Dr. Victoria Maizes: Hi, Andy. Dr. Andrew Weil: Hi, Victoria. Dr. Victoria Maizes: Well, today we have the pleasure of speaking with David Quammen you introduced me to him via his books Spillover which is really quite prescient for the moment we find ourselves in. Dr. Andrew Weil: It certainly is. He writes about so zoonotic diseases that are diseases that jump from animals to people. He wrote a lot about Ebola and SARS and he talked a lot about coming pandemics, especially ones with Coronaviruses. Dr. Victoria Maizes: Well, I'm very much looking forward to hearing what he has to say about the moment we're in doubt, and what we can learn about it that actually relates to what we teach in integrative medicine. Dr. Andrew Weil: Well, I think especially the environmental ramifications of this because major point in the book is that the reasons that zoonotic diseases are becoming more frequent and more serious is entirely do the human causes. Dr. Victoria Maizes: Let's get David on Dr. Andrew Weil: Alright Intro Music Dr. Victoria Maizes: Well, it's my pleasure to introduce David Quammen. He's an author, a journalist, and his books include the song of the Dodo, The Reluctant Mr. Darwin, and particularly relevant to this moment in time Spillover, which is a work on the science, history and human impacts of emerging diseases. He's written essays and columns for magazines, including Harper's, National Geographic, Esquire, The Atlantic, and the Rolling Stone. And David has been called our greatest living chronicler of the natural world by the New York Times. Welcome, David. David Quammen: Thank you very much, Victoria. Thank you, Andy. Very good to be with you. Dr. Andrew Weil: I enjoyed your book very much. I learned a lot from it. David Quammen: Thank you, and thank you for using the word enjoyed, which I know is perhaps needs to go in scare quotes in this particular book, but still I love hearing it because I want it to be a book that is a page turner as well as simply informative. Dr. Andrew Weil: Yeah. Dr. Victoria Maizes: Well, I think you did a remarkable, a remarkable job. I want to be sure that our listeners know what we're talking about, because they may not yet have read Spillover. Maybe you could start by just explaining what are zoonotic diseases. David Quammen: Right. So Spillover is a book about zoonotic diseases. A zoonosis is an animal infection that's transmissible to humans. Could be a virus, could be a bacterium, anything that that is an infective microbe and if a, if a virus, for instance, is passed from a nonhuman animal into a, into a human causes disease and transmits, then we call that a zoonotic disease. And it's not a fringe, a subject out on the, on the edge of medicine. It's pretty central because at least 60% of our known infectious diseases in humans, fall into this category they are zoonotic diseases. And the other 40 in a looser sense, could be considered zoonotic too, because everything comes from somewhere. And we're a relatively young species. Dr. Victoria Maizes: Give us an example or several examples of recent zoonotic diseases that people will have heard about and perhaps gotten frightened by. David Quammen: Right. Well, some of the most infamous would include Ebola. Ebola is a virus, belongs to the Filoviridae group, and it comes out of animals in Central Africa, in West Africa, and gets into humans and causes terrible misery and death. Nipah virus in Malaysia emerged in 1998. We've all heard about the hantaviruses, particularly those of you in the Southwest because it was, in the four corners area of Arizona, New Mexico, when the Hantaviruses first emerged in 1992 coming out of a particular hantavirus coming out of rodents and getting into people and then killing at a very high rate. I'm going back a little farther. Bubonic plague is a zoonotic disease. The plagues of the 14th century by way of a lice and getting into people and, and causing mayhem. Even, even AIDS is a zoonotic disease in the sense that we now understand that, the pandemic strain of HIV, HIV 1 group M passed as originally chimpanzee virus, a Simian virus pass from a single chimpanzee into a single human in the Southeastern corner of Cameroon back around 1908 give or take a margin of error. And then it had this sort of secret history for decades, slowly transmitting from one human to another until it got to some of the big cities of the Congo River, and then from there to the world. So zoonotic diseases have and I haven't even mentioned influenza. Those are also zoonotic diseases, so there's a big footprint on human history and human health. Dr. Victoria Maizes: Expressing your concern about how these genetic diseases may actually become much, much more prevalent moving into the future. Do you want to introduce that for our listeners. Dr. Andrew Weil: Yes. Well, this is a, you know, limited addresses