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<v Speaker 2>Hey Ologites Ali Ward here. So blood it's important. It's

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<v Speaker 2>kind of scary and you yourself are a pulsing, barely

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<v Speaker 2>contained leather sack of it but what is it? In

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<v Speaker 2>this episode, we'll talk to a hematologist slash oncologist about

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<v Speaker 2>what blood does and why he works with it and

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<v Speaker 2>what can go wrong and how to fix it. And

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<v Speaker 2>before we dive in, I want to say thank you

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<v Speaker 2>so much for the five hundred review mark we hit

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<v Speaker 2>on iTunes. You guys, I appreciate it so so much.

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<v Speaker 2>I read every review like total creep and it really

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<v Speaker 2>keeps me going. So I'm going to read you my

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<v Speaker 2>favorite review this week. Do you want to hear it? Okay?

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<v Speaker 2>See Magnus said, I'm afraid of death, birds and the universe,

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<v Speaker 2>and the episodes about these topics were so interesting and

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<v Speaker 2>engaging that I forgot these things terrified me while I listened. Yay,

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<v Speaker 2>she said, Ali is a great host who really knows

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<v Speaker 2>how to keep a podcast flowing in an entertaining way.

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<v Speaker 2>Very impressed. She records her parts from a closet. I

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<v Speaker 2>am in a closet right now recording this life. Also

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<v Speaker 2>a jello Ze said, I want Allie as a friend. Done, Donzo,

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<v Speaker 2>We're pals now, they say, great podcast. I even enjoyed

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<v Speaker 2>ologies that I thought I was not very interested in.

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<v Speaker 2>Can't wait for more. I always love hearing that. When

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<v Speaker 2>someone's like, I didn't think I'd care about this, but

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<v Speaker 2>it was a good episode, I'm like, yes, we did.

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<v Speaker 2>Thank you so much for leaving those reviews. They help

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<v Speaker 2>so much and they really get the show seen in her.

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<v Speaker 2>So this episode hematology comes from the Greek for blood,

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<v Speaker 2>pretty simple, and I learned about this particular ologist through

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<v Speaker 2>a blood relative, my pop. So a few months ago,

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<v Speaker 2>my dad forwarded me an announcement for a charity function

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<v Speaker 2>in LA that was a comedy show with some comics

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<v Speaker 2>that I'm like familiar with like Kamil nan Gianni and

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<v Speaker 2>Hannibal Barres, Mark Maron, Ray Romano and Nicki Glazer, all

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<v Speaker 2>these people. I was like, WHOA, how did they all

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<v Speaker 2>get involved in this? Well, there's a blood cancer called

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<v Speaker 2>multiple myeloma, and Peter Boyle, who played the dad on

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<v Speaker 2>Everybody Loves Raymond, battled it for a number of years

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<v Speaker 2>and every year, in partnership with the International Maloma Foundation,

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<v Speaker 2>his amazing family puts on this comedy benefit to raise

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<v Speaker 2>money for research. Now, my dad also has multiple myeloma,

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<v Speaker 2>so I reached out to IMF to see if they

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<v Speaker 2>needed some volunteers, and I got involved with a benefit

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<v Speaker 2>that way, and was really lucky to be able to

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<v Speaker 2>take some time of one of the lead researchers in

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<v Speaker 2>this field before the event and get him in a

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<v Speaker 2>conference room and pepper him with questions about what he does.

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<v Speaker 2>He was so nice. Now, usually I have listener questions

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<v Speaker 2>from Patreon supporters, but today all the questions are furnished

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<v Speaker 2>courtesy of mister Ward, my dad, who is kicking the

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<v Speaker 2>ass of this particular blood cancer. So when my dad

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<v Speaker 2>was first diagnosed in twenty thirteen, I didn't know anything

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<v Speaker 2>about blood diseases, even though thirty thousand people a year

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<v Speaker 2>will be diagnosed with multiple maloma and my uncle also

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<v Speaker 2>had it. Now, when my parents found out, I'm not

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<v Speaker 2>sure if anyone else who has been affected by any

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<v Speaker 2>kind of illnesses has done this, but the words multiple

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<v Speaker 2>maloma were written on a post a note and given

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<v Speaker 2>to them by like a nurse to go home and google.

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<v Speaker 2>The prognosis at that time was two years, and I

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<v Speaker 2>myself curled up in a ball, honestly like hoarsely cried

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<v Speaker 2>for a few days. Now it's five years later. My

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<v Speaker 2>dad is still doing well, and they have this now

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<v Speaker 2>faded pink post it note and its taped to their

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<v Speaker 2>computer desk as a reminder of those first really terrifying

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<v Speaker 2>months and also of a lot of hope. And at

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<v Speaker 2>this comedy benefit, a lot of the comedians I talked

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<v Speaker 2>to had to google the disease. Some on the car

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<v Speaker 2>ride over they were like, Oh, I don't know what

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<v Speaker 2>it was, which is totally fine for my family. Personally,

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<v Speaker 2>these words are on our minds every day, and the

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<v Speaker 2>people who are getting up and going to work to

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<v Speaker 2>find cures for this and other diseases are like celebrities.

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<v Speaker 2>They're amazing. So here's the d When you work at

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<v Speaker 2>a coffee shop, you probably get good discounts coffee. With

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<v Speaker 2>my work, I have access to so many science heroes

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<v Speaker 2>and getting to sit down and interview someone who's the

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<v Speaker 2>front lines of this is a pretty big perk of

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<v Speaker 2>the job. But I struggled with whether or not this

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<v Speaker 2>episode would be relatable, and some of their nitty gritty

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<v Speaker 2>about treatments I cut. So if anyone, especially if you've

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<v Speaker 2>been affected by multiple malomo, wants a copy of the

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<v Speaker 2>uncut version, email me at Hello Ali Ward at gmail

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<v Speaker 2>dot com. I can also post it on the Patreon

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<v Speaker 2>page and I'll just give you the full version with

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<v Speaker 2>all the nitty gritty. So I've shaped this episode to

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<v Speaker 2>be all about what is blood, what's the healthiest, most

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<v Speaker 2>scientifically chill way to live? What is cancer? How can

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<v Speaker 2>we make ourselves less vulnerable to cancer? What therapies are

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<v Speaker 2>being developed? How many people attend Coachella, what brought theologists

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<v Speaker 2>to this field? And the etymology of some Cantonese slang

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<v Speaker 2>involving fish. And I can say I walked away from

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<v Speaker 2>this interview feeling so hopeful about my dad's prognosis and

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<v Speaker 2>also more empowered to take care of myself. Well, I

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<v Speaker 2>can it's so easy to treat your body like garbage

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<v Speaker 2>and be like I'll get help you later, or I

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<v Speaker 2>don't like deserve to rest. I got a hustle. But

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<v Speaker 2>once you find out how much my dad's chemotherapy costs

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<v Speaker 2>each month, you will take a nap so hard and

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<v Speaker 2>you will only eat like spinach and walnut smoothies. Also,

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<v Speaker 2>this ologist has the best Scottish accent ever, So settle

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<v Speaker 2>in get your blood humped to learn all about hematology

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<v Speaker 2>with doctor Brian Derry. If you could tell me what

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<v Speaker 2>is your specific title? Are you ed? Are you an oncologist.

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<v Speaker 2>Are you my lowna specialists? What do you call yourself?

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<v Speaker 4>Okay, so I'm a haematologist and I'm an oncologist. I'm both,

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<v Speaker 4>so I'm qualified in both. And I'm an internal internist,

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<v Speaker 4>an internal medicine specialist.

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<v Speaker 2>So the site of blood does not freak you out.

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<v Speaker 4>Well, strangely enough, the site of blood is. So when

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<v Speaker 4>I got into hematology, you know, the specialty of blood diseases.

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<v Speaker 4>I got interested because it was something that I could

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<v Speaker 4>study under the microscope. So when you're learning and you're

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<v Speaker 4>a scientist, and then you can make a slide and

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<v Speaker 4>then you can look at it under the microscope. I

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<v Speaker 4>was fascinated because I could see all these different blood

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<v Speaker 4>cells and that was very exciting for me, where I

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<v Speaker 4>could distinguish the different kinds. And so that's actually looking

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<v Speaker 4>at the blood and researching the blood. That's how I

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<v Speaker 4>became interested in the first place.

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<v Speaker 2>Did you ever get a microscope when you were a kid?

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<v Speaker 2>Is a gift or something? Or when did it start?

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<v Speaker 4>This started when I went to medical school. So in

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<v Speaker 4>medical school you're you're studying all kinds of things. But

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<v Speaker 4>then when we started the part where we were using

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<v Speaker 4>the microscope. That's where I got especially fascinated.

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<v Speaker 2>Did you ever put your own blood under the microscope

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<v Speaker 2>to see what was going on? Oh?

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<v Speaker 4>Yes, you have to do that as a student.

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<v Speaker 2>Really.

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<v Speaker 4>Oh yes, you check your own blood and then you

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<v Speaker 4>compare it with you know, all these other different things

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<v Speaker 4>which you're given for comparison. You know.

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<v Speaker 2>Wow, So did you ever eat a hamburger and then

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<v Speaker 2>see what it looked like?

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<v Speaker 3>And then?

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<v Speaker 4>No? I didn't do that. Well, those things are not

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<v Speaker 4>so obvious on your blood. Okay when you're just looking

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<v Speaker 4>at it. Now, if you do chemical testing, obviously you

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<v Speaker 4>could see something, but not just looking at it.

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<v Speaker 2>And so when did you start studying oncology? Were you

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<v Speaker 2>a heematologist first and then you started getting interested in

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<v Speaker 2>blood diseases and cancers?

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<v Speaker 4>Yes, basically that was it. So I did hematology training

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<v Speaker 4>the Male Clinic in Rochester, Minnesota.

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<v Speaker 2>Heard of it. Good place. Side note, I have some

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<v Speaker 2>friends who have been treated at the Mayo Clinic and

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<v Speaker 2>they said it was the best medical care they've ever gotten.

