Pushing Past Perceived Limits - Scott Carney, Journalist and Anthropologist

Shiv Gaglani: Hi. I'm Shiv Gaglani. We're going a bit off the beaten path on Raise the Line today. Instead of talking to a medical school dean, clinician, start-up CEO, or EdTech leader, we're joined by Scott Carney, who has created a unique path of his own as an investigative journalist, anthropologist, and author.

You may be familiar with his New York Times bestseller, What Doesn't Kill Us, his most recent book, The Wedge, or his earlier works revealing some shocking truths about the worlds of organ procurement and adoption. His next book, The Vortex, about the deadliest storm ever, is coming out in March. His reporting has also appeared in many outlets including WIRED, NPR, Mother Jones, and National Geographic.

He also created and runs Foxtopus Ink, a multimedia company involved in publishing, audiobooks, podcasts, and other platforms. Oh, and also cat-wrangling. This is a personal dream for me, as Scott's work has been highly influential on my own habit formation and understanding of the human body and what we're capable of. Scott, thanks for taking the time to be with us.

Scott Carney: Hey. Thanks for having me on.

Shiv Gaglani: Hopefully, a lot of our audience is already familiar with your work. I've talked about it before in other contexts. But for their benefit, can we start by hearing more about what got you interested in investigative journalism?

Scott Carney: The story is funny. I was a kid who went abroad in college to India. I lived there for a year and I was like, "This is great! It's so chaotic!" And I loved how intense every moment is in India. Essentially, I just wanted to keep on having adventures in my life—let's just be real, a 20-year-old kid. What am I going to do? I want to travel. And I wanted to find a way to make it a real career.

I bumped around in academia for a while. I was like, "Hey! The way to travel and have fun is to be a professor!" which is not true, because when you become a professor, you're basically just fighting tenure committees for like 10 years. And I'm way too ADD just to focus on one subject. I dropped out of the Ph.D. program and started writing stories for local weekly newspapers. I think my first article was about joining a clinical trial at a place in Madison, Wisconsin for the erectile dysfunction drug, Levitra. I was locked in a room with, I think it was 30 dudes on penis poppers checking out what the maximum, livable dose is: The first stage of the human trials like, "What amount of Viagra will kill you?" I was in that trial. But I didn't die, so that was cool. That was a funny, experiential story. It was invigorating.

I moved to India shortly thereafter, after getting some traction. I was starting to write for WIRED, for NPR, and Mother Jones. I moved to the South Indian City of Chennai, where I discovered all of the women in a village right next door to where I was living had sold their kidneys. I was in the middle of this enormous organ trafficking scandal! And I was one of the first reporters on the scene, and it's been off to the races since then. I'm like, "Oh my God. I'm going to go and find out why this is even happening."

Shiv Gaglani: That's incredible. And anyone who reads your books knows that curiosity that naturally comes from you is permeating through the books: The kind of the threads you pull on even The Wedge, which I most recently read late in January, and all the things you have done personally—from climbing Kilimanjaro in shorts with Wim Hof, to the MDMA trial. 

I'd like to start by understanding how you come up with your … I guess you pull on threads, and then you do a deep dive? Or is there something where you have this massive bucket list of a thousand things you want to do and then some of those become books, some of those become articles, some of them just—

Scott Carney: I did a lot of anthropology. And there's this idea—there are two ways to approach any anthropological subject. They’re “emic” and “etic,” which are just stupid buzzwords. “Emic” is from the inside: you get involved in the culture and then understand where you are. And there's “etic” which is from the outside. the objective view: how are the natives are doing, right? And there are benefits to both sides. I don't want to knock either side. But my feeling is that there's no such thing as objectivity, especially when dealing with humans, during social interactions. There's an objective world out there. It's just how you access it is contextual. 

When I do reporting, I always acknowledge that I am in it, and I am affecting the scene that I'm in. So, it's hard to extract me. But it also allows me to do some pretty adventurous things. Like I'm going into these situations, and it is through my experience as the writer that you can understand. You can decide whether you like me or you trust me or not. But you can also see how I interact in that space.

