← Tom Bilyeu's Impact Theory
Tom Bilyeu's Impact Theory
Vegans vs Meat Eaters: Who Will Live Longer & Why You Should Care! | Jonathan Reisman Pt 1
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- [00:00]
Tom Bilyeu
Get that AMEX Gold Card ready. I'm too tired to cook.
- [00:02]
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- [00:45]
Tom Bilyeu
What's up everybody? I'm really excited for this two part episode today with Dr. Jonathan Reisman. He's one of the most profoundly knowledgeable anatomists I have ever encountered. This guy literally drug a deer into the woods so that he could skin it and look under the hood. I wasn't sure if I was going to be interviewing Hannibal Lecter or Da Vinci, both known for their penchant for dissection, by the way, but thankfully what I got was a deep dive into a host of fascinating topics revolving around how the human body works and what you can do with that knowledge to improve your own life. We even got into a discussion about primal living that puts the carnivore vegan diet debate to bed. So get ready for Part one, Jonathan Reisman, and make sure you're following the show so that you don't miss out on the second half of this conversation in Part two. And if you just can't wait for more, check out our new Impact Theory subscription that takes your podcast listening experience to the next level with ad free listening, access to archived episodes, and curated playlists on topics like health, mindset, business and relationships, making it easy for you to deep dive with experts on relevant topics. Sign up at Apple Podcasts or Supercast for all other podcast platforms. I'm Tom Billy, you, and welcome to Impact Theory. There's a quote that I want to read from one of your tweets that comes from a book which I just thought was absolutely brilliant called the Empire of the Summer Moon about the Comanches. Native Americans. And so here's the quote. You said Comanches loved eating bison. And then this is the quote from the book. Children would rush up to a freshly killed animal begging for its liver and gallbladder. They would then squirt the salty bile from the gallbladder onto the liver and eat it on the spot, warm and dripping blood. And I was like, okay, so this is a really different way of living. Imagine tracking the animal down. Your hands are all over a horse. God only knows what's on the horse. You then kill that buffalo. You then cut it open, touching its fur and all the dirt and feces and God only knows what is all over it. You cut it open, you reach inside, you pull this out, having done it so many times that the kids know which organs to beg for, and then you give it to people. And I just thought, oh, my God, the microbes that people would be ingesting would very rapidly acclimate your microbiome to whatever it is they eat. So is that part of this or is this going to be. And I know you're guessing, but is this going to be more genome, Is this going to be more microbiome? Which of those two do you think plays out being more important?
- [03:19]
Dr. Jonathan Reisman
I do think the adaptability point is a big part of it. And I do think the gastrointestinal tracts of humans, but also of all animals are very adaptable. And there is a lot of debate, you know, I've debated with people, vegans on Twitter, let's say, about what humans should eat.
- [03:37]
Tom Bilyeu
And we have to define should, right?
- [03:40]
Dr. Jonathan Reisman
So should, like what is, you know, what's healthiest for us, what makes us feel the best? Which might be two different things. What's the most moral? What's the most sustainable economically, environmentally? You know, there's many ways to ask what is the quote, unquote, proper diet for us. But I mean, I do think that, that the adaptability of the gastrointestinal tract is important. And a lot of vegans will point out, rightly, that, for instance, in the large intestines, humans can ferment plant matter, you know, cellulose and fiber from plants a little bit. Not to the extent of cows and other ruminants who have this initial very large stomach. That is a fermentation vat, basically, to draw energy from fibrous material from plants. But we can partially ferment things in our colonial, which does suggest we are, quote, unquote, supposed to eat vegetables. But not only vegetables. You know, our gastrointestinal tract does not look like a pure carnivore's tract. It also doesn't look like a pure herbivore's tract. So I think we are probably meant to be omnivorous now, to what extent should meat be only used as a flavoring or eaten occasionally, or should it be 90% of the diet? I think variability is a really important thing. And over generations, I mean, I think the microbiome adaptation over some months or years could play a role. I don't know a lot about that. That could impact how much you're able to ferment in your large intestines. But also over generations, gastrointestinal tracts can adapt in impressive ways. One of the most impressive is actually the panda bear's gastrointestinal tract, where clearly they were a carnivore in the past, almost like most other bears, but they've adapted to subsist almost wholly on bamboo alone. And their gastoline tract, their gastrointestinal tract shows that they were a carnivore, or at least a meat heavy omnivore who is now a strict herbivore. And their gastrointestinal tract was able to make that adaptation. And I think ours could adapt similarly. Whether we're living in the Arctic and subsisting wholly on animal meat and fat, or in some parts of the tropics where people do have a very strictly vegetarian diet, I think we can do a little bit of everything. And so the debate will never end
- [05:45]
Tom Bilyeu
on the human side. It's not really a question though, Right. So we do. We have some people right now, even in just North America, that are like, I'm running a carnivore diet experiment for one reason or the other. And then you obviously have people, usually for moral reasons, that have gone strictly vegan. But also in the longevity community, now that debate rages on in terms of what is it that is going to give jevity. I'll lay out my hypothesis. You've cut open a lot more bodies than I have. Since my tally is zero and yours is somewhere far north of that. That. The way that I think this plays out is from a longevity perspective, I think a vegan diet. And let's first define supplement versus non supplement, because looking at this from an ancestral perspective, I have to believe that you were in a stressed state if you were eating a purely vegan diet. So from an ancestral perspective, I'm guessing this is a hormetic response that we're leveraging now in a modern environment where we can sort of take the edges off of whatever problems a purely vegan diet would otherwise create. That's my assumption, that there would be those problems that through supplementation we take the edge off. And so we're getting an artificial look at why some people think why the longevity community seems to keep circling around a vegan diet. For people that don't know the idea of hormesis, it's saying basically it's a little bad for you, but that gets the body to respond in a way that's positive. And so, and my guesses here are not uneducated. I've interviewed enough people around this, read so many books on the topic. But I want to be clear that I'm not an expert but that what seems like is happening is if you're eating a lot of meat, you're going to be in mtor. So you're in a growth phase. You're telling your body grow, this is good times aplenty. But if you're always in that. To the earlier comment that you said that variability is probably one of the keys. And so if you're pegged on eating meat, you're going to be pegging mtor. You're going to, speaking from experience, you're going to feel awesome. But because you're pegging that out, you don't get the hormetic effect. You're not shutting down some of those growth things. You're not giving the body, hey, you need to conserve calories effectively, so lower your metabolism, do less cellular division. I'm definitely out of my depth here, but that's sort of how I imagine this process. And so while I would categorize certainly from an evolutionary standpoint that if you're purely in a vegan situation, you're going to be surviving, not necessarily thriving and if you're going hardcore on the eating as much meat as you can get, that you're going to be thriving but you're not necessarily optimizing for longevity. How does that feel?
