I Don't Know About That - Medical Misinformation

Episode Date: October 12, 2021

In this episode, the team discusses medical misinformation with Harvard Medical Professor and host of the Freakonomics, M.D. podcast, Dr. Anupam Bapu Jena. Follow Dr. Jena's podcast on Instagram and Twitter @DrBapuPod . Go to LoopedLive.com to buy tickets to our live virtual event! Find it under upcoming experiences! Go to JimJefferies.com to buy tickets to Jim's upcoming tour, The Moist Tour.See omnystudio.com/listener for privacy information.

This show is sponsored by BetterHelp Online Therapy. Visit betterhelp.com slash IDK because honestly, being human is exhausting. Hello, everybody. Guess what's going to happen? I don't know about that. He's doing a virtual event. That's right.

We're going to do the show as normal where I learn about a mystery subject from a mystery guest, but then we're going to do something extremely exciting. We're going to have trivia, bingo with the audience and have some amazing prizes. We'll also take questions. It's going to be very interactive. So let's see where it goes. Tickets are on sale now at loopedlive.com under upcoming experiences. So go buy them now under upcoming experiences on loop on Looped Live. That's L-O-O-P-E-D-L-I-V-E.com. See you then. Bars.

Bars. What's best to club someone with and what's best to get a drink? You might find out, and I don't know about that, with Jim Jefferies. There we go. The song just peed it out. No, that bit just ended abruptly. Yeah, yeah, yeah.

I just got hit with a bar. Someone just walked up to me here. Who's this guy taking the piss out of bars? We're in our new room. We're at the world-f in west hollywood here we are melrose loving it thank you to the improv for having us here they've been very welcoming and we've had a wonderful time thus far mind you were only a minute and a half in it all go tits up at any second i figured because we're in a new room you'd have all these new things to say in the intro. I saw a metal bar up there.

There's all these books on the shelf. I've done books. I've done books. No, but read the titles. The bar one was good. Yeah, it was very good. It was solid. That might have been the best one so far.

We've done 74 episodes. That was your- Right out of words. 71st best one. We've had a good- Me and Forrestrest played in a golf tournament we played rather well a week before that we played golf uh with jack and our friend andrew wantok and we got into a fight on the golf course that was fun we did we got into an argument we didn't get into a fistfight or anything we got in you me you jack in one talk remember remember? Oh, with other people. With other people.

Not with each other. Wait, I need to hear this story. We were like the sharks and the jets, man. Yeah, me and Jack and Jim were there waiting for Andrew. And Andrew got there right on time, but he was just running a little late. And these two guys said, hey, do you mind if we play through or run in late? They were a half an hour late. They were a half an hour late.

Yeah, and we're like, but there's four of us. There's two of them. golf tea time's important it comes down to five minutes two minutes this is like yeah every 10 minutes is a new tea time and you put but they were half hour late but there was only two of them and we're like sure there's four of us that we're gonna play way slower than them well we didn't we get to like the 10th hole they're still like we're waiting for them i yelled at them like hey move it along and then the guys clearly went slower which is a dickhead move. There's only two of them. Yeah, you're supposed to be going faster and then

they're trying to act like we're the dickheads. You're trying to do a favor for them. And they came at the wrong time. They took a mulligan on the first hole. You don't do that when you're playing through. He goes, oh, sorry, we'll play through. Took a mulligan, hit it in the same fucking spot. In another shot basically. Right, but the mulligan will play into the story in just a second. So we

get to the 18th hole and they're still fucking just there. can't see off they're just dicking around there's no one in front of them no one in front of them no one three and a half four hours they've been slower than four of us two of them have been and we weren't even playing well you're playing the worst we've played in years we were terrible anyway so we get there and forrest says uh on the 18th hole hey you mind if we play through yeah as a passive aggressive sarcastic very good very solid line solid and the guy's like what and he goes and we go we've and i said something like we've been fucking waiting this whole fucking time you're going too slow like this right because you haven't waited at all like yeah it's like

what are you talking about we're waiting right now like, what are you talking about? We're waiting right now. We're waiting right now. What are you talking about? We haven't waited at all. We waited all day. An extra hour of our life was taken by these people, right? So anyway, so there's one bloke who you could tell he was like, yeah, my fucking mate's a bit of a dickhead.

He's going a bit slow. And then the dickhead goes like this, well, we're playing two grand a hole. That's what he said to fucking adults he said adults said that to another adult we're playing two thousand dollars a hole and we all went two thousand dollars a hole we didn't know two thousand dollars a hole we didn't know about your two thousand dollars a hole. And then like- Which, first of all, there's no way. Yeah.

Also, Mulligan on the first shot. No one Mulligans on $2,000 a hole. You go, fucking hell, I'm winning. Mulligan, you take the shot over. You take the shot over. You go, I'm winning a bit of money here. He just hit it into the woods. But no, he thought we'd go, oh, we didn't know you were rich.

Oh, we didn't know that a rich person was in front of us playing $2,000. On a public golf course. On a public golf course. Oh, we're sorry, rich man. We should have been ever more respectful of you and your $2,000 a hole. And I hope he heard this, but I said to Forrest, I go, we have to play quick. I've got to see what car they're in.

If we get to the fucking parking lot and they get into a Corolla, I'd go, stop gambling. You can't afford it. You can't afford two grand a hole. You drive a shit box. I think they gave up on the hole. They left. They didn't even finish the hole.

We played two grand a hole and we were like, what? And his friend just went, don't worry, but let's just go home. They just called off the bet. Two grand a hole. I think we're even now, right? Yeah, yeah, yeah. Let's see. Let's settle up. Are you $22,000?

It's not the 18. Take checks. 18 holes. Even if you're playing two grand. If me and Forrest played two grand a hole, at the end of the day, maybe someone owes someone six grand or whatever like that. It's not like you're fucking Michael Jordan.

And at the end of the day, it's going to, like, I know six grand's nothing to be sneezed at. It's a lot of money. But it's still not enough for fucking four grown-ass men to go, oh, I did not know. Also, who gives a fuck? Yeah, yeah. Play faster. Yeah, who gives a fuck? Play faster. Yeah, yeah. Does that mean you have to play slowly?

It shouldn't inconvenience me. You started late, too, if this game's so important to you. Yeah, yeah. So that was our gripe of the week. Gripe of the week. Gripe of the week. Gripe of the week. What have you got for us, Jack?

Jack of the Trades. What's this one again? I don't know. What have you got for us, Jack? Jack of the Trades. What's this one again? At 8 p.m., Jack of the Trades reads inconsequential news stories. Extra, extra.

Jack's got some information. Coming at you. Extra, extra. I had something different in there. Yeah. You wrote something different in the outline. I didn't put anything in the outline. It's probably just an old outline.

Hold the presses. Hold the presses. Oh, what's going on here? Jack has some information! Can I say something real quick? We've had a comment that someone said I was too mean to Jack. There's lots of comments. Yeah, okay, a lot of comments.

I didn't know that Jack's mother could spell to write that message. And so I get in here today and Jack is upset with me because last night we went to the Dodgers game and apparently he was still upset with me talking about that because I made him. I was upset with his decision to go to a gas station. And then I stuck up for you, Jack. And then and then he told me where he's going.

He's in this neighborhood three years. But and then he said I was a backseat driver and he stuck up for himself today and all the times I've been mean to him and bullying him and stuff. This was it. We have to get to this point today.

You finally stood up for yourself, Jack. Congratulations. You've graduated. You've leveled up. You've graduated my class. You beat the final game. Everybody, Jack's finally become a man. Congratulations. You've graduated. You've leveled up. You've graduated my class. You beat the finals. You've graduated my class. So everybody, Jack's finally become a man. Jack respects himself. Oh, Arnie.

Arnie's excited. I'm really excited. What did you tell him? What did you say to him? I don't remember. It was like, I'm so mad. He's like, Max, you drive is my biggest pet peeve. He's like, don't do that. He was a little upset today.

It was awesome. You're a backseat driver. It's the thing that's one of my big pet peeves. Yeah, I was very excited for you, Jack, today. It's good. It's good. He stopped for fuel and Forrest was like, yeah, we would have made it. But then I said, so Forrest, maybe you should be really nice to Jack today,

just like as a bit. And he goes, no, I'm not doing that. But also, in Jack's defense, he said we'd make it in time. We were there for first pitch. By the skin of our teeth, but we were there. We were there. I didn't say how early we our teeth, but we were there. We were there. I didn't say how early we'd get there. The only thing I would say is you still haven't said you're welcome.

Oh, God. You're welcome. Don't leave him alone. Poor Jack. Anyway, in other news, hey, South Korean president proposes putting a ban on eating dogs. What? Yeah, South Koreans pet industry is on the rise. His name is President Moon.

He has a bunch of dogs. So he's like, hasn't the time come to prudently consider prohibiting dog meat consumption? It'll be like when prohibition happened in America. There'll be people stockpiling them. The dogs that you have now you can eat, but you can't buy new ones.

