Data Science and Your Health

Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Tom Butler (00:04):
This is the Cycling Over Sixty Podcast
season three, episode 39, DataScience in Your Health.
And I'm your host.
I'm not gonna do an extensiveupdate for this episode because

(00:26):
my interview this week was sucha great conversation and it went
on a little longer than normal.
Here are a few things that Iwant to share.
First, I want to continue toinvite people to join the
Cycling Over 60 Tour to Cureteam.
I love the idea of using thetour to cure as a launch party
for the summer cycling season.
The ride in the Seattle areatakes place on May 2nd, and

(00:47):
there are several tour to cureevents across the nation.
I know it seems like a long wayoff, but I'm looking to do some
fun things that will take timeto develop.
So I'm trying to get peoplesigned up really early.
The American DiabetesAssociation organization that
I'm working with is in thePacific Northwest, and the ride
is in the Seattle area.

(01:07):
I would love it if some of youfrom out of the area would come
visit here and ride with us.
One of the reasons that I'mpromoting it so early is to give
people time to plan a triphere.
The route is around LakeWashington, and I believe it's
worth a trip here to do thatride.
You can find a link to the teamin the show notes or go to
tour.diabetes.org forge slashteams forge slash CO60.

(01:32):
Or you can just go to the tourto cure Pacific Northwest and
search for Cycling Over 60.
If you'd like to know moreabout our plans, email us at
info.cyclingover60.org.
I took the opportunity toparticipate in a fun event a
couple of weeks ago.
If you pay attention to theCycling Over 60 Instagram, you
saw a picture of me doing myfirst cyclocross race.

(01:54):
I've talked about doingcyclocross in the past, but my
participation in this eventhappened in a very different way
than I thought it would.
I originally planned to starttraining for a race this fall.
I didn't know if I wouldactually do a race, I was going
to see how the training went.
But only a couple days beforethe race, Gehrin called me and
encouraged me to try it out.

(02:14):
The race was put on by anorganization called Lemon Peel,
and this was in Stillicum,Washington.
And a big factor for me writingit was that the course was
designed to be very friendly fornew riders.
We did a few practice lapsbefore the race, and that made
me feel pretty confident that Icould finish.
I really had no idea when Istarted the race if I would do
well or not.

(02:35):
Within seconds of the startsignal, I knew that I wasn't
going to be keeping up withothers.
My limiting factor is my heartrate.
I believe I need to keep fromgoing above 160 beats per minute
very often.
For the race, my average heartrate was 162 beats per minute.
So I was staying right at mymax.
But I just couldn't generateenough power to keep up with

(02:56):
everyone.
In fact, I was leapt by theentire group.
Interestingly, as I was loadingup my bike, some people I knew
came by and told me that therace organizers were looking for
me.
I checked in with theorganizers and found out that I
had won.
It turned out that I was theonly category four rider in the
over 60 subcategory.
So I ended up with a very funlemon peel winner medal.

(03:21):
I guess you could call it amedal.
It was actually made out ofwood.
But if you go over to theCycling Over 60 Instagram, you
can find a picture of it.
I enjoyed myself too much.
I really want to have a cyclingover 60 cyclocross team next
fall.
The truth of the matter is, Iam pretty sure I'm going to be
one of the last finishers in anyrace that I do.

(03:43):
But I still found it to be areally fun event in a specific
way.
There is something about beingin a race that I really enjoy.
Now here's the problem.
If I'm going to ridecyclocross, I do need to have a
cyclocross bike.
The bike I used for this eventwas my Trek FX3, and it really

(04:04):
wasn't the best thing.
I certainly will keep everyoneposted on my search for a new
bike.
The final thing that I want tomention is a new free program
being offered by Rode Scholar.
Starting Thursday, October23rd, there is a five lecture
series that, in their words,offers open, honest
conversations about aging.
Canon, uplifting, and groundedin wisdom rather than worry.

(04:27):
These online galleries aredesigned for those navigating
life's fourth age.
A stage not defined bylimitation, but by perspective
and resilience.
I truly like Road Scholar andthe events that they do, even
though I've never participated.
But I will be checking outthese lectures.
I'm expecting great things fromthese five lectures.

(04:48):
And again, they're free and Ibelieve really worth checking
out.
A while ago, I got a messagefrom Rob McLeod.
Rob is an avid cyclist who hasbeen heavily involved in the

(05:11):
cycling community in Salt LakeCity.
If you search for ProfessorRob's bike page, Utah, you will
find some of his writings oncycling.
I'll post a link in the shownotes.
There is a lot of interestingstuff there.
But I really wanted to have Robtalk about his professional
work.
He has been on the leading edgeof technology and health for a
long time.

(05:31):
I was really excited to get hisperspective.
And here is our conversation.
I am really pleased to welcomeDr.
Rob McLeod to the podcasttoday.
Thank you, Dr.
McLeod, for joining me.
Yeah, it's a pleasure to behere.
I'm a big follower of yourpodcast, and it's it's a real
honor to be part of it.
I'm thrilled because you bringa real combination.

(05:55):
Your your academic work, youknow, your cycling, everything.
There's a real combination ofperspectives that you bring, and
I'm thrilled to be having thisconversation.
And I'm gonna let you talkabout your background, your
professional background, andeverything in a bit.
But I want to start out byasking you to share your
earliest memory of the bicycle.

Rob MacLeod Ph.D. (06:16):
Yeah, this is this is interesting.
I um I thought back a littlebit about this, and I and it was
sort of a twofold experiencewhich has influenced me in in in
both ways.
So I remember as probably a sixor seven-year-old, you know,
getting my first bike andlearning how to ride it, and you
know, all the usual experiencesof crashing and getting better

(06:37):
and getting and gaining theindependence that a bicycle
brings.
And that's a wonderful,continues to be a wonderful part
of my life for sure.
The other aspect that I thatalso left an indelible
impression and I guess shaped alot of my relationship with the
bike was that this is one of thefirst times that my father and
I, or that I can remember, myfather and I working on

(06:57):
something mechanical together.
And so I remember him at somepoint, you know, taking the axle
out of the bike, or I don'tthink it would think it was a
little more than changing a flattire.
It was it was actually doingsome servicing on the bike.
And for me to get some idea ofwhat the internals of a of a
bicycle looked like.
And and and that's set a seedthat you know continues to this

(07:22):
day.
And I I don't think I've everhad a time in my adult life when
I didn't have some form of abicycle service space in
wherever I was living.
Even as a student, I had acloset in my living room and I
had all the bike tools in there,and I'd roll out a plastic
sheet in my living room floor,and I'd, you know, set up a

(07:45):
stand and pull the tools out andand and work on my bicycle even
then.
And ever since then, it's thismechanical aspect has always
fascinated me.
I guess as an engineer, I livein a house that I had the good
fortune to design.
And so the bike shop was builtinto the house right from the
start.
And it has, you know, more orless the it's never big enough.

(08:06):
You always underestimate howmuch space you need ultimately.
But I have this designatedspace and and and it is one of
my you know truly happy spacesto inhabit.
And and the neighborhood kidssometimes bring their bikes over
when they need a littleservice.
And so there's there's there'syou know that part of it.
And and I, as I say, both boththe the sense of a cyclist and

(08:28):
the sense of flight and themechanical aspects of a bicycle
really went back to those thoseearliest days of my memory of
first exposure to a bike.
And and I also, not too longafter that, was a few years
after I started riding, I hadanother indelible experience,
which I think most of us havehad at some point, and that is

(08:49):
of having your bicycle stolen.
So I, you know, made thebeginner mistake.
I leaned it up against a windowof some kind of store I was
going into.
I ran into the store when Icame out, the bike was gone.
And so that is also probablywas the beginning of thinking
about bicycle advocacy andtrying to figure out a

(09:10):
comprehensive way to think abouthow bicycles um should fit into
our lives and and the diverseaspects of of support that that
are needed to make cycling aviable, safe, functional means
of both transportation andrecreation and even performance
support.

(09:30):
Did you keep up with cyclingthroughout your life?
Yeah, it's there was there wassort of, you know, there was a
gap after the first bike gotstolen, and um it took a little
while to to get another one.
And then I kind of went throughearly teenage years not riding
so much, then had the enormousgood fortune.
It was another life-changingaspect of my life.