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<v Speaker 2>Next level like Mayo Clinic is like those live flat

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<v Speaker 2>first class cabin airline seats with the beds and the

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<v Speaker 2>free wine and the salmon and the cheese. When you're

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<v Speaker 2>used to a middle row seat and coach next to

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<v Speaker 2>the toilet, sitting near someone with sausage purps, it's just

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<v Speaker 2>so much better. Okay, Now back to the training of

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<v Speaker 2>one of the world's leading cancer researchers who trained at

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<v Speaker 2>the Mayo Clinic.

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<v Speaker 4>So I started off with that, and then during my training,

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<v Speaker 4>since I come from Scotland, so I was I'm an immigrant,

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<v Speaker 4>I'm a foreign medical graduate, they actually assigned you a

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<v Speaker 4>mentor or kind of like a coach. And so in

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<v Speaker 4>that process, my mentor turned out to be a doctor

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<v Speaker 4>called doctor Robert Kyle, who's actually very very famous in

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<v Speaker 4>the field of multiple myeloma.

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<v Speaker 2>Oh.

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<v Speaker 4>And so by chance he turned out to be my

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<v Speaker 4>mentor and we became good friends because we had both

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<v Speaker 4>run boy Scout troops. Really he ran the boy Scoute

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<v Speaker 4>Troup in Rochester, Minnesota, and I used to run the

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<v Speaker 4>boy Scoute Troup in my hometown in Scotland.

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<v Speaker 2>So you guys bonded and then started working together.

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<v Speaker 4>Yes, and so his interest was myeloma in more into

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<v Speaker 4>the blood cancer area HM and so I became more

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<v Speaker 4>interested in that and then ended up doing both blood

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<v Speaker 4>and cancer.

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<v Speaker 2>So let's get right into it. What is blood? If

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<v Speaker 2>you are walking around in an adult body, it contains

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<v Speaker 2>roughly five liders of blood. That's a little over a gallon, slish,

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<v Speaker 2>slashing around, so squishy. So what is it? What is blood? Well,

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<v Speaker 2>stem cells in your bone marrow mature and they change

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<v Speaker 2>into three types of blood cells, red blood cells, white

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<v Speaker 2>blood cells, or platelets. So red blood cells care oxygen

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<v Speaker 2>around the body, so you need that a bunch. And

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<v Speaker 2>red blood cells also contain this protein. It's called hemoglobin,

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<v Speaker 2>and it has iron and that combines with oxygen to

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<v Speaker 2>give hemoglobin and our blood the awesome, terrifying red color

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<v Speaker 2>that it has. Crabs, by the way, have blue blood,

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<v Speaker 2>and earthworms and leeches have green blood. And there are

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<v Speaker 2>some invertebrates like starfish that have clear blood. So unless

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<v Speaker 2>you're one of those, or a plant or a robot,

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<v Speaker 2>yours is red red blood cells. Let's be honest, life

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<v Speaker 2>of the party party would be so dead without them. Now,

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<v Speaker 2>white blood cells aka leukocytes, Those are cells of the

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<v Speaker 2>immune system and they protect the body against infectious diseases

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<v Speaker 2>and invaders. So they're like your friend who talks smacked

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<v Speaker 2>to creeps when they hit on you and you're like, ugh,

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<v Speaker 2>thank you, I didn't even see them. Finally, platelets are

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<v Speaker 2>also called thrombocytes. It's cool name, and they're part of

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<v Speaker 2>the blood. Their purpose is to stop bleeding. They do

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<v Speaker 2>this by clumping and clotting. So when you're like, ugh,

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<v Speaker 2>come on, let's leave, they're your friend who convinces you

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<v Speaker 2>to stay at the party, and you're so so glad

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<v Speaker 2>they did. If leaving a party was the same as

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<v Speaker 2>bleeding out to death, which is not, but I needed

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<v Speaker 2>an analogy. Okay, So these blood cells float in this

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<v Speaker 2>salty straw colored liquid called blood plasma and blood plasma

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<v Speaker 2>it's made of about ninety percent water and it also

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<v Speaker 2>contains nutrients and electrolytes, gases, proteins, hormones, all kinds of stuff.

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<v Speaker 2>So you are just this opaque ziplock full of a

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<v Speaker 2>complex tomato soup, which is great, But what is blood cancer?

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<v Speaker 2>It's not so great. When someone talks about cancer, it's

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<v Speaker 2>usually preceded by a body part. So someone has throw cancer,

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<v Speaker 2>liver cancer. You're like, okay, I'm not a surgeon, but

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<v Speaker 2>I can picture the general area of this cancer because

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<v Speaker 2>my brain is not made of turnups. But blood cancer

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<v Speaker 2>is confusing because it's everywhere, there's nowhere, all at once.

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<v Speaker 2>So you're about to get cocktail party literate on hematology.

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<v Speaker 2>If you're ever introduced to a hematologist at a dinner

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<v Speaker 2>party and you are able to impress them, I have

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<v Speaker 2>done my job. Okay, here's a quick rundown of blood

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<v Speaker 2>cancers that may confuse you if you see one of

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<v Speaker 2>them listed on a flyer for a charity. So I'm

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<v Speaker 2>gonna break it down so that you get the difference.

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<v Speaker 2>Leukemia it's caused by this really rapid production of messed

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<v Speaker 2>up white blood cells. They screw up the ability of

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<v Speaker 2>the bone marrow to make red blood cells and platelets.

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<v Speaker 2>That's leukemia white blood cells. Lymphoma is when these other

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<v Speaker 2>white blood cells, called lymphocytes become abnormal. They turn into

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<v Speaker 2>lymphoma cells. They multiply and they collect in your lymph notes.

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<v Speaker 2>That messes up your immune system as well. Now, my

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<v Speaker 2>loma is cancer of the plasma cells. So doctor dry

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<v Speaker 2>sums it up.

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<v Speaker 4>And so the borne marrow is where you make your blood, Okay,

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<v Speaker 4>And so when you have a cancer of the blood,

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<v Speaker 4>actually it's a cancer of the borne marrow because what

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<v Speaker 4>has happened is that the borne marrow has been damaged

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<v Speaker 4>by something and so then it's not making blood like

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<v Speaker 4>it should and maybe even has turned into a cancer

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<v Speaker 4>of the born marrow. Okay, Now, in the case of leukemia,

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<v Speaker 4>that means that you stop making the normal blood cells

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<v Speaker 4>and make the leukemia cells. In the case of myeloma,

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<v Speaker 4>it means that you have a problem with the plasma cells,

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<v Speaker 4>which is a particular kind of a cell in the

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<v Speaker 4>borne merew which is the cell which is part of

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<v Speaker 4>your immune system. So it's actually a cancer of the

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<v Speaker 4>immune system. And in your born marrow you make the

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<v Speaker 4>antibodies to fight infection.

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<v Speaker 2>Why would your bone marrow Do you like that what

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<v Speaker 2>happened and what happens to make the bone marrow turn

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<v Speaker 2>in blood cancers or what happens in general with cancer

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<v Speaker 2>to suddenly us.

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<v Speaker 4>So what causes it? Yeah, Well, I think that there's

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<v Speaker 4>been a lot of controversy over the years, specifically about myeloma,

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<v Speaker 4>because it seems like more than one kind of toxic

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<v Speaker 4>exposure can cause myeloma. Really, so for lung cancer, there's

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<v Speaker 4>a strong connection to cigarette smoking and the carcinogens, the

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<v Speaker 4>cancer causing chemicals which are in cigarette smoke. Okay, so

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<v Speaker 4>for myeloma, there's been a connection with many different kinds

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<v Speaker 4>of chemicals and so as long as like one hundred

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<v Speaker 4>years ago, it was noticed that people who work with benzene,

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<v Speaker 4>which is a solvent in paints and in factories where

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<v Speaker 4>they do all kinds of manufacturing with solvents and glues,

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<v Speaker 4>people who worked with benzene would get myeloma. Really yeah,

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<v Speaker 4>so there is a linkage which is called like a

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<v Speaker 4>proof of principle, where if you're exposed to a cancer

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<v Speaker 4>causing chemical in this case, it can sometimes cause myeloma.

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<v Speaker 2>Let's lay down a few more basics. So first off, yes,

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<v Speaker 2>cancer was named after a crab because of the way

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<v Speaker 2>veins branched off from a tumor, which sounds gross and

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<v Speaker 2>very moist. Also, cancer doesn't have to be a tumor

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<v Speaker 2>or a lump that you can like poke with a stick.

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<v Speaker 2>Cancer just means when abnormal cells divide in an uncontrolled way,

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<v Speaker 2>so some cells get a little wonky and then they

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<v Speaker 2>just keep making more wonky cells. So according to the

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<v Speaker 2>American Cancer Society, it's caused like changes in the cells DNA,

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<v Speaker 2>So that's the genetic blueprint, and some of these changes

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<v Speaker 2>can be inherited. Others can be caused by environmental factors,

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<v Speaker 2>such as, for example, these things. Ready, I'm gonna list

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<v Speaker 2>these off. There's a long list, but I'm gonna reduce

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<v Speaker 2>some that I can pronounce alcoholic beverages, benzines, tanning beds, sawdust,

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<v Speaker 2>a bunch of chemical compounds. I can't pronounce the virus

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<v Speaker 2>that causes mono diesel exhaust, estrogen therapy, processed meat, aluminum production, tobacco, asbestos,

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<v Speaker 2>and quote salted fish Chinese style. I saw that last

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<v Speaker 2>one and was like, damn, that is specific, So what

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<v Speaker 2>is up with salted fish comma Chinese style? Well, turns

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<v Speaker 2>out Cantonese salted fish is a dish common in Southern China,

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<v Speaker 2>where fish are gutted and they're hung in a heap

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<v Speaker 2>of salt to preserve it. Apparently, studies since the nineteen

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<v Speaker 2>sixties have shown that the Southern Chinese fishing populations who

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<v Speaker 2>consume it as a staple are at a higher risk

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<v Speaker 2>for cancer. This also led me down a hole of

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<v Speaker 2>Chinese slang surrounding salted fish, and in Cantonese, dead bodies

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<v Speaker 2>are referred to as salted fish, and a salted fish

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<v Speaker 2>coming back to life means a person is making a

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<v Speaker 2>comeback after their career looks belly up. And the phrase

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<v Speaker 2>those who eat salted fish must put up with thirst

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<v Speaker 2>is essentially check thyself before thou dost wreck thineself. So

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<v Speaker 2>there are a lot of things already identified as things

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<v Speaker 2>I'll mess up your DNA, but there are so many

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<v Speaker 2>environmental factors that we have no idea about yet. Do

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<v Speaker 2>you think that there's a ton of substances that we

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<v Speaker 2>are in exposure to that we'll find out later we

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<v Speaker 2>really shouldn't have been exposing ourselves to.

