tv Matt Richtel An Elegant Defense CSPAN August 22, 2019 11:24pm-12:30am EDT
>> he and his family shop here all the time so you know, i typically like to introduce him with an embarrassing story. because we have been friends for ten, 12 years, so many stories. but today i think i'm just going to class it up and mentioned that matt is a journalist writing for "the new york times," one of the pulitzer prize in that capacity and also the author of five thrillers which is how i got to know him because i was a fan. he is the author of one really gross picture book and this is his second nonfiction work. please join me in welcoming mat.
[applause] what they thought about nose picking there are three reasons the ascending order. number one, you will find a chapter called should i pick my nose, and the least important it represents my own misconceptions about the immune system but we will explain later as we get into the talk. i understand they almost always
require a medical related acoustic song on the tv, so i thought felt i should honor tha. but the third reason and the real reason, and i hope when i'm done despite what you think you will get a warm round of applause is because the guy that inspired this book and who you will hear shortly and who was a very good friend lived in major league adventurous life if he wasn't happy unless the top was down and he was rocking out and crossing the country. so, jason this is for you, don't pick your nose. feel free to sing along when we get to the chorus or any other time. music back music back to be
later i will tell you about the controversy that launched the song that i want to tell you first about my childhood. first i want to tell you about my childhood. this was my little league baseball team. i am here in the front row and there are two people that are an important part of this picture. when i was growing up, jason was mr. everything. he was all-state baseball, all-state basketball and he was a great looking guy. graduation day in high school we stayed friends. he was an unbelievable character and life was pretty rich for him
accept for one blemish. when we were in 11th grade before the picture was taken, joel in our town wearing of a yankee hat died of cancer and it through chasing for a loop. fast-forward thirtysomething years and this is only a few years ago now jason is in his 40s, the very age that his dad got cancer, jason got cancer. and it was hodgkin's and eminently curable by cancer standards you never won't cancer that if you have if this isn't a bad one to have. he didn't manage to survive all of the chemo and radiation. he survived them but so did his cancer. he was a little wayward. his wife didn't stay on track quite the same way and he missed some treatments. long story shorlong story shorte
years ago, to this, three years ago i think in 2013 he had 15 pounds of lymphoma and is doubling every few weeks. and his doctor and oncologist in denver said i love you, but it's time to go home and die. we all said goodbye to jason and jason went home and said what about that one drug in the last meeting with the oncologist and it was an immunotherapy drug you've heard a lot about them now. it was an off label drug at the time that wasn't marketed for what jason had and they managed to get a couple of doses later his girlfriend woke him up two weeks after he'd been sent home can yo use which described the other direction.
these are pictures of what happened 15 pounds doubling every few weeks. this is the point i picked up my pen and said the health and science reporter, forgive my language, what in the hell just happened. i asked myself not only with his immunotherapy, people had begun to write about that, but i said what is the immune system, what is this thing inside of us and help get the point we are tinkering about it. let me read you briefly.
cancer is one of the leading killers this isn't a cancer story, it is not a story of heart disease or respiratory disease, accidents, stroke, alzheimer's, diabetes, flu, pneumonia, kidney disease, stroke, hiv or diabetes. these are things that alien kill us. this is not the story of amy in particular injury. it is the story of all of them into the link that binds them. the glue that define the whole of human health and wellness. this is the story of the immune system. it's an account of the discovery of the immune system, particularly over the last 70 years and of the role system plays in every facet of our health.
