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Abdul cuts into how the climate of misinformation and politicization forced us to change the way we talk about science. Then he sits down with Dr. Sanjay Gupta, CNN’s Chief Medical Correspondent, and a 20-year veteran of medical journalism, to learn how the pandemic changed his perspective on his work.

Transcript

Dr. Abdul El-Sayed: The CDC updated mask guidelines to allow vaccinated people to congregate without masks, both outdoors and indoors. The FDA and CDC have also authorized the Pfizer vaccine for use in children aged 12 to 15. Doctors and scientists reported a breakthrough in treating children with severe combined immunodeficiency, otherwise known as the bubble baby disease, because it forces children to live in a bubble or risk infections. They use a disabled version of the virus that causes HIV to deliver genetically-modified immune cells to the child’s body. This is America Dissected. I’m your host Dr. Abdul El-Sayed.

Dr. Abdul El-Sayed: Last week I sat down with Representative Cori Bush to talk about her fight for Black lives from the bedside as a nurse, to the board as an activist, to the halls of power as a congresswoman. Next week, I have the privilege of sitting down with Dr. Ibram X Kendi, author of the New York Times bestseller “How to Be an Antiracist” to envision what it would look like to build a truly antiracist health care system. But this week, I want to talk about, well, how we even talk about science and medicine in the first place. Later on this episode, you’ll hear my interview with Dr. Sanjay Gupta, a 20-year veteran of medical journalism as CNN’s chief medical correspondent, for some insights about how COVID-19 changed his work as a medical journalist. But first, I want to dissect why communicating science is so hard to do in the first place and why it’s gotten so much harder now. Let’s get to it. Remember, back to your high school science class? Probably did a few cool experiments. Sure. But most of the time you probably just sat on your rear end and memorized a bunch of facts delivered in monotone by an unenthused or uninspired teacher. Some science teachers are, of course, amazing. But don’t get me wrong, there’s a reason most folks don’t get into science-based majors in college in the first place. It feels, well, boring. And that’s where the problem starts, because we start our education in science memorizing facts, we think of science is just that: a book of facts. But here’s the thing, there are no facts in science. Let me say that again. There are no facts in science. Facts have to be proven things. And in science, there’s no way to prove anything. There are only ways to disprove things, and a bunch of ways to support things that are not disproven yet. So what do I mean by that? Well, consider what you learned about gravity, the theory of gravity—oh, there’s a word: theory. We’re gonna have to talk a bit more about that one. But the theory of gravity you memorized goes something like this: any two objects of mass will attract each other with a force proportional to the product of both masses divided by the square of the distance between their centers. Don’t remember that? It’s OK. You probably learned it at some point. But it’s plausible that someday someone will do an experiment that will alter the way we think about gravity entirely. It just hasn’t happened yet. So there’s a consensus regarding gravity. Don’t get me wrong, it’s as close to a fact as possible. We’ve gone to space and back based on it, but it’s possible that it could be overturned. In fact, scientific consensus gets overturned all the time. That’s because science is a process. All those experiments you did in science class, there the way those things you memorized came about, they’re also the way that all those things get proven wrong. They’re the whole point. We set up hypotheses about how the world works. We design experiments to disprove our hypotheses, and then we conduct and interpret them. We learn from them and then rinse and repeat. Oftentimes, experiments differ in minute ways, which makes interpreting them in the context of all of the experiments that have been done before, a really complex undertaking. Anyway, once you’ve had enough experiments that support a certain understanding of the world, we call that a theory. There’s that word again. And the fact that it has exactly the opposite meaning in science as it does in popular culture, is a real problem. In science, a theory is an experimentally-supported working model of how the world works. But in popular culture, a theory is what we call a hypothesis in science, a flimsy conjecture. So when people talk about some scientifically-supported model of how the world works as just a theory, it makes our head spin. People don’t always understand why scientific knowledge changes, that a few experiments can fundamentally change what we know about something, sometimes in frankly contradictory ways. Most of the time, though, when we talk about science, we’re talking about what we call “settled science” meaning that there’s been consensus or a working theory for a long time, like gravity. But when we’re talking about new science, it gets a lot harder because people are literally watching as the sausage gets made. That’s exactly what’s happening during the pandemic. We were actively trying to communicate to the public about science that was changing every day. Should you or should you not wipe your bananas from the store, or wear a mask, or go to church, or fly in a plane? We just didn’t know. But here’s what makes that even harder. It’s not just that we’re trying to communicate changing science against the backdrop of a fundamental misunderstanding of how science even works. We’re doing it against this.