Now what I don't understand about South Korea is that they have a president and a prime minister. So I'm not too sure the government works there. Sometimes in Australia, you have a prime minister and then you have fucking hell, I forgot the bloody word. Governor General is the person above, which would be called our president if we became a republic. But they're just a figurehead. The prime minister does all the things. So I don't know if it's the same in Korea.

Okay, that's it. New story. Any other comments? Arnie, what do you think? You happy they're not eating dogs anymore? He's happy. I mean, he doesn't live in South Korea, but yeah, I think he's happy for his friends. Yeah.

Yeah. They don't eat dogs. It says President of South Korea is the leader. All right. There we go. I think that's good, though. I mean, the- And his name's Moon. There's a lot of people called Sun over there. The sun is the leader. Alright, there you go. I think that's good though. His name's Moon. There's a lot of people called Sun over there.

The Sun and the Moon. They like a lot of astrological things. Pluto. President Pluto. A gravestone missing for 150 years was found being used in a family home as a slab to make fudge right right but no but was it missing was people going i can't find that fucking thing there was

150 years passing it on to generations you look for it i've done the looking i've been looking for 50 years your 50 years take over or was it just that the fudge people flipped it over and went who's betsy wayne peter j weller died in 1849 in lansing michigan and was buried in oak part cemetery and then 1875 his grave was moved to mount home cemetery but the monument never made it to the new cemetery so they don't know where it got lost in transit so whoever worked in the in the transit department was just like this would be great for fudge So it ended up in someone's house and they would make seasonal fudge in this family for generations. But did they ever like make fudge and they go, okay, this is the secret to making fudge.

Always keep it warm. Keep it moving. Keep it moving. Sometimes it will get stuck in the RIP. It's just a mold. Yeah, exactly. Like all we have a bunch of P-E-T a bunch of they made the best fudge at halloween i don't even like couldn't you just get a slab of stone somewhere and do that maybe they just

thought it was and they never flipped it over because there was an estate sale you gotta wash that thing yeah i don't know you have to wash underneath it. Yeah, but I mean, I feel like all your dishes go in the sink, right? So bizarre. I don't know. Well, it's a huge gravestone. It was like,

I don't know. I just feel like at some point you would see the other side of it. Most of my furniture I've seen the other side. I always say

they make fudge on marble. Was it marble? I don't think granite's a good fudge make. They called it a marble slab. Yeah, it's a marble slab. It was smooth marble on call it a marble slab yeah it's a marble slab yeah they always make it i was smooth marble on one side i was thinking of like a traditional tombstone i'm like that's too porous fancy one a marble tombstone wow it was actually a cross they used to just make it on the little bit on the side

the wings the wings of the cross um a uk-based surgeon dr karan raj says the most dangerous sex position is any guesses I reckon it's the jackhammer one where you have the girl at the end of the bed with her head on the floor

and then you squat over the top of her I've seen it in porn I've tried it once I can't carry it off when you're having sex while you're driving that's dangerous

Kelly any guesses well you're having no I don't want to say that that's too dark face to face because you might have a heart attack if you see what you're doing it's reverse cowgirl i was gonna say that now you should have said it but that wasn't my dark one okay but i was gonna

say reverse cowgirl because what breaks a dick he says it's responsible for 50 of penis fractures that he's personally had to do surgeries on because during sex it can slip out in the pelvic bone can just crush it yeah yeah yeah no. I've had some dick injuries from the reverse cargo. Not like bad ones, but where I've gone, oh, it's not good. Fractured dick. Yeah. Fractured dick.

You don't want to cause for that. They said it's technically a muscle, essentially like a muscle tear, but they just call it a fracture. What do you do? How do you fix that? I pull the dick. You're going to disabled list or something? I guess so.

It can permanently curve it, they said. That's good. It's the IL. It's not the DL anymore. I don't know. They don't call it the DL anymore, Forrest. No, they don't. It's insensitive. It's the IL. It's the injury list. They don't call it the disabled list anymore in baseball.

That's right. It's injured reserve. Well, now it's the dick list. It's whoever's dick is injured. The dick list. Last news story. Researchers determined what is the most hated fast food establishment

in every country. And they determined this by Burger King everywhere. By negative tweets on Twitter. Jack in the Box. You like Jack in the Box. Jack in the Box is trash.

Jack in the Box is great. Jack in the Box can pull some things out. Their sourdough sandwich is all right. Their teriyaki bowl for some reason. Yeah, they've got a lot of options. Jalapeno poppers. Their little tiny mini tacos are garbage.

I haven't eaten one, but I can see. Oh, no, they're good. Their mascot is a fucking creep. Is it Jack in the Box? It's not Jack in the Box. No, it's Domino's. It's the United States. I thought it'd be Checkers, too.

You know who also hates Domino's? Italy. Yeah, I thought it'd be Checkers. The Italians hate Domino's? Yeah. It's not the United States. I thought it'd be Checkers too. You know who also hates Domino's? Italy. Yeah, that checks out. The Italians hate Domino's? Yeah. It's not a good pizza. I just had a puppety pup. When I went to Italy and I ordered an Americano pizza,

it came with hot dogs and french fries on it. Another one with that. I wasn't expecting it. I was like, oh, there's one called the Americano. I'll see what Italy thinks of America. And it just showed up with sliced hot dogs. Domino's used to have a cheeseburger pizza. It had like mustard.

If you want to see some good ass Domino's pizzas that you haven't seen. So you've seen the one where the crust is little hot dogs, right? Pigs in a blanket all around the side. Google this one. You won't be disappointed. In Australia, in dominoes they have ones that have meat pies in the crust oh shit meat pies do you see it yeah meat pie crust the the crust ingenuity in the australian dominoes is off the fucking hook. The 4-in-20 meat pie pizza? Yeah, the 4-in-20 meat pie pizza.

Look at it. It says what it does with a 10. Yeah, but it just looks like a pile of meat. That sounds good. Is that the one with the pie and the crust? Yeah, this one, right? Yeah, there it is. Look at all the meat.

You pull the pies out. You pull the pies out and you eat them individually. He's a little starter. Why don't you just get a meat pie? Because now you got a pizza and a meat pie. Tell me you don't want one of those. This one has a cheeseburger on top of the meat pie. Okay, what do you think is Australia's most hated fast food restaurant?

Australia loves McDonald's. And I think Australian McDonald's is slightly better, personally. They like KFC in Australia. They're big fans on KFC. I would say Hungry Jack's which is Burger King No I think it's Chipotle whatever that is there It's Wendy's We don't have Wendy's

I guess you do We have a different thing called Wendy's Wendy's is just a soft serve place That sells hot dogs and stuff like that But it's not the Wendy's that you have That'll do you a dipped cone And all that type of stuff This has a baked potato on the image Wendy's is just a soft serve place that sells hot dogs and stuff like that, but it's not the Wendy's that you have. I was going to say, Wendy's is pretty good. That'll do you a dipped cone and all that type of stuff. This has a baked potato on the image, so I don't know.

Yeah, they might do it. We don't have regular Wendy's. New Zealand hates KFC. Nothing wrong with KFC. I like KFC, not in America, but I like KFC overseas. The American ones, what they do wrong with KFC is they don't make enough sandwiches. They need more sandwiches. Yeah, and they got rid of the twister.

That was my jam in Britain was the KFC. I love the KFC in the UK. It's like Pakistan and South Korea and China all hate Subway. And the Netherlands and Belgium. Subway is dog water. Subway is shit. But Jersey Mike's. I like Jersey Mike's.

And it's the same fucking price. And it's a sub above. It's a sub above. Canada is Orange Julius. I don't even know what that above. It's a sub above. Canada is Orange Julius. I don't even know what that is. They don't even

serve food, do they? It's just smoothies. Orange Julius. That's Denny's. They have it in malls. They have it at the Galleria and stuff. Oh, really?

Look, Denny's DQ. DQ will Julie is something for you. Dairy Queen. Well, Canada hates it. I love an Orange Julius.

Any other countries you're curious about? Otherwise, that's it for Jack and Jack China Subway my friend says what about Britain eat flesh

what's the least popular in Britain Domino's Japan five guys is coming out Taco Bell Taco Bell Japan hates Taco Bell they gave it a spin in Australia

and it didn't last a fucking minute no one could understand. They thought it was Mexican. Never think it's Mexican. It's its own thing. It's its own thing and it's fantastic. It's so good. I love it.

They're learning the wrong things. That's the problem. They don't know about the cheesy gordita crunch. Cheesy gordita crunch. You can use it with queso rito. You'll be fine. You'll be fine. All right.

Now, please welcome our guest, Dr. Anupam Bapu Jena. And now it's time to play. Yes, no. Yes, no. Yes, no. Yes, no. Judging a book by its cover. All right.

Well, I already know that he's a doctor. Yeah, by the way, Dr. Jena has told us that we can call him Bapu throughout that, just so everybody knows and could be our listeners. All right, I'm good with that. Not being disrespectful. Well, I always, Doctor, I always try to tell what people's specialty is by the room that they're sitting in, but your room's very undescript. This angle is anyway. But I do see that you have a couple of very, you're a very neat man.

