Mental Wealth Podcast

Rob

Hello, welcome to the Mental Wealth podcast. Today we are delighted to welcome back Doctor Ethan Levine, a director at Eventus. And today we thought we’d focus primarily we discussed it briefly in our last episode, but we thought we’d focused today. A little bit more closely on Alzheimer’s because we discussed drug that you’ve been involved in and been in the research of the last time and the process of researching the drug and the development behind Alzheimer’s are interesting to me Mukund and the the exciting developments behind treating or at least helping treat some of the symptoms of Alzheimer’s is something that we’ve been interested in. Doctor Levine, welcome back. First of all, let’s go straight into the development of drugs. How? How, from your point of view, how does? That. Work. So you’ve started the research process. You have to. Submit this for approval. Is there something? That people would be. Surprised to know about the development of a drug from a doctor’s perspective? From a research perspective.

Dr. Ethan Levine

Yeah, there’s a couple of things and really the these were things that I learned when I was working in pharmaceuticals. I spent 12 years in pharmaceuticals for Glaxo Smith Kline. So one of the largest. Pharma companies in the world and. There was a major change in research during the time that it was there, just coincidentally, one of the things that really surprised me was that the patent clock starts the day the molecule is discovered. And and I think that that’s something a lot of people wouldn’t be aware of. So you know we’re very focused on the commercial end, how much medicines cost. But on average, you’re looking at a 10 to 12 year period of time where companies are sinking their own money in as an investment, hoping that a product will come to market. So by the time they come to market, at least when I left left. Glaxo, it was on average for significant products, $750 million had been sunk into development, so. You know, I have a personal perspective. I think that if we change the patent life to start the day, it hit the market actually and supported people doing research, we might find a way to reduce pharmaceutical costs. But instead of making companies have to recoup what they put in, understanding that only a certain. Percentage succeed anyway. But the the big change that occurred while there was a Glaxo, which I find absolutely fascinating, is that it it really did used to be a business where you’d have test tubes and you would literally just see is this product that we created going to work against this. Bacteria, this virus and so forth, but something called high throughput screening because of how computerization has really changed dramatically, changed the pharmaceutical research projects. So they have assays. Of hundreds of little test tubes that are going through a machine at a high rate of speed. So whereas before they might have been able to test A-100 compounds in a day, there were testing 10s of thousands of compounds in a day so that the success rate. Happened much more quickly, and if you’re, you know, if you’re reducing the time to discover what really might work, that’s incredibly valuable. But all that aside, you know the process to get. Approval includes, you know, you have to test. Is this safe? You have to have a second round of testing. Is this you? Know. You have to find humans that are willing to say, oh sure, I’ll take, I’ll take that. It doesn’t matter. They used to encourage us to be Guinea pigs as part of working in pharma. And, you know, some people did. It would get sick, of course, because maybe the compound isn’t quite safe. Maybe. The dosing was totally wrong and then you have a much larger scale of testing. You have Phase 3 testing where you’re really looking at efficacy. So you figured out the dose and you figure out it’s fundamentally safe. I was actually in one of the COVID vaccine trials. It’s really interesting to me that the first two times rounds I went to I got placebo both times but but that happens because you can’t. You don’t want researchers. So after you get through all that, then you have to show clear evidence that this is going to be effective and more effective than anything else out there on the. Market. Before you ever get the authorization, and then even when it comes to market, then there’s these phase four trials. Where its mass. Evaluated to take a look at are there these incidents that we weren’t aware of? You know, if you test it in 1000, you might have missed something that only shows up one in every 10,000 people, right? So you know the process of bringing drugs to market is very. Complicated and it it is highly regulated, both in the EU and in the US, but because we try to do things in a way that brings stuff to market that is fun, that are fundamentally safe drugs. And that are effective drugs, I think, you know, we’re talking about Alzheimer’s. This is a area where it’s really fascinating because there’s a lot of money being put into Alzheimer’s Research and what we’ve discovered, not surprisingly, is that there isn’t 1 cause. I mean, the bacteria is a bacteria, and if I have one specific Organism.

Dr. Ethan Levine
You you can target and see what works against that organ. But Alzheimer’s, yes, you know, plaque is an issue. Yes, inflammation is an issue. Yes, other parts, you know, people who are substance abusers will not unusually end up with something that looks like and mimics Alzheimer’s. So it isn’t 1. Thing which makes you know the cure or the the treatment much, much harder in pharmaceutical research because you’re not looking at one discrete little mechanism.

Rob

And is that similar to to how they look at cancer is cancer with multiple different elements to it and it’s sort of treating what might be breast cancer versus testicular cancer might not have different mechanisms behind it is that it’s so that obviously complicates the treatment behind it because you’re not treating that specific thing. You’re treating many different things and you might.

Rob

Fix the symptom and then it reoccurs or something else happens after.

Dr. Ethan Levine

Yeah. And with breast cancer is a great example because, you know, we have discovered some of the genetic links. So now science has advanced enough, you know that the her 2 gene. So you’re looking at if you have this genetic. Sea plants. Or maybe it’s just one gene, right?

