Plain English with Derek Thompson

I’ve had the privilege of talking to many brilliant people about artificial intelligence. And when you ask them to imagine the most beneficial consequences of this technology, they almost always give the same answer: medicine. The dream is dazzling. Superintelligent AI will cure stubborn diseases and disorders—cancer, schizophrenia, Alzheimer’s. It will diagnose all our illnesses, design new lifesaving drugs, accelerate clinical trials, and pair with wearables to fight chronic illness and extend our health spans. But which of these promises are realistic? Which are outlandish hype? And what, exactly, can AI do for us in medicine right now? To separate fact from fantasy, I talk with Lloyd Minor, dean of the Stanford University School of Medicine. If you have questions, observations, or ideas for future episodes, email us at PlainEnglish@Spotify.com. Host: Derek Thompson Guest: Lloyd Minor Producer: Devon Baroldi Links: https://www.newyorker.com/magazine/2025/09/29/if-ai-can-diagnose-patients-what-are-doctors-for https://www.worksinprogress.news/p/why-ai-isnt-replacing-radiologists?utm_source=substack&utm_medium=email Learn more about your ad choices. Visit podcastchoices.com/adchoices

The past few weeks have marked a low point for free speech principles in America. The head of the FCC openly threatened ABC for the language of a comedian. The president told a reporter that networks that are "against" him should have their licenses revoked. The vice president went on TV and told Americans to turn in their colleagues if they spoke ill of Charlie Kirk. And many have. After Kirk was killed, Suzanne Swierc, an employee at Ball State University, posted that “if you think Charlie Kirk was a wonderful person, we can’t be friends.” Within hours, Libs of TikTok, a social media account, posted her message publicly, Elon Musk retweeted it, and, with the approval of the White House, she was fired. Conservatives claim that Democrats fired first. They say it was the campus left that got "cancel culture" rolling. It was Joe Biden who pressured—or jawboned—the social media companies to take down misinformation, in violation of free expression. It was Democrats who suppressed information on the Hunter Biden laptop. So what can we say fairly and honestly about the state of the First Amendment? Is the Trump administration uniquely perverse? Are we all hypocrites? And why does it seem like so many members of each party can’t wait to use the machinery of the state to limit the speech of their political opponent? Greg Lukianoff, the president of FIRE, the Foundation for Individual Rights and Expression, joins the show to discuss. If you have questions, observations, or ideas for future episodes, email us at PlainEnglish@Spotify.com. Host: Derek Thompson Guest: Greg Lukianoff Producer: Devon Baroldi Learn more about your ad choices. Visit podcastchoices.com/adchoices

In the past few weeks, we’ve done several episodes on obesity, GLP-1 drugs, and nutrition science. What we haven’t talked about as much is the politics of food. And today’s guests say: If you really want to understand why Americans are so unhealthy, you have to see that the problem is not just our willpower, and it’s not just our food itself. It’s our food policies. Kevin Hall was a former top nutrition researcher at the NIH who retired after accusing RFK Jr. and the Department of Health and Human Services of censoring a report that questioned their description of ultra-processed foods. Julia Belluz is a longtime nutrition and health journalist. Together, they’ve written a new book, 'Food Intelligence: The Science of How Food Both Nourishes and Harms Us.' If you have questions, observations, or ideas for future episodes, email us at PlainEnglish@Spotify.com. Host: Derek Thompson Guests: Julia Belluz and Kevin Hall Producer: Devon Baroldi Learn more about your ad choices. Visit podcastchoices.com/adchoices