You've got a couple of blankets there that are wonderfully folded and put on top of each other like you've had a set designer come through. You're either very clean yourself or you have a wife who has very exact things that go on in her life. Yeah, you assume it's my room. It may not be. It's my wife's office, not mine. I see. I can tell. All right.

Are you a doctor of medicine? I am a doctor of medicine. Okay, so that narrows it down. I will tell you, this would be a very hard actual subject to guess, but it is in the world of medicine, and it's something specifically in medicine that we're going to be talking about that is going on. It's always been going on probably as far as that,

but it's really going on now. Oh, okay. So is your specialty subject people who deny medicine as a science? I might have given you too much of a clue. Yeah. Vaccine deniers, medicine deniers, people who want to give people sticks and twigs. I gave you too much of a clue. Say they're medicine.

Am I right? I mean, I've thought about those issues. You're warming up. So I am a doctor, but I do something else. I spend most of my time not treating patients. Oh, not treating patients. Oh, not treating. So you're a professor? Like you lecture? I am a professor. Yeah, that's right. All right. So when you say not treating patients, like any patients or just live patients? Like do you work on more?

Yeah, good question. So in a given year, I spent about, let's say, four weeks in the hospital seeing patients. And the remainder of the time, I'm doing something else. And I guess you're supposed to guess what that something else is. All right. So you obviously work with a seasonal disease. That's right. Yeah, exactly. Christmas Titus. Krampus. Doctor, is there anything else that you have a degree in?

You can tell, Jim. I have a PhD in economics. Oh, so you lecture on free health care and the benefits thereof? No. No? Okay, I can't convince an American doctor that. No. All right, you've got to give it to him.

I'll never get this. Don't insult our guest. Today we're going to be talking about medical misinformation. Right. Okay. There's a bit of that going around. Dr. Anupam Bapujana is a professor at Harvard Medical School and a practicing physician at Massachusetts General Hospital

and a faculty research fellow at the national bureau of economic research. He also has a new podcast called Freakonomics MD, part of the Freakonomics radio network. Dr. Anupam Bapu-Jenna has an MD and a PhD in economics. With the powers of an economist and a physician combined, Bapu is a real life unicorn with a rare dual expertise that makes him uniquely positioned to explore the world of medicine with an eye towards behavioral science and economics that's rooted in data. You can follow Bapu and the podcast on Twitter and Instagram at DrBapuPod. That's D-R-B-A-P-U-P-O-D. So, you know, we're going to be talking about, well, why don't you tell us a little bit what we're talking about?

Because you'd be better to explain it to me, Papu. Yeah, first of all, Jim, you were supposed to guess what it was. I'm surprised you didn't guess Bollywood actor. That wasn't like on your differential, like your list of different things. You think I'm going to go straight for Bollywood actor? He's trying not to get canceled.

I see, yeah, yeah. I want to say that my wife's Indian, so I get to make these jokes now. You can, yeah, you can make all the Indian jokes. You could have said Bollywood actor, cardiologist. I've been comfortable with either one. So I'm an economist. Say it again. Cricket player. Cricket player. Yeah. I wish. So I'm an economist and a physician. I do see patients clinically at a hospital called Mass General Hospital in Boston. But I spend most of my time doing research on a bunch of topics that are sort of like the freakonomics of medicine.

It's like big data, really interesting, clever, creative questions, things that you don't have to have a medical degree or an economics degree to understand. Things that kind of affect us in our everyday lives, chance occurrences that affect us and then impact our health and our healthcare outcomes. And that's how I spend most of my time. But on the podcast for economics MD, I talk a lot about my research, other people's research. And one of the core things there is like, you know, we're bombarded with information every day about a new study on this drug or that drug and COVID-19. And part of what I'm trying to do is just educate people how to think about

that work and like, whether you believe it or not believe. Right. All right. All right. So we won't get any angry emails from this podcast. But have you read all the things online? Because I have some other information. Yeah.

I have some information that might blow your mind. Yeah. Everything on Facebook. that might blow your mind. Yeah, it's everything on Facebook. That's where we research. All right. So, Bob, I'm going to ask Jim some questions about this subject. And then you're going to grade him on accuracy 0 through 10. 10 being the best.

Kelly's going to grade him on confidence. I'm going to grade him on et cetera. And 0 through 10, spoons and forks are sticking to your forehead. Jim, do you know about that? I don't know. 11 through 20, invermectin. I don't know which kind, one of those kinds. 21 through 30, you're a sheeple.

I'm a sheeple, yeah. You're a sheeple, dude. All right, so what is the difference between misinformation and disinformation? That's an interesting question. Is it interesting or do you not know it? They sound very close to each other. Yeah, that's what we're asking. But disinformation and misinformation. Misinformation is wrong information that you were given.

The information that is just- I thought you were going to say it was a female gender. Yeah, yeah. It's a beauty contest. what about the disinformation disinformation is i'm gonna go on a limb here i'm not sure but is the lack of information i thought you were gonna say it's like an eight mile yeah but at the end when everyone's rapping this information yeah okay that's what i thought you're gonna. You know how my jokes work. Yeah. What is propaganda? Propaganda is stuff that is fed to us by, you know, look,

historically you could go, the government can give you propaganda, you know, with Hitler and all that type of stuff. And, you know, he had Himmler doing all the propaganda. The government does it? It can be government, but it can come from groups who want to spread misinformation to the masses or even to smaller amounts of people. All right. Give us an example of medicine of some propaganda. Propaganda medicine.

Like something related to medicine that was propaganda. Well, okay. So you have a case of the vaccine at the moment. There's a lot of propaganda going around that there's things like it'll make you infertile or Bill Gates is putting microchips into you or stuff like that. That's the misinformation that we're being given about the vaccine. Okay. But you're saying like historically. That's fine.

That's good. Yeah. How can consumers figure out if a study or findings they're hearing about in the news is reputable? The FDA, for the most part, have to approve that something is a reputable thing and that it's approved by the American government that this is a proper medicine and stuff like that. And other people would believe it's by reading it on Twitter.

That's how you know it's real because someone's written it down. You hear about this a lot in the news, like people doing this on their own, but like how do researchers crunch data? How do researchers crunch data? Well, there would be for medicine medicine you have to have test cases you hear them advertised all the time on the radio do you want to come down and try out this new medicine and then from what i can tell most of the time they give 50 of the participants a placebo and they give 50 of the other participants the real medicine they see if uh there's changes to

the people's condition so so they always say they, would you like to try out an experimental drug? And that's like, COVID's a good example of this. There was people who had COVID who were like, yes, I'll try. When are they crunching data? Okay, well, they get that data, right? That's when you just say things. Yeah, crunching data. They get that data.

They put it into a calculator they add up the numbers and i was waiting for you to do some mouth noises yeah you just go you just go okay that number's crunch okay let's move on how do uh how do good data researchers check their work um well against other data you gotta have one bit of data and you gotta test it against the other data otherwise you're just having data just out in the willy-nilly. All right, stop saying data. What is a natural experiment? A natural experiment.

Oh, Christ. Those are good questions. Yeah, a natural experiment would be something like when we all got COVID and you can log the data on how what demographics are getting it who's getting most sick and all that type of stuff because that happened naturally not it well it might have been invented in a lab that's another argument altogether but that happened naturally out in the wild or another natural bit of data is when a fire happens and you count how many houses are gone okay um here's something that you'll have a strong opinion on how do journalists decide

what studies and findings are reliable and worth publishing sharing with or sharing with media and the problem is with journalism now journalism isn't what it used to be and a lot of journalists are just full of shit and just write whatever the fuck they want about anything trying to get clickbaits okay i've experienced this myself in my life. There's nothing that anyone can say that can convince me different. I'm not going to read any of your bullshit. I think journalism now, there's some journalists who should be ashamed of themselves. I agree with Trump on some of it.

Some of the journalists are fucking scum and they'll just write stuff without any fucking particular, and this is not just medicine, this is just out in the wild, without, you know, they do it basically like a rumour. They go, someone has said this and they go, we're not reporting this, we're just reporting that it's been said. They do it to get ahead, to break the story first,

but they haven't collected any. There's not enough investigative journalism versus just what we call journalism now. and i imagine that like in the comedy world we have people who we who we know who are comedians and then people who just call themselves comedians we go that's not a fucking comedian right and i'm sure that happens with journalists i'm sure they're journalists that are like they give us a bad name all right so our next question was can you rely on journalists to properly translate scientific studies to be understood by the general public when i say hard no no no you can't you can rely on some of them but how do you pick and choose and how do you know that your journalist is the good one yeah so the whole industry needs to be overhauled so what are so what are some

warning signs that findings it's very funny this needs to be overhauled not the whole industry because even when you watch the news in american it's not news it's opinion pieces we've brought on a person who thinks this we brought another person who thinks this so what i like to listen to the news that just goes this happened in bangladesh today this happened in tokyo today i just like this fair down like this is the stats this is what happened it's not that interesting but at least you get the right information all right so warning signs that you may be, something may not be as reputable as they reported to be. The letter Q is a big warning sign.

