When we started Evolution of Medicine, we saw a theme emerging that conversations about evolution were going to be critical for understanding all the different ways in which medicine was evolving. With that in mind, who better to have on the podcast than two evolutionary biologists? Husband-and-wife team Dr. Bret Weinstein and Dr. Heather Heying became famous in 2017 when they were kicked out Evergreen College and have been part of the “intellectual dark web” since then.
Their fame has soared during the pandemic with their DarkHorse Podcast, which has 118 live streams and counting. This podcast is incredible for practitioners because it shows that when you look at medicine through that evolutionary toolkit, you come to the same conclusion as practitioners in our community, that this lifestyle-first, root-cause approach is the way forward.
Highlights include:
- How Bret’s nagging symptoms opened him up to a new way of thinking about medicine
- Why pharmaceuticals are not evolutionarily adapted for complex chronic illness
- A deep dive on COVID, education and politics
- And so much more!
James Maskell: Welcome to the Evolution of Medicine podcast, the place health professionals come to hear from innovators and agitators leading the charge. We cover the latest clinical breakthroughs in health technology, as well as practical tools to help you transform your practice and the health of your community. This podcast is brought to you by the Lifestyle Matrix Resource Center, who provide a range of options to help you deliver successful, effective, functional, and integrative medicine. To find out more and to get started, go to goevomed.com/lmrc. That’s goevomed.com/lmrc.
Hello, and welcome to the podcast. I am super excited this week to bring on doctors Bret Weinstein and Heather Heying. They are a married couple, they are evolutionary biologists. They are authors of a new book called The Hunter-Gatherer’s Guide to the 21st Century. They have a podcast called The DarkHorse Podcast that I have listened to all through the pandemic and has been an incredible gift, and I’ve learnt a lot through it. I’m very, very excited for this podcast. The longest podcast I’ve ever recorded. It’s jam-packed with so much incredible information for clinicians and functional medicine aficionados alike. I think there’s a lot of congruence between evolutionary biology and functional medicine in the way that we think about creating health.
We talked about medicine, we talked about food as medicine and food in general, we talked about COVID. We talked about education and we talked about science, and I think there’s something for everyone in here. One of the most fascinating conversations ever had. Also what it brought up is it brought all the things that we’ve done here at the Evolution of Medicine over the years. So, we talked about community and this podcast is brought to you by the Functional Forum Communities. And so, we have meetups and communities of practitioners happening all across the country. Go to functionalforum.com.
Also, we talked about both of my books, The Evolution of Medicine, the first book, and my second book, The Community Cure. And you can go to goevomed.com to find out more about that. As I went through it, I felt like this would almost be required listening for all doctors that come into our community to understand what the evolution of medicine is all about. It’s a really amazing, almost two hours of content. I think you’ll get a lot out of it. I really enjoyed recording it. Love to know what you think, feel free to reach out to us and let us know. In the meantime, enjoy. So a warm welcome to the podcast, Bret and Heather, welcome.
Bret Weinstein: Thanks for having us.
James Maskell: So grateful to have you here on the podcast. I guess just to start off, I think there’s many ways in which our audience is going to find congruence with your way of thinking and very excited to talk a little bit about your book, because there’s so many themes in there and that chat to our medicine actually, I recommend for everyone in our community to read, but let’s just start off with…in our community, many of the practitioners and doctors have had this moment of divergence where they thought a certain way, and then something happens to either them or a loved one, and then they could never think the same way again. And one of the things that you mentioned in the book, Bret, is your respiratory issue that turned out to be based on gluten.
So can you take us through that and how that led to a divergence in thinking from the mainstream for you?
Bret Weinstein: Sure. First of all, I should say that in my case, there is pretty good evidence that it’s not even gluten it’s wheat, but in order for people to understand well enough what it is I need to avoid I speak as if I have a gluten issue. But even gluten-free items that were made with wheat trigger me, which is why I think it’s some other molecule. So yes, I lived for decades with a…it wasn’t a terrible case of asthma, but it gave me a chronic cough especially in the winter. And I tried everything. People told me I’m allergic to cats, you got to live without cats. They told me it was dust mites in the bedding.
They told us it was dust in the ducts of our house. We literally ripped out the heating system to our house and put in hydronic heat. We lived without cats for several years, dust mites didn’t change anything. I was reading that some people have the symptoms I had caused by what was described as a gluten allergy. And I thought there is no way, but I’ve tried everything else, this is a cheap experiment to run. I’ll take wheat out of my diet for a couple of weeks. And lo and behold, I got better, and not only that, but a lot of things that I didn’t even realize were symptoms of anything, just little annoying features of life went away too.
I thought I must be imagining this. I started eating it again and they came rushing back. I took it out for a month and I got even better than I had been and it’s like, well, you don’t need a PhD in a science to read the pattern there. I was just very much healthier without this. It’s one of a number of places where if one pays attention to patterns in one’s own health, one can actually identify causes and live a better life, and living a better life does not start with a pill in general.
James Maskell: Yeah. The elegance of that solution as you see it happen and how easy it was to achieve that remission, once you experience that, you really can’t go back to thinking in the old way, right?
Bret Weinstein: Absolutely. It’s a mind-blowing experience. The hardest thing for me is A, the world treats it as a dietary preference, unless you have an issue yourself or someone you know well has such an issue. People at restaurants sometimes are not terribly careful when they give you an answer about whether there’s wheat in something. And typically one’s friends, if they don’t have an issue, will treat it like a personality quirk, they don’t understand, “Nope, this is science reporting and adverse reaction to a molecule.” We could talk about why that is, which is an interesting question, but that it is, is unambiguous.
Heather Heying: And we’ve had occasions when…two occasions that I can remember where someone served him a drink that was made with an alcohol that we knew caused him to have reacted to in the past. So, to his point that even gluten-free things can trigger him. Bombay Sapphire gin is one of them. So you ended up with a drink that you’d already drunk from that I knew to have Bombay Sapphire in it, and so I just watched, and didn’t say anything. Let’s not feed into this because it’s already done, let’s see what happens. And sure enough exactly the same reactions that if you had known occurred, and it’s possible therefore to do science on yourself, to do science with your loved ones, without forcing anything on them and to just have revealed, “Okay this is absolutely real.”
A lot of people are doing this for fashion, and then there are also a number of people, presumably because we have such a not hyper novel diet and lifestyle that actually have chronic disease, that they have no idea everything that they’re experiencing as a result of.
Bret Weinstein: Yeah, I should say in this case, I think it’s very likely that this is not a hyper novel diet, because it seems to be broadly across all wheat for many of us including ancient wheats. In my case, I’m an Ashkenazi Jew on both sides. My people have been eating wheat forever. There’s no reason I should have a reaction. So my guess is this is a developmental immunological interaction with some other novel feature of our environment. The question is why are we not obsessed with the prevalence of disease that arises out of these novel mechanisms because anytime we’ve got some novel influence causing disorders, we stand to do a tremendous amount of good just by identifying it.
James Maskell: Yeah, absolutely. Well, there’s no experimentation like self-experimentation. So yeah I’m glad that you’ve been able to see that through yourself. Well, look, I really want to talk about your book because it was amazing, as someone who created a business called The Evolution of Medicine to really look at how medicine could adapt to its new environment, this environment of chronic illness that medicine wasn’t really created for, but also to look at some evolutionary concepts within medicine, and also to look at just ways in which the health system would adapt.
It really hit a lot of amazing pieces for me. So, the medicine chapter I want to talk to, but I highly recommend the whole book, but you say something in there that you don’t think that in that context, in the evolutionary context, pharmaceuticals are not necessarily an obvious fit for complex chronic illness, and I’d love for you to talk about how you came to that conclusion through an evolutionary biology lens?
Heather Heying: Well, maybe a preamble to that is, we say in the book, and we’ve been saying for decades that there are broadly three remarkable successes of the Western medical tradition, which exists in a novel world originally and now a hyper novel world, and is responding to a number of syndromes and symptoms that are created exactly by that novel and hyper novel world. Those three things are surgery, antibiotics and vaccines. Surgery antibiotics and vaccines have all saved a tremendous number of people, and they are also all used in places where they don’t have a place. Also, furthermore, to say that surgery, antibiotics and vaccines have all been remarkable, does not mean that any individual surgery or surgical procedure or any individual antibiotic or antibiotic procedure or any individual vaccine or vaccine development is itself a good representation of the group.
So I think it’s too easy, especially in the incredibly complex world we live in to say, “Oh, antibiotic’s good. Therefore, all antibiotic’s good, therefore all antibiotic’s good in all situations.” That’s a particularly easy one to point out now, although it wouldn’t have been 30 years ago, but now we understand that we’ve made ourselves sick, that we’ve limited the capacity of many antibiotics or we’re prescribing them to both ourselves and our livestock, and we made our livestock sick, and then we eat sick livestock and we make ourselves sick through indirect effects, right?
So there’s both direct and indirect effects of both over-applying and using in the case of antibiotics, antibiotics that may not be appropriate to the particular situation.
Bret Weinstein: So I would add that for your listeners won’t know my dissertation work was on tradeoffs and the way that evolution interacts with them and the core insight of the dissertation is that we have run up against the limits of understanding the way evolution works, pursuing it as an engine of improvement, right? It is an engine of improvement, but that engine of improvement runs up against physical, chemical and physiological limits, where it has to choose between desirable characteristics, right? What that it implies is that effectively if you intervene in this system, you can often get an effect in one direction, but it comes at a cost in something else.