Dr. Ethan Levine

And you think you? Know. 1020 years ago we couldn’t have done this. You know, so I I expect you know, so now with cancer, we’ve discovered some of these genetic links. We we know the likelihood of how that will progress. See, we’ve now also just at the infancy of targeted treatments where we can send something that matches. What you need to the cells that you have. You know, this is just the, I mean this is the beginning of that kind of medicine. And in Alzheimer’s, we haven’t gotten there. We, you know, we’re not at the point of no. You know, we’re thinking, you know, the compound that I was described to you the last time we talked it generically is looking at the inflammation of the.

Dr. Ethan Levine

Brain, think about inflammation. I would bet you any amount of money that there’s some subsets that it isn’t just inflammation. There’s some people with inflammation that have some. OK. Genetic component. Other people don’t have that genetic component.

Rob

I’m also wondering whether there’s a a dietary component to Alzheimer’s. You mentioned substance abuse, but I’m wondering whether we know about anything about obesity or changes in something that can be influenced by eating high sugar diet and things like that. Is that something that they found between the link between Alzheimer’s and diet?

Dr. Ethan Levine

And I’m and I’m not an expert in that arena, but I can tell you this from my own experience. There’s not a straightforward answer your question. You know, I worked in a medical school for a year, and people with obesity. There’s some people who could were absolutely healthy. And there are 200 lbs. Overweight. And you think this this person’s gotta have cardiovascular problems and would have none. They’ve gotta have diabetes and they would not have so it. It’s easy enough, at least from my perspective, to say it’s not helpful. You know if. You’re having issues. You probably wanna stay active. That’s an ingredient that pretty universally across disease sets doctors will agree on staying physically and mentally. Active will help.

Rob

Absolutely you. You mentioned inflammation actually and you I was surprised about that last time because I hadn’t heard anything about the link between inflammation and Alzheimer’s. And I had only I had heard about amyloid plaque before. It was something I don’t have a a medical background, so I’ve I’ve did a little bit of research about it. I didn’t understand anything that I read, but I I read it anyway, I’m wondering what. When you say inflammation, what is it that is is causing inflammation? Well, I’m sure there’s multiple factors, but is there something in particular? About a modern diet, a modern way of living, perhaps a sedentary lifestyle. Is there something someone you know is concerned about? A buildup of information that they can do proactively to sort of maybe not mitigate their their chances of these conditions, but at least sort of try to live more healthily and. What do we know from our research perspective on the causes of that inflammation?

Dr. Ethan Levine

Again, as as you described before, based on my understanding, participating in this research initiative, some of its genetic, some of it is associated with. I mean, this is there’s a chicken and egg factor. Does the hypertension come from the inflammation or does the hypertension cause the inflammation, right? Diabetes come from your elevated sugar come from inflammation. Or those elevated sugar cause some of that, and if you, you know this particular drug on, I really, really hope it gets the market in some due short order because it’s a, it’s miraculous, it does lower blood pressure, does lower blood sugar. And it did reverse. That cognitive functioning, so you know, so which is the chicken which is the egg? There’s a lot of factors. You know, the answer is very simple. Live a healthy lifestyle and you will optimize your chance. Because we we all know examples of people who are elite athletes who go out for a run at age 50 and have a heart attack and die. Yes, like why? Yeah. So the IT it’s. We’re a very complex Organism.

Mukund

So the drug you just mentioned that that kind of attacks the cholesterol, sugar and cognitive issues. Was that by design or was that by accident that attacked these three you?

Dr. Ethan Levine

Know when they started investigating the drug. It was actually intended as a diabetes treatment. And they accidentally discovered it enhanced cognitive function. They found that the ability to reduce sugar was not substantial enough to bring it to market. But the cognitive piece very much so. I just read something this week too, that there’s some evidence and it’s anecdotal at this point that things like a Manjaro or sampac, that they may have some of that similar kind of impact. You know, we’re still learning so much. And so much of medicine it it’s just accident. I mean, you know, you you think about I’m in aspirin where aspirin came from. One of the things that was fascinating to me in working in pharma was we actually had a museum and the museum was all these things in nature that scientists had discovered or saw that. The native population was used. In this, to address certain diseases, so a lot of it’s serendipitous, yeah.

Rob

Yeah, I was just thinking about ozempic when we were talking before. It seems to have come out of nowhere where I I hear about it and I know people that have taken it or on the the program for that and it just seems to have blown up very quickly is that is that something where you have a drug that reduces people’s weight or you have a program that reduces people? People’s weight? Is that something where as soon as they get approval. Skyrockets. Is that just something that luck of the draw, whether it’s just something that millions of people are are taking now, or is that? Has that been a long time coming? Is that sort of a a long process?