If that, if, if you're starting with the letter Q, right. Yeah. It's probably no good. Okay. She says,

um, what are some of the most common clickbait buzzwords in medical reporting? Um, uh, how is Rob Lowe looking so young? That's a lot of words. Good genes or good doctors? Is it genes, G-E-N-E-S, or genes? Yeah, clickbait would be the word autism would be a big one

to throw in there. The one, something tracking, the word tracking. Tracking. No one likes to be tracked. And other ones, pandemic is a good one. The word isn't, what the government isn't telling you, everything isn't telling you. The word patriot.

Oh, fuck me if any if anything's called patriot now or the patriots page or the the word patriot should be a good word but it's been bastardized oh fuck yeah okay a couple more questions here what freedom the word freedom's in there you know you're being hoodwinked right away all right here we go what is a peer reviewed study um it's uh what reviewed sorry a peer like p e oh it's it's it's it's it's a review something reviewed by pierce morgan oh we got that one right we know that's reliable um how do i feel like this clip is gonna end up on his page so okay should you ever take a study that has not been peer-reviewed seriously i'm not gonna forget all right next question um where are the best places for consumers to fact check news

they've seen or heard oh that is a good i would i would say um actual government web pages not just and people go we can't trust the government. Right. But things that are, that are regulated or who have shown a history of telling you the truth and stuff like that. Nothing that says the word herbal. I would say, I would say the FDA is, is the, you know, the problem is with the FDA and stuff like this, and I might sound like a bit of a hippie.

Medicines take so long to get approved and all that type of stuff. I see why people get frustrated and angry when they go, oh, maybe this does work. But I don't think taking a fucking horse tranquilizer or dewormer or something is a good way to go. Horse tranquilizer is a good way to, the dewormer, I'm not sure. A horse tranquilizer will give you a fun night out. Alright, thank you, V way to, the dewormer, I'm not sure. A horse tranquilizer will give you a fun night out. Yeah, yeah, okay. All right. Thank you, Vapu, for waiting there. How did Jim do?

Zero through 10, 10 being the best on his knowledge of these questions. Oh, shoot. 10 being the best, you know. So I tell you, I teach at Harvard. We have a lot of great inflation. No, don't inflate. Don't inflate. I'm contractually obligated to give you a score of 9 out of 10 or higher.

What? I'll tell you this, Doctor. I'll tell you this doctor. I'll tell you this. I'm happy with a low score because I'm very proud of the fact that I acknowledge that I don't know anything about this, right? The problem I think in society is everyone thinks they fucking know everything about medicine. I just go on what my doctor tells me what I should do. And that's how I sort of live me life when it comes to medicine.

So I'm not upset with a bad score on this. Yeah, give him a real score. I'm going to give you like a 7 or 8 out of 10. And that's because I'm going to weight the questions that were the most important, like more highly. So if it's a question that's not that important, I'm not going to weight that as much. Yeah, that's good. I like that. How are you doing confidence, Kevin? You know, he did seem confident for somebody who didn't know much. I'm going to give him a six. For a moron, he was off the charts.

That's 14. All right, I'm going to give you a 10. So you have 24 year sheeple. Yeah, man. Welcome to the sheeple. I'm all over that. DK. Okay.

So what is the difference between misinformation and disinformation? Yeah. So I would agree with Jim on that. I mean, either way, I think about misinformation is just wrong information. Disinformation, I would say, is moving towards taking information that you actually know might be true and telling people the opposite for whatever reason. It might be related to propaganda. It might be some objectives you have. But misinformation is just like, you don't know what the right answer is. It's just wrong. And you're telling people wrong stuff. Whereas

in disinformation, I think there's some intent there that's meeting some objective, which may not be right. Okay. Good job, Jim. I think that's basically what Jim said, if I had to summarize it in other words. That was the gist. What is propaganda? Jim said stuff that is fed to us by the government or groups who want to

spread misinformation to the masses i also mentioned hitler okay yeah i'm not i'm not gonna go in that direction i would say propaganda is it can be good propaganda it can be bad propaganda mostly we think of as being bad meaning reflective stuff that isn't true, but is, again, said and disseminated to meet some objective that some group has. Typically, I think it's bad. How can propaganda be good? Because isn't propaganda always a mistruth? I don't know, but English is my second language, dude.

I don't know. Wait a second. Bullshit. I mean, I don't know, but English is my second language, dude. I don't know. Wait a second. I mean, I don't know. Is propaganda by definition have to be bad? Like, I don't know. Well, they talk about like, for instance, like my parents watch a lot of like cop shows. They watch CSI everything. And those shows typically are called propaganda for cops.

Like you now have cops in your living room and you're like you're siding with them and all that stuff so you feel like cops are all good but that seems like one of them where they would use it in a positive way because the reputation's bad right now but i don't know i can't think of anything else you just gave me that's like a research question right there like did the introduction of the show cops that's like you know in the 1980s man it was in the u.s back then but like did that change attitudes of people towards cops or csi could be a good question yeah i mean because when they're constantly you know chasing bad guys you're never seeing the cops do anything wrong on any of these shows it's always

they're getting the bad guys so you're rooting for them so then your your perception of the entire industry changes i would assume all right so misinformation or propaganda or let's say in medicine jim said vaccines make you infertile microchips from bill gates is that all examples of misinformation in medicine i think so yeah that's that's definitely bad misinformation yeah and how when is there like a first case of that happening like in history like how far back does misinformation like medical i imagine like during the polio vaccine that was always the big vaccine that saved like smallpox and all that type of stuff but like my parents lifetime the the polio was there people like don't give it to the

children or were we all on board back then i'm sure it must have been a problem i mean this is probably centuries old i mean if you think about all sorts of cures and treatments that were being promoted you know centuries ago some people probably thought they were other people might have known that they didn't work but it might still have promoted it i'm sure that we have plenty of examples of that wow have you ever seen any snake oil in real yeah is there real snake in real life yeah i don't even know snakes could make oil they have oily skins man no it's your towel snake i have yeah it's not oily smooth put it in a blender okay what um all right um how how can

consumers figure out if a study findings are hearing about in the news is reputable jim says the FDA, for the most part, have to approve something as reputable and proper medicine. I think that's that. I mean, for a drug, that would be a good signal, a very good signal that a drug is effective and it's safe for the for the use that it's been intended for. But there's a lot of studies that come out that aren't about specific drugs or that aren't necessarily about FDA approval. If you see a new study that says that coffee has some effect on cancer or heart disease or whatever, those are the types of studies I would immediately have kind of raised a red flag in my mind because there's sort of this gold standard that we use in medicine, which is a randomized trial. You randomize some patients to one treatment, randomize other patients to another treatment, and then you measure the outcome between those two groups. That's really the most important and most solid form of evidence

that we can have. A lot of what you see in medical journals or scientific journals is not of that same level of evidence. So I'd be generally skeptical of most of that kind of work. So those ones that you always see in magazines, once a year I hear that having two glasses of red wine will give you the tannins that will be good for you, antioxidants, and it'll be good for you.

And then a little bit of chocolate, if you have a little bit of dark chocolate, that's going to be good for you. So those ones, although they may be true, aren't done reputably. That was the best talking I've ever done. What's that? We didn't hear you. What?

No, no one's talking. We're all just staring at each other. Oh, did you ask a question? Yeah, just ask me. We lost his audio. Did you guys hear that? No. Sorry.

We lost you for a second. We lost you. I thought you were just dumbfounded by me. I thought you were just sitting there going, this guy's an idiot. You don't know what I heard then? Yeah. What I heard was reputably like in auto loop. So there was some sort of like audio connection.

The one where he botched. He just went over and over and over again. Yeah, I can give you a tablet that will fix that, man. Exactly. You didn't even pronounce that properly. It was reputably. That's so weird. Reputably. I can give you a tablet that will fix that. I didn't even pronounce that. But is that, are they just bullshit? Those drink more wine? I mean, it's just like, if I were to pick up a journal or a newspaper article and I see the words

coffee, sunlight, vitamin D, I'm automatically going to be skeptical. Now, once in a while, you might see a randomized trial of the Mediterranean diet versus another diet. That would be perhaps more credible. But in general, any sort of study that looks at the association between the amount of wine you drink, the amount of days you spend on the bicycle versus your likelihood of dying from heart disease, all those things, they may be true, but you can't tell that they're true from the study

because the study doesn't actually tell you that. That doesn't mean it's not true. You just can't get that from the study. So we don't need to be getting sunlight directly on our buttholes like that one study said. I got no comment on that. I've wasted so much time. Yeah, but there's not enough hours in a day to do all the things

that people are telling you you're meant to do, to eat five fruits and vegetables, then have water, then exercise for a thing, drink a certain amount of coffee, eat a little bit of chocolate, have two glasses of wine. And then watch eight to 12 hours of TV. How are you supposed to fit it all in? What the fuck? You can't do all that shit.

It's ridiculous. Yeah. So you mentioned medical journals. So people can't really read those. I mean, they can, but I mean, I have a degree in biology and I wouldn't even like reading that. So I think- Can I ask you as a doctor something?

