第369期：阿西姆·马尔霍特拉博士

2003年，我获得了一个为期六个月的职位，在伦敦一家教学医院从事内分泌学和神经病学工作。

In 2003, I had a job, a placement for six months in one of the London teaching hospitals doing endocrinology and neurology.

正如你所知，每周总会有一些教育活动，大家会一起去吃午饭。

And as you know, you know, there's always some kind of weekly education session, and you go for lunch.

顺便说一句，这些活动经常由制药行业赞助。

Often, by the way, sponsored by the drug industry.

对吧？

Right?

制药行业

And drug industry

几乎总是会给你

almost always give you

一场讲座。

a talk.

当时有个叫雷蒙德·麦卡利斯特的人。

And there was this guy called Raymond McAllister.

他在伦敦大学学院，是一名临床药理学家，资历很深。

He was at UCL, clinical pharmacologist, very senior guy.

他上台做了一场演讲，彻底震撼了我，基本上揭示了制药行业很多行为本质上是欺诈性的。

And he gets up and he gives this talk, and it blew my mind, basically showing how the drug industry, a lot of what they do is is essentially fraudulent.

他们在营销上的花费是研发的两倍。

They spend twice as much on marketing than they do in research and stuff.

第一次听完后，我心想：哇。

And after the first time, I was like, wow.

这位先生可是位很有名望的人物。

And this guy was, like, a a prominent guy.

他看起来有点心灰意冷。

And he looked a bit jaded.

他似乎也经历过制药行业的反噬，但那一刻我意识到，这让我开始更多地质疑一些事情。

It looked like he'd you know, he probably had his own backlash from the drug industry as well, but I was like, this completely then started, you know, help I started questioning things a little bit more.

所以，我认为这件事一直在我脑海中挥之不去。

So that's where I think that stayed in the back of my mind.

我继续前行，显然后来我专攻心脏病学，特别是介入心脏病学。

I carry on, obviously, then I specialize in in cardiology and and specifically interventional cardiology.

在心脏病学内部，也存在层级之分。

So within cardiology, there's also hierarchy.

介入治疗指的是放置支架、处理急性心肌梗死等操作。

An intervention was doing things as stents, acute heart attacks.

我喜欢成为那个做这些事的人，我非常热爱这份工作，并且做了很多年。

I like the idea of being that person doing that, and I loved it, and I did it for many, many years.

所以，我想这就是当我开始走上这条道路时的情况，我想我在纪录片里也提到过。

So that's, I think, where when I started down that track around, I think and I mentioned this in the documentary.

我首先意识到肥胖流行这一问题的存在，却几乎没有人去应对它。

I think the first thing was I was becoming conscious of the obesity epidemic and it being an issue, and no one really tackling it.

我试图理解为什么这种情况没有发生。

And I was trying to understand why that wasn't happening.

我父亲对公共卫生有着极大的兴趣。

My dad had a very big interest in public in interest in public health.

他其实是一位多产的作家。

He actually he was a prolific writer.

非常多产。

Prolific.

他为《卫报》写过文章，就是那个《卫报》报纸。

He wrote for Guardian, like, you know, Guardian newspaper.

你懂的？

You know?

顺便提一下，为了给你一些背景，因为他确实对我产生了影响。

And he was considered by the way, just to give a background as well because he did have an influence me.

在他去世前的最后三十年里，他被认为是捍卫国民医疗服务体系（NHS）价值观——优质、普惠、全民免费医疗——最杰出的医生。

He was considered in the last three decades before his passing, the most prominent doctor, who was, defending NHS values, good quality, universal, free health care for all.

对吧？

Right?

而英国工党——相当于这里的民主党——授予了他‘年度国家医生’奖项。

And the Labour Party, which is the equivalent of the Democratic Party here, gave him the national doctor of the year award.

我记得去现场看他领奖。

I remember going to see him get that.

对吧？

Right?

所以他写了这么多文章，但他还写了一篇，我后来偶然看到了。

So he was writing all these articles, but he wrote an article, which I actually came across later on.

他没告诉我这件事。

He didn't tell me about it.

那篇文章大概说的是2011年左右的事。

That basically saying I think it was, like, 2011 or something.

他说我们需要对垃圾食品征税，以解决肥胖问题。

He said that we need to attach junk food to to to solve the obesity epidemic.

他确实关注公共健康。

So he had a public health interest.

而且，他和我们家人关系也很亲密，因为他热爱运动，16岁时就教我做饭。

And, also, with with us as well as a family, because he was also sporty, he taught me to cook when I was 16.

我其实就像你描述的那种美食爱好者。

I was actually some someone you described as a foodie.

我喜欢做饭。

Like, I liked cooking.

你知道的，自从16岁上大学以来，我几乎每天都做饭，大部分日子都是如此。

Like, I was you know, I cook almost every day, most days of my life since I was 16 years old in university, etcetera.

所以我对好食物有自己的热情，同时我在医院值夜班和轮班。

So I had my own passion about good food, and I was working in the hospital doing all these late shifts and on calls.

我发现，就连给工作人员提供的食物都糟糕透顶。

And I was like, the food that we're that that even for the staff is terrible.

所以我就想，这到底是怎么回事？

So there was a bit of, like, what the hell?

对吧？

Right?

你再看看工作人员，你知道吗？有50%的人超重或肥胖——这其实是真实的数据。

And you also look at the staff and, you know, 50% and this is actually true data of of fifty percent of NHS staff are overweight or obese.

这个数据至今仍然存在。

That's still a statistic that's there.

现在可能更高了。

It's probably higher now.

我心想，等一下。

And I thought, hold on a minute.

我们必须从自己身边做起。

We have to we have to start in our own backyard.

所以2011年，我给杰米·奥利弗写了信，说：不好意思。

So the 2011, I wrote to Jamie Oliver, and I said, you know, sorry.

其实是2010年。

Actually, 2000 and 2010, actually.

我给杰米·奥利弗写了信，突然之间，我知道你一直致力于改善学校餐饮，作为名人厨师你做了很多工作。

I wrote to Jamie Oliver, and I I out of the blue, you know, I love what you've been doing on, you know, the celebrity chef, what you've been doing on trying to improve school food.

我们能不能也改善一下医院的餐饮呢？

Can we do something about hospital food as well?

我没指望会得到回复。

I didn't expect a reply.

六周后，他的助理回复说，来见见他之类的。

Six weeks later, his PA replies, come and meet him, etcetera.

但当时在饮食方面，确实有这样一个因素。

But the so there was that element, like, on the food side.

但大约在同一时间，我想是2012年，《英国医学杂志》的主编菲奥娜·戈德利和她的同事们发表了一篇题为《过度医疗》的文章。

But around the same time, I think 2012, the BMJ lead editor on the BMJ by Fiona Godley and and colleagues, basically, it was called too much medicine.

我开始阅读这些关于社会过度用药的文章。

And I started reading these articles about how there was an overmedicated society.

我也将这一观点应用到自己对服用他汀类药物患者的观察中。

I was also applying it to my own experience with patients on statins.

他汀类药物是一种非常普遍开处方的药物，你知道的，我的许多心脏病患者都在服用他汀。

So statins are very well prescribed drug, as you know, and a lot of my cardiac patients were on statins.

