The VPZD Show

The all-new Nissan Nystagmus: Deviate your Driving! 😁

It's VPZD Ep. 46, ⁠originally streamed LIVE on YouTube⁠.

Chronological topic list

• Housekeeping: clarifying brain death versus severe brain damage, and why a competent examiner matters
• Zubin’s first travel speaking engagement in three years, a pain medicine panel in Dallas, and the Rodeo Goat burger
• Vinay’s panel at a biotech conference and the longevity target question
• Elizabeth Holmes and Theranos, and how John Ioannidis spotted the lack of peer reviewed papers
• Why you can’t run 100 tests off a single drop of blood
• Zubin’s Theranos lipid panel at TEDMED and whether the numbers were real
• Finger sticks versus venipuncture, and why lancets hurt
• The Nathan Fielder documentary and the 35 days before federal prison
• Holmes’s personality, her belief that the machine works, and “Theranos 2.0”
• Puppeteer or puppet: Billy Evans, Sunny Balwani, and the men in her life
• Amanda Seyfried’s reenactments and the second half of the film
• Did she commit fraud, did it harm patients, and was she scapegoated for flying too high
• Why Holmes picked a claim that could be tested in minutes, and the harder to falsify claims in biotech
• Health influencers, creatine, and observational studies as placebo
• Stanford versus Berkeley, and the CAC score as a better measured number than Theranos
• A glioblastoma device and the ambiguity of its trial
• Whether Holmes really didn’t understand the “Who’s on First” joke
• Spiritual people, pop culture, and why VPZD isn’t cognitive dissonance
• Pope Leo’s lung cancer: luck or Providence, lead time bias, or an indolent tumor
• Why Pope Leo’s case gets spun as proof that screening works, and the case against scanning non-smokers
• Whether adenocarcinoma, secondhand smoke, and a Peruvian mission shaped the diagnosis
• The Pope’s reported equanimity, and the politics of the papal job
• A New York Times Daily episode on Texas Trump voters, and why a cherry-picked anecdote isn’t a poll
• Why polling is a flawed science, plus spam calls and the “right to be left alone”
• Indian call center scammers and YouTube videos of people hacking them
• AI car dealership calls, and medical car names like the Ford Infarct and the Toyota Tetralogy
• Bryan Johnson’s post that his genome was of no use, and Anne Wojcicki’s response
• Francis Collins’s promise that genomes would guide blood pressure pills
• Zubin’s factor V Leiden and prothrombin findings, and what a genome did and didn’t tell him
• Why reading DNA like letters in a book is the wrong metaphor, and the Lego exhibit analogy
• Craig Venter’s genome talk and his “we can tell you when you will die” pitch
• Bryan Johnson’s changing positions, and what he eats
• Cheese fries, GERD, and a Dallas talk that felt like the whole room was talking
• Pain providers, opioids, the Sacklers, and the overcorrection that followed
• The parallel with SSRIs and the dilemma of taking people off a drug they shouldn’t have started
• A reported 40% rate of pancreatic cysts on MRI, IPMN, and the scan industrial complex
• Jalen Hurts’s blood clots: cleats to the calf, a long flight, and Virchow’s triad
• Lupus anticoagulant, factor V Leiden, and oral contraceptives
• Zubin’s daughter’s factor V Leiden and whether she can take the pill
• Goldfinger, a Scooby-Doo clip, and how standards have changed
• Next week’s topics and a plug to watch the Holmes documentary

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AI gave Zubin hair in our thumbnail...we truly are at End Times 😁

It's VPZD Ep. 45, originally streamed LIVE on YouTube.

