Lessons from the COVID-19 Pandemic — with Dr. Sanjay Gupta

Dr. Sanjay Gupta, CNN’s chief medical correspondent, joins Scott for a conversation about his latest book, “World War C: Lessons from the COVID-19 Pandemic and How to Prepare for the Next One.” We hear Dr. Gupta’s insights on how wealthier and poorer nations have fared against this virus, what it means to be “pandemic proof,” and how to address misinformation. Dr. Gupta also explains how people can heighten brain function to be more productive and maintain healthy lifestyles. Scott opens with his thoughts on America’s race to a super-app. Learn more about your ad choices. Visit podcastchoices.com/adchoices

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:01Scott Galloway?

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• 0:49Speaker 01

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• 1:18Scott Galloway?

  Episode 123 of 1923, Roy and Walt Disney founded the Walt Disney Company. I have been banned for life from Disney World because I tried to spread my mom's remains around the park. I guess I should have had her cremated first.

• 1:33Speaker 02

  Go, go, go!

• 1:42Scott Galloway?

  Welcome to the 123rd episode of the Prop G Pod. In today's episode, we speak with Sanjay Gupta, CNN's chief medical correspondent. He's also the host of the CNN podcast Chasing Life, as well as an associate professor of neurosurgery at Emory University Hospital and associate chief of neurosurgery at Grady Memorial Hospital in Atlanta. We hear all about Dr. Gupta's new book, World War C: Lessons From the COVID-19 Pandemic, and how to prepare for the next one. Dr. Gupta also shares his insights from his other recent book, which explains how people can heighten brain function to be more productive and maintain healthy lifestyles.

• 2:21Scott Galloway?

  I could use more of that. I can actually, I want more brain functions so I can have the lifestyle I want to destroy those brain functions. I really enjoyed this conversation. His advice around family was, I think it was moving. And overall, Dr. Groupa strikes strikes us as a pretty measured person. He's really able to take a thoughtful approach in seeing both sides of every situation. He's one of these kind of, I don't know, Doogie Howser types. He went to medical school at the age of 16 and is kind of crazy smart. And it's just nice that people that smart and that motivated decide to go into a field where they can have that sort of positive impact on people. Anyways, and he's dreamy, has good hair, which is, which is really important. All right, what's happening?

• 3:03Scott Galloway?

  We've been thinking a lot about America's race to the super app, super app. And that is how companies are going to pivot toward combining features such as payments, transportation, delivery, commerce, and social media, all on one platform, similar to the way Tencent serves as kind of the operating system for a lot of people's interaction or their digital, digital interface, if you will, in China. So let's discuss how we're seeing this play out in real time. Last week, Square pulled a Facebook and decided to change its name to Block. Where do you work? Block. Oh, God. That's awful. Block. Something about the blockchain, I think. Anyways, as a way to signal that the company isn't just about payments, it wants consumers to know that it's an overarching ecosystem of several

• 3:48Scott Galloway?

  lines of business. Block, formerly known as Prince, oh, wait, no, Block, formerly known as Square, already offers an arsenal. By the way, let's just talk a little bit about my favorite artists. George Michael, Tom Petty, and Prince, all dead. And I think they all died of opioids, but we didn't want to call it opioids for some reason. And literally everyone I listened to in college died within like a six month period. If I were R E M, I would not leave the house. I would not leave the house. Anyway, anyway, Block already offers an arsenal of super app services. Peer-to-peer payments, Cash App, crypto and stock trading, also Cash App, lending, Afterpay, music streaming, Tidal, that one made no

• 4:32Scott Galloway?

  sense to me. It's dabbled, and food delivery, caviar sold to DoorDash in 2019. By the way, I love caviar. I love caviar. I'm in New York. I practically live on caviar. My refrigerator is no joke. Champagne, Cool Whip.

• 4:48Scott Galloway?

  And that's about it. Champagne and Cool Whip. Why is the Cool Whip there? I don't know. Anyway, now what you were asking. Building social into the platform for Block, or the Block platform, is the logical next step to becoming America's first super app. This could be really interesting. What would be the gangster move? And is a non-zero probability of happening is that Jack Dorsey could reunite his sister wives and acquire Twitter via Square or Block. Block, bitter. Block and Twitter, bitter. Oh, yeah. That's the super app I can play a role in. Bitter. So let's be clear. This is a crowded space, and it's only going to get more competitive. Just last week, ByteDance, TikTok's parent company, invested $10 million in iMile,

• 5:33Scott Galloway?

  a last-mile courier service that connects mostly Chinese e-commerce companies to consumers in the Middle East. Over in India, the country's super app Paytm IPO'd with a $20 billion valuation, the largest public listing in the nation's history. However, it shed more than a fifth of its value on the first day of trading and settled at $14 billion. I wonder if they tried to issue too many shares to the market. I don't know. It's kind of weird. There's a competition in India now includes Amazon Pay, Google Pay, WeChat, and Phone Pay owned by Flipkart/Walmart. Southeast Asia also hosts many players. Gojek Line, C Limited, Tokopedia, Zalo, and more. A lot of cool names there. Not as cool as Block, but still, cool names. So again, a crowded space, but for good reason.

• 6:17Scott Galloway?

  The super app market is the digital iron throne. Super apps live on mobile, and mobile is the internet in emerging markets. India, for example, has three times as many cellular subscribers as the US. Think about that. For every one cellphone in the US, there's three in India. And Indians spend 17% more time on their phones than the US. I can't even imagine that. The firm that establishes super app leadership in America, however, I believe, I believe, will be the most valuable firm in the world. The super app in China. And in India will be the most valuable firm in those sovereigns, but the most valuable firm in the world will be the one that achieves, if anyone achieves, super app status and what is the largest economy in the world.

• 6:58Scott Galloway?

