Employers. The deadline for auto enrollment has now passed, but your legal obligation hasn't. If you're not set up for auto enrollment under my Future Fund portal, you need to act now to avoid penalties. It only takes three steps. Complete your profile, set up a payment method and run pay roll as usual. Don't wait for a penalty notice. Complete them now at my Future Fund dot I E forward slash employer brought to you by the Government of Ireland.
Well, it's definitely a do.
A rubber rewiring replumbing, but I love it. At lay A Life, we know life can change in an instant, like finding your dream home, so make sure it's protected with Ireland's fastest mortgage protection. For cover apply to day at lay A Life Insurance dot I E Insurance is provided by IPLCUE Life Essay lay A health Care Limited Trading is lay A Life and lay A health Care is regulated by the Central Bank of Ireland. For fastest providers see lay A Life Insurance dot I E forward slash Fastest.
Hey Ologites Ali Ward here. So blood it's important. It's kind of scary and you yourself are a pulsing, barely contained leather sack of it but what is it? In this episode, we'll talk to a hematologist slash oncologist about what blood does and why he works with it and what can go wrong and how to fix it. And before we dive in, I want to say thank you so much for the five hundred review mark we hit on iTunes. You guys, I appreciate it so so much.
I read every review like total creep and it really keeps me going. So I'm going to read you my favorite review this week. Do you want to hear it? Okay? See Magnus said, I'm afraid of death, birds and the universe, and the episodes about these topics were so interesting and engaging that I forgot these things terrified me while I listened. Yay, she said, Ali is a great host who really knows how to keep a podcast flowing in an entertaining way.
Very impressed. She records her parts from a closet. I am in a closet right now recording this life. Also a jello Ze said, I want Allie as a friend. Done, Donzo, We're pals now, they say, great podcast. I even enjoyed ologies that I thought I was not very interested in. Can't wait for more. I always love hearing that. When someone's like, I didn't think I'd care about this, but it was a good episode, I'm like, yes, we did.
Thank you so much for leaving those reviews. They help so much and they really get the show seen in her. So this episode hematology comes from the Greek for blood, pretty simple, and I learned about this particular ologist through a blood relative, my pop. So a few months ago, my dad forwarded me an announcement for a charity function in LA that was a comedy show with some comics that I'm like familiar with like Kamil nan Gianni and Hannibal Barres, Mark Maron, Ray Romano and Nicki Glazer, all
these people. I was like, WHOA, how did they all get involved in this? Well, there's a blood cancer called multiple myeloma, and Peter Boyle, who played the dad on Everybody Loves Raymond, battled it for a number of years and every year, in partnership with the International Maloma Foundation, his amazing family puts on this comedy benefit to raise
money for research. Now, my dad also has multiple myeloma, so I reached out to IMF to see if they needed some volunteers, and I got involved with a benefit that way, and was really lucky to be able to take some time of one of the lead researchers in this field before the event and get him in a conference room and pepper him with questions about what he does.
He was so nice. Now, usually I have listener questions from Patreon supporters, but today all the questions are furnished courtesy of mister Ward, my dad, who is kicking the ass of this particular blood cancer. So when my dad was first diagnosed in twenty thirteen, I didn't know anything about blood diseases, even though thirty thousand people a year will be diagnosed with multiple maloma and my uncle also
had it. Now, when my parents found out, I'm not sure if anyone else who has been affected by any kind of illnesses has done this, but the words multiple maloma were written on a post a note and given to them by like a nurse to go home and google. The prognosis at that time was two years, and I myself curled up in a ball, honestly like hoarsely cried
for a few days. Now it's five years later. My dad is still doing well, and they have this now faded pink post it note and its taped to their computer desk as a reminder of those first really terrifying months and also of a lot of hope. And at this comedy benefit, a lot of the comedians I talked to had to google the disease. Some on the car ride over they were like, Oh, I don't know what
it was, which is totally fine for my family. Personally, these words are on our minds every day, and the people who are getting up and going to work to find cures for this and other diseases are like celebrities. They're amazing. So here's the d When you work at a coffee shop, you probably get good discounts coffee. With my work, I have access to so many science heroes and getting to sit down and interview someone who's the front lines of this is a pretty big perk of
the job. But I struggled with whether or not this episode would be relatable, and some of their nitty gritty about treatments I cut. So if anyone, especially if you've been affected by multiple malomo, wants a copy of the uncut version, email me at Hello Ali Ward at gmail dot com. I can also post it on the Patreon page and I'll just give you the full version with all the nitty gritty. So I've shaped this episode to be all about what is blood, what's the healthiest, most
scientifically chill way to live? What is cancer? How can we make ourselves less vulnerable to cancer? What therapies are being developed? How many people attend Coachella, what brought theologists to this field? And the etymology of some Cantonese slang involving fish. And I can say I walked away from this interview feeling so hopeful about my dad's prognosis and
also more empowered to take care of myself. Well, I can it's so easy to treat your body like garbage and be like I'll get help you later, or I don't like deserve to rest. I got a hustle. But once you find out how much my dad's chemotherapy costs each month, you will take a nap so hard and you will only eat like spinach and walnut smoothies. Also, this ologist has the best Scottish accent ever, So settle in get your blood humped to learn all about hematology
with doctor Brian Derry. If you could tell me what is your specific title? Are you ed? Are you an oncologist. Are you my lowna specialists? What do you call yourself?