我观察并诊断，因为我认真倾听患者的意见，这一点也很重要。

And I was seeing and diagnosing because I listened to my patients because this is also important.

对吧？

Right?

你知道，我做的每一件事，Tro，Brian，都深受我与患者接触的影响，甚至可以说全部都源于此。

You you know, everything I do, Tro, Brian, is very much inspired and influenced, if not all of it, from my own patient contact.

但我的主要动机是成为最好的医生，这意味着要成为一位善于与患者沟通、认真倾听患者的人，等等。

And but with the primary motive to be the best doctor I can be, which also means being good communicator with your patients and listening to your patients, etcetera.

因此，我为此感到自豪，然后我试图将这种理念从诊室扩展出去，去解释整个医疗系统中正在发生的事情。

So I pride myself on that, and then I I try and expand that out from the consultation room to try and explain what's going on in the rest of the system.

我发现这些患者出现了很多副作用。

And what I found was these patients getting a lot of side effects.

我说，这说不通，因为我诊断出这种情况、让他们停药后症状改善的频率，远高于期刊上发表的数据。

I said, this doesn't make any sense because the frequency that I'm diagnosing it and getting them off the stand and things get better is way higher than what's being published in the journals.

当我读到《过度医疗》那篇文章时，我恍然大悟。

And then when I read the Too Much Medicine piece, I was like, ah, okay.

原来不只我一个人这么想。

This it's not just me thinking this.

这里还有别的事情在发生。

There's something else going on here.

这让我开启了一段旅程。

So that then started me on a journey.

最后，关于这部分对话，我遇到的一件事——你知道的，有一份教育资料让我大受震撼，让我惊呼：天哪。

And then one of the things that you know, just to finish on this this part of the of of the conversation, one of the things I came across, one of the educational pieces I came across that really blew my mind and made me think, oh my god.

我发现，我们很多药片的实际效果并没有我们想象的那么好，当时我偶然发现了一个网站，虽然记不清是谁发给我的了，叫 nnt.com。

We a lot of these pills are not as effective as we think they are, was coming across a website, and I can't remember who sent it to me, called the nnt.com.

所以每个人都可以去查一下，因为它是免费在线的。

So everyone can look this up because it's free online.

你可以看到它。

You can see it.

nnt，numbersneedtotreat，.com。

The nnt,numbersneedtotreat,.com.

这是一个由独立医生进行独立评估的网站。

And it's an independently evaluated, you know, done by independent doctors.

我认为这些内容都发表在美国某本家庭医学期刊上，经过了同行评审。

It all all gets published, I think, through one of the family physician journals in the in America peer reviewed.

他们分析了各种药物，比如降压药、二型糖尿病药物、他汀类药物等，基于行业资助的临床试验，拆解出每种药物的实际个体获益——即绝对风险降低值。

And they look at, all these drugs, you know, high blood for blood for blood pressure pills, type two diabetes, statins, etcetera, and they break down from industry sponsored trials what the actual individual benefit is, the absolute risk reduction.

当我读到这些数据，发现他汀类药物在五年内预防心血管事件的获益仅有1%，而且并不能延长寿命时，我震惊了。

And when I read that when I found that statins only have a one percent benefit, for example, in preventing a, you know, a cardiovascular event over five years without prolonging your life.

我心想，哇。

I was like, wow.

我们有必要告诉患者这些信息。

Why you know, we need to tell our patients this.

我们必须这么做，这真的是一条非常重要的信息。

We need to and we you know, this this is really important information.

我来分享一个例子：我当时在哈里菲尔德医院工作，这是英国顶尖的教学医院，拥有全国最快的心脏病急救治疗时间。

And and this and one anecdote, I'll tell you, I was now working in Harefield Hospital, which is, the premier teaching hospital with the fastest heart attack teaching treatment times in the country of The UK.

我作为住院医师在那里工作，做了大量手术，我们医院的心脏病治疗时间是全国最快的，平均称为‘进门到球囊扩张’时间。

I was a registrar working there, doing all these procedures, you know, and and we had the the fastest time where we would treat heart attacks, the average treatment time called door to balloon time.

所以当病人通过救护车被送到医院，我们实际在冠状动脉内扩张球囊以疏通堵塞时，平均耗时仅为二十分钟。

So when the patient comes in through the door of the hospital with the ambulance to us actually inflating a balloon in the coronary artery to open up the blockage, the average time was twenty minutes.

对吧？

Right?

我可不是在自吹自擂。

I'm not blowing my own trumpet here.

这其中很多是运气，但作为一名住院医师，我通过桡动脉完成的最快一次手术只用了十一次分钟。

A lot of it's luck, and then but I one of my fastest time through a radial artery as a registrar was eleven minutes.

对吧？

Right?

这些是我经常做的事情。

So these are things I was doing regularly.

而且你要记住，这些医生都是在完成研究生考试后脱颖而出的，堪称医学界的精英中的精英。

I And thought and and and you gotta remember, these are the guys who have done really when they're postgraduate examinations, you know, supposed to be the cream of the cream in medicine.

我记得当时看到关于用支架治疗急性心肌梗死的NNT数据，为了挽救一条生命需要治疗的人数是40。

And I remember coming across the NNT on treatment of acute heart attacks with a stent and the numbers you treat with for for saving a life, and it was 40.

对吧？

Right?

你必须对四十名患有急性ST段抬高型心肌梗死的患者进行治疗，才能挽救一条生命。

You have to treat forty people having an acute ST elevation and myocardial infarct of of you know, to for one, to benefit in terms of being life saving.

当然，还有其他好处，比如缓解疼痛。

Of course, there are other benefits, relieving pain.

我们还在做其他所有事情，比如阿司匹林之类的。

We're doing all the other things, you know, aspirin, whatever else.

对吧？

Right?

但这个手术本身让我惊叹，哇。

But that actual procedure and it made me think, wow.

这之所以重要，是因为我经常看到我的同事和一些专家在手术不顺利时非常生气，而他们其实应该让患者静养。

And why that's important is I would see my colleagues and some of the consultants getting really angry if if a procedure wasn't going really well, where they should just leave the patient alone.

他们会没事的。

They're gonna be fine.

你知道，完美是好的敌人。

You know, perfection is the enemy of good.

你不需要非得沿着高度钙化的冠状动脉一路到底，那样可能会引发并发症。

You don't have to, like, go all the way down the coronary artery, which is heavily calcified and and potentially cause a complication.

我们就让事情保持原样吧。

Let's just leave things be.

当你有了这种理解，就会让你更有视角，稍微好一点。

When you have that understanding, it just makes you a little bit more gives you better perspective.

我记得曾告诉一位同事，他是个非常聪明的人，另一位住院医师，我说：你知道需要治疗的人数是多少吗？

And I remember telling one of my colleagues, really smart guy, another registrar, when I said, man, do you know what the numbers need to treat is?

他一开始并不相信我。

And and he didn't believe me initially.

我说，听好了。

I said, listen.

去查一下这个网站。

Go look at this website.

接下来几天，他的表情我只能形容为沮丧至极。

And I you, for the next few days, he had this face that I can only describe as being crestfallen.

