The Peter Attia Drive - #248 ‒ OUTLIVE book: A behind-the-scenes look into the writing of this book, motivation, main themes, and more

Episode Date: March 28, 2023

Order OUTLIVE View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content Sign Up to Receive Peter’s Weekly Newsletter After more than six years of research, planning, and writing, Peter’s book, Outlive: The Science and Art of Longevity, is officially available as of March 28th. In this episode, Peter sits down with co-author Bill Gifford to provide a behind-the-scenes look into the writing process, including the motivation for making it happen, how the book evolved over the course of the writing process, and why certain topics were chosen (and omitted). Additionally, they discuss how the book is structured and touch on a few of the book’s main themes to give potential readers an idea of what they can expect. We discuss: The meaning of the book’s title and subtitle [3:00]; Finding the right art for the book cover [9:00]; Who is Bill Gifford, and how did he get involved in the book? [16:15]; How Peter’s writing evolved over the six years it took to write this book [25:00]; The structure of the book and what people can expect to learn [29:00]; How the writing of the book and the podcast interviews have shaped Peter’s thinking and approach to translating science [32:45]; Making the book stand the test of time despite the constant evolution of science and medicine [36:00]; Objective, strategy, and tactics [39:30]; Exciting possible progressions in science and medicine over the next decade [42:15]; What is holding back “medicine 3.0” from being the norm? [46:00]; How the book compares to the podcast in terms of technicality and readability for the layman [49:00]; Motivation to write the book and insights into challenges around the writing process [57:15]; Peter’s decision to be the reader for the audiobook [1:10:30]; The many painstaking last-minute changes and edits that brought the book together and made it better [1:19:00]; Peter and Bill’s favorite parts of the book [1:27:30]; The incredible team of people supporting the book [1:31:30]; and More. Connect With Peter on Twitter, Instagram, Facebook and YouTube

Hey everyone, welcome to the Drive Podcast. I'm your host, Peter Atia. This podcast, my website, and my weekly newsletter, I'll focus on the goal of translating the science of longevity into something accessible for everyone. Our goal is to provide the best content in health and wellness, full stop, and we've assembled a great team of analysts to make this happen. If you enjoy this podcast, we've created a membership program that brings you far more in-depth content if you want to take your knowledge of this space to the next level. At the end of this episode, I'll explain

what those benefits are, or if you want to learn more now, head over to peteratia MD dot com forward slash subscribe. Now, without further delay, here's today's episode. Welcome to a special episode of The Drive. As many of you may know by now after more than six years of planning and background research writing, editing, rewriting, rewriting, rewriting, my first book Outlive, The Science and Art of Longivity, is out on March 28th. And so for today's episode of the drive, I'm joined by my co-author, Bill Gifford, to answer a lot of questions that you guys have posed over the past few months on the book. This conversation is really a

discussion around the book and the behind the scenes look at the past six years that it took us to write this book leading to where we are today. It includes a lot of details around process that I haven't really spoken about elsewhere and also about, you're really frankly why it took so long. My hope is that for those of you that end up buying the book and reading it, this discussion today will prove useful. It will provide a lot of the background and hopefully explain why we wrote about what we did and perhaps even why we omitted certain things. Before we get to the episode, it's cheesy as this probably sounds. I do want to thank everyone who's listening for all your support. And I think that without you, there wouldn't be a

podcast. That's just the truth of it. And frankly, without a podcast, this book wouldn't be half as good as I believe it is. As I note in the acknowledgment section of the book, the best part of the podcast is having this forcing function to learn. I'm forced to prepare in great depth to interview someone or to be basically interviewed in response to the AMAs. And in doing that, I'm generating knowledge that I'm able to translate into this book. And so I really mean it when I say this, if there weren't podcast listeners, there wouldn't be a podcast. And if there wasn't a podcast, there either wouldn't be a book or there would be a book. And it would be a fraction of the book that I believe this has turned out to be.

And so without further delay, here's this week's special Outlive episode of The Driver. Here, Bill, how you guys doing? Good, all right? Doing good? This is the first time we've ever done three people in person. So we'll see how it goes. It should be fun. And I think what we're here to talk about is the book.

So by the time this comes out, the book will be out, which is still kind of crazy to think about, more so for probably both of you who have been much more involved in the process than me. But I think what we did is we collected a ton of questions from the audience on wanting to understand the process of the book, who Bill is, what the cover means, what's talked about,

all of that stuff. And so we collected those questions, we're gonna cover them today. And it should be kind of a fun way to learn more about the book, what's involved, kind of that inside baseball story about it. So with all that said, I think the first thing we should start with is Peter, how's the voice doing?

I would say it is like 80% of the way back to normal. Do you want to tell people who are maybe unfamiliar how the book tried to kill you through your voice? I think the book has tried to kill us in many ways, but I think most recently between reading the book for the audio book and then getting some virus and then having a hectic travel schedule to try to do some podcasts, I basically just developed the worst case of Laren Gytis and I had a pharyngeal abscess that caused my vocal chords to stop working. Yeah, which in your profession you kind of need. So it's good that they're made their way back.

Yes, but I will say this, I really enjoyed not speaking for two weeks. Sort of a valve silence kind of thing. It was just amazing. I was like, it was amazing how many things I got to tune out. Like I'd hear people call my name and I'd be like, I can't do anything about it. So just get a sit here. How did the family take that today? Is that to their advantage?

Well, absolutely loved it. The boys were, what was really funny was the first couple of days, everybody else got very quiet in response to me being quiet. Actually, it's very interesting. One of the few times social media turned out to be insightful and helpful.

After I posted, I think the second video of the direct learningoscopy, someone, a very astute, actually, a several commenters said, Hey, Peter, by the way, don't whisper. Because that was basically all I could do. I could go, like, I can sort of do this. And they said, don't whisper. Whisper is a bad form of phonation. It's actually teaching you the incorrect movements. Either don't speak or speak

normally, but at the lowest volume possible. I was like, well, that really makes up tons of sense because my throat was actually starting to hurt from all the whispering, you know, utilizing muscles incorrectly and stuff like that. So anyway, so I'm talking very quietly. And my boys, who, as you know, are not, you can use a lot of words to describe them. Quiet is not, would not be on those lists. Definitely not one of them. They got so quiet in response to me being quiet that I was like, I got to figure out a way to just do this enduringly. Next time you have like people over, you need to just be under control.

Yeah, I can't talk to you. So you learned a parenting hack? Yes, totally. The quieter you are with the quieter they are back. One of the questions that we'll get to later is will you ever write a second book, which you say no, I'm curious what Bill thinks, but maybe if you do,

that could be the parenting hacks one or one, just lose your voice. So I think we'll kind of get into it. We have a lot of questions to get through, but the first one, which I think makes the most sense and which to start with, which is relevant to the books in front of us and the cover is, people would ask, we understand how to live and what that means. But what is the science and art of longevity come

from and why was that so important to include in the title? The title was actually an evolution. So the first title I had in mind when I wrote my manifesto, which was an awful title, but it was the longevity manifesto, which of course for obvious reasons got scrapped immediately. But the working title during, call it 2016, when we were shopping, the proposal around was the long game. So that was kind of the working title that pretty quickly got replaced by Outlive for, I think, obvious reasons. I think I've talked about why I like that title so much. And why, I don't know, we never really even questioned it, right? I don't think there was ever a point where we

thought of something else for the main title. There is a moment when I think a previous publisher questioned it. Yeah. But it's just very evocative and it's very simple. And it's an action. Yeah, it could mean different things to different people, but I think of like, you're gonna outlive your expectations or outlive your parents or your grandparents. Your fate is not set in stone.

It's kind of the idea. So to your question about the subtitle, art and science is a pretty common term. People understand that this is the art and science, this is the art and science. But I felt that there are two things that needed to be communicated. One, the study of human longevity is part science and part art, but the science should come first. So that's why I wanted to flip that order and say it's the science and art of longevity.

And I think in the book book we make a pretty good case for where the application of each comes. If this were a book about mouse longevity, it could just be the science of longevity. Because in mice, you can do all of the definitive experiments and answer all these questions. And in humans is readily apparent, we will never know definitively what the answers are. And therefore, we always have to have some art involved. So Peter, another question we got is, you often talk about longevity having two components, the lifespan piece, which is how long you live,

and the health span piece, which is how well you live. The lifespan piece is kind of covered a little bit with the outlive, but we did get a question to someone wondering, was it purposeful that health span didn't make the title, or kind of what was the thought process there? See, I think out live encompasses both truthfully to bills earlier comment. Out living is more than about the chronological years of life. It's about the quality of life as well. And so I think next, the most common question we got, as it related to the cover, is, can

you explain the cover art? And I know, for those listening or watching, it went through a lengthy process of a lot of different iterations. So do you maybe kind of want to talk about that? Why you ultimately settled on this and kind of to you what it means? The cover is interesting because there were two things that in the back of my mind were enormous stressors as we got closer and closer to the finish line. And by that, I mean, basically by about the spring of 2022, exactly a year ago,

you know, we had a manuscript that was, we knew it was too long. It was probably about 190,000 words at that point. So we knew it was going to get a big haircut, but we knew we basically had the book at that point. But these two things that kind of nagged at me and kept me up at night were, how could this be represented in a cover? And who is going to read this book for the audio book? Those two things just created such a low-level anxiety for me. I can't even talk about it. And so, as the spring turned into this summer, and our publisher is like, okay, we need to get on this cover thing, and they've got kind of a checklist of, okay, for the book to come out in March,

we have to have this thing designed by here and that that that that that that I just didn't even have a sense of what one does, because I couldn't, as Bill can say, I have very strong opinions about everything. I couldn't even offer an opinion on the cover. All I could say was, I wanted to be elegant, I wanted to be kind of timeless, I don't want it to be too busy, like I had vague ideas of what I wanted, and as you know, I'm a font fanatic, so I kind of understood the fonts I wanted, but no sense artistically of what I wanted. And as you know, I'm a font fanatic. So I kind of understood the fonts I wanted, but no sense artistically of what was wanted. So then Bill sent, this is probably August, right? He sent over an email of a guy named Rodrigo Correll who I'd

never heard of before, but you sent over, I think his website. Yeah. My sister is a book designer. He's revered in those circles and we looked at some of his designs. Yeah, and I really have the box. Right. Like, yes, this is the guy, right? This is elegant. And while that's happening in parallel, the publisher is churning out designs as well. And I'm kind of like, okay, there's a couple of these that are, I could see iterating on,

and we weren't really making a ton of progress until we, I think, just collectively decided. And really, I think Bill has contributed a lot of things to the project, but if I was going to say this single most important thing Bill contributed was being adamant that we engage with Rodrigo and this was late in the game. This was October if I'm not mistaken. And I remember where I was. I was on a flight and I got an email from Bill. It was said something to the effect of because we were looking at something that I was almost going to capitulate on. It was a design. I remember what the design was. And I basically

was saying it's a solid seven out of 10. And I'm too tired to do anything about it. And Bill was like, this is bullshit, man. We've worked way too hard on this book to have a seven out of 10 cover. We go and get Rodriguez. And it doesn't matter how much it costs. And it doesn't matter how much it slows the process down. We do it.

