Health Anxiety, Vaccines and Making Sense of Medical News – Dr. Jen Ashton

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You're listening to Bulletproof Radio with Dave Asprey. Today's going to be a fun conversation that ought to be able to stay up on itunes. We're talking about the new Normal with ABC News chief medical Correspondent Jennifer Ashton, M.D. or as she's commonly known as, Jen. Dr. Ashton, welcome to the show.

Thank you, Dave. It's so good to be with you.

This is a cool episode because we've got about 50 people from the Upgrade Collective in our live audience, and I'm going to ask them for questions during the show, and at the end, I'll bring some of them on live. And if you're listening to this going, what the heck is Upgrade Collective? This is my mentorship and membership group, which you just pay a monthly fee, but I have a whole team of people who answer all of your questions about biohacking and all of that. And I participate as well with weekly calls, and it's been a huge amount of fun. So that means I get to actually look at all the people in the audience, and they get early access like this. So if you want to be a part of the community, our upgradecollective.com now, let's get into it, because, Jen, your book the New Normal, came out in February, and we're recording this, oh, about three, four months later. What has changed from when your book came first, hit the market, and now because things are moving so rapidly, is there anything that you're saying? I wish I'd have said that.

No. So that's actually one of the fun things, you know, the story behind the story, if you will, is, you know, for those of your listeners who don't know me, I'm the chief medical correspondent for ABC News, which is the number one news network in the country. And my medical specialty is women's health. I also have a degree in nutrition, which is why I'm a big fan of yours and really admire the work you've done in your books. But from the start of this pandemic, my job as chief medical correspondent was to kind of interpret and analyze and decipher the news headlines of this pandemic and then, you know, report it on live television in seconds or a couple of minutes to millions and millions of people. And so I've been living, breathing, eating, sleeping, dreaming, unfortunately, all things Covid for about a year and a half. And when my publisher came to me and asked me to write the New Normal, it's my sixth book, and you and I were chatting before we went on, you know, writing a book is kind of for all the women listening, like, having a baby, being pregnant and then having a baby, like it sounds good. And then you get into it and you get really into it, and then at the end you're a little sick of it, and then you have to raise it like a child. And the reason that I loved actually the work of writing this book is because I found that in covering this pandemic, it really was more about communication, or as much about communication, and how to explain medical and scientific concepts to the world and to the country so that people can really use that information rather than just reiterate a fact that, you know, when the book was written was true and now is not true. So every single thing I put in the book is for the most part, timeless. For exactly the reason that I knew the book was coming out in February. I finished writing it in September. I didn't want the content to be dated. And I knew that we were still going to be living with this virus and that it wasn't going to magically disappear. So really, everything that I explain in the book, you know, obviously there are multiple levels to it, but I really designed so that anyone reading it could kind of glean these lessons of, as I call how to think like a doctor, which is what we're taught in medical school. But you don't need an MD after your name to learn that those concepts. And then anyone who reads it will be able to take the latest headline because it is still evolving, and incorporate that from themselves.

One of the things that I appreciate about you is that you're actually a practicing doctor, even though you have a pretty hard, you know, hard work on GMA3. You wake up in the middle of the night, as far as I can tell, to do all the reporting that you do. But you still see patients, right?

Yeah.

Do you think that changes your perspective in your reporting to be able to say, yeah, this morning I saw someone with COVID and I saw this. Or is there a line like a firewall between the two?

No, I'm so glad you brought that up and thank you for mentioning that and for being aware of that. I do have a medical practice that I started 15 years ago and I had many, many patients who had Covid over the last year and a half. I have many patients who tragically lost both their parents to Covid. So this wasn't just, you know, as I like to say, I'm not, quote, just a doctor on tv. I take care of real patients. And in my medical specialty you know, have to deal with everything from anxiety, depression, skin problems, weight problems, hormonal problems. I just diagnosed two patients with cancer in the last two weeks. You know, fertility issues, you name it. That's what, you know, the field of women's health involves. And I absolutely feel that what I do for ABC News and GMA3 makes me a better practicing physician. And having real patients and being a real doctor in practice makes me better on the air. There's no question. And I think to bring it to the pandemic example, I think that there were a lot of really smart doctors and public health officials who. Who, I think missed the mark on communicating a lot of the information in the pandemic because they don't take care of real patients anymore. And I think that when someone does interact with a real person, it changes their approach as communicators of medical information because it becomes very real. This is not abstract. I'm not just talking to a camera. I'm talking to real people, just as I do in my office. And I definitely feel that that helped me and it helped us at ABC News a lot.

