Health Series 6 Dr Golnosh Sharafsaleh / Dementia & Brain Care / Aging & Longevity / Beating Tragedy

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Welcome to another episode of
Come Together

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We're Live.
Welcome to another episode with

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Doctor Sharif Saleh.
Thank you so much for coming.

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Thanks so much for making this
happen.

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I'm really excited to talk to
you.

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Thanks Yuvram.
And you said my name perfectly,

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so happy to be here.
Yes, I kind of bailed them the

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first name Ghanoush.
Ghanoush.

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Ghanoush close.
OK, Where's it?

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Where's it?
Where's it?

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Where?
Where's where are you from?

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Where's your family from?
It's like a traditional Persian

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name, you know, like Iran where
all the conflict is going on

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now, but like a Persian kind of
Zoroastrian, I guess.

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I don't know.
So.

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Cool.
And tomorrow's like the new

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year, I guess, so we're going to
eat fish, so that would be nice.

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Yeah, yeah.
What's What's the celebration

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usually like for New Year?
So gosh, I'm so ignorant.

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Well, let's see.
So it's kind of I think

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originated from like this
Zoroastrian holiday where it's

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spring.
And so it's the beginning of

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like new comings and new
beginnings.

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And you set up this table which
is sort of like a Christmas

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tree, but it's not a Christmas
tree.

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And there are different symbols
on it.

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Like there's a mirror on there.
And there's, there's greenery

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which represents like, is that
fertility or is there's like

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coins, like gold coins on there,
which represent like fortune and

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various things.
And, and so my mom's very good

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at setting this up.
And then my sister and I will go

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to her house with our kids and
family.

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And then my dad cooks because
he's an excellent cook.

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And that's as far as I
celebrate, you know?

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We.
Celebrate like all the holidays.

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It's kind of interesting because
you know my like Christmas and

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then my sisters like Russian
Jewish husband.

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So we have like that whole
thing.

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We just celebrate all the
holidays.

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It's kind of fun that way.
But yeah, tomorrow happens to be

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this one.
It's nice.

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It's a yeah.
I think it's cool.

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It's very cool.
Yeah, we like it.

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We like it, you know so.
So I'm so excited to talk to you

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about so many different things
and you've got lots of, you've

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got a lot of fun things to say
about a lot of different things.

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So I'm excited to, to dive into
the to to this with you And what

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kind of caught my eye originally
when I found your profile on pod

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match was a combination of
geriatric care, dementia and and

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then lifestyle health.
And I thought that was really

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great because one thing that has
been consistent, I think over

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the last few years, a lot of
people have been talking about

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how lifestyle help less rather
health helps you age more

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graciously and more, you know,
and a little bit more

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forgivingly, I would say.
And it's something actually, I

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had been arguing with my dad and
bickering with him about my mom

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takes excellent care of herself.
My dad is a little bit less so.

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And so he's not thriving and.
He's not thriving in his old

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age, is that no?
No, no I don't.

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Not physically.
Not physically, not physically,

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he's thrived more physically,
he's been, he's been in better

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shape.
But to be fair, he's almost 60.

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And you know, when you're, I
mean, when you haven't exercised

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in a little while, it's hard to
snap yourself into a new habit,

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I think.
But that was really, you know,

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so that really caught my
attention.

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And then and then when you and I
spoke, we talked about some

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heavier things that I think that
we should talk about too.

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And in your, in your book and,
and I kind of want to just, you

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know, I'm, I'm more interested
in learning from you and hear

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what you got to say.
So I'll kind of just direct your

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thoughts and just I would love
to dive into it.

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Sounds great.
OK, ask your first question.

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So let's hear about.
I'm really curious about the

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early signs of, of, of dementia
slash Alzheimer's and ways to

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recognize that in people and
ways to recognize that in

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family.
And I think it's and, and

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Alzheimer's and dementia in
general, I believe is, is much

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more common now than it was
twenty, 30-40 years ago.

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And you know, and if there's if
there's anything that we kind of

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do to be preventative about it.
Oh yeah, there are things.

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So here's the thing #1 risk
factor for Alzheimer's is age.

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So there you go.
And we're living longer.

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And I joke about this with my
patients, but in reality, you

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know, if we think about
evolution, like nature tries to

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kill us off as soon as we've
like procreated and we've raised

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our young.
But we, if we think about our,

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our lifespan, we think of it in
like childhood, adulthood, and

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then our elder hood.
And so that last third of our

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life shouldn't be where we're
sick.

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You know it.
In our childhood, we're just

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learning to figure life out.
In our adulthood, we're like

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taking care of everybody, trying
to basically just survive life.

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And then in our elderhood, this
should be a time of reflection.

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It should be a time where we
have a good health span.

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We can see the world embrace
like the things we didn't get to

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do because of all the things we
had to do in our adulthood.

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And, and unfortunately, one of
the things that happens is

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people develop chronic disease,
like they have multi like more

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comorbidities and they end up
losing their independence.

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And so I think as a
geriatrician, so a Doctor Who,

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you know, pediatrician,
geriatrician is a Doctor Who

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practices aging.
My focus is always like, let's

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keep people independent and
let's keep them cognitively

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sharp because I I truly believe
that even if physiologically we

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develop deficits.
Hey everyone real quick if

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subscribe and rate the show. 5

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stars helps a ton.
Thanks so much.

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In older age, if we have our
mental health then that will

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still keep us independent.
We can still narrate our life

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versus if we don't have that,
you know, the people who have

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dementia, these are the
individuals who end up in

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nursing facilities.
These are the individuals who

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end up being taken care of.
And maybe their their goals and

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their wishes are not honored
just because of like their care

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needs.
And so that is constantly what I

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think about.
And one of the emerging areas of

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medicine is to really try to
detect signs early, you know,

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dementia and signs of cognitive
loss.

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They start decades earlier than
before we actually have

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cognitive disease.
So around 10 years ago in my

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career, when I was first really
treating people with dementia,

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family members would bring
someone in who had some memory

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issues, but by then their
disease was like in a moderate

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stage, so there wasn't much to
do.

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Unfortunately.
Now people are coming to me

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themselves like earlier on.
And they're like, hey, I'm

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noticing that I'm having trouble
with words.

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I'm noticing that it's taking me
longer to learn things.

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I'm noticing that I'm having
trouble with names.

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And my first question is, always
has this always been the case?

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Because if you're someone who's
been bad with names forever, OK,

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that's fine.
Like, hey, buddy, this has been

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your norm.
That's not cognitive deficit.

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But if you are like, I was great
with names and now I'm

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forgetting names, there's an
issue there.

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Or if I walk into a room and I
can't remember why I walked in

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there and this is not my
baseline, then there's a problem

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here.
And we need to think about it

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and we need to screen.
And so this is where I I start

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screening people.
And some of our common

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standardized tests are only
standardized to like an 11th

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grade education.
So then you have people who are

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who have a higher education than
that and they can compensate for

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those and their primary care doc
might just say, oh, you're fine.

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There's nothing wrong with you
when something is brewing.

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So really keeping track of those
minute changes that occur that

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are not your baseline, I think
that's where something needs to

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like happen.
And, and one of the things you

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can do is if you don't have
access to a geriatrician or a

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neurologist, you know, your
primary care doc can refer you

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to a cognitive psychologist.
They can do a battery of

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neurocognitive tests and, and
try to weed out like, Hey, what

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areas of cognition do you have
deficits in?

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And, and do we need to do
something about it?

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The cool thing is you can
actually work on your brain and

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different areas of cognition.
I mean, I often send people to

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cognitive rehab so that they can
work on areas that they're

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struggling in.
They get better You didn't think

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of.
That what's what's cognitive

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rehab look like or what's your
date in that life?

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You know, just like people get a
prescription for physical

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therapy, like let's say you get
a shoulder replacement or

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surgery or hips or knees, and
you go to physical therapy and

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they lay out a plan for you.
We're going to do this and this

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and this for this length of
time, and these are your goals.

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Cognitive rehab is generally
done by speech therapists.

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They have additional training
and they will set up a goal.

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So they have initial cognitive
assessments and then they're

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going to say we're going to
improve on working memory and on

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delayed memory.
And we're going to work on

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executive function and
orientation and task management.

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And, and they will work with you
and you improve and you meet

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your goals and then you you
continue with those things.

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So, you know, there's, there's
opportunity there.

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And I think people don't even
know about it.

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I mean, when I have patients in
my office who come in for a

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cognitive assessment and I tell
them, well, I think we should

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send you to cognitive rehab.
Like they asked me the same

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point.
Like, what is that?

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I've never heard of it.
Not very many people who know it

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exists now.
It's a shame, by the way, and

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there's a lot of different types
of cool rehabs that that that

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exist that, you know, I think if
not for a little bit of stigma

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that we could really take a lot
of advantage of.

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I just did a episode yesterday
with, with, with the neurologist

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and physiologist who part of
what she researches is music in

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the brain and using music to,
you know, for, to, to help with,

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you know, with different
potential diseases.

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As far as learning or as far as
even I, I've read other accounts

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of, you know, playing music
having a huge impact on

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neurodegenerative diseases like
Ms. or Parkinson's or Tourette's

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or, you know, I mean, a whole,
there's a whole library of, of

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potential neurodegenerative
disord disorders that are really

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that, that could be helped with
music.

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And how many people think to
just play music as a, you know,

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when you're diagnosed with miss
or Parkinson's, God forbid, you

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know?
Right.

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And, and even like when we think
about dementia and music

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therapy, sometimes what's
fascinating is I'll have a

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patient who, you know, forgets
everything, but you put them in

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front of their piano and they
used to play piano forever and

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they will just like start
playing.

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And for a moment you have that
person back, you know, and it's,

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it's pretty fascinating.
It's.

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It's, it's amazing you say that
I date.

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So I dated a girl, a girl for a
bit, and her mother, while we're

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going out, had this disease.
And I think it was very, very

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hesitantly diagnosed as
Parkinson's because some of the

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symptoms matched up with
Parkinson's, the freezing up.

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But there's certain things that
didn't exist.

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She didn't really have the
tremors quite in the same way as

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I've seen a lot of other
Parkinson patients.

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They weren't sure really.
But one thing that did happen

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was she did play piano and the
accordion growing up.

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And so while we're going, yeah,
I'd ever seen, if we'd ever go

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over and anyone is playing music
or she decided to ever like pick

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up something, you could see the
you could see that like her

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whole body would loosen up or
we'd even play music and she

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would start dancing and she
could dance even those moments

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moments ago really frozen up.
It's crazy.

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It's incredible.
It's incredible.

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And sometimes like in, in terms
of, I mean, you had this a whole

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episode, but this like
neurodegenerative disorders,

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like with lasers and music, like
how different parts of the brain

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will activate And then you, you
stop that, that freezing and all

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of a sudden you have a fluid
movement.

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00:12:29,800 --> 00:12:32,800
It's, it's, you know, it's
amazing because I'm like, what

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is our brain capable of?
And even in the midst of

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disease, how can we, you know,
retrain our brain And we're,

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we're not using every part of
our brain that we need to use.

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And, you know, this whole
concept of neuroplasticity is

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it's a new emerging concept,
like when someone has a stroke

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or when someone has some type of
an insult to their brain, How

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can we learn to rewire and
rehone and learn the skills that

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00:12:58,760 --> 00:13:01,760
we had and learn to move the way
we used to?

237
00:13:02,160 --> 00:13:08,040
So, you know, I think neurology
is just a fascinating emerging

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field, especially as far as, you
know, dementia goes.

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I think that's where I'm so
interested because I'm like, if

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I can preserve the brain and
preserve independence, that's

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all I want to do.
Especially we, we have dementia

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00:13:20,320 --> 00:13:22,600
in my family.
So I'm like always like, you

243
00:13:22,600 --> 00:13:25,800
know, I, I have a personal
investment in this.

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I tell patients like I am
invested in you, you're my

245
00:13:28,240 --> 00:13:30,840
patient, I care about you, but
I'm also personally invested in

246
00:13:30,840 --> 00:13:32,800
this.
I want to figure out any new

247
00:13:32,800 --> 00:13:35,880
emerging therapies out there,
and I want to be able to

248
00:13:36,800 --> 00:13:38,680
implement them if they're
appropriate for you.

249
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Yeah, for sure.
One of the one of the really

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00:13:42,760 --> 00:13:46,000
incredible, you know, I, I've,
I've spoken to this a lot of my

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00:13:46,000 --> 00:13:48,480
podcast in different
applications all across

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different like worlds.
But one thing that everyone

253
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talks about recently is the fact
that institutional trust has

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pretty much collapsed since
COVID.

255
00:13:57,680 --> 00:13:59,600
And there's a million different
reasons why and a different

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00:13:59,600 --> 00:14:02,360
million applications.
And, you know, whatever it may

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00:14:02,360 --> 00:14:05,640
be one way or the other, one of
the, one of the benefits that I

258
00:14:05,640 --> 00:14:09,280
really strongly believe in is
that it's kind of encourages

259
00:14:09,800 --> 00:14:13,040
more open mindedness and more
play and more figuring new

260
00:14:13,040 --> 00:14:16,080
things out that like we were so
set in our ways.

261
00:14:16,080 --> 00:14:18,800
You know, it felt like forever,
even though I mean, again, in

262
00:14:18,800 --> 00:14:21,320
the, in the, in the concept of
history, I mean, talk about

263
00:14:21,320 --> 00:14:24,720
being from, you know, Persian
and like, Hey, I'm American 250

264
00:14:24,720 --> 00:14:25,840
freaking years old.
That's it.

265
00:14:26,000 --> 00:14:28,720
You know, I mean, like, you
know, we, we figured everything

266
00:14:28,720 --> 00:14:30,800
out.
And hey, there's a lot of,

267
00:14:30,920 --> 00:14:32,040
there's a lot of wisdom out
there.

268
00:14:32,040 --> 00:14:34,520
There's a lot to learn and
there's a lot to figure out.

269
00:14:34,520 --> 00:14:37,040
And sometimes it's good for
institutions, institutional

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00:14:37,040 --> 00:14:40,720
trust to break just for people
to kind of feel like, like, hey,

271
00:14:41,400 --> 00:14:44,040
you know, what if I don't know
what the doctor at Harvard said,

272
00:14:44,040 --> 00:14:45,720
then like, let me try this music
therapy.

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00:14:45,720 --> 00:14:47,200
Oh, my God, it works.
Like, that's incredible.

274
00:14:47,200 --> 00:14:49,440
Like, you know, like, OK, so
then someone in Harvard will

275
00:14:49,440 --> 00:14:51,120
pick up their being, get into
it.

276
00:14:51,120 --> 00:14:53,760
So I think that's really, it's
I, I think that we're at

277
00:14:53,760 --> 00:14:55,520
exciting time.
I'm really excited about what we

278
00:14:55,520 --> 00:14:57,280
could be accomplishing.
Yeah.

279
00:14:57,520 --> 00:15:02,000
And you're totally right as far
as I think just opening our mind

280
00:15:02,160 --> 00:15:06,240
to not just practicing medicine
or living our life based on a

281
00:15:06,240 --> 00:15:10,800
set of beliefs or set of
standards when it comes to even,

282
00:15:10,840 --> 00:15:12,280
you know, when it comes to
health.

283
00:15:13,000 --> 00:15:16,520
I have a patient I recently,
this is a funny story.

284
00:15:16,800 --> 00:15:19,480
Just this past week.
I, I somebody I recommended they

285
00:15:19,480 --> 00:15:23,560
have acupuncture and they're
like send that more of a placebo

286
00:15:23,560 --> 00:15:25,400
thing.
As for the thing that they had.

287
00:15:25,640 --> 00:15:30,440
And I like sent them a bunch of
papers and this person, you

288
00:15:30,440 --> 00:15:34,720
know, has a background where
they understand research and

289
00:15:34,720 --> 00:15:38,200
paper and I'm like, actually
not, there is a lot of data

290
00:15:38,200 --> 00:15:39,880
behind it.
And here I am as a medical

291
00:15:39,880 --> 00:15:43,720
doctor and occasionally I'll
send, I'm like, you should see a

292
00:15:43,720 --> 00:15:47,960
chiropractor for this or let's
try this supplement for this in

293
00:15:47,960 --> 00:15:49,600
addition to this medicine for
this.

294
00:15:49,600 --> 00:15:53,960
And they're like, who are you?
You have to kind of embrace all

295
00:15:53,960 --> 00:15:55,960
of it.
You know, I am a medical doctor,

296
00:15:56,320 --> 00:16:02,120
but I think like if I just stuck
to these standards, then I'm not

297
00:16:02,120 --> 00:16:06,720
going to give my patient the
entire like pot, you know, of

298
00:16:06,720 --> 00:16:09,040
everything that they could
possibly benefit from.

