Editor's Note: In this segment of One-on-One, Medscape Editor-in-Chief Eric J. Topol, MD, sits down with journalist and best-selling author A.J. Jacobs, who discusses the art of immersive storytelling. From his quest to "drop dead healthy" to a year of "living Biblically," Jacobs explains how he's developed a knack for becoming the punch line to his comedic writing, and why he’s planning the “world’s biggest” family reunion.
Who Knew? Jobs Are Scarce for Philosophers
Eric J. Topol, MD: Hello. I'm Eric Topol, editor-in-chief of Medscape. Joining me today is A.J. Jacobs, one of my favorite authors. We are going to talk about his work, some of which is on the topics of health and medicine, and some of which is way beyond that. This is part of our series in which we talk to some of the most interesting people influencing the world of health and medicine.
A.J., it's wonderful to have you here. I want to start with a little bit about your background. You went to Brown University?
A.J. Jacobs: I went to Brown and I graduated with a degree in philosophy. And there weren't a lot of jobs for philosophers at Fortune 500 companies, so I decided to become a writer. I was very fortunate in being able to scratch out a living as a writer.
Dr Topol: When you were in college or before that, had you done a lot of writing?
Mr Jacobs: I had done some. I wrote for my college and high school newspapers. Writing was almost by default because I had no other skills. But I could half-form a sentence on the page, so that was my only option.
Dr Topol: When was your first break?
Mr Jacobs: I worked at a tiny newspaper in California that doesn't even exist anymore.
Dr Topol: I thought you were from New York.
Mr Jacobs: Yes, but I moved out to California. I'm not sure why. It was a terrible career move because all of the publishing was in New York, so again I got very lucky.
Dr Topol: You were just playing hard-to-get.
Mr Jacobs: Maybe that's it. I created a mystique. I went on to work for Entertainment Weekly, and then I worked for Esquire. I have been at Esquire for 14 years.
Dr Topol: I sent you an email after you had done an interview with Chrissy Teigen. What was it like to interview a supermodel?
Mr Jacobs: She is wonderful and she is hilarious. I tell my wife this, so I'm not speaking out of school, but she gave me one of the top 10 moments of my life. During the interview we were talking about religion, and she said, "Have you ever read a book called The Year of Living Biblically? (Simon & Schuster, 2007). I said, "I have read that because I wrote it." She may have been prompted by her publicist [to say that]; that's very possible. But either way, it was one of the highlights of my life.
Learning It All -- The Hard Way
Dr Topol: You have had four New York Times best sellers. And it started with The Know-It-All (Simon & Schuster, 2004), right?
Mr Jacobs: That's right. That book was about trying to learn everything in the world. When I was a kid, my dad started to read the Encyclopedia Britannica; he didn't quite finish because he had a life. He made it to the middle of the letter B, so I thought I would try to finish what he began and remove that black mark from our family history.
And I will say, because this is a medical show, that I learned some fascinating medical facts. One was that, in 1896, the Bayer aspirin company patented a very effective cough suppressant. It was called heroin, and it turned out to have some side effects, so they had to take it off the market. But that was a lesson in unintended consequences. That's the way science works.
It was fascinating to read the history of medicine because it really gives you some perspective.
Dr Topol: So you read the 32 volumes of Encyclopedia Britannica to be the smartest person in the world. By the way, did you invent stunt journalism?
Mr Jacobs: Oh, no. You probably know about [the late] George Plimpton, [journalist and co-founder of The Paris Review]. He is one of my heroes. As a journalist, he joined a professional football team. He got hit in the face by a heavyweight fighter. I love that idea. I don't like the idea of getting hit in the face, but I like the idea of putting yourself in the middle of the story and seeing what happens.
Following the Ten Commandments and Then Some
Dr Topol: First you were the smartest guy in the world, and then you were the most religious guy. That was The Year of Living Biblically. Was that your second book?
Mr Jacobs: That was my second book, which I wrote because I grew up with no religion at all. I'm Jewish, but I'm Jewish in the same way that the Olive Garden is Italian—not very. But I wanted to learn about religion. I have a kid, so I thought one way to do it would be to dive in and live by all the rules ofthe Bible: followingthe Ten Commandments, such as love your neighbor, but also following the rules you don't think about. The Bible says you can't shave the corners of your beard. I didn't know where the corners were, so I just let the whole thing grow and I had the ZZ Top look.
Dr Topol: You looked like Moses.
