This week we're dissecting "America's Doctor." How did a smart, hardworking surgeon become one of TV's leading purveyors of junk science? Along the way we debunk green coffee bean extract, raspberry ketones, conversion therapy (!) and a salad dressing skincare regimen.
Aubrey: Hi, everybody. Welcome to Maintenance Phase, your favorite podcast about health and wellness myths and the human version of Oscar the Grouch, maybe.
Michael: [laughs] I think your favorite might be a little ambitious. I think we're a middling podcast.
Aubrey: Okay, podcast, sometimes. [laughs]
Michael: If there's lots of dishes, it's okay. It'll do.
Aubrey: We're the green bean casserole.
Aubrey: My name is Aubrey Gordon, and I am a writer, and fat lady about town.
Michael: I am Michael Hobbes. I am a reporter for The Huffington Post.
Aubrey: You can find us on social media pretty much everywhere at Maintenance Phase. You can also find us on Patreon, which is patreon.com/maintenancephase. That is also linked on our website, which is maintenancephase.com. You can also find t-shirts. If you want some t-shirts, you can go get some t-shirts.
Michael: T-shirts, yes.
Michael: Or, you cannot support us. That's fine, too.
Aubrey: Yeah, do what you want.
Aubrey: Today, we are talking about Dr. Oz, know?
Michael: Dr. Oz, Mr. Oz. "America's Doctor."
Aubrey: America's sweetheart. Dr. Oz. [laughs]
Michael: This is another one of those episodes, where it's so hard to research, because you're like, " he's trash," and then you read all the research and you're like, "Okay, he's more trash than I thought and trash in slightly different ways."
Aubrey: That seems right to me. I feel the things that I know about Dr. Oz are just these peak moments of garbage nonsense. I know about him being an Oprah, not disciple. What's the word that I'm looking for?
Michael: A Frankenstein's monster.
Aubrey: [giggles] I know about him being Oprah approved, I know about him pretty consistently promoting fat camps, and I know about him getting hauled in front of Congress.
Michael: Yes, we're going to talk about that in great detail.
Aubrey: I feel that's just from moving through the world in which Dr. Oz exists. You know what I mean?
Aubrey: I don't really feel I know more than that.
Michael: I feel the Aubrey version of, "I'm coming in fresh."
Michael: It's still pretty well-versed on this stuff compared to most of the general public.
Aubrey: All right, fine.
Michael: For listeners that don't know who he is, can you just give us the broad strokes? Who is this Dr. Oz dude?
Aubrey: Yeah. Dr. Mehmet Oz, yeah?
Aubrey: He was a frequent guest on Oprah Winfrey's show is my recollection.
Michael: He made 55 appearances between 2001 and 2009.
Aubrey: That led to him getting an afternoon talk show, where he would address medical topics and sometimes, he would take questions from the audience that were like, "I have this rash or whatever."
Aubrey: [laughs] He is like, "I don't know how long it was on the air, but I have a sense that it was on the air for 10 years, and it might still be on the air, and I don't know."
Michael: Yeah, it's still on.
Aubrey: Jesus, insane.
Michael: Yeah. They do 175 shows a year.
Michael: And he still does surgery, literal heart surgery one day a week, every Thursday.
Michael: Yeah, the show is consistently one of the top five shows on the daytime charts, just because we have to have a cameo by her every episode now. Michelle Obama has showed up on his show twice. Later on, we are going to talk about how Dr. Oz got like this. But I think it's important to establish what like this actually means.
Michael: There's basically four different categories of topics that he has on his show. The first is weight loss and weight-related diet exercise stuff, which is by far the most, that's probably 40% of his topics are in some way related to weight loss. One of them to pick a random example is apple cider vinegar that he says it like, "If you take a teaspoon of apple cider vinegar with a meal, you'll lose more weight than you would on other diets without it. Blah, blah, blah." Then of course, you look into it, and there's one study, and it's on mice, and then in 1992, and then people try to debunk it, but then he just lean in, one thing he's doing now with apple cider vinegar is he stopped talking about it as a diet aide. He started talking about it as a detox like, "You should only drink [laughs] apple cider vinegar,"-
Aubrey: [laughs] Oh, God, what?
Michael: -which is worse. Then now, he's talking about it as skincare.
Michael: Actual skincare people like, "Just because something is "natural," it doesn't mean that you should rub it all over your face every morning."
Aubrey: Right. Apple cider vinegar is natural. It's also not a great contact lens solution.
Michael: Yeah, exactly. [laughs]
Aubrey: I was like, "No."
Michael: He's also really big on anti-cancer stuff.
Michael: One of the headlines I saw on his website was, "what you can eat to defeat cancer?"
Aubrey: Good God.
Michael: Another one of the major categories of stuff that he talks about in his show is anti-aging.
Michael: There's also a fourth category of stuff. So, I'm about to send you a link.
Aubrey: Very excited. Oh, my God. Oh, no.
Michael: [laughs] I know.
Michael: I know. It's so bad.
Aubrey: This is apparently a title of an episode and it says, "from gay to straight? The controversial therapy."
Michael: He did an episode on 'gay conversion therapy' recently.
Aubrey: Yeah. The little synopsis says, "Is there a gay cure?" Dr. Oz investigates reparative therapy recently banned in California for minors. Experts on both sides speak out. Watch the heated debate. Recently banned in California for minors means that this episode happened in the last five years.
Michael: Yes. We are not in the middle of a society wide debate about whether conversion therapy for gay people is useful. That is a closed debate. We do not have questions about that as a society. We are not going to watch a segment together, because it's a fucking nightmare. But it's one of the most unethical six minutes of TV, I've ever seen. He basically brings on a bunch of gay men talking about like, "I had these urges, and then I found gay conversion therapy, and now, I don't have them anymore," which is like, "What? Are you fucking kidding me? This is Donahue episodes from the mid 90s." All this shit has been completely debunked dude.
Aubrey: Right. I don't think you and I've talked about this. This is a campaign that I worked on.
Michael: Oh, was it really?
Aubrey: For years, I worked on the organ campaign to ban conversion therapy.
Aubrey: It is a shit show. I will tell you I know inside and out that there is zero dispute amongst psychologists and psychiatrists.
Aubrey: It doesn't work. Even if it did, [giggles] why would we do it?
Michael: I think this is important for understanding the Dr. Oz phenomenon, because on some level, some of the things on his show, you can defend like helping people live longer, diet, and exercise, blah, blah, blah, fine. But then it's every fifth or sixth segment is just random moral panic bullshit.
