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Send us a textJoin Marla Dalton, PE, CAE, and William Schaffner, MD, for a fascinating conversation with cardiologist and renowned biomedical researcher Eric Topol, MD, on the revolutionary impact of artificial intelligence (AI) in medicine and healthcare. Topol shares how AI can help strengthen the patient-doctor relationship, enhance diagnostics, and reduce medical errors.Show notesA practicing cardiologist, Topol is chair and professor of Translational Medicine at Scripps Research. One of the most cited researchers in medicine, he has published several bestselling books on the future of medicine, including a new book that explores research transforming human longevity and chronic disease. He was elected to the National Academy of Medicine and was commissioned to lead a review of the UK National Health Service. Additionally, he is the editor-in-chief of Medscape and publishes the Substack newsletter, Ground Truths. Known for his groundbreaking studies on AI in medicine, genomics, and digitized clinical trials, Topol was named to the TIME100 Health list of the most influential people in health in 2024. Follow NFID on social media
„Narodil jsem se 1. dubna 1935 v Poříčí nad Sázavou, okres Benešov u Prahy. Můj otec je topičem ČSD. Oba moji dědové pracovali ve skále jako kameníci,“ cituji úvod dopisu Josefa Topola, který napsal ve svých 18 letech do divadla E. F. Burianovi.
„Narodil jsem se 1. dubna 1935 v Poříčí nad Sázavou, okres Benešov u Prahy. Můj otec je topičem ČSD. Oba moji dědové pracovali ve skále jako kameníci,“ cituji úvod dopisu Josefa Topola, který napsal ve svých 18 letech do divadla E. F. Burianovi.Všechny díly podcastu Názory a argumenty můžete pohodlně poslouchat v mobilní aplikaci mujRozhlas pro Android a iOS nebo na webu mujRozhlas.cz.
It is our deepest pleasure to bring you this episode on Norman Jewison's masterpiece of non-auteurism: Fiddler on the Roof. Both of the hosts have a long and complex relationship to both this film and its source material and could wax for hours on its rich humanism and craft. The tale of Tevye the Dairyman and his daughters remains as fascinating and exciting today as ever! We promise! This movie is not boring at all (except for maybe a couple scenes with Perchik). Topics include: changes from the original stories, Jerome Robbins' opening numbers, and a major change in Alana's life.
Al parecer los científicos no están muy convencidos de que Microsoft realmente haya desarrollado el qubit topológico Majorana, y piden detalles técnicos, ademas; Hackers del gobierno norcoreano introdujeron software espía en la tienda de aplicaciones de Android; Niantic, el creador de Pokémon Go, vende su división de juegos a Scopely, de propiedad saudí como todos los días les solicitamos sus comentarios. Hackers del gobierno norcoreano introdujeron software espía en la tienda de aplicaciones de Android http://www.lookout.com/threat-intelligence/article/lookout-discovers-new-spyware-by-north-korean-apt37 Motorola Edge 60 Fusion se filtra en renders de aspecto oficial https://x.com/evleaks/status/1899511260959641886 Niantic, el creador de Pokémon Go, vende su división de juegos a Scopely, de propiedad saudí https://www.engadget.com/mobile/pokemon-go-maker-niantic-sells-its-game-division-to-saudi-owned-scopely-160905447.html Google asegura a los propietarios de Chromecast que está trabajando para solucionar los problemas de transmisión https://phandroid.com/2025/03/12/google-assures-chromecast-owners-that-its-working-to-fix-streaming-issues/ La comunidad científica no cree a Microsoft sobre su qubit topológico Majorana https://www.reddit.com/r/Physics/comments/1iv6eko/microsoft_is_false_advertising_that_they_made/?rdt=45172 Video del día en las redes https://www.instagram.com/reel/DHHpK8FuNzy/ ESPERAMOS TUS COMENTARIOS...
Americký prezident Donald Trump podle všeho nařídil přerušit americkou vojenskou pomoc Ukrajině. Vedení Ukrajiny prý musí Trumpa přesvědčit, že chce jednat o míru, aby dodávky zbraní obnovil. „Pro Volodymyra Zelenského bude velmi složité se po tom fiasku v Oválné pracovně nějak omlouvat,” předpokládá v pořadu Osobnost Plus bývalý premiér a předseda ODS Mirek Topolánek.
Americký prezident Donald Trump podle všeho nařídil přerušit americkou vojenskou pomoc Ukrajině. Vedení Ukrajiny prý musí Trumpa přesvědčit, že chce jednat o míru, aby dodávky zbraní obnovil. „Pro Volodymyra Zelenského bude velmi složité se po tom fiasku v Oválné pracovně nějak omlouvat,” předpokládá v pořadu Osobnost Plus bývalý premiér a předseda ODS Mirek Topolánek.Všechny díly podcastu Osobnost Plus můžete pohodlně poslouchat v mobilní aplikaci mujRozhlas pro Android a iOS nebo na webu mujRozhlas.cz.
Były bramkarz reprezentacji Polski, trener bramkarzy juniorów Jagiellonii Białystok na antenie Radia Wnet zapowiada rewanżowe spotkanie mistrza Polski z Bačką Topolą. Przed tym spotkaniem klub z Białegostoku przedłużył kontrakt z 20-letnim bramkarzem Sławomirem Abramowiczem. Umowa obowiązuje do czerwca 2028 roku.Rozmowę prowadzi Kamil Kowalik.
Mistrzowie Polski wygrali z serbskim klubem 3:1, grając na jego stadionie. Rewanż w Białymstoku jest zaplanowany na 20 lutego.
AVISO LEGAL: Los cuentos, poemas, fragmentos de novelas, ensayos y todo contenido literario que aparece en Crónicas Lunares di Sun podrían estar protegidos por derecho de autor (copyright). Si por alguna razón los propietarios no están conformes con el uso de ellos por favor escribirnos al correo electrónico cronicaslunares.sun@hotmail.com y nos encargaremos de borrarlo inmediatamente. Si te gusta lo que escuchas y deseas apoyarnos puedes dejar tu donación en PayPal, ahí nos encuentras como @IrvingSun https://paypal.me/IrvingSun?country.x=MX&locale.x=es_XC Síguenos en: Telegram: Crónicas Lunares di Sun Crónicas Lunares di Sun - YouTube https://t.me/joinchat/QFjDxu9fqR8uf3eR https://www.facebook.com/cronicalunar/?modal=admin_todo_tour Crónicas Lunares (@cronicaslunares.sun) • Fotos y videos de Instagram https://twitter.com/isun_g1 https://anchor.fm/irving-sun https://www.google.com/podcasts?feed=aHR0cHM6Ly9hbmNob3IuZm0vcy9lODVmOWY0L3BvZGNhc3QvcnNz https://open.spotify.com/show/4x2gFdKw3FeoaAORteQomp https://www.breaker.audio/cronicas-solares https://overcast.fm/itunes1480955348/cr-nicas-lunares https://radiopublic.com/crnicas-lunares-WRDdxr https://tunein.com/user/gnivrinavi/favorites https://mx.ivoox.com/es/s_p2_759303_1.html
VIP pražské parkovací karty, Rozárka vs. Topol, kauza falešného tweetu Mirky Němcové, česká pivní kultura a vedle toho všeho zrušený tendr na dostavbu metra D, projektu atakující v celkové výši 100 miliard Kč. Mediální prostor bohužel opanují banality, důležité věci se neřeší. Je v tom úmysl nebo jen nekompetence? Briefing obsahuje i pasáž: „věděli jste, co všechno podporujeme z veřejného rozpočtu?” Který státní výdaj přijde nejzbytečnější vám?
Laura Angeloni"Io sono l'abisso"Lucie FaulerovaMiraggi Edizioniwww.miraggiedizioni.itPassato e presente, realtà e fantasia, compongono un mosaico di continui chiaroscuri, e lo stile è un'architettura perfetta: tenero, poetico, ironico, di straordinaria purezza.Colpita da una serie di tragedie familiari e abbandoni, la protagonista del romanzo, Marie, si trova a fare i conti col suo passato, nel difficile tentativo di approdare a un futuro. I suoi ricordi, come tasselli di una realtà frantumata che man mano va a ricomporsi, ci presentano il quadro di una famiglia spezzata dall'impeto violento di una malattia. L'amore è il collante su cui i tre membri rimasti si sforzano di ricostruire le fondamenta della loro vita, ma la battaglia più difficile, per la protagonista, è quella con sé stessa, con l'attanagliante senso di colpa che le impedisce di affrontare i propri demoni interiori e di chiedere aiuto. Inizia in treno, questa storia, e in treno finisce, ma nel percorso è condensata una gamma di emozioni infinita. Un vero viaggio nella vita, ma anche nella morte e nel dolore, un dolore che trasuda anche nelle scene che strappano un sorriso e si insinua in ogni piega, perché Marie, la protagonista, non si risparmia e non ci risparmia. Non fugge dalla violenta raffica dei ricordi, forse non ne ha la forza o forse intuisce che il buio del tunnel va attraversato, che indietro non si torna. Ed è proprio nel buio che spiccano maggiormente gli sprazzi di luce, e in queste pagine di sprazzi di luce, pur nella tragedia, ce ne sono tantissimi. I legami di famiglia, l'amore di un cane, un aquilone al vento, un fruscio di foglie, un cielo pieno di stelle, la lieve carezza di un sorriso. Passato e presente, realtà e fantasia, compongono un mosaico di continui chiaroscuri, il viaggio in treno scandisce il ritmo, tra accelerazioni e rallentamenti, e lo stile è un'architettura perfetta: tenero, poetico, ironico, di straordinaria purezza.Laura AngeloniLucie Faulerová è nata nel 1989 ed è una della più brillanti giovani autrici ceche. Dopo gli studi di boemistica ha cominciato a lavorare come redattrice editoriale. Il suo romanzo di debutto, Lapači prachu (Gli acchiappapolvere, 2017) è stato nominato ai premi Magnesia Litera e Jiří Orten.Smrtholka, del 2020, il cui titolo letteralmente significa “Ragazzamorte”, e indica la dea della morte Morana, è stato nominato per il premio Magnesia Litera nel 2021 e nello stesso anno ha vinto il prestigioso Premio dell'Unione Europea.Io sono l'abisso è la sua prima opera tradotta in italiano.Laura Angeloni nasce a Firenze nel 1970. Sposata con tre figlie, vive attualmente a Genzano di Roma. Laureata in Lingue e Letterature Straniere presso l'Università La Sapienza di Roma, lavora dal 2004 come traduttrice letteraria dal ceco. Ha tradotto in italiano romanzi di autori quali Jáchym Topol, Petra Hůlova, Kateřina Tučková, Emil Hakl, Petr Král, Tereza Boučková, Bianca Bellová, per le case editrici Einaudi, Baldini Castoldi, Atmosphere, Keller, e naturalmente Miraggi. Nel 2007 ha pubblicato il romanzo Il viaggio di Anna per la Azimut Libri, e nel 2015 il romanzo Dare il resto e poi sorridere per Echos Edizioni.IL POSTO DELLE PAROLEascoltare fa pensarewww.ilpostodelleparole.itDiventa un supporter di questo podcast: https://www.spreaker.com/podcast/il-posto-delle-parole--1487855/support.
This week, in honor of the cold movie month, we hit the slope with James Bond as we dust off the archives and talk For Your Eyes Only! Roger Moore beds a figure skater....classy! How will For Your Eyes Only hold up? Host: Nic Panel: Matt, Daniel, Jon Directed by John Glen Starring: Roger Moore, Carole Bouquet, Topol, Lynn-Holly Johnson, Julian Glover, Cassandra Harris, Jill Bennett, Michael Gothard, Lois Maxwell, Desmond Llewelyn
This week, in honor of the cold movie month, we hit the slope with James Bond as we dust off the archives and talk For Your Eyes Only! Roger Moore beds a figure skater....classy! How will For Your Eyes Only hold up? Host: Nic Panel: Matt, Daniel, Jon Directed by John Glen Starring: Roger Moore, Carole Bouquet, Topol, Lynn-Holly Johnson, Julian Glover, Cassandra Harris, Jill Bennett, Michael Gothard, Lois Maxwell, Desmond Llewelyn
Die Slowakei hautnah, Magazin über die Slowakei in deutscher Sprache
Nachrichten, Tagesthema, Magazin - Wie in Topolčianky Eiswein entsteht. Roma-Informations- und Dokumentationszentrum in der Wissschaftsbibliothek Prešov.
Comedy/theatre/screenwriting person Daryn Robinson ("She the People," "Fiddler on the Roof") joins Andy & Steph to talk about one of her favorites, 1971's "Fiddler on the Roof"! Daryn talks about how Gwen Stefani brought her to a movie she'd love for a lifetime, eventually snagging a lead role in a production! Steph talks about how she knew part of this story because of The Gilmore Girls! Andy's got info on the cinematographer who made his stockings fetish a huge part of this movie's production! Plus the gang talks about the mystique of Topol, a potential sequel idea, and defunct award categories. check out our patreon on patreon.com/dumbfuncheck out our No Skips playlist on Spotify: https://open.spotify.com/playlist/6NWZ1ETlRqC9s7gcVIoTFW?si=a1da69dc8126495a Hosted on Acast. See acast.com/privacy for more information.