Mr Jacobs: I was very Mosaic—it's true. The Bible had some interesting health advice as well. The apostle Paul recommends, in one of his letters to his disciples, to drink red wine for stomach ailments. He doesn't mention resveratrol, which is probably a good thing because those studies are a little shaky. But even back then, they were pro-wine.
Shrimp Forks and Treadmill Desks
Dr Topol: The book you wrote that has the most relevance in the medical health world is called Drop Dead Healthy (Simon & Schuster, 2012). When I read it—and that's when I first got to know your writing style—I would just break into hysteria. What was it like to do all of these incredibly healthy things?
Mr Jacobs: It came about because about 4 years ago I was in terrible shape. I wasn't traditionally fat; I was what they call "skinny fat." I looked like a snake that had swallowed a goat. My wife said, "You have to get in shape. I don't want to be a widow in my 40s." I thought, all right, if I'm going to do this, I'll take the same approach that I did with the Bible. I'm going to try everything out. I'm going to test all the medical advice I can find and see what works for me and what doesn't. That's what I did. I revamped my eating and exercise, my stress level, sleep, sex life, posture—the whole thing.
Dr Topol: Did you write the whole book on a treadmill desk?
Mr Jacobs: Yes, I did. The whole book. It took me about 1200 miles. That's one of the few things that I have kept. I can't keep everything because my whole day was taken up with healthy behaviors. But I really do write on the treadmill. I am a big fan. It keeps me awake. That's the first thing. And there are studies. I don't know how reliable they are, but there are studies that say exercising raises the level of serotonin in your brain.
Dr Topol: And one of your tricks for losing weight is to eat only with a shrimp fork?
Mr Jacobs: That was surprisingly effective, but I have abandoned that, to be totally honest.
Dr Topol: It wasn't durable?
Mr Jacobs: The idea was that you eat less if you eat on smaller plates. There have been studies about that. I actually used a fork that belonged to my 2-year-old, not a shrimp fork. That was a big lesson. I don't trust willpower. I have no willpower. Some people might have it but I have close to zero. The best way to act in a healthy way is to control my environment beforehand and treat myself like a lab rat. So if I use smaller plates, then I'm more likely to eat smaller amounts.
Dr Topol: You visited a lot of the gurus in the field during this expedition. Can you tell us about that?
Mr Jacobs: I learned the value of a second opinion, and a third opinion, and a hundredth opinion.
Fighting Alzheimer's With the 'Biggest' Family Reunion
Dr Topol: You encountered a lot in the book. It was absolutely hilarious. Now your next big project is perhaps the most ambitious of all. You are bringing the world's largest family together. Is that right?
Mr Jacobs: That's right, and you are involved.
Dr Topol: This is real; it's [based on] genetics and the whole area of the science of how we are related.
Mr Jacobs: That came about because I got a letter, out of the blue, about 6 months ago from a man who said that he was my 12th cousin and that he had a family tree with 80,000 people on it. At first I thought, when is he going to ask me to wire $10,000 to this Nigerian bank? But it turned out that he was for real, and he had this huge family tree. We are in the era now, because of DNA and the Internet, of [designing] these massive mega-family trees. They're insane; they're huge. So the family tree that I am in right now is the biggest one ever. It's literally 80 million people in 160 countries.
Dr Topol: What about the other 36 countries? Why don't you bring them in?
Mr Jacobs: We're working on it. I am related to one of the greatest scientists and doctors around now, Dr Eric Topol. You are 31 steps away. You are, I believe—I could be wrong—my aunt's great-aunt's brother-in-law's fourth great-nephew's wife's husband. Something like that.
Dr Topol: I couldn't even figure out [who are my relatives] first removed, no less, and you've figured all this out. You are really bringing these people together? What are you going to do when you have this big family reunion?
Mr Jacobs: The idea is that, now that I have this family tree, why not hold the biggest family reunion ever? It's going to be on June 6, 2015. You are invited, as is everyone. It's a benefit for Alzheimer disease, which is an incredible health crisis and underfunded. And it runs in my family, so I thought it was appropriate. Forty million members of my family suffer from Alzheimer's.
Dr Topol: How many people do you think might show up to this event?
Mr Jacobs: We want at least 5000 because that is the world record for a family reunion.
Dr Topol: You will surpass that?
Mr Jacobs: I hope so. We have all sorts of activities. Sister Sledge is going to be singing "We Are Family" live, and Dr Henry Louis Gates will be there giving a talk.
Dr Topol: Where are you holding this?