Michael: There's this infamous one word during the Ebola panic, which I think was 2013. He had a whole show about how it might go airborne at any time.
Michael: It was one of the ones that I found. He had Jordan Peterson on to do-
Michael: -divorce counselling with a couple that was [crosstalk].
Michael and Aubrey: What?
Michael: You're just going to have this random "all right, fucking ghoul help people" with like, "Oh, John works too much and he's never home anymore. Why does this exist?"
Aubrey: I was laughing in anticipation of him being like, "Let's do the carnivore diet."
Michael: I know. [laughs]
Aubrey: Not Jordan Peterson marriage counselor.
Michael: It's nuts. He's had mediums on. One of the headlines that is still up on his website is "how talking to the dead can keep you healthy."
Michael: His website has a true crime section,-
Michael: -who randomly do these like, "This girl went missing in Albuquerque or whatever." You're like, "Why the fuck are you talking about this?"
Aubrey: [laughs] No [unintelligible [00:07:37]. Got it.
Michael: I want to spoil the ending. One of the best articles that I came across on Dr. Oz was written by a doctor, doctors loathe Dr. Oz. It's an article called "Why Dr. Oz makes us Crazy?" and it's by University of Chicago doctor called Adam Cifu. He summarizes I think really well just like the central problem. Not just with Dr. Oz with his entire genre of entertainment. Bear with me, it's a long quote, but it's really good.
Michael: "The day-to-day practice of medicine is about caring for the individual. While, we, physicians fill our days providing sound advice to our patients, there are by comparison, remarkably few recommendations that we can make to the population as a whole. Everyone should exercise and wear seatbelts. Nobody should smoke or drink excessively. Everyone should receive childhood vaccines. Not only are these types of recommendations limited in number, they are also neither terribly interesting nor surprising. They would certainly not support a daily or even weekly television show." This is really the central problem with a figure like Dr. Oz.
Michael: Instead of trying to actually like be America's doctor, he's just giving everybody everything at once with no context.
Aubrey: Totally. I think most of research world is pretty unsatisfying. If you've not done the deep dive into Google Scholar, there are very few medical studies that a single study comes up with a definitive conclusion about what every individual should do differently.
Aubrey: Those things, where there are definitive findings or the things that you're talking about, which is just like, "You should probably drink some more water."
Michael: Yeah. [laughs]
Aubrey: It's a little bit of squeezing blood out of a stone, right? [laughs]
Michael: Yeah. I want to do a deep dive into the green coffee bean kerfuffle-
Aubrey: Oh, tell me.
Michael: -which I'm sure you were aware of.
Aubrey: All I know is that it was a big thing and it was a big thing mostly because of him.
Aubrey: But I don't know anything about the science behind it, I don't know anything about how it became the juggernaut.
Michael: Would you like me to walk you through it with clips and Google Scholar citations?
Aubrey: Oh, my God, everything. Yes, please.
Michael: All right, I'm going to send you a clip. It's long, but there are specifics in this clip that we need to dissect.
Michael: So, here it is.
Aubrey: Oh, okay. I will say, while we're getting queued up, Dr. Oz is standing in front of a screen. He is surrounded by these little pedestals that have flames on the side of them.
Aubrey: Then the screens behind him say, "the miracle pill to burn fat fast."
Michael: I know and it only gets worse, Aubrey. Just wait till we get into this. [laughs]
Aubrey: Oh, Lord.
Dr. Oz: This little bean has scientists saying they've done the magic weight loss cure for every body type. It's green coffee beans. When turned into a supplement, this miracle pill can burn fat fast for anyone who wants to lose weight. Naturopathic doctor and certified nutritionist, Lindsey Duncan is here with the findings. Dr. Lindsey, you love this bean. Why's that?
Lindsey: I usually don't recommend weight loss supplements, but this one has got me really, really excited. The recent study that you were talking about earlier, the participants took the capsules and they did nothing else. They didn't exercise, they didn't change their diet, they actually consumed 2,400 calories a day. They burned only 400 calories. Now, that's weight gain, not weight loss and they lost over 10% of their total body weight, and they had no side effects, zero side effects. That's remarkable.
Dr. Oz: Yeah. Are you guys interested in this?
Dr. Oz: This is a raw material for coffee that we drink. Why wouldn't just drinking coffee do this?
Lindsey: It's what we call a triple threat. Okay, it's the chlorogenic acid that causes the effect and it works three ways. The first way is, it goes in and it causes the body to burn glucose or sugar and burn fat mainly in the liver. The second way and the most important way is it slows the release of sugar into the bloodstream. When the two are combined together, you get this synergistic effect that basically burns in blocks and stops fat, but it also is natural and safe.
Dr. Oz: The capsules, you can buy where?
Lindsey: You buy it online. You want to make sure that this is important that it's pure. You go to your web browser, you type in 'pure green coffee beans' or 'pure green coffee bean extract,' and you make sure that it doesn't have all the additives, the excipients, the binders, the cellulose, the silica, and all the other stuff. So, look under other ingredients to make sure that it's a pure product.
Aubrey: It's such bullshit but it's such compelling bullshit.
Michael: [laughs] Do you want to keep going? Are you bummed that we stopped?
Aubrey: Oh, I hardly even know where to start with this. You have to make sure that it's pure, but there's no regulation on supplements.
Aubrey: Even just street drug dealers will tell you shit is pure.
Aubrey: It feels certain, but both of these people probably know better than to just say, "Hey, check and make sure it's pure."
Michael: Oh, sweet, sweet Aubrey.
Michael: It's so much worse than you think, Aubrey. It's so bad. [laughs]
Aubrey: Oh, okay, tell me.
Michael: All of this information is from a Federal Trade Commission lawsuit. What we find out from the discovery files once everything goes public, this guy, Lindsey Duncan, he's not a medical doctor. He has a naturopathic degree from the Clayton College of Natural Health, which is a school that the State of Texas has said confers fraudulent and substandard degrees.
Michael: He seems like he's just like a doctor on this, like, "I'm just somebody who cares about your health." He's actually a marketing executive for a company that makes supplements.
Aubrey: Yeah, that's right.