Because of the perverse incentives surrounding the way pharmaceuticals are generated, we typically underplay the costs and overplay the benefits of these things, right? It’s not hard to find a compound that when you dump it into a system as complex as a human being, gives you an effect, the effect may be temporary, the effect may be not worth the cost in some other function. So from the pharmaceutical industry’s perspective, giving people a drug that has a cost may be a positive because there may be another drug that you have to treat the side effects with. From the point of view of the net health of the individual making the decision far better to figure out what the root cause of the disorder might be and intervene at that level, rather than take a medicine with unknown effects, which they all have.
I would point out a couple things. One thing that’s very suspicious about our approach to medicine. If you think about why…let’s take medicines that ancient people extracted from nature, typically from plants or fungi, these compounds are secondary compounds. They’re compounds that were built by the organisms in question to dissuade animals from eating them. So these other creatures, these plants typically and fungi have found ways to intervene in every functional system in the body and disrupt it by putting in a chemical. So if every system in the body to paint with too broader brush can be regulated too high or too low, there’s a poison out there in nature to move it in the other direction.
But the key to doing it well is titration, right? To the extent that you’re going to borrow, let’s say a medicine from foxglove, right? You’re going to borrow a heart poison from foxglove , then the right thing to do is not simply say, “This is the medicine that fixes that problem.” The point is what is the exact level at which this medicine fixes the problem and does minimal harm, right? Restores the system to a balance. The fact that titration is not at the core of the way we prescribe medicines, we do a very gross job of deciding what the correct dose is, tells us that we are not acting in a sophisticated way with respect to these compounds.
Heather Heying: If I might add one additional category by which pharmaceuticals are often not the appropriate approach for treating human health and disease, is that because we are focused on the short time horizon, as everything that evolves is, we see a symptom and we think treat, sometimes the symptoms themselves are actually adaptive. So sometimes you get rid of the symptom and you don’t deal with the underlying cause, which is exactly what Bret was speaking to. But in other cases, you may actually be getting rid of the body’s response that is itself dealing with the underlying cause. So the two examples that come to mind are fever in some cases.
Obviously some fever can get so high that it will kill you, but very often fever is itself the body’s adaptive response to take you outside of the homeostatic limits of the pathogen. By reducing fever, you actually perhaps produce an environment in which the pathogen can persist for longer, and then morning sickness. Nausea during pregnancy, especially during the first trimester, can be excruciating just like fever can be excruciating. But in general, it is a signal to the mother that there is something in her environment, be it dietary or otherwise that needs to change. And getting rid of the nausea without getting rid of the thing that needs to change puts you at risk, both from the thing that you’re taking to treat nausea, especially when you have a less than three month embryo on board.
But also you risk continuing to expose yourself and the embryo to whatever it is that is causing the nausea in the first place. So we need to think more carefully, and this is not something that market-driven pharmaceuticals do a great job of, about what is the underlying reason for the symptom that is upsetting you right now?
James Maskell: Look, I would say two would be very welcome in functional medicine circles, because you’ve really just laid out exactly the many reasons why doctors in our community go in this direction. In my estimation, the root cause communication breadth there is exactly the way that doctors think about what they’re doing is getting to the root cause. But actually you just said Heather, I think it would endear you even to a more sophisticated crowd within the broader evolution of medicine, community who have come to the conclusion that even just first generation functional medicine of looking for the root cause must be understood in the context of the body’s adaptations and so forth.
That fever example is classic. I think look, you’re right in the zone. People are with you now on this podcast because that’s incredibly well shared. I want to come to a particular story you shared in the book, I think-
Bret Weinstein: Can I jump in and just make one point?
James Maskell: Yeah.
Bret Weinstein: There’s a root cause here that isn’t physiological that I think needs to be front and center in a discussion like this. There is what we would call path dependency in the way we teach medicine, and it has produced an absurd medical environment, right? Because of a territoriality between academic disciplines, and because of just the simple historical order of discovery, medicine is still taught as if Darwin had not explained what produced the body in the first place, right? Most people who hear that, who haven’t interacted with doctors about evolutionary topics or themselves been to medical school, think that that must be an exaggeration, but evolution is the core organizing principle for medicine.
And yet it is largely not taught in medical school, right? The implications of an adaptive physiology is just simply absent from the curriculum, even though it obviously would enhance a doctor’s capacity to be scientific and to sort through the likely root causes of any pathology they encounter.
Heather Heying: Let me just add one thing to that, the classic treatise in this space, Why We Get Sick by Nesse and Williams was published in the early nineties, and we happened to be at Michigan where Nesse was, so we were able to learn from him. And at the time, he with joint appointments both in the medical school and in whatever academic department he was in, he thought as did we all, wow, how did we get to the early ’90s, mid ’90s without having a distinctly and explicitly evolutionary approach to medicine and all the major medical schools, hopefully all the medical schools will at least know it’s happening.
That’s now 30 years ago, and very little has changed. So that’s remarkable that that book, which sure is in need of updates and they talk about things like fever there, right? Is stand and still as this important tone from 30 years ago that has barely budged the needle in terms of how medicine is taught.
James Maskell: Well, they say it takes 17 years from science to change in practice. That’s a thing that’s talked about in healthcare, and there’s no thought that wow, that’s incredibly destructive or think of all the people that are going to suffer in the meantime, it’s just like, medicine evolves one death at a time, right? So it’s happening in that way. The other piece I want to get into is this idea of individualized medicine, and you had a great example in your book. I think, was it Laura? You were talking about the difference between normal ups and downs in mental health and psych meds and whether or not that’s appropriate and who it’s appropriate for.
You talked a lot about, there’s this variation between individuals that’s not really adequately thought through in the current state of what’s the best for the average human medicine, which is what we have right now. So do you want to dive into that a little bit?
Heather Heying: Yeah, absolutely. And so if memory serves, Laura is someone who’s reported on in, I think it was in Atlantic, maybe it was Harper’s. I can’t remember which or New Yorker article from a number of years ago. She’s this just this extraordinary young woman who had it all and then started to experience symptoms of depression and was given just one after another psych meds. As the story is reported, and I think it’s the New Yorker, both she and her doctors come to understand her as a machine, as a system that, “Okay, well, I’m going to take this one thing, but in order to deal with the side effects from that, I take the second and then in order to deal with side effects from that, I take the third.”
Because I’m a machine, we will be able to get this just right and humming along very smoothly. And this is we argue in the book and everywhere, an error that really does amount to, do you see the human body and every…depending on exactly what you think, but many billions of years of evolution that we have taken to get here through an engineer’s eye or through a biologist’s eye? If you think that we’re a machine, you don’t think we’re all that complex, and you may imagine that we’re static and that one single solution will get you there. And if you think that we are a complex system that is evolved and that can take feedback, and that therefore all also has individual perturbations, both from development and yes, genetics, but especially from development, then there is not, there is no chance of being a one size fits all solution.
Either for all individuals or even probably for an individual across a lifetime, through which they are changing developmentally, and just in terms of what they’re being exposed to.
Bret Weinstein: So I want to add two things. You can rely on the fact that development will be treated too lightly in virtually every conversation about pathology. And the thing about something like a human being is, yes it is an evolved complex system. It’s actually layers of complex systems put together in a master complex system, but it is not even that. We tend to arrive at the adult, we study the adult, and what we don’t understand is that development actually changes the nature of the adults in question. And so, much of what looks like tremendous variation in individuals is real, but it’s not necessarily reflective of differences in the genome, right?
So you will typically hear people talk about the fact that they’ve discovered that people in one category have more white matter than people in another category or something like this as if what they’ve just discovered is that there is some evolutionary historical predisposition in this way, rather than the developmental trajectory of somebody in one or this category or the other has resulted in a developmental feedback. So, we have to always pay attention to development and its role. And it’s hard to study because what you tend to want to do to reduce noise in the study is get everybody within an age class or something like that, rather than study all of the different stages that may be explanatory.
The second thing I want to say though, is that there is an error in both medicine and psychology, which is a failure to distinguish between adaptive pain and maladaptive pain, right? Pain is understood to be a pathology, right? And it’s not a pathology, it’s obviously an active adaptive of something. If you walk into a psychologist’s office and you’re in great pain over your social circumstances, it may be that it’s not that you have some oversensitivity, it may be that you’re being a jerk to your friends and they hate you. If you’re being a jerk to your friends and they hate you, treating your pain will make it worse, right?
You will become less sensitive to it rather than treating the thing that causes it. And the same thing is true, when you walk into a doctor’s office, your pain may be protective of you. Or it could be Phantom pain that isn’t doing you any good. And until we just realize, anytime a patient reports pain, the question is, “Oh, is it good or bad pain? That’s the first question you should ask.
Heather Heying: Yeah. Pain or discomfort, right. And you got there, but fever and nausea in the physiological space and depression or mania in the psychological space. Well, what is it that is causing that? Let us go there first and understand exactly, as Bret said, is this adaptive or maladaptive? That ought be the first question.
James Maskell: Well, look it’s quite telling that the NIH validated metric for pain is what is your pain out of 10, right?
Heather Heying: That’s it.
James Maskell: That’s it. If it’s high, let’s do something and if it’s low, great.
Bret Weinstein: Right. No, it should be how much pain are you in and how much pain you deserve to be in. You want to compare those two numbers.
James Maskell: Exactly. Yeah that’s so funny. Yeah, I think that’s such a great point and yeah, I’m excited to have those conversations too, because ultimately I think the longer and longer that you spend on…what I see with doctors is they may have one little moment that brings them to functional medicine, but the longer that they spend across with people, these pieces start to take up a much bigger part of their brain space, and then also they start to really think about, “Okay, who is this person across from me? What is the totality of their life circumstances? What are they actually capable of achieving? What’s going on the psycho spiritual level that is driving these patterns of behaviors?”