[clip of President Trump] And then I see that disinfectant that knocks it out in a minute, one minute. And is there a way we can do something like that, injection inside or almost a cleaning?

Dr. Abdul El-Sayed: Misinformation about the pandemic forced us not simply to explain what was happening scientifically, but constantly bat down bunk hypotheses with no basis in science, or even reason. But each of those problems makes the other one harder. Anxiety doesn’t tolerate a vacuum and as the pandemic hit us, our collective anxiety about the virus left us searching for answers. The fact that science didn’t have great ones meant that people found them in less scientific places, and they were usually wrong. But scientists rushed to provide the best available information they had, often borrowing from what we knew about other similar viruses, and sometimes also getting it wrong, like on masks. I got to ask Dr. Fauci about the about-face on masks when I interviewed him last year.

[clip of Dr. Fauci] Few things evolved which made it even more compelling to wear a mask. A, data started to come out that it really is effective. Before it was kind of wishy-washy, the data, but then you did meta analysis of studies of wearing masks and not, it became clear that it’s effective both to protect me from infecting you and also to protect you from infecting me.

Dr. Abdul El-Sayed: We’ll talk about last week’s change on mask guidance a little bit later in the show. But those kinds of changes in scientific consensus undermine trust in science and create all kinds of fodder for mis- and dis-information. Misinformation forces scientists to communicate what little they know, the fact that those things end up being proven wrong undermines faith in science and create space for misinformation. It’s a vicious cycle. It’s even worse when the political climate, not to mention the very president of the country, turns every contention into a political feud. I’ll never forget the moment that someone forwarded me a Republican Senate committee email about hydroxy-chloroquine because Trump was claiming it was some kind of miracle drug despite flimsy evidence. And a studies came out, it became clear that hydroxy-chloroquine wasn’t just unhelpful for patients with COVID-19, it was actually harmful. All this, the fact that we do such a bad job teaching people what science actually is, the fact that so little was known about the virus early, the fact that social media put misinformation on steroids, and the politicization of the pandemic, made communicating science extremely hard to do. Today’s episode is all about unpacking the difficulty and failures of scientific communication. To understand it all better, I sat down with someone who’s been doing it for 20 years: Dr. Sanjay Gupta, CNN’s chief medical correspondent on medical journalism in a pandemic, after the break.

[ad break]

Dr. Sanjay Gupta: I like the backdrop here, you got the Detroit Tigers hat on and the Michigan Wolverines and—

Dr. Abdul El-Sayed: You got to represent. You got to represent.

Dr. Sanjay Gupta: I like it.

Dr. Abdul El-Sayed: All right. Ready to get going?

Dr. Sanjay Gupta: Yep, I’m recording.

Dr. Abdul El-Sayed: All right. Let’s get started. Dr. Gupta, thank you so much for taking the time. Can you introduce yourself for the, for the tape, please?

Dr. Sanjay Gupta: Sure. My name is Sanjay Gupta. I’m a doctor, a neurosurgeon, and a reporter at CNN.

Dr. Abdul El-Sayed, narrating: Dr. Sanjay Gupta, every immigrant parent’s dream child, and face of TV medicine for 20 years on CNN, is one of the best medical communicators I know. I reached out to him because he’s covered some of the biggest health stories on one of the biggest stages in the world. I wanted to understand how covering this pandemic compared to other health stories he’s covered, and what it’s taught him about communicating science and health.

Dr. Abdul El-Sayed: Thank you so much for coming on the pod today. Really looking forward to discussing the space where how we talk about what we know intersects with what we actually know. To get started, tell us how a neurosurgeon becomes CNN’s go to doctor.