  So this is, I think this is kind of the battle, the end all battles, if you will. These companies are investing billions, specifically Google and Apple. If you think about it, are investing billions to try and prevent a super app from emerging and going around what is the kind of arbiter, ultimate tollbooths of our digital life, and that is Google and Apple. So to a certain extent, the App Store is in many ways a super app, but more than anything, it's the ultimate block from anyone establishing a super app. The radical transformation of Apple under Tim Cook really has been a decade-long project to extend the company's ecosystem, to nullify the potential for a super app to sit on top of iOS. It explains why Apple now offers both credit and debit systems, and why you can use your Apple ID to sign into a huge range of third-party services,

• 7:43Scott Galloway?

  and why Cook is giving Reese Witherspoon and Jennifer Aniston hundreds of millions of dollars to produce an inferior version of Murphy Brown. I just don't get that. Do you get it? I watched it, The Morning Show, fine, talented people, but it's literally the same budget as Game of Thrones, same budget. So I say, can I trade in The Morning Show for another season of Game of Thrones? Seriously, that's all we need. Can the blockchain accomplish that for us? The likely epicenter for aspiring super apps is fintech, payments in particular. They get data, they get outsized market capitalizations, it can help them go buy the other stuff. So PayPal, which owns Venmo, could likely be the epicenter here, and also Block. Fintech unicorns are taking over the world and we don't, they don't get,

• 8:28Scott Galloway?

  they actually, they get a lot of recognition, but not the recognition they deserve. CB Insights reported that as of Q3 2021, there were 206 of these billion-dollar unicorns, which is double what we saw in the same quarter in 2020. Think about that. The unicorn barn has doubled in just 12 months, and that is the fintech unicorn barn. Fintech funding in the US alone grew 121% year-over-year and reached nearly 15 billion in the third quarter of this year. That's equivalent to nearly half of total Q3 21 funding, even though the US only makes up about 39% of total deals. So what does all of this mean? I've lived through a half a dozen of these techno-social transitions from the PC era to

• 9:10Scott Galloway?

  dot coms, through mobile, to social, and now this. Every shift has created more wealth than the one before, but also levied more harm. One thing they all had in common is that we never really saw them coming. In hindsight, these things look obvious, but none of these transitions have manifested as we've expected, which is one of the wonderful things about the world. You kind of have your list of what you think is going to happen, and then the future happens. For the most part, unfortunately with big tech, the expectations have been more naive or more optimistic than the reality. The externalities have been really severe, or in some, the reality has been worse than our expectations. We were supposedly going to be solving world hunger and flying around the world in mini-jets

• 9:55Scott Galloway?

  and pods, and instead we got 280 characters. That was a big innovation, which meant you could plan an instruction at half the time, I guess. Anyways, the difference now is that we can see super apps coming, or at least I think that there's a battle going on and someone is going to try and establish a new operating system sitting on top of things called a super app. As consumers, investors, and elected leaders, we have a chance to do better, don't we? We have a chance to do better this time, to set the stage for competition and empowerment, not co-option and enragement. So a few thoughts. You could have Twitter turnaround, or you could have Square turnaround in a man bites dog scenario. You could have Square acquire Twitter and overnight it's sort of a Tencent light. It would be interesting to see. I don't think Facebook is, Facebook's sort of the logical one to be the super app, but

• 10:40Scott Galloway?

  they, I don't think have had a lot of success around innovation as it relates to anything that's homegrown. They're very good acquirers, potentially they could acquire their way to super app. But I think, again, it probably comes from fintech. PayPal could be the epicenter, but what could be the super app? Or might it be that iOS and Google become our, continue or extend or put out their elbows and maintain their sort of super app status? I don't know. It's going to be interesting. But what we do know, what we do know, or what I believe we know, is that in five years, the most valuable company in the world will likely be associated with a term, and that term is "super app." Stay with us. We'll be right back for our conversation with Dr.

• 11:25Scott Galloway?

  Sanjay Gupta.

• 11:30Scott Galloway?

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• 13:50Scott Galloway?

  Welcome back. Here's our conversation with Dr. Sanjay Gupta, the chief medical correspondent for CNN.

• 13:58Scott Galloway?

  Sanjay, Dr. Gupta, where does this podcast find you?

• 14:02Speaker 04

  In my basement, in a little closet that used to be just for linens and stuff like that, that seemed like the perfect place to try and soundproof a bit and turn into a podcast with.

• 14:14Scott Galloway?

  So you've been at the forefront of this pandemic since the early days. And in your new book, World War C: Lessons From the COVID-19 Pandemic, you share what you've learned about the virus's behavior and what we can do to remain resilient against the next pandemic. As someone who's really been at the helm of the bobsled through all this, can you, can you kind of give us sort of your raw, unvarnished thoughts on what's gone on here?

• 14:41Speaker 04

  The years before the pandemic, the United States was often thought of as the most prepared country in the world for a pandemic and for all sorts of different reasons. I mean, they had a pandemic preparedness plan at one point. Obviously, a wealthier country was at the forefront of a lot of research on vaccines and therapeutics and all that. And I think what has happened is that, maybe because of that, that hubris to some extent, I think a lot of basic preparedness strategies were not really implemented. Some of it, some of it totally, totally defensible in the sense that things didn't work that they thought would work. But some of it, you know, the idea of not leaning into basic

• 15:23Speaker 04

  public health practices because of the belief that, you know, eventually, science will rescue us. So we don't necessarily have to do the same things that other countries do. And I don't, I really honestly, Professor, don't say this to malign anyone as much as a sort of looking back, almost like an autopsy into what happened and to, and to basically state that, look, you have to account for that in your risk assessments of things. We tend to think that just explain things really clearly and logic will win the day. But, you know, that's not the case. And it hasn't been the case well before this pandemic as well. So this was not the black swan event, Scott. I think that's what really struck me. You know, SARS back in 2003.