Okay, so I'm a haematologist and I'm an oncologist. I'm both, so I'm qualified in both. And I'm an internal internist, an internal medicine specialist.
So the site of blood does not freak you out.
Well, strangely enough, the site of blood is. So when I got into hematology, you know, the specialty of blood diseases. I got interested because it was something that I could study under the microscope. So when you're learning and you're a scientist, and then you can make a slide and then you can look at it under the microscope. I was fascinated because I could see all these different blood cells and that was very exciting for me, where I
could distinguish the different kinds. And so that's actually looking at the blood and researching the blood. That's how I became interested in the first place.
Did you ever get a microscope when you were a kid? Is a gift or something? Or when did it start?
This started when I went to medical school. So in medical school you're you're studying all kinds of things. But then when we started the part where we were using the microscope. That's where I got especially fascinated.
Did you ever put your own blood under the microscope to see what was going on? Oh?
Yes, you have to do that as a student.
Really.
Oh yes, you check your own blood and then you compare it with you know, all these other different things which you're given for comparison. You know.
Wow, So did you ever eat a hamburger and then see what it looked like?
And then?
No? I didn't do that. Well, those things are not so obvious on your blood. Okay when you're just looking at it. Now, if you do chemical testing, obviously you could see something, but not just looking at it.
And so when did you start studying oncology? Were you a heematologist first and then you started getting interested in blood diseases and cancers?
Yes, basically that was it. So I did hematology training the Male Clinic in Rochester, Minnesota.
Heard of it. Good place. Side note, I have some friends who have been treated at the Mayo Clinic and they said it was the best medical care they've ever gotten. Next level like Mayo Clinic is like those live flat first class cabin airline seats with the beds and the free wine and the salmon and the cheese. When you're used to a middle row seat and coach next to the toilet, sitting near someone with sausage purps, it's just
so much better. Okay, Now back to the training of one of the world's leading cancer researchers who trained at the Mayo Clinic.
So I started off with that, and then during my training, since I come from Scotland, so I was I'm an immigrant, I'm a foreign medical graduate, they actually assigned you a mentor or kind of like a coach. And so in that process, my mentor turned out to be a doctor called doctor Robert Kyle, who's actually very very famous in the field of multiple myeloma.
Oh.
And so by chance he turned out to be my mentor and we became good friends because we had both run boy Scout troops. Really he ran the boy Scoute Troup in Rochester, Minnesota, and I used to run the boy Scoute Troup in my hometown in Scotland.
So you guys bonded and then started working together.
Yes, and so his interest was myeloma in more into the blood cancer area HM and so I became more interested in that and then ended up doing both blood and cancer.
So let's get right into it. What is blood? If you are walking around in an adult body, it contains roughly five liders of blood. That's a little over a gallon, slish, slashing around, so squishy. So what is it? What is blood? Well, stem cells in your bone marrow mature and they change into three types of blood cells, red blood cells, white blood cells, or platelets. So red blood cells care oxygen around the body, so you need that a bunch. And
red blood cells also contain this protein. It's called hemoglobin, and it has iron and that combines with oxygen to give hemoglobin and our blood the awesome, terrifying red color that it has. Crabs, by the way, have blue blood, and earthworms and leeches have green blood. And there are some invertebrates like starfish that have clear blood. So unless you're one of those, or a plant or a robot, yours is red red blood cells. Let's be honest, life
of the party party would be so dead without them. Now, white blood cells aka leukocytes, Those are cells of the immune system and they protect the body against infectious diseases and invaders. So they're like your friend who talks smacked to creeps when they hit on you and you're like, ugh, thank you, I didn't even see them. Finally, platelets are also called thrombocytes. It's cool name, and they're part of the blood. Their purpose is to stop bleeding. They do
this by clumping and clotting. So when you're like, ugh, come on, let's leave, they're your friend who convinces you to stay at the party, and you're so so glad they did. If leaving a party was the same as bleeding out to death, which is not, but I needed
an analogy. Okay, So these blood cells float in this salty straw colored liquid called blood plasma and blood plasma it's made of about ninety percent water and it also contains nutrients and electrolytes, gases, proteins, hormones, all kinds of stuff. So you are just this opaque ziplock full of a complex tomato soup, which is great, But what is blood cancer? It's not so great. When someone talks about cancer, it's usually preceded by a body part. So someone has throw cancer,
liver cancer. You're like, okay, I'm not a surgeon, but I can picture the general area of this cancer because my brain is not made of turnups. But blood cancer is confusing because it's everywhere, there's nowhere, all at once. So you're about to get cocktail party literate on hematology. If you're ever introduced to a hematologist at a dinner party and you are able to impress them, I have done my job. Okay, here's a quick rundown of blood cancers that may confuse you if you see one of
them listed on a flyer for a charity. So I'm gonna break it down so that you get the difference. Leukemia it's caused by this really rapid production of messed up white blood cells. They screw up the ability of the bone marrow to make red blood cells and platelets. That's leukemia white blood cells. Lymphoma is when these other white blood cells, called lymphocytes become abnormal. They turn into lymphoma cells. They multiply and they collect in your lymph notes.