他简直震惊了。

Like, he was just shocked.

他甚至不知道自己受训去做的这件事竟然是这样的。

He didn't even know this of something that he was trained to do.

但你知道，我觉得当我把这些全部串联起来时，它让我开始重新塑造我对医学的主张。

But he was you know, I'm just so so I think for me, when you pull that all together, it then made me sort of shape my advocacy on on on on medicine.

但同时，当我开始独立研究营养科学时，我也意识到，患者并没有得到正确的信息。

But, also, I was when I started looking at the nutrition science as well independently, I also realized that, you know, patients weren't get being given the right, you know, the right information.

有太多东西可以聊了，特洛伊。

There was a I mean, there's so much to talk about, Troy.

你知道的。

You know this.

但我深入研究了胆固醇假说，发现高胆固醇本身其实并不是心脏病的重要风险因素。

But, you know, I I did a deep dive into the cholesterol hypothesis, realized that high cholesterol in its own right is actually not a significant risk factor for heart disease.

如果你尝试对甘油三酯和HDL进行校正，你甚至可以说它根本不是一个风险因素，然后你会发现，这一切都源于商业对信息的操纵以及随之而来的洗脑。

You could argue it isn't a risk factor at all once you try correct correct for triglycerides and HDL, and then realize that, you know, everything rooted in commercial corruption of the information and an indoctrination that went with that.

那么，我们该如何解开这个谜团呢？

So then it was like, how do we unpick this?

我们该如何改变现状，真正改善患者的预后？

How do we change things to actually improve patient outcomes?

当然，我已经这样做了十多年了。

And I've, of course, I've been doing that now for, you know, probably for over a decade.

而现在你正在

And now you're

关注绝对风险和相对风险，开始看清他们是如何篡改数据时，你会惊呼：天哪。

looking at absolute risk, relative risk, and you start looking at how they fudge the numbers and you go, oh my gosh.

当你真正理解了这些，你会说：哇。

Like, how like, when you understand it, you say, wow.

这真的有帮助吗？

Is that helping?

因为这和他们在医学中所做的事情是一样的。

Because it's it's the same thing that they're do what they do in medicine.

比如，你肥胖、患有糖尿病。

Like, you're you're obese, diabetic.

你有这么多健康问题。

You have all these health problems.

他们只是给你开他汀类药物，然后你就没事了，我也就脱身了。

They just put you on a statin, and you're fine, and I'm I'm absolved of all wrong.

如果你心脏病发作，那不是我的问题。

If you have a heart attack, it's not my problem.

我做了正确的事。

I did the right thing.

对吧？

Right?

这基本上就是他们在做的，却完全不谈论生活方式。

That's basically what they're doing, and they're not talking about lifestyle at all.

你是第一个谈论生活方式的人，我记得这一点。

You were the first guy talking about lifestyle, and I remember that.

这也是你引起我注意的原因。

That's how you got on my radar too.

你展示了医生休息室里的所有自动售货机，以及它们给病人提供的食物。

You were showing all the vending machines in the doctor's lounge and what they're feeding the patients.

你心想，天哪。

You go, oh my gosh.

我们到底在做什么？

What are we doing here?

这太疯狂了。

This is insane.

对吧？

Right?

但这背后也是钱的问题。

But it's money too.

确实是。

It is.

但即使就这一点而言，布莱恩，你知道，在疫情高峰期，我曾非常明确地指出过新冠结果与肥胖之间的关联。

But even on that point, Brian, you know, in the middle of the pandemic, I I I I was very vocal, you know, about making the link between COVID outcomes and and obesity.

事实上，我们现在已知所有代谢健康问题都会大幅增加新冠死亡或住院的风险。

And in fact, we know now all the metabolic health problems massively increase the risk of of COVID death or hospitalization.

特别是在美国，数据显示，如果你患有高血压，相比完全健康的人，死亡或住院的风险高出三十倍以上。

Certainly, in The States, they showed, like, if you were hypertensive compared to someone's completely healthy, there's, like, a more than thirty fold increased risk of of death or hospitalization.

想象一下吧。

And imagine right.

所以这是一个问题。

So this is a problem.

让我们坦诚面对我们的同事，说实话，我至今仍未完全理解他们的思维模式，除了这是一种故意的视而不见之外。

And let's be honest with with our colleagues, right, who and I just I still haven't fully understood the the mindset other than it being willful blindness, if you like.

但你知道，在疫情高峰期，当我开始大力强调并有充分证据表明肥胖与新冠不良预后之间存在关联时，

But, you know, in the middle of the pandemic, once we made you know, I'd become very vocal about and we've got there was good evidence showing that there was a link between obesity and and poor outcomes from COVID.

伦敦一家教学医院发推说，他们非常高兴收到了10000个——等等，是1000个免费的 Krispy Kreme 环形甜面圈，作为疫情期间给医护人员的赠品。

One of the teaching hospitals in London tweeted out that they were really happy that they would they there was I think they they had been donated 10,000 no.

就在新冠疫情最严重的时候，医院为员工提供了这些免费甜甜圈。

Like, a thousand free Krispy Kreme doughnuts for the staff during when COVID was at its worst.

我当时就觉得，这传递的完全是错误的信息，于是发了一条推文表达我的看法。

And I was like, this is totally the wrong message and put a tweet out.

我当时就想，这简直不可接受，我不能对此保持沉默。

I was like, this is I'm I'm not gonna you know, this is unacceptable.

对吧？

Right?

我有责任和义务指出这种行为的不当之处。

This is it's actually my duty and responsibility to call this out.

backlash 我的意思是，虽然有很多人支持我，但也有很多知名医生完全不理解我的立场。

And the backlash I mean, there was a lot of people on my side, but there were a lot of prominent doctors that were like, they didn't get it.

他们觉得我小题大做，甚至觉得好笑，开始在推特上晒自己在医院吃甜甜圈的照片。

And they just thought it was, like, that I was out of order, and they then thought it was funny to start tweeting pictures of themselves basically eating these donuts in hospital.

我当时就想，我们这里传达的信息完全错了。

I was like, we're totally sending out the wrong message here.

我们其实也很清楚。

We actually know as well.

我想在那个时候，我们已经知道，即使是非糖尿病患者，如果因高血糖住院，也会导致病情恶化。

We knew, I think, by that stage that if you're admitted to hospital with high blood glucose, even if you're nondiabetic, worsened your outcomes.

对吧？

Right?

所以，你知道，这简直太疯狂了，但这种情况至今仍在继续。

So so so I was you know, that is just that is crazy, but that's still ongoing.

我认为，这反映出我们的同事对营养对健康的影响仍存在严重的无知。

And that I think that represents a huge deep ignorance that still exists amongst our colleagues about the impact of nutrition on health.

而且，他们对这些药物的作用有着严重夸大的看法。

And, again, they have a grossly exaggerated view of these pills.

是的。

Yeah.

看看埃利·朱罗杰。

Watch Eli Jouroj.

他是一名医院医生。

He's a hospital doctor.

他说，看吧。

Goes, look.

我看到的首要问题是肥胖，他因为被指责贬低肥胖人群而在推特上遭到长达四天的攻击。

The number one thing I'm seeing is obesity, and he got attacked for, like, four days on on Twitter for being fat shaming people.

