• Rob Orman

11. Masks, Race, and Authenticity with ZDoggMD

Our guest today is Dr. Zubin Damania (aka ZDoggMD), an internist, hospitalist, and healthcare evangelist. ZDogg is dedicated to turning the practice of medicine into the healing art that it should be, rather than the leviathan of bureaucracy, roadblocks, and nonsense that it sometimes seems to be. In this episode we cover: the morality of masks and not wearing them in public, racism, suspension of the scientific method in the early phases of the pandemic, Star Wars, and much more.

We discuss:

The RECOVERY Trial which found that steroids reduced mortality in certain COVID patients [02:10];

  • The Randomized Evaluation of COVID-19 Therapy study included patients with clinically suspected or laboratory confirmed COVID and randomized them to receive either dexamethasone 6 mg/day for up to 10 days (2000 patients) or usual care (4000 patients).

  • The primary outcome was 28 day all-cause mortality.

  • The number needed to treat (NNT) for dexamethasone to save 1 life was 33, and the benefit was greatest for ventilated patients (NNT=8.5).

  • 40% of ventilated patients who didn’t get dexamethasone died vs. 29% mortality for those who did.

  • Writeups on First10EM, REBEL

The optimal way to introduce Star Wars to someone who has never seen an episode [07:50];

How ZDogg prepares for the flow state of an unscripted live show or polemic [12:30];

Why wearing a mask in public during the COVID pandemic is like paying taxes [17:50];

Virtue signalling, and how it is a way to make ourselves feel less guilty for something in which we feel complicit [23:00];

The time when Rob was most proud to be ZDogg’s friend [23:55];

Pandemic & Protest: Racism As A Social Determinant Of Health [23:55];

The fundamental unfairness when judged on something that you cannot control, such as race [28:30];

The challenge of being both authentic to yourself but also using your large social media platform to spread important messages [34:40];

Things that surprised ZDogg about COVID-19: the abject incompetence of our public health apparatus, our woeful unpreparedness, not learning (or at least applying) lessons from other countries, American exceptionalism, the rise of conspiracy [37:25];

The danger (and benefits) of dissemination of anecdotes and putting the standard scientific process on hold in the mad rush to find therapies [40:15];

How distancing has disrupted the fabric of society [41:35];

The importance of recognizing your emotional response and biases [44:25];

Victims of misinformation and how they’re influenced by FLICC: False experts, Logical flaws, Impossible expectations, Conspiracy thinking, Cherry-picking studies [46:20];

How infrequent hand-washing demonstrates that quality in healthcare is equated with what’s financially incentivized rather than what really makes a difference [51:20]; and

Much more.

Shownotes by Melissa Orman, MD

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