That messes up your immune system as well. Now, my loma is cancer of the plasma cells. So doctor dry sums it up.
And so the borne marrow is where you make your blood, Okay, And so when you have a cancer of the blood, actually it's a cancer of the borne marrow because what has happened is that the borne marrow has been damaged by something and so then it's not making blood like it should and maybe even has turned into a cancer of the born marrow. Okay, Now, in the case of leukemia, that means that you stop making the normal blood cells
and make the leukemia cells. In the case of myeloma, it means that you have a problem with the plasma cells, which is a particular kind of a cell in the borne merew which is the cell which is part of your immune system. So it's actually a cancer of the immune system. And in your born marrow you make the antibodies to fight infection.
Why would your bone marrow Do you like that what happened and what happens to make the bone marrow turn in blood cancers or what happens in general with cancer to suddenly us.
So what causes it? Yeah, Well, I think that there's been a lot of controversy over the years, specifically about myeloma, because it seems like more than one kind of toxic exposure can cause myeloma. Really, so for lung cancer, there's a strong connection to cigarette smoking and the carcinogens, the
cancer causing chemicals which are in cigarette smoke. Okay, so for myeloma, there's been a connection with many different kinds of chemicals and so as long as like one hundred years ago, it was noticed that people who work with benzene, which is a solvent in paints and in factories where they do all kinds of manufacturing with solvents and glues,
people who worked with benzene would get myeloma. Really yeah, so there is a linkage which is called like a proof of principle, where if you're exposed to a cancer causing chemical in this case, it can sometimes cause myeloma.
Let's lay down a few more basics. So first off, yes, cancer was named after a crab because of the way veins branched off from a tumor, which sounds gross and very moist. Also, cancer doesn't have to be a tumor or a lump that you can like poke with a stick. Cancer just means when abnormal cells divide in an uncontrolled way, so some cells get a little wonky and then they
just keep making more wonky cells. So according to the American Cancer Society, it's caused like changes in the cells DNA, So that's the genetic blueprint, and some of these changes can be inherited. Others can be caused by environmental factors, such as, for example, these things. Ready, I'm gonna list these off. There's a long list, but I'm gonna reduce some that I can pronounce alcoholic beverages, benzines, tanning beds, sawdust,
a bunch of chemical compounds. I can't pronounce the virus that causes mono diesel exhaust, estrogen therapy, processed meat, aluminum production, tobacco, asbestos, and quote salted fish Chinese style. I saw that last one and was like, damn, that is specific, So what is up with salted fish comma Chinese style? Well, turns out Cantonese salted fish is a dish common in Southern China, where fish are gutted and they're hung in a heap
of salt to preserve it. Apparently, studies since the nineteen sixties have shown that the Southern Chinese fishing populations who consume it as a staple are at a higher risk for cancer. This also led me down a hole of Chinese slang surrounding salted fish, and in Cantonese, dead bodies are referred to as salted fish, and a salted fish coming back to life means a person is making a comeback after their career looks belly up. And the phrase those who eat salted fish must put up with thirst
is essentially check thyself before thou dost wreck thineself. So there are a lot of things already identified as things I'll mess up your DNA, but there are so many environmental factors that we have no idea about yet. Do you think that there's a ton of substances that we are in exposure to that we'll find out later we really shouldn't have been exposing ourselves to.
This is so absolutely true. Is one of the very very big concerns that I have. And so since the industrial and chemical revolution, since the Second World War, over one hundred thousand chemicals have been introduced into the environment that we are exposed to one hundred thousand, and all of those only a handful have been carefully studied and have proper regulations with regard to use and cautions and things like that.
