. Jesus.

[Kara Swisher]

Oh, God. The best thing if I had to take away two things from this series I did, is don't be poor and have a lot of friends. And GLP1s and AI detection is really interesting and so is CRISPR. Like, wow, this scientific stuff is really fascinating. We'll be back in a minute. Support for this show comes from hims. There's an endless amount of weight loss advice out there, but if you want to reliably reach your goals this year, you can take out the guesswork with weight loss by HIMSS now offering access to FDA approved GLP1 medications, including WeGovy. With WeGovy at HIMS, you can lose up to 20% or more of your body weight. When combined with diet and exercise, it helps you regulate your appetite and eat less, so success is within reach. And now WeGovy is available in a pill, so there's no needles needed. Ready to reach your goals, visit hims.comcara to get a personalized, affordable plan that gets you. That's h ims.com kara k-a r a hims.com Kara Weight loss by hims is not available in all 50 states. Govy is a registered trademark of no Nordisk as to get started and learn more, including important safety information, WeGovy clinical study information and restrictions, visit HIMSS.com.

[Dr. Jeffrey Swisher]

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[Kara Swisher]

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[Amy LaRocca]

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[Kara Swisher]

So I want to finish up talking about two more things is prevention. Broadly. One of the things I think I really do say in this series is GLP1s are really interesting and so is this AI cancer detection and not just cancer detection, drug discovery and things like that. And of course the AI people oversell it it as always that it's going to solve every problem. Jeff, first you and then Katie and then Amy talk about what you're seeing that you think is really promising in whatever area you're in.

[Dr. Jeffrey Swisher]

Well, okay, so let me just very briefly, GLP1s and GIP medicines are very promising and I think that we're going to find more and more indications for them aside from diabetes management, weight loss, et cetera, anti inflammatory effects of these drugs. But cardiac beneficial effects especially now they're going to transition to more oral forms of it that'll allow more people to kind of overcome that resistance to injecting themselves as far as AI medications go. I had the pleasure this past weekend of being at a party with Mark Tessier Levine who was the president of Stanford for many years and until Peter

[Katie Couric]

Baker's son got him fired. But go ahead.

[Dr. Jeffrey Swisher]

I know, I know. Yeah, I know. That was such a really sad. He's a charming, charming man. And anyway his company is looking at what he calls the high hanging fruit of the AI drug market. There's a lot of low hanging fruit associated with AI drug discovery, but there is a lot of other medications which will be very specific towards cancer therapies, monoclonal antibodies, et cetera. I mean look at colon cancer. Recently there was a Large study, I think it's called the CASS study that just finished in January, that benefited my wife because the standard chemotherapy protocol, which was called folfox, oxaliplatin, flurouracil 5 fu,

[Katie Couric]

that's what my husband had.

[Dr. Jeffrey Swisher]

Right. And that's what my wife had too. But the five year mortality of just that is still pretty high in stage three and stage four. But now the addition of an antibody called atezolizumab has radically changed that. And this is due to these drug companies which are now using novel drugs to develop monoclonal antibodies. And it's changing, everything is changing. Malignant melanoma is changing. Colon cancer, potentially it'll change pancreatic cancer. The third area, Kara, and you've mentioned it before, is the use of MRNA vaccines and the ability to potentially develop vaccines against cancer. There's very promising things with a very fatal cancer called glioblastoma, which is brain cancer cancer. And some of these potential vaccines may actually cure this once completely fatal, almost completely fatal type of cancer. So those are the three areas I'm really interested in.

[Kara Swisher]

Katie, what do you when you're looking into this stuff right now?

[Katie Couric]

Well, I'm excited. I think you're right. It's probably been overhyped. But there's so much to be frightened about when it comes to artificial intelligence. I think people are like, ah, but look what it will do for healthcare. And obviously for my area of interest, early detection, AI is going to be a game changer because I think what it can do is. And Jeff, you can help me explain this. But you know, the large data sets that they can compare scans to are going to be really helpful to recognize very, very early stage, for example, breast cancer. And there's a woman who I read about, I want to interview her. Kara, you should talk to her. She is both a scientist and a breast cancer patient and she worked on AI early detection. And it will not only be able to detect early, but it's gonna be predictive. It's gonna be able to say you are at high risk for getting breast cancer in the next five years and then you can monitor it accordingly.

[Kara Swisher]

It's called organ clocks. I just interviewed Eric Topol, he's like, oh, I'd love him feel, yeah, like detection of individual organs. And that's to me was his.