Below is a brief video snippet from our conversation. Full videos of all Ground Truths podcasts can be seen on YouTube here. The current one is here. If you like the YouTube format, please subscribe! This one has embedded one of my favorite TikTok's from Will. There are several links to others in the transcript. The audios are also available on Apple and Spotify.Transcript with links to both audio and videos, commencement addresses, NEJM article coverageEric Topol (00:06):Hi, it's Eric Topol from Ground Truths, and I've got an amazing couple with me today. It's Will Flanary and Kristin Flanary, the Glaucomfleckens. I've had the chance to get to know them a bit through Knock Knock, Hi! which is their podcast. And of course, everyone knows Dr. Glaucomflecken from his TikTok world and his other about 4 million followers on Instagram and Twitter and all these other social media, and YouTube. So welcome.Will Flanary (00:43):Thanks for having us.Kristin Flanary (00:44):Thank you. Happy to be here.By Way of BackgroundEric Topol (00:45):Yeah. Well, this is going to be fun because I'm going to go a quick background so we can go fast forward because we did an interview back in early 2022.Kristin Flanary (00:56):Yes.Eric Topol (00:57):And what you've been doing since then is rocking it. You're like a meteoric, right. And it was predictable, like rarefied talent and who couldn't love humor, medical humor, but by way of background, just for those who are not up to speed. I guess you got your start, Will, as a class clown when your mother was a teacher in the sixth grade.Will Flanary (01:22):Yep, yep. I misbehaved a little bit. It helped that I still made good grades, but I cut up a bit in class.Eric Topol (01:32):And then you were already in the comedy club circuits doing standup in Houston as an 18-year-old.Will Flanary (01:40):It was all amateur stuff, nothing, just dabble in it and trying to get better. I was always kind of naturally funny just with my friend group and everything. I loved making people laugh, but doing standups is a whole different ball game. And so, I started doing that around Houston as a high school senior and kept that going through college and a little bit into med school.Kristin Flanary (02:02):Houston was a good training ground, right? That where Harris Wittels was also coming up.Will Flanary (02:07):Yeah. A lot of famous comedians have come through Houston. Even going back to Bill Hicks back in the, was that the 80s, I think? Or 90s?Eric Topol (02:17):Well, and then of course, it was I think in 2020 when you launched Dr. Glaucomflecken, I think. Is that right?Will Flanary (02:28):That's when it really started to take off. I was on Twitter telling jokes back in 2016.Kristin Flanary (02:39):GomerBlog before that, that's actually where it was born.Will Flanary (02:41):I was doing satire writing. I basically do what I'm doing now, but in article form, trying to be The Onion of medicine. And then the pandemic hit, started doing video content and that's really with lockdown. That's when, because everybody was on social media, nobody had anything else to do. So it was right place, right time for me and branching out into video content.On to Medical School Commencement AddressesEric Topol (03:11):Alright, so that's the background of some incredible foundation for humor. But since we last got together, I'll link the Medicine and the Machine interview we did back then. What has been happening with you two is nothing short of incredible. I saw your graduation speeches, Will. Yale in 2022, I watched the UCSF in 2023 and then the University of Michigan in 2024. Maybe there's other ones I don't even know.Kristin Flanary (03:45):There's a few others.Will Flanary (03:45):There's a few. But I feel like you've done, I'm sure your fair share of commencement addresses as well. It's kind of hard to come up with different ways to be inspirational to the next generation. So fortunately, we have together, we have some life experiences and learned a thing or two by doing all of this social media stuff and just the things we've been through that I guess I have enough things to say to entertain an interest.Eric Topol (04:18):Well, you're being humble as usual, but having watched those commencement addresses, they were the best medical commencement addresses I've ever seen. And even though you might have told us some of the same jokes, they were so great that it was all right. Yeah, and you know what is great about it is you've got these, not the students, they all love you of course, because they're probably addicted to when's your next video going to get posted.(04:44):But even the old professors, all the family members, it's great. But one of the things I wanted to get at. Well, I'll start with the graduation speeches, because you were such an inspiration, not just with humor, but your message. And this gets back to you as a couple and the tragedies you've been through. So you really, I think, got into this co-survivor story and maybe Kristin, since you are the co-survivor of two bouts of Will's testicular cancer, and then the sudden cardiac death. I mean, people don't talk about this much, so maybe you could help enlighten us.Tragedies and Being a Co-SurvivorKristin Flanary (05:26):Yeah, it's funny because the experience of being a co-survivor is nothing new. It's as long as we've had human beings, we've had co-survivors. But the concept around it and giving it a name and a label, a framework to be able to think about it, that is what I think is new and what people haven't talked about before. So co-survivor is just this idea that when a medical trauma happens to a patient, the patient has their experience and if they survive it, they are a survivor and they have a survivor experience. And also, most people are closely attached to at least one other person, if not many. And those people are co-surviving the medical event along with the survivor. That event is happening in their lives as was happening to them too. If someone comes in with a patient to the hospital, that person, you can just assume by default that their lives are pretty intimately or profoundly intertwined or else why would that person be there? And so, thinking of it as there's the patient and then there's also a co-patient, that family members in the past have only been thought of as caregivers if they've been thought of at all. And that is certainly one aspect of the role, but it's important to remember that whatever it is that's happening to the patient is also affecting the family members' lives in a really deep and profound way.Eric Topol (07:04):That's really helpful. Now, the fact that you recognize that in your graduation speech, Will, I think is somewhat unique. And of course, some of the other things that you touched on like playing to your creativity and the human factors, I mean, these are so important messages.Will Flanary (07:23):Well, in the discussion about co-survivorship and because I talk about that whenever I do my keynotes and when I do the commencement addresses, but all credit goes to Kristin for really being the driving force of this idea for me and for many others because as a physician, we take care of patients. Our focus is always on the patient. And it really wasn't until this happened to me and my family and Kristin in particular that I started to understand exactly what she's talking about and this idea. And so, Kristin gets a lot of credit for just really bringing that term and that idea to the forefront.Eric Topol (08:09):Yeah, well, you saved his life. It's just not many have that bond. And then the other thing I just want to mention now, you've been recognized by the American Heart Association and a whole bunch of other organizations awarded because of your advocacy for CPR. And you even mentioned that I think in one of your commencement addresses.Will Flanary (08:31):Yeah, I tried to get the crowd to do CPR. Like team up, partner up, and it kind of fell flat. It wasn't quite the right time, I think, to try to do a mass class on CPR. So maybe next time.Eric Topol (08:47):Right. Well, so you had this foundation with the Glaucomflecken General Hospital and taking on 37 specialties and all these incredible people that became part of the family, if you will, of spoof on medicine and your alter ego and these videos that you would do. And sometimes you have three or four different alter egos in there playing out, but now you've branched into new things. So one which is an outgrowth of what we were just talking about. You've been on this country tour, Wife & Death.“Wife and Death,” A Nationwide TourKristin Flanary (09:28):Yes.Eric Topol (09:29):Wife and death. I mean, yeah, I guess we can make the connect of how you named it that, but what is it you've been selling out in cities all over the country, and by the way, I'm really upset you haven't come to San Diego, but tell us about wife and death.Will Flanary (09:44):Yeah. Well, we have this amazing story and all these medical challenges we've been through, and then developing the Glaucomflecken brand and universe, and we've done keynotes together for years, and then we thought, let's have more fun with it. Let's do keynotes. They're great. We can get our message out, but sometimes they're just a bit stuffy. It's an academic environment.Kristin Flanary (10:15):They're usually at seven in the morning also, so that's the downside.Will Flanary (10:21):So we thought, let's just put together our own live show. Let's put together something that we could just creatively, we can do whatever we want with it. I could dress up as characters, Kristin, who has these beautiful writing and monologues that she's put together around her experience and just to create something that people can come into a theater and just experience this wide range of emotions from just laughter to tears of all kinds, and just have them feel the story and enjoy this story. Fortunately, it has a happy ending because I'm still alive and it's been so much fun. The audiences have been incredible. Mostly healthcare, but even some non-healthcare people show up, and we've been blown away by the response. Honestly, we should have done bigger theaters. That's our lesson for the first go round.Eric Topol (11:21):I saw you had to do a second show in Pittsburgh.Will Flanary (11:24):We did.Kristin Flanary (11:26):That one sold out too. Something about Pittsburgh, that was a good crowd, and there was a lot of them.Will Flanary (11:33):It was almost like in Pittsburgh, they rarely ever get any internet comedian ophthalmologists that come through. I don't know.Eric Topol (11:41):Well, I see you got some still to come in Denver and Chicago. This is amazing. And I wondered who was coming and I mean, it's not at all surprising that there'd be this phenomenal popularity. So that's one thing you've done that's new, which is amazing. And of course, it's a multidimensional story. The one that shocked me, I have to tell you, shocked me, was the New England Journal partnership. The New England Journal is the most stodgy, arrogant, I mean so difficult. And not only that.Kristin Flanary (12:17):You said that. Not us.Partnering with the New England Journal of Medicine!Eric Topol (12:19):Yeah, yeah. They'll get this too. They know we don't get along that well, but that's okay. You even made fun of journals. And now you're partnering with the New England Journal, God's greatest medical journal, or whatever. Tell us about that.Will Flanary (12:39):Well, so one thing that I really enjoy doing, and I've done it with my US healthcare system content is almost like tricking people into learning things. And so, if you make something funny, then people will actually sit there and listen to what you have to say about deductibles and physician-owned hospitals and all these inner workings. DIR fees and pharmacy, all these things that are really dry topics. But if you can make them funny, all of a sudden people will actually learn and listen to it. And the New England Journal of Medicine, they approached me with an idea. Basically just to take one or two of their trials per month. And I just make a skit out of that trial with the idea being to help disseminate some of the research findings that are out there, because I guess it's getting harder and harder for people to actually read, to sit down and read a journal article.(13:43):And so, I have to credit them for having this idea and thinking outside the box of a different way to get medical information and knowledge out to the masses. And you're absolutely right, that I have been critical of journals, and particularly I've been critical of the predatory nature of some of the larger journals out there, like Elsevier. I've specifically named Elsevier, Springer, these journals that have a 40% profit margin. And I certainly thought about that whenever I was looking into this partnership. And the reason I was okay with doing it with the New England Journal is because they're a nonprofit, first of all, so they're run by the Massachusetts Medical Society. That's the publisher for that journal. And so, I feel okay partnering with them because I feel like they're doing it in a much better way than some of the bigger journal corporations out there.Kristin Flanary (14:54):Well, and also part of the deal that we negotiated was that those articles that you make skits about those will be available open access.Will Flanary (15:03):Oh yeah. That was a prerequisite. Yes. It was like, if I'm going to do this, the articles that I'm talking about need to be free and readily available. That's part of it.Eric Topol (15:14):I think you've done about five already, something like that. And I watched them, and I just was blown away. I mean, the one that got me where I was just rolling on the floor, this one, the Belantamab Mafodotin for Multiple Myeloma. And when you were going on about the Bortezomib, Dexamethasone. We'll link to this. I said, oh my God.Will Flanary (15:40):Yeah. The joke there is, you don't have any idea how long it took me to say those things that quickly. And so, I was writing this skit and I'm like, wouldn't it be funny if somehow that triggered a code stroke in the hospital because this person is saying all these random words that don't have any meaning to anybody. Man, I tell you, I am learning. Why would I ever need to know any of this information as an ophthalmologist? So it's great. I know all this random stuff about multiple myeloma that I probably would never have learned otherwise.Kristin Flanary (16:21):It's the only way, you won't read a journal either.Eric Topol (16:23):Well, and if you read the comments on the post. These doctors saying, this is the only way they want to get journal information from now on.Will Flanary (16:33):Which is double-edged sword, maybe a little bit. Obviously, in a 90 second skit, there's no way I'm going to cover the ins and outs of a major trial. So it's really, in a lot of ways, it's basically like, I call it a comedy abstract. I'm not going much further than an abstract, but hopefully people that are actually interested in the topic can have their interest piqued and want to read more about it. That's kind of the idea.Eric Topol (17:06):Yeah. Well, they're phenomenal. We'll link to them. People will enjoy them. I know, because I sure did. And tenecteplase for stroke and all that you've done. Oh, they're just phenomenal.Will Flanary (17:20):Every two weeks we come out with a new one.Eric Topol (17:24):And that is basically between the fact that you are now on the commencement circuit of the top medical schools and doing New England Journal videos on their articles. You've crossed a line from just making fun of insurance companies and doctors of specialties.Kristin Flanary (17:44):Oh, he has crossed many lines, Dr. Topol.Eric Topol (17:46):Yeah. Oh yeah. Now you've done it, really. Back two years ago when we convened, actually it's almost three, but you said, when's it going to be your Netflix special?Will Flanary (18:02):Oh, gosh.Eric Topol (18:02):Is that in the works now?Will Flanary (18:04):Well, I'll tell you what's in the works now.Kristin Flanary (18:06):Do you know anyone at Netflix?Will Flanary (18:09):A New Animated SeriesNo. We're working on an animated series.Eric Topol (18:12):Oh, wow. Wow.Will Flanary (18:13):Yeah. All these characters. It's basically just this fictional hospital and all these characters are very cartoonish, the emergency physician that wears the bike helmet and everything. So it's like, well, what do we have together? What do we, Kristin and I have time for? And it wasn't like moving to LA and trying to make a live action with actors and do all, which is something we probably could have tried to do. So instead, we were like, let's just do an animated series.Kristin Flanary (18:48):Let's have someone else do the work and draw us.Will Flanary (18:51):So we've worked with a writer for the first time, which was a fun process, and putting together a few scripts and then also an animator. We learned a lot about that process. Kristin and I are doing the voiceovers. And yeah, it's in process.Kristin Flanary (19:10):We're the only actors we could afford.Will Flanary (19:12):Right, exactly.Eric Topol (19:13):I can't wait to see it. Now when will it get out there?Will Flanary (19:17):Well, we're hoping to be able to put it out on our YouTube channel sometime early next year. So January, February, somewhere around there. And then we can't fund the whole thing ourselves. So the idea is that we do this, we do this pilot episode, and then we'll see what kind of interest we can generate.Eric Topol (19:37):Well, there will be interest. I am absolutely assured of that. Wow.Will Flanary (19:42):Let us know if you know anybody at the Cartoon Network.Kristin and Will Flanary (19:45):Yeah, we're open to possibilities. Whatever, Discovery channel. I don't know.Eric Topol (19:51):You've gotten to a point now where you're ready for bigger things even because you're the funniest physician couple in medicine today.Kristin Flanary (20:05):Well, that's a very low bar, but thank you.Will Flanary (20:08):There are some funny ones out there, but yeah, I appreciate that.Eric Topol (20:11):Well, I'm a really big comedy fan. Every night I watch the night before, since I'm old now, but of Colbert and Jimmy Kimmel, just to hear the monologues. Trevor Noah, too. And I can appreciate humor. I'll go to see Sebastian Maniscalco or Jim Gaffigan. That's one of the things I was going to ask you about, because when you do these videos, you don't have an audience.Will Flanary (20:39):Oh yeah.Eric Topol (20:40):You're making it as opposed to when you are doing your live shows, commencement addresses and things like that. What's the difference when you're trying to be humorous, and you have no audience there?Will Flanary (20:55):Well, whenever I'm filming a skit, it's just all production. In fact, I feel like it's funny. I think it's funny, but it's really not until I see the response to it, or I show Kristin, or what I have is where I really know if it's going to work. It's great to put the content out there and see the responses, but there's nothing like live interaction. And that's why I keep coming back to performing. And Kristin's been a performer too in her life. And I think we both really enjoy just the personal interaction, the close interaction, the response from people to our story.Kristin Flanary (21:36):We do most of our work alone in this room. I do a lot of writing. He does a lot of playing.Will Flanary (21:44):Dress up.Kristin Flanary (21:44):All the people in his head, and we do that very isolated. And so, it's very lovely to be able to actually put names to faces or just see human bodies instead of just comments on YouTube.Will Flanary (21:59):Meet people.Kristin Flanary (21:59):It's really nice.Will Flanary (22:01):We've been doing meet and greets at the live shows and seeing people come up wearing their costumes.Eric Topol (22:07):Oh, wow.Will Flanary (22:11):Some of them talk about how they tell us their own stories about their own healthcare and talk about how the videos help them get through certain parts of the pandemic or a difficult time in their life. And so, it reinforces that this means something to a lot of people.Kristin Flanary (22:29):It's been really fun for me, and probably you too, but to get to see the joy that he has brought so many people. That's really fun to see in person especially.Eric Topol (22:42):No question. Now, when you're producing it together, do you ever just start breaking into laughter because it's you know how funny this is? Or is it just you're on kind of a mission to get it done?Will Flanary (22:54):Well, the skits I do by myself. And sometimes when I'm writing out the skit, when I'm writing the skit itself, I will laugh at myself sometimes. Not often, but sometimes they're like, oh, I know that's really funny. I just wrote a skit that I'm actually going to be debuting. I'm speaking at the American Academy of PM&R, so the big PM&R conference. I'm writing a skit, it's How to Ace your PM&R residency interview.Will Flanary (23:28):I was writing up that skit today and kind of chuckling to myself. So sometimes that happens, but whenever we do our podcast together, we definitely have outtakes.Kristin Flanary (23:38):Oh yeah, we've got some.Will Flanary (23:40):We crack each other up.Kristin Flanary (23:41):We do.Will Flanary (23:42):Sometimes we're getting a little punchy toward the end of the day.Eric Topol (23:47):And how is the Knock Knock, Hi! podcast going?Will Flanary (23:51):It's awesome. Yeah.Kristin Flanary (23:52):Yeah. It's a really fun project.Will Flanary (23:54):We still enjoy. You can work with your spouse and in close proximity and still be happily married. So it's doable everyone.Kristin Flanary (24:06):That's right. And we're in that phase of life that's really busy. We've got kids, we've got a gazillion jobs. House, my parents are around, and so it's like the only time all week that we actually get to sit down and talk to each other. So it's actually kind of like a part of our marriage at this point.Will Flanary (24:28):We're happy to involve the public in our conversations, but we couldn't do it because we have all these things going on, all our hands and all these little places. We can't do it without a team.Kristin Flanary (24:41):Yeah, absolutely.Will Flanary (24:41):And that's the thing that I've learned, because I've always been a very loner type content creator. I just wanted to do it all myself. It's in my head and I have trouble telling others, describing what's in my head. And Kristin and our producers have helped me to be able to give a little bit of control to others who are really good at what they do. And that's really the only way that we've been able to venture out into all these different things we've talked about.Eric Topol (25:12):Well, I think it comes down to, besides your ability to get to people in terms of their laughter receptors, you have this incisive observer capability. And that's one of the things I don't, I can't fathom because when you can understand the nuances of each specialty or of each part of healthcare, and you haven't necessarily interacted with these specialists or at least in recent years, but you nail it every time. I don't know how you do it, really that observational, is that a central quality of a comedian, you think?Will Flanary (25:52):There's definitely a big part of that. You got to get the content from somewhere. But for the specialties, it's really first about just getting the personalities down. And that doesn't change over time.Kristin Flanary (26:08):Or around the world.Will Flanary (26:09):Or around the world. We hear from people from all over the world about, oh, it's the same in Guatemala as it is in the US.Kristin Flanary (26:18):Surgeons are the same.Will Flanary (26:19):Yeah.Kristin Flanary (26:20):Emergency is the same.Will Flanary (26:21):Which has been really cool to see. But so, I draw on my experience interacting with all these specialties back in my med school and intern days. You're right, as an ophthalmologist, we don't get out very much.Eric Topol (26:33):No.Will Flanary (26:35):So very few people have ever seen an ophthalmologist. We do exist. But then beyond that, I do have to include some actual medical things. And so, I actually, I do a lot of research. I find myself learning more about other fields sometimes than I do in my own field. So especially the further out I get from med school, I know less and less.Eric Topol (27:00):Yeah, that's what I was thinking. But you're always spot on. It's interesting to get that global perspective from both of you. Now you're still doing surgery and practicing ophthalmology. Have you reduced it because this has just been taking off so much more over the recent years or keeping it the same?Will and Kristin Flanary (27:21):Nope, I'm still. Do you know how many years I had to come along on all of this medical training? He is not allowed to give this up.Will Flanary (27:29):I know there's something called a sunk cost fallacy, but this is no fallacy. There's enough of a sunk cost. I got to stick with it. No, I still enjoy it. That's the thing. It actually, it informs my comedy, it grounds me. All of the social media stuff is built upon this medical foundation that I have. And if I stopped practicing, I guess I could maybe cut back. But I'm not planning on doing that. If I stop practicing medicine, I feel like it would make my content less.Kristin Flanary (28:07):Authentic.Will Flanary (28:08):Less authentic, yeah. That's a good way to put it.Eric Topol (28:09):Yeah, no, that makes a lot of sense. That's great you can get that balance with all the things you're doing.Will Flanary (28:17):And if I stop practicing medicine, they're not going to invite me to any more commencement addresses, Dr. Topol. So I got to draw the line somewhere.Eric Topol (28:28):One of the statements you made at some point earlier was, it was easier to go to become a doctor than to try to be a comedian. And yeah, I mean you proven that.Will Flanary (28:38):A lot of ways. That's true.Eric Topol (28:40):Wow. I am pretty awestruck about the rarefied talent that you bring and what you both have done for medicine today. And the thing is, you're so young, you have so much time ahead to have an impact.Will Flanary (28:57):You hear that Kristin, we're young. Look at that.Kristin Flanary (29:00):That's getting less and less true.Will Flanary (29:01):Kristin, she just turned 40. It's right around the corner for me. So I don't know.Will Flanary (29:11):We got some years left.Eric Topol (29:12):You're like young puppies. Are you kidding? You're just getting started. But no, I think that what you brought to medicine in terms of comedy, there's no other entity, no person or people like you have done. And just the last thing I want to ask you about is, you have a platform for advocacy. You've been doing that. We talked about co-survivor. We talked about nurturing the human qualities in physicians like creativity and also taking on the insurance companies, which are just monstrous. I'll link a couple of those, but the brain MRI one or the Texaco.Will Flanary (29:54):Texaco Mike.Eric Topol (29:55):Yeah, that one is amazing. But there is so many. I mean, you've just taken them apart and they deserve every bit of it. Do you have any other targets for advocacy or does that just kind of come up as things go?Will Flanary (30:08):It kind of comes up as things go. There's things I keep harping on. The prior authorization reform, which I've helped in a couple of different states. There's a lot of good people around the country doing really good work on prior authorization and reforming that whole process. And I've been able to just play a small part in that in a couple of different ways. And it's been really fun to do that. And so, I do plan on continuing that crusade as it were. There's certain things I'd like to see. I've been learning more about what pharmacists are dealing with as well as a physician. Unfortunately, we are very separate in a lot of ways and just how we come up in medicine. And so, I have had my eyes opened a lot to what community pharmacists are dealing with. For all the terrible things that we have to deal with as physicians in the healthcare system. Pharmacists have just as much, if not more of the things that they're doing that are threatening their livelihoods. And so, I had love to see some more reform on the PBM side of things, pharmacy benefit managers, Caremark, Optum, all of them. They're causing lots of problems.Eric Topol (31:24):I couldn't agree with you more. In fact, I'm going to have Mark Cuban on in a few weeks and we're going to get into that. But the pharmacists get abused by these chains.Will Flanary (31:33):Oh, it's bad. It's really bad.Eric Topol (31:35):Horrible, horrible. I feel, and every time I am in a drugstore working with one of them, I just think what a tough life they have to deal with.Will Flanary (31:45):I guess from an advocacy standpoint, the good news is that there's never a shortage of terrible injustices that are being foisted upon the public and physicians and healthcare workers.Kristin Flanary (31:59):Yes. The US healthcare system is ripe for advocacy.Will Flanary (32:01):Yes. And that's a lesson that I tell people too, and especially the med students coming up, is like, there's work to be done and get in touch with your state societies and there's always work to be done.Eric Topol (32:18):Now you've stayed clear of politics. Totally clear, right?Will Flanary (32:24):For the most part, yeah. Yeah. It depends on what you consider politics. It depends on what you consider politics.Eric Topol (32:32):It being election day, you haven't made any endorsements.Will Flanary (32:36):I haven't. And I don't know. I can only handle so much. I've got my things that I really care about. Of course I'm voting, but I want to talk on the things that I feel like I have the expertise to talk about. And I think there's nothing wrong with that. Everybody can't have an opinion on everything, and it means something. So I am happy to discuss the things that I have expertise about, and I'm always on the side of the patient and wanting to make life better for our patients. And that's the side I'm on.Kristin Flanary (33:25):I think also he never comes out and explicitly touches on certain topics, but it's not hard to tell where he falls.Will Flanary (33:34):If you really want read into it all.Kristin Flanary (33:38):It's not like it's a big secret.Eric Topol (33:40):I thought that too. I'm glad you mentioned it, Kristin. But it doesn't come out wide open. But yeah, it's inferred for sure.Eric Topol (33:49):I think the point being there is that because you have a reach, I think there's no reach that it has 4 million plus people by your posts and no less the tours and keynotes and everything else. So you could go anywhere but sticking to where you're well grounded, it makes a lot of sense. And anyway, I am going to be staying tuned. This is our two-year checkup. I'm hoping you're going to come to San Diego on your next tour.Kristin Flanary (34:21):We're working on 2025 plans.Will Flanary (34:23):Oh, we got more shows coming up. And we'll hit up other parts of the country too.Eric Topol (34:28):I feel like I got to meet you in person, give you a hug or something. I just feel like I'm missing out there. But it's just a joy to have had a chance to work with you on your podcast. And thanks for coming back on one of mine. There's lots of podcasts out there, but having you and joining you is such fun. So thank you.Will Flanary (34:54):This has been great. Thank you for having us.Kristin Flanary (34:55):Yeah, thank you.*****************************************Thank you for reading, listening and and subscribing to Ground Truths.If you found this fun and informative please share it! Yes, laughter is the best medicine.All content on Ground Truths—its newsletters, analyses, and podcasts, are free, open-access.Paid subscriptions are voluntary. All proceeds from them go to support Scripps Research. Many thanks to those who have contributed—they have greatly helped fund our summer internship programs for the past two years.Thanks to my producer Jessica Nguyen and to Sinjun Balabanoff for audio and video support at Scripps Research.Note on Exodus from X/twitter:Many of you have abandoned the X platform for reasons that I understand. While I intend to continue to post there because of its reach to the biomedical community, I will post anything material here in the Notes section of Ground Truths on a daily basis and cover important topics in the newsletter/analyses. Get full access to Ground Truths at erictopol.substack.com/subscribe
Apache Arrow is a columnar format and multi-language toolbox for fast data interchange and in-memory analytics. Project website I spoke with Matt Topol at Community Over Code in Denver last month about the various subprojects, and how you can get …
Above is a brief video snippet from our conversation. Full videos of all Ground Truths podcasts can be seen on YouTube here. The audios are also available on Apple and Spotify.Transcript with links to audio and external citationsEric Topol (00:06):Well, hello it's Eric Topol with Ground Truths, and I'm really delighted to welcome Dr. Rachael Bedard, who is a physician geriatrician in New York City, and is actually much more multidimensional, if you will. She's a writer. We're going to go over some of her recent writings. She's actually quite prolific. She writes in the New Yorker, New York Magazine, New York Times, New York Review of Books. If it has New York in front of it, she's probably writing there. She's a teacher. She works on human rights, civil rights, criminal justice in the prison system. She's just done so much that makes her truly unique. That's why I really wanted a chance to meet her and talk with her today. So welcome, Rachael.Rachael Bedard (00:52):Thank you, Dr. Topol. It's an honor to be here.Eric Topol (00:55):Well, please call me Eric and it's such a joy to have a chance to get acquainted with you as a person who is into so many different things and doing all of them so well. So maybe we'd start off with, because you're the first geriatrician we've had on this podcast.Practicing Geriatrics and Internal MedicineEric Topol (01:16):And it's especially apropos now. I wanted maybe to talk about your practice, how you got into geriatrics, and then we'll talk about the piece you had earlier this summer on aging.Rachael Bedard (01:32):Sure. I went into medicine to do social justice work and I was always on a funny interdisciplinary track. I got into the Mount Sinai School of Medicine through what was then called the Humanities and Medicine program, which was an early acceptance program for people who were humanities focused undergrads, but wanted to go into medicine. So I always was doing a mix of politics and activist focused work, humanities and writing, that was always interested in being a doctor. And then I did my residency at the Cambridge Health Alliance, which is a social medicine program in Cambridge, Massachusetts, and my chief residency there.(02:23):I loved being an internist, but I especially loved taking care of complex illness and I especially loved taking care of complex illness in situations where the decision making, there was no sort of algorithmic decision-making, where you were doing incredibly sort of complex patient-centered shared decision making around how to come up with treatment plans, what the goals of care were. I liked taking care of patients where the whole family system was sort of part of the care team and part of the patient constellation. I loved running family meetings. I was incredibly lucky when I was senior resident and chief resident. I was very close with Andy Billings, who was one of the founders of palliative care and in the field, but also very much started a program at MGH and he had come to work at Cambridge Hospital in his sort of semi-retirement and we got close and he was a very influential figure for me. So all of those things conspired to make me want to go back to New York to go to the Sinai has an integrated geriatrics and palliative care fellowship where you do both fellowships simultaneously. So I came to do that and just really loved that work and loved that medicine so much. There was a second part to your question.Eric Topol (03:52):Is that where you practice geriatrics now?Rachael Bedard (03:55):No, now I have ever since finishing fellowship had very unusual practice settings for a geriatrician. So right out of fellowship, I went to work on Rikers Island and then New York City jail system, and I was the first jail based geriatrician in the country, which is a sort of uncomfortable distinction because people don't really like to think about there being a substantial geriatric population in jails. But there is, and I was incredibly lucky when I was finishing fellowship, there was a lot of energy around jail healthcare in New York City and I wrote the guy who was then the CMO and said, do you think you have an aging problem? And he said, I'm not sure, but if you want to come find out, we'll make you a job to come find out. And so, that was an incredible opportunity for someone right out of fellowship.(04:55):It meant stepping off the sort of academic track. But I went and worked in jail for six years and took care of older folks and people with serious illness in jail and then left Rikers in 2022. And now I work in a safety net clinic in Brooklyn that takes care of homeless people or people who have serious sort of housing instability. And that is attached to Woodhull Hospital, which is one of the public hospitals in New York City. And there I do a mix of regular internal medicine primary care, but I preferentially see the older folks who come through, which is a really interesting, painful, complicated patient population because I see a fair amount of cognitive impairment in folks who are living in the shelter system. And that's a really hard problem to address.Frailty, The Aged, and LongevityEric Topol (05:54):Well, there's a theme across your medical efforts. It seems to me that you look after the neglected folks, the prisoners, the old folks, the homeless people. I mean that's kind of you. It's pretty impressive. And there's not enough of people like you in the medical field. Now, no less do you do that, but of course you are a very impressive author, writer, and of many topics I want to get into with you, these are some recent essays you've written. The one that piqued my interest to start to understand who you were and kind of discover this body of work was the one that you wrote related to aging and President Biden. And that was in New York Times. And I do want to put in a quote because as you know very well, there's so much interest in longevity now.Eric Topol (06:51):Interrupting the aging process, and this one really stuck with me from that op-ed, “Time marches forward, bodies decline, and the growing expectation that we might all live in perfect health until our 100th birthdays reflects a culture that overprizes longevity to the point of delusion.” So maybe if you could tell us, that was a rich piece, you got into frailty, you related it to the issues that were surrounding President Biden who at that time had not withdrawn from the race. But what were you thinking and what are your thoughts about the ability to change the aging process?Rachael Bedard (07:36):I am very interested in, I mean, I'm incredibly interested in the science of it. And so, I guess I think that there are a few things.