HS 324 - The Power of Hope: Thinking Yourself to a Longer, Healthier Life with Dr Allan Hamilton

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This is Jason Hartman. Occasionally we have a guest host and today we have Fernando guest hosting for me. So I hope you enjoy this episode. It's fascinating. Dive in and enjoy and make sure you Visit us@hartmanmedia.com to check out all of our great shows and be sure you have actually subscribed to the show so you don't miss any episodes.

This is your host, Fernando Aries, in partnership with the Hartman Media Company, filling in for Jason Hartman. Today I have a pleasure to welcome Dr. Alan Hamilton. Dr. Hamilton is a physician and a medical consultant to ABC's medical drama Grey's Anatomy. He's also the chairman and professor of neurosurgery, psychology, radiation, oncology and electrical and computer engineering at University of Arizona in Tucson. I believe it's quite a combination. He's the author of the best selling books that the Scalpel and the Encounters with Surgery, the Supernatural and the Healing Power of Hope. He also wrote Zen Mind, Zen the Science and Spirituality of working with horses. Dr. Hamilton has been a featured guest on NPR, PBS, CNN, ABC Evening News, and the NBC Today Show. So this should be a fascinating interview. Welcome, Dr. Hamilton. It's a pleasure to have you in the show.

Well, thanks for having me, Fernando.

Well, let's get right into it. I watched a TED Talk that you gave in Tucson and there you talk about hope, hope being this powerful medicine that has so much to do, what we call the placebo effect. Now, I know that trials have shown people that often react to this placebo effect in nearly the identical manner as an actual drug. And these placebos, they actually show dopamine release and other chemical responses and they mimic the effects of the drugs without actually having an active ingredient. Isn't this incredible? It almost undermines our, I guess, understanding of how our mind has these overriding powers on our Biology. These placebo effects called dummy pills, they seem to work far better than anyone have imagine. And how does this work? Can you explain to us?

Well, I think you're right, Fernando. I think it is a demonstration of just how powerful a human mind can be. And as you said, when we do functional studies, you know, we give a group of subjects an injection of narcotic and we look at their brain and how it's reacting. We'll see in particular certain areas like the nucleus accumbens and things that are called ventral tegmental area. They'll light up, and those are areas that are associated with dopamine release. And then if we give somebody an injection of saline, but we tell them that it's an opiate, we'll see the same areas of the brain light up. It's as if the brain saying, well, if this is opiates, I should have this reaction. And then it creates that reaction. So one way is to look at them as sort of dummy medicines. I really never liked that expression because I think in some ways it implies that there's something dumb or stupid about reacting to them when there really. There really isn't. What it is is a demonstration that your mind is so powerful that it can actually mimic pharmacologic effects if it believes that it is receiving those meds. By the same token, Walter Buchanan, who was a Harvard physiologist in the 1920s, wrote a book about voodoo death where he investigated cases where people had profound beliefs about witchcraft and voodoo and literally went on and died in a matter of several days. I saw that myself when I was in Africa. So you say to yourself, wait a minute, wait a minute. A perfectly healthy guy can die in three days, which I saw myself. And you go, yes, that's how powerful the mind is, that it can kill you if it believes that you're going to die. So, you know, how does this work? Well, we know that our emotions have very powerful effect not only directly on the brain, which makes sense, but also on all of our immune functions. So the way to think of this is our immune function is plugged into our state of mind and the way we're feeling. So going back to the original opening where we talked about longevity and happiness and, well, being, one of the really important things about that is to remember that being happy, being fulfilled, feeling satisfied, are all important for your immunological state. In other words, you are going to be able to fight off infection better if you're happy. For example, even something as simple as if I put a group of Subjects in front of a television, and I show them a funny comedy show, okay? Show them dumb and dumber, okay? And I sample. While they're watching, I sample their blood, okay? And then I take another group of people and we take them to see Slasher movie, you know, Friday the 13th or something like that. Freddy Krueger, okay? And I sample their blood. Now I take their white cells out of that blood and I put them into a petri dish with staff. In fact, with staph microbes, the group that's been watching the funny movie is going to kill 50% more staph bacteria than the group that was watching the thriller. Oh, wow. So that's how profound the effect can be. And then imagine that multiplied over months, days, years, decades. It's very important to be aware that the brain is extraordinarily powerful in ways that we don't know. And the point of that TED talk was really hope is such a powerful tool for patients to recover that doctors need to pay extreme attention. Not that they give patients false hope, but that they give them hope. You know, hope is the desire to prevail against overwhelming odds. There's nothing false about it. It's just that we want to harness that ability of the patient to be hoping for a positive outcome, because, again, that has profound effects on the quality of their life and can even have profound effects on the outcome.

