Chris Keefer

Host

Decoupled Podcast

Mar 29, 2021

Ep. 297: Chris Keefer, Decoupled Podcast
00:00 / 01:04
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Bret Kugelmass
So we are here today with Dr. Chris Keefer, who is an emergency physician and also host of the Decoupled podcast. Chris, welcome to Titans of Nuclear, you've certainly earned a slot based on the work you've been doing lately.

Chris Keefer
It's an honor to be on your show, Bret, and I've been following your work for some time. And your podcast was definitely motivation for me to get up and going. So thanks for having me on.

Bret Kugelmass
Well, I have so much to that. I'm just like, personally curious about because I, you know, came across your podcast as well. I know, this is a lot of just podcasters talking about podcast stuff, but it's probably appropriate. And also, before we get too deep into it, I just want to let the audience know, Chris also recorded an episode with another podcast The Climate Fix, which was just extraordinary. It was an hour and a half, you guys went so deep on so many topics that I'm personally interested in. So I recommend everyone pause, find that one, download it, listen to it, and then come back to this one.

Chris Keefer
Sounds good, Bret. Sounds good.

Bret Kugelmass
So, Chris, let's get started. So like you are a doctor primarily, right? Like that's your thing?

Chris Keefer
Yeah, I'm an emergency physician. I have a full time practice here in Toronto. You know, COVID has made it interesting. But yeah, I it - to some degree they call emergency medicine the hobbyist specialty. Because, you know, we work very intensely when we're at work. You know, they've done sort of workplace studies to see your productivity while you're at work, and we're sort of on task 95% of the time, there's no kind of chitchat around the water cooler, you're just going you barely make time to pee or eat. But you kind of are able to leave your work at work to a large degree. So it does enable you to especially if you don't sleep very much to find the time to engage in some other things, some other activities.

Bret Kugelmass
Yeah, I would, I was gonna push you on that I was like, how does a doctor have time to do anything else but being a doctor? And you answered that straight away. But let me let me, can we go a little bit further into your past in history, just to I'd love to like, maybe illuminate some of the things that you have made you into who you are? Like, when did you first develop an interest in medicine? And like, what were some of the pivotal moments like go as early back as you want that plays into who you are.

Chris Keefer
I mean, I was primarily actually interested in visual art when I was young. And I, I mean, I liked drawing anatomy. I grew up in the country and you know, did a bit of like hunting and like snaring rabbits and stuff. And I was always fascinated by the anatomy and drew a lot of pictures and things like that, and didn't have any doctors in the family. But certainly, I don't know, it was it was attracted to that idea of of taking on a caring role having a, like, a pragmatic skill that I could put into service of other humans, right, I have a deep interest, you know, in terms of my values in you know, just trying to improve the conditions of my fellow my fellow people out there, right, and...,

Bret Kugelmass
Okay, but hold on, has it always been the way cuz I know, some people start feeling that later in life, but what about like, when you were a kid, or in high school? Were you always like, somewhat interested in other people?

Chris Keefer
No, I wasn't, I wasn't like gunning for medicine, my whole my whole career. And in fact, you know, I, I'll be honest, like, I sort of did what I was good at, which tended to be the humanities, art, that kind of thing and didn't know, I didn't see a big role for a science and math and kind of engineering education for myself, because it just, I didn't see a professional situation in which, which that would be useful. And actually, I did have a moment. You know, I sort of got interested in medicine in my undergrad. But I said, you know, what, it's it's hopeless, like I stopped math in grade 10. You know, I did some biology because that was kind of the easy, the easy science to pursue that you can do without necessarily the strong, you know, math and chemistry and physics background. I remember sitting on the bed with my dad and talking about how I was thinking about, you know, wanting to do medicine. And, and I was like, but I don't know if I can do it. And he just he said, you can do it, son, I believe in you. I'm getting a little, you know, glassy eyed here, but it was a big moment. And it's a big gamble. Right? Medicine is a very, very competitive area to get into. And I only pursued these science studies at the time, because I wanted to get into medicine. And so you're making this gamble, right, I mean, my medical school, there's 4000 applicants for 200 spots. Right?

Bret Kugelmass
Well we should set the stage, you grew up in Canada?

Chris Keefer
That's right. Yeah.

Bret Kugelmass
And where in Canada?

Chris Keefer
In Ontario, which I affectionately call the you know, the France of North America, because we're about 61% nuclear, so we're just behind France in terms of nuclear energy.

Bret Kugelmass
And you went to school up there too, you're Canadian through and through?

Chris Keefer
Yeah. Born and bred, for sure. Yeah.

Bret Kugelmass
Okay. So yeah, it's a very competitive program somehow, you know, without having learned any of that.

Chris Keefer
And the reason the reason I'm telling that story is is not sort of to talk about, you know, it's so competitive, you know, so impressive that I got in or anything, but just that it was a gamble. And at that moment in time, I didn't really understand the value of a science education. And boy, has that ever become clear to me, you know, as my life has progressed, in terms of interpreting the world, right, understanding the difference between correlation and causation, understanding concepts, like relative risk, you know, that have just illuminated so much and allowed me - you know, I'm a very curious person, I'm constantly fascinated and trying to understand the world. And I think about how crippled my education could have been, and how limited my faculties could have been. If I hadn't taken that, that diversion. And I actually, I was in second year university and went back to high school and basically crammed chem, physics, calculus over a summer. You know, I was in with a bunch of, you know, 16-17 year olds, and a few kind of refugees that were upping their education. It was it was pretty fascinating. But yeah, all that brought me to, to make an application and very luckily, I got in and the rest is history.

Bret Kugelmass
Yeah, but you got to be pretty motivated. Sorry, I'm gonna dwell on your past or a little bit more. But you got to be pretty motivated to do something like that to go back all like, did you learn motivation anywhere? Like prior to that, like, were you like a Boy Scout? Or like, I mean, like, were there other formative moments growing up, other than like, your dad's encouragement, which it sounds like was very influential, were you kind of honing the skills of motivation, or self motivation?