Mr Jacobs: It will be at the New York Hall of Science, which is on the grounds of the World's Fair. It's a great venue. We have a lot of scientists, such as Dr George Church from the Harvard Genetics Department, who is going to talk about genetics because the world family tree does have some scientific value.
There are scientists at Massachusetts Institute of Technology who are studying these massive trees to see how traits and diseases are passed down. I don't think it has yielded any scientific fruit quite yet, but it has huge potential.
Dr Topol: Are you going to write a book about this? You haven't started that one yet?
Mr Jacobs: No. Hopefully my publisher is not watching because I have not started writing.
Dr Topol: That is quite a project. Is it a way to address the dysfunction in government?
Mr Jacobs: A little bit. I was able to figure out how all of the senators are related to each other, so hopefully they will be a little more understanding and compassionate. We'll see. It's an idealistic goal, but once we realize how connected we all are and that we share 99.9% of our DNA, we will treat each other with a little more kindness. We will realize that there is no such thing as racial purity. We are a big mix.
Dr Topol: We are a bunch of mutts.
Mr Jacobs: It's democratizing. People will no longer be able to say, "I'm related to (or I'm descended from) Mary, Queen of Scots, and you are not, so I'm better than you." Now, everyone can say, "I'm descended from Mary, Queen of Scots." Anyone is. With these trees, you can figure it all out.
What About Google Glass?
Dr Topol: Your biggest platform is probably Esquire, in terms of your reach to your audience and fans. One of my favorite articles you recently wrote was on "glassholes" and Google Glass. Can you give us the skinny on Google Glass? What are your thoughts about that?
Mr Jacobs: I enjoyed [using Google Glass]. You are going to get some pushback from people on the street calling you a glasshole, but I found that it was pretty amazing. It's like a little television screen. If you are talking to a friend who is yammering on about coworkers you don't know, you can just turn on CNN and watch. It has that advantage.
It will have fascinating medical applications. Whether Google Glass catches on or not, wearable technology and wearable computers are going to happen in a big way.
Advice From Nearly 170,000 Friends
Dr Topol: At least you won't lose things so easily. You are also doing crowdsourcing for etiquette with Facebook, with [nearly 170,000] people. How do you use this group?
Mr Jacobs: That came about because I was asked to write an advice column for Esquire and I felt that I had no advice. I'm not an expert on anything. I truly believe that we shouldn't trust a single expert. I am wary of trusting a single expert. Trust the aggregate, but not a single person.
Dr Topol: You were made to crowdsource, right?
Mr Jacobs: Yes. I am a big believer in it, but it has its limits. You don't want to have everyone working on brain surgery. But for many problems, crowdsourcing is incredibly powerful. Social etiquette is one of those problems. I decided that instead of answering the questions myself, I'll ask my [nearly 170,000] Facebook followers.
Dr Topol: That's a lot of followers. How did you get so many?
Mr Jacobs: I do have a lot of Facebook followers. I will put up a question and then they will all weigh in. It's great because you get a much better range of advice than I would give myself. One person said, "I have a friend who wants to come over and stay at my house. I have the room. I just really don't want to have this person stay." The responses were fascinating. It made me think differently. It changed my life in one small way.
One person pointed out that the problem, when people come over and stay with you, is that they take up all of your time. Even if they are trying to be helpful, they ask questions like, "Where should I put the plates? Where should I put the cups?" And someone said, "Listen, there are only so many places in the kitchen where you can put the plates and cups. Just look." I thought that was good advice. When you go to someone's house, take the initiative. You can find where the plates and cups are.
Up Next: More Health Experiments?
Dr Topol: Where is your career going now? Are you going to continue the stunts and experiments?
Mr Jacobs: I do love it. People might get sick of it, which is fine. But right now I'm enjoying it.
Dr Topol: We would like you to stay in the health and medicine sphere because Drop Dead Healthy really hit it big. Maybe we can encourage you, after you have done the family reunion, to come back to medicine.
Mr Jacobs: I would love to. If you would be my advisor, I could test every gadget in the world and pass them out. That would be great. I need a lot of advisors.
Dr Topol: Maybe between your Facebook followers and all the other social media people, we can help you out.
You have lit up a lot of people with great humor and a message, too, with your experiments that have not been easy to pull off. These are not things that most people would even conjure up. Thank you so much for your work.
Mr Jacobs: Thank you.
Dr Topol: This has been fun. We appreciate you joining us on One-on-One.