[Katie Couric]

Yeah. So I'm super excited about that. The other thing I am really excited about, but I think they're not ready for prime time. And I get very distraught when I see them advertised on these various cable news Networks are so called liquid biopsies. Being able to determine if there is early stage cancer cells kind of floating around your bloodstream that can kind of indicate early on, oh, this is a. We talked a little bit about colon cancer and the screening protocol is now starting at age 45. Only one in five people between the ages of 45 and 50 get screened. So we've gotta get the word out about that. But you know, when Jay got diagnosed, you guys, I was like, oh, are people under 45? Or in this case it was 50 back in 1998. Are these just expendable individuals because there was no screening for them? And I am hearing more and more about people in their early 40s, 40s, 30s, even 20s being diagnosed with this disease at an advanced stage, often metastatic colorectal cancer. It is so upsetting to me. So I'm hoping that there can be some test that's less invasive and more accessible, not as expensive, not as disruptive for your, you know, daily activities like a colonoscopy might be, and that these blood tests can be used, you know, to everyone who's going to get a physical. I don't know, I can't even tell you guys how crushing it is. I had coffee with an oncology fellow about two months ago and she said, I had a very rough day. I just had to tell a 21 year old college student with no family history, not lynch syndrome, no familial polyposis, no kind of high risk, that he had stage four colorectal cancer. And it just crushes me. And I hear these stories. I'm interviewing a 31 year old, I think next week, who is dealing with it. And of course I'm excited about trying to figure out why this is happening. Epidemiological studies are so hard to conduct, but there is something going on in our environment. It's not just, just obesity or a sedentary lifestyle. You know, it's a confluence of things that include ultra processed food, maybe microplastic forever chemicals, over prescription of antibiotics. I don't know what is happening, but something is going on. And there's 17 cancers. 17 cancers are increasing among people under 50. So what the fuck is going on?

[Kara Swisher]

Yeah, it'd be great to have a government who studies these things. Amy, what about you?

[Amy LaRocca]

Well, I was excited to hear you both talk about some of the AI things because again, you know, I'm typically around writers and you know, it's like AI is the devil. And then I was at the Aspen conference last summer. I was speaking at The Aspen Conference, and I sat next to this woman who was talking about digital twinning.

[Katie Couric]

What is digital twinning?

[Amy LaRocca]

Well, Katie, it's when you can replicate your biological self through AI and then you can kind of run the test.

[Kara Swisher]

So they test. They. I have an interview with Reed Jobs talking about this. Who's the son of beautiful. Yeah.

[Amy LaRocca]

So it's basically like you can test. There's all these very specific cures for very specific cancers. But to test them is so expensive and so time consuming. So you might have lung cancer, but you might have this 1% of lung cancer that they know how to treat. But to know if you have it is so complicated to know.

[Kara Swisher]

Anyway, Jeff, you made a sigh there.

[Dr. Jeffrey Swisher]

Well, I think it's very simplistic.

[Amy LaRocca]

I am not a physician.

[Dr. Jeffrey Swisher]

No, the degrees, unfortunately, is a very interesting concept. I mean, especially actually. It's more interesting from a morphologic standpoint than an actual physiologic, biochemical standpoint, because the degrees of freedom involved in the human body, it's enormous. You're talking 10 to the trillions kind of complexity. And so some of these things are in their nascent area, and they are exciting. And I think Reed Jobs is a perfect example of somebody who really will be the future of what medicine could be. But just keep in mind, we're very, very early, very early in the blastocyst stage, if you know, developmental biology.

[Katie Couric]

Well, that idea is so exciting because I used to feel like when it came to cancer therapeutics, and I don't know, Jeff, if you feel like this, and I'm sure going through what you're going through with your wife, but, you know, they would just kind of throw it against the wall and see what sticks. And I remember there was one doctor when Jay was sick who could take a tissue sample and put it in a petri dish and then, you know, see how it interacted with. And, you know, when he was sick, it was 5fu and Leucavor, and that was it. And that had been around since the 50s, so they hadn't even added the oxilliplatin yet, you know, when Jay was sick. But this idea that, you know, cancer is like a million different diseases and a million different biologies, how it interacts with your body. It just varies from patient to patient. But the idea, I think, is so exciting that instead of using people as human guinea pigs and just trying these therapies and testing their, you know, checking

[Amy LaRocca]

their CEA levels, that you can run all these possibilities.

[Katie Couric]

Yeah, that, to me, is thrilling. If it could happen.

[Kara Swisher]

It is, actually. It is. The problem is when they over promise, like, Jeff was the first person who told me Elizabeth Holmes was full of shit. Just so you know.