Okay, one second, I'm just going to bury my face in my arm and grown for like an hour.
And so I really do have a deep concern that we will discover many many cancer causing chemicals have been out there and we've not been paying it tension. Now
we've learned a little bit about this. So for example, with the nine to eleven event in New York, all these chemicals were released with the fire, with the combustion, and then there was a big development of myeloma in people after the nine to eleven event because they were exposed to fire retardants and solvents and all kinds of different chemicals that were suddenly at high levels and really causing a problem.
Wow.
So we're still having to look at cases and try to find correlations between exposure.
That is correct. So we're at this point of checking correlating.
And as a scientist, do you like getting the data and trying to crunch the data or are you more interested in kind of the care aspects of being a doctor? How do you approach getting all that data? Quick question anologyites do you say data or this messes with me every time I say it, and so I usually just say it both ways in a conversation. That way, I am guaranteed to be wrong every time I looked into it. And it seems to be a matter of regional dialect.
Although I landed on this webpage of a woman named Susan Ryan. She's an American dialect coach who insists that it's data, and for some reason I found her helpful recording very soothing. And then I went down some holes and listened to her say a bunch of other.
Words data, data, database, database, data, database.
And Susan, according to her bio, is also quote a former Alcatraz Park ranger, avid birdwatcher, and a Lingui file who makes a mean scrambled egg a la Julia child. I would roll in her posse for sure if she wanted to be friends. Okay, so does doctor Derry prefer crunching the data or being bedside right?
So over the years I've done both types of things, which I would say is quite challenging and became increasingly challenging over the years. And so I've always seen patients in the clinic. You know, I had a myeloma clinic, so one or two days a week I would always just see myeloma patients. But in addition to that, for most of my life I ran a lab where I was studying myeloma and crunching numbers from cell cultures from
statistics and all kinds of things like that. So I've done both kinds of things mostly my whole career.
Oh wow, so you've gotten both of them. Yes, and then what are you working on now? Tell me, like a little bit about gene editing or crisper. How does that factor into your work? Crisper, by the way, is spelled with no E, and at first glance, it looks like an app that disrupts them let us in straight. But CRISPER is a DNA sequence that stands for clustered regularly interest based short palindromic repeats. You're fine, you don't have to memorize that. And CRISPER technology lets geneticists edit
parts of the genome. It's crazy and exciting. And doctor Derry I feel weird calling him just Brian, so I just keep calling him doctor Derry. I don't know anyway, Doctor Derry is working on a bunch of things for something called the Black Swan Research Initiative. The name has a cool, weird origin. It kind of surprised me. Why is it called black Swan?
Because you are you're looking for something that is it's hard to find and you may not recognize it. Right away. In the western world, everybody thought swans were white, and so you have this idea swans are white. But then the first ships went to Australia and over by Perth on the West coast and they sailed up the Swanee River and lo and behold the swans were black. So they realize that you have to open up your mind and look at things a little differently and say, okay,
there are swans. Usually they're white, but actually in Australia they're black, and in other parts of the world they're brown and maybe slightly different different colors. And so it's a project where you have to open your mind and be open to different strategies to solve your problem.
Are you seeing a lot of scientists and oncologists finding the genes that could make one more susceptible to cancer? Are those getting identified?
Absolutely? This is a very very active area of research, and so through the Black Swan Project, we have a couple of groups doing just this, so that in Germany we have a group looking at family myeloma, So they are looking at families where there are two or more in individuals within the family that developed myeloma, and we're collecting a whole series of these families to figure out, well, what is it that's that's causing this susceptibility, And we're
studying them at the genetic level. And what I can tell you already is that there are several types of genetic predispositions.
So side note, my uncle Joe also had multiple maloma. He did not make it, which is another reason why I'd love to interview ologists like doctor Derry. It's so crazy to me that people are doing this and just walking among us, like buying a phone case at Target. You might never know that this person behind you in line is working on something you could save your life or a family member's life. It's it's nuts. So how long before you can see things like gene editing like
chrispur being used in the treatment of oncology? How long? How far away is that.
It's happening now? Oh, it's happening now. How So what you can do is you can edit the immune cells. So you may have heard about a very active type of therapy called immune therapy, and one type is called car T cells. And this is a situation where you take the immune cells, the T cells from the patient and then you engineer them and then you give them back.
So car T stands for chimeric antigen receptor T cell therapy car T, So if you hear this, the essential deal is that car T cell therapy is a way to get immune cells called T cells, which is a type of white blood cell, to fight cancer by changing them in a lab so that they can find and destroy cancer cells. Pretty awesome.