Why has all the medicines got difficult fucking names? Why can't people just be like sleepy tablet? This is a question Jim has asked many of our guests. I don't understand. Everything's so long. Romophleba, plasoplasan, and all that type of stuff. Clitruchy, Poptopam. He pronounced that better than Rapidly.

All these things, right? Yeah. I feel like lawyers do this as well. Lawyers talk in lawyer talks, so we have to keep employing them, right, so that they can talk to each other in their special language that we don't understand. Is there a little bit of that going on with doctoring? I mean, so for the generic names, there's often like a basis for it.

But the brand names like Chantix for a smoking cessation drug, I have no idea where they get those names from. I mean, they're often hard to produce. Genuvia, that sounds like someone's name. I don't know that I would look at that and say that that's like a drug name but i mean people must be like studying the effects of like different drug names on the likelihood of the person gonna take the drug i gotta believe that's what they're doing i think jim means the actual the the medical like the the breakdown of the comical compound of the drugs he doesn't like that yeah why is it so difficult what do you have

personal against that? It's too difficult for him. I get a bit of thrush every now and again. I've got to get myself some cream, and then it has the chondroxolazolem is the chemical that I need. The azoles, the fluconazole, the ketoconazole. Yeah, I need the ketoconazolem. The ketoconazolem makes my testicles

smell nice again, right? And so I have to pick up bottles because I have a different lotion in britain that works and there's lotrum over here and so i got to pick it up and go has it got closure across the whole glam i feel like he's trying to do a spell right now i know i just don't want to hear that yeah jim asked this asked this question to me because he just doesn't want to pronounce it once every so often in a pharmacy. Yeah, yeah. I need clogged in my head.

Tablets. Hair stay in my head. Tablets. Okay. Rolls right off the top. So as I was saying, so the average person is not only are they not going to have access to a lot of these medical journals or research, but even if they did,

despite what you hear on the internet now, I'm looking at my own research is like, they, they wouldn't know how to be able to even read a lot of that stuff properly, at least. Right. So we're supposed to listen to doctors, right.

Isn't that the idea or what what do we do yeah i mean like so just started the journal itself the journals many of the good journals now have gotten a lot better about making the material um more reader friendly so there's like a scientific description of what's going on and there's often kind of description that's broken down into easier to digest terms like here's what what the study did. Here's what it shows. Here's what applies to. That sort of information, I think, is more easily digestible by people.

Though obviously reading the journal itself, the article itself would be really difficult. And of course, you know, talk to your doctor, but there's problems with that too if the doctor hasn't read the study or doesn't know about the study. It's challenging. It is, it's challenging. I mean, this is like an area

that's ripe for bad information, um, to be spread. people use so like significant in a scientific study means that it's detected but it doesn't necessarily mean a lot whereas when we think of significant it means oh this is a big deal so it's interesting like how do journalists even know how to translate that stuff if they don't have medical degrees and how and then now they're giving all this information to us and freaking everybody out because they're using this language kind of inappropriately. You've got to get rid of the word positive, right? In medical things. Yeah. HIV positive. That's not positive. That should be negative. That should be negative.

What about pregnancy? Your herpes is positive. HIV is sad. You're positive with a pregnancy. That's not always positive either for us. But a lot of times it is. A lot of times it isn't. We've got to find some different words there as well, right? So, okay.

Anyway, I think Kelly asked an actual question. Yeah, no. So, Kelly, I would say it's actually not on the journalist. I wouldn't expect journalists to be able to digest an article like that. I would say that if a study's crappy, there's really a couple of people to blame, right? One is the group of people who are trained in science who did the crappy study. I mean, that's on us. That's not on a journalist to interpret some crappy work that I did or my other colleagues did. And then the second thing is, most of the time, journalists talk to other people who are like scientists who may understand the

material. And I think it's on them to be able to say, look, here's why I would not believe the study. And journalists just got to kind of depend on that information, but that's where I would look. And to be honest, in our field, we're not even as good at policing ourselves as we really should be because there's a lot of bad stuff that gets published for reasons that I don't even actually understand. Is anyone allowed to submit a study? Am I allowed to give a study out? Like if I have a rash on one leg and a rash on both of my legs and I find some leaf and I rub it on one leg and I try a different leaf on another leg and then this leg heals up, is that a study that I'm allowed to publish? Not that particular study.

Where is this leaf, by the way? I haven't done it yet. Actually, this is a prospective study. I got you. I don't think you want to rub a leaf on your other leg. You want to leave the other leg alone. No, no, no. Compare it.

Well, it's two different leaves. I'm comparing the two different leaves. But maybe if the one leaf makes another rash and the other rash would have went away without the leaf all right it's over the course of five years i have two different leaves one i've always got rashes on my legs it's all you need to know is the leaf poison ivy i don't even know what that looks like poison ivy is one of those things i've seen in american movies my whole life and i i don't know what it looks like i'm scared to all fuck every time i collected a golf ball out of the woods, I'm like, I'm going to get it. I'm going to get this fucking point.

Leaves of three, let it be. Leaves of three. I don't know, man. It just happens in camp films in America. I've gotten it before. It's terrible. So am I allowed to publish a study? You might encounter some challenges if you try to publish that study.

But I mean, if you recruited a thousand of your best friends and you randomize half of them to the same leaf. Yeah. And randomize. Half of them died. Yeah, exactly. Then there's other issues there.

But like, I think just like if you had a high quality study, I would hope that as a field, we'd be able to accept that. You don't have to be a medical doctor to do it, but it certainly doesn't hurt. Bobby, why are you so nice? Just tell him no. Because he's a nice guy. You it, but it certainly doesn't hurt. Why are you so nice? He's a nice guy.

Just say no when Jim says, can you publish his own study, I think. You're a celebrity. You can talk about your results on Twitter like some people did with ivermectin and stuff. Why is my opinion like, what I'm asking is, can only doctors do these things or the rest of us?

No, I think doctors should do. So, Jim, let me say this. If you had a good idea, I would I would happily work with you on it. But it's got to be a good I mean, not to dismiss the the leaf on your left leg versus right leg. But if you if you came to me with like a randomized trial about whether or not laughter helps people live longer and you are going to randomize comedians. I don't think I'm the comic to do that. Yeah. I'm very divisive.

How would you do that study? See if laughter helps you. I mean, I've thought about this, right? I mean, like I would say when I when I go into a room, the first thing I start with is like with a joke. So like I'm in here in Boston and it's often the case that patients will wear like a hat with a red socks uh logo on it and i'll go in there and i'll walk there i said i love football and then they look at me as if i've said something that's like you know uh poisonous i'm like and then i tell them i'm just joking i understand that the red socks are a baseball team and that's just like an ice cracker you're gonna

get your ass kicked in boston for that what you're asking is interesting because I've heard that, like, if you laugh every day, you'll live longer. And I say that to people as a fucking fact. In fact, I've often credited myself to making people live longer. Laughter is the best medicine. Yeah, laughter is the best medicine. But, of course, there's no fucking stats on this. Yeah, how could you?

You go to the same comedy club every week and then you see people dropping off. I'll tell you, people who go to comedy clubs on the regular aren't living longer. They're some fun people. Two drink minimum. That'll kill your laughter. Yeah, but you have your two glasses of wine every night

with the antioxidants. Yeah, duh. Okay, so what would you get? How many people would you need for the study for the laughter? Oh, I have no idea, but I'm saying I would love to do a study on whether laughter is the best medicine, but I don't know. Here's an example. I had a relative who

lived to be 100 who was miserable. Never laughed. Just putting it out there. I think the misery kept it going. I had a relative who lived to 102 and they loved to laugh, so that's two more years. Study done. I don't know kept it going. I had a relative who lived to 102 and they loved to laugh. So that's two more years. Study done. I don't know.

Case closed. Let's do the German. So Jim, when you tour internationally, what's the country that you get the... Germans aren't known for big laughter, are they? That was good in Berlin. It was fun. Berlin was good.

Vienna was good. Are there any countries Where you're like You guys are all gonna die That's a misnomer The whole idea That there's certain countries That don't laugh

We travel the world People laugh You will get certain Different qualities Out of audiences Like the Dutch Are very respectful If your joke fails

They'll let you They'll wait They'll wait to the next one The Swedes as well Great try Yeah they think it's like A language barrier So they let you free on that one they clap they clap when the punch yeah yeah they clap when they get a punch line like this right yeah we did not understand

but very good yeah they they stop and reset they stop and reset where a different audience you'll get more hecklers in britain than you will but that if you beat a heckler in Britain, they will respect the shit out of you. You mean you punch them? No, no. If you put them down a few times, people will go, oh, that was fucking good, mate. You fucking put that cunt in his place. Right?

They'll love it. Where Americans, if you put a heckler in their place, sometimes the audience can turn and you go, that was a bit much. We're all just trying to have fun. You're like, oh, fucking what have I meant to do here? This guy ruined my show. Yeah, yeah.

All right. So do you want to do, are you guys looking to do some research. Yeah, yeah. All right. So do you want to do? Are you guys looking to do some research together then? Yeah. All right. So let's figure out something we can do. Like, how many dwarfs do you know? Because I know about six.