And I was like, yeah, that's right. I don't want to regret this. I don't want to be sitting here in 10 years going, why did we do that? So then we reached out to Rodrigo, had a long call with him. And I guess this is what makes great artists, great artists, is even having this call just talking with him about the book.

He didn't have a chance to read the whole book because it's long. And I mean, within three days, he threw up 30 covers. And they're all different. Totally different. But all sort of evocative. There are some images that I liked and that you liked and other people liked, but different ways to kind of evoke this concept of longevity and outliving and living better and all that stuff. It's really easy to also get that wrong visually. I was

telling Nick about the Korean cover of my book, Spring Chicken, that portrays a fat guy on a beach chair like frying an egg and that's supposed to mean longevity. So there's many ways it can go off the rails. So there was something about this. I don't think this was your favorite at first either. What was it at first? But it was in my top six. So I remember he sent over 30 and I think we each decided to pick our top five or top six.

This was on for all of us. It had a very different font. There were a number of things about it that were different at the time. And I think the font threw me off the first time round. Fonk. Yeah, Fonk. I'm very particular about my fonts. And to make it very long story short, we ultimately decided this was the one we were going to make the winner. And, you know, I wish I could sit here and tell you that the blue, green, yellow, pink all signify something.

I can't tell you that. What I can tell you is it signifies a bunch of things to me. It signifies kind of a keyhole that you're walking through. It's a passage, but it also looks like a target. And that's a big part of this. There's a very subtle theme in this book about lots of metaphors that revolve around archery. Anyway, I could talk about it, length them, not sure Bill, what you think. It's different. I showed it to different people like my partner, Maratha, and various other people.

And everybody kind of liked it, but they had a different reason to say, I like it because it's like an aura. I like it because it's like you're going into the beyond, into the future, or you know, the little guy there. That's not forget him. He's an important part. That was a design. So it's different things to different people. And that spoke to the art side of it. Science in art. I think that it speaks to what art is, right? Art means different things that different people. And in that sense, I think the cover, I just wanted a cover that I would like to look at. I have certain books that I love looking at their covers. And so I wanted this to be one of them. It is interesting too, as you kind of mentioned,

what makes Rodrigo so good. And when we saw that list of 30, you were just every time you would look at another one, you're like, this could easily be it. There literally wasn't a bad one on his list of 30. That's the thing. Like every one of those was reasonable. And there were a handful that were exceptional.

And there was one that was perfect. Yeah, it just shows people who are experts at their craft, how good they are and how they can think so differently. And this cover, it turned out really, really well. And I think I drove everybody absolutely insane with all the font changes I made. I was gonna say, I think to say your fanatic about fonts does not do it justice how fanatic you are about fonts.

Yeah, one little inside baseball thing here, if you go with this font, the commas work out to be much cruder. And so I was like, no, we can't do that. We have to use a different font for the comma because the comma I really wanted to be Sarah to a sans-saref font otherwise. And everyone was like, only Rodrigo was like, yeah, that totally makes sense. Everyone else was like, Jesus Christ.

Yeah, I wanna go. Everyone else was like, this comma's gonna cost us book not actually getting done because the cover won't be done on time. So I think it kind of pivots to the next question and Bill, you hinted at a little bit, but a lot of people were kind of curious who is Bill Gifford, what's his backstory, how did he get involved in the book? So do you kind of want to give a little rundown of kind of who you are, your story, and then ultimately, how you initially got connected with Peter and the project, which was six years ago now? And of 2017, yeah.

I got an email out of the blue for me, right? Yeah, I knew who you were. I think in particular, I had read your insane 13-part series about cholesterol. I was like, this is epic. I had read that in the course of researching my own sort of more personal book about longevity, Spring Chicken, which came out in 2015. I thought I was done with longevity, honestly, but this seemed interesting. But sort of to real back, where other kids' dads were throwing the football, passing the old baseball around,

my dad took me to the library. So I became a writer eventually. And I just love writing and words, and I thought I would be a poet at one point when I was in college, but then I realized I like writing to people and sort of connecting with people and evolved from sort of general journalism into writing more and more about scientific and medical topics and writing about like sports performance and then doping and cycling and then more general health related topics and then got interested and like Peter did you know you reach a certain age and you're like huh what is happening here you know I'm not the guy I was 10 years ago and there's this interesting process going on that's this big sort of biological mystery it's super fascinating

going on, it's this big sort of biological mystery. It's super fascinating. And it has not been solved. It still has not been solved. So I ended up writing about longevity. And I write a lot about athletes too. So I found myself writing about older athletes as well. Like Phil Mayor, the skier, came back to racing when he was 50. So I followed him around and he was competing against 22-year-olds. So that kind of longevity kind of fascinates me as well. You don't actually don't know if I know this story, but you mentioned you first reached it out to Bill. So what caused you to do that throughout the writing process? So in 2016, I was working with an agent.

This book got sold to a different publisher. And I was the author of the book and I'm working on it nights and weekends, you know, while I'm doing my day job. And I finally have kind of the first part of the book to submit. It was just under 40,000 words. And I submit it to my agent who then submits it to the publisher now. By this point, the editor who had bought the book had left. So, there's this woman who's at the publisher, and I seem to like her and I thought she really got the concept of the book, but unfortunately, and I guess this is not uncommon in publishing, within a couple months of me coming on with the publisher, she gets a better job at another

publisher, so she's gone. So now another editor basically comes on, it's now her book, but she doesn't really have as much invested in it. And so I submit this first section to them, and it is met with a very lukewarm response. And they really had two huge criticisms of it. The first was, it's too technical. I can see why that's the case. The second was, there was no story in it, right? There was no narrative. It was mostly just a scientific treatise on the subject matter. I guess both my agent and the publisher said, look, we think you should bring a co-author

in who can help massage and smooth this out and make it a better book for the lay person to read. So I said, okay, how do we go about doing that? And they said, we've got a long list of people to introduce you to. I said, great. So sure enough, the courting began. This is back when I was in New York constantly. This was back when I traveled a lot to work there. So basically every week that I'm in New York, I'm meeting another author. And usually what would happen is they would send me one of their books. I'd read as much of the book as I could get through or skim it or something and then sit down with them. And I kind of went through five or six of these.

I was like, there's no way this person gets it. This person has no clue what I'm trying to write about. And this is not going to work. Then I talked to Bob Kaplan. And I said, Bob, here's the problem. Do you have any ideas? He goes, yeah, let's go find somebody who's already written about what you find interesting and see.

And the very first thing that I remembered, what year did you write that Bloomberg piece on Rapa Mison? Was that 2015? So that came out 2015, yeah, early. It's actually interesting that you wrote it back then because this was still sort of pre-hype of neuroscience. Yeah. But there was an article in Bloomberg, I guess, 2015, that because I was obsessed with

this stuff, I read everything that came out. And this was the first one that I read that I was like, this is a very good article. Most of them were so simplistic. They just missed the point. But this was a very good article. So I said to Bill, I mean, I said to Bob, I said, this is the guy, because he already gets it. I'm not going to have to like explain to him this, that other thing. Or at least I said, like, my intuition is that he will get it.

Did I contact you through Twitter? How did I do remember reaching out to you? Was it through your website or through your email? I think you just emailed me. So somehow I just got Bill's email. Maybe it was on the article. I don't remember what the email said, but I do remember we met for dinner on the Upper East Side one day in late 2017. I think I probably just said everything I just said now, which is, so what did I send you to read? What was the version I had sent you at that point? It wasn't the 38,000 words. It was more like, I think I probably by that point. It was kind of the proposal. It was more like, I think I probably buy that.

It was kind of the proposal. It was like 5,000 something. And interesting, I was just thinking about it. I think some of the DNA of that is definitely in part one. Like if you did a text analysis, you'd probably find some bits of that sprinkled in there. You know, I had the sort of the central, central ideas in part one. So you had a start, starting is super hard, and then keeping going is even harder, and then figuring out that you're done is the hardest of all.

So you had a start. I had no idea how hard this would be. I mean, I'm sure every first-time author says that, but this was so much more difficult, so much more time consuming than anything I could have imagined. I do remember in the early days, we spent a lot of time in front of a whiteboard. Indeed, in my office. Yes. And that was the easiest way for me to communicate, kind of broad strokes was,

this is how I think of these as pillars, this is how I think of these as foundations, this is this, this is that. Yeah, we had a lot of these as foundations, this is this, this is that. We had a lot of pillars and foundations. Yeah, frameworks. Lots of frameworks. And I feel like that was the easiest way, I think, to get us on the same page about

how I was thinking about it. But the structure that emerged in the final book, which is basically three big sections that communicate each important and builds on the other. I feel like that didn't really crystalize until, gosh, I mean, 2019. 2018 is a blur to me. I don't remember the difficulty. I mean, I do in some ways, but if version one of the book was what we just talked about, the sort of pre-bill,

then there was version two, which was the book that got written basically from the beginning of 2018 through the beginning of 2020. And it, even in that period, the two things I remember, first of all, I remember you ordered about half the menu at that Turkish restaurant, and the waiter was like, all for you?