this, but it's very clear that the, the recent appearance of zoonotic diseases and their potential to get worse and affect people. This is human caused, and that there are many human activities that are contributing to the spillover of these diseases, from animals to humans, you know, among them, climate change, deforestation, agricultural practices, our eating habits, moving into the habitats that humans previously weren't in having closer contact with animals. I mean, there's so many factors like this. Also, I think a root problem is overpopulation and increased population density. That more and more people are living in crowded situations in cities. All of this favors the appearance of these diseases. David Quammen: I couldn't agree with him more. All those things, including the population size and the population density that he mentioned at the very end, I also would include, among the drivers of this, I think of there being three huge problems that we face on this, this planet. In terms of the way we live with the rest of the planet, the way we live with the natural world and the consequences for us. And those are climate change, the threat of pandemic disease, and loss of biological diversity. And they all, they, they converge at their causes. They all come from the same causes. And those are the causes that Andy just listed. Dr. Andrew Weil: Which of those can we do anything about? You know what? No, it's not at all clear given there's still a lot of people out there that deny the climate change exists. Many people that have no awareness that their choices affect, the potential for zoonotic diseases to appear. Which of these things is there a chance of modifying? David Quammen: That's a, that's a hard question. I think that, the beginning of the way to answer that question is to think about this horrible event that's happening to us now. Horrible for humans and horrible for, for economies, horrible for people who have to make a living every day. This pandemic, we have to think about it, a little bit oxymoronic only as, as an opportunity for major change as well as it is a great, a great tragedy, tragedy. And in the technical Greek sense because it's, it's results from our own choices. Dr. Andrew Weil: I hope it's a wakeup call and I hope it's a practice run that we begin to think about changing our ways. David Quammen: Yes. It's almost unimaginable to me that we could come out the far side of this and then not look back and say, “well, that was terrible we've got to do something different”. But even the people who tend to be deniers of science, deniers of climate change deniers of the, of the importance of loss of biological diversity, even just the inherent importance of that its almost unimaginable to me that after this, people could still be in denial on those points. Dr. Andrew Weil: However, I have to tell you one quick story. I grew up in Philadelphia in 1942 and my father's mother lived with us. She had lived through the 1918 flu pandemic and Philadelphia was the hardest hit city, and she told me stories of horse drawn carts of corpses going in the streets. That had a very powerful effect on my young mind and I tried to ask people about it and find information and nobody, there was nothing out there. This was like in the 1950’s it is astonishing to me. There was a general cultural repression of that event, that it was so horrific that people just stuffed it away. And it wasn't until relatively recently that scientists took any, what was that? Why did that act that way? You know, it was many years when I and people paid no attention to it. David Quammen: That's right. It was peculiar to me to, I mean, I grew up, I'm just a little bit younger than you. I grew up in the 50’s and the 60’s and you were never aware that there was this huge event in human history in American history, that that began in 1918 rather than ending in 1919. And then there were books like John Barry's very good book on, the, the pandemic of 1918, 1919 and a few other things. I'm not sure when I, when the light bulb went on for me, but there was a light bulb. It's like, what? And when I was first reading about it, they were saying 20 million people had died, and I was, what! 20 million people died from something I've never heard of. And now they're saying 50 million or more. And of course, it was tricky because nobody knew viruses existed until the 1930’s so this was a huge cataclysmic disaster caused by not just an invisible agent in the literal sense, but something that was sort of mystic seeming in those days. Dr. Andrew Weil: Now it was also before radio, so information did not get around as much. So things are different today and that we are all connected in this worldwide event. So maybe this will make it easier for people to think about. David Quammen: I hope so. I'm reading a book right now called The