- [08:42]
Dr. Jonathan Reisman
I mean it seems to make sense. I also am not an expert in this area and I think the science is still murky, but I mean it seems to make sense to me. But I think going back to sort of lifestyle and activity level, the food that we have available today for anyone in North America, let's say, who has disposable income is so dramatically different from what people have had available in the past. The choice of oils and fats to fry things in is sort of mind boggling at this point. When you go to a grocery store versus 100 years ago when it was basically animal art and butter was sort of your choices. And so now we can import things from olive growing parts of the world like olive oil also. And our lifestyles are so different. So I think you put someone in a hunter gatherer society who has to work really hard to put food on the table. What's the optimal diet for them? I feel like they're going to need more meat and fat perhaps than someone in a modern lifestyle.
- [09:37]
Tom Bilyeu
What's driving that hypothesis? The ability to extract calories, perhaps?
- [09:42]
Dr. Jonathan Reisman
I guess this is all sort of working on what's theoretically making sense in my own mind and how our lifestyles have changed over the recent centuries. But I do suppose that what's optimal for a human living a modern lifestyle where you don't actually have to work very hard for your food physically, and you have all these foods available from all over the world, not only from your own client, your own environment. I think it's so hard to know. I feel like what's optimal for people
- [10:07]
Tom Bilyeu
that don't know your story. You're a physician, you talk a lot about two topics which I think are the reason I wanted to talk to you about this is they collide in this moment we're talking about right now perfectly, which is understanding all the different systems of the body, the different, God, what do you call them, the liquids, the bodily fluids. Bodily fluids, perfect. So all of the different systems of bodily fluids that they produce, all of that and then nutrition. And you're coming at nutrition from an anatomy. Eats is the name of your Twitter feed. And on that feed it says you are what you eat. So when I look at these two worlds colliding of, okay, you've got operation of the body and then you've got the things you take in and you are what you eat. How do those two worlds come together? And what would you need to know from the body, whether it's urine, blood, whatever to know is this diet quote unquote, working?
- [11:08]
Dr. Jonathan Reisman
The science of nutrition is. Has changed a lot in recent decades. And I think I'm in general very skeptical of what doctors have to say about nutrition. And I think just because they don't learn about it partially, they don't learn about it. When I was in medical school, I went to a public medical school in New Jersey. We had one nutrition course and it was actually had just been started and that was in about 2000, 2010 and just before. So before that there had been no nutrition course in the medical school and it had just started and it was just very basic. But I think nutrition science is just so hard to get right and nutrition studies are so hard to do just because there's so many variables that have to be controlled in people's lives. And I Think that's one reason that study that doctors seem to flip flop on things back and forth like eggs. I feel like in my since I was a teenager, I've seen them flip flop back and forth. And to add to that, I think the way the media portrays nutrition science, or the latest study, or the latest, perhaps very low quality study that shows that eating chocolate is very good for you is going to be a headline everywhere and sort of disproportionately impacts the way people understand nutrition. Sort of nutritional science through headlines is a very bad way to understand what's good and what's bad for us. I do think though, medicine is very focused on sort of is someone having a disease or not. And I think when you get into the finer points of nutrition, about optimizing the human body, optimizing performance, it's almost beyond the realm of medicine. I can say someone's urine, let's say the tests I can do on the urine are limited. I can say everything looks normal. I often say that to my patients when I get their blood and urine tests back. But it's hard to measure or there is no measurement I'm aware of. Is this diet optimal for you? I can show that you are not having any vitamin deficiency, that you're not in a state of protein malnutrition, or you're not malabsorbing fat in your gut and failing to absorb it, let's say. But going beyond that and optimizing, taking it from you have no nutritional deficiencies to taking it to the optimization is sort of a bigger step that I think medicine is just very, in the very beginning stages of, I think.
- [13:23]
Tom Bilyeu
Okay, so going back to the question, if you were trying to take your best swag, what would you look at? So my gut instinct is that it's going to be blood. Maybe stool would be the ones that I would really want to see if, if to just speak to your current lifestyle, which I would say is, and maybe we disagree about this, but I would say is 80% what you eat, 20% activity, sure. Loving relationships, all that stuff. But man, if you want me to impact the quality of your life, give me sleep and diet. I'm over everything and I'm laughing. Blood, stool, or are there better things to look at in somebody's bodily fluids?
- [14:09]
Dr. Jonathan Reisman
Do you mean to determine their state of health?
- [14:11]
Tom Bilyeu
Yeah, so I really care about the things that I do. What impact do they have? And so this is all building towards me asking, when you cut open that first cadaver and you saw that the lungs were Black, you were like, this guy smoked, right? And so I just. Dude, I again, I understand that to some extent, I'm just ignorant enough that I have so much confidence in what I think it's very dangerous, but it also allows me to move forward in my life. So I am convinced that at some point we're going to realize, oh, when you cut open the arteries and you see this, that tells me that they ate this. And I think it is only a lack of being able to draw a direct correlation between the two because the two worlds are so divorced. So the guy cutting open your heart and looking at your arteries and, you know, being in charge of repairing that, he's not studying nutrition, and the guy studying nutrition is not cutting open your heart. But I have a feeling that the second that those two things are married and you've got a guy who just knows nutrition for forwards and backwards, or this is probably going to get solved by AI. But whatever entity that is both cutting open the person and looking at what people eat is going to be like, oh, this is easy when you're eating a bunch of highly processed food. And this is my punchline. If you're eating a bunch of highly processed food, your arteries are going to look like trash and you're going to be storing fat everywhere and it's going to glom on to your organs and that's just going to literally choke the ability for the fluids to move through the body in the way that they should choke it off and you die. And that's like the end of the story. And again, because I'm like on this side of ignorance, it's. That just seems so clear to me. But I, I am hoping you will either say, yes, that all makes sense, or slap the ignorance out of me. Either way, I'll take it.