This year, American tech companies will spend $300 billion to $400 billion on artificial intelligence, which is in nominal dollars more than any group of companies have ever spent to do anything. Notably, these companies are not remotely close to earning $400 billion on artificial intelligence. That's why you’re starting to hear some people wonder if the AI build-out is turning into the mother of all economic bubbles. The prospect of an AI bubble should scare us. Roughly half of last quarter's GDP growth came from infrastructure spending on AI, and more than half of stock market appreciation in the last few years has come from companies associated with AI. If the AI spending project blows up in the next few years, as our next guest says it might, the implications for technology, the economy, and politics would be immense. Paul Kedrosky is an investor and writer. Today we talk about the AI capex boom: how it works, who’s financing it, how its financing works. We put the AI build-out in historical context. And then we spend a great deal of time walking through what could go wrong and when it might go wrong. If you have questions, observations, or ideas for future episodes, email us at PlainEnglish@Spotify.com. Host: Derek Thompson Guest: Paul Kedrosky Producer: Devon Baroldi Learn more about your ad choices. Visit podcastchoices.com/adchoices

Matt Belloni, the host of the Town podcast and the author of Puck’s 'What I’m Hearing' newsletter, joins the show to talk about Jimmy Kimmel's punishment, what happened behind the scenes at ABC and Disney, Bob Iger's legacy, and what this means at a moment when media companies are bending the knee to the Trump administration, which is clearly using its position to punish free speech despite rising to power by promising to do the opposite. If you have questions, observations, or ideas for future episodes, email us at PlainEnglish@Spotify.com. Host: Derek Thompson Guest: Matt Belloni Producer: Devon Baroldi Learn more about your ad choices. Visit podcastchoices.com/adchoices

To read more of Derek's reporting on GLP-1 drugs, you can subscribe to his Substack here. GLP-1 drugs like Ozempic and Zepbound don't just help with Type 2 diabetes and weight loss. They seem to curb alcohol, cocaine, and tobacco use among addicts. In some studies, they prevent strokes, heart attacks, chronic kidney disease, sleep apnea, and Parkinson's disease. They’re associated with a lower risk of several cancers, including pancreatic cancer and multiple myeloma. Arthritic patients on the drugs experienced relief from knee pain that was “on par with opioid drugs.” A small study found that they reduce migraine headaches by 50 percent. And emerging research suggests they might even slow the rate of memory loss among people diagnosed with Alzheimer’s. Is all of this real? And if it’s real, how is one drug doing so many different things? And if it is doing all those things, why shouldn’t we be developing versions of the drug for just about everyone? Today we have two guests: David D’Alessio, chief of endocrinology and metabolism at the Duke University School of Medicine; and Randy Seeley, a professor of surgery, internal medicine, and nutritional sciences at the University of Michigan. We talk about how these drugs work—why they seem to do everything—and how our understanding of them could make them better, more effective, more broadly useful. If you have questions, observations, or ideas for future episodes, email us at PlainEnglish@Spotify.com. Host: Derek Thompson Guests: David D’Alessio and Randy Seeley Producer: Devon Baroldi Disclosure: Dr. Seeley has received research support from several pharmaceutical companies, including Eli Lilly, Diasome, and Amgen. Learn more about your ad choices. Visit podcastchoices.com/adchoices

In the past few years, we have witnessed a frightening spiral of political violence. We’ve seen the killing of Charlie Kirk; the killing of Brian Thompson, the health insurance executive; the assassination of a Minnesota House Speaker and her husband; the shooting of a Minnesota state senator and his wife; several attempted assassinations of Donald Trump; an attack on Nancy Pelosi’s home and husband; a plot to kidnap the governor of Michigan, Gretchen Whitmer; and calls to lynch Vice President Mike Pence on January 6. As The Atlantic’s Adrienne LaFrance writes, this is looking to be "an age of assassinations." LaFrance, the executive editor of The Atlantic, has written tens of thousands of words, including cover stories for the magazine, on the history of political violence in the U.S. Today, we talk about media coverage of political violence before getting to the hardest question: How can America survive a period of mass delusion, deep division, and political violence without seeing the permanent dissolution of the ties that bind us? If you have questions, observations, or ideas for future episodes, email us at PlainEnglish@Spotify.com. Host: Derek Thompson Guest: Adrienne LaFrance Producer: Devon Baroldi Learn more about your ad choices. Visit podcastchoices.com/adchoices