Michael: About a month before, he comes on Dr. Oz, he gets an email that eventually ends up in the Federal Trade Commission lawsuit from the Dr. Oz show and they say, "We're hearing about this green coffee bean extract. Do you know anything? Have you heard anything about this? There's this study that's coming out showing weight loss, have you heard anything about this?" He at this point has never heard of this thing. He immediately writes back and says yes, "I've heard of it. I'm really excited about it." Then that same day, starts calling manufacturers to start producing green coffee bean extracts.
Aubrey: Oh, God.
Michael: It's dark. Over the next month, he calls up like Walgreens, and Amazon, all these other retailers and says, "Look, I'm going to be on the Dr. Oz show. You guys need to have this on your shelves and ready."
Michael: Another really important thing. Remember in the clip how he said like, "You need to take 800 milligrams of it twice a day and you need to look for the pure version of it, whatever?" These are search terms that he bought on Google.
Aubrey: Oh, what?
Aubrey: He's done SEO-
Aubrey: -to make sure that when people search those terms, they will get his version and not anybody else's version?
Aubrey: Fuck, oh.
Michael: According to the lawsuit, all of this is completely deliberate. All of the wording that he uses on the show is deliberate. He's going back and forth with the producers of Dr. Oz like working on the script four weeks before this airs. So, he knows exactly what he's going to say.
Aubrey: Oh, that's so upsetting so truly. I feel I don't have a ton of Pollyanna kind [crosstalk] of moments.
Michael: I know. [laughs]
Aubrey: I really, really, really thought this episode was going to be like, "He's been reckless, this is an evil master mind scheme to just to sell shit."
Michael: The closest thing we have to defense of Dr. Oz is that Dr. Oz does not sell and never has sold supplements. The only thing that he sells is he has a sleep store on his website where he sells pillows, and mattresses, and shit. I think Dr. Oz probably didn't know, but also, they didn't do any background checks on this guy.
Aubrey: Right. Zero due diligence.
Michael: Zero due diligence.
Michael: While we're at it, the study that they mentioned on the Dr. Oz show, the study that shows that people do no diet, they do no exercise, all they do is they start taking green coffee beans, and then all of a sudden, the weight magically melts off.
Aubrey: Oh, yes. They also said like, "This miracle pill for 16 weeks, the weight just drops off." I was like, "This is all of the language from Phen-Fen and Rita.
Michael: Dude, yes. It turns out that this study is a total scam. The study was initiated by the manufacturer of green coffee bean extract.
Aubrey: Oh, God.
Michael: The study was on 16 people already, huge red flag that it's that small. They found a researcher in India, and then hired a researcher to do this study, to recruit participants, and then what they find out this is all part of the FTC lawsuit eventually. They find out that the researcher is constantly changing things. She's not putting the data into the study well, so people's weights are fluctuating all over the place. She's mixing up, who's in the green coffee bean group and the placebo group.
Aubrey: Oh, no. [laughs]
Michael: Basically, the company that makes this green coffee bean stuff loses confidence in this researcher and they hire two more researchers at the University of Scranton, they basically take her data, which they already knew was bad, because the numbers have been changing all over the place, and they present it at a conference. So, it's never actually published, but it's presented at this Cleveland Clinic conference. That is the entire basis for this claim that you can do no diet and exercise and lose 10% of your body weight.
Aubrey: Right, which is also again, since time immemorial, this has been the magic claim-
Aubrey: -at the very least. If we had found something like that, you would hear it from your doctor.
Michael: It's so much of this really to me comes back to this idea that there's something doctors don't want you to know. This is language that Dr. Oz uses on his show all the time. He's like, "This is what the Western medical system won't tell you." It's like, the obesity epidemic is a pretty entrenched component of our culture and if there was a cure for it that was this easy, you wouldn't just be hearing about it in a four-minute segment on a dodgy TV show?
Michael: It would be cover of Time it would be cover of Newsweek, it would be a huge fucking deal.
Aubrey: Right. Even then, it would be Phen-Fen.
Michael: Yeah, exactly. [laughs]
Aubrey: Even then, it would still like, "Maybe kill you, probably make you super sick [laughs]"
Michael: So, do you want to know how he got this way, Aubrey?
Aubrey: How did he get this way? What's his backstory?
Michael: It's a fascinating and tragic story. Mehmet Oz, he's born in 1960. He grows up in Ohio. His parents are Turkish, so, he spends summers in Turkey growing up. His father is also a surgeon and just seems to be one of those dads that just like wants you to be number one all the time. The story that Dr. Oz always tells is that he tells his dad, "I'm one of Time Magazine's one hundred most influential people in America" and his dad immediately says, "What number are you?"
Michael: He goes to Harvard for undergraduate in 1985. This actually turns out to be a really important moment for him. He meets his wife, who at the time is named Lisa Lemole. Her dad's a surgeon and her mom is like a woo-woo new age person. It seems as soon as Dr. Oz marries Lisa, this is when he starts dabbling in alternative medicines. In 1986, this is wild, he got a dual MD, MBA from the University of Pennsylvania. [crosstalk] worked his ass off.
Aubrey: [laughs] Right, but also, it feels that's some solid foreshadowing to be like, "I am going to be good at doctoring, and businessing."
Michael: Businessing. Yeah. Then he immediately gets a post at the Columbia Presbyterian Medical Center in New York. This is when all the doctors, all his colleagues, everybody says that he's a wildly talented surgeon. Julia Belluz is this really great journalist for Vox, goes and interviews a bunch of his colleagues, and most of them say, "I would let Dr. Oz do surgery on me. He wins prestigious awards. He has 11 patents-
Michael: -for various open heart aortic valve, something, something stuff. But then, this is also when he gets more serious about the alternative therapies." This is an excerpt from an article that Julia Belluz wrote about Dr. Oz, basically, trying to answer the question like how did he get this way? This gets published in 2014. She says, "With his father-in-law's encouragement, he began to explore music therapy, energy fields, and therapeutic touch, and began to offer them to his surgical patients. Here, too, Lisa played a major role. She is a reiki master and soon became famous at New York Presbyterian for encouraging the practice of reiki in the operating room. Are you familiar with reiki?
Aubrey: I am a queer lady from Portland, Oregon.
Michael: Okay. [laughs]
Aubrey: So, yes, I am. [laughs]
Michael: You are doing it right now. [laughs]
Aubrey: Yeah, the idea is that you're doing this laying out of hands, but you're not actually touching someone, right?
Aubrey: The idea is that you're manipulating their energy field.
Michael: Yes. I think this is a really big moment, because on some level, the reiki stuff seems fine to me.