- [15:56]
Dr. Jonathan Reisman
Gotcha. Let me say, I certainly make it. I certainly think it makes sense. I certainly think the point at which the cardiothoracic surgeon who's cutting open your chest, let's say, to look at your arteries versus the nutritionist, we're such a long way from those two sort of meeting and marrying each other and knowing for sure. I guess the trick is that it takes these large population studies to know what is optimal for people. And that doesn't always tell you what's optimal for the individual, honestly. And studies in the past have been very poor quality and not controlled well for all the variables that exist. Like for instance, some of the recent multinational studies on, let's say, salt intake, they're done on much larger scale. They're done with more powerful computers to compute the statistics and do the statistical analysis in a more efficient and better way. And there's more money behind it. And they're discovering that perhaps the salt cutoffs, let's say, are not as low as we thought. So I think every, you know, everyone sort of agrees that eating huge amounts of salt is not good for you. But where's the cutoff between salt that's in an okay amount and salt that's too much? And it turns out that we've been being much too strict, you know, and it seems like people could eat more salt without the effects that we've been warning about for a while. So, for instance. So those sorts of bigger, better run studies are overturning a lot of what we have thought in the past. But I do think, you know, when you cut open a person, let's say, you could look at their arteries and see that they're. There's more plaque built up on the walls, or they're stiffer with more calcium because of injury. You could look at their liver and see there's more fat accumulated there. And a fatty liver disease, which could be either from alcohol or could be from the modern lifestyle and diet, which causes non alcoholic fatty liver disease, which is very common.
- [17:45]
Tom Bilyeu
Give me what you think is actually going on there. So the alcohol one's pretty simple, right? When you say modern lifestyle, that's an abstraction. Get into the specifics. What, in the modern lifestyle? Sitting around.
- [17:56]
Dr. Jonathan Reisman
Yeah. So I think, you know, again, it's complicated since there's so, so many things happened at once to change human life and human diet over the last, let's say, century and a half in the developed world that it's hard to pinpoint, but doctors refer to something called the metabolic syndrome, which is a constellation of conditions that include type 2 diabetes, high blood pressure, high cholesterol, chronic kidney disease, and fatty to liver disease. And that whole constellation, which can appear to different extents in different people, someone might have all those, someone might have a few or one. That constellation of diseases, that syndrome seems to be much more common these days. And is that due to some. Probably due to the change in our lifestyle, less physical activity, a change in diet. But what is it exactly that's doing it? Perhaps a combination of the two, but you see a lot of people, obesity obviously plays a role in there as well, but I see a lot of patients who are not obese at all and still have some version or some portion of them. Metabolic syndrome. And I think it seems like something about modern life has caused that or at least has made that much more common these days. But what exactly is it? I think is really hard to know. I think doctors, when they've tried to show causality of eating this causes that we've gotten into so much trouble and ended up looking like idiots so many times and continuously we still do that. I'm so hesitant to draw conclusions, you know, until the platonic ideal of the large population, nutrition studies are complete to show us, like what really is causing us to be less healthy.
- [19:31]
Tom Bilyeu
I find if you want to know what somebody really believes, you need only ask what they do with their kids. What do you do with your kids?
- [19:37]
Dr. Jonathan Reisman
So I encourage my kids to eat as wide a variety as possible. I feed them, including Oreos occasionally. So for instance, in my mind, I feel like, you know, processed food seems to be not the optimal choice of what you should eat or what your kids should eat. A lot of studies seem to suggest that. Would I bet my life on it? No. Do I think if you went back to a hunter gatherer, people who do an Olympic athlete's amount of physical work each day and gave them lots of Doritos, like, would it really make them less healthy? I kind of don't think so. Because they're living such a physically active lifestyle and their diet is so well balanced with everything else they eat. Like maybe they could eat a lot of junk food and be fine. I don't know. And that study is probably impossible to do. But I do find it silly. For instance, I hear pediatricians sometimes recommending that a child's diet have more olive oil and less butter. And there is no study on children that shows olive oil is better. There's study on probably unhealthy American 60 year olds, maybe that show olive oil might be better than butter, even those. I'm skeptical of those studies. But to then take that nutrition, that nutritional data or evidence from adults and apply it to otherwise healthy children I think is very silly. And I think there's no reason to think olive oil is more healthy in a healthy child than butter.
- [20:55]
Tom Bilyeu
What's the difference between the way that a kid will respond and an adult?
- [21:00]
Dr. Jonathan Reisman
I think it has to do with, at least in the doctor's mind, it has to do with sort of risk factors. There's some evidence that unsaturated fat is better than saturated fat for things like coronary artery disease. Although that evidence also I think is I'm a little skeptical of it. Or at least the. I don't believe the full picture has totally been drawn yet. So I think for the adult with five out of the six conditions of the metabolic syndrome, who's already had three heart attacks and has eight stents in their heart, yes, probably nitpicking their source of fat is more worthwhile than in a healthy child who almost, no matter what they eat, is not going to have coronary artery disease for decades to come. So I think there's a lot of applying nutritional information from one population to another, for instance, from adults to children, or for instance, from, let's say, white Europeans to other people, when the variability is just too great, especially between adults and children.
- [21:57]
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- [22:27]
Tom Bilyeu
This is so interesting to me. So I want to go back to the primal way of living. So you had another tweet that was like, you should embrace the primal side of life as readily as you embrace the intellectual side of life. Do you mean that spiritually or do you mean like, that's just going to be better for you at a cellular level?
- [22:50]
Dr. Jonathan Reisman
Well, that's a good question. I guess that plays into the psychology and how psychology and our emotional lives affect the cellular level. You know, clearly there's some, some correlation there between our emotional and psychological lives and how well our guts work. You know, there's a lot of conditions that we deal with, IBS and others that, where there seems to be some connection with, you know, mental duress or psychiatric disease and gastrointestinal function, let's say, or sleep and psychiatric illness and health. There's a lot of connections there between the body and the mind that, that we really haven't figured out yet. And I think doctors sort of pooh pooh a lot of those things, but the causality is not clear. But it's clear there's some tie in with psychology and I think being. Embracing the primal side of life. I guess by that I sort of meant, you know, realizing where we came from, understanding where our food comes from, that for 99.9% of human history we've lived by, lived and eaten and survived by killing other things, whether it's ripping mushrooms out of the ground. Felling trees, killing uprooting plants, or killing other animals, you know, that's sort of where we come from. That's where everything we put into our mouth comes from. From the flesh of another organism. Not all of them have to die for us to eat. Yes, fruit do fall from a tree that continues to live. But I think even just recognizing where things come from, and I do try to instill that in my kids. You know, meat doesn't come from the store. It comes from the body of another animal. And you are made of exactly the same stuff. And if we zoomed in with a microscope on that piece of meat or the muscle in your leg, no one would be able to tell the difference, because we're made of the same stuff. And I think that is. I understand why people are sometimes grossed out by that, but there's certainly a beauty there. And I often tell my kids about the circle of life. I say, and that's one of them, you know, that everything that dies becomes food.
- [24:47]
Tom Bilyeu
Why do you want them to understand that?