• 16:09Speaker 04

  That had a 10% fatality rate. 10%. This is probably hovering closer to 0.5%, 0.6%. Still very deadly, but like five or six times worse than flu. But if you imagine the idea of a very transmissible virus like this one with a much higher mortality rate, that's what everyone has been worried about. And this wasn't it. And so hopefully there's some lessons learned because if we had treated the original SARS like this with a high transmissibility, that would have been a catastrophe.

• 16:38Scott Galloway?

  So there's a narrative that mostly from more conservative factions in the US that this is like the flu, we've overreacted, the flu kills people everywhere, that this is just endemic, it's part of a static part of our society and there's been an overreaction. In your book, you argue that it's actually possible to become pandemic proof, that just as we think of national security or even internet security, we need to make investments into pandemic security. So how do we get there? If you were asked to develop our pandemic proofing, what do you think we should do?

• 17:14Speaker 04

  Well, first of all, I mean, the idea of having it sit somewhere, not necessarily a new agency or anything like that, but having a pandemic preparedness agency or unit of some sort makes a lot of sense. Because I think what ends up happening is we end up thinking about these potential pandemics almost like weather events. They're just gonna happen, they're preordained, nothing you can do about it, shelter in place, survey the damage once it's done. And instead of thinking about it more like a defense sort of proposition, hey, let's invest, let's go ahead and run the drills, make sure that we know anything that could happen, we know that we're prepared. Some people will argue that you're spending too much on preparation for something that

• 17:57Speaker 04

  hasn't happened, that'll always be a debate, but you don't have to litigate all these decisions in the throes of something. So part of being pandemic proof means setting up this pandemic preparedness plan.

• 18:10Speaker 04

  Continuing to support it, invest in it. I mean, and again, we had one. George W. Bush in 2004 pushed for a pandemic preparedness plan. And this is a couple of years into the war on terror. So everyone was like, you know, are you kidding me? We have other things going on. And he had read John Barry's book, The Great Influenza, and felt adamant that we needed it and even put a price tag on it, which was about 30 bucks per citizen per year. And he said, for that, because you're funding virus hunters out in the field. They find the jumps from animals to humans. You're funding universal vaccine platforms. You're funding public health so you can find the real genesis of these outbreaks

• 18:51Speaker 04

  very early as opposed to when they've already spread quite robustly, as was the case here. So, you know, all these different strategies, and there's lots of them, for about that price, you can essentially, you're not going to prevent new pathogens from emerging. That is the world in which we live. But the idea that they have to turn into a pandemic like this, I think that's very preventable.

• 19:15Scott Galloway?

  You say that an outbreak anywhere in the world is an outbreak everywhere in the world. What insight can you share about how wealthier and poorer nations have fared against the virus?

• 19:25Speaker 04

  Well, there's always a disparity. You know, I've covered, as I mentioned, these outbreaks for 20 years. And there has been another pandemic, which was H1N1 2009. But I've also covered Zika and Ebola and malaria and tuberculosis and HIV/AIDS. And when you sort of look at these things, typically, there's a disparity in terms of how some countries fare versus others. And that was the case here as well, but in almost the exact opposite way that you'd expect. As a general rule, not across the world, but as a general rule, wealthier countries did poorly. Smaller percentage of the worldwide population and a desperately higher percentage of cases, hospitalizations, and deaths. So that was pretty horrifying, to be honest,

• 20:10Speaker 04

  when you started to actually look at these numbers and see what was also going on in other parts of the world. Places that had their first patients diagnosed on the same day the first patient was diagnosed in the United States. And seeing our trajectory go into exponential growth and their growth stay relatively flat. So there was a lot of disparity here, and it continues, to be honest. But...

• 20:38Speaker 04

  Again, so much of that was preventable. And it's not that there was some magic therapeutic or something else that was present in these other places that was not in the United States. But we just didn't lean into it the way that I think a lot of people just expected we would.

• 20:56Scott Galloway?

  So let me put forward a thesis, and you confirm it or push back on it. So 5% of the world's population, I don't know, what are we, 12, 15% of the world's infections? And I realize those numbers are moving targets. But to your point, wealthier nations had disproportionately higher infection rates relative to their population, right? Isn't it because we're arrogant and fat that the virus didn't get the memo about our exceptionalism? And while some people, and we're always blaming the right for politicizing mass, haven't we on the left politicized obesity? Aren't we arrogant and fat and the virus preys on that?

• 21:33Speaker 04

  Yeah, I think with regard to outcomes, like if someone were to get sick, severely sick, be hospitalized, I think there's direct tie-ins to how healthy we are not. And the same can be said for a lot of wealthy countries, these diseases of affluence, if you will, diabetes, heart disease, obesity, things that definitively put people at higher risk of getting sick. I think it's a little bit less of a straight line to just cases, just the spread of a virus. You know, people who had these diseases, they weren't necessarily more likely to come in contact with the virus, but if they got it, they were more likely to get sick. So at one point, it was 25% of the world's cases

• 22:17Speaker 04

  for just under 5% of the world's population. That, I think, is harder to explain away. And I don't think the, you know, I think you're right. The idea that people haven't talked about our pre-existing health conditions enough is true. And I've obviously been talking about it for a long time. And and most people, when they think about getting healthy, they they think about it in the in the sort of context of, oh, this will prevent a heart attack 20, 30 years down the line. But I think one thing this pandemic did was remind us of just how important good health is always, not just to prevent decades future disease. And, you know, I think that that's going to be a message that hopefully comes across. I think there was a component,

• 23:01Speaker 04

  Scott, to cut to it, that people would commingle it too easily with shaming people. They would assign responsibility for obesity. And and I'm not sure that served the purpose that they thought it did. It's a problem. It needs to be addressed. But we spend $4 trillion a year on healthcare. 70% of disease in this country is probably preventable if you if you really dig into it. And most of that is due to diet. So if we spent 1% of our healthcare budget just on making sure people had access to to healthy foods.

• 23:34Scott Galloway?

  Food deserts.

