Robots, Research & Rubik's Cubes

Unethical research in Guinea-Bissau; Robots won’t fix maternity care deserts; Louisiana tries to extradite California doctor.

Americas public health system teeters on the edge of an ICU admission thanks to the abysmal leadership of RFK Jr and his Clown Car of Public Health officials. This week, the doctors discuss the origins of proposed unethical and exploitative research in Guinea-Bissau. Next, Louisiana attempting to extradite a California doctor for prescribing abortion medications. And Dr. Oz thinks robotic ultrasound machines will close Alabama's maternity care desert.

Marley is not interested in the US buying his country.

Trump’s “Great Healthcare Plan”

Unethical research in Guinea-Bissau

• Inside Medicine 
• Guardian article about the response from the African CDC and officials in Guinea-Bissau
• Rolling Stone gets the receipts
• Criticism of researchers in Vaccine
• Harriet Washington’s Medical Apartheid

Abortion News

• Louisiana hopes to extradite a California physician
• Dr. Oz’s on robot ultrasounds in Alabama
• A robot-assisted ultrasound machine and a robotic-assisted surgery device
• RFK Jr slammed for criticizing Germany’s “interference” in the patient-physician relationship.
• ProPublica: Women With High-Risk Pregnancies Have Limited Options Under Abortion Bans

💊Take Two and Call Me in the Morning

• Arghavan’s carousel of owl impressions
• Beginner method to solving Rubik’s cubes
• Emily Elbert's country blues skills
• Merlin BirdID

Thanks for listening to The Present Illness with Drs. Arghavan Salles and Alyssa Burgart!

Follow us on TikTok and Instagram @ThePresentIllness

Credits

• Production by Arghavan Salles and Alyssa Burgart
• Editing by Alyssa Burgart
• Theme Music by Joseph Uphoff
• Social Media by Arghavan Salles

Transcript

Alyssa Burgart (00:00)
No matter, no matter

the circumstances, if you're like, wow, "I am hurting kids," that is the moment in which to immediately stop.

Arghavan (00:07)
Hey there, fellow nerds. Welcome to another episode of The Present Illness, the podcast where two physicians try to make sense of the world around us. And that world is unfortunately febrile and very under-diagnosed. ⁓ I'm Arghavan Salles a surgeon scientist and your friendly neighborhood doom scroller in residence.

Alyssa Burgart (00:24)
And I'm Alyssa Burgart an anesthesiologist and bioethicist who's tracking news and health law like the EKGs full of spikes and surprises.  The Present Illness is where we dig into public health, politics, culture, and ethics with a scalpel in one hand and a meme in the other.

Arghavan (00:37)
Huge thanks to everyone who's listening now Extra love to our subscribers and followers and people who are leaving ratings ⁓ and a warm welcome to anyone who just stumbled in from the US trying to buy Greenland.

Alyssa Burgart (00:49)
We live in the dumbest timeline. swear. ⁓ I did see this like super cute video of, little boy who's who lives in Greenland. ⁓ basically like acting like he's the muscle who's going to tell president Trump, like hands off Greenland. So I will put, I will put a link to that in the show notes because, ⁓ his name is Marley and he's very, very cute. And he's like, it's, it's very funny cause he's very small. He's trying to be tough.

Arghavan (00:51)
haha

I bet he's still stronger than our president. Also, think this idea, mean, there's just so, and we're not, this is not our main topic today, but I just want to say the idea that we're gonna spend billions of dollars buying land that does not need to be bought and taking over people who do not want to be taken over. Meanwhile, people in the US literally cannot afford food and healthcare ⁓ and that we're investing so much.

in ICE at the same time, like more than most countries invest in their entire military we're putting into ICE, is not what I call governance, or governing, I should say. It's grift. Anyway, querying on.

Alyssa Burgart (02:01)
Well, don't you worry. The Great American Health Plan has been, ⁓ you know, announced. So.

Arghavan (02:06)
yes, yes, and we haven't talked about it. Anyway, it's a sham is the short version, guys.

Alyssa Burgart (02:12)
The things it claims to be doing that are like so revolutionary are things that are like already in the ACA that we already have, which is kind of funny.

Arghavan (02:19)
Well, and the idea that we'll move on, but the idea that giving people, I don't remember the exact amount, but $1,000 or $2,000 is gonna have any impact on people's actual abilities to seek healthcare when like one doctor visit could cost you that amount of money. And nevermind a single emergency room visit, or if you, God forbid, need to have surgery. mean, it's gonna come nowhere near covering.

really anyone's costs unless you literally have nothing happen to you and you don't go see anyone and you just have like an excellent healthy year, then maybe. But how often does that happen?

Alyssa Burgart (02:55)
It's not gonna cover, it's not gonna help anyway. So we are glad that you are all here. As a note to new listeners, we sometimes talk about tough topics or things that are sort of intense. So, you know, if you have little ones in the car, like maybe pop in those headphones.

We had a lovely five-star review on Apple Podcasts, so I thought I would read it to you. You want to hear it? Okay. The Doctor is in. The hosts help digest difficult issues and bring to light some of the lesser-known health and political issues in modern-day America. Thank you, WuzerBruzer

Arghavan (03:21)
Please!

I do, I do very much.

We'll take.

What a name. ⁓ I love how creative people get with their names.

Alyssa Burgart (03:44)
Well, Arghavan I know that we are not going to talk about the Great American Health Plan. We are not going to talk in depth about Greenland. I understand that we're instead going to talk about Guinea-Bissau. Is that right?

Arghavan (03:54)
Yes, let's

talk about another country whose business we're meddling in. Why not? So listeners who had listened to our previous episode about this might remember this study. But for those who didn't or those who need a refresher, basically the U.S. government, our country, our taxpayer dollars are going to the U.S. government has decided that our tax dollars are going to fund Danish researchers to do research, I would say exploitation of

children in Guinea-Bissau, which is a country in Africa. This was basically very quietly done and it got posted to something called the Federal Register in December and that's around the time that we talked about it. And now there's a lot more information that's come out. So the background of the study when we first learned about it back in December was that the US government, our HHS, Health and Human Services, was giving these researchers, these Danish researchers, $1.6 million to study

Well, let me back up to randomize newborns in Guinea-Bissau to either get the hepatitis B vaccine or not get the hepatitis B vaccine at birth. As we discussed before, that's extraordinarily unethical because we know the hepatitis B vaccine is extraordinarily effective at decreasing transmission of hepatitis B from a pregnant person to the newborn. And we know that even if the pregnant person doesn't have hepatitis B,

A lot of people in the community have hepatitis B and many may not even know that they have it. And ⁓ in Guinea-Bissau, the estimated rate of hepatitis B positivity among adults is almost 20%. So it's very likely that a newborn who is not vaccinated would come into contact with someone who has hepatitis B unless they don't come into contact with anyone, I suppose, but that's just not real life in most cases.

So withholding that vaccine from half of the newborns in the study is extraordinarily unethical because basically is dooming them or making it very likely that they're going to get hepatitis B. And we know that newborns who get hepatitis B have a very high likelihood of having it become a chronic infection. 90 % of them will have a chronic hepatitis B infection. And we know that of those who have chronic hepatitis B, about 25 % of them will die from liver cancer or cirrhosis. So.