Dr. Ethan Levine

I can actually tell you a personal and kind of funny story associated with that. The short answer to your question is I think everybody is desperate for a quick cure to the extra. Pounds. And if you tell me, just stick this in you you know, and once a week and you’ll lose weight. A lot of people line up to do that. And I do have type 2 diabetes. I assume there’s a genetic component cause my brother and sister do as well. Although neither of our parents did, which is fascinating. And you know my I’ve maintained my sugar even with those epic in in the marginal range. Not not what I would call good. And my endocrinologist used a Jedi mind trick on me. Because he knows my personality, he said. Well, we’ve. Proven that you know you’re not going to change your sugar by your behavior. Diverse psychology and the short answer to what happened was within 30 days I got my sugar into the mid sixes. It which is more than a point and a half below what it had been stable at for years. So the, you know the answer. Yeah. These drugs people want a quick fix, but the reality is if you, you know, you make a change in your behavior, you’re probably more for. Any kind of disease? Almost. You’re you’re more likely to have a better result. That’s just getting people to understand. 6 Triscuits actually is one serving.

Speaker

Right, yeah.

Dr. Ethan Levine

Which to me seems rather outrageous.

Rob

Yeah. Yeah, they they seem to. At least say that, yeah.

Dr. Ethan Levine

It’s not a quick fix. You know. Yeah, thing in mental health, people love a quick fix. If I can hypnotize you and make you change your behavior, you’d be thrilled. You know, spend an hour and you, you’re a better you.

Rob

I wonder how much that comes of just the lack of time and or or you know what that says about society, where we’re just, we want this thing done and then we want to move on with our lives. We don’t wanna a lot of people as you were.

Rob

Enduring results come from actually putting in the work and doing it yourself and some sort of making it click within your own brain rather than like you said, where was and pick you up a needle. You lose the weight and then hopefully you keep it off but.

Rob

Who knows what that?

Dr. Ethan Levine

I can speak more, you know, to the US, but I suspect you know in the UK you may have a bit of this issue as well. There’s a reason we have fast food.

Rob

Yeah, and that seems to be what the last 30-40 years, the obesity epidemic in well Europe as well, but certainly in North America has become a much more much wider scale.

Dr. Ethan Levine

Yeah, people, people want a quick solution. You know, I I want my meal. In fact, they almost don’t care what it costs. They want it fast. And you know, they that’s kind of become, you know, epidemic in our society. Yeah.

Rob

I mean aside sort of side train on that is that I wonder with the increase in price in fast food whether we’re? Less fewer people eating fast food and more people eating healthier options because it’s more. It’s getting more expensive for them to eat. McDonald’s, Burger King, whatever it is. But you know, we’ll see about that.

Dr. Ethan Levine

I don’t my answer is I don’t think so. I mean, I love to cook, but I mean, I absolutely love to cook. I have a wonderful garden and my favorite meal to cook is eggplant Parmesan, and I was thrilled to discover that my eggplants are now regenerating. I’m having a second.

Dr. Ethan Levine

Crop this year.

Mukund

Ohh.

Dr. Ethan Levine

I think people are hooked on fast food.

Rob

Yeah. And that that sort of dietary component to a lot of what we’re talking about is something that I’m sure we’ll find out about more in the future. I was also wondering stem cells have been a big topic of conversation, at least for the last decade or so. And we we’ve sort of briefly touched upon the research process behind that. How much do you think of a an impact stem cell research can have in regenerative medicine in general can have on treating these conditions? Alzheimer’s dementia as a whole. You know these sort of conditions where we’re trying to figure out what the what the component is and then maybe a genetic element to it. So something like stem cell banking for example, where someone can sort of store their genetic data for a certain period of time and then we may figure out later that there is a specific tailored solution to that individual. Do you think that kind of? As medical merit for the future, is that something that you see? Is going towards.

Dr. Ethan Levine

Absolutely. I’m a Star Trek future person, you know, I I think that if you understand what we’re made of and you understand how essentially to recreate how we were supposed to be. You know it’s it’s pretty endless. I mean, I think the fascinating pieces are where we’re trying to bring back extinct animals.

Rob

Yeah.

Dr. Ethan Levine

You know, yeah. But it makes perfect sense, because if I’m not, let’s just take the diabetes. So you know, you’re you’re looking at the pancreas. So if there’s something, my pancreas is not doing and you could get a healthy stem cell to essentially regenerate, regrow my pancreas. I’m good.

Mukund

The woolly mammoth.

Dr. Ethan Levine

Good to go and if you can really commercialize it, I think it increases lifespan because as a part wears out, you know you’re just. A way to inject the new.

Rob

Yeah, I wish I understood more about the actual process of how that works, but it does, like you say, it does seem sort of. Science fiction, it does seem sort of like there’s a Star Trek element to it where they their ability to regenerate organs and it, from what I’m reading about stem cell research, it doesn’t seem that it’s that far in the future. We’re getting pretty close to a lot of these. So sort of so-called Star Trek medical developments, where they are able to sort of treat conditions that we’ve seen right now to be almost impossible to resolve.