他说，不是的。

He's like, no.

这确实是我看到的情况。

That's what I'm seeing.

他只是在指出他所观察到的现象，我曾与彼得·麦卡洛以及三位当时治疗新冠最顶尖的医生坐下来交谈。

He was calling out what he was seeing, and I I sat down with Peter McCullough and three other docs who were, like, the top docs treating COVID at the time.

我问他们，最让你们害怕的是什么？

And I asked them, what's what scares you the most?

高糖和低LDL胆固醇。

High sugar and low LDL cholesterol.

就是那些人，而且维生素D水平很低。

That's the people and low low vitamin d levels.

对吧？

Right?

是的。

Yeah.

而且你

And you

哇，真的。

go, wow.

这些是受过专业训练的专家。

These are the experts trained.

其他人呢？他们根本没有治疗过病人。

The the other guys aren't they they haven't treated a patient.

他们告诉我们该如何治疗这种疾病过程。

They're telling us how to treat this disease process.

你就会觉得，这真是太奇怪了，不是吗？

And you go, that's just weird, isn't it?

你难道不会把所有医生聚在一起，好好谈谈吗？

Wouldn't you have a sit down with all the doctors and hey.

什么有效果？

What's working?

什么没效果？

What's not working?

当彼得·麦库洛赫下来时，他问我。

When Peter McCullough came to down, he asked me.

他说，布莱恩，什么有效果？

He said, Brian, what's working?

对你来说什么没效果？

What's not working for you?

对你来说最好的方法是什么？

What's the best thing for you?

他并没有告诉我他在做什么。

He wasn't telling me what he was doing.

对吧？

Right?

他并没有强迫我，比如说我必须照他做的去做。

He wasn't forcing down, like, saying you're gonna follow what I do.

更像是一种，你知道的，当一个人开明时，会说：‘这个对你有用吗？’

It's more of a you know, when someone is open minded and say, oh, is that working for you?

让我看看这个，观察会发生什么。

Let me look at that and see what happens.

对吧？

Right?

是的。

Yeah.

我想回来，因为某种程度上，这其实只是一个巧合。

I wanted I wanted to come back because to to a point, it's actually, like, a just coincidental thing.

你知道，你发现了这个网站 nnt.com，大概在2010年或2011年左右。

You know, you find this website, the nnt.com, you know, right around 2011, 2010, 2011.

就在同一时期，2010年，我正在耶鲁大学内科住院医师项目当实习生。

You know, just a little coincidence at that same exact time, you know, 2010, I'm an intern in, you know, in the Yale internal medicine residency program.

那时候，CMS——也就是负责管理医疗补助和医疗保险的中央机构——强制要求医院报告接受流感疫苗的患者和医护人员数量。

And that was the time when CMS, you know, our central sort of Medicaid or central medical services organization that that runs Medicaid and Medicare, it had forced a rule on hospitals to report the number of patients and the number of health care workers that have gotten the influenza vaccine.

第二年，他们对疫苗接种率低于90%的医院处以罚款，但当时并没有任何证据支持这一做法。

And then in the following year, what they did was they they levied a penalty if the rate of vaccination was under ninety percent, and there was no evidence to support this.

那一年，如果他们每次就诊收入是100美元，那么只要报告患者接种率低于90%，就会被扣到99美元。

And in that year, you know, so, basically, if they were getting paid a $100 per visit, you know, it would be $99 if they reported that they, you know, had a patient vaccination rate of under ninety percent.

再下一年，规则改为要求医护人员的接种率必须达到90%以上。

And then the year after, it was if their employees had a vaccination rate of under ninety percent.

因此，那段时间，医护人员被强制接种流感疫苗。

And so what happened during that time was the forcing of the influenza vaccine on health care workers.

我是个实习医生，这挺讽刺的。

And I'm a medical intern, and it's funny.

就在你作为心脏病专家转向NNT的同一时间，我 literally 去了 nnt.com，查了流感疫苗预防一例流感所需的接种人数。

Same exact time you're turning to NNT as a cardiologist, I literally went to the nnt.com, and I looked up the influenza, you know, vaccination rate to prevent one case of flu.

大概是五百人左右。

And it was something like five hundred people.

对吧？

Right?

当他们，你知道，这个数字可能甚至更高。

When they when they you know, it's it's maybe even more.

所以当他们要求我接受这项强制规定时，你知道，他们取消了个人豁免——你只要说你不想打，他们就取消了这个选项。

And so when they asked me to accept this mandate, you know, and they removed the personal exemption, like, you just said you don't want it, you know, they removed that.

是的。

Yeah.

我不得不真的去和我的神父谈谈这件事。

I had to, actually go talk with my priest about this.

因为对我来说，唯一的选项是宗教豁免，但如今包括纽约州在内的多个州已经取消了这一豁免。

Because the only option for me was a religious exemption, which has since been removed now in several states, including New York state.

所以，哇。

So Wow.

现在这真是个小得不可思议的巧合。

Now so little little coincidence.

就是那个nnt.com网站上提到的同样的事情。

The same thing that, you know, the nnt.com.

我们应该找到那个制作这个网站的人，你和我。

We should find whoever made that website, you and me.

我们或许该去采访他们。

We should maybe interview them.

你知道的？

You know?

我们还应该感谢他们，因为听起来好像我确实这么做了。

And we should be thanking them because sounds like Well, I did.

让我们睁开了眼睛。

Opened our eyes.

不。

No.

事实上，我确实如此。

So I did actually.

最终，我成为了nnt.com编辑委员会的一员，并且因为撰写了这篇发表于2014年《美国医学会杂志·内科学》的文章，全面揭示了冠状动脉支架的真相。

Ultimately, I end up becoming part of the editorial board for the nnt.com and actually published on on stents because I then wrote this article in JAMA Internal Medicine 2014, the whole truth about coronary stents.

然后我就这么做了。

And then I did it.

所以我上了那个网站，也是编辑委员会的一员。

I so I'm on that site, and I was part the editorial board.

而那个创办网站的人

And the guy that founded it

他让我越来越惊叹，老兄。

He just amazed me more and more, man.

你还没做过什么，哈西姆？

What have you not done, Hassim?

嗯，没有。

Well, no.

我的意思是，事情是这样的，我说了，我觉得这件事需要引起大量关注。

I mean, the thing is I you know, what happened was, I tell you, is that I thought this needs to get a lot of attention.

对吧？

Right?

每个人都需要来参与。

And everyone needs to come.

所以当2012年《过度医疗》系列文章或社论发表时，BMJ收到了大量快速回应信，我写的那封是我第一次就心脏支架问题发表的重要文章。

So when the Too Much Medicine articles or editorials were in 2012, and there was a huge kind of rapid response letters to the BMJ, I wrote the first time I I my first I'd already had a major publication to do with heart stents.

对吧？

Right?

但我最早在BMJ上发表的一篇文章是一封信，引起了很大关注。

But one of my first pop my first publication in BMJ was a letter, which got a lot of attention.

我说过，那封信的标题是，减少过度医疗危害的第一步是理解NNT。

And I and I said, it was some the title of the letter was something, the first step to winding back the harms of too much medicine is is is understanding the NNT.