This was back when I was eating just one meal a day. So it was like I would fast all day and then basically throw down 3,000 galleries at dinner. So I was like, whatever this is gonna be, it's not gonna be dull. Then the other thing is sort of we had a basic template, we kind of outlined, okay, what's the book gonna be? It's gonna be 25% kind of this part one's manifesto stuff.

And then it was going to be basically a biology of aging book. I mean, that was kind of where we were going, you know, the rapamycin stuff and the kind of mechanisms that, you know, the hallmarks of aging, almost like the molecular cellular level stuff. You were like, oh, you know, 10% tactics. I don't want any tactics in it. I want to be five percent tactics. We can make an appendix with a couple tactics in it.

Now, we have 200 pages on tactics. What did the publisher say when you said, I'm actually going to not tell anyone what to do in this book? They were apocalyptic. You know, you mentioned it was so hard to kind of write. And it obviously took a very long time. What do you think was so hard to kind of write and it obviously took a very long time. What do you think was so hard about the process?

Was it translating the science into something that was more of a story? Was it figuring out how to verbalize the frameworks? Was it just getting what was in your head cohesively on paper? I think there are a couple of things. So first of all, I love writing. I've been blogging for as long as I can remember. But that's a very different style of writing. Bill was talking about my 13-part cholesterol series.

You don't have any constraints when you're blogging. You can go as deep as you want to go because you are attracting an audience of similar weirdos who are going to go as far down the rabbit hole as you will take them. And so I think the biggest struggle I had switching to this kind of writing, and it's so funny for me to look at this version of the book now and compare it to what I was writing in 2018. And I remember Bill really tolerated a lot of my stupid things that I was writing. And basically how he tolerated it was he made a lot of footnotes. He was like, all right.

I really want to delete all of this. But we're gonna make it a footnote. And of course, four years later, three years later, I was the one deleting those footnotes. And I was like, this is so gratuitous. Like, it doesn't matter that much. That, to me, is a remarkable evolution. I guess that everyone has to go through.

You know, Bill presumably went through this 30 years ago, right? But for me, that was new. That was like, no, but I do need to explain the extracorporeal circulation of the liver in this section. And Bill is like, I don't think that's really important. And I was like, no, no, Bill, you don't understand. If the reader doesn't understand portal blood flow here, they will never understand why glycogen gets there.

And he's like, Peter, I can assure you there are seven people who give a shit about that. And I was like, no, no, Bill, it's important. He's like, let's make it a footnote. Fine, let's make it a footnote. I was pissed. And then of course, two years later, I'm like, let's make it a footnote. Fine, let's make it a footnote. I was pissed. And then of course two years later, I'm like, that's so goddamn irrelevant.

Get rid of it. But you have to know it though, to be able to write intelligently, like you have to know it, and you have to know what's going on. But then you also have to decide, you talk about like getting in the weeds, and you have to know all the weeds

to write well about science. But then you also have to ultimately, both got pretty good at this. Get pretty harsh about what you're going to leave out. And we left out a lot of stuff. I mean, so much. Stories and science. I mean, I think I've told this story before, but I remember when I was writing probably my first or second scientific paper, you do a lot of experiments, most of which don't make it into the paper. I forget who it was that told me this. I think his name was Dan Powell was one of the postdocs that I was in the lab with and he said,

you just have to learn how to kill your babies. You're going to throw out the 90% of this. And I just think that that for me was hard. Getting to that point of, if the reader doesn't know all of this stuff below the surface, can they appreciate the piece of the iceberg above? And I think ultimately the readers will determine if we've struck that balance correctly, I think we have. And I'll tell you why I think so. I think it became readily apparent when I read the audio version of the book because when you're reading it out loud, it's very different from when you read it the way one edits their own writing. You're obviously reading it much slower and you realize the unnecessary

interruptions of endless footnotes that are incremental in what they're adding. It's interesting to hear you talk about it because I haven't read the first iteration, which I think you said, practically none of it made the final version, right? Certainly in direct content, absolutely not. In spirit, some of it. I just can't imagine what it was, is if you handed them a whole manifesto, zero tactical advice, and literally explaining every little nuance of the liver, like I would just love to see the face of the person who came in after that

publisher left and read this and just was like, what the hell are we going to do with this thing? I'm sure they were freaking out. You mentioned it there, but there's three main parts of this book, right? So let's talk about what ultimately made it into this final version. Do you kind of want to walk through what the structure of the book is, kind of some of that content? We don't have to get into detail, but just kind of what people can expect to read about. There's three parts. I think the first part sets up the structure of the book.

It gets the frameworks across. You'll certainly, as a reader, understand the problem statement. Again, I think you can't solve or even attempt to solve complicated problems if you aren't asking the right questions and you don't have the right frameworks. That's something that we pos it very clearly here. And that's really what part one is about. And that's not just explaining what longevity is and isn't, but it's explaining something

called medicine 3.0, which is the vehicle through which you pursue this thing. Then part two, probably the most technical part of the book, where we get into the scientific underpinning of everything coupled with get to know your opponents. There's no denying this. A big part of this book is trying to figure out how to live longer. Now, not in terms of science fiction living longer, but I think we argue very convincingly that a person reading this book, who puts these principles into practice, is really thinking about it, elongating their life by five to ten years. But to do that, you really have to understand what are the things that are coming to take your life.

So we kind of go through all that in part two. And then part three is, how do you put this into practice? It is that which I initially didn't want to write about, but ultimately think that section just turned out better than I ever could have imagined it. It kind of organically evolved and kept growing and changing, but going back to Part two, we were looking at, you know, because we're both fascinated by centenarians. We were looking at that chapter and kind of hammering out that chapter. We kind of had a little bit of a revelation where it's not like a big mystery how these people live to 100 when most people live to 80. You know, they get heart disease much later if at all they get cancer much later if at all or maybe never and they get neurodegenerative disease later or never. And so it's kind of like,

that's the ballgame, right? You've got to figure out how to delay all of those diseases, which you call the horseman. And we didn't even contemplate writing these chapters at the beginning. Then we decided, we have to, because we have to like know the enemy, know the opponent. That's right. Yeah, the first version, the first version that we wrote, which is the second version of the book, was way heavier in the molecular science of aging. We came at this much more through, let's go really deep into it, let's go really deep into nutrient sensing pathways, let's go really deep into all of these things, which of course I found super interesting. But ultimately,

we pivoted much more towards this insight, which is there are two completely different strategies to live long. One is figure out a way to extend the period of time you live once you have a disease. And by the way, that's everything medicine 2.0 does. Wait till you have a disease, and by the way, that's everything medicine 2.0 does. Wait till you have a disease, and we're gonna figure out a way to just drag you through that and keep you from dying. Okay, that strategy's worked a little bit. Strategy two, which is medicine 3.0 is no way. We have to figure out the time,

we have to figure out a way to drag out the time you live without a disease. And you can't play that game if you don't know everything about these diseases. You have to become so intimately familiar with each of the horsemen. And of course, therefore, each of those horsemen has a very robust chapter. As I'm listening to you talk, I'm kind of curious, do you think, for as tough as it was to write the book and all the pain to go through that process over the years,

do you think how you practice medicine with your patients, kind of what we talk about on the podcast, weekly newsletters, how all that structured? Do you think it would evolve to what it is if you didn't write the book? I think they help each other for sure. You can't write well if you don't think well, and you could argue it's hard to think well if you're not able to write well. So I think the relentless process of streamlining and figuring out how to get to the point sooner, all of those things would absolutely force me to reconsider how things were happening. By the way, I think a lot of what's written in there comes

out of just the conversations I'm having with patients. I know there were certain times when I even asked patients, hey, do you mind if I record our Zoom today because I just wanna be able to go back and listen to how we talked about it, and they'd be like, sure. And so I would walk them through all of their cardiovascular disease risk and then go back and listen to it after and go, okay,

yep, this is a good version of this talk because I give the same talk to patients constantly. Sometimes they hit better and sometimes they don't. And so having some recordings of those was really helpful to kind of go back and remember how what worked. When you started the podcast, I think it was about six months, yeah, it's about six months into the book writing process. I think that gradually that made you more cognizant of how to communicate science and medical topics, Maybe by nature, you're

very data-driven, kind of mathematical guy, and you'll want to maybe just present numbers and facts straight up. And I think doing the podcast, you kind of learned how to speak and introduce these subjects in a more sort of user-friendly way. It was an interesting progression. subjects in a more sort of user-friendly way. It was an interesting progression. We started the podcast in June of 2018 and I remember in the summer of 2017. So before we were still working, when I was still working on version one, I was effectively podcasting but without podcasting. In other words, I was flying around interviewing people, going up to Boston to meet with David Sabatini, meeting with Matt Kabralin, meeting with the post oxen there, labs, sitting down and recording these interviews with them. And it was effectively my foray into

podcasting without, but it was all for the book. These were all just interviews that were used to drive the book. And yes, what an evolution in that. That's another, we'll save that for another discussion. But boy, how difficult podcasting is to... It's kind of funny because some of those initial interviews ended up being some of those initial interviews Ended up being some of the first podcast we released. That's right I think we did end up using at least three of probably a dozen of those as actual podcasts And I think too the first interview we did with in you go and Rick Johnson That stem from you wanting to go talk to them or the book.

And we just kind of double dipped. So it is kind of funny to think about. A lot of those interviews would, you'd come back and you'd be like, you got to listen to this Billy, you got to listen to it, and you go. And those fed into the, not only the writing of the book, but sort of the evolution of thinking behind the books. And it kind of fits in with a question we got asked quite a bit, which is it took you six years to write the book.