Dr. Ethan Levine

There’s a fascinating piece of research. It’s actually relatively older. You know what the Bubble Boy syndrome is? People, you know, they can’t be exposed. The environmental stuff. And they tried stem cell research and I think of the nine people that were part of the study, seven of them, all of a sudden could live outside. You know, it’s it’s, it’s remarkable and, you know, I think in the mental health arena, we’re really. In our infancy. Because we don’t understand, we actually really, truly don’t understand. What what’s the etiology of mental health issues. And we just, you know, we don’t get it I I. On the board of something called the Foundation of Hope here, and we gave money to researchers looking at different mental health issues. And one of the most. Remarkable, remarkable projects that we helped fund was related to postpartum depression, and this researcher discovered. Actually, there’s only basically 2 genetic valves, so to speak, that or gates. That create postpartum depression and I can’t remember if they were both open or both closed. A person would end up with postpartum depression and. If it was half and half if there was some environmental factor, but something like that, you talk about stem cells. If let’s say it was both open, that would cause it. You change by putting the right kind of cell into the person’s body. You could guarantee nobody would get postpartum. And how huge, you know, would be happy. That’s what they’re working on now is the way to get that right. The right cells into the old woman’s body. Just it’s extraordinary.

Rob

Now it’s not. It might. There might not be an answer to this, but is that about the individual or is that finding this one cell that’s going to work for everybody? Is that finding you know, the right sell for Ethan, the right self for Mukund, right, self for rocket. Do you think that that’s what it is with stencils? Or are we looking for this one? Sort of so-called catch all treatment that’s going to work it’s, let’s say, for postpartum depression.

Dr. Ethan Levine

Well, you know, as we were discussing cancer before, it’s the right cell for Mukund or for Rob, but because cancer is not cancer, it’s it’s multiple things, yeah. Postpartum depression, they found exactly the same to the genetic valves, essentially, in every single person that they tested, everybody who had postpartum depression.

Dr. Ethan Levine

Was somebody who had that condition? So in that in that situation you could? Very comfortably create one solution for everyone. Wow.

Rob

So they and that’s that means I would imagine at least it makes the research process a little bit more straightforward. Yeah, you know.

Dr. Ethan Levine

Absolutely and faster.

Rob

What you’re looking for? Is that something? That’s a a near term thing. Or is that if they know already the mechanism behind it? We’ve talked previously a few minutes ago about the research process, but is that something where it now has to go into human studies and it has to go into the health?

Dr. Ethan Levine

It’s well advanced right now. It’s a. Near term thing, OK.

Rob

Excellent.

Dr. Ethan Levine

Yeah, there’s, I think for your listeners, they might find this fascinating that, you know, there’s a website, clinicaltrials.gov, and it lists every single clinical trial in the US it’s currently 66,000 trials going on in the US low. You know the EU, obviously there’s very Advanced Research, to say nothing of, you know, the countries all over the world having their own research. But it’s us alone 66,000 and the nice thing about that website, too, for people who are looking for a solution to something that ails them, you can search it and it comes up with contact information. You can find out if you’re if you seem appropriate. Can call and potentially get enrolled in any of those 66,000 trials.

Mukund

Changing gears a little bit, what do you think is the connection between gut health and the brain?

Dr. Ethan Levine

I’ll tell you I’ve not been involved in research there, but I can tell you my, you know, personal perspective. Now all of us have different kinds of gut related. Challenges or most of us do at different times in our life. And it profoundly affects how someone feels. So my instinct is that there is a connection. One of my mentors used to always say there is no mind. There’s only body. There is no body, there’s only mine. You can’t separate the two. So if something’s not. Working then it’s going to impact the other part. Yeah. I mean, you eat, you know it. It’s common sense. I eat a nice salad. And if if you happen to like meat, you know, you know, you have chicken or whatever on it. You feel good after. For dinner. Or tofu or whatever your preference is. You eat a massive steak, potatoes, and a Key Lime Pie. You know, that would be my preference.

Mukund

My I am partial to pecan pie rather than me.

Dr. Ethan Levine

Our pecan pie. Alright, we’ll lock it in there. You’re gonna feel sluggish, you know? So something’s going on connecting between your gut and and your. I mean, even your ability to think. You know when you eat those heavy meals. I find that my brain’s a little foggy.

Mukund

Because more of the blood is more consumed in digesting the food. From what I understand right, there’s not.

Dr. Ethan Levine

Yeah.

Mukund

Enough to power the brain’s thinking process at that time. That’s why you go to sleep or food induced coma. Kind of a thing. What you say, right?

Dr. Ethan Levine

Yeah, right, right. So it it makes sense. So if you take that on a broader level, looking at people have tendencies because there is a genetic component, some of us have more of a tendency to get. In our gut health, it’s not working quite right. You look at the proliferation of prebiotic and you know all those products out there. There’s a reason people are taking them because it does make a difference in how they feel.

Mukund

Yeah. And also fiber, right? That also adds to the gut health, yeah.

Dr. Ethan Levine

Yeah, right.

Rob

Right. Yeah, there’s there’s a question that comes to mind talking about things that make you feel good about it and things you can take. I’m wondering how caffeine impacts the brain. I’m just wondering whether we have obviously millions of people need caffeine in the morning now they feel they feel like they. I’m I’m interested in this like there you go. Yeah, I. Yeah. Also here.

Dr. Ethan Levine

Still drinking?

Mukund

I haven’t had my cup yet, so.