So just become more and more sophisticated a model and it moves further and further away from reductionism towards holism and-
Bret Weinstein: Well, hold on. We know that you’re an economist and the glaring perverse incentive surrounding the way medicine is dispensed now, right? What you’ve just said is that medicine gets better as a doctor spends more time with a patient. But of course, from a bean counter’s perspective and an HMO, right? The question is, well, how much of the time that the doctor spent with the patient was actually useful? And it’s hard to justify even the small talk between doctor and patient, but the point is, it may be that there is no shortcut, right? You may have to have small talk for the doctor to notice we were just talking to a pulmonologist we know, who says he doesn’t look for every cough, but he hears every cough.
It may be that the guy has to hear you speak for a half an hour before he’s gotten enough data to figure out what’s up with you. And the temptation to just cut these appointments down to 20 minutes and then we give you your prescription and you walk out the door, that’s a system designed to fail.
Heather Heying: Well, and I think 20 minutes is a generous estimation. I’m thinking…
James Maskell: Seven.
Heather Heying: Yeah, just personally, I happen to be, to know, and to see an excellent naturopath and an excellent osteopath and I also know some MDs. And the MD appointments tend to be like you say, closer to seven than to 20, if that, and the naturopath and osteopath appointments are always scheduled for an hour and they often run long. They never run short, right? And so too, a problem is the death of the site visit, right?
Of house calls, because now you can actually engage not just with the person, but you learn a lot by walking in someone’s door about whether or, oh, you live in filth, or it’s overcrowded, or I smell last night’s dinner. It suggests that there’s not good ventilation, right? You can learn a tremendous amount and how can house calls scale in a modern environment in which we live cheek to gel with people? It’s not clear, but there was clearly value in it.
James Maskell: Well, there’s a lot I want to unpack from that. So just to your last point, one of the interesting things about telemedicine is that now your camera is in your house.
Heather Heying: Yeah.
James Maskell: So I can see you now, and I can see you’re in your dark horse podcast, studio booth, but I can’t see the rest of your house, but we’ve been in the business of running these virtual groups for the last couple years. And we’ve had a couple situations where someone says, “Well, yeah, I’ve been eating the diet and I’m having salad for lunch and I’m having these healthy vegetables.” And go, “Okay, great. Well, why don’t you take us to the fridge? Let’s go and have a look.” And if it’s only Cheetos and beer, you know you may not be getting the full story. And actually, it’s a window into the home environment because people are now being seen in their home and there is an opportunity with the camera that you have to be able to get some part of that, certainly not the smell, but other parts of it.
The other thing I want to say is that know the topic of my first book, The Evolution of Medicine was really speaking to what you just said. Seven minutes is generous, but it’s actually only 14 seconds, because after 14 seconds is when you get cut off telling your story, typically in medicine. So you have 14 seconds to communicate what’s going on. And then, automatically you’re being put into an algorithm and then, at the end of that algorithm of them is some drug, and then it’s like prescribed and then you’re out the door, and that works really well for making money, but not for reversing complex chronic illness. So in the first book, we really talked about why it was imperative for doctors to leave the system, hang their own shingle, and to be able to practice in a way, and that naturopathic doctor and that osteopathic doctor in that case probably have done that if they’re able to do hour like appointments, because it’s very difficult to do our appointments on the insurance system.
Insurance is adapting a little bit. In 2021, we saw the biggest change in insurance billing, which is allowing, maybe the beginning of a resurgence inside the system. But what you described there was the core reality why for the first half of what I’ve been doing for the last little while, and certainly the decade 2008 to 2018, it was like, get out the system. It’s not serving you, build on an integrity based with your patient. And that had a couple of things that happened as a result that, one, more and more doctors started to move in that direction because they felt like a moral compulsion to practice in that way.
But secondly, this type of medicine became unaffordable because as long as there’s an hour and a half first appointment with the most expensive provider, you’re putting a financial blockage in the way of the lower 70 percentile of Americans for getting this type of care and that’s what we’re working on right now. But I think you definitely hit the nail on the head there, and I appreciate both of those categorizations and those contextualizations.
Bret Weinstein: Well, it’s also true that there’s effectively a cryptic competition. I mean, you could describe it as between two schools of thought, but really, between a pharmacological approach to everything and a systems approach, right? A doctor is supposed to be a scientist. This is a machine in front of him and, yes, I do like the analogy of a machine better than Heather does. But, anyway, it’s not a machine in the sense that your car is, it’s an aqueous machine for which there’s no instruction manual, right? But the point is it’s built to work. And to the extent that it is not working, that is because one of the systems, one or more of the systems that is designed by nature to accomplish something is failing to.
And the idea that adding something extra to the system is your best first move is preposterous on its face, right? Imagine we took this approach to automobiles. Your car is misfiring. And instead of answering, how do we restore the systems that cause the spark plug to fire at the right moment? We say, “Well, is there something that we could graft onto your car, an extra something that would make it work better?” That’s not a rational approach to a malfunction. You may have to resort to such a thing, but it should be a last resort.
James Maskell: The analogy that we use in functional medicine is taking a piece of tape and sticking it over the engine light.
Bret Weinstein: Yeah.
Heather Heying: That’s good.
Bret Weinstein: That will work to deal with at least one of the symptoms.
James Maskell: So look, the chapter on medicine was awesome and I highly recommend everyone watch that, but right after that, you had the chapter on food, which goes right into it. And when we started the Evolution of Medicine, I would say we were at peak paleo, right? The paleo movement was big. And people were talking about eating for the environment, and the brand of paleo, I guess, has gone down a bit and other things have come up and it’s all very confusing.
But when we started, that was a concept that was really coming into the mainstream as people were thinking, how are we adapted to eat and what should we use and what fuel should we use? So I’d love for you guys to just share a little bit about some of the conclusions you’ve come to with regard to food in your book. And obviously, I would say if root cause is one shining concept that people in our movement align with, the other is really food is medicine. And so, I’d love to get your take on that.
Heather Heying: For sure. Well, one of the themes of the book is we use an evolutionary concept called the, boy, I’ve now lost it.
Bret Weinstein: You want room to think?
Heather Heying: My goodness. Yeah, go for it.
Bret Weinstein: All right. So I’m going to jump in here. Let’s talk about a hidden issue at the core of the question of food and what you should be eating. We, modern folk have something marvelous that no ancestor had, which is we have access to tremendous variety in our foods, and that has a hidden health consequence that we never think about, which is it is almost impossible to track a pattern, right? If you’re eating different stuff from different parts of the world, every night you have something different for dinner and it has ingredients that wouldn’t naturally be together and the person who made it may choose a different set of ingredients, there’s no way to detect. There’s too much noise, not enough signal for you to identify. I mean, how many years did I live with a severe allergy to wheat without being able to detect the pattern when I eat wheat, I get sick, right?
That’s because there was wheat in so many things that it was a constant, and I thought that these were just features of life and then I had a mysterious asthma on top of it. So the point is, in order to even identify a basic connection between I eat that, I eat that nightshade, and then I don’t feel well in some way, you have to reduce the complexity of your diet, which is a very unnatural thing for us to do. But scientifically speaking, it’s analogous to purging all the phenomena from your experiment, but the one variable in question in order so you can see its effect in isolation. You have to do that thinking to overcome the downside of the admittedly, fantastic variety of foods that we have at our disposal.
Heather Heying: Indeed.
Heather Heying: I’m swimming in acronyms. I was coming up with all the wrong acronyms. So what I was looking for was the EEA, the environment of evolutionary adaptiveness, which is not new with us. This is a longstanding concept, specifically in thinking about human evolution. The idea that there was a moment in our past, which we’re adopted and we argue in the book and, again, well, not again, but the title of the book, a Hunter, Gatherers Guide to the 21st Century, seems to hearken back to that EEA, that environment of evolutionary adaptiveness on the African Savanna, maybe 200,000 years ago, maybe 100,000 years ago depending on exactly what moment you’re thinking about. Well, we argue in the book that there’s not an environment of evolutionary adaptiveness, there are environments of evolutionary adaptiveness.
And you go farthest back and most inclusive, we are life, and we are animals and we are vertebrates and we are mammals. And I’m skipping a lot of things here, but we’re mammals and we’re primates, and we’re monkeys and we’re apes and we’re humans. And within humans, we are indeed, hunter, gatherers, but we’re also, agriculturalists, and we’re all so post-industrialists. And so, each of those ever smaller nested groups reflects a moment in history and an environment, effectively, of evolutionary adaptiveness to which we are to some degree, adapted. And so, paleo, I think is basically predicated on the idea that there is one and only one EEA. That we are fundamentally hunters and gatherers. Although, paleo is mostly focused on the hunter part from the African Savanna, and that we’ve basically been static since then.
That our anatomy and physiology is best adapted to that moment. And the fact is that the vast majority of humans on the planet now have 10 to 12,000 years of agriculture in their lineage, in their history. And that’s a lot of time for humans to have adapted to an agricultural environment in which for instance, we’re eating a lot more complex carbs. And hunter, gatherers were actually eating complex carbs too, they were digging roots and corms and tubers and such. So, it wasn’t even a complex carb free diet back in, say, 100,000 years ago on the African coast or Savanna’s. But certainly, agriculturalists have been doing that. And the post-industrialist diet is not so good for us. We can pretty much all agree to that, but it’s very, very new with a lot of new compounds. So I think if memory serves, we begin the food chapter by saying, “Okay, what’s the best diet for humans? Let’s just give you that answer,” right?