[Dr. Jeffrey Swisher]

Oh, my God.

[Kara Swisher]

Like, I wasn't gonna cover her anyway, but she was around the tech sector quite a bit. She tried to look like Steve J.

[Amy LaRocca]

And you just said, no, no, no.

[Kara Swisher]

Jeff was like, you can't do that with a blood sample. You guess physics.

[Katie Couric]

He kept yelling, a vial that you'd find in a dollhouse. I went to see her when I dropped my daughter off at Stanford. And I called her and I was like, can I just come and say hi? And this was when she was such the it girl, you know, on the COVID of every magazine. And it was fascinating, but she seemed so sincere.

[Kara Swisher]

Of course she was.

[Amy LaRocca]

Did you smell a rat? Did you think, oh, 100%.

[Katie Couric]

Well, Jeff did. I'm like, so trusting and think the best of people. And I was like, wow, this is so exciting.

[Kara Swisher]

No, he definitely was like, you can't do that.

[Katie Couric]

When she wouldn't do an interview. And I remember she did an interview at Vanity Fair. I don't know, Kara, if you were there at one of these summits.

[Kara Swisher]

Yes, I was there.

[Katie Couric]

And do you remember Maria Shriver interviewed her. And I raised my hand and I said, said, can you explain how you can take a minuscule, a tiny drop of blood and determine so many different diseases from such a small sample of blood? I just don't understand it.

[Dr. Jeffrey Swisher]

Well, she said a chemistry happens. Was her direct quote. Yes. A chemistry does in fact happen.

[Amy LaRocca]

A chemistry happens.

[Dr. Jeffrey Swisher]

The math is not math.

[Kara Swisher]

Yeah. Jeff kept yelling math at mathing.

[Dr. Jeffrey Swisher]

And I'm like, you know what? And this is where statistics and knowledge of basic science is a fundamental thing in life. Looking at all of these things.

[Kara Swisher]

Yes. I was sitting at a table, of all people, with Bob Iger. And he goes, huh? You're always looking for women interview. You should interview her. I said, I think she's a liar. And he goes, why? And I said, she lied about a couple of small things, like who she was dating, where she was living. Cause I knew where she lived. You know what I mean? And she told all these lies and stories. And I said, then there's too much press. And then my brother says, there's no math to it. And so I think she's a liar. And he said, you think everyone's a liar. And I go, I think you're not a liar. And it was a really interesting moment. Then a week later, it all got out and he Goes, how did you know? And I said I. I didn't. She just lied about her home. Like it sounds dumb.

[Katie Couric]

We're a good yin and yang, Kara. I believe everyone.

[Kara Swisher]

And you believe no one. I don't.

[Amy LaRocca]

But you asked the killer question. You didn't believe her.

[Kara Swisher]

So let me finish up. After all we've discussed, what's the number one thing each of you would tell people about prioritizing about your health? And what's your secret to a longer life? Katie, then Amy, then Jeffrey, who I hope lives the longest of all. Cause he's my beloved brother.

[Dr. Jeffrey Swisher]

Aw, thank you.

[Katie Couric]

Well, I hope we all live a long way.

[Kara Swisher]

All right, Katie.

[Katie Couric]

I guess for me, I mean, I think it's just like the boring stuff, Kara. It's like eating well and moving your body, getting plenty of sleep. And I also really believe in the power of community. You know, I interviewed Vivek Murthy a lot when he was Surgeon General about the. The loneliness epidemic and how isolation and loneliness can be so detrimental to your health, so. And laugh. I try to enjoy my life and be positive. I mean, it's sort of boring and obvious, but that's what I do.

[Kara Swisher]

And by the way, there's more science to community, Much more by far than there is red light. But go ahead, Amy.

[Amy LaRocca]

It's true. I agree with everything Katie said. It is the basics. Everyone is like, oh, come on, you did all this research. Like, come on, you can tell me. And I'm like, God, I wish I'd be doing it. But it's the really boring stuff. It's getting enough sleep. It's drinking enough water. It's not eating junk food. It's being with your people. It's loving freely and all of those things. And as you said, it's also not being poor, because the things that we're calling basics right now are really not available to a lot of people in the this country.

[Katie Couric]

That's so true.

[Amy LaRocca]

And I think it's really important to acknowledge that. And I think when I said I had a really important moment when I was researching this book, when Covid happened, Look who got sick and who died in America, it was not subtle. It was like a flashing neon sign. When you look at who got sick and who died in America of COVID you're 100%. It should have been the wake up call about how our healthcare is handled in this country. The racial and the socioeconomic divide was stark as could be. So the things we're calling basics are not basic for a lot of people

[Katie Couric]

that is so important. I'm so glad you both called that out.