• 23:35Speaker 04

  It would go a long way. It would go a long way. It wouldn't fix it, but it would go a long way.

• 23:39Scott Galloway?

  I hearken back to remember the Presidential Fitness Awards?

• 23:42Speaker 04

  Oh, sure.

• 23:42Scott Galloway?

  In school. It just felt like fitness, if you will, like PE was mandatory. It just felt and we had, I don't know, I agree with you that it's not fair to shame the victim or shame the person. But it does feel as if we don't want to talk about that this virus is not politically correct. And it does it does target certain things that, as you said, these diseases, diseases of affluence. So do you think America sort of missed, it's a loaded question, did America miss an opportunity to be a real leader here globally?

• 24:18Speaker 04

  Yeah, I think that's that's absolutely the case. Because, again, we were the country I think many other countries were looking to. The indices had us at number one in terms of pandemic preparedness. So I think, you know, there was an opportunity. Not only to really reduce the spread, save a lot of lives, save a lot of hospitalization, a lot of heartache, a lot of suffering, but also set an example for the rest of the world. I think a lot of countries were looking to the United States initially to see how they were going to respond to things. And to be honest, you know, there's still a lot of that, there's still a lot of examples that are set in terms of the world of development, the vaccines, all that sort of stuff. But I think for some basic things, there were

• 25:03Speaker 04

  missed opportunities here. And everyone says things got politicized, which I guess is the case. But things always get politicized, right? I mean, even before this pandemic, there were measles outbreaks, right? And measles outbreaks in New York and in Minnesota, Southern California, and those were also politicized. They were political, but a different politics. That tended to be younger liberal parents who weren't vaccinating their kids. So I'm not sure that, you know, that's, the politics of it is the nugget. This sort of, these sorts of issues have been there for a long time, but they've obviously been greatly, greatly magnified because of this pandemic.

• 25:44Scott Galloway?

  So we're, I think, second only to Russia in terms of vaccine misinformation. And I'll give you math and you tell me where I got it wrong and right. And you, one of the things I've struggled my entire career is the difference between being right and effective. And one of the things, one of the reasons I think you are effective is you demonstrate more grace. You don't immediately put people on the defensive, I get angry, say, get very reductive, I, you know, the problem is we're fat. That's probably not a productive, that's probably not productive language. But you went on Joe Rogan, and I look at Joe Rogan and think that he is a source of death, disease, and disability.

• 26:25Scott Galloway?

  Which is an incendiary statement and you you go on and you have a three hour conversation and try to talk to him about, you know, how we combat misinformation. And it just, there's something very unhealthy, I think, when people are turning to Joe Rogan and not Dr. Sanjay Gupta for information on how to treat and prevent COVID. I mean, what's happened here? Is it, is it the medical, is it our medical institutions have lost trust? Is it that we live in a world of social media? But it feels as if we are listening to the wrong people. What's, what has happened here and what can be done?

• 27:05Speaker 04

  Well, I think there has been a significant erosion of trust. And to add layers to this, there's also been a perception, more and more so, that scientists are increasingly thought of as arrogant, didactic, and elitist, all that. And I think if you put that into the sort of fabric of social media where information is democratized and you would have a hard time, even, you know, someone who's got good intent may have a hard time distinguishing good versus bad information. I mean, when I did Joe Rogan's podcast, and you know, the thing is, he's got a lot of people who listen to him. And he talks about the idea that, you know, he's trying to be a critical thinker. And I wanted, I really was curious,

• 27:50Speaker 04

  like, what does that look like? And I think we went into it, sort of knowing that we probably weren't going to agree on what we think, but I was curious how he thought about things. But I think what, you know, when you're saying, hey, look, here is a study from the CDC, which shows that if you are vaccinated, you are eight times less likely to get infected. And if the response is, so you're saying you could still get infected? That's the response, right? Well, yeah, I'm giving you numbers here. So it doesn't really work, the vaccine.

• 28:23Scott Galloway?

  You can still die with a seatbelt on or an airbag, right?

• 28:25Speaker 04

  Right. And then you start going down these paths. And it's frustrating. Our people, you know, studies versus people's own anecdotal experience. I had a friend who got sick after taking the vaccine. What, you want me to get sick after taking the vaccine? Is that what you're telling me I should do? When you're gonna come visit me in the hospital if I take the vaccine and get sick? They turn these into very emotional arguments based on anecdotal data. That, you know, I can't refute it. I don't know these people. But when you start citing the big studies, but they're coming from sources like the CDC, and there's already distrust because you remember they told you not to wear masks and they told you to wear masks? I mean, they obviously don't know anything about what they're talking about.

• 29:09Speaker 04

  I don't trust anything they say. So instead, I'm gonna Google, you know, articles from various newspapers that editorialize studies and that's gonna be my bible. And it's dangerous. It really is. I mean, I think the conversations are important, Scott, in terms of last thing you ask is what to do about it? I don't know. I mean, I don't know the answer to that. But I don't know that sitting on the sidelines and saying, hey, I'm just gonna continue talking to people who already probably mostly agree with me is the right answer. I do think social media has an obligation to better be able to distinguish between good and bad information. Right now, you know, certain piece of information will get flagged and things like that. But that's not gonna work going into the future

• 29:52Speaker 04

  because people can get confirmation bias just like that. Snap their fingers. Google right now, five-year-old dies of COVID vaccine, and you will find articles that you will then share with people to validate your point of view. And it's frightening. It really is, and it's dangerous.

• 30:10Scott Galloway?

  So to Joe Rogan's credit, he has a huge audience, but he brought you on for three hours. And my sense is he really wanted to hear your view. And after spending three hours, I think Joe Rogan, maybe with the exception of Tucker Carlson and a few other people, has more influence over people's actions than almost anybody right now. And did you walk away optimistic? What were your thoughts when you left that three-hour conversation with Joe Rogan?

