034 - Gene Therapy, AI, and the Next Era of Health with Dr. Hillary Lin | ClearCardio

GLP-1s.

I'm a fan.

What's your exercise prescription?

Honestly, it's just movement through the day.

Every day, move, do something that you like, or at least a test that gets your heart rate up and gets you hot and sweaty.

Walking is probably one of the biggest things. That, that and drinking enough water, making sure you're hydrated.

You know, I can't make you immortal. Yeah, I'll admit that. But I tell my patients, at age 120, When you're super centenarian, I'm gonna tell you to buy a motorcycle, get that Harley, do not buy a helmet, start drinking, drink heavily, and start taking up skydiving. Oh, and all the drugs I've been giving you?

Yeah.

Throw those away.

I think cancer is so scary to people because it's still so random. You could be the healthiest person in the world and it's like a lightning strike and you get cancer. And, you know, sometimes there's not much you can do. But that being said, I'm actually very optimistic about the future.

Welcome everybody. This is Dr. John Osborne, Chief Medical and Scientific Officer of Clear Cardio. Welcome to another phenomenal, and they keep getting even more and more phenomenal, episode of The Power of Prevention here at Clear Cardio. Today we have an incredible, very accomplished woman doctor whom I had the incredible pleasure of running into a longevity meeting about a month ago or so in Napa. It was amazing meeting 300 incredible people from all kinds of array, from medicine, investors, Scientists, all kinds of people. Somehow, obviously, they screwed up and invited me. But Hillary was there, one of the stars of of the program. We had a chance to to get to know her. I got to know her. As usual, she learned more about me than I did about her, which is really more reflective of me because I monopolized the discussions on preventative cardiology. Here's the time we're going to set things straight. Okay, so now we're really going to focus on one of the most amazing longevity physicians there is, and we're really going to hear her story. I want to hear all about how she evolved.

I heard a little.

Interesting discussions earlier. I heard a little bit about her professional career in the past. This is all going to be about longevity from one of the top longevity doctors in the United States. And before we go on, I do have to give a shout out to Jordan Schlain and John Patel. They're the people that put together this cool doc thing. You can find it on their website. It's doc something or other. Really, really phenomenal time. They have it every year and amazing people. And again, Hillary being one of the standouts of that, that program. So Hillary, thanks so much for being on Power's Prevention. You were kind enough to have me on your podcast and I bored you with all the preventative cardiology propaganda that I spew. But now this is all about you. So I want to hear all about— tell us, start at the beginning. Tell us your professional career, your journey, how you ended up doing what you do. I want to hear about your company and longevity. If you want to throw in some medical stuff with your dad, which we talked about earlier, that would be, I think, very interesting too. Kind of brings cardiology and longevity together as well. But again, this is all about you. I'll let you determine kind of where you want to—

Sure, sure. Thank you so much. I find you and your story and all your knowledge so interesting, so I only hope to be as interesting for your audience. My parents certainly had questions with all the professional decisions I've made, starting from a very young age. I come from a family of Taiwanese doctors, a long, long line of doctors. I would say at an average Christmas when we were all still getting along, we'd get together, there were over 12 doctors at the table.

Wow.

For people who don't aren't as familiar with Taiwanese culture, like many other Asians, we love doctors. And in my family, it just became a thing for many generations.

So you didn't let them down?

Yes, but in a lot of ways, I made them quite confused. I did the quote unquote expected or right things for the first part of my life. You know, I became a pre-med, I studied biology, I did research, I was at Stanford for a long time for undergrad, for medical school, for internal medicine, Residency. And all along that time, I had a big question mark in my head because on the one hand, love medicine, love patients. You know, what drew me was actually learning the stories of patients, and I love that part. And then on the other side of it, I was so confused as to why healthcare felt completely like the antithesis of what health space care ought to be. I sometimes joke, and it's a little bit true, that I was burnt out almost from day one of medical school. It's not what you'd think. So I, For clarity, I didn't grow up—

Your medical school, did you have a white coat ceremony?

We did.

So I can imagine you at your white coat, first time you ever put it on, right? Officially in the pictures, you're going, yeah, I'm outta here.