i was going to read a little bit war but i think the u. get the picture. longevity, wellness, well-being, happiness. over the next couple of years, i went over every misconception that that idled over a lifetimet the system that is inside of us. i began with the most basic idea even married to a doctor who is a wonderful educator in our family, i totally listen to a limited. but nonetheless i had a lot of misconceptions i think many of us share. let me see what is next on the slide. note to self, reading, did that, what comes next, movie
reference, site out, avoid copyright. okay. so, i began with a misconception that the immune system was a zealous force keeping everything out of our bodies that would do us any harm and to some extent, it serves that purpose, but the most basic thing i learned i've since thought of in the context of the movie the matrix. everybody remember that? okay, remember in the matrix if you haven't seen it, i'm going to kind of give stuff away but i can't put an image here on account of the lawsuit thing. in the matrix remember those old ones and zeros around, and he realizes that he's surrounded by a world unseen by many of us. the most essential basic thing i learned about the immune system comes predicate to explaining how it works and that is we are
surrounded by an invisible world at this moment on the surface them on you,under chairs, on yo, certainly on your shoes there are bacteria, virus, parasite, myriad organisms, ones and zeros of life all around us and this is so essential in explaining the immune system because if it had been the way that i conceptualized it when i began my journey is something that seeks to attack anything alien we would have scorched earth and nuclear winter. in fact, the immune system is quite different than i conceptualized and in one way if i wantei want to define to begi, can i see the next i'd because it will help me, don't pay attention to that slide, really
what the immune system is this a calibration device that is aimed at assessing how to get along in the world in the least violent way possible. what it tries to do is cooperate with all of those that surround us and be as cooperative as possible because when it must, you can come through. wave to the cameras. you are adorable. then it must go to the war and act as a police state, the violence is so pronounced and defined that it's more dangerous than almost any pathogen you
will ever encounter. so, i've come to think of the immune system as the love child of a bouncer and a ballet dancer. it has immense power to survey ultimate spy, to look inside and to do terrific damage, but it tries to do so by treading as widely as possible. i want to tell you about some of the other characters in the book. in order to describe this massive system and i won't begin to do with justice in 15 minutes i hope the book does i get some justice, i felt i needed to bring in not only jason who represents only a single kind of perspective, the perspective he lends to the story is the one where the immune system is insufficient.
for a variety of reasons we can either discuss or you will read in the book couldn't rise to the challenge of fighting the cancer, but that is only a part of the conversation. i mention it can get out of whack very easily. it's a police state that holds itself in check, but when it does not, we run into characters who are insufficient, they are characters in this book who if you prefer the goldilocks metaphor, their immune system was too much. each of the women profiled in this book suffers from although indian disorders. their stories are both thrilling and so commonplace. i was unaware until i got into this book and to some extent until i got older and began to see what people around me suffer when it comes to autoimmune
disorder hell privilege this is. it's more than it's ever been in part because we are aging. i'm seeing it more for that reason but in particular it is far more prevalent in women than men. it's a topic i go into in the book. i'm really struck by when we get to the q-and-a they've asked me to limit for the moment, but we can talk about why women are more susceptible to the autoimmune disorder. i was struck by how the they'ven kind of invisible and i seek to bring light to that topic how they happened but also why they can feel so invisible. they can seem invisible for two reasons. one, and this is how they were.
i brought these up for a couple of reasons, this is a cutting of a woman who was deemed her images are in the book essentially deemed hysterical you know how over the ages we have heard it's in your head. it's extremely excruciating to go to the doctor and have a doctor say i'm sorry there is nothing inside you alien that would be causing this. therefore it must be in your head. therefore doesn't follow in this case just because it is invisible doesn't make it any less real. this is your body attacking yourself, but the other thing i put up here is a public notice in search of a werewolf. the first named rheumatoid condition was lucas. people thought maybe you were disfigured from the bite of a auto immunity in here.
these are when and where it's been over powering. this is what her hand looks like now. she was a professional golfer. she isn't terribly well remission and this is what her hand can click on a typical day. she sent me this picture from inflammation. give me one more. the last character by choosing the buck probably is the most marvelous to me of all. i mentioned one with too little or too much. you are looking at a man with an extraordinary immune system. need robert was so extraordinary that the national institutes of health studies it now to understand why it is so perfect. what is the evidence? following night 1977, robert g-golf h. i v.. he was infected.