And the answer is, sorry, no, there’s not going to be a best diet for humans, right? Both because we come from different places and just to pick two easy examples, what would be the best diet for humans that was both best for an Inuit and a [Maasai 00:40:04], right? There’s not going to be one because the environments in which they have lived for so long are so fundamentally different. But then, back to the individual, right? The individual life paths and trajectories that people have gone through means that a 5 year old girl, a 15 year old boy, a 30 year old pregnant woman and a 60 year old man and an 80 year old postmenopausal woman are all going to have very different dietary needs.
And those will be reflected somewhat in their desires, their hungers, and to some degree, they won’t be in this modern environment because we are being told, “Hey, we know what you like.” And pretty universally, there are some molecules that just satiate, that are appealing, sugar and fat and salt. But those things in different ratios throughout the life, and depending on your sex and your reproductive status and such. So, there is no best diet for humans. There may well be a best diet for you at this moment that can be predicted based on your history. But paleo, yeah, it’s probably good for some people, but not for everyone and certainly not for all.
Bret Weinstein: I want to stand up for paleo a little bit because I think it’s wrong, but it’s wrong in the way that a prototype is not an excellent machine, right? And the style of thinking that says, “You are not adapted for modernity is right, and the idea that you are therefore, adapted for something else is right.” And paleo isn’t even a terrible guess because we spent so long as hunter, gatherers, our lineage did. But the problem is what it misses is the rapidity that evolution can have under intense, selective pressure. And so, yes, we have millions of years of effective hunting and gathering, and we have thousands of years as agriculturalists, but we are much closer to those thousands of years.
And those thousands of years applied intense pressure to our species, but not even our species. It applied intense pressure that was differential based on what your ancestors were doing, whether your ancestors were terracing hillsides and growing rice, or whether they were raising meat, fishing the oceans. And so, we should expect not only that paleo is too simple an answer, but that the answers are going to be specific to population. And frankly, because many of us are of mixed origin, that raises other questions. What do we expect of the health requirements of somebody whose parents come from two different populations with very different diets, for example?
James Maskell: Well, based on what you just said and actually, bringing back your experience Bret with gluten, I would argue that because of that complexity that you just shared, it’s actually extremely difficult to have a top down approach to dietary changes and guidelines. And actually, the most elegant organized approach is essentially more like an individualized elimination diet like you went through where you take a bunch of things out, you reduce the signal, get the noise, you get the noise out, you get the signal, you see what works for you.
You work backwards and you build out your own strategy. And if you look at functional medicine, that’s typically one of the first things that happens because it doesn’t cost that much. It’s on the individual. It takes a little bit of application and engagement, but that’s actually, a fundamental underpinning of the functional medicine operating system and good practice, because you can do it with sleep and you can do it with stress and you can do it with exercise as well. So, the elimination diet is one of the reasons why I think functional medicine is very elegant.
Bret Weinstein: Go ahead.
Heather Heying: One of the tricks as all the clinicians in your audience will know with elimination diets is convincing patients that actually cheating ruins the experiment. That a little bit, and you experience this with gluten, but I’ve heard many, many stories across many kinds of elimination diets that you just take in a little bit, if you think, “Well, I just have to get this down to 5% of what I used to be eating of it.” You’re not going to clear your system, and you’re not going to get information, and it’s worse than if you haven’t done anything because you will think you have data now and you actually have misleading data.
Bret Weinstein: Especially if it’s immunological, right? The tiniest, tiniest contact with wheat sets off my syndrome, so that somebody who thought, “Well, I’ll figure out if I have a wheat problem, I’m going to try to eat no wheat.” No, it’s got to be weeks and it’s got to be perfect.
Heather Heying: It’s got to be zero.
Bret Weinstein: Or you don’t know, you have no data. The other thing I was going to say though, is that the idea that there is no way around the elimination diet for figuring out if you’re responding to some component of your food, right? And yet, most people can go an entire lifetime and never once engage in the experiment and not realize that they may be suffering for something for no reason. It may be a small component of their diet, but one that regularly shows up, something that would be easily avoided and basically, you’ve got two mindsets.
What’s more likely to work? A mindset in which you walk into a doctor’s office and they have an effective checklist that tells them what pharmaceutical to give you, which you will presumably need to be on forever if you’re responding to some component of your diet, or running an experiment, that, yes, is annoying but once we’ll reveal a tremendous amount and not having to take some novel compound that is sure to have side effects that you will not be able to predict, right? It’s no contest.
James Maskell: Yeah, absolutely. Well, look, I appreciate you sharing that. I guess I do want to talk about COVID, I do want to talk about politics. I do want to talk about vaccines and I want to get into that, but I have a pet theme that I love to talk about and that’s my second book that’s called, The Community Cure. And the book is really about functional medicine delivered in groups and what it takes to solve loneliness as a driver of all-cause mortality and how that’s done and how that is being done and giving examples of how it’s done.
But one of the things that I would love to just get your thoughts on just from a bigger picture and from the book as well is just from an evolutionary biology point of view, the importance of community, the power of community, and one of the features of modernity is isolation to a certain degree and how that translates into health and function and the way that we live in society.
Bret Weinstein: Well, the first thing to say is that it’s a mistake, an evolutionary mistake to think about an individual human. And it’s not that an individual human isn’t a meaningful thing, but it always exists in a social context. Always has. There’s no environment on earth in which an individual can survive independently to the extent that you might have examples in your mind of people living as hermits, they’re still using things. They’re using metals that were mined by somebody who knew things about how to do that and how to smelt them.
Heather Heying: Or they’re having food delivered to them.
Bret Weinstein: Right. There’s always another component. Surviving alone is not a possibility because we’re not built for it. We’re inherently social creatures. And I think Heather and I knew this before the pandemic happened, but the pandemic revealed something about our psychological fragility. That those people who did not have somebody with whom they were very closely bonded, with whom they could be frank about their doubts and their concerns about what they were hearing. People who did not have that, who had on the online friends and online connections were sitting ducks for bad, possibly malicious information.
And those who did have that, weathered the storm a lot better, because no matter what came across your screens, you could say to somebody, “This isn’t a adding up to me for this reason. I have a bad feeling about this message, which doesn’t seem to me can be right.” So anyway, the upshot is we are built to be communal. We now do in the modern internet environment, have a new communal nature that is springing up, but it is not inherently a substitute for what we had and having a partner isn’t a nice feature of life. It’s an essential component and people should prioritize it.
James Maskell: Heather, can you talk to it with regard to postpartum depression? Because I’ve always thought that when in history has the mother gone back to their own house with no other support, not from the tribe. And is it just a feature of the society that we’ve created, that postpartum depression because their mothers are cut off from their community, which is in no way evolutionarily consistent?
Heather Heying: Yeah. I mean, obviously, the medicalization of the entire pregnancy, birth, and neonatal process, much ink has been spilled on it. And it is doing almost no one any good. That said, medicalized approaches have saved some people under some circumstances, but once you have these tools, then you bring them in, and you use them even when they’re not necessary. So, the sending the woman home to be alone with a baby, especially if it’s her first and she’s never really interacted with a baby before, actually reminds me a little bit of the advice during COVID too. If you’ve got it, just go home, get your family sick and wait and see if you get so sick that you need to go back to the hospital, at which point, it might be too late to help you.
It is simultaneously and abdication of responsibility by society and, in that case, medicine and imagining that the tools are so empowering that at any moment that you step in with them, then it’s going to be a solution. I actually just received yet another heartbreaking letter from a woman who’s enduring some postpartum depression, although she doesn’t put it in those words, but is finding exactly this. The isolation that she’s experiencing with a new baby in the era of COVID where she has not fallen in line with the beliefs of her peers. And the impossibility of connecting is heartbreaking, as I said. And I guess if I can take it bigger than humans for a moment, the evolution of sociality is far older than us. We’re not the only ones who were social.
And the usual suspects are things like dolphins and wolves and other apes and elephants and parrots and crows and such. And what we all share is not just being social, but we have long childhoods and we tend to have generational overlap in the communities in which we live. And part of what that brings is people living together with whom they do not automatically agree or have the same perspective. And even in a hunter, gatherer situation, in which it’s small bands of people, who’ve known each other entire lives and will continue to know each other their entire lives. The perspective of a five-year-old, a 15-year-old, a 30-year-old, a 60-year-old and an 80-year-old are quite different.
And increasingly, what we have is either complete isolation, like with the response to someone who has had a medicalized birth and is sent home to tend to her baby mostly in solitary confinement at some level, but also, the well discussed silo-ing of people in the online community is such that increasingly you only see other people who already think like you do, and this itself can feel like community, but it’s actually incredibly isolating. Because anytime you do disagree with one of these people who you’ve come to understand to be just like you can feel like, well then is there anyone?
And if you are surrounded by people who have a variety of life experiences, perspectives, skills, and opinions, then when disagreement happens, A; you’re less likely to assume disagreement means dislike of the human being, and it also can leave you with a sense of, okay, that’s great. Let’s figure this out because we’re still part of the same community. We still care about one another.
Bret Weinstein: Yeah, and in this context too, the perverse incentives surrounding the managers of our online environment are also an important player. Because a human being is built to assess the likelihood that certain things are true and one of the tools that we use to do that is to figure out, well, how much doubt is there about these truths amongst people who have some insight? Well, if your online platforms are purging people who disagree with something on the basis that it is deemed to be misinformation, then what it leaves is the appearance of a consensus around something where there is no natural consensus.