Yeah, I know. I should have just taken a left turn and run. It's a product of the system. We're trained from such a young age and you don't get the opportunity to experience what life is like outside of medicine for a very long time. A big chunk of your early adulthood. For me, you know, people think I come from a family of doctors. I should have known what I was getting into. And the reality is, didn't grow up with any of the doctors. I grew up with my mom as a single parent here in the US. And so my dad and everybody else was in Taiwan. I never really understood what the system entailed.

Tell you the family secret. No, really hard and tough.

And has sometimes nothing to do with healing. It took me the ravages of residency to really screw my head on in the direction that I've went on to later, which was I matched to go into oncology and I was ready to be an oncologist, do the whole oncology thing.

So where'd you match for oncology? I gotta ask.

Columbia in New York City. Everyone there, by the way, was wonderful. Nothing against Columbia. The one thing that happened was I had way more time to sleep compared to residency, you know, and therefore I had more time to think and clarity of mind. And I realized that there was no way going down this traditional path That I was going to be able to do what I wanted in medicine and innovation and all of that. That's when I took a real departure. There were a few years actually where I thought I was just not gonna practice clinical medicine ever.

Hmm.

And I was working with early startups in a variety of fields, as diverse as cancer screening to sleep medicine and relationship wellness. It was very interesting time. And eventually though, I decided that I still love practicing medicine. It's just, I needed to find the way to do it that didn't tear at my soul.

So you're doing these paramedicine things. How did you get involved with that? Or how'd you find these people? Or I'm just curious how that journey went.

Yeah, it was really a graduate school of its own. It's sometimes how I think about it. It's having a residency in the business world of life. And it, I was lucky to be at Stanford before that entire time, because at Stanford, obviously Silicon Valley, there's a lot of talk about entrepreneurship. I went to hackathons, I went to all the workshops. I joined, uh, the business school, not for the full program, but for a certificate program. It was like a mini MBA. And that all geared me up for the mindset of what it was like to enter the startup world. And even so, it took me several years trying to start companies with different teams to really figure it out. It's a tough thing to do. I don't think we talk about it enough, what even small-time entrepreneurship is like. And, and, you know, you've started your own business and you've been running it for a long time. And that's a tough thing for a lot of doctors. We don't get taught that in medical school, as you know. But fast forward several years, the pandemic hit, a number of interesting things happened in my life. I happened to also be going through a divorce at the same time. I was in New York City. The entire city was scary. They shut down, but then it kind of was centering for me as well. I decided that I was still very early on the entrepreneurial journey. I wanted to start my own venture-backed company, which I did. It was called Curio in the field of mental health. And I also expanded my practice. I had started working with some telemedicine practices at the time.

Maps.

Yeah.

Yeah. Yeah.

Maps and all that. And did basically primary care type medicine for several years. And I've continued that in various forms, even as I've built businesses. That are quite separate from my clinical practice. But Curio was an interesting endeavor because this is out there. So before I entered the field of longevity, I was in the field of psychedelic-assisted therapy. I still deeply believe in it. Talk about a field of healing that doesn't get a lot of validation in the traditional system, but it's a tough one. And that's what we found even as we had early success. It's a tough one to Get entrenched in for regulatory reasons, for cultural reasons a lot of the time, and monetary reasons. It's, it's, uh, thankfully in a lot of ways kind of anti-capitalistic, but when you're starting a company that's backed by VCs and it's going to take a form factor that might be sort of the antithesis in some ways that whole healing culture looks like. I'm excited still, but I think it'll take its time. Journey goes along several years later. We essentially transitioned away from doing that business, me and my co-founder. Just because it wasn't going to hyperscale. Like I mentioned, it was a venture-backed startup. And so we all went different directions and my path was towards longevity. I started with a 2-pronged approach. One was my entire clinic became a longevity-focused clinic. And this is still all telemedical, by the way. I've kind of stuck strong to that. And I think we can do about 90% of what we do with telemedicine and referrals to the right people.

All I'm missing is, is checking pulses and murmurs.

Yeah.

And frankly, I put you in the CT machine.

And then we've got everything.

One of the great things about COVID being the eternal optimist that I am, is it really opened up telemedicine. I mean, we should have been there. We should have been way ahead. No reason not to be and using it as a tool like every other tool we use. But it really was the major impetus issue.

