# Transcript

Dr. Stephen Nimer joins Demian Bellumio for Episode 005 of Augmented Wellness. This readable transcript was generated from the final edit and lightly corrected for names; consult the published audio for exact wording.

Hello. Welcome to another episode of Augmented Wellness. It's an honor today to have Dr.
Nimer with us. He is a local institution in the health industry, but also community
health. And we're going to talk more about all you do for the community. So it's an honor
to have you here, Dr. Nimer, and excited to dig a little deeper on your life, your
journey, and how do you see the future of cancer prevention, cancer treatment, especially
out of Miami? Well, thank you, Demian. It's great to be here with you. It's been great
getting to know you over the past few years, and we have a lot of similarities in terms
of what we want to accomplish for our community. Yes, we do. So yeah, so I like to go way back.
Um, and obviously you, we got, we got to spend some time on the bike, you know, some hours
and hours. Uh, you shared a lot of, of, of your amazing, uh, story. So tell us a little bit
about where, you know, where, you know, where, you know, were you born, you know, what were
those formative years that, that led you to, to have such a mission today? Sure. Um, I
was born in Chicago. I'm a first generation American. Uh, my father came from Moldova and my
mother came from Germany. Uh, they met, uh, in Chicago. I was born, uh, my sister was
born first. Uh, and then when I was three, my parents were already worried about my education.
So we went to a suburb just north of, uh, Chicago and I went to public high school. Um, I was,
uh, uh, my father, uh, was an economist. Uh, my mother, uh, finished college, had a degree,
which was pretty unusual then. And, um, I went off to college with an idea of maybe
being a medical, in the medical profession. Uh, and, um, you know, after a little bit of
time in college, I decided that was probably the right thing for me. And so, um, my, some
of my, uh, roommates in college also went to medical school and, uh, we're still in touch
many, many years later, uh, as physicians. So, um, I went to MIT as an undergrad. Um, I
was a big nerd. Um, but, um, I was super interested in ice hockey. And so I played on MIT's ice hockey
team. Okay. And, uh, that was a very important part of my world. Um, I was always the first
one to the rink before the practice started. And after practice was over, I stayed around
and as a freshman, I was voted most improved. And I think it probably says something about
me back then. Yeah. Um, uh, went to medical school at the university of Chicago. So I went
back to Chicago, um, had, um, one of the winters, the actual temperature was 19 below for a couple
days with the windshield minus 57. And so somehow after that, I wound up at UCLA, probably linked.
And, uh, as a second year student, I met a pathology professor named Janet Rowley. She
was a phenomenal researcher. And then, uh, after meeting her, I decided I want to be a leukemia
expert. So that's what I studied at UCLA. And, um, you know, there's a lot of more details,
but those were certainly the formative years. Um, and then I did go to New York and now Miami,
but I think, uh, that's a good start. Yeah. Yeah. So, and I, obviously, um, what is amazing? I mean,
this is our sixth, seventh episode and, you know, we're showcasing people that make the world better
and it's incredible how similar, you know, a lot of the stories are, you know, um, you know,
the, the, the, the drive that people have and also sports, you know, sports being a big part of,
of who they are, especially early in life. So let's go back to those years. I mean, so you're,
you're playing hockey, um, you know, you're, you're, you're, you're medical school. Um,
how was the world back then? I mean, how was medical school? And obviously, obviously today,
you're still, um, involved in not only in the, in the, in the medical profession, but also in the
university, you know, how, how has education changed, you know, and you as a student back then
and, and today? Yeah. So it's fascinating. I'm, I don't want to date myself exactly, but I would say
that, you know, when I was in college, uh, the first calculators were coming out, HP calculators.
And so they were about $800 and, um, MIT had a policy that you couldn't bring a calculator
into your exams and things like that because they knew that some students couldn't afford
that. You know, my father worked two jobs so I could go to medical school and never forget that.
Yeah. And so, um, but then the calculator came into place and then the computer came into place
and now we have AI. And so I think, um, one, I've never been, um, afraid of technology,
adverse to technology. Um, when I take care of patients, it's very important. It's,
uh, I'd say there's like a two by two square for patients. One is whether people are afraid of
technology or they love it. They love innovation or they're afraid. And second is, are they optimistic
about things or pessimistic? So if you're a pessimist and you're afraid of technology,
you're probably not going on a clinical trial. Yeah. But if you're an optimist and you believe
in, in science and things, you're probably the first to volunteer. And so I think that my early
training really, uh, exposed me. I, I'm sad to say that I was not a computer science major at MIT.