And so, we over process the fact that all of the voices and everybody wearing a white lab coat with the stethoscope around their shoulders is saying the same thing. And that’s because the ones who were wearing the coat and had the stethoscope who were saying something different had been banished, right? That’s a hard environment to interpret because there’s basically, the equivalent of survivor bias in the data set. And were people able to hear the full range of opinion on these topics? The thing that would strike them is there is absolutely no consensus, right? We are not yet there.
James Maskell: Absolutely. Well, that’s a natural segue into talking about the pandemic and for those people who listen to the podcast regularly, we normally cut off sometime between half an hour and 40 minutes, but we are going to keep going because this is amazing. And I’m really, really excited to connect with you here. And before we get into the pandemic, I know that you travel in some interesting circles, both of you and you probably connect with interesting people. And I guess I just want to tell you directly, that there could be a lot of, there’s no hope for medicine, right? There’s no hope because of all the problems that we just shared and so forth.
And I will just tell you now, from my experience in the last few years, and particularly the last two years of creating virtual groups of people where people come in because they have a certain diagnosis and then work over a period of six months together to do the fundamentals of health creation, do elimination diets, work on these things together, you have diversity equity and inclusion happening in this group. You have the “yes’s” bringing “not yet’s” along with the journey. And I guess I just want to say to you that in this model of group delivered functional medicine, in my mind, rests the potential for the most elegant transformation of medicine that’s ever occurred. And that essentially a structure where big groups of humans can keep each other well for a fraction of the cost of any kind of conventional care. And so I just want you to know that as you go out into the world to know that in our world today and in this community, that is being worked out in every, from centering pregnancy for pregnant women that reduces preterm birth by 35% to cardiology with Dean Ornish, to Jim Gordon’s mindfulness based stress reduction groups to the Cleveland Clinic Center for Functional Medicine. This is happening. And I just want you to know that because I know that hopefully that message will be able to transmit through your connections.
But the thing that I really wanted to shift into is to talk about the pandemic. And I guess to contextualize it, the totality of my life experience over the last 16 years put me in a very interesting position at the beginning of a pandemic to have a different level of sense making than other people. Like I’ve seen lifestyle driven chronic illness. I’ve seen environmental driven chronic illness. I’ve understood the sort of gaps in the germ theory. And you know, how there’s a lot of talk in functional medicine about the terrain and really understanding how the same germ can have different effects across different broader populations. So I had all of that context. And then coming into the pandemic, our community went in a number of different ways.
And we could talk about the sort of the ways in which our community went, but I’m not sure if I ever would’ve heard about you guys, if it wasn’t for The DarkHorse Podcast. And I would just say that for myself, what I’ve recognized is that even though I come from economics and being in functional medicine for this time, and you guys come from evolutionary biology, one of the things that I want to just comment on is that as the podcast says moved along, and I think I’ve listened to at least a 100 out of 117 thus far, I would say that your view on what’s happening in the world and your level of sense making with almost everything from the vaccines to the truckers and everything in between, we’ve arrived at the same conclusions. And I guess, I don’t know… I guess maybe we can just start by commenting on the significance of that.
Bret Weinstein: Yeah. Well, it’s one of the strongest signals that you have something right. And I say this as primarily an evolutionary theorist, right? The signal that I look for when I have a hypothesis and I’m chasing it down is if I discover that somebody has arrived at the same thing, from a very different perspective, from a different start, a set of evidence from a different school of thought, maybe even from a different discipline, that is strongly reinforcing. Because the chances of coming up with the same model in two different ways, if the model isn’t highly accurate, is almost zero. So it’s wonderful to hear that you’ve arrived in the same place. I do think there’s an analogy between what we at least were doing during the pandemic and what we’ve described here as the best approach in medicine, right? We deployed an evolutionary toolkit, which is relevant to multiple levels of analysis in the pandemic, right? It’s relevant to the epidemiology, to the virology, to the medical conundrum faced by who contract COVID. And the fact is-
Heather Heying: The game theory of the perverse incentives of the various players.
Bret Weinstein: The game theory of the perverse incentives to the medic nature of the discussion around COVID. And the fact is it’s not a perfect toolkit as no toolkit is. But it’s an excellent toolkit from which to start making sense in this environment. And it worked very well, which we know because it was predictive of things that we could not have known early that turned out to be true. So anyway, it’s very gratifying to hear that you’ve arrived in the same place from a different perspective.
Heather Heying: Yeah, and I’ll just say, you use the word “consilience” here. That the explanatory power of consilient analyses is extraordinary. When as you say, you’re coming from an economist background, and you’re working with a number of doctors who came from that background, and there are so many people now who have arrived at, or were arriving throughout, through a series of presumably…you know, we’ve all made errors. I assume. Maybe. I won’t presume to speak for you. Maybe you haven’t. But we’ve all had misunderstandings, and it is incumbent on anyone who is trying to understand the world, really regardless of how far they share it, but certainly if they’re sharing it with a public to come back to that public when they do discover errors and say, “Yep, this one…this I think I got wrong,” or “I misspoke here and you could misunderstand that.” But specifically when like, “Oh, I actually think I got this part wrong.”
And in, so doing, you actually reveal to people how it is that you refine your understanding of reality. That is the scientific process. Even if it’s not done wearing lab coats and eye protection and using glassware. And it also doesn’t involve the explicit and formal collection of data. But it does allow for iterative thinking and refinement of ideas. And yeah, it is remarkable how many people are actually showing up, having had similar suspicions about things like very novel technologies in the form of the mRNA vaccines and who…for us at first with regard to those, our sense was probably we’ll end up getting them. We’re going to wait as long as possible because it is not possible to have long-term data on them because they are so new.
And low and behold, before we were forced to, to travel or anything, it became clear that actually we weren’t going to because the safety signal and the efficacy signal in opposite directions were both so strong. And one of the things that’s been surprising is that suspicion of brand new technology and relying on an understanding of systems and of, in our case evolutionary biology, but of what kinds of things you already know seems like a very sort of old school, frankly liberal approach. And somehow that approach has been reversed such that those of us who are taking it are often told that we are acting in an anti-liberal way. And that has been one of the very surprising things about the public response here.
James Maskell: Yeah. I think some of the most interesting characters in the pandemic are people who clearly would be considered, I guess, left wing in ideology. I’m thinking of a Glenn Greenwald or a Russell Brand, or a Bret Weinstein, who have come to be painted with the right-wing brush because ultimately…How do you make that sort of shift? And I’ve tended to sort of focus my attention and my sense making on those kind of voices, because ultimately if you’ve had a dramatic shift in the way that society views you, it must mean that you are holding onto some principle that you haven’t been able to be shaken on and therefore possibly worth listening to.
Bret Weinstein: Yeah, it’s a tell when the mechanism to get people not to listen to you is…
Heather Heying: Name calling?
Bret Weinstein: I’m thinking of it like, it’s just like, it’s some costume that you’ve been fitted with, but it fits so atrociously that you can tell somebody has plunked it on to you with the purpose of getting other people not to listen.
Heather Heying: It’s like that Monty Python skit. She’s a witch.
Bret Weinstein: Right.
Heather Heying: She is wearing the hat and the nose.
Bret Weinstein: Yeah. I was actually going to say earlier that Monty Python had published on the question of the medicalization of the birth process. And it is funny. There are a lot of places where they have anticipated this and you’re right, exactly. Dressing people up as witches is exactly what happened to me and Glenn Greenwald.
Heather Heying: This ain’t my nose.
Bret Weinstein: And Joe Rogan, Russell Brand, all those people. Yeah.
James Maskell: Yeah, absolutely. Absolutely. I think that’s super, super interesting. Well, on that topic, I guess. You said something once that I’d love to unpack for my audience, which is that in general, you would be definitely down with vaccines but not so down with taking pills. But in this particular case, you decided to take pills and not vaccines. And just to unpack some of that sense making for the audience.
Heather Heying: Oh yeah.
Bret Weinstein: So the first thing to say is that when the vaccines showed up, when it became clear what their nature was, we had a number of reactions to them. The first one was that’s fantastic, right? This is a new platform, a new mechanism for generating vaccines. And it is indeed very exciting for lots of reasons, including that it can very rapidly generate a vaccine. That said, there was so much about these vaccines that was not familiar from other previous vaccine technologies, that it was very clear to anybody who is aware of the history of medicine, that there were hazards that could not possibly be ruled out. And that there were hazards, that they were serious, and that therefore the claim that these vaccines were known to be safe was inherently wrong, right? The most that one could possibly have said at the moment that these vaccines were released was that so far, nothing had emerged to suggest that they were unsafe.
But the analogy I used was if you…safe does not mean harmless. It means known to be harmless. If you pick up a gun off the table and you put it to your head and you pull the trigger, it may go click and not harm you. But it does not mean that the behavior was in any way safe. It was in fact, very unsafe. And so the recognition that basically most people were looking at these vaccines and they were misled by the fact that they were going to be delivered in a syringe, which felt very familiar. Right? But that in fact, that syringe was misleading. That everything about the delivery mechanism here was novel and that that opened all kinds of possibilities, put us on alert that there was something that needed to be understood.
And on the flipside, at the time, the medication that we became initially focused on was something that had been extremely well studied. Something that had been given literally billions of times around the world had a safety record better than virtually any other drug in the pharmacopeia. And so basically the normal analysis, which would’ve said that a vaccine is a very elegant way to influence immunity, right? That was not true in this case. That this was a highly novel and unknown way to intervene. And that this particular drug, unlike some novel drug that’s been produced in response to a new pathology is actually a very old drug with a lot known about it, right? Those things turn the tables on the usual analysis. And as Heather indicated, as we waited, delayed our own vaccination, ultimately we were not vaccinated, but as we delayed, waiting to see if any sort of signal emerged that would tell us something that we wanted to know, in fact, a signal did show up and it was overwhelm.