[Amy LaRocca]

So when people say to me, like, yoga or Pilates, I like, look, if you're talking yoga versus Pilates, like, you're fine.

[Katie Couric]

You know, I think about this all the time. I helped a friend of mine's dad who has a rare cancer get into a well known institution and talk to a really experienced, smart doctor where I think his clinician had no expertise in his specific kind of cancer. And I was thinking, like, this just sucks, you know, like, if you're not educated and informed about a certain situation, or you don't have contacts or connections, even if you aren't necessarily poor, you're kind of screwed. And I wish we could fix the whole healthcare system and, you know, it shouldn't rely on your zip code whether you can not only eat healthy, but whether you live or die and these social determinants of health. If you want to get really depressed about healthcare in America, just look at, you know, who lives and who dies with certain diseases, diabetes, it's terrible.

[Dr. Jeffrey Swisher]

Yeah, yeah, exactly, right? Zip code makes a huge difference.

[Kara Swisher]

All right, Jeff, finish this up.

[Dr. Jeffrey Swisher]

So, I mean, quality over quantity. I mean, I'm a very strong believer that life with. Without quality, you don't need to have quantity. It's just not worth it. So, I mean, the basics. Floss your teeth, hydrate, eat good food. And most importantly, as Kara is going to point out in her series, have connections. Have social connections with your friends and family. Be present and help others. And I think when you help others, you form a network that expands like ripples in a pond. And that's where we can do the most, most good for everybody and, you know, for ourselves. And that's how we live long and healthy and happy lives.

[Katie Couric]

What about my fish oil?

[Dr. Jeffrey Swisher]

Yeah, your fish oil's good. Yeah, except you get fish breath with fish oil.

[Katie Couric]

You get. You burp a lot.

[Kara Swisher]

Put that down and go cook yourself a piece of salmon.

[Amy LaRocca]

I'm having salmon.

[Katie Couric]

My husband's making me salmon right now.

[Kara Swisher]

Have that. Well, then put the fish oil down. You need the fish oil.

[Amy LaRocca]

It's too much.

[Kara Swisher]

Oh, my God.

[Dr. Jeffrey Swisher]

No, it's fine, it's fine. Fish oil's not gonna hurt you. Just don't take the whole bottle.

[Katie Couric]

But thank you, Jeff.

[Dr. Jeffrey Swisher]

You know, and I read your colonic chapter in your book, Amy.

[Katie Couric]

Holy moly.

[Dr. Jeffrey Swisher]

How did you agree to do that?

[Amy LaRocca]

You know, I was like, I'm not gonna do that. I'm never gonna do it again. It was horrible. Oh, my God, that subway ride home to Brooklyn.

[Kara Swisher]

All right, we'll end on that. And then you can see what happens to me when I take ketamine in the first episode of the show and anyone anyway. Oh, never again.

[Dr. Jeffrey Swisher]

Hey, it's a great drug. I use it on people every single day. It's a fantastic medication.

[Kara Swisher]

Yeah, it's a medication that shouldn't be taken by Elon Musk, who's then running our country. But I'll tell you anyway, thank you all so much. I really appreciate it. We could talk for a long time and maybe I'll have you back to talk more. I wish you all a long and happy life. I really do. And a health span and not just a lifespan, which is the way you say it these days. Anyway, thank you so much, Katie, Amy and Jeffrey.

[Katie Couric]

Thanks, Kara.

[Amy LaRocca]

Thank you.

[Dr. Jeffrey Swisher]

Thank you.

[Kara Swisher]

One small thing before we go. Want career advice from Kara Swisher? Now's your chance. Send a video to onoxmedia.com and you might be featured. I can't wait to see what you've got. Ask any question. I'll try to answer it. Today's show was produced by Christian Castro, Russell, Michelle Eloy, Katherine Millsap, Megan Birney and and Kaylin Lynch. Nishat Kurwa is Vox Media's executive producer of podcasts. Special thanks to Bradley Sylvester. Our engineers are Fernando Arruda and Rick Kwan and our theme music is by Trackademics. If you're already following the show, you're living a long and happy life. If not, put the red light mask down. Go wherever you listen to podcasts, search for on with Kara Swisher and hit follow. Thanks for listening to on with Kara Swisher from Podium Media and you, York Magazine, the Vox Media podcast network, and us. We'll be back on Thursday with more.