(09:53):
My father was a professor aswell, and Dee had a sabbatical,
and which is a wonderful elementof university life that I'm not
very good at taking advantageof in my own professional
career.
But the idea is fantastic thatyou get to go to another lab,
another setting, anotherenvironment, and learn new
techniques and broaden yournetwork of scientific

(10:13):
connections.
And it's an incredibly healthypart of academia.
So he had one of thesesabbaticals, and by then we were
four children.
I'm the oldest of foursiblings, and he decided that it
was time for us all to go toanother country, learn another
language, and be exposed to awhole different culture.
And he was able to merge thatgoal with his academic goals,

(10:35):
and so we ended up ended up insouthern Germany in a beautiful
city called Freiburg.
And so, of course, theirbicycle culture is everywhere.
And all of my friends atschool, I was, you know, more or
less thrown into a Germanschool and told to figure it
out.
And so while I was learning thelanguage as quickly as I could
and making friends, I realizedif I'm gonna hang out with these

(10:56):
guys, I at least need a bike,if if not eventually a moped or
something motorized, but atleast I need a bicycle to get to
and from school.
So that was my you know, firstpurchase of uh what back this is
the early 70s, you know, whatwe call generically the
10-speed, right?
So the first kind of racingstyle of bicycle.
And I remember finding one ofthese somewhere used and

(11:17):
bringing it home, and my fatheragain helping me with it and
getting it set up to take toschool.
And this is also where I againlearned an important mechanical
lesson because my my father hadnever seen a derailer before.
He was, you know, he was goodwith his hands, and you know, he
was more a carpenter than amechanic, but was, you know,
willing to figure this out.
So we put the bike together, wegot it going, everything was

(11:39):
fine.
And I was riding it to schoolvery proudly for the first day.
And it was a little hill I hadto get up to get to the school.
And I went to put the bike inthe smallest gear.
And I don't know if you everexperienced this, but the
derailler immediately went intothe spokes, ended up wrapped
around the axle, and was wassnapped in half, literally.
It was one of these old plasticirrit was the name of the

(12:01):
company that used to make theseplastic body derailers for a
thing at the time.
And it just snapped thederailler in half.
So so rather than ridingproudly onto the into the school
that day, I was, you know,walking, dragging my bike onto
the school feeling verydespondent, discouraged.
So so again, that led to awhole new set of lessons both in

(12:22):
bike mechanics and and also ofthe relationships that one can
forge through this commoninterest in bicycle.
It came about because one of myclassmates, you know, he heard
my story, saw my bike, andspontaneously said, Oh, yeah, I
can move to my place.
We can figure this out.
And so, through somecombination of time with him and
then, you know, getting a newderailler, he actually taught

(12:44):
me, you know, how to set up aderailleur property and how to
get it on the bike so that itshifted but didn't run off the
rails.
And so, again, deepening themechanical, you know, uh aspects
of bicycling and also the thisrelationships and the notion of
the importance of relationshipsthat are formed through common
interests.
He and I were very different interms of our background and

(13:07):
upbringing.
He was he was German, that wasa small difference in the end,
but but you know, came from ayou know wonderfully modest
background and you know, livedin an apartment, and you know,
like most German sort of middleclass people do.
And so it was an amazingopportunity to also learn about
German culture, what it's likein a typical German family.

(13:28):
And we ended up spending a lotof time together, and then and
then we started doing a fewadventures where we would go off
on rides into the foothills andinto the higher mountains
sometimes of the Black Forest.
That was my first exposuregoing up Nova Scotia.
It's not a terribly mountainousplace, but it was it was the
first exposure, you know, tomountains, to you know, serious

(13:50):
cycling culture, and and fromfrom then on, I was pretty much
addicted.
So I cycled a lot during thatyear.
It was a bit of a hiatus when Icame back.
Uh, I cycled some, but again,it wasn't as as conducive, you
know, in this part of Canadawhere I was living at the time.
But then the big move came whenI, you know, was in my

(14:12):
undergraduate years.
I was spending them mostly inGermany, the summers at least.
And then after my undergraduatedegree, I I moved, uh, ended up
moving to Austria.
I lived there for about sevenyears, and that was where you
know things really took off.
Don't tell anybody, but I usedmy student loan to to buy a nice
bicycle.
And uh and because I was goingto university there as well.

(14:35):
And so so I was going touniversity and working and
riding my bike and and and andof course, you know, living in a
place like Austria isincredibly conducive to
bicycling as commuting, but alsobicycle as adventure
opportunities, bicycle touringand riding in the mountains.
And I and I've certainly neverlet up.

Tom Butler (14:56):
You talk about these experiences and including uh
the bicycle being taken, beingstolen, and then kind of you
know, looking at the whole, youknow, how do we make the
environment how uh moreconducive to a bicycle?
And then being exposed to adifferent culture, uh do you

(15:17):
feel like you're atypical as faras your view of transportation?
Because we're so car-centric inuh the US, and uh it seems like
you had some experiences thatkind of opened you up to to not

(15:38):
being so car-centric.
Is that a fair assessment?

Yeah, absolutely, absolutely.
And and and it's it's you know,we just recently met some new
neighbors who grew up in NewYork and spent the last 25 years
in New York City, and they sortof described their urban life
and they did some bicycling, butI learned, you know, over time
that it doesn't have to be shortcommutes and dense cities that
are conducive to a non-motorizedform of transportation.

(16:04):
Even in Austria, I livedoutside of the city, so I had a
fairly long commute by bike.
And when I first got there, Ithought, oh well, this is way
too far.
I'll never be able to do thison my bicycle.
And so uh for a little while Ihad a motorcycle.
This is you know what you dowhen you're in your 20s.
I had my motorcycle, managednot to have an accident with it.
But then found myself when theweather was okay, and I felt

(16:27):
like I had the time.
And I thought, well, why don'tI ride my bike?
Let's just see how this goes.
And so I, you know, I tried it.
And then little by little, themotorcycle was gathering dust
and the bicycle was getting moreuse.
And so I thought, okay, this islet's sell the motorcycle
before, you know, there'snothing worse or more dangerous,
I think, than a motorcyclistwho doesn't ride regularly.

(16:48):
It it's it's a skilled skillyou have to develop, cultivate,
and maintain.
So I thought, okay, I'm I'm youknow, I'm not using it, let's
get rid of it.
And then by then I was I wasgetting into riding, you know,
many days a week, not every day,you know, weather permitting.
And this at that time wasprobably, I don't know, maybe a
10 kilometer one-way commutewith some climbing.
I lived in a village above thecity, so I was climbing every

(17:11):
day.
And that really set the tonefor you know what it's possible
to do, and started me down thepath that I'm very much on now.
I have a daily commute that'sabout 15 kilometers each way.
I climb 300 meters or athousand feet to get back to my
home every day, and I ridethroughout the year, even here
in Utah, where we have some, youknow, some sometimes some

(17:33):
pretty serious winter weather.
So it's so it, you know, itsort of expanded what's
possible.
But at that time, just as apractical possibility, I don't
think I really analyzed it asmuch as I have in in later
years.
And now it's become such animportant part of my physical
health and mental well-being.
And it it's just a part of myroutine that I deeply miss when

(17:55):
I actually have to take the carfor some practical reason, the
weather really does prohibit it.
So I think that, you know, it'sthat's been a process that took
time to develop.
And I just along with themindset that, you know, we all
hear about, but sometimes it'shard to put into practice that
there's no such thing as badweather.
There's just bad clothing.
And and so it it took a whilefor for me to turn that into a

(18:19):
practice, and you know, anddevelop the techniques and
clothing and whatever other bitsand pieces accumulated that
make riding all year round areal possible.

Tom Butler (18:28):
I love the fact that you have this mindset that I
think is is definitely abicycling mindset, and that
comes in a lot of differentforms.
Today, I want to talk aboutyour view of technology when it
comes to healthcare.

(18:49):
You have been involved in somany interesting things.
I'm not gonna try toencapsulate it, but how do you
talk about your professionalbackground?
How do you explain who you areas a professional to people?

Sure, that is an interesting question.
I I give a a number ofpresentations to students here
at the University of Utah, someof them about career and the
pathway to a career.
And I emphasize that manyinteresting careers are are what
I would call nonlinear orcertainly not predictable.
And mine was like that.
So going to Austria for allthat time was certainly not part

(19:27):
of a typical uh academiccareer.
I I went there for a couple ofyears to do a master's degree,
and seven years later I cameback with my master's degree.
I I did manage to get that, buta whole lot of life experience
and professional scientificexperience that certainly shaped
the future.
But along the way, and themaster's degree I got ended up

(19:47):
not being in what I do now, butactually an audio and sound
engineer.
So Austria is a wonderful placeto experience music, especially
classical music, of course,deep traditions of very famous
classical composers who dominateand a longstanding support from
the public for preservation andpublic access to both classical

(20:10):
and contemporary music.
Wonderful setting to appreciatethat.
But along with that, there'salso quite a deep tradition of
the technical aspects of audioengineering and sound recording.
There's great Austrian acousticcompanies that are, you know,
still important today.
So it was a wonderful place todo both those things.
So on the one hand, I was offdoing sound engineering and

(20:30):
taking music courses andlearning how to do composition
and what the differentinstruments sound like.
But in my day job, I waslearning about the heart and how
the heart works.
And that institute that I wasin was focused very much on the
small scale, cell scale.
And so that became thefoundation for what's you know

(20:50):
now become my career.
So I continued to study theheart.
I came back to Canada.
I decided to do a PhD inphysiology and get some serious
training in the biomedical andmechanistic aspects of how the
heart works.
Then that was a fairly shorttime back in Canada.
And then in 1990, I moved hereto Utah to initially be a

