Is modern medicine still evidence-based, or have we quietly mistaken rigor for certainty?

Evidence-based medicine is essential. It’s why we save lives, advance care, and trust modern healthcare. But as medicine has become more specialized and disease more complex, something subtle has happened. Rigor has increasingly turned into reductionism, and evidence is often applied in ways that don’t fully match the realities of clinical practice or patients’ lived experiences.

In this episode of The Trip Lab, I take a careful look at what we mean when we say “evidence-based medicine.” We explore the difference between statistical significance and clinical significance, how guidelines are created and why they are evidence-informed rather than infallible, and why many patients feel unwell despite having “normal” labs.

This conversation also examines how modern research methods struggle to capture complexity, particularly in chronic, system-level disease. We look at where reductionism has helped medicine advance, where it now falls short, and why ancient healing systems and emerging fields like systems biology, functional medicine, and precision medicine are pointing us toward a more integrated future.

This episode is not a rejection of evidence. It’s an invitation to reclaim it. To restore clinical wisdom alongside data, and to practice medicine with both rigor and curiosity.

In this episode, we cover:

• What “evidence-based medicine” actually means and how it’s evolved
• Statistical significance vs. clinical significance
• The strengths and limitations of medical guidelines
• Why reductionist models don’t fully explain chronic disease
• Why patients can feel unwell even when labs are “normal”
• How medicine might evolve to better study complexity
• Why medicine is both a science and an art

The podcast name, The Trip Lab, nods to psychedelics, but a “trip,” psychedelic or otherwise, is ultimately an exploration. A willingness to step outside familiar frameworks, question what we think we know, and notice connections that weren’t obvious before.

If you’ve ever felt tension between what the data says, what the guidelines allow, and what the patient in front of you actually needs... or if you are a patient who has been failed by modern medicine, this episode is for you.

Why do psychedelic experiences so often feel spiritual, sacred, or life-changing? Why are mystical-type experiences so closely linked to lasting therapeutic benefit? And why does medicine struggle to talk about them at all?

In this episode, we explore the neuroscience and psychology behind mystical experiences in psychedelics. We examine how shifts in brain networks involved in meaning, identity, and self-referential thinking can give rise to experiences of unity, insight, and transcendence, and why these subjective moments may matter more than the drug itself.

A grounded exploration of what psychedelic science is revealing about meaning, consciousness, and healing.

NAD has become one of the most talked-about molecules in longevity medicine—showing up in supplements, IV clinics, lab testing, and bold claims about aging and healthspan. But what does the science actually show?

In this episode of The Trip Lab, we take a clear, evidence-based look at NAD and use it as a lens to explore the broader field of longevity medicine. We break down what NAD does in the human body, why it’s linked to the hallmarks of aging, and why declining NAD is often a signal of cumulative cellular stress rather than a simple deficiency.

We also dive into the realities of NAD testing, the limitations of blood-based biomarkers, and what clinical trials of NR and NMN supplementation have—and have not—demonstrated so far. Along the way, we unpack why longevity research is both exciting and vulnerable to overhype, and why translating aging biology into meaningful human outcomes takes time.

This episode is for anyone curious about longevity medicine who wants clarity without hype—and a better framework for thinking about promise versus proof.