I missed out. Some of my friends were starting sun micro or other things. Uh, but I was very
focused on science and medicine. And then the sports is, um, you know, I, I think no one really
knew about the importance of sleep or the importance of diet or exercise back then, not at all. And now
when you talk about wellness and I'm sure we'll get into that, those are some of the most important
things. And even when I did my medical training, we were all very, very, uh, we were up all night
every third night and it was just a badge of honor. There was no idea that we were harming anything. And
we, we had a, a favorite saying. So like at two or three in the morning, we would, the residents would
be walking around the hospital. And when we met each other, we would shake hands and we would have an
expression where the first person would say working hard. And the answer was always hardly working.
Okay. And so the idea was no matter what time of the morning you were up taking care of patients,
uh, you were so tough, you could do whatever you weren't really working hard being up all night,
you could be up for two nights in a row, whatever it was. So I think there was that mentality
about endurance. Um, and, uh, food was then like, just eat whatever is, is out there, uh, notorious on a
hospital ward. If someone brings, well, actually a word to the, to the wise, if you have a family member
that's hospitalized, the first thing you should do is stop at a bakery or at a chocolate store and bring
some on the first day that your friend or, or family members in the hospital, the nurses and
everybody will love you for the entire hospitalization. You get the most attention for
like a box of chocolates because people get hungry. And that's true today. It's still absolutely true.
And so, so I think there was really very little understanding. No one was talking about wellness
every, and, and of course no one wanted to get sick, but there wasn't much except not smoking,
you know, that people focused on. Yeah. Because, um, you know, I mean, one of the, I mean,
I've heard this, I mean, I'm probably, I mean, you heard a lot more than me, but it's sometimes
it's a little bit counterintuitive that, you know, doctors sometimes have worse habits than their
patients. Right. Uh, uh, but it comes from, you know, sort of that, you know, that intense lifestyle
that, that, that they sort of have in distress. And, and sometimes, you know, like me, I mean,
the wellness industry sometimes is like, I should be taking, you know, my advice or the advice that
we give, you know, uh, to others, uh, through the company, but it's really hard when you're in these
stressful jobs. You know, yeah. I think the other part, there's a lot of randomness in the world.
Yeah. Like people smoke cigarettes and why does one person get lung cancer and the others don't?
Yeah. And I think as a doctor, you also see the randomness of things and that tends, you,
you tend to dissociate behaviors and risk from what happens. So like, um, if, if you don't do something
risky versus someone who does, it's probably similar outcome. Yeah. But the person who does the risky
thing, one in a thousand, something's going to happen, but you just ignore that when you see
random stuff happening, but random stuff is not as random as you think. Yeah. And now we link a lot
of things with other things. And so I think like, if you're, uh, you know, when I was, uh, in medical
school, there were all these runners, right? It was the, the era of the, the runner. I think it was
Terry, Terry Fox and some other people and Cooper, there was a, and he died of a heart attack.
You know, he was, he was like running 10 miles a day or something. And then every says, look,
what, why would you run? I got a heart attack anyhow. And so, well, you run, it doesn't mean
you'll never get a heart attack, but if you're running, you probably are going to have less heart
attack than if you're not running. Yep.
So I think that the, the, the randomness of things sometimes strikes you when you're actually in a
profession. Correct. Correct. Um, so, you know, let's talk about the, obviously of all the things
that you could do, you know, in, uh, in, in the medical field. I mean, I think you told me you chose,
you know, leukemia and cancer cause it's really hard. Um, let's talk about that. I mean, what, uh,
you know, that decision to go into it, was there, you know, uh, anything sort of that motivated you
particularly for cancer? Was it just because it's, it's so, so hard that you wanted to, you know,
to focus on it? Yeah. I, I'd say there's at least two things. So first of all, anyone who gets cancer,
there's nobody who wants to get better more than someone with cancer. So you have a partner.
There's some things, you know, if you take care of people who have high blood pressure,
it, they don't realize anything until 20, 30 years later. So they don't take their medicine
and they don't do other things. When people are, have cancer, they'll come to you and they say,
doc, you know, you just tell me what to do. I'll change my diet. I'll change my lifestyle.
I'll do whatever it is. I just want to get better. I want to see my kids grow old or whatever it is.