(21:12):
postdoc and then eventually afaculty member.
And so the heart is is, ofcourse, a naturally a
fascinating organ, but it'srelevant, I think, because it
does tie into our health and ourfitness and and so many aspects
of our daily lives.
Nobody is truly unaware oftheir own heart.
And all of us have hadillnesses in our family that

(21:33):
have affected people's hearts.
So it's a great entry pointinto lots of interesting
conversations.
From a scientific perspective,of course, it's as all
specialists will tell you,whatever they're studying is the
most important organ and themost fascinating thing to know
about.
But and I certainly suffer fromthat illness.
But it's also, yeah, one ofthese central organs to what we
do.
And because it's tied so muchto our physical health, um, it

(21:58):
became sort of a naturalcomplement as I thought more
about the heart and generallythe cardiovascular system, all
its pieces, and then broadlyabout the musculoskeletal, you
know, all the pieces that aresort of tied together through
the cardiovascular system, theyoverlap so much with all kinds
of questions about fitness,fitness from the casual person

(22:21):
recovering, maybe even from aheart attack, who needs to get
themselves in some kind of shapeall the way to the elite
athlete.
And living in a place likeUtah, it's easy to get exposure
to that complete rain.
So so I've I've literally, youknow, countered people just
trying to get a lifestyle backafter serious illness from

(22:42):
cardiovascular disease all theway up to to Olympic and Tour de
France caliber athlete.
This is the beauty of living ina place like Utah, that we
really do have the spectrum.
And and so bringing thatexperience with the people
around me, you know, back to myresearch and thinking about what
these relationships might meanand how we identify maladies,

(23:06):
how we track people, how wefollow our own health, this just
became a natural fascination.
So I had a polar heart ratemonitor, you know, very soon
after they came out, and Icontinue to play with whatever
gadgets I have just to monitorwhat's going on in my bike.
And and then I try and bringall that into my classrooms.
So I'll I'll use data I'verecorded on myself while riding

(23:29):
my bike as an exercise for mystudents to analyze and
interpret so that they canunderstand all the various
things that come into powergeneration, mechanical power
generation on a bicycle.
I've I've managed to tie allthe pieces, I think, together in
a way that makes me feel notcompletely scattered, but with a
lot of different aspects toexplore, depending on whatever

(23:52):
current opportunities uh I'mfortunate enough to have.

Tom Butler (23:55):
When you moved to Canada to study, uh was there
always this element of theconnection between technology
and the human heart, or did thatconnection evolve over time?

Yeah, that's an interesting question.
So that probably startedalready when I was in Austria.
Uh, you know, I I was in awhat's called medical physics
department, which can mean lotsof different things, but there
were people around me, a closefriend to this day, who was very
involved in elite athletes.
He himself was an outstandingathlete, and he became a sports

(24:32):
scientist, studying, you know,both biomechanics and
physiology.
And it was just alwaysintriguing to talk to him and
learn from him.
He was working, he's workedwith a number of different
actually ski teams in Austria.
And of course, Austria skiteams are the most elite
athletes in the country,generally, probably even more so
than the soccer player.
And so he was working, he wasdoing you know fitness training

(24:54):
with the Alpine ski team.
And so it was fascinating toshare his observations about,
you know, that the training theywere doing, you know, uh at
this extreme level, and thentying that back to the research
that he was doing in the lab.
We were both in, you know, inthe same lab setting.
You know, it was always sort ofpart of the mix to think about
how this material, theseconcepts we're studying in

(25:17):
textbooks or trying tounderstand a scientific
perspective, how do theytranslate, you know, into the
practice, in this case, ofextreme elite sports.
What we know, one of theobservations that came strongly
and got reinforced even morewhen he switched to actually ski
jumping.
He became actually a verywell-known figure in the world
of the science of ski jumping.

(25:39):
He's designed ski jumps.
There's Innsbruck ski jump,which is uh used in
international competitionregularly, is his design.
And so he figured out a lot ofthe mechanics of ski jumping.
And one of the interestingperspectives he had when he
started into this field is he hehe he knew enough about
computing, he had a physicsbackground, he knew about the

(25:59):
compute, computational modelingaspects enough to know that
there was potential.
That's where he and Ioverlapped a lot.
I've I've always been involvedin computing and using computers
to both understand and simulatephysiology of disease and
health.
And so he started thinkingabout how he might create a
model of ski jumping in order topredict certain behaviors.

(26:22):
It turns out this was during anera when it was a change in the
style of ski jumping and andsome of the elite jumpers were
suddenly crashing more than theyhad before, in part because of
this new style of jumping.
He was already working with theteam, so they came to him and
said, you know, you're thephysicist, you figure this out.
Like, why are we crashing?
I mean, these are fabulousjumpers, world-class jumpers.

(26:42):
All of a sudden, out of theblue, they're they're crashing.
So that got him into a deeperanalysis of the whole thing.
But the key point here is thathe went to all his simulation
friends like me and said, Okay,how accurately can we do these
models?
We would say things like, oh,10%, maybe 5%.
You know, that's enough.
We can design cars or lots ofthings with that level of error.

(27:03):
You know, that's an acceptablelevel level of error.
He said, you know, 5% is thedifference between a world
champion and someone who has nochance of making the when it
comes to that level of sports.
And he said, you have to beable to get me down to one or
two percent to even be vaguelyrelevant because it really comes
down to one or two percent.
This kind of made me appreciatejust the the impact of this

(27:28):
uncertainty, this approximateknowledge that we have and how
this plays out at the high endof sports.
And that helped that has helpedto this day frame you know how
I think about physiology and thediseases that we study as well,
that that small changes inunderlying conditions that we
barely can measure andoftentimes can't even include in

(27:51):
our thinking, and have profoundinfluences on somebody's health
or at the other extreme intheir athletic performance.
And I just recently heard justrandomly an interview between
Peter Atia and and LanceArmstrong.
And Lance Armstrong, of course,you know, we in the bicycle
world have probably mixedfeelings about we've all heard
of them.
And so the question was, whatyou know, what do you think all
those drugs did for yourperformance?

(28:13):
And he said 10%.
And and when you and I thinkabout many aspects of our lives,
what's 10%?
I mean, you know, a 10%increase in salary, sure, we
noticed that, but it's notlife-changing.
But 10% longer on our commutetime, you know, what these are
not big numbers you know, in inour daily lives.
But 10% at that point, that endof the spectrum literally meant

(28:37):
the difference betweensurviving as a professional
athlete and not even being beingon the team, which of course
led to all kinds of problemswith drug use in in cycling, um,
which legacy we're not we'restill living with, or not, of
course, proud of.
But the point is, from myperspective, that the relatively
small changes in our function,our physiology can make really,

(29:01):
really big differences in how weperform.
And I would argue in how wefeel, and so so it it allowed me
to focus on on maybe some ofthe little things that have
helped shape my perspective bothon you know in physiology and
arguably psychology and life ingeneral.

Tom Butler (29:17):
Well, it really is an interesting illustration, you
know, of human potential, youknow, that in some aspects, two
percent, three percent can makea difference, and to try to
improve the systems to give itthat kind of accuracy, that's
very interesting.
You are deputy director of thescientific computing and imaging

(29:40):
institute, and you're also anassociate professor of internal
medicine.
And I'm thinking thatthroughout your career, uh from
the time you start forming, youknow, your pursuit of of
computing and health.
And heart function.

(30:01):
I mean, I'm think there's justbeen a dramatic change.
There's just been advancementsin computing and imaging, and I
mean, uh, you know, just theaspect of those early computers
that you were modeling, youknow, the computing power on
those we probably have on ourphones, I imagine.

(30:23):
You know, so you've seen someincredible advances in medical
imaging.

Yeah, the the the the advantages, the
advances in computing broadlyand imaging and everything that
derives from the power that wehave in computing.
Certainly it's been a centralpart of my when I was in high
school, I was one of those nerdswho would you know sneak into a
room that we had in our highschool that had a paper teletype
terminal, and you could sort oftype a few commands and it

(30:51):
would go off to some computersomewhere and give you some
feedback.
And when I first my first jobas a as an undergrad student in
research was, you know, we hadcards, literally those old
computer cards that you'veprobably seen in movies and
things.
And that really was how weprogram computers.
So so yes, I you know, I'vefollowed this along.

(31:12):
I mean, I you know, I was bornthe same year as Bill Gates and
Steve Jobs, and of course, notnearly as famous, but I I sort
of share with them, you know,moving through this computer
generation and engaging in it ina in a different way, I mean,
completely different way, butstill, you know, benefiting from
the progress.
So that, you know, in the early80s, I was doing email.