299
00:16:09,040 --> 00:16:14,360
So I am, I do take a very
holistic approach when it comes

300
00:16:14,360 --> 00:16:19,720
to cognitive health, not only as
far as thinking, OK, let's

301
00:16:20,160 --> 00:16:23,440
detect cognitive impairment, but
then let's talk about what are

302
00:16:23,440 --> 00:16:27,840
these, what are these other
factors that could be causing

303
00:16:27,840 --> 00:16:29,800
progression of your cognitive
impairment?

304
00:16:30,040 --> 00:16:32,760
For instance, like diet, you
know, I work with people on

305
00:16:32,760 --> 00:16:37,600
their diet and really focus on
like a diet that like kind of a

306
00:16:37,600 --> 00:16:43,880
mind diet, sort of a keto flex
diet where that their brain is

307
00:16:43,880 --> 00:16:47,040
also benefiting from that and
they're not having like glycemic

308
00:16:47,040 --> 00:16:49,480
index issues.
I focus on blood pressure

309
00:16:49,480 --> 00:16:53,480
control, sleep apnea, exercise.
I mean, exercise is like a huge

310
00:16:53,480 --> 00:16:55,680
part of what I do with my
patients.

311
00:16:55,680 --> 00:16:59,480
And then in my office I use the
scale called the in body scale.

312
00:16:59,480 --> 00:17:00,600
I don't know if have you heard
of it tell.

313
00:17:02,040 --> 00:17:03,960
You about it?
Talk about it.

314
00:17:04,440 --> 00:17:07,319
So I don't even want to talk
about it because I'm a little

315
00:17:07,319 --> 00:17:10,880
bit like hurt.
But like Peter Attia, you know,

316
00:17:10,880 --> 00:17:12,040
he was all over the Epstein
files.

317
00:17:12,040 --> 00:17:14,960
But his book was good.
Outlive was a really good book,

318
00:17:14,960 --> 00:17:17,400
you know, but he talks.
About, by the way, I.

319
00:17:18,319 --> 00:17:23,200
Mean, I was like, I was so sad.
I read the book three times and

320
00:17:23,200 --> 00:17:26,000
I like preached about it and
then all of a sudden my partner

321
00:17:26,000 --> 00:17:28,480
was like, did you hear what
happened?

322
00:17:30,400 --> 00:17:33,080
Crap is that every man?
Is that every single man?

323
00:17:33,400 --> 00:17:37,520
But anyways, it's still a very
good book, you know, and but the

324
00:17:37,640 --> 00:17:40,480
the in body scale doesn't just
look at your weight or your BMI.

325
00:17:40,480 --> 00:17:43,120
It actually looks at your
skeletal muscle mass.

326
00:17:43,280 --> 00:17:45,120
It looks at your percent body
fat.

327
00:17:45,120 --> 00:17:47,640
And for my patients, again, as
you're aging, I don't want

328
00:17:47,640 --> 00:17:50,480
people to get frail.
So I'm constantly like, all

329
00:17:50,480 --> 00:17:53,240
right, are you doing the
exercises we're talking about?

330
00:17:53,240 --> 00:17:55,720
Are you building muscle and all
of those things?

331
00:17:56,120 --> 00:18:01,200
You know, managing the body
holistically is protecting the

332
00:18:01,200 --> 00:18:04,000
brain essentially.
So I do that, you know.

333
00:18:04,720 --> 00:18:06,800
It's awesome.
It's I actually so it's funny

334
00:18:06,800 --> 00:18:09,960
you actually bring that up
because I got AI sell medical

335
00:18:09,960 --> 00:18:13,520
equipment on the side.
I actually not in the side as a

336
00:18:13,520 --> 00:18:16,600
living and, and one of the big
things that have been very

337
00:18:16,600 --> 00:18:19,600
popular now or bone or bone
density machines that people are

338
00:18:19,600 --> 00:18:22,040
buying for whole body
composition and body fat

339
00:18:22,040 --> 00:18:24,400
composition.
And someone calls me up in

340
00:18:24,400 --> 00:18:28,040
Austin, TX a couple of months
ago, tells me, hey, you know, I

341
00:18:28,040 --> 00:18:29,440
want to buy this machine.
I'm like, that's cool.

342
00:18:29,440 --> 00:18:30,960
And he goes, yeah, if you give
me a good deal, like, you know,

343
00:18:30,960 --> 00:18:33,200
I'm buddies with this guy, you
know, yeah, you heard of Doctor

344
00:18:33,200 --> 00:18:34,760
Peter Tia.
And I'm like, yeah.

345
00:18:35,160 --> 00:18:37,800
Then I'm like he's like, yeah,
you know, and we were trying to

346
00:18:37,800 --> 00:18:39,880
base our our health model on him
and.

347
00:18:40,200 --> 00:18:44,480
And by the way, you know, like.
I know.

348
00:18:45,160 --> 00:18:47,320
So that to be like a case of
separating the art from the

349
00:18:47,320 --> 00:18:49,480
artist.
They're like, you know, like.

350
00:18:49,760 --> 00:18:53,120
So hard.
Science and the dude and like,

351
00:18:53,440 --> 00:18:55,600
you know, like, what do you say?
What do you do about that?

352
00:18:56,400 --> 00:18:59,040
Oh, my sister was said that
about Kanye.

353
00:18:59,040 --> 00:19:01,480
She's like, you got to separate
the artist.

354
00:19:04,160 --> 00:19:05,600
I was like, all right, all
right.

355
00:19:07,040 --> 00:19:09,920
Yeah.
It's, it's still very difficult,

356
00:19:09,920 --> 00:19:12,600
you know, because I think as a
female, a physician, and it was

357
00:19:12,600 --> 00:19:17,240
like, I was just so
disappointed, you know, and,

358
00:19:17,240 --> 00:19:21,720
and, and, and my partner was
like, do we burn the books

359
00:19:21,720 --> 00:19:23,120
because we have a little
library?

360
00:19:23,120 --> 00:19:25,080
And she was like, but we're not
book burners.

361
00:19:25,440 --> 00:19:30,080
Are we book burners?
No, but yeah, but I do.

362
00:19:30,200 --> 00:19:33,200
I do think there was.
Every book by every creep that

363
00:19:33,200 --> 00:19:35,280
was out there, then we would not
have a lot of literature.

364
00:19:35,280 --> 00:19:38,040
Burning every book, yeah.
But really the concept, you

365
00:19:38,040 --> 00:19:42,600
know, makes sense in that book.
And I did, I think, develop a

366
00:19:42,600 --> 00:19:48,280
lot of my thoughts as far as and
sort of I adapted a lot of

367
00:19:48,280 --> 00:19:51,920
things there, but it was only
like in in one realm of, of

368
00:19:51,920 --> 00:19:53,760
mine, like health framework that
I use.

369
00:19:53,760 --> 00:19:57,440
You know, when I, I see people
in aging, I, I call it, you

370
00:19:57,440 --> 00:19:59,440
know, it's like, it's the art of
health span.

371
00:19:59,640 --> 00:20:04,400
So health is this acronym where
the HS like how we age and then

372
00:20:04,400 --> 00:20:07,080
the Ms. of a geriatrics which I
think.

373
00:20:08,320 --> 00:20:12,680
Are for not just the geriatric
population, but they are

374
00:20:12,680 --> 00:20:15,880
relatable to everyone, which is
like, So what matters to you?

375
00:20:15,880 --> 00:20:19,600
Before I even treat you like I
shouldn't just to all this

376
00:20:19,600 --> 00:20:22,640
medicine, I should understand
what actually matters to you.

377
00:20:22,960 --> 00:20:25,760
And then what your mindset is
that you know, is it a mind

378
00:20:25,760 --> 00:20:29,520
disease or is it like your
mindset, your multimorbidity,

379
00:20:29,520 --> 00:20:31,760
the medical problems that you
have, the interactions between

380
00:20:31,760 --> 00:20:34,360
them, the medications and then
your mobility keeping you

381
00:20:34,360 --> 00:20:36,600
upright.
And then the E was the is

382
00:20:36,640 --> 00:20:40,080
energies from a cellular level
to disease specific level that

383
00:20:40,080 --> 00:20:42,440
are energy dependent.
And that's where like Peter

384
00:20:42,440 --> 00:20:45,200
Atilla was talking about, you
know, some of the energy

385
00:20:45,200 --> 00:20:47,800
dependent diseases where you
think about cardiovascular

386
00:20:47,800 --> 00:20:51,480
disease, cognitive disorder,
cancer, metabolic disease.

387
00:20:51,480 --> 00:20:54,800
Well, that's just like in the E.
And then the A is for activity

388
00:20:54,960 --> 00:20:57,480
and how our bodies are like
meant to be in motion and not

389
00:20:57,480 --> 00:21:01,120
like going to the gym, but what
do we want to be able to do and

390
00:21:01,120 --> 00:21:04,760
our reserve and capacity.
The L is the longevity piece.

391
00:21:04,760 --> 00:21:07,840
So then you know, those pillars
of lifestyle medicine like

392
00:21:07,840 --> 00:21:12,440
social engagement, diet, sleep,
you know, those pieces.

393
00:21:12,440 --> 00:21:15,240
And then the T is for
transformation and how we do

394
00:21:15,240 --> 00:21:18,000
transform.
So like, you know, these

395
00:21:18,000 --> 00:21:21,160
longevity people that I, I'm,
I'm sort of, I think I stand

396
00:21:21,560 --> 00:21:25,520
outside of their realm is like,
no, we are supposed to age and

397
00:21:25,520 --> 00:21:27,920
our life is not supposed to be
forever.

398
00:21:28,120 --> 00:21:32,560
And so then how do we adapt to
that transformation?

399
00:21:32,560 --> 00:21:36,240
So our adaptation to change so
that we can live fully and have

400
00:21:36,240 --> 00:21:38,000
the best quality of life
possible.

401
00:21:38,240 --> 00:21:43,640
And the last age is habits and
something I used to always say,

402
00:21:43,640 --> 00:21:46,400
and everyone was like, where did
you get that?

403
00:21:46,400 --> 00:21:49,280
I'm like, I don't know, I pulled
it out of somewhere, but I used

404
00:21:49,280 --> 00:21:50,880
to be like, what's the reset
technique?

405
00:21:51,280 --> 00:21:55,840
So I guess nobody like had used
it before because I ended up

406
00:21:55,840 --> 00:21:57,200
buying the domain.
It's mine.

407
00:21:57,200 --> 00:22:01,320
I don't do anything with it, but
anyway, but it's like these

408
00:22:01,320 --> 00:22:05,440
incremental changes, you know,
our life moves along and our

409
00:22:05,440 --> 00:22:08,240
habits like you walk into a
room, you flip on a light,

410
00:22:08,240 --> 00:22:11,520
that's your automatic habit.
So how do we build our small

411
00:22:11,520 --> 00:22:15,280
habits in into our life, kind of
like Atomic Habits.

412
00:22:15,280 --> 00:22:19,760
That book is a fantastic book,
but but then, you know, we can't

413
00:22:19,760 --> 00:22:22,480
maintain our habits all the time
because life happens.

414
00:22:22,480 --> 00:22:25,520
So how do you have these like
small incremental resets so that

415
00:22:25,520 --> 00:22:28,880
you can sort of pick up and just
redefine yourself again so that

416
00:22:28,880 --> 00:22:31,880
you're not like giving up?
You know, so I can, I kind of

417
00:22:31,880 --> 00:22:35,720
see health in that framework.
And then that's my approach when

418
00:22:35,720 --> 00:22:40,360
I take care of a patient.
And surprisingly, my patients

419
00:22:40,360 --> 00:22:44,120
are like super motivated.
Like they come back and most of

420
00:22:44,120 --> 00:22:47,600
them are doing amazing.
You know they do all the things

421
00:22:48,440 --> 00:22:52,840
and it works so when they do.
I would, I would guess that part

422
00:22:52,840 --> 00:22:57,560
of the reason why they do so
well is because I think that for

423
00:22:58,040 --> 00:23:02,000
a lot of people, if you're
getting treated, you are

424
00:23:02,320 --> 00:23:05,760
receiving something and you
expect, and your role is very

425
00:23:05,760 --> 00:23:09,040
passive and with a lot of
lifestyle type of medicine,

426
00:23:09,240 --> 00:23:12,160
you're putting the person's
decision making in their own

427
00:23:12,160 --> 00:23:17,280
hands and say, Hey, if you want
to be healthy, you need to sit

428
00:23:17,280 --> 00:23:18,960
down and stand up three times a
day.

429
00:23:18,960 --> 00:23:22,160
You know, if you want to be
healthy, walk up and down a

430
00:23:22,160 --> 00:23:25,680
flight of stairs and to say,
Hey, this is in your hands.

431
00:23:25,680 --> 00:23:27,960
I can't force you to do it.
And, and you will see that

432
00:23:27,960 --> 00:23:30,920
you'll feel better if you do it.
But like, I think that I think

433
00:23:30,920 --> 00:23:33,160
that when you give people
license to take care of

434
00:23:33,160 --> 00:23:36,000
themselves and you say, hey,
there's a very tangible playbook

435
00:23:36,000 --> 00:23:39,680
that links your movement with
your cut, with your cognition,

436
00:23:40,200 --> 00:23:42,720
let's be on top of that.
Like they'll say, hey, if that's

437
00:23:42,720 --> 00:23:45,120
all it takes and that's all, and
then I didn't realize that, then

438
00:23:45,120 --> 00:23:47,200
let me keep on doing it.
That's awesome, you know.

439
00:23:48,360 --> 00:23:53,400
Yeah, I think in, in, in some
senses, though, you know, like

440
00:23:53,560 --> 00:23:55,600
sometimes, because I do have
elders.

441
00:23:55,600 --> 00:23:58,720
Most of my patients are elders.
I have a few like in their 40s

442
00:23:58,720 --> 00:24:01,640
and 50s who came to me because I
took care of their parents and

443
00:24:01,640 --> 00:24:03,600
they're like, they're doing
better than me.

444
00:24:03,640 --> 00:24:06,400
Will you take me on as a patient
Now?

445
00:24:06,440 --> 00:24:09,520
I have like these young adults
that I don't like, I'm like, Oh

446
00:24:09,600 --> 00:24:12,320
my God, that's amazing.
You know, this is fascinating,

447
00:24:12,360 --> 00:24:17,280
like new area of exploration.
But you know, sometimes my elder

448
00:24:17,280 --> 00:24:20,600
patients are like, oh, you
don't, you don't know, like you,

449
00:24:20,680 --> 00:24:23,080
you don't know what having
chronic pain is like.

450
00:24:23,080 --> 00:24:26,680
I'm like, oh, but I do, you
know, and I tell them I'm like,

451
00:24:26,680 --> 00:24:29,600
you know, I had both my hips
replaced like literally a year

452
00:24:29,600 --> 00:24:32,160
ago and they're like you did.
I'm like, yes.

453
00:24:32,200 --> 00:24:35,680
And I was limping and I wasn't
sleeping and it was like 3 years

454
00:24:35,680 --> 00:24:37,960
of no sleep and paint chronic
pain.

455
00:24:38,760 --> 00:24:42,600
But I did what I needed to do,
you know, and, and I was just

456
00:24:42,600 --> 00:24:45,680
unfortunately like born wrong,
like a dog, you know, dysplasia,

457
00:24:45,680 --> 00:24:50,680
but you move on, you know, or
they're just like, they don't

458
00:24:50,680 --> 00:24:53,920
get it.
Like I share my personal stories

459
00:24:53,920 --> 00:24:57,080
with them, which I think help
them to see that I'm also human.

460
00:24:57,080 --> 00:25:01,520
So I, I sometimes do this very
take this very non traditional

461
00:25:01,520 --> 00:25:05,600
approach to medicine, which I
think we also need to think

462
00:25:05,600 --> 00:25:10,520
about as physicians.
Like I, I made a house call the

463
00:25:10,520 --> 00:25:12,960
other day because the patient
had had surgery and when I got

464
00:25:12,960 --> 00:25:17,440
there, the dogs needed walks.
So I ended up like walking the

465
00:25:17,440 --> 00:25:19,480
dogs.
There were these cute little

466
00:25:19,480 --> 00:25:24,280
puppies and I met the neighbors
like, oh, I'm the doctor.

467
00:25:24,440 --> 00:25:26,520
But you know, you kind of meet
your patients where they need to

468
00:25:26,520 --> 00:25:27,680
be.
Like, I mean, that's like a very

469
00:25:27,680 --> 00:25:31,040
drastic example, but you need to
meet your patients where they

470
00:25:31,040 --> 00:25:33,040
need to be.
They need to see the human side

471
00:25:33,040 --> 00:25:34,720
of you, the imperfect side of
you.

472
00:25:34,720 --> 00:25:39,120
So they can be like, all right,
this person doesn't know, you

473
00:25:39,120 --> 00:25:42,800
know, or like, it's OK.
Like they're not perfect either.