Chronological topic list

• Shout out to Dentalica, the Metallica cover band of dentists
• Follow up on the failed execution and whether healthcare professionals should take part in executions
• Firing squad and livestreamed executions as a case for the state owning its violence
• Childhood abuse, fetal alcohol syndrome, and whether crime is a medical problem or a moral one
• A bilingual doctor barred from speaking Spanish to her patient after failing a hospital proficiency test
• Nobel Prize snubs in optogenetics, including Ed Boyden, Feng Zhang, and the Wayne State researcher
• Rosalind Franklin, narrative, and why credit in science is so messy
• Why science is full of forced moves while art is not, and what that means for AI
• Clinical breakthroughs like Gleevec that never win Nobels
• Political Nobels, Obama, and Bob Dylan skipping the ceremony
• Academic AI studies that are outdated by publication, plus a Lancet “phase one” chatbot trial with no control arm
• AI models guessing Trump’s IQ and the case that the voting booth is the health check for politicians
• Why Zubin doesn’t vote, and the billionaire tax
• The seven levels of wealth and the arc from Rolex to no watch
• NYU’s three-year medical school and the cherry-picked comparison groups
• Zubin’s fourth year of medical school and finishing Berkeley in three years
• Reforming medical training from college through the extra fellowship year
• Teaching critical thinking over memorization as the line between charlatan and expert blurs
• Zeke Emanuel’s Eat Your Ice Cream, reverse causality, and confounding in observational studies
• The descriptive versus prescriptive fallacy in medicine and spiritual awakening
• Counseling cancer patients about alcohol
• SSRIs, RFK Jr., withdrawal, and why long-term data can’t separate benefit from dependence
• Brain zaps and SSRIs in awakening circles
• Vinay’s accidental decaf month and the nicotine gum trend
• Brain death, advance directives, and who you’d trust to pull the plug
• Moral anguish, organ and cadaveric nerve consent, and an ICU nurse’s perspective
• Airplane rules, annual PPD testing, and the absurdity of medical bureaucracy

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Should we be medicalizing state-sanctioned executions? Is meditation actually safe? Do liquid biopsies save lives? EASY QUESTIONS ONE AND ALL 😂 Originally streamed ⁠⁠⁠⁠LIVE on YouTube⁠⁠⁠⁠! (#44)

In this episode, we talked liquid biopsies for multi-cancer screening, the evidence behind recent blood test trials, and the risks of false positives and overdiagnosis. We dove into meditation’s possible benefits and harms, including anxiety, dissociation, and psychosis, as well as concerns about using it as a productivity tool. Finally, we hit physician involvement in state executions and the ethics of lethal injection, along with honest conversations about cancer prognosis and goals of care.

• ⁠⁠⁠⁠⁠Dr. Prasad's "Plenary Session" podcast.⁠⁠⁠⁠⁠
• ⁠⁠⁠⁠⁠Dr. Damania's "ZDoggMD Show" podcast.⁠⁠⁠⁠⁠
• ⁠⁠⁠⁠⁠More on Vinay.⁠⁠⁠⁠⁠
• ⁠⁠⁠⁠⁠More on Zubin.

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Easy topics for easy times 🤭 Originally streamed ⁠⁠⁠LIVE on YouTube⁠⁠⁠! (#42)

• Using Beethoven's Archduke Trio as a lens for why AI-generated art still falls short of true creative risk-taking
• Whether AI companies calling for regulation are protecting the public or protecting their own competitive lead
• The "Chernobyl of AI" idea, and skepticism toward vague doomsday percentage predictions
• Burnout across the AI industry, and a personal parallel to burning out in medicine before starting ZDoggMD
• Why doctors, unlike coders, are resistant to AI encroaching on their work
• A court ruling on whether the raw audio of an AI-assisted medical visit is discoverable in a malpractice suit, and a comparison to body cam data
• The DOJ's civil rights division investigation into UCSF and other med schools over affirmative action compliance post-SFFA v. Harvard
• Whether standardized test scores, grit, or adversity best predict who becomes a good doctor, and the weak evidence behind racial concordance studies
• A broader reflection on how identity and tribalism shape reactions to contested topics, using the Israel-Palestine debate and the Macklemore/Ed Sheeran episode as examples
• Institutional neutrality, the NIH funding fight involving Russ Vought, and why one-sided political stances put universities at risk
• Addressing a live comment about their COVID-era track record and clarifying actual positions
• Closing thoughts and sign-off

• ⁠⁠⁠⁠Dr. Prasad's "Plenary Session" podcast.⁠⁠⁠⁠
• ⁠⁠⁠⁠Dr. Damania's "ZDoggMD Show" podcast.⁠⁠⁠⁠
• ⁠⁠⁠⁠More on Vinay.⁠⁠⁠⁠
• ⁠⁠⁠⁠More on Zubin.