Michael: If a surgeon is a little kooky and they think that playing classical music helps you recover faster or there's some things in ancient Chinese medicine that might help surgical patients recover from a heart surgery, the placebo effect is a real thing. If the doctor is convinced that these therapies work and the patients are convinced that these therapies work, they probably do actually have some beneficial effects.
Aubrey: Yeah, very, truly couldn't hurt.
Michael: But then it seems from this little seed, he then starts just expanding more, and more, and more. In 1994, he opens his own clinic and then he starts doing hypnosis, and aroma therapy, and prayer. It just becomes like this weird grab bag,
Aubrey: Right. He's not adopting whole cloth additional systems of medical thinking, right?
Aubrey: He's not going like, "We're going to do a hybrid of Western surgery, plus, principles of Chinese medicine, plus, blah, blah, blah." He's just going like, "Yeah, sure. Sounds like a good idea."
Michael: Right. There's no theory behind it. He's just vacuuming up whatever's around.
Michael: Whatever he got. All right.
Michael: Yeah. Another really important thing that starts happening in the mid-90s is he starts to get mainstream press attention. The surgical team that he's part of in New York does a bunch of firsts, a bunch of genuinely, really innovative surgeries and gets press attention.
Michael: Once journalists start swimming around and they realize there's this charismatic, handsome doctor, who does these weird, kooky things in the operating room, but it's also really effective, stories start trickling out of this clinic. Julia Belluz interviews one of his former Nurse Practitioners. She says, "It became about Oz, not about the project, not about the patients, not about the work that all became secondary to his rise at the top. He was always acting, he didn't know this patient, he was not connected to this patient. We'd give him a two- or three-minute soundbite and he'd sit there in front of cameras like he done this work and had this deep connection."
Aubrey: Yeah, it's so sad, because I can totally understand why people get irritated and I can also totally understand how this would be so enticing for someone whose dad just always wanted them to be number one.
Aubrey: Oh, I feel for you bud but also, this might not be the way.
Michael: And also, he has the confidence of an evangelist. You know, I mean, the guy's literally doing heart surgery on people. He's saving people's lives. It's very easy after that to say, it wasn't the heart surgery, it was the reiki that saved somebody's life.
Michael: I know. This is also 2001 is when he gets his TV show for the first time. So, little known fact. Dr. Oz' roommate in college ended up becoming the President of the Discovery Channel.
Aubrey: [laughs] What?
Michael: After them talking, and him getting all this press attention, and doing this interesting surgical stuff, eventually, he and his wife pitch the show to the Discovery Channel called 'Second Opinion with Dr. Oz.' They do a series of 13 episodes, where every episode is him interviewing a celebrity about some health issue. Fatefully, his first episode is about obesity and he interviews Oprah. This is how they come in contact. She really likes him and she starts thinking, "Hey, why don't I have this guy on my show? He's charismatic, he's smart, he's interesting."
Aubrey: Yeah, he's a super likable dude.
Michael: Yes, exactly.
Michael: He has a way of presenting information in a way that makes it really easy for people. One of his first appearances on Oprah famously, he comes on with a heart, like an actual heart, and he's like, "This is a healthy heart." Then he pulls out a big gross white marbled heart and he's like, "This is a heart if you have obesity. Look, how bad it is." But this showmanship, this way of having visual aids, this becomes his trademark.
Aubrey: Yeah, I absolutely-- As you're describing that, I was like, "Oh, I absolutely remember." Both watching that show and then hearing the way that people talk to me afterwards, it was this wild moment of supercharging the like, "Don't you care about your health?
Michael: I know.
Aubrey: I also remember from prop world that he had one episode that I saw at one point. I might have been getting my nails done or something, where he was like, "Let's talk about your colon." He had this big fabric tube setup that was like have people walk through the inside of their colon.
Michael: There's a lot of pooping stuff that I cut out this episode, honestly.
Michael: He's obsessed with [unintelligible [00:25:05] and the way that your poo is supposed to look and how it's supposed to sound. This demystification of these kinds of things that you're "not supposed to talk about" is actually a big part of his brand.
Aubrey: "Are you happy now, dad? I'm the number one poop doctor."
Michael: I can't believe you brought up the poop stuff. I really wanted to skip [laughs] the poop stuff."
Aubrey: I'm so sorry.
Aubrey: He was watching one of those dystopian future things, where I'm like, "In the future, people laugh at a doctor talking about pooping?"
Michael: I know. [laughs]
Aubrey: What is this? The Hunger Games, huh?
Michael: In 2009 is when he finally gets his own show.
Aubrey: So, it's been 11 years.
Michael: One of the most interesting studies I found was a BMJ study that did a systematic content analysis of what he presents on his show. They watched 40 episodes, they got 479 health recommendations from those 40 episodes, and then they picked 80 of them at random to look at the evidence. What they found is that only 46% of them had any evidence to support them and 15% had evidence against them, evidence that they don't work.
Michael: Nestled among the bullshit weight loss, intermittent fasting, take a green coffee bean pill, you'll find things like how to get a better night's sleep, how to get more fruit into your diet? Here's tips for how to quit smoking. It's not all bullshit, but the fact that it's half bullshit and half not, and he's toggling between them without necessarily good road signs for this as evidence and this doesn't, that's the central problem.
Aubrey: Right. I would actually argue that that is more destructive-
Aubrey: -than be straight up medicine show pitch of just like, "I've got your miracle cure right here."
Aubrey: Really, it just fortifies this soup that we're all living in all the time, which is when it comes to health, and wellness, and weight loss, and nutrition, and all of that kind of stuff, we're in this mucky combination of real verified information, and marketing, and wishful thinking.
Michael: Right. For the rest of the episode, I want to walk through the way that he defends what he's doing.
Aubrey: Oh, interesting.
Michael: Most of this comes from his 2014 congressional testimony, which I think is a rich text.
Michael: The clips from that testimony that go viral are the back and forth between him and the senators, and I mostly think those are bullshit, because the senators are just playing to the cameras.
Michael: But when you give congressional testimony, you have to give a long, detailed statement. Dr. Oz' statement is actually very interesting, because it's the first time that he's ever in detail had to defend the impact that his show has on the health of Americans.
Aubrey: That's so fascinating. As you're saying this, I'm realizing that I don't think I've ever heard him answer for any of this on his own terms. I watched the Claire McCaskill and Dr. Oz back and forth, which was, I will say, totally playing to the cameras, totally political theater, don't care.