America is sicker than ever. That’s what the data says, anyway. Psychological and psychiatric diagnoses have soared. Between the 1990s and the mid-2000s, bipolar disorder among American youth grew by a factor of 40, while the number of children diagnosed with ADHD increased by a factor of 7. Rates of PTSD, anxiety, and depression have soared, too. Perhaps in previous decades doctors missed millions of cases of illness that we’re now catching. Or perhaps, as the New York Times writer David Wallace Wells has written, “we are not getting sicker—we are attributing more to sickness.” We used to be merely forgetful. Now we have ADHD. We used to lack motivation. Now we’re depressed. We used to be introverted. Now we experience social anxiety. Today’s guest is Suzanne O’Sullivan, a neurologist and the author of 'The Age of Diagnosis: How Our Obsession with Medical Labels Is Making Us Sicker'. O’Sullivan argues that too many doctors today are pathologizing common symptoms in a way that’s changing the experience of the body for the worse. When doctors turn healthy people into patients, it’s not always clear if they’re reducing the risk of future disease or introducing anxiety and potentially harmful treatments to a patient who's basically fine. Rather than see the age of diagnosis as something all good or all bad—a mitzvah or a disease—I want to see it as a social phenomenon, something that is good and bad and all around us. If you have questions, observations, or ideas for future episodes, email us at PlainEnglish@Spotify.com. Host: Derek Thompson Guest: Suzanne O’Sullivan Producer: Devon Baroldi Learn more about your ad choices. Visit podcastchoices.com/adchoices

In the second of our two-episode series on Donald Trump, economics, and power, we talk to Henry Farrell, a professor of political science at Johns Hopkins. Farrell has written extensively on how the United States has in the last few years weaponized its economic power to force other countries to do its bidding, through sanctions or the freezing of bank accounts. Today, we consider the many ways that Trump has weaponized the office of the presidency against American interests and how his authoritarian style matches up against China as both countries race toward superintelligence. If you have questions, observations, or ideas for future episodes, email us at PlainEnglish@Spotify.com. Host: Derek Thompson Guest: Henry Farrell Producer: Devon Baroldi Learn more about your ad choices. Visit podcastchoices.com/adchoices

Today is the first of two interviews this week trying to answer this question: What is Trumponomics? From the 1980s to the 2010s, it was generally assumed that Republicans and Democrats had settled differences in economic policy. Republicans wanted lower taxes and less spending on welfare. Democrats wanted higher taxes and more social spending. Reality didn’t always conform to those differences. George H.W. Bush famously raised some taxes, and Bill Clinton famously reduced some welfare spending. But generally speaking, the socialists voted for Democrats and the corporate libertarians and free-market folks found their home in the GOP. What’s interesting about Trump's theory of power and economics is that he doesn’t just scramble this divide. He obliterates it. Some of Trump’s measures are so classically Republican, you could imagine the ghost of Ronald Reagan signing off on them. After all, his signature legislative accomplishment in both terms are two huge corporate income tax cuts. But when Trump announced that the government was taking a stake in Intel, Bernie Sanders cheered the news and Gavin Newsom called him a socialist. Trump has single-handedly instituted the biggest tariffs in 100 years—tariffs that are so unusual and extralegal that a federal court just ruled that most of them are, in fact, against the law. He’s waging war on the Federal Reserve, grabbing at an institution that has historically enjoyed independence when it comes to setting interest rates and managing monetary policy. Trumponomics is capitalist and socialist; it’s obsessed with defeating China and also obsessive about copying China; it’s sometimes focused on keeping America from getting ripped off and sometimes focused on issues so personal they have nothing to do with the national interest at all. Today’s guest is Greg Ip, the chief economics commentator at The Wall Street Journal. According to Greg, the best way to see clearly what Trump is up to is to see his economic policy as what he calls “state capitalism.” If you have questions, observations, or ideas for future episodes, email us at PlainEnglish@Spotify.com. Host: Derek Thompson Guest: Greg Ip Producer: Devon Baroldi Learn more about your ad choices. Visit podcastchoices.com/adchoices