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<v Speaker 4>This is so absolutely true. Is one of the very

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<v Speaker 4>very big concerns that I have. And so since the

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<v Speaker 4>industrial and chemical revolution, since the Second World War, over

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<v Speaker 4>one hundred thousand chemicals have been introduced into the environment

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<v Speaker 4>that we are exposed to one hundred thousand, and all

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<v Speaker 4>of those only a handful have been carefully studied and

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<v Speaker 4>have proper regulations with regard to use and cautions and

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<v Speaker 4>things like that.

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<v Speaker 2>Okay, one second, I'm just going to bury my face

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<v Speaker 2>in my arm and grown for like an hour.

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<v Speaker 4>And so I really do have a deep concern that

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<v Speaker 4>we will discover many many cancer causing chemicals have been

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<v Speaker 4>out there and we've not been paying it tension. Now

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<v Speaker 4>we've learned a little bit about this. So for example,

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<v Speaker 4>with the nine to eleven event in New York, all

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<v Speaker 4>these chemicals were released with the fire, with the combustion,

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<v Speaker 4>and then there was a big development of myeloma in

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<v Speaker 4>people after the nine to eleven event because they were

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<v Speaker 4>exposed to fire retardants and solvents and all kinds of

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<v Speaker 4>different chemicals that were suddenly at high levels and really

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<v Speaker 4>causing a problem.

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<v Speaker 5>Wow.

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<v Speaker 2>So we're still having to look at cases and try

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<v Speaker 2>to find correlations between exposure.

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<v Speaker 4>That is correct. So we're at this point of checking correlating.

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<v Speaker 2>And as a scientist, do you like getting the data

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<v Speaker 2>and trying to crunch the data or are you more

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<v Speaker 2>interested in kind of the care aspects of being a doctor?

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<v Speaker 2>How do you approach getting all that data? Quick question

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<v Speaker 2>anologyites do you say data or this messes with me

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<v Speaker 2>every time I say it, and so I usually just

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<v Speaker 2>say it both ways in a conversation. That way, I

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<v Speaker 2>am guaranteed to be wrong every time I looked into it.

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<v Speaker 2>And it seems to be a matter of regional dialect.

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<v Speaker 2>Although I landed on this webpage of a woman named

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<v Speaker 2>Susan Ryan. She's an American dialect coach who insists that

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<v Speaker 2>it's data, and for some reason I found her helpful

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<v Speaker 2>recording very soothing. And then I went down some holes

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<v Speaker 2>and listened to her say a bunch of other.

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<v Speaker 5>Words data, data, database, database, data, database.

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<v Speaker 2>And Susan, according to her bio, is also quote a

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<v Speaker 2>former Alcatraz Park ranger, avid birdwatcher, and a Lingui file

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<v Speaker 2>who makes a mean scrambled egg a la Julia child.

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<v Speaker 2>I would roll in her posse for sure if she

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<v Speaker 2>wanted to be friends. Okay, so does doctor Derry prefer

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<v Speaker 2>crunching the data or being bedside right?

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<v Speaker 4>So over the years I've done both types of things,

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<v Speaker 4>which I would say is quite challenging and became increasingly

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<v Speaker 4>challenging over the years. And so I've always seen patients

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<v Speaker 4>in the clinic. You know, I had a myeloma clinic,

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<v Speaker 4>so one or two days a week I would always

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<v Speaker 4>just see myeloma patients. But in addition to that, for

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<v Speaker 4>most of my life I ran a lab where I

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<v Speaker 4>was studying myeloma and crunching numbers from cell cultures from

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<v Speaker 4>statistics and all kinds of things like that. So I've

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<v Speaker 4>done both kinds of things mostly my whole career.

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<v Speaker 2>Oh wow, so you've gotten both of them. Yes, and

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<v Speaker 2>then what are you working on now? Tell me, like

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<v Speaker 2>a little bit about gene editing or crisper. How does

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00:21:51.799 --> 00:21:54.640
<v Speaker 2>that factor into your work? Crisper, by the way, is

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00:21:54.640 --> 00:21:57.599
<v Speaker 2>spelled with no E, and at first glance, it looks

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<v Speaker 2>like an app that disrupts them let us in straight.

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<v Speaker 2>But CRISPER is a DNA sequence that stands for clustered

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<v Speaker 2>regularly interest based short palindromic repeats. You're fine, you don't

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00:22:08.039 --> 00:22:11.839
<v Speaker 2>have to memorize that. And CRISPER technology lets geneticists edit

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00:22:12.240 --> 00:22:16.079
<v Speaker 2>parts of the genome. It's crazy and exciting. And doctor

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00:22:16.119 --> 00:22:18.200
<v Speaker 2>Derry I feel weird calling him just Brian, so I

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<v Speaker 2>just keep calling him doctor Derry. I don't know anyway,

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00:22:20.279 --> 00:22:22.119
<v Speaker 2>Doctor Derry is working on a bunch of things for

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<v Speaker 2>something called the Black Swan Research Initiative. The name has

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<v Speaker 2>a cool, weird origin. It kind of surprised me. Why

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<v Speaker 2>is it called black Swan?

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<v Speaker 4>Because you are you're looking for something that is it's

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<v Speaker 4>hard to find and you may not recognize it. Right away.

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<v Speaker 4>In the western world, everybody thought swans were white, and

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<v Speaker 4>so you have this idea swans are white. But then

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<v Speaker 4>the first ships went to Australia and over by Perth

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<v Speaker 4>on the West coast and they sailed up the Swanee

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<v Speaker 4>River and lo and behold the swans were black. So

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00:23:04.599 --> 00:23:07.039
<v Speaker 4>they realize that you have to open up your mind

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00:23:07.519 --> 00:23:09.680
<v Speaker 4>and look at things a little differently and say, okay,

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00:23:09.960 --> 00:23:14.200
<v Speaker 4>there are swans. Usually they're white, but actually in Australia

404
00:23:14.240 --> 00:23:17.200
<v Speaker 4>they're black, and in other parts of the world they're

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<v Speaker 4>brown and maybe slightly different different colors. And so it's

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<v Speaker 4>a project where you have to open your mind and

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<v Speaker 4>be open to different strategies to solve your problem.

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<v Speaker 2>Are you seeing a lot of scientists and oncologists finding

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<v Speaker 2>the genes that could make one more susceptible to cancer?

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<v Speaker 2>Are those getting identified?

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<v Speaker 4>Absolutely? This is a very very active area of research,

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<v Speaker 4>and so through the Black Swan Project, we have a

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<v Speaker 4>couple of groups doing just this, so that in Germany

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<v Speaker 4>we have a group looking at family myeloma, So they

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00:23:56.119 --> 00:23:59.480
<v Speaker 4>are looking at families where there are two or more

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<v Speaker 4>in individuals within the family that developed myeloma, and we're

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00:24:03.480 --> 00:24:07.000
<v Speaker 4>collecting a whole series of these families to figure out, well,

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<v Speaker 4>what is it that's that's causing this susceptibility, And we're

419
00:24:11.599 --> 00:24:15.160
<v Speaker 4>studying them at the genetic level. And what I can

420
00:24:15.200 --> 00:24:21.720
<v Speaker 4>tell you already is that there are several types of

421
00:24:22.759 --> 00:24:24.319
<v Speaker 4>genetic predispositions.

422
00:24:24.440 --> 00:24:27.680
<v Speaker 2>So side note, my uncle Joe also had multiple maloma.

423
00:24:27.799 --> 00:24:30.200
<v Speaker 2>He did not make it, which is another reason why

424
00:24:30.519 --> 00:24:33.400
<v Speaker 2>I'd love to interview ologists like doctor Derry. It's so

425
00:24:33.559 --> 00:24:35.759
<v Speaker 2>crazy to me that people are doing this and just

426
00:24:35.880 --> 00:24:39.000
<v Speaker 2>walking among us, like buying a phone case at Target.

427
00:24:39.160 --> 00:24:42.200
<v Speaker 2>You might never know that this person behind you in

428
00:24:42.240 --> 00:24:44.680
<v Speaker 2>line is working on something you could save your life

429
00:24:44.799 --> 00:24:48.200
<v Speaker 2>or a family member's life. It's it's nuts. So how

430
00:24:48.279 --> 00:24:51.839
<v Speaker 2>long before you can see things like gene editing like

431
00:24:51.920 --> 00:24:54.759
<v Speaker 2>chrispur being used in the treatment of oncology? How long?

432
00:24:54.839 --> 00:24:55.640
<v Speaker 2>How far away is that.

433
00:24:56.160 --> 00:25:01.599
<v Speaker 4>It's happening now? Oh, it's happening now. How So what

434
00:25:01.640 --> 00:25:06.839
<v Speaker 4>you can do is you can edit the immune cells.

435
00:25:06.839 --> 00:25:11.960
<v Speaker 4>So you may have heard about a very active type

436
00:25:11.960 --> 00:25:15.319
<v Speaker 4>of therapy called immune therapy, and one type is called

437
00:25:15.920 --> 00:25:19.839
<v Speaker 4>car T cells. And this is a situation where you

438
00:25:19.880 --> 00:25:22.640
<v Speaker 4>take the immune cells, the T cells from the patient

439
00:25:23.359 --> 00:25:25.720
<v Speaker 4>and then you engineer them and then you give them back.