Chris Keefer
I mean, if I get interested in something, I'm hungry for it, right. And, you know, in terms of, you know, kind of an apprenticeship learning model, I mean, you know, I will if there's someone who I see has a skill set that I'm interested in, I will devote myself 100% and, and dive in and learn that and work extraordinarily hard. I mean, prior to my interest in medicine that hadn't necessarily been an academic focus. You know, delving into my past, I've lived a very, you know, very rich and varied past, I've done a lot of things I talked about this a bit on my podcast in terms of like, how I've come to be where I am and how unlikely it is, because I very much grew up, you know, with a set of politics or coming out of a sort of, I talked about sort of being a kind of a tribe, right, in terms of how we identify, you know, our peer group, our thought leaders, the kind of passive opinions that we formed, just based upon our identity, as you know, I'm kind of a leftist, or I grew up in a bit of like, a hippie community or in high school, I hang out with this crowd or whatever, right. But, you know, I was actually quite a, quite a Luddite. Early on, I was, you know, very concerned, again, with issues of, you know, distributive justice of, of social justice. And for me, I was, you know, I was looking in a very naive way. And technology is this, like this tool that just leads to, you know, social stratification, hierarchical power relations, concentration of, of knowledge and expertise in a way that's kind of anti democratic. And it's just fascinating, because I see that now, amongst the people that I'm arguing with, and I can have a deep sort of compassion and deep understanding of where they're coming from, I think in a way that someone who's maybe more immersed in a different, you know, tribe or education would not. And so, you know, that led me to, you know, really take it to an extreme, I was very fascinated with nature. You know, trying to deeply understand nature, I grew up in the in the country, there was a huge woodlot, where I live next to, and I probably spent most of my days out there. But it wasn't, you know, it wasn't good enough for me. So I ended up packing up and going to Yukon, the Yukon Territory, which is kind of right next to Alaska, because I wanted to learn not so much from like a conservation biologist who goes out into the field, two months of the year to study, you know, a single, you know, nematode or something. I wanted to understand someone who, who kind of lived with the land or off the land and understood it. So So I went and apprenticed with a trapper of all things. And, you know, I lived in I canvas wall tent throughout a minus 50 degree, Yukon winter, like, I've done some really varied things, and it's equipped me with a way of, of, I guess, kind of understanding, empathizing and hopefully being more convincing, when I engage with, you know, people who, who don't share my same opinions on nuclear energy, for instance,

Bret Kugelmass
It sounds like, it's the variety of experiences that you have, that that have honed in your skills of empathy building yourself in someone else's shoes.

Chris Keefer
Sure, and I mean, I think like the values that, you know, I was born with and that I have maintained throughout our, you know, they continue onwards, certainly, I guess the the, the means of arriving at the goals that, that my values are concordant with have had changed, I've really kind of reanalyzed things and seeing some of the naivete of my earlier thinking. And, you know, just done a lot of research, a lot of talking and, you know, we talk about the podcasting thing, but I mean, it's such an incredible vehicle, to be able to process things much more deeply read someone's book, it's fascinating, you get to call them up, you get to talk about them for an hour, you get to form a personal relationship. And maybe that carries on and you say, Hey, I got this other question for you. And it's just so enriching. Yeah.

Bret Kugelmass
And I don't know if I'm, if you've experienced this, like I have, but oftentimes, I find that I read what someone publishes. And I have one impression. And then when I get to ask those, like, supplemental or auxiliary questions, I actually come away with maybe a different interpretation or understanding of the content.

Chris Keefer
Yeah, yeah, that makes sense. I mean, just certainly deeper, right. I mean, we talk in our in our presence, sort of zeitgeist, about, you know, what is it intensive reading versus extensive reading? You know, because it's just so easy to scroll through Twitter or, you know, read short articles, but we've really kind of impoverished ourselves intellectually by not deep diving material. And so, you know, podcasting interviewing a guest, you know, I take it very seriously. So I do sort of, you know, probably 16 to 24 hours of prep for each guest.

Bret Kugelmass
Wow. Okay, so that's where you and I differ a little bit, because I take the other approach, I take the approach that I don't want to know much about them going in, I want to know their general, like, subject matter enough to like, ask good questions. But I don't want to know what they're gonna say, because I want like the audience to be as surprised as I am. And like, that connection with the audience as it's happening a little bit.

Chris Keefer
I mean, I think I'm just acknowledging that even if I do spend, you know, 24 hours reading their material, I'm still going to be in that position. Because, you know, I mean, it's just I've been so blessed with the kind of guests that I've had on and they're deep people with with just huge sources of knowledge.

Bret Kugelmass
Yeah, it's amazing. Okay, so people probably don't even really know what we're talking about yet. So we're going to like inch through your career a little bit further. Becoming doctor, I assume that you have to deal with some medical radiation nuclear stuff, or you're learning about it at some point. But what was the moment that like you started, like, thinking deeply about nuclear topics?

Chris Keefer
I mean, it's interesting, like in terms of my attitudes towards nuclear, like I said that, you know, this kind of this idea of a sort of tribal affiliation kind of leftie, probably a little more on the crunchy granola spectrum. I remember, in Ontario, as I was saying, we're 61%, nuclear, we have three large nuclear plants. And I remember kind of driving on the highway, you know, from Toronto, to Montreal, and you see the signs for Pickering. And, you know, there's a nuclear station there. And I used to kind of, like, speed the car up a little bit and be like, hold my breath, which is just so ironic, because this is a totally air pollution resource that like, got rid of coal in our province, right. And later on, during my medical studies, I was at McMaster University, and they actually have a nuclear engineering program. And there's a there's a reactor like a research reactor on campus. And I remember like, you can basically like, go up to it and touch the outside containment. And I remember just being like, what is this doing here? Like, isn't this dangerous? Like, should I lead a protest against this, like, I've always had an activist bent right. And, you know, I was never sort of, I didn't have like a huge sort of Paul on the road to Damascus kind of conversion moment. You know, I was never a committed anti nuclear activist, I've always, you know, really cared about the Environment and Conservation, but been motivated more as a humanist, around human rights issues, refugee health issues, indigenous issues, things like that. But in terms of, you know, within my medical career, you know, coming into contact with ideas around nuclear and radiation, you know, it's very interesting, if you look at a pie chart of the background radiation, that's the the average American receives, right? It's, you know, about 2.7 millisieverts, you look at that pie chart, and that the section of that that's not, you know, radon or cosmic rays. And the, the section that's artificial is about 15% of the pie chart, well, 14% of that is medical. Right, so you look at that little sliver that's not medical, there's, you know, tiny, like fraction of a percentage, that's, you know, the legacy of atmospheric weapons testing, there's an even smaller fraction that's, you know, from nuclear accidents, but fully, you know, 93% of the artificial radiation that you receive as a North American every year is, for me pulling the trigger on ordering a diagnostic test, mostly. Right. So, and doctors -

Bret Kugelmass
You said pulling the trigger on ordering a diagnostic test, I'm gonna, like, other things that I've heard. You know, it's like there's a, there's a certain amount of caution, before a doctor commits to applying radiation to a patient. And most people would say, okay, that's a no brainer. But is it a no brainer? Are there certain levels of radiation that are more serious than others? Can you walk me through like, you first, like what you know about that, but also, like, what your training was initially as a doctor, and how that might differ?