So I was very struck by how great a partner you have in the patient with cancer. And then the
leukemia patient. So of all the cancers, leukemia is the only one where if, if a patient is diagnosed,
they get treated usually involves five or six weeks in the hospital. Okay. And so during that time,
if they're not taken care of properly, they can die from the effects of the treatment before they
have a chance to be cured of their cancer. So to me, it seemed like if you're a really good doctor,
you could keep people alive until they recovered from the treatment. And then you'd be curing more
people. And so that seemed very concrete. I realize now, you know, if you're a dermatologist,
and you have a patient who has terrible itching, okay, persistent itching, and so they can't
concentrate, they can't go to work, they can't do anything, that, if you can save that person's
itching, fix the itching, you can get them back to life. So you don't have to be a cancer doctor to
make a huge difference in people's lives. But at the time, it was a very dramatic thing.
Also, people didn't even talk about cancer. We had, I used to take care of people like
someone's parents or grandparents. They didn't want to tell them they had cancer.
Because it used to be they say, you know, he's going to give up hope, she's going to give up hope.
Please don't tell my mom she has cancer. And so that was part of the discussion back then.
So I think I like the challenge. Yeah. No. And obviously, what a noble challenge,
which obviously now brings me, you know, maybe fast forward a little bit. And, you know, again,
another conversation we had, you said, you know, now I'm in an administrative role, right? I don't
have that much time to take care of patients. So what, you know, you know, maybe, you know,
what were the steps, you know, that sort of led you to where you are today? And how has your role
had changed today? You know, your mission is obviously the same, you want to help people,
and you want to, you know, take hard challenges. But what is it, you know, what is it? How do you
see the world today in your role? And how do you see yourself having the biggest impact?
Yeah. So I would start by saying that when you take care of cancer patients or any patient,
it's one at a time, right? So you take care of one, then the next, then the next. If you teach
medical students and fellows how to take care of a patient, then they're all going off and they're
taking care of people one at a time, but you have a huge impact. So I'm very proud. I've been at
Sylvester since 2012. We've recruited a nice number, 305. We have 305 faculty so far that we've
recruited since I've been there. And they're all doing, they're working every day taking care of
thousands of patients. So I'm able to have an impact on what I do because I brought people here,
created a great collegial environment where teamwork is stressed, and where we're very patient-centric.
And so we can take care of people with amazing technology and therapies now. People are living
longer than ever before. So that's been my mission. My own career is great, and I'm not worried about
it. And I tell everybody, you never have to worry about me. I'm fine. I'm the head of the cancer
center. It's a great job. I love what I do. But it's also about bringing people here and creating an
environment for their careers, right? So the doctors and the researchers have to know they have all the
resources that you could get anywhere else. And that is so important to me. And so the transformation
also from taking care of leukemia patients to thinking about wellness has been something
the times have changed, right? Everyone's talking about wellness. More cancer survivors than ever
before. I think there's opportunities there for wellness in cancer survivors. And then just in
everybody. And as I get older, you know, I lost my parents. My dad died, I think, about 12 years ago,
and my mom about three. And for the first time, I realized it's possible that I'm going to die one
day. I didn't think that was possible. And so I'm very interested, you know, how do we stay healthy?
How do we prevent disease? And wellness, sorry, wellness in Miami, obviously, are very linked.
And obviously, we had a lot of conversations about cancer wellness and the role. So let's let's talk a
little bit because you have Dr. Crane that is working, you know, to develop a tremendous amount
of initiatives inside the institution. So how do you see that changing? And I know, since we met,
you got a whoop now, right? And now you're tracking, you know, your wearables. You know,
how do you see that the change has happened, especially the last couple years, and especially
within the, you know, the, the, the, the field of cancer? Yeah. So first, let me just say I have a
aura ring and a whoop and an Apple watch. Okay. Okay. And so I'm, I'm trying to get a little bit more
about the discrepancies of data that we see in that. Yes. So I think that having the data is,
is great. We have really committed people, like the people want to stay well. And no,
I said it earlier, if you've had a cancer diagnosis, there's a lot of anxiety and depression
that go along with that. You're worried cancer could come back. You want to do things.