(31:35):
And when I came back fromCanada or from Austria to Canada
in 1985, I mean, most of thefaculty in our department had
never heard of me.
And and, you know, one of mylittle side jobs was teaching
all the faculty and eventuallythe other students how to do
email because it was totallynew.
Internet was just gettingstarted, and and so we're we're

(31:55):
just sort of you know seeingthese things emerge.
A little historical side noteis that University of Utah was
the fourth node on the internet.
So we're quite proud of this.
And and and so so it's it'svery much part of the culture
here locally.
But even before I came here, Ijust kept seeing these
improvements of storage, ofspeed, of visualization, graphic

(32:20):
capabilities of computers, andas you say, even our even our
phones have have just madeastounding improvements.
And so throughout my career,I've been at, you know, at times
at a point where I say I havean idea for what I would like to
use the computer to do, but thecomputers can't do it yet.
And this continues on.
And uh I I would say it's ledup in the sense that we have

(32:44):
amazing capacity, which isimproving dramatically and has
improved dramatically in thelast 10 or 15 years.
But when we started thescientific computing and imaging
institute, which was around,which was in the early 90s, so
this was together with acolleague, Chris Johnson, and
there's a there's a bicycleconnection here, I'll come back
to, but but when he and Istarted this thing, we were both

(33:05):
working in, you know, trying todo computer models of some
aspect of the heart and thephysiology and behavior of the
heart.
And we just kept running intoobstacles.
We would go, I remember, youknow, going to the official
computer center on our campusand saying, you know, can we use
your computer?
And they looked at us strangelyand said, you know, who are
you?
Sort of explained.

(33:25):
And they said, You want to useour computer for what is it you
want to use it for?
And what makes you think thatyou can do that?
You know, you should haveaccess to this very expensive
computer back here that we'rebusy using to keep track of, I
don't know, student records oryou know, the finances of the
university, whatever they weredoing with it.
And they basically showed usthe door.
And and so we regrouped alittle bit and said, okay, this

(33:48):
isn't working.
Fortunately, we were just at aperiod where still quite
expensive, but relativelyportable computers were
emerging.
So from some of the majorvendors again, early 90s.
So we managed to convince a fewcompanies to give us some
computers to play with and alittle bit of technical help.
And we just started exploringwhat these computers could do

(34:10):
and doing things that I guessothers hadn't done with them in
our area.
And and it just kind of wentfrom there.
And we I would say werecognized reasonably early on
that we were not that special inthe sense that that there were
probably other people out therewho, if they could get access to
computing, could do amazingthings, and that the problem was

(34:32):
the access.
The computers had reached apoint where they were powerful
enough.
Even the computer science thatyou need to run the computers,
solve problems.
That was at a mature enoughstage.
But that there was this hugegap between where the computer
scientists were and where thescientific practitioners were,
in our case, the medicalpractice.
And we thought we we need to beable to make both sides aware

(34:54):
of this opportunity and buildbridges between the computer
science and the applicant.
And that became the basis ofthe scientific computing and
imaging, or we call it skibecause we're at Utah.
The Ski Institute, you know,took off, you know, because of
the relationships that we wereable to build.
We were able to exchangebecause again, we were trained
enough medically andbiomedically that we could

(35:16):
discuss problems like this withour biomedical counterparts and
say, you know, you could use acomputer to do this analysis,
whatever.
So that's what got it started.
And then, you know, along camekind of imaging, mature imaging,
especially magnetic resonanceimaging, which provided us with
a window into the structure ofthe heart in my case and the
brain and other research casesthat we just didn't have before

(35:39):
the ability to reconstruct inthree dimensions, soft tissue
and all the structure.
That became a whole notherdoorway and an opportunity for
us that we quickly tried to makeuse of and continue to make use
of.
So at every step of the way,and I think we're still doing
this today, kind of trying togauge what's possible with

(36:00):
computers today and how can weturn that technology into
something that ultimately helpspeople.
I'm a biomedical engineer.
I'm that's professorship is inbiomedical engineering, and
that's very much at thisinterface in the technology,
biology, and then applicationsto medicine.
And I ask my students why inthe world would you take on this

(36:21):
challenging field of study?
They almost all say, because Iwant to help people.
I I don't necessarily want tobe a doctor, although some of
them do, but I really want tohelp people, and I'm kind of a
geek, right?
I mean, you know, I grew upfiddling with things, being an
engineer.
And but I I I want to see myengineering directly as possible
go toward helping people, andthat's what our our field is.

(36:42):
So so it's a very resonant basefor kind of thinking.
And then I guess briefly toclose the loop.
So the bicycle connection hereis that when I first came here,
I, you know, loved the thecycling here is really quite
amazing.
The weather is perfect for it.
And so Johnson and I wouldevery odd day of the month,
there's a canyon here that goesfrom the city up into the

(37:05):
mountains called City CreekCanyon.
And every odd day of the month,it's open to cyclists.
And so every odd day of themonth, we would finish our day,
the end of our working day, wewould get on our bikes and we
would ride up the canyontogether.
We would talk and scheme, plan,figure out what are we going to
do next, what's the next move,what's the next grant
opportunity, who's the nextcollaborator we could find, how

(37:28):
are we going to go forward?
And so the whole basis of youknow the institute, which is now
a couple hundred people and hasits own building and all this
wonderful stuff, way beyond whatwe ever thought would be
possible.
Those were its origins.
And I and I contend that thatmixture of kind of physical
exertion, being outdoors.
So once you get into the canyonroad, there's no traffic, bikes

(37:50):
and pedestrians, and you'regoing uphill, so it's quite
calm.
You know, you're exertingyourself, but you you know, we
would do it at a pace we couldstill talk.
And it was just that settingand those conditions, both in
our bodies and around us, isjust the perfect place to let
your mind run, explore ideas,speculate on what we might do.
It really did form the basis,not only for a great friendship,

(38:13):
but but also for the ideas thatthat we were able to convert
into practice.

Tom Butler (38:19):
That's such a great story, you know.
I go out, you know, fortwo-hour rides uh frequently,
and never listen to anything,you know.
And there's several elements toit.
One is just uh I it gives methe space.
I don't have to do anythingelse.
It's not easy for me to respondto text messages or anything

(38:41):
while I'm writing, and sothere's just the space to just
think, and then I do believethere's blood moving, there's
oxygen moving.
I I think there's probably anelement of brain function, and
then there's an element ofrhythm.
And I've talked before on thepodcast, it seems to me like

(39:03):
there's almost this uhphysiological meditation body
movement kind of element tobeing in a rhythm on a bike when
you get on a long flat andyou're just keeping the 90 uh
revolutions per minute orwhatever.
I it just seems like it's a itcreates a unique space to really

(39:24):
contemplate things.

Yeah, you're absolutely right.
And the really fun part, again,this is me geeking out as a
scientist, but you know, we havethose perceptions which we
share and they're very real, butnow we know the neuroscience
behind a great deal of becausethere's compelling evidence of
the benefits of physicalexercise for our mental health,
you know, for our psychologicalwell-being, and exactly these

(39:48):
sort of zones we get in, thesort of meditative almost
aspects that that allows us tothink freely, that allows ideas
to percolate up.
These are now, you know, thestudy, the topic of studies of,
you know, and this again iswhere imaging comes in.
There are their imagingmodalities that can give us at
least indirect insights intowhich part of our brains are
active during certain exercisesor certain activities generally.

(40:11):
And they suggest that indeedimportant parts of our brain are
activated during exercise likethis.
Exercise that is not somethingwe need to focus on.
So, you know, this is thebeauty, as you say, the rhythm
of it.
You get into rhythm, you getinto a groove, don't have to pay
too much attention, assumingyou know, there's not too much
traffic.
Same is true with running andswimming, these sort of aerobic

(40:34):
sports where there's a naturalrhythm involved that are very
different from playing tennis oralpine skiing, really have to
focus, or mountain biking.
That's a very different type ofbrain activity that's going on
in those two differentscenarios.
And there's somethingintrinsically beneficial on top
of that, which is also beingdocumented, just being outdoor.

(40:54):
There's many studies on tryingto understand what is it about
being outdoors that just makesmost people feel better.
Like just going for a walk,just being outdoors.
There's something that happensin our brain in that sort of
space.
Now, again, there's lots ofstudies to show or try and
explore whether it's just thevisual or is it the sound, is it

(41:16):
the smells of the outdoor?
Like, what is it thatstimulates our brain in this
way, which is you knowfascinating.
But practically speaking, allwe really the takeaway is just
go do it because you'll feelbetter.
And cycling, you know, fits sowell into that paradigm.
I think it combines all ofthose aspects of, as you say,
the blood flow, the circulation,the the disconnection with the

(41:40):
daily, you know, requirements,which we have to get to at some
point in our lives.
But but we decouple from allthose external stressors, and
then we build a physiology, aphysiological base and a
neurophysiological that reallyallows us to recover, to have
thoughts that build ourhappiness.
That, you know, I don't know ifyou can see here.

(42:01):
This is my sort of famous myt-shirt.
So, you know, life is anintegral of happiness over time.
And so, so, you know, the morewe can improve and do things to
improve our happiness, andthere's that's a whole field of
study by itself, the more we cando that, you know, the I think
the just more content and happyand productive and all those
things that we feel with ourlives and and and cycling and

(42:24):
and sports like it are just youknow perfect for that.