474
00:25:42,800 --> 00:25:50,480
So I, I, I always remind them
how abnormal and inadequate.

475
00:25:50,480 --> 00:25:54,280
And, you know, I tell them about
my failures of like the night

476
00:25:54,280 --> 00:25:55,840
time.
I get up and have a little piece

477
00:25:55,840 --> 00:25:58,920
of chocolate and then I have to
reset again.

478
00:25:58,920 --> 00:26:01,040
Like what did you just do, you
know?

479
00:26:01,040 --> 00:26:04,400
But I think that's the other
part of medicine that's that's

480
00:26:04,400 --> 00:26:06,640
important.
Just the human part that we

481
00:26:06,640 --> 00:26:09,280
don't, that will help our
patients succeed.

482
00:26:10,320 --> 00:26:13,000
I for sure, for sure.
It's very interesting because

483
00:26:13,000 --> 00:26:15,200
they bring that up because
there's two things.

484
00:26:15,200 --> 00:26:17,960
So there's two responses.
I'd love to hear your thoughts

485
00:26:17,960 --> 00:26:22,760
to the first part is I'm reading
a book now called Empire of Pain

486
00:26:23,000 --> 00:26:27,000
and it's about the Sackler
family and painkillers and to do

487
00:26:27,040 --> 00:26:30,880
pharma.
And one thing that Arthur

488
00:26:30,880 --> 00:26:34,280
Sackler was who's the, I guess
the leader of the clan and, you

489
00:26:34,280 --> 00:26:38,680
know, the the father of the
family, so to speak, was famous

490
00:26:38,680 --> 00:26:43,440
for was he kind of linked
advertising and the public's

491
00:26:43,440 --> 00:26:49,240
perception of MD's and doctors
and associated and sold that as

492
00:26:49,240 --> 00:26:52,880
a package to the American public
and said, hey, doctors are

493
00:26:52,880 --> 00:26:55,600
doctors are not wrong.
Doctors are above people.

494
00:26:55,600 --> 00:26:59,880
Doctors are always right.
And we in our medical sense are

495
00:26:59,880 --> 00:27:02,640
only trying to achieve the
highest truth, which is

496
00:27:02,640 --> 00:27:07,800
scientific truth and rigor and
basically use that as a method

497
00:27:07,800 --> 00:27:11,440
to get away with selling, you
know, incredibly, incredibly

498
00:27:11,440 --> 00:27:14,920
addictive painkillers as strong,
stronger than heroin for for

499
00:27:14,920 --> 00:27:18,280
decades, right.
And on the other hand, and on

500
00:27:18,280 --> 00:27:22,400
the other hand, my grandfather,
who's a gastroenterologist for,

501
00:27:22,680 --> 00:27:28,120
you know, for 50-60 years in
Miami Beach, he has lifelong

502
00:27:28,120 --> 00:27:31,680
patients.
And he was lamenting to me how

503
00:27:31,840 --> 00:27:35,720
the new hospital systems that
have taken over that are buying

504
00:27:35,720 --> 00:27:39,040
out private practices don't
allow a doctor patient

505
00:27:39,040 --> 00:27:41,880
relationship, essentially.
And that you're basically not

506
00:27:41,880 --> 00:27:44,200
encouraged to ever kind of like
whoever you walk into the room

507
00:27:44,200 --> 00:27:45,640
is who you're dealing with.
And then you walk out of the

508
00:27:45,640 --> 00:27:46,920
room and you never deal with
them again.

509
00:27:47,200 --> 00:27:51,200
And he's like, I used to check
in on my patients on a daily

510
00:27:51,200 --> 00:27:53,280
basis and they would call me and
they tell me I'd saved their

511
00:27:53,280 --> 00:27:56,480
lives just from being their
doctor, not from there being

512
00:27:56,480 --> 00:27:59,960
their GI, from being the doctor.
So like, you have two to the way

513
00:27:59,960 --> 00:28:01,840
that people could treat being a
doctor.

514
00:28:02,120 --> 00:28:05,240
You have like the Sackler type
of family that just, you know,

515
00:28:05,240 --> 00:28:07,760
holds themselves as above
everyone and wants to take

516
00:28:07,760 --> 00:28:09,880
advantage of the rest of the
mortals down here.

517
00:28:10,160 --> 00:28:12,480
And then you have the doctors
that are doing the work of

518
00:28:13,680 --> 00:28:16,680
caring for people, you know,
and, and part and again, you

519
00:28:16,680 --> 00:28:19,440
know, and I think that there's a
misconception today or maybe a

520
00:28:19,440 --> 00:28:23,640
reconception of, of a doctor,
someone that just tells you

521
00:28:23,640 --> 00:28:26,640
what's wrong with you.
And the primary purpose is

522
00:28:26,640 --> 00:28:29,800
diagnosing not not as much
preventative and not as much,

523
00:28:30,760 --> 00:28:33,560
you know, the building up and
the lifestyle aspect that you're

524
00:28:33,560 --> 00:28:36,720
referring to.
But I I hope that with with

525
00:28:36,760 --> 00:28:40,360
technology and AI, it's going to
be easier for people to come

526
00:28:40,360 --> 00:28:43,400
become more.
You have a personalized form of

527
00:28:43,400 --> 00:28:46,800
healthcare for sure.
I think that's kind of what

528
00:28:46,800 --> 00:28:49,880
healthcare needs to be like.
What, what is it that you want

529
00:28:49,880 --> 00:28:52,440
me to help you with?
And that's really my question.

530
00:28:52,440 --> 00:28:54,880
Every time they come, patients
come in, I'm like, what can I

531
00:28:54,880 --> 00:28:57,080
help you with?
What are you concerned about?

532
00:28:57,280 --> 00:29:01,560
You know, and, and that's sort
of where the the approach

533
00:29:01,560 --> 00:29:03,680
starts.
And then I and then I also tell

534
00:29:03,680 --> 00:29:06,480
them like, OK, well, I've
detected this and this and, you

535
00:29:06,480 --> 00:29:09,440
know, I have patients who are
like, I am not taking the statin

536
00:29:09,440 --> 00:29:12,080
drug.
I'm like, OK, let's work on

537
00:29:12,800 --> 00:29:17,600
doing it another way and and we
can try this, you know, and I

538
00:29:17,600 --> 00:29:21,840
really, I guess that's the
reason I left at the corporate

539
00:29:21,840 --> 00:29:23,680
world.
And yeah, I know we're going to

540
00:29:23,680 --> 00:29:27,080
talk about my book, but I always
am like, if somebody in

541
00:29:27,080 --> 00:29:31,120
corporate medicine reads my
book, they will never hire me in

542
00:29:31,120 --> 00:29:35,480
a hospital again because I slam
the hospitals.

543
00:29:35,680 --> 00:29:39,080
And, you know, I was getting
involved with administrative

544
00:29:39,080 --> 00:29:41,840
care administration.
I was, I was in a faculty, I was

545
00:29:41,840 --> 00:29:44,640
a teacher forever as a program
director.

546
00:29:44,640 --> 00:29:48,360
And so I was getting involved in
the with the C-Suite operations

547
00:29:48,360 --> 00:29:51,200
a little bit.
And, and I think once with one

548
00:29:51,200 --> 00:29:54,360
of the execs, I kind of really
got into it.

549
00:29:54,360 --> 00:29:55,880
And I got home and I got really
mad.

550
00:29:55,880 --> 00:29:58,680
I was like, OK, I told my
husband and he's a physician

551
00:29:58,680 --> 00:30:00,160
too.
He's a critical care doc.

552
00:30:00,160 --> 00:30:02,040
And I said, Jace, what's his
name?

553
00:30:02,320 --> 00:30:04,720
I like either.
They don't know what they're

554
00:30:04,720 --> 00:30:09,280
talking about.
I don't know or they're lying to

555
00:30:09,280 --> 00:30:12,000
me.
But I've only learned medicine

556
00:30:12,000 --> 00:30:14,720
and I have to figure this out.
So I'm going to go to Business

557
00:30:14,720 --> 00:30:16,240
School.
And that's what we did.

558
00:30:16,240 --> 00:30:19,320
The two of us went to back to
Business School and got our

559
00:30:19,320 --> 00:30:21,520
MBAs.
I was like for three years, you

560
00:30:21,520 --> 00:30:26,760
know, here were full time docs,
full time parents and like our

561
00:30:26,960 --> 00:30:30,800
early morning study dates and
our nighttime study dates.

562
00:30:31,000 --> 00:30:33,440
And you know what happens when a
doctor goes to Business School,

563
00:30:33,640 --> 00:30:36,520
the OCD and type A personality
comes out.

564
00:30:36,520 --> 00:30:38,920
So you still get like a four
point O And I remember I'd been

565
00:30:38,920 --> 00:30:41,800
in Business School with these
other students doing projects

566
00:30:41,800 --> 00:30:43,720
and they're like struggling.
They were just out of their

567
00:30:43,720 --> 00:30:45,320
bachelor's and they're like, how
are you?

568
00:30:45,520 --> 00:30:48,160
How are you not struggling?
Because I'm like, I don't know,

569
00:30:48,440 --> 00:30:51,720
there's this like crazy comes
out and I, and I have to like

570
00:30:51,720 --> 00:30:55,240
prove something to myself.
But what it taught me, what it

571
00:30:55,240 --> 00:30:59,640
really reinforced in me was that
I can, I can take my time with

572
00:30:59,640 --> 00:31:04,240
my patients, I can make money, I
can be profitable.

573
00:31:04,800 --> 00:31:07,760
And one day, you know, it was
towards the end of business.

574
00:31:07,760 --> 00:31:09,800
So I walked into the clinic
where I worked for this

575
00:31:09,800 --> 00:31:11,880
hospital.
I turned on the lights and I

576
00:31:11,880 --> 00:31:15,560
think COVID had sort of jaded me
anyways, you know, like I was

577
00:31:15,560 --> 00:31:18,120
just like this, something's got
to give.

578
00:31:18,120 --> 00:31:20,520
This is not good.
And I was doing a lot of

579
00:31:20,680 --> 00:31:23,560
palliative care consults.
So I think emotionally I was

580
00:31:23,560 --> 00:31:29,880
just drained being with people
as they were dying and, and I

581
00:31:29,880 --> 00:31:33,400
was like, I'm keeping these
lights on, nobody else's.

582
00:31:33,440 --> 00:31:37,240
If I don't walk in here, like
the nurse doesn't get paid, the

583
00:31:37,240 --> 00:31:41,680
front desk doesn't get paid.
And and then the execs in the

584
00:31:41,680 --> 00:31:44,080
C-Suite don't get paid and
they're taking my money.

585
00:31:44,280 --> 00:31:46,320
No one's going to take my money
ever again.

586
00:31:46,320 --> 00:31:48,480
So then I was like, OK, I'm
going to come up with this whole

587
00:31:48,480 --> 00:31:50,320
plan.
And, and I left, you know, and I

588
00:31:50,320 --> 00:31:54,560
called my one of my fellows,
Kate, who's my partner now.

589
00:31:54,920 --> 00:31:57,560
And I was like, hey, we're going
to do this.

590
00:31:57,560 --> 00:32:00,240
We're open this practice.
And either it's going to work

591
00:32:00,240 --> 00:32:04,280
and it's going to be great or
it's going to suck and we're

592
00:32:04,280 --> 00:32:06,080
going to just be employed
physicians again.

593
00:32:06,080 --> 00:32:08,760
But either way, you know, it
can't be any worse than this.

594
00:32:09,040 --> 00:32:12,600
And it and it works, you know,
and it's like we're trying to,

595
00:32:12,920 --> 00:32:17,120
we're looking at adding another
physician now and you know, who

596
00:32:17,120 --> 00:32:20,880
are five years into it, Like
we're both at our capacity for

597
00:32:20,880 --> 00:32:22,640
patients and it's been
wonderful.

598
00:32:22,840 --> 00:32:25,000
But I get to spend an hour with
my patients.

599
00:32:25,000 --> 00:32:27,040
I get to go to the hospital and
see them and I get to go to

600
00:32:27,040 --> 00:32:30,680
their home and I get to see them
and I get to be like the doctor

601
00:32:30,680 --> 00:32:34,720
I wanted to be and I envisioned
not like what they expected me

602
00:32:34,720 --> 00:32:38,760
to be, you know, and, and, and
that's so valuable and I'm like,

603
00:32:38,760 --> 00:32:42,400
we need more doctors and I so
now one of the, my motivations

604
00:32:42,400 --> 00:32:45,080
for having medical students is
to show them, but like guys,

605
00:32:45,640 --> 00:32:47,320
there are other ways to
practice.

606
00:32:47,320 --> 00:32:50,960
You do not need to work for this
institution.

607
00:32:51,480 --> 00:32:53,960
Unfortunately, that's the model.
They they teach us to be a

608
00:32:53,960 --> 00:32:58,320
commodity and then the patient
relationship goes away and then

609
00:32:58,320 --> 00:33:01,320
patients suffer, People suffer
because of that.

610
00:33:01,440 --> 00:33:05,080
You know it's awful you.
Know what you can't you can't

611
00:33:05,080 --> 00:33:09,560
count health without
relationships because like the

612
00:33:09,560 --> 00:33:12,920
worst thing that you can do to a
human being, the worst, the

613
00:33:12,920 --> 00:33:15,160
worst thing they do to you in
prison is solitary confinement.

614
00:33:15,560 --> 00:33:18,440
And like, and the worst thing
that you do, you could do to

615
00:33:18,440 --> 00:33:21,280
someone is to just take away
their relationships and people,

616
00:33:21,600 --> 00:33:24,920
people that people will, God
forbid, kill themselves over

617
00:33:24,920 --> 00:33:28,360
over relationships, You know,
like you could have all the

618
00:33:28,480 --> 00:33:30,400
world, you could have all the
comfort, you could have a house,

619
00:33:30,400 --> 00:33:32,720
you could have friends, you
know, like if you don't have it,

620
00:33:32,840 --> 00:33:36,520
but the chances are actually
like if like you probably don't

621
00:33:36,520 --> 00:33:37,920
have friends if that's the place
you're at.

622
00:33:37,920 --> 00:33:41,360
But the point is that
relationships are everything and

623
00:33:41,840 --> 00:33:46,000
your health for sure.
And, and it's funny because for

624
00:33:46,000 --> 00:33:49,080
a long time, you know, people
have said, OK, well, emotions

625
00:33:49,080 --> 00:33:51,680
and like relationships and
stuff, that's like one thing.

626
00:33:51,680 --> 00:33:53,320
But like we need to stick with
the tangible.

627
00:33:53,320 --> 00:33:58,280
But they do have a tangible,
tangible impact on, on for sure

628
00:33:58,280 --> 00:34:00,640
human beings.
And definitely the, the, the

629
00:34:00,640 --> 00:34:03,000
old, the, I guess the people in
the, the later stages in their

630
00:34:03,000 --> 00:34:05,520
lives.
But I know, for example, that my

631
00:34:05,520 --> 00:34:08,239
my grandfather, my mom's dad.
Sorry.

632
00:34:08,440 --> 00:34:11,880
Yeah, My mom's dad was off his
nails his whole life and he was

633
00:34:11,880 --> 00:34:16,360
living by his own.
My grandmother died 2530 years

634
00:34:16,360 --> 00:34:19,960
ago and he didn't even go on a
date since the day she died.

635
00:34:19,960 --> 00:34:25,639
Like he was like my wife, but he
lived alone and he took care of

636
00:34:25,639 --> 00:34:27,639
the house and he was A and he
was a professor.

637
00:34:27,920 --> 00:34:30,760
And then when he retired, he
still kept, he'd come to our

638
00:34:30,760 --> 00:34:32,280
house to help take care of our
house.

639
00:34:32,639 --> 00:34:37,199
And then he, I think went like
91 or 92, he had a stroke.

640
00:34:37,719 --> 00:34:41,560
And the second he stopped being
able to help himself and the

641
00:34:41,560 --> 00:34:44,320
second he stopped being able to
go to the supermarket and get

642
00:34:44,320 --> 00:34:46,800
his own girls, he used to walk 3
miles a day at 90 years old, you

643
00:34:46,800 --> 00:34:48,679
know?
And the second that the

644
00:34:48,679 --> 00:34:53,120
relationships and the and the
and the and the independence

645
00:34:53,280 --> 00:34:56,199
faded away, he was like, check
me out, like, you know.

646
00:34:56,280 --> 00:34:59,760
I know this is I'm ready to.
Yeah, exactly.

647
00:34:59,960 --> 00:35:03,360
This is what I'm here for.
And and you don't want to be a

648
00:35:03,360 --> 00:35:04,200
burden.
That was the other thing.

649
00:35:04,200 --> 00:35:06,160
And like to feel like you're a
burden is terrible.