Chris Keefer
Yeah, I mean, certainly, you know, the linear no-threshold hypothesis. You know, I wouldn't describe it as a scientific consensus, but it is a regulatory consensus. And it permeates medicine as well.

Bret Kugelmass
So what is that? What is that? What is linear no-threshold?

Chris Keefer
I mean, so basically, this idea that there is, you know, a linear relationship between what we call stochastic effects of radiation. So deterministic is basically you get into these really high doses, like, you know, to gray and above, and no matter what, you're going to get acute radiation sickness, which is terrible, bone marrow suppression, you know, sloughing off of your digestive tract, very life threatening stuff, like, you know, the Chernobyl, first responders got, you know, I think there was

Bret Kugelmass
This acute radiation sickness. This isn't like a scrambling of the DNA, this is more like a burn from the inside out.

Chris Keefer
Yeah, I mean, it's, you know, rapidly dividing cells that are deeply impacted. So you're, you know, the most rapidly dividing set of cells you have in your body is basically in your bone marrow, your immune system. And so your immune system becomes completely suppressed and you're incredibly vulnerable to getting secondary bacterial and fungal and viral infections. And then other rapidly dividing cell structures as I was saying, in your digestive tract kind of slough off and you're not able to digest food and you know, get nourishment. So you know, this was this was, again, what impacted. I'm going to blank on the numbers. I think it was about 136, Chernobyl workers and first responders, of which I believe 28 died, and I mean, they received some really good treatment, Robert Gale, this incredible American physician, you know, who'd done a lot of work with bone marrow transplants traveled to the Soviet Union at that time he brought with him one of the first colony stimulating factor medicines which we use. You know, in cancer patients who we are intentionally suppressing their immune system are giving radiation therapy to to stimulate those white blood cells so that their immune system doesn't tank and he actually injected himself. He did the first kind of human clinical trial because the Soviets were like, you got this experimental treatment you're not you're not going to go in, you know, experiment with us. And he said, Fine, I'll do it to myself, prove it safe. And then he used it on the ARS patients and ended up saving a lot of lives. So there's there's such cool stories. I mean,

Bret Kugelmass
Yeah, the history. Yeah, the history books with all this. But just to kind of hone back in on some numbers that you were using? Yeah. Like, gray is. Gray is like, two or three gray is that's that's the big dose that we're talking about. That's the one that can wash up your insides.

Chris Keefer
Yeah, yeah. And then so the linear no-threshold, which was the original question, basically, so that there's that sort of what we said deterministic effect, you get two grays, you're getting acute radiation syndrome, I forget the lethal dose 50. That's the kind of dose at which 50% of people will die. things around four or five grays, I don't think anyone's survived seven or eight, like as a whole body dose, right? in cancer treatment, we give, you know, cumulative doses of, you know, I'm not a radiation oncologist, but going off of the back of my hand here at like 30 grays or something right to a focal piece of tissue, and we fractionate it so we divide that dose up, over, you know, a treatment period of a month, say. So it's there's a lot of complexity here. But the linear no-threshold, again, says for what we call stochastic effects, which are kind of random effects, notably in relation to radiation, cancer, right? That you're the slightly increased risk of cancer, that a dose of radiation may or may not give you. We establish that relationship in a linear no-threshold in a linear model. And we have strong evidence that correlates to doses that get down to around 100 millisieverts, again, seeing a very tiny increase. But below that the data is very heterogeneous. So and it's a very hard thing to study, you know, once you're getting down to looking at a variable and then, you're like, you're looking at something like radiation and the number of variables that are there that could determine the outcome. And so you have this kind of scatter plot of data points on either side of that idea of that that line, which can show sometimes even potentially a beneficial relationship to low dose radiation. You know, that's, I'm quite conservative in that regard. I look at a kind of scatterplot. Like that. And so you just can't really draw conclusions from this. But certainly, it's, it doesn't look like there is a strong relationship one way or the other. I don't think there is, you know, in my personal opinion, in terms of my review of the literature, and and again, like, I try and and challenge my cognitive biases. So I'll read some papers that, you know, there's a Australian paper that looked at cancer and brain cancer incidence in Australian children exposed exposed to CT scans and claimed to have found, you know, a significant increase. And, you know, there's, like, the, the example of that study is, there's this thing called reverse causation. So who's getting a CT scan, you know, and we're looking for an effect, that's one in several 1000, probably seven or 8000, right? Well, people getting CT scans, there might be a reason they're getting a CT scan. And that might be because they're getting some symptoms that may eventually be a cancer, or, you know, the only way to truly do that study is to just take random children off the street, you know, what we call sort of a multicenter, double blinded, randomized control trial, where you'd have to again, just randomly select kids, put them in either a real CT scanner, or a sham CT scanner, scan them, follow them up throughout their lives, you know, try and look at all the other variables, did they smoke later in their life, this, that or the other? And the problem is, you can't like definitively really establish that relationship one way or the other. And so there's this element of like, well, what if, yeah, and and then this precautionary principle, which, which I think is become a really dominant cultural paradigm. And I can go into why I think that is, but its affect, it's affecting a lot of the potential for human progress.

Bret Kugelmass
Yeah, I want to put a pin on the precautionary principle to come back to it. But I want first, I want to talk about this, this concept that we've been discussing, which is like what is the correct way to model the amount of radiation the relationship between the amount of radiation you receive, and, and the health outcomes of that, and what we've been discussing is that, you know, historically, the model that everyone uses is this linear, no-threshold model, in which what they say is, no matter how low you go, there's still some negative health impact. And what we're discussing is that while they say that, we don't necessarily have the data to back that up, that's more of us just being you know, quote, unquote, better safe than sorry. But in reality, the data is much more complex. When you get to these lower,

Chris Keefer
You know, the linear no-threshold

Bret Kugelmass
Per during medical treatments and such.

Chris Keefer
Yeah, and the linear no-threshold defies everything we know about the study of toxicology, right? Where you know, back to Paracelsus. You know, the dose maketh the poison, right. Everything is poisonous at a high enough dose. I've literally had a patient who, you know, like we saved his life. But he almost poisoned himself with water, he drank about eight liters of water and under an hour, you know, that changed the osmolality of his brain, he, you know, he absorbed a ton of water into his his brain, cerebral edema, his spinal cord is almost crushed by his swelling brain. You know, he needed intensive care, you know, for water, right. And so then the analogy that I'm using here is, you know, that was eight liters in an hour. So the linear no-threshold, if you applied it to water would say that, well, if you drink a liter in an hour, you know, then your mortality will be 1/8. of you know, what it would have been for this guy who without, you know, incredible medical care would have died.