So the key to how it works is the belief system. The person has to believe that this is actually going to do, you know, have its intended effect. Now, if we were to try to tap into that and do this to ourselves, you know, make ourselves better and perform better in any way that we want to. There is a little bit of an issue there where our intellect might get in the way, meaning that it knows that the active ingredient, whatever it is, is not there. But I would like to believe that my mind and my biology can literally be changed by my belief. But there is this conflict. Do you know what I mean? How do we get past that if we were to try to tap into that ourselves?

You know, my latest book is called lead with your lessons from a life with Horses, which is really based on 30 years of training horses. I mean, my day job is being a brain surgeon, but my advocation outside of that is I've been training horses for 30 years. And one of the things that's really important about horses is that you can't really be verbal with them. They don't really react to verbal language at all. They react to intuitive body language and the kind of the posture and the energy that you're putting out in your body. So one of the things that you have to do with horses is if you want that horse to carry out a particular activity, let's say you want a horse to go over a jump, you have to organize your own feelings, your own thoughts, your own energy, so that you can see in your mind's eye what's going to happen. And it's what I call, you know, what other people call, but what I call intention. In other words, I have to have this perfect intention of. I can see what the horse is going to do. I can see all the movements. I can see him collect all the. All of his power in his hind legs, and I can see him project over the fence and then land. And when I can see it all before, perfectly shaped and focused in my mind, then the horse will be able to do it very easily. When I start to doubt myself or I start to get confused and overthink it, then the horse will not be able to carry it out. Well. And so there's this, you know, it's sort of like Nike, you know, just do it. You know, don't think about it. And so there's a lot about that, which is, you know, if you overthink things, you kind of start, you know, get paralysis through analysis. And so one of the nice things about the horse is the horse is going, don't think about it. Just do it, feel it, just make it happen. And so there's this training that goes on while you work with horses about how to sort of put your intention out there and try to make shape it so that things will happen with the horse without you really cognitively dissecting it apart into, you know, this step and this step and this step and this step. Because that doesn't work.

Yeah, it's as if, I guess, bringing that intention from, you know, away from the head and into your emotion, into your feelings, your gut, so that you can translate that into, in your case. So working with horses really is an analogy of how we can work with humans in ourselves as well. I guess that's what your takeaway is from that, isn't it?