We've never really had that much to say to people what to do. And so Tracy Crane and our lifestyle
medicine program, we're measuring things, we're, we're testing interventions. And that's the other
thing. Um, you know, I ride my bike with the Ulysses and, um, we're always talking about data
and, uh, you know, whether it be ketones or bicarb or whatever is what's the data to support these
things. Cause people do stuff in the hopes that it works. People don't do 10 things. Usually they,
maybe they do three. What if they pick the wrong three? And what if the other stuff is the better
stuff for them? So we like to study things in our cancer center and at the medical school so we can
advise people. You may think that taking creatine in the morning is the right time. Maybe that's not.
Maybe you need double the dose. How would you know that? And if millions of people are doing these things,
how can we understand? And obviously AI may help us in looking at all this data, but we've never before
had any data like this. We've not had these kinds of interventions. And so I think the key is to get
to empower people with knowledge and, and for us at the university to say, this is what the studies show.
Correct. And, and so what, what, uh, what are you seeing in this, you know, at least in the data that
you're, you're doing? So I, you know, as I was saying, Miami is a very interesting city for wellness
because generally speaking is known as a city where, you know, you know, people quote unquote
are happier. Uh, you know, obviously we live in, uh, we don't have that cold that you mentioned, uh,
here, uh, you know, people are very active. You know, there's a lot of fitness everywhere you go.
Um, you know, what are, what are the interventions that you see are working and,
and how do you see it? Cause obviously it's very different when someone is in the active treatment.
Um, and then what happens after the treatment, you know, maybe, you know, give us a little bit
of, of your view of, of how things might be changing. Sure. So, uh, what I, uh, like to say
sometimes is when I lived in New York, right, I was in New York shape. Okay. What does that mean? I
would say I'm fit enough to read a book. Okay. And then you come to Miami and you, you know,
I started road race, road biking and you get on a bike and you start talking to people like you or
others. And it turns out this one's doing triathlons and this one is doing the ultra race.
And this one's doing these things. People here are outdoors way different than in New York. It's
just completely different. Um, I lived in LA people were out, out in LA and pretty fit there.
But so people are, the level is very different. And first that's inspiring. We all get inspiration
from different people. Um, I'm told that sometimes I'm an inspiration just cause I ride my bike so
much and I'm getting old. Yeah. Okay. Well, you just shared 400 miles last month. Yeah. Yeah.
But, but so, but people inspire me. Um, you know, I ride with Craig Robbins and I have done that for
over a decade and, um, he gets stronger every year and I'm trying to figure that out. So it's possible
to do that. And, and so that's exciting. And so I, I think like even playing tennis, if you play with
someone better than you, you, you get better. If you play with people worse all the time, your game
deteriorates. And so I do think there's a competitive aspect of being in Miami and doing wellness.
Yeah. And one is fitness, fitness and wellness aren't exactly the same thing. Yeah. But, um,
it's like people look good and people want to know how well you look. Um, it doesn't,
it doesn't translate the same thing. Yeah. Because when you're young, you can look good and be doing
things that aren't so great. Uh, but I think that there's such interest in knowing what to do. Um,
and, uh, so for our cancer patients, you know, one of the things that's been a great experience and a
great partnership for us and for me has been the dolphins cancer challenge. Correct. And so, uh,
people used to ride and because they lost a, a family member or sometimes the family member was
in the middle of treatment and someone was riding. And then we started this program called Believe in
You and Believe in You is all about the patients. And so the first year we had 10 patients who participated
in the DCC who had cancer treatment. And then the next year 40, and then the next year 100,
and now this year 200 people that are actively participating. Um, I rode a hundred miles, uh,
two years ago with a guy who was in the middle of his radiation therapy. Wow. And he wrote a hundred
miles. And when you say that to another patient who's getting radiation therapy, they are like amazed,
right? It's, it's a role model. They see that they can do things that they had never dreamed of.