于是我写了这篇文章，发表在BMJ在线或其他平台上，获得了大量关注。

So I wrote this thing, and it got published in the BMJ online or whatever else and a lot of likes know?

实际上，正是在那之后，当我开始为《卫报》和《观察家报》撰稿时，BMJ邀请我为他们撰稿。

And, actually, it was after that, and I was writing for the Guardian, the Observer newspaper as well, that BMJ asked me to start writing for them.

到了2013年底，我写了一篇关于饱和脂肪并非主要问题的文章。

And then by the end of two thousand and thirteen, the piece I wrote saturated fat is not the major issue.

我在文章中提到他汀类药物的NNT，指出我们让数百万人过度服用他汀类药物。

I put the NNT on statins saying we've over kept millions of people on statins.

你知道，如果你曾患过心脏病，他汀类药物在降低死亡率方面的获益是83人中1人，而在预防非致命性心脏病发作方面是39人中1人。

You know, if you've had a heart attack, your benefit is one in eighty three for mortality, one in, you know, one in thirty nine in preventing a nonfatal heart attack.

但事实上，根据一项随机对照试验，地中海饮食对这些患者的益处是他汀类药物的三倍。

But, actually, a Mediterranean diet from one randomized controlled trial, to be fair, actually had a threefold benefit versus statins in those patients.

对吧？

Right?

所以我整理了这些内容，让人们对饮食和药物进行对比，实际上，饮食方面的效果可能远胜于药物，而且还没有副作用。

So that was what I put together to give the people a comparison saying, actually, we are the diet side is probably gonna be way more effective than than the and it comes with our side effects.

这就是我如何与那位人士建立联系的，他后来成为了NTT.com的主编，然后联系了我，说：‘哇。’

So that's how I got and then the that guy who started the editor in chief of the ntt.com then got in touch with me and said, wow.

你知道，你的文章让我们的网站彻底爆了，因为那篇BMJ的文章下载量巨大，成了国际新闻。

You know, you've blown our website out of the water because this article, like, BMJ thing got, you know, so many downloads became an international news story.

所以我们就这样和他建立了联系。

So that's how we connected with him.

然后我们在纽约见了面，之后他离开了，另一位编辑接任了职位，而我进入了编委会。

And then we we had a meeting in New York, and then, you know, he he left, and then there was another editor that took over, and I was on the editorial board.

但同样，我要坦诚地跟你们说，我在公共卫生政策、控糖行动、循证医学倡导等领域担任过许多不同职位。

But, again, this is also part of part and parcel of the you know, just to be very candid with you guys, I've had lots of different positions, right, in health policy, action on sugar, visiting press of evidence based medicine.

我曾是公共卫生合作组织的主席。

I was president of the public health collaboration.

我甚至还是Entity.com和Tro的编委会成员，但我并不想点名或指责任何人。

Every and even on the editorial board of entity.com, Tro, and I don't wanna name people and point, you know, point fingers.

这些组织中的每一个，我几乎都被解雇了。

Every single one of those pretty much organizations, I was let go of.

并不是因为我做错了什么，也没有任何具体原因。

Not because I had anything wrong, not for any particular reason.

他们找了一些借口，但最初在“减少糖分摄入”组织，是因为我谈论了他汀类药物的过度处方问题。

They made some sort of excuse, but it was you know, originally with action on sugar, it was to do with the fact that I was talking about statin over prescription.

我不点名这些人，但这个组织的负责人之一拥有多效药丸的专利，他们不希望我谈论他汀类药物，尽管我只是代表“减少糖分摄入”发声。

And one of the lead I won't name these people, but one of the lead people within that organization, that group that runs it had a patent on the polypill and didn't want me to talk about statins even though I was like, I'm only representing the action of sugar.

这是我自己独立的事情。

This is my own separate thing.

突然间，我就被解雇了，尽管我几乎是该组织的创始成员之一，还帮助它进入了主流视野。

Suddenly, didn't you know, I was I was let go of even though I start pretty much with a founding member of that organization and got them into the mainstream.

就连在公共卫生合作组织，问题也是因为他们受到外部力量的影响，针对我关于新冠疫苗的立场，尽管该组织一半的理事都没有接种疫苗。

And and even with the public health collaboration that you know, the the whole issue with them started because they got they got influenced by external forces around my COVID vaccine stance even though half of the trustees' trove of the public health collaboration did not get vaccinated.

他们还感谢我，因为其中一些人与NHS合作，我曾发起运动，反对医疗工作者的疫苗强制令。

And they thanked me because some of them working with the NHS, I I campaigned to overturn vaccine mandates for health care workers.

然后，突然间，一年后，他们说我们该分道扬镳了，因为他们在这疫苗问题上承受了压力，关于我的疫苗立场，尽管我说过我们可以把这事分开处理。

And then suddenly, like, a year later, I was seeing we think we should part ways because they were getting pressure on this whole issue of the vaccine, my stance on the vaccine, even though I said we can keep that separate.

所以我想说的是，你知道，这正是最难的部分，我认为，从个人层面来说，对权力说真话对我来说并不难，即使我被大药厂、大食品公司等攻击。

So the point I'm making is that, you know, this is the hard part, I think, and the most I have as on a personal level, speaking truth to power is not that big a deal for me when I get attacked by big pharma, big food, whatever.

对吧？

Right?

他们会对与这些人有关的人进行污名化。

There's there's smearing of people linked to them.

但当这种压力来自你自己的同事和你自己的群体时，那就特别难以应对了。

When it comes from your own colleagues and your own tribe, that's particularly hard to deal with.

这很难，因为这些外部力量也是如此。

It's hard because these these outside forces too.

而且，你知道，当我们谈话时，阿齐姆，我记得我曾经在某个问题上持过一种立场。

And, you know, I mean, when we talked, Azim, you know, I I took a stance one way on the back.

你持了不同的立场，而我则是基于我所看到的数据做出判断。

You took a different stance, and I and I had data based on what I was seeing.

所以那天早上我们喝咖啡的时候，我心想你会来找我，说：布莱恩，你别再谈这些事了。

So when we had our coffee that morning, I was thinking you're gonna come to me and go, Brian, tone it down on this stuff.

别提这个了。

Don't talk about it.

你却说，哦，你看到了些什么。

You go, oh, you had seen something.

那到底是什么让你改变了对这件事的立场？

So what did you see that made you go, I'm gonna change my stance on this?

到底是什么触发了你的转变？

Like, what was it that that was your trigger right there

那时候？

at that time?

所以，布莱恩，这是个很好的问题。

So so, Brian, great question.

但这里也有些微妙之处。

So there's a nuance here as well.

让我们回到2020年。

So let's go back to to 2020.

我当时在医学期刊上发表文章，欧洲科学家们登上主流电视节目，主流报纸也纷纷将肥胖与新冠联系起来。

I'm the guy writing articles in medical journals, European scientists getting on mainstream TV saying there's a problem, you know, in the mainstream newspapers, linking obesity with COVID.

对吧？

Right?

这些我都做了。

So I did all that.

在此基础上，我写了这本书。

And then on the back of that, I wrote this book.

我的出版商说我在为艾利站台。

My publisher said I was writing a stand for Eli.

