The Peter Attia Drive

View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content Sign Up to Receive Peter’s Weekly Newsletter Susan Desmond-Hellmann is a physician and scientist whose remarkable career has spanned clinical medicine, oncology, biotech innovation, and global health leadership. In this episode, Susan shares insights from her journey training in internal medicine during the early AIDS crisis, treating HIV-related cancers in Uganda, and developing groundbreaking cancer therapies like Herceptin and Avastin. She reflects on her leadership roles at UCSF and the Bill and Melinda Gates Foundation, offering lessons on guiding large-scale health initiatives, navigating uncertainty, and fostering scientific innovation. The conversation explores the promise of precision medicine, the integration of patient care and policy, and the evolving role of artificial intelligence in transforming diagnostics, drug development, and global access to care. We discuss: Susan’s medical training, the start of the AIDS epidemic, and the transformative experiences that shaped her career [3:00]; Susan’s experience working on the frontlines of the HIV/AIDS crisis in Uganda [12:30]; Susan’s time working in general oncology and her transition to biotech where she helped develop taxol—a top-selling cancer drug [26:30]; Genentech’s origins, and its groundbreaking use of recombinant DNA to develop biologic drugs [33:45]; Susan’s move to Genentech, and her pivotal role in the development and success of Herceptin as a groundbreaking therapy in targeted oncology [44:00]; The rise of antibody-based cancer therapies: the development of Rituxan and Avastin [52:15]; The step-by-step drug development process and the scientific and strategic challenges involved [1:01:30]; The ethical and economic controversy surrounding Avastin’s high cost and limited survival benefit [1:12:30]; Susan’s tenure as chancellor at UCSF: leading during a financially strained period, and her strategic approach to fundraising and institutional development [1:14:45]; What Susan learned as CEO of the Bill and Melinda Gates Foundation: strategic processes and decision-making frameworks [1:26:00]; Susan’s philosophy of leadership and how she sought to build an empowering, values-driven culture at the Gates Foundation [1:35:15]; The erosion of public trust in science during COVID, the communication failures around controversial treatments like ivermectin, and the need for better public health engagement and transparency [1:39:30]; The role of AI in transforming medicine: from drug development to cancer detection and beyond [1:53:00]; and More. Connect With Peter on Twitter, Instagram, Facebook and YouTube

Sean Mackey, a renowned pain medicine professor at Stanford, dives deep into the complex nature of chronic pain. He discusses the evolutionary purpose of pain and how different individuals experience it uniquely. Mackey explores various treatment strategies, from traditional medications to innovative techniques like TENS, emphasizing the intertwined nature of physical and psychological factors. He also shares insights on the impact of sleep on pain sensitivity and the historical evolution of pain management, providing a comprehensive view of this multifaceted challenge.

This discussion dives into the intriguing world of nicotine, unpacking its distinction from tobacco and its various health effects. The addictive properties and risks associated with nicotine use, like cardiovascular issues and mood changes, are examined. Different delivery methods are evaluated for safety, ranging from traditional cigarettes to newer alternatives. The potential cognitive benefits and performance enhancements linked to nicotine are explored, along with strategies for quitting and minimizing health risks.

Sanjay Mehta, a seasoned radiation oncologist with over 20 years of experience at St. Joseph's Medical Center, delves into the fascinating world of radiation therapy. He discusses groundbreaking advancements that target cancer while sparing healthy tissues. Mehta also unveils the promising role of low-dose radiation for treating arthritis and sports injuries, challenging misconceptions about radiation safety. To lighten the mood, he shares a fun conversation about cars with Peter, connecting their mutual passion for speed and engineering.

This conversation dives into health and well-being for seniors, emphasizing the importance of strength training to maintain independence and prevent falls. It highlights the critical role of nutrition, particularly protein intake, alongside strategies for better sleep and brain health. Peter discusses emotional wellness and social connections as key factors for aging gracefully. The discussion also addresses chronic disease management and the need to focus on quality of life, making it clear that it's never too late to enhance longevity and well-being.

In this discussion, Dr. Ashley Mason, a clinical psychologist and UCSF associate professor, shares her expertise on cognitive behavioral therapy for insomnia. She breaks down effective techniques like time in bed restriction and managing racing thoughts. Listeners learn about the significance of sleep hygiene, optimal temperatures, and the influence of blue light on sleep. Dr. Mason also highlights how mindfulness can support sleep treatment and introduces innovative uses of AI in personalized sleep therapy. It's a treasure trove of insights for better sleep!

In this engaging discussion, listeners are introduced to a practical framework for evaluating dietary supplements. Key topics include the complexities of popular options like creatine, fish oil, and vitamin D. Insightful critiques challenge conventional wisdom about supplement effectiveness. Additionally, there's a focus on the need for personalized analysis and critical thinking, empowering individuals to make informed choices regarding their health strategies. Creatine’s benefits are specifically explored, including its role in athletic performance and cognitive function.

In this discussion, Jeff English, a trauma-focused clinical counselor and outreach specialist at the Bridge to Recovery, delves into the intricate nature of trauma. He introduces the metaphor of the 'trauma tree' to illustrate how early wounds shape behaviors. Jeff emphasizes the efficacy of group therapy, the importance of vulnerability, and navigating personal growth within relationships. He shares insights on finding a great trauma therapist and recognizing when to seek help, all while unpacking the deep complexities of healing from trauma.

Explore the fascinating world of aerobic performance, featuring insights on VO2 max and how dietary tweaks can enhance endurance. Delve into the complexities of insulin resistance and the rising costs of the healthcare system. Discover effective strategies for diagnosing and treating autism and ADHD in children, while also learning about the essentials of strength training. Peter shares personal adjustments to his patient care practices influenced by these enlightening discussions, inviting listeners to rethink their approaches to health.

Ralph DeFronzo, a distinguished diabetes researcher, discusses his groundbreaking insights on insulin resistance and its effects on metabolic health. He delves into the impacts on organs like the liver and muscles, the revolutionary euglycemic clamp technique, and the emerging role of drugs such as SGLT2 inhibitors and GLP-1 receptor agonists. The conversation also touches on the alarming rise of type 2 diabetes in adolescents, addressing lifestyle and genetic factors. DeFronzo’s deep knowledge offers a masterclass on diagnosis, treatment, and the future of diabetes care.