Rob

Also. You. You’re behind Mika. So I’m. I’m fascinated by this idea that there’s something we just everybody does. Start the day with it. It’s a billion dollar industry now. What is the mechanism? What is caffeine doing in our brains that whatever you want to call it motivates us, gives us energy, starts our day in the so-called right way. What is the mechanism there? What’s happening in the brain? When I take my morning cup of coffee.

Dr. Ethan Levine

Not not an expert you know, particularly in the mechanism, but I can tell you of the research that I’ve read, which is. It’s interesting. It’s a it’s a mixed lesson. You know, it’s a stimulant. It actually shows some positive correlation for, you know, for. Cardiovascular health. For mental health, it’s the you know, the old Greek saying. Everything in moderation, nothing in excess, you know it. It’s something that it’s pleasurable, you know, I think not. A small amount of it is if you think about that. When you have the coffee screwing or the tea, you know it’s brewing. You have that odor. I love teas because you can create all these different odors that create a different sensation for you. As well, and coffee is not coffee, this is. Plenty of variety. So you you have the sense of satisfaction and it’s like, you know, even the ads on TV that first sip, it creates pleasure. It’s when somebody has had and I don’t know, you know, 8 or 10 cups in a day it. Then it starts I I don’t know what the exact number. It’s probably different for each of us, but then it starts creating some harm.

Rob

Yeah, certainly. I’ve to get to a different topic. I’ve experienced panic attacks before in my life. And I’ve noticed the very close connection between the amount of caffeine I drink and the panic attacks, and I soon switched to decaf for a few months after that. But I’m like, hang on a second, something’s going on here. I had five coffees yesterday and now I’m having a panic attack. Something’s going.

Dr. Ethan Levine

On my, my suggestion would be just to reduce the number of coffees not to switch to decaf.

Rob

To produce. Yeah. So maybe one rather than decaf, yeah. Yeah, I definitely still need that cup of coffee in the morning. It’s interesting, though that again, these are fascinating topics because we don’t quite understand the mechanism. We know it’s pleasurable, we know it. What makes us feel nice. We know there’s some sort of emotion tied to the process of coffee, but we don’t know the exact biological reason as to why we’re we we feel this way. It’s interesting.

Dr. Ethan Levine

Well, it’s a stimulant, and stimulants feel good. I mean, you think of, I mean, some of the addictions that people get engaged in, it’s frequently. Produces a sense of stimulation of some sort or another, and then people like that feeling.

Rob

This might be sort of a a matter of conversation, but do you think people that like that feeling they like it because they’re missing something else? There is a balance there that they’re not getting from somewhere else because for example, people with addiction issues. I know that’s not something that maybe there’s a a reason for for every sort of a catch all reason for. But you think there’s sort of a. A balance on the other side of that, where they’re addicted and then they’re maybe they’re missing a different part of their comfort in their brain. For example, they they need something to sort of stimulate something where they don’t artificially that they’re missing organically.

Dr. Ethan Levine

Sometimes a cup of coffee is just a cup of coffee.

Rob

Fair enough.

Dr. Ethan Levine

Think that it it’s not, it’s just pleasurable. Yeah. Yeah. Things can be used as substitutes. I mean, pretty much anything can but. I think by and large it just it feels good. You know, I’m an ice cream, if you like ice cream or pecan pie? A perfectly bag. Piece of pecan pie, maybe with ice cream. Maybe not. No, it’s pleasurable. There’s no other. There’s nothing more to read into it other than it’s pleasurable.

Rob

Yeah, I guess there’s a we’re talking about. Like pleasure. Like the the pleasure chemicals in our brain. The epinephrine is that is that one norepinephrine. Yeah. There’s the neurotransmitters. I’m sort of fascinated by and their mechanism in the brain and how that works. Is there a connection between things like caffeine or maybe sort of the things we even things we eat between the neurotransmitters and our brain? Because I know a lot of, I don’t know. I I’ve read that a lot of antidepressants work with the neurotransmitters and that’s how the sort of mechanism, at least the research suggests that’s how they work. I’m just interested. What the role of neurotransmitters are and how we can influence those with our diet?

Dr. Ethan Levine

Yeah, I again not not an expert on the science of it, but you know, all the older antidepressants were focused on the neurotransmitters. That was the first route and the and the newer ones are looking at different mechanisms of action. There’s very clear research shows exercise. For example, will trigger the same the same response in the body the the runners high. Right. There’s a lot of things that you can do. The question really is for me, what’s the safest, best route for you or me as an individual? You know what? What works for me? One thing will work for me. It won’t work for another. Some people don’t respond. I’m a huge believer in. Exercise. You know, I I think that, I mean it doesn’t matter. You don’t have to be the fastest person in the world. But if you get up in one day, you walk 10 steps and the next day you walk 20. I have one of my daughters as a athlete and was a collegiate athlete and she bought herself this new fancy watch that. Tells her exactly what to do to get the next high from exercise, but but. Works. I mean there there’s there’s a program out there you can download called from couch to 10K. Yeah. And it tells you, you know, exactly how to do. I think that that that’s the stuff that it does the same thing as an antidepressant does. It’s just the challenge for people with depression. Because there is a biological change in the body, you know the neurotransmitters are not working effectively. So. And the antidepressants help get them through. Because eventually in most cases, not all most cases your body will write itself. You know, it might be 6 months, a year, whatever the time frame. But if you can speed that up, you can get back to full functioning faster. And and that’s the basis for, you know those kinds of medicines.