When I sort of dig deep on your book, the New Normal, it's really a book about resilience. Like, oh, you have to be tough enough to handle what life brings your way. Here are things you should do for it. How do you balance being resilient with. I'm gonna use a charged word here, with hiding? The idea is you're supposed to stay home for two weeks so that we don't overwhelm the er and somehow that morphed into never leave your home until some vaccine or until something happens where some people were home for six months and never saw someone, which isn't what I thought lockdowns did. So how do you have that conversation with a patient or with millions of people on your show to be like, you know, there's risk, but there's also reward. How do you bring people out of the fear mindset?

Well, you hit the nail right on the head, which is. And I have a whole chapter about this in the book, which is I go through how to stratify risk. You know, my job as a doctor, as a healthcare provider, is to interpret and analyze information and discuss it with a patient and then actually do something that is almost unheard of today, which is respect their decision and a principle called patient autonomy, even if it goes against what I would do personally.

What?

Yeah, I know. Really novel concept, patient autonomy.

Is that legal?

I know, I know. It's crazy. So. So I think that that doesn't happen a lot today. And when someone, let's say you gave the example of a parent with a child who's thinking of vaccinating that child. Look, I'm a parent and I have vaccinated my children, but I hear from a lot of people, while the risk of death is so low for kids. And my answer to that is what you said, which is there are worse things than death in medicine. And so that shouldn't be the litmus test for every decision we make, you know, is whether or not something could kill us. It's quality of life. It's what are the risks of long term, you know, damage with this virus or with a treatment or a test or those are the things that have to be discussed. It's not just life or death.

Tell me more about patient autonomy and how that is. When you have this sort of politically correct medical decisions, we have standard of care that's forced by insurance companies sometimes. How do you sit there calmly when a patient says, I'm going to do something that you as a doctor think is bat, you know, what? Crazy?

Well, I think this is something that we are taught formally in medical school, which is these biomedical ethical concepts. And the one of patient autonomy is a big one. You know, this is the other way of saying that is this is not a dictatorship. This isn't the dark ages where some doctor comes in and issues a mandate or an edict and, you know, the patient, you know, just mindlessly follows it or is forced to follow it. And, you know, I learned this firsthand when I was a resident and in OB gyn. It's a surgical subspecialty. I operated on many, many patients who, whose religion was Jehovah's Witness and they don't accept blood products. And you know, I counseled them on their options and the risks of death. If they don't accept blood during surgery, if they were to have a hemorrhage and you know, the risks other than death that could happen to them. And you know, at the end of the day, I respected their decision, period. That's, that's, you know, my job is not to make a judgment on someone's decision. And it's certainly not to kind of get angry at them if they decide to do something that, that I don't do or that I wouldn't recommend. You know, I just don't think that's modern era medicine. And it's definitely not modern era medical ethics. So I think that what we're hearing in the media, unfortunately is you know, just kind of this. Yes, absolutely. From a public health standpoint, from a global public health standpoint, for example, there is this push to vaccinate the entire world. But you know, I think what we're not hearing enough is that if after getting the right information, a person decides not to get vaccinated, we have to respect that decision even if we don't agree with it. And I want to be clear. Again, as I said, I vaccinated my children. I got my vaccine very early with my hospital. I believe in the vaccine, I recommend the vaccine. But guess what? I also respect the people who don't want to get it. I'm not going to cast them aside and not give them my medical attention because they've made that decision. And I don't think we're hearing, unfortunately, that side enough.

I really respect you saying that there's a big rush to judgment. Companies like Amazon are putting a little green dot on your badge. If you're vaccinated and you don't have to wear a mask, but everyone else does. So the mask becomes sort of like the scarlet letter. So hearing trustworthy doctors saying, look, people have a right to make their own decisions and you don't know if someone might have a medical condition like autoimmunity, where there's extra concerns. So having medical freedom, patient autonomy, and just being behind that. Thanks for standing up for your patients rights. And I think that takes a special kind of caregiver.

Thanks, Dave.