I can't believe it because it's been around since the '90s and we just never picked up on it. I've got kind of an interesting, diverse practice. I say that because I've got some folks who are in their 30s. And I've got some folks who are in their 60s and every age in between. And everyone's general goal is to be as healthy for as long as possible. But their attention to their health is variable. While everyone is there because they're excited about longevity, they know that that's what I do. There's some folks who are more on the biohacker trend and they're always pushing me for peptides and so forth. And, and then there's a few folks who are dealing with like a number of really just gnarly chronic conditions, like chronic headaches that have a mysterious cause and so forth. Just like odd things. I think what it is, is that while I call it a longevity clinic, really it's kind of concierge clinic where I can spend a lot of time with you. And so I have time to talk through all of these sort of more complicated details and symptoms and, and we can do very bespoke testing and interventions dependent on your situation.

In my concierge practice as well. I always tell people my secret sauce. I mean, yeah, my experience, all the cool imaging equipment, hardware, whatever. But my real secret sauce is Dawn doing what we're doing here. Just listen. Tell me your story, right? I really do believe maybe less physical, but history is absolutely critical, right? To understand the body, the mind, all of those things. And I think our secret sauce is we have it, right? That does not work in the insurance world.

Many of my colleagues still practice in an insurance I call insurance-gated health system. If they're lucky, they'll get like 20 minutes. But, you know, most of them are trying to— it's the revolving door of 7 to 15 minute visits. Even my oncologist colleagues, they have like 40 patients in a half-day clinic and, and they're just seeing like follow-ups of like breast cancer patients, which is really terrible.

Hamster wheel of medicine. I always practiced like that. Administrators yelling at me, you're making people wait, all that stuff. Then when I finally made the coming over concierge, it was like, Great. People stop yelling.

This is the kind of medicine that actually feels good.

And it's why I went in medicine. And I think obviously I expect you too. You love people. You love doing things for them. You love taking all that knowledge and wisdom and all that stuff and translating into how can you make that patient, of course, live long, but live better.

Even though it's, again, we call it a longevity clinic, but it's really about living well. And we do a lot of things. Of course, you know, people don't think about the actual lifespan aspect of this much. I have to remind them. The preventative medicine that you and I were talking about, especially with cardiac disease.

If you think about healthspan versus lifespan, healthspan is your healthy life, right? But without lifespan, which is just how many breaths you take and how many heartbeats you have, without lifespan, you can't have healthspan. You can certainly have a long healthspan and lifespan, but unless you have a long lifespan, you're never going to have a long healthspan. So make sure you tend to the little details, the stuff in the weeds, like, oh, heart health and stuff to make sure that you have ample time, no stupid, predictable, preventable deaths. And that's what I take care of.

I like to say.

I think it's so important and I'm after folks all the time. And now I've got a few more tools that I can reach for after our conversations. And I try to be on top of that for everyone. It's not just the heart disease. We spoke about cancer. Cancer is tougher to figure out detection and it progresses so differently. Depending on what sort of malignancy you may or may not be brewing, and and it comes and goes in all of us. We've got little tumorous cells coming up, and then they go away all the time. So it's a tricky thing to screen for. And then there's that whole world, two worlds I'd like to say that are more mysterious. One is that of metabolic illness, which we're getting a lot more clarity on these days, and people care about it a lot more. And then related but different is the inflammatory world. We discussed this in the heart context, but it affects everyone. Everyone in terms of their, you know, brain fog, their thinking, their fatigue, their energy levels, everything. I mean, like people who just care about their aesthetics, their skin or something like that. It comes up all the time and it's so poorly defined and hard to put a finger on. These are big, broad topics. And what I have found is no matter how well you have treated yourself, there's always something that comes up. And I'm not bringing it up for them. Most of the time my patients are coming up, it's like, Okay, we solved one thing and now it's like there's something else that they're thinking about. Like, you know, even if it's something good, they're planning for future fertility plans or, or something like that. There's always something to work on, which is why I find what I do to be very exciting.

It's kind of like science, right? You find every question and you got 5 more. Why? It's so exciting. It's great.

Yeah.

Just realize you will never— it's going halfway to the wall and again halfway, right? You're never gonna get to the wall, but frankly, That's what I love. It's fine. It's infinite. At some point, my staff will get tired of changing my diapers and pushing my wheelchair. But up until that moment, you know, so much that we can do and learn from people and do to help people to have that long healthspan and lifespan.

