← The Peter Attia Drive

#06 - D.A. Wallach: music, medicine, cancer screening, and disruptive technologies

Jul 23, 2018 2h 19m 15 insights
<p>D.A. Wallach is a true polymath: recording artist, songwriter, essayist, investor, and so much more. In this episode, among the highlights, D.A. provides compelling and colorful insight into how the music industry works today vs the past, liquid biopsies, how to approach healthspan, cancer screening, and how we can reach a "singularity" in medicine.</p> <p>We discuss:</p> <ul> <li>How to learn music as a kid and an adult [<a href="">7:30</a>];</li> <li>Chester French's early struggles and ultimate success [<a href="">16:45</a>];</li> <li>Learning to learn, fostering curiosity in kids, and balancing creativity with structure [31:30];</li> <li>D.A.'s musical inspirations [44:30];</li> <li>History of the music industry, Spotify, and other disruptive technologies [50:00];</li> <li>The past, present, and future of medicine, hospitals, and healthcare [1:05:30];</li> <li>Investing in health [1:16:30];</li> <li>What D.A. is most excited about in the future of medicine [<a href="">1:22:00</a>];</li> <li>Liquid biopsies, how to make sense of the morass of sensitivity, specificity, positive predictive value, negative predictive value, true negatives, false positives, false negatives, and true positives in cancer screening...and the swiss cheese metaphor [<a href="">1:33:00</a>];</li> <li>The immune system, inflammation, and allergies [2:05:45]; and</li> <li>More.</li> </ul> <p> <span> Learn more at <a href="http://www.peterattiamd.com/"><span><u>www.PeterAttiaMD.com</u></span></a></span></p> <p> <span>Connect with Peter on <a href=""> <span> <u>Facebook</u></span></a> | <a href=""> <span> <u>Twitter</u></span></a> | <a href=""> <span> <u>Instagram</u></span></a>.</span></p>
Actionable Insights

1. Adopt Bayesian Thinking for Diagnostics

Understand that the utility of a medical screening test depends on your prior probability of having a disease (e.g., genetic risk). A positive test result updates your likelihood, but its significance varies greatly based on your initial risk, not just the test’s sensitivity.

2. Prioritize Test Specificity

When evaluating diagnostic tests, prioritize high negative predictive value (specificity) to avoid false negatives, meaning you never want someone with cancer to be told they don’t have it. You can tolerate some false positives (people without cancer told they do) if the follow-up is manageable.

3. Layer Diagnostic Tests Strategically

Combine different screening tools, like mammography, DWI MRI, and future liquid biopsies, to leverage each test’s strengths and weaknesses. Use liquid biopsies as confirmation rather than leading candidates, especially for conditions requiring invasive follow-up.

4. Focus on Theoretical Frameworks

When encountering a new subject, prioritize understanding its theoretical framework or ‘skeleton’ rather than getting lost in details. This approach helps grasp the underlying structure and how things work.

5. Nurture Children’s Curiosity

Instead of teaching curiosity, focus on not stifling it, as children are born with it. Avoid sanctioning questions or ‘why’ questions to foster an environment where their natural inclination to understand is fed, not suppressed.

6. Balance Rote Practice with Exploration

When learning an instrument or any skill, start by playing around and exploring without a rigid framework before introducing theory. Theory becomes an ‘amazing gift’ that answers questions you’ve already encountered through exploration, rather than an imprisoning set of rules.

7. View Technical Skill as More Colors

Embrace learning technical skills in any creative field, as they provide ‘more colors to paint with’ and expand expressive options without diminishing authenticity. It doesn’t cost anything to gain more ways to articulate your ideas.

8. Develop Singing as Musical Speaking

Approach singing by thinking of it as ‘musical speaking,’ controlling pitch deliberately. This mental reframing can make learning to sing easier and improve vocal control, similar to how physical activities are mastered.

9. Prioritize Preventable Suffering

Focus efforts and investments on reducing suffering from preventable diseases and conditions that afflict people prematurely or in the second half of life. This pragmatic approach addresses immediate human health challenges.

10. Evaluate Tech: Short-Term Over, Long-Term Under

When assessing new technologies like genomics or blockchain, recognize that their short-term impact is often overestimated, while their long-term, transformative potential is frequently underestimated. Focus on the collective intelligence and effort being directed towards the technology.

11. Advocate for Rapid Standard of Care

Physicians and the community should actively work to streamline the process by which definitive scientific advancements, like new medical treatments, become standard of care for all patients everywhere, overcoming bureaucratic hurdles.

12. Encourage Drumming for Kids

For children learning drums, emphasize that they don’t necessarily need to know musical material as well as other instrumentalists. As long as they can quickly learn or figure out a beat, they can play along, which can make it more enjoyable and less practice-intensive.

13. Connect with D.A. Wallach

If you are a ‘genius’ or have an interesting, novel idea that could be deemed genius, reach out to D.A. Wallach via his Twitter (@DAWallach), Instagram (@DAWallach), or website (DAWallach.com).

14. Listen to ‘Time Machine’ Album

Explore D.A. Wallach’s music by listening to his most recent solo album, ‘Time Machine,’ which was released around 2016.

15. Connect with Peter Attia

For more information, show notes, blog posts, or to sign up for a weekly email, visit peteratiyamd.com. You can also connect on Twitter, Instagram, and Facebook using the handle @peteratiamd.