Rules of Contagion by smart young statistician I guess he would call himself named Adam Kucharski. And it's about it's about understanding how, not just how diseases pass from one human to another, but how ideas… Dr. Andrew Weil: Yea and emotions. David Quammen: Yes, emotions and, and some things that you would never expect to be contagious in fact, are contagious and are all the more contagious now with the great connectivity that we have. Dr. Andrew Weil: You talked to me before we started about my general thoughts on infectious disease. Dr. Andrew Weil: So to me, the most interesting fact is that it's possible to live in a balanced relationship with many of these organisms. Many people think that you get an infection because you're unlucky enough to cross the path of a “bad” microbe, but in fact, there are posters, there's that really influenced the way that microbes behave. One example of that, if you look at Helicobacter pylori, I know, which is so tightly associated with ulcers, stomach ulcers, there are many people walking around with, have that organism in their stomach who have no symptoms and no problems. So it's not just presence of the organism, it's that there's some change in the host that allows the organism to go on that destructive. David Quammen: Yeah, that's right. Dr. Andrew Weil: That's very interesting. Yeah. No, this is the reservoir host of many of these diseases. They live with them and don't suffer any harm from it. David Quammen: That's right. That's right. And the idea, yeah. I mean, people tend to think that, well, we want to, you know, we want to use antibiotics and every other tool we can to, to rid our bodies of microbes. Now people, of course, I'm sure you've done shows on this now, people are becoming aware of the microbiome. The fact that we are these complex ecosystems, that we've got more microbial cells in our bodies than we have human cells I think by a factor of somewhere between 3 and 10. And yeah. I'm sure you know more much more about this than I do, but Helicobacter pylori is now better understood, correct me if I'm wrong on this as something that you do not want to rid your body of that, even though it is associated with ulcers in middle aged people, it's also part of an ecosystem that keeps you healthy when you're younger. Am I roughly right? Dr. Andrew Weil: Yeah, that's right. And that's, that is, to me, a fascinating idea. Also, you know, all of these microorganisms have a place in, in ecology. You may think people think viruses are inherently bad. As with all microbes, it's only a small percentage that are pathogenic. Many of them are probably beneficial you're working with transmission of genes by viruses, and this is very important. We may have acquired many genes through, our contact with viruses. Even the viruses that look scary to us. They may have some place in the ecosystem and there is a potential for our living in a more balanced relationship with them. David Quammen: Yeah. Yeah, I agree. We're just beginning to scratch the surface of, of understanding, our relationships with, with viruses. and, and as you say, they, among other things, and I wrote about this in my more recent book, the Tangled Tree, viruses, some viruses become an endogenous retroviruses insert themselves into our genomes and stay there. The virus genome becomes part of our genome in some cases that has no apparent function, but in some cases, including some, some viral genomes that were inserted in the mammal lineage very early on they become crucial. Genes like, like a gene known as sensitin number two, which is absolutely essential to successful human pregnancy, creating a boundary between the placenta and the fetus. That stretch of our DNA is an endogenous retrovirus inserted sometime in the evolution of mammals by a virus that infected us. Dr. Andrew Weil: Fascinating. Dr. Andrew Weil: I often hear people say that it's in the interest of a pathogenic microbe evolved toward being less very long, that it's not in the interest of microbes to kill a high percentage of people. Diseases tend to settle down in your book and say that that's not necessarily what we observed. What do you think will happen with this virus? David Quammen: Very interesting question. Yes. First of all, that is, that is a common belief, sort of a folk belief with people who know a little bit about viral infections. So don't they evolve toward being, don't they sort of become tame? They evolve toward being less virulent over time. And the truth is that yes and no, depending on the case, some do, some don't. Some might involve evolve in the other direction. It depends on, you know, it's all the ABC’s of Darwin. It's evolution by natural selection. And, virus is, as they replicate, their populations contain genetic diversity. And so they're selected by the competition and whatever it happens to be the