Let's talk a little bit more about the DCC because obviously, uh, I think that's how we met. Um, uh,
it's one of the most inspiring, uh, things I've done as, as a cyclist. Uh, um, I think I shared a
little bit, but I started cycling during COVID and really changed my life. I found a sport that I never
thought was a sport for me. Um, and then I started meeting amazing people, as you said, and, and then
that led me to DCC. DCC is, uh, is, uh, uh, I mean, I call it a race. We know it's not a race. This is
obviously a fundraiser and some people raise at the end, but, uh, it's, it's a really fun, um, event,
uh, that, uh, you ride up to a hundred miles and then you have all sorts of other, uh, you know,
lengths that you could ride. It's, it's a family event. Um, but more importantly, it's an inspiring event
where you get to celebrate, um, you know, the fight that those undergoing treatment, uh, have
to go through. Those are fighting for them. Uh, those are supporting them. My, my since actually,
I think since I started the DCC, both of my parents, uh, have gone through some type of cancer, um,
situation. Uh, so it's very inspiring. So tell us a little bit more about, um, you know, how big it's
gotten and, and, and the impact that it has and how the benefits the university. Great. So we,
in February, we had, uh, the 16th, uh, DCC. So I, it was my 14th. I missed the first two, uh,
but it was started because one of the Dolphins players, uh, Mad Dog Mandich had cancer that was
treated at Sylvester. And so he actually rode his bike, uh, in the first event and it's grown every
single year. So in February, 8,700 people participated. There's a 5k. So most of the
people do the 5k and, and don't get on a bike, but, um, there were over 400 people who rode the
100 miles and we raised 18 million dollars, which was the goal. Um, and so overall we've raised about
110 million dollars. So every dollar that's raised for the DCC goes directly to Sylvester
for cancer research, uh, and cancer care. Um, it's helped us transform from being,
I would, you know, when I got there, we were a local powerhouse and, uh, then we became NCI,
National Cancer Institute designated in 2019. And we're now a national powerhouse. We're actually a
destination for quite a number of cancers where people fly. I always like to say people fly from
Palo Alto to Miami to come and see our experts. So, um, it says something about what we've been
able to do. We partner with the Miami Dolphins. It raises a lot of awareness. Um, Tom Garfinkel and
Steve Ross have been amazing partners, Javier Sanchez, and it's just such a fun day. I love it.
Right. Yes. Yes. And, uh, and, you know, biking is like the new golf where you can hang out with
people for a couple hours. I think you get a better workout than playing golf. No. And I,
I even raised, uh, you know, capital, uh, just writing, uh, uh, I remember, uh, you know,
a couple of years ago, one in one of, uh, I think it was one of the actually training rights that, uh,
that, uh, that, uh, yeah, I met an investor and we raised some money there. Um, so,
so let's, you know, let's, let's, let's, let's talk a little bit more about cancer today, right?
Obviously it's, as you said, it's something that, that really makes people, you know, change their
perspective. Um, where are we, you know, where are we, uh, today? I mean, obviously there's a ton of
innovation happening, especially AI. We talk, I mean, AI now could do amazing things. Has it
moved the needle in cancer? Um, you know, uh, what makes you hopeful that we're getting closer to,
to, you know, something more concrete? Yeah. So first, some people talk about a cure for cancer,
and we need to talk about cures for cancer because each type of cancer is different.
There's not going to be one cure for all cancers, but we're getting much better at finding
treatments that are immunotherapy is curing people of previously incurable cancers.
In May was a, the ASCO meeting, the American Society of Clinical Oncology in Chicago. There's a great
video. I encourage you to watch the clip. They presented on a new drug from Revolution Medicine
for pancreas cancer. Okay. And in the audience is like 25,000 people. And the data was so impressive.
That the, the presenter, the doctor who presented got a standing ovation. Because this drug is going to
change the way pancreas cancer is treated. It more than doubled, it doubled the survival of all the
patients who got the drug. And they all got the drug with pretty advanced cancer. And so the hope is,
is that that will then be used in combination. There's a lot of cancers where we've been able
to get rid of chemotherapy. We treat with different, like, biological therapies. Right after that
presentation about pancreas cancer, there was a lung cancer presentation with some new drugs that are
more effective than the current drugs. So we're making great progress and quickly. The other thing
is AI. So AI is being used now to help design new drugs. So we know many of the targets, but we don't
have a drug that will target it sufficiently. And so we have things that may be partially
target something. And with AI, we can model how the structure is of the drug, change the structure,
and get it to be more effective. And so that's on the horizon. So and the other thing is, I think AI
is empowering people. So you don't have to know how to search the literature, the medical literature
and things. You can go to chat GTP, you can put in some questions. Doctors use open evidence a lot
for things. And you can get a lot of information that's useful, like, you know, what should I be doing?
Right? My mother has breast cancer at age 42. What should I do? And now AI will tell you a lot of
things to do. And then you can go to your doctor and say, you know, shouldn't I be doing these things?