There was a lot that changed in those six years, as it relates to science. There's a lot that's gonna change in the next 10 years. And you, when you announced the book, you kind of wrote about your go with this book is it would still be applicable in 10 years. People were curious, you know, how do you think about one writing a book that can stand the test of time to what changed a lot in your mindset and

where did you evolve in that whole process? I mean, I think a lot of things changed in me in the six years. Some of them just obviously very personal things, some of which I've written about in the book, but I think more it has to do with emphasis. There were things at the beginning that were much more the emphasis in my mind and other things became more important over time. For example, at the outset of the writing of this book, I probably placed more of an emphasis on nutrition than exercise as one of the important drivers, one of the important levers we have at our disposal. And I would say that my views on that have flipped. I think that exercise has a bigger impact than nutrition. And certainly on the positive side, nutrition can have a pretty big negative impact, but once it's corrected, it doesn't have this enormous upside, whereas exercise has an enormous

downside in its absence and an enormous upside in its presence. So that's, you're reading a different version of this book than you would have read six years ago with respect to that. Or two years ago. Yeah, one year ago. Obviously, this book written five years ago would have not had anything about emotional health. There's not a lot on it, but there's something on it, and I think it's relevant. It's very framework focused, which I think lends to a more timeless piece, because frameworks or scaffolding are there upon which to place information and substitute information. So if the framework says delay the time that you do not have disease, that's relatively timeless

as a strategy. Now we're going to learn different things about these diseases. In 10 years, my hope is that taking one example, liquid biopsies should be a heck of a lot more valuable in 10 years than they are today. That's going to completely change our approach and our efficacy of screening. You'll have a different tactic that you'll use in a toolkit to go about this strategy, but the goal is still the same. So you're talking about liquid biopsies for cancer detection. Yeah. So if you can detect cancer much earlier,

treating it's a whole different thing. It's interesting because anyone who's listening to podcasts for a long period of time will know, hear you talk about things in a different way as you learn more information. And I think sometimes a natural reaction from people is to be frustrated at that. And like, well, what did you say this one time

and then you kind of change your mind? But I think to what you just said, which is really important, it's probably we're spending a few minutes on it is you focus heavily on objective strategy tactic. And that's probably the reason why in the initial version, it had zero tactics, which a lot of people are probably like, how do you write a book that doesn't tell people what to do? But for you, it's, how do you write a book that tells people tell people what to do? But for you, it's, how do you write a book that tells people what to? It's all about objective and strategy because as new information comes in, the tactic may change that the objective and strategy doesn't. You kind of maybe want to talk people through how you think about that objective strategy tactic

because I think it is applicable for anyone who's going to read the book to really understand that or knowing how to take this information and still make it applicable years down the road, not just months down the road. Well, there's a whole chapter on it in part one, which is, you know, why is it that we spend so much time hammering this idea? And it's a simple concept, but it's amazing how often it's ignored. So for starters, you do have to define the objective. I won't say any more on that now, but again, the objective, you'd be amazed at how many people would struggle to define their objective. Oh, I'm taking this 27 different supplements because I'm hacking my, you know, whatever. And it's like,

okay, what is your objective? And if you can't clearly state that, then there's so much fog around this. The strategy is very important. And again, we open each chapter with a quote, but of the quotes, my favorite, has to be the one that opens that chapter, which is the Sun Zoo quote, about strategy tactics without strategy as the noise before defeat or something. That's right.

So we go to great lengths using lots of examples to really help a person understand the difference between a strategy and then the tactics that they employ. And we do this because we say the tactics are the most malleable things here. They're the things that are going to change the most. And to your previous question, those are the things that have already changed the most, right? So give you another example. How much emphasis did I use to place on fasting?

How much emphasis do I place on fasting today? Totally different. I am positive that there is some set of drugs that I am either not taking now or don't even know what they are now that I'll probably be taking in 10 years. And similarly, there's probably something I'm taking now that in 10 years, I'm going to say the evidence for this sucks, I'm not going to do it. So if I can't take that and anchor it back to a strategy, which is the reason I would take this or wouldn't take this is because it feeds into one of these three overarching principles that guides the subjective. I'm really just doing a bunch of random things that aren't in concert, but you're also able and open to changing your mind. You know, one of the things I noticed early on is you're not a dogmatic person if you get information

or a new interpretation of the existing data that causes you to see something differently and fasting is a big one. I was a little bit relieved, actually, because I knew I was going to have to do it myself just to be able to write about it but was looking forward to it but then you kind of got off the fasting. It served a purpose for you. And again, there's still times when I think it makes sense, but yes, it just is one specific example of, you know, this isn't something that everybody needs to be doing. One of the questions we got was, what areas of a book do you think within the next 10 years will

evolve the most? You know, you mentioned there like liquid biopsies and cancer detection. Is there anything else that you kind of think about when you write this book, if you're like, if I was going to update this in 10 years, and I had to make a guess on which sections I would want to refocus on? Is there anything that you would think, another way to think about it is, you know, what in this sphere you kind of really excited about progress in the next 10 years. We've gone out, taken a very aggressive posture on cancer screening for the reason that Bill

alluded to a moment ago, which is certainly in doing research for this book and getting really deep in the weeds. There simply is no ambiguity that the earlier you catch cancer, the better your odds are at treating it while it remains local. Given the exact same histology of cancer, treating it when there are a billion cells versus treating it when there are a hundred billion cells with the exact same therapy has such dramatically different outcomes that there should be no question about that. You basically have to put yourself into different camps. Are you of the mindset that we will come up with systemic cures for cancer, regardless of size and stage in the next couple of decades? Or do you think it is more likely that

we will get better and better at finding cancer when it is smaller and smaller and treating it with existing therapies? Now those don't have to be mutually exclusive, but the question is which one of those you think is more likely, and I think the latter is much more likely. And, you know, we present it as such. Gold number one, don't get cancer. Gold number two, if you do get cancer, catch it as early as possible. And then, and only then, gold number three is we get into what are the most promising things. So I think that's another area where what we're seeing right now with immunotherapy is so exciting. And I think we are right on kind of the verge of unlocking the next layer of immunotherapies.

And by the way, I think this gets to another part of your question, which is, what else would I be excited about in 10 years that is not in this book? Because I think it's too soon for prime time. But if we could reprogram immune cells, so you've heard a lot of talk about reprogramming. Well, reprogramming gets talked about nonstop and there's so much nonsense there. But there is one subset of the human body that if it could be reprogrammed would change the game and that's the immune cell. And by the way, that's much easier to reprogram than like your heart or your liver or things like that in my opinion, because of how easily we can access those cells. If we could epigenetically

reprogram T cells, I think it's a totally different game when it comes to cancer therapy and cancer incidents. I would say maybe neurodegeneration. Yeah, that's a good one too. But that's someplace where we're kind of nowhere in terms of effective treatments for Alzheimer's disease or Parkinson's disease. Hopefully better data on prevention. You know, right now, and we do this in our practice as well, we're taking very much a kitchen sink approach, which is there are a handful of things that, especially for dementia, less clear for the movement disorders, there are a handful of things that unambiguously reduce your risk of dementia. There seem to be at least three, four, if we

were going to be right clear, exercise, management of lipids on the AD and dementia side, sleep and not having diabetes. Those things you can take to the bank. We talk about 27 other things for which the data are not clear yet. To have more clarity around that would be great. And as someone who's not in the scientific field, how you talk about cancer makes a lot of sense in the idea of, if you have better treatment than earlier, catch it, you want to screen as early as possible. But you talk about the book, kind of the difference between medicine 2.0 and 3.0, and how that's

not the case now. Why do you think that's, I don't want to say controversial approach to it, but why is that not the norm? Because from the outside looking in, it's hard to poke holes in that idea. Do you mean why is the traditional view of cancer screening different from the view we present? Yes. If I'm going to be fair and charitable to the outside view, it would be that we're basically asking two different questions. The question and the solution that we're proposing

is at the individual level. The outside view, I think, is at the population or societal level. So there was a recent study that got a lot of attention in Europe. I think it was published in the Greenland Journal of Medicine that looked at colonoscopies. The study took a large group of people and they were randomized into two groups. So one group was standard of care, don't do anything. The next group was suggested that they should have a colonoscopy in the next decade. The end of the decade they were compared for rates of colon cancer and colon cancer mortality and all caused mortality. And while there was a slight benefit to the group that were recommended to get a colonoscopy, it was nothing to write home about. The

relative and absolute difference in colon cancer and colon cancer deaths while statistically significant didn't seem very clinically significant. And opponents of colonoscopy said, look, this is proof positive that colonoscopies don't save lives. The route of it is no. It's proof positive that telling people to maybe get a colonoscopy once every 10 years, when by the way, I think less than 40% of them actually did, probably doesn't save lives.

That's very different from the example and the approach that we take. I'm 50. I've already had three colonoscopies. I get them every three years and I will continue to do that until my life expectancy is so short that it becomes irrelevant. Again, totally different approach. Am I suggesting that everybody get a colonoscopy or three? Of course, I'm not.

What I'm suggesting is that everybody think about their own risk reward trade off and decide what's the cost benefit analysis. So there's an enormous cost to doing that. My insurance company doesn't pay for most of those. They've paid for one of the three. There are risks of bowel preps. You do a bowel prep in

a person who's significantly older, who runs risks from the electrolyte abnormalities that come from those things. I certainly wouldn't want my 86 year old dad getting a colonoscopy under any circumstance. That ship is sailed. The bowel prep alone could injure him, let alone the sedation of it. So one has to be very thoughtful and measured in how they think about doing these things. The long answer to your question is, I think when people talk in blanket statements, like cancer screening is bad, they're generally speaking through the lens of policy and population. And it kind of leads to another question we start to come through quite a bit, which is sometimes on the podcast, it can get technical, can kind of get in the weeds. A lot of people were curious,

how is the book compared to that in terms of technicality? Is it something that, obviously, if you're an MD, PhD, you're gonna be able to understand, but what about for just the layman? Do you think they'll be able to get as much out of the book? And was that kind of the hope and how you wrote it? And my guess is we can get Bill's response to it.