Heather Heying: And just to go back to your original question about historically, why have we been enthusiastic about vaccines and less enthusiastic about pills? I think that can be revealed in what we have done with regard to two diseases, which is rabies and malaria. So we have both been tropical biologists. We’ve traveled a lot in places, and Bret was working on bats for a while. So we ended up being vaccinated against rabies. And we’re very, very grateful for it. As are all people who end up handling bats a lot. And rabies is such a terrifying disease for which there is no treatment beyond a certain point. That the idea that there was actually a vaccine that was available to us and that we had access to, it was extraordinary. We were so grateful.
Compare that to our experience, both of us in slightly different circumstances, but with malaria over the years where I have been on, I think, four different kinds of prophylaxis, some of which has been horrifying. You know, it causes paranoia and hallucinations and those types of things.
Bret Weinstein: Lariam?
Heather Heying: Lariam. Mefloquine. Exactly. And it ranges. And of course, some of them work on some of the species of malaria and not on others. And it’s all very complicated and you have to be very much on it. And, if you made the mistake of getting on Lariam and now you’re, as I was in Madagascar for many months, you don’t have any access. Like, well, I’m just stuck with the nightmares for months. I have been hoping for a good malaria vaccine since the early nineties and since we started traveling to places and doing research in places like Central America and Madagascar. And, so far, no go. It hasn’t happened.
But the bias has always been for us…because the thinking behind what a good vaccine does is so elegant, is one of these remarkable innovations of humans. That yes, if you have that treatment for a disease that is as dangerous as rabies, as malaria, maybe as COVID in some of its instantiations for some people, then that is preferable to being on some kind of treatment for life. Because no matter how safe, the drug to which Bret was referring earlier is ivermectin. And it’s incredibly safe, but I at least, and I know I speak for you Bret as well, don’t want to be on anything for the rest of my life. I want to be able to eat good food invariate, but I don’t want to be taking anything for some indefinite period. So, I’d rather get my immune system to get on board with knowing some pathogen, so that it’s going to be prepared when it meets it. But we don’t have that for SARS-CoV-2.
Bret Weinstein: If I can add one thing. Even in the case of our initial bias two years ago, in the direction of vaccines, this pandemic has been an education. And what I am now realizing is that I had a degree of the naivete that looks at the syringe and thinks that’s probably an elegant intervention. And even now just discovering the distinctions between a attenuated live, attenuated vaccine, and a killed vaccine that is heavy with adjuvants. I am now aware that there are perverse incentives in the production process that mean that one should be very careful. I think I would be remiss if I did not point out the connection potentially between the regular use of adjuvants. These are irritants that are added to vaccines to cause the immune system to wake up and react. The likely connection between the use of adjuvants and the many strange allergies that have blossomed since the number of vaccines has gone up is conspicuous.
So does my sensitivity to wheat have to do with the fact that I received an adjuvant in a vaccine as a younger person and that my immune system reacted to wheat that I had eaten. That seems likely. Is it possible those vaccines could be rendered safer if I had been given an instruction like for two weeks after vaccination, you should be very careful not to eat the following foods, right? Maybe there is such a way to do that. Or maybe the answer is actually, this is a dead end and we should not be producing vaccines with adjuvants. We should be pursuing ways to do this with live attenuated pathogen. And I don’t think we know the answers to those questions. But I do think once again, for the millionth time in the history of medicine, we have discovered that something that was promising had consequences we didn’t anticipate.
James Maskell: Absolutely. Yeah. And look, I think what’s happening at this exact moment is many people who have got this education during the pandemic are now reflecting on the rest of the world and asking good questions. So, one question that you might ask: If Heather suddenly fell pregnant and you guys were having another small child, would you give the Hep. B vaccine at birth? With whatever micrograms of aluminum in that. And does that make sense, given that your child is unlikely to become a drug user in the first 13 years of their life? And they only weigh eight pounds at that moment. So, those kind of questions, I’m excited to learn. Some people are very scared that people are asking these questions. I mean, you see someone like Vinay Prasad, who is scared that this whole charade and the way that it’s done has reduced confidence in vaccines and will for a whole generation. And I think it’s probably likely because of just the way that people have been sort of fed something that ended up not being truth and start to look into things like, well, where did this immunity for vaccine makers come from and why did it arrive? And what was happening in 1984 that meant that in 1986, they had to pass this bill. And you start going down those kind of questions and suddenly your Bobby Kennedy.
Heather Heying: Yeah. And if they want us to believe them, they ought not lie to us.
Bret Weinstein: That’s a good rule. I would add two things. With our own children, we did get one thing very right. It is now clear, which is with respect to the entire schedule of vaccines. Our rule was delay every vaccine as long as reasonable. Right? And the reason for that was that the later you give the vaccine, the more of development has already taken place. And therefore the less of a disruption it can have. So it doesn’t make any sense to vaccinate early for something that there’s no chance of contacting the pathogen. And your Hep. B is a great example, but I would say we should couple that with another insight, I think. So vaccinate as late as possible for everything, thereby reducing whatever harm they may be, but also it’s clear that we have not sorted out the question of whether or not there is a net cost for each vaccination.
James Maskell: Brett, I want to stop you there because I have my own theory on vaccines, and I wanted to drop it on you guys today.
Bret Weinstein: All right.
James Maskell: Get your thesis on it.
Bret Weinstein: Awesome.
James Maskell: So here’s my theory. And I think it’s pretty simple. I’ve only shared it once. And a few people started saying, “Wow, this kind of seems reasonable.” And I didn’t talk about it for a long time, but you guys are the perfect people. And you were just about to go there. The obvious thing to me is that vaccines operate…you have two things, right? You have a historical value, right? Net positive. Supposedly net positive or what we believe to be positive. And then you have a situation where we have the greatest rise in chronic pediatric illness in human history that no one knows what it came from. And there are certain individuals that may be the edge of the bell curve that very clearly have been injured by vaccines. Right?
So how do you put those two things together into a theory? The obvious theory from an economist is that vaccines suffer from something that everything else suffers for, which is diminishing marginal returns. And that the first vaccine for polio saves millions of lives. But the 72nd vaccine in the course for a human to grow up in America is you’ve probably passed the point of the top of the bell curve, and now you’re coming down the other side, and it’s likely to cause the range of chronic illnesses that kids have today. What do you think of that theory?
Heather Heying: Yes.
Bret Weinstein: So, well, first, I hate to do this to you, but I’m going to correct your terminology. It’s a hypothesis. It will become a theory if it’s true, which I think it likely is. But I would point out two things about it. On the one hand, it may be that… There’s the question. Once we say diminishing marginal returns, there’s a question about what the shape of the curve is with respect to this particular parameter, right? And so if we look at a given vaccine and it’s boosters. Let’s take the COVID vaccines. You might have one shape of a diminishing returns curve. And if you look across all vaccines, it might be a much better picture, right? Because effectively, when you alert the immune system to the existence of antigens associated with a pathogen, to the extent that you do that across a wide range of pathogens that aren’t similar, you may get a higher payoff per individual instance.
Now what you will also get is at least linear growth of the adverse consequences, the side effects of these things, which I now know we do not do a good job of tracking, right? And so there’s a question about…there should be a general question. How dangerous is the disease? How common is the disease? How do we rate the unknowns with respect to the cost, to the system of administering the vaccine? And were we to do that analysis with a reasonable term for the expected downstream consequences, we would, I believe, view vaccines as a very precious technology that should be treated with extreme care. That is to say, we shouldn’t just vaccinate. We shouldn’t look for a vaccine for every possible condition and vaccinate reflexively as if it’s costless. That’s nonsense. It won’t be costless. And we do have a great many mysterious diseases that are changing in frequency for which the explosion in the number of vaccines on the vaccine schedule is suspect.
But the other side of this is it is certainly going to be true, given the way pharma and government interact, that there will be an over enthusiasm for vaccines and that the customer won’t know what’s hit them, the customer patient. Because in effect, pharma can convince government it’s a very good idea to give a child this vaccine at this age. And then the point is the salesman becomes the doctor, whether the doctor knows that’s what they are or not.
Heather Heying: The doctor becomes the salesman.
Bret Weinstein: Right? The doctor comes into the room and says, “Well, yes. We typically vaccinate for this disease at this age. And it’s a good idea that you do it.” And the point is pharma is speaking through them. The doctor is not in a good position to say, “Actually, we don’t know the full spectrum of effects here. And the disease is very like unlikely to be one that your child is going to encounter. I’d recommend you pass.”
Heather Heying: Yeah. So I really like this. I think diminishing marginal returns with regard to the vaccines, any vaccines, is a great model. And then add to it, all of these other things, including for this disease, do we need one at all? For this disease, if we need one at all, do we need it for everyone? And for this disease, if we do need one at all, is this particular instantiation compelling? So put aside the SARS-CoV-2, the RNA vaccines for the moment, or really any of them as far as I know. I’m thinking about the cholera vaccine. I used to run study abroad trips a lot in which I was required to mandate yellow fever vaccination for my students. And I encouraged some of the other ones given where we were going.
And cholera was on the list that the CDC was recommending. And I always said to them, you don’t need this. We are going to be traveling to remote places. That is true. But we will have access to clean water. And cholera is not a risk to you. And furthermore, the cholera vaccine isn’t very effective. So this was an analysis that I was able to…I was allowed. I was encouraged to share back in the mid-eighties. And yet when you try to have that conversation now about a completely new vaccine, it’s considered somehow blasphemous. When, of course, we should be considering all of those issues.