650
00:35:06,160 --> 00:35:08,960
And the truth is that you said
something really, really awesome

651
00:35:08,960 --> 00:35:11,360
at the beginning of the podcast,
which is that we go through it

652
00:35:11,360 --> 00:35:12,960
like different stages in our
lives.

653
00:35:13,240 --> 00:35:16,760
And the later stage of our life
is to, you know, aside from

654
00:35:16,760 --> 00:35:20,680
enjoying is to be the wise
people for our family and for

655
00:35:20,680 --> 00:35:23,480
the community and the world
around us and to say, Hey, we've

656
00:35:23,480 --> 00:35:25,160
lived through a lot of this
stuff.

657
00:35:25,160 --> 00:35:26,680
And you don't need to do this
this way.

658
00:35:26,680 --> 00:35:28,480
And you don't need to go through
this pain and this hurt.

659
00:35:28,480 --> 00:35:32,080
And you don't have to do this.
And like, when you have that,

660
00:35:32,320 --> 00:35:35,240
like that gives you a reason to
exist, that gives you a place in

661
00:35:35,240 --> 00:35:37,200
the world.
My, my grandfather, when he was

662
00:35:37,200 --> 00:35:40,800
a doctor, he aged 10 years the
year that he retired.

663
00:35:40,880 --> 00:35:43,520
And it was, you know, it was
heartbreaking, but that's, you

664
00:35:43,520 --> 00:35:47,040
know, the way that life is.
Yeah, I was at a meeting tonight

665
00:35:47,040 --> 00:35:51,080
with a a couple of the older
doctors in town and one's like

666
00:35:51,080 --> 00:35:53,560
68, the other one's in the 70s
and they're working.

667
00:35:53,560 --> 00:35:57,440
And like, we still love to work.
My God, stay in it.

668
00:35:57,600 --> 00:36:01,000
And this is, you know, these old
school docs that I'm like always

669
00:36:01,000 --> 00:36:03,880
just so inspired by.
But again, that's kind of what I

670
00:36:03,880 --> 00:36:09,200
talk about in my book as well.
It's all it's like this sort of

671
00:36:09,200 --> 00:36:12,720
I, I try to really honor my.
Patients, let's talk about your

672
00:36:12,720 --> 00:36:16,360
book now.
Well, OK, so I wrote this book

673
00:36:16,360 --> 00:36:20,680
called Life Love, and in between
a geriatrician's journey through

674
00:36:21,400 --> 00:36:25,000
aging and the meaning of life.
And it started out I was

675
00:36:25,000 --> 00:36:29,520
speaking at a women's conference
in 2016 and, and it was a, you

676
00:36:29,520 --> 00:36:32,120
know, it was supposed to be like
a motivational talk.

677
00:36:32,360 --> 00:36:36,440
And I had just lost my son to a
congenital heart defect a few

678
00:36:36,440 --> 00:36:38,880
months earlier.
So I'm speaking at this

679
00:36:38,880 --> 00:36:41,000
conference and I kept thinking
like, what am I going to talk

680
00:36:41,000 --> 00:36:43,480
about?
Like, like I'm, I've come out on

681
00:36:43,480 --> 00:36:46,880
this other side, you know, of
having a child who was in

682
00:36:46,880 --> 00:36:52,640
Hospice and which is, you know,
I kind of like always think the

683
00:36:52,640 --> 00:36:55,320
universe like puts things in
front of like, I kind of felt

684
00:36:55,320 --> 00:36:59,800
like our son James like had like
we were meant to have him

685
00:36:59,800 --> 00:37:01,440
because we knew how to take care
of him.

686
00:37:01,480 --> 00:37:05,080
You know, it's the things that
we did and based on, you know,

687
00:37:05,080 --> 00:37:07,960
managing patients at the end of
their life or doing the critical

688
00:37:07,960 --> 00:37:10,000
care things.
But also it taught us like how

689
00:37:10,000 --> 00:37:13,760
to be better human beings
Because for the first time when

690
00:37:13,760 --> 00:37:16,760
like I had to give him morphine
when he was short of breath in

691
00:37:16,760 --> 00:37:20,320
Hospice, like I freaked out.
I was having a hard time, yet I

692
00:37:20,320 --> 00:37:24,560
realized I so comfortably write
these scripts for morphine for

693
00:37:24,560 --> 00:37:28,080
my Hospice patients.
And then it it clicked like this

694
00:37:28,080 --> 00:37:30,880
is hard for people.
So he helped me be a better

695
00:37:30,880 --> 00:37:34,280
human, I think a better doctor.
But anyway, some of the talk was

696
00:37:34,280 --> 00:37:39,120
about my experience and how I
went through that whole stage.

697
00:37:39,200 --> 00:37:43,200
And what really got me through
it was the lessons that my

698
00:37:43,200 --> 00:37:45,920
patients had taught me.
And what I was talking about in

699
00:37:45,920 --> 00:37:48,560
the book was, you know, I get to
sit with these people.

700
00:37:48,560 --> 00:37:51,840
I don't have like 1 mother and
one father, one set of

701
00:37:51,840 --> 00:37:54,320
grandparents or whatever.
I have many every day.

702
00:37:54,320 --> 00:37:58,280
And and I almost feel guilty
because they pay me to take care

703
00:37:58,280 --> 00:38:00,840
of them, but I almost owe them
more.

704
00:38:01,160 --> 00:38:04,680
But the book talks about, like,
how fragile we are and how much

705
00:38:04,680 --> 00:38:09,280
we need to appreciate our lives.
And each chapter has a theme and

706
00:38:09,280 --> 00:38:12,320
has stories from my elder
patients and the lessons that I

707
00:38:12,320 --> 00:38:16,600
learned, you know, like about
love and just the stories of how

708
00:38:16,600 --> 00:38:20,040
these people are meant to be
together and how they're

709
00:38:20,040 --> 00:38:23,960
together for decades and finding
the spaces in between and not

710
00:38:23,960 --> 00:38:28,280
taking advantage of the time
that we have or, you know, at

711
00:38:28,280 --> 00:38:31,080
the thought of empathy and
transparency.

712
00:38:31,080 --> 00:38:36,200
And and so this is all of these
themes and not, you know, really

713
00:38:36,200 --> 00:38:39,560
not, not, not lying to yourself,
not lying to others.

714
00:38:39,920 --> 00:38:43,520
And the very last chapter of the
book is called relevance.

715
00:38:43,520 --> 00:38:46,480
And I was sitting with a patient
and this person, I mean, this

716
00:38:46,480 --> 00:38:50,760
person is like has been my hero.
And they're very sick.

717
00:38:50,760 --> 00:38:55,160
I mean, almost dying.
And they looked at me one day

718
00:38:55,160 --> 00:38:57,560
and I said, I no longer feel
relevant.

719
00:38:57,880 --> 00:39:03,040
And I just, and I you know, I
know these people like so

720
00:39:03,040 --> 00:39:05,480
intimately.
I think I spent so much time

721
00:39:05,480 --> 00:39:08,920
with them and in my head I was
like, I can't handle this

722
00:39:08,920 --> 00:39:11,080
anymore.
So I started to like, I pulled

723
00:39:11,080 --> 00:39:16,560
like my Eckhart Tolle stuff out
and I have things in there from

724
00:39:16,560 --> 00:39:19,240
like philosophers on failing,
like Pima Chodrin.

725
00:39:19,240 --> 00:39:23,000
And so there's a lot of, it's
poetic, it's philosophical, but

726
00:39:23,000 --> 00:39:25,280
I thought about it.
I thought, OK, So what happens

727
00:39:25,280 --> 00:39:30,200
when I'm no longer a doctor and
I'm no longer a mother and I'm

728
00:39:30,200 --> 00:39:34,200
no longer a wife?
Where do I find relevance when

729
00:39:34,200 --> 00:39:37,080
all of my labels have been torn
away?

730
00:39:37,080 --> 00:39:40,640
And how do I sit with myself and
I'm still relevant as this human

731
00:39:40,640 --> 00:39:43,680
being, you know?
So the book, I think, I'm hoping

732
00:39:43,680 --> 00:39:46,440
it teaches people these
wonderful lessons that I've

733
00:39:46,440 --> 00:39:49,520
learned from my elders.
It tells a little bit of about

734
00:39:49,520 --> 00:39:52,680
my story and my upbringing and
then the way I met my husband.

735
00:39:52,680 --> 00:39:56,680
And that was very special.
But at the very end it says, you

736
00:39:56,680 --> 00:39:58,320
know, what?
If you want to learn anything

737
00:39:58,320 --> 00:40:01,960
about this world and about.
Surviving this world and living

738
00:40:01,960 --> 00:40:03,760
a better life.
Just sit with your elders.

739
00:40:03,760 --> 00:40:05,960
Just sit with them and they will
teach you all the lessons you

740
00:40:05,960 --> 00:40:09,640
need to know.
And it seems like you sort of

741
00:40:09,680 --> 00:40:12,480
have some of that in you.
You know, you have your

742
00:40:12,480 --> 00:40:14,480
grandfather's stories, and you
seem to.

743
00:40:14,520 --> 00:40:17,080
Old people.
You love old people.

744
00:40:17,520 --> 00:40:18,960
I love them too.
I love old people.

745
00:40:19,000 --> 00:40:22,640
I'm an old soul myself, so I,
well, I used to, I used to visit

746
00:40:22,640 --> 00:40:25,280
the assisted living homes in
college and organize, have

747
00:40:25,280 --> 00:40:29,600
students, you know, organize
trips and you know, and I, and

748
00:40:30,320 --> 00:40:32,760
you know, I've always been an
old soul as far as, you know,

749
00:40:32,760 --> 00:40:35,600
music and culture and stuff.
So it's, you know, we'd say like

750
00:40:35,600 --> 00:40:38,760
Frank Sinatra and we'd sing some
of the classics and you know,

751
00:40:38,760 --> 00:40:40,840
we'd hang out, we'd have
birthday parties in the assisted

752
00:40:40,840 --> 00:40:43,960
living homes.
And there's the sweetest woman

753
00:40:43,960 --> 00:40:45,480
named Ruth.
And I remember her.

754
00:40:45,480 --> 00:40:49,960
So she had, she's super, super,
super short term memory loss,

755
00:40:49,960 --> 00:40:51,760
but was an incredible physical
shape.

756
00:40:52,240 --> 00:40:54,280
Yeah.
So she's always down to around

757
00:40:54,280 --> 00:40:57,080
looked great.
And she would ask me, we would

758
00:40:57,080 --> 00:41:00,280
have the same conversations 30
times in half an hour.

759
00:41:00,560 --> 00:41:02,720
And I would tell, you know, I'd
be like, So what do you study?

760
00:41:02,720 --> 00:41:04,560
And I'm like creative writing
and just like, cool.

761
00:41:04,560 --> 00:41:05,560
It's just So what are you
studying?

762
00:41:05,560 --> 00:41:07,000
And I'm like astrophysic
writing.

763
00:41:07,000 --> 00:41:08,400
Oh, that's amazing.
Yeah.

764
00:41:09,800 --> 00:41:13,120
Pretend like you had the first
conversation every time, which

765
00:41:13,120 --> 00:41:18,360
is OK, you know.
But so much you, you, you, you

766
00:41:18,360 --> 00:41:21,240
learn, listen, there, there,
there's no, I, I, we always, I,

767
00:41:21,240 --> 00:41:23,560
I always grew up, I grew up
Orthodox Jewish.

768
00:41:23,560 --> 00:41:28,960
And, you know, and one thing
that that we always had was just

769
00:41:28,960 --> 00:41:32,520
like, you know, the, the, the, I
guess the Jewish perspective is

770
00:41:32,520 --> 00:41:34,600
that the older the people are,
the closer they are to the

771
00:41:34,600 --> 00:41:37,560
original source.
And so the fact that they

772
00:41:37,560 --> 00:41:39,960
deserve, you know, so we didn't
grow up looking at old people

773
00:41:39,960 --> 00:41:42,280
like they're relevant.
We looked at them like, you

774
00:41:42,280 --> 00:41:45,240
know, they've.
Got spiritual source.

775
00:41:45,360 --> 00:41:49,360
Yeah, but the source to like,
like this is where you get your

776
00:41:49,360 --> 00:41:52,560
enlightenment from, you know,
you, you, you hang with, with

777
00:41:52,560 --> 00:41:53,280
them.
Yeah.

778
00:41:53,280 --> 00:41:57,360
And I, you talk about some a
friend of my best friend when I

779
00:41:57,360 --> 00:42:01,160
was 13, I, I talked about her.
I had always wanted to write

780
00:42:01,160 --> 00:42:04,520
about her, about Alma.
I was, she was 80 when I was 13.

781
00:42:04,520 --> 00:42:05,840
And I used to always go to her
house.

782
00:42:05,840 --> 00:42:07,840
So I was never in trouble
because I was always at Alma's

783
00:42:07,840 --> 00:42:10,040
house.
And we used to watch Doctor

784
00:42:10,040 --> 00:42:12,840
Zhivago together.
And she used to tell me she was

785
00:42:12,840 --> 00:42:15,400
like, she lived in Germany
during World War 2.

786
00:42:15,480 --> 00:42:19,480
And so she told me all about
just everything she had

787
00:42:19,480 --> 00:42:23,240
witnessed and experienced.
And so I have stories of that

788
00:42:23,240 --> 00:42:27,680
and in my book too.
And but she taught me about

789
00:42:27,680 --> 00:42:29,360
love.
She was always like, you know,

790
00:42:29,480 --> 00:42:33,880
when and her husband had passed,
but she was like, the love you

791
00:42:33,880 --> 00:42:37,880
have when you meet, like your
husband is going to be so

792
00:42:37,880 --> 00:42:41,160
different than any other love.
I mean, and it was just, again,

793
00:42:41,160 --> 00:42:44,480
I remember like when I first met
my husband, I was like, oh,

794
00:42:44,520 --> 00:42:46,040
that's what she was talking
about.

795
00:42:46,560 --> 00:42:48,040
That's what Alma was talking
about.

796
00:42:49,280 --> 00:42:55,600
You don't know until.
Well, my my friend Mel she she's

797
00:42:55,600 --> 00:42:57,960
been reading my book.
So I was telling you earlier she

798
00:42:58,320 --> 00:43:01,200
wrote this thing and said I was
like, dear God, lady, I just

799
00:43:01,200 --> 00:43:04,240
finished chapter 2 in tears.
This is so moving and then do

800
00:43:04,240 --> 00:43:07,640
not tell Jace, but I secretly
like him as a human.

801
00:43:07,640 --> 00:43:12,400
Now is my husband comes across
as this like very just stiff,

802
00:43:12,680 --> 00:43:16,240
like, you know, he does what he
does, but I have the, I have

803
00:43:16,240 --> 00:43:18,920
these other parts of him that
nobody else does, you know, and,

804
00:43:18,920 --> 00:43:23,960
and, and I think in the book, I
show that, that this other human

805
00:43:23,960 --> 00:43:27,200
that nobody's used to seeing,
you know, this other incredibly

806
00:43:27,200 --> 00:43:33,000
wonderful soft human.
But yeah, so I hope, I hope

807
00:43:33,000 --> 00:43:36,400
people like the book.
I really wrote it for, you know,

808
00:43:36,560 --> 00:43:38,720
caregivers.
I wrote it for anyone who's

809
00:43:38,720 --> 00:43:42,960
struggling with aging.
And, and I wasn't even sure like

810
00:43:43,120 --> 00:43:46,880
how it was going to go, but I
just felt like I need to get

811
00:43:46,880 --> 00:43:53,160
these words out and, and I need
to be as like poetic as I want

812
00:43:53,160 --> 00:43:56,120
to be in it because all I'm used
to writing is like medical

813
00:43:56,120 --> 00:43:58,120
things.
Yeah.

814
00:43:58,400 --> 00:44:00,600
This was definitely a lot more
fun.

815
00:44:00,600 --> 00:44:02,880
And it was heavy and it was also
therapeutic too.

816
00:44:02,880 --> 00:44:05,400
So.
And I thought, you know, what,

817
00:44:05,400 --> 00:44:08,680
if it, if it becomes a great
book and becomes a great book,

818
00:44:08,680 --> 00:44:11,120
and if it it doesn't, that's OK
too.

819
00:44:11,120 --> 00:44:15,560
You know, it was just my way of
honoring the people that have

820
00:44:15,560 --> 00:44:16,840
given me so much.
So.

821
00:44:17,120 --> 00:44:21,600
Yeah.
I wanted to and this is please,

822
00:44:21,680 --> 00:44:24,320
you know, as as much as you feel
comfortable with the talking

823
00:44:24,320 --> 00:44:26,920
about being measured that you
lost your son James.

824
00:44:27,400 --> 00:44:29,600
Yeah.
What can you.

825
00:44:29,880 --> 00:44:32,160
You said that he he that he had
a heart condition.