440
00:25:26.000 --> 00:25:31.200
<v Speaker 2>So car T stands for chimeric antigen receptor T cell

441
00:25:31.279 --> 00:25:34.799
<v Speaker 2>therapy car T, So if you hear this, the essential

442
00:25:34.880 --> 00:25:38.079
<v Speaker 2>deal is that car T cell therapy is a way

443
00:25:38.079 --> 00:25:40.359
<v Speaker 2>to get immune cells called T cells, which is a

444
00:25:40.359 --> 00:25:42.960
<v Speaker 2>type of white blood cell, to fight cancer by changing

445
00:25:43.000 --> 00:25:45.160
<v Speaker 2>them in a lab so that they can find and

446
00:25:45.200 --> 00:25:47.400
<v Speaker 2>destroy cancer cells. Pretty awesome.

447
00:25:47.519 --> 00:25:52.680
<v Speaker 4>With the gene editing approach, you can really edit and

448
00:25:52.839 --> 00:25:57.640
<v Speaker 4>tweak those T cells to really recognize an attack in

449
00:25:57.720 --> 00:26:01.000
<v Speaker 4>a very specific way the cancer that you're interested in.

450
00:26:01.000 --> 00:26:05.359
<v Speaker 4>In China, they are already doing this. They have a

451
00:26:05.400 --> 00:26:09.920
<v Speaker 4>trial where they're treating lung cancer using these edited T cells,

452
00:26:10.559 --> 00:26:13.960
<v Speaker 4>and we're starting to look at doing it in myloma.

453
00:26:14.079 --> 00:26:17.920
<v Speaker 4>It's like science fiction that we're moving so quickly.

454
00:26:18.759 --> 00:26:21.039
<v Speaker 2>When you're doing your research, are you splitting your time

455
00:26:21.079 --> 00:26:25.240
<v Speaker 2>between chemical therapies and also these genetic therapies that can

456
00:26:25.319 --> 00:26:26.440
<v Speaker 2>kind of prevent or treat it.

457
00:26:27.240 --> 00:26:30.599
<v Speaker 4>Yes. So the way that this kind of slots into

458
00:26:30.640 --> 00:26:35.000
<v Speaker 4>the day to day activity is that most patients when

459
00:26:35.319 --> 00:26:38.279
<v Speaker 4>they start out, we have these therapies that we know

460
00:26:38.720 --> 00:26:41.799
<v Speaker 4>can work well, but then we know that those will

461
00:26:42.599 --> 00:26:45.359
<v Speaker 4>produce remissions for a few years. But then when that

462
00:26:45.480 --> 00:26:50.279
<v Speaker 4>impact is starting to wear off, then they need new therapies.

463
00:26:50.799 --> 00:26:54.640
<v Speaker 4>And so this is the perfect situation and opportunity to say, Okay,

464
00:26:55.519 --> 00:26:59.119
<v Speaker 4>what are the new therapies that can rescue and treat

465
00:26:59.359 --> 00:27:03.279
<v Speaker 4>at this point? And then from those like the car

466
00:27:03.400 --> 00:27:06.599
<v Speaker 4>te cells look very promising and so we're thinking, my god,

467
00:27:06.839 --> 00:27:10.440
<v Speaker 4>they are really rescuing pretty well in the relapse situation.

468
00:27:10.559 --> 00:27:12.799
<v Speaker 4>Maybe we should be using them even earlier.

469
00:27:13.680 --> 00:27:15.839
<v Speaker 2>And so are we five or ten years off from

470
00:27:15.880 --> 00:27:17.279
<v Speaker 2>this happening in the US do you think?

471
00:27:17.359 --> 00:27:21.640
<v Speaker 4>Or no, it's happening. This is a very rapidly changing field.

472
00:27:21.680 --> 00:27:26.039
<v Speaker 4>So car te cells have been approved, not using the

473
00:27:26.160 --> 00:27:31.200
<v Speaker 4>crisper but just in general. They've been approved for leukemia

474
00:27:31.319 --> 00:27:35.119
<v Speaker 4>and lymphoma in the US. And so this has been

475
00:27:35.359 --> 00:27:40.720
<v Speaker 4>described as like a new space race Sputnik two, where

476
00:27:41.359 --> 00:27:43.920
<v Speaker 4>the Chinese are working on it and the US are

477
00:27:43.960 --> 00:27:46.960
<v Speaker 4>working on it. It's really like competitive.

478
00:27:46.640 --> 00:27:48.759
<v Speaker 2>Are your friends or is it a little bit like,

479
00:27:48.799 --> 00:27:50.480
<v Speaker 2>oh what are you working on? Is it like watching

480
00:27:50.519 --> 00:27:52.160
<v Speaker 2>cooks on a cooking competition.

481
00:27:52.640 --> 00:27:55.359
<v Speaker 4>There is quite a bit of that. They're all cooking

482
00:27:55.440 --> 00:27:58.799
<v Speaker 4>up their own brew, you know, and you know, there's

483
00:27:58.839 --> 00:28:01.480
<v Speaker 4>a little bit of competition and that what you're cooking

484
00:28:01.519 --> 00:28:06.640
<v Speaker 4>could be the best you know and it's it's good.

485
00:28:07.880 --> 00:28:10.799
<v Speaker 2>I welcome this competition. I'm like, whatever it gets you

486
00:28:10.799 --> 00:28:13.359
<v Speaker 2>guys working fastest, I'm into it right.

487
00:28:13.920 --> 00:28:17.200
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488
00:28:18.000 --> 00:28:22.519
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489
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490
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491
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492
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493
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494
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496
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498
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499
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500
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501
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<v Speaker 2>Well, it's definitely a do a.

502
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503
00:29:20.960 --> 00:29:23.880
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504
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507
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509
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510
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511
00:29:44.640 --> 00:29:46.960
<v Speaker 2>My dad has had some questions he wanted me to

512
00:29:47.000 --> 00:29:49.319
<v Speaker 2>ask you. He is as a patient and also as

513
00:29:49.359 --> 00:29:52.799
<v Speaker 2>a former journalist who loves to research. Thanks, He's on it.

514
00:29:52.880 --> 00:29:57.640
<v Speaker 2>He's on all the blogs he wanted to know. He

515
00:29:57.720 --> 00:30:00.799
<v Speaker 2>wants to know why cancer drugs are so expensive, how

516
00:30:00.880 --> 00:30:03.240
<v Speaker 2>much of the cost is research related, and how much

517
00:30:03.319 --> 00:30:07.240
<v Speaker 2>is related to protection against lawsuits. Okay, once again the

518
00:30:07.279 --> 00:30:09.799
<v Speaker 2>listener questions, they're all from a dad this week, because

519
00:30:09.880 --> 00:30:13.519
<v Speaker 2>this is a spec ep of ologies and this question

520
00:30:13.559 --> 00:30:16.480
<v Speaker 2>is about the cost of pharmaceuticals. His chemo therapy comes

521
00:30:16.480 --> 00:30:18.680
<v Speaker 2>in a pill form he takes every day at four pm,

522
00:30:18.759 --> 00:30:22.200
<v Speaker 2>and it's called Revlimid. It's saving his life and it's

523
00:30:22.240 --> 00:30:25.039
<v Speaker 2>thankfully covered by a program called Veterans' Choice, but the

524
00:30:25.200 --> 00:30:28.640
<v Speaker 2>retail price if it weren't covered, would be over sixteen

525
00:30:28.720 --> 00:30:33.000
<v Speaker 2>thousand dollars per month. Why does it cost so much?

526
00:30:33.759 --> 00:30:38.200
<v Speaker 4>Right, so, this is really a lot of reasons why.

527
00:30:39.519 --> 00:30:43.720
<v Speaker 4>The main reason that's poot forward, why certainly on behalf

528
00:30:43.759 --> 00:30:46.160
<v Speaker 4>of the form of companies, is that they have development

529
00:30:46.240 --> 00:30:49.079
<v Speaker 4>cost you know, they're testing this drug, testing that drug,

530
00:30:49.119 --> 00:30:51.240
<v Speaker 4>and then they've got to do all these trials which

531
00:30:51.240 --> 00:30:54.799
<v Speaker 4>are very expensive, cost millions of dollars to test and

532
00:30:54.799 --> 00:30:56.440
<v Speaker 4>make sure it's safe and things like that.

533
00:30:56.559 --> 00:30:59.680
<v Speaker 2>This drug did cost several million dollars to research and develop,

534
00:30:59.759 --> 00:31:03.279
<v Speaker 2>but it's made twenty billion dollars for its parent company

535
00:31:03.519 --> 00:31:05.799
<v Speaker 2>since it's released in two thousand and four, and the

536
00:31:05.839 --> 00:31:08.759
<v Speaker 2>price keeps going up. Now, on the other side, it's

537
00:31:08.759 --> 00:31:10.839
<v Speaker 2>hard not to be grateful that people are even working

538
00:31:10.880 --> 00:31:13.799
<v Speaker 2>on this. Also, the makers are being sued class action

539
00:31:13.880 --> 00:31:16.319
<v Speaker 2>lawsuit because they failed to share some information that would

540
00:31:16.319 --> 00:31:19.200
<v Speaker 2>help get a cheaper generic out there. Come on, guys.