Your other question: How do I choose these topics? I feel I'm intensely ADD. My thoughts are all over the place all the time. And if I get fascinated by something, and then I absorb everything I can about it, and then I vomit it onto a page as quickly as possible so that I can move on to the next thing, the next shiny object that flits across my eyeballs. A lot about this job is careful research, but also being like, "I have to move on to the next subject because there's too much out there that I want to look at."

Shiv Gaglani: Your book, on climate change and the deadliest storm, is coming out in a month, from when we are recording this. That is definitely a departure from the last two books on the limits of human endurance and resilience. Let's talk about that. What got you interested in climate change, and can you tell us a bit about the book? And if there are any applications for that book to human health? Clearly, there are, and I would love to hear your take on it.

Scott Carney: There are definitely ways that all of my books are related. In one of the last lines in What Doesn't Kill Us, I talked about how our world is changing, and how this idea of cold is maybe going to go away for many people. Your winters are going to get shorter. You're not going to have the seasonal adaptations. That's part of it.

But I'll say, I actually started writing and getting interested in the book that became The Vortex before I even met Wim Hof. It is actually predated in many ways all of that stuff. It started when I was hanging out in Bangladesh doing a story for Foreign Policy about this 13-year-old girl who got shot on a border wall between India and Bangladesh.

India had built this whole wall around all of Bangladesh. If you can think of the map of Bangladesh, India is, like, hugging it. It's got this arm around it, basically—with a little bit of Myanmar over by the fingers. India built this wall because they were worried about climate refugees. I was like, "Why would they do that?" We know Bangladesh is going to sink, right? We all heard of that story. But why would you go through the efforts of building a wall? I tracked that back to this historic storm, where 500,000 people died. There was a war and then millions and millions and millions of people crossed the border over to India.

If you can think about how America responded to a few thousand immigrants coming over in migrant caravans. Think about what a nation would do with millions crossing the border. That's why India has built this wall, and they've armed it with ... I mean, they kill a lot of people. You know how America arrests a lot of people? These people shoot a lot of people. The Vortex is a story of how that war happened, and then we're tracing it forward to say, "Here is where we are now."

It's all an allegory for climate change around the world. As the Earth heats, we're going to have more storms—that's a fact of the climate. As you get more storms in the more vulnerable areas, you roll the dice every time as to whether or not this will affect political systems in the same way it destroys beach houses and villages. Many of those storms will have massive political ramifications.

Shiv Gaglani: Absolutely. The drumbeat has become louder. I think there were 18 multibillion-dollar storms just last year. One of my favorite spots, not too far from where you are in Denver, is Tahoe. I was there when the fires were coming through, and then I was there when the blizzards came through in December. It was kind of crazy. I actually just pre-ordered the book while we were—

Scott Carney: Nice. That's a sale for me. That's $2 in my pocket in a few months.

Shiv Gaglani: In a few months. Exactly. You do it because you love it. Our audience is a lot of current and future health care professionals, so they're very much science-based, evidence-based. Some of them have anthropology backgrounds. I would love to hear about when you went out to meet Wim Hof for What Doesn't Kill Us, and writing the story. You were going out there to debunk him, right? Like you thought he was kind of a cult leader?

Scott Carney: Yes.

Shiv Gaglani: Now, can you take us back to that moment when you first started experiencing things yourself, where you're like, "Wow! There's actually more here that western medicine just doesn't understand about the body."

What are some of the most surprising things that you came to realize? What are the lasting habits that you have as a result of all the investigative journalism you've done?

Scott Carney: I'm going to have to answer this question in two phases. One is Scott Carney in 2011 when I first heard about Wim Hof and first met him. And then we'll need to fast forward to Scott Carney in 2022 where some of my opinions have changed.

Now, back in 2011, I had heard about Wim Hof. I saw this photo of this mid-50s guy sitting on an iceberg. I was getting out of shape, and I was like, "Oh man, this guy's got something that I don't have!" And he was not famous then at all. He'd done a couple of media stunts. He was more like a clown, an ice clown at best. And I was the first journalist to go there and write about him seriously. So, I flew out to Poland, and I had just written a major article that then became a book called The Enlightenment Trap, about people who pursue superpowers—that idea that yoga makes you a superhuman, we see the superhuman language on Instagram stuff all the time—how that drive towards transcendence, and almost magic, makes people crazy, and sometimes gets them killed. I wrote a whole book about that, and I was very skeptical of gurus who are offering superpowers.