i mentioned what the immune system is and the act of balance that it's the. one of the most astounding questions that most struck me as so profound about the immune system. the friends we may confront in the living world, believe it or not, the immune system you kerry in you is pick your belief takef system, scientific, divine, whatever it is must be described
as a less than miraculous because it has an answer to the following problem, and i'm going to read you the problem. see how handy these are, and they are big not like the small notes that people keep here. a huge challenge is they are highly variable. bacteria and viruses replicate very quickly. bacteria can multiply every 20 or 30 minutes. some faster at each act of reproduction creates an opportunity for change, a mutation, moving around of genetic sequences that can turn a virus or bacteria that our body has figured out how to fight into a virus or bacteria that our body doesn't know how to defend itself against.
the human reproductive cycle gives rise to the new generation roughly every 20 years. we can't possibly survive an arm race with organisms that change if sucat such a rapid pace. to deal with so many threats including ones that might not even exist yet it needs to be from reproducing pathogens or a prprotein-based life form from outer space. it is amplified by more simple
to define it in a way that i expressed i do want to give you one. she said the only thing i have to apologize for in the first 100 or so pages is that occasionally i write a pep talk saying stay with me this stuff is complicated. but one of the hardest parts of the topic is the vocabulary. you will discover in the book a bunch of vocabulary i tried to define it. all of these terms represent an incredible function at your body is doing at the subconscious level to protect you.
let's come back to this. hopefully we will pause for some question and then a couple more list concluding thoughts. the practice is i realize i covered a lot of ground to try to give you a bit of an overview about the book. it would be hard to do justice to the breadth of it without keeping you here for longer than you would like to do a. that's one thing. maybe then we can have some questions about anything you want to ask about to the extent that i'm aware. i will defer to someone in the audience.
one of the things that i've discovered and some of you may know about this because it's been out there is an article that's been circulating a lot and i wrote a few weeks ago in "the new york times" about the hygiene hypothesis. it's actually poorly named but one of the things researchers have realized is returning to that image of the ones and zeros and all the inputs around us it benefits enormously by interacting with those viruses and bacteria. many of them would live with us innocuously but in any case our immune system goes to boot camp by interacting in the natural world. it's thought of as the hygiene hypothesis when it observed people that were in the overly
hygienic circumstances and in these environments got my allergies but it turns out the hygiene hypothesis has been expanded a little bit into what some call the old friends back in the sun that really what you need when we sanitize our environment we are not just walking the problematic pathogens but we may also be blocking all of those friendly or other microbes that help inform our immune system. so i ask the question of a couple of immunologists for this reason not to justify my behavior explicitly.
i asked some scientists could not conceivably be a part of an evolutionary biological approach to informing your immune system? one immunologists said to me we need to study that question we don't know the answer. we've taken it for granted because for many years that represented the input of the boe knocknoxious pathogens. it may be an open question. let me tell you about stress. the book outlines this isn't a magic bullet book for each search in salary and you will never have a problem again, blithe anwifeand avocado on youe will cease to. this goes more to the principle that underlies the solutions. there are four listed here. you will see the science but i want to highlight one because i
think that it's worth putting a fine point on the day in age we live stress has an immediate profound effect on your health for your immune system. to understand why it's quite old. two pictures were sold in the savanna 100,000 years ago so picture your cell phone won't hear your running for the lion shifting resources away from some of these function that are essential what happens in the
modern society, we are blessed in this society in this version of society that we are on now we're anything tantamount to it we face lots of threats that they can feel on a biological levelevel in a visceral level oe obligations very quickly thereafter i got the stomach flu i know all those rules and i had to nap more than usual. thank you for not laughing. i just want to emphasize the book has more science but the sleep and stress chapters play