(07:49):One thing is that the framework that, the part that gives me pause the most is this framework that anything less than perfect health is not a life worth living. So if you're going to have a long life, life should not just be long and sort of healthy in relative terms to your age cohort, but healthy that when you're 80 you should feel like you have the health of a 45-year-old is my understanding of the culture of longevity science. And while I understand why that's aspirational and everybody worry about my body's decline, I think it's a really problematic thing to say that sick bodies are bodies that have disability or people who have cognitive difference are somehow leading lesser lives or lives that are not meaningful or not worth living. I think it's a very, very slippery slope. It puts you in a place where it sort of comes up against another trend or another emerging cultural trend, which is really thinking a lot about physician-assisted suicide and end of life choices.(09:04):And that in some ways that conversation can also be very focused on this idea that there's just no way that it's worth living if you're sick. And that's just not true, I think, and that's not been true for many, many, many of my patients, some of whom have lived with enormous disability and incredible burden of illness, people who are chronically seriously ill and are still leading lives that for them and for the people who love them are filled with meaning. So that's my concern about the longevity stuff. I'm interested in the science around the longevity stuff for sure. I'm interested in, I think we're living in this really interesting moment where there's so much happening across so many of the chronic disease fields where the things that I think have been leading to body decay over the last several decades for the majority of the population, we're sort of seeing a lot of breakthroughs in multiple fronts all at once. And that's really exciting. I mean, that's really exciting. And so, certainly if it's possible to make it to 100 in wonderful health, that's what I'd wish for all of us. But to hold it up as the standard that we have to achieve, I think is both unrealistic and a little myopic.Eric Topol (10:28):Yeah. Well, I certainly agreed with that and I think that that particular essay resonated so well and you really got into frailty and the idea about how it can be potentially prevented or markedly delayed. And I think before we move on to one of those breakthroughs that you were alluding to, any comments about the inevitability of frailty in people who are older, who at some point start to get the dwindles, if you will, what do you have to say about that?Rachael Bedard (11:11):Well, from a clinical standpoint, I guess the caveat versus that not everybody becomes frail and dwindles exactly. Some people are in really strong health up until sort of their final years of life or year of life and then something happens, they dwindle quickly and that's how they die. Or some people die of acute events, but the vast majority of us are going to become more frail in our final decades than we are in our middle decades. And that is the normal sort of pattern of wear and tear on the body. And it is an extraordinary framework, I think frailty because the idea of this sort of syndrome of things where it's really not a disease framework, it is a syndrome framework and it's a framework that says many, many small injuries or stressors add up to create a lot of stress and change in a body and trauma for our body. And once you are sort of past a tipping point of an amount of stress, it's very hard to undo those things because you are not sort of addressing one pathologic process. You're addressing, you're trying to mitigate many processes all at once.(12:31):When I wrote that piece, it was inspired by the conversation surrounding President Biden's health. And I was particularly struck by, there was a huge amount of clinical speculation about what was going on with him, right? I'm sure you remember there were people, there was all of this talk about whether he had Parkinson's and what his cognitive status was. And it felt to me like there was an opportunity to do some public education around the idea that you need not have one single sort of smoking gun illness to explain decline. What happens to most of us is that we're going to decline in many small ways sort of simultaneously, and it's going to impact function when it tips over a little bit. And that pattern of decline is not going to be steady day over day worsening. It's going to be up and down. And if you slept better the night before, you might have a better day the next day. And if you slept badly, you might have a worse day. And without knowing anything specific about his clinical situation, it felt like a framework that could explain so much of what we were seeing in public. And it was important also, I think to say that nothing was necessarily being hidden from anybody and that this is the kind of thing that, this has accumulated stress over time that then presents suddenly all at once after having been submerged.Eric Topol (14:01):Yeah, you reviewed that so well about the wear and tear and everything related to that. And before I move on to the second topic, I want to just circle back to something you alluded to, which is when Peter Attia wrote about this medicine 3.0 and how you would be compressed and you'd have no comorbidities, you'd have no other illnesses and just fall off the cliff. As a geriatrician, do you think that that is even conceivable?Rachael Bedard (14:35):No. Do you think it is?Eric Topol (14:37):No, but I just wanted to check the reality. I did challenge on an earlier podcast and he came up with his pat answer. But no, there's no evidence of that, that maybe you can delay if there ever was a way to do that. But I think there's this kind of natural phenomena that you just described, and I'll refer people also to that excellent piece that you get into it more.Rachael Bedard (15:06):Peter Attia, I mean, he is certainly the sort of standard bearer in my mind of that movement and that science or that framework of thinking about science. And there's stuff in there that's really valuable. The idea of thinking about lifestyle in your middle decades is having meaningful impact on how you will age, what your final years will look like. That seems intuitively true, I think. And so, thinking about his emphasis on exercise, I mean, his emphasis on exercise is particularly intense and not super achievable for the average person, but the idea that you should sort of be thinking about keeping your body strong because it will decline eventually. And so, you want to do that from a higher peak. That makes a lot of sense to me. The idea that where we sort of draw pathologic disease cutoffs is obviously a little bit arbitrary. And so, wanting to think about optimizing pre-disease states and doing prevention, that's obviously, I think pretty appealing and interesting. It's just really in an evidence free zone.Ozempic for the IndigentEric Topol (16:18):Yeah, that's what I confronted him with, of course, he had a different perspective, but you summed that up really well. Now let's switch to a piece you had in New York magazine. It was entitled, What If Ozempic Is Just a Good Thing? And the reason, of course, this ties into the first thing we're discussing. There's even talk now, the whole GLP-1 family of drugs with the dual triple receptors, pills to come that we're going to be able to interrupt a path towards Alzheimer's and Parkinson's. Obviously you've already seen impact in heart disease, liver disease, kidney disease way before that, diabetes and obesity. So what are your thoughts? Because you wrote a very interesting, you provided a very interesting perspective when you wrote that one.Rachael Bedard (17:11):So that piece I wrote because I have this unbelievably privileged, interesting clinical practice. In New York City, there is public health insurance basically available to anybody here, including folks who are undocumented. And the public hospital system has pharmacies that are outpatient pharmacies that have, and New York Medicaid is very generous and they arranged through some kind of brilliant negotiating. I don't quite know how to make Ozempic to make semaglutide available to people who met criteria which meant diabetes plus obesity, but that we could prescribe it even for our very, very poor patients and that they would be able to get it reliably, that we would have it in stock. And I don't know how many other practices in the country are able to reliably provide GLP-1s to marginalized folks like that. I think it feels like a really rare opportunity and a very distinct perspective.(18:23):And it has just been the most amazing thing, I think to have this class of drugs come along that, as you say, addresses so many problems all at once with at least in my prescribing experience, a relatively mild tolerable side effect profile. I have not had patients who have become incredibly sick with it. And for folks where making that kind of impact on their chronic illness is so critical to not just their longevity, but their disease status interacts so much with their social burden. And so, it's a very meaningful intervention I think around poverty actually.(19:17):I really feel that almost all of the popular press about it has focused very much on use amongst the wealthy and who's getting it off label and how are they getting it and which celebrities are taking it, and what are the implications for eating and diet culture and for people who have eating disorders. And that's a set of questions that's obviously sort of interesting, but it's really interesting in a very rarefied space. There's an unbelievable diabetes epidemic in this country, and the majority of people who have diabetes are not the people who are getting written about over and over again in those pieces. It's the patients that I take care of, and those people are at risk of ending up on dialysis or getting amputations. And so, having a tool this effective is really miraculous feeling to me.Eric Topol (20:10):Well, it really gives me some hope because I don't know any program like that one, which is the people who need it the most. It's getting provided for them. And we have been talking about a drug that costs a thousand dollars a month. It may get down to $500 a month, but that's still a huge cost. And of course, there's not much governmental coverage at this point. There might be some more for Medicare, Medicaid, whatever in the future, but it's really the original criteria of diabetes, and it took almost 20 years to get to where we are right now. So what's so refreshing here is to know that there's at least one program that is helping to bridge the inequities and to not make it as was projected, which was, as you say, for celebrities and wealthy people more exclusively, so that's great. And we still don't know about the diverse breadth of these effects, but as you well know, there's trials in Alzheimer's. I spoke to Steve Horvath recently on the podcast and he talked about how it's reset the epigenetic clock, GLP-1.Rachael Bedard (21:24):Does he think so?Eric Topol (21:26):Whoa. Yeah, there was evidence that was just presented about that. I said, well, if that does correspond to aging, the thing that we spoke about first, that would be very exciting.Rachael Bedard (21:37):It's so wild. I mean, it's so exciting. It's so exciting to me on so many levels. And one of them is it's just exploding my mental model of disease pathogenesis, and it's making me think, oh my goodness, I have zero idea actually how metabolism and the brain and sort of cardiovascular disease, all of those things are obviously, what is happening in the interplay between all of those different systems. It's really so much more complicated and so much more interdependent than I understood it to be. I am really optimistic about the Alzheimer's trial. I am excited for those results, and I think we're going to keep seeing that it prevents different types of tumors.Eric Topol (22:33):Yeah, no, and that's been shown at least certainly in obese people, that there's cancers that gets way reduced, but we never had a potent anti-inflammatory that works at the brain and systemically like this before anyone loses the weight, you already see evidence.Long Covid and ME/CFS(22:50):It is pretty striking. Now, this goes back to the theme that was introduced earlier about looking after people who are neglected, who aren't respected or generally cared for. And I wanted to now get into Long Covid and the piece you wrote in the New Yorker about listening to patients, called “what would it mean for scientists to listen to patients?” And maybe you can talk about myalgic encephalitis/chronic fatigue (ME/CFS), and of course Long Covid because that's the one that is so pervasive right now as to the fact that these people don't get respect from physicians. They don't want to listen to their ailments. There's no blood tests, so there's no way to objectively make a diagnosis supposedly. And they're basically often dismissed, or their suffering is discounted. Maybe you can tell us again what you wrote about earlier this year and any updated thoughts.Rachael Bedard (24:01):Have you had my friend Harlan Krumholz on the show to talk about the LISTEN study?Eric Topol (24:04):Not yet. I know Harlan very well. Yes.Eric Topol (24:11):I know Akiko Iwasaki very well too. They're very, very close.Rachael Bedard (24:14):So, Akiko Iwasaki and Harlan Krumholz at Yale have been running this research effort called the LISTEN study. And I first learned about it sometime in maybe late 2021. And I had been really interested in the emerging discourse around chronic illness in Long Covid in the 2021. So when we were past the most acute phase of the pandemic, and we were seeing this long tail of sequelae in patients, and the conversation had really shifted to one that was about sort of trying to define this new syndrome, trying to understand it, trying to figure out how you could diagnose it, what were we seeing sort of emerge, how are we going to draw boxes around it? And I was so interested in the way that this syndrome was really patient created. It came out of patients identifying their own symptoms and then banning together much, much faster than any kind of institutional science can ever work, getting into message boards together or whatever, and doing their own survey work and then coming up with their own descriptive techniques about what they were experiencing.(25:44):And then beyond that, looking into the literature and thinking about the treatments that they wanted to try for themselves. Patients were sort of at the forefront of every step of recognizing, defining, describing this illness presentation and then thinking about what they wanted to be able to do for themselves to address it. And that was really interesting to me. That was incredibly interesting to me. And it was also really interesting because by, I don't know exactly when 2021 or 2022, it was already a really tense landscape where it felt like there were real factions of folks who were in conflict about what was real and what wasn't real, how things ought to be studied, who ought to be studying them, what would count as evidence in this realm. And all of those questions were just really interesting to me. And the LISTEN study was approaching them in this really thoughtful way, which was Harlan and Akiko sort of partnering really closely with patients who enrolled.(26:57):And it's a decentralized study and people could enroll from all over the world. There's a portion of patients who do have their blood work evaluated, but you can also just complete surveys and have that data count towards, and those folks would be from anywhere in the world. Harlan did this amazing, amazing work to figure out how to collect blood samples from all over the country that would be drawn at home for people. So they were doing this decentralized study where people from their homes, from within the sort of circumstances of their lives around their chronic illness could participate, which that was really amazing to me. And then they were partnering really thoughtfully with these patients just to figure out what questions they wanted to ask, how they wanted to ask them, and to try to capture a lot of multimodal data all at once.(27:47):Survey data, journaling so people could write about their own experience in a freeform journal. They were collecting blood samples, and they were holding these town halls. And the town halls were on a regular basis, Harlan and Akiko, and anybody who was in the study could come on, could log onto a Zoom or whatever, and Harlan and Akiko and their research staff would talk about how things were going, what they were working on, what questions they had, what the roadblocks were, and then they would answer questions from their participants as the study was ongoing. And I didn't think that I had ever heard of something quite like that before. Have you ever heard of anything?Eric Topol (28:32):No. I mean, I think this is important to underscore, this was the first condition that was ever patient led, patient named, and basically the whole path was laid by the patient. So yes, and everything you summarize is so well as to the progress that's been made. Certainly, Harlan and Akiko are some of the people that have really helped lead the way to do this properly as opposed to, unfortunately one and a half billion dollars that have been put to the NIH for the RECOVER efforts that haven't yet led to even a significant clinical trial, no less a validated treatment. But I did think it was great that you spotlighted that just because again, it's thematic. And that gets me to the fourth dimension, which is you're the first prison doctor I've ever spoken to. And you also wrote a piece about that called, “the disillusionment of a Rikers Island Doctor” in the New Yorker, I think it was. And I wonder if you could tell us, firstly, now we're four years into Covid, you were for a good part of that at Rikers Island, I guess.The Rikers Island Prison Doctor During CovidRachael Bedard (30:00):I was, yeah.Eric Topol (30:00):Yeah. And what could be a more worrisome spot to be looking after people with Covid in a prison? So maybe you could just give us some insight about all that.Rachael Bedard (30:17):Yeah, it was really, I mean, it was the wildest time, certainly in my career probably that I'll ever have. In the end of February and beginning of March of 2020, it became very apparent to my colleagues and I that it was inevitable that this virus that was in Wuhan and in Italy was coming to the US. And jails are, we sort of jokingly described them as the worst cruise ships in the world. They are closed systems where everybody is eating, sleeping, going to the bathroom, everything on top of each other. There's an incredible amount of excess human contact in jails and prisons because people don't have freedom of movement and they don't get to do things for themselves. So every single, somebody brings you your mail, somebody brings you your meals, somebody brings you your medications. If you're going to move from point A to point B, an officer has to walk you there. So for a virus that was going to spread through what we initially thought was droplets and then found out was not just droplets but airborne, it was an unbelievably high-risk setting. It's also a setting where folks tend to be sicker than average for their age, that people bring in a lot of comorbidity to the setting.