When I met Wim, my commission was basically to debunk him. Like: "Look at this guy selling this crazy idea that you can control your immune system. You can stand on icebergs forever and blah, blah, blah." But as an anthropologist who dives in, who actually tries things and just doesn't look from the outside, I decided I had to try his method. And one thing about Wim which is so amazing is how earnest he is, right? He believes this to his soul, and you're like, "All right, you're in. I'm going to go and I'm going to give you this much leeway to try it out."

And lo and behold, it just works, right? I do the breathwork, and all of a sudden I'm holding my breath for three minutes at a time. I do more push-ups than I've ever done before while holding my breath. And over the course of a week, I do all these ice stunts where I end up climbing up a mountain in my skivvies, and I'm hot the whole way up. And I'm like, "Oh my God! This is crazy! Is this prana coming down from heaven? Or is there an anthropological biological explanation?"

Being science-based, I'm very interested in science. And this was before a lot of the immunological research had been published, although they were conducting those trials around the same time that I was there. It turns out, exposing yourself to elements of various sorts, as long as it's not damaging you, really does make you stronger. It allows you to increase your threshold of resilience. And this autoimmune reversion thing is really cool.

I will say that once I started doing the Wim Hof Method … I used to have canker sores all the time, which are like mouth ulcers that just suck. I mean, they're not lethal, but they just suck. And I would think of myself as a canker survivor. I couldn't smile or laugh or anything like that. After I did the method, I just kept up with it, I never got them again. 

I was like, "Oh my God! It has this real tangible effect!" And weirdly, more than anything else, that's what keeps me coming back to the Wim Hof Method. You'll lose a habit for a little while for whatever reason and you're like, "Ah, I'm not going to do something else." And a canker sore, it'll be like, "Hello! I'm thinking about showing up." You know about those prodromal early symptoms. And I'm like, "Oh, get to get back into it!" And I do the method and it goes away fast. I get this stick always pushing me back into the method, and that's been great.

Now, fast-forward to 2022 Scott. I initially wrote that book about Wim Hof and said he was an amazing guy. It's not a cult. There's real science. I will say that if I wrote What Doesn't Kill Us today, after Wim Hof has risen to this international celebrity that he is now, I think my book would have been a little more critical of the way that fame has framed the Wim Hof Method in the present day.

It has become very over-masculine. It has become very anti-science. Wim used to go get all these studies done about him. It was very science-based. We injected people with endotoxin, we have this data, we have numbers, we have real people with PhDs looking at it.

Now, it's Gwyneth Paltrow, Joe Rogan. It's like fame has taken over what the Wim Hof Method is. And it's actually eclipsing science. There was a video posted three or four days ago on Instagram of Wim Hof “walking on water.” There's a little platform under the surface of the water, but he's walking out there like Jesus. And I'm like, "Whoa! This is not the image of science that I have!" I have this very conflicted feeling about the Wim Hof Method lately, just because it's turning away from its scientific roots, which are there, and it works, into this more celebrity-focused, sort of fluffiness which I really don't like right now.

Shiv Gaglani: That's really interesting. Going back to some of the things you were talking about in The EnlightenmentTrap, in terms of superpowers and people pushing themselves: Your book was one of the first, if not the first I read that ... Now, there's a bunch of books that talk about this type of stuff, like there's Stealing Fire. James Nestor is going to be on the podcast talking about breath, which is interesting. Is it all just breath-holds like Wim Hof? Or do you do other kinds of Pranayama breathing? This is where The Wedge was really interesting, because fast forward nine years after it came out—nine years after, I guess, you first met Wim—and The Wedge expands upon that and talks about psychedelics. And all these things are now big in mental health.

We've had folks from CALM. We had the chief medical officer of CALM, we had the chief medical officers for cerebral come on. Many of them are involved in psychedelic research as well in clinical trials. Of the things that you’ve experienced, what are you most excited about in the next decade in terms of physical health, building resilience? Do you think it's going to be a psychedelic renaissance? Do you think it's going to be a breathing renaissance? What are you most excited about for our audience to think about when they're seeing patients, or themselves trying to be resilient?

