The VPZD Show

Ego, placebo and a $9,000 leather jacket. Plus Moderna’s cancer vaccine, Calley Means on Rogan, and why Washington is basically undrainable.

Another live episode of VPZD!

Topics (in chronological order):

Two middle-aged men in leather jackets, creatine and the renal failure myth

Creatinine vs GFR, and why creatine raises one but not the other

The Jensen Huang scandal: Nvidia, an alleged Chinese spy and chip export controls

Why this one is a national security story, not just a scandal

Placebo, suggestion and the pharma drug dinner

Jensen’s ego unraveling and the leather jacket as identity

What a Jensen collapse could mean for Nvidia, the S&P and the economy

Congressional stock trading, nepotism and Zuck’s control of Meta

California’s billionaire tax and why it failed

The Prop 38 immunotherapy bond measure

Brian Johnson, castration, vocal range and the Denny’s where Nvidia began

Moderna’s cancer vaccine: preventive vs therapeutic vaccines

Melanoma, pembrolizumab and the neoadjuvant approach

The 0.58 hazard ratio and why it tanked the stock

Should taxpayers fund mRNA cancer vaccines?

Dog lymphoma, BTK inhibitors and how dogs and humans suffer

Early-onset colon cancer in marathon runners

The Skinner box pigeon and our love of patterns

The NEJM editorial: a vaccine against every cancer mutation?

The ideal three-arm Moderna trial and misspent NIH money

The J&J drug dinner callback: myasthenia gravis and the FcRn blocker

Calley Means on Rogan: lobbying, school lunches, ultra-processed food and SNAP soda

The FDA’s COVID vaccine compromise and why trials get halted

The Moderna vs Pfizer observational study and negative controls

John Mandrola, the Watchman device and debating people vs ideas

COVID sniffing dogs, impeachment talk and a drug dinner skit

Paying for what works, and small molecules vs immunotherapy

Wrap-up, Donna Tartt and Murakami’s Norwegian Wood

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Another "slow news week" 😂

Originally streamed Live on YouTube!

The blue tsunami: why the election results were a surprise, and why incumbents tend to lose

The political pendulum: voters keep choosing “shake it up” candidates who can’t deliver

Obamacare as a Heritage Foundation blueprint that expanded access but never tackled cost

Tariffs, the war with Iran and whether Hegseth should be impeached or resign

Impeachment fatigue and why divided government may let Trump make deals

RFK Jr., food system reform and special interests

Populism on both sides: Abdul El-Sayed and Talarico

Doctors who go into politics, including Amy Acton, Nirav Shah and Richard Pan

Why healthcare is unsolvable inside its current paradigm

Peptides, drug approval and the FDA approving things that don’t work

Whether AI and drug discovery could be the paradigm shift

Pluto, new dwarf planets and Neil deGrasse Tyson

Better doctors or better technology? Why outcomes improved since 1950

Medicare for all: could it separate what works from what doesn’t?

Hospitals giving flu and COVID shots before discharge

Preemptive Alzheimer’s treatment and the shifting definition of the disease

Observational data confounding: vaccines and dementia, “Eat Your Ice Cream,” and Tylenol and autism

Why the AI-made thumbnail took 17 prompts

Bringing back old-school conservatives, a new Democratic identity and the cost of living squeeze

Why the FDA can’t weigh cost and why Medicare must pay

Aladdin, Will Smith, Fresh Prince and Bryan Johnson

Med school culture and the Affordable Care Act’s EMR meaningful use mandate

Alex Jones’ theory that Trump is a Democratic sleeper agent

The Learjet crash: icing, narrow flight tolerances, private jet safety and the young co-pilot

What aviation safety culture (including the Korean Air lesson) can teach healthcare

Iran, incomplete information and what the public never sees

Ending the clock change, and the Titanic submersible and the fear of death

Daylight saving time vs standard time, circadian rhythms, school start times and being “fun employed”

Why you shouldn’t second guess a clinical trial, and betting markets on trial outcomes

The ER baby declared dead and found alive, and pool dangers for small children

Quasi-experimental designs, and the Hep B trial in Guinea-Bissau

Richard Pan, vaccine absolutism and pharma money

All-cause mortality and number needed to treat

Flu shot mandates, how flu vaccines get tested and why test-negative studies fall short

The med school research arms race and the case for putting phones away

Book recommendations: Elena Ferrante, Jonathan Franzen, Stephen King and Haruki Murakami

Kundalini, awakening and meditation retreats

Cold showers and sick days: the Dutch randomized trial

Perimenopause, why Gen X is making it trendy, and more Murakami

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

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

Chronological topic list

Housekeeping: clarifying brain death versus severe brain damage, and why a competent examiner matters

Zubin’s first travel speaking engagement in three years, a pain medicine panel in Dallas, and the Rodeo Goat burger

Vinay’s panel at a biotech conference and the longevity target question

Elizabeth Holmes and Theranos, and how John Ioannidis spotted the lack of peer reviewed papers