I think like, what is more fun than just working on yourself, really? Self, your health, less stretching your lifespan or even health. It's kind of a form of self-improvement. And that's why actually people aspire for this longevity. It's not really because it's very hard for a human brain to understand the concept of being alive for 100 years. That's impossible to really feel, but we can understand improving oneself. And that's kind of the ethos of longevity.

Hello everybody and welcome.

This is Dr.

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So let me ask you what right now, top of your head, is particularly exciting in the longevity field, maybe on the diagnostics, on the therapeutics. So give us an insight of, you know, I always like to say I'm from 2035.

What am I thinking?

I keep coming back to 2025 and telling you what to do and no one listens. But tell me, since you're from 2035 in the longevity world, we've met many times 10 years from now. What do you see happening right now that's really exciting, new, either in diagnostic side or the therapeutic side?

100%, it's gene therapy. And we spoke about this for the heart disease treatments, but we're starting to see evidence for every single field because many diseases that we deal with today have some kind of genetic theory or basis or mechanism. When we were at that doc conference, for example, I learned about the Alzheimer's sort of gene therapies that are coming around the corner. When I say coming around the corner, it's probably gonna take us, uh, 20 years. It's there. The gene has been identified, the theory is all set, and now it's just setting it into motion. And we've seen now, I've lost count. I think there's like at least 4, if not more. Diseases that have been cured through gene therapy.

You know, stuff like sickle cell anemia, horrible, horrible disease, right? I mean, you could provide supportive therapy, really, you couldn't do anything about it. Well, now, you know, we, we have gene therapy for sickle cell anemia, which is a horrible, horrible disease, right?

Yeah. Yeah.

And hemophilia and all kinds of, you know, these tend to be monogenic rare disease, rare, uh, but there's a lot of them and it's incredible what we've accomplished just over the last few years. We're just chronic, horrible, debilitating diseases and it's just kind of how slow you could You could get the slope, right?

Yeah, exactly.

Less like that and more like that. Where now we can, we can cure these things.

And it's paradigm changing. And I think this is one of those things like, you know, everyone's excited about AI. I am too. Let's talk about that. But one thing about things like AI is you have no idea what the world's going to look like in X number of years, like say 3 or 5 years, because it's accelerating and progressing in a very unpredictable way. I feel the same way about how gene therapy is going to completely change our approach to medicine. We just We can't even conceive of that right now, because right now we're all worried about treating people for chronic disease. That's our main focus in medicine, unfortunately. And that's going to go away one day in the next decade, perhaps. All of that may go away. So what does that mean? What, how do we train doctors? Like, meanwhile, for those of us who are striving to— people talk about the longevity escape velocity, where you just live long enough and then we'll have all the cures for all the ailments that might kill you. It's a little bit like that. It's what will it take to just Live long enough and be a healthy substrate, a healthy body for the gene therapies that are coming around the corner in the next couple of decades.

Kicking the can down the road long enough and reasonably healthy enough, it'll be waiting for us.

I worry most honestly that we're going to do ourselves the most harm. Human society, I mean.

Oh, I agree. When you talk about the future, assuming we don't blow ourselves off the face of the earth in the meantime, much easier to do than what we're talking about, alas.

And another thing, this is not an intervention, but I'm very excited about patients Advocacy and agency, the initiative that consumers or patients, if you will, are taking to take charge of their own health. And that's so different. Like you see generations before where it's just like, I'll just do whatever my doctor says, or like my doctor didn't say that was a good idea, so I won't do it. And now people are skeptical in a healthy way, sometimes overly skeptical and problems arise there.

Yeah.

But there's some healthy skepticism, and I think when that's backed up by Doing your own research. I'm a fan of using LLMs, AI. If one knows how to use it, it's a great tool. And then going to your physician or clinician, whoever it is, and asking for certain things. For example, a CT angiogram with an AI screen on top of it. I think it's amazing.

I'm going to do kind of some quick— I'm certainly not necessarily a longevity person. You're the expert. I'm just going to throw out some terms and then just stream of consciousness. Okay. Metformin.

It's a Promising, although probably not by itself.

Rapamycin.

Very exciting, although again, probably not by itself and still early for humans.

I'll say vitamins.

It should be personalized. I went from being like vitamins are complete BS to being like, okay, it's obviously good for the right person, but effective if you have some kind of deficiency that you're trying to treat.