Rob

Yeah, I actually did the the couch to 5K during COVID myself when everything was closed and I was like, well, I may as well start running and that’s when I started to get in better shape. So I know for sure individually, there’s these programs are beneficial and they can. Sort. Of kick start something for you. I think that it’s they certainly I think also have. As she was saying, those steps like knowing that you don’t have to run 5K, you can just go 1K. You can just get them. Then the next thing, and that that’s probably true of a lot of mental.

Dr. Ethan Levine

Health steps too, right? There’s a great movie. I mean, I absolutely love this one. What about Bob? You know Bill Murray was in it, and it talks about the concept of. Baby steps if you haven’t seen it, you’ve got to see it.

Rob

They say yeah, I. Got it.

Dr. Ethan Levine

It’s heartwarming and hilarious, but the concept of changing your life through these baby steps, this is spot on. As a sidebar to that actually was filmed in the Roanoke, VA area and I was living there then and flew up to New York one time and Bill Murray happened to be on the airplane.

Mukund

Ohh nice.

Dr. Ethan Levine

I was more excited to meet him than he was to meet me.

Rob

I’m sure he gets that a lot.

Dr. Ethan Levine

I’m sure he does.

Mukund

Actually, Rob and mine are kind of mantra is progress is achievement like one extra step. You know, so. One extra step might not mean much, but one extra step a day for a month for a year that matters a. Lot. So each progress is an achievement by itself, right? Like like baby steps? Like what? Like, similar to kind of?

Dr. Ethan Levine

Yeah.

Mukund

What you said, right?

Dr. Ethan Levine

There’s a very, very old movie. It’s a Disney movie about something in there. When? You know Mickey Mouse, I guess was told was asked the question, you know, do you want this amount of money or would it be more if I gave you a penny today and two pennies tomorrow and you know, when you work the numbers up and keep doubling it every day, you’re quite a wealthy person. By the end of.

Mukund

Yeah, yeah, I think the, I think it came from from a chess board.

Dr. Ethan Levine

Year. Yeah, yeah.

Mukund

One grain of rice in each piece or each square. Would that give you more grains at at the 64th square? Or is it more you want a fixed amount or something like?

Dr. Ethan Levine

That. Right, exactly. Yeah.

Mukund

Very interesting.

Dr. Ethan Levine

And then then that works for you know, for your own happiness and and for your health. People who go cold Turkey on anything. I guarantee they’ll be back. I mean, that’s, you know, going back to the weight loss question. You know the. People. They don’t want to do it. They want to have it happen today. But if you just eat 1 less triscuit a day, eventually they’ll get down to the six.

Rob

Yeah, you’ll get to your goal. You’ll just do it a few.

Dr. Ethan Levine

Steps at a time. Yeah. You go ahead. Yeah.

Mukund

I was going to ask going back to the initial conversation, right in terms of Alzheimer’s, what age do you see it, see the onset of Alzheimer’s usually?

Dr. Ethan Levine

Yeah. And it’s a very good question because. It’s one of those where it’s very different for everybody and part of you know, part of that is we don’t understand the. Which is it? Genetic. And it’s in place and it’s going to happen. My mother situation. She had a brain aneurysm that burst. She was fine. And three hours later, she was in a coma and she recovered, you know, thank God she recovered completely. From something they told us to, you know, plan for her passing. But now, 30 years later. She has advanced dementia and I am 100% convinced it came from. That. That whatever process started in her. Led to where she is today because there was nothing in history family history that would suggest that. So typically if if you look at memory care facilities, you know we serve quite a a few of them. You’re typically seeing people coming in somewhere in that 65. The 75 year range, it’s not and it’s usually because mom or dad is getting lost. My they’re confused. They can’t take it. Bottom line, they can’t take care of themselves. Occasionally we’ll see somebody come in. You know they’re beyond 80, but that’s pretty rare. It’s it’s, I think the, you know, in the bell curve, the highest number is around 7. I mean, there are exceptions obviously on both ends, but generally somewhere around there. So I mean, I guess in terms of giving us some perspective for anybody who’s worried about they’re heading down that route where their spouse has told them they’re getting close, if you make it into your mid 70s and you’re functioning. Pretty well. By and large, you’re not likely to end up there.

Mukund

So now going to a current events that’s happening in the US with age, a big consideration or a big talking point for the presidential candidates. What? Are some misconceptions you think people have when it comes to old people holding positions of high power and the impact on others?

Dr. Ethan Levine

Yeah, it is a very interesting question because it’s obviously in the US anyway. This has been a big topic of conversation and you know, fascinating to me in the theory of. Pivoting. You know how things look before now all of a sudden, you know it looks different because the the other party is the older party. But I think people connect forgetfulness with inability to make good decisions.

Rob

That’s a great point.

Dr. Ethan Levine

You know that I may be forgetful, but I may be very sharp in being able to articulate my thoughts and beliefs. It’s not a misconception that people do slow down. You know, if I could run a 4 minute mile when I was 20, I’m not going to be able to run a 4 minute. When I.