James Maskell: Yeah. Well, that level of sense making that you shared there, and Brett, what you said about the doctors becoming the tools of the pharmaceutical industry, like that level of sense making is where I was sitting, coming into the pandemic that allowed me to sort of understand that context. And many other doctors do in that way, too. There’s so much to say on that topic. I’m glad you brought up Africa. My dad lives in Africa. I recently read Bobby Kennedy’s book and the worst part of it, the most horrifying part of it is to understand one, that products that get banned in Western countries end up in Africa. The way that those are tested and that whole structure there is horrifying. And I would encourage anyone with any sort of moral radar…that’s a very important thing to know and understand before we make conclusions about what should or should not be happening in the world.
But I want to sort of put, I guess a little bit of cap on that. Because I do want to talk about politics for a minute here too because actually it comes in quite nicely from what we were just talking about. You said something in the book, which is that liberals are prone to underestimate diminishing returns. And I think we just had a perfect example of it right there. But conservatives underestimate negative externalities. And you know, these are both economic terms, so you’re definitely talking in my wheelhouse. I’m sort of tasking myself or I’m sort of stepping into the ring to try and bring the functional, naturopathic, environmental lifestyle medicine [inaudible 01:23:16] the future. And I guess I’m tasked with bringing these sides, I guess, together in the context. So, I just, I guess I’d love to just get your thoughts on how you kind of came to that conclusion. And I guess spend a little bit of time just talking about the state of politics and what it’ll take to bring reconnection in times of great division.
Bret Weinstein: So let’s think about it this way. And I think that the key insight, right? We all have two kinds of friends. We have friends who may be liberal or conservative and think that their answer is simply correct. And then hopefully our smarter friends recognize that actually neither side is correct. And that the dynamism in the system comes from the tension between two different kinds of insight. And so the role of liberals in a system is to drive us towards solving solvable problems. But if that’s your bent, if you are the kind of person who identifies problem and thinks, “You know, there’s a way we could do better on this.” Then you are liable for reasons that have to do with the way trade-offs function, to be a little bit insensitive to the kinds of consequences that come from solution making that render a given solution not worthwhile. So let’s take an example like affirmative action. Affirmative action is a solution to a problem, but it also has consequences for how people view each other’s competence and things like this. So it’s not clear that it was a good solution.
On the flip side, if the role that conservatives play in a system is to constrain liberal solution making so it doesn’t run away and inflict us with all kinds of damaging consequences, then it results in a kind of stodginess, a failure of vision to recognize that a problem that we have is real, is worth addressing, and could in fact be made better. And so what we argue is that in effect, you need these two things to function, just like many systems in the body, like the motion of your arm is controlled by two muscles that pull in opposite directions to allow you to have fine control. If the battle was won by one of these muscles, your arm would just be extended, it’s useless.
Anyway, our point basically is that liberals are a bit too optimistic about solution making and conservatives are a bit pessimistic, and that I will say, we have found ourselves rejected by the current Left, which I think is an indication that the current left is pretty naive, but embraced by many on the Right, who accept us as liberals. Now, there was a question, many suggested, “Oh, you’re welcome to conservatism.” Our point is no, our view of the necessity of solutions hasn’t changed. We’re still liberals. But each of the people that we have bonded with on the other side of that divide is also aware that they are not interested, they are conservatives who are not interested in conservatism winning. They are interested in conservatives and liberals teaming up to make the system function.
And so I will just conclude by saying, you can tell a wise liberal if they understand that they should not be committed to solution making in all circumstances. So I always say that I’m a liberal who hopes to live in a world so good that I get to be a conservative. And the whole point is you’re either headed somewhere, then if you got there, you’d stop trying to improve things, or you’re not, or you’re just trying to improve things because it’s like a fashion statement. And it is the intent to get somewhere worth conserving that we should all be interested in, I believe.
Heather Heying: Yeah. Something you said, brought up…I haven’t thought to frame it this way before, but in a way, there’s an opposite temporal direction fantasy for maybe traditional conservatives and traditional liberals. Traditional isn’t the right word here, but it is a fantasy about the past for conservatives and a fantasy about the future for liberals. And those of us who insist on continuing to call ourselves liberals or even progressives, although we bear very little resemblance to most people who would use those terms about themselves now, are looking for a way to make the world a better place for everyone, but it’s not utopian. We are anti-utopian. And similarly, those who imagine that we can get back to a past that was somehow perfect, that’s also a fiction. I will just say that I never saw coming the adduction is to abduction as conservatives is to liberals. So that’s a new one.
Bret Weinstein: Yeah. I had something else I wanted to say.
James Maskell: I guess, I don’t know if it’s completely connected of this topic, but one topic you brought up in your book and I’ve heard you talk about a lot in the podcast that I wasn’t aware of is this idea of Chesterton’s Fence. And I’d love for you to describe that for the listeners, because I think like an obvious one in my world is like, “Well, let’s just get rid of the appendix.” And I think that was early on when I started to learn about the microbiome. It was just such an obvious example of like, we don’t know what we don’t know, and let’s not go arbitrarily cutting things out if there is some potential upside that we don’t understand yet. And I think it talks to this because it might be conservative to think, well, we should probably just wait and see, and maybe it does something that we don’t understand yet, as opposed to the progress of like, this thing causes appendicitis, let’s take it out on everyone.
Heather Heying: Yeah. Well, I mean, I think Chesterton’s Fence has at its base an understanding that if a system has existed, it at least at some point had a function. And so the fence might well not…the idea is two people walking along a road, run into a fence, and one of them says, “Let’s get rid of it.” And the other guy says, “You shouldn’t get rid of it until you know why it’s here.” Basically. That’s a relatively simplistic argument with regard to the fence because there’s a good chance that someone did build the fence and it really doesn’t no longer have a function and a person could get rid of it. But the point is you shouldn’t be allowed to get rid of a thing until you know what its function is or was supposed to be.
But we say in the book, we say, you know, let’s apply that, let’s talk about out Chesterton’s breast milk. Really? Formula replacing breast milk? Are you certain? Chesterton’s religions. Chesterton’s indeed appendix, Chesterton’s organs. And we talk in the book about how 100 ago, there was a move of foot to take the large intestines out of people by many in the medical establishment, because they imagined that it wasn’t functional. So this is an absurdity when you talk about the large intestine, but still today, many people think that the appendix is just “vestigial.”
Bret Weinstein: In college, I heard the story of the appendix in the biology class of its being vestigial and knew it was wrong. Evolutionarily speaking, the story doesn’t make any sense. It turns out more reasons than I understood. One, it is not the remnant of a cecum that ancestors had because there’s no phylogenetic evidence that our ancestors had a cecum. So it’s some object that exists. It’s built out of material, that material has a cost. And as you point out, there’s another cost of the thing becoming gangrenous and killing you. That’s an awful lot of cost to bear for this structure, which implies a benefit. I guess I would just say, this is one of the reasons that we so love the evolutionary toolkit that we used to do analysis is that it doesn’t depend on having the full story in order to know that there is a story.
In other words, it’s actually a mechanism. It’s like a treasure map that has Xs on it. You know that the appendix has to have a utility. That the very nature of it guarantees that evolutionarily it will have had one. And to the extent that you can’t spell it out, it tells you there’s something valuable to be discovered. And it was years later that it was discovered what it’s likely purpose was, which is the basically preserving an isolate of a functional community of gut flora to repopulate after an illness, which then does explain exactly why you can take it out without a serious harm. And our ancestors were stressed for caloric resources and nutrients in a way that we are not. And so for them to have an elegant system that repopulates the gut quickly and therefore reduces the loss after a gut infection was vital. For us, it may be desirable, but it is not essential for life.
And so the idea that the whole story ultimately puts itself together over the course, you know, it was decades after I had my initial thought, “I don’t know why the textbook is telling me this wrong story, but it’s obviously wrong.” So anyway, that’s a plug for evolutionary biology. If you want to see ahead into what medicine and science is going to discover later about human beings, evolution is the way to go.
James Maskell: Well, let’s, let’s look ahead to wrap up here. And I do want to talk about education because obviously that’s what you’ve been involved with. And obviously, there is a reeducation sort of necessary. Ultimately, a lot of the people that we’re speaking to have gone out beyond their own medical education for further education to try and stay more relevant and have the tools to deal with today’s chronic illnesses. I think one of the themes that I came into this pandemic with too, or some of the sense making was that just science was broken and that’s something that we’ve definitely agreed on. And you’ve actually helped my understanding of how that happened. How did money come into science and cause it to be, you know, create divorced from the truth.
I was like, I’m going to remember it terribly. But one of the funniest things I ever heard on the podcast is when you were talking about that guy who created ridiculous papers and pushed them around and they all got peer reviewed, and the whole thing was a big joke and got fired. Would you tell that better than I can? Because I just think it speaks to just the sort of nature of what science has become and I think plugs into like what hope for our education system moving forward. You know what I’m talking about right?
James Maskell: There was a friend of yours who made up some—
Bret Weinstein: Yeah. Yeah. So Pluckrose and Lindsay wrote papers. They actually thoroughly educated themselves in critical theory. They are actually all now deeply steeped in it. They’re not believers in it, but they—
Heather Heying: Postmodernism.
Bret Weinstein: —they speak it natively. And so they wrote papers that were absolutely preposterous and submitted them to journals for review. And in fact, got several of them reviewed before someone blew their cover.
Heather Heying: And one of them won an award.
