Brain Surgeon REVEALS How To Heal Trauma & DESTROY NEGATIVE THOUGHTS! | Dr. Rahul Jandial

Being in a better frame of mind, exercising, eating right, feeling calm, stress, all of that changes things physiologically that make your whole body better at fighting cancer. That we agree on, that's measured. Now, let's go back to the brain. I think you gotta have a dream.

The School of Greatness.

Really?

Yeah.

Please welcome Lewis Howes. You've worked as a brain surgeon and neuroscientist for a while now. And so you're an expert on all things the brain. and also the mind. Trying to be. Which I think is kind of fascinating. Or you're in a constant studying process of it. I'm curious, the first question I have is what do you think is the biggest factor since you've studied both the brain and the mind? What is the biggest factor that holds us back from thinking in terms of abundance and thinking in terms of positivity? Why do we stay stuck on negative thinking, negative thoughts, and limited mindset so much?

Yeah, that's a big question. So the simple answer is that the stories we've been told about what's going on in our skull, they're just wrong.

Interesting.

Okay, so the first thing is there's no wires. We're not hardwired. There are no gears. So let's go backwards. Way back when, like ancient Egypt, they thought it was just like flan or something. The soul was in the heart. And I believe, you know, I can see that. I've opened chest before for cardiac surgery and it's fierce. And what they would do is stick a straw up the nose and slurp out the brain, just get rid of it. So for a while, I could understand the complete misunderstanding. Then when sort of like, you know, Speakeasy's and Industrial Revolution, all the pictures about the brain, you see them as gears. But modern time, we're starting to think about as wired. I'm wired for this, I'm wired for that. You're not wired for anything. It's an ecosystem filled with throbbing 100 billion microscopic jellyfish sparking electricity at each other, trying to approach each other, shaving down pruning, branching, arborizing. So when I use those words like arborization pruning, those are neuroscience words in rigorous neuroscience journals, but it hasn't sort of made it to pop culture. So I think part of what keeps us stuck is that we think, oh, I'm wired this way or I have to rewire and it's too on/off rather than flows. It's not freeway from A to B, it's the way you see a school of birds flow and they roll over each other, Aurora Borealis. That's how thoughts and that's how feelings float through the ether of our minds. When you start to understand it like that, then you know every day something new is possible. Is it easy?

No.

But it's possible. That's the real way to think of your brain, mind and behavior that it's completely plastic in the sense that you're never the same person just from a moment ago since we've met.

That's a good introduction to this. I'm curious because you do surgeries on a weekly basis where you open the skull, mostly the top of the skull.

Well, all different areas. It's like ice fishing, so we make holes out. Take holes out. Wherever we need to get, we make.

The hole underneath it so we can get there.

So it may not be a full.

Top of the skull.

No, that's in Hannibal Lecter's movie. So you're taking little holes.

Yeah.

Little holes. The slickest brain surgeons, meaning who can do it the best, make the smallest hole to get right where you need.

To, the smallest incision, and do the most, you know, the least amount of damage, I guess, to the whole skull. Have you ever had to take off.

The top, the whole top? No, but in trauma, after boxing, sports, car accidents, sometimes we take off two big pancake sizes on the left and right. Really? So when the brain is throbbing, the rest of the, yeah, you take the lid off. Really? But you don't take the whole thing off, 'cause you got a giant vein coming down the middle. So that's, you can't do the Mohawk part. So you take two sides. Yeah, so if you look at, When I travel through South America, you look at the trephinations, the holes in the skulls, they're always on the side. You can't make holes in the middle and still live. Really? Giant veins splitting the two hemispheres. Oh, so that's just in the movies. Yeah.

Okay.

Yeah, that's the silence of the lab. Exactly.

But that's a good question though, that.

There'S a, it's a targeted approach. Interesting.

You want the patient to feel it the least. Right, of course. Right, of course. What's been one of the biggest, realizations from studying neuroscience but also studying the brain and actually opening up pieces of the skull, looking in there surgically doing things to optimize it. What was one of a big aha moment for you of studying both areas where you're like, wow, there's something that I didn't think was possible that is actually possible for human beings to do. Is there anything?

Yeah, a really good question. It ties back to your first question about what holds us back. So the thing that shocked me was that we could actually remove parts of the brain and people would go home a week later. I'm not saying there isn't some subtle neuropsychiatric issue, but for example, I had a guy come in, he's a framer, and they have the pneumatic, it's not hammer and nails as many people conceive it to be, but boom, boom, boom. And a lot of times when a recoil is back, they'll pop a nail through the orbit or nose into their frontal lobe.