Why you can’t run 100 tests off a single drop of blood

Zubin’s Theranos lipid panel at TEDMED and whether the numbers were real

Finger sticks versus venipuncture, and why lancets hurt

The Nathan Fielder documentary and the 35 days before federal prison

Holmes’s personality, her belief that the machine works, and “Theranos 2.0”

Puppeteer or puppet: Billy Evans, Sunny Balwani, and the men in her life

Amanda Seyfried’s reenactments and the second half of the film

Did she commit fraud, did it harm patients, and was she scapegoated for flying too high

Why Holmes picked a claim that could be tested in minutes, and the harder to falsify claims in biotech

Health influencers, creatine, and observational studies as placebo

Stanford versus Berkeley, and the CAC score as a better measured number than Theranos

A glioblastoma device and the ambiguity of its trial

Whether Holmes really didn’t understand the “Who’s on First” joke

Spiritual people, pop culture, and why VPZD isn’t cognitive dissonance

Pope Leo’s lung cancer: luck or Providence, lead time bias, or an indolent tumor

Why Pope Leo’s case gets spun as proof that screening works, and the case against scanning non-smokers

Whether adenocarcinoma, secondhand smoke, and a Peruvian mission shaped the diagnosis

The Pope’s reported equanimity, and the politics of the papal job

A New York Times Daily episode on Texas Trump voters, and why a cherry-picked anecdote isn’t a poll

Why polling is a flawed science, plus spam calls and the “right to be left alone”

Indian call center scammers and YouTube videos of people hacking them

AI car dealership calls, and medical car names like the Ford Infarct and the Toyota Tetralogy

Bryan Johnson’s post that his genome was of no use, and Anne Wojcicki’s response

Francis Collins’s promise that genomes would guide blood pressure pills

Zubin’s factor V Leiden and prothrombin findings, and what a genome did and didn’t tell him

Why reading DNA like letters in a book is the wrong metaphor, and the Lego exhibit analogy

Craig Venter’s genome talk and his “we can tell you when you will die” pitch

Bryan Johnson’s changing positions, and what he eats

Cheese fries, GERD, and a Dallas talk that felt like the whole room was talking

Pain providers, opioids, the Sacklers, and the overcorrection that followed

The parallel with SSRIs and the dilemma of taking people off a drug they shouldn’t have started

A reported 40% rate of pancreatic cysts on MRI, IPMN, and the scan industrial complex

Jalen Hurts’s blood clots: cleats to the calf, a long flight, and Virchow’s triad

Lupus anticoagulant, factor V Leiden, and oral contraceptives

Zubin’s daughter’s factor V Leiden and whether she can take the pill

Goldfinger, a Scooby-Doo clip, and how standards have changed

Next week’s topics and a plug to watch the Holmes documentary

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

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

Chronological topic list

Shout out to Dentalica, the Metallica cover band of dentists

Follow up on the failed execution and whether healthcare professionals should take part in executions

Firing squad and livestreamed executions as a case for the state owning its violence

Childhood abuse, fetal alcohol syndrome, and whether crime is a medical problem or a moral one

A bilingual doctor barred from speaking Spanish to her patient after failing a hospital proficiency test

Nobel Prize snubs in optogenetics, including Ed Boyden, Feng Zhang, and the Wayne State researcher

Rosalind Franklin, narrative, and why credit in science is so messy

Why science is full of forced moves while art is not, and what that means for AI

Clinical breakthroughs like Gleevec that never win Nobels

Political Nobels, Obama, and Bob Dylan skipping the ceremony

Academic AI studies that are outdated by publication, plus a Lancet “phase one” chatbot trial with no control arm

AI models guessing Trump’s IQ and the case that the voting booth is the health check for politicians

Why Zubin doesn’t vote, and the billionaire tax

The seven levels of wealth and the arc from Rolex to no watch

NYU’s three-year medical school and the cherry-picked comparison groups

Zubin’s fourth year of medical school and finishing Berkeley in three years

Reforming medical training from college through the extra fellowship year

Teaching critical thinking over memorization as the line between charlatan and expert blurs

Zeke Emanuel’s Eat Your Ice Cream, reverse causality, and confounding in observational studies

The descriptive versus prescriptive fallacy in medicine and spiritual awakening

Counseling cancer patients about alcohol

SSRIs, RFK Jr., withdrawal, and why long-term data can’t separate benefit from dependence

Brain zaps and SSRIs in awakening circles

Vinay’s accidental decaf month and the nicotine gum trend

Brain death, advance directives, and who you’d trust to pull the plug

Moral anguish, organ and cadaveric nerve consent, and an ICU nurse’s perspective

Airplane rules, annual PPD testing, and the absurdity of medical bureaucracy

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

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

⁠⁠⁠⁠⁠Dr. Prasad's "Plenary Session" podcast.⁠⁠⁠⁠⁠

⁠⁠⁠⁠⁠Dr. Damania's "ZDoggMD Show" podcast.⁠⁠⁠⁠⁠

⁠⁠⁠⁠⁠More on Vinay.⁠⁠⁠⁠⁠

⁠⁠⁠⁠⁠More on Zubin.

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