Exercise. There you go.

I mean, all right, 100%.

What's the perfect exercise? I mean, I think we're both agreeing with that. In fact, I like to call it vitamin E. Right. People ask me about supplements and all this stuff. I say vitamin E. Oh, really? How much? Uh, probably at least, uh, 30 minutes a day. And, and I'm sure it's personalized, you know, for everybody, but what's your exercise prescription?

Honestly, it's just movement through the day.

I think people get so like, oh, I got to do this many steps and pounds and minutes, you know? No, no, no, no. Every day, move, do something that you like, or at least to test, to get your heart rate up and get you hot and sweaty. Yeah. to your lifestyle, that works, that you can do, and physically and all those things. All the rest is kind of detail.

People are all obsessed with zone 5, zone 2, and that's all great, by the way. I'm not saying that's not good.

If you want to, it's fine. Yeah.

You can push the limits, but like zone 1, probably, but like just some activity throughout the day is so important because sadly most people are sitting at their desk or in their car. Well, actually I have a secret, which is I'm standing right now on a treadmill.

Okay.

Very good. Yeah. I'm standing all day.

I'm gonna have a walking desk.

You should do it.

You know, frankly, while I'm spending all this screen time and stuff, I wanna do something healthy. So that's gonna be by the end of this year. I'm gonna have my walking desk.

Well, we know how circulation is so incredible for all parts of our body, but especially like brain health. And walking is probably one of the biggest things. That and drinking enough water, making sure you're hydrated and that everything is moving smoothly through your vasculature. These secrets are cheap.

Jobu blends.

I'm a fan. They are probably too strong in dose for people who don't need that dose. So I'm curious about the lower doses or the microdoses, so to speak.

So from psychedelics to GLP-1s, right?

I think, yeah, absolutely. There's something to that. Well, there's the whole entire testing suite.

How have you evolved in that? Because I think it's very interesting. Like what tests, when, who?

Really, it's a constant evolution because the I believe that we don't know all the answers yet, and that includes we don't know all the exact tests that we should be getting for each person. If you're asking me, like, should a person get 100, 200 biomarkers checked every year? I think that's excessive. Testing is relatively risk-free. The only risk is really getting overly anxious about something that might not—

As long as you don't run into anemia of chronic investigation.

We're probably in the consumer longevity world a little bit overexcited about these gigantic panels, and you don't really need That, especially not every year.

On the lipid cardiovascular side, just get your Lp once, right? It's normal.

I know.

Save the blood money.

But yeah. And the problem is it's, it's hard when you are standardizing a protocol and I understand that.

Right. Because, because they end up, you don't want anybody to, you don't want to miss anybody.

Right.

Sometimes you go, oh yeah, well, it's an Lp. It was fine before.

It was fine. Click a template, right? And it's just like, all right, just get it again. It's not going to hurt. Actually, this is a good point where, so I'm building something new as well called CareCore and the way that I practice in my concierge clinic where I've got lots of time to personalize versus what we're building into CareCore, which I'll describe, is quite different. CareCore is a technology platform that helps a person, whether a clinician or a brand of some kind that wants to expand into longevity type care. So that's blood tests and medications and so forth.

A Mad Libs approach to longevity.

It's a little bit like that because you need to have all the options available and to preset what is available before you turn it on, because it is a platform that's meant for scale. And the whole mission is accessibility for longevity. That's very different though, because in my personal clinic, I spend like an hour and a half sometimes, like talking through everything. I'm like, oh, I'll debate like, okay, this test or that test. I'll think about it really hard. And we have that luxury. But if you are creating something to democratize longevity, Mm-hmm. it's certainly gonna be a little bit more standard. And we wanna keep the quality high, but sometimes that means You, you end up testing Lp a few times.

It's great. And I think I have the same sort of idea when I'm with my patients. I am constantly learning stuff that I thought last week was correct. I'll find out this week, or as I think about it, right, do the research and development. That's kind of a practical— as I'm just listening, learning, sitting with patients. Yeah. It's all constantly evolving, which again is why I love medicine.