It's not just, they're going to have like an infection. No, they're going to have an infection and many of them will die from that infection because the vaccine was withheld. Go ahead.

Alyssa Burgart (06:20)
⁓ Well, Arghavan but do we know the root cause of this chronic illness?

Arghavan (06:26)
The hepatitis ⁓

Alyssa Burgart (06:28)
hepatitis B virus. I mean,

this is the thing and this is, you know, for folks who are going to, you know, clock that this is all related to RFK juniors, like attack on hepatitis B vaccination, like we know the, we know the reason that people get chronic illnesses, like hepatitis and it's a virus, which is why when you prevent the virus, you prevent the illness.

Arghavan (06:55)
Well, right, isn't it funny that I think what you're getting at is like, chronic hepatitis B is very clearly caused by hepatitis B. Hepatitis B is the root cause of chronic hepatitis B. And for a guy who's like so fixated on, supposedly fixated on root causes to want to stop us from addressing root causes is a little backwards and hypocritical. But, okay, back to the study in Guinea-Bissau. So that was already, what we knew then was already problematic. And...

More information has come out. So people may know that the funding for health and human services that goes out to other researchers or even within the NIH's own research labs or to the CDC, cetera, all of that has been cut significantly as part of the nonsense that's happening, the supposed decrease of waste, fraud, and abuse, which in fact, there's just been proliferation of waste, fraud, and abuse. But anyway, that's a different story. So funding has been cut.

In the context of funding being cut, for example, my NIH grant was cut, right? So I'm one of the researchers who was deeply affected by this. Our funding was cut and our government decided to give $1.6 million to Danish researchers. Already weird, right? Where's that coming from? Why is that happening? Well, Rolling Stone published last week an analysis of emails that somebody gave them, which was very nice of them. Thank you, whoever did that.

looking at how this came to be, actually. And it happened very quickly. And I want people to know that, like, when I submit or anyone like me submits an NIH grant, it takes usually about a year to get a response and to know whether you got funded or not. And often you'll apply multiple times to get one project funded. So multiple years you'll spend trying to get one project funded. Well, these researchers did not respond to a call for applications, right? That's normally what happens with grants like these, like,

The NIH says, we want to work that looks at AI in health care, for example. I just mentioned that because I know they care about AI, not that I care particularly about that question. But anyway, so they might put out a specific call, and then researchers who work in that area will put together a proposal. That is not what happened here. Instead, the researchers, these Danish researchers, contacted HHS and said, hey, we want to do a study. And basically, HHS said, OK, great. Here's almost $2 million.

you

Alyssa Burgart (09:18)
So, and just to clarify, for folks who don't understand, when you apply for NIH funding, for example, it goes to this special thing called study section. It gets accepted to be reviewed by a group of scientific experts. They give it a score. There's a new scoring system now, but it's a whole rigmarole. And that's part of why it takes a while is because it's supposed to go through this rigorous process to decide whether or not to fund it.

Arghavan (09:44)
Exactly, because it's taxpayer money and it should go to the projects that researchers and scientists who are familiar with the field, determined to be the highest quality work. So it's the best possible use of taxpayer dollars. That's why there is that process. And this didn't go through any of that. And what these emails suggest is that basically, well, let me back up and tell you one other piece of information, which is that these Danish researchers were already under scrutiny.

in Denmark for inappropriate research practices. And so there was an article that came out in the journal Vaccine. ⁓ I don't remember the exact date, but in the fall that people can look at. I read it. It's very interesting. But they had basically been asked to review the work of these specific researchers. And they found many statistical anomalies, maybe you could call them, but like questionable things that were in

the work of the researchers who are funded. The two main researchers are Abhi and Stabelben, and they happen to be married. ⁓ Anyway, so these experts who wrote this piece for vaccine had looked at a number of different studies produced by this Danish team and found lots of things like not announcing their outcomes that they were planning to look at before they did the study.

looking at multiple, multiple, multiple comparisons, but not doing a statistical adjustment for having done multiple comparisons. Probably the most egregious one that I actually didn't see in that vaccine article, but I saw in the Rolling Stone article was that this team had done a study of the DPT ⁓ vaccine, Protestative Stiptheria Tetanus vaccine, and they had found in, and I have not read this study, but the summary that I saw was that basically it was kind of more like an observational study. It wasn't a randomized trial. And they thought,

that this vaccine was associated with death more in female patients than in male patients. And so they had published that. Wait, wait, gets, there's more. But wait, there's more. Then these same researchers did a randomized controlled trial and then they never published those results. And that, why? Why? I'm sure you've heard.

Alyssa Burgart (11:45)
I'm sorry, I'm sorry, but like...

Because

they figured out they were dumb and their question was dumb

Arghavan (12:05)
and that people didn't die from the DPD vaccine and specifically girls did not die from DPD. So anyway.

Alyssa Burgart (12:08)
You

Well,

okay, and I have a, I think there's a separate point to be made here. You know, they didn't publish them. It is also possible that they could not get these results published, but I'm, from what you're saying, it sounds like maybe they didn't even try because it showed that their silly thesis was silly.

Arghavan (12:25)
I don't

It's my understanding that they did not try to publish.

Yes, and somehow somebody figured this out 14 years after the trial that they had never published it. And that's part of why they were under such scrutiny in Denmark, because this had just come to light. And so these researchers

Alyssa Burgart (12:51)
Give me a second to appreciate that,

Okay, okay. I'm done laughing.

Arghavan (12:59)
Okay, great. So basically, they, ⁓ we're laughing, but it's actually like very sad. anyway, so these researchers were under criticism in their own country. There was this piece coming out in vaccine that was going to heavily criticize their work and add to this scrutiny and the suggestion that they were doing basically unethical things with the way they were presenting their data and that what they were publishing probably was not accurate, right?

Alyssa Burgart (13:00)
You

Arghavan (13:28)
⁓ Or at least questionable. So all of that was happening. And so what did they do? They emailed folks in our Department of Health and Human Services because they had a feeling right that they would be receptive because what is the whole agenda of our HHS? We've talked about many times is to get rid of vaccines. So they had these Danish researchers they have this Relationship with the country Guinea-Bissau and they have something called the bandham health project and that's how they've done

their previous studies in Guinea-Bissau. So they basically approached our government and said, hey, we have this relationship with this country, an African country with African children who you don't care about. They didn't say that, but I'm just pointing that out for folks. And importantly, in Guinea-Bissau, with those high rates of hepatitis B, they do not yet have a universal newborn vaccine.

because they don't have the funds for it. But GAVI, which is the Global Vaccine Alliance, is going to start universal newborn hepatitis B vaccination there in 2027. So these Danish researchers contacted our government and said, hey, we have time just until 2027 where we can take advantage of the fact that these newborns don't have access to something that they actually should have access to. And we can exploit that and exploit these children to put together a study

that's going to show that hepatitis B vaccine hurts people. That's essentially what they did, okay? That's what they said in these communications I'm like, you summarizing. And because they found a receptive audience, our government from October to December, two months, said, yeah, sure, we'll give you 1.6 million. By the way, for those who follow Bill Ackman, my understanding from the Rolling Stone article is that he had agreed prior to this to give this group 1.8 million if they could find matching funds. And our government said, sure.

will match those funds, almost, 1.6 million instead of 1.8. Yeah, I know, that was a new thing I learned in that article. So we go from October, these essentially disgraced researchers not knowing what they're gonna do next with their careers, it's worth noting they're like 57 and 81, retirement is an option. meaning I don't think that they were, I mean, I don't know their financial situation, but it seems like...