This happened.

And they drive in.

With a nail in their brain?

Right, so that's the first one. I was like, wait, no, no, totally. I got pictures on my phone that we're not gonna show anybody, but you.

Can have a penetrating injury to certain.

Parts of the brain. Of the brain, and you drive in. Holy cow. So that's the first thing I realized was, so there isn't a region in the brain for creativity, there isn't a region in the brain for this. So the first thing I had to realize was, no, this thing is working in a as an environment, as an ocean filled with like a kelp forest and jellyfish. So if you drop something into the ocean, you're not gonna disrupt, there's no spot for something. And that ties back to what, you know, what I want people to walk away with is that you have to think of your thoughts and feelings and the working of your flesh inside your skull as a garden, as an ecosystem. Just 'cause you have one weed, or one spike doesn't mean the harmony is disrupted. So, for example, one frontal lobe we can surgically remove if needed after trauma or tumor and patients function. They drive, they talk on the phone. Again, you don't want this. One occipital lobe doesn't leave you blind. It's that people think occipital blindness. No, if I take out a tumor from the right occipital lobe, I just can't trust my left rear view mirror when I drive. It's a field cut. Your world goes from this to this. So when I first started seeing that, because I assumed you hit any part of the brain, it's your dust. Because people will say, the left side.

Of the brain is for this, and the right side of the brain is for this. And I use more of the right side of my brain, and that's why I'm creative or whatever it is, or I'm more analytical because I use this side of the brain, or my fear-based side of the brain is heightened. So you're saying if one part of the brain is under attack, tumor, trauma, a nail, whatever it is, something happens to that part of the brain. It may not hold you back from your creativity or your critical thinking potentially.

No, because the rest of your brain can compensate. Now let me give you, now that's not true for the entire brain, so let me just go backwards a little bit, but those were the aha moments I had. I mean, I'd seen bowels, I'd taken care of patients, AIDS was going crazy, the 80s, I've seen a lot. The first time I saw somebody do brain surgery, I was like, is that possible? Can you even remove the skull? And they're like, yeah. And then they were, can you remove that tissue to get to the tumor? They're like, yeah, you just have to understand how the whole thing works globally in harmony. Now, the way I think of the brain is like a mushroom. And so you've got the canopy and all the magic and the thoughts spark from the top. the surface. And then they send things down to the stalk, which comes deep to your mouth and comes out of the bottom of your skull and then turns in your spinal cord. So if I want to move my left hand, my right brain says, Move your left hand. It sends down signals that come under my armpit, they come into this nerve and that's what happens.

Crazy.

So what if those lower parts, there is something, you hit that, you lose something. Something down here. The reptilian brain, the spinal cord, Every millimeter does something because it's a lot of, think of it as cables, even though it's not wires, but there are a lot of tracks, T-R-A-C-T-S. There are a lot of tracks that are communicating the things that the canopy thought of. And in that area, if there's a nail injury, you do get a certain deficit. But in your thinking, your feeling, your emotions, your love, your fear, it's not a fear spot or a love spot. It's sort of again, the aurora borealis in the worlds of a school of birds just flowing in different energy, right?

Or a school of fish or something.

Exactly.

That's fascinating.

I want people to walk away with, okay, so what that leaves people with is the fear I have is real, but it's not fixed. It's not wired, it's not permanent. And through effort, through exposure therapy, through whatever it is, whatever your process is, that school of fish can flow in a different way. To me, that's infinitely powerful that we are new every day. That also gives us the responsibility to hold on to our positive attributes. We can spiral away every day, and we can spiral downward, and we can spiral upward any day.

Wow. And so have you studied brains where someone came in at one point and then maybe a year or five years later you saw them again, and you were able to look inside their brain?

Another good question.

And what did you see different with the brain? I wonder, can we enhance our brain by the way we think and our behaviors and our actions and the way we love ourselves and treat ourselves internally and emotionally? Or can we hurt our brain by doing the opposite?

That's a profound question. Again, let me start with a very sort of dramatic example to set the point to the larger takeaway. On occasion, for epilepsy that shuts down kids, we have to actually take away half of the brain. It's called a hemi, you know, hemispherectomy.

You have to take out half of the brain.