- [24:50]
Dr. Jonathan Reisman
Perhaps because I find it so beautiful and intellectually satisfying and stimulating and fascinating. And I think those are important lessons to understand where things come from. I think that's something I've always been interested in, not in childhood, but actually in adulthood. I got interested in where do these things from the store come from, or how is technology made from how metals are extracted from the ground and how all the way back to the beginning of how we take from the natural world and turn it into the things around us that seem so artificial and seem to have no connection to the natural world. Of course they have their source in the natural world. I was similarly fascinated with a lot of the medications that we use in modern medicine. Many of them come from the natural world, from fungi, from plants, from the bodies of other animals, even from the bodies of other humans. We make medicines out of everything, just like we make sort of useful devices for our own life out of everything. And I think there's a beauty in that. And it helps you understand the world and why the world is the way it is, why things are shaped the way and act the way they are and do, why people lust after the things they lust after. You know, the circle of life, of food and death, is also the circle of life of how feces becomes fertilizer for plants to grow more food. You know, there's all these sort of intertwining circles. And I think. I don't know. I guess having my kids understand the way the world works is part of my job as a parent. So that's. I feel like those are good lessons.
- [26:18]
Tom Bilyeu
One of the things that I was drawn to reading your book, and this may be a misread on you, but one of the things I took away, which may be projection, is that you take a very dispassionate look at the way that the body works. There's a story that you tell in the book. The note I took was like, is this guy Hannibal Lecter? You were driving down the road, you saw a deer on the side of the road. You pulled over, drug the deer into the woods so that passersby would not see what you were about to do, and you skinned the deer. Now, you've been trained how to do this. So it wasn't like, oh, the first roadkill I see, I just want to cut it open and see what's inside. But so when I was reading all of that, I was like, so if I were going to have an epitaph put on my tombstone, I would want it to say, you're having a biological experience. Now, to me, there's something deeply spiritual in that. But I'm trying to get people to understand there's a very grounded, real way your body works in a certain way, your mind works in a certain way. The things you eat will react in a certain way. That may be too complex for today's technology for us to track what that is, but there is a way, and ultimately, I think through AI and better technologies, we'll actually be able to track all that stuff. And it will really become de rigueur to say, okay, on a lifespan, you're working out this much, sleeping this much, getting this much sunlight, eating these things with that microbiome, this is going to be the outcome of plaque in your arteries. And that will really be able to build some terrifyingly predictive models, which right now, for anybody wants to cut through the bs, look at the insurance industry. They're literally betting that they know what are the things that are going to kill you and keep you living longer. And so I think they're the people to beat, but I think that ultimately we'll be able to beat that. So anyway, that's how I think people ought, and I use that word on purpose, people ought to look at the world if they want to have a better life. Is that. Have I misinterpreted you, that you have a similarly like. You just need to understand what's going on at a cellular level. And that's why you say you are what you eat. And that's why you're fascinated by skinning an animal, or is there something more spiritual to what you were just walking through? With the circle of life and understanding where we fit?
- [28:35]
Dr. Jonathan Reisman
I think that it's a little bit of a combination. I got interested in the life ways of ancient peoples in my early 20s, and like I said, I wanted to know just where everything came from, how everything was made, how people figured out everything that we know these days. And so one of the things I did in that journey of exploration was take a wilderness survival course where I learned how to make stone tools in the way that people did for most of our history, certainly much longer than we've dealt with any of the technology surrounding us today. How you know everything from tracking an animal to making rope, from the bark of a tree to setting traps, you know, kind of everything that a person in their natural state, let's say, in nature, with no artifice around them except their own body, their own flesh, how would they survive? Or how would they manipulate the world around them in order to make themselves more comfortable and more able to survive? So the use of skins to make clothing and even to make paper, let's say, you know, parchment, America's founding documents, are basically written on animal skin. And so the use of skins, I guess, just really fascinated me. And this was before I went into medical school. I certainly do think there's something spiritual there, I think. But for me, the spirituality is in understanding how people have lived throughout history and what our bodies are kind of designed to do. Whoever, whoever or whatever you think the designer is, clearly our bodies have a design in a particular way. You know, every body part and every bodily fluid has a purpose that seems particularly designed for a specific problem of everyday life with the human body. Everything, everything that we're made of and everything, the way it's shaped, the way it flows, makes perfect sense from the human mind perspective of problem solving and kind of getting the job done and keeping the human. So I think I like understanding the world around me. There's a pleasure in that fascination and that understanding. I sort of just have always wanted to know more and how everything works. And I think there is, for me at least, a spiritual side to that knowledge to understand why our bodies are the way they are, why we act the way they do, why human history proceeded the way it did.
- [30:53]
Tom Bilyeu
So do you think that you're naturally un squeamish, or is it this sort of loop of wanting to understand where it's from, that bringing both a biological and a spiritual connection to everything that gives you an intellectual framework to not be freaked out.
- [31:12]
Dr. Jonathan Reisman
I think I'm definitely not squeamish to start with, though I do think something I learned in medical school, when we started dissecting our cadavers. On the first day of school, we met our cadavers. It was four students for each body. And I think everyone was surprised by how quickly we got used to it. Even people who were, let's say, not more squeamish than I am, let's say. Like, I have a friend who ended up being a psychiatrist who I write about in the book. And the sight of blood made him faint for most of his life. And here he was in front of a dead human body. He was now tasked with cutting open. Is there blood, though, in a cadaver? There isn't blood, but he's sort of just a squeamish person, sort of. Blood was not the only thing that freaked him out, but no, there's no blood. It's actually all been drained out and replaced with a preservative, sort of similar to formaldehyde, though not exactly formaldehyde. But even he, throughout medical school, got less and less squeamish. He would be on, let's say, his surgery rotation, where he was cutting open a lot of bodies, seeing a lot of blood, and blood didn't phase him anymore. But then for the next six weeks, he was on his psychiatry rotation, and that squeamishness crept back in, and he sort of lost that.
- [32:18]
Tom Bilyeu
Interesting.
- [32:19]
Dr. Jonathan Reisman
Lost what he had gotten used to. I think I started from a less squeamish baseline. And then I think just the intellectual understanding or the desire to understand how things work sort of helped me not be squeamish even further. You know, being fascinated with the process of turning animal skin into buckskin or clothing or leather, I just find so fascinating. There's no room for squeamishness.
- [32:42]
Tom Bilyeu
Why do you have to rub brains on it?