541
00:31:19.359 --> 00:31:23.160
<v Speaker 4>But then ultimately there is this question that for example,

542
00:31:23.240 --> 00:31:26.000
<v Speaker 4>Revlomid has been on the market for quite a number

543
00:31:26.000 --> 00:31:29.559
<v Speaker 4>of years now, and so you would say, well, you know,

544
00:31:30.079 --> 00:31:32.839
<v Speaker 4>absolutely there were development costs, but you know this is

545
00:31:32.920 --> 00:31:36.680
<v Speaker 4>ten years later, you know, fifteen years later, so maybe

546
00:31:36.720 --> 00:31:40.440
<v Speaker 4>this would be the time to have a more reasonable cost, right,

547
00:31:40.680 --> 00:31:46.920
<v Speaker 4>And so this is something that is really prominent at

548
00:31:46.920 --> 00:31:50.200
<v Speaker 4>the political level right now. I mean, what are reasonable

549
00:31:50.279 --> 00:31:55.079
<v Speaker 4>drug costs? And so that has become a complicated process

550
00:31:55.160 --> 00:31:59.400
<v Speaker 4>where the companies they extend their patents and then even

551
00:31:59.400 --> 00:32:02.519
<v Speaker 4>the generic folks when they come in, they don't reduce

552
00:32:02.599 --> 00:32:05.440
<v Speaker 4>across so much, you know, so everybody's in it to

553
00:32:05.480 --> 00:32:08.960
<v Speaker 4>make a buck. And so this is in my opinion,

554
00:32:09.240 --> 00:32:14.359
<v Speaker 4>very tragic and difficult because this is not like selling

555
00:32:14.640 --> 00:32:17.200
<v Speaker 4>cars or watches, you know, where you say, well, this

556
00:32:17.240 --> 00:32:20.000
<v Speaker 4>is a beautiful watch. You could have a markup, that's fine,

557
00:32:20.359 --> 00:32:23.880
<v Speaker 4>But this is drugs that are to save people's lives,

558
00:32:23.960 --> 00:32:27.119
<v Speaker 4>and so I'm not so happy about markups in that environment.

559
00:32:27.279 --> 00:32:29.599
<v Speaker 2>If you want to know why watches can be so expensive.

560
00:32:29.640 --> 00:32:31.599
<v Speaker 2>By the way, and you deeply enjoy some j Z

561
00:32:31.839 --> 00:32:35.480
<v Speaker 2>watch puns, listen to the horology episode of Ologies Just

562
00:32:35.519 --> 00:32:37.319
<v Speaker 2>get It, Just say it. What you could buy for

563
00:32:37.400 --> 00:32:40.519
<v Speaker 2>sixteen thousand dollars a month instead of twenty eight pills

564
00:32:40.640 --> 00:32:41.720
<v Speaker 2>or thirty pills.

565
00:32:41.960 --> 00:32:44.200
<v Speaker 4>Right, Oh my gosh, I know. And so you see,

566
00:32:44.200 --> 00:32:47.799
<v Speaker 4>in other areas it's been easier to work around it. So,

567
00:32:48.279 --> 00:32:51.279
<v Speaker 4>for example, in the area of surgery. So people say, well,

568
00:32:51.319 --> 00:32:54.839
<v Speaker 4>you know, I could get my need replaced in Nevada,

569
00:32:55.279 --> 00:32:57.839
<v Speaker 4>or maybe I could fly to Thailand and get it

570
00:32:57.880 --> 00:33:01.079
<v Speaker 4>replaced and it would be half the price, even including

571
00:33:01.119 --> 00:33:01.960
<v Speaker 4>the cost of the flight.

572
00:33:02.240 --> 00:33:05.079
<v Speaker 2>You know, it's so crazy. I know, I you know,

573
00:33:05.119 --> 00:33:07.599
<v Speaker 2>we joke that my dad, my dad's five hundred dollars

574
00:33:07.640 --> 00:33:10.400
<v Speaker 2>pills are like Kim Kardashian level. If you spent that

575
00:33:10.440 --> 00:33:13.839
<v Speaker 2>amount of money on like champagne and Yah, you'd be

576
00:33:13.960 --> 00:33:17.680
<v Speaker 2>rolling exactly. So instead of taking that one five hundred

577
00:33:17.680 --> 00:33:19.720
<v Speaker 2>dollars pill a day that's saving his life, my dad

578
00:33:19.759 --> 00:33:23.240
<v Speaker 2>could be every day getting bottle service, which starts at

579
00:33:23.279 --> 00:33:26.920
<v Speaker 2>around four hundred dollars at LA's douche As nightclubs. Or

580
00:33:27.039 --> 00:33:30.119
<v Speaker 2>he could be buying every day one pair of Easy

581
00:33:30.279 --> 00:33:36.039
<v Speaker 2>Clear PBC stiletto pumps. Dad. A PBC pump isn't a

582
00:33:36.079 --> 00:33:40.160
<v Speaker 2>plumbing thing. It's like a clear plastic high heel designed

583
00:33:40.200 --> 00:33:41.759
<v Speaker 2>by Kanye West.

584
00:33:42.000 --> 00:33:45.519
<v Speaker 4>And so I think I do see that this has

585
00:33:45.599 --> 00:33:48.039
<v Speaker 4>to be addressed. It is unsustainable.

586
00:33:48.200 --> 00:33:52.440
<v Speaker 2>So do oncologists collab, do they work together? Do they

587
00:33:52.480 --> 00:33:53.119
<v Speaker 2>play nice?

588
00:33:53.240 --> 00:33:56.319
<v Speaker 4>I would have to say though that outside of the US,

589
00:33:56.359 --> 00:34:00.160
<v Speaker 4>we've been really, really excited and had the opportunity to

590
00:34:00.200 --> 00:34:03.440
<v Speaker 4>work with some great teams, you know, outside of the US,

591
00:34:03.480 --> 00:34:06.599
<v Speaker 4>who are doing amazing things. One of the coolest projects

592
00:34:06.640 --> 00:34:10.719
<v Speaker 4>that we're doing is in Iceland. What so we're studying

593
00:34:10.840 --> 00:34:12.039
<v Speaker 4>everybody in Iceland?

594
00:34:12.320 --> 00:34:12.800
<v Speaker 2>Everyone?

595
00:34:13.000 --> 00:34:13.480
<v Speaker 4>Everyone?

596
00:34:13.599 --> 00:34:15.000
<v Speaker 2>How many people are in Iceland?

597
00:34:15.199 --> 00:34:16.960
<v Speaker 4>Three hundred and forty thousand? That's it?

598
00:34:17.360 --> 00:34:20.679
<v Speaker 2>Yes, Oh gosh, that's like that's like studio city in

599
00:34:20.840 --> 00:34:24.079
<v Speaker 2>La That's like Los Felas or something. Right, Okay, I

600
00:34:24.199 --> 00:34:27.559
<v Speaker 2>was way off. The population of the La suburbs Studio

601
00:34:27.599 --> 00:34:31.480
<v Speaker 2>City is thirty seven thousand, Los Felas just about the same,

602
00:34:31.679 --> 00:34:33.960
<v Speaker 2>So I was wrong. But three hundred and forty thousand

603
00:34:34.159 --> 00:34:37.920
<v Speaker 2>is less than the population of Staten Island, And it's

604
00:34:37.960 --> 00:34:42.599
<v Speaker 2>about equal to the total attendance of one Coachella weekend,

605
00:34:43.159 --> 00:34:47.039
<v Speaker 2>which is a very bone chilling statistic. Coachella is so crowded,

606
00:34:47.079 --> 00:34:47.480
<v Speaker 2>you guys.

607
00:34:47.599 --> 00:34:50.079
<v Speaker 4>But it's a whole country, and so there are so

608
00:34:50.159 --> 00:34:54.559
<v Speaker 4>many opportunities where you could test and then offer therapies

609
00:34:54.920 --> 00:34:59.360
<v Speaker 4>to a whole country where you're not excluding anyone. So

610
00:34:59.400 --> 00:35:03.840
<v Speaker 4>they're all part of the same electronic medical record system. Wow,

611
00:35:04.159 --> 00:35:07.719
<v Speaker 4>so you know what's happening to everyone from the time

612
00:35:07.760 --> 00:35:11.719
<v Speaker 4>they're born all the way through until they're getting diseases

613
00:35:11.760 --> 00:35:15.840
<v Speaker 4>and having issues. So the other thing that happened is

614
00:35:15.880 --> 00:35:20.079
<v Speaker 4>that there's a big genetic company in Iceland called Decode

615
00:35:20.199 --> 00:35:23.400
<v Speaker 4>Genetics that actually did DNA sequencing of.

616
00:35:23.360 --> 00:35:25.519
<v Speaker 2>All the people everyone.

617
00:35:25.719 --> 00:35:30.199
<v Speaker 4>Yes, wow, mind boggling cost. In real money, it would

618
00:35:30.199 --> 00:35:32.880
<v Speaker 4>have cost billions of dollars, but they did it in

619
00:35:32.920 --> 00:35:35.199
<v Speaker 4>a different way where it didn't cost them quite so much.

620
00:35:35.239 --> 00:35:39.840
<v Speaker 4>And so this is incredibly powerful, incredibly powerful, and so

621
00:35:40.639 --> 00:35:44.679
<v Speaker 4>we will learn what are called the driving mutations, the

622
00:35:44.719 --> 00:35:49.400
<v Speaker 4>ones that are leading us forward. And this will be

623
00:35:49.639 --> 00:35:53.159
<v Speaker 4>a huge opportunity for Crisper. So once we say, oh

624
00:35:53.239 --> 00:35:57.239
<v Speaker 4>my god, this is the gene, well, we would be

625
00:35:57.280 --> 00:36:01.719
<v Speaker 4>able to edit it wow, and prevent and to treat.

626
00:36:02.280 --> 00:36:05.440
<v Speaker 4>So it's going to lead in to all these new

627
00:36:06.559 --> 00:36:07.920
<v Speaker 4>molecular opportunities.

628
00:36:08.280 --> 00:36:11.679
<v Speaker 2>Thanks Iceland. I asked if eating walnuts helps, because we

629
00:36:11.800 --> 00:36:14.119
<v Speaker 2>read that eating walnuts helps, and you guys, my dadd

630
00:36:14.119 --> 00:36:17.679
<v Speaker 2>eats walnuts every day. Maybe walnuts are magic. Maybe walnuts

631
00:36:17.679 --> 00:36:19.880
<v Speaker 2>are the brains of aliens from another dimension and they

632
00:36:19.920 --> 00:36:23.000
<v Speaker 2>fix everything. Maybe they just have a lot of antioxidants.

633
00:36:23.159 --> 00:36:26.039
<v Speaker 4>But you do need to have your body and your

634
00:36:26.079 --> 00:36:29.639
<v Speaker 4>immune system in the best shape to accept all these

635
00:36:29.719 --> 00:36:33.199
<v Speaker 4>kinds of therapies. Right, And it's clear that having your

636
00:36:33.239 --> 00:36:39.559
<v Speaker 4>best diet, your best vitamin combination is absolutely helpful, but

637
00:36:39.639 --> 00:36:42.239
<v Speaker 4>you shouldn't have too high of an.