Tom Butler (42:28):
This season of the podcast, I've really moved into
a realm where I'm talking aboutthe bike as a medical device,
you know, and some people feeluncomfortable with that because
it's like, well, a medicaldevice, isn't there some kind of
approval for a medical device?
And and I I think that's a fairthing to question, but if you

(42:49):
think of exercise as medicine,you know, if we're gonna embrace
that concept, then I think thebicycle is as good of a medical
device as anything you can find.
And I I'm thinking from whatyou're saying is that imaging
and analysis is really verifyingthat exercise is medicine.

Exactly.
Exactly.
I mean, I think especiallythese functional MRI studies
have have really given usimportant clues because we we
know in sometimes remarkablydetailed terms what different
parts of the brain are, youknow, more or less responsible.
I mean, there I was gonna saythere, there, there's there's a

(43:32):
lot of generic knowledge, but itturns out that there's some
difference between individuals,of course.
But there's enough genericknowledge that certain parts of
our brain are responsible forcertain actions.
And if we can identify whichparts of the brain are active
under which behaviors, then wecan start to tie those behaviors
and those responses todifferent types of brain

(43:53):
activity.
And that's generically providedus with this insight into why
it is that these things havehave, why they feel good, why
we, you know, we as sort ofamateurs just experience a
feeling of calm, feeling ofinspiration, or or we have
insights, we have ideas.
I mean, some of my best, but II would argue some of my worst

(44:14):
ideas have probably come to mewhen I'm out riding my bike.
And it just you're in thatspace where ideas percolate.
There's more and more evidencethat, again, imaging,
especially, has uh allowed us toconnect to neurological
functions and neurophysiologicalmechanisms.
And then when you tie that intowhat we know about the brain
and the brain has evolved andthe various aspects of the

(44:37):
brain, you know, primitivelimbic brain, the more cognitive
brain, and the variousperceptive aspects of the brain.
Where do we where do we thinkabout words?
Where do we put logical ideastogether?
Where our language centers.
And you know, there's we'retying all this together in
wonderful ways that continue topoint to exercise as probably

(44:57):
one of the most fundamentalsteps to general health, not
just physical health, butliterally to mental health,
happiness, results ofimprovement in symptoms of
depression and anxiety and allthe these horrible disorders
that are really affecting,especially our young people, and
this is where it comes togetherfor me.
Positive benefits of exercisethere are just getting more and

(45:19):
more compelling all the time.
It is the best medication.
Very many comparisons made.
If you know you sort of listall the benefits of exercise,
and then you compare that withthe benefits of any medication
you can think of, even the theother ones that we agree are
more or less benign that reallyhelp us deal with pain or
whatever.
If you had a drug that did 10%of what exercise would be, you'd

(45:41):
have you'd have a blockbusterdrug.
And so it's so it's very clearthat the benefits are enormous.
The trick now, and I'm, youknow, while that exploration
goes on, it's incrediblyimportant.
The trick now, of course, ishow do we how do we get people
to bring exercise into theirlives?
Because lots of us know what weshould be doing and have a very
hard time executing.

(46:02):
And so now we're into thisplace where how do we attract
people to, you know, whateversport it is, in our case, our
shared love of cycling, how dowe get people into cycling?
How do we how do we make iteasy for them to get into the
sport in a comfortable way wherethey feel supported, where they
don't feel revealed, where theydon't feel they have to get

(46:23):
competitive, where where theyjust have mechanical support,
where they, you know, they'rethey're they're not abandoned
somewhere by the side of theroad with a flat tire and no
knowledge of how to fix it.
There are so many things we ascyclists, I think are doing and
should be doing to enhance atleast, you know, some part of
the population to spend some oftheir time doing, you know, what
is arguably one of the bestlife sports that I can imagine.

(46:46):
I mean, you know, running tendsto be one of those sports that
has a limited lifespan.
Most people, when they get to acertain age, joint problems,
whatever, it makes it verydifficult to run.
Hiking works pretty well forlots of people, but you know,
hiking in nice areas can be alittle hard to get to.
I mean, you know, we're spoiledhere in a place like Utah, but

(47:06):
it, you know, it can be a hardone.
Cycling fits everywhere.
You know, you can cycle in NewYork City.
It is one of those great sportsthat can provide a life of
physical activity.
And I think our job, maybe mineas a scientist, is to continue
to explore the benefits, but Ithink our collective as a
community, as a bicyclecommunity, I think our role

(47:27):
should be, and for an amazingjob in that area, our job should
be to make cycling attractive,feasible, doable by explaining
it, by you know, encouragingpeople the right way, guiding
them gently.
You know, maybe it's time toget a pair of bike shorts, you
know, maybe it's time to thinkabout a little improvement in
your bicycle.
It's gentle things like that,but at the same time, just

(47:48):
basically saying, welcome to anamazing sport, and we want you
to be part of our supportive,wonderful community.

Tom Butler (47:56):
Have this kind of intersection.
I have a master's of publichealth and health promotion and
education, have a master's inmarriage and family therapy, and
so which is kind of you know,really a systems degree.
So it's this kind ofcombination about you know, kind
of healthy behavior systems,you know, and it had all this
knowledge, and and yet yearafter year after year, I kept

(48:20):
saying, Man, I gotta dosomething here.
This is the year that got himto do something.
It took pictures, you know,literal pictures, but a picture
of my function, my metabolicfunction, that I'm like, okay,
if I don't do something aboutthis now, you know, I I'm gonna
lose the opportunity to reallyimpact this.
And and I'm glad I did.

(48:41):
For me, being able to look at aheart as much as we can, you
know, through imaging orfunctional capacity
measurements, you know,whatever, and say, look, here's
the difference between a healthyheart, someone who stayed

(49:02):
active, or someone who gotactive, and the heart of someone
who's 75 who never got active.
Uh, that's incredibly valuableat the same time.
I think what you're talkingabout is there is a societal
element, and I'm reallyinterested in how we can build a

(49:22):
community that has some thingsthat are built into it that are
counter-cultural, because thecultural element just frankly is
a sedentary element, and so youknow, combining like some
cultural elements with some realgood data about you know what a

(49:43):
difference it can make, I Ithink in there there has to be
both those components toactually make real change.

Yeah, no, I no, I totally agree.
And and you know, what youwould know as a public health
expert, that there's lots ofthings that we know would be
good for society and good forour population, yet are
incredibly difficult to get intocommon regular implementation.
This is this is one of theaspects of studying the heart

(50:11):
that's so compelling that whilewe work on different details of
the heart and how it works andhow to fix it, how to understand
the illnesses, it turns outthat to make a massive
improvement in cardiovascularhealth, we don't need to do any
more research.
We we we know enough now uh toto change, you know, for
enormous percentages of thepopulation.

(50:31):
You know, while that mightundermine my future career, I I
don't care because I, you know,this is this is really I I'd
love to see society do better.
And so, so I think we're forcednow to think about things just
as you're describing of how dowe combine the information,
which is important.
People want to know why they'redoing something.

(50:54):
And and and just telling them,do it, it's good for you, trust
me, it is no longer enough, atleast you know, among any
discerning person who thinksabout anything at all.
So there has to be someinformation to compel or to
motivate them to think about.
Unfortunately, that's notenough to change lifestyle and

(51:14):
behavior.
So we need to combine that withopportunities that sort of tap
into what individual sensationsare about what's enjoyable.
We have to find a way to makeexercise an enjoyable thing and
a and a beneficial thing.
And so that's where we have toexplore like, you know, what
role does exercise play for eachindividual?

(51:36):
And how can we sort of justencourage them to explore it?
And and that's so varied.
And and you know, you've seenwith your group rides and the
and the sort of bike clubactivities, that that
companionship, that being in agroup can be amazingly
supportive, really can bringpeople out on the weekend, even
when it's raining, because youknow, I got to go because the
group's waiting for me, and I'vetold people I'm gonna be there

(51:58):
for the ride, and you know,they've they've gone to all this
trouble to organize the foodstations.
So I, you know, I have toparticipate.
I I learned about this, youknow, I I've organized sentry
rides, you know, for for anumber of years, my early years
here.
So I I've seen how that playsout and how how incredibly
motivating that can be.
And that's one view of it.
And then another view, whichwhich I have to say is the one I

(52:20):
live more now, and so I canconvince people maybe more
authentically about, is to say,yeah, but just just go out on
your own, just like you'reexplaining, just go out on your
own and ride your bike for, youknow, and just not not you don't
have to go far, you don't haveto go fast, just find a nice
place, just just go out and doit for a little bit and then see
how you feel, you know, likereflect a little bit afterwards

(52:42):
and say, how was that?
You know, and you might say,Yeah, my knees are sore or or
you know, my back's a littlesore, but you know, I feel good.
And and I, you know, I thisplays out, you know, in our
home.
My my wife is sometimes alittle hard to get motivated
some mornings to go for a ride,but you know, I I you know, I
sort of I convince her and I'vedone everything I can to make

(53:02):
cycling work for her.
And she grumbles a little bitand she moans about having to
go, but then every time we doit, we come back and she's like,
Thank you so much for you knowmotivating me to go out and do
this.
And I think that through thisrange of approaches and and some
sensitivity to individual needsand pleasures, we can find ways

(53:26):
to get people to ultimately bein that place where they're
doing the right thing and feelgood about what they're doing,
and of you know, and enjoy thehealth benefits and and all the
other psychological benefitsthat that come with it.
It's gonna need this sort ofempathetic, appropriate, gentle,
coaxing, guiding, supportingcombination uh to make it work.