- [32:44]
Dr. Jonathan Reisman
So there's many, right? So skin, you know, when you take skin off a living animal, human or otherwise, it will either rot and it will stay wet and rot, or it will dry and be really hard, almost like cardboard. Neither of which is good for clothing, let's say, or any other material that we'd want to use in our daily life. So you have to find a way to make it dry so it doesn't rot, but have it soft. And so humans throughout the world have figured out many different ways of doing that. But one of the common ways in North America, the tribes, a lot of them used brains, and there's something about brains. It could be these molecules called glycolipids where half the molecule's sugar and dissolves in water and half the molecule is lipid and dissolves in fat. It could be those two sided molecules, sort of like an emulsifier that attaches to the collagen fibers in skin. And the wavy, the way I picture on the molecular level, these wavy fatty acid tails between the fibers are keeping things lubricated perhaps, I don't know that anyone knows. No one's committing a lot of money to researching why brain tanning a hide works so well. But I think that people have also used eggs. People which have emulsifiers that are used like in the yolk especially are used in food products like called lecithins or lecithins. People have rubbed liver into hides, soap into hides and all kinds of other things. So I don't know that it's known why it works, but the product is really amazing. And the transformation too, which I had seen before I dragged that deer into the woods, I had seen the transformation from this stinky, wet, gross, sloppy hide into this luxurious material that's almost finer than the highest quality suede that I've seen and just got so fascinated with that transformation. So I think in this gross, raw thing in front of me, I see that finished product, perhaps because I've been through the process before and you use your own muscles and sweat to soften the hide once the brain's been applied. I just love the physicality of it and the hands on nature of it and the transformation. So I perhaps seeing that transformation in my mind helped me be even less squeamish about the initial product, which can be quite unpleasant.
- [34:55]
Tom Bilyeu
All right, so there's certainly moral implications to killing animals and things like that. But before we get to that part of the carnivore vegan debate, I would love to get a better understanding of when you say that we are what we eat. That's one of the things where I think about vegetable matter and I'm like, I get why there's going to be things in that that are going to be useful to us at a cellular level. But also seems impossible to get all the muscle built up and everything that we would need without eating meat. Now I know it's not true because I know that people can certainly with supplementation, eat a vegan diet forever and certainly live. So you make a point of saying that we are what we eat. What is my takeaway from that?
- [35:39]
Dr. Jonathan Reisman
All right, so on the most basic biochemical or physiologic level. To me, it means that nothing in our body stays the way it is for very long. Even the longest lived cells, which might be in the muscles of the heart or in the brain, even those have a turnover. There's this constant churn in everything that we're made of, where nothing, no individual specific molecule is going to stay there for long. Everything is constantly being broken down and rebuilt from new material materials. And you could think of that constant churn as metabolism. And we're constantly replacing everything in us, right? Just like you can never put your foot in the same river twice because it constantly changes. Our bodies are constantly changing from minute to minute. And the new material for rebuilding everything comes from food. You know, there's also obviously the. The oxygen in the air is a big part of it too, that gets incorporated into a lot of what becomes human flesh. But most. And water, of course, but everything else is food from other organisms that goes in our mouth. We break it down in our intestines and absorb it and use it as the building material to refashion ourselves. And we're constantly refashioning ourselves. Nothing is ever staying the same for long. And that's part of staying healthy. If you're not changing, you're stagnating. So in many other ways, perhaps in a business environment too, you have to sort of constantly innovate, constantly change, constantly renew yourself. And so the same is true in the human body. And so it's all food that becomes us. I mean, every bit of flesh came from food or from the air that we breathe.
- [37:12]
Tom Bilyeu
And is it at a cellular level?
- [37:15]
Dr. Jonathan Reisman
Completely.
- [37:17]
Tom Bilyeu
It just doesn't matter whether it comes from meat or from plants. I've heard people say that plants, vegetable matter does not have a complete amino acid profile. True, False.
- [37:28]
Dr. Jonathan Reisman
So I'm not a nutritional expert, but I do think, you know, there's many vegan diets that if you're not careful and don't pay attention to certain nutrients, you can become deficient. You know, B12 is a common vitamin that's found in all sorts of meat products and much less in plants. And if you're not careful, you can be deficient in that. Same with protein. You know, there are many plant sources of protein and if you're careful, it's not hard to get enough protein. But it's perhaps much easier to get protein if you're eating animals. I do think with the way the food supply is these days, the way that nutritional supplement supply, the nutritional understanding of what the human body needs, and our lifestyles where we don't have to jump out of a tree branch onto the back of a deer and strangle it to put food inside. You know, if you did that, what's that?
- [38:16]
Tom Bilyeu
I have never heard of that as a method for killing a deer.
- [38:19]
Dr. Jonathan Reisman
Well, if you don't have any weapons, let's say if you're found yourself in the wilderness with no weapons, perhaps that's always an option.
- [38:26]
Tom Bilyeu
Do they teach that in survival?
- [38:28]
Dr. Jonathan Reisman
No. I mean, you giveth and you take it away.
- [38:31]
Tom Bilyeu
For a second there, I thought this was like a thing and there was like a known tribe that they would just choke them out.
- [38:36]
Dr. Jonathan Reisman
Yeah, well, there is. There's actually one of the first wilderness survival courses I took was in New Jersey. There's this guy named Tom Brown who sort of grew up in the Pine Barrens, a sort of wilderness area in southern New Jersey, and was supposedly taught by this older Indian Native American from the Southwest who had migrated there. And that was something. In one of his stories, he actually does do that. Jumps out of a tree with a huge knife and kills a deer. That is against all hunting laws. I am not advocating, do not try this at home. I've never done that and probably would never. I mean, weapons are not hard to find these days, so it's rare to find yourself naked and afraid. Perhaps in the wilderness somewhere we have to resort to that. But I guess I just meant that you don't have to physically exert yourself almost at all. Even nowadays, more than 10 years ago, you can do everything without leaving your house. You know, my kid gets piano lessons. We don't have to take more than 10 steps over the piano and it's through the computer. Everything we do these days requires less and less physical activity, almost approaching, you know, the singularity of never having to move. So I think that but with all the supplements available, with the food supply where we can get anything from any part of the world at any time, winter or summer, and with our understanding of nutrition, I think that you probably can be healthy as a vegan, as where in a hunter gatherer society, you didn't really have a choice as much in the past as you do today.
- [40:02]
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- [41:02]
Tom Bilyeu
All right, so then let me ask the obvious question. Why do you eat liver? Like if you could eat strawberries and be fine, what are you doing?