638
00:36:42.079 --> 00:36:46.079
<v Speaker 2>Expectation walnuts are not a reliable cure. But duh. But

639
00:36:46.320 --> 00:36:48.760
<v Speaker 2>this next part rules totally blew my mind.

640
00:36:48.920 --> 00:36:55.360
<v Speaker 4>And so I've been most interested to study places where

641
00:36:55.400 --> 00:36:59.639
<v Speaker 4>people live to be over one hundred, where they're apparently

642
00:36:59.679 --> 00:37:03.440
<v Speaker 4>pretty healthy, and the question is what are they eating?

643
00:37:03.519 --> 00:37:06.800
<v Speaker 2>Yeah, exactly, probably not as much jack in the box

644
00:37:06.840 --> 00:37:07.199
<v Speaker 2>as we do.

645
00:37:07.360 --> 00:37:10.719
<v Speaker 4>But that is the summary. That is the exact summary.

646
00:37:11.119 --> 00:37:14.880
<v Speaker 4>So the first place, they're called blue zones, and the

647
00:37:14.920 --> 00:37:19.039
<v Speaker 4>first one is a Greek island close to Turkey called Ikaria,

648
00:37:20.000 --> 00:37:23.880
<v Speaker 4>And so they have a Mediterranean diet as you might expect, right,

649
00:37:24.320 --> 00:37:27.960
<v Speaker 4>and so they have also very low stress. They have

650
00:37:28.559 --> 00:37:32.440
<v Speaker 4>no clocks on the island, so they're not concerned about time.

651
00:37:32.679 --> 00:37:33.480
<v Speaker 2>Are you kidding me?

652
00:37:34.000 --> 00:37:38.840
<v Speaker 4>So they have low stress, they have no clocks, no mortgage. See,

653
00:37:38.960 --> 00:37:42.239
<v Speaker 4>these are families that have lived there for hundreds of years,

654
00:37:42.320 --> 00:37:46.960
<v Speaker 4>and so they're just living there and they have you know, chickens,

655
00:37:47.119 --> 00:37:49.559
<v Speaker 4>they can go fish in the ocean, and they some

656
00:37:49.599 --> 00:37:52.599
<v Speaker 4>grow some grapes, have some nice red wine, and they

657
00:37:52.599 --> 00:37:57.039
<v Speaker 4>have a Mediterranean diet, and so this combination seems to

658
00:37:57.039 --> 00:38:01.480
<v Speaker 4>be rather healthy. But there is no jack in the box, right,

659
00:38:02.400 --> 00:38:05.760
<v Speaker 4>you know. And they don't they don't eat junk food,

660
00:38:05.800 --> 00:38:09.559
<v Speaker 4>they don't eat diet, they don't have diet drinks. You know,

661
00:38:09.599 --> 00:38:14.039
<v Speaker 4>they do drink wine, they do drink teas, they put

662
00:38:14.079 --> 00:38:17.719
<v Speaker 4>honey in as a sweetener, so they do a lot

663
00:38:17.719 --> 00:38:20.480
<v Speaker 4>of like healthy things, and so it is possible to

664
00:38:20.599 --> 00:38:24.039
<v Speaker 4>come up with like a healthy diet.

665
00:38:24.239 --> 00:38:26.079
<v Speaker 2>So all you have to do is move to an

666
00:38:26.079 --> 00:38:29.719
<v Speaker 2>island utopia and you're fine now if you're not into

667
00:38:30.159 --> 00:38:33.519
<v Speaker 2>Greek isles. Some of the other Blue zones are Okinawa,

668
00:38:33.679 --> 00:38:40.159
<v Speaker 2>Japan Island, Sardinia, Italy island, Nicoya in Costa Rica, which

669
00:38:40.159 --> 00:38:42.320
<v Speaker 2>is a peninsula. I'm blowing your mind right now, but

670
00:38:42.400 --> 00:38:47.679
<v Speaker 2>peninsula comes from pennae in Sula, which means almost an island,

671
00:38:48.239 --> 00:38:51.719
<v Speaker 2>case in point. And finally, okay, what's the last island?

672
00:38:51.719 --> 00:38:56.039
<v Speaker 2>You think it's going to be? Lo Molnda, California, which

673
00:38:56.079 --> 00:38:59.440
<v Speaker 2>is not an island. It's this weird outskirt suburb of

674
00:38:59.480 --> 00:39:03.199
<v Speaker 2>Los Angeles. There's a group of Seventh Day adventists that

675
00:39:03.239 --> 00:39:06.559
<v Speaker 2>live a life so chill that this one little area

676
00:39:06.719 --> 00:39:10.360
<v Speaker 2>counts as a blue zone. Very shocking. So some commonalities

677
00:39:10.360 --> 00:39:13.960
<v Speaker 2>that lead to these long, relatively disease free lives are

678
00:39:14.199 --> 00:39:19.599
<v Speaker 2>family putting it ahead of other concerns, less smoking, semi vegetarianism,

679
00:39:19.719 --> 00:39:24.679
<v Speaker 2>the majority of food consumed derived from plants, moderate physical activity,

680
00:39:25.480 --> 00:39:32.599
<v Speaker 2>social engagement, and finally, beans commonly consumed are legomes. So

681
00:39:32.639 --> 00:39:35.000
<v Speaker 2>it's part diet, part behavior.

682
00:39:34.719 --> 00:39:39.000
<v Speaker 4>And also a healthy pattern of behavior, which is to

683
00:39:39.440 --> 00:39:42.519
<v Speaker 4>we can't ignore the time, but we can certainly try

684
00:39:42.519 --> 00:39:44.920
<v Speaker 4>to reduce that time stress factor.

685
00:39:45.239 --> 00:39:49.320
<v Speaker 2>Right, I am doing everything the opposite of everything you

686
00:39:49.679 --> 00:39:53.679
<v Speaker 2>just described, and also scare me out of diet drinks?

687
00:39:53.679 --> 00:39:56.039
<v Speaker 2>Should I? We shouldn't be drinking diet drinks, right you

688
00:39:56.079 --> 00:39:56.519
<v Speaker 2>should not?

689
00:39:56.800 --> 00:39:57.119
<v Speaker 6>Okay?

690
00:39:57.760 --> 00:40:00.559
<v Speaker 2>Good to know? How do they kill us?

691
00:40:00.639 --> 00:40:03.840
<v Speaker 4>And things like coke they do have that brown color

692
00:40:03.880 --> 00:40:08.440
<v Speaker 4>of the colke. That caramel is not so healthy in fact,

693
00:40:08.559 --> 00:40:13.000
<v Speaker 4>so the dyes are not so healthy. And then the

694
00:40:13.039 --> 00:40:17.400
<v Speaker 4>things like asparteam that the sweeteners those are not good either.

695
00:40:17.480 --> 00:40:19.480
<v Speaker 2>So I just started down a rabbit hole about diet

696
00:40:19.519 --> 00:40:23.719
<v Speaker 2>sodas and the links to various diseases and increased weight gain.

697
00:40:24.079 --> 00:40:27.760
<v Speaker 2>And a higher incidence of depression, and man, go research

698
00:40:27.800 --> 00:40:30.079
<v Speaker 2>it if you want to be scared off. I have

699
00:40:30.159 --> 00:40:32.840
<v Speaker 2>to do another episode just all about that. It reminds

700
00:40:32.880 --> 00:40:35.239
<v Speaker 2>me of the days when our parents generation smoked like

701
00:40:35.360 --> 00:40:41.480
<v Speaker 2>indoors and on airplanes and in like neonatal ICUs and

702
00:40:41.519 --> 00:40:43.920
<v Speaker 2>in offices, and they were like, yeah, everyone knew was bad,

703
00:40:43.960 --> 00:40:45.800
<v Speaker 2>but you know, this is what people did, and now

704
00:40:45.800 --> 00:40:46.719
<v Speaker 2>we find it horrifying.

705
00:40:46.840 --> 00:40:49.960
<v Speaker 4>There's a number of different things about those drinks that

706
00:40:50.079 --> 00:40:58.280
<v Speaker 4>can be negative. So juices, water, wine, teas, those are

707
00:40:58.320 --> 00:40:59.760
<v Speaker 4>all good, but diet drinks no.

708
00:41:00.079 --> 00:41:03.519
<v Speaker 2>Okay. Good to know that cements my position on that

709
00:41:04.119 --> 00:41:06.920
<v Speaker 2>I may have had one yesterday kilously, I've been like,

710
00:41:06.960 --> 00:41:11.079
<v Speaker 2>what am I doing to myself? So what are in

711
00:41:11.159 --> 00:41:14.400
<v Speaker 2>terms of other or actually this is a personal question,

712
00:41:14.440 --> 00:41:17.960
<v Speaker 2>but being a doctor and a hematologist noncologist, how often

713
00:41:18.079 --> 00:41:22.840
<v Speaker 2>do you notice symptoms in yourself like back pain or

714
00:41:22.880 --> 00:41:25.000
<v Speaker 2>does my shoulder herd? Or do I have this? Or

715
00:41:25.079 --> 00:41:28.360
<v Speaker 2>are you pretty much not a hypochondriac because you know

716
00:41:28.400 --> 00:41:30.320
<v Speaker 2>so much about medicine, Because I feel like the rest

717
00:41:30.320 --> 00:41:32.480
<v Speaker 2>of the population walks around every day being like do

718
00:41:32.559 --> 00:41:35.119
<v Speaker 2>I have cancer? As an oncologist, do you do you

719
00:41:35.159 --> 00:41:35.719
<v Speaker 2>think about that.