(31:55):And it's not a setting that does well under stress. I mean, jails and prisons are places that are sort of constitutionally violent, and they're not systems that adapt easily to emergency conditions. And the way that they do adapt tends to be through repressive measures, which tends to be violence producing rather than violence quelling. And so, it was just an incredibly scary situation. And in mid-March, Rikers Island, the island itself had the highest Covid prevalence of anywhere in the country because New York City was the epicenter, and Rikers was really the epicenter within New York. It was a wild, wild time. Our first seriously ill patient who ended up getting hospitalized. That was at that time when people were, we really didn't understand very much about what Covid looked like. And there was this guy sitting on the floor and he said, I don't know. I can't really get up.(32:59):I don't feel well. And he had an O2 stat of 75 or something. He was just incredibly hypoxic. It's a very scary setting for that kind of thing, right? It's not a hospital, it's not a place where you can't deliver ICU level care in a place like that. So we were also really worried about the fact that we were going to be transferring all of these patients to the city hospitals, which creates a huge amount of extra burden on them because an incarcerated patient is not just the incarcerated patients, the officers who are with that person, and there are special rules around them. They have to be in special rooms and all of these things. So it was just a huge systems crisis and really painful. And we, early on, our system made a bunch of good guesses, and one of our good guesses was that we should just, or one of our good calls that I entirely credit my bosses with is that they understood that we should advocate really hard to get as many people out as we could get out. Because trying to just manage the population internally by moving people around was not going to be effective enough, that we really need to decant the setting.(34:18):And I had done all of this work, this compassionate release work, which is work to get people who are sick out of jail so that they can get treatment and potentially die in a free setting. And so, I was sort of involved in trying to architect getting folks who were sort of low enough security risks out of jail for this period of time because we thought that they would be safer, and 1500 people left Rikers in the matter of about six weeks.Rachael Bedard (34:50):Which was a wild, wild thing. And it was just a very crazy time.Eric Topol (34:56):Yeah. Well, the word compassion and you go together exceptionally well. I think if we learn about you through your writings, that really shines through and what you've devoted your care for people in these different domains. This is just a sampling of your writings, but I think it gives a good cross section. What makes you write about a particular thing? I mean, obviously the Rikers Island, you had personal experience, but why would you pick Ozempic or why would you pick other things? What stimulates you to go after a topic?Rachael Bedard (35:42):Sometimes a lot of what I write about relates to my personal practice experience in some way, either to geriatrics or death and dying or to the criminal justice system. I've written about people in death row. I've written about geriatrics and palliative care in sort of a bunch of different ways. I am interested in topics in medicine where things are not yet settled, and it feels very of the moment. I'm interested in what the discourse is around medicine and healthcare. And I am interested in places where I think the discourse, not just that I'm taking a side in that discourse, but where I think the framework of the discourse is a little bit wrong. And I certainly feel that way about the Ozempic discourse. And I felt that way about the discourse around President Biden, that we're having not just a conversation that I have a strong opinion about, but a conversation that I think is a little bit askew from the way that we ought to be thinking about it.Eric Topol (36:53):And what I love about each of these is that you bring all that in. You have many different points of view and objective support and they're balanced. They're not just trying to be persuasive about one thing. So, as far as I know, you're extraordinarily unique. I mean, we are all unique, but you are huge standard deviations, Rachael. You cover bases that are, as I mentioned, that are new to me in terms of certainly this podcast just going on for now a couple of years, that is covering a field of both geriatrics and having been on the corrections board and in prison, particularly at the most scary time ever to be working in prison as a physician. And I guess the other thing about you is this drive, this humanitarian theme. I take it you came from Canada.Rachael Bedard (37:59):I did.Eric Topol (37:59):You migrated to a country that has no universal health.Rachael Bedard (38:03):That's right.Eric Topol (38:03):Do you ever think about the fact that this is a pretty pathetic situation here?Rachael Bedard (38:08):I do. I do think about it all the time.Eric Topol (38:10):In our lifetime, we'll probably never see universal healthcare. And then if you just go a few miles up north, you pretty much have that.Rachael Bedard (38:18):Yeah, if you've lived in a place that has universal healthcare and you come here, it's really sort of hard to ever get your mind around. And it has been an absolute possessing obsession of my entire experience in the US. I've now been here for over 20 years and still think it is an unbelievably, especially I think if you work with marginalized patients and how much their lack of access compounds the difficulty of their lives and their inability to sort of stabilize and feel well and take care of themselves, it's really frustrating.Advice for Bringing Humanities to Medicine in a CareerEric Topol (39:14):Yeah, yeah. Well, I guess my last question to you, is you have weaved together a career that brings humanities to medicine, that doesn't happen that often. What's your advice to some of the younger folks in healthcare as to how to pull that off? Because you were able to do it and it's not easy.Rachael Bedard (39:39):My main advice when people ask me about this, especially to students and to residents who are often the people who are asking is to write when you can or pursue your humanities interests, your critical interests, whatever it is that you're doing. Do it when you can, but trust that your career is long and that you have a lot of time. Because the thing that I would say is I didn't start publishing until I was in fellowship and before that I was busy because I was learning to become a doctor. And I think it's really important that my concern about being a doctor who's a hybrid, which so many of us are now. A doctor or something else is you really do want to be a good doctor. And becoming a good doctor is really hard. And it's okay if the thing that is preoccupying you for the first 10 years of your training is becoming a great clinician. I think that's a really, really important thing to do. And so, for my first 10 years for med school and residency and chief residency and fellowship, I would write privately on the side a fair amount, but not try to publish it, not polish that work, not be thinking in sort of a careerist way about how I was going to become a doctor writer because I was becoming a doctor. And that was really preoccupying.(41:08):And then later on, I both sort of had more time and mental space to work on writing. But also, I had the maturity, I think, of being a person who was comfortable in my clinical identity to have real ideas and insights about medicine that felt different and unique to me as opposed to, I barely understand what's going on around me and I'm trying to pull it together. And that's how I would've been if I had done it more, I think when I was younger. Some people are real prodigies and can do it right out the gate, but I wasn't like that.Eric Topol (41:42):No, no, I think that's really sound advice because that's kind of the whole foundation for everything else. Is there a book in the works or will there be one someday?Rachael Bedard (41:53):There may be one someday. There is not one now. I think about it all the time. And that same advice applies, which is I believe in being a late bloomer and taking your time and figuring out what it is you really want to do.Eric Topol (42:10):Yeah. Well, that's great. Have I missed anything? And obviously we only can get to know you in what, 40 minutes to some extent, but have I not touched on something that you want to bring up?Rachael Bedard (42:23):No, I don't think so. Thank you for this conversation. It's been lovely.Eric Topol (42:28):No, I really enjoyed it. I'll be following your career. It's extraordinary already and you've got decades ahead to make an impact and obviously thinking of all these patients that you look after and have in the past, it's just extraordinary. So what a joy to talk with you, Rachael, and I hope we'll have a chance to do that again in the times ahead.Rachael Bedard (42:51):Me as well. Thank you so much for inviting me.**********************************************Thank you for listening, reading or watching!The Ground Truths newsletters and podcasts are all free, open-access, without ads.Please share this post/podcast with your friends and network if you found it informative!Voluntary paid subscriptions all go to support Scripps Research. Many thanks for that—they greatly help fund our education and summer internship programs.Thanks to my producer Jessica Nguyen and Sinjun Balabanoff for audio and video support at Scripps Research.Note: you can select preferences to receive emails about newsletters, podcasts, or all I don't want to bother you with an email for content that you're not interested in. Get full access to Ground Truths at erictopol.substack.com/subscribe
In this episode, renowned Czech Translator, Alex Zucker spoke about his translated work , the novel - ' Life After Kafka'. The novel was originally written in Czech. Alex Spoke about the book, writer Magdalena, and about bringing the voice of characters into the English translation. Currently he is on a book tour with the author in the USA. There is a link provided in the show notes giving the details of the book Tour.Alex Zucker is a renowned translator of Czech literature into English. He has translated works by acclaimed Czech authors such as Jáchym Topol, and Petra Hůlová.Boo k Tour Details - https://www.blpress.org/books/life-after-kafka/* For your Valuable feedback on this Episode - Please click the link below.https://tinyurl.com/4zbdhrwrHarshaneeyam on Spotify App –https://harshaneeyam.captivate.fm/onspotHarshaneeyam on Apple App – https://harshaneeyam.captivate.fm/onapple*Contact us - harshaneeyam@gmail.com ***Disclaimer: The views and opinions expressed by Interviewees in interviews conducted by Harshaneeyam Podcast are those of the Interviewees and do not necessarily reflect the official policy or position of Harshaneeyam Podcast. Any content provided by Interviewees is of their opinion and is not intended to malign any religion, ethnic group, club, organization, company, individual, or anyone or anything.This podcast uses the following third-party services for analysis: Podtrac - https://analytics.podtrac.com/privacy-policy-gdrpChartable - https://chartable.com/privacy
Rozpad vládní pětikoalice by měl přimět ODS podle bývalého premiéra a někdejšího předsedy této strany Mirka Topolánka k úvahám, jestli projekt Spolu neopustit. Podle něj by měl nyní premiér Petr Fiala (ODS) přijít se zjednodušeným konceptem, jak dovládnout do voleb, které budou příští rok. „Ať se teď stane cokoli, tak značka ODS je ohrožená. A já bych ji chtěl zachránit,“ říká pro Český rozhlas Plus Topolánek.
Rozpad vládní pětikoalice by měl přimět ODS podle bývalého premiéra a někdejšího předsedy této strany Mirka Topolánka k úvahám, jestli projekt Spolu neopustit. Podle něj by měl nyní premiér Petr Fiala (ODS) přijít se zjednodušeným konceptem, jak dovládnout do voleb, které budou příští rok. „Ať se teď stane cokoli, tak značka ODS je ohrožená. A já bych ji chtěl zachránit,“ říká pro Český rozhlas Plus Topolánek. Všechny díly podcastu Osobnost Plus můžete pohodlně poslouchat v mobilní aplikaci mujRozhlas pro Android a iOS nebo na webu mujRozhlas.cz.
Ptáme se prof. MUDr. Ondřeje Topolčana, náměstka ředitele Fakultní nemocnice Plzeň pro vědu a výzkum a primáře oddělení imunochemické diagnostiky.
In “The Deserter,” Sarah A. Topol reports the story of Ivan, a captain in the Russian Army who fought in Ukraine and then ultimately fled the war and his country with his wife, Anna. Topol spoke to 18 deserters while reporting in eight countries across four continents over the last year and a half; their experiences helped paint a vivid picture of the Russian war operation and its corruption, chaos and brutality.Narrated by Liev Schreiber.“The Deserter” is a five-part special series in collaboration with The New York Times Magazine.
In “The Deserter,” Sarah A. Topol reports the story of Ivan, a captain in the Russian Army who fought in Ukraine and then ultimately fled the war and his country with his wife, Anna. Topol spoke to 18 deserters while reporting in eight countries across four continents over the last year and a half; their experiences helped paint a vivid picture of the Russian war operation and its corruption, chaos and brutality.Narrated by Liev Schreiber.“The Deserter” is a five-part special series in collaboration with The New York Times Magazine.All five parts of this audio feature can be found here or by searching for “The Deserter” on the NYT Audio app or wherever you get your podcasts.The text version of the story can be found here.
Svet okolo nás je zložitý a tak sa ho snažíme si zjednodušiť. Občas sa to podarí tak dobre, že z toho vznikne nová oblasť matematiky. Čo je to topológia? Aké rozdiely medzi telesami sú podľa nej dôležité? A ako súvisí so svetom okolo nás? O tom všetkom diskutujú Jozef, Samuel. Máme novú knihu – Rozhovory o vesmíre https://www.martinus.sk/2901887-rozhovory-o-vesmire/kniha Podcastové hrnčeky a ponožky nájdete na stránke https://vedator.space/vedastore/ Vedátora môžete podporiť cez stránku Patreon https://www.patreon.com/Vedator_sk Všetko ostatné nájdete tu https://linktr.ee/vedatorsk Vedátorský newsletter http://eepurl.com/gIm1y5
Oh my! It's the start of Season 3! We begin SEASON 3 with Sci-HIGH-ence Fiction Theater Month, the month where we ask: "what the hell were they on?"
"Ter ouvido e ter vivido são coisas bem diversas em sua natureza psicológica, mesmo quando têm o mesmo conteúdo." Este artigo se encontra no volume 12 das Obras Completas de Freud da Companhia das Letras, na tradução de Paulo César de Souza. --- Support this podcast: https://podcasters.spotify.com/pod/show/freudqueeuteescuto/support
Tématem poslední doby a nejspíš i budoucích dekád je dostavba jaderných bloků v elektrárně Dukovany. Podle bývalého premiéra Mirka Topolánka je jádro jedna z mála cest, které nám mohou pomoci k energetické stabilitě. Evropská unie se nepoučila z minulých krizí, a kromě energetiky se dělí i v řadě dalších otázek. Co z toho vyplývá pro Českou republiku?
This podcast episode features a discussion on the ethical development and use of AI in the field of Applied Behavior Analysis (ABA). The panel, consisting of CentralReach subject matter experts, explores the potential benefits and challenges of integrating AI into ABA practice. They share insights on how AI can be used to enhance efficiency, support clinical decision-making, and maintain high ethical standards. The conversation also expounds upon the importance of transparency, client consent, and the evolving role of behavior analysts in the context of advancing technologies. To earn CEUs for listening, click here, log in or sign up, pay the CEU fee, + take the attendance verification to generate your certificate! Don't forget to subscribe and follow and leave us a rating and review. Show Notes References and Resources: American Nurses Association, ANA Center for Ethics and Human Rights, (2022). The ethical use of artificial intelligence in nursing practice. www.nursingworld.org CentralReach (2024). Ethical AI integration in ABA: A framework for success. https://www.youtube.com/watch?v=uyvBEuUfRbA Cedars Sinai, (2024). Pursuing the ethics of artificial intelligence in healthcare. https://www.cedars-sinai.org/newsroom/pursuing-the-ethics-of-artificial-intelligence-in-healthcare/ Cox, D. J., & Jennings, A. M. (2024). The promises and possibilities of artificial intelligence in the delivery of behavior analytic services. Behavior Analysis in Practice, 17, 123-136. Beam, A. L., & Kohane, I. S. (2018). "Big data and machine learning in health care." JAMA, 319(13), 1317-1318. Ford, E., et al. (2016). "Extracting information from the text of electronic medical records to improve case detection: a systematic review." Journal of the American Medical Informatics Association, 23(5), 1007-1015. Ghafghazi, S., Carnett, A., Neely, L., Das, A., & Rad, P. (2021). AI-Augmented behavior analysis for children with developmental disabilities. Cybernetics Magazine, Vol (10). Grote, T., & Berens, P. (2023). A paradigm shift? On the ethics of medical large language models. Bioethics, 38, 38-390. DOI: 10.1111/bioe.13283 Hosny, A., et al. (2018). "Artificial intelligence in radiology." Nature Reviews Cancer, 18(8), 500-510. Panesar, S., et al. (2019). "Machine learning in neurosurgery: a systematic review." Neurosurgical Focus, 46(5), E2. Rajkomar, A., et al. (2018). "Scalable and accurate deep learning with electronic health records." NPJ Digital Medicine, 1(1), 1-10. Schork, N. J. (2019). "Artificial intelligence and personalized medicine." Cancer Treatment and Research, 178, 265-283. Sheikhalishahi, S., et al. (2019). "Natural language processing of clinical notes on chronic diseases: Systematic review." JMIR Medical Informatics, 7(2), e12239. Stade, E.C., Stirman, S. W., Ungar, L., Boland, C. L., Schwartz, H. A., Yaden, D. B., Sedoc, J., DeRubeis, R. J., Willer, R., Kim, J. P., & Eichstaedt, J.C. (2024). Toward responsible development and evaluation of LLMs in psychotherapy. Stanford University:Human-Centered Artificial Intelligence https://hai.stanford.edu/sites/default/files/2024-06/HAI-Policy-Brief-Responsible-Development-LLMs-Psychotherapy.pdf Topol, E. J. (2019). "High-performance medicine: the convergence of human and artificial intelligence." Nature Medicine, 25(1), 44-56. Torous, J., & Hsin, H. (2018). "Empowering the digital therapeutic relationship: virtual clinics for digital health interventions." NPJ Digital Medicine, 1(1), 1-3. Zhavoronkov, A., et al. (2019). "Deep learning enables rapid identification of potent DDR1 kinase inhibitors." Nature Biotechnology, 37(9), 1038-1040.