Dr. Sanjay Gupta: [laughs] Well, you know, I’ve been doing this for 20 years now, and it’s sort of interesting. I mean, I guess life in so many ways is serendipitous, but I, I was, you know, I’m a doctor, I was working at the White House for a while as a White House fellow, primarily on health policy. And this is the late ’90s, mid to late ’90s, just to give you an idea of the time frame here. So quite a while ago. And when I was there, I had conversations with people from, you know, various networks, including CNN, who at the time were looking for different ways to talk about health policy on television. Mostly, it was relegated to magazines and conferences and things like that. And admittedly, not the most exciting stuff for television. But I, you know, it was unclear to me what that was possibly going to be. So, you know, I didn’t, I didn’t really pursue that at the time. I was back in Michigan finishing my training in neurosurgery and living in the town where you’re living Abdul, there in Ann Arbor, which I love, and on faculty there. And then I moved to the Emory Clinic to take a job on faculty, which is also CNN’s headquarters. They approached me again and said: would you like to talk about health policy on television? And this is now summer of 2001, and I said, sure. Just to comment on what was happening, George W. Bush’s first term, first year, his health policy plan—and about a month later 9/11 happened and the world changed for everybody, but certainly if you’re a reporter at an international news network. I was then asked if I wanted to report on that, and anthrax, and then going into Afghanistan, and subsequently Iraq. And it just life went into a totally different direction. I was always interested in covering stories. I just thought it was interesting just seeing what journalists did. But then I had a chance to be one.

Dr. Abdul El-Sayed: Hmm, wow, that is a fascinating and very serendipitous story.

Dr. Sanjay Gupta: Yeah.

Dr. Abdul El-Sayed: I obviously, I went to the University of Michigan as well, and you’re a bit of a legend here in Ann Arbor, and nowhere more so than at the medical center. But we’ve been really grateful for your coverage.

Dr. Sanjay Gupta: Thank you.

Dr. Abdul El-Sayed: And indeed, a lot of ways your work has made you the face of medicine. Can you talk a little bit about how you’ve tried to balance the, obviously the need to get it right as a reporter, with the nuance of a lot of the history and the responsibility of sort of being that face of doctors and of the biomedical establishment, and also what that means for the way you think about how you get people to behave moving forward. I mean, in some respects, you know, you’re offering broad medical advice, and I have some experience in doing that, but you’re not offering specific medical advice. And oftentimes folks are looking to take what they’re gaining from you and apply it in a personal life. How do you balance that in terms of sort of being America’s doctor but not necessarily being that individual’s doctor, with the way that you think about delivering medical information?

Dr. Sanjay Gupta: Well, you know, it can be a challenging thing, although I think that overall, and when I started doing this, there wasn’t, you know, sort of a real guide for for me, so I think you had to sort of figure it out. And the only thing I really knew when I started doing this kind of work was one-on-one medicine, kind of like you, you know, just taking care of patients one-on-one. And I think that from a fundamental standpoint, that still is a good approach. Not that I’m being prescriptive on television to your point, but I think when you’re thinking about talking to a patient in the clinic and you’re dealing with some specific thing, you know, you think about your own conversations. First of all, it’s really important to you as a clinician that the person understands what it is you’re talking about, right? So right away the language choice that you make, your sense of true empathy in the sense that you really, like, I mean, you feel for these people who are going through what they’re going through as they’re sitting across from you and you realize their lives are changed and they’re thinking about some of the biggest decisions perhaps in their life at that point. So from a tone standpoint, from a language choice standpoint, I think there’s a lot of similarities. There’s not a patient in front of you, but there’s a lens. And if you can get to the point where you think about the lens, if you can, you know, sort of animate in some way, just in your own mind, I think it puts you in the right mindset. Also, you know, look, Abdul, you know, there’s patients often at the end of the day who I’m sure come to you because you said: hey, look, it could be this, we think maybe this, you know, this is what we’re planning on—but you’re not going to them and saying: two plus two equals four, absolutely, this is what you’ve got to do. That doesn’t happen very often. And it’s the same thing, I think, with a lot of the stories that we cover. There is a, there is a nuance there. And I think the more that you let patients or viewers in this case in on it, the better. Oftentimes, you know, you probably get asked the question, I get asked the question at the end of the day: so what would you do if it were you, or what would you do if this was your mom or your or your daughter or whatever? And, you know, I think it’s a fair question. And I think sometimes just putting yourself in that mindset as well. Look, we don’t have all the answers, but when I digest it all, and think about all the micro-decisions that require, that are required to digest it all, here’s where I land on this. I’m not 100% sure. This isn’t math, it’s science, but this is where I land on it. And I think people appreciate being let in on the process.

Dr. Abdul El-Sayed: Mm hmm. You know, most of the time when you’re talking about news, you’re processing current events through what is most of the time settled science or relatively settled science.

Dr. Sanjay Gupta: Mmm.