我说，等等。

I said, pause that.

你目前是世界上最具影响力的医生，正在谈论这种与免疫系统和代谢健康之间的关联。

You're the most prominent person in the world of doctor at the moment speaking about this link with, you know, the immune system and and and metabolic health.

你能在六周内写完一本书吗？

Can you write a book in six weeks?

我确实用六周时间写完了这本书，而且反响不错。

And turned I off this book in six weeks, and it did well.

这是一次周日时间测试。

It's a Sunday time test.

它叫《二十一日免疫计划》。

It's called twenty one day immunity plan.

所以我做了所有这些事。

So I did all of that.

但我之所以提到这些，是因为我对感染致死率也有很深入的理解，我知道这实际上只对70岁以上的人群才真正重要。

But the reason I'm mentioning that is I also had a very good understanding of the infection fatality rate, and I knew that was only really significant for people who were 70.

一旦你到了70岁，这也就是杰·巴塔查里亚和约翰·伊奥尼迪斯所做的圣克拉拉研究。

And once you got, you know, 70, and that was also the Santa Clara study that was done with Jay Bhattachary, John Ienidis

嗯。

Mhmm.

你知道，儿童和非常年长的人之间的死亡率相差了上千倍。

You know, there was a thousand fold difference in the mortality rate between, you know, being a a child and being very elderly.

对吧？

Right?

所以，但事实上，我们现在都知道，如果你70岁，没有任何重大风险因素，那么从新冠疫情初期开始，你的感染致死率就和流感差不多。

So but, essentially you know, and we know this now that if you're 70, you know, with no major risk factors, your infection fatality rate, even from the beginning, you know, of of COVID was similar to the flu.

明白吗？

Okay?

所以我了解所有这些信息。

So I knew all of this stuff.

这些信息。

Stuff.

当然，了解这些也让我意识到，你知道，我知道针对呼吸道病毒的疫苗效果并不好。

And, of course, knowing all of that made me also realize, well, you know, you know and I knew vaccines for respiratory viruses aren't particularly effective.

提到了流感疫苗。

Chose talked about flu vaccine.

我知道，我并不是来劝大家不要打疫苗的，但关于疫苗到底有多有效，证据非常薄弱。

It's you know, I'm not here to tell people not to take it, but the evidence is very weak on just how effective it is.

而且，我知道所有这些事情。

And, you know, so I knew all of this stuff.

而且顺便说一下，对我来说，当时发生了很多个人事情，让我有点措手不及。

We get and and by the way and, you know, I think for me, there's a lot of personal things that were happening, which kind of blindsided me a little bit.

但最先发生的事是，我开始被叫作反疫苗者——2020年时，一位喜欢我这本书的欧洲科学家的编辑说，我们对抗COVID最好的方法是优化代谢健康，并引用了我的书。

But the first thing that happened is I started getting called I was being called an anti vaxxer in the 2020 when the editor of European scientist who loved the book said, our best defense against COVID is something like optimizing metabolic health and reference my book.

对吧？

Right?

我发了这条推文，结果一些知名医生拿它来指责我是反疫苗者。

And I tweeted that out, and there were some prominent doctors who used that to say I'm an anti vaxxer.

对吧？

Right?

我当时就觉得这太疯狂了，因为我只是说你应该增强免疫系统，关注代谢健康。

And I was like, this is just crazy because I'm saying that you should improve your immune system, you know, focus on metabolic health.

我没说不要打疫苗，但那才是我们最好的防御方式。

I didn't say don't take a vaccine, but that would be a a really best our best defense.

我就说了这些。

That's all I said.

所以我就想，好吧。

So was like, okay.

所以那在2020年就已经开始了。

So that was already starting then 2020.

这有点奇怪。

It was a bit odd.

到了2020年底的时候。

We get towards the end of 2020.

当然，疫苗接种开始了。

Of course, the vaccine rollout starts.

那时候我这边也有很多事情在发生。

And I'm you know, lots of stuff going on.

我们回头再谈这个，但我，你知道的，我失去了

We'll come back to that, but I, you know, I lost

我昨天失业了。

my job yesterday.

抱歉打断今晚的谈话。

Sorry to interrupt this evening.

顺便说一句，大家仅仅因为新闻稿就欢呼起来。

Everybody cheered with just the press release, by the way.

那些可能说你是反疫苗者的所有医生，其实都在为疫苗欢呼。

All of those doctors who probably said you're an anti vaxxer, they were all cheering the vaccine.

我记得当时在推特上

I remember being there on Twitter

是的。

Yeah.

就凭着辉瑞的一则新闻稿。

With just a press release from Pfizer.

是的。

Yes.

我当时就想，你们谁都没审阅过。

And I was like, none of you have reviewed it.

它还没有经过同行评审。

It's not been pure through peer reviews.

你们不知道长期效果。

You don't know long term

信息。

information.

对任何事情都不了解。

Know on anything.

完全正确。

Absolutely.

所以当时所有这些都在发生。

So there was so that was all happening.

而且在个人层面上，我当时也挺有压力的。

Then also on a personal level, I was I was up against it a little bit.

我正经历一些事情，特别是我正试图回到 NHS 工作。

I was having a few things going on, especially I was trying to get a job back in the NHS.

你知道的？

You know?

我不太喜欢谈我的私人事务。

I I I I'm not big on my private work.

现在情况好些了，但当时我确实挺不容易的。

Things are okay now, but I was having listen.

我对你们说实话吧。

I'll be very candid with you guys.

对吧？

Right?

想象一下，我是一名心脏科顾问医生。

Imagine I'm a consultant cardiologist.

我正在做这些事情。

I'm doing all these things.

我的大部分工作都不赚钱，因为那是 activism（倡导活动）。

Most of my work doesn't pay me because it's activism.

这没关系。

That's fine.

但现在我陷入了一个境地，不得不向我父亲借钱，因为我实在无法负担生活开销。

But I'm now in a situation where I'm having to borrow money from my own father because I I can't, like, keep up with my expenses, like, as in living expenses.

对吧？

Right?

所以我现在身处这一切之中。

So I'm in all of this.

我正在努力重返NHS工作。

I'm trying to get a job back in the NHS.

心内科团队告诉我，他们知道我能力出众。

I'm getting told by cardiologists, team, we know you're great with what you do.

你和同事相处得不错，诸如此类。

You get on with your colleagues, blah blah blah.

但因为在2019年，有一篇文章——我们稍后再谈，因为这件事也引发了不少风波——刊登在《星期日邮报》上，因为我继续推动他汀类药物的透明度运动，基本上就是说我和佐伊·哈科姆、马尔科姆·肯德里克这些优秀的全科医生和营养学专家，因为我们说他汀类药物无效，所以我们在地狱里有位置。

But because in 2019, there was this article, we'll come back to it later, because there's a lot of a bit of drama around that as well, published in the mail on Sunday because I carried on the the statin campaign of transparency, basically saying me and Zoe Harkom and Malcolm Kendrick, you know, these these these other brilliant GP and and nutrition scientists, you know, there's a place in hell for us because we say statins don't work.

2019年的时候，这些事都在发生。

And there was all that stuff going on in 2019.