We remove, you got everybody can Google it. It's not like it's something we invented today. It's been going on for decades, yet because a lot of the people in this space are not actual brain surgeons, we're not getting a lot of those stories from there. But there's a tremendous story there that when there's a medical need and the parents ask for it and it helps the child, we can actually make a big incision and take away a frontal lobe, a parietal lobe, an occipital lobe that's sparking seizures. And when they wake up, that left side doesn't work. Three years later, when you see them, they're out.

No, they're out.

Yeah.

This is not even sci-fi.

They can move, they can function fully again.

So the remaining hemisphere can reorganize. The linebacker can also be the defensive end, can also be sometimes even on offense. There are different roles those neurons play.

Yeah.

And how do we know that?

Because you removed half the brain and it's still functioning.

And we took a picture three years later and that half brain was still gone.

Still gone?

Yeah. It didn't sprout back. It's not like a liver where we cut half of it off and the mom goes some back, you take a chunk of it and you put in the kid. So that part is still missing.

Gone.

Yet that function has returned.

That's crazy.

So that's what I mean about different players on the team can cover for each other. I want people to know that that's true plasticity and it's not rewiring, it's not regrowing, it's actually whatever you have is repurposed. And how do they do that? Well, through the electrical flows of the mind. There's... Wow.

So not the electrical flows of the brain.

Right.

The electrical flows of the mind.

Of the mind. So what is... People are like, okay, now he's gone. Now he's selling crystals in Malibu. No, no, no, stay with me. When you walk, you played, right? And we talked about that briefly. I didn't know that about you. It's fascinating. I think there are a lot of parallels with surgeons and athletes. I think surgeons want to be athletes. They became surgeons. Yes. When you walk up to a stadium, there's every single, you know, so I was at SoFi.

That's incredible.

I've been there, it's unbelievable. I don't think people understand. It's the world's largest pit. You come in near the top, 'cause of the LAX flight path. You come in and, and you look down.

They dug deep. It's amazing.

It's good to be in my hometown. When you walk up and you see the pieces, 70,000 fans, think of those as neurons. We have 100 billion. Those little magical sparks from the jellyfish that I described, because they look like that. They're not squares. So you can talk, people are talking and moving. That's how people conceive or conceptualize the brain. But what happens when they roar together? That's what I mean by the electricity in the air. There's an energy.

You feel it.

It's an epiphenomenon. Okay, now let's build an engine. The parts are there, you fire it up, and there's a hum, right? That's more than just the engine and the pistons. A symphony, you've got the musicians. I'm less familiar with this. But they create something bigger. That's what I mean about the mind, that it's not a forward-backward electricity zinging around on wires. It's that thing that happens when you have a hundred billion throbbing, growing, branching neurons. And it's electricity based. You can put a sticker on and light a small light bulb.

Really?

Yeah.

And so that's how we measure for-.

Have you done this before?

Oh yeah, but this is decades old. This isn't like- So what I want people to say is like, understand is when we remove the right hemisphere and the patient comes back three years later, kids, and they can function again, no new wires sprouted, nothing was spliced. What remained created a new roar, created a new hum, created, you know, recovered the function. So it's not always easy for people to understand, but that's the truth. And that's our current understanding of how the brain leads to the mind.

Wow.

Yeah.

Can the brain function without the mind?

If you get knocked out in a ring, you're not thinking.

Right.

And if we put electrodes, there's dampened electricity, but that stock, remember I mentioned the mushroom? That can still keep you breathing and protect your airway and keep your heart still going. So the reptilian areas of the brain, the ones that we share with many animals, will function. Will function without a mind, without that if you equate mind with consciousness, thought, love, emotion. So it's like the Babushka dolls where you have...

So it can function, but it's not... It's baseline functioning. It's keeping you breathing.

It's a high level cognitive function that we...

So the mind is really what's keeping everything activated.

That's in concert.

Right, right.

The mind can think down the heart rate that the reptilian brain keeps going if you get knocked out. So they're integrated and so you put it nicely, the mind can keep things going. But if you have brain death, then there's no mind, there's no electricity.

The brain.

Brain death. So unfortunately.

What's that mean?

Meaning sometimes the heart, the body is alive, but the brain has died.

How does that happen?

Well, we'll get into some, I think it's important for people to understand. So car accidents, brain swelling, those 100 billion neurons, they burst from smashing into each other. We put a catheter in the thigh and we squirt dye and we see there's no blood going into the skull. It's a dark vault.