Bret Kugelmass
Yeah. And can you give it to me give the other example can we talk about maybe something that you and I, or that the general public might intuitively understand is dangerous, but that we also that we also intuitively know, at lower levels, has beneficial effects, can you come up with an example

Chris Keefer
Yeah, for sure. So you know, gravity is a pretty big hazard, right? You're afraid of heights? A little bit?

Bret Kugelmass
Yeah, sure, of course, right. So,

Chris Keefer
You know, jump off, jump off 100 foot cliff and and see what happens, you know, work on your Stairmaster, and jump off a one foot step. And you're gonna see benefits and bone mineral density and the architecture of your bones. I mean, like, weight bearing exercises are good for us. And that's the same kind of idea, right? That in delivering a threshold says that, okay, one person jumps from a 100 foot cliff, that's 100% fatal, or maybe not, maybe a few people can survive that with some horrific trauma afterwards. But a one foot jump will then be in a one 100 of the the danger. And it just again, it defies human reasoning, it defies everything that we know about toxicology,

Bret Kugelmass
And this is because of the human body is, is programmed to respond to stress by making itself stronger, low levels of stress. And and I guess you were talking about the bone density example. Like, yeah, people know that, like when you work out more when you apply stress to parts of your body. Yeah, you when you tear muscle, you know, by working out, you're applying stress, you may actually be damaging a cell, like permanently destroying a cell, but the the aggregate response of your body to repair ends up leading towards you being in a better condition at the end than when you started. And I think that's another problem. When people look at the radiation, they might say, Well, I know how radiation interacts with a single cell, and it does damage definitively, even the smallest amount of radiation will hurt a cell, I'm looking at a cell right now, they might say that, but what they're doing in that sense, is they're neglecting your systems response, the stress response, that might actually yield some benefit, is that right?

Chris Keefer
I mean, they're also ignoring the kind of middle you with within which, you know, cell damage occurs, right. And the vast majority of damage to DNA within cells is from oxidative stress from

Bret Kugelmass
Tell me more about that. What is oxidative stress?

Chris Keefer
I mean, basically, it's you know, as you've probably heard of free radicals and all sorts of, you know, nutritional supplements that can

Bret Kugelmass
I drink pomegranate juice to get rid of the, for the antioxidants, right, is that what we're talking about?

Chris Keefer
Exactly. And so, you know, that stress on your body, you know, in terms of we talked about single and double stranded DNA breaks, right? Single stranded DNA breaks happen all the time, they're no big deal, we have great repair mechanisms to deal with that. Especially because the other strand of that DNA sort of provides the template with which to repair the broken strand, double strand is a little more complicated. And sometimes that does lead to bigger problems. But, you know, in an average day, there's something like 10,000 single strand breaks in your in the DNA of a cell.

Bret Kugelmass
So one cell and one and one cell, you're telling me there's 10,000 breaks in DNA, like, someone who doesn't know anything about this might be like, oh, shit, my DNA is broken?

Chris Keefer
Well, that's that's the thing like, since you know, the linear no-threshold, that hypothesis, you know, probably became sort of the standard in the 50s, around the release of the, the BEIR report, the Biological Effects of Ionizing Radiation. That the first iteration of that report, you know, the work of Herman Miller, you know, in terms of popularizing this idea, based upon his, you know, Nobel Prize winning research on fruit flies, where he bombarded them with absolutely enormous rates of radiation and found, you know, mutations in further generations, right. But, so there was this conception at that time, like the sciences moved so, so much further in terms of our understanding of cellular biology at that time, you know, we were just learning about what DNA actually was. And, you know, the first ideas about it were that it was this sort of immutable structure, right, that was very fragile, and maybe that's based on like the guys, you know, in the guys and the woman, Rosalind Franklin, they were actually putting together the models and you know, maybe they're made out of something brittle and if you broke it, the whole thing would fall apart like a house of cards, but in any case, our understanding of the repair mechanisms themselves has, you know, greatly greatly changed. And, you know, he, you know, in terms of the stress that the the oxygen oxidative stress on your DNA versus say, you know, the impact of a stray gamma ray from background radiation, it's something in the order of 1000 to one, right, in terms of that effect, or the number of breaks you're gonna have, right? So we obsess about, you know, there, you're right, there is this potential damage, you know, there's a mechanism for that. But it's, it's just, it's a very, very, very trivial amount. And let's say that radiation had only negative effects, you know, for humanity, then you might be able to say, like, you know, I wouldn't really advocate, hey, Bret, you should strengthen your constitution by taking tiny bits of lead every day or ingesting small amounts of arsenic or mercury. Right. You know, but radiation, there's so many positive benefits, you know, in terms of just talking about medical isotopes and diagnostic imaging, I mean, it's incredible what we take for granted. But, you know, literally, you know, at least 10s of millions, probably hundreds of millions of medical diagnostic tests every year, cancer treatments, you know, the list of sterilization of surgical instruments, you know, it's it's absolutely enormous, the positive contributions, none of this not even getting into nuclear energy, and, you know, clean air and carbon free electricity and avoiding climate change, like, so we have to understand relative risk. And this is just an enormous challenge that we face as people who advocate nuclear energy, because we're up against fear and gut reactions. And, you know, you can always find a scientist that's going to back you up, right, you can always, you know, find a fringe scientist. And that's really what the anti nuclear movement has done. You know, and especially if you look at the quality of the studies that are done on things like the Chernobyl accident, you know, someone who's trained in, you know, epidemiology and in what we now call evidence-based medicine, which is kind of the new paradigm with which we assess the validity of a treatment or an investigation, right? We do these randomized controlled trials, it's based in you know, whether we're seeing a statistically significant impact. And the old model is mechanistic. Right? So it's like, yes, you know, there's a mechanism here, it's plausible, okay, that's medical evidence, the paradigm has shifted. So I'm hopeful that, you know, physicians that have been trained in the last 10 to 20 years are going to be able to take a much more learned approach, and understand relative risk, understand correlation and causation much better and make better decisions. And, you know, that's kind of leading into Doctors for Nuclear Energy. But that's, that's kind of what I'm hopeful for.

Bret Kugelmass
Yeah. And can you before we get on to the, like, the organizations that you formed, and the advocacy work that you've been really pioneering? Can you since you mentioned, Chernobyl, can you walk us through, like, what happened, how people came into contact with radiation. We mentioned already, like the people who were cleaning it up and they got the acute radiation sickness, those are the grays, they got the scrambling amount, who else got affected by radiation? And how did it happen? And what do we know about that?