于是我失去了在NHS的工作。

So I lost my job in the NHS.

他们没有明说，因为不能直接这么说，但一个月后，你就被通知：你的服务不再需要了。

Didn't say explicitly because they couldn't say that, but a month later, like, your service is no longer required.

我试图重返NHS，却遇到重重障碍，似乎都是因为我在《星期日邮报》上那篇关于他汀类药物的文章。

I was trying to get a job back in the NHS and all of the all these barriers happening and saying, it seems because of your stat in this mail on Sunday thing.

好吧。

Okay.

行。

Fine.

所以我对这件事感到有点压力。

So I'm a bit stressed out about that.

我们来到了2020年底。

We get to the end of 2020.

现在我的父亲，就像我之前说过的，是一位退休的全科医生，非常稳重的人。

And now my father, who was, as I've told you, was a, you know, retired GP, very measured guy.

你知道，像他那个年纪、七十出头的许多人一样，对新冠疫情有着严重夸大的恐惧。

You know, he, like many people of his age in his early seventies, had a grossly we now know grossly exaggerated fear of COVID.

嗯。

Mhmm.

但更重要的是，你知道，他担心自己家族中最后幸存的成员——我，已经失去了他的长子，接着在2018年我们又失去了妈妈。

But more than anything else, I you know, he was worried that the last surviving member of his family, me, having lost his eldest son, then my mom we lost my mom at the you know, in 2018.

他担心我会感染新冠并死去。

He thought I was gonna get COVID and die.

我们为此来回争论过。

And we had back and forth.

爸爸，你听我说。

I was dad, listen.

我很好。

I'm fine.

别担心这个。

Don't worry about it.

他却说：不。

He's like, no.

不。

No.

不。

No.

你必须打疫苗。

You need to have the vaccine.

如果你来帮我找一个疫苗接种点，你可以拿到早上剩下的余量。

If you come and help find a vaccine center here, you can get the leftovers from the beginning.

说实话，一开始我挺不情愿的。

So I was quite reluctant at the beginning, to be honest.

即使打完第一针后，我还记得在疫苗中心外和他吵了一架，他像训孩子一样责备我。

And even after the first dose, I remember having an argument with him outside the vaccine center, and he scolded me like I was a a child.

我是个不听话的孩子，因为打完第一针后我感觉不舒服。

I was a I was I was a disobedient child because I didn't feel well after the first one.

我没把现在的情况和之前联系起来，但当时我就想，哦，我真的不想打，然后我就说，好吧。

I didn't I I didn't link anything to what I do now, but I was like, oh, I don't really feel like having and it was like and I was like, okay.

算了，管他的。

Well, screw it.

我去把疫苗打了。

I'm gonna go and get it done.

我打了第二针。

I get it done, second one.

打完之后我感觉不舒服。

I didn't feel well after it.

我遇到了各种各样的事情。

All sorts of stuff happened to me.

但当时发生的是，我也意识到我未必真的需要它，但我还是想，好吧。

But what happened then was I also realized I didn't necessarily need it, but I thought, okay.

如果它真的能在某种程度上阻止传播，那我就要帮个忙，我得保护我的病人。

Well, if it does stop transmission in some way, then I'm gonna help you know, I'm gonna need to protect my patients.

然后我和一位名叫格林达·奇达的电影导演朋友之间发生了来回的讨论。

And then there was a back and forth going on with a friend of mine who's a film director called Grinda Cheddar.

她拍过很多电影。

She's made a lot of movies.

《弯刀》是其中之一，《光之迷恋》讲的是布鲁斯·斯普林斯汀，相当有名。

Bend it like Beckham's one of them, Blinded by the Light on Bruce Springsteen, quite well known.

她会来找我咨询医疗建议，还给我发了大量博客文章。

And she comes to me for medical advice, and she was sending me all these blogs.

但那时我还没看到任何真正靠谱的（信息），说实话。

Now I hadn't seen any good, honestly, at that point.

我通常会去寻找这类信息。

I would normally look for this stuff.

我还没看到任何有信誉的人出来表示疫苗有问题。

I hadn't seen any good credible person coming out with saying the vaccine's an issue.

《英国医学杂志》的编辑菲奥娜·戈德利，他们反对过度医疗，但却是坚定的疫苗支持者。

The the the BMJ, the editors Fiona Godley, who are against, you know, against too much medicine, very provax.

网上有一些博客，但有些内容纯粹是疯传的谣言，比如说什么疫苗里有微型芯片。

There were a few blogs here and there, but some stuff was just crazy stuff that's being circulated saying there were microchips in the vaccine.

但这让我退却了。

But the and that put me off.

我当时想，天哪。

That was like, oh my god.

这简直太荒谬了。

This is like this is just crazy.

对吧？

Right?

所以我跟格琳达说，不行。

So I said to Grinda, I said, no.

这毫无道理。

This doesn't make any sense.

听我说。

Listen.

我对疫苗的有效性无法有信心。

I can't be confident on the efficacy.

对吧？

Right?

我这么说是因为，我们并不清楚这些呼吸道病毒疫苗的效果一向不太好。

I said that because we don't know with all these, you know, these respiratory virus vaccines don't do that well.

但我看不到，而且说实话，我根本想象不出它会有什么危害。

But I can't see and, honestly, I couldn't even perceive of a problem of harm.

对吧？

Right?

作为一名心脏病专家，我基于我的患者情况来判断，我这辈子从未见过疫苗引起的伤害。

As a cardiologist, I'm informed by what my patients I've never seen a vaccine injury in my life.

我觉得这根本不是个问题。

I couldn't see it as being of an issue.

我能理解为什么有些人想等一等，也能理解为什么70岁的人不需要打这个疫苗。

I could understand why people wanted to wait, and I could understand why people 70 didn't need to have it.

事实上，我甚至建议过一些人，尽管我自己打了。

And I, in fact, advised people even though I took it.

我是说，你知道吗？

I was like, you know what?

你可能不需要打，因为你年轻又健康。

You probably don't need it because you're young and fit.

对吧？

Right?

那时候就已经有这样的情况了。

So that was even happening then.

然后，你知道，她因为体重和二型糖尿病属于高风险人群，所以她打了疫苗。

And then, you know, I she was a bit she was high risk because of her weight and type two diabetes, so she took it.

然后她发推文说她打了疫苗，并且采纳了我的建议。

And then she tweeted out that she'd had it and that she took my advice.

《早安，英国》节目当时认识我，问我是否愿意来谈谈疫苗和疫苗犹豫的问题？

Good morning, Britain that knew me then asked me, would you come and speak about the vaccine and vaccine hesitancy?

特别是来自少数族裔背景的人群，接种率非常低。

Because people from ethnic minority backgrounds in particular were very low on the uptake.

然后你是个公众人物，还是印度裔，等等等等。

And then you're a public figure and you're you're Indian origin and blah blah.

而我后来再也没有被邀请回去，因为我没有上节目去指手画脚。

And the and then I never got invited back on because I didn't go on there and start waving the finger.

我说，我能理解为什么会有这种犹豫。

I said, well, I can understand why the hesitancy is there.

我说，看看制药行业的欺诈行为。

I said, look at the fraud of the drug industry.