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Exploring the issues of the day, (Mackle)more or less 🤭 Originally streamed ⁠⁠LIVE on YouTube⁠⁠! (#42)

Topics covered: the Macklemore/Ed Sheeran controversy over political statements at concerts; land acknowledgments and performative activism; T-Rex body temperature research using tooth enamel isotopes; amateur archaeology and human evolution theories; the fluoride-in-water debate, weighing dental benefits against IQ concerns; a University awards ceremony disrupted by political chanting; Jonathan Haidt's three great untruths and campus culture; why Middle East politics resist typical activist framing; Wall Street Journal's editorial inconsistency on FDA drug decisions; statistics deep dive on p-values, split alpha, and confidence interval interpretation; new ACGME resident work-hour rules and their unintended consequences; administrative burden as the real driver of resident burnout; Angela Duckworth's concept of grit, examined through the lens of descriptive versus prescriptive reasoning; ambition, cortisol, and the psychology of never feeling successful; Harry Potter and the Cursed Child as a surprisingly good stage production; a JAMA study on pilots, flight attendants, and radiation-induced cancer; skepticism toward routine dental X-rays; hot tub-associated lung disease and questionable AI-generated medical advice; cold plunge trends and the lack of supporting data; why subtle political art works better than explicit statements; the controversy over AI assistance in solving a famous unsolved math problem; concerns about LG smart TVs recording audio and network data; and closing thoughts on 90s hip-hop versus the explicitness of modern rap.

• ⁠⁠⁠Dr. Prasad's "Plenary Session" podcast.⁠⁠⁠
• ⁠⁠⁠Dr. Damania's "ZDoggMD Show" podcast.⁠⁠⁠
• ⁠⁠⁠More on Vinay.⁠⁠⁠
• ⁠⁠⁠More on Zubin.

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We're trying to become better listeners, SO PREPARE FOR SOME SHOUTING 🤭 Originally streamed ⁠LIVE on YouTube⁠! (#41)

We cover the new pancreatic cancer drug daraxonrasib and its rash side effect, survival benefit, and cost; what makes pancreatic cancer especially deadly; Vinay’s clinical background across hematology and oncology; how mechanistically cancer actually kills; the challenge of finding good podcast guests and why authenticity matters more than plugging a product; vaccine mandates and the difference between individual versus population-level benefit; the USPSTF’s recent upheaval and the challenge of evidence-based guidelines on contested topics like depression screening, mammograms, and prostate cancer screening; observational versus randomized evidence, with examples spanning flu vaccines, shingles vaccines and dementia, and Tylenol in pregnancy and autism; the OpenAI Navier-Stokes controversy and AI’s role in mathematics; AI in medicine and a JAMA perspective piece on AI replacing physicians; statins, coronary calcium scores, and personal decision-making around cardiovascular risk; weight stigma in medical training and the complexity of obesity; alternative medicine, longevity influencers, and Vinay’s evolving views on certainty; the ethics and mechanics of prediction markets and biotech stock betting; and reflections on active listening and communication style on the show.

• ⁠⁠Dr. Prasad's "Plenary Session" podcast.⁠⁠
• ⁠⁠Dr. Damania's "ZDoggMD Show" podcast.⁠⁠
• ⁠⁠More on Vinay.⁠⁠
• ⁠⁠More on Zubin.

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Yeah it's been over a year but you can't keep a couple of handsome brown guys apart forever 😎 A BRAND NEW VPZD EPISODE, originally streamed LIVE on YouTube! (#40)

• ⁠Dr. Prasad's "Plenary Session" podcast.⁠
• ⁠Dr. Damania's "ZDoggMD Show" podcast.⁠
• ⁠More on Vinay.⁠
• ⁠More on Zubin.

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We're back, just cuz we had dinner and felt like a live nightcap. Enjoy!

Watch the originally live YouTube video here.

• Subscribe to "The VPZD Show" on your favorite podcast app.
• Dr. Prasad's "Plenary Session" podcast.
• Dr. Damania's "ZDoggMD Show" podcast.
• More on Vinay.
• More on Zubin.

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Another live episode, we touch on a BUNCH of stuff, including Trump's transition, possible FDA appointments, RFK Jr., letters we've gotten about reproductive rights, was Harris or her team afraid to have her go on Rogan, a deep dive into COVID infection fatality rate and what to do about vaccines, and MUCH more. Watch the video version here.

Subscribe to The VPZD Show on your favorite podcast app. Check out VP's Substack Vinay Prasad's Observations and Thoughts as well as Sensible Medicine. Here's all our previous episodes together.

More on Vinay.

More on Zubin.

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Regardless of your political leanings, this live podcast WILL traumatize you 😻.