best tactic for success is what will be selected for what will be, fixed as an adaptation. And if that means being more virulent so that you send people to bed, more quickly, and they're shut, you know, they're shedding bodily fluids. They've got terrible diarrhea or vomiting or whatever, and that is spreading to their family members. That might be a successful strategy. That would be associated with high virulence. If they're walking around like we have with this virus, people who are infected and shedding virus and they're feeling no symptoms, they're these sort of cryptic, silent spreaders that can also be a very effective strategy for a virus. Now, this virus I've been, I've been reading the, the evolutionary biologists who are looking at this virus from different samples over different periods of time, different places they're building family trees of this virus. And one of the things they're saying is that this virus it's a Coronavirus, so it has a relatively high potential evolve ability, a relatively high mutation rate, not anything like influences, but relatively high, but it doesn't seem to be changing. It doesn't seem to be evolving. Why is that? Well, their speculation is because it's already so successful. It doesn't need to change. It's getting around the world lickety split. It's extending itself in space and time, which is what the Darwinian imperative is. Replicate and extend yourself in space and time. That's what natural selection, is working to produce is re reinforcing. Dr. Andrew Weil: And interesting case is poliomyelitis, you know, up until the mid 20th century. Most people that came into contact with that virus came into contact with it early in life and people were living in less hygienic conditions and early in life, getting that infection caused the diarrheal illness that was a minor consequence. You came into contact with that virus after the nervous system had matured and was fully myelinated, then there was a potential to get paralytic polio. So it was only when people were living in more hygienic conditions, and this was especially middle-class people and upper middle-class people in North America that there was no contact with the virus until kids got older. And then there were these epidemics of paralytic polio. Yeah. So that's another interest. Just an interesting look at that. Again, host factors determine the way a virus behaves. David Quammen: Yeah, absolutely. It makes me think of my mother's younger brother. My, one of my heroes, my uncle Greg, who was a pediatrician in Lacrosse, Wisconsin in the 50’s, and were, and there was a polio outbreak and he was working long hours to take care of these kids who had polio and he got polio. And, and he survived, but it paralyzed his throat and he couldn't swallow right for the rest of his life. Wonderful man. Anyway. But yes, that's a polio is very interesting. And the other thing that's interesting about polio is because is that it has been with us so long that like smallpox. It is not in the strict sense of zoonotic disease. It is a disease of humans only. So we have eradicated smallpox, and the reason we've, come close to eradicating polio is that it has no reservoir in nonhuman animals Dr. Andrew Weil: What's your take on the anti-vaxxers? I, this just completely astounds me David Quammen: Yes. Right. Well, I agree. I mean, the consequences of anti-vaxxer. A passion. Yeah. The consequences are great. I mean, are huge and horrible. the, on the other end, the motivations are hard to imagine except that there is this streak in the American character or the streak in the American population of, you know, rugged, individual, cowboy mentality ethic. Don’t tell me what to do. Rejection of experts, generally projection of science, somewhat more specifically, rejection of evolutionary biology in particular, and rejection of the idea of, of vaccines. It's a, it's not entirely unique to Americans, but boy, we certainly have more than our share of it. Dr. Andrew Weil: Yep David Quammen: With, with dire consequences. I mean, I'm, I'm also very interested in the case of measles, the story of measles. and I think that that's going to have some, applicability to our thinking about. What's going to happen with this virus, this corona virus? Dr. Victoria Maizes: One thing that struck me when I read Spillover, I mean, I think you were totally prescient because you talked about the good luck that humankind had in 2003 but you said it wasn't just good luck that we had speed and excellence of laboratory diagnostics, that we had brisk efficiency, that cases were isolated and contacts were traced and quarantines were instituted, and we also had a rigor of infection-controlled hospitals. But the other point is outbreak. Dr. Victoria Maizes: But the other point you mentioned was that that infection, unlike this one, people. Had symptoms