We're always learning. And really like, it might scare people to learn that we are constantly learning and it's the practice of medicine. Yeah. Yeah, but we get— as long as we're getting like the big chunks right, and I tell that to patients as well, I'm like, just make sure you've got the big chunks right. Obviously you don't wanna hurt yourself. Don't smoke, wear your seatbelt, don't go crazy with eating processed food, that sort of a thing. And then all the other stuff is optimization, which is very good if that's what you're going for. But you also don't have to take it so seriously because people will drive themselves nuts over tiny little details.

Exercise, people with the monitors looking at their heart rate, and then suddenly their entire world is like their heart rate. I'm gonna say, get it up, get hot and sweaty, that's fine, just move.

My partner actually, who's an AI scientist, so he's a technologist and very analytical, the other day he was telling me, he's like, the heart rate zones on the treadmill are off from— and I was just like, it's not a big deal. And the same thing goes for one problem that does come out of overtesting sometimes is people try to fine-tune their levels of whatever it might be, vitamin D or like their hormone levels, and they get really obsessed. And I think it's really important to understand too that tests aren't infallible. They, first of all, we've got reference ranges.

We have our own variance, right? Which people, if you see a test that's like 6.92, you go, that's 6.92. No, it's 9-ish.

Check it at a different part of the day, even just go to a different lab. Like there's so many differences that might occur. And if you're checking against a reference range, That might not match you in particular, whether by sex or ethnicity or the population of the country you live in. And so that's how they came up with it. Those are big topics. I still think it's very good that people are generally excited and engaged in their health. That's the main thing.

And having great discussions and asking those questions. I think we've gone from old sort of medicine is the soup kitchen. I just show up with the bowl, here it is, to now, hey, no, I'm going to be the cook. I want to be a chef. And just that power and agency. And I think it's great. On our side, it Many times means more time because you have to explain, well, let me tell you, let's get into the weeds of this, right? We're doing this, not this, and this is whatever. That's great because again, we have the secret sauce, which is the time to spend with our patients and educate and all of those things.

Education. I love that concept because I actually was talking to another colleague of mine, another physician, and he said, you know, like I went into medicine because I wanted to educate people. And in the traditional systems nowadays, you have zero time to do that.

It's purely triage.

Okay.

You're going to die. Sorry. It's just purely triage, which is psychically, emotionally just deadly.

I remember, I don't know if, uh, this existed in, in your grade school experience, but I had a health class that I love. I feel like that's not that common. I don't think every primary school, grade school has health.

Of course, when I had my health class, it was mostly about bleeding and leeches.

The barber surgeon class is what they called it. But, but I think that's a— we should start very early. People really don't seem to understand some basics. Like, I still run into people every so often who don't know that antibiotics don't treat viruses and so forth. It's fascinating.

It'd be a long discussion too.

Yeah. Yeah.

And I think as I recall, the term doctor from Latin derives from teacher or educator. Saw that somewhere, could have been on a bathroom stall somewhere, but anyway, a long, long time ago. And I just thought, yeah, I mean, that's why I love doing what I do, right? Learning stuff, talking to people. And I think the education always works both ways, right? I learn stuff from my patients. I learn what to do sometimes, and hopefully I'm helping educate them as well. That's what makes it so fun and exciting. So So I think we're really educators at heart, pun intended. And then hopefully along the way, saving some lives and stamping out disease. And as I like to say, and this time I'm gonna get it straight.

That's a perfect way of describing it. And my little note about that is I always think about bottoms up versus top down. And in medical school, whatever PhD program some people go through, we learn bottoms up. We learn the theory, we learn about what should happen according to textbook, but then the top down, the empiric evidence is When we actually see our patients and their experiences of taking XYZ intervention or living a certain experience, then that teaches us. And that's why experience is such an integral part of doctoring.

Oh, I agree. One of my favorite sayings is good judgment comes from experience. Experience comes with bad judgment. But I really do believe every day I'm just a smidgen better than I was the day before.

Yeah. Yeah. I mean, if, if only we could all say the same. I get my ups and downs, but it's a wonderful way to go through.

Is in the right direction. Maybe there's some deviations from that line of slope, but the slope is good.

I agree. I think, you know, health is one of the most fascinating areas and it affects all of us, which is what makes it so fascinating. I started my academic life in psychology, actually. That was what I wanted to do.

You realized you weren't insane.

No, I get that all of mine too. It's like you get interested in what afflicts you most. I almost went into psychiatry, so, you know, I actually loved it. And the only reason I didn't go into it was there's so much of health that I wanted to get involved with.