826
00:44:32,160 --> 00:44:34,880
What how old is he?
What happened as as much as

827
00:44:34,880 --> 00:44:36,640
they're comfortable with.
Yeah, I know.

828
00:44:36,760 --> 00:44:38,120
I'm pretty comfortable talking
about it now.

829
00:44:38,120 --> 00:44:39,960
It was 10 years ago.
He would have just.

830
00:44:40,240 --> 00:44:41,120
Yeah, sorry.
It's.

831
00:44:41,240 --> 00:44:43,920
One of the it's one of the
hardest things we could go

832
00:44:43,920 --> 00:44:46,920
through.
It is, but you know, I think it

833
00:44:46,920 --> 00:44:52,440
was also one of those lessons
that helped me see another side

834
00:44:52,440 --> 00:44:54,920
of medicine and it also helped
me see another side of humanity

835
00:44:54,920 --> 00:45:00,160
because you know, I have always
been super like pro-choice and

836
00:45:00,320 --> 00:45:05,800
doctor physician relationship.
And you know, so when I was it

837
00:45:05,800 --> 00:45:08,960
was my third child.
So I had Mila and Zoe and then

838
00:45:10,080 --> 00:45:15,280
we had it and then we had James.
But we, I went to the hospital

839
00:45:15,920 --> 00:45:18,760
to get my ultrasound.
I was so excited because I had

840
00:45:18,760 --> 00:45:20,920
the other two in medical
training, so I didn't have a

841
00:45:20,920 --> 00:45:26,680
chance to like do all the fun
pregnancy things that moms get

842
00:45:26,680 --> 00:45:28,480
to do.
As I went there and all of a

843
00:45:28,480 --> 00:45:33,600
sudden the radiologist came and
was like your baby's heart like

844
00:45:33,680 --> 00:45:36,440
the apex.
So the the side of the heart is

845
00:45:36,440 --> 00:45:38,240
pointed to the right, it's
supposed to be pointed to the

846
00:45:38,240 --> 00:45:39,360
left.
I was like where are all the

847
00:45:39,360 --> 00:45:41,320
other organs and everything else
was in the right place.

848
00:45:41,320 --> 00:45:44,680
So anyways, he ended up having
this very severe congenital

849
00:45:44,680 --> 00:45:51,520
heart defect called heterotaxy.
And they said that he would he

850
00:45:51,520 --> 00:45:54,760
was fine as long as I carried
him.

851
00:45:54,760 --> 00:45:59,960
But when he was born, he would
have days to months to live.

852
00:46:00,400 --> 00:46:03,080
And then we could opt for some
surgical procedures that were

853
00:46:03,080 --> 00:46:05,640
going to be palliative.
You know, he would have been, he

854
00:46:05,640 --> 00:46:10,840
would have always been sick and
and then if he lived to two, he

855
00:46:10,840 --> 00:46:12,560
could have had tried to have a
heart transplant.

856
00:46:12,560 --> 00:46:15,400
Well, I think my husband and I
had so much.

857
00:46:16,120 --> 00:46:19,120
We read a lot and we did a lot
of research and I think a lot of

858
00:46:19,120 --> 00:46:22,560
like soul searching.
But when we met with the

859
00:46:22,560 --> 00:46:25,600
cardiologist, they were sort of
surprised when we said first

860
00:46:25,600 --> 00:46:27,320
they were like, well, you could
terminate the pregnancy.

861
00:46:27,320 --> 00:46:28,880
And so here's what's
interesting.

862
00:46:28,880 --> 00:46:33,280
You know, here you're like,
like, you know, it was like

863
00:46:33,640 --> 00:46:37,400
these decisions that people have
to make about like life and

864
00:46:37,400 --> 00:46:39,920
termination of life and all this
stuff sort of came into it.

865
00:46:39,920 --> 00:46:41,760
And I was like, what are you
talking about?

866
00:46:41,760 --> 00:46:43,680
Like, why would I terminate my
pregnancy?

867
00:46:43,840 --> 00:46:45,920
You know, they're like, it's not
like, what the heck are you

868
00:46:45,920 --> 00:46:48,400
talking about?
Like, so, you know, we carried

869
00:46:48,400 --> 00:46:51,240
him and then they thought
because I was going to continue

870
00:46:51,240 --> 00:46:55,000
the pregnancy that I was going
to do all these medical things.

871
00:46:55,000 --> 00:46:57,080
And then I was like, what are
you talking about?

872
00:46:57,480 --> 00:46:59,520
It's like, I'm not going to let
him suffer.

873
00:47:00,000 --> 00:47:04,760
I can't do that to him.
And so we took him home.

874
00:47:05,000 --> 00:47:11,480
And you know, the only time I
saw my husband cry was our

875
00:47:11,480 --> 00:47:14,960
pastor came to the hospital and
baptized him there because we

876
00:47:14,960 --> 00:47:18,600
don't know how long we had that
was that was really awesome.

877
00:47:18,600 --> 00:47:23,280
And then we took him home and
eight weeks.

878
00:47:23,280 --> 00:47:27,000
So he lived 8 weeks and he, he
died at home.

879
00:47:27,000 --> 00:47:35,040
And, and then I, it just, I
think I, I learned so much about

880
00:47:35,040 --> 00:47:40,320
myself and I learned so much
about, you know, how I need to

881
00:47:40,320 --> 00:47:43,280
be sensitive in a different way
just because I, I perceive

882
00:47:43,280 --> 00:47:45,440
things in a certain way as a
physician.

883
00:47:45,680 --> 00:47:50,480
So I think he definitely changed
the way I practice medicine.

884
00:47:50,720 --> 00:47:54,440
But then also, like I had said,
my patients had sort of prepared

885
00:47:54,440 --> 00:47:56,520
me for all this, all the lessons
they had taught me.

886
00:47:56,880 --> 00:48:01,680
And after he had died, sometimes
I you, you question like, what

887
00:48:01,680 --> 00:48:03,080
did I do?
Did I do the right thing?

888
00:48:03,080 --> 00:48:05,080
Should he have done all these
surgical procedures?

889
00:48:05,440 --> 00:48:07,960
And I ended up talking to a mom
who had had a kid who had

890
00:48:07,960 --> 00:48:11,560
heterotoxy who passed away.
And she's just sort of crying.

891
00:48:11,560 --> 00:48:13,680
And I said, are you OK?
And we were just talking.

892
00:48:13,880 --> 00:48:15,280
Her son passed.
My son passed.

893
00:48:15,800 --> 00:48:20,320
And she said, I, I did all the
medical things and I spent so

894
00:48:20,320 --> 00:48:25,240
much time being his nurse that I
never got a chance to be his

895
00:48:25,240 --> 00:48:27,480
mother.
And you had every minute you

896
00:48:27,480 --> 00:48:30,480
spent with him, you were his
mother.

897
00:48:30,560 --> 00:48:34,960
And we did, we took him on hay
rides to see the Easter Bunny to

898
00:48:34,960 --> 00:48:38,600
the bar with his cousins, little
4 LB baby and her like, you

899
00:48:38,600 --> 00:48:39,920
know, I'm like, you're going to
live it up.

900
00:48:39,920 --> 00:48:41,800
I don't know how long you're
going to live, but you're going

901
00:48:41,800 --> 00:48:46,080
to live your life up, kid.
And it was, it was really cool.

902
00:48:46,080 --> 00:48:48,880
It was incredible.
And then, yeah, you know, and

903
00:48:49,080 --> 00:48:51,960
you also learn how much like,
like I learned how much my

904
00:48:51,960 --> 00:48:54,760
husband loves me because we were
at the doctor and they were

905
00:48:54,760 --> 00:48:57,680
like, we shouldn't have another
pregnancy because you have these

906
00:48:57,680 --> 00:49:00,160
complications.
And I'm like, well, you know, we

907
00:49:00,160 --> 00:49:02,520
could probably have another baby
after James.

908
00:49:02,520 --> 00:49:05,880
And, and he was like, she will
never have another pregnant.

909
00:49:05,920 --> 00:49:09,040
You know, when he thinks like he
thought my life was at risk and

910
00:49:09,040 --> 00:49:11,240
I was like, wow, he really loves
me.

911
00:49:11,240 --> 00:49:15,200
That's so sweet.
And you know, but then we got

912
00:49:15,200 --> 00:49:19,040
involved with foster care and
after that and we were doing

913
00:49:19,040 --> 00:49:24,800
respite foster care and somehow
again, like life works out the

914
00:49:24,800 --> 00:49:27,560
way that works out.
You know, we, we ended up with

915
00:49:27,560 --> 00:49:31,400
Peyton in our life and, and we
were able to adopt her.

916
00:49:31,400 --> 00:49:33,960
And so I ended up somehow with
three anyways.

917
00:49:35,200 --> 00:49:40,480
And you know, you just kind of
like, I think that's the other

918
00:49:40,800 --> 00:49:45,360
part that I I talk about in my
book too, is like I had just

919
00:49:45,360 --> 00:49:48,160
planned my entire lifeout since
I was 6, like I'm going to do

920
00:49:48,160 --> 00:49:49,920
this by this time and this by
this time.

921
00:49:49,920 --> 00:49:52,360
And even if things didn't work
out a little bit, I still

922
00:49:52,360 --> 00:49:56,480
figured it out and everything
still stuck to my calendar until

923
00:49:56,800 --> 00:50:01,040
like the the world God and
everything that all the powers

924
00:50:01,040 --> 00:50:05,080
that be were like, no, no, life
doesn't work out that way.

925
00:50:05,360 --> 00:50:09,840
You go with the flow like you
have to you know, you you can't

926
00:50:09,840 --> 00:50:12,960
do that.
And and that was, you know, it

927
00:50:12,960 --> 00:50:15,680
takes, it takes like 37 years
for me to have that lesson,

928
00:50:15,720 --> 00:50:21,120
which was pretty incredible.
I'm kind of thankful for it.

929
00:50:21,480 --> 00:50:26,400
But but even now, you know, and
I think that it just changed who

930
00:50:26,400 --> 00:50:28,480
I am.
And yeah, I don't sometimes I'm

931
00:50:28,480 --> 00:50:32,440
like so inappropriate because I
was in a patient's room the

932
00:50:32,440 --> 00:50:34,600
other day in the hospital and
I'm wearing jeans because they

933
00:50:34,600 --> 00:50:36,760
end up in the hospital.
I just went because I didn't

934
00:50:36,760 --> 00:50:39,040
know.
And I have my head be on the

935
00:50:39,040 --> 00:50:42,200
bed, like my legs were up.
And the nurse came in like, who

936
00:50:42,200 --> 00:50:43,600
are you?
And I showed him my doctor

937
00:50:43,600 --> 00:50:45,160
badge.
Like they thought I was the

938
00:50:45,160 --> 00:50:47,240
patient's daughter.
I was like, well, I kind of am.

939
00:50:47,280 --> 00:50:48,840
I'm their advocate.
I'm.

940
00:50:49,160 --> 00:50:52,000
I was taking the charts, seeing
what was going on, you know, and

941
00:50:52,600 --> 00:50:57,120
and then, yeah, he helped me, I
think be more human than

942
00:50:57,120 --> 00:50:59,320
anything any other time in my
life.

943
00:51:00,280 --> 00:51:03,800
So I just let things go now.
It's incredible that you can,

944
00:51:03,800 --> 00:51:06,440
that you, I mean, you know, I
mean, I, I don't know what the

945
00:51:06,440 --> 00:51:08,880
alternative is.
And I know the alternative is,

946
00:51:08,880 --> 00:51:15,280
but I mean it's incredible that
you like that you, you're able

947
00:51:15,280 --> 00:51:18,600
to, you're able to turn it into,
meaning you're able to turn it

948
00:51:18,600 --> 00:51:21,920
into, into something tangible
that you take with you.

949
00:51:21,920 --> 00:51:27,800
You know, I, I did, I, you know,
I guess I, I did a breath work

950
00:51:27,800 --> 00:51:29,480
class.
My wife had encouraged me to try

951
00:51:29,480 --> 00:51:34,840
1 and it was more of that like
and I breathe out until you, you

952
00:51:35,440 --> 00:51:38,960
know, I was in and exhale and I
wanted to and I've done

953
00:51:38,960 --> 00:51:41,240
psychedelics before.
So I was a little familiar with,

954
00:51:41,640 --> 00:51:43,760
with, you know, the kind of
place that I was supposed to end

955
00:51:43,760 --> 00:51:49,160
up at.
And, and I at this point, I've

956
00:51:49,160 --> 00:51:50,600
been a father, this is probably
a year ago now.

957
00:51:50,600 --> 00:51:52,040
And I've been a father for two
years.

958
00:51:52,440 --> 00:51:55,840
And I was still struggling with
the idea of me being a father.

959
00:51:55,840 --> 00:51:58,840
And I was not, I don't think I
was still, I still, I still

960
00:51:58,840 --> 00:52:01,320
thought of myself and I'm still
transitioning in my head from

961
00:52:01,320 --> 00:52:04,960
thinking myself as like a kid
and a teenager to being like a

962
00:52:04,960 --> 00:52:08,160
dad that's responsible for, you
know, for two kids right now

963
00:52:08,160 --> 00:52:14,240
and, and a home and a wife and a
family and, and my grandfather

964
00:52:14,240 --> 00:52:16,720
and my grandfather had just
passed away, you know, a couple

965
00:52:16,720 --> 00:52:20,720
months earlier.
And I was doing this deep

966
00:52:20,720 --> 00:52:24,080
breathing and I, I, I swear to
God, I felt his soul.

967
00:52:25,160 --> 00:52:28,560
And he was like the father
figure kind of role of my life.

968
00:52:28,560 --> 00:52:31,440
My dad, who I work with, I'm
very, very close with, is always

969
00:52:31,440 --> 00:52:32,960
more of like a friend.
Yeah.

970
00:52:32,960 --> 00:52:36,680
And he didn't, like, he wasn't
the authoritative father figure

971
00:52:36,680 --> 00:52:39,760
that, like, you look up and say,
like, this is a dad.

972
00:52:39,760 --> 00:52:41,560
You'd be like, oh, this is like,
this is my dad.

973
00:52:41,760 --> 00:52:42,800
Love him.
He's funny.

974
00:52:42,920 --> 00:52:45,080
Yeah, he's cute.
My grandfather was like, you

975
00:52:45,080 --> 00:52:47,280
know, like this Holocaust
survivor and like, you know,

976
00:52:47,280 --> 00:52:50,080
strict, strict but loving and
has priority set straight.

977
00:52:50,400 --> 00:52:54,560
So, you know, I'm doing this
breathing.

978
00:52:54,560 --> 00:52:59,600
And like he came to me and like,
and I was just like sitting with

979
00:52:59,600 --> 00:53:04,000
his presence.
And it just helped me process

980
00:53:04,000 --> 00:53:09,280
for a minute like, hey, like he
was scared and he made it and

981
00:53:09,280 --> 00:53:13,040
you were scared and like your
life is a total breeze and like

982
00:53:13,040 --> 00:53:15,200
you're going to be fine.
And like he's with you.

983
00:53:15,200 --> 00:53:17,760
And like, like, you know, like
you have the direction and you

984
00:53:17,760 --> 00:53:22,000
have the people and like, and,
and almost felt like it almost

985
00:53:22,000 --> 00:53:25,800
came to a little bit of some
kind of resolution, some kind of

986
00:53:25,800 --> 00:53:28,160
spiritual resolution that I
really, really felt like, and I

987
00:53:28,160 --> 00:53:30,560
felt like, you know, he had to
be acknowledged that like he

988
00:53:31,000 --> 00:53:32,880
behaved a lot of the way that he
did a lot of time because he was

989
00:53:32,880 --> 00:53:36,040
afraid and frustrated.
And, you know, I and I had to

990
00:53:36,040 --> 00:53:38,680
come to the conclusion like I,
it was a fearful kid.

991
00:53:38,680 --> 00:53:40,560
And I don't have to be a fearful
kid anymore.

992
00:53:40,560 --> 00:53:44,120
I could just be a dad now that
like learns from his grandfather

993
00:53:44,120 --> 00:53:47,120
how to be a dad and like you
learns and like, and what's

994
00:53:47,120 --> 00:53:50,520
incredible is what's you've
taken that lesson from, you

995
00:53:50,520 --> 00:53:55,000
know, the elderly community and
applied it to your life and a

996
00:53:55,000 --> 00:53:57,920
child and, and child like, you
know, like, which you would

997
00:53:57,920 --> 00:54:01,240
imagine is the total opposite.
But I feel like they, the wisdom

998
00:54:01,240 --> 00:54:04,640
is so deep that and, and they,
they, they have to cross, you

999
00:54:04,640 --> 00:54:07,760
know, like they, they
definitely, you know, they,

1000
00:54:07,800 --> 00:54:09,880
they, they, they, they flow into
one another.