720
00:41:36.400 --> 00:41:39.760
<v Speaker 4>Yeah, I do. I think that I'm not a hypochondriac,

721
00:41:39.840 --> 00:41:43.119
<v Speaker 4>and I think it does help to understand that, you know,

722
00:41:44.840 --> 00:41:47.239
<v Speaker 4>we all like might tweak her back one day, you

723
00:41:47.280 --> 00:41:48.880
<v Speaker 4>get up the wrong way, or you you know your

724
00:41:48.920 --> 00:41:51.239
<v Speaker 4>on or you walk the wrong way, but it's not cancer,

725
00:41:51.320 --> 00:41:54.159
<v Speaker 4>you know, and you know it'll be gone in a

726
00:41:54.159 --> 00:41:57.000
<v Speaker 4>few days, so you don't need to rush to get

727
00:41:57.039 --> 00:41:59.760
<v Speaker 4>scans and blood tests and things that you'll be you'll

728
00:41:59.760 --> 00:42:02.519
<v Speaker 4>get over it. And so I think there's a tendency

729
00:42:02.599 --> 00:42:04.639
<v Speaker 4>to think that, you know, if you come down with

730
00:42:04.679 --> 00:42:07.840
<v Speaker 4>a really bad cold or something, that it's going to

731
00:42:07.840 --> 00:42:11.519
<v Speaker 4>be the start of something really bad. Right now, we

732
00:42:11.559 --> 00:42:15.119
<v Speaker 4>don't want to ignore those things, of course, but certainly

733
00:42:15.119 --> 00:42:19.880
<v Speaker 4>individually maybe less immediately worried.

734
00:42:20.119 --> 00:42:23.760
<v Speaker 2>Right so you at least know what to look for. Yes, okay,

735
00:42:24.000 --> 00:42:28.559
<v Speaker 2>that's good. So okay. Doctors aren't usually paranoid hyperchondriacs. I

736
00:42:28.639 --> 00:42:33.679
<v Speaker 2>will say there is a hugely studied reluctance, particularly in men,

737
00:42:33.840 --> 00:42:35.800
<v Speaker 2>to go to the doctor when they feel a little off.

738
00:42:36.239 --> 00:42:39.480
<v Speaker 2>Men also have shorter life expectancy. So if you're feeling

739
00:42:39.559 --> 00:42:42.360
<v Speaker 2>off and you can't catch your breath, your bones hurt,

740
00:42:42.400 --> 00:42:45.719
<v Speaker 2>your vision gets weird, whatever your symptoms for whatever, go

741
00:42:45.800 --> 00:42:49.199
<v Speaker 2>to a doctor. My dad ignored feeling awful for months

742
00:42:49.360 --> 00:42:51.719
<v Speaker 2>and my mom finally forced him to go and by

743
00:42:51.800 --> 00:42:55.599
<v Speaker 2>that point they just legit admitted him to the hospital

744
00:42:55.639 --> 00:42:58.800
<v Speaker 2>for blood transfusions. She saved his life. Way to go, Nancy,

745
00:42:59.000 --> 00:43:02.880
<v Speaker 2>So dudes, go to doctors. Dad, go to the doctor.

746
00:43:02.920 --> 00:43:04.920
<v Speaker 2>Next time Mom tells you too, do you have to do?

747
00:43:04.960 --> 00:43:06.360
<v Speaker 2>You have a lot of people in your family that

748
00:43:06.400 --> 00:43:08.920
<v Speaker 2>are call you a text you and say doctor durry.

749
00:43:09.760 --> 00:43:12.519
<v Speaker 4>Well, yes, quite a few, although I would say that

750
00:43:12.559 --> 00:43:17.199
<v Speaker 4>within my family and friends that are not so hypochondriac.

751
00:43:16.679 --> 00:43:18.079
<v Speaker 2>That's good. Maybe it's a Scottish thing.

752
00:43:18.159 --> 00:43:21.599
<v Speaker 4>It's a Scottish thing. Yes, yes, so so my mother

753
00:43:21.719 --> 00:43:24.800
<v Speaker 4>lived to be close to one hundred and my sister's

754
00:43:25.519 --> 00:43:29.719
<v Speaker 4>pretty old, you know, so we were not like we're fortunate.

755
00:43:29.800 --> 00:43:32.760
<v Speaker 4>We're not an unhealthy group of people.

756
00:43:32.880 --> 00:43:36.280
<v Speaker 2>Good. You've probably stayed away from diet coke and hamburgers. Now,

757
00:43:37.079 --> 00:43:40.280
<v Speaker 2>last couple questions, last two questions. What is something that

758
00:43:40.480 --> 00:43:44.039
<v Speaker 2>is the part of your job, part of your work

759
00:43:44.039 --> 00:43:47.239
<v Speaker 2>that is the most challenging. That is maybe the thing

760
00:43:47.280 --> 00:43:51.079
<v Speaker 2>that's more of a slog or something that is difficult.

761
00:43:51.199 --> 00:43:52.679
<v Speaker 2>And then I'll ask you what your favorite thing is.

762
00:43:53.679 --> 00:43:58.960
<v Speaker 2>What is something anything from parking to h Yeah.

763
00:43:59.000 --> 00:44:01.360
<v Speaker 4>Well, I think that the saddest and the most difficult

764
00:44:01.440 --> 00:44:04.719
<v Speaker 4>thing has been the way that medicine has changed over

765
00:44:04.719 --> 00:44:07.880
<v Speaker 4>the years that I've been practicing. Medicine is where, you know, I,

766
00:44:08.239 --> 00:44:11.360
<v Speaker 4>for many years practice practiced it on an individual basis,

767
00:44:11.400 --> 00:44:14.000
<v Speaker 4>where I would have my patients, you know, and I

768
00:44:14.039 --> 00:44:16.280
<v Speaker 4>would take care of them. If they went to the hospital,

769
00:44:16.280 --> 00:44:17.760
<v Speaker 4>I would see them, and then when they came out,

770
00:44:17.800 --> 00:44:21.400
<v Speaker 4>I would take care of them. But now medicine's become

771
00:44:21.400 --> 00:44:24.400
<v Speaker 4>a business. You know, I take care of them, you know,

772
00:44:24.599 --> 00:44:27.239
<v Speaker 4>I'm not there on the Saturday. Somebody else takes care

773
00:44:27.239 --> 00:44:29.000
<v Speaker 4>of them. They end up in the hospital, and then

774
00:44:29.079 --> 00:44:32.440
<v Speaker 4>this happens, and that happens, and then it's a whole

775
00:44:32.679 --> 00:44:39.039
<v Speaker 4>bureaucratic nightmare where the individual individuality of the patient care

776
00:44:39.559 --> 00:44:47.199
<v Speaker 4>has really lost that personal possibility. The paperwork is enormous,

777
00:44:47.920 --> 00:44:51.920
<v Speaker 4>and then there are so many challenges when you see

778
00:44:52.039 --> 00:44:56.000
<v Speaker 4>your patient. And I would say that the biggest one

779
00:44:56.239 --> 00:45:00.159
<v Speaker 4>is something that we touched on already, is you know,

780
00:45:00.239 --> 00:45:05.400
<v Speaker 4>I want to give this cocktail, this medicine, will my

781
00:45:05.559 --> 00:45:07.760
<v Speaker 4>patient be able to get it and to afford it,

782
00:45:08.639 --> 00:45:11.639
<v Speaker 4>and this is just so difficult, and as I travel

783
00:45:11.679 --> 00:45:15.840
<v Speaker 4>around the world. Obviously there are issues here in the US,

784
00:45:15.960 --> 00:45:17.639
<v Speaker 4>but outside of the US.

785
00:45:17.920 --> 00:45:20.079
<v Speaker 2>So once again, as much as the price of some

786
00:45:20.199 --> 00:45:23.719
<v Speaker 2>therapies are infuriating, we are lucky to have them.

787
00:45:24.079 --> 00:45:29.000
<v Speaker 4>I mean, there are whole countries that don't have revelement.

788
00:45:29.320 --> 00:45:32.840
<v Speaker 4>I mean, so that means that they don't have access

789
00:45:32.960 --> 00:45:37.599
<v Speaker 4>to anything beyond therapies that we had in the year

790
00:45:37.639 --> 00:45:43.360
<v Speaker 4>two thousand and So this is a really a sad

791
00:45:43.400 --> 00:45:45.440
<v Speaker 4>and difficult thing for me to see that there are

792
00:45:45.440 --> 00:45:48.199
<v Speaker 4>so many patients that don't have the treatment that they

793
00:45:48.360 --> 00:45:49.480
<v Speaker 4>deserve and that they need.

794
00:45:50.760 --> 00:45:54.519
<v Speaker 2>I imagine also the work that you do. You have

795
00:45:55.119 --> 00:45:58.119
<v Speaker 2>such an interest in seeing how each of these patients does.

796
00:45:58.639 --> 00:46:02.360
<v Speaker 2>Getting to follow through is probably it's probably pretty gratifying,

797
00:46:02.920 --> 00:46:03.639
<v Speaker 2>right right.

798
00:46:03.760 --> 00:46:06.440
<v Speaker 4>So now you know I have patients that I see

799
00:46:07.119 --> 00:46:08.039
<v Speaker 4>twenty years later.

800
00:46:08.239 --> 00:46:11.000
<v Speaker 2>Ah, that's great. Tried really hard not to cry at

801
00:46:11.000 --> 00:46:12.280
<v Speaker 2>this point of the interview.

802
00:46:11.960 --> 00:46:16.519
<v Speaker 4>Which is fantastic, you know, and you know, they'll remind

803
00:46:16.599 --> 00:46:18.679
<v Speaker 4>me that when I first met them, I said that

804
00:46:18.760 --> 00:46:20.800
<v Speaker 4>my expectation was three or four years.

805
00:46:21.039 --> 00:46:21.440
<v Speaker 2>Wow.

806
00:46:21.559 --> 00:46:23.960
<v Speaker 4>And then you know I had a patient recently. She

807
00:46:24.039 --> 00:46:26.599
<v Speaker 4>and her husband they reminded me that I'd said that,

808
00:46:27.159 --> 00:46:28.760
<v Speaker 4>but it was it's twenty years now.