我说，你知道吗，处方药是继心脏病和癌症之后第三大死因。

I said, you know, prescribed medications, third most common cause of death after heart disease and cancer.

但我又说，但与医学中我们做的其他所有事情相比，我仍然相信传统疫苗更安全。

But I said, but compared to everything else we do in medicine, I still believe this to be the case, traditional vaccines are safer.

对吧？

Right?

事情就是这么发展的。

And that was how how it went.

但那时我已经开始出现自己的问题了。

And but I'd already started to have my own issues.

接种疫苗后的几周内，我就陷入了抑郁。

I went into I went into depression within a few weeks of having the vaccine.

我好几天都出不了门，因为一点力气都没有。

I couldn't leave my house for a few days because I had no energy.

这些事情我都跟乔·罗根提过。

There's all these things which I which I mentioned to Joe Rogan.

所以直觉上我觉得有些不对劲。

So there's something intuitively that didn't feel right.

然后，几个月后，我遇到了一位我的门生，一位杰出的心脏病专家，是我认识的最聪明的人之一，他擅长从临床试验数据中抽丝剥茧，随便写几篇文章或评论就能轻松发表在顶级医学期刊上。

And then, you know, a couple of months later, I meet one of my mentees, brilliant cardiologists, one of the brightest guys I know, like, genius in tearing you know, putting unpicking data from from trials and whatever else and can publish in, you know, higher higher medical journals for fun just by writing articles and editorials.

对吧？

Right?

他说他没有打疫苗，想再等等，不是因为他有任何确凿的证据。

And he said it seemed he'd not he he told me I've not had the vaccine, and he said he wanted to wait, not because he had any hard evidence of anything.

他说他想等，但他在辉瑞公司在《新英格兰医学杂志》论文的补充附录中发现，疫苗组有四例心脏骤停，而安慰剂组只有一例。

He said I was I want to wait, but I also saw something in the Pfizer's New England Journal of Medicine paper in the supplementary appendix, which showed there were four cardiac arrests in the vaccine group and only one in the placebo.

他说，虽然数字很小，单独来看没有统计学意义，但他认为，如果这真是一个信号，那我们就麻烦了。

And he says, it's small numbers, not statistically significant in its own right, but he said, if that's a signal, we're gonna have a problem.

所以，那时我就把这件事记在心里了。

So then I that's where the you know, that was there in the back of my mind.

然后我们就到了2021年。

We then get to the 2021.

我一生中最艰难的经历和记忆之一，是我父亲给我打电话。

One of the most difficult experiences and memories of my life still is, you know, my dad calls me.

他出现了心脏相关的胸痛。

He has cardiac sounding chest pain.

他在曼彻斯特。

He's in Manchester.

我在伦敦。

I'm in London.

我让他叫救护车。

I tell him to call an ambulance.

他联系了邻居，最终发生心脏骤停并去世了。

He calls his neighbors, ultimately has a cardiac arrest and dies.

随后，我参与报道了一起长期存在的救护车延误问题，当时政府和卫生部在全国各地都面临公众的质疑。

I then get involved in in covering an ambulance delay that was being, you know, the the the the government and the Department of Health that had from the public for for months that was happening all across the country.

我对此进行了报道，并登上主流媒体，BBC新闻也对此进行了广泛报道。

You know, publish on that and make mainstream gone BBC News talking all about that stuff.

但我父亲的尸检结果出来了。

But my dad's postmortem findings come back.

起初，人们说，哦，你不知道吗？他只是心脏病发作。

And, initially, people say, oh, don't you know, he's just had a heart attack.

这有什么意义呢？

What's the point?

我说，不是这样的。

I said, no.

这说不通。

This doesn't make sense.

我几年前给父亲做过一次钙化评分。

I we you know, I did a calcium score on my dad a few years earlier.

对吧？

Right?

结果是200多。

And it was, like, 200 and something.

所以他当时的情况算是中等程度。

So he had, like, moderate.

对吧？

Right?

但他后来瘦了。

But he then lost weight.

他戒掉了糖。

He'd quit sugar.

他的状况更好了。

He was in a better position.

他的降压药也减量了。

His blood pressure pills have been reduced.

所以，从代谢健康的角度来看，了解冠状动脉疾病的发展和进展过程，至少也应该是稳定了。

So if anything, knowing how coronary disease develops and progresses from metabolic health point of view, it should have stabilized at the very least.

他出现了严重狭窄。

He had critical stenosis.

我当时就想，这说不通。

I was like, this doesn't make sense.

他真的压力很大吗？

Was he really stressed out?

你知道的。

You know?

我实在不明白为什么会这样。

I I I couldn't I couldn't understand why.

然后到了2021年11月，对我来说，那是个顿悟的时刻。

And then November 2021, for me, that was the light bulb moment.

斯蒂芬·甘德里在《循环》期刊上发表了一篇摘要，指出在接种mRNA疫苗后的八周内——顺便说一下，我最近见了他一面，想弄清楚他身上到底发生了什么，这里有个有趣的故事。

Stephen Gundry publishes an abstract in circulation, which reveals that within eight weeks of the mRNA vaccine and by the way, I'll tell you an interesting story about Stephen because I met him recently to find out what happened with him.

他本人应该不会介意我告诉你，他的经历非常引人入胜，正是这些经历让他理解了这一切。

And he hasn't I'm sure he wouldn't mind me telling you this, but his story is fascinating with how he got to this understood this.

对吧？

Right?

所以他发表了一篇论文，研究了数百名中年患者，在接种两剂辉瑞和莫德纳mRNA疫苗后的八周内，与心脏病相关的炎症标志物的基线风险从五年内11%的心脏病发作风险上升到了25%。

So he published his paper looking at, you know, I think hundreds of his patients, middle aged, and within eight weeks of having two doses of mRNA, Pfizer and Moderna, the baseline risk looking at inflammatory markers correlated with heart disease went from eleven percent risk of heart attack in five years to twenty five percent.

我当时想，原谅我粗俗的表达。

And I was like Pardon my language.

我当时恍然大悟。

I was like, penny drops for me.

好吧。

Okay.

仅凭这一条数据，但对我而言，作为一个长期研究心脏病——一种慢性炎症性疾病的人，这或许能解释我父亲身上发生的事。

One bit of data, but this now for me, someone being that publishes on heart disease being chronic inflammatory condition, this would explain probably what happened to my dad.

如果这是真的，那么在现实世界中我们一定会看到相应的迹象。

And if this is real, we will see a signal in the real world.

随后，一位《泰晤士报》的记者给我打了电话，他几周前就联系过我，说苏格兰自七月以来出现了无法解释的心脏病发病率上升，增幅达25%。

And then I get a times journalist call who called me a few weeks earlier saying, we've got an unexplained increase in heart attacks since July, twenty five percent increase in hospital in Scotland.

接着，一位牛津大学的内部人士给我打电话，说一组研究人员通过影像检查意外发现，接种疫苗者体内存在冠状动脉炎症的迹象，而未接种者则没有。

I then get a whistleblower from the University of Oxford that called me up saying a group of researchers that have accidentally found through imaging that in vaccinated, there is a signal of coronary inflammation, which is not there in the unvaccinated.