Well, you're welcome. One question for you. So you can get these three different kinds of vaccines in the US and you can get the Pfizer Moderna or the Johnson and Johnson. And I'm wondering which of them gives me the least risk of Bill gates controlling me with 5G and magnetizing my brain.

So here's the thing, and again, I think you and your listeners will hear, you know, my philosophy of a common thread here in terms of this. You know, there's certainly no shortage of conspiracy theories out there with respect to the pandemic, and that includes vaccines, people like Bill Gates, Tony Fauci, et cetera, et cetera. Okay, first of all, I do find all of those theories interesting, by the way. I just literally have had very little time to do a deep dive into the theories because I'm too busy reading the science about literally how this virus is affecting people's bodies. And another way of saying that is I'm more focused on the imminent future rather than the long term future. So again, that risk stratification, it to me is, I Want to protect myself short term, and I'll worry about the chip and the microchip, et cetera, down the road after we get through this tsunami that we're. That we're facing. But I think that, again, it comes down to what are the risks we know about versus the risks we don't know about. And look, there's endless lists of risks that we don't know for sure about, you know, and I can very easily go down those roads myself if I had the time to do so. You know, I just try to keep myself more, you know, focused on the hard assets, if you will, which is data, facts, what's going on right now and what's on the horizon as I see it, rather than getting, you know, decades ahead of myself into the what ifs and unknowns, because there's actually enough, quite enough, to, you know, do a deep dive in. When you just look at the logistics and the science and the data that we have, you know, that's not to say that there isn't, you know, other things to ponder. I just think that then you get into this realm of, well, what's the end point? I mean, where does that stop? And I only have so many hours of the day to digest things, to learn things, to keep up with things. And a lot of that time is based in the hard asset world of science, not the theoretical world of the what ifs. Um, but, you know, that's kind of my feeling. And, you know, even someone I work with in my medical office said, well, this is. She actually thinks that there is an element of control here. And I said, you know what, Bring it on. Amazon already knows everything about me from my buying habits. So if someone wants to know more, go ahead. I mean, it's already, trust me, they don't need this to do that. So that's kind of my tongue in cheek, but I'm being pretty serious about how I feel about it. Actually.

It's really pragmatic saying you already have almost no privacy and we just don't know it. And as a guy who worked in the computer security industry and is an engineer, it makes me angry when people say there's nanoparticles. Therefore, it will be tracking your health and sending it up via satellite. Like, guys, I was CTO of a health tracking company from the wrist, and before that, a stick on cardiac monitor. And that's just garbage science. Like, stop it. You're discrediting people who might have a point that, gee, the pharmaceutical industry is making a lot of money by fanning the flames of fear, that's a real thing. And aliens with lasers controlling your thing is probably not real. And if we can sort those out, we might have a conversation about taking all the money back from the pharmaceutical companies, which would change everything. But that's not the conversation we're having because we're focused on aliens. So I would love to see a little bit more rigor when we look in the future. And that said, bad people do bad things and sometimes good people do bad things because they have bad data. Which leads to our next question. How do you know that the data you're getting is good data?

Well, you know, all we can do is rely on what are really the bastions of medical and scientific literature. And that is the biggest peer review medical journals in the world and how their vetting process occurs. And I'm going to go back and cite an example for your listeners that I'm sure you remember from the last year, which. And by the way, so what are those sources? New England Journal of Medicine, the Lancet, jama, British Medical Journal. Those are really the big ones, right? Nature, Science Magazine, and then organizations like World Health Organization and cdc. Are they perfect? Any of those that I just named? Absolutely not. And in the last year we saw retractions issued by the New England Journal, and I think it was the Lancet actually, if I remember correctly, on a Covid related article, which they pretty much in short order found out or discovered that the methodology of the research was flawed or not up to their standards, and they retracted the paper. That is how it should work. That is reassuring that there is a vetting process, that you can't just submit something to the New England Journal of Medicine or JAMA and have it be published. You know, these are the premier medical journals in the world and their editorial board is, you know, very, very selective of the most credentialed experts. And they have a very rigorous standard to get something published that was expedited in the last year and a half because of the pandemic. But if they felt something didn't meet their standards, they retracted it or didn't publish it. So and we saw that happen and I was glad to see it happen. But that is really where we go for our sources on ABC News as the largest news network in the country. And personally, I go directly to the individual doctors that are making these statements or writing these papers. So I am speaking to the CDC director, Dr. Rochelle Walensky, personally. I'm speaking to Tony Fauci personally, Deborah Birx, the Surgeon General et Cetera, et cetera. I mean, this is what that level of news media access gets you, is the individual themselves who authored the paper, who did the research, the CEO of the pharmaceutical company who can tell me about the clinical trials and not just the press release. And, you know, are they perfect sources? Nothing's perfect, but they're as good as it can be.