1001
00:54:09,880 --> 00:54:13,400
And, and if you're willing to if
and you look and it sounds like

1002
00:54:13,400 --> 00:54:16,400
you're, you've been able to
accept it from either end, you

1003
00:54:16,400 --> 00:54:18,480
know, from learning from the
youth and learning from the

1004
00:54:18,480 --> 00:54:22,120
elderly.
And it's, it's extremely,

1005
00:54:22,120 --> 00:54:24,560
extremely admirable and it's
really, really beautiful to be

1006
00:54:24,560 --> 00:54:27,440
able to just even listen about
and hear about.

1007
00:54:27,440 --> 00:54:32,360
So I really, really, I give you
so much credit for for choosing

1008
00:54:32,360 --> 00:54:34,240
to handle things in the way that
you do.

1009
00:54:35,200 --> 00:54:37,480
Which, you know, it's really
interesting being on this

1010
00:54:37,480 --> 00:54:41,320
podcast with you because like
you're, you know, looking at

1011
00:54:41,320 --> 00:54:44,280
you're like, you're obviously
like younger, yes, young family

1012
00:54:44,440 --> 00:54:49,120
and, but like, and culturally,
like after having this

1013
00:54:49,120 --> 00:54:52,200
conversation with you, like wow,
we are like a lot alike, you

1014
00:54:52,200 --> 00:54:59,800
know, as far which like, I think
we've, I think like we've, we've

1015
00:54:59,800 --> 00:55:01,560
lost that.
Do you know what I mean?

1016
00:55:01,560 --> 00:55:04,000
Like I, I wish we would have
more of that.

1017
00:55:04,000 --> 00:55:08,440
And, and, and I, and I love that
you can talk about this because

1018
00:55:08,440 --> 00:55:11,400
I do think like you being
younger, you can definitely be

1019
00:55:11,400 --> 00:55:17,840
like this amazing role model for
your peers, you know, because

1020
00:55:18,040 --> 00:55:19,320
I'm like, I know how.
Role model.

1021
00:55:19,840 --> 00:55:22,240
I've encouraged them.
To you know, it's.

1022
00:55:22,520 --> 00:55:24,440
I am, you know, I'm just a
regular dude.

1023
00:55:24,440 --> 00:55:26,400
I, I don't think, I don't think
myself very highly at all.

1024
00:55:26,520 --> 00:55:27,640
I think a lot of people are
working.

1025
00:55:27,760 --> 00:55:30,720
Like, you know, it's like you're
when you're some someone who's

1026
00:55:30,720 --> 00:55:32,440
like relatable.
Like if you, you know someone

1027
00:55:32,440 --> 00:55:36,640
who's like, OK, no, like I, I
can relate to you in this sense.

1028
00:55:36,640 --> 00:55:42,120
You know, just like, I think I'm
like mid career women are

1029
00:55:42,160 --> 00:55:45,320
struggling with some of the same
things I'm struggling with.

1030
00:55:45,320 --> 00:55:51,600
Can like relate to me, you know,
and it's like, so, you know, but

1031
00:55:51,600 --> 00:55:56,080
but what's cool is every stage
is like beautiful and every

1032
00:55:56,080 --> 00:56:00,720
stage is just like, embrace it
because you're going to lose it

1033
00:56:00,720 --> 00:56:05,440
even with your babies.
Like, Oh my gosh, like I, I keep

1034
00:56:05,440 --> 00:56:08,280
looking at Mila's pictures when
she was a baby and I'm like, Oh

1035
00:56:08,280 --> 00:56:12,040
my gosh, I've got this like big
teenager that's taller than me

1036
00:56:12,040 --> 00:56:16,760
and like, where did that go?
So I don't, I don't know.

1037
00:56:16,760 --> 00:56:21,520
I feel like our life is so, is
so short and we're so lucky to

1038
00:56:21,520 --> 00:56:25,480
be alive, you know, and, and
we're so lucky to, to get to

1039
00:56:25,480 --> 00:56:27,560
experience life.
And I think we shouldn't take it

1040
00:56:27,560 --> 00:56:30,320
for granted.
I think that's what elders teach

1041
00:56:30,320 --> 00:56:33,320
us.
Yeah, and I think it goes hand

1042
00:56:33,320 --> 00:56:34,960
in hand with everything we've
been talking about.

1043
00:56:34,960 --> 00:56:37,360
When you love your life, you
want to take care of it, you

1044
00:56:37,360 --> 00:56:40,880
want to, you want to cherish it.
And like, I mean, I, I've had, I

1045
00:56:40,880 --> 00:56:42,720
had friends that just came over
and they're a little bit

1046
00:56:42,720 --> 00:56:47,440
helicopter parents either first
times and they are, you know,

1047
00:56:47,440 --> 00:56:50,800
and like, you know, we, we, we
understand, like I like, you

1048
00:56:50,800 --> 00:56:52,280
don't want that person to get
hurt.

1049
00:56:52,280 --> 00:56:55,160
You like you don't want it and
you know, you want to protect

1050
00:56:55,160 --> 00:56:56,360
them.
But at a certain point, like,

1051
00:56:56,360 --> 00:56:58,520
you know, there's a great book,
The Anxious Generation by

1052
00:56:58,520 --> 00:57:01,000
Jonathan Haidt.
Shot a great book, yes.

1053
00:57:01,640 --> 00:57:04,160
It's the most important book
I've read other than any

1054
00:57:04,160 --> 00:57:07,000
religious book I've read.
I like that book is like.

1055
00:57:07,360 --> 00:57:10,200
It's transformational.
It's a fantastic book, yes.

1056
00:57:10,960 --> 00:57:12,080
I read.
Everyone should read it.

1057
00:57:12,640 --> 00:57:16,280
I mean, he's, he's an incredible
social psychologist.

1058
00:57:16,640 --> 00:57:19,360
But what was the other book he
wrote that I read first?

1059
00:57:19,360 --> 00:57:23,360
But he's, he's incredible, yeah.
Another favorite He wrote a

1060
00:57:23,360 --> 00:57:25,600
book, The Coddling of the
American Mind, too.

1061
00:57:26,800 --> 00:57:28,640
That wasn't the one I was
thinking about something.

1062
00:57:28,840 --> 00:57:31,440
I mean, I was thinking about the
Dan Ariely book and it was like,

1063
00:57:31,720 --> 00:57:37,200
it's it's hard to remember which
one, but he's so smart and he's

1064
00:57:37,200 --> 00:57:39,960
so right on.
You know, like 10 years ago I

1065
00:57:39,960 --> 00:57:42,920
was like telling my in laws
like, don't let don't let Mila

1066
00:57:42,920 --> 00:57:44,800
on this phone.
It's going to give her ADD.

1067
00:57:44,880 --> 00:57:48,080
And now you're like up.
Sia told you all the studies are

1068
00:57:48,120 --> 00:57:52,480
up too late now.
Yeah, that's it.

1069
00:57:52,560 --> 00:57:53,680
It's gone.
It's gone.

1070
00:57:53,680 --> 00:57:55,560
I have it too.
I have it too.

1071
00:57:55,560 --> 00:57:57,920
I've been hit, I've been hit.
I'm addicted.

1072
00:57:57,920 --> 00:58:01,960
I'm addicted for sure.
I wanted, I wanted to, I wanted

1073
00:58:01,960 --> 00:58:04,840
to ask you because my wife was
really excited when I was

1074
00:58:04,840 --> 00:58:07,520
preparing for this.
I was, I was talking through, I

1075
00:58:07,520 --> 00:58:09,880
was going through your website
with her and we're talking a

1076
00:58:09,880 --> 00:58:14,040
little bit about de prescribing
because I think that, you know,

1077
00:58:14,040 --> 00:58:16,880
we talked about the American
pharmaceutical treadmill that

1078
00:58:16,880 --> 00:58:19,760
people are on where you always
on it and it just keeps on.

1079
00:58:19,760 --> 00:58:21,840
It keeps on chugging along and
like no matter what you're

1080
00:58:21,840 --> 00:58:23,800
doing, it's just always tagging
more on it's.

1081
00:58:23,800 --> 00:58:26,160
Never taken more.
Yeah, exactly.

1082
00:58:26,160 --> 00:58:29,160
And so how do you go?
I'd like to hear how you go

1083
00:58:29,160 --> 00:58:34,240
about de prescribing.
And I think that a lot of this

1084
00:58:34,240 --> 00:58:36,200
stuff does not just exist in a
vacuum.

1085
00:58:36,200 --> 00:58:39,800
If it applies for geriatric, I'm
sure it applies for, you know,

1086
00:58:40,040 --> 00:58:41,640
young adults.
I'm sure it applies for

1087
00:58:41,640 --> 00:58:43,480
middle-aged people, I'm sure it
applies for youthe.

1088
00:58:43,480 --> 00:58:47,040
So what are some things that
you've learned about the process

1089
00:58:47,040 --> 00:58:50,960
of de prescribing people and
what replaces that?

1090
00:58:51,920 --> 00:58:55,640
So when people this is how I am,
I, I see medicine, you know,

1091
00:58:55,640 --> 00:58:58,560
you're like in your 40s, your
blood pressure goes a little

1092
00:58:58,560 --> 00:59:01,960
high, you start to get a little
blood pressure medication.

1093
00:59:02,320 --> 00:59:05,920
Do you know?
And then cholesterol goes up and

1094
00:59:05,920 --> 00:59:09,000
you get a little bit of a my
little my middle child just

1095
00:59:09,000 --> 00:59:14,000
wanted, but you're you're you're
Hey, Zoe, you're you're.

1096
00:59:14,600 --> 00:59:18,800
Well, good, yes.
OK, so in your 40s, you take a

1097
00:59:18,800 --> 00:59:22,760
little bit of medication,
another one for cholesterol, and

1098
00:59:22,760 --> 00:59:26,240
then your blood sugar goes up,
they give you something else and

1099
00:59:26,240 --> 00:59:29,000
then you have a side effect from
the cholesterol medication or

1100
00:59:29,000 --> 00:59:31,800
the blood pressure medication.
So you get on something else.

1101
00:59:31,800 --> 00:59:34,720
You know that we call that the
the prescribing cascade where

1102
00:59:34,720 --> 00:59:37,440
they, you know, you end up on
another medication for the side

1103
00:59:37,440 --> 00:59:39,280
effect.
So like on a nausea medicine now

1104
00:59:39,280 --> 00:59:41,840
because you have nausea from
another medication, he's like

1105
00:59:41,840 --> 00:59:46,480
the time you're like 60, you're
all of a sudden I'm like 6 to 10

1106
00:59:46,480 --> 00:59:49,720
medications.
And we consider polypharmacy is

1107
00:59:49,720 --> 00:59:52,240
when you take a lot of
medications and then and there's

1108
00:59:52,240 --> 00:59:55,360
like over 110 definitions of
polypharmacy, but the most

1109
00:59:55,360 --> 00:59:57,360
common one is 5 or more
medications.

1110
00:59:57,800 --> 01:00:01,520
And, you know, as we age, the
way we take a medication and the

1111
01:00:01,520 --> 01:00:04,800
way that medication is
distributed, the way it's

1112
01:00:04,800 --> 01:00:07,760
metabolized and eliminated from
our body changes because our

1113
01:00:07,760 --> 01:00:11,640
body changes, You know, our skin
changes, our kidney changes, our

1114
01:00:11,640 --> 01:00:15,720
liver changes.
And, and, and so we have to, as

1115
01:00:15,720 --> 01:00:19,360
a geriatrician, we have to think
about, well, is this medication

1116
01:00:19,360 --> 01:00:22,680
still appropriate?
And so when I see a patient, is

1117
01:00:22,680 --> 01:00:24,800
this medication still
appropriate for their kidney

1118
01:00:24,800 --> 01:00:26,840
function?
Is this medication still

1119
01:00:26,840 --> 01:00:29,800
appropriate for like primary
prevention?

1120
01:00:29,960 --> 01:00:33,480
Is the risk of prescribing it,
you know, is the benefit

1121
01:00:33,480 --> 01:00:37,000
outweigh that risk?
And, and thinking about side

1122
01:00:37,000 --> 01:00:39,160
effects that they were, they're
experiencing.

1123
01:00:39,400 --> 01:00:42,440
And I kid you not, I had a
patient in my office who came in

1124
01:00:42,880 --> 01:00:45,720
who I was testing in like the
moderate dementia stage.

1125
01:00:45,960 --> 01:00:49,240
I took her off of half her
medications over a six month

1126
01:00:49,240 --> 01:00:52,960
period and she tested in the
normal cognitive range.

1127
01:00:53,120 --> 01:00:59,280
So she was and, and I mean, this
was like the classic, I cannot

1128
01:00:59,280 --> 01:01:02,160
believe they.
So she was able to drive again

1129
01:01:02,160 --> 01:01:05,200
and she was about to move in
with her son and she was able to

1130
01:01:05,200 --> 01:01:07,920
go back home.
I mean this is I mean I.

1131
01:01:08,640 --> 01:01:11,800
Prescribing.
Yes, and I think, you know, and

1132
01:01:11,800 --> 01:01:15,800
then these some of these are
like extreme cases, but you

1133
01:01:15,800 --> 01:01:20,440
know, we, we have to really be
as a, as a good doctor, we think

1134
01:01:20,440 --> 01:01:22,760
about prescribing, but we have
to equally think about de

1135
01:01:22,760 --> 01:01:24,720
prescribing.
Now when we think about younger

1136
01:01:24,720 --> 01:01:28,080
people.
So if that young person before

1137
01:01:28,080 --> 01:01:31,840
they were placed on their blood
pressure medication, what was

1138
01:01:31,840 --> 01:01:33,920
the reason for their blood
pressure issue?

1139
01:01:34,120 --> 01:01:36,640
Was it because of their weight?
Do we need to think about weight

1140
01:01:36,640 --> 01:01:38,760
management?
Is it because of, you know,

1141
01:01:38,760 --> 01:01:40,680
stressors and they're like
cortisol at all levels?

1142
01:01:40,680 --> 01:01:43,360
Is it because of hormone levels?
Like you have to kind of think

1143
01:01:43,360 --> 01:01:46,920
about this person holistically,
You know, is it a genetic?

1144
01:01:46,920 --> 01:01:50,480
Is it a genetic factor?
Is it a kidney factor?

1145
01:01:50,480 --> 01:01:52,360
So really I'm thinking about
that.

1146
01:01:52,360 --> 01:01:56,040
And then if we can sort of
address the underlying issue

1147
01:01:56,040 --> 01:01:59,840
before we prescribe that
medication and see if we can get

1148
01:02:00,200 --> 01:02:02,360
and achieve the goal that we
need without the prescription

1149
01:02:02,360 --> 01:02:03,720
medication.
And sometimes we need the

1150
01:02:03,720 --> 01:02:05,960
prescription medication.
I mean, medicine is cool.

1151
01:02:06,680 --> 01:02:11,800
It's we've created all sorts of
awesome things, but sometimes we

1152
01:02:11,800 --> 01:02:15,240
go overboard.
So, you know, if the cholesterol

1153
01:02:15,400 --> 01:02:19,880
example, you know, can we lower
the cholesterol by by thinking

1154
01:02:19,880 --> 01:02:23,160
about a more plant based diet?
And every time people are like,

1155
01:02:23,320 --> 01:02:26,840
why can't I can't be a vegan,
you know, or I don't ever tell

1156
01:02:26,840 --> 01:02:30,360
them you need a ketogenic diet
And they're like, I can't just

1157
01:02:30,360 --> 01:02:32,280
eat meat.
And I'm like, no, my husband is

1158
01:02:32,280 --> 01:02:34,360
a vegan and he eats a ketogenic
diet.

1159
01:02:34,360 --> 01:02:38,520
Like it's not about meat and
it's not about, you know, he

1160
01:02:38,520 --> 01:02:41,520
gets plenty of protein.
I can't.

1161
01:02:41,520 --> 01:02:43,200
I eat what is.
Different protein.

1162
01:02:43,400 --> 01:02:45,000
What is what does he, what does
he get for?

1163
01:02:45,240 --> 01:02:48,800
What food does he eat for that?
So lots of soy, like I would say

1164
01:02:48,800 --> 01:02:53,800
tempeh and, and like lots of
beans, you know, and I make like

1165
01:02:54,120 --> 01:03:02,680
these alternative common foods,
like I'll make like a falafel,

1166
01:03:02,680 --> 01:03:07,160
but it has like walnuts in it
and nutritional yeast and you

1167
01:03:07,160 --> 01:03:10,280
know, and I'll, it's, it's baked
and not fried.

1168
01:03:10,280 --> 01:03:14,040
And, and then we eat like very
good, like like good oils, you

1169
01:03:14,040 --> 01:03:15,880
know, not seed oils.
Those are inflammatory.

1170
01:03:16,240 --> 01:03:19,120
But yeah, like great.
Like good olive.