together very deeply in the adrenaline that you create has a direct effect on limiting your immune system and when you don't sleep you don't turn those signals off either so can i have one more slide back read something that tells you to boost your immune system i would look at its kind of like this you do not want to boost your immune system, you want to support your immune system. thesthese are two decidedly different things a boosted immune system is a disk regulated immune system, joint pain, fatigue, fever, exhausti exhaustion. so think twice about that mantra that has gained currency for no good reason in modern society. the other walkaway line is i'm
not going to tell you how the story ended. it was quite dramatic but one of the things the immune system teaches us is that we are not meant to live forever. it is a system that is aimed at not foremost preserving the individual, but preserving the species. >> i would love to take your questions. go thank you for listening. [applause]
>> have you done research on emotions or trauma in particular and trauma that has it been dealt with clicks the impact of stress and trauma specifically trauma on the immune system. i will be cautious and not speak directly i don't know about trauma per se but it can lead to things like anxiety and depression that do have a very direct effect on the immune system and sleep i cannot speak trauma per se in
the immune system but i would suspect they are linked. when people are lonely you see the immune system troubled. when they are trust one - - stressed the immune system can go into dysregulation. one quick study. there have been some terrific studies done around stress and test taking remember finals and herpes? do you know how herpes works? it's a nasty and beautiful virus in relation to the immune system the epstein-barr virus is the most common in it can be held in check by the immune system at the ganglia at the base of the brain stem.
but then to crawl down into your mouth when you're stressed or traumatized or depressed they are held in check by a healthy immune system - - system so when it weakens, quite literally the herpes crawl down into your mouth. one thing that research has noted when they got stressed around test taking time and that lonely your students have a harder time. there is some evidence that connects that i don't know with the psychotherapy that you do but put that with loneliness and depression and anxiety i can connect to that.
>> [inaudible] >> they are just looking at autoimmune disorders and how it connects to those issues you are describing and the reason is coming to understand autoimmune disorders themselves, they are so complicated that getting out the cause and effect is exceedingly difficult. any other questions i can't answer? [laughter] >> the relationship with the system quick. >> yes i can give you some of this in part thanks to the guy sitting behind you who is a friend and tennis buddy of
mine who made a suggestion to a guy at caltech who is one of the leading experts who help me to understand the main character of the chapter of the subject so those who are not as initiated the micro biome is the biosphere of bacteria - - bacteria that lives inside of you half of the body cells are bacteria mostly in your gut. we are not war with most of the bacteria around us. that we know on the immune system side the bacteria we are their hotel and their tent and their youth hostel. we are their home. they want to cooperate with us. a word of caution about the micro biome. talking about autoimmunity and
how early the researches micro biome research i could say the most embryonic research of any field that will blow up to be extraordinary. it has the potential to tell us as much as we have ever known about human health. but when you think of the collection of orifices in your gut billions of cells, the cells it is exceedingly hard so if somebody tells you they know the answer to the micro biome question they are not telling you the truth. but at caltech they can tell you profound things. kids. kids. speak up. we cannot hear you. here is my favorite bits of
trivia. what researchers have discovered. the micro biome once the body to live and remember the immune system has a terribly difficult task to deal with all the pathogens in the microbes in assessing what to do. it turns out the micro biome remarkably enough sends signals across the gut line we thought it was so sealed we call it immune privileged that nothing got in or out going from the bacterial cells telling the immune system a bunch of things instructing the cells in your immune system to either ramp up or slow down. with the basic answer. there is a relationship that we are just understanding but
we know it will be exceedingly important and a healthy gut is essential to overall health and the immune system which is the river that runs through it. do you remember i said it sends signals that might say attack the immune system but it might say stop? i just want to make clear in this conversation i may have done this in passing but a big part of the molecules of your immune system are designed to put the brakes on it. those molecules are designed to stop it because you see what happens when it gets out of control. we would not be here today without the immune system to put the brake on it. >> i have a bad immune system. but now i understand where
you're coming from. is there anything that actually would do that clicks. >> let's set aside of which we know very little despite what they claim the world's leading immunologist that you read about in the book at national institutes of health i would not be surprised i would not known his name but if i say his name in front of any researcher they fall down as if springsteen. do you know bob springsteen at