- [41:10]
Dr. Jonathan Reisman
Right? Me personally, do you mean? Yeah, well, one, I like it. I did not like it as a kid. Chopped liver was a tradition in my family. It was on the table at every holiday. I thought it was totally gross. I thought it tasted like rotten iron. Pretty much whatever that is, it was delicious. But then after, as I talk about in the book, learning about the liver and just understanding this incredibly complex organ that does a million and one things on a daily basis to keep our bodies alive and healthy, realizing that that complicated, amazing thing inside each of our abdomens is pretty much the exact same thing, although from an animal that is chopped up in that bowl on the table at the holiday, it's sort of similar to that, you know, perhaps that transformation of the gross, wet, raw hide off an animal into that beautiful buckskin that has a million and one uses in daily life. It's sort of like, oh, these two things are connected. That's exactly where this thing comes from. I never considered that the chopped liver from this internal organ that is so complex inside the abdomen of these animals, and now it's mixed with fried onions on the holiday table. So I think that fascination alone probably helped me similarly get over my squeamishness and get over my childhood disgust for the dish. And like many things, but how does
- [42:26]
Tom Bilyeu
it get you over it tasting like rotten iron?
- [42:29]
Dr. Jonathan Reisman
You know, humans can get used to a lot of things. Not only, let's say, the sight of their cadaver and the smell of the cadaver lab. As a medical student, which people do get used to, but also, I mean, the taste of alcohol, let's just say when I first tried hard liquor as a teenager, I wasn't impressed with the taste. And now I love it. I don't even know if that do I actually like the taste or do I just more like the effect? And I know that's the, you know, that's the beautiful buckskin at the end of the. Dealing with this gross hide. Or do I actually like the taste? I think I actually like the taste. Even though it still sort of burns your mouth, it's pretty gross, but it's still this amazing thing. And so I think humans, we can get used to a lot, and there's a lot in the food world too, that takes some getting used to. And that is an acquired taste. And I think liver is one of those. And now that I've tried it so many times, I love it. And if it was a holiday without it on the table, I'd probably be outraged.
- [43:22]
Tom Bilyeu
That's so interesting. Okay, so why do so many animals go straight for the liver?
- [43:27]
Dr. Jonathan Reisman
It's a good question. I, I just read about some orcas off South Africa that have been killing sharks and eating only their liver and leaving the rest of it, which I find very interesting. I guess they have good taste, probably is part of it, but they, you know, I'm not really sure why. Perhaps there's a. Are they going because of a nutritional deficiency? It's possible. You know, there's a lot of nutrients in liver. It's one of the most nutrient packed thing you can put into your mouth. Not only iron, which contributes to the taste, but a variety of other things as well. I don't know why animals go for that, but that's a fascinating topic. Like which body parts do animals go for first? Often it's the internal, internal organs. Sometimes it's the bone marrow, which is very fatty and a great source of fat. I mean, polar bears will often eat all the fat off seals as the first thing. But in the Arctic, it's a particular matter of kind of calculating nutrients. And fat is clearly the source of nutrients that everybody needs just because it's so nutrient dense and calorie dense. So I think that's an interesting fact. But what is the process there of the, of the animals? Are they considering, oh, am I in the mood for the meat today? Am I in the mood for the liver? Does my tummy hurt? So I'm going to avoid the fat today? I'm not sure that that kind of processing happens, but I do wonder, I also wonder, for instance, how do adolescent lions know to bite the animal's neck? How do they know that's going to kill them? Is it just because they saw their parents do it? Is it because they understand something about the physiology and that's where the big blood vessels are? I'm not really sure. Maybe it's just what their parents taught them to do.
- [45:05]
Tom Bilyeu
That's interesting. Again, not afraid to have a hypothesis. I'm perfectly willing to find out that I'm wrong. Trust me, I'm dogmatic. But interesting. Right. Turn here into other elements of your book which get into all of our organs, including our sexual organs. If I had to guess, the biting the neck is very akin to as a guy thrusting deeper when you orgasm, which I always found super weird. Like, all of a sudden, this one thing feels so. It is the thing I must do. It feels so right. I'm like, this is just making it better. Nobody told me to try it. Just every impulse that I had was like, do this. The same with lordosis. I don't know if you've heard about that and who knows if this research is actually true, but I heard something and I was like, oh, my God, that makes so much sense that women actually like the feeling of that posture where you're arching your lower back a little bit. And I was like, that would make sense because in certain positions, it's going to allow you the ability to penetrate more deeply, which is going to increase the likelihood that you get them pregnant. So you put together the woman wanting to arch her back and the guy wanting to thrust deeper right at the moment of climax. It's like, okay, like, that makes sense. So for a juvenile lion to just have the. The instinct. I don't know what better word to use for it, where it just. That's the most attractive part. So when you're going for it, every instinct you have has, like, honed you in on the neck. Because from an evolutionary perspective, those that did that got more kills and thusly live longer. I mean, that's obviously a guess, but from an evolutionary perspective, that makes a lot of sense to me.
- [46:40]
Dr. Jonathan Reisman
Yeah, that makes sense. You know, the lions that were had the instinct to bite the tail didn't survive as much because they didn't get as much food to the ones that, you know, went for the neck. And maybe going for the leg makes you more likely to get kicked in the face or something. So that doesn't make sense. But, yeah, I think, you know, that desire to thrust is kind of part of the sexual desire. You know, just the feeling you have when. Let's say when. When you're turned on. It's almost like nothing can stop you from completing the act. And clearly that's part of the. The intelligence of the human organism is that, like, nothing will get in your way from completing that act, because that's sort of what the species has to have to survive. And then, you know, as soon as the orgasm's over, everything is different and that desire just like completely disappears. It's almost one of the few ways or instances in which physiology really turns on a dime and goes from this unquenchable urge to this completely different state. And all these hormones and other things are released at that time as well. But yeah, I think there's an intelligence to what we do, even if we don't understand it. And some of that is instinct. What is instinct? Is it stuff we unconsciously picked up from our parents? Is it stuff that's just in our genetics? I don't think anyone knows, but maybe we'll know more in the future.
- [47:57]
Tom Bilyeu
Yeah, almost certainly true. As we look at AI's ability to track so many data points and just the. When you think about, we're good at large language models right now, but we will for sure. I mean, this is. Again, I don't know for sure, but it seems inevitable that we'll start being able to put other data into AI. It will be able to go through, find these crazy patterns and begin linking them all. AI is super fascinating. Have you thought about where AI is going from a standpoint?