Election reactions, media polarization, what this might mean for healthcare and WAY more than you cared to hear about Peyronie’s disease 🍆🤓. Watch the video version here.

Subscribe to The VPZD Show on your favorite podcast app. Check out VP's Substack Vinay Prasad's Observations and Thoughts as well as Sensible Medicine. Here's all our previous episodes together.

More on Vinay.

More on Zubin.

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In this episode we discuss Joe Rogan/Trump Interview insights, the ‘science’ of polling, irrational COVID policies, erosion of trust in the medical establishment, the dangers of public health dogma, Trump Derangement Syndrome™️, reflections on the US political system, Zubin’s TikTok verification drama, what creates successful social media reach, TikTok’s cringey docs, the impact of shame on medical practice and education, Rogan’s fixation on physical fitness, why Yoga kicks ass, Vinay’s literary review of Elena Ferrante's Neapolitan series, and Zubin’s personal experience with psychedelics (watch THAT video here).

Video version of this episode here.

Subscribe to The VPZD Show on your favorite podcast app. Check out VP's Substack Vinay Prasad's Observations and Thoughts as well as Sensible Medicine. Here's all our previous episodes together.

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Former New York public health official Jay Varma's hypocritical sex parties during COVID, why we refuse to talk to most reporters, VP’s take on the new schizophrenia drug, the 10 year anniversary of VP’s PARADIGM-HF heart failure drug trial smackdown, how much an MD/PhD with 100 years of training makes when they finally finish school, Marty’s new book, a Stanford and Emory conference where VP is speaking on public health controversies, and much more!

Subscribe to The VPZD Show on your favorite podcast app. Check out VP's Substack Vinay Prasad's Observations and Thoughts as well as Sensible Medicine. Here's all our previous episodes together.

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Marty's in tha' house to rap about his new book, out Sept. 17th! Blind Spots: When Medicine Gets It Wrong, and What It Means for Our Health. Video version here.

Subscribe to The VPZD Show on your favorite podcast app. Check out VP's Substack Vinay Prasad's Observations and Thoughts as well as Sensible Medicine. Here's all our previous episodes together.

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The three horseman of the apocalypse are BACK! We talk Marty’s new book, CVS as a PBM and the effect on independent community pharmacies, Biden’s medicare drug price negotiations, media health reporting biases, COVID and testing rules, Paxlovid efficacy, the media and lab leak theory, garbage research and health equity, lab leak vs. wet market, medical education is broken and what to do about it, why the med school curriculum is crap, how to fix medical conferences, why debate in medicine is now taboo, ABMS and medical board exam monopoly, culture of obedience in medicine, and more!

Here's a sneak peek of Marty Makary's new book BLIND SPOTS: When medicine gets it wrong and what it means for our health(now available for pre-order).



Subscribe to The VPZD Show on your favorite podcast app. Check out VP's Substack Vinay Prasad's Observations and Thoughts as well as Sensible Medicine. Here's all our previous episodes together.

Learn more about your ad choices. Visit https://megaphone.fm/adchoices

The most epic medical bromance in history is BACK and we've brought our A-game 🔥 Video version here.

Topics covered:

00:00 Intro, WE'RE BACK!

4:02 Zubin's Dad's Passing

30:00 Physician Maintenance of Certification (MOC)

48:18 Chat GPT and Medicine

52:24 Letting DOJ Know About MOC Monopoly

54:04 Colon Cancer Screening

1:04:30 Whole Body MRI Scans

1:12:24 GI Jokes

1:13:57 Masking In Hospitals

1:23:07 Doctors' Attire and Behavior (Professionalism)

1:27:21 What's Up With Braces?

👉 Ain't The Way To Die, including resources on end-of-life planning.

👉 Link to let DOJ know about MOC.

👉 Previous episode w/Dr. Paul Teirsteinon MOC (Maintenence of Certification)

Subscribe to The VPZD Show on your favorite podcast app. Check out VP's Substack Vinay Prasad's Observations and Thoughts as well as Sensible Medicine. Here's all our previous episodes together.

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Famous docs who can’t process evidence, prior authorization in healthcare and care variation, private equity and gray areas in medicine, the decline of academic medical centers, indoctrination in education, does Paxlovid actually work in populations that matter and the biases of observational trials, fake twitter medical experts, why hospital maintenance workers have more common sense than healthcare leadership, Cochrane mask review, CDC director masking comments and ivermectin, politics in science and why politicians simply can’t be honest, and more! Video here.