Bret Weinstein: Won an award. Now, there is a fly in this ointment though. And what we told them when they revealed the hoax to us before it was revealed to the public, what we said to them was, “That’s hilarious and tragic, but you needed to run this experiment on science journals too.” Because as much as science journals wouldn’t have fallen for the diversity, equity, and inclusion critical theory stuff, science journals are afflicted with a parallel pathology. One born of group think and perverse incentives. And basically, you have to understand that what has really happened is that a system of discovery has been plugged into an economic architecture that has overwhelmed it. And science used to function because in the end, the way you did well in science was to be right. Now, you can be wrong and you can advance your career and it may be discovered 50 years after you’re gone that you had it incorrect, but it means nothing to you. So it’s the economic system has overwhelmed the incentives in a scientific system.
Heather Heying: And two of the prime ways that is happening are peer review, which sounds like an amazing idea and could probably be done in a way that was effective and not gameable. But because we have such a reductionist, canalized training system in medicine as well, but science, we are more familiar with what is going on in science. When you submit a paper and it is sent out for peer review, it is likely to go out to the same people over and over again. And those are likely to be people who you already know or are working with because there’s only depending on how big your field is, six, eight, 10, maybe it’s 60. But generally a small number of people who think that they have the capacity, who are specialists enough to assess your paper.
And so you end up with a small group of people who are typically going to be reviewing each other’s work. And even though it’s blinded, of course, they can tell because they all know what each other are doing in the labs. And in order to get along, in order to make progress career wise on an individual level, you are not going to be able to say to people when they’re doing very poor work, “Actually, I really don’t think this paper should be published.” And so there’s that perverse incentive to basically keep on patting each other on the back and encouraging work, regardless of how good is. And of course, papers, the publisher perish model of academia is papers are the indicator of success and papers are the indicator along with grant money.
So big science is encouraged not because big science is better than little science, but big science costs money. And that itself is a telling statement right there. Like the idea that the science that is most encouraged is the science that costs the most money is absurd, and it’s really backwards of what should be. But because universities take a cut that’s anywhere from 40% to 75% or even higher of all the grant money that comes in, they encourage A, scientists to only basically do big science and to do that to the exclusion of teaching and governance, so that they’re involved in less and less of the other aspects of a university life. And that research is then going to be funded more if it gets published. And then those people with the papers who have patted each other on the back in order to get peer review can go and get the next grant.
And so it becomes basically a business proposition. You know, “What do you do?” “Well, dominantly I’m I do science, but I’m actually a PI, principal investigator, which means what I do is I get grants, I get grants and then I put my name on papers and other people do the hypothesis testing and the analysis and the writeup and the literature review. But I’m the last name on the paper, which means I’m the guy who got the money.” And the that’s so too much of what is happening in science these days. And frankly, it’s even worse in medicine because the funding.
In fact, just today, I think I was reading in the magazine science that the new budget for NIH, NSF have come out. We need to be funding given that science does take money to do, but I was actually surprised at the relative…I shouldn’t have been maybe, but at the relative budgets of NIH, NSF is getting, I’m going to get these numbers wrong, but something less than 10 billion a year, and NIH is getting an order of magnitude more than that, maybe not quite, maybe just five times more than that, but a lot more.
Bret Weinstein: But the problem is if you zoom back out, you will realize that actually the system we have built is not necessarily interested in making discoveries, that the reason that all the individual scientists and doctors went into these fields, those things get changed by effectively the developmental environment that they are in as they are incentivized in these ways. And in some sense, it’s a little bit like the vaccine again that we mistake for elegant because it comes in a syringe that looks familiar. When people say peer review, they think, “Well, that’s how science is done. Peers have always reviewed other scientists work. Are you against that?” And the answer is, no, peer review doesn’t mean review by peers. No scientist is against reviewed by peers, but peer review is an invention, a system that is done behind closed doors anonymously, and it breaks science.
And one of the things that was so interesting at the beginning of the pandemic was that there was no time for peer review, right?
Heather Heying: Yeah.
Bret Weinstein: Peer review disappeared because the thing was so rapidly moving that everything was being done on pre-print servers.
Heather Heying: It was amazing. It’s was the Wild West.
Bret Weinstein: Yes. Did that mean that the quality of thinking went down? No, it went up because it democratized and it brought everybody in and there was lots of bad work as there is lots of bad work in the standard peer review system. But the fact is we were able to make better sense without the peer review system than with it, which ought to tell us something.
James Maskell: Yeah. It’s interesting you say that. So early in the pandemic, I was on a Facebook thread with a lot of doctors, mainly from San Francisco that I really respect and very quickly they were iterating on the best pro COVID protocols. It ended up looking like hydroxychloroquine and zinc and those kind of things. And then it wasn’t until a few weeks later that that was politicized where like the chatter suddenly went down and everyone was a bit confused as to what was happening, because that was literally just like smart people all working on the front lines. I just happened to be in that group because someone added me to it and witnessing it, and then going, hang on, is this really being recommended by Trump because he’s got a cut in it? Which was sort of like what was on the TV, or how have these doctors come to the same conclusion, and I’m just sort of just working inside of it. So that was some of my first tells that like, hey, this there’s something weird going on here.
One question that came in related to education that I want to ask you is, you know, your kids are a bit older than my kids, but I have this question too. What are you going to do for their higher education? I mean, you’ve been famous for being at Evergreen and the culture there sounded amazing obviously before you left, but what are your hopes for ongoing higher education for your boys?
Bret Weinstein: Well, we have a problem which is implied in your question, which is that there is no answer to this, which doesn’t necessarily mean that they should not go. We have institutions that are actually actively miseducating students. They’re teaching them increasingly things that aren’t true. Do you send your kid to such a thing? That depends. It may be that they have to go to such a thing in order to get a degree to get a role in civilization that is suited to them, and somehow they need to develop an immunity to the wrong things that they will be taught.
Heather Heying: But that’s recognizing that that’s four years and a lot of money for a credential as opposed to foreign education.
Bret Weinstein: What that is a racket.
Heather Heying: Yes, absolutely.
Bret Weinstein: And so let’s at least recognize the racket and recognize that the amazing thing about this racket is that it is so powerful that it has managed to prevent there from being a single institution where those of us who don’t want any part of that nonsense can send our offspring. So we call that the zero is a special number problem. And the answer you’re looking for doesn’t exist, but hopefully someone will generate an institution that succeeds in producing a model for how to educate in modern times without this perverse incentive.
Heather Heying: What we don’t need is Harvard 2.0, or recreation of the ag schools. Some of what exists now could be saved. There are two initiatives, two new institutions of higher ed that I have some hope for. There is Ralston College in Savannah, Georgia, which will, I guess, actually be accepting students for the first time this fall. And then there’s the University of Austin, which is newer but faster growing in Austin, Texas. And we have some affiliation with and our eye on both of those and have hope that they are not merely anti diversity, equity, and inclusion in the worst sense of those words, but rather actually interested in seeking truth, understanding the tensions between orthodoxy and heterodoxy, and celebrating both in whatever forms they arise in.
James Maskell: Beautiful. Well, look, you got a bit of a head start on me. So by the time my eight-year-old is ready for it, there should be a few more options. And look, I want to say thank you for today. I mean, I really feel like, as I was listening to this and we went through the whole thing, I kind of feel like when new doctors come into our ecosystem and are like, “Hey, what’s this whole thing about?” I could just play them this and they’d be like, well, either you deeply resonate with these concepts and these ideas, and you want to be part of that solution and you want to show up to be in community with other doctors who are doing it, and you want to shift medicine in a way that is likely to deal with complexity, or this is repulsive somehow, and that’s fine too for now. Because ultimately if we want to flatten the curve of healthcare costs, that is going to take a lot of people and a lot of action to make that happen.
So I guess I just want to share my appreciation for the work what you do, the way that you stood up in the pandemic. It’s interesting because we are filming now, basically two years after the beginning of the pandemic or almost exactly. I was actually in India when the whole thing went down, had to fly back quickly. But I would say that it’s really interesting to look back and see what you were talking about two years ago on social media, because it was the very early days and no one knew what was what and a great, great journey. But I want to say thank you for what you’ve shared.
When I said I was going to be interviewing you, there’s a lot of people from my community who share much appreciation for the way that you have participated and led in the pandemic. I hope that as things move forward, that some of what you propose I hope is wrong and some I hope is right based on like the desire to see the least amount of suffering, I guess, and just grateful to have this time with you and to connect and a lot of gratitude from our community to the evolutionary biology community for giving us a framework to understand what’s real, what’s not, and what’s possible.
Heather Heying: Well, we are grateful and honored and it has been such a terrific conversation. We hope, I will speak for both of us here, to continue to have interactions here and have connections.
Bret Weinstein: Yeah. Lovely to discover a parallel world of people who are apparently thinking clearly about this.
James Maskell: Beautiful. Well, this has been the Evolution of Medicine podcast. I’ve been here with Bret Weinstein and Heather Heying. They are authors of a book called A Hunter-Gatherer’s Guide to the 21st Century. I highly, highly recommend it. I listened to it twice on audio book. I love the way actually you go back and forth in the chapters, works very well. But it’s good to have a copy too. Thanks so much for tuning in. We’ve got some epic podcasts actually coming up. I’m getting re-energized on this format from conversations like this. So thanks so much for tuning in and we’ll see you next time.
Thanks for listening to the evolution of medicine podcast. Please share this with colleagues who need to hear it. Thanks so much to our sponsors, the Lifestyle Matrix Resource Center. This podcast is really possible because of them. Please visit goevomed.com/lmrc to find out more about their clinical tools like the group visit toolkit. That’s goevomed.com/lmrc. Thanks so much for listening and we’ll see you next time.
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