• 30:36Speaker 04

  Well, my most immediate thought was that he's not, he's not ever going to get vaccinated. You know, that was a sort of a through line through the discussion. And, you know, he is just not going to do it, although he did say at one point that he had considered getting vaccinated, but then did not because of logistical issues. What I thought was that, I didn't think that I was going to change Joe Rogan's mind. And to be fair, I didn't expect that all of a sudden he'd be like, oh, my gosh, I've learned all this new stuff.

• 31:07Scott Galloway?

  And rolling up my sleeve.

• 31:08Speaker 04

  And yes, I didn't think that was going to happen, but I did, you know, I did hear from a lot of his listeners in various ways, people who said that, you know, questions were answered, that they really hadn't gotten answers to before because they're not watching the news, they're not reading the newspaper, they're getting most of their information from people like Joe Rogan and on social media. So I think that maybe it was worthwhile, especially at a time when we're trying to, you know, close this pandemic down, or at least control it, you know, get more people vaccinated. I will say again, the thing about Joe and others like him, and I, you know, Joe's a very, I think he's a thoughtful guy. I mean, we talked a lot on the phone beforehand. But what I couldn't tell is the motivation.

• 31:49Speaker 04

  Does, do you see yourself as a creator of chaos? Or do you see yourself as sort of a guardian of the galaxy? And I think that he sort of sees himself more as the guardian of the galaxy. Hey, guys, you're all missing it, okay? Let me tell you what those guys won't tell you. You know, Pfizer here, this and the other thing, they're in it for the money, you know, CDC, they're in bed with Pfizer, you know, they got this whole rabbit hole of conspiracy theories that they go down. But for him at least, I don't think he's just trying to throw bombs, although many people interpret it that way. I think he sees himself as the guy who's catching things other people are missing. And he thinks he's being legitimately, he's protecting people as a result.

• 32:33Speaker 04

  But it was a, you know, I think in the end, I thought it was, it was worthwhile in that it may have influenced some of his, his listeners. There's a lot of people who listen and some of them may have been on the fence, just never having heard this, some of this information before.

• 32:52Scott Galloway?

  Coming up after the break.

• 32:53Speaker 04

  So intense activity, great for your cardiovascular system, but if it's your brain, you're trying to hack, as you said, moderate activity, it makes a much bigger difference. And you find in places where moderate activity is built into lifestyle, those are some of the places that do have the lowest rates of dimension in the world.

• 33:13Scott Galloway?

  Stay with us.

• 33:20Scott Galloway?

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• 34:05Scott Galloway?

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• 34:28Speaker 01

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• 34:58Scott Galloway?

  The book you wrote that's had the biggest impact on me or is most relevant is you a book you wrote last year, Keep Sharp, Build a Better Brain at Any Age, where you talk about trying to debunk some of the myths around aging and cognitive decline. Can you give us some hacks around how to maintain great brain health?

• 35:16Speaker 04

  Sure. You know, I if I just want to tell you quickly, you know, I I wrote this book in part because I've been studying neuroscience for a long time. The conventional wisdom is, you know, we all heard it since we were kids that you have a certain amount of brain cells, neurons, and you you have those cells, you're given a certain number, you drain the cash as you get older. Bad habits will drain the cash faster, all that sort of stuff. The only time you could grow new brain cells, it was thought was when you're a baby, your brain was still forming and in response to an injury or a stroke or something like that. But over the last, you know, really 10 to 15 years now, if you go to the neuroscience

• 35:59Speaker 04

  meetings, there's so much enthusiasm around the idea of what's called neurogenesis, the idea that you can grow new brain cells at any age. And that was, I found that incredibly inspiring and it had real practical purposes in the world of as a clinician to help people recover from things, but also just for every day. If you could grow new brain cells throughout your life and we weren't necessarily that great at doing it, how do we do it? And what benefit might we accrue in terms of our overall brain function, but the possibility of reducing disease like dementia, for example, in particular?

• 36:37Speaker 04

  So that was, that was sort of what propelled me to write the book. And it was basically, you know, a three-year project of talking to these neuroscientists all over the world, going to places where they had really, really low rates of dementia, so low that if someone developed dementia, it would get written up in the medical journal. That's how unusual it was. So I was like, what are they doing? How do they, what do they know we don't know? You know, it was all that. It was looking at the large epidemiological studies and then really bolstering it with the, with the scientific evidence of why things like this would work. So, you know, when it came to, to diet, for example, I think because people have thought of the brain really, truly as a black box and that it's only measured by its inputs and its outputs, people really didn't get an understanding of, of the inner workings of it. That's changed.

• 37:21Speaker 04

  And when we really start to, to look deep, we realize that the old adages like what's good for the heart is also good for the brain are somewhat true, but, but not completely true. Like activity, we say, go do intense exercise for your cardiovascular health, you know, run hard, work out hard, whatever it may be. But what you find is that for the brain, activity is fantastic, but moderate activity releases something known as brain-derived neurotrophic factor, which is this, this kind of miracle growth for the brain. Those are the words of a very esteemed neuroscientist that I interviewed. Problem with doing intense exercise, intense activities, you also release a lot of cortisol,

• 38:05Speaker 04

  a stress hormone, and that kind of counteracts the, the B D N F, this, this neurotrophic factor. So intense activity, great for your cardiovascular system, but if it's your brain you're trying to hack, as you said, moderate activity, it makes a much bigger difference. And you find in places where moderate activity is built into lifestyle, those are some of the places that do have the lowest rates of, of dementia in the world. So that's just an, an example of sort of where we were, how we thought about things and how it's slightly different. It may not sound like a huge difference, but you start applying that across populations and you can start to dramatically reduce incidence of some of these diseases that we worry about, or at least, at least improve function. There was another thing, I'll just tell you quickly.