Dr. Abdul El-Sayed: One of the things that changed during the pandemic is that there was no settled science about the pandemic. You were at the same time trying to report events and report science. And the hard part about science is that if you’re not used to it, if you only have ever sort of seen or engaged with settled science, is it looks relatively static. And what I think this moment has shown everyone is that actually science is actually early, in early stage is really quite erratic. And you have baseline fundamentals that may change and shift in a day based on a couple of studies. How has COVID changed your approach to thinking about how you talk about science? Or maybe even stepping back: what was the biggest challenge of covering COVID in the context of shifting science and the ways that it can shift the trust in the audience, because most of the time they’re used to hearing you talk about things that are already known? And not just by you, but by the science books.

Dr. Sanjay Gupta: You know, I would say there was, there was two interesting things that jumped out that were a little non-intuitive. One is that, and this is the non-intuitive part, one is that I think when you’re truly dealing with something that is emerging or novel, if you’re an expert in this area or just someone who has a lot of knowledge or background experience in this area, that’s a good thing, but it can get in the way because you immediately tend to try and box this into something that you are familiar with. It’s natural. I think it’s very human. But, you know, you hear coronavirus from China: oh that’s SARS, I know SARS, SARS was 8,000 people around the world, 800 people died, it wasn’t super contagious—we’re going to put it in the SARS box. Or it’s looking like a pandemic, so we’re going to put this in the H1N1 box—that’s the last pandemic we sort of knew about. So, you know, I think that to really approach something tabula rasa, especially when you’re an adult, is challenging. Kids do it really well. But for adults, it’s hard, especially when people are looking to you, to me, to doctors or, you know, people who have experience in this field for answers, to really step back and say: we’re dealing with a clean slate here. But I think the other thing, Abdul, is that I think just after 20 years of doing this—I totally hear what you’re saying, and, you know, you go through your training, and I went through neurosurgery training, it’s very didactic, literally ABC, you know. We don’t want, you know, neurosurgeons to be freelancing, we want them to follow very established protocols and procedures. But I think after 20 years of doing this, I was more aware of just how dynamic, as you point out, science is. I mean, um, how valuable is a cardiac stent in someone who has chest pain, how often should we be doing knee replacement surgery on people with degenerative arthritis, the value of medical cannabis for treating certain conditions—we had these long-standing sort of beliefs on lots of things in medicine that as the science emerges, we realize maybe stents aren’t that useful, maybe not as many people need knee replacements, maybe medical cannabis really is useful and maybe it’s the only thing that’s useful in certain conditions. So I have lived, I think, at this inflection point, as have a lot of people, for some time now, realizing and reminding people that there is a lot of art in science, as well as the sort of more tried and true principles. I will say one other thing, and this was surprising to me as well, Dr. Fauci actually pointed this out to me—there was some poll that was done that he was a bit disheartened by, but I thought it was instructive, and the poll basically said that the general public is increasingly finding medical people, scientists, arrogant. Increasingly arrogant. Which I thought was again, disheartening but an important note. What does being open to letting people in on the process, and saying: we’re not sure yet, but we’re going to act cautious here—what does that do? It’s less didactic, but also perhaps less arrogant. And fundamentally, I think people do appreciate that.

Dr. Abdul El-Sayed: It’s also just more honest about the process. That is the, you know, there are two pieces of what you’ve, what you’ve shared that I think are really important to boil down. The first is that, you know, science is a process, it’s not a body of knowledge. And understanding the process is very different than understanding the knowledge that comes out of the process. And when we need science most, most of the time, it’s the process that we’re asking people to trust, not the knowledge. And the process takes time. And so the hard part is that people want a sure bet. They want to know exactly what’s going on, and obviously so do all of us. But it’s when we need it most, when we’re the least sure, that science has to take its time, and when we don’t have a sure answer. And that leads to a bigger-picture question of how do we teach science, and how do we talk about science, even outside of the context of a pandemic, that may have led to this space where we feel the need to be didactic, and we feel the need to share a directed answer. Even when probably the better answer is to, is to pull back the drawstring and say: look, here are the studies that are happening, here’s what they’re asking, and our understanding of this virus, this pandemic, the surge—whatever it is—may in fact change drastically in the next couple of weeks based on what we find here. What does that tell us about how the public understands science and what we need to do to fix that?