• Subscribe to "The VPZD Show" on your favorite podcast app.
• Check out our new Substack collaboration, "Sensible Medicine" here.
• Dr. Prasad's "Plenary Session" podcast.
• Dr. Damania's "ZDoggMD Show" podcast.
• More on Vinay.
• More on Zubin.

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We were both victims of the "tripledemic" and now have Long Cold but we're BACK! In Episode 30 we dive into the recent focus on sudden deaths and cardiac arrest in athletes such as Damar Hamlin and whether vaccine causation can be attributed as many online "experts" insist, Vinay's new myocarditis paper, FDA withholding Moderna human data from advisory committee members during bivalent EUA approval, do medications really "expire" and much more!

Video: https://youtu.be/DOQF2JNZug4

• Subscribe to "The VPZD Show" on your favorite podcast app.
• Check out our new Substack collaboration, "Sensible Medicine" here.
• Dr. Prasad's "Plenary Session" podcast.
• Dr. Damania's "ZDoggMD Show" podcast.
• More on Vinay.
• More on Zubin.

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The boys are back in town 🔥. We talk about the future of social media, Elon Musk's Twitter, misinformation policing failures, metabolic health, being your authentic self and more.

Here's VP's Sensible Medicine article we referenced.

Topics & Timecodes

00:00 Verbal & non-verbal communication, listening & presence

02:43 The future of social media, Zuckerberg, Elon's authenticity, Twitter & the blue checkmark disaster

10:49 Z's alleged 30-millionaire status, calculating net worth, the importance of supporting content & creators you care about

14:54 Sensible Medicine & VP's Misinformation Police article, suppression of ideas vs. presenting a better counter-argument, the far left & tribal identity

27:08 Terrible midterm election predictions, Dr. Oz's inauthenticity & subsequent loss, pseudo-science "influencers"

33:26 America's Frontline Doctors & Simone Gold's alleged implosion

35:02 Masking kids & NEJM's paper, observational vs randomized control trials, bad science & its overlap with politics, myocarditis, MedScape & the attack on Mandrola

46:30 Insulin resistance, the pros & cons of glucose monitoring as "health entertainment", metabolic health, cold plunge

1:07:53 Bob Califf tweets & long Covid claims, Ashish Jha changes his tune

1:13:36 Authenticity, being seen for who you authentically are, ZDadd tech support, post-meditation retreat realizations

1:25:23 Predictions on the approaching world shift, final thoughts

• Subscribe to "The VPZD Show" on your favorite podcast app.
• Check out our new Substack collaboration, "Sensible Medicine" here.
• Dr. Prasad's "Plenary Session" podcast.
• Dr. Damania's "ZDoggMD Show" podcast.
• More on Vinay.
• More on Zubin.

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ZD visits VP studios for a broad discussion about colonoscopy, Florida's surgeon general Ladapo and Science magazine, the new oath taken by UMN medical students during their White Coat ceremony, and MUCH more. The only thing missing is VP's signature black leather jacket 🔥

Watch VP's breakdown of the NordICC colo trial here, here, and here. Read UMN's white coat oath and learn more about Ladapo and the Science magazine editorial here.

• Subscribe to "The VPZD Show" on your favorite podcast app.
• Check out our new Substack collaboration, "Sensible Medicine" here.
• Dr. Prasad's "Plenary Session" podcast.
• Dr. Damania's "ZDoggMD Show" podcast.
• More on Vinay.
• More on Zubin.

Learn more about your ad choices. Visit https://megaphone.fm/adchoices

We discuss firing of the NYU professor who's class was too hard, the problems with screening for medical school admission, Dr. Glauckomflecken's maskless Twitter selfie thing and the nature of virtue signaling, why JEDI aren't woke enough according to Scientific American (cuz eugenics of course), a recent study on personality changes due to the pandemic, CRAZY liberal arts college masking policies, and much more!

• Subscribe to "The VPZD Show" on your favorite podcast app.
• Check out our new Substack collaboration, "Sensible Medicine" here.
• Dr. Prasad's "Plenary Session" podcast.
• Dr. Damania's "ZDoggMD Show" podcast.
• More on Vinay.
• More on Zubin.

Learn more about your ad choices. Visit https://megaphone.fm/adchoices