Scott Carney: One of the things that is really good about psychedelic research is that they're doing real science on it. They have control groups, they have the whole thing. They're really trying to understand the benefits of psychedelics, which are there. But I think that there's a problem in the way we frame psychedelic research where we say, "Look, we have a depressed person. We have a patient with a symptom." And we give them this chemical—MDMA or psilocybin or ketamine or whatever. We do this chemical, and we give it to them. And then later they are better or worse. Right? We have this clinical design study. 

But for me, what is missing in a lot of the ways that the clinical trials are framed is that it's not the chemical that changes the person. It's the experience that the person on the chemical has that changes the person.

I think ketamine may be possibly different. I'm going to put that in a little box because I haven't fully studied ketamine. But when I've done, say, mushrooms or MDMA, the reason why I've had such interesting breakthroughs, is because of the thoughts that have emerged in my mind. Then I remember, and I go back to those thoughts, and a lot of scientific research is missing this subjective component, which is absolutely critical. 

The reason why you're not depressed anymore isn't because of the chemical change. It's because you realize that you're mortal and you only have so much time in your life, and "Oh my God! I have to go!" Like carpe diem. That was the thing that flipped them out of the depression. And the chemical maybe opens the door to that realization. But there is really this chewing that goes back and forth.

I'm not 100% certain that the way we frame clinical trials, the way we talk about psychedelics—at least in the clinical literature—that it really answers that subjective component. We treat it like a blood pressure drug in a lot of these trials because they want this very discreet endpoints. And it's really hard to quantify the reason why I had to say "carpe diem" at the end of my trip into the universe.

So that is something that I hope does get explored more in the clinical setting. There are certainly just amazing novel uses. I mean, in the chapter where I did MDMA with my wife—that's the street drug ecstasy—I had two clinicians come in and observe us. They were going to guide the session, and the amazing thing about MDMA is it makes everything happy. Like if you touch your skin, your skin feels amazing, you want to dance. But if you're actually just talking to somebody, it's like you almost chemically can not react negatively to someone's statement.

If I said to my wife, "You know what, I hate your mother." She's not going to say, "Well, I hate your mother!" and that would blow up and we’d have that whole fight. Instead, she'd be like, "Yes, sometimes these things work this way." And then you have this very productive conversation where everything has to end on a positive note, because you're dumping all of those feel-good chemicals into your brain. That session, when we reconnected with the psychiatrist afterward, who had never actually seen an MDMA session before—they had just read about them. They were both gobsmacked because they said it was like watching six months of couples therapy play out over the course of six hours, or whatever the half-life of that drug was.

It's a really neat shortcut to therapy. And it's important to say that it is both the subjective experience—the negative statement said by me or my wife—and then the positive response, which allows you to have this very useful therapeutic outcome where that played out in our relationship for the next year. We were able to go back to some of those tools and be like, "Oh, okay. I understand how this works."

Shiv Gaglani: That's an awesome nuance. I’d love to connect you to two people at some point. One is my board member of Osmosis, Mitch Rothschild. His wife, Rachel Yehuda, she's a National Academy of Medicine psychologist running MDMA-assisted therapy for veterans with PTSD.

One of the reasons I love reading your stuff is you have the science hat and then you're in it. You experience it. You can talk meaningfully about both the research and then your own experience with it. You qualify it quite a bit by saying, "This is my experience and this is what the research says."

She, and then one of my investors, Zeshan Muhammedi at MBX Capital, his whole thesis is around he psychedelic renaissance that's happening. It's experiential. It's exactly what you said. It isn't just a wonder drug, like the Viagra drug which we talked about at the beginning of the podcast. It's the experience of post-integration work, right?

Scott Carney: Yes.

Shiv Gaglani: Same with Wim Hof, right? Like any method, it's not a magic bullet. It makes you have realizations on the drug that then eventually if you integrate correctly, could be good. And that's the same with the Ayahuasca Method that you were doing too. Where do you think western medicine is with regards to accepting this stuff? And what do you think needs to happen? 

Part of my interest here is that we're seeing daily how many nurses and doctors are dropping out of the workforce with burnout. They're getting PTSD. I mean, you can't be an ICU nurse or physician over the last two years without having some PTSD from the thousands of people who died in front of you. Many of which were preventable. What kind of message would you want to get across to them? Or where do you see the tides turning? Do you think we're going to be shut down again by the government? Or do you think there's legit stuff that's going to happen over the next 10 years? I'm asking you to prognosticate, but...

