The wellness industry is lying to you

Right. That's fish oil. Fish oil.

You know what? You get no. Put that down and go cook yourself a piece of salmon.

Thanks for having us.

Glad to be here, Kara.

Thank you. Good to be here, Kara.

Okay. Well, I think many people remember my husband Jay was diagnosed with stage 4 colon cancer in 1997 and died 9 months later. He was just 42 years old when he passed away and our daughters were six and two. It was really my first experience losing someone close to me and my first experience with cancer in a real way. And so I think because of my position at the time, I was co-anchor of the Today Show, I used that as an opportunity to educate the public about colorectal cancer, which is now the number one cancer killer of people under the age of 50. And we can talk in a little bit, Kara, about early onset cancers, which are on the rise. But subsequently,

I lost my sister Emily to pancreatic cancer just a couple years later when she was 54 and a rising star in the Democratic party in Virginia. Anyway, as a result of those two losses, I became a fierce advocate for colon cancer screening and cancer research in general. I am one of the co-founders of Stand Up to Cancer and really advocating for early detection screening and more research dollars committed to finding better treatments and one day hopefully a cure has really been my most important life's work.

I think I hope, you know, one of the things that I've been able to accomplish is to destigmatize these diseases. You know, I think even though Ronald Reagan had, you know, polyps and I guess did he have early stage colon cancer? I can't remember. There's still this shame and discomfort about talking about that part of our bodies. And like every part of our body, as Amy will tell you, we have to keep that healthy.

And I think I later was diagnosed with early stage breast cancer just a few years ago. And so I use that as an opportunity to educate women about dense breasts and the fact that mammograms alone can't necessarily detect breast cancer, especially in the 42% of women over the age of 40 who have dense breasts. So, I've really tried to use my personal experiences, Kara, dealing with these various forms of cancer to educate, first educate myself and then share what I've learned with the public at large and it's been really gratifying work for me.

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

Thank you.

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

Well, as you mentioned, I'm a physician. I have been a doctor now for what, more than 35 years. I'm an anesthesiologist and so a lot of my practice, more and more because insurance pays for it, is doing anesthesia for colonoscopies and upper endoscopies. So I certainly see a tremendous amount of those kind of cases and I do also, my specialty is liver transplantation and just general surgery as well. So I'm seeing a lot of younger and younger patients, you know, with cancer, not just, you know, colon cancer, but colon cancer that's metastasized to the liver and to other areas where that is now a problem. And I don't know, Katie, I'm so sorry about your husband. It's just tragic. I don't know if you know that Kara and I lost our dad when he was 34 years old. He had a berry brain aneurysm.

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

It's so. But you know, Kara asked how we got involved in health issues. Oops, the lights just went out on me here. See, I'm in a... Anyway, I'll see if I can get him back on again. We are, you know, we're from a health family because, you know, we've had other, my aunt was a physician as well and I personally have had issues with, I have muscular dystrophy as well. And I've been dealing with that since age 40. And very recently, unfortunately, in the last year, my wife was diagnosed with stage three colon cancer.

Yeah. So, and she's doing well. But I mean, certainly, I suppose over the course of this, we can talk about some of her experiences.

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

Thank you. I feel good.

Well, that's where we can talk about issues about screening, etc. I mean this is something that I'm sure this conversation we can discuss about screening and about the values of, you know, predictive testing and various things like that. Yeah, anyway.

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

Exactly. And that's and it's very true with colon cancer. Many people like my wife for instance who had a normal colonoscopy 10 years ago out of the blue developed colon cancer just 6 months before her next colonoscopy.

Of course it is. Unfortunately, that's what the guidelines are.

Yes, we'll go into that.

You know, I read a book a while ago called The Death of Expertise. So many people, I guess I don't know really why it's happened, but this idea that experts shouldn't be trusted is so counterintuitive and antithetical to everything I believe. You know, people with this deep knowledge of a topic, and I mean I think part of it is what Amy has investigated, which is this plethora of wellness influencers, right, who purport to have a background that would allow them to give medical advice and they don't know shit from Shinola basically while we're on the subject of colonoscopies. And there's just this widespread effort to basically tell people things that have nothing to do with expertise. And I mean there's a whole psychological thing going on with misinformation. I was talking to David Axelrod earlier today, we were going to be doing a panel on truth and facts and

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

I think there's a few things that are super problematic within the medical profession that have happened. One is the increase in sort of for-profit endeavors inside of the medical community, right? So, if you have a doctor who's pushing their own for-profit supplement line, for example, we all know that supplements, they're not great, right? They're not going to improve your health. Very few...

That's not true. Some are good. I mean, like if you have a diagnosed deficiency in vitamin D, if you have a diagnosed deficiency, iron deficiency, you need to supplement. But really, the first line of defense should be a healthy diet.