before they shed the virus. So like you said, they were in bed, they were in hospitals and they weren't there for as likely to spread it widely. And yet this Coronavirus is the opposite. So how did that happen? That we have the same family, the same Coronavirus, but you immediately have shedding even during this asymptomatic period. David Quammen: Yeah. Well, it's a different virus. This is, this is the nightmare virus for the reason that you just mentioned, plus some other reasons. We don't know yet whether exposure to this virus and having had a case of it and surviving it, whether that's going to confer immunity. We all know that. We know that. Dr. Andrew Weil: I would say probably, David. David Quammen: I certainly hope you're right. Yeah. And, and I, and I take your point that, that most, most scientists and, and doctors expect that there will be some immunity because you, you know, the antibodies are there, you can measure antibodies, but we can't guarantee that. So how has this virus, why does it happen to be so, so much worse, so different? Well, this virus is only about, I think it's about 75% similar in genome to the SARS virus COVID- 1 this virus is 96%, similar to a bad virus that was discovered, five years ago. Among bats living in a cave and Yunan province discovered by a team that included, who's led by a woman named, Jung Li Shi at Institute of Virology. And she published in 2017 a paper warning about this virus that she had found. So now the, that the Corona virus that we have now is related to that. It's like a first cousin to the virus that she found and it's different enough in its genome that it has some different properties it, I think that it's been said to, affect, cells of the upper respiratory tract as well as the lower respiratory tract, whereas SARS 1 infected mostly the lower respiratory track. So that when people really had they were coughing desperately and spewing and, and dispersing this virus. And, and now it seems that before they start to cough, are dispersing this virus on their breath on a spoken word on an exhalation, possibly because the virus is, is occupying these cells much higher in the respiratory tract. This is, this is just sort of guesswork on my part based on some, some reading the science and the Ace two receptors that this virus attaches to. But, but those are certainly differences that you're not surprised to find in a Coronavirus that has a genome, only 75% identical to the original source. Dr. Victoria Maizes: So many people believe that the SARS COV 2 probably spilled over from a wet market in China. Can you talk about wet markets and bushmeat and what role those play in zoonotic diseases? David Quammen: Wet markets, quote unquote wet markets generally, the phrase is used for markets where there is a lot of fresh food on sale, ranging from vegetables through seafood, through meat of domestic animals, through live domestic animals, and on into wild animals. Wild animals bred in captivity. And then at the far extreme wild animals captured from the wild. And when you put all those things together in sort of wonderfully robust, chaotic situation under, you know, under a tin roof somewhere. Then you have, first of all, you have a resource for, for people who may be living in a city and they can get fresh food. But on the other hand, you have an absolutely ideal situation for mixing viruses from one species to another. And I've seen some of these wet markets, in Africa, as well as in China. And you may see, captive, wild birds of all sorts in cages for sale, not just as pets, but for food. You can see reptiles, snakes, turtles, tortoises, frogs, toads, mammals of various sorts, wild mammals, civics, pangolins, bamboo rats, bats. When I was in China researching my book, it was one of the periods when Chinese regulations had suppressed the trade in wild animals. So what I saw included much of what I just mentioned, but it did not include wild mammals like bats and pangolins. Dr. Andrew Weil: David, one of the things I learned from your book that I didn't know was that the Chinese preference for eating wild exotic animals is a recent phenomenon that this was among wealthy Chinese and it became a status symbol to be eating this that's not a cultural vendor. David Quammen: It's called the era of wild flavor or “ye wei”. There is some difference of opinion on it there. Some people were still saying, well, this is an ancient cultural practice. We shouldn't criticize it. But there are others who say, including, a young colleague of mine named Wo Fe Yu. Wo Fe Yu Chinese journalists now working in the US and he did an op-ed for the New York times or a couple of months ago, and he looked at that and he found he went to the old texts and Chinese, the things that people were literally saying, Oh, this is an ancient tradition. And he found evidence in those old texts