One of the things that's hit the news lately, in fact, Facebook allows you to talk about it now, so it must be real, is whether or not the coronavirus may have been engineered in some way by humans. And I'll be flat out, guys, I'm not an expert in this. I don't actually know, and I don't think I'm that qualified to really judge that. And I am qualified to listen to experts, but I also have a hard time listening to an expert who may have been involved in creating it by funding labs and things like that. I can ask weird questions because it's my show and it's a relatively small podcast. You're on a big show. If you ask hard questions of big names, they might not come back. How do you navigate that where you have a big relationship? You know, your news network does, and you want to ask hard questions. Do you get to the point where you can't ask hard questions or do you just do it anyway?

I would say we definitely don't get to the point where we don't ask hard questions, but we do it, and we do it anyway. But we do it in a way that reflects the years and years of practice and experience that we have in doing that. So that we, you know, you're right. We. If we sideswipe someone, they wouldn't come on our program again, and therefore, millions and millions of people would lose the opportunity to hear from that person in the future. So that doesn't help people. But there's a way, you know, and I can't speak for. Obviously, I'm not speaking for the network. I'm not speaking for my colleagues at the network. I can only speak for myself, which is that, you know, I do my research before I speak to one of these people and interview them, whether it's on the record, on the air, or off the record. And because in the field of network news journalism, medical journalism, communication, there are ways that I know to ask a question where I can get at the answer or the information that I want to get at without being offensive or. Or without embarrassing anyone that we're interviewing. And I think that that's the skill and the expertise and experience that comes with having done this job for 14 years. But it's a very tricky line to walk because, again, there's no, you know, the people who are on our programs are guests. They're not paid by the network. So, you know, they sometimes they have an agenda. And it's our job as journalists to get at the information that we feel is important and that people need to know and not necessarily just, you know, we're not there to give someone or an organization or a company an infomercial.

I think your reporting has been really credible, and you do a great job of staying in the middle and not doing the polarized kind of news that's characterized the whole pandemic. So thank you genuinely for having that skill. One reason I'm asking is I've interviewed you. I've interviewed Lara Logan. I'm working on being a better, call me a type of reporter. If you do get interviews for a thousand podcasts, you have to develop something. So I'm asking that in part for my own thing, because I don't want to sideswipe guests either. It's rude, right? You can be kind and get to the answer, or you can be a jerk. Why are so many reporters jerks?

I don't think at the network level there are that many jerks who are reporters, to be honest with you. We've been doing it too long, and, you know, that's the top of the pyramid in terms of news journalism or media journalism right now. But it's not easy. It is not easy. And, you know, we don't. Even though it looks like we're out there alone, we're not. We have teams of producers, and we have a whole legal department at every network that, you know, vets the people who show up on our air and on our network and our platforms and make sure that facts are checked and that things are done up to the highest journalistic standards. But it's not easy sometimes, you know. And I think that part of the reason why every network has doctors on as journalists is because, you know, it's literally like being fluent in a language. So when I interviewed the CEO of Pfizer, I know certain questions to ask him, doctor to doctor, that a regular correspondent or anchor or producer doesn't know. Right? That's why ABC has me there. And I also know how to read between the lines on the answer so that I can tell, is this a canned answer that's part of a press release, or am I getting at something that really hasn't been uncovered yet? Because the only people who have been asking about this are not MDs. And so, you know, that's where I feel the most useful to the network and therefore to the viewing audience.

I've been dying to ask a doctor this question, is my vaccine status protected by hipaa?