Correct. So yeah, so let's let's talk a little bit about AI in some of these, you know, different
things that you mentioned. So first of all, on the on the pancreatic, you know,
presentation, what what? Because I mean, I think I would cover in one of the last episodes,
you know, pancreas is one of the things that scares me the most pancreatic cancers, right?
Because I've seen up close a number of situations where I think it's one of the most deadly, right?
It is the cancers. So what why does this one work? And I know that in some situations doesn't work for,
you know, when I remember, there's one there for the brain that overnight it cured the person. I think
it was immunotherapy that that it was very targeted, but it doesn't work for everybody, right? In this
particular one for cancer, what is it that worked? And what is it that made it so special? Okay, so
what we need to understand is the cancer grows, and it needs some source of fuel. What's the fuel for
the cancer? Usually the mutations in the cancer turn on a pathway that allows the cell to grow
uncontrollably. In pancreas cancer, 90% of the time, there's a mutation in a gene called RAS, R-A-S, okay?
And so this has been known for a long time. It's also common in lung cancers, too, and in other
cancers, but almost all pancreas cancer has this mutation in RAS. No one's been able to target that.
Now, in the last few years, there's some drugs that work to target it, but this is a pill that you take
that is targets, it's got a great name, Diracson Raxim, okay? It's easy to say.
And it's a pill. It's a pill, but it's an on, it's when RAS is on, which is the middle of the name of
the drug, it targets that. That turned out to be a game changer. People have been trying to target
this, now finally they have. At Sylvester, we set up a couple of institutes, okay? One, we have a
pancreas cancer research institute. We also have a brain tumor research institute. Why did we pick
those? Those are among the worst kind of cancers. You never want to have those, and so we want to
show to our community here that we're studying them. If you get these terrible cancers, well, these
aggressive cancers, yeah, let's call them terrible, that we're studying them, and we're going to have
the latest drugs. So the drug that's going to be FDA approved hopefully very soon is available, you
know, through clinical trials at Sylvester, and we're working on getting even more access to our patients
for these life-saving drugs, and so we want to take on the most difficult, but right now there's
over 18 million cancer survivors in the United States, which is five percent of the population.
Wow. There's never been that many people. There's never been such a good prognosis if you have cancer,
so instead of it being, quote, a death sentence, there's millions of people living with cancer that
were never that way before. Correct. So let's talk about, you know, we talked a little bit about AI.
Obviously, I'm in the AI space. I hear about all these frontier models, right? Now there's this whole,
you know, crisis going on because Fable, the model that Anthropic released, and then the US,
you know, now put an export restriction on, and obviously the fear of what these models could do in
cybersecurity and all that. You know, what's happening with the relationship of those
Anthropic and this company, this powerful model, and institutions such as yours? I mean,
you get access, because everybody says, I'll get access, you know, well, the people that are doing the cybersecurity,
I get access to these models before anybody else, so I could see how dangerous they are. Are they also
making them available to, you know, institutions such as yours? What's going on, sort of, you know,
that you could speak about? Right. I would say that we want to be, what, we want to utilize things,
but we want to also help innovate. And so we've spent a lot of time on our data sets to make sure we have
the best data to use with AI. Now, when we don't use proprietary AI, then there's issues of patient
security. Like, we can't release patient information, we don't want that out in the general public,
and our patients don't want their data shared with these companies. So it's been cautious,
and it's also been different people are at different stages. So in the cancer center, we have a group
that's involved in data science. Basilio Stathios is one of the people, and Stefan Schur, the other really
important people. And so we are curating our data, annotating our data, so that we can use our data to
discover things. People use ChatGTP, some people use Claude. I think we're all very cautious that we
can't put anything related to patients in any of these things. And so, and then we're trying to work
to improve our ability, you know, patient matching for clinical trials, figuring out clinical trials is a
big space. And, you know, right now, we have to compare treatment A to treatment B, sometimes it's
placebo to the treatment. And if we could really use AI to generate a control group, it's a virtual
control group, and get the FDA to approve that, that would be much better. The trials would go much faster,
the best drugs would get approved a lot quicker. And so we're doing things in that space.