Maybe you don't need to keep pushing on if you've reached the end of the road, if people have caught on to your gig, and maybe because you're harming so many children, maybe you should just stop doing that.

Alyssa Burgart (15:56)
no matter your age.

Arghavan (15:57)
Well, I mean, that's true. ⁓ But I'm just

like, if you're

Alyssa Burgart (16:00)
No matter, no matter

the circumstances, if you're like, wow, I am hurting kids, that is the moment in which to immediately stop.

Arghavan (16:08)
Well, yeah, but that's not gonna, that logic won't work for these people, right? I'm thinking about if you're these people who clearly have no problem, ethically, morally, whatever, harming children, that's not gonna get them to stop, right? But if you're like, hey man, this was good while it lasted. You know, like my fraud was good while it lasted, maybe this is my exit. Like when you're 57, 81, it's probably fine. Like take the off ramp that's offered to you and be lucky that people aren't prosecuting you.

for the harms that you've caused. But anyway, they didn't do that. They just said, we'll just go to the United States where our anti-vaccine friends will help us. And their anti-vaccine friends were more than happy to help them. then they were planning to start this study in January. That's also very fast to get your funding in December and start the study in January. But then what happened was the, so there was quite an uproar among the scientific community when this news came out in December that.

this was being funded, that these specific researchers were being funded, that this unethical study that was going to exploit children in Guinea-Bissau was happening. massive uproar. The African CDC, as I saw reported last week, said, we cannot let this study happen. And initially, the folks in Guinea-Bissau either hadn't said anything or they were still going along with it until I saw, or not, I shouldn't say going on, but like they hadn't, I think they hadn't said no yet. And then I saw late last week that they also said,

no we cannot let this study happen. In the meantime the researchers were like it's still going to happen and so they published a new yes we're still going to exploit the

Alyssa Burgart (17:43)
This is, I mean, for

folks who are listening, like my face is doing a lot of work here. I mean, it just.

trying to really do a lot of self-regulation here.

Arghavan (17:51)
I

mean, it's a, you're a bioethicist, you know? So like you see all the glaring travesties that are happening here. And for, mean, just that, if people, not only is it a scientific community saying, no, this is inappropriate, but the continent that the study will be on, the CDC of that continent is like, no, you cannot do this. And then we get to the point where the country that you've actually already had a relationship with, a working relationship with, and even they are like, no, we cannot do this.

for you to still say, yeah, but we're still gonna do, I mean like, is outrageous the levels of entitlement. So then they published a new version of their research protocol, I think it was on Friday, so almost a week ago. Now, the things that, there's so many problems, but the most glaring problem that I actually hadn't even been aware of back in December when we talked about it is that there is not to my knowledge any plan to test pregnant people.

So originally when we were discussing this, my assumption had been that they were going to test these pregnant people. And if a pregnant person was positive for hepatitis B that they would give that newborn the vaccine and that they were randomizing those where the pregnant person did not have hepatitis B. That's already extraordinarily problematic even if that's what they were doing. But in reality, it turns out that's not what they were planning to do. And when you have a country where

one out of five people has hepatitis B, adults has hepatitis B, and you don't test the pregnant people, that means one out of five of the newborns is going to be at great risk of contracting hepatitis B. When we have a treatment or an intervention, the hepatitis B vaccine that would prevent that and would prevent them from getting chronic hepatitis B and would prevent them from getting liver cancer and cirrhosis and would prevent them from premature death.

And so in the revised protocol, as far as I could tell, they are still not testing the pregnant people who will be enrolled in the study. So that's terrible. And from a scientific perspective, if you think about like, what is the scientific contribution that could be made here? Their question, this particular group has been really interested in what they call non-specific effects of vaccines.

Now we talked, did we ever end up talking about shingles? Now I can't remember. With the shingles vaccine, don't think we're gonna talk about it.

Alyssa Burgart (20:23)
We haven't folks.

have been wanting to talk about the shingles vaccine for the longest time, but every goddamn week in this country, there's a new terrible thing that pulls up our attention. So we have not talked about the shingles vaccine in depth, but I know that you and I both desperately want to.

Arghavan (20:38)
Okay, we will do it. We will do it. But what I wanna say, the two second version of it, because it's relevant to this, is you could say that there's multiple studies now that suggest, they're correlational studies, okay, they're not randomized trials, but they suggest that the shingles vaccine is associated with a lower risk of dementia. So that is also a nonspecific effect of a vaccine, right? Like you don't give the shingles vaccine to prevent dementia, you give it to prevent shingles, but it's like this other kind of benefit.

That's a nonspecific effect, but what they're talking about are negative nonspecific effects. So you're gonna get the hepatitis B vaccine and then maybe you're gonna die from it, or you're gonna get the hepatitis B vaccine and actually the things they say...

Alyssa Burgart (21:18)
I mean,

to be fair, mean, this is, if you died from a vaccine, which is extremely, extremely, extremely rare due to, for example, profound allergic reaction, untreated Guillain-Barre, I mean, all sorts of things that are exceptionally rare, that is an outcome that is looked for early in the testing of vaccines.

Arghavan (21:42)
absolutely, absolutely.

Alyssa Burgart (21:43)
I mean,

it's not like we would be like, no, no one had any idea there was this weird non-specific effect that nobody had ever heard about before.

Arghavan (21:52)
Yeah, but they're thinking is, or not they're thinking, but what they're trying to show is that actually these vaccines are harmful, right? That's the whole agenda, is that there's harm here that we haven't measured before. But do know how they wanna measure it? They wanna look at mortality in 42 days. Okay, if a newborn gets hepatitis B, they're not dying in 42 days. They are dying years later in their teens, in their 20s, and so you're not capturing that.

Alyssa Burgart (22:16)
Okay,

and this is also again, a very important thing about monitoring for vaccination. If you're going to have a life threatening event due to a vaccine, it is like within the first like 15 minutes to an hour. I mean, and in an hour, like we're way out.

So this is just so dumb. It's just the dumbest, most unscientific, unethical nonsense.