Memory is the glue of life. Without it, our focus softens, our experience of the world blurs, and our identities melt away. But as people age, their memory declines. Many billions of dollars have been spent to understand the biological basis of dementia and to devise a cure. In most cases, they have failed spectacularly. But what if, rather than study the brains of people with advanced memory loss, we instead studied the brains of people with the opposite condition: extraordinary memory and brain health in old age? For the past few decades, Sandra Weintraub, a scientist at Northwestern University, has been part of a team studying the brains of "super-agers," people 80 and older who have the memory ability of people in their 50s. In a new paper published this year to considerable fanfare, she found that super-agers didn't have much in common. They didn't share a diet, or an exercise regimen, or a set of maladies or medications. One thing, however, united them: their social relationships. Today's guest is Sandra Weintraub. We talk about the science of memory and the brain and the protective benefit of social connection for our minds and ourselves. If you have questions, observations, or ideas for future episodes, email us at PlainEnglish@Spotify.com. Host: Derek Thompson Guest: Dr. Sandra Weintraub Producer: Devon Baroldi Learn more about your ad choices. Visit podcastchoices.com/adchoices

Today’s pod is about the economic story of the moment. It’s about new technology that supporters claim will transform the U.S. economy, an infrastructure build-out unlike anything in living memory that demands enormous natural resources, fears that corporate giants are overbuilding something that can never return its investment, an uncomfortable closeness between corporations and the state, fears that oligarchs are screwing the public to generate unheard-of levels of private wealth. Just a small catch. This show isn’t about the present or AI in 2025. It’s about the railroads and the late 1800s. To be sure, everything I just said could plausibly be the introduction to a podcast about artificial intelligence. Last quarter, the growth of AI infrastructure spending—on chips, data centers, and electricity—exceeded the growth of consumer spending. The economic researcher and writer Paul Kedrosky has written that as a share of GDP, AI is consuming more than any new technology since the railroads in the late 1800s. There is no question that the transcontinentals transformed America. They populated the West; practically invented California; turned America into a coast-to-coast dual-ocean superpower; revolutionized finance; made possible the creation of a new kind of corporation; launched what the historian Alfred Chandler called the managerial revolution in American business; forged a new relationship between the state and private enterprise; minted a generation of plutocrats, from Jay Gould to Leland Stanford of Stanford University; galvanized the anti-monopoly movement; and completely reoriented the way Americans thought about time and space. “The transcontinentals ... came to epitomize progress, nationalism, and civilization itself,” the historian Richard White wrote in his epic history of the transcontinentals, 'Railroaded.' But he continued: “They created modernity as much by their failure as their success.” Today’s return guest is Richard White. Our acute subject is the transcontinental railroads and the 19th century. But our deeper subject is the nature of transformative technology and the messy business of building it. If you have questions, observations, or ideas for future episodes, email us at PlainEnglish@Spotify.com. Host: Derek Thompson Guest: Richard White Producer: Devon Baroldi Learn more about your ad choices. Visit podcastchoices.com/adchoices

According to analysis by Financial Times writer John Burn-Murdoch, something extraordinary has happened to Americans’ personalities in the last decade. Longitudinal tests indicate that we’ve collectively become less extroverted, less agreeable, and more neurotic. The most significant thing Burn-Murdoch found is that measures of conscientiousness among young Americans appears to be in a kind of free fall. Today, John and I talk about his research. We discuss personality tests, the value of conscientiousness, and how the modern world might be scrambling our personalities by making us less interested in other people and more consumed with our own neurotic interiority. If you have questions, observations, or ideas for future episodes, email us at PlainEnglish@Spotify.com. Host: Derek Thompson Guest: John Burn-Murdoch Producer: Devon Baroldi Learn more about your ad choices. Visit podcastchoices.com/adchoices