Yeah, I mean, the book's 112 lessons that I've, like, acquired by horses teaching me over 30 years. And then, you know, saying, okay, what's the lesson from the horse? And how does that apply to your life? And so if you think about creating wealth, for example, or creating health, you have to put the intention out there. You know, you can't just Start saying, well, you know, I'm going to. I'll do this. I'll take this first step. And of course, taking the first step is important, but you want to say, hey, I can imagine what it feels like to be healthy like this. Or I can imagine what it means to create from an entrepreneurial perspective, this service, this product that creates this demand and this wealth. And if you just sit there and analyze it, you know, that's not necessarily going to make it happen like it will when you envision it. Not that I want to quote Donald Trump all that much, but, you know, I think one of the things that's interesting to me about Trump and listening to him is that he very often will say, look, a lot of my decisions just come from a kind of a gut check, a quick analysis. And if you think about that, that intuitive ability in business people to make decisions and feel where the market's going to go is very, very important. So a good example would be, I like to use his bicycles, okay? If you think about the old clunkers that we used to have in the 50s, 60s, whatever, and they had these bikes with that just had a single chain and a brake, you know, that was it. And then people started getting all these gears, okay? So there was a handful of bicyclists, actually mostly on the west coast, who said, you know, I'd like to get off road, and I need. I need a beefier frame, so I need to borrow my dad's frames. But I want that 10, that 20 speed, 30 speed, 60 speed, whatever it is. And then I have to start modifying it, put suspension forks on it that they borrowed from motorcycles. So what happened was these guys would start making their own bikes, and bit by bit, people would go, oh, why don't we collect an inventory? And finally it occurred to people, well, you know what, Rather than just give the inventory, why don't we build mountain bikes? Well, those mountain bikes now represent over 35% of the total market, the total market now for bicycles worldwide. Okay, right. So you turn around and say to yourself, well, who was that? They suddenly goes, wait a minute, let's just stop making a few dozen bikes a year, and let's create a marketplace that has never really been developed before. Well, that's sort of putting the intention out there. That's sort of saying, we will invest in building mountain bikes and mountain frames and all of the equipment, and we'll design them so that it's all an integral part, and we'll design a completely new market for bicycles. And that isn't somebody who sat in the basement, you know, and said, okay, you know, let's have some new market, let's new product. And that isn't like Google pulling 100 people around in a conference and saying, what's the new market going to be? It was an organic evolution where suddenly somebody said, here's an incredible opportunity. Let's make it happen.

It's a perfect example of who's informing who. I know that there are studies that show that our gut informs our brain much more than the other way around. And I think that's what you seem to describe an example of is there. There is this gut feeling, this intuition that something feels right and there's an opportunity. It tells the brain, start acting towards, you know, this objective and then the steps that need to be taken are taken, isn't it?

I agree with you. I mean, our gut, our intuition, our ability to assemble signals that we don't even understand and put them together is vitally important. Like I teach my residents in neurosurgery and brain surgery, when the little hairs in the back of your neck stand up, you better listen to them because something's wrong with the patient that you haven't figured. But you really need to pay attention to that. And it's one of these things that a good surgeon is an intuitive surgeon. And you know, I think I go, look, your gut's telling you something your body hasn't yet been able to record, right? So it's out there in advance of you. It's out there like a scout going, hey, I smell something happening here, you better pay attention to it. So yes, I agree. Good businessmen, good surgeons, good teachers, I mean, good parents are intuitive. Yeah, you want to harness that. If you think about it, just think about when you take an exam, you know, and you write the answer down, then you go back and you go, oh, no, maybe, maybe this is like, maybe that could be right. But maybe that's what they mean in this question. You rethink it and you rethink it and you always will put the wrong answer down if you go back and change.

Yep, don't trust that first, first instinct. Yeah, I can agree to that 100%.

Yeah.

Now you, you have a very interesting background because you combine medicine with your electrical and computer engineering learnings and degrees. Now let's talk a little bit about longevity. This is one of the two prongs on our show. Can you tell us what computer guided methodologies, if you will, are you currently working on to extend life and prevent that?

The first Thing is, you have to sort of understand what computers are very good at. Okay. So what I used computers for in my career was creating three dimensional maps that were based on very advanced imaging, MRI and CT scans, and taking millions and millions of data points and creating a three dimensional picture so that the surgeon could see through the brain. Because you could layer these pictures in front of them so on a heads up display. Okay. So it allowed you to actually see as you were moving the microscope, you could see down below where you were. And so the idea was, you're going to hurt less brain if you know exactly where you're supposed to go. And the computer's very precisely guiding you there. Okay, so what are the things that computers are really good at? One is collecting vast amounts of data much faster than we can at this point. And the second thing is being vigilant. I mean, human beings can't focus on something and constantly pay attention. They just turn off after a while, you know, but computers don't, they don't get tired, they don't say, oh, you know, I should call my family, I should do something, I'm kind of bored. They just do what they're supposed to do. So one of the areas where computers are going to be vital is in what we call personalized health care data, which is you and I eventually are going to spend our lives hooked up to the equivalent of our iPhones and thousands of data points are going to be streaming into that phone every minute. Our heartbeat, our oxygenation, our blood pressure, our blood sugars, all sorts of things are going to start feeding into that. How we're walking, you know, how much we're drinking, how much we're sweating, all the rest of that. So once computers start to analyze that data, they can start to say, well, you know, I picked up a couple of extra beats on your EKG and you need to go in and have that checked out. And what computers are really good is at detecting trends in data before we see them. So an experiment in my particular specialty was with controlling giving medications for brain swelling. So for a human, you know, you look at the tracing on the, in the ICU and you go, okay, it's above 20, let's give this medicine. But what the computer can do is say, well, now it's 15, it bumped up to 16, it dropped down to 15, bumped up to 17, dropped down to 16, 18 dropped down to 17. So it sees that trend and it says, give the medicine early. So what happens is when we compare a computer to a human being, the computer does A much better job of smoothing it out because the computer is looking at tiny little trends in the data that we can't even detect and saying, I've seen this little trend in the data before, you can react to it. So those are the kinds of things where computers are going to monitor what we take for medications, when we need to take the medications. They're going to be sending all sorts of data to a centralized computer where it'll get analyzed so that they will help us live a much better lifestyle, but also detect trends that quite frankly, a once a year visit to the doctor's office may not be able to detect at all.

