He says there's a biopsy here says he from the professor of pathology in New York on a very well to do VIP of his rectum and there's the letter. So it said, Dear Basil, please look at this. It's very unusual, but I think this is carcinoma. So he showed it to me and he says, what do you think of it? And I said it's not carcinoma, it's squamous metaplasia, which is where the glandular tissue becomes squamous tissue and it looks very like cancer.

He says, are you? He says, going to disagree with the professor of pathology in New York. I said, I sure am, he says. He says, he won't like it, he says, but I like it and I'm sure

the patient will like it because I was right. Welcome to the Fat Emperor podcast. I'm your host,

Ivor Cummins. We're supported by the Irish Heart Disease Awareness charity,

which advocates a simple CT scan to reveal your CAC score. So know your score and take action

to prevent that premature heart attack. Everything you need to know will be right here.

Okay, today we have the best of Irish. We have Dr. Gerold O'Lee, well known on Twitter and on other formats. And he's a histopathologist, a consultant with massive expertise in autopsy and in histopathology. Delighted to meet you, Geroad again.

Delighted to meet you, I either as we've met several times before

absolutely i think in iceland and in a few other far fun places yeah yeah cork even in dublin

oh yeah crazy places like that well you know what i thought i'd start off with we usually start off

talking about low carbon weight loss and we're going to touch on that later but one thing that occurred

to me lately and it's occurred to me many times and it drives me crazy is bias in science and in

research and the way the humans have this confirmation bias and focus on what fulfills their beliefs

rather than being excruciatingly honest and just looking at the data and accepting

when it doesn't tell them what they want to see and you had a few great stories from your

pathology days we had an experience some years ago where a particular new marker was being

assessed on a particular tumor to suggest its prognosis etc etc and when we started

doing it we were getting a positive rate of 14 percent and other places rapidly began to report 25

percent and all the literature said 25 percent this is positive in about 25% of cases. So we discovered when getting our brains together with other Irish hospitals that there was one other hospital who was getting 14% and all of them were reporting 25%. I went to meetings in England and 25% was what you did and if you

weren't getting 25%, you could go to special courses which would raise your reporting rate to 25%.

So we were left with this conundrum. Is it 14% or is it 25%? What we did first is we got one of our technicians to do 100 cases, which had previously

been reported as negative, to see if any of them were positive, and they were to a complete

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