- [48:28]
Dr. Jonathan Reisman
Definitely, quite a bit. And I do think the processing power of computers in general has been helping with epidemiologic studies, such as in nutrition on. I would love to see AI play a bigger role in these sort of large multinational studies on things like nutrition and salt and saturated fat and other things. I think they could probably do a lot more, hopefully in an unbiased way to help us understand things. And I think more processing power is needed and better statistical methodology can help. So I'd love to see AI be applied in that area. You know, I think AI, it's been. I mean, it's been getting better and better. Some of my colleagues have. One of my colleagues, in fact uses ChatGPT4, has it open on his computer while he's working beside me in the ER and uses it to help him, you know, does he need it? I mean, he's been at this job for years without it, but he just started using it recently, actually finds that it helps him write some of his notes, or at least some of the things that we have to put in our note is we write a note on every patient we see, of course, otherwise no one can bill, no one gets paid, and we get angry letters from our employers. But in that note, you have to put your differential diagnosis, meaning what could this be? The patient came in with xyz. I found ABC on the exam. The labs show, you know, efg, what could it be? And you give a list of things traditionally in order of decreasing likelihood, like, it's most likely this, but could also be these other five things. ChatGPT4 is really good at giving you those differential diagnoses. And I've done it with him just for fun, and it came up with just exactly right, like exactly what I would have written. The other thing is even Google for years, you know, a lot of Doctors Poo, poo Dr. Google. But Google is great at making diagnoses, especially of rare syndromes. You know, you could put in, for instance, blood in the urine and coughing up blood, and it willone of the first two hits will be something called goodpasture syndrome, which is something all medical students learn about. A rare autoimmune condition where there's blood in your urine and blood in your sputum. Or the other day I looked up swollen joints, rash, blood and stool. And the first hit is something called Henoch Schonlein purpura, which is a not too rare condition in kids. And it gets it exactly right. And a lot of things are like that.
- [50:55]
Tom Bilyeu
Have you compared Google to AI?
- [50:58]
Dr. Jonathan Reisman
I have seen it done on AI and it does it better. I mean, the same, if not better, but it's definitely good at those. Those rant. Those rare diseases that have a very particular constellation of symptoms like that Google's been good at for a while. Decades since it's been around, basically. I think it's harder, for instance, to say, let's say this person with a fever and a cough, do they have just a viral respiratory tract infection or do they have a pneumonia that needs antibiotics? That's a bit of a finer point that I'm sure AI will get much better and be better than humans.
- [51:33]
Tom Bilyeu
You need to interact with the patient in some way.
- [51:36]
Dr. Jonathan Reisman
Yeah. So it's almost like you put a whole bunch of clues together. There's not one yes or no answer. There's very few yes or no answers in medicine, blood tests, even imaging. There's a lot of X rays that you could show to multiple radiologists, and some will say it's pneumonia and some will say it's not pneumonia. I've worked in rural hospitals where the radiologists seem to call pneumonia on every single X ray I do, no matter what. Even if the person doesn't have any symptoms of pneumonia, they don't know that. They're just looking at the X ray. And so a Lot of it is, you know, we talk about the art and science of medicine. It's a lot more art than science, to be honest. And so no two artists will paint a picture the same way, no matter how much detail you give them about what it should show. And in a similar way, you give the same patient to different doctors, they will end up diagnosing them differently. So to know. Yeah, you have to put together clues. So talking to the patient, how have their symptoms been, their vital signs? Is there a fever? Is their oxygen low? Listening to their lungs, even watching them from across the room, how they breathe, that is a very important skill I try to instill in the emergency medicine residents I work with in Camden, New Jersey, at Cooper Hospital. It's almost more important than listening with your stethoscope to what the lungs sound like. It's just looking how someone's breathing and picking up the very subtle clues that they are struggling to breathe or having what we call respiratory distress. It's almost like a sommelier reading all these details that others would miss into the taste and smell of wine. And you have to train yourself. You have to look at thousands of people breathing both normally and abnormally to kind of refine your sense of, is this normal or is this not normal?
- [53:21]
Tom Bilyeu
That's hard. If you walked into an ER little bay and didn't know anything about that person other than they need attention, what's the sequence that you go through to diagnose what's going on?
- [53:32]
Dr. Jonathan Reisman
Assume they can't speak and I don't know what they came in with because usually I have a sentence of information.
- [53:37]
Tom Bilyeu
Yeah, assume you have nothing and they can't speak to you.
- [53:40]
Dr. Jonathan Reisman
One of the first things I'll do, just looking at the patient, you actually get a lot of information from their skin, believe it or not. So the skin can take different tones in different kinds of critical illness. I had a patient once who had a perforated ulcer in the stomach, meaning such a bad ulcer that actually ripped through and released air and stomach contents into his abdomen. Oh, and he was green. And. And I looked up at. I saw his skin. I looked up at the monitor. The nurse had already put him on the monitor, and his heart rate was 130, so very fast. And he looked like he was in pain and he looked sick, quote, unquote. And when doctors and nurses use the term sick, that's what they mean by sick. Like, whoa, something terrible is happening. And we need to. Like, we need three other people in this room right now to start everything and figure out what's going on. You know, when people say, and I think, think it's funny because I a lot of, you know, the way parents use, oh, my child is sick. That's not the same word that doctors will say when someone is sick. It's like they either need surgery like now or they need to be in an ICU or, or they're going to die if we don't do anything. So. So a lot of it's from the color of their skin. And I think doctors talk about gestalt also, meaning just sort of overall picture, like how does it look? Does it look like something bad is happening or not? And I think a lot of that has to do with the color of their skin. I had a guy just recently who came in with sudden onset left sided chest pain and couldn't breathe. And he looked gray, his skin. I was like, oh boy. And I ended up had no breath sounds on the whole left side of his chest. And when I did an X ray I saw he had a collapsed lung. So a hole in his lung had sort of torn, not too dissimilar from the hole in the guy's stomach with the ulcer. And air had escaped from the lung into the space between the chest wall and the lung. And the lung had collapsed. So I could not hear any breath sounds on the entire left side because there was no air movement. The lung was collapsed down and not up against the wall. So I couldn't hear it. He needed a chest tube. So one of them sort of get the air out. Yeah, to get the air out. Because that air was, you know, that lung couldn't expand against it. It was sort of air locked into that space between the lung and the wall. We call that a pneumothorax. So one of the most brutal things I do to people, I give them lots of pain medicine and numb it up beforehand, but was basically make a hole sort of under the armpit between the ribs through muscle fat membrane and then into the space. And when you pop through, it's like, I mean that air rushes out and it was like under pressure in there.
- [56:03]
Tom Bilyeu
How do you stop it from getting back in?
- [56:05]
Dr. Jonathan Reisman
So it wants to come out, but then we actually put a tube in and then close up the hole around the tube.