With the gene editing approach, you can really edit and tweak those T cells to really recognize an attack in a very specific way the cancer that you're interested in. In China, they are already doing this. They have a trial where they're treating lung cancer using these edited T cells, and we're starting to look at doing it in myloma. It's like science fiction that we're moving so quickly.
When you're doing your research, are you splitting your time between chemical therapies and also these genetic therapies that can kind of prevent or treat it.
Yes. So the way that this kind of slots into the day to day activity is that most patients when they start out, we have these therapies that we know can work well, but then we know that those will produce remissions for a few years. But then when that impact is starting to wear off, then they need new therapies. And so this is the perfect situation and opportunity to say, Okay, what are the new therapies that can rescue and treat
at this point? And then from those like the car te cells look very promising and so we're thinking, my god, they are really rescuing pretty well in the relapse situation. Maybe we should be using them even earlier.
And so are we five or ten years off from this happening in the US do you think?
Or no, it's happening. This is a very rapidly changing field. So car te cells have been approved, not using the crisper but just in general. They've been approved for leukemia and lymphoma in the US. And so this has been described as like a new space race Sputnik two, where the Chinese are working on it and the US are working on it. It's really like competitive.
Are your friends or is it a little bit like, oh what are you working on? Is it like watching cooks on a cooking competition.
There is quite a bit of that. They're all cooking up their own brew, you know, and you know, there's a little bit of competition and that what you're cooking could be the best you know and it's it's good.
I welcome this competition. I'm like, whatever it gets you guys working fastest, I'm into it right.
Imagine the place where you can escape for a day, get immersed in a world of rooms, inspiration and expertise, where you can lay in luxury, accommodation and kids cam fees from ninety five sets. Tickets are free to everyone and include all the attractions you've just imagined. A day out at the Kia, The Kia the wonderful.
Every day Employers. The deadline for auto enrollment has now passed, but your legal obligation hasn't. If you're not set up for auto enrollment on the my Future front portal, you need to act now to avoid penalties. It only takes three steps. Complete your profile, set up a payment method and run payroll as usual. Don't wait for a penalty notice. Complete them now at my Future fund dot Ie forward slash Employer brought to you by the Government of Ireland.
Well, it's definitely a do a.
Rubber rewiring replumbing, but I love it.
At laya life we know life can change in an instant, like finding your dream home, so make sure it's protected with Ireland's fastest mortgage protection. For cover apply today at Layerlife Insurance dot i E insurance is provided by iplqu Life Essay, lay A health Care Limited trading is Laya Life and Layer health Care is regulated by the Central Bank of Ireland. For fastest providers see lay A Life Insurance dot I E forward slash Fastest.
My dad has had some questions he wanted me to ask you. He is as a patient and also as a former journalist who loves to research. Thanks, He's on it. He's on all the blogs he wanted to know. He wants to know why cancer drugs are so expensive, how much of the cost is research related, and how much is related to protection against lawsuits. Okay, once again the listener questions, they're all from a dad this week, because this is a spec ep of ologies and this question
is about the cost of pharmaceuticals. His chemo therapy comes in a pill form he takes every day at four pm, and it's called Revlimid. It's saving his life and it's thankfully covered by a program called Veterans' Choice, but the retail price if it weren't covered, would be over sixteen thousand dollars per month. Why does it cost so much?
Right, so, this is really a lot of reasons why. The main reason that's poot forward, why certainly on behalf of the form of companies, is that they have development cost you know, they're testing this drug, testing that drug, and then they've got to do all these trials which are very expensive, cost millions of dollars to test and make sure it's safe and things like that.
This drug did cost several million dollars to research and develop, but it's made twenty billion dollars for its parent company since it's released in two thousand and four, and the price keeps going up. Now, on the other side, it's hard not to be grateful that people are even working on this. Also, the makers are being sued class action lawsuit because they failed to share some information that would help get a cheaper generic out there. Come on, guys.
But then ultimately there is this question that for example, Revlomid has been on the market for quite a number of years now, and so you would say, well, you know, absolutely there were development costs, but you know this is ten years later, you know, fifteen years later, so maybe this would be the time to have a more reasonable cost, right, And so this is something that is really prominent at the political level right now. I mean, what are reasonable
drug costs? And so that has become a complicated process where the companies they extend their patents and then even the generic folks when they come in, they don't reduce across so much, you know, so everybody's in it to make a buck. And so this is in my opinion, very tragic and difficult because this is not like selling cars or watches, you know, where you say, well, this
is a beautiful watch. You could have a markup, that's fine, But this is drugs that are to save people's lives, and so I'm not so happy about markups in that environment.
If you want to know why watches can be so expensive. By the way, and you deeply enjoy some j Z watch puns, listen to the horology episode of Ologies Just get It, Just say it. What you could buy for sixteen thousand dollars a month instead of twenty eight pills or thirty pills.
