34:22
Hi, everyone. I'm Josh Woodward and I lead Google Labs, Gemini and AI studio. Today on dialogs, we have an incredible special guest, doctor Eric Topol. He's a bestselling author. a cardiologist. He's also the founder and director of the Scripps Research Translational Institute. He's someone I look to when it comes to AI and medicine and where it's all going. His Deep Medicine book was one of my favorites.
His latest book, Super Agers, is incredible about longevity. We get into all that and more in this episode. I can't wait for you to watch doctor Eric Topol, thank you so much for being here on dialogs. It's just such a great honor to meet you. Oh my gosh. Josh, this is for me. It's a grill thrill, so thanks for having as a cardiologist, leading scripts, an author, someone I've read, I really have so many questions for you. I want to start maybe bigger picture. You've seen a few different waves of technological shifts in the medical profession over your career. Or you're being kind? Because I'm on the old side and I've seen a lot of
I would say the first big one was the smartphone in 2007. Yeah. Because once you had a camera, you're connected to the internet. You can take pictures not just of skin rashes, but of a cardigan a scan of any type in medicine. So that really was a big game changer right there. And then for me as a cardiologist, the next big one was putting your fingertips and getting your Cardi Graham and said, whoa. what did that feel like the first time you did that? Yeah, the first time I did it, I said, I are you kidding me? for all the years, you know, having all these leads put on.
having a technician have to come in you could get this through your fingertips. It was a shock. Yeah. I'll never forget the first day I did it. That was soon after the smartphone was introduced I think certainly the ability to diagnose atrial fibrillation now through your wristband watch it's so accurate now. It's like 99% sensitive 99% specific. it's really been extraordinary picking up what is a very serious arrhythmia for its stroke risk and being able to diagnose that is enormous advance in medicine. I think it was in deep medicine. You talked about this shift from so much of medicine historically has been reactive, and how it's shifting to be more proactive.
Can you talk a little bit about that and sort of the impact that has for patients, but also for doctors, the fact that we are only treating, treating, treating, trying to deal with sick, sick sickness instead of preventing, preventing, preventing that's the shift that has to take place. And I believe it will in the future. Yeah. I want to come back to that because I just finished Super Agers, and that's a big theme in that book, too. this idea that AI in sort of the patient's hands, but in the doctor's office actually has the chance to not just be about efficiency, but about empathy and that kind of shift that can happen.
And reclaiming time for doctors and where they're going to invest that time. the whole idea that you could use technology to enhance the human bond, which is what is the essential aspect of what was striking there was the idea that we went into medicine because we actually care for people, that relationship whereby you know, the doctor has your back, that you can trust that doctor, that whatever is happening, you know, you have this person who really does care about you. And what happened along the way over decades was a steady erosion of this relationship. it wasn't because as the people going in to be physicians really had lost their way, it was because they were squeezed so hard
that the time with a patient for a clinic appointment was being dropped steadily from a new patient, like, have an hour to having 12 minutes. Right. And, you know, to be able to get the entire history of a person and to respond to their concerns and what needs to be done in 12 minutes of somebody you've never seen before. It's ridiculous. the whole idea was somehow, could we use AI to give back time to clinicians. And that would of course be the big step towards returning to the presence, the trust, the sense of care.
So it isn't just that physicians felt that they couldn't care, which is the main reason why they get so disenchanted. They couldn't care for their patients because of being squeezed. But also the patients felt that our still feeling to, to a degree that they weren't being looked after. That no one sides were feeling short. Yeah, absolutely. So this was really a big turning point There's also the other side, which is that patients are more autonomous. They have so much more capability and charge. for example, if they want their labs, they can put their labs and get interpretations.
They can look at trends of their labs. They can get ready for a visit to the doctor or the things that they don't understand after. they can get a lots of help through these AI tools. So that's decompressed the need for doctors as well and given patients more charge. So together, this gift of time, we're on the march to restore time and rebuild the patient doctor relationship. I'm curious. When you think about medical schools today, how do you think you teach empathy to a whole new generation of doctors? most people who are going to go to medical school, they have some natural empathy
or they realize they don't and they wind up doing something else or specific specialties that's not really required just listening is the first step. Just listening intently and giving a person a chance to express their concerns. That's so incredibly important. But also, you know, that whole idea of compassion and empathy is a communication skill that you try to teach. And most people, it will promote their sense of empathy, which is already there. If you are giving advice, graduating or doctors in training right now.