Michael: Oh, yeah.
Aubrey: Very compelling political theater. It's fun to watch.
Michael: We're going to it later in the show.
Michael: He makes four claims in defending his show and we're going to walk through them one by one.
Michael: The first claim that he makes is that he's educating viewers about their health. This is what he says in his congressional testimony. "When we write a script, we need to generate enthusiasm and engage the viewer. Viewers don't watch the show, because they're seeking dry clinical language. They watch because we use language that's familiar to them, which they would use when speaking to friends and loved ones.
Aubrey: Which is a laudable goal.
Michael: If he was actually doing that, yes, that would be great. [laughs]
Aubrey: Totally. I feel this is going to be probably how this testimony all plays out where I'm like, "That sounds good and reasonable." You're going to be like, "But it's not what he was doing."
Michael: Okay. I should not have done this. This was the biggest waste of my fucking time, but I read one of his books.
Aubrey: No, Mike.
Michael: It's called You: the owner's manual. It was actually really easy, because it's mostly recipes and shit. There's very little actual content in his book. But there's a difference between boiling scientific information down for a lay audience, and fucking lying to them, and he consistently lies.
Aubrey: Give me a flavor of some of those lies.
Aubrey: What are some of the things that are just categorically untrue?
Michael: Okay. I'm going to read to you from his miserable book.
Aubrey: Oh, God.
Michael: "You don't need to be a road scholar to stay mentally strong. Simple changes can do the trick. Take another study. One, the measured brain function of retirees, who frequented a Starbucks in Illinois. The half who just sat and drank their coffee got no smarter, while the half who drank their coffee while walking for 45 minutes at least three days a week actually improved their IQs." Parentheses-- no word on how many bathroom breaks they needed.
Aubrey: Oh Lord.
Michael: The explanation, physical activity improves arterial function and better arterial function improves brain function.
Aubrey: I feel I'm going to go into the methodology flaws of this study and be like, "Right, but these kinds of people have access to these kinds of spaces to do walking about what" and then you're just going to be like, "It wasn't a study, it didn’t happen"
Aubrey: Look, I got start to pick it apart, but I also know that I'm going to be too generous with how I pick it apart. [laughs]
Michael: [crosstalk] exactly what I was expecting.
Michael: You would find some specific things to nitpick at.
Michael: Then the twist. I'm like, "The study does not exist, Aubrey, which is true."
Aubrey: Yeah. [laughs]
Michael: I spent half a fucking day looking for this actual study. I put it out on Twitter. I was like, "If you have any background in neuroscience, cognitive function, anything, have you ever heard of this study? I looked at literature reviews. I could not find a study that found people in Starbucks. Some of them drink coffee and some of them walked and drink their coffee. This study does not exist."
Aubrey: Oh, God.
Michael: I want to be clear. This is the first study in his book that I looked for.
Michael: It's not I went through his book, and I wrote down all the studies, and it looks like, "Well, that one's real and that one's real. Oh, this one's fake." This is the first one I looked into and it's not a fucking real study. There is no study that measured the effect of walking on IQ and what actual cognitive neuro people say, they don't use IQ as a variable in studies like this, because IQ does not change like that. That's not how these studies work.
Aubrey: It didn't even happen. It's not even making you smarter, because didn't even happen. That study doesn't exist. Oh, my God, Mike.
Michael: Also, can I just be a total dick?
Aubrey: Yes, of course.
Michael: All of his things like, "Oh, we need to use colloquial language. We just like to talk to folks how they are folks," and then listen to this fucking sentence. Physical activity improves arterial function and better arterial function improves brain function.
Michael: That's a shitty sentence.
Aubrey: Like, "Exercise increases your blood flow and your brain needs blood to function."
Aubrey: Oh, Jesus.
Michael: This is why science communication is hard is because you don't want to misrepresent anything, but you do want to get it across in a way that people can absorb it. That's something that Dr. Oz instead of doing the difficult work of coming up with metaphors that can help people understand complex phenomena or whatever. He's just like, "This is a breakthrough revolutionary thing. Walking and coffee IQ." You're like, "Well, you're not actually simplifying anything. You're making stuff up." Those are two different things.
Aubrey: He's coming up with these studies that don't exist, or if they do, he's not citing them, or whatever.
Aubrey: Then he's building giant fabric colons for a TV set and like [crosstalk] flames of green coffee beans and whatever. We're like, "Oh, it's not science."
Michael: Yes. So, okay. Second defense that Dr. Oz offers for himself. He is giving people an alternative to Western medicine.
Aubrey: No, he's not.
Michael: I know. It's not spoiling the episode.
Michael: For this one, we're going to do a little table read.
Aubrey: Oh, my God. [laughs] Okay, are you sending me a link?
Michael: Yes, I was going to play the clip of his exchange with Claire McCaskill in the congressional hearing, but it's just really long and really boring. I took the transcript and I condensed it down. We're going to do a distilled version of this.
Michael: Do you want to play Dr. Oz or do you want to play Claire McCaskill?
Aubrey: I'll be Claire McCaskill. That sounds fun.
Michael: Okay. This is from the 2014 congressional hearing. Congress was looking into false weight loss claims.
Aubrey: Oh, dang. All right, it is.
Michael: it's long.
Aubrey: It's serious business.
Michael: I know.
Michael: Your motivation is that you're mad at Dr. Oz and you need viral moments for your Twitter feed later today.
Aubrey: All Right.
Michael: All right. Grill me.
Aubrey: Now, here are three statements you made on your show. "You may think magic is make believe, but this little bean has scientists saying they found the magic weight loss cure for every body type." "I've got the number one miracle in a bottle to burn your body fat. It's raspberry ketone." [laughs] Sorry, it sounds like a delicious salad dressing.
Michael: You are breaking character already.
Aubrey: I know. I'm sorry.
Michael: It is deeply unprofessional, Aubrey.
Michael: Very disappointed.
Aubrey: "Garcinia Cambogia, it may be the simple solution you've been looking for to bust your body fat for good. I don't get why you need to say this stuff, because you know it's not true."
Michael: With regards to whether they work or not, take the green coffee bean extract as an example. I'm not going to argue it would pass FDA muster if it was a pharmaceutical drug seeking approval, but among the natural products that are out there, this is a product that has several clinical trials.