Chris Keefer
You got an hour? That's a huge question, obviously, right. And I don't have the exact numbers at my fingertips, right. But as I was mentioning before, something around 128 people got acute radiation syndrome. And that was people that were working in the plant at the time, kind of first responders to the accident. You know, this was a graphite moderated reactor, which had a super criticality and, you know, the graphite caught on fire, there was an explosion that spewed the stuff all over the place, there people picking up bits of graphite and uranium and tossing them back into. And so that kind of crater where the reactor had been up on the roof, spraying water on it. So these are the folks that got really significant doses of radiation and who got acute radiation syndrome. You know, Geraldine Thomas, I think you guys have interviewed on this podcast would be able to give you a much more sort of learned approach, but some of the things that I've taken away from, from what she's described, I mean, she's, again, the director of the Chernobyl tissue bank. She's a specialist in thyroid cancer. And in terms of the, you know, the impacts beyond those, those workers that got an acute radiation syndrome. And, you know, it's not just obviously that their bone marrow was depressed or that they lived or died. I mean, the ones who lived also had severe thermal burns, but also radiation burns, I don't want to minimize the fact that hey, of those, I think it was around 130 people who got acute radiation syndrome, you know, only 28 died. I mean, that's amazing. But, you know, we have to be real that the other 100 have had other major health effects. Interestingly, they haven't all died of cancer. In fact, there's not really a strong relationship in terms of what those from that cohort have actually died of, you know, often it's car accidents, cirrhosis of the liver, other non radiation, affected causes of death,

Bret Kugelmass
Right, but like, I think like the average person, maybe average person who knows something about nuclear in history, thinks That the more harmful result from Chernobyl or any nuclear accident would be something related to cancer can can you explain, like, what's happening there? Why do people? Or what do people think? Why do they think that? What's the reality?

Chris Keefer
Yeah, I mean, it's it's based on linear no-threshold calculations, right. So like we were saying before that 100 foot jump versus a one foot jumper, a one centimeter jumper, one millimeter jump, like, if you apply that logic to the world population. And you use linear no-threshold, you can generate use a random number generator, right? Just change the combinator and you can you can, you can claim that there's going to be this excess number of cancers, and then you can say, well of those cancers, that these many people will die from them. But it's just absolutely ridiculous. Because, you know, I always ask people this question like, if especially if you're in the States, like, would you would you if you got a great job in Denver, Colorado, would you move there? I mean, I would, I mean, other than I'm Canadian, and, you know, kind of a bit of a dumpster fire right now. But I love skiing, I love the outdoors, I love the American Southwest, I've moved there in a heartbeat if I can have my Canadian healthcare and whatever else, right. But you know, I'd be getting 10 millisieverts of radiation a year, right? From this background.

Bret Kugelmass
And so you're saying when people apply, when some people calculated the total amount of hazard that was caused from a nuclear accident, what they did was they applied little bits of radiation over a large population to calculate a large number of deaths. But what you're saying right now is that if you apply that same methodology to Colorado, where there isn't a significant increase in radiation over, let's say, New York, then we would also calculate the huge number of deaths. But do we see that in New York?

Chris Keefer
No, absolutely not? Absolutely not. And then, you know, there's these questions of, you know, this idea of artificial radiation is different than natural radiation, we've decisively answered that it is not, right? And then people like, Well, what about like a hot particle or an internal emitter? As if that's only you know, coming from an unnatural source, I mean, we breathe in uranium atoms all the time. And these are these are the smallest, the smallest units in our universe. And we use sieverts, right, which which applies in multiplication factors for say like an ingested alpha emitter gets, you know, 20 times factor added to it, right compared to an external source. So that's all factored into millisieverts. That's why it's a kind of a useful measure, you know, grays is absorbed dose and millisieverts is absorbed dose with like tissue weighting factors with the type of radiation, whether it's alpha, or beta, or gamma. So, you know, it's a lot to demystify, and I kind of understand why a lot of my colleagues are just like, linear no-threshold, let's just take it because it takes a lot of work to educate yourself further. And kind of circling back a little bit like, you know, and you know, talking about pulling the trigger on doing a diagnostic imaging test. I mean, there is that anxiety in the back of your head, if your training says, Hey, like you do enough of these over your career, that little kid in front of you, you know, that maybe that's the one in your career that you're going to give a brain tumor to. Right. And the idea of inflicting that as a physician is it's very scary. Yeah. So it's, it's again, having that compassion and understanding where people are coming from rather than just, you know, sometimes being like, writing them off is just an uneducated idiot, who hasn't taken the time to sort of do the research. It's, it's, you know, it's there's, it's very understandable why people arrive at the conclusions that they do.

Bret Kugelmass
It's kind of understandable. But on the other hand, I hope that doctors, which have to learn a lot of things like, like, doctors, in my experience, are very smart. And you have to master like many different subject matters, and are constantly making risk trade offs would do what doesn't seem to me to be that much research to come to their own conclusion about the risks of low dose radiation compared to the benefits that they see every single day. I mean, if you ever come up with a statistic on how many lives have definitively been saved, in with the use of medical radiation, versus how many people have ever died from radiation in the world?

Chris Keefer
I think that's that is out there. And actually, just like, in the few minutes before this interview, I was actually looking for it. I mean, James Hansen, did some work looking at lives saved from nuclear displacing fossil, and that's about 1.8 million lives. But you know, from radiation, I mean, I think that would be far exceeded from effects of medical radiation. Absolutely. And getting back to your question about, you know, yes, physicians, we need to learn a lot of things. We are trusted by our communities to be experts. Do I expect all of my colleagues to have deep dive into this topic as much as I have? No, but I'll tell you who I do expect amongst my colleagues do a deep dive of this. The the anti nuclear physicians, if you're gonna stake an opinion, on, you know, the, what you perceive as the risks of radiation or and you have not done a solid amount of research on that, like, shame on you, right. And we know from high quality evidence, because again, you can compare the quality of studies, like the UNSCEAR report on Chernobyl or the Chernobyl Forum report again, multi agency multi country hundreds of experts consensus decision making, versus Greenpeace and Green Party funded research like the TORCH report the other report on Chernobyl or the Yablokov, I don't know whether to call it a report. It's just a bunch of, you know, abstracts from conferences and news articles that you kind of pinned together into something. You know, from that, that, that quality of evidence, you can draw some some pretty major conclusions that the major harms from Chernobyl and Fukushima were the psychological impacts of panicked evacuations, and of unnecessarily, unnecessarily large and unnecessarily prolonged evacuations. And there are physicians like Helen Caldicott, who have said, you know, extraordinary things like, you know, more people will die from Chernobyl than from the Black Death. I remind you, the Black Death was 100 million dead, right, like you're trivializing a plague. And you're terrifying people. And I mean, you could see her in the aftermath of the Fukushima accident just chortling. And, you know, just loving her moment in the spotlight to terrify people. And that cost lives.