For years now, even as headlines about the development of AI have become more frequent and more dire, I really never worried about it much, because I couldn't think of anything in scripture that sounded a great deal like a superintelligent machine. I'd read the end of the book (Revelation), I knew how it ended, and it wasn't in a robot apocalypse... so all the fears surrounding that possibility must therefore be much ado about nothing. (I did write a fictional trilogy for young adults back in 2017 about how I imagined a near-miss robot apocalypse might look, though, because I found the topic fascinating enough to research at the time. It's called the "Uncanny Valley" trilogy, where the "uncanny valley" refers to the "creepy" factor, as a synthetic humanoid creature approaches human likeness.) When I finished the trilogy, I more or less forgot about advancing AI, until some of the later iterations of Chat GPT and similar Large Language Models (LLMs). Full disclosure: I've never used any LLMs myself, mostly because (last I checked) you had to create an account with your email address before you started asking it questions. (In the third book of my series, the superintelligent bot Jaguar kept track of everyone via facial recognition cameras, recording literally everything they did in enormous data processing centers across the globe that synced with one another many times per day. Though at that point I doubt it would make any difference, I'd rather not voluntarily give Jaguar's real-life analog any data on me if I can help it!) Particularly the recent release of Chat GPT Omni (which apparently stands for "omniscient" --!!) gave me pause, though, and I had to stop and ask myself why the idea that it could be approaching actual Artificial General Intelligence (AGI) made the hairs on the back of my neck stand up. I recently read a book called "Deep Medicine" by Eric Topol on the integration of AI into the medical field, which helped allay some potential concerns--that book contended that AGI would likely never be realized, largely because AGI inherently requires experience in the real world, and a robot can never have lived experiences in the way that humans can. It painted a mostly rosy picture of narrow (specialized) AI engaging in pattern recognition (reading radiology images or recognizing pathology samples or dermatological lesions, for instance), and thus vastly improving diagnostic capabilities of physicians. Other uses might include parsing a given individual's years of medical records and offering a synopsis and recommendations, or consolidating PubMed studies, and offering relevant suggestions. Topol did not seem to think that the AI would ever replace the doctor, though. Rather, the author contended, at the rate that data is currently exploding, doctors are drowning in the attempt to document and to keep up with it all, and empathic patient care suffers as a result. AI, he argues, will actually give the doctor time to spend with the patient again, to make judgment calls with a summary of all the data at his fingertips, and to put it together in an integrated whole with his uniquely human common sense. Synthetic Empathy and Emotions? But, "Deep Medicine" was written in 2019, which (in the world of AI) is already potentially obsolete. I'm told that Chat GPT Omni is better than most humans at anything involving either logic or creativity, and it does a terrific approximation of empathy, too. Even "Deep Medicine" cited statistics to suggest that most humans would prefer a machine for a therapist than a person (!!), largely due to the fear that the human might judge them for some of their most secret or shameful thoughts or feelings. And if the machine makes you feel like it understands you, does it really matter whether its empathy is "real" or not? What does "real" empathy mean, anyway? In "Uncanny Valley," my main character, as a teenager, inherited a "companion bot" who was programmed with mirror neurons (the seat of empathy in the human brain.) In the wake of her father's death, she came to regard her companion bot as her best friend. It was only as she got older that she started to ask questions like whether its 'love' for her was genuine, if it was programmed. This is essentially the theological argument for free will, too. Could God have made a world without sin? Sure, but in order to do it, we'd all have to be automatons--programmed to do His will, programmed to love Him and to love one another. Would there be any value in the love of a creature who could not do anything else? (The Calvinists might say that's the way the world actually is, for those who are predestined, but everyone else would vehemently disagree.) It certainly seems that God thought it was worth all the misery He endured since creation, for the chance that some of us might freely choose Him. I daresay that same logic is self-evident to all of us. Freedom is an inherent good--possibly the highest good. So, back to AI: real empathy requires not just real emotion, but memories of one's own real emotions, so that we can truly imagine that we are in another person's shoes. How can a robot, without its own lived memories, experience real empathy? Can it even experience real emotion? It might have goals or motives that can be programmed, but emotion at minimum requires biochemistry and a nervous system, at least in the way we understand it. We know from psychology research on brain lesions as well as from psychiatric and recreational medications and experiences with those suffering from neurodegenerative conditions that mood, affect, and personality can drastically change from physiologic tampering, as well. Does it follow that emotions are 'mere' biochemistry, though? This is at least part of the age-old question of materialism versus vitalism, or (to put it another way), reductionism versus holism. Modern medicine is inherently materialistic, believing that the entirety of a living entity can be explained by its physical makeup, and reductionistic, believing that one can reduce the 'whole' of the living system to a sum of its parts. Vitalism, on the other hand, argues that there is something else, something outside the physical body of the creature, that animates it and gives it life. At the moment just before death and just after, all the same biochemical machinery exists... but anyone who has seen the death of a loved one can attest that the body doesn't look the same. It becomes almost like clay. Some key essence is missing. I recently read "The Rainbow and the Worm" by Mae-Wan Ho, which described fascinating experiments on living worms viewed under electron microscopes. The structured water in the living tissue of the worm exhibited coherence, refracting visible light in a beautiful rainbow pattern. At the moment of death, though, the coherence vanished, and the rainbow was gone--even though all of the same physical components remained. The change is immaterial; the shift between death and life is inherently energetic. There was an animus, a vital force--qi, as Chinese Medicine would call it, or prana, as Ayurvedic medicine would describe it, or (as we're now discovering in alternative Western medicine), voltage carried through this structured water via our collagen. That hydrated collagen appears to function in our bodies very much like a semiconductor, animating our tissues with electrons, the literal energy of life. At the moment of death, it's there, and then it's not--like someone pulled the plug. What's left is only the shell of the machine, the hardware. But where is that plug, such that it can be connected and then, abruptly, not? The materialist, who believes that everything should be explainable on the physical level, can have no answer. The Bible tells us, though, that we are body, soul, and spirit (1 Thess 5:23)--which inherently makes a distinction between body and soul (implying that the soul is not a mere product of the chemistry of the body). The spirit is what was dead without Jesus, and what gets born again when we are saved, and it's perfect, identical with Jesus' spirit (2 Cor. 5:17, Eph 4:24). It's God's "seal" on us, vacuum-packed as it were, so that no sin can contaminate it. It's the down-payment, a promise that complete and total restoration is coming (Eph 1:13-14). But there's no physical outlet connecting the spirit and the body; the connection between them is the soul. With our souls, we can see what's ours in the Spirit through scripture, and scripture can train our souls to conform more and more to the spirit (Romans 12:2, Phil 2:12-13). No one would ever argue that a machine would have a spirit, obviously, but the materialists wouldn't believe there is such a thing, anyway. What about the soul, though? What is a soul, anyway? Can it be explained entirely through materialistic means?Before God made Adam, He explicitly stated that He intended to make man after His own image (Gen 1:26-27). God is spirit (John 4:24), though, so the resemblance can't be physical, per se, at least not exclusively or even primarily. After forming his body, God breathed into him the breath of life (Genesis 2:7)--the same thing Jesus did to the disciples after His resurrection when he said "Receive the Holy Spirit" (John 20:22). So it must therefore be in our spirits that we resemble God. Adam and Eve died spiritually when they sinned (Genesis 3:3), but something continued to animate their bodies for another 930 years. This is the non-corporeal part of us that gets "unplugged" at physical death. Since it can be neither body nor spirit, it must be the soul. Andrew Wommack defines the soul as the mind, will, and emotions. I can't think of a single scripture that defines the soul this way; I think it's just an extrapolation, based on what's otherwise unaccounted for. But in our mind, will, and emotions, even before redemption, mankind continued to reflect God's image, in that he continued to possess the ability to reason, to choose, to create, to love, and to discern right from wrong. The materialists would argue that emotion, like everything else, must have its root purely in the physical realm. Yet they do acknowledge that because there are so many possible emotional states, and relatively few physiologic expressions of them, many emotions necessarily share a physiologic expression. It's up to our minds to translate the meaning of a physiologic state, based on the context. In "How Emotions are Made," author Lisa Barrett gave a memorable example of this: once, a colleague to whom she didn't think she was particularly attracted asked her for a date. She went, felt various strange things in her gut that felt a little like “butterflies”, and assumed during the date that perhaps she was attracted to him after all… only to later learn that she was actually in the early stages of gastroenteritis! This example illustrates how the biochemistry and physiologic expressions of emotion are merely the blunt downstream instruments that translate an emotion from the non-corporeal soul into physical perception--and in some cases, as in that one, the emotional perception might originate from the body entirely. This also might be why some people (children especially) can mistake hunger or fatigue for irritability, or why erratic blood sugar in uncontrolled diabetics can manifest as rage, etc. In those cases, the emotional response really does correspond to the materialist's worldview, originating far downstream in the "circuit," as it were. But people who experience these things as adults will say things like, "That's not me." I think they're right--when we think of our true selves, none of us think of our bodies--those are just our "tents" (2 Cor 5:1), to be put off eventually when we die. When we refer to our true selves, we mean our souls: our mind, will, and emotions. It's certainly possible for many of us to feel "hijacked" by our emotions, as if they're in control and not "us," though (Romans 7:15-20). Most of us recognize a certain distinction there, too, between the real "us" and our emotions. The examples of physiologic states influencing emotions are what scripture would call "carnal" responses. If we're "carnal," ruled by our flesh, then physiologic states will have a great deal of influence over our emotions-- a kind of small scale anarchy. The "government" is supposed to be our born-again spirits, governing our souls, which in turn controls our bodies, rather than allowing our flesh to control our souls (Romans 8:1-17) - though this is of course possible if we don't enforce order. With respect to AI, my point is, where does "true" emotion originate? There is a version of it produced downstream, in our flesh, yes. It can either originate from the flesh itself, or it can originate upstream, from the non-corporeal soul, what we think of us "the real us." That's inherently a philosophical and not a scientific argument, though, as science by definition is "the observation, identification, description, experimental investigation, and theoretical explanation of phenomena." Any question pertaining to something outside the physical world cannot fall under the purview of science. But even for those who do not accept scripture as authority, our own inner experience testifies to the truth of the argument. We all know that we have free will; we all know we can reason, and feel emotions. We can also tell the difference between an emotion that is "us" and an emotion that feels like it originates from outside of "our real selves". As C.S. Lewis said in "Mere Christianity," if there is a world outside of the one we can experimentally observe, the only place in which we could possibly expect to have any evidence of it is in our own internal experience. And there, we find it's true. Without a soul, then, a robot (such as an LLM) would of course exist entirely on the physical plane, unlike us. It therefore might have physical experiences that it might translate as emotion, the same way that we sometimes interpret physical experiences as emotion--but it cannot have true emotions. Empathy, therefore, can likewise be nothing more than programmed pattern recognition: this facial expression or these words or phrases tend to mean that the person is experiencing these feelings, and here is the appropriate way to respond. Many interactions with many different humans over a long period of time will refine the LLM's learning such that its pattern recognition and responses get closer and closer to the mark... but that's not empathy, not really. It's fake. Does that matter, though, if the person "feels" heard and understood? Well, does truth matter? If a man who is locked up in an insane asylum believes himself to be a great king, and believes that all the doctors and nurses around him are really his servants and subjects, would you trade places with him? I suspect that all of us would say no. With at least the protagonists in "The Matrix," we all agree that it's better to be awakened to a desperate truth than to be deceived by a happy lie. The Emotional Uncanny Valley Even aside from that issue, is it likely that mere pattern recognition could simulate empathy well enough to satisfy us--or is it likely that this, too, would fall into the "uncanny valley"? Most of us have had the experience of meeting a person who seems pleasant enough on the surface, and yet something about them just seemed ‘off'. (The Bible calls this discernment, 1 Corinthians 12:10.) When I was in a psychology course in college, the professor flashed images of several clean-cut, smiling men in the powerpoint, out of context, and asked us to raise our hands if we would trust each of them. I don't remember who most of them were - probably red herrings to disguise the point - but one of them was Ted Bundy, the serial killer of the 1970s. I didn't recognize him, but I did feel a prickling sense of unease as I gazed at his smiling face. Something just wasn't right. Granted, a violent psychopath is not quite the same, but isn't the idea of creating a robot possessed of emotional intelligence (in the sense that it can read others well) but without real empathy essentially like creating an artificial sociopath? Isn't the lack of true empathy the very definition? (Knowing this, would we really want jobs like social workers, nurses, or even elementary school teachers to be assumed by robots--no matter how good the empathic pattern recognition became?) An analogy of this is the 1958 Harlow experiment on infant monkeys (https://www.simplypsychology.org/harlow-monkey.html), in which the monkeys were given a choice between two simulated mothers: one made of wire, but that provided milk, and one made of cloth, but without milk. The study showed that the monkeys would only go to the wire mother when hungry; the rest of the day they would spend in the company of the cloth mother. My point is that emotional support matters to all living creatures, far more than objective physical needs (provided those needs are also met). If we just want a logical problem solved, we may well go to the robot. But most of our problems are not just questions of logic; they involve emotions, too. As Leonard Mlodinow, author of "Emotional" writes, emotions are not mere extraneous data that colors an experience, but can otherwise be ignored at will. In many cases, the emotions actually serve to motivate a course of action. Every major decision I've ever made in my life involved not just logic, but also emotion, or in some cases intuition (which I assume is a conscious prompting when the unconscious reasoning is present but unknown to me), or a else leading of the Holy Spirit (which "feels" like intuition, only without the presumed unconscious underpinning. He knows the reason, but I don't, even subconsciously.) Obviously, AI, with synthetic emotion or not, would have no way to advise us on matters of intuition, or especially promptings from the Holy Spirit. Those won't usually *seem* logical, based on the available information, but He has a perspective that we don't have. Neither will a machine, even if it could simultaneously process all known data available on earth. There was a time when Newtonian physicists believed that, with access to that level of data in the present, the entire future would become deterministic, making true omniscience in this world theoretically possible. Then we discovered quantum physics, and all of that went out the window. Heisenberg's Uncertainty Principle eliminates the possibility that any creature or machine, no matter how powerful, can in our own dimension ever truly achieve omniscience. In other words, even a perfectly logical machine with access to all available knowledge will fail to guide us into appropriate decisions much of the time -- precisely because they must lack true emotion, intuition, and especially the guidance of the Holy Spirit. Knowledge vs Wisdom None of us will be able to compete with the level of knowledge an AI can process in a split second. But does that mean the application of that knowledge will always be appropriate? I think there's several levels to this question. The first has to do with the data sets on which AI has been trained. It can