Aubrey: I've tried to really do a lot of research in preparation for this hearing. The scientific community is almost monolithic against you, in terms of the efficacy of the three products that you call miracles. When you call a product a miracle, and it's something that you can buy, and it's something that gives people false hope, I just don't understand why you needed to go there.
Michael: My job I feel on the show is to be a cheerleader for the audience. When they don't think they have hope and when they don't think they can make it happen, I want to look and I do look everywhere, including in alternative healing traditions for any evidence that might be supportive to them. You pick on green coffee bean extract, with the amount of information that I have on that I'm still comfortable telling folks that if you can buy a reputable version of it, and I say this all the time, I don't sell it. And these are not for long-term use.
Michael: [noise] it's over.
Aubrey: Oh, God.
Michael: What do you think?
Aubrey: it is total political theater, because he doesn't say anything substantive.
Aubrey: It's a satisfying exchange.
Aubrey: But there's nothing in there where she goes, "No, these are the studies." How do you respond to all these studies that say, "This doesn't do shit."
Michael: Right. The thing that jumps out at me about this and I think because I've read so many interviews with him, and he does this all the fucking time, and it drives me nuts. He does this three-step move. First of all, he says, "Green coffee bean extract is good, because look at the studies that show how much weight you can lose by taking this extract." Then somebody pushes back on him and they say, "Well, that study was only of 16 people, that study wasn't very high quality." Then instead of responding to those points, he then says, "Well, it's alternative medicine. I don't know if it would necessarily pass FDA muster, but there's different healing traditions around the world and we couldn't possibly apply those standards." It's like, "If we can't apply those standards, then why were you saying that you should take it, because of a study?"
Aubrey: Right. Totally. [laughs]
Michael: No, pick one.
Aubrey: This is an alternative treatment. The way that we know that is because of Western studies. [laughs]
Aubrey: And it is doing right by those medical traditions either.
Michael: Well, that's the thing. Green coffee bean extract is a fucking pill that is made by a multinational corporation and then you're saying, "It's alternative."
Aubrey: In a lot of ways, it mimics the medicine show stuff that we talked about during our snake oil [crosstalk] conversation. People have been rightfully disappointed by Western medicine. People have had bad experiences. I'm a fat lady. You don't need to tell me about bad experiences and doctors' offices. What he's doing is glomming on to this vague, but not totally founded idea that there is someone else is doing it better or somewhere. It's riding the coattails of the genuine mistrust that folks have for understandable reasons often.
Michael: Yes. Also, another really interesting thing. There's a lot of really good articles by doctors. People, who literally practice Western medicine, they say that it's also kind of bullshit to be saying, "These are alternative medicines, who couldn't possibly measure them with Western medicine." What these doctors point out is that, if you talk about something like yoga, that's an alternative medicine seen as very woo-woo, 20 years ago, the medical benefits of yoga are extremely well documented. That's not some woo-woo thing like we couldn't possibly say that yoga is good using our techniques of Western medicine. There are hundreds of studies showing that yoga improves people's lives.
Michael: Things like meditation, and getting a good night sleep, and eating a balanced diet, we can measure the effects of those things. Those are not somehow alternative. I don't know why we're acting as if these are somehow these mystical practices that we couldn't possibly assess? No,
Aubrey: Not every treatment from every corner of the world has been tested or studied. There has to be money behind that, there has to be all of this different kind of stuff. So, we're not saying like, if it's good Western medicine "will have validated it." But in this case, so, if we take green coffee extract, we have an incredibly moneyed supplement company that stands to gain astonishing levels of wealth.
Aubrey: This stuff has the money and the systems to be studied and to see if its effects are what we think they are, and that hasn't happened. So, at the very least, that's a red flag, dudes, that's a red flag.
Michael: There's this weird fake dichotomy between alternative and Western medicine, and neither one of those terms are remotely defined.
Aubrey: Right. It's this floating signifier.
Michael: Yeah. And it also, it feels to me it prevents change, too. Because what you're against is Western medicine, you're just going to do all this naturopath random stuff. You're not going to try to get better policies for universal healthcare or maybe doctors should be able to spend more than seven minutes with their patients. There're specific changes that we can make to the American healthcare system to make it more responsive to people.
Aubrey: Right. If you have a critique of that system, "Listen, I'm an organizer, I am fucking onboard." This is not how that happens.
Michael: I do think the fact that Dr. Oz is a lifelong republican is under disgust.
Aubrey: Oh, no.
Michael: This is a very republican worldview that it's the free market is going to solve these problems.
Aubrey: Yeah, there's nothing we can do to change our medical system except for the many massive things that are done to change our medical system.
Aubrey: I just hate that shit. This is one of my extreme pet peeves is you can't change the world, you can only change yourself kind of thing.
Aubrey: Oh, Western medicine is going to be what Western medicine is going to be. But listen, what you got to get onboard with this is green coffee extract, or raspberry ketones, or what the fuck ever.
Michael: His next claim-
Aubrey: Oh, Lord. Okay
Michael: -is that, he never endorses specific products.
Michael: This is an excerpt from his opening statement at the congressional hearing. "I started as a guest on The Oprah Winfrey Show in 2004 and had my first experiences with scam advertising at that time. When we discuss supplements like acai berry and resveratrol, there wasn't anything special about my description of them. But immediately the internet ads began springing up using pictures of us showing quotes claiming the Miss Winfrey and I were supporting these products and selling them." This is basically his main claim that, "Look, did we mention something called resveratrol on our shows? I guess, we mentioned it. Sure. All of a sudden, these random internet con artists start selling it and saying that we're endorsing it. How dare they?"
Aubrey: Yeah, but also, you are fucking endorsing it, dude.
Michael: Dude, do you want to hear the actual transcript of what he said about resveratrol on Oprah?
Aubrey: Oh, God. Okay.
Michael: Keep in mind. He is saying, "How would anyone get the impression from this that I'm endorsing this product." Here's the actual words that he said.
Michael: "Resveratrol does one other thing. It turns on a system in your body that prevents your cells from aging. Now, think about it. Where do they grow these grapes? On trees, on hillsides, right? It's not a very hospitable environment. These grapes are sending a signal to us that life might not be so good. So, why not turn on that cellular chemistry that you have that allows you to live longer and better?"
Michael: It's like, "Oh, yeah, how could anybody get the impression that you're endorsing this product?"
Aubrey: Also, how does any plant survive on a hill?
Michael: I know. [laughs]
Aubrey: So inhospitable.
Michael: I know.