So if it's so much swelling, the blood can't flow, there's so much inflammation, It's hard for blood to flow.

Instead of a heart attack, you've had a complete brain attack.

Can you recover from that?

For a day, no, no, no.

You can't recover from this.

Not even miracles. When it's 100.00 out, there's never anything left. But for a day, since the heart nerves have their own pulse.

Yes, they're pumping.

When we can put machines and things and to keep people going for a day or so, that's where the world of organ transplantation comes in. So, a lot of guys, a lot of people who ride motorcycles, they have that kind of injury and their bodily organs are healthy and they often are the ones that provide transplants for other people.

The brain is... Brain is functioning.

Body is alive.

Really?

In that setting, there's no mind, there's no electricity coming out. So, when you're asking about mind and brain, And so that's a fascinating area for people to know those examples, to understand themselves better, right? And it comes back to that we are electrical currents. We're not wires, we're not switches, we're not gears, we're not gears.

Electrical currents.

Yeah, they flow. What is that? So like you go to a lake and you drop a big, you jump in there, whatever, right?

Yeah, yeah, yeah.

There's a wave that moves through the lake, but the water molecules didn't ride with it.

Right.

Right?

Right.

So that's the hum, the symphony, the roar, the electrical global waves that are pulsating through our brains. And when people say they're in the zone or they're in a flow state or they're in a meditative state, that global energy flow, those waves, They're different. They can be measured and categorized. Really?

Yeah.

What does that mean when someone's in a flow state in terms of the mind-brain connection? What is happening? Are these 100 billion jellyfish like in symphony and they're humming at a high level? They're working in concert.

Let me jump in right there. Actually, that's perfect. Actually, you would think that if somebody's about to hit a game-winning shot, their best performance is when they're at a high level, meaning wild, frenetic. Actually, no. When they're super calm. somewhere in between.

Okay.

So, not asleep, but not, hey, I'm on my third espresso just taking in stuff in the morning.

Focused.

Focused, but relaxed. And there is a measured state for that, and it usually has to do with sort of medium brain waves. That's something I'm writing about right now. And whether you meditate or you're under that, the two-minute drill in football, or you're a ballerina and you have that that perfect, you know, dance routine coming up or maneuver, you are actually disengaging some of the things that would get in the way of you releasing a performance. So you're not thinking the performance, you're getting out of the way.

You're being, you're just being. Yeah.

And that has a different measurable electrical flow state, you know, and it's not revved up.

It's not hyperactive.

Somewhere in between.

Above calm, but calm.

It's not fifth gear, it's not idle. They're at their best and they've seen.

That in athletes and different things. What's the fastest way for a human.

Being to get into a flow state? For that, in my opinion, there are no shortcuts.

Because what it takes is a lot.

Of practice and it takes is a lot of learning. And then when you are performing.

And being confident in your abilities and yeah.

But it's executing, you know, I don't think you can get no, I might be wrong, but when I see my kids, I don't think you can get into a flow state. rolling through Instagram. It's actually delivering a skill you've trained for. So you have a craft that you've trained for and you're performing it at a high level. So you see race car drivers talking about stuff like that. So it is sort of your craft performed just at the edge of your comfort level. Like video games, if they're too hard, kids will check out. they're too easy to check out. So something about it tends to be a physical maneuver. I always find that fascinating where, you know, you can think, I guess you could think yourself into one of those states, but you see it a lot with people who do a physical task that's challenging, rewarding, something they're engaged in and at the level of their performance. So, you know, it's a two-minute drill at the end of a football game.

Of course, yeah, it's go time, man.

Yeah.

Did you play football? No, I love sports though, 'cause I.

Think there are a lot of parallels. Yeah, of course. The challenging thing is, I don't know if I'd-- I don't have kids, but I don't know if I'd let my kids play football. After all the head trauma that I took-- I mean, every day we were just taught back in the late 90s to just lead with the head, hit with the head. Now it's illegal.

You can't hit the head at all.

Monday Night Football used to open up with the two helmets-- Crash, crashing, yeah. I remember that. And the trauma that, you know, I feel like I've had a heel for the last 15-18 years now. I don't know if it's worth it. I think, I guess if you're not hitting the head anymore, it's different, but.