Right, Oh my gosh, I know. And so you see, in other areas it's been easier to work around it. So, for example, in the area of surgery. So people say, well, you know, I could get my need replaced in Nevada, or maybe I could fly to Thailand and get it replaced and it would be half the price, even including the cost of the flight.
You know, it's so crazy. I know, I you know, we joke that my dad, my dad's five hundred dollars pills are like Kim Kardashian level. If you spent that amount of money on like champagne and Yah, you'd be rolling exactly. So instead of taking that one five hundred dollars pill a day that's saving his life, my dad could be every day getting bottle service, which starts at around four hundred dollars at LA's douche As nightclubs. Or he could be buying every day one pair of Easy
Clear PBC stiletto pumps. Dad. A PBC pump isn't a plumbing thing. It's like a clear plastic high heel designed by Kanye West.
And so I think I do see that this has to be addressed. It is unsustainable.
So do oncologists collab, do they work together? Do they play nice?
I would have to say though that outside of the US, we've been really, really excited and had the opportunity to work with some great teams, you know, outside of the US, who are doing amazing things. One of the coolest projects that we're doing is in Iceland. What so we're studying everybody in Iceland?
Everyone?
Everyone?
How many people are in Iceland?
Three hundred and forty thousand? That's it?
Yes, Oh gosh, that's like that's like studio city in La That's like Los Felas or something. Right, Okay, I was way off. The population of the La suburbs Studio City is thirty seven thousand, Los Felas just about the same, So I was wrong. But three hundred and forty thousand is less than the population of Staten Island, And it's about equal to the total attendance of one Coachella weekend, which is a very bone chilling statistic. Coachella is so crowded, you guys.
But it's a whole country, and so there are so many opportunities where you could test and then offer therapies to a whole country where you're not excluding anyone. So they're all part of the same electronic medical record system. Wow, so you know what's happening to everyone from the time they're born all the way through until they're getting diseases
and having issues. So the other thing that happened is that there's a big genetic company in Iceland called Decode Genetics that actually did DNA sequencing of.
All the people everyone.
Yes, wow, mind boggling cost. In real money, it would have cost billions of dollars, but they did it in a different way where it didn't cost them quite so much. And so this is incredibly powerful, incredibly powerful, and so we will learn what are called the driving mutations, the ones that are leading us forward. And this will be a huge opportunity for Crisper. So once we say, oh my god, this is the gene, well, we would be able to edit it wow, and prevent and to treat.
So it's going to lead in to all these new molecular opportunities.
Thanks Iceland. I asked if eating walnuts helps, because we read that eating walnuts helps, and you guys, my dadd eats walnuts every day. Maybe walnuts are magic. Maybe walnuts are the brains of aliens from another dimension and they fix everything. Maybe they just have a lot of antioxidants.
But you do need to have your body and your immune system in the best shape to accept all these kinds of therapies. Right, And it's clear that having your best diet, your best vitamin combination is absolutely helpful, but you shouldn't have too high of an.
Expectation walnuts are not a reliable cure. But duh. But this next part rules totally blew my mind.
And so I've been most interested to study places where people live to be over one hundred, where they're apparently pretty healthy, and the question is what are they eating?
Yeah, exactly, probably not as much jack in the box as we do.
But that is the summary. That is the exact summary. So the first place, they're called blue zones, and the first one is a Greek island close to Turkey called Ikaria, And so they have a Mediterranean diet as you might expect, right, and so they have also very low stress. They have no clocks on the island, so they're not concerned about time.
Are you kidding me?
So they have low stress, they have no clocks, no mortgage. See, these are families that have lived there for hundreds of years, and so they're just living there and they have you know, chickens, they can go fish in the ocean, and they some grow some grapes, have some nice red wine, and they have a Mediterranean diet, and so this combination seems to be rather healthy. But there is no jack in the box, right, you know. And they don't they don't eat junk food,
they don't eat diet, they don't have diet drinks. You know, they do drink wine, they do drink teas, they put honey in as a sweetener, so they do a lot of like healthy things, and so it is possible to come up with like a healthy diet.
So all you have to do is move to an island utopia and you're fine now if you're not into Greek isles. Some of the other Blue zones are Okinawa, Japan Island, Sardinia, Italy island, Nicoya in Costa Rica, which is a peninsula. I'm blowing your mind right now, but peninsula comes from pennae in Sula, which means almost an island, case in point. And finally, okay, what's the last island? You think it's going to be? Lo Molnda, California, which is not an island. It's this weird outskirt suburb of
Los Angeles. There's a group of Seventh Day adventists that live a life so chill that this one little area counts as a blue zone. Very shocking. So some commonalities that lead to these long, relatively disease free lives are family putting it ahead of other concerns, less smoking, semi vegetarianism, the majority of food consumed derived from plants, moderate physical activity, social engagement, and finally, beans commonly consumed are legomes. So it's part diet, part behavior.
