Jay Motley, MD

Founder MindWell | Ketamine | Husband-Dad of 5 | Widower | From obese to 2:50 Marathon 💪🏽 | Obsessed w/ Health | Longevity | Opinions:not medical advice

[Jay Motley, MD @motleymd]

At 20 years old my doctor informed me I was overweight, hypertensive and would be doomed to a life of medications and health problems if I didn’t change!

Here’s the secret to how I lost 60 lbs in around a year and kept it off for over 20 years…

[Jay Motley, MD @motleymd]

@patrickc How does anesthesia actually work?

[Jay Motley, MD @motleymd]

Every clinician should be able to spot collider bias on sight.

The “healthy smoker who lived to 90” is the canonical example, and yes, survivor bias is a special case of collider bias.

Other ones we see constantly:
• Obesity paradox in CHF and COPD inpatients

• Better outcomes in low-birth-weight babies of smoking mothers

• Berkson’s bias in any hospital-based association study

If you condition on survival, hospitalization, or elite status, the variable that got the patient into the sample is influencing every correlation you compute downstream.

[Marios Georgakis @MariosGeorgakis]

Among elite chess players, those with the lowest IQ are the best.
Among NBA players, the shortest ones are the best.
Among Hollywood actors, the least attractive are the most talented.
Among elite academics, those with poorer early academic performance are the best.
Among people with high LDL & high plaque burden, LDL is barely correlated with plaque burden.

Learn collider bias. Nice catch by @AlexTISYoung

[Jay Motley, MD @motleymd]

https://t.co/ORq6HB1LCO

[Jay Motley, MD @motleymd]

@anishmoonka Wrote about that topic here earlier this year! Cool stuff: https://t.co/eb0T6PWf31

[Jay Motley, MD @motleymd]

@forallcurious I love it, I wrote about this earlier this year: https://t.co/eb0T6PWf31

[Jay Motley, MD @motleymd]

I just had the most amazing, spontaneous moment while walking Lilla to the bus stop this morning.

While we were walking, someone sent me a birthday text.

It was beautiful, thoughtful, specific, and clearly written by someone who’d taken real time to say something that mattered to someone who mattered. It was the kind of message you read twice.

It wasn’t meant for me. I’m 45 and it’s not my birthday. 🙂

But I did know the person who it was meant for, so I thanked them for the accidental kindness, let them know they had the wrong number, and could’ve just gone on with my morning.

But, here’s the thing, I was walking Lilla to school when it came through, and I couldn’t let the moment pass.

I showed it to her. I said, “This wasn’t written for me. But read it.”

She read it.

I said, “Somebody sat down and wrote that. They thought about this person and what they meant to them, and they put it into words on a random Wednesday morning. For a birthday.”

Then I said what I actually wanted her to hear:

“You want to be the kind of person that somebody writes this for.”

I don’t mean popular or well-liked; those are important, but I mean the kind of person who is so special that someone stops, opens their phone, and takes the time say something real and meaningful. Something that takes longer than “HBD.”

Because here’s what I hope she picked up from this. Joy is not expensive. A text like that takes two minutes, a voicemail, or a handwritten note. Showing up. The bar for making someone’s day is low, but it’s so easy to just not do the little things to make it happen. I am certainly guilty of this.

This morning someone accidentally made mine.

And my daughter got to watch me smile at something that wasn’t even for me.

That’s the whole lesson. Be someone worth writing to, and write to the people who are worth it.

Don’t wait. Don’t assume they know.

Two minutes. That’s all it costs.

Have a great day friends 😊

[Jay Motley, MD @motleymd]

Great thread! IMO, one thing worth layering in: that 15-20% baseline assumes general population incidence rates.

But the denominator shifts before any test is applied. Combined lifestyle optimization (WFPBD, high-volume exercise, alcohol/tobacco abstinence, sleep quality) shows reduced cancer incidence ~30% and mortality ~50% in large meta-analyses vs. the least healthy cohort, independent of screening.

The Galleri miss this week is an interesting development: detection is our last line of defense. I’d argue that prevention changes the prior probability that there's anything to detect.

You can't Galleri,Colonoscopy, EGD your way out of a high-inflammation, high-IGF-1, disrupted-sleep biology, but we can change that biology, and it compounds with every year we do.

[Jay Motley, MD @motleymd]

@forestmanjohn I use one every morning!

Utopia Kitchen 304 Grade... https://t.co/cgaEEmUvMD

[Jay Motley, MD @motleymd]

Incredible!

[liemandt @jliemandt]

https://t.co/1erhwwi01p

[Jay Motley, MD @motleymd]

@jliemandt Incredible! I’m hoping to lead an effort to bring one here to Greenville.

[Jay Motley, MD @motleymd]

We should think in probabilities.

[Math Files @Math_files]

Bayes’ theorem is probably the single most important thing any rational person can learn.

So many of our debates and disagreements that we shout about are because we don’t understand Bayes’ theorem or how human rationality often works.

Bayes’ theorem is named after the 18th-century Thomas Bayes, and essentially it’s a formula that asks: when you are presented with all of the evidence for something, how much should you believe it?

Bayes’ theorem teaches us that our beliefs are not fixed; they are probabilities. Our beliefs change as we weigh new evidence against our assumptions, or our priors. In other words, we all carry certain ideas about how the world works, and new evidence can challenge them.

For example, somebody might believe that smoking is safe, that stress causes mouth ulcers, or that human activity is unrelated to climate change. These are their priors, their starting points. They can be formed by our culture, our biases, or even incomplete information.

Now imagine a new study comes along that challenges one of your priors. A single study might not carry enough weight to overturn your existing beliefs. But as studies accumulate, eventually the scales may tip. At some point, your prior will become less and less plausible.

Bayes’ theorem argues that being rational is not about black and white. It’s not even about true or false. It’s about what is most reasonable based on the best available evidence. But for this to work, we need to be presented with as much high-quality data as possible. Without evidence—without belief-forming data—we are left only with our priors and biases. And those aren’t all that rational.

[Jay Motley, MD @motleymd]

@elonmusk In

[Jay Motley, MD @motleymd]

@KenDBerryMD This version is even better.

[Jay Motley, MD @motleymd]

Best version I’ve seen yet from Dr. Beth.

[Jay Motley, MD @motleymd]

This is Huge!

I’ve spent years hoping for tools that help patients understand their health before crisis hits.

ChatGPT Health feels like it will be a real step toward shared ownership of care.

Used well, it should help us take even better care of the people we serve at @_MindWellHealth

[OpenAI @OpenAI]

Introducing ChatGPT Health — a dedicated space for health conversations in ChatGPT. You can securely connect medical records and wellness apps so responses are grounded in your own health information.

Designed to help you navigate medical care, not replace it.

Join the waitlist to get early access.

https://t.co/MdpqDg7Ecg

[Jay Motley, MD @motleymd]

Are psychedelics the future of mental healthcare?

https://t.co/o42M3zBk7P

[Jay Motley, MD @motleymd]

I bet you’ll learn something you never knew about bananas.

https://t.co/4NJppLMrCd

[Jay Motley, MD @motleymd]

@CliftonSellers Congrats! It’s looking great.

[Jay Motley, MD @motleymd]

@sweatystartup Wow, those are really low. I'd think to drive them that low you must be on at least 2 meds?