1171
01:03:19,120 --> 01:03:24,000
Like it's so it's, yeah, I mean,
that's, that's a lot of a lot of

1172
01:03:24,080 --> 01:03:27,320
lots of nuts.
And, and you know, sometimes

1173
01:03:27,320 --> 01:03:31,320
I'll make stews and mix a lot of
nuts in there or it's and my, my

1174
01:03:31,320 --> 01:03:33,520
elder patients that they're
like, I'm going to go vegan.

1175
01:03:33,520 --> 01:03:36,680
Like you are not going to go
vegan because you are going to

1176
01:03:37,400 --> 01:03:40,280
get sick.
We haven't been sick many years

1177
01:03:40,760 --> 01:03:43,320
to, you know, to get to a place
where you're meeting your macro

1178
01:03:43,320 --> 01:03:46,480
micronutrients, but I can help
you get more plant based, you

1179
01:03:46,480 --> 01:03:50,520
know, and and still maintain
that and lots, you know, lots of

1180
01:03:50,520 --> 01:03:55,160
vegetables and you know, it's
it's not hard it, but it is

1181
01:03:55,160 --> 01:03:58,480
hard, you know it.
You have to have like someone

1182
01:03:58,480 --> 01:04:02,760
who's patient with you.
And so like I had a guy kind of

1183
01:04:02,760 --> 01:04:05,880
leave you with this big one, but
came to me depressed because

1184
01:04:05,880 --> 01:04:09,160
wife had died, didn't know how
to cook was like 304 lbs.

1185
01:04:09,440 --> 01:04:12,440
The sweet man.
So didn't like had gained all

1186
01:04:12,440 --> 01:04:14,880
this weight, diabetes was out of
control, blood pressure was out

1187
01:04:14,880 --> 01:04:17,440
of control.
And, and I had, I told them, I

1188
01:04:17,440 --> 01:04:20,120
said, listen, we're going to
make some changes.

1189
01:04:20,320 --> 01:04:22,720
But for the next three weeks,
every time you go to the grocery

1190
01:04:22,720 --> 01:04:24,800
store, I need you to call me.
I'm going to show you how to

1191
01:04:24,800 --> 01:04:26,640
read food labels.
So we did.

1192
01:04:26,640 --> 01:04:29,360
I showed him how to read food
labels, how to prep food, how to

1193
01:04:29,360 --> 01:04:32,520
make food.
So over 2 years he went from 304

1194
01:04:32,520 --> 01:04:37,240
lbs to 240 lbs.
And that was, do you have that,

1195
01:04:37,600 --> 01:04:39,120
do you have this process on your
blog?

1196
01:04:39,160 --> 01:04:42,800
Like, do you have this like in a
commonly available, accessible

1197
01:04:42,800 --> 01:04:46,600
way that like anyone could like
take a look at this because like

1198
01:04:46,680 --> 01:04:49,840
we care about, I think young,
the young, young, the generation

1199
01:04:49,840 --> 01:04:51,320
cares about health nowadays.
They really.

1200
01:04:51,320 --> 01:04:56,080
Do I know I love that too.
So I'm I'm writing this book

1201
01:04:56,280 --> 01:04:59,720
because all this stuff is like
kind of mish mashed in my blog

1202
01:04:59,720 --> 01:05:02,960
post because and in the blog
post come from a patient asks me

1203
01:05:02,960 --> 01:05:05,720
a question and I'm like, oh, I
need to write about this.

1204
01:05:05,880 --> 01:05:07,920
You know, I got to I got to make
sure they have access to this

1205
01:05:07,920 --> 01:05:09,680
information.
And then I'm in the office and

1206
01:05:09,680 --> 01:05:11,880
I'm like, oh, hey, you need your
Omega threes.

1207
01:05:11,880 --> 01:05:15,440
Here are your plant based Omega
threes and here are your animal

1208
01:05:15,440 --> 01:05:17,200
mice Omega threes.
Print out the thing.

1209
01:05:17,200 --> 01:05:20,080
Here's the blog post.
But I'm writing this book now.

1210
01:05:20,080 --> 01:05:22,240
I'm actually on the very last
part, the H the habit.

1211
01:05:22,240 --> 01:05:26,560
So I try to like package it all.
So it is in this like sequence.

1212
01:05:27,000 --> 01:05:31,080
But you can find like all this
information on jerryacademy.com

1213
01:05:31,280 --> 01:05:33,640
and and the blogs not for old
people.

1214
01:05:33,640 --> 01:05:36,560
It's for everybody, you know,
who's who thinks about their

1215
01:05:36,560 --> 01:05:39,000
aging and we should think about
our aging and like our second,

1216
01:05:39,280 --> 01:05:43,440
third decade of life, not just
like when we're 50 and 60.

1217
01:05:43,520 --> 01:05:47,240
We've lost all that time, you
know, So I, I love how younger

1218
01:05:47,240 --> 01:05:51,280
people are thinking about it.
I mean, my 15 year old measures

1219
01:05:51,640 --> 01:05:54,840
her food and kind of
obsessively, but in a really

1220
01:05:54,840 --> 01:05:56,680
healthy way.
She makes her lunch every day,

1221
01:05:56,920 --> 01:05:59,640
but make sure she has like, she
measures everything that she

1222
01:05:59,640 --> 01:06:02,120
puts in there, you know, and I'm
like, this is, this is kind of

1223
01:06:02,120 --> 01:06:06,360
good.
OK, Maybe like the OCD parents,

1224
01:06:06,360 --> 01:06:10,960
the Type A parents have, you
know, done that to her.

1225
01:06:11,720 --> 01:06:14,440
But it's OK, you know it.
But you know, yeah, all of this

1226
01:06:14,440 --> 01:06:16,280
stuff, you could kind of, you
can find it in the blog.

1227
01:06:16,280 --> 01:06:20,040
There's like healthy things and
I and I keep adding more to it.

1228
01:06:20,560 --> 01:06:24,880
But, yeah, I'm hoping I have to
find, like, a literary agent

1229
01:06:24,880 --> 01:06:28,920
first for this book to see if I
can get, like, what as far as,

1230
01:06:28,920 --> 01:06:31,440
like, publication goes.
But I just was like, I got to

1231
01:06:31,440 --> 01:06:33,040
start writing this.
And.

1232
01:06:34,080 --> 01:06:36,960
But all the information is like,
in bits and pieces in the blog.

1233
01:06:36,960 --> 01:06:39,560
You just, like, look for the
thing you want to look up.

1234
01:06:39,800 --> 01:06:42,360
But yeah, he got a dog.
He ended up walking.

1235
01:06:42,360 --> 01:06:44,280
He ended up moving closer to his
daughters.

1236
01:06:44,560 --> 01:06:47,320
Like, this was all
transformative, you know, after

1237
01:06:47,320 --> 01:06:51,160
losing 60 lbs and he was
continuing to lose weight.

1238
01:06:51,160 --> 01:06:54,360
But, you know, it was, it wasn't
hard.

1239
01:06:54,360 --> 01:06:56,400
Somebody just needed to teach
him what to do.

1240
01:06:57,000 --> 01:07:00,640
Yeah, I I totally agree.
I, I have AI have a group of dad

1241
01:07:00,640 --> 01:07:06,640
friends around here and you know
where I live and you know, I and

1242
01:07:06,640 --> 01:07:10,800
when I have one particular
friend who since I've met him a

1243
01:07:10,800 --> 01:07:13,920
couple of years ago, probably
lost 150 lbs without

1244
01:07:13,920 --> 01:07:16,800
exaggerating.
And no one ever like told him

1245
01:07:16,800 --> 01:07:19,360
that he was overweight And like
he never had, like he told me he

1246
01:07:19,360 --> 01:07:21,120
had a, you know, a doctor was
like, Hey, you got to be

1247
01:07:21,120 --> 01:07:24,200
careful.
But what happened, I think was

1248
01:07:24,600 --> 01:07:28,120
he became, he became friends
with me and a couple other guys

1249
01:07:28,120 --> 01:07:30,320
that do exercise a lot and just
talk about it.

1250
01:07:30,440 --> 01:07:32,520
You know, we just talk about
like, we like really talk about

1251
01:07:32,520 --> 01:07:34,520
how good we feel and how it's
part of our everyday schedule.

1252
01:07:34,520 --> 01:07:36,800
And then, and then, and then,
you know, we have a group chat

1253
01:07:36,800 --> 01:07:38,720
and he's, you know, and then he
started sending like, you know,

1254
01:07:38,720 --> 01:07:42,160
the videos of, of people jogging
and like, you know, so one day I

1255
01:07:42,160 --> 01:07:44,240
got a random Tuesday, someone's
in the video of them jogging.

1256
01:07:44,240 --> 01:07:47,200
And then within the next hour or
two, everyone else in the video

1257
01:07:47,200 --> 01:07:48,920
of them, Hey, you know what, I
have 20 minutes now.

1258
01:07:48,920 --> 01:07:50,520
Let me get up and let me work
out for a little bit.

1259
01:07:50,520 --> 01:07:54,040
And like, I think that he's also
such such an integral part of,

1260
01:07:54,400 --> 01:07:57,840
of health as far as building
habits and encouraging healthy

1261
01:07:57,840 --> 01:08:02,240
habits, because a habit, you
know, it's hard to build when

1262
01:08:02,240 --> 01:08:03,640
you're kind of swimming against
the stream.

1263
01:08:03,960 --> 01:08:06,520
But when it's your, when it's
your norm, then it's like, hey,

1264
01:08:06,520 --> 01:08:08,840
you almost want to do it.
Like, I mean, you know, all the,

1265
01:08:09,160 --> 01:08:11,880
and you could talk about the
motivation and the value or not

1266
01:08:11,880 --> 01:08:13,320
and how much intent matters or
not.

1267
01:08:13,320 --> 01:08:16,279
At the end of the day, if
someone's losing 150 lbs at 35

1268
01:08:16,279 --> 01:08:18,760
years old, that's awesome.
You know, like, I don't, you

1269
01:08:18,760 --> 01:08:21,040
know, if, if you're doing it
with your friends, you're doing

1270
01:08:21,040 --> 01:08:22,960
it, you guys are laughing,
you're doing it, you guys, you

1271
01:08:22,960 --> 01:08:25,680
know, agree that, you know,
cutting back on drinking for,

1272
01:08:25,760 --> 01:08:29,720
you know, drinking X amount XY
and Z is probably beneficial.

1273
01:08:30,359 --> 01:08:31,960
You know, the way you eat,
probably beneficial.

1274
01:08:31,960 --> 01:08:34,200
Stop eating at a, you know,
particular restaurants or

1275
01:08:34,200 --> 01:08:38,800
particular types of food.
And like we just, everyone is

1276
01:08:38,800 --> 01:08:41,960
just doing better now than they,
they had before and their lives

1277
01:08:41,960 --> 01:08:43,680
are crazier.
They're, you know, it really

1278
01:08:43,720 --> 01:08:49,359
helps with balance for sure.
Yeah, like we love craft beers

1279
01:08:49,359 --> 01:08:52,960
and it's really cool that
there's all these like non

1280
01:08:52,960 --> 01:08:54,880
alcoholic craft.
Beers.

1281
01:08:56,439 --> 01:08:59,800
Every time we go somewhere, you
know, like now we are like,

1282
01:08:59,960 --> 01:09:02,200
let's try the non alcoholic
craft beer.

1283
01:09:02,200 --> 01:09:04,840
Oh, Asheville's like the best
beer place ever.

1284
01:09:05,319 --> 01:09:11,399
Have you been to burial?
Oh, yes, burial's close to me.

1285
01:09:11,479 --> 01:09:13,279
Yeah, it's.
Incredible.

1286
01:09:13,279 --> 01:09:16,399
I get beer shipped from them
down to South Florida and make I

1287
01:09:16,399 --> 01:09:19,240
make my dad go there to pick to
pick up for me.

1288
01:09:19,240 --> 01:09:21,960
Here's a log cabin right near
there and I make him go to

1289
01:09:21,960 --> 01:09:24,840
burial and ship me beer.
Oh my gosh.

1290
01:09:24,880 --> 01:09:27,520
Yeah.
No, we we love it.

1291
01:09:27,520 --> 01:09:30,560
I mean, we, we love, we love
craft beer, but that's kind of

1292
01:09:30,560 --> 01:09:33,359
really cool because the whole
like shift, because it's just

1293
01:09:33,359 --> 01:09:35,640
kind of like an experience.
And now they they make all these

1294
01:09:35,640 --> 01:09:38,359
like, yes, amazing.
Like Sierra Nevada has a whole

1295
01:09:38,359 --> 01:09:43,680
bunch of really yummy, you know,
non alcoholic beers, but a lot

1296
01:09:43,680 --> 01:09:45,520
of.
You guys right?

1297
01:09:45,560 --> 01:09:47,479
Voodoo Rangers Sierra Nevada to
the same company.

1298
01:09:48,920 --> 01:09:52,080
Yeah, and then who?
Like Hillman Brown?

1299
01:09:52,120 --> 01:09:58,080
I mean, there are so many.
Such a.

1300
01:09:58,840 --> 01:10:00,440
Cool.
Like, you know, and then that's

1301
01:10:00,960 --> 01:10:04,640
like our, our weekend.
We're at a brewery with our kids

1302
01:10:04,640 --> 01:10:07,800
and there's like music and we
just chill out and it's good.

1303
01:10:07,800 --> 01:10:10,160
That's the culture's good.
But again, like, there are ways

1304
01:10:10,160 --> 01:10:12,440
to, to live healthy now, you
know, They're just like, you

1305
01:10:12,440 --> 01:10:14,480
know, if I have one beer a week,
OK.

1306
01:10:14,640 --> 01:10:16,240
But then if I want something
else, yeah.

1307
01:10:16,240 --> 01:10:18,280
Like my husband only drinks some
alcoholic beers now.

1308
01:10:18,280 --> 01:10:21,640
He's just kind of giving up
alcohol completely.

1309
01:10:21,880 --> 01:10:25,360
I still do like a glass of wine
a week or a beer once a week or

1310
01:10:25,360 --> 01:10:27,040
something.
Just that's good.

1311
01:10:27,040 --> 01:10:30,840
You know, what do you do?
We have our vices and then we

1312
01:10:30,840 --> 01:10:35,000
reset again, right?
Yeah, definitely, definitely.

1313
01:10:35,040 --> 01:10:36,320
You guys have great music there
too.

1314
01:10:36,320 --> 01:10:38,120
You guys have an awesome music
scene there.

1315
01:10:38,120 --> 01:10:39,720
Billy Strange just played three
nights there.

1316
01:10:40,400 --> 01:10:42,440
I know my nurse went every
night.

1317
01:10:43,040 --> 01:10:44,680
She thought it was there.
She got tickets every night.

1318
01:10:45,000 --> 01:10:47,840
And then what did I just do?
Oh, I just bought tickets to

1319
01:10:47,840 --> 01:10:50,320
Lollapalooza to take my two
daughters.

1320
01:10:50,560 --> 01:10:53,080
And she saw that.
Yeah, I was on the like on the

1321
01:10:53,080 --> 01:10:54,960
website today trying to get the
tickets.

1322
01:10:54,960 --> 01:10:58,360
And then my oldest was like, I
can't go.

1323
01:10:58,680 --> 01:11:02,480
I have volleyball tryouts.
Like, OK, I already bought the

1324
01:11:02,480 --> 01:11:05,120
tickets, so I'll sell it when I
get there.

1325
01:11:05,960 --> 01:11:10,000
Like, really?
Wow so cool, it's a great place

1326
01:11:10,000 --> 01:11:11,160
to live.
How long you been in Asheville

1327
01:11:11,160 --> 01:11:13,480
for?
We've been in Asheville, let's

1328
01:11:13,480 --> 01:11:19,680
see, like since 2020, but I was
only an hour away and then we've

1329
01:11:19,680 --> 01:11:22,320
been in North Carolina since
2013, so.

1330
01:11:22,640 --> 01:11:27,000
So my dad has a log cabin about
half an hour from Burnsville,

1331
01:11:27,240 --> 01:11:29,760
which is Tennessee from you
guys.

1332
01:11:29,960 --> 01:11:33,520
Yeah, city to him is Johnson
City, TN.

1333
01:11:34,480 --> 01:11:36,400
It's only like an hour from us.
Yeah, it's close.

1334
01:11:36,440 --> 01:11:37,760
It's not.
Far Yeah, yeah, totally,

1335
01:11:38,040 --> 01:11:40,400
totally.
And we and, and when I was yeah,

1336
01:11:40,400 --> 01:11:44,480
during COVID in 2020, you know,
I my, my, my there was this log

1337
01:11:44,480 --> 01:11:46,720
cabin no one's around it's the
middle of nowhere.