the nih? [laughter] thank you. was that genuine? or facetious? [laughter] he would tell me we don't even know what to tell you what to eat or not eat or what specific things power or don't power your immune system we are not at that specificity yet. but there are things today that will boost the immune system they are extraordinary and dangerous. the reason jason returned from the grave nine toes in the grave because he took a drug that unleashed the immune system. here has cancer traditionally is fought we try to fight the pathogen itself the mutation itself by pouring toxins into the body, chemotherapy is
aptly named talking about throwing agent orange into your body. i hate saying that because i know people who have gone through it it's a delicate way to describe a horrible process. but with the way we are trying to find one - - fight cance cancer, can we boost the immune system? the way we think about it no now, rather than attacking the tumor with toxins, could we cause the immune system to do what it was built to do in the first place? can we take the brakes off so it attacks the tumor? that is beginning to work in untold ways. the winner of the nobel this year was a guy who was at
berkeley and when he discovered if you give a certain kind of molecule to a mouse and now a human i will oversimplify a bit attached to the molecule you can cause them to attack and in jason's case the brakes were put on the immune system i will not answer why but the drugs can pull off the brakes that comes with a tremendous risk then you invite all the things that can happen when you get the overzealous police staying. >> some therapies looking at the particular tumor and they find those mechanics of the immune system but insufficiently so and will
amplify that. is that something the mechanism we will be seeing as the new therapeutic model for the future quick. >> i think the models will take as many shapes as there are innovators and creative medical people. what you are describing is a combination of personalized medicine to understand the individual and his or her relationship to the disease and talking about the london patient was cured of hiv but also is not more important but more fundamental but we are beginning to see molecules and what they do and we are beginning to tease apart the t cell or b cell with all of these nodes and in general we know if this node does this
, if we monkey without relationship between this node and this tumor cell physically. one of the challenges built on economies of scale on a personalized level. i do know there are people in the room who are in the business from genentech those are the solutions people are trying to solve. can we make this economical to do it on a more personalized level? on a broad-based level boosting the immune system or in the case of autoimmune disorders we are putting the brakes on the immune system in the same way but when you do that it's the infection and everything that comes with it but as we get better that will happen. >> but behavior has changed
quick. >> if you have my own behaviors have changed. i knew about the things that i mentioned like sleep and nutrition and stress. quite literally i can watch the one / one relationship between now what i know is going on in my body and the science and i will tell you actually i am less journal phobic we had each gotten less journal phobic because of the training of the immune system but i also realize that frankly having a periodic head cold or the occasional flu is not that bad for you. a case can be made realize nobody has time to be sick but a case could be made that is part of health and is easy to
say intellectually it's hard to accept in the moment that where my habits of most concretely changed is around the handling of raw meat because i understand this to be part of a really heavy area of possible transmission of higher concentration of noxious pathogens than you would otherwise face meaning in any other environment. our kitchen looks like infection control i do this and then i turn on the sink. i'm being careful to wipe down the counters. there was a short in the new york times that i wrote and oversaw much of last year having to do with drug-resistant infections.
but i would encourage really good hygiene around raw meat. very simple but true. >> i have a question. the body does things in the order that it knows will sustain it. so the immune system under ordinary circumstances has a very high priority and the idea that seems to be so prevalent in society that probably is not immune abuse - - boosting at all. but people are so credulous
that if it has everything to do if you do this or that or the othe other, you can start for six months but your immune system has a high biologic priority will give up other stuff. >> she makes a really interesting point how credulous we are around certain ideas i thought about this a bunch in the course of writing the book as we get to the point like every time somebody touches a banister and why we are so worried but a lot of our habits around health derive from an understandable place. i found a quote in exodus about ritual handwashing.