And also a healthy pattern of behavior, which is to we can't ignore the time, but we can certainly try to reduce that time stress factor.
Right, I am doing everything the opposite of everything you just described, and also scare me out of diet drinks? Should I? We shouldn't be drinking diet drinks, right you should not?
Okay?
Good to know? How do they kill us?
And things like coke they do have that brown color of the colke. That caramel is not so healthy in fact, so the dyes are not so healthy. And then the things like asparteam that the sweeteners those are not good either.
So I just started down a rabbit hole about diet sodas and the links to various diseases and increased weight gain. And a higher incidence of depression, and man, go research it if you want to be scared off. I have
to do another episode just all about that. It reminds me of the days when our parents generation smoked like indoors and on airplanes and in like neonatal ICUs and in offices, and they were like, yeah, everyone knew was bad, but you know, this is what people did, and now we find it horrifying.
There's a number of different things about those drinks that can be negative. So juices, water, wine, teas, those are all good, but diet drinks no.
Okay. Good to know that cements my position on that I may have had one yesterday kilously, I've been like, what am I doing to myself? So what are in terms of other or actually this is a personal question, but being a doctor and a hematologist noncologist, how often do you notice symptoms in yourself like back pain or
does my shoulder herd? Or do I have this? Or are you pretty much not a hypochondriac because you know so much about medicine, Because I feel like the rest of the population walks around every day being like do I have cancer? As an oncologist, do you do you think about that.
Yeah, I do. I think that I'm not a hypochondriac, and I think it does help to understand that, you know, we all like might tweak her back one day, you get up the wrong way, or you you know your on or you walk the wrong way, but it's not cancer, you know, and you know it'll be gone in a few days, so you don't need to rush to get scans and blood tests and things that you'll be you'll
get over it. And so I think there's a tendency to think that, you know, if you come down with a really bad cold or something, that it's going to be the start of something really bad. Right now, we don't want to ignore those things, of course, but certainly individually maybe less immediately worried.
Right so you at least know what to look for. Yes, okay, that's good. So okay. Doctors aren't usually paranoid hyperchondriacs. I will say there is a hugely studied reluctance, particularly in men, to go to the doctor when they feel a little off. Men also have shorter life expectancy. So if you're feeling off and you can't catch your breath, your bones hurt, your vision gets weird, whatever your symptoms for whatever, go
to a doctor. My dad ignored feeling awful for months and my mom finally forced him to go and by that point they just legit admitted him to the hospital for blood transfusions. She saved his life. Way to go, Nancy, So dudes, go to doctors. Dad, go to the doctor. Next time Mom tells you too, do you have to do? You have a lot of people in your family that are call you a text you and say doctor durry.
Well, yes, quite a few, although I would say that within my family and friends that are not so hypochondriac.
That's good. Maybe it's a Scottish thing.
It's a Scottish thing. Yes, yes, so so my mother lived to be close to one hundred and my sister's pretty old, you know, so we were not like we're fortunate. We're not an unhealthy group of people.
Good. You've probably stayed away from diet coke and hamburgers. Now, last couple questions, last two questions. What is something that is the part of your job, part of your work that is the most challenging. That is maybe the thing that's more of a slog or something that is difficult. And then I'll ask you what your favorite thing is. What is something anything from parking to h Yeah.
Well, I think that the saddest and the most difficult thing has been the way that medicine has changed over the years that I've been practicing. Medicine is where, you know, I, for many years practice practiced it on an individual basis, where I would have my patients, you know, and I would take care of them. If they went to the hospital, I would see them, and then when they came out, I would take care of them. But now medicine's become a business. You know, I take care of them, you know,
I'm not there on the Saturday. Somebody else takes care of them. They end up in the hospital, and then this happens, and that happens, and then it's a whole bureaucratic nightmare where the individual individuality of the patient care has really lost that personal possibility. The paperwork is enormous, and then there are so many challenges when you see
your patient. And I would say that the biggest one is something that we touched on already, is you know, I want to give this cocktail, this medicine, will my patient be able to get it and to afford it, and this is just so difficult, and as I travel around the world. Obviously there are issues here in the US, but outside of the US.
So once again, as much as the price of some therapies are infuriating, we are lucky to have them.
I mean, there are whole countries that don't have revelement. I mean, so that means that they don't have access to anything beyond therapies that we had in the year two thousand and So this is a really a sad and difficult thing for me to see that there are so many patients that don't have the treatment that they deserve and that they need.