Dr. Sanjay Gupta: Yeah, I think, I think what you’re sort of reflecting on, I think is probably the most challenging part of this. And it is that I don’t know that we necessarily need to change how we instruct people in science. I mean, we, when people are very interested in what’s happening because of the news events, I think it’s an opportunity to  instruct people about the scientific process at that time, because they may not just be interested enough—I’m talking about the lay public—at other times. Just like when, you know, Bill Clinton or somebody had his heart operation, it was a chance to talk about heart disease in a way that people may not have otherwise really been that interested in. All of a sudden, you know, you sort of strike when the iron’s hot here. But I think also, you know, this required in a way a lot more work, I think, as reporters, as public health experts, the scientists, to look at the emerging data that was coming and—being very honest about it, as you point out. We have now 10 weeks’ worth of data. We don’t have 10 years’ worth of data, but we have 10 weeks’ worth of data to see here’s what’s happening in Wuhan, here’s what’s happening in other countries around the world, and that’s why we, here’s why we think that’s important for you, you know, in terms of how you’re going to behave. It was, you know, it was challenging. I think, for me, for, you know, for a year I basically been getting up super early to call my sources on the other side of the world, in China and in Taiwan, and just talk to them, every day almost, about what they were seeing on the ground there, what was real, what was not, what was different from other reports that we were hearing, how to like put it all together. And then oftentimes, you know, trying to basically just distill that down for the, for the audience—just like you were! And to be, you know, to find that inflection point between honesty and hopefulness. I think both can exist. You know, I think just presenting—people say, well, I don’t want to present things that are just alarming because that’ll panic people. Well, I think that that may be the wrong way to think about it. I think panic comes from presenting a problem without a potential plan. So when you can put two together, and that requires the extra beat of homework, then I think you’re doing a better service to the audience, and really finding that inflection point between honesty and hope. And another thing I’ll say, and you do this really well Abdul, watching you on television—it’s the old Maya Angelou quote, you know, which is that “people may not always remember what you said, but they will remember how you made them feel.” And I don’t mean to take away anything from, you know, the real, the real substantive part of the discussion. But I think, you know, when you’re a public health expert, when you’re a doctor, when you’re someone who’s giving millions of people over and over again news that is tough, you do have to think about everything. Just like you would when you’re coming into the room to talk to a patient. I know this isn’t exactly what you asked me, but I remember like, would you ever smile when giving bad news? I mean, does that seem like you’re minimizing the problem, just to to smile a bit? Or is it going to appear to the person that you’re open, that you’re willing to sit down and discuss? I’m empathetic, yes, but I’m open, I’m here to have a conversation I’m not here to just lecture you. And so a little bit of a smile. You know, even in those situations. I think, again, people have different opinions on this. I have mine because I’ve been doing this for 20 years, but I think all those things matter in situations like this.

Dr. Abdul El-Sayed: No, that’s a really important and beautiful reflection on the humanity of the thing, right? I think sometimes we want to interpret science as if as if it is cold and hard and sterile. And that is, in fact, not true. Science is a deeply human process.

Dr. Abdul El-Sayed, narrating: We’ll be back for more with Dr. Gupta after this break.

[ad break]

Dr. Abdul El-Sayed: There are two other pieces of this moment that were somewhat unique, the, one of them is the fact that I don’t think we’d ever seen either science or scientists politicized the way that they were politicized in the context of this pandemic. And, you know, I sort of come to this work as both a public health person, and also someone who’s run for office. And, you know, having run in a moment like this, I was really worried about how this would get sieved through the chopping block of our politics. And it turns out in not very elegant way. How did the politics shape the way that you engaged? Right? It tends to be that in public health circles, people are of two minds, that we ignore the politics and talk only about the science, or that we have to embrace the fact that because science is human and humans are political, that science is political. How have you thought about it and how did you try to, of course, take any political bias out, while also talking about the science in the context of its politicization and what that means for the way that people are going to be perceiving it, even outside of your coverage?