(53:47):
And it's it's what I do with mystudents.
I mean, the last thing I sayevery especially on Friday
classes is you know, whateveryou do, get outside for some
exercise this week.
Like, you know, I don't care ifyou know if you're late for
your homework, let me know.
But you know, I want I want toknow that as many of you as
possible are are out there doingstuff.
And they know, you know, theycan't help but know that I ride

(54:08):
my bike, that I'm active.
They they I'm very open andvulnerable with them about it.
And don't try never to say itout of any feelings of pride or
of ego, but just simply to say,please, you know, give it a try.
Because and if I see them, Iyou know, this is the lovely
part.
I encounter them on my rides.
I I bump into my students, andit's a great moment.

(54:28):
See them out there.
Love to acknowledge them, talkto them, find out how their
day's going, where that's whattheir cycling story is.
And I hope in that small way tobe, you know, you know, living,
yes, what I what I think reallyis beneficial, being authentic
and consistent in a way thatthat maybe you know could

(54:50):
motivate a few of them to giveit a try.

Tom Butler (54:53):
Well, that's fantastic.
And you're you're bringing upall kinds of stuff that I could
just run with.
Yeah, we could talk about thisfor an hour, you know.
But I want to get back to tosome of this.
I can you um talk about theDelphi Data Science Initiative.
What is the aim of thatinitiative?

Sure, sure.
That it's a it's a naturalconsequence of what I described
before of this ongoing effortthat I've been lucky enough to
be involved in of exploringwhere computing is from a
technical perspective, and thentrying to see where we could
connect it to other areas ofscience.
And so Delphi is a medicalinitiative.

(55:36):
It includes membership fromacross our school of medicine
and health sciences generallyhere at the University of Utah.
And it really reflects a goalto employ the contemporary, what
we call data science technique.
So, so data science is uh not anew form of science.
You know, performing astatistical analysis of some

(55:57):
measurements is arguably a datascience method.
But as time has evolved and andwe've gotten more sophisticated
in how we can explore thesedata sets, and we've gotten
bigger data sets that, ofcourse, reveal more information.
The computing tools have haveallowed us to analyze data in

(56:17):
completely new ways.
And it's a fundamentaldifferent, a fundamentally
different approach to sciencethan we've had in the past,
which has often been driven bythis idea that we have an
underlying notion of how Ainfluences B.
We, you know, we we enter awarm room and our perspiration

(56:37):
rate goes up because our body istrying to cool very direct.
And we and we we even representthat as a mathematical set of
equations sometimes, write downyou know, straight, sometimes
very straightforward math andand explain the behavior.
Data science does not take thatapproach, it just says there's
patterns in those data sets thatwe yet, even with our

(57:02):
sophisticated brains, reallycan't see the patterns in
without some help.
And the data science techniquesare are the ways that give us
insight into these patterns orconnections that we see.
And sometimes those connectionsjust lead to sort of what I
would say relate phenomena.
You know, they they you know,when you look statistically and

(57:23):
you look at somebody's age andtheir weight, you might see a
connection, start to assumethere's there's some mechanistic
relationship age and weight.
But as you get deeper into thedata science and get richer and
richer data sets, then you canget into the more subtle
questions and oftentimes themore meaningful questions of,
you know, it's not just age, youknow, it's age combined with

(57:46):
their medical state, combinedwith their lifestyle, combined
with their eating habits, youknow, all the there's a whole
bunch of factors that drive thatoutput of, let's say, weight or
longevity or whatever ouroutput number is.
And so Delphi was created totry and leverage those computer
techniques in the data sciencespace in a broad range of

(58:09):
applications.
And so for me, it was anotherfabulous opportunity to listen
to clinical colleagues say, Ihave this data set.
I've been collecting thesedata.
I just thought, I don't know,it's like this is the stuff I
can get from my patients easily,and we can anonymize it and
protect their privacy and do allthose sorts of things.
But uh now I need somebody tohelp me analyze it.

(58:30):
And so then I have a number ofconnections with more technical
computer scientists,mathematicians, physicists who
may not understand much aboutmedicine, but they have some
really fun techniques thatthey're dying to try out on a
good data set.
And so the the general approachhere is can we bring those, can
we build a bridge between thosethose groups on particular

(58:54):
projects?
That very much fits into theethos of what we've always been
about at the Ski Institute.
And I would argue that ethosis, you know, percolated out
across the campus.
This is a very intellectuallyopen community, and there are
very few boundaries betweeninstitutes, departments,
whatever on the campus.
It's never been a problem for aphysician to wander down to the

(59:17):
math department and say, I needsome help, you know, explaining
something that might bemathematically interesting.
So Delphi is is really seekingto do that.
So it has a very broad range ofapplications and has has you
know led to some reallyinteresting projects, metrics
that we in science worry about,like papers published and
support we can get to continuethat research.

(59:40):
So Delphi has been, yeah, I sayit just it's been a felt like a
natural progression for me togo from some of the physics
based or the mathematicallybased approaches I've pursued in
the early parts of my career,now into these data science
approaches.
Now, of course, data science inthe modern vernacular is kind
of code for artificialintelligence.
A lot of these techniques we'retalking about are, you know,

(01:00:03):
come out of that long-standingeffort to improve our
understanding of data throughmethods like machine learning.
And there's a lot of underlyingtechnologies that sit
underneath AI.
And what we see as AI and whatgets the headlines as AI is
really just one small part of itthat it's an important part for

(01:00:24):
sure, but there's a lot moretechnology underneath the hood
that we can apply in a range ofsettings and really make novel
breakthroughs that we couldn'totherwise do.
Where the where the complexityof the data available is so
large that there's no simpleequation that's going to link
all these things together.

(01:00:45):
We need to take a differentview.
And the data-driven view is areally fascinating one and it is
the contemporary approach thatwe're trying to chase.

Tom Butler (01:00:56):
It's so interesting because there's so many
components to it.
And then there's the likeyou're talking about the

(01:01:26):
scientists who are developingways of using the computer to
analyze things, and you know,the analytic expertise that it
takes to do that.
And then there's the hardwareand having the chipsets that are
able to uh to move at a speed,and you know, in addition to be

(01:01:49):
cooled and all the things thathave to happen in order to have
that massive computationalpower.
So it what a unique time tolive in to seeing some of those
things being stretched to thelimits, uh, which is sounds
similar to when you were saying,Boy, we could, you know, way

(01:02:10):
back when you're saying, hey,can we use your computer at the
university?
Because this is this isstarting to get more complex,
and now you're at an you know atotally different place, but
that same thing of seeing theboundaries being stretched from
what we have available.

Rob MacLeod Ph.D. (01:02:28):
Yeah, yeah.
And and uh, you know, the thegood news is that here on the on
the university campus, thingshave also evolved in a good
direction where where that thatyou know now in the world of
computing, we haveadministrative computing and we
have academic computing and youknow, the administrative
computing, it's important, trackof emails and all that good
stuff.
Then we have a scientificcomputing, and things have

(01:02:50):
evolved now on that front.
That scientist the thehardware, the people who
maintain the systems, work inparallel with us.
So they're also under the samedirector as as they're kind of a
parallel organization with usat the Ski Institute.
So uh, you know, so now we webring those two worlds even
closer together so that weunderstand where the new

(01:03:12):
developments are and thelimitations are in hardware, try
and figure out how to makesoftware that leverages
strength.

Kind of looking at a specific example, and and this
might not work.
I'm hoping this works, but um,you know, you a long time ago
ago got introduced to thecarvonin formula.
Are you familiar with thecarvonin formula?
Okay, so no, I don't know.
It is you've probably heard ofit, you just don't even hear it,
but it's it's the 220 minusage.

(01:03:40):
Oh, yes, yeah.
And so that was someone lookingat data and analyzing data and
saying, okay, I think this is away for us to estimate max heart
rate.
That formula just I believe hasno relevance for me at all.

(01:04:00):
You know, my you know, if Itake 220 minus a, I wouldn't be
able to, you know, basicallybike down the street if I was
going to stay below that heartrate.
And so and I don't know, youknow, I I I don't have a good
way right now of knowing what mymax heart rate is.

(01:04:21):
I don't want to go to failure,you know, and say, okay, now I
know because my heart failed.
It's that really rough uhformula from you know decades
ago that now things have changedso much as far as how could

(01:04:41):
look at an individual person andsay, this is a good training
heart rate for you.
I don't does that does thatbring up thoughts for you?