You know, I think that's not really a doctor question, that's a legal question, a lawyer question. It is true. I mean, it's, you know, I believe that most stories that are in the news today, and this is no different, can be seen through a medical lens or a legal lens or a financial lens or sometimes all of the above. And this is definitely an all of the above. So, you know, there have been editorials written already now by lawyers, by doctors, by sociologists who are saying, no, we do have a right to ask people their vaccination status because this is about public health, not your individual personal health. Now, I don't really have an opinion on that because as you know, I stay in my lane and thank God I'm not making policy about this. Really happy about that. But I don't remember, we haven't really been in this situation before. So I think a lot of this is being figured out in real time. And I don't think we know yet. I think it's TBD to be determined.

That makes a lot of sense. I feel like if it's okay for public health to ask about vaccines, we also should for public health be asking about what you've been eating for the last year and how much you exercise. And then your employer and your insurance company, everyone should have full access to things that affect public health. I think it's a slippery slope and I'm worried about it. And we'll see what happens. I know you studied nutrition, so you know that's a part of public health too, but somehow we haven't touched it yet. All this leads to the seventh chapter of the New Normal. Your book, it's about anxiety. And so people have anxiety about, do I have to disclose my vaccine status? Will my kids be shamed if they do or don't get a vaccine, depending on where they go to school? What do health fears do to your actual health? Because you have a whole chapter in the book about what is your fear doing to your health?

Well, listen, fear, fear in its worst case scenario can be paralyzing, right? I mean, we see it all the time in medicine. People who are afraid to know the answer, to know the results, to take a test, to go to the doctor. And some of that fear is, well, substantiated and well founded. And sometimes it's not, but it does. Ultimately it doesn't really matter, does it? Because it's, it's still fear. And if it holds someone back from doing something, then it's harmful. Not all fear is harmful, though, remember? Right. I mean, I think you or I would be afraid to jump into a shark tank. You know, we'd be afraid to go into like lion den at the zoo like that. That's appropriate fear. But sometimes fear is not appropriate and it's not helpful. And I think that we're starting to see, see some degree of that with general kind of health and wellness behaviors that have kind of always been percolating, I think, under the surface. But certainly in the last year and a half with the pandemic, they've really kind of bubbled to the surface.

Is there something that you recommend? I know you have six steps in that chapter of your book about how to deal with health anxiety, but is there one step that stands out, something you recommend listeners could do if they're really worried about getting or not getting the vaccine or getting or not getting coronavirus or getting or not getting insert name of medical condition. What can you do to turn the fear down?

Well, I think one of the most important things in the book in the sense of those kind of chapters that I kind of take people through as to how to pandemic proof themselves and their circles, does have to do with diet and nutrition, which, you know, I, obviously, I know is an area that you feel super passionately about as well, because I think this pandemic really was a glaring example of how we really have to be ready for anything. You know, no one could have expected or anticipated that we would be in this situation. Well, infectious disease experts have been expecting this, but of course, no one really listened to them. But, you know, certainly In December of 2019, if someone had said, oh, guess what, in a year this is the situation we're going to be in, people would have thought that person was crazy. But in fact, here we are, right? And what I think we can all agree to is that in the last year and a half, whether we were, you know, sheltering in place, working from home, on lockdown, lost their job, working more hours than we normally do, whatever that everyone, it was a stressor, a major stressor to our lives, physically and mentally. And in times of stress, the fuel we put into our body, which is what we eat, you know, or nutrition or lack thereof, literally is. It's the pavement for how we respond to it. Another Way of saying that to incorporate not just nutrition and what we eat, but fitness and how we move is I say to people all the time, look, we're a very superficial society and culture, and I'm certainly putting myself in there as well. Vanity kind of is like, rules the roost. And all of us want to be in shape because of. Primarily because of how we look right externally. But I like to remind people that we should probably also spend a few moments regularly thinking like, no, you know what? It's not just about vanity. It's about being prepared for battle. Literally. Right, so what do I mean by that? I mean, if you get into a car and you're in a car accident, you better believe that your state of fitness the second you have that accident is going to determine how quickly or if you recover at all. That's not about the number on the scale. That's not about how defined your arms look in a tank top. This is about how fit and healthy you are on the inside. And the fact of the matter is, we don't plan for car accidents. We don't plan for pandemics. We don't plan for heart attacks, strokes, cancer, diagnoses. But the condition we're in when all of those things happen to us is predicated by what we eat, how we move, and how we rest. And I think if we look at that like we should always be in training to go to battle, we would be more resilient. We would be in a better place. And that doesn't mean we have to be perfect, but it does mean that we're always prepared.