Yeah. It's a big, big deal, but you know, it's kind of isolating 'cause you gotta divorce yourself from all the other reasons that we learned the TCA Krebs cycle.

Yeah.

I will say in your oncology journey and all that, I really felt, I love my oncology colleagues and all that went into oncology, 'cause I think really that is ultimately applied psychology. I mean, you have to. There is so much that, you know, you're gonna diagnose her cancer, treat the cancer, stage the cancer, restage the cancer, do all those things. My favorite, best oncology friends, they're really great psychologists. They're really dealing with people who are really very sick, very desperate, very scared, and, uh, be able to kind of talk 'em off the ledge that way. It's really the people and the personalities and—

I actually originally went into oncology for that very reason at a younger age. I don't think about it so much now, I think it was the psychedelics, but younger in my career, I remember thinking, what is it that I'm both scared of the most, but is the most meaningful. And it was the contemplation of life and death. So of course, we all doctors deal with life and death in some form. I mean, you certainly are, you're in a field, number one killer, right? But people, for what it's worth, think about death way more when they have cancer or are dealing with cancer.

Mm-hmm.

And so that contemplation was actually what drew me there. And the reason was cuz I was rather scared of it in the beginning of all my career. I was like, okay, I'm just going to go straight towards the thing that bothers me the most. So I thought about it, went into that field. And I still do think that it's spiritually the field that I'm meant to be in. But again, it was narrowing my interests. Like I, I wanted to do more. And so I'm happy that I ended up doing what I have done so far, but I still love it for that reason.

And I'm going to say, and please accept compliment, I think some of the finest human beings I've ever ran into are oncologists, just as far as Just their warmth, their personality, their caring. Oncologists and pediatricians.

I could definitely agree with that. I mean, hanging out with my friends in oncology, but the pediatricians, they're truly selfless.

If one makes a broad paint with a big, big paintbrush stereotypic, stereotypic kind of comment, I'll say pediatricians and oncologists, really in general, pretty amazing human beings.

Not to mention the pediatric oncologists.

When those come together, oh man.

I think what people don't recognize sometimes from the outside is that every doctor is different from another doctor. Each doctor is different. And that is so key because I think when I was a kid growing up, I remember thinking doctors are doctors, but that's not true. It's, it's for what it's worth, medicine has become rather siloed and people find their own little niche. But I think we're coming around as we're democratizing knowledge. And again, going back to AI, I think AI is going to democratize knowledge more than ever.

That's right.

And it's going to empower both the generalist as well as the specialist.

Mm-hmm.

Because both can learn about the other very quickly, and it's going to bring different types of practitioners, doctors, clinicians together actually, so that we can all do a lot more than we currently are.

We're gonna close out, but I wanna touch on, we, we talk a lot about heart disease. Hmm. Why is that anyway? I want to hear about cancer, early detection, what the tools are, where we're going. Because I think that's a big concern is if you recall, probably not, from my silly little talk I give, I said, I think the big concern most people have is CNN, right? Cardiovascular. Well, most of them probably don't worry about it until they have it, but cardiovascular, which is the reality. And then neurodegeneration, Alzheimer's, cognitive issues, memory, and then neoplasia. Give us your insight into where we are in cancer and detection and And diagnostics. And obviously I think most of your stuff early on in your career was focusing on, you have cancer now, how would you take it? And so—

And unfortunately what's sad is when you are an oncologist, it's very rare that you can cure people, especially a medical oncologist. That's something that, you know, is tough for everybody in that field. But to go on that thought process, I think cancer is so scary to people because it's still so random.

Mm-hmm.

We feel like you could be the healthiest person in the world and it's like a lightning strike and you get cancer and sometimes there's not much you can do. But that being said, I'm actually very optimistic about the future because right now screening is so bad is the reality. We've solved a few things. Cervical cancer screening is—

The Gardasil, the vaccines.

Yeah. Unbelievable.

And even that, we still need to do better. We're not getting those out to all the folks that would benefit from them. Yeah.

Yeah, no, I know. So, so we've figured out like roughly one. And then actually the others that we have screenings for, like colon cancer, breast cancer, prostate cancer, to some extent lung, they're imperfect. There's always something off about the scheduling or the modality. So it's still a far way from being perfect. We can't say what you say often about heart disease, which is that you can detect it and you can prevent it with absolute certainty.