Arghavan (22:43)
It makes no sense. It makes no Because

they're also not tracking hepatitis B infection among the newborns. Like that's not an outcome, at least according to their protocol. They're not going to be testing these newborns to see whether they got hepatitis B. Nope, not doing that. Not interested in documenting that. And there's lots and lots of things, but I do want to just say real quick that the outcomes they are most interested in aside from like death.

are two things that have really not been associated with the hepatitis B vaccine. One is they use the term neurodevelopmental disorders. They don't say which disorders, they just say, we're gonna look for, these are the types of unethical research practices, by the way, that are being pointed out by others. We're just gonna say neurodevelopmental disorders as a blanket term, and then we can look at any number of things that we want. And if we look at 20, 30 of these things, then eventually one of them will be statistically significantly positive, and then we'll be able to say that hepatitis B vaccine,

causes this thing, even though that will not statistically or in reality be true. So that's one thing. And then the other is atopic dermatitis, which is a rash. That's like one of the main things they're interested in is whether anyone has a rash after getting the vaccine. It's very strange. I think ⁓ RFK Junior is like into it or something. I'm not sure, but like scientifically it makes no sense. Also, it's not a serious outcome. Do you know what I mean? Like it's not a life-threatening outcome to get a rash that's gonna resolve within a few days or a week.

Alyssa Burgart (24:06)
I don't know, especially when you compare it to like, I don't know, liver cancer.

Arghavan (24:10)
Yeah, like maybe you trade that off, right? Even if there were like a high risk of a rash, I personally would accept the risk of a rash to avoid getting liver cancer or cirrhosis. Also to your point about like safety monitoring, they don't have any in their protocol specific end points that a data safety monitoring board would look out for. So typically you have a data safety monitoring board that will look at outcomes at certain intervals. And then for example, if you see that in one condition,

it wouldn't be true for this particular state, but like, let's say it was a chemotherapy agent or something, and those who got the chemotherapy were more likely to die, you know, within a certain period of time, then they might stop the study early. Or if they see like huge benefit to whatever the intervention is, it would be unethical to keep it from the patients who are in the control condition. So there's anyway, there's these data safety monitoring burns, and usually there's like preset outcomes. If XYZ happens, we will end this trial early. And they have no...

preset outcomes for their data safety monitoring board so they can just do whatever they want.

Alyssa Burgart (25:10)
Well, and for

people who I feel like this is like such a niche thing to biomedical research that a lot of people don't understand is that these data safety monitoring boards DSMBs, I have been on one of those. is an incredibly tedious activity. You have a whole group of people. You have to review a bunch of data and ⁓ you work with one of the statisticians to understand how many patients have been recruited so far, what interventions have taken place.

Where is everybody in the scope of the trial? What are the outcomes? Are there any sort of consequences that may be linked to the study intervention? And then you have to go through each of those and ask the researcher specific questions. And these are all people who are not part of the trial. They're not participating in the trial. It is a separate, it's like an advisory and oversight committee specifically for safety. And so this is a critical

aspect of designing a trial is what are the responsibilities of this data safety monitoring board and to your point, what are the main things that are being monitored for so that we can do ethical work and not hurt kids or any patients, participants of course.

Arghavan (26:21)
Mm-hmm.

Yeah, yeah, absolutely. And I do want to just shout out that a lot of what I've been talking about has been also covered. I mentioned the Rolling Stone article, but a lot of this came out in our friend Jeremy Faust's Inside Medicine newsletter. And so we'll put a link to that in the show notes so people can get a really thorough breakdown of all the questionable and unethical practices that they're ⁓ engaging in. I do want to mention at least one more before I might have another one, but at least one more thing is that there's no placebo. So anybody who's heard

Artie Jr. talking about his anti-vaccine stuff that he says constantly. He's often complaining that we don't have placebo-controlled trials, which first of all is not true. We have had placebo-controlled trials for pretty much everything. But also, once you have...

Alyssa Burgart (27:10)
So

placebo controlled trials are actually not the appropriate thing for certain types of research. it's also so just.

Arghavan (27:16)
Correct, like once you have a vaccine

that's effective, when you develop a new vaccine for the same thing, it is unethical to test that vaccine against nothing. You would test it against the previous vaccine. Just like you have a new, if you have a therapeutic, like a chemotherapy agent that is effective at reducing mortality or morbidity for specific cancer, and you come up with a new agent, it would be unethical to compare that new agent to nothing, because you'd be withholding treatment from that other half of the patients. Anyway, so R.F. Gay Jr. has long,

been going on these tirades about how we don't have placebo controlled studies. And yet he has funded this study in a matter of two months funded this study that doesn't have a placebo. And I don't think that most of us, I think most of us think, as I said many times, this is an unethical study regardless, but if you were going to actually do this study, what they're doing, I didn't mention this earlier, it's like kind of a side point is they're giving.

they're looking at two other vaccines, but everyone in the, all the newborns will get these two other vaccines or the BCG and the oral polio vaccine. And then the difference will be whether they also get the Hep B or not. And so the parents will know, right? Cause either the kids getting three shots or two. ⁓ And that's why it's kind of silly to be on like, you know, like constantly talking about how we need placebo controlled studies. And then the study that you fund,

doesn't have a placebo, it's unethical to begin with, but even if you were gonna do it, you should have a placebo so that at least the parents don't know whether the kid got it or not so that you can decrease the bias in the reporting of problems. Do you see? It's just so stupid.

Alyssa Burgart (28:47)
So, well, and

it's also like, again, it's so, this is why it's such a problem to bypass the standardized systems that are meant to evaluate the scientific validity of doing these kinds of projects. Because, I mean, this never would have made it to study section. Just like a handful of people who actually know anything about doing vaccine research would have been like, this is a piece of garbage. No one should ever do this. Wow.

This seems super unethical and also dumb. What a waste of money. Why would we spend money on this? Nobody who genuinely understands how research is supposed to be conducted, ethical research that will result in a hypothesis, that you can take a hypothesis and study whether or not that hypothesis is verifiable or not. This is dumb.

Arghavan (29:25)
Yeah.

yeah, like I think probably a high school student could write something that makes more sense than this because presumably the high school student wouldn't be trying to meet some sort of fake agenda or it's not fake. It's a real agenda. It's just like not a scientific one. So there's other other things going on in this study. But I think we've covered I'm just looking at my notes. I think we've covered the majority.

of the issues. There were also just to be thorough, there were also some reports that the study had already started and then others that it hadn't and the according to the researchers themselves, they said it hadn't started yet. So they were submitting this new protocol in the hope that it would address, don't know what, because it still seems extraordinarily problematic. But they were submitting this new protocol to like get the go ahead because we were on this like race against time.

for 2027 when all newborns in Guinea-Bissau will actually get the care that they should receive. And as others have said, like if you're gonna give these researchers $1.6 million, just use it to give those newborns the vaccines that we know will save their lives.

Alyssa Burgart (30:55)
And the, this is a whole other thing is like, there is.

long history of public health research that says, hey, at this point in time, we introduced this public health measure to improve the health and safety of a population. And then guess what? You have an opportunity to be like, hey, we can study data from folks who, because of their age, because of whatever, were in this pre-time before this intervention was offered.

And then you compare them to the people who got the intervention after the appropriate public health intervention was made. And so the idea that like, ⁓ no, there's no opportunity to study anything in Guinea-Bissau because people are going to get access to like regular stuff. It's dumb. And it's just infuriating to consistently see our government have these, again, the clown car of public health just.

deeply committed to destroying American health as well as the health of the world, to dump money into this nonsense.