I was actually gonna turn this question over to Bill first, and then I'll chime in, but I'd like to hear Bill's thoughts on that. I have a strong thought on this. I think we're both fascinated, probably you more than me, and kind of go down these rabbit holes of, the technical details, which I call the alphabet soup. Once you start streaming together, a lot of acronyms like APOE and Pisan and all this stuff, it turns into alphabet soup. I sort of think of the podcast as like your playground to go deep with these scientists. And it's tremendously valuable, right? Because they

don't have really other, you can't go on fresh air as a scientist and get into that level of detail. But I would say it's considerably less technical than a podcast, but the basic message, we cover a lot more ground. So we can't really go too deep on any one particular topic like I was listening to the episode about HDL. It's super interesting, but like mind-bogglingly complicated. And we just didn't have the time or the need to go that deep. And you know, I do hope that they figure out how to enhance the function of HDL. But we can go this on. There are probably some sections.

Actually, that's interesting. The cardiovascular section. Pretty detailed, actually. You go pretty detailed in that section. So we have to. And again, I think part of it is we're trying to add enormous value in writing this. There's a lot of kind of me two books out there on this subject matter. And by me two, I just mean like it's just another book that is literally adding no value.

Saying the same thing. Yeah, it's just saying something. And our goal here was like there's no chapter in this book, none that should ever just be another version of checking that box. And so on the chapter of atherosclerosis, I mean, yeah, I think we do go probably deeper than certainly our editor would have wanted. She was kind of to her credit just accepted the fact that she might not understand every word of it, but you don't need to necessarily understand every word of it to understand what to do about it.

And if you do want to go deeper, because we do get into HDL, and we do comment on the fact that HDL functionality is not captured by HDL cholesterol and HDL particle number, an APOA concentration, and all of those things. And we do have to talk about them in delian randomizations and what they've taught us with respect to HDL cholesterol and what they haven't taught us and things like that. So that's probably a little more technical than maybe the average person would want. But I think that overall, this book is very readable

by a person who is curious. And I agree that it is definitely a notch below the technical depth of what we often do in our podcasts. It's not meant to be a textbook either, but kind of the way I think of it is you want people to learn more than they expected without even realizing that they're learning, kind of like package it in a story or metaphor. And the athero sclerosis chapter is a good example of that, because you know, everybody knows about good and bad cholesterol. I think Peter got a little triggered by that, and we're just going to go to town.

And in the writing process, how is that like between the both of you and the sense of where you often try to keep Peter in check in terms of the scientific aspect of it, trying to bring stories in kind of, how would you both do that throughout? Because obviously, the book is a good chunk now. It clearly could be four times as long if you went into the detail that you could go. So, where in the writing process did you decide, okay, this deserves to go deep. This doesn't, was there ever disagreement about that? Or kind of how did that work?

I think Bill always thought about it through the lens of the reader, and I think there was a very healthy tension between us on those things, for sure. And I say healthy because I think both of us would sit here and say, never once, did we have a disagreement that was about ego? We had lots of disagreements about content, but it was like Bill saying, I don't think a reader needs to know this. And I'm saying, Bill, I think a reader does need to know this. And it wasn't about like, I want to put this in because it's mine. It was never about that kind of stuff. So, yeah, I think there was always a great and healthy tension about that. I think once, you know, there's a backstory here, which we didn't really get into,

but this book basically got killed in 2020. And then it died. It was left for dead. And it only got revisited with a whole new publisher and a whole new editor and a whole new process. And so that process, which was now 2021 into 2022, introduced a new player into the mix, which was our editor at Penguin.

And I don't have anything to compare Diana to as far as other editors, but she struck me as relatively hands off. Was she be described as more of a hands, more of a conceptual editor as opposed to a line editor? Yeah, and she gave great sort of guidance. You know, she had some give and take. But I think between you and I, like it took us about six months to kind of get the right voice and register.

Who are we writing this book for? I think you weren't quite clear. No, I think initially I was, I'm writing this like I would write a scientific article. I'm writing this like I would be writing in a journal, a scientific journal for people who know. And I think Bill initially was like, no, no, no, we're going to write this more like I'm making this up. It's not what was actually said, but like we're going to write this for USA today.

And I think in the end, we probably settled on the New Yorker slash the New York Times slash the Wall Street Journal. It's halfway in between and it's the right voice. It is. And again, I go back to, I finally realized it's absolutely written the way it should be based on how it sounded when I finally read the book out loud, which by the way, we dodged a bit of a bullet because I was given this advice by Sam Harris a couple of years ago and I didn't follow it because I never had the time.

But Sam said to me, do not do your edits silently. When you were editing this book, read it out loud. Yeah, that's good writers advice. Yeah, and I was like, I mean, I acknowledged what he said, and I never had the time to do it because when push came to shove, this is like nights and weekends. And if I got to get through a 5,000 word section, I don't have the fricking time to sit there and read that out loud. And so as we got closer and closer to that reading, my anxiety was peaking because I was like,

I haven't actually sat here and done this exercise. And there were a lot of last minute edits that came out of that. Probably many more than anybody would have been comfortable. I mean, I think you said 400. You pushed it to the very end. And also not only like line edits, but also like, hey, we just saw the study

about Tao deposition and women. Yeah, women are more perfect. Can we put this in? It feels like, oh my god, we're going crazy. But I think just kind of going back to something you said, like a lot of times you come up with something or some idea or there'd be some new study about Tau, can we put this in? It's like, well, we'd find a way to do it that worked and kind of weave it in and massage it in.

But a lot of times it would be you realize like something so significant might only warrant a sentence in a book of this nature. And I think that was just a general process of getting comfortable, but it is the way these things need to be done. And I'm really glad with the way this turned out, because if this had been written in the voice that the first version had been written, and it would have been accessible to so many fewer people, the feedback again from that first version was not just

that it's so technical, but there is no story in here. There's no protagonist. There are no journeys. There's nothing to follow. And that was one of Diana's insights. What's the thread that pulls the reader? That was for big saying, what's the thread that pulls the reader through the book? And they were there. We just had to kind of expose them, let them kind of shine. One of the questions we get asked a lot, which is, you often said, this is only a book you're ever going to write. And a lot of people are like, there's no way. And I think even Bill joked that he doesn't think this is only book you're going to write.

And whenever people would ask that I always be like, oh, there's not a chance Peter writes another book, there's no way. But as I'm here and you talk now, kind of thinking myself, how do you not write another book in 10 years on an update to all this? You went into this being like, look, I want to write one book, I wanted to contain everything, which is why you did the objective strategy tactics like we talked. What makes you think that you'll actually never write another book? Again, I think if we're being reasonable people, we could never say never, right?

I just think a couple of things would have to be true for me to write another book. I'd say that. One thing that would have to be true is, I would have to have something to say. I think this process is so difficult. I mean, I see these people that write a book a year. I don't understand how they're doing it.

Again, let's just put those people aside. But for someone like me to do this, with the unbelievable inertia that's required to do it, the desire, the drive to need to say something must be so great that you have to be able to overcome that pain. So that's condition number one. I would have to have something so overwhelming to talk about. Second condition is I would have to be at a different place in my life than I am today. I would not want to repeat what I have done for the past five years, which is work on something so difficult on nights and weekends. This has been, I've paid a price for it that is probably higher than I would like to have paid, and I don't want to do that

again. So I think the second equally important condition is I will need to be at a point in my life where I'm not working 24-7, and writing this will not kill me, meaning it's not something I have to do nights and weekends. I can write it during the daytime. That just means my life looks different than it looks today, right? That means my kids are a lot older. That means I'm not working as hard on my practice or other things as I am today, where those are my jobs, and this is my hobby. So I think if those two conditions were met, if I had something really amazing to write about or update or tweak, and I could do it in a civilized manner, I would be open to it. One of the questions that we got came through, which I thought was really interesting and fits well with thread

you just went on is, did you want or need to write this book? Because you can mention it there. There's obviously no shortage of books on health, books on longevity, whatever you want to call it. And so going back to the framework, you just laid out. What do you think to you was so important to say that you were like, I need to get this out there and I need people to have these insights. I think it's hard to speak to the motivation at the outset. When I started this in 2016, it was two years before having a podcast.

So it never occurred to me at that time to have a podcast, or I probably would have had a podcast. And maybe if I did have a podcast, I wouldn't have thought to write a book because in some ways a podcast is an easier way to communicate. It's less formal, but it's easier and you can communicate much more through a podcast. So I think the more interesting question for me to think about is let's go back to where we were in December of 2020, Bill.

So basically in February of 2020, this project is nuked. It's dead. We're done. Publishers fired me. And nobody wants a book about longevity in the pandemic anyway. Yeah, it's like, it's over. And I'm over it. Like I'm so frustrated. And I feel bad that I've wasted so much of Bill's time because he's put in two full years at that point.

And he's going to have nothing to show for it. Like, he's not going to have a book to show for it. For me personally, I don't care. Like, I don't need a book, whatever. And I don't know. Bill and I probably didn't talk for nine months. It was sort of done. I felt bad and Bill didn't make me feel bad or anything like that.

That was just the nature of things. So, that was the end of it until late, late, late 2020, when Michael Ovitz somehow asked me about it. I don't know what brought it up. We were talking about his book, which I love. And somehow it came up that, oh, I had kind of written a book too, but sort of got scrapped. And he was like, oh, send it to me.

And so I called Bill and I was like, hey, Bill, do we still have the G doc that has like whatever the last version was of that thing before it died. And he's like, yeah, I could probably find it. And I was like, do you mind sending it to me? So he did. And I sent it to Michael. And I remember this was around Christmas of 2020. He read it in two weeks, which is saying something because it was a pretty long-ass thing.