Right.

Not of heart disease. So even colon cancer, which, you know, is usually that gold standard, we sometimes get polyp growth in between that yearly. There's just not the same. Cancer grows in unpredictable speeds is what it is. And you can't catch it all the time unless you have a continuous monitor. And that's actually what I'm optimistic about is as we are understanding more about the omics world of detection, so proteomics, And lipidomics and so forth. So there's going to be tools in the future. I don't know how far, because we're still so early, is the truth, when we'll be able to do like a daily, either a blood or even a saliva test, and it will tell you, you've got a little bit of cancer today, but check again tomorrow. Maybe it'll go away because your immune system was functioning.

Yeah, it does, right? I mean, there's like earliest stuff, right? Pops up and then our body goes after it and T cells and—

They're in the future, but it's not here today.

And I think the only way we're really gonna do it as humans is using AI. And I think it's just way too complicated for our, our hands around.

Oh, definitely. Yeah. You need machine learning. So that's detection. And more and more, there's even better ways of personalizing interventions once you do have cancers. So we of course saw the immunotherapy revolution over the last decade, and that's been amazing. And we're getting more and more personalized with that. So that plus combo therapies that are personalized. I met, uh, one of several companies that does ex vivo sort of testing. They take your tumor cells and they do, they use AI and they figure out like what actually, yeah, kills off those cancer cells. And, and I'm like, that's amazing. That's something that they're pricing it at about $8,000, which is costly, but when you have cancer, it's, uh, you know, perhaps—

It's with it. Can't take it with you. So.

Yeah, exactly. Personalized interventions plus immunotherapies. And similar types of interventions are very exciting to me. I still, again, think we're quite a ways away from getting to where we are with heart disease though.

So, well, my goal, you know, I can't make you immortal, but again, no stupid, predictable, preventable deaths. I tell my patients, I give them a carrot at age 120. What I'm going to tell them will change dramatically because at age 120, I'll remind them, I cannot make you immortal. We'll do everything we can in the meantime, but no stupid predictable cardiovascular deaths. But at age 120, when you're super centenarian, I'm going to tell you to buy a motorcycle, get that Harley, do not buy a helmet, start drinking, drink heavily, and start taking up skydiving. Oh, all the drugs have been given you. Throw those away.

Right.

Because we've now pushed cardiovascular longevity where it won't be relevant anymore to you.

So that's hilarious. Yeah.

rest for that, right? I mean, we'll kind of go, yeah, you know, we did that for 50, 60 years. We've now pushed that so far into the future that it's frankly no longer relevant. Can't make you immortal. But that's where healthspan and lifespan really kind of come together, right?

Absolutely.

But I am looking forward to riding my bike around town without a helmet being drunk as a coot. So that'll be fun. Yeah. But probably better to do skydiving. Less chance you'll actually like lay out.

If you were going to get hit by a vehicle, you want it to be Fatal in that situation, not, not just debilitating.

No morbidity, only mortality.

Exactly.

Awesome. I really, really appreciate all your time. I think I took more of your time than—

Oh, this is so fun. Thank you.

Allowed, but I appreciate that. It's been a great discussion. I hope we can do this again sometime. We'll both be learning stuff and what we say 6 months down the road will be different than what we say today, which is exciting.

So absolutely.

Thank you so much, Dr. Lin, for joining us, sharing your journey, your growth, where we're headed. And I always like these discussions to be just the first of hopefully many.

Thank you so much.

Everybody for tuning in. Prevention is power. Here we talked about a lot of non-cardiovascular stuff, because again, we want to save your life, but you know, we don't want anything else to get you either. Thanks everybody for joining us today. Be sure to subscribe, check out Hillary Lin's website and YouTube channel, which are Hillary Lynn MD.

Hillary has 2 L's. Everything is Hillary Lynn MD, HillaryLynnMD.com.

Got it. So check out Hillary. Hopefully this was interesting. I'm going to prevent you from having cardiovascular disease, strokes, heart attacks, balloon stents, bypass surgery, and Hillary will take it from there.

Awesome.

All right.

Thanks for having me.

Have a good day. Take care. Thanks again. Bye-bye. Bye.