Michael: It's also not very convincing.
Aubrey: Things grow everywhere. What are you talking about? [laughs]
Michael: On some level, I have a teaspoon of sympathy for Dr. Oz, because of course, after this show airs, all these scam companies appear out of nowhere, and apparently, they started selling 30-day supply of resveratrol, and people would sign up for it, but then they would make it impossible to cancel. At the same time, they're saying, "It's endorsed by Dr. Oz and Oprah." So, a lot of people end up getting mad at Dr. Oz and Oprah.
Aubrey: It's totally shitty and also, at some point, he has to acknowledge and the show has to acknowledge that that is an ecosystem that has sprung up around their show.
Michael: Well, this is the thing is that, if he had said on his show, eat avocados, avocados are good. Avocado sales probably would have spiked or whatever, but you wouldn't have all these fucking grifters coming out of the woodwork, because that's not a grippy sector. Anytime, you're sending people to essentially a used car dealership, they're going to get scammed, because you're sending them into this extremely grifty sector of the economy. You can't just say like, "I bought a Honda Civic, and I love my Honda Civic, and it's a handsome car." They'd be like, "I can't believe all these people bought Honda Civic."
Aubrey: Right. [laughs]
Michael: 4 million people watch your show.
Aubrey: He's not even meeting the Instagram threshold where you have to be like "#ad."
Michael: This is actually, I think the biggest flaw in the congressional testimony is that over and over again, the senators will press him on selling these scam products and then he will push back and say, the problem is that they weren't really selling the products. This is what he says. "I once confronted an egregious advertiser of Garcinia Cambogia on my show in part, because we found not only was he stealing my name, he was also only providing 10% of the active ingredients."
Michael: It's like, "You don't get it, do you? McCaskill, nobody follows up on this." The active ingredient is bullshit. It doesn't matter if it's 10% or 100%. There's a darkly hilarious section of the congressional testimony where he's going back and forth with one of the male senators and they're like, "So, what are your policy ideas for fixing these scammy weight loss grifty sector of the economy?" Dr. Oz' main policy idea, like, how to fix it. He's like, "We need a database of products that are really endorsed by celebrities."
Michael: That's for you. That's to protect you Dr. Oz. That's not to protect other people.
Aubrey: Look, I need to know that Kim Kardashian really endorsed 'Flat Tummy Tea.'
Michael: Okay. Last claim, we're going to talk about.
Michael: This one sounds really mean. I've been mean, I've been not terrible in this episode and this is the least charitable.
Aubrey: oh, my God.
Michael: The final claim that Dr. Oz makes is that he's gotten better.
Michael: One of the last things that he says in his congressional testimony is, he's talking about the green coffee bean extract thing. He never says, I'm sorry, but the closest thing he ever does to saying I'm sorry, he's like, "We made some mistakes there. As an example of how I've learned, we recently had a product on our show called Yacon syrup." Have you heard of this, Aubrey?
Aubrey: Not Ever.
Michael: It's basically an extract from sweet potatoes, the syrupy stuff that comes out of sweet potatoes.
Aubrey: Sure, when you bake a sweet potato, there's that little goo, that puddle of goo. Yes.
Michael: He says like, "Look, we recently did a segment on the show. We didn't call it a miracle, we didn't call it magical, we were really responsible." Of course, as soon as I was reading this, I was like, "I need to see the segment."
Michael: It's like, "Let's see the new and improved Dr. Oz. So, we are going to watch this clip.
Aubrey: Oh, my God.
Michael: This is the new and improved Dr. Oz. This is Dr. Oz on his best behavior.
Aubrey: Oh, my God.
Dr. Oz: To women up here, I've got a woman that's a little bit on the big side. You come next to me.
Female Speaker: I'm coming next to you. You won't bite me. [laughs]
Dr. Oz: I won't bite at all. All right. On this side, a little bit of a thinner woman. Researchers think that the first way this syrup works is to speed up your metabolism. If you do have excess fat, one of the reasons we think that's happening and a lot of you don't want to look like that. May I have that right?
Female Speaker: Yes.
Dr. Oz: Right. If we believe as more and more of us in the science field are that the bacteria in your gut are what's making you heavy, then the question becomes, can we change that? That gut bacteria you have is very different. It's caused by having too many processed foods and a poor diet. You don't want those kinds of bacteria. Those are fat bacteria. This thin person's gut, however is filled with more of the good bacteria. I like to call it skinny bacteria. That's one of the reasons that people who are thin tend to stay thin. That's the first way that scientists believe that Yacon syrup works. The next way that we believe that Yacon syrup may work for weight loss is that it makes you feel full. In order to demonstrate this, I have to put you in a little bit of risk. So, come on up here. I'll help you up.
Michael: We're stopping now. It's a fucking nightmare from here on.
Aubrey: [laughs] I don't even know why he's hooking her into a sex swing.
Michael: He ends up doing this thing where he talks about how Yacon syrup affects your hunger and satiety hormones. It lifts up the level of satiety hormones and then he lifts her off the ground.
Michael: It's him trying to do, like, make a fun explanation out of an extremely simple scientific concept.
Aubrey: When they step onto the stage, there is this wall of screens at the back of the stage that has a profile of a thin white woman in a bra and panties. I would say a pretty small fat white woman also in a bra and panties. That's what he's referring to when he goes, "Most of you don't want to look like this, right?"
Aubrey: The woman that he has brought up from the audience absolutely looks like that.
Michael: Yeah, I know.
Aubrey: She is the size and shape that he is talking about while he's asking the audience, "You don't want to look like that, do you?
Michael: I know. She seems nice.
Aubrey: She seemed lovely.
Michael: I guess, he's careful to say that it's not a miracle and it's not magic. He doesn't technically use the word that he used in the green bean extract clip. But he straightforwardly says that it speeds up your metabolism, he straightforwardly says that it gives you skinny stomach bacteria, he straightforwardly says that it makes you feel full for longer. He's still making a bunch of claims, specific claims that are not true.
Aubrey: At this point, he doesn't need to say that it's a miracle cure. He has the miracle cure show.
Aubrey: That's what people tune in for.
Michael: He's basically making the argument that it is this miracle thing without saying the word miracle. But there's not a meaningful difference between those two things. Telling people that switching from sugar to Yacon syrup is going to lower their blood pressure, ease their constipation, of course, he mentions constipation, speeds up your metabolism, and makes you feel full for longer. That's what people want from a miracle weight loss cure is for those four things.