And he said, look, man, this has got to be published. And I was like, well, we don't have a publisher. And I explained all the, you know, how much hair was on this dog. And then the rest is kind of history. He just said, well, yeah, no, no, no, he goes, look, we'll get this published. The question then becomes why at that moment in time that I go back in the ring?

Because I was clearly out of the ring. And by that point, we had a podcast. I wasn't looking for things to do. And honestly, I think it kind of comes down to some of the stuff I write about in the very last chapter of the book. I think there was a coming to peace with some of my demons and a realization that I wanted to do it. I really had a strong desire to put this material out there in basically the formats in now, which turned out to be such a blessing. Had it not been for getting fired by the old publisher, had it not been for COVID, had

it not been for all of the crises that emerged, this book looks a lot different and truthfully I think it's not as good. But to answer your question, I think it was want more than need, but I don't think that want really found it's why until the end of 2020, the beginning of 21. Yeah, Bill, so hearing that, I mean, what are your thoughts on that process? And also during that nine months of silence to you, did you ever think the book would see the light of day? I think deep down, I knew that it would because there had been so much work that went into it. There was so much that it's original and interesting and amazing. I felt like it would be a tragedy that wasn't published and I was kind of depressed and sad for a while. So I was very glad to get your call about your friend, Michael Ovitz wanting to see it.

I was like, yes, this is going to happen. It was kind of interesting watching Peter kind of like become a writer in certain ways. You're talking about like working on nights and weekends and you're just kind of tortured by this thing that's like hanging over your head and it won't go away and it has to be good. It has to be perfect. And so one of the stages of that process is deciding that the whole thing sucks. And you know, there's all kinds of stories about writers throwing their, all their manuscripts in the fire. Ah, and it's a process you have to go through.

And especially in science writing, right? There's like a first draft that we call it like the shitty first draft. And you have to write it. And it doesn't mean you're a shitty writer or a shitty thinker. You're just getting it all out there. And then it's like, what do we got? And then the process, you think you're done. So I remember finishing the first drafts, like, okay, sweet, I'm done. And I think

at about that point, you had sent me an espresso machine. It's like, this was nice of Peter to send me this espresso machine. Now that we're done, but we weren't done. We're not even close. You've got the first draft. It's like you've run the first half of the marathon. Don't put the sticker on your car. You got to run the other half of the marathon before you're done. So it was a marathon. And like a marathon, anybody who's run one or swam one or done these things,

you know that the physiologic halfway point is not the exact actual halfway point. You know, my wife just ran a marathon recently and, you know, in training for this. So that the physiologic halfway point is not the exact actual halfway point. You know, my wife just ran a marathon recently in training for this. I mean, it was all about the training for the physiologic hits. And in that 26 miles, you don't physiologically hit the half point till 20. So you'll hurt as much in the last 6.2 miles. It will be as difficult metabolically and physiologically in the last six miles as the first 20 were. And I think the same is exactly the same for this writing process, right? What we did

in the last nine months was more valuable than the previous five years. Right. I kept telling you that through the process like you got to trust this process. Yeah, you got to trust it and it's going to get a lot better in the last six months Then in the first however many years and that's just the nature of the beast. I remember this summer sorry last summer so it was July of 2022 we were on a pretty tight deadline at this point so this was when Penguin said this book has to come out in March. And if

you reverse engineer that, the manuscript needed to be final by the first week of September. And we were six weeks away from that. And there were gaping holes in this thing. Like, you could drive a tractor truck through some of the holes in this thing. And I had a feeling that I have not had since I was on a very difficult swim in 2008, 2009, where I was in the water and nothing was going well. This was actually early on after I tore my labor and I was in so much pain and the current was moving in the wrong direction, everything was going wrong. And you

know, these things are very psychological. It's just like running. It's like cycling. I mean, once your brain is hurting, nothing goes right. And I remember at one point realizing I still had seven hours to swim and every stroke, I felt like someone was sticking a dagger into my shoulder. And there's just a part of me that was like, I don't want to do this anymore. I just don't want to do this. And I remember thinking, for at least an hour, all I thought about was quitting, all I thought about was just getting out of the water. All I had to do was put my hand up and touch the boat and I was disqualified and the swim was over. And I didn't, for better or worse, I kept swimming. I don't think it changed anything in my shoulder. I still still going to need shoulder surgery regardless.

But I came back to this in July of 2022. And I remember talking about this with Jill. And I remember thinking, in the next six weeks, we will have to work so hard to get this thing submitted. And we don't have a choice now. Meaning we can't stretch that out for six months. It's you have six weeks to finish, do what you can in six weeks. And I remember saying to Jill, I'm so torn right now because I am so tired, I don't want to do anymore. I know that our publisher

would accept this right now as is because it's good enough. But in my mind, it's not good enough. And the only way this thing is going to be good enough to what we think it deserves is I'm going to have to kill myself for the next six weeks. Everything I do will revolve around this. And I will have to rewrite and rewrite and chop out and do all these things. I just remember saying to Jill, like, I want to quit right now. I've never wanted to quit so bad. And quitting, this is a soft quit. It's just a saying, I'm gonna back off.

It's not that I'm not gonna finish, I'm just gonna back off. And I'm glad that I didn't. I don't know how you felt at that point, but that's, I really was. Pretty similar. Like, I'm done with this. I don't even know if I care anymore.

Most people won't notice the difference between this version and the version we might be able to get to in six weeks. One thing we share in common is maybe you're more than me, but like a perfectionism. And to me, that goes to the level of the writing. I would be going through every single sentence, like, is this the best way that this sentence can be cast or are these in the right order? You know, how are we structuring this? I was doing that constantly and spent most of that summer doing just that.

Yeah, it felt like in a pretty deep hole in the deadlines looming, but you know, deadlines are good because like nothing would be finished without a deadline. So at a certain point, you have to like take your hands off it and say, all right, this is what it is. It did get a lot better even between then and you know, when they finally yanked it out of our cold dead hands, it got better, it got a lot better. More readable. That was the proverbial darkness before light was that August, September was really hard. And that's what I think every person was trying to tell me before, which is you have to trust how much this is going to converge at the end. Yeah, it's kind of funny here in that timeline because by the time this comes out, we'll

have released a podcast with Ethan Weiss and you guys were talking about blood pressure on it. You were like, you know, Ethan, my blood pressure has always been normal, but in August, I started taking a reading and it just was higher, but I could calm down. And he was like, well, did anything change during that time? You were like, yeah, I had a book deadline. So it's kind of funny to just see how much this book is trying to kill you along the way of not only the blood pressure, the voice, just every little bit of stress. Let's talk about the audiobook. You kind of mentioned it there. I know you struggle a lot with should I read this or should I not? And part of it was you've said yourself sometimes like reading that much you'll struggle with. It was not only that, it was the time aspect,

the commitment. What made you ultimately decide to read it? Because the overwhelming feedback we got from the audience was they didn't want to hear someone else read this book if it wasn't you. And this is where kind of having your own podcast probably hurt you is everyone knew your voice and knew what it sounded like. You weren't a voiceless figure who was just a writer. So what made you ultimately decide, all right, I'm gonna go do this audiobook. Well, I mean, first I should explain why I didn't want to do it. And I think I had some pretty good reasons for not wanting to do it. First of all, I'm not a great out loud reader. I think I do have mild dyslexia. I certainly do when it comes to spelling. So I can't spell if my life depends on it.

And when you hear me read even to my kids, you know, Reese is eight. So he can read. So if I'm reading to him, he's catching mistakes that I'm, he's catching words that I'm flipping back and forth. So that was one reason there was just, ugh, this is going to be very hard for me to do. The second is I did the math pretty quickly, meaning I had figured out how long it took me to read a page.

I multiplied it by how many pages that were in the book, and I knew that I was going to basically be in a recording studio for two weeks. I also knew that meant that that was the one week a year that I kind of wind down as between Christmas and New Year's. I was going to be in a recording studio all day every day. And I just knew how I felt, which was, I'm exhausted. I'm exhausted. I actually need a week to recharge.

I don't need two more extra weeks of work. The third thing was when Rick Rubin was in town visiting over the summer, he was beginning the process of recording for his audio book, and he had a sound engineer set up a studio in our basement. So he was beginning to do his read, he and his family stayed with us for a couple weeks. And one day he was like, Hey, why don't you go in the studio with my engineer and just read a bit and see how it goes. And I was like, All right, that's not a bad idea. So I did. And I read it. And I

sent it to you guys. And you guys finally acknowledged what I was saying, which was, yeah, that's pretty rough. Like, dude, there's no intonation in your voice. You sound like a robot reading that. So now we've got confirmation on my worst fear, which is I'm a lousy reader, coupled with all these other things. So those were all the reasons I didn't want to do it. And I think those were all very compelling. On the flip side of that, I don't remember who suggested it. If it was you or somebody suggested that I at least meet with this woman named Stacey Snell, who I guess is a kind of a freelancer, but works for Penguin, and she would be the producer director of my audiobook. Maybe Stacey had just said, let me go and spend an afternoon with Peter and do some coaching. So sure enough, one day, and this is probably like November, she comes

over here and we do some reading. And for two hours, we read, but she coached me on reading. And she gave me some really amazing tips that seem so self evident, but they made a difference. So for example, first is reads slower. And I should have known this because I consume virtually all of my books in audio first, and then certain ones I go back and read in paper. But I listen at about 1.8 to 2x depending on the author. And so in my mind, that's the cadence of an audio book. But if you ever actually go and listen to an audiobook on 1x, I mean, it sounds like this. So what she reminded me was, it needs to sound pretty slow at 1x speed. The other thing she said is, and she could tell right away, she's like, you're not present when you're reading. It's clear to

me how bored you are of this book, and I can't blame you for it. You've read every word a thousand times, but your boredom is showing in your reading. She's like, a good reader reads this, like it's the first time they've seen these words. You have to get there. And I was like, wow. And she's like, oh, and by the way, reading slow makes that easier. The slower you read, the easier it is for you to be present with every word. So armed with Stacy's feedback, I decided I'm going to do this. And so a couple days before starting it, I had a session with one of my therapists and obviously

one of the things you talk about in therapy is like, what are you worried about? What's going on your life? And I said, well, you know, what are you worried about? What's going on in your life? And I said, well, you know, I'm really worried in a couple of days. I start this reading process. And so Katie said, well, what's your why? Why are you doing this? And let's write those down. So I had three reasons why I was writing this.

