Rajpaul Attariwala, M.D., Ph.D.: Cancer screening with full-body MRI scans and a seminar on the field of radiology

**Peter Attia** (0:04)
Hey, everyone, welcome to The Peter Attia Drive. I'm your host, Peter Attia.
The Drive is a result of my hunger for optimizing performance, health, longevity, critical thinking, along with a few other obsessions along the way. I've spent the last several years working with some of the most successful top performing individuals in the world. And this podcast is my attempt to synthesize what I've learned along the way to help you live a higher quality, more fulfilling life. If you enjoy this podcast, you can find more information on today's episode and other topics at peterattiamd.com.
Hey everybody, welcome to this week's episode of The Drive. I'd like to take a couple of minutes to talk about why we don't run ads on this podcast, and why instead we've chosen to rely entirely on listener support. If you're listening to this, you probably already know, but the two things I care most about professionally are how to live longer and how to live better.
I have a complete fascination and obsession with this topic. I practice it professionally, and I've seen firsthand how access to information is basically all people need to make better decisions and improve the quality of their lives.
Curating and sharing this knowledge is not easy, and even before starting the podcast, that became clear to me. The sheer volume of material published in this space is overwhelming. I'm fortunate to have a great team that helps me continue learning and sharing this information with you. To take one example, our show notes are in a league of their own. In fact, we now have a full-time person that is dedicated to producing those, and the feedback has mirrored this.
So, all of this raises a natural question. How will we continue to fund the work necessary to support this?
As you probably know, the tried and true way to do this is to sell ads, but after a lot of contemplation, that model just doesn't feel right to me for a few reasons. Now, the first and most important of these is trust. I'm not sure how you can trust me if I'm telling you about something when you know I'm being paid by the company that makes it to tell you about it.
Another reason selling ads doesn't feel right to me is because I just know myself. I have a really hard time advocating for something that I'm not absolutely nuts for. So if I don't feel that way about something, I don't know how I can talk about it enthusiastically. So instead of selling ads, I've chosen to do what a handful of others have proved can work over time, and that is to create a subscriber support model for my audience.
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Again, the podcast will remain free to all, but my hope is that many of you will find enough value in, one, the podcast itself, and two, the additional content exclusive for members to support us at a level that makes sense for you. I want to thank you for taking a moment to listen to this. If you learn from and find value in the content I produce, please consider supporting us directly by signing up for a monthly subscription. My guest this week is Dr. Raj Attariwala. Raj is an amazing guy. I've known him for several years. He's incredibly well-trained. He first actually went down the engineering pathway doing his PhD in biomedical engineering at Northwestern, then decided he wanted to go into medicine and sort of apply his engineering approach to that. So he went back to medical school, did his residency in radiology, and then went on to specialize in nuclear medicine and spent a great deal of time at some of the top institutions in North America, Memorial Sloan Kettering, UCLA, USC, et cetera. He's now back in Vancouver, and what he's been up to for about the past decade has been effectively creating a new way of doing MRI. So he's sort of what I think can only be described as an MRI ninja. And that is to say he's been able to tinker with the hardware and the software to create a completely revolutionary product and process by which to look at the body using this technology of magnetic resonance. Now, I think this is a bit of a technical episode, but I also think it's one that anybody who's ever had an X-ray, a CT scan, an ultrasound, an MRI in their life needs to listen to. Why? Because truthfully, most doctors don't actually understand this stuff in great detail. You have to really go out of your way in medical school and residency to understand radiology. I was obsessed with it. I went out of my way to learn about it. I learned a little bit about it, but obviously nothing to the level of what someone like Raj knows. And so what we did in this episode, which you can sort of divide into two halves, is as follows. The first half is sort of a history of radiology. So we start with talking about what an X-ray is, how it works, what the radiation does and doesn't mean. CT scans, ultrasounds, PET scans, nuclear medicine scans, all of these things. And I promise we've done this in a way that is really geared towards the patient. I think we do a pretty good job of always bringing it back to language that makes sense and we don't get terribly lost in the physics. And of all areas in medicine where you can get lost in the physics, this is head and shoulders above the rest. Second half of this episode, we really do this deep dive into cancer screening and this particular type of MRI technology that Raj has almost single-handedly developed, although he would probably bristle at the sound of me saying that because he's just such a modest fellow. What I enjoy about this episode is it gives me a little bit of a chance to talk about cancer screening. This is something I'm incredibly passionate about and it's something I love talking about with my patients. The show notes for this are gonna be important because one, radiology is obviously a very visual field. You see things and much more than you sort of hear things. So we're gonna do a great job to pair a lot of what we discuss with images, especially once we get into the confusing MRI stuff and we try to explain the difference between a T1 weighted image and a T2 weighted image and a diffusion weighted image and things like that. The second thing is we're going to link to some of the material that we use with our patients on cancer screening because I know this is a very controversial topic and I suspect that this episode is going to generate just a lot of controversy, but I want to be clear that cancer screening is a very personal decision and it comes with risks. And the biggest risk of course is a positive which then leads to subsequent screening, emotional distress, potential harm. We talk about all of this stuff and as I said, we'll link to some of the materials that we've prepared specifically for our patients that I think just create a nice primer for how to go through that. So without further delay, please enjoy my conversation with Dr. Raj Attariwala. Hey Raj, thanks for carving some time out today in the middle of your busy day. I've probably done what no one else has done before, which is shut down this clinic, huh?