Dr. Ethan Levine

That’s just, that’s a fact of life. People forgetting names, things like that. You know, I think it’s a misconception to think that that’s something that is indicative of somebody developing dementia, you know, senility, because, you know, we particularly somebody in public.

Speaker

This.

Dr. Ethan Levine

Office. Is exposed to so many people it it doesn’t. You know, if they forget their wife or you know, or their children. OK you know that then that’s a different level of concern. But if they’re forgetting people who are in the general population, they have a lot more stimulation. You know, if I give you 3 Jelly beans and one of them is red, you can pick it out. But if I give you 100 Jelly beans and tell you to pick out that red Jelly Bean, it’s gonna be harder for you to do it. I think that this concept and this was interesting, something I read this morning that the symptoms of of aging that are being alleged to one of our candidates candidate themselves, reframed it this morning.

Speaker

MHM.

Dr. Ethan Levine

Well, this is a skill I’m learning to be have a skill in rambling that was in the news. You can check it out now you know it. It’s not the going from topic to topic that is a symptom and some of us. Myself, and in particular, I can think of, I cover 345 topics in any conversation at the same time with my friends who can handle it, because that’s just. My nature, you know, I contextually is the stuff making sense when stuff stops making sense. Then as a psychologist, then I start having a little bit more suspicion that that that this is in fact a cognitive impairment.

Rob

I I know certainly with the the US election, when it was when Biden was the nominee. They were saying that Biden was flubbing his lines a lot and and making mistakes during speeches. But he was doing that 20 years ago and that that wasn’t a frame of conversation. I was getting frustrated. So I’m saying he has.

Dr. Ethan Levine

Yeah.

Rob

Speech impediment that he’s had that for so long and that that was becoming, it’ll be a conversation.

Mukund

He had a subtler from what I understand, right?

Rob

Sort of thing. Yeah. Yeah, yeah, yeah. He has a study. Of some childhood. And they were saying it has to do with aging. And they were saying, well, he’s obviously in his late 70s, early 80s at that point. This is. And. And I was saying, well, in his 40s and 50s, he was making the same mistake from his beaches. So I think a lot of it is obviously. Politically motivated, you can use any sort of stick to beat someone with when it and aging seems to be the stick that people are using these days on both sides, is it?

Rob

When you look at look at someone like Donald Trump, people have accused him of being a narcissist of saying yes, malignant narcissism and these sort of other mental health. And again, these could be stakes to beat people with, but he’s certainly unique. He’s different than a lot of political characters. And I think that’s something that has come up a lot. Is that something that?

Rob

When you look at someone like that does that I know you can’t diagnose people without knowing them and having them as your patient, but do people in general do they become more easy to influence? So if you’re a politician, are you more easy to influence a if you have a narcissistic personality and B as you get older? And these conditions? Alzheimer’s. Perhaps become more relevant? Is that something that you would be confused about or concerned about?

Dr. Ethan Levine

Sorry, answer a couple of there’s a couple of different pieces to that are that are interesting to me. One is, I think by and large people’s personalities are set early in life. So you know, Donald Trump. Joe Biden, for probably the pretty much the same way they were when they were in their 20s. I I don’t think that they are likely have changed a whole. A lot, maybe a little bit. You know, the question about can they be influenced more? You know, it’s kind of there’s a fine line, but any of us who are really obsessed with her, how good we are, if you start telling me, Oh my gosh, you’re so good. I’m gonna. Listen to you more because like you. Because you like me. I mean, I’m not. I don’t care if, honestly, me, personally, I don’t care if you like me or don’t like me. If if we have something in common and some mutuality, then that’s a friendship. You know, you could flatter me all day long and. I’ll just. Stare at you, I guess. But somebody who truly has those kinds of. I don’t. I don’t know. You know, there’s a difference between diagnosable narcissism. And people who want to be flattered, that doesn’t mean there are narcissists. You know, they they have a big.

Rob

Which is the.

Dr. Ethan Levine

Ego. And they want people to stroke that ego. It may not be a clinical problem. It just may be. That’s their perf. Finality.

Rob

What’s the difference between their clinical diagnosis of narcissism versus a personality?

Dr. Ethan Levine

They can’t help themselves. Yeah. Somebody who is clinical. I mean, it really is embedded in there. And because I would bet if you look at a Donald Trump or, you know, whoever in 100 different situations, he will look different in some situations. If I happen to, you know, watch him at. With his wife, Forest Kid, I suspect that he’s somewhat. I don’t know. I’ve never been there. But his public persona, I mean, he he’s created a persona. I mean, he’s no, you know, you’re fired.

Dr. Ethan Levine

But that’s show business, right? And that doesn’t mean necessarily that he is narcissist. I’m. I’m not saying he’s not just saying, you know that. That kind of behavior really got a lot of. Positive response people. People love seeing him say you’re fired.

Rob

Yeah, I’m wondering. We’ve heard about chicken and egg before. Like I’m wondering whether the attention came first or his personality came first. He just sort of feeding on the the attention that he’s getting and then he’s he’s going leaning more and more into it as you suggest.