- [56:11]
Tom Bilyeu
How do you close the original hole that allowed it to leak in so
- [56:13]
Dr. Jonathan Reisman
it heals itself actually quick? Yeah, the hole in the lung heals itself usually and then. Or just like shuts itself, you know, just by just like blood will clot sort of membrane that has a hole will sort of stick back together. And so as he breathes, you know, that lung is expanding and just sort of pushing that air out. And you. You also use sort of complicated physiology, but you use a water seal where you put that tube and into water and air is bubbling out, but air can't get back in because there's that water sort of blocking it. Yeah. It's almost like a fermentation lock if you're brewing beer or making alcohol. Sort of a similar process where air can bubble out through it because you have to Release all the CO2 that the yeast is producing by fermenting the sugar.
- [56:57]
Tom Bilyeu
I want to know who figured that
- [56:58]
Dr. Jonathan Reisman
out the first time. Yeah. But air cannot get back in. So it's very similar process.
- [57:03]
Tom Bilyeu
Fascinating.
- [57:04]
Dr. Jonathan Reisman
Yeah. So the human body is just like a vat of brewing beer, basically.
- [57:08]
Tom Bilyeu
That's exactly what I would have said.
- [57:09]
Dr. Jonathan Reisman
Yeah.
- [57:09]
Tom Bilyeu
No, that's so interesting. So diagnosis is something that I'm really fascinated by, the ability, because you have to do this in business. So I'm constantly doing this in a business. So you're trying something. It's what I call the physics of progress. You're trying something, it's not working, or at least it's not working as well as you wanted. But you have to figure out why it's not working. And then your ability to accurately diagnose the problem is everything. And so in business, it's twofold. You have to diagnose the problem, and then you have to figure out what new thing you have to do in order to fix it. I imagine this is exactly what you're doing in the body. So going back to AI diagnosing the problem, where would you assume you have the sensors to collect the data? Where would you put the sensors in AI if you were trying to, you know, just going back to what. What is the optimal way to live? Where would you put the sensors? Is it. You put them in the sewage, you put them in the grocery stores. Like where. Where would you want to read the data to get at a population level? What's happening? Hmm.
- [58:10]
Dr. Jonathan Reisman
That's an interesting question. You're not talking about like an individual body. Where would you want to go?
- [58:15]
Tom Bilyeu
Population for now, we can then boil it down, but this will help me figure out what are the things you think we should be paying attention to. You've been very clear about physical activity, so I'm guessing there's something we would want to track there. But I don't know where else you think at a population level, we need to understand.
- [58:32]
Dr. Jonathan Reisman
That's a good question. I guess, you know, the, the effluence of the body are one thing and sort of the flow. Yeah like things flowing out from the body. So everything that comes out of us, feces, urine, tears, sweat and so what are the societal equivalents of effluents? I guess, you know, what's in the sewage is certainly a big one. I guess that's our kind of our main one. You know, you could think about exhaled air. There's a lot of studies actually on measuring, let's say diagnosing lung cancer by looking at exhaled air. You know, is there something that some peptides, small proteins or other markers of a cancer that people are exhaling or even in like head and neck cancers like of the throat, the back of the tongue, the larynx, etc. Very common in parts of Asia, perhaps partly due to chewing betel nut and chewing other things that are might be carcinogenic if you're chewing massive amounts of them all day every day for decades. And so there's a lot of studies on, you know, a simple fast screening test where they could just exhale into something and it could perhaps read markers of a tumor. I do think that's, you know, that is something AI can help with. Right. Look, look at, analyze the stool of a million people. 500,000 of them don't have colon cancer and 500,000 do. And what does their, what's in the stool of those, you know, more in the stool, let's say of the people with the cancer than not a lot of these things are in very small amounts, which makes it hard. But I do think that's something that AI could help with. And if we have those sorts of screening tests that would be so much better than what we have now. You know, there is no screening for so many kinds of cancer. Pancreatic, ovarian and other common ones, or even lung cancer. You know, there's some debate about should heavy smokers get a CAT scan every year to look for tumors. And, and it seems like that might be the benefits might outweigh the risk there, especially in heavy smokers. But it's not clear because the risks
- [60:29]
Tom Bilyeu
are you have to do a radioactive dye.
- [60:31]
Dr. Jonathan Reisman
No, just the radiation of the test itself. So like a CAT scan is not a radioactive dye. Other imaging in medicine is, but it's just a CAT scan is kind of like a few hundred x rays from every angle and then the computer puts that all into one 3D image.
- [60:50]
Tom Bilyeu
So you get slapped around with radiation.
- [60:52]
Dr. Jonathan Reisman
Yeah, it's like hundreds of X rays. You know, it's almost like taking an X ray from every side and then using all that to create a 3D image, which is how it works. But it's radiation. You know, it's not great, but it's sort, you know, like in every, everything in medicine, it's do the benefits outweigh the risks? And nothing is risk free. So it's all a matter of, you know, figuring out that balance and the calculus might be different for different people. I often talk to people about, you know, the risks and benefits of certain things. And I say, we could do this or we could do that, you know, and there's benefits to doing both ways. I don't think one way is right. You know, what are your, what are your values? What do you want to do? What do you think is best for you?
- [61:33]
Tom Bilyeu
So you don't think one way of treatment is right because of value systems?
- [61:37]
Dr. Jonathan Reisman
Well, sort of like let's say someone has a, a very early skin infection and some doctors would just say, oh, put some antibiotic cream on it and keep an eye on it and come back if it gets worse. And other doctors would say, oh, start these oral antibiotics right now. And you know, I often. This is exactly how I say it to people. You know, I say neither is wrong. Both of those are acceptable, let's say. But are you the kind of person who wants to jump on this infection, who wants to jump on everything and be aggressive with treatment right away, and you're not afraid of the possible side effects of antibiotics, then sure, I'll give it to you. Or are you the kind of person who wants to only take antibiotics if it's absolutely necessary and would rather just sort of go the way of using an antibiotic cream and keeping an eye on it, knowing that there's a risk it could get worse and you could end up on antibiotics in a few days from now and it might be at a more progressed state than it is right now. You know, that's. I don't think either of those are wrong because many of those infections will turn around with antibiotics. So what's the right thing to do? I feel like that's a big part of the debate about what's the right thing to do is difficult. And that goes back to the art of medicine. It's sort of value judgments. And so I like to give patients the. I like to put the decision making in their hands. I have the key to the prescription medicines because I'm a doctor, but I'll often, even sometimes give them a script and say, only fill this in a few days. If you're not any better, you make the decision. Here's the prescription for the antibiotic. You decide for yourself because either way is right. There's no wrong answer. Waiting is not wrong. And jumping on it now with an aggressive treatment of antibiotics is not wrong. So I feel like I'm a consultant for people, you know, I'm a plumber. I'm advising. What is the problem? Here are some solutions. You know, you decide what's in your budget, what you want, what you want to get out of life, what's important to you, what you're afraid of, and. And you make the decision.
- [63:31]
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