that no, even the old sages were saying, don't eat wild food. You're going to get sick. Don’t eat wild animals. Dr. Victoria Maizes: Was there some use of at least parts of those animals for medicinal purposes. Cause that's something I've always heard about traditional Chinese herbal remedies that they sometimes use some very unusual animal parts for health promotion. David Quammen: Absolutely. That's right, Victoria. And that range is, I'm not an expert on this, but that range is from tiger parts and bear parts to, to pangolin scales. There's a huge illegal, global trade in, in these poor, magnificent animals. Pangolin sometimes known as spiny ant eaters. You know, they look like a cross between an Armadillo and the anteater. But they are unique. They're unique family. I think there are eight species that they believe they're all threatened or endangered seminar. Africa semination a lot of them wind up in these wet markets in China. They are prized not just for their meats, but also for these scales, the scales that they carry which are used in traditional medicine. Dr. Andrew Weil: I was at a wet market in Guangzhou let’s see 25 years ago. It was pretty horrifying. There was a bear carcass that was mostly stripped and there was a Chinese man who was taking around with a big grin set to me we eat, everything four legs except the table. David Quammen: It's interesting because Guangzhou, Southern China, where this is particularly profession, Guangzhou was where I was, when I was doing my research, also, city of Guangzhou, city of Guilin, and a one Chinese colleague of the scientists I was traveling with, who was Southern Chinese himself. As we were looking at these birds that were on sale and bats that or on sale he said to me, we in Southern China, we eat everything that flies except an airplane. Dr. Victoria Maizes: I want to get back to something that you said a little while ago, Andy, and that's a people's lack of awareness about what they eat and how that potentially increases our risk of zoonotic diseases. Dr. Andrew Weil: Well, I think, the, our dependence on animal foods is a major factor in climate change, in destruction of soils, in bringing us in contact with animals in a way that facilitate these spillovers of zoonotic diseases to humans. So that's an area where we do have choice and maybe, you know, that's one we could work with. I don't tell people to become complete vegetarians or vegans, but I think we could get started by reducing the amount of animal foods in the diet, that would be a big step in the right direction. David Quammen: Yeah, yeah. I agree with that. Absolutely. And, And the conditions. And I mean, I'm not, I'm not a vegetarian. I aspire to becoming more vegetarian every week, and I'm working on, but that's still aspirational. But I, I recognize the importance of eating less and less meat. And also eating less and less meat produced in industrial scale factory farming situations, which carry some of their own risks and impacts, you mentioned some Andy, but, but the spillover of zoonotic diseases is one of them. In some of these cases that I write about in my book, situations of factory scale, industrial scale, animal husbandry have contributed to the passage of viruses from wild animals into humans. Advertisement: Body of Wonder is brought to by AWCIM + Covid-19 Dr. Victoria Maizes: David, you mentioned that you're not a vegetarian, that you do eat meat. And Andy, you said that you suggest that people eat less meat, but don't suggest they necessarily become vegetarian or vegan. Can you tell our listeners what you think the healthiest meat would be to eat at this moment in history? David Quammen: Wow. Dr. Andrew Weil: Oh, that's hard. I think we'd argue about what the best meat is I mean maybe wild game, but their pros and cons about that, but I think I feel fairly certain that the worst meat that people can eat as beef. Because I think that the ways that we're raising cows for food has a much more devastating environmental impact in terms of climate change of destruction of soil pollution of water and then bringing animals and people in contact in a ways that probably facilitate the these development of these new diseases. David Quammen: Wild game is the game is also complex, Andy, because. I mean, and this is something I'm asked about, you know, bushmeat when you hear the term bushmeat and bushmeat usually is applied to, wild animals eaten by people in African villages and those might be, those might be monkeys. They might be chimpanzees, they might be forest antelope. They might be porcupines. But it has an sort of a negative onus to it while a bushmeat. I live in Montana. My friends go out, shoot a deer, shoot an elk in the fall, we don't call that bushmeat. We call that game, and it has sort of a positive, robust onus to it, but still it's, it's eating wild