People ask me how I stay so optimistic. The honest answer: I read the data, not the headlines.

This is biblical. A woman in her eighties. Ten years into Alzheimer's. Hadn't spoken a full sentence in five years. Takes one, 5 gram dose of psilocybin. She slept 19 hours and woke up and spoke for hours about her life, recognized family and held real conversations. She regained bladder control after five years, walked on her own. and dressed herself. Gains held for weeks.

I'm a cardiologist. I've held dying hearts in my hands in the cath lab at 3 AM. And I need to tell you something that changes everything about how we prevent heart attacks. For decades, the entire field was built on one target: lower LDL cholesterol. Statins save lives — that's settled science. But too many of my patients did everything right — took their statins, hit their numbers, lived clean — and still ended up on my table with a ruptured artery. We were treating the smoke while the fire kept burning. The fire is inflammation. And the evidence is now overwhelming. The CANTOS trial proved it first — lowering inflammation independent of cholesterol reduced cardiac events. But the newer data is what keeps me up at night. AI-enhanced CT angiography can now detect inflamed arteries by measuring changes in the fat surrounding your coronary vessels — the perivascular fat attenuation index. Higher inflammation in the fat around even one artery independently predicts cardiac death. When multiple arteries show inflammation, the risk multiplies dramatically — even in patients whose cholesterol looks perfect. This isn't theoretical. This is measurable. Right now. On a scan you can get this month. Low-dose colchicine — a drug that's been around for centuries for gout — is now FDA-approved specifically for reducing cardiovascular events. It works by quieting the inflammatory cascade that destabilizes the plaque sitting in your arteries. A pill that costs pennies is saving lives the statins couldn't reach. And the next wave is already in Phase 3 trials. Ziltivekimab — an IL-6 inhibitor — targets the central inflammatory pathway driving atherosclerosis. Phase 2 data showed a 90% reduction in hsCRP. The ZEUS cardiovascular outcomes trial is enrolling now, with results expected late 2026 into 2027. If positive, anti-inflammatory therapy will become standard in managing heart disease alongside lipid-lowering. The era of inflammation-targeted cardiology is arriving. But it goes deeper than drugs. AI is now predicting heart failure and cardiac events 5 years before symptoms — integrating CT imaging, electronic health records, and genetic data with accuracy that jumps far beyond traditional risk calculators. And polygenic risk scores — a simple genetic test that flags inherited cardiovascular risk — are now formally recognized as a risk-enhancing factor in the 2026 ACC/AHA guidelines. A single blood draw can reveal risk that's been silently building since birth. Decades before the first chest pain. Here's what this means for you right now — today: Ask your doctor for a high-sensitivity CRP test. It's cheap, routine, and measures the systemic inflammation that standard cholesterol panels completely miss. You can have perfect LDL and inflamed arteries that are quietly preparing to rupture. If your hsCRP is elevated, discuss low-dose colchicine with your physician. It's FDA-approved for exactly this. Push for a coronary CT angiography with AI plaque and inflammation analysis if you have risk factors. This isn't the stress test your parents got. This is 3D visualization of your actual arteries — with AI quantifying not just how much plaque you have, but what kind it is and whether the surrounding tissue is inflamed. Consider polygenic risk score testing — especially with a family history of early heart disease. It's now guideline-supported. And the foundation that never changes: move daily, eat real food, sleep 7-9 hours, manage stress, and know your numbers — ApoB, Lp(a), hsCRP, fasting insulin. I left Iran as a child with nothing. I rebuilt everything in a country that gave me the freedom to become a physician. I've spent twenty years watching patients get second chances. The ones who haunt me aren't the ones who died on my table. They're the ones who survived but never acted on what the science was telling them — years before the event that didn't have to happen. You can have perfect cholesterol and still have a heart attack. Inflammation plus genetics can drive plaque rupture in arteries that look "fine" on a standard panel. The myth that normal cholesterol means you're safe has cost more lives than I can count. We now have the tools to detect the fire — not just the smoke. AI to see it. Genetics to predict it. Drugs to quiet it. And the ancient basics — movement, real food, sleep, purpose — to prevent it from starting. Prevention is the new cure. And the science to make it real is no longer coming. It's here.

USA. Summer. It is 95 degrees outside, and I am shivering inside a sandwich shop. I have discovered how Americans forge strong souls. Outside, the sun is trying to kill everyone. Inside this small restaurant, it is winter. My breath does not fog, but it is thinking about it. A man near me is eating a cold sandwich while wearing a jacket. In summer. Indoors. In Japan we would simply turn it down. Americans do not turn it down. And now I understand them better than they understand themselves. This cold is not an accident. This cold is a gift. The owner has built, inside his shop, a second season. He invites you in from the brutal heat and hands you the one thing the sun has denied you all day: a reason to be cold. To endure it is to be tempered. You walk in soft and sweating. You walk out sharp and clear, a slightly stronger person than you were. So I did not complain. I removed my outer layer and offered it to the woman at the next table, who was hugging herself. She said, "Oh, no, I'm fine, thank you." She was not fine. Her lips were blue. But she, too, understood the training. She would not break first. I respected her deeply. The owner asked if everything was okay. "It is perfect," I said, through my teeth, which were chattering. "Thank you for the winter." He said, "...I can turn the AC down if you want?" I told him no. A man does not ask the mountain to be shorter. I stayed two hours. I ordered a hot coffee to survive. Then a second one, to hold. By the end I could no longer feel my hands, but my spirit had never been clearer. So now, on the hottest days, I seek out the coldest rooms. I sit. I shiver. I sharpen. And when I finally step back out into the summer heat, and it wraps around me like a warm bath, I feel it. Reborn. A man who has survived the winter, in August, indoors, for the price of a sandwich.