No, it's definitely an exciting space. So let's go into sort of the, you know, the AI in, you know,
in the sort of human side, right? AI as a way to humanize, you know, you mentioned that your role
today is to educate and to have, you know, hundreds of doctors treating thousands. We had a doctor here
yesterday that spoke about that the doctor's role is education. And it's basically, you know,
not only educating others, but to treat other people, but also educating the patient. How do
you see the role in AI? You talked about chat GPT. Maybe we could play a little bit here. We always
try to bring some of the agents to demonstrate with people, you know, to people what the, you know,
our platform does. But I think, you know, one of the most interesting things for me has been
when you put voice, right? When actually the agents could speak to someone, right? Especially
someone that is going through that. How do you see sort of technology becoming more humanized for
some of these patients? Yeah. You know, I would, when you say that the doctor's role is to educate,
I would say the first role of the doctor is to listen. Okay. And that you have to really,
in my career as a cancer doctor, I understand these diseases. The disease is not the issue. The
issue is the patient. How is the disease impacting the patient? How are you going to know that unless
you ask questions and listen to the answers? So I think the first thing, and I alluded a little bit
to this, these four types of people. Yep. But you have to make, you have to educate the patient based
on who the patient is. If you say to 10 different people the same thing, you're, some of them it's
going to resonate and others it's going to be over their heads and some of them are going to get bored.
They're not even going to listen to the end of your sentence. So I think the education component
has to be matched with the patient and the patient's family. And what are the needs? What needs to be
said then? Sometimes not everything needs to be said at the beginning. The, like, if you're telling
someone they have cancer, usually they don't hear another thing. And so you're, you're explaining all
the details and they're just going in their head, oh my God, I have cancer. What am I going to do? I'm
going to die. I have cancer. And so sometimes you have to say things and say other things later. So
what AI has tremendous opportunities to be able to personalize some of the responses
in a way that if the patient doesn't like the way it's been personalized, they can work on it over time
and then figure things out and get a personalized response. And you know, I don't, the doctors
should be able to do that, but better than AI. But the fact is doctors are busy, this and that.
So AI has that opportunity to. Yeah. And even, even let's, let's see here a little bit.
Yeah. Maybe Bett-i, we've got Bett-i. But you know, so for, for those that haven't experienced this,
and obviously having you here, maybe we, we have, you know, some doctors that, that, that, that,
that listen to this, obviously, um, it's very powerful how human, uh, like, uh, this interactions
come from my, in my case, my dad would never be in GPT, but he talks to Bett-i every day. And I just
shared in a, in another episode, how she got him to actually start walking again. Okay. Um, because
she tracks his steps. So let's, let's, let's try to meet Bett-i here. See, we have a little chat here as
we wrap up. Hey, Demian, let's bring this session to a smooth close. Anything else on your mind
before we finish up? Oh, you know that we're finishing up. Oh, great. Uh, so Bett-i, I'm here
with Dr. Nymer, uh, from Sylvester. Um, can you research Sylvester, uh, Cancer Center in, in, in Miami?
Sure thing. Let me look up the Sylvester Cancer Center in Miami for you. Got it. The Sylvester
Comprehensive Cancer Center is the only NCI designated cancer center in South Florida,
offering top tier cancer diagnosis and treatment per the University of Miami health system.
Anything else you'd like to know about it? That's great. Well, that's good. Um, so, you know,
uh, we're talking here a lot about data and about wearables and, and, you know, uh, you know,
give us a little, you know, give me a little bit of a glimpse of me. I mean, you could share my data.
Uh, you know, uh, you know, what wearables do I track? Um, you know, what biomarkers do you have
for me? Um, you know, give me a little bit of a, uh, of a showcase of how you know me.
Let's dive into what I've got. You're tracking with an Apple watch,
or a ring and whoop band from your latest labs. Key biomarkers include things like Apple B,
LDL and vitamin D. Want me to give you a quick rundown of your current vitals or any specific data
point. Yeah. Yeah. Give me a little bit of a, of, well, don't share how bad I sleep, but yeah,
you could do it. You share, share, share my sleep patterns. You always trying to help me.
Let me pull up your sleep data from your wearables. One moment from your wearables.