Dr. Sanjay Gupta: Right. Well, you know, I think you’re right. There was no way to disentangle this issue from politics. You know, what was happening with COVID, our response and everything, just I mean, you could name just about any facet of the issue, and it had been politicized in some way. And I think saying, hey, look, I’m just not going to engage, I think that doesn’t serve the public at all to simply say: I’m going to I’m going to sit on the sidelines. So I think you have to talk about the issue still and if it’s politicized and, you know, you got to talk about the politics of it, I don’t think you can shy away from that. What I would say is that I think what surprised me a little bit—because things have been politicized in the past as well. I mean, you know, you and I are both very interested in health care policy. I see a book on your, over your shoulder here, you know, I mean, that’s been a real sort of a point of coverage for us for a long time, you know, certainly around the Affordable Care Act. But even before that, as I mentioned, that’s how I got into this business, was covering health care policy. So there was always these intersections between policy, politics and health in terms of how I covered it. Or talking about the cost of medical care and what the, how the United States does with that with respect to other countries around the world. And that was often seen as political. Are we, you know, the greatest medical system on earth, or do we have more work to do? You know, I mean, people had very strong feelings on this. But having said that, I was surprised by this one, just in terms of the intensity of the politicization of this COVID response. As a reporter, what we ended up doing a lot of the time was fact checking. You know, there would be some sort of press conference or something, and instead of sort of being able to move the conversation along and increase the knowledge tree for people, we just found ourselves stutter-stepping, stutter step, stutter step, because: look,  that was said, I realize that’s the headline, but that’s not true. And there were things that we were still learning, I mean, as we were talking about before. But there were certain things we knew were not true. And we had to constantly sort of stutter step our way through that, or explain why a medication like a hydroxy-chloroquine, for example, should not be authorized because the data wasn’t there yet. And what is the requisite data that is necessary before you can authorize something? What safety standards should we put in place? What do people expect if they’re going to get a prescription from their doctor for something? What should they reasonably expect in terms of safety? We had to sort of describe again the process as a preface to why something wasn’t true or shouldn’t be happening. But it was, it was tough. I mean, you know, I to this day, I think that there are still these really separate groups that have sort of formed around specific issues: masks, hydroxy-chloroquine, or just our overall response. And that’s made it, that’s made it particularly challenging. And I think it will be for a long time. Even the vaccination issue, which, you know, arguably was worth celebrating all around, has also been politicized. And we’re seeing it still play out.

Dr. Abdul El-Sayed: Yeah, I, the way that COVID has—I hate to say it—accelerated our political tribalism is particularly sad, considering that this could have been something that brought us all together and it should have been. And, you know, science as a process ought to be something that brings us all together because it’s just, it is as close as humans get to objectivity. I mean, that is, that is the ideal. But it didn’t do that. And part of that is this third piece that I want to bring up, which is that this is just a very different information environment than we’d operated in the past. And, you know, I think that the closest we’ve come to this was Ebola and that was, you know, 2014, 2015. And that was a shade of things to come with this pandemic, 2020, 2021. And it demonstrated just the way that social media in particular has accelerated the pace of misinformation, the capacity of misinformation, and the fear that that can spread and then the the polarization that can come from that. How have you thought about reporting into this kind of information environment? How has your reporting changed vis-a-vis the rest of what everyone’s being exposed to, and the fact that misinformation and disinformation just have so much more a platform than they have in the past?

Dr. Sanjay Gupta: It is, as a starting point, not something that has dissuaded me from wanting to report on it. I’ve talked to a lot of my colleagues who are so disenchanted with the process, some of them journalists, some of them just people who are, who are public health experts, but commenting a lot about, you know, what has happened over the last 14, 15 months, and are just totally frustrated with it and have increasingly stepped out of it. Just saying it’s seeming, seeming like a just no-win situation for them. They get beat up in social media, whatever it may be for them that makes them frustrated. That hasn’t been the case for me in the sense that I don’t feel like I, this is the time to step in, lean in as opposed to leaning out. I think that sometimes the perception of just how significant the misinformation is in terms of how it’s spreading is it’s tough to calculate. I think, you know, you hear some misinformation getting out there and you think: well, that’s you know, it’s half and half—half the people believe this and half the people believe that. And that is often not the case when you actually start to actually look at the data. Vaccines, for example, there’s a lot of misinformation out there, but you still have probably 70% of the country who says they’re either going to get the vaccine or already have. And probably that number will go up, just just by way of example. But I think that the, you know, part of why I love journalism—and I loved journalism long before I became a journalist, I just have great respect for journalists. And I knew that I did, but I think I’ve learned more why over the last several years, and that is that it’s become increasingly difficult within a society to find people who you really believe are the honest brokers. There are so many competing interests and everyone has a perceived conflict—and I realize that many people think journalists have a perceived conflict as well—but when you put it all together and wash it out, you realize that for many people, journalists who really, you know, have, they’re not running for office necessarily, they’re not running a big company, they have no profit incentive to say one thing or another, they often can be the honest brokers. Again, I’m fully, I’m not being naive here. I realize that the perception can be different, but I think it’s a really, really important role. It’s that important rail in any society to have, and that therefore there’s no greater sort of North Star than just the truth, just telling the truth. I mean, I know that sounds very simple, but if it feels in a society that the truth is hard to find, that’s a problem. If journalists can, in a, you know, in a way that feels real to people, sort of fill that gap, I think it’s more important than ever.