So because of the way the healthcare system is set up, a lot of people go to the emergency room when they're sick. They don't have a GP who they have a relationship with. So if you're feeling sick, you don't call, you don't have your doctor who you're able to reach easily, right? So the idea that Dr. Oz is so-called America's doctor is more true than... I mean, you're getting a lot of your health information on social media, on television because you don't have that personal relationship with a doctor who you trust, who's someone you know, you have known for years, who's familiar with your health history. So you don't have that relationship, so you don't have anyone that you trust, so you're turning to these other sources, these parasocial relationships.

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

I think that's totally fair. I think what I mean by it, I think the supplement market has gone berserk.

Yeah.

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

Well, I mean, I'll take a middle road. Some supplements have shown some benefit, like creatine has some benefit. Vitamins have some benefit for people who are vitamin deficient. If you have a balanced diet, you're getting mostly more than you need for vitamins and minerals and as Katie says, you tend to just pee out stuff. Now, the fat-soluble vitamins like vitamin D, vitamin E, etc. can be problematic. If you have an excess, there is something called hypervitaminosis D where that's a problem. It's very rare. I mean, if you want to spend your money on worthless things, go for it.

But the one thing is when you say doctors, I mean, that's a very tiny percentage of physicians. Most of us are literally clinicians. We care about our patients. We want to do the right thing.

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

I mean, listen, whenever I would impart medical information, I would talk to experts. I would talk to doctors, you know, and of course everything that I talked about when it came to colorectal cancer was vetted and, you know, was scientifically proven stuff, you know. I didn't watch a lot of Oprah to be honest with you. What I got upset with is I think there was a big piece on Dr. Oz and the fact that he was financially benefiting from all these different cures and, you know, berries and, you know, supplements and pills. Yeah. Like, and I thought this is so wrong and he was such a well-respected... I think he was a cardiac surgeon if I remember correctly and I remember, I know a lot of doctors, I think just because of my cancer advocacy work, and he was so highly thought of and then a complicated figure because he was such a sellout. And I just think it was irresponsible obviously for in cases when he was giving junk science to have Oprah platform somebody like that. At the same time I think it's really interesting because I think it does speak to what you were asking earlier of Jeff and Amy, like what has the medical community done wrong? Why has there been this vacuum? And I think a lot of it is because not only do people not know their doctors, doctors, as Jeff can tell you, have very little time for their patients, you know, they have what, 15 minutes to meet with them. And I think the other problem that I've always noticed is people in the medical profession are notoriously bad at explaining stuff in an accessible, understandable way. You know, I know Alan Alda had this whole organization, I think he still does, where he works with scientists helping them explain things in simple terms so people can understand. I had to learn how cancer and cancer therapies work because I was so desperate to find something for my husband. So, I had to know like, oh, anti-angiogenesis. That's like when you cut off a tumor's blood supply. So, imagine a grape and the vine being cut and the grape shriveling up and dying. That's apoptosis. That's what happens to a tumor and cancer. But they're so bad at kind of helping people visualize stuff. I think it's created a lot of confusion.

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

So all right, so in the area where I know obviously a lot about is anesthesiology and I'll give you two areas in anesthesia where there is so much misinformation and one of those is epidural anesthesia for labor. The amount of nonsense that is on the internet about epidurals and, you know, horrible things. I actually wrote a Substack piece called 'You Might Get Groceries' in my Substack about my personal experience as an anesthesiologist when my wife went into labor. And it was a hilarious situation where, you know, a doula went up and put up these crazy things about all these horrible, you know, dying of narcotic overdose when the child is 22, things like that. And so I went up to the board and I wrote, you know, trip to the grocery store, and I wrote, you know, attacked by aliens, anally probed, blah blah blah. And I wrote down at the corner, you might get groceries. I mean, because the reality is it's nonsense what most of people are posting. The other is spinal anesthesia, for instance. Nonsense. There's so much nonsense about this kind of anesthesia in general. So my area, I can see how easily it is to have misconstrued information on the internet. I can't even imagine how complex somebody like an oncologist, when they're trying to write super complex stuff, how much nonsense there is about. And again, everybody has an opinion not based on anything but opinion with no expertise whatsoever. It gets very difficult to explain very complex things and medicine has gotten very complex. I mean when we look at drugs like Repatha which is a, you know, PCSK9 inhibitor, you know, what does that even mean, right? When you're throwing all these names around and we do that, we tend to use complex language to describe very complex things and it's very difficult to make it simple and I think that's where we could benefit from trying to do that.

Yeah. My husband and I have this like game that we play called 'I don't know, but if I had to guess,' which is like we're intelligent people and you take like a tiny shred of information and then you sort of spin out a narrative thread. And I feel like that is kind of what wellness social media does, right? And I think of it like collagen is my favorite example. Like you will never find anything that tells you collagen products work. Like you can drink it, you can slather it, you can... you will not find it. You will not find a single thing that tells you you're going to get that collagen to grow again in your face. Like unless you find a time machine, like that's just it. It's not happening. But you can just picture like all these rooms where people are like, 'Collagen. Okay. So, it's the thing that makes your skin young again. So, maybe if you push it like this or like, you know...' You can find the demos with like these people being like, 'The method is you make it warm and then you smush it or you drink it and then you gargle it' or whatever it is. Like, you just make up the stories.