only learn from the patterns it's seen, and it will (like a teenager who draws sweeping conclusions based on very limited life experience) assume that it has the whole picture. In this way, AI may be part of the great deception mentioned by both Jesus (Matt 24:24) and the Apostle Paul (2 Thess 2:11) in the last days. How many of us already abdicate our own reasoning to those in positions of authority, blindly following them because we assume they must know more than we do on their subject? How much more will many of us fail to question the edicts of a purportedly "omniscient" machine, which must know more than we do on every subject? That machine may have only superficial knowledge of a subject, based on the data set it's been given, and may thus draw an inappropriate conclusion. (Also, my understanding is that current LLMs continue learning only until they are released into the world; from that point, they can no longer learn anything new, because of the risk that in storing new information, they could accidentally overwrite an older memory.) A human may draw an inappropriate conclusion too, of course, and if that person has enough credentials behind his name, it may be just as deceptive to many. But at least one individual will not command such blind obedience on absolutely every subject. AGI might. So who controls the data from which that machine learns? That's a tremendous responsibility... and, potentially, a tremendous amount of power, to deceive, if possible, "even the elect." For the sake of argument, let's say that the AGI is exposed only to real and complete data, though--not cherry-picked, and not "misinformation." In this scenario, some believe that (if appropriate safeguards are in place, to keep the AGI from deciding to save the planet by killing all the humans, for example, akin to science fiction author Isaac Asimov's Three Laws of Robotics), utopia will result. The only way this is possible, though, is if not only does the machine learn on a full, accurate, and complete set of collective human knowledge, but it also has a depth of understanding of how to apply that knowledge, as well. This is the difference between knowledge and wisdom. The dictionary definition of wisdom is "the ability to discern or judge what is true, right, or lasting," versus knowledge, defined as "information gained through experience, reasoning, or acquaintance." Wisdom has to do with one's worldview, in other words, or the lens through which he sees and interprets a set of facts. It is inextricably tied to morality. (So, who is programming these LLMs again? Even without AI, since postmodernism and beyond, there's been a crisis among many intellectuals as to whether or not there's such a thing as "truth," even going so far as to question objective physical reality. That's certainly a major potential hazard right there.) Both words of wisdom and discernment are listed as explicit supernatural gifts of the Spirit (1 Cor 12:8, 10). God says that He is the source of wisdom, as well as of knowledge and understanding (Prov 2:6), and that if we lack wisdom, we should ask Him for it (James 1:5). Wisdom is personified in the book of Proverbs as a person, with God at creation (Prov 8:29-30)--which means, unless it's simply a poetic construct, that wisdom and the Holy Spirit must be synonymous (Gen 1:2). Jesus did say that it was the Holy Spirit who would guide us into all truth, as He is the Spirit of truth (John 16:13). The Apostle Paul contrasts the wisdom of this world as foolishness compared to the wisdom of God (1 Cor 1:18-30)--because if God is truth (John 14:6), then no one can get to true wisdom without Him. That's not to say that no human (or robot) can make a true statement without an understanding of God, of course--but when he does so, he's borrowing from a worldview not his own. The statement may be true, but almost by accident--on some level, if you go down deep enough to bedrock beliefs, there is an inherent inconsistency between the statement of truth and the person's general worldview, if that worldview does not recognize a Creator. (Jason Lisle explains this well and in great detail in "The Ultimate Proof of Creation.") Can you see the danger of trusting a machine to discern what is right, then, simply because in terms of sheer facts and computing power, it's vastly "smarter" than we are? Anyone who does so is almost guaranteed to be deceived, unless he also filters the machine's response through his own discernment afterwards. (We should all be doing this with statements from any human authority on any subject, too, by the way. Never subjugate your own reasoning to anyone else's, even if they do know the Lord, but especially if they don't. You have the mind of Christ! 1 Cor 2:16). Would Eliminating Emotion from the Workplace Actually Be a Good Thing? I can see how one might think that replacing a human being with a machine that optimizes logic, but strips away everything else might seem a good trade, on the surface. After all, we humans (especially these days) aren't very logical, on the whole. Our emotions and desires are usually corrupted by sin. We're motivated by selfishness, greed, pride, and petty jealousies, when we're not actively being renewed by the Holy Spirit (and most of us aren't; even most believers are more carnal than not, most of the time. I don't know if that's always been the case, but it seems to be now). We also are subject to the normal human frailties: we get sick, or tired, or cranky, or hungry, or overwhelmed. We need vacations. We might be distracted by our own problems, or apathetic about the task we've been paid to accomplish. Machines would have none of these drawbacks. But do we really understand the trade-off we're making? We humans have a tendency to take a sliver of information, assume it's the whole picture, and run with it--eliminating everything we think is extraneous, simply because we don't understand it. In our hubris, we don't stop to consider that all the elements we've discarded might actually be critical to function. This seems to me sort of like processed food. We've taken the real thing the way God made it, and tweaked it in a laboratory to make it sweeter, crunchier, more savory, and with better "mouth feel.” It's even still got the same number of macronutrients and calories that it had before. But we didn't understand not only how processing stripped away necessary micronutrients, but also added synthetic fats that contaminated our cell membranes, and chemicals that can overwhelm our livers, making us overweight and simultaneously nutrient depleted. We just didn't know what we didn't know. We've done the same thing with genetically engineered foods. God's instructions in scripture were to let the land lie fallow, and to rotate crops, because the soil itself is the source of micronutrition for the plant. If you plant the same crop in the same soil repeatedly and without a break, you will deplete the soil, and the plants will no longer be as nutritious, or as healthy... and an unhealthy plant is easy prey for pests. But the agriculture industry ignored this; it didn't seem efficient or profitable enough, presumably. Synthetic fertilizer is the equivalent of macronutrients only for plants, so they grow bigger than ever before (much like humans do if they subsist on nothing but fast food), but they're still nutrient depleted and unhealthy, and thus, easy prey for pests. So we added the gene to the plants to make them produce their own glyphosate, the active ingredient in RoundUp. Only glyphosate itself turns out to be incredibly toxic to humans, lo and behold... There are many, many more examples I can think of just in the realm of science, health, and nutrition, to say nothing of our approach to economics, or climate, or many other complex systems. We tend to isolate the “active ingredient,” and eliminate everything we consider to be extraneous… only to learn of the side effects decades later. So what will the consequences be to society if most workers in most professions eventually lack true emotion, empathy, wisdom, and intuition? Finding Purpose in Work There's also a growing concern that AI will take over nearly all jobs, putting almost everyone out of work. At this point, it seems that information-based positions are most at risk, and especially anything involving repetitive, computer-based tasks. I also understand that AI is better than most humans at writing essays, poetry, and producing art. Current robotics is far behind AI technology, though... Elon Musk has been promising self-driving cars in the eminent future for some time, yet they don't seem any closer to ubiquitous adoption now than they were five years ago. "A Brief History of Intelligence" by Max Bennett, published in fall 2023, said that as of the time of writing, robots can diagnose tumors from radiographic imaging better than most radiologists, yet they are still incapable of simple physical tasks such as loading a dishwasher without breaking things. (I suspect this is because the former involves intellectual pattern recognition, which seems to be their forte, while the latter involves movements that are subconscious for most of us, requiring integration of spatial recognition, balance, distal fine motor skills, etc. We're still a very long way from understanding the intricacies of the human brain... but then again, the pace at which knowledge is doubling is anywhere from every three to thirteen months, depending on the source. Either way, that's fast). On the assumption that we'll soon be able to automate nearly everything a human can do physically or intellectually, then, the world's elite have postulated a Universal Basic Income--essentially welfare for all, since we would in theory be incapable of supporting ourselves. Leaving aside the many catastrophically failed historical examples of socialism and communism, it's pretty clear that God made us for good work (Eph 2:10, 2 Cor 9:8), and He expects us to work (2 Thess 3:10). Idleness while machines run the world is certainly not a biblical solution. That said, technology in and of itself is morally neutral. It's a tool, like money, time, or influence, and can be used for good or for evil. Both the Industrial Revolution and in the Information Revolution led to plenty of unforeseen consequences and social upheaval. Many jobs became obsolete, while new jobs were created that had never existed before. Work creates wealth, and due to increased efficiency, the world as a whole became wealthier than ever before, particularly in nations where these revolutions took hold. In the US, after the Industrial Revolution, the previously stagnant average standard of living suddenly doubled every 36 years. At the same time, though, the vast majority of the wealth created was in the hands of the few owners of the technology, and there was a greater disparity between the rich and the poor than ever before. This disparity has only grown more pronounced since the Information Revolution--and we have a clue in Revelation 6:5-6 that in the end times, it will be worse than ever. Will another AI-driven economic revolution have anything to do with this? It's certainly possible. Whether or not another economic revolution should happen has little bearing on whether or not it will, though. But one thing for those of us who follow the Lord to remember is that we don't have to participate in the world's economy, if we trust Him to meet our needs. He is able to make us abound for every good work (2 Cor 9:8)--which I believe means we will also have some form of work, no matter what is going on in the world around us. He will bless the work of our hands, whatever we find for them to do (Deut 12:7). He will give us the ability to produce wealth (Deut 8:18), even if it seems impossible. He will meet all our needs as we seek His kingdom first (Luke 12:31-32)-and one of our deepest needs is undoubtedly a sense of purpose (Phil 4:19). We are designed to fulfill a purpose. What about the AI Apocalyptic Fears? The world's elite seem to fall into two camps on how an AI revolution might affect our world--those who think it will usher in utopia (Isaac Asimov's “The Last Question” essentially depicts this), and those who think AI will decide that humans are the problem, and destroy us all. I feel pretty confident the latter won't occur, at least not completely, since neither Revelation nor any of the rest of the prophetic books seem to imply domination of humanity by machine overlords. Most, if not all of the actors involved certainly appear to be human (and angelic, and demonic). That said, there are several biblical references that the end times will be "as in the days of Noah" (Matt 24:27, Luke 17:26). What could that mean? Genesis 6 states that the thoughts in the minds of men were only evil all the time, so it may simply mean that in the end times, mankind will have achieved the same level of corruption as in the antediluvian world. But that might not be all. In Gen 6:1-4, we're told that the "sons of God" came down to the "daughters of men," and had children by them--the Nephilim. This mingling of human and non-human corrupted the genetic line, compromising God's ability to bring the promised seed of Eve to redeem mankind. Daniel 2:43 also reads, "As you saw iron mixed with ceramic clay, they (in the end times) will mingle with the seed of men; but they will not adhere to one another, just as iron does not mix with clay." What is "they," if not the seed of men? It appears to be humanity, plus something else. Chuck Missler and many others have speculated that this could refer to transhumanism, the merging of human and machine. Revelation 13:14-15 is probably the most likely description I can think of in scripture of AI, describing the image of the beast that speaks, knows whether or not people worship the beast (AI facial recognition, possibly embedded into the "internet of things"?), and turns in anyone who refuses to do so. The mark of the beast sure sounds like a computer chip of some kind, with an internet connection (Bluetooth or something like it - Rev 13:17). Joel 2:4-9 describes evil beings "like mighty men" that can "climb upon a wall" and "when they fall upon the sword, they shall not be wounded," and they "enter in at the windows like a thief." These could be demonic and thus extra-dimensional, but don't they also sound like “The Terminator,” if robotics ever manages to advance that far? Jeremiah 50:9 says, "their arrows shall be like those of an expert warrior; none shall return in vain." This sounds like it could be AI-guided missiles. But the main evil actors of Revelation--the antichrist, the false prophet, the kings of the east, etc, all certainly appear to refer to humans. And from the time that the "earth lease" to humanity is up (Revelation 11), God Himself is the One cleansing the earth of all evil influences. I doubt He uses AI to do it. So, depending upon where we are on the prophetic timeline, I can certainly imagine AI playing a role in how the events of Revelation unfold, but I can't see how they'll take center stage. For whatever reason, it doesn't look to me like they'll ever get that far. The Bottom Line We know that in the end times, deception will come. We don't know if AI will be a part of it, but it could be. It's important for us to know the truth, to meditate on the truth, to keep our eyes focused on the truth -- on things above, and not on things beneath (Col 3:2). Don't outsource your thinking to a machine; no matter how "smart" they become, they will never have true wisdom; they can't. That doesn't mean don't use them at all, but if you do, do so cautiously, check the information you receive, and listen to the Holy Spirit in the process, trusting Him to guide you into all truth (John 16:13). Regardless of how rapidly or dramatically the economic landscape and the world around us may change, God has not given us a spirit of fear, but of power, love, and a sound mind (2 Tim 1:7). Perfect love casts out fear (1 John 4:18), and faith works through love (Gal 5:6). If we know how much God loves us, it becomes easy to not be anxious about anything, but in everything, by prayer and petition, with thanksgiving, present our requests to God... and then to fix our minds on whatever is true, noble, just, pure, lovely, of good report, praiseworthy, or virtuous (Phil 4:6-8). He knows the end from the beginning. He's not surprised, and He'll absolutely take care of you in every way, if you trust Him to do it (Matt 6:33-34). Discover more Christian podcasts at lifeaudio.com and inquire about advertising opportunities at lifeaudio.com/contact-us.
Evan Mullen is a resident in the Department of Medicine at Stanford University. Stephen Morrissey, the interviewer, is the Executive Managing Editor of the Journal. E. Mullen, E.J. Topol, and A. Verghese. Academic Freedom in America — In Support of Institutional Voices. N Engl J Med 2024;391:1-3.
Really, 007! chatted to the delightful actor and figure skater Lynn-Holly Johnson about her memorable role as Bibi Dahl.She shares stories from the set of For Your Eyes Only, including filming with John Glen, Roger Moore and Topol, as well as meeting Charles & Diana at the Royal Premiere... Thanks for listening - we think you'll love it too! Disclaimer: Really, 007! is an unofficial entity and is not affiliated with EON Productions, Metro-Goldwyn-Mayer Studios Inc. and Danjaq, LLC. Hosted on Acast. See acast.com/privacy for more information.
La tertulia semanal en la que repasamos las últimas noticias de la actualidad científica. En el episodio de hoy: Cara A: -Universo entre Canciones (8:20) -Fallecimiento de Bill Anders y Ed Stone (12:30) -Prueba IFT4 de Starship (hablamos de IFT3 en el ep 456) (20:00) -Patrocinio de Babbel (código COFFEEBREAK en la oferta de 3 meses + 3 meses gratis) (44:30) -La noticia de los defectos topológicos como materia oscura (sobre defectos topológicos hablamos en ep250) (48:00) Este episodio continúa en la Cara B. Contertulios: Jose Edelstein, Francis Villatoro, Héctor Socas. Imagen de portada realizada con Midjourney. Todos los comentarios vertidos durante la tertulia representan únicamente la opinión de quien los hace... y a veces ni eso.
La tertulia semanal en la que repasamos las últimas noticias de la actualidad científica. En el episodio de hoy: Cara B: -La noticia de los defectos topológicos como materia oscura (sobre defectos topológicos hablamos en ep250) (00:01) -Recogida de muestras lunares de Chang'e 6 (11:51) -Conferencia Benasque (Huesca) y Amplitudes 2024 (20:51) -Las auroras de Mayo vistas por la sonda MAVEN en Marte (ver ep454 para corrientes ionosféricas inducidas) (47:41) -Gliese 12 b, un exoplaneta templado a solo 12pc (55:21) -Cómo usar una misión a Urano para detectar ondas gravitacionales (1:25:51) -Agujero negro de masa intermedia en el cúmulo M15 (1:39:21) Este episodio es continuación de la Cara A. Contertulios: Jose Edelstein, Francis Villatoro, Gaston Giribet, Héctor Socas. Imagen de portada realizada con Midjourney. Todos los comentarios vertidos durante la tertulia representan únicamente la opinión de quien los hace... y a veces ni eso.