Well, I know you, so I know six, I guess. No, I'm just saying a case study of somebody. No, we're talking about laughter and medicine. Why did you bring... Oh, I was just going a case study of somebody. No, I'm talking about laughter in medicine. Why did you bring... Oh, I was just going to do a medical study. I was just trying to think of the easiest pool of people I could get together. He's just like planning on throwing Brad Williams

and seeing if people laugh. No, I'm not throwing anybody. I'm giving them vitamin C and checking the color of their piss. A lot of studies. All right. All right. When people are doing research how do like researchers crunch data like how do the good data researchers check their work like like versus what jim would do with a leaf would that be bad again not not to not to minimize his scientific

contributions already i mean at a young age he's already made a lot of impact. It's about being careful. It's about thinking through the questions, thinking about what are the things that you would worry about as alternative explanations. For example, if you're studying the relationship between red meat consumption and some outcome like heart disease, and you find that people who eat more red meat have more heart disease, you can't just conclude that the red meat consumption is causing the heart disease. Anything that people who tend to eat more red meat, whether they smoke more, whether they're less active, whatever it may be, that could be what's causing the heart disease. So you want to be, like, one big thing is just

to be thinking about what are the various mechanisms that could explain what you are finding and then say, all right, can I narrow down to this particular example? Is there an instance where there was a red meat shortage or where cattle prices went through the roof and people stopped using or eating red meat? That might be a better way to sort of stay that question in a real world setting in a way that's plausibly more causal. You could actually say that a decline in red meat consumption led to some health outcome. Do you feel like that's probably one of the, like, I feel like that's one of the bigger things

that happens these days is people hear information and automatically assume it's a cause and effect relationship as opposed to like, there's a positive correlation here. And so now people are jumping to that conclusion of cause and effect. And that's why there's so much misinformation going around. Like people are just assuming that. I think that's, I mean, that's absolutely right.

I mean, you see that with like nutritional, nutritional epidemiology studies, like, you know, peanuts cause this, coffee causes this, like that's kind of rampant there. We've seen a lot. I mean, the COVID-19 pandemic has put science really in the, in the, uh, in front and center in people's minds. And so there's tons of studies coming all the time, but how this drug does this. Two weeks later, this drug has the opposite effect.

You're kind of left wondering, well, what do I do with this? None of these data are typically randomized data. So you really should take it with a grain of salt. So we're like, okay, in America, we have adverts for medicine, right? And I don't think there's another country in the world that does that. I might be wrong, but it feels like there isn't. I've travelled the world and I haven't seen any other ads. I find that a little bit frustrating because it says,

tell your doctor to give you Chantix. Ask your doctor to give you Chantix. I shouldn't be asking my doctor anything in my opinion. They should be telling me what I need. Because I feel like maybe that feeds into the whole Americans think that they're there. They know what's best medicine now, because they're told to tell you what they need.

Is that a real problem? Or is that just me bitching as a foreigner? It could be a little bit of both. I mean, I mean, I never get to take that off the differential though. I would say like, there's,

there's two views on this. One view of the world is that the doctor knows everything and we don't need patients to be informed about drugs through either ads or whatever other ways because the doctor knows that. There are people who think that, but probably a lot of doctors who think that. That's not my view. My view basically is that more information, good information is better. If patients are aware of treatments that they might not otherwise be aware of, don't leave it on the doctor to be knowing everything that's going on in your life. If there's a treatment that you've heard about, just ask your doctor. Your doctor isn't then forced to prescribe you that drug. If you don't have that disease, the doctor should not prescribe you that.

But if you did have it and the doctor hadn't thought about it because there's 10 other medical problems he or she's focusing on, and you do have that condition, it's impacting your life, it might be reasonable to consider that or another treatment. So in general, I think that information is good because no one is holding the doctor's hand to the fire saying you have to prescribe this drug or this antibiotic because a patient asked you. That's within the doctor's ability to choose to do or not. Okay. All right. I changed my view on that a little bit. That's right.

That's my goal. I did. I just changed my view a little bit. See, it can be done, people. It can be done. That's true information. So what is a natural experiment? And I know this is a lot of what you talk about.

Jim said these like, what did he read this? What demographics are getting the virus? When a fire happens, you can count how many houses are gone. So what is a natural experiment? And maybe we can do some examples of that. Yeah, I'll give you. So a natural experiment is like, so I already talked about what a randomized, I'll give you a natural experiment. It's like so I already talked about what a randomized trial is.

That's a randomized experiment. A researcher investigator takes a group of people and they randomize different groups to different treatments and then they measure the outcomes. That is a randomized experiment. Now, many questions that we might be interested in, we can't actually do that because it's either costly or infeasible, whatever it is. But sometimes nature affords us these examples where patients or people are just by chance, by nature, exposed to different events. And because it's by chance, because it's random, you can still say something about cause and effect. If I am by chance exposed to one treatment and Jim is by chance exposed to something else, simply because of the doctor who happens to treat him and the doctor who's different who happens to treat me, as long as those things are random, we can then measure what the effect of those treatments are on us. I'll give you an example. There's a question about whether or not small social gatherings with people that you know and trust could lead to COVID-19 disease spread, right? And we hang out with a lot of doctors because that's what I am. And I thought early

on, if I'm hanging out with other medical professionals, they're probably careful. Maybe the risk of me getting or my family getting COVID-19 from one of them is lower because these are medical professionals, right? It's not an unreasonable view to have. Certainly, if there's people you know and trust, you might think that. But it's hard to study, right? People who gather more are different in a lot of other ways than people who gather less. So you couldn't just look at the relationship between people who are gathering socially and people who are not and say, well, okay, people who gather more are more likely to get COVID-19.

It could be that they mask differently. It could be that they travel a lot of other places. A lot of different explanations. So a natural experiment is, and what we did is we looked at people's birthdays. We had data from a large insurance company. We knew when everybody in a household had a birthday. And all we did is we looked at people

in a household who had a birthday and we compared those households to other households in which no member in that house had a birthday and we compare those households to other households in which no member in that house had a birthday in any given week and what you see is what that week they had a birthday or these just people who never had birthdays no that week that week no they were so it's like july in los angeles um and you got a bunch of households where someone in the house has a birthday in that second week in july and you got a bunch of households where someone in the house has a birthday in that second week in July. And you got a bunch of households in Los Angeles where no member in that household

has a birthday in July. And then we just looked at the rates of COVID-19 in those two groups of households in the following two weeks. And guess what you find? The households in which someone had a birthday, the likelihood of COVID-19 infection is about 30% higher than in households where no one had a birthday. Is it because I'm blowing out the candles? Yeah. So you're saying that it's cake related? Cake related. That's exactly right. If you eat cake, you get COVID. You heard it here first. Cause and effect. Cake is COVID. Cake is COVID. Cake is COVID, yeah. It's like COVID, yeah. I could be blowing out the candles,

but it's probably just people getting together, right? But the key is, it's not just getting together with randoms. It's getting together with people that you know and you trust and you do so thinking I'm not going to get COVID-19 or my son or daughter is not going to COVID-19 because I trust these individuals. Yeah. And still there's a risk. And we show that that risk exists.

Yeah. That makes sense. Because it's like, you know, we're in this room together. All of our like, yeah, we trust everybody in this room. We podcast together. We went to the Dodgers yesterday with 54,000 of our friends. I just got back from Miami. So I'm about to fly off to Florida to do meet and greets.

Oh God. But we trust each other in here. Right. But that is interesting because in the beginning of the, especially in the beginning of the pandemic, people had their little pods, right? And so it'd be like five friends, they've got their pod. But as you looked deeper,

every single person in that pod also had another pod that was very small. And so when you extrapolate that, everybody is hanging out with a bunch of people. Everybody had their pod and everybody had their person in the pod that they didn't trust. Yeah. Where you're like, this person's our weak fucking link. Stephanie's out at the

club again. So wait, what would it be called if that person got cast out of the pod? What's that? What would it be called if that person you didn't trust got cast out of the pod? Good riddance? Podcast! Podcast! You're good. I thought the Boston Red Sox strike was good, but that You're good.

I thought the Boston Red Sox strike was good, but that was very good. That was very good. Edit that out. Alright, so then that's an example of a natural experiment basically is. Alright, so and that's a gist of

like what your podcast, right? Cause I, I know a little about Freakonomics. I forget. Wasn't there a show on HBO? Like the, when that Freakonomics, cause that's, you're associated with that whole thing,

right? That's your podcast is called Freakonomics. What is Freakonomics? Freakonomics MD is the name of your podcast. Explain to us what the term means, Freakonomics. So I would, the way I would describe the term is,

is that it, Freakonomics, and let me just talk about Freakonomics of MD, which is the Freakonomics of Medicine. It's basically combining economics and medicine in a way that's creative, that uses big data, and in a way that is kind of digestible. Like the birthdays and COVID example that I gave you. I mean, we could have been just chatting right now and you could have said like, oh yeah, I just had a birthday and my cousin came and he got COVID. You could have said that and that might have sparked an idea in my mind or your mind like, wait, if I had data on thousands of people or millions of people, some of whom had birthdays and some of whom didn't, could I then study the effect of those gatherings on COVID-19 diagnosis? So the podcast is really about these sorts of examples that are, I think, very understandable.