Bret Kugelmass
Yeah. Okay. So tell me because you've been and to maybe further set the stage for people like so you've got this podcast, you've also you got these doctor, Doctors for Nuclear group, like you have really gone deep into studying this and meeting with experts and forming advocacy groups, have you developed an opinion? Or a theory as to where the anti nuclear sentiment itself comes from?

Chris Keefer
Oh, absolutely. I mean, I think it's, I think it's quite clear. I just had Spencer Weart on my show a couple of weeks ago. And I mean, this is the man who has, he's a physicist, PhD physicists and astrophysicists who's became a historian of science and has just, you know, absolutely deep dived this, where a real mastery of the psycho psychological literature, and he's, you must have watched, like, every shitty movie from the 50s onwards that had anything to do with radiation. But, you know, you can trace this this quite, quite conclusively. And I mean, you know, I would say, to sum it up, especially in terms of physician, anti nuclear advocacy, this really has to do with the horror of nuclear weapons. And the fear, you know, especially as, you know, the hydrogen bomb came about as the US lost its monopoly on nuclear weapons, as everyone became vulnerable with, you know, Sputnik, and then, you know, ballistic missiles and your ballistic missiles, the fear enemy, you know, I'm not sure your exact age, but I mean, my generation, I was kind of what was seven or eight years old, when the Berlin Wall fell, I don't really have any conscious memory or trauma in the way that my father did doing kind of duck and cover hiding under his table in the classroom as the Cuban Missile Crisis played out, right. But, you know, so an opportunity to try and eradicate nuclear weapons from the world. You know, that's obviously in terms of use don't understand anything about geopolitics, you know, the cats out of the bag, that technology exists, it, activists are not going to convince, you know, these large nations as idealistic as we'd like to be. And I am a real idealist, and I engage in what I call aspirational politics, but it's not going to happen. So the concern became, well, you know, we're building bigger and bigger bombs, we're testing all the time, and we're doing these atmospheric tests, right. And one of these tests that Castle Bravo tests ended up, you know, having a yield much higher than was expected. And, you know, they evacuated an area to do this test, but the yield was larger. And this Japanese fishing vessel, the unfortunately named Lucky Dragon, you know, the members on board that ship got acute radiation sickness, which you're describing earlier, went back to Japan, one of them died. You know, and so this, this fear about Fallout was was really, you know, brought to the forefront and I think, Spencer Weart talks a lot about, you know, this kind of avoidance mechanism. So, you know, the, the sort of impact of nuclear weapons, it's just so horrific to think about, and like the blast injuries and the fire and everything else. And the power of them, the sort of civilizational ending power is so traumatic to think about, that we sort of transfer some of our worries, and particularly kind of what's unique about these weapons is radiation. Right? And certainly, you know, we've seen fallout you know, on the Lucky Dragon and if you kind of model especially kind of ground burst nuclear weapons strikes, I mean, it's, it's, that's really significant, what could happen with radiation. But in any case, you know, these these activists started to try and shut down atmospheric nuclear weapons testing, and the way they did that was, you know, radiation's so special, you can't you can't sense it unless until your skin starts turning red, right? And so you get kind of a sunburn from it. We don't have any sensory organs that can detect and distinguish dose and the way that we can with another hazard like fire, but with a Geiger counter, I mean, you can detect the decay of a single atom. Right. And so, there were studies done like this baby tooth survey in the states where they got 400,000 they had the tooth fairy came by and got 400,000 teeth at, you know, 10 year intervals and found, you know, the level of strontium 90, which is a, you know, isotope is only produced artificially had risen in the in the level in these children's teeth. And I mean, you think about like milk and babies, there's nothing more sacred in the world did that strontium 90 have any impact? You know, in terms of a dose relationship to these children? Like Absolutely not. But, you know, if I'm to make that advocate, if I'm to make that argument, I sound like I'm an Edward Teller, like I'm a promoter of nuclear weapons, I'm absolutely not. But in terms of being honest about the science, you know, global follow up from atmospheric nuclear weapons wasn't a really a health issue. It was a convenient thing to latch on to to stop atmospheric weapons testing. And I applaud that it's great that we stopped atmospheric weapons testing. But then when weapons testing went underground, you know, the activist didn't have anything to sort of point at anymore. And so they really diverted their attention towards nuclear energy, which, you know, became a big, big deal in the 70s, around the time of the OPEC crisis and things like that.

Bret Kugelmass
But why are these nuclear activists so powerful in terms of their ability to stall nuclear energy development? I mean, they're activists for all sorts of stuff, you know, like, how many times have I heard in the news that like Nike employees slave labor when putting their shoes together? Or even like the stuff in your plastic water bottles? You know, there's all sorts of news about that. I don't think they ever made a lot of change that. So like, how come they were so successful in stalling nuclear energy growth when they're activists all over the place that aren't successful in other industries?

Chris Keefer
I would say that the fossil fuel industry has a little something to do with that, you know, in terms of like, nuclear threatens the market share of fossil fuel industry? I'm not I know, I had Rod Adams on my show a little while ago. And, you know, he's like, this is not conspiracy theory. This is what, you know, executives at companies do, they identify threats? You know, certainly there has been direct fossil fuel funding of anti nuclear activists. I won't say I can't claim that that's, you know, how widespread that is, but there's definite examples. And there's lots of indirect examples, say Bloomberg, or Tom Steyer, giving lots of money to Sierra Club or NRDC, which uses some of their money in anti nuclear activities. When a nuke plant shuts down, what happens it gets replaced by usually gas in this day and age, there's big money to be made in that. So that's certainly part of it. I mean, the the kind of appeal to emotion as I was saying, the psychological trauma of living through the Cold War makes it a very hot button potent issue, it's hard to distinguish that every technology in the world is dual purpose, right. I mean, the the steel that makes the iron that makes your ploughshare makes the sword as well. Right. We have to wrestle with that we're a technological species. And I think this is probably getting into this idea of the precautionary principle, but you know, as as applied to weapons, I mean, that, you know, you can see, I think, especially before climate change loomed, certainly, you know, the air pollution argument for nuclear energy is incredibly strong.

Bret Kugelmass
Tell me more about that, yeah, let's, let's double click on that for a second.