Scott Carney: Funnily enough, one of the books that I'm working on is about the future of western medicine and eastern protocols. And I think that we are seeing more integrative approaches across the board. Eastern medicine has some really nice benefits, right? And we know, as well that western medicine is freaking awesome. And you don't want acupuncture for your compound fracture. At least not immediately. And the question that I often have is, at what point is it right to switch paradigms from an eastern approach—mean that very broadly—from these complementary medicine models, to the acute care that western medicine is so amazing at.

It is often understood that the ability of western medicine to manage chronic illnesses is not very good. We're not where we should be. We treat things with drugs that have side effects, the drugs decrease in efficacy. And you are managing the symptoms. It's a big mess. It's not as clean as fixing a compound fracture.

Some of that eastern medicine is built entirely around the concept of working on chronic illnesses in the first place. And some of it is total bullshit, and some of it is actually really awesome. Like what I found with the Wim Hof Method, I think it's really awesome. It's really useful. It will not cure cancer to my knowledge, it will not cure AIDS. But it's really good for anxiety, it's good for depression. It seems to help all autoimmune illnesses that I've come across.

The question that physicians need to think about is, at what point do you want to switch paradigms? At what point do we say, "Okay your Wim Hof Method. Keep doing that. Sure. But now we really need to get you on some blood pressure medicine because you're gonna die”?

I don't know if that point is defined. Like, how do you find a gray area? I do think it's important not to just discount what people do daily to build, to use an old term, their vital force, right? This is a word that we use in the 1800s. Like, you build up your vitality, your overall health so that your system could thrive, versus western medicine, which might be more like scorched Earth in a way. "Oh, you've got a bacteria in your system. We're going to just flamethrower all the bacteria in your body, and then you're going to be all right." Which does work, right? And then you'll return to homeostasis afterward. 

But those two approaches are diametrically opposed, right? Like, I can't build up my vitality and throw a flamethrower on my intestines at the same time. So, how do we decide when that vital force method is now no longer worth it because you've gone into some sort of acute care where we need to bring out the flamethrowers? That's what I I hope clinicians can think about better than I can, because I'm just a guy who has some interesting thoughts. I have so much respect for doctors. And a lot of doctors are already thinking along these lines anyway. I'm not doing anything new here.

Shiv Gaglani: I think again, you brought it into focus in a way that has made it accessible and interesting to a whole generation. I mean, when I was in med school, we had three days on nutrition. That was it. Three days on nutrition and obviously, Hippocrates would roll over in his grave because he said, "Let thy food be thy medicine and medicine be thy food."

I think that's also nuanced, where even western psychologists like Carl Jung were anti-yoga, not because they didn't believe in things like yoga as being helping with vitality, as you say. But because they believe in the western hands, they would be abused in the way maybe Joe Rogan or Kim Kardashian abused the Wim Hof Method. Who knows? That's really interesting. I know we're coming up on time. And you have very nuanced thoughts. Two rapid-fire questions for you. One is The Vortex is coming out next month. What are you currently writing about that you're most excited about? What are you doing right now that you wouldn't mind giving a preview to our audience about?

Scott Carney: It's just so funny because I have six books in the works. I have The Vortex coming out. I'm working with my wife, who's a podcaster, and we're putting out a series of kid's books. One is about Bigfoot, the other is about extraterrestrial life where we try to take on on these bizarre and fictional-ish topics. But then you apply science to them, so we use it to teach. You know, Bigfoot, crazy! But let's talk about evolution. How would Bigfoot exist? Or space aliens. Are we visited by UFOs? Let's talk about the physics of what that is. So that's one section of my company, Foxtopus.

I help. I'm a co-author on that stuff. I have a book that I'm just working on right now, about Santa Anna, the guy who stormed the Alamo and killed all those Texans. I want to write a biography of Santa Anna to talk about how Mexico actually, maybe should have been the superpower in North America, and it shouldn't have been the United States. And by the way, those guys in the Alamo were just like slave-trading assholes anyway. Who cares if they got massacred. I mean, I have a lot of different stuff coming down the pipeline.