There'S still gonna be clashing. I mean, I got a couple of thoughts about that. I mean, one thing that I didn't like about it was I think they knew this was bad for us and they kept trying to hide it from us. Of course. Hey, just tell us it's bad. Just tell us smoking's bad. We know boxing's bad. Nobody goes into boxing and says, I don't know. Yeah, but you you held information.

That.

You know, traumatic head injury in football was sort of messing people up. That's one of my things with it. On the other side is if it's something you love and it's an opportunity for you to advance in your life, who am I to say no? As long as the risks are made aware. Like, hey, if you bang your knee against the wall 30 times a day for 10 years, your knee's gonna be jacked up. It's no different for your brain. Got it. I still want to play. You know what I mean? It's more about that to me. We all live in different worlds and safety and risk and... What's... My sons didn't play though. They could have, but they didn't.

They didn't.

They played flag and they all played baseball.

Yeah, it's probably safer. So the brain has the ability to heal from traumatic, from trauma then. Physical and emotional trauma. Because I feel like the emotional hidden trauma can be more painful and harder to recover for some, the psychological, emotional trauma than the physical trauma. You can see it and you can treat the physical trauma in a sense, but depending on how intense it is, but the emotional psychological hidden traumas, I feel like, are invisible and people don't think they need to treat it because they don't see a broken arm and say, I need to go to the doctor because my bone is sticking out. put a splint on it and heal it up. We're not trained that way.

There is no easy answer. Yeah. But what I will say is that trauma, these are my concepts. They're not, I'm not, yes. There's therapeutic trauma. And what I mean by that is resetting a bone after it's broken, the pain of a cancer surgery, but then you know that your cancer has been cut out. Like that, that's good pain.

Right.

And we're just talking about physical trauma. Yes. Then there's emotional trauma if people are attacked, that's also intimately connected to emotional trauma, right? So the people who don't have memory after certain injuries or operations, they never have PTSD because they don't remember it. So the emotional context and memories related to trauma, be it emotional, physical or a combination, requires memory. That's cool. I like to think about, like, just as a concept. I don't have a solution for. I don't. Hey, don't do these three things. You'll be better. Sort of not my approach, because when people did that with me, I was like, how do you know what I'm going through, man? You look at me, you think everything's good. Are you sure? Are you sure I wasn't attacked last night? Are you sure I didn't find out that my patient didn't do well last night? Are you sure? I didn't find out a loved one was diagnosed with something. You know, like, I just don't want to put people in boxes. In fact, I want people to know that they are new every day. I'm not even the same version of myself I was before the last few years. How can I be understood as a group of people, a man or a surgeon? You know, I just want people to think of each other as individuals and dynamic. That said, I never judge people's trauma to be better or worse. People are looking or stronger or justified. They're looking at everybody's gonna have a traumatic event in their life. Whether it's a car crash or hearing this, it's unavoidable. It's partly because we put ourselves out there. It's partly because the way we approach the world is to be completely adaptive. If we're rigid, then there's less chances for trauma, but that's a life less well lived. So when you put yourself out there, traumatic experiences are unavoidable. That said, okay. So that said, yeah, you get a bruise.

What I'm hearing you say is that if we don't have the memory of the traumatic event, we don't have PTSD. We don't have trauma, we don't have a trauma tail.

Right, so that's the That's the concept that I want people to walk away and say, Memory is important, but memory is the thing that determines whether the event remains traumatic in your life.

Whether it's painful still for you.

So let's get into that.

So we just need to heal the memory of the trauma.

That's exactly where I'm taking it. Very good. So memories are not files in a cabinet. In the brain.

How is memory categorized?

There are some regions that if we remove them, you would lose memory, but memory is not only there. It relies on pulling from memories of smell to new, like for example, smell is very interesting. It's one of the five senses that we can't tamp down with our thinking. So the perfume or cologne, smell and memory are intimately intertwined. And so you're pulling from all different parts of the brain. Again, memory is a certain electrical flow in the brain. But it's not, it's malleable, it's moldable. Just because you have a certain memory today doesn't mean that that experience, good or bad, will remain good or bad. Our positive vibe right now can be made negative, our negative vibe right now can be made positive as we look back at our day to day. So when you see memory that way, then you say, okay, wait a second. I was attacked or I was hurt or something really traumatized me and when I think of it, when I smell that smell, when I see that color, I am traumatized again.

I clench up, I have stress, fear, anxiety.

So.

The emotional context to a memory is what you can change. You don't want dementia, you don't want to delete the memory because that's a different problem. you- don't wanna block it. you- don't want, yeah, but what you wanna do is change the emotional context.