„Úplně živoucí Václav Havel,“ rozplývá se spisovatel Jáchym Topol nad jedinou reportáží z vězení, kterou exprezident sám k vydání nepřipravil. Světlo světa spatří při výročí založení Knihovny Václava Havla, která si už dvacet let za cíl klade kultivaci veřejné debaty. Proč si její ředitel nemyslí, že bychom na tom byli s otevřeností dialogu tak špatně, jak se mnozí obávají? „Myslím, že jsme se dokázali do velké míry zbavit přetvářky, ve které jsme vyrůstali,“ míní Topol.Všechny díly podcastu Host Lucie Výborné můžete pohodlně poslouchat v mobilní aplikaci mujRozhlas pro Android a iOS nebo na webu mujRozhlas.cz.
„Úplně živoucí Václav Havel,“ rozplývá se spisovatel Jáchym Topol nad jedinou reportáží z vězení, kterou exprezident sám k vydání nepřipravil. Světlo světa spatří při výročí založení Knihovny Václava Havla, která si už dvacet let za cíl klade kultivaci veřejné debaty. Proč si její ředitel nemyslí, že bychom na tom byli s otevřeností dialogu tak špatně, jak se mnozí obávají? „Myslím, že jsme se dokázali do velké míry zbavit přetvářky, ve které jsme vyrůstali,“ míní Topol.
Think about the last time you felt let down by the health care system. You probably don't have to go back far. In wealthy countries around the world, medical systems that were once robust are now crumbling. Doctors and nurses, tasked with an ever expanding range of responsibilities, are busier than ever, which means they have less and less time for patients. In the United States, the average doctor's appointment lasts seven minutes. In South Korea, it's only two.Without sufficient time and attention, patients are suffering. There are 12 million significant misdiagnoses in the US every year, and 800,000 of those result in death or disability. (While the same kind of data isn't available in Canada, similar trends are almost certainly happening here as well).Eric Topol says medicine has become decidedly inhuman – and the consequences have been disastrous. Topol is a cardiologist and one of the most widely cited medical researchers in the world. In his latest book, Deep Medicine, he argues that the best way to make health care human again is to embrace the inhuman, in the form of artificial intelligence.Mentioned:“Deep Medicine: How Artificial Intelligence Can Make Healthcare Human Again” by Eric Topol“The frequency of diagnostic errors in outpatient care: estimations from three large observational studies involving US adult populations” by H. Singh, A. Meyer, E. Thomas“Burden of serious harms from diagnostic error in the USA” by David Newman-Toker, et al.“How Expert Clinicians Intuitively Recognize a Medical Diagnosis” by J. Brush Jr, J. Sherbino, G. Norman“A Randomized Controlled Study of Art Observation Training to Improve Medical Student Ophthalmology Skills” by Jaclyn Gurwin, et al.“Abridge becomes Epic's First Pal, bringing generative AI to more providers and patients, including those at Emory Healthcare”“Why Doctors Should Organize” by Eric Topol“How This Rural Health System Is Outdoing Silicon Valley” by Erika FryFurther Reading:"The Importance Of Being" by Abraham Verghese
In this episode, Senior translator Alex Zucker spoke about his work, Translation contracts and the Czech Author Jachym Topol.Alex Zucker has translated novels by the Czech authors Magdaléna Platzová, Jáchym Topol, Bianca Bellová, Petra Hůlová, J. R. Pick, Tomáš Zmeškal, Josef Jedlička, Heda Margolius Kovály, Patrik Ouředník, and Miloslava Holubová. He has also Englished stories, plays, subtitles, young adult and children's books, song lyrics, reportages, essays, poems, philosophy, art history, and an opera. Apart from translating, he organises, on a volunteer basis, with the National Writers Union and the New York City chapter of SURJ (Showing Up for Racial Justice). Conversation: Harshaneeyam: Welcome, Alex, to Harshaneeyam.Alex Zucker: Hi, Anil. I am so glad to be here. Thank you for having me. Harshaneeyam: Before we move on to your literary journey, translations and all, I follow you on Twitter, and I see that you are very vocal about the current situation in Gaza. I also read that you worked for a human rights organisation earlier.Alex Zucker: Yes, of course. For about five years, I was the communications officer for a genocide prevention organisation called the Auschwitz Institute for Peace and Reconciliation, AIPR. Now, as a communications officer, I was always a little bit disturbed at our name, because actually we had nothing to do with peace and reconciliation. We were working in genocide prevention. But they've since changed their name, by the way. But [that was] after I left. This was a small organisation, about five staff people based in New York City, doing education and training for mid-level government officers in genocide prevention. The idea of the organisation was that, all too often in history, there are government leaders whose countries are engaging in atrocities that are not quite maybe yet at genocide, or [actually] genocide, and of course there can be resistance from outside the government, [but] unless the government decides to stop it, it's not going to stop. So the idea of [AIPR] was if they could get to these mid-level government officials, those people would rise up [through the ranks] and become the leaders of their country, and they would be people committed to preventing genocide. I want to say also that by prevention, what we meant was not military intervention. That's stopping, maybe, a genocide in progress, but preventing meaning that it never happens in the first place. Also, keeping in mind that genocide, as people have been pointing out in relation to the situation in Gaza, but as in any genocide, it doesn't necessarily involve killing, right? It can be preventing births within a group, any kind of creation of conditions that make it impossible for a group to survive. The key is that the intention is to destroy the group as such. So it has to be focused on a group of people, not just individuals. Having worked in that organisation for five years, I read a lot about genocide historically. I also was following very closely many genocides that were happening in the world at that time. For instance, in Myanmar, in the Democratic Republic of Congo, which is happening again now, in Sudan, that was happening the first time back then. I think the reason that I feel compelled to speak up about Gaza is because the genocide is being perpetrated by a state, Israel, that gets a huge amount of support from the government that I pay taxes to. To me, that's a very straightforward moral and ethical equation. 95 per cent of the aid that the U.S. sends to Israel is military, right? Russia's invasion of Ukraine, now the second time, two years ago, and probably committing genocide there as well, but none of my money goes to Russia, so I don't feel responsible [for that]. I mean, it's not that I don't care about what's happening to Ukrainians, but as a human...
Traditioooon! On the one hand, listen to this episode for piously popping-off bangers. On the other hand, listen to this episode for daughters dating increasingly problematic bad-boys. The person most confused by the film this week was: Tevye, our king and eternal mood. See omnystudio.com/listener for privacy information.
What do a nine minute song about a bird, the chest hair of Israel's greatest entertainer, an FBI pursuit of a missing lead sheet, and a list of firings as long as Paul Sorvino's range have in common? They were all part of the madcap, wild, manic, and tumultuous ride of Stephen Schwartz and Joseph Stein's The Baker's Wife. Get ready as original cast members Carole Demas, Kurt Peterson, Teri Ralston, as well as original press agent Joshua Ellis, look back on Topol, Patti LuPone, David Merrick, and a meadowlark longing to break free. BROADWAY BOUND PLAYERS Nicole Weitzman as Patti LuPone Cole Winston as Stephen Schwartz If you like what we are doing DONATE HERE Fair use is a legal doctrine that promotes freedom of expression by permitting the unlicensed use of copyright-protected works in certain circumstances. Section 107 of the Copyright Act of 1976 provides the statutory framework for determining whether something is a fair use and identifies certain types of uses—such as criticism, comment, news reporting, teaching, scholarship, and research—as examples of activities that qualify as fair use.
View the Show Notes For This EpisodeGet Free Weekly Health Tips from Dr. HymanSign Up for Dr. Hyman's Weekly Longevity JournalGet Ad-free Episodes & Dr. Hyman+ Audio ExclusivesDr. Eric Topol is the Founder and Director of the Scripps Research Translational Institute, Professor of Molecular Medicine, and Executive Vice-President of Scripps Research. He has published over 1,200 peer-reviewed articles with more than 330,000 citations, was elected to the National Academy of Medicine, and is one of the top 10 most cited researchers in medicine. His principal scientific focus has been on individualized medicine using genomic, digital, and AI tools.This episode is brought to you by Rupa Health, Pendulum, Thrive Market, and Fatty15.Streamline your lab orders with Rupa Health. Access more than 3,000 specialty lab tests and register for a FREE live demo at RupaHealth.com.Pendulum is offering listeners 20% off their first month's subscription of Akkermansia for gut health. Visit PendulumLife.com and use code HYMAN.Head over to thrivemarket.com/Hyman today to receive 30% off your first order and a free gift up to $60.Fatty15 contains pure, award-winning C15:0 in a bioavailable form. Get an exclusive 10% off a 90-day starter kit subscription. Just visit Fatty15.com and use code DRHYMAN10 to get started.In this episode we discuss (audio version / Apple Subscriber version):The first phase of AI's application in medicine (7:19 / 5:40)How medicine will incorporate AI over the next few years (9:59 / 8:19)Retinal imaging (16:45 / 15:05)Expert-informed AI (20:02 / 18:23)The impending and biggest shake-up in the history of medicine (22:18 / 20:38)How AI can improve issues of medical error (26:08 / 24:29)Using AI to personalize medicine and prevent disease (33:01 / 29:11)The obesity crisis and toxic food environment (41:04 / 37:14)How AI can help restore the patient-doctor relationship (46:53 / 43:03)Using AI as a guide for medical self care (50:34 / 46:44)Reimagining research in the era of AI-enabled medicine (56:58 / 53:07)Dr. Topol's Substack, Ground Truths.Deep Medicine: How Artificial Intelligence Can Make Healthcare Human Again Hosted on Acast. See acast.com/privacy for more information.
Having experienced the extravagance of Moonraker, Michael, Rob, and Karen are not upset at all when the Bond series goes back to basics in For Your Eyes Only. John Glen makes his directorial debut, Roger Moore returns as an age-appropriate Bond, and there are plenty of twists and turns with Carole Bouquet (sigh), Julian Glover, Topol, and... is that Charles Dance?
Today, I'm so excited to announce my episode with veteran actor Richard Topol, who is starring in Our Class at BAM through February 4th. Tune in to hear fascinating stories, including: how he almost went on for Al Pacino, what it was like acting with Larry David, how he got Covid at a theater in March 2020, a mask mishap during PRAYER FOR THE FRENCH REPUBLIC, the power of Larry Kramer's JUST SAY NO, working on THE SCHOOL FOR SCANDAL with Tony Randall, the loyalty of Denzel Washington, the Rubik's Cube of INDECENT, and so much more.
Welcome to Hooked on Movies!! In the month of January, we will remember stars that we lost in 2023. In this episode we are celebrating the career of Topol with his role in the movie Fiddler on the Roof which came out in 1971 --- Send in a voice message: https://podcasters.spotify.com/pod/show/hookedonmovies/message
Hosté: Přemysl Sobotka (ODS), bývalý předseda Senátu Petr Blažek, ředitel, Muzeum paměti XX. století, historik, Ústav pro studium totalitních režimů Jáchym Topol, programový ředitel, Knihovna Václava Havla Pořadem provázela Jana Peroutková. https://www.ceskatelevize.cz/porady/1096898594-udalosti-komentare/224411000370116/
Our annual look at the musical theatre giants who left us in 2023: Fiddler on the Roof's Topol, Sheldon Harnick, and Joanna Merlin, as well as Tony Bennett, Harry Belafonte, Inga Swenson, and more.
Un trabajo reciente continua con los esfuerzos realizados por matemáticos y geómetras para entender la dinámica del mundo financiero con la intención de desarrollar un "sistema de alerta sísmica" que permitiría anticipar el desarrollo de una crísis financiera con meses e incluso años de anticipación. Gracias por sus comentarios, interacciones, apoyo económico y suscripción. Escuche y descargue gratuitamente en MP3 2023/11/14 Finanzas Topológicas. Gracias por su apoyo a El Explicador en: Patreon, https://www.patreon.com/elexplicador_enriqueganem PayPal, elexplicadorpatrocinio@gmail.com SoundCloud, https://soundcloud.com/el-explicador Spotify, https://open.spotify.com/show/01PwWfs1wV9JrXWGQ2MrbY iTunes, https://podcasts.apple.com/mx/podcast/el-explicador-sitio-oficial/id1562019070 Amazon Music, https://music.amazon.com/podcasts/f2656899-46c8-4d0b-85ef-390aaf20f366/el-explicador-sitio-oficial YouTube, https://youtube.com/c/ElExplicadorSitioOficial Twitter @enrique_ganem Lo invitamos a suscribirse a estas redes para recibir avisos de nuestras publicaciones y visitar nuestra página http://www.elexplicador.net. En el título de nuestros trabajos aparece la fecha año/mes/día de grabación, lo que facilita su consulta cronológica, ya sabe usted que el conocimiento cambia a lo largo del tiempo. Siempre leemos sus comentarios, no tenemos tiempo para reponder a cada uno personalmente pero todos son leídos y tomados en cuenta. Este es un espacio de divulgación científica en el que nos interesa informar de forma clara y amena, que le invite a Ud. a investigar sobre los temas tratados y a que Ud. forme su propia opinión. Serán borrados todos los comentarios que promuevan la desinformación, charlatanería, odio, bullying, violencia verbal o incluyan enlaces a páginas que no sean de revistas científicas arbitradas, que sean ofensivos hacia cualquier persona o promuevan alguna tendencia política o religiosa ya sea en el comentario o en la fotografía de perfil. Aclaramos que no somos apolíticos, nos reservamos el derecho de no expresar nuestra opinión política, ya que éste es un canal cuya finalidad es la divulgación científica. ¡Gracias por su preferencia!
You've probably heard that there's an updated COVID-19 vaccine on the market, and maybe you've already gotten your updated booster. But there are new kinds of vaccines in development that go beyond just tweaking protection to better cover circulating variants.In one promising development, researchers adapted the decades-old MMR (measles, mumps, and rubella) vaccine into one covering measles, mumps, and multiple variants of SARS-CoV-2—and, rather than a shot, they delivered that experimental vaccine via a nasal spray.Dr. Eric Topol, founder and director of the Scripps Research Translational Institute, joins Ira to talk about the approach, the advantages of nasal vaccines, and other vaccines on the horizon that make use of the mRNA technology that was the focus of this year's Nobel Prize in Physiology or Medicine. Topol hopes that the mRNA approach will be widely applicable to a range of diseases and conditions—from conventional pathogens to cancers and autoimmune disorders. To stay updated on all-things-science, sign up for Science Friday's newsletters. Transcripts for each segment will be available the week after the show airs on sciencefriday.com.
With the national state of emergency for Covid-19 now officially over, we invited physician and author Topol to reflect on his experience writing a regular online newsletter attempting to counter the misinformation flooding the internet. Called Ground Truths, it takes an unsparing dive into what went right and what went wrong over the last three years.
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