• 38:49Speaker 04

  That I found fascinating, and that is that if you look at the brains of people who have Alzheimer's disease, and typically it's diagnosed later in life, but because we have so much technology now, if you actually were to look at scans of those brains decades earlier, when the person had absolutely no symptoms, no clue that Alzheimer's might await them, you would find changes in the brain. You would find some changes in the brain. Now, they are obviously not clinically relevant because the person felt fine. You wouldn't have known it if you hadn't scanned the person for something else. Usually got scanned for a car accident or headache or something unrelated. And so what does that tell us? It tells us that this disease begins a lot earlier, yes, but it also tells us

• 39:31Speaker 04

  that it is possible to have a brain that has these changes in it that does not become a brain that is manifesting Alzheimer's disease or dementia. So instead of spending tons of money, billions of dollars on these therapeutics to rid the brain of plaque, which haven't really worked nearly as well as anybody hoped or expected, what about the things that actually teach people to have that brain function despite the plaques? And I think that that's a lot of what the scientists have been working on as well.

• 40:04Scott Galloway?

  So I love this. And this is the, I'll take away several things, but this is the one thing I think I'll remember, and that is, because I did not know this. I knew that extreme or vigorous exercise, push yourself hard, my belief, and you've confirmed it, is that that is good for you. But that you want to do a crossword puzzle, you want to engage in conversation, you want to read a book. But I did not know this. You want to avoid, and maybe this is impossible, exceptional moments of stress where you're overloaded with information. In other words, how do we? So I understand the action around exercise. Push yourself harder, do that next set. You know, up the peloton, if you will.

• 40:47Scott Galloway?

  But as it relates to the hack around avoiding those moments of extreme overwork or stress with the brain, how do you take action against that? What kind of situations you're trying to avoid?

• 40:56Speaker 04

  I think that the thing that I took away from it and spending a lot of time with these, again, these scientists who now incorporate this into their life is that they're not shying away from, this was all around activity, first of all, leaving aside cognitive exercises like crossword, brain training, anything like that, which I can talk about because I also found fascinating. But, but the, the idea that, you know, if cardiovascular health, which we should all be thinking about, I mean, heart disease is still the biggest killer in the country. An intense exercise can be helpful, but we also recognize some of the downsides of that now when it comes to the brain. It does release a lot of cortisol. It's predictable. It's not so much stress related as, as people typically think about, I'm overtaxed, I've got too much on my plate, whatever.

• 41:39Speaker 04

  It is truly cortisol release in response to, to high activity, to really stressing the body.

• 41:47Scott Galloway?

  Oh, so the two are connected. So that extreme exercise while being good for your heart and your muscles or whatever is, is bad for the brain?

• 41:55Speaker 04

  Right. It, it, it at least doesn't allow the good stuff, this neurotrophic factor, to actually exert its good, good impact on the brain. It kind of counteracts the B D N F, this neurotrophic factor. So it's, it, it doesn't make a lot of evolutionary sense, but if you do look at, I spent time with this indigenous tribe in Bolivia, their hunter gatherers.

• 42:16Scott Galloway?

  As we all do. As we all do, Sanjay. No big deal.

• 42:19Speaker 04

  Part of the fun, part of the fun. But when you do that, you realize that the hunters, like, like them, they, they're not ever really running after their prey. They're, they're outrunning their prey, they're outlasting their prey. They just walk in track and walk in track and they end up, eventually they wait for the animal to tire out and they eventually go in there with their bow and arrow. So it, it's, it's like when, when you look at these lifestyles of people who do have, that's, that's an extreme, obviously, in indigenous tribe, but even in these blue zones or these places where people live long lives with far fewer of these, these sort of diseases of aging, you, you see these patterns of lifestyle that emerge. And we saw that for some time, but now we can actually start to explain why that, that might make a difference.

• 43:03Scott Galloway?

  Let me ask it a different way. What is Sanjay Gupta's workout routine?

• 43:08Speaker 04

  So I have a really strong family history of heart disease. My father had bypass surgery in his late 40s. His father, my grandfather, died in his 50s of a heart attack. So it's something I really am very mindful of. So I have, I do intensely exercise every day. I do something either. Covid made it a little bit challenging to do things like swims because I love swimming as well. But I will run, do weights or and or bike on a Peloton or something like that every day, which is important to me. But I'll also try and I take a half an hour walk or so with a friend or my wife or a child, one of my kids, just about most days of the week as well.

• 43:51Speaker 04

  A brisk walk and we'll, we'll connect, which I think is also very good for the brain. We'll talk about our problems. Talking about your problems is a way of, of really, I think, magnifying the relationship. Like if you're vulnerable to somebody, it really magnifies the relationship.

• 44:08Scott Galloway?

  So I just want to put pause on that. I understand doing that with your wife. Do you do that with your kids? Do you talk about what's upsetting you or the things you're struggling with with your kids?

• 44:18Speaker 04

  Yeah, I do. I mean, you know, I modulate myself a little bit. I mean, that's not the same conversations I'd have with my wife. I think people oftentimes separate their work and their personal life balance. They draw this line like a one. I just, that wasn't possible for me. And as a result, what I found was letting them in on things as opposed to.

• 44:40Scott Galloway?

  It's cathartic. I love sharing my day with my spouse. This is what I'm struggling with. This is what's great. It's going on at work. I find it's a way to kind of ease into, ease into the other part of your life.

• 44:51Speaker 04

  And there's, there's a shortcut that really happens when you're doing it with someone like that because they know, they know the matrix in which this is all being said, right? I'm not, I'm not coming to them de novo. They're like, oh, well, that must bother you then because of X. This also happened. Or, ah, shoot, I know you really wanted that and that didn't happen. So I'm, you know, I'm bummed. I'm sad for you, but you know, like, or I'm thrilled for you, depending on what it is, you know? So with my kids, you know, I do a lot of listening too. You know, I think it's, it's important. I mean, I think that they want to talk, but they won't unless it's some sort of environment where they feel like they can. And going on a walk where there's no one else around and it's just us and get the heart beating a little bit and it makes, it makes a difference. Good for me, it's good for them.