And I wrote those three reasons down on a piece of paper. And those were with me in the recording studio. And the three reasons were very simply one, the listeners of the podcast will expect this and deserve it. In other words, we feel really grateful. Obviously, I don't need to just say this, but we have a very loyal group of listeners to this podcast.

And to your point, there is an expectation that the person whose voice they listen to is the one that reads it. I think it's a correct expectation. I think they deserve that. The second is a pet peeve of mine when I'm listening to technical books that are not read by the author is how many mistakes there are when things are read incorrectly. It bothers me to know and I mean I remember listening to one book where the author had written the word causal multiple times and every time the word causal was

misread as casual. It's like how that got missed, I don't know. But I thought about how many technical words are in this book and I was like, I'm going to lose my mind if a person. And I basically said, I'm going to end up having to be in the recording studio anyway just to make sure everything is said correctly. And then the third reason was just a very personal one, which was, right now none of my kids are old enough to appreciate this book. None of them are gonna read this book anytime soon, but one day they will and one day they might listen to it.

And in fact, I thought further, and this is kind of a weird thing to think about because we don't normally think this way, but imagine Hemingway had read some of his audio books and now distant relatives of Hid could listen to it and listen to him reading it. And I thought, long after I'm dead, my great-grandkids could still listen to this, but they'll hear me reading it, and I think that will be more valuable than hearing someone else read it. So it's really more of like something for kids and grandkids to one day have. It's also there are a lot of stories in there about your early life and

your medical career and there's some fairly dramatic ER stories and you know your story is kind of like embedded throughout the book and especially in the last chapter. So I think it would have like you had to read it. You just didn't realize it. Yeah, I think that's true. But it is a daunting and kind of terrifying task at the same time, but I don't know, are you glad you did it? Oh, I was 100%.

I'm 100% glad I did. Zero regret on that. And just glad with the way it turned out, having Stacy there in my ear for the whole thing was incredible. I couldn't imagine if I had to do it with somebody else. It's funny is there'll be a lot of times we'll be like, Peter, you got to do this. And I'll be like, no, I suck at this.

I can't do it. And it's like, okay, yeah, yeah, just go ahead and do it. You're like, okay, and you send it. It's like, yeah, this is totally fine. And I think that's only how I expected when you sent over the sample from the studio and the basement. I remember listening to it. And you're like, he's right.

And I was like, this is bad. Like, there is no sugar coating it. And I remember talking to Lacey, and I was like, I honestly think it's so bad because people hear him talk on the podcast, and clearly you can speak. But you sounded like you'd never read anything in your life. You were a caveman dropped in,

and you were just like, what is all this stuff around me? You've got these phonetic symbols and like, go. Yeah, and it was, it was just a conversation of, we can't let them do this. This is going to be embarrassing. But then Stacy came in and really cleaned it up. I know I listened to some of the audio and it does sound really good. So to see that progression, maybe down the road

will lease a snippet of the initial, just so people can hear the difference of it because it's blackmail material. It's strong. Actually, really, we got to make sure Stacey doesn't before, after on her website or something. Working with me will get you from here to here on the before and after.

That's funny. And you kind of talked about it earlier where, you know, reading the book caused you to make some edits. Some some edits. Five hundred and sixty three or was it me hundred and sixty three? I think that's the closest Bill and Diana came to wanting to kill me. I think if they could have, if they could have killed me and nobody would have found out about it, they probably would have. And been like, oh, God, so tragic that something happened to Peter this week. Well, you know, anyway, posthumously we published this book with your name on it.

Well, at least it has is. I think there is a little Easter egg in the audio version as well. That's a little different to which probably also led to some of them trying to stress. Do you kind of want to talk about that piece of it? Sure. So before we turned the book over to Penguin, so back when was in the old version that died, you know, it was a very similar structure to the way it is now, just a much longer, less elegant version. So the end of the book, the 17th and final chapter had it ending. And I loved it. Bill was sort of ambivalent.

When Diana saw it, she hated it. She was like, I don't get it, this sucks. And I was like, what do you mean you don't get it? I even like sent her YouTube videos to help her understand it, to get the reference. She's like, I don't get it. It's the dumbest thing I've ever seen. This is awful.

At this point, Bill was like, I kinda see Diana's point. I don't think it's good. And I was like, all right, fine. So they took it out. So we took it out. This is awful. At this point, Bill was like, I kind of see Diana's point. I don't think it's good. And I was like, all right, fine. So they took it out. So we took it out. This is months ago. It's long been forgotten. So I'm in the studio finishing,

and I finish the whole book. And I said to Stacey, I said, hey, Stacey, do you want to see the alternative ending? She's like, what do you mean? And I was like, this book ended with a totally different thing. And where you see it ending now, there used to be a whole page after this. And she's like, oh, really? Let me see it. I was like, let me see if I can even find it. So I'm like rummaging through my computer. And I find it. I give it to her. And I'm like, read it. And she reads it. And she's in tears. And I was like, what do you think about ending? She goes, I think

it's beautiful. And I was like, well, you want me to read that? And we can decide if maybe that goes in. And she's like, yeah, I'd go. So I went back in the booth and I read it. And I go home that day and I email Bill and Diana. And I'm like, all right, guys. And by the way, you got to put this in context. They are at the point of wanting to kill me for changing words at this point literally I'm like can we get rid of the the here and this word needs to be like this versus this like and I'm saying I want to add another page and a half to this manuscript like it's going to screw up everything I won't get into the details of those conversations. They were not pleasant But suffice to say the answer was oh hell no

So I accepted the fact that it would never make its way into the written version of the book. But I said, but would you at least entertain this being in the audio version? And they were like, of course not. Like you can't have the audio version and different from the written version. And if we kind of left it at that, I think. But then I asked Stacy to send it once it was edited, and I just forwarded it on to Bill. So it sounds good the way you read it. Stacy to send it once it was edited, and I just forwarded it on to Bill. So it sounds good the way you read it.

So I was like, this is good, this is moving. Try to find a place to kind of massage it in or put it in someplace, maybe not as the ending, but someplace in the manuscript that kind of didn't work without going into detail like that last chapter probably evolved the most of any chapter in the book and we got into a place where it was working and that part had dropped out so decided as a compromise to leave it in the audio as the Stanley Kubrick director's cut. I think it's great but honestly like I feel like as far as print the last few paragraphs of the book, and especially like the last line, is something that sticks with me.

I think about that every day, that line, and I won't say what it is, but every day when I walk the dogs, I think about that. When I'm thinking about like, when am I going to do today? Like, how am I thinking about this day and the week to come? That line sings in my head. So I'm glad it's there. I think we captured the best of both worlds. I think even if we thought it could have been shoved in at the end, I think it would have been logistically impossible because of how it changes the pages of the book and stuff like that. So I think it's an elegant way to do it.

And I know that also if people are anything like me, a lot of times you want an audio book and you want the paper book, you want to fold your pages, you want to mark it over, you want to do that kind of stuff. So I think it worked out just fine. Frankly, I was clad on some level that you were making like little line edits and stuff like this. It makes it better. There's always stuff you can find that, you know, I did a lot of things that probably didn't

even notice, but it got so much better. There is like a huge sprint at the end to just make this thing sound right. You're getting these like PDFs from the publisher like, okay, your book's done. Here's your PDF. Just proofread it and see if there's any spelling mistakes. And of course, I think we kind of both went to town. I guess the industry standard is you would do three passes on the PDF final copy. Once you are out of working in Word doc, you're into a fully typeset PDF copy. And it's expected that like the first round of passes on that, you might find some mistakes.

The second by the third round, there's none. We got up to six or seven passes on a PDF. I mean, these people, they were incredibly patient with us. The lovely people at Penguin Random House worked very hard to absolutely. They were accommodating all of our last minute changes. And they also now understand why we say with you the only thing you do in moderation is moderation. That's right. And also it's just really funny to just think about the aspect of they probably thought of you like a child like we left Peter unsupervised to record this book and he just tolerately went off script and speaking of things that we joke like what could go wrong did go wrong voice everything else you want to talk about the first

day in the recording studio what happened so we're two recording studios to choose from in Austin and Stacyacey's like it's totally up to you which one do you want to do when I was like well this one seems a little closer to my house than that one and given that I'm going to be over there every day what's minimized the community. So we went to the closer one. So first day we go in there and I sit down and I we just jump right into it and I'm reading the book in chronological order, of course. I just hear a weird little hissing sound. And I call out to the engineer and I say, hey, do you hear that?

And he says, yeah, but that's not being picked up on the recording. I said, okay, I can get over it. Like it's annoying, but I can work through it. So I keep reading, get through the introduction, get through chapter one. I'm like, yeah, it's annoying, but I can work through it. So I keep reading, get through the introduction, get through chapter one. I'm like, yeah, it's getting louder. You're sure it's not being picked up on the mic? He goes, no, I can tell you, it's not being picked up on the mic. And I'm like, yeah, this can't be right, because I can hear it with my ears. You're wearing a headset in there, and it's not coming through the headset. It's what I'm hearing in the room. And I know how sensitive

the mics are in those studios. I mean, they're insanely, they're so sensitive that if you're moving your feet on the floor, it's being picked up. So we keep having this back and forth where he keeps insisting that this is not being picked up. I just finally said, like, I'm not going to tell you I know your world, but I know how recording works. And if I can hear this with my ears off sound in the recording studio, it must be picked up. And then he kind of pivots and says, well, we'll be able to strip it out in post. Okay, so it is being picked up. So finally, I'm one paragraph away from finishing the third chapter, which was all we were going to get through that day. That's a big day to get through the intro and then three chapters, but they were short chapters. So it's a full day of

reading. And I remember this. I had literally one paragraph to go and we were done for the day, and he goes, you know what? I think we are picking it up. I'm like, what? I think there's a grounding issue. So to make it a long story short, we ended up having to go to the other studio, anyway, because we couldn't record there. And they assured me that they would be able to fix that in post, and they could not. So when I finished the book, they were like, you gotta come back and reread that first day again. I think that also was a good thing in a weird way, because I think I was a better reader by the end than I was at the beginning. And so in a way, I got a day to practice where it didn't count.