That always prepared, highly resilient state. That's why I named one of my companies Bulletproof. It's that feeling that I've got enough energy to handle whatever life brings my way. It's resiliency. And hearing you talk about it in the context of a car accident, any stressor that's unpredicted, well, that. That's what we're all working on building. And that's ultimately what your book was about. When I read between the lines, the new normal is you should be highly resilient and you should be healthier than you were before. Because the pandemic really highlighted the fact that If I have 4.6 comorbidities, maybe it's not going to take much more to push me over the edge. What do you think about a couple questions from our studio audience?

Yeah, I would love it.

All right, let's do it. Tina, you ready to ask a question? We're going to Have Chris patch in.

Fabulous. Thank you so much. This has been really, really interesting. Really appreciate you being here. You actually touched on this already, but I'd like to ask a little bit more detail. We saw early in the pandemic that people with metabolic syndrome, type 2 diabetes, obesity, et cetera, were much more at risk. And you touched just now about nutrition and resiliency. Why do you think the message did not get out that people should take charge of their metabolic health? Now, they might not have been able to lose £100 in two months, but we've been in this for a year and so much of that could have been turned around and instead we're hearing, have a Krispy Kreme doughnut when you get a vaccine. So I don't understand why that message didn't get out more than it did.

Well, first of all, thank you for your kind words, and you are 100% correct. And if you or I knew the answer to that, really, then we would. We could give Tony Fauci a rest or, you know, we could be leading the world on this, or at least the country's response is in a. In a better way. But I think that part of it is, look, there's. There's only two components to that equation. There's the message and there's the messenger, right? For the most part, you know, you can say three if you include the person who's receiving the message. But the message is what you just said, that this is our wake up call, and it's been a big one and it's been a loud one, which is this virus, just like many other diseases, just like many other pathogens, does not like people who are super healthy. Other way of saying that is this virus has a field day with people who are overweight, obese, or, you know, come into their exposure or their infection with metabolic syndrome or insulin resistance, right? So that's the message, the messenger. Unfortunately, I think more often than not had a way of delivering that message that was either demeaning or insulting or patronizing or full of blame, accusatory. And again, it goes back to Dave's. One of his first questions to me, which is that I still see patients, anyone who takes care of real patients knows that the second you blame or accuse or berate, that's it. You have lost the battle. You will not get that person to do the behavior that he or she needs to do or should do for their health, because who would respond to that, right? This is like kindergarten teaching 101. It's like coaching philosophy 101. It's the same thing in medicine and public health. So I think that the messengers could have been better. I think the message could have been more clear. Right. And then lastly, to be fair, the person receiving that message needs to be open to it. Right. But I put that a distant last because, you know, I really like. I don't know if you guys have heard. It's one of my favorite sayings, but. And I talk about it in the book, which is be careful when you point a finger of blame because there's usually three fingers pointing back at you. So, you know, we can blame someone for being overweight or, you know, going to eat a crispy Kreme doughnut, but what about the fingers pointing back at us? What have we not done? What have we failed, you know, to this end? And so I think that that's the way I look at it, is by looking holistically or 360 degrees at all three, really, of those elements and kind of do a debrief and say, what. What was done? What could have been done better? What do we still need to do?

Thank you so much. I really appreciate that.

Thank you, Tina. Let's go to A.J.

Thanks, Dave. The question I had is recently they changed the COVID death to COVID death with. I mean, death with COVID and death by Covid. And why did it take so long to make this change? Because I really felt that in the beginning, this really created a crisis. People were so scared because the numbers seem so huge. And now they've delineated it into two categories.