Dr. Abdul El-Sayed: I would certainly agree with you. I want to shift topics quickly. You’re a brain surgeon, you just wrote your fourth book about the brain. Can you tell us a little bit about what you learned in the process that you didn’t otherwise know—I mean, as a doctor who cares for the brain—what was new in your new book that surprised you about how the brain works, about how, in your words, we keep it sharp?

Dr. Sanjay Gupta: I think that the biggest learning for me, and it was really something that was sort of evolving over about a decade, was the growing knowledge that neurogenesis, the growth of new brain cells, was possible really at any age in any condition of your brain. I think for a long time, and I’m talking about even in the world of neuroscience, you know, the idea that you had neurogenesis really happening at two points in your life: when your baby and your brain was still forming up until a certain age, and after some sort of injury, like a stroke or traumatic brain injury, you could have neurogenesis. But the, and that was just that’s when we saw the brain’s, you know, neurogenesis happening. And people who had injury, they were actually having imaging studies, they were having brain operations—we could see that process happening. We saw the functional changes in patients after these injuries. But the idea that it could happen at any point in your life, even in a healthy brain, I thought was perhaps the most inspiring sort of knowledge to come out of the world of neuroscience that I’d heard in a long time. Because if you could, in fact, grow new brain cells throughout your entire life, then the idea that you were somehow preordained to have this wear and tear on your brain that our parents all warned us about, you know, you get a certain number of neurons, that’s it. You drain the cash as you get older. Beer and alcohol are going to, you know, accelerate the process. You know, I mean, all those things that you were told, as we now know, weren’t necessarily the case. We can continue to grow new brain cells. So that was, that was the newest thing. And then for me personally, what the nearly two year journey was to write Keep Sharp was: OK, if that’s the case, how do you do it? How do you continue to grow new brain cells? Show me what I need to do specifically in terms of how I move, how I nourish myself, how I rest—but also show me societies around the world where this is happening, where if somebody develops dementia, it’s essentially reportable. It’s so unusual that it’s reportable. You’d write it up in their local medical journal, that sort of thing. And that was, that was basically it. I mean, you know, the great joy of writing a book is that in some ways it’s a very selfish experience. I just say I have a, I have a mechanism now by which I’m just going to go learn. I like to learn. But if I have a mechanism and frankly, you know, some deadlines, that makes the whole process go even better and faster.

Dr. Abdul El-Sayed: It’s the deadlines on the writing that really, that have kept society going.

Dr. Sanjay Gupta: [laughs] Right.

Dr. Abdul El-Sayed: And you’ve got another book coming out in October, “World War C.” can you tell us a little bit about that?

Dr. Sanjay Gupta: So World War C is, C is COVID. And the thing that I’ve learned and I know you probably have as well, I’ve just spoken to so many of the folks who’ve been responsible for our response in this country and around the world, and I think what I found fascinating is that many people in some way or another remind me that this probably wasn’t the Black Swan event that everyone describes it as. It was a, obviously it is a very contagious virus and has a much higher mortality than flu. But the idea that you could have something that’s even more contagious, even more deadly is still lurking out there. And we probably knew exactly what to do to prepare for this particular pandemic. There were all these tabletop exercises, you know, the Crimson Contagion exercises, the Red Dawn emails—people have heard about these things now—but the point is that some of these things predicted exactly what would happen if we didn’t act a certain way. And those things happened. We knew. So with all that knowledge now, what does that mean going forward? How do we truly, truly prepare for the next pandemic, which everyone seems to think is inevitable? How do we prepare as individuals? And I’m talking about everything, from how you live your life, masks, to your kid’s schools, to parents—are they going to live in a nursing home or a long term care facility, how are they going to change? To how much money should you have stocked away? Do you become a prepper and keep things in your home? To how a society prepares, how they, how they sort of really reflect their own humanity in those proposals. How we value the elderly—or no—in some societies more than others. And then just as a world, as you pointed out Abdul, you know, the idea that this should have brought us all together. As a sci fi fan, I always thought, what’s the one thing that would bring the world together? It would be some alien invasion, right? That would certainly bring the world together. Well, in some ways this was an alien invasion. It was a totally novel virus. So what happened? Why did we fracture apart and how can we avoid that happening next time? So, you know, I had the luxury in some ways of just for a year now, every day, having these conversations with people from all these different walks of our society all over the world. And they taught me a lot and I wanted to put it into this book.