Chris Keefer
Sure I mean, so we've we've gained more and more knowledge about the hazards from from air pollution. You know, and recently, the WHO has even increased their estimates from, I believe, 7 million people a year dying from, from air pollution to about 8.5. 3 million of that is from outdoor air pollution, largely coal, also, you know, cars, all sorts of different emissions in that regard. And 4 million is indoor from people, you know, basically cooking over cow shit and, and wood, you know. So, it's an absolutely enormous burden of disease. And that's what I was pointing to in terms of James Hansen's study using the net, which was looking at the number of lives saved by nuclear displacing things like coal.

Bret Kugelmass
Yeah, and, and this is every year you're talking about, you're talking about

Chris Keefer
Every single year,

Bret Kugelmass
Approaching 10 million lives every year lost from air pollution,

Chris Keefer
and those are lives lost. That's not just disability, right. So if you if you have the misfortune of growing up as a child in Delhi, your your lungs are scarred. You're like if you do pulmonary function tests on these children and monitor it over time, big big, like 30, 40% decrease in their lung function. prematurely, babies are born prematurely at astronomical rates in areas with high high levels of air pollution. And again, these these kind of anti nuclear activists, you know, it's kind of inflammatory language, they they have blood on their hands, but if you look at you know, Ralph Nader's role in shutting down I believe they were developing three or four nuclear reactors in Ohio to deal with the air pollution crisis there. Ralph Nader wrote in there, use some incredible fearmongering you know, the, if there's an accident, the living will envy the dead. And, you know, these nuclear plants were quietly turned into coal plants and continue to, you know, kill and you know, each individual coal plant I don't have the statistics in front of me. But it's hundreds of people per year that that can die as a result of their I think it depends on the scrubbers and everything that's installed. But there's there's a death count.

Bret Kugelmass
And I think one of the things that always bugs me is because some people will then say, Okay, well, I still don't like nuclear, of course I don't like coal. So let's just replace it all with renewables. But I think that they're forgetting that per year, death counts, because if you can solve it one year faster, let's say, because nuclear is more scalable, or there's a better supply chain, you know, for the fuel, or the raw materials that go into it, because you can do so much more with so much less. And we've seen countries go from like, 0%, nuclear to 80% nuclear in a decade. If you can do it faster. It's that many more lives saved, you could do even one year faster, you're talking about 8 million lives saved, you can do two years faster that's 16 million lives saved. And I think people forget, it's not just about saving, it's not just about getting to a solution. It's about getting to a solution quickly as well.

Chris Keefer
Okay, but not just quickly, because that's, that's a key argument that the anti nuclear folks use against us, which, you know, they're saying, well, a nuclear, you know, it shouldn't, and I followed your work closely, but it can take 10, you know, 15 years to build, that's too slow. We've got this 12 year timeline, the world's gonna end if we don't get it done in 12 years, durability is a really important factor, right? So if we can build nuclear plants that, you know, are being relicensed now, or refurbished into 80, 100 year long lifespans, that's very different than, you know, wind and solar farms, you know, that needs to be replaced every 20, maybe to be very generous every 30 years, on an ongoing basis at a scale that's just unimaginable. I mean, the the work that, I believe it's Mike Conley, and I'm forgetting his co authors name, you know, they did you know, they've done the math on this and the calculations of Okay, so you, let's say you follow kind of Mark Z Jacobson's climate plan, which is to be 100% and 100%, renewables in the US by I forget what date something like 2030 Once you've installed all of that solar capacity, and you know, paved over, you know, states the size of I'm forgetting what states but very large land masses with solar panels, you know, you get into a pattern where you needing to replace, you know, 2 million solar panels a day forever, you know, once you get to scale. So durability is really, really important as well. And, you know, and also, I mean, this is kind of going a bit further afield, but, and I've really been doing a lot of thinking about the grid, as a commons as a source of kind of social benefit to us all, when I'm trying to counter these kind of small is beautiful decentralization arguments, you know, the grid is a lifesaver. It's, it's really important, then, you know, as damaging as fossil fuels have been, it's, you know, I've developed a lot more of a nuanced take on it, not like I would love to see fossil fuels completely replaced ASAP, you know, with nuclear and synth fuels and other things, and some hydro or whatever else, but you have to recognize that, you know, lifespans have dramatically increased, like industrialization as dirty and gross as it's been. And as messy as it's been. The outcomes have been, you know, dramatically longer lives, you know, vaccines, water.

Bret Kugelmass
The thing is access to energy yields prosperity across many different facets of life.

Chris Keefer
Yeah, yeah. 100% 100%.

Bret Kugelmass
So, okay, so you start, you looked into nuclear, you started these organizations, you know, I guess, like, you know, you're the President of Canadians for Nuclear, I mean, like, you've really now, like decided that like this is, it's very clear to the lanes that you're going, this is like a lifelong mission for you. Now.

Chris Keefer
That's pretty impressive for me, because I tend to be a little bit ADHD, I mean, medicine has been one thing, I've been able to kind of sustain my focus now for, you know, whatever, 16 years of my education and practice, but in general, I, you know, I'm just a very curious person, I'm a bit of a magpie, well, that's shiny, that's exciting, and, you know, deep dive that and find that kind of mentor and trying to pull everything I can out of them in terms of their knowledge. But yeah, I mean, I've said this before, but you know, emergency medicine really appealed to me because of this idea of a triage ethic, right? How do you use the limited resources, you have to have the biggest impact on the world? And, you know, ultimately, you know, you can talk about being left or right, you know, my, my driver, in terms of my sort of politics is I want to see everybody reach their full human potential and capacity. And so, you know, climate change threatens that air pollution threatens that, and I've come to the understanding that energy is this master resource, which, you know, can really allow human flourishing to its greatest extent. And if that energy can be delivered in a way that you know, again, decouples it from ecological impact, then you can have these dense cities you can have, you know, your energy produced on a tiny, tiny footprint, you can, you know, rewild and preserve vast tracts of wilderness, which is another, you know, it's a humanist value. I appreciate it. I think it's good for humans to have a bunch of nature set aside to go and, you know, restore their mental health. But you know, that's, that's, that's my take. And that's why I think I've maintained this focus, and I don't see it coming to an end, it's highly improbable if you told my, you know, even 30 year old self, hey, and, you know, in six or seven years, you're gonna be, you know, doctoring. And then basically a full time pro nuclear advocate, I would have laughed you off the, you know, I forget what the expression is, I would have laughed at you, right?