Aging is arguably the root cause of most major diseases (loss of function in our cells). Four years ago, we made a bet that aging was treatable, and NewLimit was born. NewLimit now has a prototype drug that reverses the age of some human cells (restores function they had when they were younger), and a clinical trial scheduled for next year (with more drug candidates in the pipeline). Grateful to Founders Fund, Thrive, Greenoaks, and the rest of the investors for this latest round. @jacobkimmel and the team are just getting started.

The aging research will continue. Thank you @foundersfund for leading, @ThriveCapital, @Greenoaks and @QuietCapital for joining and all our insiders for coming back.

The opposite of paranoia is pronoia, the irrational belief that the universe is conspiring in your favor. I have built my entire career on pronoia and I highly recommend it.

Wearables need a setting called “lie to me”

For the next 7 days, I'm going to wear a Whoop, Oura Ring, Fitbit Air, and Apple Watch all at the same time. The goal is to see the differences in sleep and recovery metrics as well as user experience. Anything else would you want to see from this test?

I was deeply critical of the wheel. It turned out I was wrong.

Your grandchildren will not understand why anyone was afraid of AI. The same way you don't understand why anyone was afraid of electricity in the 19th century.

How old is too old to ______________? Great question @KelliJBennett ‼️ Join us at ageinappropriate.substack.co…

I realized fundraising was the first time in my life I got rejected at scale. And honestly, as a woman, I was not emotionally trained for it. Before the feminists come for me, let me make my point. I think the first real arena where most people experience power, desire, status, and rejection is dating. And dating trains men brutally. A lot of men learn very early that if they want someone, they have to walk across the room, risk looking stupid, get rejected, survive it, and do it again. They learn that rejection is volume, timing, targeting. It’s a numbers game. A lot of women are trained very differently. Especially if you’re a pretty girl, you don’t usually walk into a bar looking at a guy thinking: “Can I have him?” You only think: “Do I want him?”. You don’t build your identity around shooting your shot 100 times and surviving 99 no’s. You don’t get trained to ask directly, get rejected publicly, and act normal 5 minutes later. You get trained to be “chosen”. To be impressive enough that the opportunity comes to you. And then you start building a company. And the whole paradigm changes. Suddenly, everyone can say no to you. Investors say no. Candidates say no. Customers say no. And when your rejection muscle is weak, your brain does the dumbest thing possible: it makes the “no” mean something about you. That you’re not smart enough. Not compelling enough. I think this is one of the most underrated gender differences in fundraising. Not that men are inherently better at it. But a lot of them have built thicker rejection scar tissue earlier. They know how to hear no and keep moving. They know how to make it less personal. They know how to treat it like volume, timing, targeting, iteration. I didn’t. I’ve raised 3 rounds. On the surface, the story looks great: I raised with Sequoia, OpenAI, Khosla. Woohoo. The real story is less sexy: every round wrecked me. I lost 5kg each time. I probably donated a few years of life expectancy to the cap table. Because every round, I only got 1 term sheet. One. EVERYONE else said no. And when almost everyone says no, your body does not care about the intellectually correct explanation. It only hears: Maybe they’re right. Maybe you’re not that compelling. Maybe you’re not the founder you thought you were. For a long time, I thought confidence meant learning not to take the no personally. I don’t believe that anymore. Maybe some people are built like that. I’m not. 30 years of being trained to be chosen does not turn into resilience because someone in a Patagonia vest says fundraising is a numbers game. So now I think confidence is something less glamorous. Confidence is taking the no very personally. Letting it ruin your day, losing your appetite, spiraling for hours… And still taking the next meeting. Confidence is just being bothered as f*** and not letting it make you smaller. I still don’t fully believe my own BS as I’m writing this, but I guess that’s the point. Can’t wait for the next round to find out.

this is a great idea. if someone wants to unlock the pod for everyone for $100k (this appears to be the going rate), I'll see it and do it. just do the Foundry level, and it'll get flagged

My 6 year old has officially taken over doing the dishes. “Mama, this is my favorite chore!” 😂 I should also add, we don’t assign chores. She just asked to help me then recently moved from loading the dishwasher to washing the dishes. I’m the loader now. 💞

Heard. Mostly we try and give the podcast away as a public good. We interview the world's top scientists and researchers and try and spread this knowledge to as many people as possible. We also spend a ton of money and time filming in their labs and writing about them. We have to run a minimal amount of ads to make all this work. It's a labor of love for us. From where we sit, it felt weird to give your company a generous amount of air time and then get worked over for it but can understand that you're not familiar with everything we do or that we don't generally paywall things.