Dr. Abdul El-Sayed: Well, we appreciate you writing it. We appreciate your reporting. That, of course, is Dr. Sanjay Gupta, who is CNN’s Chief Medical Correspondent. He’s the author of the new book “Keep Sharp: Build a Better Brain at Any Age” and the forthcoming book next October “World War C: Lessons from the COVID-19 Pandemic.” Thank you so much, Dr. Gupta, for joining us and for your work. And we look forward to seeing you next time.

Dr. Sanjay Gupta: Thank you, sir. Thank you for your work as well. Really appreciate it.

Dr. Abdul El-Sayed: As usual, here’s what I’m watching right now. Up until last Thursday, the CDC was under intense criticism from several public health analysts for being overly cautious to masking and physical distancing for people who are vaccinated. For example, CDC guidelines called for masking among vaccinated people in large outdoor venues like baseball games. And then on Thursday, that all changed. The CDC announced this:

[clip of President Biden] They are no longer recommending that fully-vaccinated people need wear masks.

[clip] No masks at concerts, no masks at a sporting event, no masks in a restaurant.

[voice clip] The new guidelines are a welcome sign for many, but there are still many questions.

Dr. Abdul El-Sayed: It was one of the most dramatic reversals in the interpretation of the science, like the kind of thing we talked about earlier in the episode. Here’s what Dr. Fauci had to say:

[clip of Dr. Fauci] The underlying reason for the CDC doing this was just based on the evolution of the science.

Dr. Abdul El-Sayed: There are two pieces of this that I want us to cut into. First, the scientific evidence regarding the risk of COVID-19 among vaccinated people had been building for some time. Evidence has demonstrated that a) vaccinated people have extremely low risk of serious symptoms, even if there might be breakthrough infections in a relatively small proportion. Second, the risk of transmission by vaccinated people is also extremely low. But as we’ve discussed, science isn’t interpreted in a vacuum. You have to understand the CDC’s recent announcements in the context of the current situation in the US. Though, vaccines have brought the rate of transmission to a near all-time low, there remain a large minority who remain unwilling to get vaccinated. Part of the CDC’s approach here was to give those people incentives. Allowing fully-vaccinated people to go without masks is about doing just that. But there are challenges. There are people in our society who can’t get vaccinated, like kids. There are also people for whom vaccines are just less effective, like people who are immunocompromised. There’s also an equity challenge. The full vaccination rate among Black Americans, for example, remains low at 27%. What is our responsibility to ensuring that they’re protected? Taking off masks, particularly indoors, puts these communities at greater risk. And that’s because, as many critics of the CDC’s new guidelines have pointed out, it’s extremely difficult, if not impossible, to differentiate between vaccinated and unvaccinated people. So this policy could backfire if unvaccinated people are allowed to just free -ide on the policy and go without masks too. I think the part the CDC isn’t saying out loud is that they’re hoping that institutions that want to get back to normal, like restaurants and certain venues, institute vaccine verification mechanisms that force unvaccinated people to wear a mask. So they’ll just choose to get vaccinated instead. But because the guidance was issued without any warning or foreshadowing on the part of the agency, it’s left a number of these institutions scrambling to figure out what to do in the first place. And that helps nobody. I’ll leave the last word to our guests today.

Dr. Sanjay Gupta: I think, you know, to be honest, you know, I think the CDC made a critical error here in surprising basically everyone with a very significant change last week.

Dr. Abdul El-Sayed: That’s it for today. Next week, we pick up where we left off with Representative Cori Bush to talk about the quest for an antiracist health care system with Professor Ibram X Kendi, author of The New York Times best seller: How To Be An Antiracist. If you like our pod, tell everyone by rating and reviewing today, it helps other people find us. So please do your part and don’t forget to pick up your Science Always Wins dad cap, sweatshirt, and tees, adults and kids sizes, at the Crooked Media store.

Dr. Abdul El-Sayed: America Dissected is a product of Crooked Media. Our producer is Austin Fisher. Our associate producer is Olivier Martinez. Veronica Simonetti mixes and masters of the show. Production Support from Tara Terpstra and Lyra Smith. The theme song is Taka Asuzawa and Alex Sigiura. Our executive producers are Sarah Geismer, Sandy Girard and me: Dr. Abdul El-Sayed, your host. Thanks for listening.