Well, first of all, the short answer to your question is, I don't know why they did that. Number one, I don't know who did it. I don't know why it took so long. What I can tell you is that the way that we characterize and aggregate this type of medical and public health data in this country, talk about something that's in critical condition. This is what this is, a big one. And in fact, it put us, as you intimate, behind the eight ball from day one. Because we can't address a problem until we have an accurate picture of how big the problem is. And when one hospital or region or state is filling out their death certificates one way and another is filling out their death certificates another way, and the computers or people who aggregate that data are looking at apples and oranges, it's impossible to get a real picture of what's going on. Now in terms of the clinical background to that, I will tell you as a doctor who has filled out death certificates before when I was in my residency, that the top box, which always gets checked off, is cardiopulmonary arrest, Right? Now, why is that? That's because what happens when someone dies? Their heart stops and their lungs stop, right? So a lot of times the person filling out the death certificate will check that box because, well, a, it's accurate, right? But B, it's at the top. So they'll check that. Then, you know, maybe they'll go to some other, you know, substances down the hemorrhage, they'll check some, you know, other boxes on a death certificate. And then again, how that piece of information is analyzed. There could be Covid there, but that person that might not have caused the cardiac arrest, Right? You can have Covid and also have a stroke. Sometimes they're related, sometimes they may not be related. And that complicates our ability to get a good grasp on numbers. You're absolutely right. And this isn't the first time we've seen that, by the way. We've seen that with the maternal mortality crisis in this country over the last 20 years, where pregnant women would die and they would have a hemorrhage or kill themselves or die of a cardiac issue and pregnancy wouldn't even be on the death certificate. So how do we know how many pregnant women are dying? Because they died of suicide, not of pregnancy, but they happen to have been pregnant. And it's a massive, massive problem. And in my book, the New Normal, I talk about silver linings. And one of the things I talk about is that we have got to get our IT in this country up to speed, stat, as we say in the hospital, real fast, because we were behind coming into this, and it affected our ability to respond to this pandemic in an appropriate way.

Thanks for that detailed response. I appreciate that.

Thanks, A.J. that whole section in your book on silver linings was awesome. I teach people to focus on gratitude even if things are a total disaster. Well, hey, you're still there to look at the disaster, so there's something to be grateful for, right? I thought you did a great job of saying, look, here's some things that are going to come that are positive from this. This isn't a Pollyanna perspective in the book at all. It's just one saying. Look, we now have awareness where we didn't. So pay attention to that because that helps the turn off anxiety. So I thought you nailed that part of the book in particular.

Thanks, Dave. I mean, I do really believe. I do believe that when we are emotionally fatigued or frustrated or frightened because of uncertainty, you know, that that kind of, I call it the attitude of gratitude is really important. But also the scientific mind is an inquisitive mind, and it's an open mind, and it's one that is always looking to learn from a different angle, a different viewpoint, even from mistakes. I mean, think. Let us all think back to when we were in high school and we would have lab classes in science. Not every lab experiment went perfectly, right? I mean, God knows there were plenty that did not go as intended. But you still learn from those errors. You learn from those mistakes. And medicine, science and public health is a constantly evolving, dynamic, you know, area where if you don't look back and see where you've been, learn what went right, what went wrong, and how you're going to do it differently, then we would be stuck in, you know, in one point in time. So I do think it is really important to look at where we've been and what we've learned through the last year and a half and to set our sights on what will improve in the future. And I do think there are a lot of things that will improve.

You were, I'm going to say, courageous, where you said, all right, I'm going to decide to get a vaccine. And I have some listeners who are saying I would never, and other people saying, if you don't, you're a bad person. So all the shame in judging stuff, I just don't do that, and it's dumb. But what you said was, I have a food allergy. I have some concerns. I've weighed the risks and the rewards, and I've decided I'm going to do it. And you shared it on camera. How did you decide which of the three vaccines to get, given that you had an allergy concern?