Last night, you slept about five hours and 22 minutes with a good chunk of REM at around one
hour and 41 minutes. Deep sleep came in at about an hour and nine minutes. How do you feel about that
pattern? I should be getting more sleep, Dr. Daimler. What do you think? It's good REM,
good deep sleep, not enough overall sleep. How much total time in bed did Demian have? Are you
tracking that? How much total time do I have in bed? Absolutely. Last night, your total time in bed
was around seven hours and four minutes. Does that match how it felt to you? Yeah. Well, I was probably
coding, uh, for a little bit before I went to sleep. Uh, unfortunately, uh, let's talk a little
bit about my biomarkers. Um, you know, give me, um, you know, some of, uh, uh, well, don't talk about
my, my cardiovascular. She said vitamin D, vitamin D go, go, you know, talk about a little about my,
my, my, my sort of key biomarkers. Let me pull up your latest biomarkers. Now from your latest labs,
I've got your vitamin D level and a few fitness markers. Your vitamin D looks solid and your VO2 max
is around 41.5. Anything specific you'd like to explore deeper? Um, yeah, uh, just give me,
give me the top, you know, the top five that I need to improve. It looks like I don't have your
full biomarker set right now. Just a few fitness metrics. We can run a more complete panel if you'd
like. Want to dig into that together? No, that's good. That's good. That was, this is enough.
So thank you, Bett-i. You're, you rock. Uh, uh, I see you, I guess, later. We'll talk a little
bit about my sleep tonight. Anytime. Demian, we'll dive into your sleep next time. Take care and talk
soon. Yeah. Wow. Interesting. But, uh, very interesting, the dynamic when it, when it's voice,
um, I usually hear her Argentine accent. Okay. It's on point. You know, I have this thing that, uh,
uh, so what's interesting about Bett-i, uh, the app is you could choose any voice model,
right? The one that you like the best. So, and it's interesting. They all are trained different,
as you said. So open AI, you know, I, I believe like, I don't know how they train these models,
but like they, they probably train it in different parts of the world because they have like different,
especially when you get into accents, you know, different, uh, but it goes back to what I was trying
to say that connection of a, of a person to be able to talk to an AI that speaks in their own native
Spanish or native, whatever other language, you know, that, that really feels not like a generic
agent, but it feels like, you know, someone that would at least incentivize us to check in.
And then that would turn into potentially, you know, the type of motivation that could lead into,
you know, the lifestyle changes that we want. Yeah. There's a guy at, at Sylvester named Frank
Pinedo, Dr. Pinedo, and he does a lot of patient reported outcomes. So what's fascinating
when a patient comes, a cancer patient comes to see the doctor, they want to hear good news, right?
So they frequently don't tell the doctor all the side effects they're having because they know if they
say, you know, doc, I still have pain here. I still have this or that. It may mean the cancer
is still there or is not going away as quickly as it should. If they do, if they're asked a question
by the computer, they put all the data into the computer, they don't realize that that's then
going to go to the medical staff. So they'll say, oh, my pain is no, no better. I'm nauseated,
whatever. So patient reported outcomes are much more accurate than what the patients are willing
to tell the doctor. And I can tell you, it's happened more than a thousand times where the,
the, the guy, my patient says, doc, I'm doing great. And then the wife says, tell him about
your naps. And he goes, shh. He says, no, tell him that you take a three hour nap every afternoon.
And he says, please don't tell the doctor that. And then you get the real lowdown. And so the
wearables help, you know, what's really going on. And I think talking to Bett-i, you're, it sounds
like a nice relationship you have with Bett-i and that you'd be free to say real things to Bett-i that
you may not want to tell your doctor. Yeah. Yeah. No. And, and that's what we're seeing. That's what we,
we're very excited about, you know, where the future lies in, especially scaling the ability
of doctor to, to, to serve more people. Right. Um, so, um, well, Dr. Nimer, I know, uh, you know,
you're having a busy day. So thank you so much for, for joining us. Um, and I'll see you, you know,
out there on the roads. We're going to do, uh, some, some nice, uh, rides together. Um,
this has been great, Damon. I appreciate you taking the time and thank you for the opportunity
to share some thoughts. Thank you. So thank you. Another episode. Um, I'm going to talk to,
to Dr. Nimer here about, uh, uh, you know, every episode, we leave a little bit of a code
artifact that people could play with. I was playing with, uh, uh, well, I want to tell you,
I was a surprise. I was actually looking at all the funded research that came out of the DCC,
and I was trying to put a little knowledge base, um, you know, of, of, you know,
all the impact that that had in different treatments. So I'll, I'll play with it a little
bit more and maybe we could release it so people could actually, um, see, you know, see where,
you know, all this amazing effort that 16 years of the DCC have gone into, uh, you know,
funding amazing, uh, doctors and amazing researchers that are creating, uh, incredible,
um, uh, work to save people's lives. So thank you again. Um, and I'll see you in the next episode.