• 45:37Scott Galloway?

  But the revelation here and the thing that has me a little bit freaked out is I've always thought, I do CrossFit and I push myself exceptionally hard. It's kind of my antidepressant and I'm really cooked by the end of it. What you're saying is that's the reason I'm so fucking stupid and losing my shit, that there may be a downside to that, that it might be okay, ease up a little bit. Is that, do I have that wrong?

• 45:57Speaker 04

  No, I don't think, I think you can keep doing the exercise that you're doing, but if you can find time, which sounds like you do, to do things that are more moderate activities. Like people, the human body wasn't designed to sit or lie for 23 hours a day and then go to the gym for an hour. That's not how we were designed. So the idea that moderate activity in there as a, with purpose.

• 46:19Scott Galloway?

  Take a walk.

• 46:20Speaker 04

  Yeah, with purpose, not just a primary walk for no reason, but maybe a secondary part of an activity as part of a discussion with family member or something like that, I think is really good. And the science, like more than anything else, when I was doing Keep Sharp, it's that type of activity that had the best evidence behind it for neurogenesis. It's almost as if you're signaling, hey, man, I don't want to go anywhere. I'm here. I'm active. I, you know, I want to keep the brain sharp. I'm thinking a lot as I'm doing this activity. So build me some more brain cells. And, you know, I feel like I can envision that now when I'm doing these walks and I really relish the time when I have it.

• 46:57Scott Galloway?

  So I usually, towards the end of the program, ask you to provide advice to your younger self. What I want to, I want to be more selfish here, and that is you have kids that are about to, or college age, or pre-college age, right? You're thinking about, so I don't want to say about to lose your kids, but your, the kid's about to leave the house. I started late in life. I have an 11 and a 14 year old and I look at it, okay, I got one for another four years. I got one for another seven. What advice would you give me?

• 47:22Speaker 04

  I don't think you should ever...

• 47:27Speaker 04

  Live with regrets or guilt, first of all, because I think those are toxic. And they don't serve the purpose that you might think they will. It makes you unhappy and it makes people around you unhappy and uncomfortable. So, I mean, I started that way because it leads to what I think is, I'm sure, advice that you've heard before. And that is that, you know, you're, you probably know some of your happiest times, you know, when your brain really feels like it's the health, like, what is a healthy brain? A healthy brain, someone described it to me as one that has a really, really well-defined and large circle of us. You let people into your, your life.

• 48:12Speaker 04

  And, you know, you really want them there and you, you respect their, their points of view and listen to them and whatever it may be. So I do that. My, my best times in life, as someone who is now in my early 50s, have been those times with my kids. And it is, it is getting better, even as they get older. I mean, because now the conversations are, I mean, they're amazing. I mean, kids is like they're, they're, they're experiencing novel things every day. Adults don't get to experience novel things as much, but kids do. And just having those conversations is really, it's, it's helpful. And it's not because I feel guilty not doing it. It's because I find it really instructive. It's influenced my reporting. It's influenced how I think about things.

• 48:56Speaker 04

  You know, sometimes I feel like I'm missing the boat. And then I talk to a 16-year-old daughter and she's like, let me tell you how I think about this. But I'm not, I'm not a, I'm not a great person to probably give any kind of parenting advice. I mean, most people would say probably spend too much time working, not enough time just sort of relaxing, enjoying life. And I just don't think that's the way that I'm wired. It's not, it's not a good thing. I'm not suggesting this as some desirable trait, but I would get really antsy, you know, even when we go away on vacations and stuff, I always needed something to do. So as the kids got older, doing something was with them. It would be something, but we would do it together.

• 49:38Scott Galloway?

  And along the lines of, I've read a lot that the best thing you can do for your kids is to be a good husband to your wife. Any thoughts on being a good husband?

• 49:47Speaker 04

  I think the key really that I've come to, and again, I say this with great humility. But you have to ask yourself, do you fundamentally really respect your spouse, your partner? Do you have respect and mean it? Because if you do, then you're going to be dying to know what she thinks or he thinks about things, you know? You're going to be, you're really going to value that person's opinion. I see when I'm interacting sometimes with couples and I could see like if somebody cuts the other person off several times, kind of dismissive of their points of view.

• 50:26Scott Galloway?

  Yeah, the eye roll.

• 50:27Speaker 04

  Yeah, I find that to be a significant red flag. I mean, there was a, you may remember, I think it was, I think it was Gladwell that wrote about this marriage counselor in the Northwest, who said, what, within a few minutes of watching a couple interact, discussing anything about their relationship, he was predictive of how long their relationship would last. And I read that and actually called the guy. I read his studies and was really curious about that.

• 50:52Scott Galloway?

  Yeah, it was the eye roll. They said if you see an eye roll, it means that there's trouble in Mudville.

• 50:58Speaker 04

  There's this dismissiveness. So, you know, find somebody that you love, find someone that you respect as well and, you know, make sure that, make sure that you're always nurturing that respect, you know, finding new reasons to respect her, which I do. I mean, she's, look, she's got me through this. I've known my wife a long time. I was a resident in neurosurgery during arguably the busiest time of my life, maybe up until now. I think the pandemic sort of rivaled that, but in a hundred hours a week, really no social sort of life and a socially awkward guy. I mean, if you, if you, I chose to go to medical school when I was 16. I got accepted into this accelerated program, so I knew that.

• 51:38Scott Galloway?

  Hold on, hold on. You went to medical school at 16?

• 51:41Speaker 04

  I got accepted, you know, it was a program called.

• 51:44Scott Galloway?

  So you're like Doogie Howser Gupta here?

• 51:46Speaker 04

  Well, you know, they

• 51:47Scott Galloway?

  Sixteen?