1338
01:11:47,080 --> 01:11:49,720
And I used to go with my, and I
was like, I'm sick and tired of

1339
01:11:49,720 --> 01:11:52,240
being locked up.
So I, I would take a group of

1340
01:11:52,240 --> 01:11:54,400
friends and, you know, we'd take
5 or 6 of us.

1341
01:11:54,400 --> 01:11:57,200
We'd go to like in the cabin and
going to Asheville during the

1342
01:11:57,200 --> 01:12:00,080
day and then, and then go back
to the mountain at night.

1343
01:12:00,120 --> 01:12:01,840
It's awesome.
I love that part of the.

1344
01:12:02,760 --> 01:12:07,080
It's such a fun, different place
and like anything goes, you

1345
01:12:07,080 --> 01:12:09,760
know, you go downtown and
somebody's just doing yoga and

1346
01:12:11,320 --> 01:12:16,680
everybody else walking.
It is just like a wild just and

1347
01:12:16,680 --> 01:12:20,400
people are just so, I don't
know, like everyone is so

1348
01:12:20,400 --> 01:12:24,040
helpful and kind and and I
think.

1349
01:12:24,320 --> 01:12:26,120
That was affected by the by all
the flooding.

1350
01:12:27,640 --> 01:12:29,960
Yeah, it was.
That was hard.

1351
01:12:30,000 --> 01:12:32,960
That was awful.
Luckily, like our house was

1352
01:12:32,960 --> 01:12:35,920
fine, but we didn't have water
or electricity for many, many,

1353
01:12:35,920 --> 01:12:39,600
many weeks.
And I had to close my office

1354
01:12:39,760 --> 01:12:45,120
because we had no running water.
And eventually I, we, we opened

1355
01:12:45,120 --> 01:12:47,440
and we were like, we'll just
bring water in.

1356
01:12:47,440 --> 01:12:50,240
And you know, it made house
calls and it made, I mean, it

1357
01:12:50,240 --> 01:12:53,560
was, it was, it was crazy.
And then our virtual assistant,

1358
01:12:53,560 --> 01:12:56,560
she lives in the Philippines,
you know, we made international

1359
01:12:56,560 --> 01:12:57,600
news.
She called us.

1360
01:12:57,600 --> 01:13:01,720
And I was like, are you guys OK?
We were trapped in our house for

1361
01:13:02,720 --> 01:13:05,520
like, we like on our street, we
couldn't get out for like 3

1362
01:13:05,520 --> 01:13:08,440
days.
And then we're every, nobody was

1363
01:13:08,560 --> 01:13:10,880
helping, you know, because
nobody could get to anybody.

1364
01:13:10,880 --> 01:13:13,560
And finally all the night
everyone took their like

1365
01:13:13,560 --> 01:13:16,720
chainsaws and cleared the roads
so you could get out.

1366
01:13:16,720 --> 01:13:18,800
And by the time we got out, we
didn't know there was like

1367
01:13:19,160 --> 01:13:23,600
everything was shut down and it
was crazy.

1368
01:13:23,600 --> 01:13:28,320
And we ended up getting our kids
out of town so that they could

1369
01:13:28,320 --> 01:13:30,240
go.
And, and then we ended up coming

1370
01:13:30,240 --> 01:13:32,480
back to help, you know, do
whatever we needed to do.

1371
01:13:32,840 --> 01:13:37,120
But it was, that was wild.
I can't believe we went through

1372
01:13:37,120 --> 01:13:39,120
that.
Hopefully the last one And

1373
01:13:39,120 --> 01:13:41,920
Asheville's just perfect now
because I, I really do love it

1374
01:13:41,920 --> 01:13:43,360
here.
It's like my favorite place I've

1375
01:13:43,360 --> 01:13:44,960
ever lived.
That's awesome.

1376
01:13:45,040 --> 01:13:46,520
I love.
Yeah, I'm happy to hear that.

1377
01:13:46,520 --> 01:13:46,880
Yeah.
That.

1378
01:13:47,040 --> 01:13:49,040
So we've we've gotten stuck
there, if you want to.

1379
01:13:49,040 --> 01:13:53,240
The truth is that as far as like
America goes, if you want to

1380
01:13:53,240 --> 01:13:56,600
kind of have trouble in America,
like, you know, like natural

1381
01:13:56,600 --> 01:13:59,000
trouble and stuff like that,
like N Carolinans treat each

1382
01:13:59,000 --> 01:14:01,480
other so well and like the
people like gone.

1383
01:14:01,600 --> 01:14:04,280
You know, we've got stuck in the
mud so many times or you know,

1384
01:14:04,280 --> 01:14:06,320
like we've broken down or
something's happened.

1385
01:14:06,320 --> 01:14:09,240
And like the people are just
good people.

1386
01:14:09,240 --> 01:14:12,440
They just, they just have that,
like they just have that

1387
01:14:12,440 --> 01:14:14,360
goodness in their heart.
I really like, I really, I

1388
01:14:14,400 --> 01:14:17,920
really being around there.
Before you wrap up, I want to

1389
01:14:17,920 --> 01:14:24,000
ask your advice and final
thoughts on things for people to

1390
01:14:24,000 --> 01:14:27,960
avoid as far as their brain
health and development as they

1391
01:14:27,960 --> 01:14:30,960
age, and things for people, A
couple of things to avoid, a

1392
01:14:30,960 --> 01:14:34,360
couple of things to proactively
take care of and do.

1393
01:14:35,400 --> 01:14:37,720
OK, so processed food, like
avoid it.

1394
01:14:38,040 --> 01:14:41,760
It is a killer.
No, that's a tough one, but it's

1395
01:14:41,760 --> 01:14:45,000
a it's a killer and everything
is now processed, you know, like

1396
01:14:45,040 --> 01:14:47,760
just anything that comes out of
a box, try to avoid it.

1397
01:14:48,120 --> 01:14:50,800
Eat fresh foods.
I would, I would say it's

1398
01:14:50,800 --> 01:14:55,040
probably the big thing, but
avoid processed food, avoid not

1399
01:14:55,040 --> 01:14:56,760
sleeping.
That's really, really bad.

1400
01:14:56,760 --> 01:14:59,120
Make sure you get at least 7
hours of sleep because lack of

1401
01:14:59,120 --> 01:15:02,280
sleep, you know, and I, I
struggle with not getting enough

1402
01:15:02,280 --> 01:15:05,680
sleep, but insomnia can increase
your risk of dementia.

1403
01:15:06,560 --> 01:15:09,800
Make sure that you know, don't,
don't smoke smoking is bad.

1404
01:15:09,800 --> 01:15:11,920
Don't, don't vape.
We don't know all the data yet,

1405
01:15:11,920 --> 01:15:15,320
but bad things are happening
like we're finding bad things.

1406
01:15:15,800 --> 01:15:18,480
So don't don't put anything in
your body that's harmful.

1407
01:15:18,480 --> 01:15:22,040
Just like treat your body like
it's a temple, you know, try to

1408
01:15:22,040 --> 01:15:26,560
really know alcohol is the best
thing, but a little, you know,

1409
01:15:26,560 --> 01:15:30,880
try to don't drink daily because
that's not good for you either.

1410
01:15:31,120 --> 01:15:35,000
So those are the things that I
would say exercise almost daily,

1411
01:15:35,000 --> 01:15:37,640
not just cardiovascular.
You know, you should probably do

1412
01:15:37,640 --> 01:15:40,360
weight training.
I hardly ever do like

1413
01:15:40,960 --> 01:15:43,440
cardiovascular stuff.
It's like I'm basically doing

1414
01:15:43,440 --> 01:15:45,200
weight training.
And most of the time when you're

1415
01:15:45,200 --> 01:15:47,080
weight training, you're hitting
that zone too.

1416
01:15:47,080 --> 01:15:49,360
So you're getting your
cardiovascular needs met

1417
01:15:49,360 --> 01:15:51,840
anyways.
But yeah, I'm strength training.

1418
01:15:51,840 --> 01:15:56,520
I think like almost everyday you
should be doing something to

1419
01:15:56,520 --> 01:15:59,280
stay active.
And then, you know, I think

1420
01:15:59,280 --> 01:16:01,840
there's some good stuff about
fasting that's going to that's.

1421
01:16:02,760 --> 01:16:05,280
We're.
Still figuring all that out, but

1422
01:16:05,280 --> 01:16:08,160
I don't I don't not into this
like these big long fast.

1423
01:16:08,160 --> 01:16:10,680
I'm still trying to figure that.
I know David Sinclair talks

1424
01:16:10,680 --> 01:16:12,880
about these fast.
You know, he wrote the book

1425
01:16:12,880 --> 01:16:14,840
Lifespan.
He's like so smart.

1426
01:16:15,120 --> 01:16:20,200
But I, I'm, I'm more of a, hey,
let your body do a natural fast.

1427
01:16:20,200 --> 01:16:22,880
So don't eat late at night.
Finish your dinner at 6:00 PM.

1428
01:16:23,200 --> 01:16:25,320
Don't eat anything else.
Just have some water until the

1429
01:16:25,320 --> 01:16:28,320
next day before you want to eat.
Eat when you're hungry.

1430
01:16:28,320 --> 01:16:31,040
Don't don't suffer, but eat
something good.

1431
01:16:31,520 --> 01:16:33,280
I mean, those are like the basic
things I tell.

1432
01:16:33,400 --> 01:16:38,200
People, that's really cool.
So avoid smoking, avoid vaping,

1433
01:16:39,400 --> 01:16:42,360
processed foods, a lot of
alcohol.

1434
01:16:42,840 --> 01:16:45,800
And what was the last thing to
use?

1435
01:16:45,840 --> 01:16:47,240
I think the top.
Three, sleep.

1436
01:16:47,240 --> 01:16:48,640
Make sure you're getting plenty
of sleep.

1437
01:16:48,640 --> 01:16:50,160
You know, sleep.
Right.

1438
01:16:50,160 --> 01:16:53,720
Project to.
Get enough sleep, exercise, and

1439
01:16:53,720 --> 01:16:58,320
potentially stretches of fasting
in whatever capacity that might

1440
01:16:58,320 --> 01:17:01,040
be.
So from from dinner time to

1441
01:17:01,040 --> 01:17:02,920
breakfast time, breakfast time
to dinner time.

1442
01:17:03,240 --> 01:17:04,880
Whatever.
Yeah, just kind of, you know,

1443
01:17:05,520 --> 01:17:06,720
these natural fast eat when
you're.

1444
01:17:06,720 --> 01:17:07,760
Hungry.
Does that include water?

1445
01:17:07,760 --> 01:17:10,400
Does that include water or no?
Oh, yeah, yeah.

1446
01:17:10,400 --> 01:17:12,840
I think like you should just
drink as much water as you want.

1447
01:17:12,840 --> 01:17:16,000
Like water is key.
Do you know, even like you can

1448
01:17:16,000 --> 01:17:18,480
even stay hydrated with some
coffee and tea if you're like

1449
01:17:18,480 --> 01:17:21,320
going throughout the day.
You know, I mean, as a doctor,

1450
01:17:21,320 --> 01:17:23,680
like people are like, oh, when
do you take lunch?

1451
01:17:23,680 --> 01:17:28,240
I'm like, I don't take a lunch.
So all I do is I have, you know,

1452
01:17:28,240 --> 01:17:32,440
my breakfast, which is sometimes
like couple of eggs or like a

1453
01:17:32,720 --> 01:17:36,760
protein ball or something.
But then that somebody from the

1454
01:17:36,760 --> 01:17:39,240
gym makes and some coffee.
But then the rest of the day,

1455
01:17:39,240 --> 01:17:42,400
like if I'm hungry, I'll have
like a handful of nuts and then

1456
01:17:42,400 --> 01:17:46,080
I get home and I eat.
But doctor, diets are perfect.

1457
01:17:46,080 --> 01:17:47,720
You don't.
We don't worry too much about

1458
01:17:47,720 --> 01:17:49,680
weight gain.
We just don't really have an

1459
01:17:49,680 --> 01:17:52,760
opportunity to sit down and chow
down just fine.

1460
01:17:54,360 --> 01:17:56,040
Busy enough to not get
unhealthy?

1461
01:17:56,200 --> 01:17:59,480
Basically is this is the answer?
Yeah, and I'll, I'll put up some

1462
01:17:59,480 --> 01:18:04,200
more blog posts on like specific
like diet things.

1463
01:18:04,200 --> 01:18:07,720
I think that that would be a
fun, you know, a good thing to,

1464
01:18:07,720 --> 01:18:09,240
to put up.
And I always tell people like

1465
01:18:09,560 --> 01:18:11,600
don't like follow all my vitamin
supplement.

1466
01:18:11,720 --> 01:18:14,720
It's not advice.
It's just information so that

1467
01:18:14,800 --> 01:18:19,040
you can advocate for yourself,
you know, and, and you can talk

1468
01:18:19,040 --> 01:18:22,280
to your healthcare professional.
And that's the other piece of it

1469
01:18:22,400 --> 01:18:27,280
before my Internet knocks out.
But you know, if there are only

1470
01:18:27,880 --> 01:18:31,600
only 13% of people have access
to a geriatrician, we are, we

1471
01:18:31,600 --> 01:18:35,440
need 30,000 by 2029 when the
last of the baby room returns

1472
01:18:35,440 --> 01:18:37,800
65.
And we only have a like close to

1473
01:18:37,800 --> 01:18:39,720
7000.
We have those retiring.

1474
01:18:39,720 --> 01:18:43,280
We only train 250 a year.
And so I think healthcare really

1475
01:18:43,280 --> 01:18:47,320
needs to become like your own,
like you have to own it.

1476
01:18:47,480 --> 01:18:53,080
And yeah, I do think AI and tech
is going to help us achieve some

1477
01:18:53,080 --> 01:18:55,760
of that where they're going to
be a little bit of a lack in

1478
01:18:55,760 --> 01:18:58,040
healthcare.
And then people should advocate

1479
01:18:58,040 --> 01:19:01,120
for themselves and seek, seek
truths other than some of the

1480
01:19:01,120 --> 01:19:04,560
weird, like weird stuff, you
know, that that's out there

1481
01:19:04,760 --> 01:19:06,520
like.
You mean like to live forever,

1482
01:19:06,720 --> 01:19:09,160
be like a lizard person kind of
thing?

1483
01:19:09,600 --> 01:19:12,360
Like drink something you're in
or I don't know.

1484
01:19:12,720 --> 01:19:13,960
Yeah, yeah, yeah, yeah, yeah,
yeah.

1485
01:19:13,960 --> 01:19:16,440
All the Epstein popular stuff.
Avoid all the Epstein.

1486
01:19:16,720 --> 01:19:18,920
Falls no.
Avoid all that, yeah.

1487
01:19:19,160 --> 01:19:25,760
Seriously doctor, this is such a
fun conversation and honestly I

1488
01:19:25,760 --> 01:19:28,280
had such a blast.
This was a emotional roller

1489
01:19:28,280 --> 01:19:33,280
coaster, but so informative and
so much fun and quite frankly,

1490
01:19:33,640 --> 01:19:36,640
this was awesome and you killed
it, so thank you so much.

1491
01:19:36,640 --> 01:19:37,920
For taking.
Popping on.

1492
01:19:38,560 --> 01:19:40,560
Thank you.
And then yeah, I'm going to

1493
01:19:40,560 --> 01:19:42,760
connect with you because I do
want one of those like bone

1494
01:19:42,760 --> 01:19:44,080
density machines.
I was looking.

1495
01:19:44,960 --> 01:19:46,040
At Oh, definitely.
Yeah.

1496
01:19:46,040 --> 01:19:48,400
Like maybe we can connect.
Definitely.

1497
01:19:49,080 --> 01:19:51,120
Definitely.
I'll do what I can for you,

1498
01:19:51,480 --> 01:19:52,440
Doctor.
Thank you.

1499
01:19:52,440 --> 01:19:53,400
Of course.
Thank you.

1500
01:19:53,920 --> 01:19:56,400
Thank you.
We said goodbye, but before we

1501
01:19:56,400 --> 01:20:00,560
go, how do we find you?
OK, so you could check out

1502
01:20:00,560 --> 01:20:05,520
jerryacademy.com,
geriacademy.com it has a link to

1503
01:20:05,520 --> 01:20:07,960
my book if you're interested.
And then the book again is

1504
01:20:07,960 --> 01:20:11,240
called Life, Love and the In
between, a geriatricians journey

1505
01:20:11,240 --> 01:20:12,960
through aging and the meaning of
life.

1506
01:20:13,240 --> 01:20:15,200
So.
And I'll put that link on the

1507
01:20:15,200 --> 01:20:17,960
website and on the on the
episode page.

1508
01:20:17,960 --> 01:20:19,520
So I want to be able to find it
very easily.

1509
01:20:20,200 --> 01:20:21,600
That sounds great.
Thank you.

1510
01:20:23,240 --> 01:20:23,560
OK.