animals. The ecosystem of Montana isn't anywhere near as biologically diverse is the ecosystem in a central African forest. And maybe that partly accounts for the fact that there are no known zoonotic pathogens that we're sure that you can get from the wild meat that is available in Montana. Except now we're worrying about chronic wasting disease, which is a prion disease, not known to be transmissible to humans, but, it has made me suspicious of, of deer and elk meat in Montana because I've read enough about prions to know that I don't want that. David Quammen: I would agree with that too. And you know, we have, we haven't entirely stopped being, beef feeders, but we eat very little beef occasionally when we can get it, meat that I think highly of if you're going to eat meat or red meat, is, is bison, bison farmed, in a, you know, in a, in a wild ranch pasture situation. Dr. Victoria Maizes: So for people who do want to become less dependent on meat and more plant focused on their diet, do you have any suggestions about how to make that transition. Dr. Andrew Weil: Well, I would say By getting familiar with the range of plant proteins out there. There's an enormous variety of soy products, not refined and manipulate things like tempeh, for example. That's the first thing I would say is to find out what else is out there, and then rather than having meat be the centerpiece of meal that, an occasional food and that you don’t need and have that as the course. I became a first lacto-vegetarian in the 1970s and I would serve meals to people and everybody looking around waiting for the main course. So that's what people need to unlearn that habit. David Quammen: Let me add to that, because I'm in the midst of this journey and I think about this all the time with some, with some guilt but, as I say, I'm, you know, I'm not a full vegetarian now, but I would say that, for any of those of us who are in the midst of this journey, and we know which direction we want to move in, and we should move in, which is a way from meat, first of all, don't wait for factory farmed pseudo-meat. Dr. Andrew Weil: Right. David Quammen: That's not the answer. Just, just think about other tastes and I would say two other steps. Get yourself a really good vegetarian cookbook. With spicy, interesting recipes and, and get a good bottle of wine. Dr. Victoria Maizes: I have two more suggestions. You mentioned contagion earlier. So one contagious idea in the United States is Meatless Mondays, and that can perhaps be a new habit that people form, and another that's been popular is Vegan Before Six and we know that in both of those, the environmental benefit of just reducing that amount of meat consumption is actually substantial for the planet. David Quammen: Yeah. Yep. Absolutely. I agree. I agree. Dr. Andrew Weil: So that's why Victoria, I tell people rather than tell people to become vegetarians, to do things in small steps, any steps in that direction are helpful. David Quammen: Yeah. You know what, I think about this too, in, in sort of a practical way, and I hope it's not a smart Alec way. this is, this is related to my suggestion about get a good cookbook. I admire Paul McCartney in 10 different ways, but I know that it would be easier for me to be a vegetarian if I had his personal chef. If he would loan me his personal chef three or four days a week. I promise I would be vegetarian those days. Dr. Victoria Maizes: Yes, I agree. I've had the lovely experience of sometimes going to health resorts that serve three delicious vegetarian meals a day, and it's easy there. David Quammen: Andy, tell me, tell me more about your thinking about the human ecosystem, the microbiome, and the way that the choices that we make in the course of a day or the course of a year affect that and in turn affect the prospects of our health. Dr. Andrew Weil: Well, you know, the microbiome. This is really one of the great revolutions in medical thinking that's happened. When I was in medical school. I was taught that we had these organisms in our gut that they help with digestion. And that was about it. And the people that took, I ate yogurt or took acid offload supplements were considered health and to see the change in thinking that's coming come up. It's just amazing thing that it turns out, as you said, we have more microbial DNA in us than human DNA. Clearly, we're hybrid organisms and also the microbiome appears to be the, the major determinant of our interactions with the environment. And probably also the brain has a great deal to do with our resistance to infection and the way that potentially pathogenic germs behave if they get into us it is also clear that the more diversity you have in your microbiome and that this is has a lot to do with how you eat, and that the more, you know, the tendency in our population to be eating more and more refined