Maybe they're in med school, they're doing their residency and they're not sure about AI. What kind of advice or perspective would you offer? the way I look at it is, is not going to be that many years from now when we're not going to be talking about AI because it's going to be so deeply part of routine practice in every aspect. there will be a time when some of the arguments are basically put aside, that we realize that there are certain things that we can't do, doctors can't do, and clinicians in general, that we have to rely on help and embrace the help rather than trying to fight it. So we're not there yet, but we're headed there. this reminds me so much of the when we went through genomics in medicine.
Oh. How so? Well, when we first started sequencing the human genome and it was a novelty and we were talking about how, you know, when is this going to become mainstream in medicine. if you're an oncologist now, we don't talk about that anymore because it's part of the care of patients that you're going to get genomics of the tumor to figure out what is the best treatment. That's what's going to happen with AI eventually, just a matter of when Because the more you use AI, more you realize that this is pretty remarkable power. And if we can harness this power, it's just going to make medicine so much better so many things that we can really get out of AI that a lot of people
didn't envision I think is the biggest of all, which powering prevention, All right, let's talk a little bit about your latest book, Super Agers, which I finished recently. I've always curious. I'd love to ask authors, where did the idea for the book come from? And maybe what were some of the things you took away writing it? what was happening was I had been working on this house band for years. We'll give you two doing genome sequencing of what we called the welder Lee, which was later recalled, renamed Super Agers. there were lots of pseudoscience and influencers out there peddling longevity and making lots of mistakes,
So I said, I got to get this thing straight. There's so much confusion. There's also this misplaced emphasis on longevity when what we really want to do is keep people healthier, longer, what people don't miss, is that the average person in the US has got about 15 years in this six span, the difference between someone's house band and their lifespan. So we got to bring that down to as low number as we can What can we do to bring down six band maximize health span? And that's basically what was the impetus for it. But I'm curious, as a reader, what was your main takeaway? I would say the concept of a health span is very interesting, but I think how you broke out the various parts
some parts were like, get good sleep, eat well, exercise. The things are like, oh yeah, yes. And you do that. But then there were other things that you tease out. Things like the importance of relationships, the importance of being in nature, the importance of physical touch, I also thought it fit some of the theme we talked about, of how you can be more proactive instead of reactive as Yeah. I'm so glad you mentioned that, because what I got out of it was these three big age related diseases cardiovascular, cancer, neurodegenerative are eminently preventable.
I had no idea. that we're talking about a 20 year runway for these three diseases. Right, right. Are we that stupid that we can't get ahead of this when you have 20 years? And then I'm thinking, wow, with AI and all these layers of data, we should be able to very precisely say you're at high risk for this age related condition want to ask you a little bit about how you're using AI kind of in your own life. And I know we had talked about you've been using one of our products, Gemini Notebook, but I'm just curious, pass along any kind of feature request you have back to the team.
Like tell us a little bit about how you're using that product or any others and sort of how you're working it into your own day to day life. Well, that's one of the treats for me to get to talk with you This is my favorite AI tool. No, and I use it just about every day. Thank you. Sometimes multiple times a day. I spent a couple of hours every morning reading papers And I know I can miss things because these articles now are so dense.
Yeah, any figure might have nine panels. Right. And they have supplementary material. Yeah. And oftentimes even I can't even understand it or parts of it. So I'll take the paper and the supplementary materials. I'll throw it into notebook. Yeah. And I'm just amazed. So between the slides and the video and the audio and the infographic. Yeah. This paper, I have new appreciation. Then I'll do it for books. and I'm going to get all kinds of things synthesized it's mind blowing And we think of it as a tool. Tool for thought.
Yeah. Where the job is not to replace the expert in this case, hopefully it's making you kind of learn and understand and explore. Just kind of magnifying that. Yeah. But ultimately you're the judge of what it comes back and how you put it together and kind of hopefully kind of propels your thinking. So that's that's always been the spirit of that project. There'll be a new crop of graduates coming through the medical school system. And just curious for your advice and sort of wisdom you'd pass on to them, kind of as they're entering into this age where they'll be both cutting edge
medicine with AI, sort of any kind of parting words you'd have for them. I wish I were them. I mean, they are so darn lucky We talked about the information era for decades, but they're really going to hit it Yeah. they have the ability to get back that patient doctor relationship that's so precious, which is the essential core of medicine and the going to have this empowerment of not just treating of preventing diseases. And that's the thing that's tricky because if you prevent it and never happens, it's kind of invisible. But the fact that we're going to have so many more super agers because of the physicians of the future. So they are going to hit it really big in terms of the capabilities
that we didn't have, that we haven't had, and they are going to get reap all the benefits of this new era. Well, it's just a wonderful conversation. And thank you so much for your time. So much for us to think about. So thank you again. Doctor. Oh thank you. Josh really appreciate it. Yeah, thanks.