uncle in exodus talks about ritual handwashing you can see how some don't eat pork or beef many practices were born out of a very understandable lack of control over the environment that not only did we not control but not understand. one of the things about the. we find ourselves in which is very fertile ground as a journalist, to educate about places where we have not only learned and a million places where the industrialized
process with very good or understandable reasons like getting more calories to more people we have seen this side effect of obesity and it requires a reorientation around a new set of facts so talk about boosting the immune system it is understandable for many years we believe the reason we were getting sick is because the immune system was not strong enough it stands to reason the same way you might look at the sky to make the assumption what the stars are. what we have learned the more we learn but what we find ourselves we have a chance to correct where we overcorrected that is a more nuanced relationship with those around
us and it does take time because economic forces stay invested in those marketing messages that have worked. a very good example is the antibiotic that are vastly overused by 30 percent the cdc will tell you here in the united states but they were sold very effectively for a very long time for pharmaceutical companies now those horses get involved they begin to correct - - connect to a powerful message it's hard to undo those. >> it is like probiotics they don't say if you should or should not but which one you should take or we can improve our memories from an extract of jellyfish i don't think jellyfish have a nervous system. [laughter]
i'm a pharmacist so people say i don't want to take drugs that they come up with supplements that they have no idea what is in it. i don't like chemicals in my body but everything is a chemical. it has gone off the rails. >> one of the areas, just to point out one other area where you see, she talks about people with the supplements with this incredible disconnect whatever you believe about marijuan marijuana, make no comment on it here but the fact it is sold as medical marijuana when there is almost no research except in three very specific areas that have good control the studies but it is passed repeatedly under the heading of medical is the extraordinary notion.
i'm not here to take a position but there is almost none. are you desperate to go home and read? [laughter] >> vaccines were a very early method to our benefit but now these same people taking money for supplements are with the vaccine. >> a vaccine, good vaccine is brilliant and i don't think there is a good argument again a good researched effective vaccine for quite don't want to pick a fight tonight but we can brawl outside. but i do want to say once you understand how the immune system works and why it does
, and they care that goes into the vaccine that work, it is an extremely potent way to head off the following scenario. i haven't gotten into this but i want to explain one of the reasons why vaccines are so important and effective. in fact there are two immune systems or two kinds of immunity one is innate that rushes to the scene of the infection or a splinter and there are signals without mad free-for-all to fix and kill and rebuild and destroy the infection and rebuild do tissue. but then there is a second one called the adaptive immune system this is built up of the very sophisticated t cells and b cells precisely connected molecularly the very infection you are facing.
one is generic and one is precise. here is the problem, it takes time to generate activity. first, the body must decide what is the nature and then it must find proper cells the majesty is extraordinary i will not belabor it here but it takes time we were facing very dangerous pathogens like smallpox or polio or other things, you do not want to wait five or seven or ten days for the immune response to rev up and find the right cells and do what it is capable of because by then you could be dead. and a vaccine done well provokes the immune system to have a blueprint before you ever face it is not just your
child's life at risk but other children in the classes who could be at risk if people stopped taking them. >> thank you we have a great privilege to have book tv here thank you for great audience thank you to c-span if you're interested i will sign some books. have a great night. thank you very much. [inaudible conversations] >> all of the authors could push through whatever barriers they had to write about their
deepest struggles in one of the essays that comes to mind is such a raw and honest account of grief and it also reflects today it is not an uplifting book. >> the reality is i have to arm them not only with a set of skills that allow them to flourish in school and values but also a way to make sense of the hostility that they encounter every day from people whose responsibility who treats them that way as community members.
c-span2. [inaudible conversations] good evening everybody. can you hear me okay? i am the deputy director here at policy - - politics and prose. thank you for coming out tonight if you have not already picked up a calendar with the rest of the events scheduled for july and august rehab calendars by the information desk and a full list of ts