The engineering view: observability vs medicine

We track our steps, sleep, calories… even glucose. So why are we STILL getting sicker?

In this episode, Dr Karan sits down with Josh Clemente (former SpaceX engineer and founder of Levels) to explore a big question: Are health wearables actually helping us, or are we just collecting data with no real direction?

Josh explains why aerospace treats “health” totally differently to medicine, why we should measure when we’re healthy (not just when things go wrong), and what “biological observability” could mean for the future of healthcare.

🎧 Stay tuned to find out:

➡ Why “if you’re healthy, there’s no reason to measure” is backwards

➡ What SpaceX taught Josh about monitoring systems vs monitoring humans

➡ Why data is neutral (and why interpretation is everything)

➡ The biggest risks of wearables: anxiety, obsession, disordered habits

➡ Why CGMs can be powerful, but easy to misuse without context

➡ What a real “health operating system” might look like in 3–10 years

➡ The uncomfortable truth about health inequality and the future of tech

#DrKaran #HealthPodcast #MedicalScience #HealthEducation #Wearables #CGM #MetabolicHealth #Longevity #Levels

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📕 Chapters

(0:00) Coming up (episode teaser)

(0:57) Intro: the biggest self-experiment in history

(1:48) We have more health data than ever… so why are we unhealthier?

(4:14) Dr Karan’s CGM “flip-flop” (healthy users tracking glucose)

(6:38) Engineer vs doctor: two ways of solving the same problem

(6:45) SpaceX/NASA life-support mindset: monitor everything

(7:36) “Hundreds of data channels” for spacecraft… zero for humans

(8:50) “Measure when healthy” (scarcity mindset vs abundance mindset)

(9:44) The airplane analogy: monitoring should reduce anxiety

(10:24) What medicine can learn from aviation safety

(12:47) Survivorship bias and why healthcare optimises the wrong thing

(14:14) Why we only measure once disease shows up (and why that’s insane)

(15:24) “I’m lean but my glucose runs hot” (why averages can mislead)

(16:46) Personalised care needs data (but not obsession)

(23:35) Health proxies, blue zones, and why we get cause and effect wrong

(24:45) The dark side of wearables: sleep anxiety, CGM “gamifying” health

(26:16) Goodhart’s Law: when a target becomes the measure

(28:11) CGM isn’t the goal, it’s a tool (context matters)

(30:26) The future: multi-marker wearables and a “digital twin”

(35:14) How close are we to continuous monitoring (3–10 years)?

(37:04) AI as the interface to complexity (and what it enables)

(39:40) The missing lever in most health advice: your zip code

(41:15) Will this tech widen inequality, or become accessible?

(44:44) CGMs vs misleading food marketing (and how systems might change)

(46:11) Is living longer worth it if you obsess over data?

(47:44) Fatherhood, healthspan, and avoiding the avoidable

(48:32) Josh’s bloodwork story: seeing trend lines and making small tweaks

(50:03) “Health isn’t easy, but it is simple”

(51:15) Closing

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About Dr Karan:

Dr. Karan Rajan is a doctor, author, and educator dedicated to making health and medical science accessible to all. Through evidence-based analysis, he tackles topics from nutrition and metabolism to brain health and longevity, while dispelling myths with a touch of dark humour.

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