We're not breaking down basic biology or biochemical pathways, complicated stuff like that. We're talking about things that you would experience in your daily life, but you just never thought about how it impacts your health or the healthcare that you receive. but you just never thought about how it impacts your health or the healthcare that you receive. Yeah. I remember seeing, gosh, my memory is going, but there was something in one Freakonomics episode and it was like, the rate of crime going down at the same time, like correlated with legalized abortion or something like that. Or yeah.

You knew you saw that one, Jack? Yeah. Okay. Yeah. I thought that was really interesting. You said nothing then. What do you mean? I can't explain. You said abortion. Jack saw it. No, no, no, no.

When abortion was legalized, as time moved on, crime rates went down, and it was tied in with each other. Because people didn't have to shoplift diapers? I mean, it makes sense. When people, especially in poverty, are forced to have children and they're poor. I mean, being poor is another reason that crime spikes is because people have to do things to survive.

So it would make sense that abortion would play into that. You had mentioned wanting to maybe run through a potential experiment with Jim or maybe brainstorm something you want to do it yeah yeah yeah all right okay so jim so what i'm gonna do to you is i'm gonna flick my left nut and flick my right nut yeah you gotta get your game tight here all right so i'm just gonna tell you a story all right okay and i want you to just come up with whatever research ideas you can come up with on the spot. I'm going to tell you a story. And it has to do with whatever idea you have has to do with something related to the story. All right. So a few years ago, my wife was running this race in Boston. It's called like

the race to remember something like I should remember the name, but I think it's called the race to remember. It's like a 5k race. It started in a part of Boston called the Seaport and it went through downtown Boston. It passed through the hospital where I work. And my wife, this is her first time on the race, and she says to me, Babu, why don't you come and watch me on the race route? So I thought, okay, I'll do that. So I'm driving down the main thoroughfare to go to the hospital to park in my parking spot so I can go outside and watch her on the race route. And as I'm getting close to the hospital, I got to turn around because the

road was blocked. So basically, I came back home and then hours later I saw my wife and my wife said something to me. And it wasn't like WTF. They always do. So she said something to me. And so the first question is you have a guess for what she said to me and give me your guess. And I'll tell you what she said. And then I want you to come up with an idea. Did you see me running the race or something to that effect? She said, no, she didn't say that. Cause she knew I couldn't see her.

How did she already know? Oh, cause I told her, I told her, I was like, you know, boo, boo, the road was blocked. So I had to drive back home. And she said something to me. She had insight. Let me put it this way. She had interesting insight that led to a question. It would have been, why could all these other people stand on the side of the road and watch me?

How did they get there? Yeah, close. It was close. But she said to me, she's like, well, what happened to all the people who need to get to the hospital? She knew I was trying to park at the hospital. She says to me, well, what happened to all the other people who need to get to the hospital? She knew I was trying to park at the hospital. She says to me, well, what happened to all the other people who need to get to the hospital? That was what she said.

Okay. And what ideas come to mind? Okay. So when the race runs again next year, right, you make sure that someone really sick on the other side of the racetrack, maybe five or six people. No, no, make it 1,000. Racetrack.

I think it's like a marathon. Marathon. Yeah. The course. On the other side of the course, you have 500 people. You make them all sick, right? Give them something to make them sick. And then you see how many of them can get through to get to the hospital

to see if there is a good thoroughfare where you can get through medical science. See? Nailed it. Nailed it. You basically 80% nailed it. Or what you do is the people who are leaving the hospital, like you've just had your baby, time to go home, you see how it goes for for them whether they get really frustrated

or upset how many calls you get going why did you make me fucking leave at this time because we couldn't get through and then you can go did you see my wife run and then how did you do and then you can act like you saw it yourself yeah let me just piggyback on that and i get to the idea imagine imagine you had a patient who was like ready to be discharged from the hospital that day, but they knew there's going to be a ton of traffic so that an ambulance couldn't come and take them to the rehab facility or wherever they had to go afterwards. And so as a result, that patient was held an extra day and then it got a hospital acquired infection.

You could use that natural experiment. The patient happened to be hospitalized a week before the marathon was being run. They happened to be ready to be discharged from the hospital the day the marathon occurred. And just by chance, they had to be kept an extra day in the hospital because it was going to be too hard to discharge them. Or they were discharged a day earlier. But whatever it is, you then have an experiment where you can say, well, what's the effect of holding a person in the hospital a day longer than we otherwise would have planned to? Are they more likely to get a hospital-acquired infection, for example? That could be something, just picking it back up what you said. But what we did is we looked at cities that host marathons.

It's basically what you said. We looked at cities that host marathons, and we looked at people who had a heart attack or a cardiac arrest. That's when the heart stops. And we compared the mortality of those people on the day that city held a marathon compared to the surrounding days. And what you find is that if someone by chance who just lives near the marathon route has a heart attack or their heart stops, they're about

15% more likely to die than if they have a heart attack on other days. These marathons are a fucking menace. Yeah, that's why you don't run them for your health. I don't run them. I don't run them. Here's another one.

I don't run them because I don't want people dying, man. I don't want people dying. Yeah, same. And another thing you could do is if you felt like a heart attack coming on in the morning, like, oh, I'm a bit of indigestion. Oh, my chest is a bit bad. Then you go run the marathon because then you're already halfway across the route, you see.

You get involved in the marathon. They've got people lining the street there, and they can take you over to the other side. That's the quickest way to get to the hospital, people. And it's kind of cooler to have a heart attack doing something physical. Like, wow, look, they were running a marathon. Like, good for them. Instead of having a heart attack sitting on a couch.

Does this fall into the category of misinformation or disinformation? I'm not sure. This is new information. New information. Yeah. New information. Yeah. I think this is misinformation because they have the right information.

They're just putting the wrong stuff out there, Jimmy. Yeah. Yeah. Yeah. So I live in, I'm from Miami originally, and there's always something, there's always an art festival or a food and wine festival. Oh, they'll kill people all day.

Yeah. But sometimes there's flea markets. Yeah. You got blood on your hands. Sometimes there's two or three going on at a time. So I never really thought about that until you said that is like, there's people dying because of these people are just want to go to their wine and food festival and the traffic's clogged up and they can't get to their hospital.

Yeah. So I'm just saying like, Jim, next time you think about going to that Christina Aguilera concert, just think twice about what that means for the people in that community. Is she still doing concerts? I don't know. Is she? You tell me. I don't know. You guys are Hollywood.

I don't know. Look, I'm still trying to fucking free Britney one thing at a time. She's too good. You have to go. But yeah, that's the whole argument made where when people are like oh kov you know kovid has such a low mortality rate and it's like yeah but if the hospital beds are full then any of these situations also affects the health care of somebody getting in a car what are the stats in this because like in australia at the moment in many cities they're here as well when kov was peaking, they stopped all other operations.

They just stopped them. They just went, not at the moment, we're too full. Have we lost a lot of people to that, or is that a very minute amount of people that we've lost? From those elective procedures, I don't think we probably lost. I mean, there's three kind of big effects of the pandemic. First is the direct effect of the pandemic on people getting COVID-19. That's like the most important effect. The second is going to be from people who delayed care for things that were time sensitive where they needed to get care,

but they didn't go either because the hospitals were full or they were afraid of going, they're afraid of getting COVID-19. That's the second group. And we know there's higher mortality in that group as well. And then the third kind of cause of mortality might just be like stress related to the pandemic itself. If you look at just what we call all-cause mortality, that's just overall mortality, not specific to COVID-19 deaths, but overall mortality, we did see increases early in the pandemic, kind of early to the middle of the pandemic.

So that suggests that the deaths that we were seeing that were in excess of what we would expect it weren't just coming from people literally dying of COVID-19. They may have been coming from these other two channels as well. Did suicide go up? I imagine it did, but I don't know that for a fact. I don't know. I don't know.

That would be one of those things like we're talking about. Did COVID make suicide rates go up or was it something else combined with COVID or was it someone's birthday probably? Yeah, it was a birthday. It's all birthdays and marathons. Birthdays and marathons, that's the real pandemic, people. Every fucking year there's another birthday. I'll say this right now.

You run a marathon on your birthday, you will die. This is not something to be taken lightly. This isn't misinformation. This is a fact. You run it on your birthday, you'll die. Even more. Yeah. If the marathon doesn't get you, the birthday will.