Yeah, absolutely.
I mean, at one point in mycareer, I was very involved in
the bike racing community hereas well.
I was the president of a localbike racing club, and we would
go out on training rides, andwe'd be you know a mix of
generally fairly fit people.
Um, there was certainly theracing team, they were the
elite, and then there was therest of us, and and you know,

(01:05:10):
most of the people in the groupwould do a little bit of racing,
various forms, either timetrials or criteria.
And I remember going on a rideup a canyon near here.
I mean, this what makes ridingso great here is we have city is
it's on a high plateau, it'srelatively high, it's four and a
half thousand feet, but it'syou know, it's more or less
flat.
And then the mountains juststart right behind the city.

(01:05:32):
So we ride up the canyon.
This is some of the mostpleasurable rides and the
coolest in the hot days ofsummer.
So we were doing one of ourregular rides up the canyon.
So Rob, the physiologist, wasriding up to different people as
we were riding up the canyon,saying, What's your heart rate?
What's your heart rate?
What like because we're allkind of you know going at the
same pace, we're all as a grouptogether.

(01:05:53):
There's a reasonablevariability in age.
Uh, you know, I was probablyaround 40 or so in my 40s by
that stage.
And we had certainly people intheir 20s, and I don't think we
had many people older than that.
But so it, so you know, but wewere all generating the same
power rough.
And the range of numbers,people would just look down at

(01:06:15):
their heart rates or look attheir watches and say, Oh, yeah,
I'm at 130, and this personwould be 110, and this person
would be cooking along 160.
And and the and I realizedthen, okay, the real this is the
reality of physiology.
This is this is the thedifferences naturally, you know,
variability, naturalvariability that exists in us as
humans.

(01:06:35):
And it really opened my eyes toyou know what we're talking
about.
Because, like you, I neverfound that formula was very
informative.
Really interesting part aboutour lives today is we have
better measurement technology.
So we can track our heart rateas long as we're active, and but
that also we can use variousother input data points like the

(01:06:58):
power we generate, right?
You know, I have a set ofpedals on my bike that measures
the power and that provides someinput.
And this is where the overlapwith the data science happens.
So there are better and bettermodels that tap into more
variables across a wider rangeof populations, which
paradoxically allow us to moreindividualize the analysis of

(01:07:21):
our personal.
So we can feed our data intoone of these models.
And this is what's happening inthe world of mostly performance
sports, you know, it willtrickle down to us.
And we see a little bit whenyou input your data into Strava
or some other application likeit, it's going into a model.
And it's, you know, if you doif I ride and don't necessarily

(01:07:43):
have my power meter or my powerpedals, it will still come up
with an estimate of the powerI'm generating.
And those models are gonna andare getting more and more
sophisticated.
And they're using these AItools, so not large language
models, but uh the other aspectof AI, which is machine learning
and you know, allowing modelsto predict individual behavior
based on a deep well of data.

(01:08:06):
And so we're gonna see betterand better predictions of our
performance and analyze this,especially if we follow this
over time and see how things areevolving.
You know, at our age, youalways often wonder how much
longer can I keep this up?
You know, what can I expect ofthe inevitability of age
affecting my performance?
And you know, what are the realboundaries and what are the

(01:08:28):
boundaries that are in ourheads?
Because society has told us,oh, you're over 60, you know,
you're gonna go downhill at someprescribed rate, and you almost
feel obliged to follow thatdecline.
And and we're, you know, we'relearning that that a lot of that
is just not correct.
So I think, you know, in waysthat we may not even notice,
because again, the software isgonna percolate up into these

(01:08:49):
applications that some of us useto track our data.
We're gonna see more and moreaccurate predictions.
So so now as another example.
So when I finish a straw a rideon Strava and I upload the
data, I get a little summarythat tells me what kind of
workout I have.
You've probably seen the samething.
And it notices, oh, you spentsome, you know, you did some
good three-minute powerintervals there.
That you that's you know, it'sbetter than last week.

(01:09:11):
So this is where the datarevolution is going to one of
many ways, it's gonna play outin so much of we do, and and and
definitely is gonna affect uhthe or give us data that we can
use to make our some of ourhealth decisions, some of our
training decisions, and youknow, some of our nutrition
decisions.
Or, you know, started playingwith an application just to, I

(01:09:35):
was just a little curious, youknow, what's my protein output
like?
The big topic, of course, now.
Right.
How much protein do we need,and especially as we age and as
we exercise?
So I, you know, I'm playingwith one of these apps and just
you know, to see what it willwhat it will tell me.
And and I'm sure it will haveinsights, some AI type methods
that I I hope will give me somesome insights, uh you know, how

(01:09:58):
my uh you know, what my overallnutritional status is.

Do you have a sense of how general practitioners are
thinking?
Do you are do you think thatthey are well aware of kind of
all the tools that areavailable?
Um, you know, the dataanalysis.
Um is that working its way intothe curriculum, or do you think

(01:10:26):
there's a long way to go withthat?

Yeah, it it's definitely coming into the
curriculum.
In fact, generically, the useof computers I've seen come into
the curriculum at ouruniversity over the course of
the last 20 years.
It was a time when a medicallibrary was just full of
journals, textbooks.
And now our medical library hasa whole floor dedicated to
computers and simulation and youknow, various things that uh

(01:10:50):
expose the medicalprofessionals, not just medical
students, but PAs and nurses andwhoever's getting trained to
the use of computers in theirpractice.
So we're definitely seeing moreand more of that over the last
couple of decades.
Of course, the currentrevolution almost is coming with
the advent of machine learningand AI techniques.
And this is where um there'ssome huge, I would say, very

(01:11:15):
optimistic signs that there arenew methods, data science-driven
methods that really can helpwith the management of patients,
but that they are largelyliving in the research world.
That we had a wonderfulpresentation by a very, very
well known uh, he's actually acardiologist by training, but
much better known as kind of adoctor, very broadly imaginative

(01:11:39):
and wonderfully grounded doctorin this space.
His name is Eric Topel.
He's had a long career.
He's you know, he's also aboutmy age and came to visit last
fall.
We he had a wonderfulpresentation he did, and we had
some great chats, and and he haswritten a book on AI and
medicine some some some timeago, which was actually turns
out to be quite prescient.

(01:11:59):
He gave a wonderfulpresentation and showed example
after example of where AI couldchange medical practice.
In each case, backed up ascientific publications, studies
that illustrated the benefits,improvements over unassisted
guidance or unassisted decisionmaking, and quite quite
convincing.
And at the end of thepresentation, he said, Yeah, but
none of these have actuallybeen tried, none of them are

(01:12:21):
incorporated yet into practice.
And that's the stage we're at.
We have all these tools thatshow fabulous potential, but now
we're we've got to get intothis hard work of trying them in
clinical practices, initiallyin academic medical centers,
probably, because that's the wayit often goes.
And then we're going to see howthey percolate out into the

(01:12:44):
community.
And you get, you know, veryfamous advanced clinics like the
Mayo Clinic, you know, theyhave a this is a system I know a
little bit about that, theyhave a dashboard for analyzing
ECGs using some verysophisticated machine learning
approaches to try and improvediagnostics of their patients.
ECG is a wonderful targetbecause it's a very cheap,

(01:13:07):
painless, non-invasivemeasurement to make.
So it's very tempting to tryand extract all that we possibly
can from it.
It has shown, indeed, thatthere's lots of information that
we never thought would beembedded in this in this signal.
Cardiologists would have said,yeah, the we figured that out,
you know, 100 years ago.
We had the ECG, we figured itout 40 years ago, maybe.

(01:13:27):
We have our algorithms, theytell us certain things, but
there's just hard limits to whatthe ECG can do for us.
Those limits are now changingand and and very surprising
features.
Like it's with very goodaccuracy, it's possible to tell
the sex of a subject from theirECG, something that nobody
thought would be real.
No, nobody ever even guessedthat that information was

(01:13:50):
somehow embedded in an ECGsignal, but it appears to be.
There's lots of other, arguablymore medically relevant details
that are in an ECG.
The Mayo Clinic has, you know,put together a system.
They claim it's part of theirdaily practice.
And and and that will only, Ithink, only be a matter of time
before that does make its wayout.
And then they're, of course,studying carefully the impact of

(01:14:13):
the system.
How does it improve patientcare?
How does it improve outcomes,all those important things?
So we're in that stage whereproof of concepts are there
across almost all of medicine.
And now we're at this stage ofsort of this hard work of
adapting it to practicalutility.
And I'll close by saying, youknow, the the one piece of

(01:14:35):
technology that does seem tohave penetrated very quickly
into medical practice, it's it'svery simple in concept.
It's a little device thatrecords the audio of the patient
doctor interview and extractsthe relevant information from
that interview and stores thatin the patient's electronic
record.
So the doctor, instead ofsitting at a computer taking

(01:14:58):
notes and obviously beingdistracted, I mean, you cannot
possibly operate a computer andpay attention to, I would argue,
anything, and certainly not apatient, you know, at the same
time.
I mean, multitasking is highlyoverrated in many people's
minds.
Lots of evidence to supportthat too.
So the the idea that you couldjust let this device keep track