Shiv Gaglani: Is the forward going to be written by Ted Cruz? Or...

Scott Carney: My marketing plan is to get banned in Texas. Easy.

Shiv Gaglani: Yes. Hilarious. The children's book education stuff is very resonant. We're a teaching company. You can see it in my background here. We love that kind of work. And what else? Did you want to add anything else to that?

Scott Carney: Yes. And I'm working on another book about the future of medicine, which is the stuff that I was talking about. When do you switch? What is complementary medicine? What is the standard of care? I don't know. We're playing with the title “standard of care” because it sounds so comforting. "Oh, you're getting the standard of care here." So, that is what you should get. But when you actually look at where that term comes from, it's an insurance term. It's like, “this is the minimum you need to apply to not to get sued.” That's a very different concept when you walk into an office.

What does it mean that insurance defines medicine? There are all these problems. The people come to doctors and think they're scientists. Piffle. I mean, there's some science involved, right? But if you look at what Lester King used to write about medicine, it's really about a relationship between the doctor and the patient trying to figure out symptoms and signs, and there's so much subjectivity and outcomes that cannot be determined.

But Americans, we want answers, right? We want certainty. And medicine doesn't offer certainty. There's no scene where someone's like, "Doc, how much time do I have to live?" And you'll check a chart and like, "Oh, well, it's 62 days." This is a fiction that Hollywood comes up with. But people believe that that's the way medicine should be. I want to examine that fundamental relationship in yet another book that I'm writing.

Shiv Gaglani: We’ll definitely bring you back on the podcast for that. That could be an entire episode, or more because that is like at the crux of art versus science taught in medical schools. We work with over 150 of them, and that nuance is missing, and that nuance is also the reason I think general society has this issue with the infodemic, which we talked about a lot, where yes, western medicines said don't mask at the beginning of the pandemic. And now it's definitely mask. Things change, and we don't know. And people don't understand that nuance. They're looking at people like Fauci as the end all be all. But they don't know. They have a better sense than you do. But they don't actually know.

Scott Carney: The gray area is so important. We want to be so black and white in the world like, "We're right! And I can do 140 characters on Twitter. I could just destroy you!" Right? It's like these stupid conversations that we have in the world where we think there is an answer to complex, nuanced, impossible-to-answer uncertainties. It's like we're all children. Everyone is like a nine-year-old child who just wants their parents to tell them how the world really should work. And the parents, or the doctors in this case, have to create a convenient lie to make them follow in line with what the best possibility might be. I don't have much faith for the future of the world. We're all in it together.

Shiv Gaglani: Yes. After reading Yuval Noah Harari books, I've lost a bit of faith too. But hopefully, we'll see things turn around. There are obviously some bright spots. My last question for you is: What advice would you give to our audience? Many of them are just beginning their careers as healthcare providers, or are in the field already. But you have such an interesting, storied career. What advice would you give them about meeting the challenges of COVID and beyond?

Scott Carney:Be a dilettante. Hyperspecialization does not make you a happier person in general. Can you imagine? What do you tell a doctor who's going into the field right now? It's like, "Get ready to hang out in front of a computer a lot more than you do in front of a patient." I don't know. The whole reason why integrative medicine is amazing is not necessarily their theories are better. I mean, in some cases they may be. But it’s because they hang out with patients more, and there's less paperwork. Go into integrative medicine so you don't have to deal with paperwork? There's my very specific advice.

Shiv Gaglani: I would say again, just even reading books like yours, and being exposed to things that normally aren't taught in med school, but should be, or could be. And your upcoming book, which I think, again, we will definitely have you back in the podcast for if you're willing to join, is super fascinating.

Scott Carney: Sure.

Shiv Gaglani: With that Scott, thanks for taking more time than I had allocated for your time. I really am excited to have you on, excited about all your writings. I'll read The Vortex as I mentioned. I'll ping you after I read that. Thanks so much for everything.

Scott Carney: Love it. Yes. Absolutely. And thank you so much for having me on. It's been a blast to chat with you.

Shiv Gaglani: And with that, I'm Shiv Gaglani. Thank you to our audience for checking out today's show. And remember to do your part to flatten the curve and raise the line. We're all in this together. Take care.