809
00:46:28.840 --> 00:46:30.960
<v Speaker 2>That's great. I love it when doctors are wrong in

810
00:46:30.960 --> 00:46:32.920
<v Speaker 2>that fashion. That must be the best.

811
00:46:33.079 --> 00:46:34.119
<v Speaker 4>That's the best, okay.

812
00:46:34.679 --> 00:46:38.760
<v Speaker 2>And so what is your favorite thing about hematology or

813
00:46:38.800 --> 00:46:40.800
<v Speaker 2>blood or what you do, Like, what is the thing

814
00:46:40.800 --> 00:46:43.880
<v Speaker 2>that just really kind of gets you excited about starting

815
00:46:43.920 --> 00:46:44.320
<v Speaker 2>your week?

816
00:46:45.000 --> 00:46:47.440
<v Speaker 4>Well, I think the most exciting thing is that we

817
00:46:47.519 --> 00:46:50.719
<v Speaker 4>are starting to make so much progress, that we have

818
00:46:50.800 --> 00:46:53.800
<v Speaker 4>these new drugs, that patients are living longer, and so

819
00:46:53.840 --> 00:46:55.960
<v Speaker 4>that when I see a new patient now it's kind

820
00:46:55.960 --> 00:46:58.320
<v Speaker 4>of not like, oh my god, you know it's going

821
00:46:58.360 --> 00:47:00.320
<v Speaker 4>to be two, three, four years. You know, Oh, I

822
00:47:00.320 --> 00:47:03.280
<v Speaker 4>can say, well, we're expecting you to live at least

823
00:47:03.280 --> 00:47:06.119
<v Speaker 4>seven to ten years, and during those seven to ten years,

824
00:47:06.159 --> 00:47:07.920
<v Speaker 4>we'll probably have something even better.

825
00:47:08.079 --> 00:47:08.639
<v Speaker 2>That's great.

826
00:47:08.800 --> 00:47:12.280
<v Speaker 4>You know. So it's really more of a joy. It's

827
00:47:12.280 --> 00:47:14.840
<v Speaker 4>still a lot of hard work, but it's a much

828
00:47:14.880 --> 00:47:17.440
<v Speaker 4>more positive situation than it was before.

829
00:47:17.599 --> 00:47:20.960
<v Speaker 2>Try not to cry while editing this, but still crying

830
00:47:20.960 --> 00:47:23.239
<v Speaker 2>a little bit. That's great. That's got to be. That

831
00:47:23.599 --> 00:47:25.639
<v Speaker 2>has to give you so much motivation for doing your

832
00:47:25.639 --> 00:47:26.480
<v Speaker 2>best on the job.

833
00:47:26.760 --> 00:47:29.559
<v Speaker 4>Exactly exactly, Well.

834
00:47:29.639 --> 00:47:32.159
<v Speaker 2>This has been so this has been so informative. Thank

835
00:47:32.199 --> 00:47:34.559
<v Speaker 2>you so much for sitting down with me. I can't

836
00:47:34.559 --> 00:47:36.960
<v Speaker 2>believe it all started with blood under a microscope.

837
00:47:37.440 --> 00:47:40.920
<v Speaker 4>Right, well, thank you for your very insightful questions, which

838
00:47:41.880 --> 00:47:44.519
<v Speaker 4>very very good to have a chance to talk to

839
00:47:44.559 --> 00:47:45.400
<v Speaker 4>you about these things.

840
00:47:45.519 --> 00:47:47.920
<v Speaker 2>Of course, some of them come directly from Larry Ward

841
00:47:48.199 --> 00:47:48.639
<v Speaker 2>in the matter.

842
00:47:48.719 --> 00:47:51.559
<v Speaker 4>Right, Let's tell Larry Ward that I am very happy

843
00:47:51.599 --> 00:47:54.960
<v Speaker 4>to give these answers and many more as the questions

844
00:47:54.960 --> 00:47:55.599
<v Speaker 4>pop in his head.

845
00:47:55.639 --> 00:47:57.239
<v Speaker 2>Okay, oh good, Thank you so much.

846
00:47:57.280 --> 00:47:57.639
<v Speaker 4>Doctor.

847
00:47:58.239 --> 00:48:01.880
<v Speaker 2>This is great. Sum Let's all move to tiny islands

848
00:48:01.920 --> 00:48:04.159
<v Speaker 2>and live to be one hundred or at least stop

849
00:48:04.199 --> 00:48:06.679
<v Speaker 2>eating garbage and go to the doctor when we're sick.

850
00:48:07.199 --> 00:48:08.639
<v Speaker 2>So I want to say a huge thanks to the

851
00:48:08.639 --> 00:48:11.280
<v Speaker 2>Peter Boyle family and Lorraine Boil for their work in

852
00:48:11.599 --> 00:48:14.880
<v Speaker 2>raising millions of dollars to find a cure for multiple maloma,

853
00:48:15.000 --> 00:48:18.679
<v Speaker 2>and to Peter Anton and Randy Lovett and everyone at

854
00:48:18.679 --> 00:48:22.440
<v Speaker 2>the International Maloma Foundation for access to doctor Durry. Thank

855
00:48:22.480 --> 00:48:26.079
<v Speaker 2>you to him. More info is at myeloma dot org.

856
00:48:26.519 --> 00:48:29.599
<v Speaker 2>Also side note, my mom has MS, so if there's

857
00:48:29.599 --> 00:48:33.480
<v Speaker 2>a neurologist out there, holler at my face. Thanks to

858
00:48:33.679 --> 00:48:36.320
<v Speaker 2>Stephen Ray Morris for editing this down to the wire

859
00:48:36.599 --> 00:48:40.360
<v Speaker 2>because I'm so behind after getting stuck in the Northeast

860
00:48:40.440 --> 00:48:43.719
<v Speaker 2>bomb cyclone storm this past week, I'm so behind. He's

861
00:48:43.840 --> 00:48:46.239
<v Speaker 2>editing this like hours before it goes up. Thank you, Steven.

862
00:48:46.280 --> 00:48:48.519
<v Speaker 2>I owe you a million dinners. Thanks to Hannah and

863
00:48:48.599 --> 00:48:51.320
<v Speaker 2>Aaron for running the Ologies Facebook group, which you can

864
00:48:51.360 --> 00:48:54.519
<v Speaker 2>totally join. Thank you for being great friends. Also, all

865
00:48:54.599 --> 00:48:57.920
<v Speaker 2>kinds of Ologies merch is available at ologiesmerch dot com.

866
00:48:57.920 --> 00:49:01.000
<v Speaker 2>There's t shirts and hats and pins, and the sales

867
00:49:01.039 --> 00:49:03.639
<v Speaker 2>help make this podcast possible, So thank you Shannon Feltus

868
00:49:03.639 --> 00:49:06.079
<v Speaker 2>and Bonnie Dutch for that. They do awesome design work

869
00:49:06.360 --> 00:49:08.639
<v Speaker 2>and I heart them. If you like the podcast and

870
00:49:08.639 --> 00:49:10.599
<v Speaker 2>you want to support it, you can become a patron

871
00:49:10.639 --> 00:49:13.159
<v Speaker 2>for as little as twenty five cents an episode at

872
00:49:13.199 --> 00:49:16.559
<v Speaker 2>patreon dot com slash Ologies. You may notice I do

873
00:49:16.639 --> 00:49:19.159
<v Speaker 2>this ad free, so this helps me pay the cost

874
00:49:19.239 --> 00:49:22.880
<v Speaker 2>of production. You can also help so much for zero

875
00:49:22.960 --> 00:49:26.119
<v Speaker 2>dollars just by signal boosting. You can rate and review

876
00:49:26.159 --> 00:49:31.079
<v Speaker 2>on iTunes. That helps so much. So does instagramming, tweeting

877
00:49:31.119 --> 00:49:34.880
<v Speaker 2>about the podcast, telling a friend Ologies is at Ologies

878
00:49:34.920 --> 00:49:38.800
<v Speaker 2>on Twitter and Instagram. I'm Ali ward on both and

879
00:49:39.400 --> 00:49:44.800
<v Speaker 2>for your end of the episode. Secret. Okay, oh no, okay. Once,

880
00:49:46.599 --> 00:49:48.119
<v Speaker 2>I didn't want to pick up a phone when somebody

881
00:49:48.119 --> 00:49:51.840
<v Speaker 2>called me, so I didn't answer. But while it was ringing,

882
00:49:52.159 --> 00:49:55.119
<v Speaker 2>I fully clothed, got in the shower, walked into my

883
00:49:55.119 --> 00:49:57.360
<v Speaker 2>shower without the water on, stood there for just a

884
00:49:57.360 --> 00:49:59.440
<v Speaker 2>few seconds while the phone rang, and then I stepped

885
00:49:59.440 --> 00:50:02.639
<v Speaker 2>out so that I could technically say later, I'm so

886
00:50:02.679 --> 00:50:04.360
<v Speaker 2>sorry I was in the shower when you called and

887
00:50:04.400 --> 00:50:07.920
<v Speaker 2>not be lying, which is insane. It would be better

888
00:50:07.960 --> 00:50:09.639
<v Speaker 2>just to lie or say that I didn't feel like

889
00:50:09.639 --> 00:50:11.760
<v Speaker 2>talking to you, but lying seem so evil, So I

890
00:50:11.760 --> 00:50:14.199
<v Speaker 2>don't know. I don't know. I'm working it out. So

891
00:50:14.239 --> 00:50:16.039
<v Speaker 2>now that's your end of the show. Secret. Okay, that's

892
00:50:16.039 --> 00:50:17.599
<v Speaker 2>it for this week. Thank you so much for listening.

893
00:50:17.679 --> 00:50:20.760
<v Speaker 2>I like you so much. Very honestly, go ask smart

894
00:50:20.800 --> 00:50:26.199
<v Speaker 2>people dumb questions, because curiosity is never not cool. Okay,

895
00:50:26.519 --> 00:50:40.360
<v Speaker 2>bye bye. Pacodermatology, hobbiology or do zoology, lithology and technology, meteorology, paratology, ethology, zeriology, elinology.

896
00:50:49.719 --> 00:50:53.000
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899
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