Now, Alan, are you worried about patients that, you know, I'm all about the self quantified movement and having information from your body available. I was one of the designers of the Apple Watch when I worked at Apple and I can't wait until there is more sensors that can tell us a lot more about our body. But there is this side of it and being a physician, I wonder what your take on it is. The side of the self diagnosis by the patient looking at this data and making decisions that perhaps a physician or somebody that is better trained can put together the different pieces of data and interpret it in a more precise way. Is that a concern?

I think it is, Fernando. And you, given your background with the Apple Watch and so on and Fitbits and those sort of things, you begin to sort of see where the technology could take us. You know, we've looked at things like that for the battlefield so that we could tell if the soldier was wounded, how quickly we needed to get medical attention or which person, which soldier, the medic should pay attention to. But going back to your question is where is the patient in this process? And part of the trend is first, patients are having less and less easy access to health care. Okay. So, you know, it's getting harder and harder and harder to kind of find that older rhythm where you could go and see the doctor when something happened and they could see you right away or even earlier than that when they used to make house calls. All of that's gone by the roadside.

Yep.

So to some extent, patient doesn't have any choice. They and their family are going to have to be empowered to sort of say, hey, I've got to start making some medical decisions and decide this needs to be followed up or that needs to, you know, I need to tell the doctor to pay attention to that because I'm feeling this and what have you. The second thing is a lot more of Our healthcare is going to be delivered by computerized analysis and non what we call physician extenders who are not physicians but extend the care. So PAs nurse practitioners, but with computers helping us, they basically are giving us the benefit of artificial intelligence. So you can imagine that if a computer could say to me as a physician, look, Alan, I've examined these 10 parameters and when I put them into my database, which is based on 5 million people that you, you can't possibly hold, I'm looking at these trends and the first and second leading diagnosis would be these. And I would order these tests based on that historical experience. Well, that makes me a better, smarter physician, but it also makes you a more empowered patient. If the computer says, I think you ought to contact your doctor now and they ought to be ordering these tests on you and I'm sending that information into your doctor, we can almost see a stage where we're using kiosk based medicine in some ways to help us overcome this issue of access.

Yeah, I think it's great. I think it brings the discussion to a much more productive level where the patient is aware of the thought process that would go into as input to the physician or to the assistant and can have a deeper conversation of what the pros and cons are. I like it.