I imagine also the work that you do. You have such an interest in seeing how each of these patients does. Getting to follow through is probably it's probably pretty gratifying, right right.
So now you know I have patients that I see twenty years later.
Ah, that's great. Tried really hard not to cry at this point of the interview.
Which is fantastic, you know, and you know, they'll remind me that when I first met them, I said that my expectation was three or four years.
Wow.
And then you know I had a patient recently. She and her husband they reminded me that I'd said that, but it was it's twenty years now.
That's great. I love it when doctors are wrong in that fashion. That must be the best.
That's the best, okay.
And so what is your favorite thing about hematology or blood or what you do, Like, what is the thing that just really kind of gets you excited about starting your week?
Well, I think the most exciting thing is that we are starting to make so much progress, that we have these new drugs, that patients are living longer, and so that when I see a new patient now it's kind of not like, oh my god, you know it's going to be two, three, four years. You know, Oh, I can say, well, we're expecting you to live at least seven to ten years, and during those seven to ten years, we'll probably have something even better.
That's great.
You know. So it's really more of a joy. It's still a lot of hard work, but it's a much more positive situation than it was before.
Try not to cry while editing this, but still crying a little bit. That's great. That's got to be. That has to give you so much motivation for doing your best on the job.
Exactly exactly, Well.
This has been so this has been so informative. Thank you so much for sitting down with me. I can't believe it all started with blood under a microscope.
Right, well, thank you for your very insightful questions, which very very good to have a chance to talk to you about these things.
Of course, some of them come directly from Larry Ward in the matter.
Right, Let's tell Larry Ward that I am very happy to give these answers and many more as the questions pop in his head.
Okay, oh good, Thank you so much.
Doctor.
This is great. Sum Let's all move to tiny islands and live to be one hundred or at least stop eating garbage and go to the doctor when we're sick. So I want to say a huge thanks to the Peter Boyle family and Lorraine Boil for their work in raising millions of dollars to find a cure for multiple maloma, and to Peter Anton and Randy Lovett and everyone at the International Maloma Foundation for access to doctor Durry. Thank you to him. More info is at myeloma dot org.
Also side note, my mom has MS, so if there's a neurologist out there, holler at my face. Thanks to Stephen Ray Morris for editing this down to the wire because I'm so behind after getting stuck in the Northeast bomb cyclone storm this past week, I'm so behind. He's editing this like hours before it goes up. Thank you, Steven. I owe you a million dinners. Thanks to Hannah and Aaron for running the Ologies Facebook group, which you can
totally join. Thank you for being great friends. Also, all kinds of Ologies merch is available at ologiesmerch dot com. There's t shirts and hats and pins, and the sales help make this podcast possible, So thank you Shannon Feltus and Bonnie Dutch for that. They do awesome design work and I heart them. If you like the podcast and you want to support it, you can become a patron for as little as twenty five cents an episode at
patreon dot com slash Ologies. You may notice I do this ad free, so this helps me pay the cost of production. You can also help so much for zero dollars just by signal boosting. You can rate and review on iTunes. That helps so much. So does instagramming, tweeting about the podcast, telling a friend Ologies is at Ologies on Twitter and Instagram. I'm Ali ward on both and for your end of the episode. Secret. Okay, oh no, okay. Once, I didn't want to pick up a phone when somebody
called me, so I didn't answer. But while it was ringing, I fully clothed, got in the shower, walked into my shower without the water on, stood there for just a few seconds while the phone rang, and then I stepped out so that I could technically say later, I'm so sorry I was in the shower when you called and not be lying, which is insane. It would be better just to lie or say that I didn't feel like talking to you, but lying seem so evil, So I don't know. I don't know. I'm working it out. So
now that's your end of the show. Secret. Okay, that's it for this week. Thank you so much for listening. I like you so much. Very honestly, go ask smart people dumb questions, because curiosity is never not cool. Okay, bye bye. Pacodermatology, hobbiology or do zoology, lithology and technology, meteorology, paratology, ethology, zeriology, elinology.
Imagine the place where you can escape for a day, gets immersed in a world of rooms, inspiration, and expertise, where you can lay in luxury accommodation, Hank Kids cam fees from ninety five sets. Takets are free.
To every one and include all the attractions you've just imagined, a day out at the Gia, the Khia, the Wonderful every Day Employers.
The deadline for auto enrollment has now passed, but your legal obligation hasn't. If you're not set up for auto enrollment on the My Future Fund portal, you need to act now to avoid penalties. It only takes three steps. Complete your profile, set up a payment method and run pay roll as usual. Don't wait for a penalty notice. Complete them now at my future Fund dot i e. Ford slash Employer Brought to you by the Government of Ireland.