Dr. Ethan Levine

Well, it’s addictive. You’re talking about Earth. I mean, that’s an addictive thing. And you know, as a person who in my organizational psych role, you know, I I’ve done executive coaching with people running multimillion dollar businesses.

Rob

It’s like.

Dr. Ethan Levine

And the reason that I had a successful career there, I don’t know if I told you this last time, but my our CEO, one of the founders as well gave me an award the first year of the company, the Pito Award pain in the ***. Because I would tell them what I really thought because most people don’t, you know, they’re they’re too. I mean, this is one of the problems in how our political system is constructed. People are afraid to say. No, they’re afraid to say I don’t like like that. I may vote for you, but not like XY and Z. But people are afraid because if you have power, this is perception. You have power. You can hurt me right now. So.

Rob

Speaking truth to power, yeah.

Dr. Ethan Levine

Is it clinical? I I don’t know it. It is a characteristic and it’s embedded.

Rob

Just going back to the the aging element to it, obviously if if I think Trump is 78 now, he becomes 82. If he gets four years from maybe 83 by that point, I’m not sure.

Dr. Ethan Levine

I think 83 but doesn’t matter.

Rob

With that I mean. Obviously it depends on the individual, but that that’s not something that you’d be concerned about having someone of that age is it basically just to do with the health of the individual that mental health, an 83 year old making decisions that affect obviously 400 million people and the rest of the world with it is that. Not something that you’re concerned.

Dr. Ethan Levine

My personal opinion at that age, why would you want to? 100% that that’s what I always said too. And you, you think of, you know, all of us have careers and you think of when you know when I have really felt at the peak of my abilities, it’s more likely around in our 30s, you know. Maybe maybe 40s where you learned a little bit more, but not at 80 because.

Rob

You can’t become. Why? I certainly couldn’t become because I’m not a U.S. citizen. But you can’t become president and say you’re 35. Correct. That’s correct. That seems strange to me that you are at allow someone in their late 80s C president, but not a 30. 4 year old.

Dr. Ethan Levine

Well, I I don’t. I don’t know. I I look at some of these, you know, tech geniuses and see what they’ve done in their 20s and 30s and thinking well, it would, the country would be handled differently, you know, to me it doesn’t make sense. Why would you? The world is young. Yeah. You know, the world is changing. And you want somebody who’s adaptable to change and we are more adaptable when we’re younger. We’re more set in our ways as we get older. All of us. You know we because we’ve formulated opinions. So you want somebody who can go with the flow and deal with it and whatever changes and you have to have somebody that can wake up at 3:00 in the morning and deal with the nuclear crisis halfway across the world and not need their, you know. You know they’re 8 hours sleep. You know I love Joe Biden as a person, but when he. That I think the answer is I’ll just go to bed earlier I. Don’t. Think that’s a good answer? You know, because you can’t control in the in the Presidency, you can’t control what’s going to happen when it’s going to happen. Now everybody’s got their own opinions politically for one reason or another. But I just think generically. As we age, you know that kind of job you’re looking for, somebody who’s, you know, young, younger and and vibrant and malleable. You know that they they have to deal with ambiguity because. You know what’s the right answer? You know, you know, the Middle East is a mess, and there’s been a mess for thousands of years. There isn’t one. There’s not one right answer because you choose one answer. You just really hurt a whole. Another group of people. I mean, it’s not. It’s not. A black and white situation and you have to have malleability to understand how to navigate, you have to be flexible in your thinking because it is not clear. So that’s just my own opinion. My preference in the US election, and I prefer malleability.

Rob

I always think about the picture of Obama before he started as president. The picture afterwards and I’m thinking, how is that gonna look as a 78 year old starting, you know a four year term, I understand maybe Trump doesn’t feel the same stress Obama would, but yeah.

Dr. Ethan Levine

Well, you have to presume the person looked good to start with.

Rob

Yeah, that’s that’s true. There is a sort of a reversal and.

Mukund

Great.

Dr. Ethan Levine

If you go back in history in the US looking at Presidents before, when they started and when they finished, they aged tremendously.

Rob

Lincoln was the one. The picture I saw was unbelievable. He was just this virile, handsome guy and it. Just. Go once afterwards, it. Obviously the civil war and things like that, but yeah, incredible.

Dr. Ethan Levine

I I don’t know why that brings to mind. You’ve probably heard the joke. The reporter. You know, if it was today’s day. And age with reporters everywhere going up to Mrs. Lincoln and saying, well, other than the incident, how was the show? Yeah, yeah.

Rob

I really appreciate your expertise, Dr. living. It’s just been fascinating. Fascinating for me to learn. I’m such a a NEO fight when it comes to this stuff, I don’t know a lot about anything, but I I I really enjoy speaking to experts such as yourself. And again, it’s. It’s really appreciated to have an hour of your time. On a Saturday.

Dr. Ethan Levine

Well, it’s my. My pleasure really.

Mukund

Hope to have you again soon. Thank you so much. Thank you, rob. Till next. Time bye.

Rob

Enjoy your Saturdays. Bye for now.