Last week, the Bureau of Economic Analysis published the latest GDP report. It contained a startling detail. Spending on artificial intelligence added more to the U.S. economy than consumer spending last quarter. This is very quickly becoming an AI economy. I’m interested in how AI will change our jobs. But I’m just as curious about how it will change our minds. We’re already seeing that students in high school and college are using AI to write most of their essays. What do we lose in a world where students sacrifice the ability to do deep writing? Today’s guest is Cal Newport, the author of several bestsellers on the way we work, including 'Deep Work.' He is also a professor of computer science at Georgetown. One of the questions I get the most by email, in talks, in conversations with people about the news is: If these tools can read faster than us, synthesize better than us, remember better than us, and write faster than us, what’s our place in the loop? What skills should we value in the age of AI? Or, more pointedly: What should we teach our children in the age of AI? How do we ride this train without getting run over by it? If you have questions, observations, or ideas for future episodes, email us at PlainEnglish@Spotify.com. Host: Derek Thompson Guest: Calvin Newport Producer: Devon Baroldi Learn more about your ad choices. Visit podcastchoices.com/adchoices

Subscribe to Derek’s new Substack. In 1991, the median age of first-time homebuyers was 28. Now it’s 38, an all-time high. In 1981, the median age of all homebuyers was 36. Today, it’s 56—another all-time high. This is the hardest time for young people (defined, generously, up to 40!) to buy their first home in modern history. Derek talks about the history of how we got here and then brings on Bloomberg columnist Conor Sen to talk about the state of American housing today and how the national housing market has broken into “two Americas.” If you have questions, observations, or ideas for future episodes, email us at PlainEnglish@Spotify.com. Host: Derek Thompson Guest: Conor Sen Producer: Devon Baroldi Learn more about your ad choices. Visit podcastchoices.com/adchoices

Even before the cancellation of 'The Late Show With Stephen Colbert,' the business of comedy was changing rapidly. Twenty years ago, comedians aspired to be late-night hosts, or to star in movies, or to have their own sitcoms. But in 2025, late-night shows are going extinct, adult comedies in Hollywood are a thing of the past, and popular sitcoms are so rare these days that Gen Z viewers are still watching 'The Office' and 'Friends.' Instead, many comedians rightly recognize that they can make more money as solo acts. In comedy, as in much of our culture, the age of institutions is giving way to an age of individuals talking to individuals. Lucas Shaw, a reporter for Bloomberg and frequent commentator on the Town podcast, joins the show to talk about the cancellation of 'The Late Show With Stephen Colbert' and what it says about the history and the future of comedy and media. We also talk about the death of adult comedies, the retreat of sitcoms on TV, why comedy as a field is becoming more of a solo business—and what that says about entertainment culture more broadly. If you have questions, observations, or ideas for future episodes, email us at PlainEnglish@Spotify.com. Host: Derek Thompson Guest: Lucas Shaw Producer: Devon Baroldi Learn more about your ad choices. Visit podcastchoices.com/adchoices

Sign up for Derek's Substack here. Harvard economist Jason Furman returns to the show to answer two big, burning questions. First, if Trump's economic ideas are as bad as most economists say, why isn't the U.S. economy doing much worse? Second, if Trump fires Jerome Powell, would it be the final blow that finally pushes the economy into a recession? If you have questions, observations, or ideas for future episodes, email us at PlainEnglish@Spotify.com. Host: Derek Thompson Guest: Jason Furman Producer: Devon Baroldi Learn more about your ad choices. Visit podcastchoices.com/adchoices