Well, I think the other side of the coin is everybody always looks at technology is taking away from people. But think about technology. We text each other moment to moment. I can call some a family member. As technology really hurt our relationships with people. Well, yeah, if we let it degrade the relationships. But in point of fact, by and large, most of us have used it to stay much more intimately connected than we ever possibly could have. True. And I think the same is true for technology. Imagine now I'm at home, my computer has just given me an alert. I now log on. I tell my medical doctor's office that this problem has come to my attention. They received the same alert and onto the computer. I mean, now we can do it with Skype and FaceTime, but it'll get even more developed over time. I now can talk to the healthcare provider and you know, the healthcare provider can say, well, let me take a look at that rash that, you know, we picked up. Okay. Oh, well, look at that. You know, I'm gonna send that over to a dermatologist, they'll call you back and they'll come back onto your computer in five minutes with a diagnosis and recommended treatment course. So, you know the idea that in the middle of the night I could be in the patient's room, talking directly to them, as opposed to driving in a half an hour and driving back a half an hour. Now I can see them moment to moment. That will improve my capacity as a physician and it will give me more contact. So you can imagine in the middle of the night, you don't have to say, well, do I go to the emergency room or should I wait to take my baby in? In the morning, you can log on and suddenly there's somebody face to face with you going, well, you know, baby looks more upset than I'd expect. Let's bring him in. But I'm going to call it ahead and make sure that you're on the schedule so that when you get there, you're not waiting. You're moving right into the room that we've set aside for you. Because the computer's looking at all the patients that it needs and reserving rooms as they go. There are ways you can see all of this technology making our lives much, much better and making our access much better.

Yeah, like you said, the empowerment aspect, I mean, it just, to me, it really makes me more comfortable. You know, maybe that's not true for many people. They're expecting someone to just tell them what to do. But knowing the pros and cons, because there's always the different aspects of, you know, you could do this, but this is a possible negative outcome, or this is a procedure that is a little bit more risky. But, you know, in your case, it might be better. I would like to know rather than be told. I feel much more comfortable that it's the whole point of empowerment. Right.

And that technology can act like a personal health coach. Sure. It can guide you. You know, it can say, hey, you should be doing this conditioning, or, don't eat so much of that, eat more of this, you know. Yeah.

It can be extended to the maintenance aspect. You don't need to be sick before you consult. If you have this access and you're empowered to know the trends, you can make better choices. I think then it becomes a matter of choice. You know, if somebody is aware and willing to make changes, you know, the information will be readily available. I think it's a great time to be alive.

Yeah. And we may be alive a lot longer than we ever have before we're seeing that trend. You know, if you think actuarially a generation ago, lifespan of an average American male was 64 years old, and now it's closer to 78. Cardiac deaths are down considerably. Cancer deaths are down. Cancer is likely to be a problem that we see more frequently as causes of cardiovascular death go down because we're living longer. And as you live longer, you run an increased risk of developing mutations that get the cancer. But again, having a surveillance system that's out sniffing around like a bloodhound really helps.

Yeah, I agree 100%. Now, Ellen, we're coming out to the end of the show, but I do want to ask you about your ties with Grey's Anatomy. And as I mentioned earlier in the intro that you were a medical consultant to abc. What did you do to have this position to become a consultant to Hollywood.

Now done over 200 episodes of Grey's Anatomy. And I did four years of private practice, which was a spin off show. I started off actually doing special effects. So going back to computers, we did a lot of artificial tissue that were made by computers and done with 3D printing. And so I got contacted by Grays to help them with some special effects. And then I got contacted a second time to do that. Then on the third time, they said, hey, you know, would you help us with this or help us with that? And one thing led to another and, you know, now I'm a senior medical consultant for the show and I have a lot of fun. You know, I'm a writer and I trained actually as an English major before I went into medical school.

You cover a very broad spectrum.

That's amazing. Yeah, I just, I'm very lucky. I kind of have had, you know, Rod Serling from the Twilight Zone was my creative writing teacher for two, two years. So I love working with the writers and I love their creativity. And they'll often say to me, well, we want this, this, this or this to happen. Can you come up with a medical scenario that would allow us to have this kind of tension or this particular dramatic turn? And it's a lot of fun. I have to say. It's a very creative, imaginative aspect of my life.

That is excellent. Very, very good. Before we go, please give out any URLs and links. Where can people find out more about you?

Sure. So it's easy. All you do is look for allenhamilton.com a l l A N and that'll lead you right to my website. And you can, it'll lead you to any of the books, if you're interested, or anything about Hollywood or talks that I give and that sort of thing and my blog. And so all you need is one stop shopping. Alanhamilton.com Excellent.

Well, Alan, it's again, been a pleasure having you and you Have a great day. Okay?

You too, Fernando. Thanks for having me.

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