So I didn't decide which of the three vaccines to get. At my hospital in Englewood, New Jersey, we got the Pfizer vaccine in December and January. I was in the second group of eligible physicians and hospital workers. So when my time came up, I didn't have a choice to say, well, I'd rather wait, or I really want Moderna or anything like that. So it was Pfizer. That was really the only option I had. And in terms of weighing my risk of an anaphylactic reaction, again, it goes back to those four questions. Risk of getting the vaccine, risk of not getting the vaccine, benefit of getting it, benefit of not getting it. And then I put in their risk of having an anaphylactic reaction, which at the time in December when I went to get my dose was less than one in a million at that point. And subsequently, you know, I think went to 1 in 90,000 with, I think, the Pfizer vaccine. Anyway, I'll roll the dice with those numbers. My risk of getting Covid was much higher. And then as I explained on the air, it's not just the risk of getting Covid. And as I said to you in the beginning, I really wasn't worried, particularly about dying of COVID Right. Because if you're dead, you're dead. I would like not to leave my children without a parent, but they're 21 and 22 and, you know, they. They would be okay. God forbid they would be taken care of if. If I were to die. I'm more concerned with getting Covid and getting some long term residual effect where I can't use my brain or I have myocarditis and I have heart damage. I'm not willing to take the chances with that. And so for me, it was again, about what is more likely. And I put real numbers in those boxes when I asked myself those questions. And that's why it really wasn't a difficult decision for me to make. You know, I had my EpiPens there. I spoke to my allergist before. He recommended that I take a Claritin or Zyrtec before, but not Benadryl. And, you know, I got my. I was observed for half an hour after the vaccine, and it was fine. But again, it's all about, like, as you said, putting on your seatbelt when you get in a car. Right. I mean, that's a bigger risk. My risk was probably greater driving to get my vaccine than it was of having an anaphylactic reaction and dying of it. So it wasn't a difficult decision for me to make.

I love it that your allergist mentioned the claritin and Zyrtec H1 and H2 histamine blockers. It seems like if everyone had those when they were getting the vaccine, they might not feel as crappy for as long. But I've never found a doctor willing to just say it. It's interesting your allergist brought that up, but only in the context of food allergies. Have you heard anything else about that?

I don't think that it's known. And again, remember the Claritin or Zyrtec, those over the counter histamine blockers? If you gave them, quote, unquote, to everyone, you would have a certain number of People who would have some kind of adverse reaction just to those medications. And then you would have to be able to justify is that small risk worth it based on how low the risk is of an allergic reaction. And that's why these recommendations, you know, may go on doctor to patient. And yes, I did consult my doctor. I'm not, I don't take care of myself. But they're not wide, sweeping recommendations for that reason is, you know, they haven't studied 200 million people yet to be able to make that judgment.

And the final thing has nothing to do with your new book, the New Normal, and has nothing to do with the pandemic or coronavirus. It has to do with your medical clinic, that thing that you do there where you run high frequency electrical current over someone's butt to make it bigger. Does it work?

Oh, okay, so it's not. So you're talking about this device called emsculpt, which is a basically high frequency magnetic generated muscle contraction that you can do on the glutes. I really got it for my patients after I tested it out, by the way, myself personally, on my abs. The company or the machine also makes it for arms and legs, but I don't have those, sadly. But absolutely it does work. And this is something called emsculpt, and it's non invasive. It takes 30 minutes and you definitely feel it. It generates 30,000 muscle contractions in 30 minutes. And its primary effect is to hypertrophy, the muscle is to build muscle. The secondary effect, which happens at about a four week after treatment time period, is loss of fat.

So.

So it incites apoptosis in the fat cells. And it does work. I'm gonna tell you something now, not on everyone, right? It's not gonna take someone who's 50 pounds or more overweight and give them like a Jennifer Lopez body. But if you're within like 10 pounds to your goal weight, will you see and feel a difference? Yeah, I've definitely. I can attest to that. It's particularly good for women my age who, you know, have like a little bit of like the, as my kids call it, the fupa, the fat upper pelvic area from, you know, little baby paunch that no matter how many sit ups I do, I was still having it. That got sucked right in. So anyway, it's been good. People like it, I like it. Cool technology. And again, risk benefit, very low risk.

It's a real biohack. And I love it that you're doing that in your, in your doctor's office in your clinical practice because a lot of people say, oh, it's impossible that you could add muscle faster than you're supposed to or burn fat faster locally, but you can do with magnets, electricity, there's all kinds of cool stuff. So the fact that you're on the cutting edge doing some of these biohacking protocols I think adds to your credibility as someone who's open minded and considering the future. And certainly that comes through in your book. Dr. Jennifer Ashton, thank you for being on Bulletproof Radio. Thank you for taking some hard questions and thank you for your expertise in asking lots of people lots of stuff for a long time. I appreciate you, Dave.

Thanks so much for having me and it was a real pleasure. Sorry for the bad signal issues, but if you or your listeners want to stay in touch with me, I do recommend run my own Instagram @drjaston. It's not a bot, it's not a team, it's really me. And I love to connect with people that way. So I hope we can talk again in the future.

I will share your Instagram and links to the show on my channel as well. Thank you.

Bye, Dave.