Arghavan (32:01)
Yeah, and I did want to say one thing, because you mentioned like that staff or research reviewers would have had problems with this. So there were some internal staff at ⁓ NIH, scientific staff who got wind of this and apparently raised multiple concerns. And it will surprise no one to know that their concerns were not listened to whatsoever. So there were people, it's not like nobody knew, there were people who said, hey, this isn't right. ⁓ And they decided to fund it anyway. And it's just such a slap in the face.

obviously unethical, it's exploitation of black children. And for those of us who are like out here fighting for that research funding, trying to do meaningful work with high standards to have to be in competition with people who just are pushing an unscientific and harmful agenda that will get children on another continent killed. It's tough, it's a tough pill to swallow. And I know we've got like a lot of

tough pills around here, but it's tough. Yeah, I'm enjoying this timeline in any way, to be honest.

Alyssa Burgart (33:06)
know. Well, and you you mentioned, know, obviously at the outset of this topic, that this is exploitative, you know, unethical research. And I think the other word that you used earlier was, you know, the incredible entitlement to try to get research for this. And I think something that is that that I hope people recognize is in this case in particular is the entitlement to black bodies. The entitlement, you know, again, as you mentioned,

folks in the United States aren't exactly thinking super deeply about how it is that this may impact children on another continent, and especially children who are Black. And so this entitlement to Black people's bodies is something that is, we are no stranger to here in America. ⁓ And you'll see for folks who go and read more about this ⁓ unethical study being proposed in Guinea-Bissau.

You know, there's a lot of understandable comparisons to the scandal in Tuskegee related to the, again, use of black people's bodies in an unethical way. And so for folks who aren't aware, the full title of the study was called the Tuskegee Study of Untreated Syphilis in the Negro Male. And it was done from 1932 to 1972. So we're just over 50 years to this study finally being stopped.

And basically people were known to have syphilis and the researchers initially wanted to know what would happen if syphilis simply wasn't treated. And so then we ended up having people who did not get appropriate access to penicillin, which is known to kill syphilis and in order to treat syphilis to prevent the most severe natural progression of disease. you know, of course this was in a population where

You know, a lot of these folks worked on plantations, it took place in Macon, ⁓ Macon, Georgia, pardon me, Macon County, Alabama. And ⁓ there are many, many, many unethical studies that have happened in the United States. A wonderful book by Harriet Washington called Medical Apartheid that of course really gets into the details of the way that racism is really built into so much of

the history of research in the United States. And so we should be learning from these many, mistakes that have taken place in the past that have cost people their lives, that really show the hand of racism. But rather today, I think that's the additional level of ⁓ harm is seeing that not only are we not learning that lesson appropriately, we are investing money into specifically doing this type of unethical research.

Arghavan (35:47)
you

Yeah, and people have pointed out rightfully that of course this study would not get approved by an institutional review board, which those are IRBs, those exist to review research protocols to make sure that we aren't being unethical in our conduct of research, in particular in human subjects research, right? That's the whole point of IRBs is for human subjects research to make sure that we are treating people appropriately. And this study could never get.

done in the United States because it would never get approved in the United States. And so that is part of why I'm sure RFK Jr. and his team were so happy to fund this because they knew it wouldn't have to deal with an IRB. And look at the last thing really for real that I'll say about this is that, the really, really last thing is that the changes to the hepatitis B vaccine recommendations that were made by our government erroneously and harmfully

in December. ⁓ One coincide with all of this. So if you remember the announcement about the change to the hepatitis B recommendation, it was either like the day before the same day as the study got posted to the federal register. And so there is some insinuation in that Rolling Stone article that part of the reason this change was recommended for hepatitis B was because of these researchers in Denmark.

these researchers with faulty research methods and studies that have been really called into question multiple times that they affected US vaccine recommendations is wild and related that even the changes to the US hepatitis B vaccine recommendations still require testing of the pregnant person and the newborn hepatitis B dose for a newborn who's born to a pregnant person who has hepatitis B. So even as

egregious as our changes were here. This study is one step further removed and even more terrible. Okay, that's it. I'm done talking about it.

Alyssa Burgart (37:57)
Okay, and I also just want to say like there's a lot of good research that comes out. It's like not all Danes, not all research that comes out of Denmark is garbage. Like it is these specific researchers.

Arghavan (38:02)
quick.

Thank you for pointing that out and and it's been Danish researchers who've a lot of Danish researchers who've been like upset about yes, yes I hope I hope nobody got that impression, but if you did I apologize Danish

Alyssa Burgart (38:13)
horrified.

I

just wanted to clarify. For any listeners we have in Denmark, we love the good science that's happening there. Love it. ⁓ On to the next. Well, there's one brief thing that I want to tell people about. I think that ⁓ depending on what we see come out of this in the future, we may talk about it in more detail. But I do think it's relevant. You and I are in California.

Arghavan (38:22)
Yeah, thank

Okay, all right, on to the next. What did you want to talk about today?

Alyssa Burgart (38:49)
There is a physician who was using their telehealth privileges and writing prescriptions for abortion medications and wrote them to a patient who lives in Louisiana. And just last week, the Louisiana officials tried to ⁓ demand that California extradite this physician to Louisiana to be because they're saying that they were illegally ⁓ mailing abortion medication.

⁓ Something that we should probably talk about in more detail sometime is are the sort of zombie laws related to that. They're called the Comstock laws. ⁓ But Governor Newsom in California has has very clearly denied that request. Like, no, we are not going to send you our physician for like doing their job. ⁓ But this is a really great example of why, you know, clinicians who provide abortion care in states where it's where it's legal still.

I have to be very careful about travel. I have to be very careful about going to states that may actually be like, no, we're going to charge you with a crime because you are an abortion doctor. ⁓ So thank you, Governor Newsom, for not abandoning our physician and throwing them into a Louisiana jail.

Arghavan (40:09)
Well, I mean, that does seem like the bare minimum, anyway, that's a different topic. I did want to say, because it's related, folks may have seen, I don't know if you saw this, but folks may have seen RFK Jr. We did like a little speech about Germany and how their health care is terrible because it's just terrible what everything he said.

Alyssa Burgart (40:12)
Hahaha

Arghavan (40:39)
He dared to write a letter to the German health minister criticizing their actions specifically related to physicians who had basically helped people evade mask mandates and vaccine mandates in the early part of the pandemic. But the reason I'm mentioning it here is that in his little, set of comments, he goes on at length, at length about how in a healthy democracy, the government doesn't interfere.

between patients and physicians and a government doesn't. Yes, and a government doesn't punish. No, I'm serious. like making these comments like such gravitas. I am old white man. have gravitas. Anyway, he's like, we, ⁓ the government. ⁓ absolutely. Like so serious. Like he's fighting the fight for the good hardworking physicians out there who want to care for their patients. He says.

Alyssa Burgart (41:17)
my god! I can't!

with a straight face.