(01:15:22):
of things and really focus onthe patient and really use the
highly evolved medical intuitionthat good diagnosticians and
practitioners develop over timeis an incredible opportunity, I
think, to improve medical care.
If we could have we could havethis sense when we're talking to
our primary care physicians atleast, that they're actually

(01:15:43):
listening to us, they'rewatching our faces, they're
getting our body language,they're picking up on the
subtleties because they don'thave to worry about taking
notes.
And because, of course, youknow, there has to be a record
of makes sense, there has to bea record of this appointment,
and they're under all kinds oftime pressure, blah, blah, blah.
So the challenge that thatTopel posed in this talk, and
I've heard other peopledescribe, is what will the

(01:16:06):
medical profession and thehealthcare industry and the
insurance companies drive a lotof it?
What will they do with thatextra time that a physician in
principle will have because theydon't have to take notes?
And he, of course, as adedicated clinician, says we
should protect that time.
We should protect and use thatextra time to really engage with

(01:16:29):
our patients and to add valueto what we as physicians have
developed as a skill set that nomachine has so far in the
world.
And and and we all have ourareas of expertise where I would
argue we have an intuition of asituation that isn't something
you can write down, it doesn'tfit into a textbook, it's just a

(01:16:52):
certain sense of for thissituation, this is the way to
respond.
This is the solution, this isthe approach we're gonna use to
fix this problem.
And if physicians can get theopportunity to focus on that
skill set, they will be moreeffective as physicians.
And maybe just as importantly,they will feel more satisfied in

(01:17:12):
their profession.
They will feel like I'm notbeing replaced by a machine
anytime soon.
There's not going to be an AIthat takes over my medical
practice.
I can actually focus on whatI've trained for and what I've
developed great intuition for,and be ultimately more effective
looking after.
So this little bit oftechnology, this ability to
transcribe a conversation, is itit has the potential to be

(01:17:36):
transformed.
If you know the medicalindustry complex, whatever you
want to see it as, if they'reallowed, you know, to operate in
a way that that places thepatients first, not bottom line
and profit.

Uh it is an elevated view of the opportunity of
having more time.
And that sounds wonderful.
I I hope that that elevatedview can win out.

So yeah, I have I have I have clinical
colleagues who are completelyskeptical who say, no, no, no,
that you know, we're gonna haveto see twice as many patients.
That's what's gonna happen.
Right.
So I but I I I I think it's alittle bit emblematic of what it
is that we will see these toolsaccomplish or at least enable
if we handle it right.
So in my world as a professor,I can use AI tools in ways that

(01:18:29):
can save time in preparing myclasses, doing some of the main
mundane tasks, some of theroutine things.
And if that saves time for meto actually spend more time with
my students and listen to themmore carefully and work with
them more closely, I see that asbeneficial and incredibly
gratifying.
I did not become a professor tospend all of my time on
paperwork or on all thebackground tasks.

(01:18:51):
And it'll be up to everyprofession to evaluate where
these things can help them andand what to do with with the you
know space it creates.

Well, let's end up this way.
Do you have any cyclingadventures coming up?

Yeah, you know, we were we were just
talking about this on theweekend.
So not not a lot directly insight, but just to give you a
sense of of what often happens.
I travel a great deal.
This is part of the life ofmany academics to go to research
meetings and collaborate withother people and often in other
countries.
And so around 1995, I purchasedmy first folding bicycle from a

(01:19:32):
company called Green Gear, itwas called then, now Bike
Friday.
So it fits in a suitcase and Itravel with it whenever I'm
going anywhere for any amount oftime.
Sometimes a harmless, let'ssay, you know, quasi-harmless
conference can turn into abicycle adventure quite
spontaneously.
So that inevitably happens.
And I've had some fabulousopportunities to, I mean, I've
ridden over there's a pass inthe Pyrenees that was actually

(01:19:56):
the very first mountain passever used in the Tour de France
called the Tour Malais.
And I was traveling betweenSpain and France, you know, for
two related, very professionalactivities, but I got to carve
out a couple of days in betweenand could unpack my little
folding bike and ride up thetourmalie.
And so we have a lot ofventures that sort of happen

(01:20:18):
that way.
What we also have taken todoing is traveling to a place
where there is a lot of goodcycling, finding a home base,
and and rather than bike touringfrom A to B with or without
support, we will settle inideally a small village
somewhere remote.
This year we were in the inpart of the Provence or the

(01:20:41):
northern part of the Provence,and and we, you know, rented a
little Airbnb.
And I had my folding bike, andmy wife rented an e-bike from a
village nearby, which is, ofcourse, easier and easier to do
these days.
And so every day we would wakeup and you know get rolling at
some point mid-morning, and thenwe'd ride for a few hours and
end up at some beautiful littlemedieval village on some other

(01:21:03):
part of the valley, and getthere just in time, just
randomly in time for a nicelunch.
And then we would enjoy a nicelunch, explore the village, and
then make our way home again.
So a lot of the adventures endup, you know, being those kind
of trips.
And then every once in a while,like I say, this year, the the
other big adventure of somethingI've always wanted to at least

(01:21:23):
see and explore, is is the theagain famous at the Tour de
France climb up the Alp d'Oise.
And so I we I did a little bitof research and just you know I
knew about this little villageat the base, and so we rented a
place there.
And I I did indeed get to ridemy bike up the Alp Dues this
year.
So that's sort of the flavorthat our our adventures often

(01:21:46):
take.
Just finding a nice spot andnot feeling compelled on any
given day to do any particularride.
And we love that unstructuredapproach.
It it it's we're so dialed innow that it just runs, you know,
sort of by itself.
We know what we have to take,we know what we have to do, you

(01:22:07):
know, we we we know how to dothe research to find the rental
bikes, and so that's become ourour ongoing flavor.
And I think, you know, there'llbe lots of that in the future.
We just haven't decided yetwhich which opportunities to
attach to my professional lifethat we're gonna take advantage
of.

I love it.
That just sounds delightful forsure.
Well, Dr.
McLeod, thank you so much.
I'm glad you reached out andintroduced yourself, and we got
to have a bit of an emailexchange.
And I'm just reallyappreciative of you coming on
and giving a view of somethingthat you know I just don't see.
I don't think a lot of peoplereally see kind of what's behind

(01:22:45):
the scene as far as thesethings that are are happening to
improve the way that we canmeasure what's going on
physiologically with us thatenable us to, like you talked
about, a paradox, but enable usto to look more individually by
being able to gather more dataacross many realms.

(01:23:09):
So thanks for for coming on andand bringing your expertise to
the podcast.

Thank you.
It's been a great pleasure.
I really applaud um what you'redoing with the podcast.
I think you're playing anincredibly motivating role for
those of us on the latter sideof 60, encouraging us to stay
active and and I wish good luckgoing forward.

Well, thank you.
And uh maybe we'll talk againsometime.

Sounds great.
All right, bye now.
Bye-bye.

We hear all the time that AI is going to transform
every industry.
I don't think that'shyperbolic.
In my opinion, we need toembrace what AI can provide in
the area of the pursuit oflongevity.
Obviously, AI is far fromperfect, but my experience is
that there are some interestingoutputs that can come from AI

(01:24:04):
with its ability to analyzedata.
We certainly live in aninteresting time.
Not only are we seeing the riseof AI, but also we have access
to more and more technology thatis providing individual data.
Rob mentioned power pedals.
I really appreciate being givena set of power pedals a few
months back.
As I look at being able tocompete in cyclocross, I have

(01:24:27):
two sets of data that areextremely helpful.
My goal is to be able togenerate over 200 watts for 45
minutes while keeping my heartrate under 160 beats per minute.
If I can do this, I think I'llbe happy with my performance
during a cyclocross race.
And that also gives me a baseto try to grow from.
On August 17th, 2023, I did anepisode that was an interaction

(01:24:51):
with AI.
I think I'll do somethingsimilar and have a conversation
with AI about a training programfor doing better with
cyclocross next year.
Stay tuned for more informationon that.
I hope that as the weather getsworse here in North America,
that you are finding some greatfall riding.
I also hope that you have whatyou need to enjoy getting out in

(01:25:11):
less than ideal weather.
And remember, age is just agear change.

All Episodes

Episode Transcript

Popular Podcasts

Stuff You Should Know

Dateline NBC

On Purpose with Jay Shetty

.css-15opob5{left:0;position:absolute;top:0.8rem;} All Episodes

.css-14f5ked{margin:0;word-break:break-word;display:-webkit-box;-webkit-box-orient:vertical;box-orient:vertical;-webkit-line-clamp:2;overflow:hidden;}Data Science and Your Health

Episode Transcript

Popular Podcasts

.css-r6mb8g{margin:0;word-break:break-word;display:-webkit-box;-webkit-box-orient:vertical;box-orient:vertical;-webkit-line-clamp:1;overflow:hidden;}Stuff You Should Know

Dateline NBC

On Purpose with Jay Shetty

All Episodes

Data Science and Your Health

Stuff You Should Know