and processed factory that food is one of the factors that's changed for the microbiome, for the worst the other is use of antibiotics, they wreak havoc with the microbiome and the gut. And I, you know, I still, although there's been a positive change in how they're used, I still think in great many instances, they're used as unnecessary and the way they agriculture continues to be a real problem. So you know, those, those factors and other one, two other factors in our population, I think have really sabotaged the microbiome, which are less obvious. One is the incredible rise in cesarean deliveries. Do you know that now, one in three births in this country is on cesarean. And most of that is not for medical reasons. It's for convenience of doctor. We're patient. And when the baby is born vaginally, the organisms colonize the gut come from the birth canal. When a baby is born by, C-section. The organisms that come from the mother's skin have totally different population. So you know, when you look at that in combination with the change in eating, antibiotic use, and the other one is the client of breastfeeding, which contributes greatly to the breast milk contributes to the development of the organisms you want in that microbiome. Our microbiomes as a really suffer in this population, and that's something we need to address. Dr. Victoria Maizes: Another exciting thing about the microbiome is that it's introducing new therapies that would have been unimaginable. A fecal transplant as a way to perhaps cure diseases ranging from maybe more obvious like bowel diseases, inflammatory bowel disease to depression, much less obvious. David Quammen: Yeah. And fecal transplant. I mean, it's, it's a, as I understand it, it's a very, very specific, very informed, very targeted sort of microbiome therapy. And even though it has sort of an unsavory name, it makes to me a whole lot more sense than the idea that if you have problems with your digestion, you can go to your local organic co-op store and buy some container of acidophilus milk off the shelf and that's going to fix your, your particular ecosystem. David Quammen: To follow on from that. You mentioned going to medical school. When did you go to medical school? Dr. Andrew Weil: I graduated in 1968. So 64 to 68. David Quammen: it's my impression I've never been anywhere near medical school. It's my impression, and I keep asking about this. Yeah. That's, The Darwin is not taught in medical school. It seems to me that that is a glaring mistake. What is your thought? Dr. Andrew Weil: Yeah. I think that the whole, perspective of evolutionary biology on health and medicine is just, is fascinating. And, there's a lot of insights to be gained there. What are you working on now, David? What's your next project? David Quammen: Well, I'm just finishing a piece related to Covid-19 for the new Yorker. That'll be out next week. and my larger project, I was working on a book, was an I’ll explain that that on, for Simon and Schuster on evolution. And cancer on cancer has an evolutionary phenomenon. The whole field of cancer, evolutionary biology, which is, which is little known except with a relatively small group of researchers. But it's been fascinating to me for a dozen years. and it's an important perspective on cancer. But in the last month, Simon and Schuster, and as recently as February, I spent a month in Tasmania doing research on the Tasmanian devil, which is a carnivore marsupial carnivore, that is, that is dying off from a genuinely contagious cancer and infectious form of cancer. And that's, at one end of the spectrum of strange phenomenon that are related to the evolutionary potential of tumor population, tumor cell populations, but Simon and Schuster has asked me “for the love of God, would you please push that book to the back of the desk and do a book for us on Covid-19” so it's, I generally, my operating principle has been right about things that other people are not writing about that doesn't, it doesn't apply in this situation every publisher in New York is going to have a Covid-19 book, but Simon and Schuster has asking me to do there. David Quammen: And of course, it's, it's important for us to know about the origins because knowing about the origins of this pandemic is necessary to help us prevent the next one. Dr. Victoria Maizes: Yes. Well, thank you so much, David, for taking this time to talk with us. It's been fascinating. I feel like I've learned so much from you over the course of the last 45 minutes. Well, it's a pleasure for me. Pleasure to interact with you and to interact with Andy and to learn some things from Andy, which, which I certainly have. Dr. Victoria Maizes: Well, let's stay connected and good luck with your new book David Quammen: Thank you very much. Thank you. All right. Take care. Outro Music Advertisement: My Wellness App