Aubrey: I have to say now that I know your aversion to the poop stuff, I very much want to find the poop center. [laughs]
Michael: Please don’t [crosstalk] episode. This is our poop episode. This is as close as we're getting.
Aubrey: No this and olestra.
Michael: Oh, yeah, huh.
Aubrey: Poop episodes.
Michael: Of course, I looked up the science on Yacon syrup. It's a bunch of fucking mice studies. It's a real thing. It appears that there's actually some use of Yacon syrup concert for diabetics, because it's a way of sweetening foods, but it's much less sweet than sugar. Okay, is it a completely useless thing in the world? No, it seems fine. But also, it has side effects if you eat too much of it and also, most people that switch from sugar to Yacon syrup just end up using more Yacon syrup, because they want the sweetness.
Aubrey: Yeah, totally.
Michael: I just think it's incredible. Does he not think that we can see him? He goes in front of Congress and he's like, "Look how much better I am now?" Is this you better?
Aubrey: No, I don't think it's that he thinks we can't see him. I think if we're looking at this through strategic communications perspective, he knows that his audience is not watching his congressional hearings. But people who watch Dr. Oz and the people who watch fucking C-SPAN.
Michael: Yeah, no kidding.
Aubrey: There's not a lot of overlap, guys. He's aware that he just has to give quotes that sound reasonable and get out of there. The whole thing is just like a whole mess.
Michael: There's a huge elite accountability story here, too.
Michael: There was an open letter from 10 prominent physicians to Columbia saying that Columbia should no longer have him working there.
Aubrey: Oh, wow.
Michael: There's been attempts at the American Medical Association, but the American Medical Association can't really do anything, because all the licensing is done at the state level, and then the state level says that they can't do anything, because it would be setting a bad precedent, etc., etc. It's very white-collar crime. Over and over again, every form of accountability that would ever impose any minor tiny consequences on Dr. Oz finds an excuse not to do it.
Michael: One of the defenses of him in inside higher ed, which is doing this panic thing about free speech, doctors, professors, tenure, etc., they say the real reason these writers are seeking to fire Oz from Columbia is a form of public shaming and it's like, yes.
Michael: People should be shamed for constantly lying.
Aubrey: Or, at the very least, you shouldn't be continually provided with the tools to continue to lie to people.
Aubrey: You have an ethical obligation to your patients and to people, who think they are your patients. You can't just keep doing everything as you have been doing it if it's actively hurting people.
Michael: Stop being bad. Yes.
Aubrey: Stop being bad, dude. Stop being bad.
Michael: And also, since the congressional hearing, if anything he's gotten worse, so, in 2016, he does a physical exam on Trump-
Michael: -live on TV. Yeah, he had Trump on and Trump, he's like, "Why didn't you release your medical records?" Trump is like, "I did release my medical records." Dr. Oz is like, "Sounds good."
Michael: Then he does this theatrical fake physical exam, which he doesn't in any way touch. It's not a real physical exam, but he just asks Trump a bunch of these questions and Trump is able to answer yes or no. Then he's like, "You seem you're in good physical health."
Aubrey: [Laughs] Jesus Christ.
Michael: And then, this is amazing synergy convergence for our show. In 2018, Trump appoints him to the President's Council on youth fitness. [laughs]
Aubrey: Oh, God. That old chestnut.
Michael: I know, which is like all the bullshit fads coming together.
Michael: The last thing I googled on Dr. Oz' website was what he's been doing this year during COVID and I'm going to read you some headlines.
Aubrey: Oh, God. Okay.
Michael: "COVID-19 and immunity, the vitamin and mineral prescription plan recommended by experts. This shopping list will help you choose foods for COVID-19 immunity." This is my favorite one. "Should zinc be added to treatment protocols for COVID-19 patients?"
Michael: In his defense, he has not been a COVID anti-vaxxer. He's been very clear about like, you should get vaccinated for COVID. That's the one saving grace, but he spent a lot of 2020 spreading basically some pretty bad information about COVID. COVID immunity is not going to come from the fucking grocery store, dude.
Aubrey: All of those headlines sounded to me like Troy McClure educational films.
Aubrey: I was an actor.
Aubrey: I need my eyeballs to be there widest.
Aubrey: Again, if we're talking about playing on folks anxiety about mortality, I don't know if there's any clearer way to do that than say, "Oh, you got to take zinc, otherwise, you're going to get COVID."
Michael: Fucking zinc, dude.
Aubrey: This is the kind of stuff that makes me feel not hopeless, but despairing.
Michael: Dude, yeah.
Aubrey: All of this stuff makes it seem weight loss is super simple. All you need to do is buy this supplement, all you need to do is have the right gut bacteria, all you need to do is blah, blah, blah, blah, blah. The idea that you could spend this much time talking about how terrible it is to be fat, and all the ways that you don't have to be fat, and that that would not impact the way that people think about and treat fat people, or disabled people, or chronically ill people, or what have you is fully bananas. So, it's also not only is he playing real fast and loose with the truth, and sometimes, just making it up, he's also feeding these fires, right?
Michael: Mm-hmm. We should let Dr. Oz have the last word on this show.
Michael: This is toward the end of his congressional testimony. You're not going to believe this, because "You know what the biggest disservice I've done for my audience? It's not the flowery language that Senator McCaskill is criticizing me for, it's that I never told them where to buy the products."
Aubrey: [laughs] Fuck, how dare they think I'm trying to sell something.
Michael: This is what he sees as his central sin that he was not selling them reliable versions of raspberry ketones or whatever.
Aubrey: I love the idea that he's like, "How dare people think I was selling them things? That's actually my biggest mistake is that I wasn't."
Michael: I know.
Aubrey: [laughs] No, sir.
Michael: That's it. That's our tour through the yellow brick road of Dr. Oz' bullshit.
Aubrey: I have to tell you I was excited coming in to just be like, "Yeah, that guy seems like garage."
Aubrey: This is significantly darker.
Michael: Then I made it really sad and horrible. I'm sorry. [laughs]
Aubrey: No, no, no. This isn't horrible. It is way more sinister.
Michael: It's sinister, dude. I know.
Aubrey: Systemically sinister.
Michael: But actually, you know what's really good? If you're reeling, take a little bit of Yacon syrup.
Aubrey: [laughs] Get out of here.
Michael: One teaspoon, gut bacteria.
Aubrey: I'm going to hang up on you.