• 51:48Speaker 04

  Yeah, yeah, I started college when I was sixteen, but accepted to medical school. Yeah, that's a whole nother podcast. I'd be curious to see your thoughts on those types of. But it was for it was for people who were reasonably sure, although at sixteen, how sure can you be of anything? I guess, but reasonably sure they wanted to be doctors. But my point is that it was it was years of that. It was seven years of neurosurgery training. It was a year of fellowship after that. And that's, you know, it's two decades of my life. And I have a wife who kind of came to me at some of the busiest, darkest times during that those two decades. And really, kind of, you know, we've been together since.

• 52:26Scott Galloway?

  Sanjay Gupta is the chief medical correspondent for CNN and host of the CNN podcast Chasing Life. In addition to his work for CNN, Sanjay is an associate professor of neurosurgery at Emory University Hospital and associate chief of neurosurgery at Grady Memorial Hospital in Atlanta. He serves as a diplomat of the American Board of Neurosurgery. And in 2019, Gupta was elected to the National Academy of Medicine, considered one of the highest honors in the medical field. He joins us from a closet in Atlanta. Stay safe, Dr. Gupta. Enjoy those walks.

• 52:57Speaker 04

  What an honor, Scott. Thanks for having me. Hope to speak to you soon.

• 53:09Scott Galloway?

  Algebra of happiness. Picking a partner, I was struck by Dr. Sanjay Gupta's description of his kind of criteria or how important he thought it was, respect for his mate. And he talked about sort of decompressing at the end of the day. And people, everyone talks about the importance of a distinction between work and your home life. And what I have found is that it is almost impossible to just turn it off. If you're successful, your professional life is going to slowly but surely take over your life for certain stretches, not only just Monday through Friday. Professional endeavor has taken over my life for several decades. And right now, it's taken over my life again because I'm working a lot. And this is a function of opportunity. This is a good thing.

• 53:52Scott Galloway?

  But having people in your life that you can decompress with and talk about these things with and share with, and I'm starting to share them with my sons. I thought it was really interesting what Dr. Gupta said. I tell them a little bit about what I'm up to and trying to incorporate time together into sort of that decompression. But that's not what I'm going to talk about. I'm going to talk about what are the values or how do you pick a mate? And there's some research here. So first and foremost, or I think table stakes, I think you have to be physically attracted to this person. And there's a certain, I don't know if it's political correctness or wokeness that likes to think that we should pick people on attributes for anything but how much you're attracted

• 54:33Scott Galloway?

  to them. Being physically attracted to someone is table stakes. You have to want to touch this person and have sex with them. And that comes from a variety of places. It doesn't necessarily, it doesn't mean they have to be hot. It also doesn't mean they have to look the way that the traditional media complex has trained you to believe what are the standard or the mores of physical attraction. I went out with some women who were beautiful by traditional standards, that by what society was telling me was, oh, you should be very attracted to this person because she's six feet tall and has high cheekbones. And the reality is, I'm not attracted to that body type. And it really isn't important what

• 55:17Scott Galloway?

  anybody else thinks. And nobody knows what happens between you and that person in terms of the chemistry and the smells and what, quite frankly, just what gets you hot for each other. That is singular, and it says, I choose you. It's really important. And I think one of the keys to a healthy relationship is constantly expressing affection and sexual desire. I think people want to feel wanted. That's number one. The second is values, and that is things like religion. How close are we going to live to our parents? What is the role that our families are going to have in our, you know, kind of religion, things like that. And then the third one is money. What is our approach to money? And this kind of, kind of stitches in career.

• 56:02Scott Galloway?

  And the number one source of divorce and relationship angst or marital angst isn't infidelity or even lack of attraction, it's disagreements over money. We live in a capitalist society, money is so important, and it's so important that you sync up with people. But what Dr. Gupta said that really struck me is that the healthiest relationships I've had have had those first two. I'm attracted to the person, our values sort of sync up, but more than anything, more than anything, I really value this person's opinion. This is somebody I can come home to and say, this is what's going on with me across a variety of scenarios, and I value that person's input.

• 56:46Scott Galloway?

  And I have a lot of friends, or a number of friends, and I look at the fissures in their relationship, and I think they really don't give a shit what the other person thinks. So, a long-winded way of saying, when you meet somebody and you think about establishing a long-term relationship, there is a litmus test on a variety of issues, whether it's business, whether it's relationships, whether it's a view of the world, do you care what this person thinks? Do you respect their opinion? Because you are going to be around this person a lot, and to be successful, one plus one equals three, you want someone who can be an advisor to you, a confidant, and who's, quite frankly, sometimes can save you from yourself. It's very hard to read the label from inside the bottle.

• 57:27Scott Galloway?

  This is, this is your spouse, this is your wife, this is your husband, this is your sexual partner, this is the person you're going to have kids with, but this has to be also someone you trust and someone whose opinion you value. Our producers are Caroline Chagrin and Drew Burrows. Claire Miller is our assistant producer. If you like what you heard, please follow, download, and subscribe. Thank you for listening to the Prop G Pod from the Vox Media Podcast Network. We will catch you next week on Monday and Thursday.

• 58:05Scott Galloway?

  What original scripted television are you watching?

• 58:09Speaker 04

  What am I watching?

• 58:10Scott Galloway?

  Oh no, you're not watching anything, right? You don't have time. Is that right?

• 58:15Speaker 04

  I watched Queen's Gambit when that was out last year.

• 58:17Scott Galloway?

  Okay.

• 58:18Speaker 04

  I mean, I, it has been really-

• 58:20Scott Galloway?

  Last year.

• 58:21Speaker 04

  Last year, but I just watched it this year.

• 58:22Scott Galloway?

  That's how you go to medical school at 16. You don't have a, you don't even have a subscription to this shit, do you?

• 58:27Speaker 04

  No, I do. I have, I have the subscribe.

• 58:29Speaker 05

  We just moved into our new house and I didn't realize just how close we were to the neighbors. That's when my friend told me about blinds.com.

• 58:38Speaker 06

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• 58:59Speaker 02

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