Arghavan (41:37)
We should not be punishing physicians for providing care to their patients. The whole time he was talking, I was like, does he know? Like, does he know what country he's in? Does he know what his healthcare system is doing? And I brought it up because of abortion, because you mentioned that doctor, but it's also relevant to gender affirming care, which you and I both care a lot about and talk about frequently. Like for both of those things, it's what the United States is currently doing.

is exactly the opposite of what he's saying, right? It's telling physicians we cannot do these things. In fact, they're asking, right, for data from health centers across the country on the gender affirming care that they're providing. Like they want to monitor what is happening at these hospitals. And he sits there with a straight face and says, no healthy democracy would intervene between a patient and a physician or to punish a physician. Anyway, I posted a video about it. I don't think, I think like five people saw it, but it's really upsetting to me that.

People will watch that video and believe that he means the words that he's saying. And that there's no like, I feel like the cognitive dissonance switch has been turned off in all these people. Like as he's saying all this, there's nothing in his brain that says, huh, is this like at odds maybe with what we're doing? Huh, maybe. Yeah.

Alyssa Burgart (42:54)
There's nothing to see here.

Arghavan (42:56)
They're it seem like anything going on up here. Like, you know, when I'm talking to you, I'm talking to you, making my videos, I'm always like, wait, did I say something about that before? Like, you know, like synapses are synapsing, you know what I mean? And it's not clear that that happens for him or anyone else in that administration. Anyway, I'm gonna stop talking about that. Okay.

Alyssa Burgart (43:18)
I don't know how I missed that particular interlude, I'm glad I did and I'm glad that I got to hear from you.

Arghavan (43:27)
Well, I'm always happy to weird and silly things. the European people, not just Germany, but like I saw something from someone in the government of France responding back and people were not having it, which is good to hear. mean, they were like, why don't you worry about the fact that your life expectancy in your country is shorter than ours? Maybe do something about that. Like who the F are you to tell another country what to do with their health care? Also, I was like,

Alyssa Burgart (43:56)
He's not a doctor, that's what he is.

Arghavan (43:58)
Well, he's definitely not doctor. like, is he really sitting there thinking, everything's going so great here in the US, what else can I do? Where else is my knowledge useful? Like, that what's going on? Like, I don't know. I'm just trying to figure out, you I'm always trying to make sense of this world, which is very challenging. But like, what is it that goes on in here where you're like, you know what I need to do next? I need to tell a whole nother independent country what to do with their healthcare when I don't even know anything.

about healthcare to begin with, and I'm doing everything I can to fuck up the healthcare in the country that I live in, that I'm in charge of.

Alyssa Burgart (44:33)
And I, and I'm realizing, course, that like, as much as I made that comment about him not being a physician, of course, I can't believe that I have to like, in actual seriousness, say the following words like, Dr. Oz, real doctor. Dr. McCary, real doctor. Dr. Bhattacharya, mean, technically a doctor, but no residency, but like, you know, these people are doctors. They're just terrible doctors.

Arghavan (44:59)
Right. And they're just going along with the grip. So speaking of...

Alyssa Burgart (45:02)
I

actually had to explain to someone recently that Dr. Oz was an actual doctor, that it wasn't like a euphemism that he's a doctor. They were like, no, no, there's no way that he's really a doctor. And I was like, he's a surgeon. And they were like, to humans?

Arghavan (45:20)
Yeah, he did at one point. He's a cardiothoracic surgeon. He at one point operated

Alyssa Burgart (45:24)
Can

you imagine that man being your heart surgeon?

Arghavan (45:28)
Genuinely cannot but since we're about it, you know the an abortion so in states that have abortion bans there have been a lot of OBGYNs Obstitution gynecologist have left and we talked about I think specifically with regard to Idaho before on the but It's true of a lot of these states where they can't really practice Evidence-based care anymore. And so in a things a press conference

Alyssa Burgart (45:45)
Mm-hmm.

Mm-hmm.

Arghavan (45:58)
Dr. Oz was talking about, I believe it was Alabama, I'll fact check myself in the show notes, but I believe it was Alabama. And he was talking about how there's a lot of maternity care deserts in that state. And he's...

Alyssa Burgart (46:11)
And for people that don't know, maternity care desert is like there's large areas where there's no place to deliver a baby. There's not access to OBGYNs or midwives or people with training to help safely deliver and then like provide prenatal and postnatal care, et cetera.

Arghavan (46:27)
Right, and because of the big brutal bill, which is what I'm gonna call it now, there's gonna be more maternity care deserts because more hospitals are gonna close or at least close their labor and delivery units. But anyway, so there is a dearth of access to or there's lack of access to maternal care in a lot of counties in Alabama. And he said these words, but what's really cool is we now have robots that can do ultrasounds. Okay, so there's really nothing cool.

Alyssa Burgart (46:56)
I'm sorry,

wait, no, I'm sorry, what?

Arghavan (47:00)
Yeah, he's, mean, like, he genuinely said that, like, with a straight face, like, it's really cool that we have these robots. Now, first of all, I think you and I both know ultrasound is very user dependent, meaning operator dependent. Like, it's the person who's doing the ultrasound that determines the quality of the ultrasound. what, I don't even know what, yes, it is a whole profession. But also like, what is he talking about? Like, what robots do we have that can do ultrasounds? I'm not aware of a single thing like that that exists, but even if, even if there were, let's pretend.

Alyssa Burgart (47:17)
Yeah, it's like a whole profession.

Arghavan (47:28)
Let's pretend there's a robot who could do a grade A, like excellent ultrasound. And let's say the robot finds that there's a problem with the fetus. Let's say there's anencephaly where there's no brain. Is the robot gonna deliver that news? Imagine being that pregnant person. Like what is he thinking? That's what, again, I don't.

Alyssa Burgart (47:49)
I

have some difficult news to disclose to you.

Arghavan (47:53)
Your baby has no brain. Like what? And then he was like, then they'll transmit the images to physicians in other states. Like in what world is this your solution to having driven OB-GYNs out of your state? And why is it not, hey, maybe we should allow people to practice evidence-based care and maybe people have a right to actual healthcare by licensed professionals who can talk them through these challenges.

What do you mean your answer is that it's really cool to have a robot? What do you mean?

Alyssa Burgart (48:26)
Also, this whole idea of, mean, and you're a surgeon and I'm an anesthesiologist. And so I remember when the DaVinci robot became more available and so many patients would be like, is the robot gonna do the surgery? And I'm like, no, no. The robot's in the room. It's like a piece of equipment that gets used, but like.

Arghavan (48:35)
Mm-mm.

No.

Alyssa Burgart (48:52)
There's a lot of people that have to actually operate the robot and dock the robot and there's a doctor controlling the robot and it actually takes an immense amount of skill to use the robot. The robot is not like, this is not like the robot is the surgeon. It's like the robot is the tool.