Bret Kugelmass
And the decouple word that you call that. That's because your podcast is the Decoupled podcast. So everyone should be subscribing to that as well. But But I want to know, like, I, I've been listening to you, it's amazing to watch your evolution, I feel like it's something I went through as well over the course of a few years of just getting to talk to so many people. Yeah. But I know, at least in my situation, like things have changed from like, where I started, and just wanting to learn to them wanting to do something about it. Where is your like evolution going, you're going to continue to interview people, I'm sure that you're going to continue to speak at conferences and webinars and really become a thought leader in a space, I'm sure that where else does it go from there? Like, what's your win if you if you could say, my work will amount to this, and this will have an impact much broader than myself? Like, where is it going?

Chris Keefer
Yeah, I gotta say, you know, like, the, the, the podcast is rewarding in the sense that I just get to chase my curiosity and meet incredible people, polymaths, etc, right? The political work, you know, I'm an activist, I want to see change in the world, it's not about really leaving a legacy, but precisely, you know, changing the world for the better helping people flourish. What is that going to look like? I mean, the evolution has been interesting, like, you know, this all started, probably three or four years ago with a, you know, I had a little fight with someone about climate change, and whether it was, you know, being caused or exacerbated by by human activity, or not, this guy was an Arctic driller. And, you know, I didn't, I hadn't done any research. So I kind of knew in terms of my like, again, my tribal beliefs that climate change was, was a human caused, or human exacerbated, but I didn't have the data. And so it really led me on the journey to look into it, which made me a doomer, right, you start you start diving into climate change, and you can get pretty depressed about it. And, you know, my ex wife, you know, I was just the buzzkill at the party and being like, Hey, did you know this, you know, horrifying apocalyptic fact about what lies ahead and 100 years, and she's like, Just shut up and do something about it. And, you know, she wanted me to sort the compost a bit better, and, you know, take up the recycling, and probably buy, like, you know organic food, and, you know, it led me down this rabbit hole of, you know, terms of where my curiosity led me, and my training led me into sort of this more kind of eco modernist framework, you know, which then led to just reading a lot and, you know, wanting to take action. So, you know, the, the global Stand Up for Nuclear events, were probably what sort of launched me into actually being an activist, you can do a lot of arguing online and expend a lot of your energy trying to convince the unconvinceables. But for me, that was useful to a point, I hold my arguments, and maybe really, you know, concede a few things, but also really understand and, and get an evidence base for my arguments. But after a while, you want to make a difference in the world, right? So, you know, rather than convincing the unconvinceables, as you look at, there's a much larger demographic here, right, and if I can, if I can reach out to them and help convince them. So, you know, that led to these Stand Up for Nuclear events, participating in those, you know, holding one events in Canada in 2019. And then that expanding to three events across the country, and then networking, with you know, there are actually a fair number of people that are quite positive about nuclear energy and very committed. And you know, Margaret Mead said, Never doubt that a small group of committed individuals can change the world. In fact, it's the only thing that ever has. And, you know, we're starting to do that. And so this this three kind of one day a year events turned into a national organization now. You know, and so, in terms of kind of building, that that base of advocacy, you know, I've been sort of casting around, and I've been talking with leading politicians across the country, I've been very fortunate. Certainly, it helps being a physician and having a compelling story. But I'm very interested in engaging with people that work in the sector, particularly nuclear energy workers. I mean, there's 60,000 of them in Canada. And, and they understand the merits of their of their sector, they understand, you know, the benefits of what they're doing and they understand radiation in a way that a lot of other people don't the things that they are incredibly stigmatized, right. It's not as bad as Germany by any means. But there's a kind of cultural consensus nuclear bad poison pollution, you know, waste etc. Right? There's people don't immediately think, oh, wow, I've got clean air. Oh, well, there's medical, oh, my surgical instruments are sterile. Oh, you know, people don't see that behind the scenes stuff. And so as a group of sort of citizen activists, you know, and being able to shine, positivity and appreciation to nuclear workers, you know, I'm really hopeful that that's going to activate that base. And I mean, these are people that are directly under effective losing their jobs in their communities being devastated. Right. So that's been, you know, beyond just the the Canadian focused activism, which very much involves reaching out to workers and unions, you know, internationally trying to create networks of solidarity between, you know, plant plant workers at this threatened plant in Belgium and see Diablo canyon in the States, and how can we sort of activate those relationships and, you know, understand that an injury to one is an injury to all and support each other. And I mean, I guess that plays into my progressive past and, you know, my political biases, but I really do think that so far, that's been an untapped potential of, of nuclear advocacy. So that's, that's another area where I'm focusing my efforts on kind of long winded way to answer your question. I mean, I really hope to, to shift the Overton window to create an ecosystem of organizations and advocates on the pro nuclear side that can at least mirror what's what's happening on the anti nuclear side, to shift that Overton window. And hopefully, to convince my governments and governments around the world to make policy decisions that are based on sound science and engineering principles, and that follow follow the evidence. And God is ever an uphill battle. And I do think about, you know, the kinds of psychologies that lead to folks like you and I sort of engaging in this, you know, this Sisyphus, that Greek, you know, pushing the boulder up the hill, and why we do it, and why we get a sick pleasure out of it. I mean, I guess we're kind of like ultra endurance athletes that just love the burn. But yeah, I mean, I hoped I hope to shift the window, and I hope, you know, locally, I hope to save my local nuclear plant, I hope to, to get the rest of Canada off coal, we have a lot of hydro, so our electricity is actually pretty clean across the country, but we have some kind of high emitting provinces. You know, I'd like to get a climate plan that is sort of nuclear and hydro focused onto the national agenda. You know, these are, these are some of the little aspirations and ambitions I have, I think it's less ambitious than your sort of global open 100 plan. Although, you know, it is it is funny sort of talking, talking with friends. I'm like, you know, Bret's kind of crazy. But if you were to sort of to give someone you know, if I were gonna hand the reins over to, you know, one sort of technocrat to solve climate change, like, I gotta say, of all the people I've talked to Bret's plan is insane, but but it actually makes the most sense.

Bret Kugelmass
Well, Chris, as we wrap up this episode, I just want to say again, like what a pleasure has been listening to you, learning from you, and kind of watching you grow into this space, I expect nothing less than amazing things that come from your work. So thank you.

Chris Keefer
Well, thanks, Bret. I mean, it's a, it's great being a part of this broader ecosystem, like I said, and, you know, to be a part of, you know, just started a little network of podcasts. But also, you know, as you've seen, as well, the relationships that you build through podcasting, the people you get to meet, it's just, it's so rewarding, and we're a lot stronger than we think we are. If if we can organize, if we can grease our networks and call upon each other's strengths and form organizations and change the world. So let's, let's get on with that.

Bret Kugelmass
Awesome, can't end on a better note than that.

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