Couples are having kids much later in their lives. As young people spend more of their 20s and 30s getting established in their careers, and marriage is delayed, and home buying is delayed, the unstoppable force of delay runs up against the immovable object of human anatomy. It is harder for a 40-year-old to get pregnant than for a 20-year-old to do so. The best solution we have for the fertility dilemma of the modern age is in vitro fertilization. IVF is a decades-long practice based on science, so you might think that the procedure is highly predictable, something close to an act of precision engineering. But people who have gone through the process know it can be messy, painful, frustrating, and expensive. So, what would a real scientific revolution in fertility look like? How close are we to a game-changing invention in this space? Today’s guest is Ruxandra Teslo, a scientist and writer. We talk about the fertility dilemma that exists, the fertility technology that doesn’t exist, and how a revolution in egg science could produce a second baby boom. If you have questions, observations, or ideas for future episodes, email us at PlainEnglish@Spotify.com. Host: Derek Thompson Guest: Ruxandra Teslo Producer: Devon Baroldi Learn more about your ad choices. Visit podcastchoices.com/adchoices

Sign up for the Derek Thompson newsletter. In Game 7 of this year's NBA Finals, Indiana Pacers guard Tyrese Haliburton tore his Achilles in the first quarter while attempting to drive to the basket on an injured calf. It was the third major Achilles injury of the 2025 NBA playoffs. Curiously, Achilles tears are typically an older-dude injury, as they're most common in middle-aged men, according to a 2018 study published in the Journal of Biomechanics. So the sudden clustering of this injury among star athletes in their prime has inspired a lot of head-scratching among NBA fans and even the league itself. “We had already convened a panel of experts before Tyrese’s most recent Achilles rupture,” NBA commissioner Adam Silver said. When you zoom out from basketball and consider the broader landscape of sports, the injury surge seems quite real. In baseball, we’ve seen a huge increase in the so-called "Tommy John surgery," which repairs a torn UCL in a pitcher’s elbow. In soccer, ACL injuries have been rising, particularly in women's soccer. And that's before we get to the huge amount of media attention that’s been paid to concussions in football. What's going on here? Vern Gambetta, a conditioning coach, trainer, and adviser to professional soccer, baseball, basketball, and Olympics teams, explains why major injuries might be surging across sports—and what it tells us about the risks of pushing the human body to its physical limit. If you have questions, observations, or ideas for future episodes, email us at PlainEnglish@Spotify.com. Host: Derek Thompson Guest: Vern Gambetta Producer: Devon Baroldi Learn more about your ad choices. Visit podcastchoices.com/adchoices

The California housing crisis is a disaster and an emergency. Housing construction per capita has steadily fallen in the last few decades, while home prices, rent, and homeless rates have all soared. By some estimates, the state is three million units short of housing demand—the equivalent of seven San Franciscos. One of the major barriers to building more housing has for decades been provisions in the California Environmental Quality Act. Signed by Gov. Ronald Reagan in the 1970s, the CEQA has been called "the law that ate California." It essentially allows anybody with a lawyer to stop any project they don’t like, for any reason. But this week, Gov. Gavin Newsom signed two bills to defang the CEQA. Housing reform advocates are calling it one of the most important legislative breakthroughs in modern state history. It could make it easier to build downtown housing and other urban development projects such as health clinics and childcare facilities. As Newsom wrote, “I just enacted the most game-changing housing reforms in recent California history. We're urgently embracing an abundance agenda by tearing down the barriers that have delayed new affordable housing and infrastructure for decades." Assemblywoman Buffy Wicks wrote the bill to encourage more high-density housing projects, while State Senator Scott Wiener wrote the bill to exempt several types of projects from environmental review. Wicks and Wiener are today’s guests. We talk about the long road to breakthrough, the art of political persuasion, and the future of abundance in California. If you have questions, observations, or ideas for future episodes, email us at PlainEnglish@Spotify.com. Host: Derek Thompson Guests: Buffy Wicks and Scott Weiner Producer: Devon Baroldi Learn more about your ad choices. Visit podcastchoices.com/adchoices