Arghavan (49:09)
It's an autonomous robot. Yeah, and I'll just disclose for transparency, I do some consulting work with Intuitive Surgical, but the basic gist of it is exactly as you described. It's a tool that surgeons can use. And I mean, when I was practicing, I enjoyed it just because it's kind of fun, you know, but it is 100 % controlled by the surgeon. There is not a single move that that robot makes. The reason it's called a robot

and it's different from what I think people think of as robots is that you can control it remotely. So the surgeon sits in the side of the room where there's something called a console, which is how you control the robot. And the robot is at the bedside, like is at the patient. ⁓ And so the instruments are put in through with control of the robot. And there's a bedside assistant, mind you. There's a human also at the bedside. Because again, the robot cannot do anything. It can't like pick up an instrument for you and put it in. There's a human.

who connects an instrument to the robot, then there's another human sitting at the console controlling what happens with that instrument.

Alyssa Burgart (50:11)
And these tools

can malfunction. There are unique dangers to using these tools. I actually, while we've been talking, I just looked up what is a ultrasound robot, just to get some pictures of what are we talking about? And oh, it looks very interesting. And it's interesting. This website I'm looking at is called A Deco Tech. So guess it's supposed to be Echo, bringing ultrasound.

Arghavan (50:23)
I am so curious what you found.

Alyssa Burgart (50:40)
They have a lot of nice pictures of like smiling people with like these weird tools being applied to them. But it's, know, the ones that are being used apparently remotely, there has to be some sort of a trained professional who may or may not be an ultrasonographer who has to like set it up. And then somebody remotely, I guess, is able to read it. My concern would be because it's got these like arms that the

I guess the remote person can use to adjust it. would really worry, mean, having had an ultrasound before and using, I use an ultrasound to do a number of procedures. And when you do an ultrasound on an awake person, like sometimes you have to apply quite a bit of pressure. have to constantly be checking in with the patient. Am I hurting you? I want to know if I need to stop. Is this okay? Is this okay? You know, and you have to be able to immediately stop. And so I am, I don't know, this looks all really freaky to me.

So the idea that this is a great replacement for actually having trained professionals is bananas.

Arghavan (51:44)
No, it's clearly not. I don't know if he thinks we're stupid or what, or like, we're just gonna go along with it. But also I wouldn't... I think he's got different motivations that are prescribing his actions. But to your...

Alyssa Burgart (51:49)
I think he's stupid, for what it's worth.

All

those years on TV rotted his brain.

Arghavan (52:02)
Well, I think he found that money is nice to have and influence is also nice to have. so whatever, you know, like I think these are just normal human behaviors, to be honest, not that everyone is susceptible to them, but money and power and influence are quite seductive for a lot of people. And once you have it and you learn what it will take to keep it, I think a lot of people will just do that. But I want to just add one thing to your point about the patient.

right, when you're doing an ultrasound and you also have not just the check-ins, but you have feedback, nonverbal feedback, like the look on the person's face or if they move an arm or something, you know, like there are signs that they're uncomfortable before they'll say anything. And those are to be much harder to pick up on if you're not in the room. Anyway, people, pregnant people deserve health care and that should not be controversial. And I'm like so deeply upset and have been for years now.

Alyssa Burgart (52:38)
Mm-hmm.

Arghavan (52:58)
that that is somehow controversial to say in this country. There's, okay, there's much say so much here, but I will just add that if people haven't read it, ProPublica published, they have just done such excellent work covering impact of the Dobbs decision on healthcare for pregnant people in this country. And I think it was last week they published a new profile of another, yet another woman and another black woman, I believe, who,

Alyssa Burgart (53:12)
Mm-hmm.

Arghavan (53:28)
did not receive the healthcare that she deserved and died because of it. And she had an arrhythmia. She had a known heart problem and arrhythmia during pregnancy and was denied cardioversion. And then she, because they were supposedly concerned about the fetus and then she... ⁓

Alyssa Burgart (53:46)
Okay, just also, it's pretty important to pause for folks who do not understand. So the fetus can't stay alive if the pregnant person's heart is not pumping blood effectively. Blood cannot get effectively to the fetus. So to be clear, when a pregnant person has an arrhythmia,

Arghavan (53:48)
Yeah.

Alyssa Burgart (54:07)
that usually needs to be treated so that the pregnant person doesn't die and therefore the fetus doesn't die.

Gotta have the blood go round and round.

Arghavan (54:20)
That's right. And yet she was denied that care. And then she tried to get an abortion. She was early enough in her pregnancy. I forget what state she was in. We'll put the link in the show notes. But she was early enough that she could have qualified. But it was hard to get in to a clinic because also people were coming from other nearby states because they couldn't get abortion in their state. And so

I think she was given an appointment a few weeks out and she literally did not make it.

So that's what's happening in our country. That is the healthcare that we are providing to pregnant people in this country.

Alyssa Burgart (55:04)
But hey, robots.

Arghavan (55:08)
And our head of Health and Human Services thinks that he's got something useful to share with another country that does indeed have a longer life expectancy than we do. And also our life expectancy is going to go down as we have more of these communicable illnesses coming back and killing children. Like I just heard somebody read that somebody else in our federal government was talking about polio vaccine and how we don't really need that. Anyway, we do, to be clear, we absolutely do. Yeah.

Alyssa Burgart (55:34)
Ahem.

Just like, it's so exhausting. It's so exhausting.

Arghavan (55:44)
It's yeah, and I think it's so hard like I think you and I both care a lot about people and it's really hard to see that decisions are intentionally being made that are going to harm a lot a lot of people many of whom will not understand why that happened or what the cause was of the harm that was caused to them that was done to them even the propo publica had another article I think it was earlier this week where they talked about ⁓

how a lot of times women who find themselves, mostly been, I think all the cases they've talked about been women, women who find themselves in this position where they have some sort of health problem that is risking their life and then they don't get the care they need, they are often surprised because they're like, I thought there was supposed to be an exception for this treatment and we've talked before that those are not real exceptions.

Alyssa Burgart (56:37)
Mm-hmm.

Arghavan (56:43)
heartbreaking to see that, because you know, you and I fall this closely, but a lot of people don't. And so then when they're in that position where they actually need health care, they don't know like we do that it's not going to happen. And so they can't plan for it or plan around it. And then terrible, terrible things happen and literally people die. And those are conscious choices and decisions that have been made by our legislators in different states around the country. And if you think, if anyone thinks it's not coming.

at a federal level in one way, or form, whether it's banning IUDs or birth control or whatever other thing, I don't think you're paying attention if that's what you think, because that's definitely the next step in what they're trying to do.

Alyssa Burgart (57:29)
Yeah,

but don't worry, we'll talk about it here on the pod, you know?

Arghavan (57:31)
We will, we will,

we will. But that's one of the ways is through the Comstock law, which you mentioned earlier, which is to basically ban certain things in the mail. Yeah, anyway.

Alyssa Burgart (57:37)
Yeah.

Absolutely. ⁓ you know, we ended up talking about a different way that the government is interfering in people making decisions about their bodies. And originally I had planned on talking about gender affirming care, but we have had such a rich conversation. I'm going to save that for next week. So next week we can talk about gender affirming care.

Arghavan (58:03)
Great, yet another way to violate people in the US and our autonomy. Great. Can't wait to hear more about it.

Alyssa Burgart (58:09)
Mmm.

