The Exchanges

Q What, what was their re, I mean, I, maybe there was a good reason why they did that. Like, if you had to make the argument for why that was a good reason, if you, if you could, What was their reason?

A Well, Flexer who wrote that report in, uh, 19 oh nine. So it's still the guiding law today was a paid lawyer of Rockefeller who invented the pharmaceutical industry as byproducts of oil production. He figured he could make them into certain, uh, pharmaceutical cures. So he is the father of the modern pharmaceutical industry and the funder of our top med schools like Johns Hopkins. And he did see economic opportunity and basically professionalizing medicine, siloing conditions and making money by, by treating. Um, I think there's a way you could spend that in a positive way. I mean, it was the wild west and a lot of witch doctors out there. And I think in their minds, they were trying to make it more professionalized, but there was a clear economic opportunity to name and silo conditions. Um, and then profit from the intervention, not from making people healthy. And there was a very clear, you know, you look at Johns Hopkins, uh, the, the guy that started that school, William Halstead, he denigrated nutrition, denigrated any type of holistic thinking. To this day in medical education, when my sister brought up that somebody with migraines might need to have a dietary intervention, her attending surgeon said, stop being a pussy. We, we didn't go to nutrition school. This kind of idea of delegitimizing any exploration. Um, first day of Stanford med school, uh, Casey, uh, was told …

AI assessment note: “it was the wild west and a lot of witch doctors out there”

Q was their, their genuine conclusion after doing the research and the study was that the opioid thing is overblown and we should pay more opioids for Americans, right? Do you believe that they felt like a little conflicted, like, hey, my gravy train shuts off if this goes down, so let's find some middle ground. Do you feel like they are intentionally misleading or that that's genuinely what they believe?

A Very, very good question. I think the reason maybe a lot of listeners and I used to have Trouble believing this is because how can this be so evil? So let me break this down. The genius of the healthcare system is that it takes very good people and puts them into a system with plausible deniability. So the problem is that nobody actually has full responsibility for why the outcome that the healthcare system should be solving for, which is people getting sick, why that's exploding as everyone's making money. You know, the doctors can say it's the food company's fault. The food companies can say it's personal responsibility. The med schools can say, we can't control what Americans do. We're just gonna keep growing and making money. The pharma companies, you know, rally about, you know, making stands and curing the sick patients in front of them. So everyone, the, the systemic design of the, uh, of the healthcare industry is, is actually genius, um, because it can allow people actually almost a virtue signal about doing the right thing while producing, um, well, not, not necessarily evil. It's evil, but, but it's producing what the system's designed to do, which is growth. So that's one dynamic with the healthcare system. If you go down to your question, Sean, and I've really, Casey's been exploring this. We talk about this in our book. I have to put some culpability on people in …

AI assessment note: “takes very good people and puts them into a system with plausible deniability”

Q and, and shaped the way you think about the world. You said something that the most formative experience was a HBS class. So Harvard Business School class where a professor said that the most depressed group of people he ever studied was HBS people 10 years after graduation. Um, what is that story and why would Harvard Business School grads 10 years later be the most depressed group of people?

A Yeah, it kind of made me think about the Scott Galloway interview you guys did where he's like, you know, don't chase your passions. I just, I really don't think that's the right advice. I don't think we have an epidemic of people, you know, not, you know, fully, I don't think we have an epidemic of people chasing their passions too much. Um, you know, what I've generally seen, um, is a lot of our trauma and expectations for society, you know, throwing really good human capital into suboptimal roads. Um, and yeah, so at HBS, and it's just one microcosm, You know, but, but just something I saw, everyone writes their application essay about, you know, transforming and disrupting the world, disrupting healthcare, disrupting, you know, energy, big industries, having a big impact. And then, like many things, you, you get into that room of, you know, of a thousand people, of kind of, you know, A-type people, and, uh, it's a conformity factory. Um, so, 85 to 90% of people by the end of the two years end up going into traditional industries, into finance, into energy. You know, my friend, uh, personally wrote an essay about transforming healthcare went to McKinsey, and, you know, I was on the team that, uh, helped prescribe more opioids on their side that, that recently had to set a lawsuit. So, So you have this dynamic. I think this happens at many layers throughout the country where,…

AI assessment note: “it's a conformity factory. Um, so, 85 to 90% of people by the end”

Q Can you explain, I don't know how much you know, but can you explain how Ozempic actually works? What does it do? That lets you, that, that causes the weight loss. Uh, what is the function? Uh, what is like the pathway that it uses?

A Yeah. I mean, so, so the truth is we don't fully actually know all the mechanisms, but GLP one is a, uh, our body actually produces it and it gives us the feeling of satiety. So it actually is basically just a supplement that's jamming our body with more of this peptide. Um, it's like taking a bunch of vitamin D or taking another supplement. You're basically taking a supplement of a peptide that our body Naturally produces to trick our body into feeling full. Um, so, you know, again, that, that's not really solving the root cause. A couple quick points to what Sam says. I think we're in full agreement. I think the drug should be available. I think people should be able to hack with it. You know, but Scott Galloway was recently talking to you guys. I think, I think he mentioned this. He said this is the biggest, a bigger economic opportunity for the country than AI. He said that the vast majority of American people should be on this. That's the stance of the medical Community. The stance of the various medical associations and the FDA is that this drug should be prescribed to the median American. Basically that it's so hopeless that we're so addicted to ultra processed food that we need to stimulate ourselves with the peptide in order to trick ourselves into feeling full. Essentially it is liquefied anorexia. I mean, truly, truly that's what it is. It's, it's, it's, it's making …

AI assessment note: “peptide that our body Naturally produces to trick our body into feeling full”

Q Is this legal? Like, can you Google, like, like, psilocybin retreat near me? Yeah,

A yeah, so I, I, I, I did it in a, it's legal in some countries. Um, there's a, uh, phase three FDA approval in the United States, um, to make it legal, which we're, Justin and I are actually advocating a lot on, too. I think it fits into the whole root cause health thing that we're trying to push forward. There's sort of religious exemptions. There's a state by state, um, decriminalization. So I'm not going to give legal advice. I would, I would urge people to find a responsible legal, uh, way, uh, to do it therapeutically in a, in a trusted, safe setting. Um, and, um, yeah, and Sam, it's, it's just, it's just about whenever you, you feel called, but, uh, But it's four hours. It's exploring your, you know, your, uh, it's holding us all back, right? Just different narratives and stuff. I mean, I think you guys are amazing how openly you talk about kind of your mental models and stuff. It's just a way to like zoom out and re-explore those.

AI assessment note: “it's legal in some countries. Um, there's a, uh, phase three FDA approval”

Q So what, what, what did you, what did you eat for breakfast, and what are you gonna eat for lunch?

A No matter what dietary philosophy you are, I try to eat whole foods. I had eggs, right? Pasture-raised, so, so look, look into the quality. So the first step is to reduce ultra-food consumption. That's the thing I'd say, first and foremost, that is what most people are not doing. Even if you don't get into the type of, types of food you're eating, That's the first step. I guarantee you, if you are on the hunt to rid your, uh, fridge of ultra-processed food, being on the hunt for those three, those unholy trendy of three ingredients, added sugar, processed grains, and seed oils, you're gonna get to the next level of the quality of the food. The first thing to do is ultra-processed food.

AI assessment note: “I had eggs, right? Pasture-raised... So the first step is to reduce”