It's funny how it ended up, you ended up getting a free practice run, which at the time, I don't know if we thought of it that positively, like wasting day on something you were dreading doing, but I think the audio version ended up really well. One of the last questions that we got, which I think is a really interesting question based on the whole conversation we had. And I think we can start with you based on the whole conversation we had and. I think we can start with you bill because I'm curious what you think is related to this which is looking back at everything that I'm in the book. Did you have a favorite chapter that you guys wrote is there anything that stands out for whatever reason you really look back finally at that chapter.

look back fondly at that chapter. It's sort of like picking favorite child. So there are these four chapters, kind of core chapters about the horsemen diseases, metabolic disorders, atherosclerosis, heart disease, cancer, and Alzheimer's disease. And those, they were not in the original plan. And kind of the way those all came together, it was a huge heavy lift to try and like understand each one of these disease processes really. And it took a huge amount of research and me spending time with Bob Kaplan, who was kind of our research guru for the book project. And just kind of hammering these things out. That was pretty intense, pretty intense experience. And I feel a real sense of accomplishment about how those chapters all came out. I feel really good about them.

As far as like the chapter that progressed the most from like most improved, I think, is the final chapter. And just from where that started to where that ended up, I think that has to be probably my favorite or chapter. It's interesting because you didn't like that chapter initially. I know that you and Diana both, that was probably your least favorite. And Michael, in the early discussions we had, Michael was like, it should be a separate book.

This is part of this book or is this part of a different book. The second book you're going to write. And I didn't agree with that either, but it had to change. And you know, I'm always thinking about like Nick said where the reader is coming from like you said. So that chapter ended up being one of my favorites, probably my favorite. I think there were sections of various chapters that I really liked. I think that the insights that come out of the atherosclerosis chapter are so important and probably have the potential to save more lives than anything else. I really think that I don't pull any punches in my views on how we are mistreating this

condition and why it does not need to be the leading cause of death. No chance of that. I do think that, and that's also one of those things where earlier versions of it didn't get to the point quick enough. They had too much in it that didn't matter enough. And it was really a very late, late addition was that the really clear pivot to the causality stuff at the end that I think is a much more insightful way to talk about it. So I'm very proud with how that turned out. I think for me, the exercise chapters, there are three chapters on exercise, which speaks to the importance that that plays

in this book. And that was probably the one where even as recently as like July or August of last year, I was like, I don't see how we get this to the finish line. I don't see how this gets done. And we were trying at that time to do too much When we instead focused on what we could do in a book, because again, it's not a picture book, this is not a how to exercise book where you're gonna have like a picture of every single step of like, here's how to deadlift, here's how to do this, here's how to do that.

And we were trying to do all of that in writing, at one point. At a credible level of detail. Just wasn't, wasn't happening. Couldn't make sense. Like you can't explain these things in writing. So, I think a big aha moment we had was, hey, let's restructure this, which we did. Be, let's simply make a page of videos that explain some of these things

so that we don't drown the reader in anatomic kinesthetic lingo that won't actually serve the purpose. And so when I look at how those three chapters form together and coalesce around the Centenary and Decathlon in the Marginal Decade, I'm really proud of that. You mentioned Bob's name a few times, kind of both of you, but I know this was a, beyond just the two of you, there was a lot of people involved in the research, the writing, the

science piece. Because one of the questions that we got was, you know, how many people do you think were involved in the writing of this book? Well, Bob did the heaviest lifting in terms of, because Bob was working on the research full time. So basically the way it would work is I would be writing and I would be saying, Bob, I remember there was a study that sort of had this, like I mean, the end notes on this book are probably 500, probably more than that. I would say, Bob, can you go and find me the citation of this study? I kind of vaguely remember reading it a year ago, blah, blah, blah, blah, blah, blah,

blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, blah, a year ago, blah, blah, blah, blah, blah. Or it would be, want to write about this, is the answer this or this, Bob, can you go figure it out? So this was really important research that was being done. But then the other thing that had to be done was all the fact checking. And one of the things that I took is wise advice from other authors who had written scientific books is you can't just rely on a publisher to fact-check your book.

They can fact-check some things, but you have to have an independent person to come in and do scientific fact-checking. So we had one analyst named Vin Miller who did a lot of that work because Bob was too close to it at the time. If Bob's the guy pulling the citations, can't have Bob fact-check it. So had to have a separate analyst that was working on fact checking. And then once we got into a much, much later version,

then we had Bob go back and do specific certain fact checks on certain things, which also meant, and God bless Bob, because this was long after Bob had left. He came back and did a night weekend, like he was the guy that organized the end notes. And that was another thing that just gave me chest pain. Yeah, me too. The unbelievable thought of what it would take to organize the end notes to this book and the version control problems that we had with multiple different documents. I mean, it was so stressful. And by the way, it should go without saying, people are going to find mistakes in this. It's impossible that we got it all right. It's impossible

that we got every end note perfectly. I guarantee you we have a citation in there that we got wrong. That's why you have second and third editions to books. So folks should let us know when they see those things and we'll do that. But I think we did as good a job as one could do in this regard and having a lot of people to shoulder some of those lifts. I spent a lot of time putting my head together on zooms and going back and forth with Diana when you were off doing things and kind of trying to work out the literary side of the book and how to structure it and how to make these different chapters move better, basically, is a better way of putting it. So I worked very closely with Diana and Bob.

Actually, Bob would give me the full research download on, literally, I'd say, like, hey, Bob, I'm trying to understand how APOE works. And boom, a G-Doc would appear the next day with like tons of sites and studies. Just go down the rabbit hole with Bob about that. So he was great with that. Yeah, Bob has a endless number of G-Docs. I would love to know how he stores all of them, because you asked Bob a question. You are getting a G-Doc in response. I spent like weeks, we probably all spent weeks talking about the monkeys, the Chloric Restriction

monkey study. I'm glad that they stayed in the building. I was really worried that the Bethesda, Wisconsin monkeys were gonna get chopped, but the end of the month a great place for them. And it's a fantastic story to tell. There are a lot of folks in here that I put in my acknowledgements.

And in fact, it's pretty unusual, I think, that an author will read the acknowledgements in the audiobook. But there was no hesitation in my mind when we finished the book and I said, look, I'm going to not just read the epilogue, but the acknowledgements. They were like, oh, that's unusual. A lot of authors don't, but it's a very sincere heartfelt. Thank you to a lot of people who have played an enormous role in my broad education on this topic, which

has been going on for more than a decade. And also some of the real specifics, broad education, you know, the podcast guests. Again, the podcast started basically as a research tool for the book. And then of course, one of the things I do mention in the acknowledgment section, which is true and interesting. Every single person that I ever sent a chapter out to for technical feedback and review did so. There's not one person that I sent a chapter to. And every chapter of this book, every technical chapter has been reviewed by a technical expert in that field, at least one, at least one. That's

right. And oftentimes at least more than one. There is not one example where I said, hey, do you're so and so, can you read this cancer chapter? Can you read this athero chapter? Can you read this? Where that person didn't come back with incredible feedback. The word is overused, but I'm humbled by that. It means a lot to me, I think it makes this book a better book. When you decided to read the acknowledgments, did they try and get you to read the footnotes as well? Or is that did that not make the audio book? You know, it's funny and Bill,

you probably don't even realize this, but I took a hit or miss approach on footnotes. Some of them I read and some of them I actually didn't. Oh, the ones at the bottom of the page. The true footnotes in the bottom of the page. Now, which obviously we took 98% of them out. You were delighted,

I'm sure. And of the remaining ones, some of them I just felt, they don't flow with the text. I'm sure. And of the remaining ones, some of them I just felt, they don't flow with the text. I'm trying to put myself in the mindset of the reader, or the listener, rather. And if the footnote was so tangential that it would be difficult to get back into the book, I didn't read it. There were some funny tangents that maybe didn't need to be read or yeah, exactly. I think there's one about making all your dates read Richard Feynman. I definitely didn't read that about it, but I don't even know if that one stayed in there. And Steven Rosenberg, you made them read the transform cell also about immunotherapy. Well, Peter, Bill, anything either of you want to end with as we kind of end the podcast

and again, the hope going into this wasn't to answer specific questions about the book. I'm sure we'll do a podcast down the road, which is once people have had time to dive into it, like answer specific questions. We should do a book AMA at some point. And obviously, I've been on a few podcasts already for the book and the coming months, I will be on many podcasts. We have a number scheduled where we'll get into the book into the subject matter. But I think this was a unique opportunity to talk about something we'll

probably otherwise never really talk about. A little behind the scenes. It was an honor and a pleasure to work with you. And I learned a lot, obviously, but as far as like thinking and rethinking about these issues was exciting adventure. And a little tough to get it on the page sometimes and get it just right, but I'm proud. I hope you're too proud of what we have come up with. I really am, Bill. It's hard to imagine this having worked out any other way.

So I'm glad that all the way back in 2017, they said, Peter, this will be a better book if you write it with someone. And that, you know, they even back then trusted me to go and find who that person was and I think this is the best book I could have ever been a part of. So thank you Bill. All right. Thank you for listening to this week's episode of The Drive. If you're interested in diving deeper into any topics we discuss, we've created a membership program that allows us to bring you more in-depth, exclusive content without relying on paid ads. It's our goal to ensure members get back

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