Mmm.

Arghavan (58:14)
Such scary things happening in this so-called great nation. Anyway, we...

Alyssa Burgart (58:16)
you

Well,

yeah, what are you, let's talk about how people can, you know, put one foot in front of the other. Let's do take two and call me in the morning.

Arghavan (58:28)
Yeah. Yeah.

Okay. So one of my absolute favorite things, and I've been, as you know, but for folks who listen, I've been going through a rough period here because I have two grants that are due next week and there's a lot of other stuff going on. it's been a rough go, but one of the things I've been really appreciating are these owl impressions. I don't know if you've seen any of these. Yes, like the bird. They're, oh my gosh, there you need to check out.

Alyssa Burgart (58:50)
I'm sorry, owl like the bird, because I love owls.

Arghavan (58:56)
these owl impressions, they're amazing. They're like basically people saying they're usually they say their name and they say, this is my impression of an owl. And then of a specific kind, it'll be a Puerto Rican owl, a Mexican owl, an owl who is Christina Aguilera, an owl who is Chat GPT, an owl who is Michael Jackson, an owl who is Obama, ⁓ et cetera. So what I love is people are so creative and so funny. And these videos are super short. can see like,

watch a ton of them very quickly because they're all like, Hi, my name is Bob. This is my impression of an owl if the owl were Obama. And it's like, ⁓ that wasn't a good impression. They do a better job. But like I just saw one yesterday that was Jeff Goldblum. It was pretty good. ⁓ One was, this was pretty good. This was if the owl of the owl were Jack from the movie Titanic and the guy drinks a bunch of water and he goes,

know, like he's gurgling the who. The chat GBT one, I think you'll really appreciate. It's a woman who's holding water and she's just pouring water as she says, ⁓ you'd like me to do an impression of an owl? No problem. I can do that. Would you like an owl to be? And it's just pouring water the whole time.

Anyway, I have loved it. I do have two carousels now on my Instagram of just like one of them is 20 owl impressions, the other one's think 19 or something. So if anybody wants 20 or almost 40 owl impressions, you can go to my Instagram and these are the ones that I think are the best that are out there, but I'm sure there will be more because people keep posting them. So that's one. other thing, I should have brought it in the room. The other thing is I came across a lovely woman who's done a tutorial on how to solve a Rubik's Cube, which is something I've never even

wanted to do really. But she has like this, I'll put a link in the the show notes, but she has the six part explainer of like the steps to solving a Rubik's Cube. And she's one an excellent teacher, two, like so passionate about Rubik's Cube that I was watching this on a break from my grant writing like on Sunday. And I was like, I need to go get a Rubik's Cube. And so I did I went out on Monday and I got a Rubik's Cube and I've been solving it like whenever I need a little break, go do a little Rubik's Cube and

Alyssa Burgart (1:00:50)
Okay.

And have you ever owned a Rubik's Cube before? Oh, this is exciting. Oh, maybe you can bring it next week and you can show me how you solve it.

Arghavan (1:01:19)
No.

I can play all the time. But I will say I just have been working with her beginner's method. I feel pretty good now about the beginner method, but I haven't watched, she has like an advanced series. I have not watched that yet, but I think you need the advanced series to like gain speed, right? Because that's the whole, eventually you want to get like really fast at it. I'm still like.

Alyssa Burgart (1:01:34)
Mm-hmm.

Mmm.

And then you can like go to a party and alienate everybody.

Arghavan (1:01:53)
Are there competitions? I think there's competitions if you want to do. Anyway, I'm just doing it for something that makes me feel good. You know, it doesn't take a lot of time and I can just do what I'm like, I need a break from grant writing or whatever, because it doesn't take that even if you're slow at it, it really doesn't take that long, like a few minutes to do. So yeah, I'll put a link in the show notes. How about you? What would you recommend to folks?

Alyssa Burgart (1:02:00)
I love it.

Amazing.

⁓ so I came across, so I love, ⁓ I mean, we've talked about it before. I really like Jesse Wells. I'm really into, I'm into music generally, ⁓ especially like Americana, country blues, that sort of stuff. And, so I can, I really like a protest song. So as much as I think like we live in a hellscape, I am absolutely loving some of the art that is coming out of this time. ⁓ and there's a really

beautiful guitarist. does country blues and sings really well and her name's Emily. I don't know if I'm pronouncing her name correctly, so apologies if I get it wrong, but Emily Elbert. So I will put a link to one of her recent just great lyrics and incredible, incredible country blues guitar skills. And then because you were talking about owls, it just made me think if people don't know, I mean, listen, I will tell you the

Anesthesiologist to birder pipeline is strong, okay, because it's like, it's quiet. It's something where you're like kind of co-playing, like you're around other people, but you don't have to talk to them because you're really just listening for birds and looking for birds. ⁓ And so I really like the Cornell ⁓ Ornithology Lab has ⁓ a bird ID app that is fabulous. And so you can actually, it has a couple of different ways. Like back in the day, the early version of the app, you would just, like if you saw a bird,

Like I like to go to shoreline and see the shorebirds, for example, which is not too far from where you and I live. ⁓ And I like to figure out like, what are these random birds? And so you can, you can fill out this little questionnaire and it gives you a list of like, are these, are any of these your bird? And you can be like, that one's my bird. Well, now they also have one where you can record the birds singing and it will compare it to the database of birds in that area and help you identify the bird. So.

reason I bring this up in the context of owls is there is for sure a great horned owl that hangs out in my neighborhood. And I just periodically you can hear it. And ⁓ back in December, we have this tree right outside of our bedroom window. And we were just like, we just like turned off the light or whatever to go to sleep. like, the bird was the there was a great horned owl right outside of our room in this tree. And we just laid there and listened to this bird like

just be like happy, just like a happy, making happy cooing bird noises. And it was super cool. So.

Arghavan (1:04:48)
That's awesome. I love that. Thank you.

Alyssa Burgart (1:04:49)
I like to reflect on that experience.

Arghavan (1:04:52)
As you should, anything that brings you peace or joy in this time, pause on that. All right, well, thanks all for listening. That's it for this week's episode. If you didn't like what you heard, this has been the Scott Jennings podcast. If you liked it, don't forget to subscribe to The Present Illness. Leave us a review if you don't mind, or at least a rating, and then tell folks you know.

Alyssa Burgart (1:04:54)
you

Yeah

All right, well, you can follow us on TikTok, Instagram, YouTube. We're at The Present Illness and you can stay on top of all of our TPI related news.

Arghavan (1:05:22)
We will be back next week with more headlines, hot takes, and doom scrolling, hopefully wrapped in some laughs.

Alyssa Burgart (1:05:27)
So until then, agitate, hydrate, take a nap, and we'll see you next week on The Present Illness. Production by Arghavan Salles and Alyssa Burgart, Editing by Alyssa Burgart, Social Media by Arghavan Salles, Original Music by Joseph Uphoff, and don't take medical advice from two random people on a podcast. This show is for informational purposes. It is meant to be fun and it is definitely not medical advice. So please take your medical questions to a qualified

professional.