We talked a little bit. You said a couple of these two would use it like vitamin d sunlight something so um what are some of the most common clickbait buzzwords in medical reporting jim said how is rob lowly looking so young good genes are good doctors autism tracking pandemic isn't patriot and freedom so i like isn't uh i would probably say anytime I see an article that has the word coffee vitamin d sunlight exercise not that these things may not help certainly exercise I think will obviously help but anytime I see a study with those words in it I'm already that's like a red flag for me because it's almost certainly not a randomized trial but studying the effect of coffee

on some outcome that you might care about how do you you, but why do you think, I mean, it's just because, well, obviously this is what you studied. Well, I'll give you a great example. I just, I just saw a study last week about people who bicycle, who bike more days per week, have lower rates of heart disease and heart attacks. Like, I mean, of course they do, right? I mean, the people who are able to bike five days a week are obviously different than the people who can only bike one day a week or cannot bike at all. So it's not that the biking, the bicycling is causing them to live longer lives or be less likely to have a heart attack. That could be true, but you certainly couldn't infer that from that

relationship. I mean, you would want to get an example of either randomizing people to having bikes and then studying what happens to people who are given bikes and people who weren't. Are they less likely to die of heart attack? Or constructing some neat natural experiment where some people by chance had access to a bike. I'll give you an example. Let's suppose that you had information on everybody who had bikes and some people by chance had their bike stolen and they didn't replace the bike for like a month. I'd be looking at mortality in the month after that person had their bike stolen, which chance people were exposed to some event, bicycling or not, and then only setting the effect of that event on some outcome you care about.

You know what started, this isn't about medicine, but that always bothers me, is the one they always do. They go, 70% of all car accidents happen within five miles of your home. And you go, oh, that is bad. Yeah, because people don't pay attention. No, it's because 70% of your driving is five miles from your fucking home. That's why. Yeah. Good point. You're always just driving up and around.

Of course that's where the accidents happen. Yeah. And also, you're always going home. It's always that destination. You hear a similar statistic when they say like x percent of health care spending happens at the end of life and then people use that that fact to then say we are spending too much on end-of-life care we should be you know encouraging people to think using the hospice etc and like that's like a refrigerator like x percent of the maintenance

cost of a refrigerator comes when it's about to break. Cause you're trying to break it. I mean, it's like that. You don't spend money when you're healthy. You don't spend money in a refrigerator when it's working, it's working.

Yeah. They always used to give a stat out, the stat out in Britain. This only happens with universal healthcare, but it's done out in Britain. They used to go that the average smoker costs, costs the NHS 40,000000 a year, right? They were always big on this.

And it's like, yeah, but they're paying £5 in taxes on each packet of cigarette. I would argue that every smoker pays for their cancer in Britain. That's just a little thing that I have to say. If you want to take the taxes away, you can bitch about the taxes. But they're being taxed. That's not an official public health announcement. No, no, no.

I'm not condoning smoking. Smoking's terrible. Also, smokers tend to pay more on their insurance anyway. Oh, yeah, yeah, yeah. That's just guilting people. Before we get to the end here, I kind of want to wrap this all together with the journalism and where are the best places for consumers to fact check the news they've seen or heard because it's kind of all related.

There's so much information out there, whether it's people that are actual journalists or people on Facebook that say they're journalists and have a blog or something like that. But where are the best places for consumers to fact-check news they've seen or heard? Government web pages, Jim said? Things that are written in media. Yeah, I don't know. So what do we do? I know you can run studies and natural experiments and you can figure stuff out,

but right now it just seems like the world's imploding with this kind of like so we all know that tucker carlson's your number one stop yes after that what do we read here's morgan so you're saying tucker and then sean hannity and then who the peers review my name my neighbor my old neighbor, she knows a lot. She's got all the data together. She's got all the data together. Yeah, what I have a pipe in my dad reads.

There's a girl I went to high school with that sells essential oils on Facebook. Should I listen to her? She's four. Okay, great. Piers Morgan, five. After that,

I would say a distant, no, I would say like, I think the government websites are actually quite good. Especially medical societies will be good to the extent they have something that's patient

facing. If you go to the American Heart Association website, they're probably going to have useful information about what are the basic sorts of medical treatments that are useful, what are the basic sorts of things you should be thinking about in terms of improving your health from a cardiovascular perspective. There's reputable

medical websites as well. But I think there's a basic understanding that people can have of what these sorts of studies are like, how they're done. And in general, if it's not randomized, I would be cautious about it. Now, what do you say to somebody who... Because whenever I watch the TV and I'm watching TV Land and I'm watching Golden Girls in the middle of the afternoon, there's always an advert that goes, did you take Zoloft in 1997 and then blah, blah, blah, blah, blah and you're having heart complaints? Mesh.

We have a class. There's always a mesh in your stomach. Talcum powder is killing fucking everybody. These are all things that were approved and put out there and now in hindsight, like flamidamide. Flamidamide was a drug that the government approved and then caused deformities and now is widely considered one of the biggest fuck ups in government history. Look, I'm one of these people who sort of do trust the government in certain senses with medicine. But why should anyone believe the government?

I'm trying to play devil's advocate here. Because it's about trade-offs, right? I mean, mistakes will always happen. And to think that the FDA will never make mistakes, I think that's unlikely. The FDA will have to, by definition, make mistakes. But their main objective, and I think it's the right objective is to balance the speed and safety of drug approvals. Because for every drug for which there are adverse effects that were not identified early on, but they get identified later, the question would be, well, should we have approved that drug waiting 10 years? If so, how many lives would have hung in the balance because those people couldn't have

had access to that drug that worked? This is always going to be a problem. We know we make trade-offs all the time in our life. When the speed limit is 55 and you're driving 75, you're trying to get somewhere faster because that is important to you, but you're taking a risk when you're doing that. The same thing is true for drug approvals. We're balancing the speed and the effectiveness of getting drugs to people who need them now versus safety concerns. And so that will always happen. I don't think it happens often. It's not a substantive enough problem in my mind that I would say if the FDA approves a drug, that I'd be concerned, really concerned about safety effects. I mean, anything's possible, but it's not something that would come to my mind either as a prescriber of these drugs or as a patient who would take them. Yeah, that was a beautiful answer, by the way. That actually summed up. Yeah, it made a lot of sense to me. That was a good answer. Fucking good answer. And also, I feel like with the drugs,

they sort of do give you all the side effects. Maybe they might miss one or two every now and again. Yeah, they're like, you'll want to kill yourself you might die that's the thing with the vaccine the vaccine they're just like this take the vaccine or stop you getting covid you might have a sore arm after you have you might have some flu like things and whatever and then take the vaccine the blazing and then you watch another one take uh take this pill that will give you an erection uh make it you may kill yourself yeah you're like this may never get an erection, you may kill yourself. Yeah. Your dick might fall off. Yeah, you're like this.

May never get an erection. May have an erection in the last four hours, and you may kill yourself. And you're like this. All right, I like those odds. Deaf want to have sex, though. There used to be one for restless leg syndrome, and then one of the side effects was compulsive gambling.

I was like, Jesus, that's a bad one. That's the one with Chantix. They go, you're going to have some funky-ass dreams, man. That's not what they say. I was like, all right, let's go for this, man. All right, before we get to the dinner party fact, I just wanted to remind everybody that Dr. Jenna or Bapu or Dr. Anupam, Bapu Jenna, his podcast is called Freakonomics MD. It's part of the Freakonomics

Radio Network, so make sure to check that out. Subscribe to that if you want to hear more about this kind of stuff. It's very interesting. And you can follow him on Twitter and Instagram at DrBapuPod. D-R-B-A-P-U-P-O-D. So our dinner party fact, we asked our guest

to give us some sort of fact that's interesting and obscure that our listeners and viewers can impress people with, like a dinner party or a bar or something. Do you have anything for us? Yeah. So I know, Jim, I saw one of your bits and I know you have an interest in guns. So I'm going to give you a gun related fact. I love guns. I bet 10 or 12.

So this is a fact from my own research. What we showed is that during the dates that the National Rifle Association hosts its annual convention that happens once a year, the dates vary, the locations vary. During the dates of those meetings, gun injuries in the U.S. fall by about 10% during the exact dates of those meetings. And then they return back to normal. This is just kind of normal gun injuries, not necessarily violent, but just injuries. And the reason that we speculate why is because you've got a lot of gun enthusiasts who might otherwise be at home using firearms recreationally as they might, or unintentional injuries that might occur. That don't happen because those individuals are actually at the NRA convention itself. So that's again, a fun fact for you.

No, that's because they're not at home being a good guy with a gun. Yeah. I bet you crime. No, that's fucking fascinating. 10%. 10% is a lot.

Is that a real stack? Can I throw that around? Yeah, you can put it here. Put it one, two in a year. Yeah. Yeah.

Fucking. I'm all over that. It's like a fucking fat kid on a cupcake. I'm fucking love that one. It may, might not be as responsible as we thought. Is the NRI bad? All right, well, thank you very much for being with us. And like I said, Freakonomics MD, part of the Freakonomics Radio Network.

Well, thank you for having us. Are you going to do anything you want to? He didn't have us. We had him. Yeah. No, that's it. You have anything you want to plug, you got anything you want to he didn't have us we had him you have anything you want to plug doctor anything you want to say listen to Freakonomics MD it's a fun show you'll enjoy it

and maybe one day we'll talk about laughter is the best medicine thank you doctor for a bit of common sense there ladies and gentlemen if you're ever at a party and someone says to you, marathons are good for you, go, I don't know about that, and then run away for five miles.

Good night, Australia.