Attached to that memory. what happens if we, you hear this from people a lot who might have been traumatized as kids where they kind of blocked the memory and then they remember it. Whenever resurfaced, it's very raw. It's very raw. yeah. But they've stuffed it, they've blocked it, they've numbed it, addicted it, whatever you wanna call it. Driven it to addiction.

Yeah, exactly. So what happens when, I don't know. I don't know about the kids stuff as much, because that's a different space. And I don't want to stay where I feel real comfortable with what I've been reading and learning. So emotional context of memory for adults, in the right setting with the right.

Person.

They have their techniques. You can actually work through the trauma of the memory and the experience by going to certain therapists, who help you get better with that.

Process the memory.

Yeah, just to take the emotional pain, the emotional trauma and dampen that so you can say, for example, yeah, I was, you know, I'm just bringing examples from my world. Yeah, when I was diagnosed with cancer, that's a traumatic event. And then you see my patients, you see them over time through different ways, When they say it, they say I was diagnosed with cancer and I did this. Their face is different describing it later than it was immediately after receiving the diagnosis. So through that, that's a real life example, right? It doesn't have to be all the.

Stuff.

Related to violence and all that.

Sure.

The traumatic experience of a cancer diagnosis and how patients cope with that immediately, and then you see them months later, years later, because I'd be a mess, right? I'd be like, okay, this is-- I wouldn't be able to cope. But surprisingly, not some of them, most of them cope. They get dressed, they come in for their three-month scans, which to me would be a traumatic experience every time. Is this guy gonna tell me it's back or it's bigger? I mean, think about it, like, getting that thing in your mail or email. I gotta go in for this. scary news again. But somehow they cope and that's where in life on a knife's edge, I learned so much from them that it's possible to cope with traumatic experiences. I'm not saying you as an individual can, I'm not saying I can, but when you look at a group of cancer patients and most of them cope, live, move on from very traumatic emotional experiences as well as physical experience of cancer pain and cancer surgery, right? That's the lesson I want everybody to go through in their mind when they're dealing with their own challenges. Wow.

What's the biggest lessons you've learned from the cancer patients you've treated on the way they process and handle their journey from first hearing about if they have cancer in the brain or a tumor or something to recovery, what's the biggest lessons you've learned there?

It doesn't all end well.

Really?

Some suffer, many suffer, you know, in their own ways. So it's not this, you know, nobody wishes cancer upon somebody else or on you, you know. So it's not like, you know, it's not like this thing, like it's not an opportunity. And I don't want to ever present it that way. But those that have coped well, they invariably say, I wish I would have lived my life the way I am now after a cancer diagnosis.

Oh man.

I wish I would have lived my life having seen the finish line relatively, because it changes how they live and they're not sad. It's a generalization. Like I said, some have suffered, many have suffered, but they wish that they would have made quality of life a priority throughout life, not after the cancer diagnosis. Something about seeing the finish line on the horizon makes people go, I don't like that guy. I'm not gonna see him much. This is something I enjoy. I want to, you know, they get after it. They get to the business of living in the way they want to deep down inside, but often have been encumbered by the weirdness of interpersonal relationships and.

Career and pressure and everything else. How do you show up in your personal life after seeing all this for the last couple of decades?

Or I guess-- that's a heavy question. I can't say that I've always dealt well with it. The human stories were important, but I was just going for perfection of the craft.

You were trying to be a precise surgeon, just trying to remove it and fix it. And then-- you- weren't as connected to the human stories. You were just like, let me-- I.

Wouldn'T say I was disconnected, but the-- From the fifth to the 10th year approximately when the craft became occupied less of my mind.

'Cause it was more automatic. Obviously everyone's specific, but it's more automatic.

I was in a rhythm.

Yeah.

And I actually enjoyed the challenge. And that's what you want as a cancer surgeon who's trying to be the best for you and be the best for them at this craft. That's an interesting intersection. They want me to be the best. They want me to have ambition at being the best surgeon. which means tackling the biggest cancer and the people who chose me to perform their surgery have the fewest complications. Biggest mountain, fewest complications. That's a personal ambition that aligns with what the cancer patients wanted. So that was an interesting thing.

It.

Drove me and at the same time I could see that since I take care mostly of stage four cancer and there's no stage five.

Really? that stage five means what?

There is no stage five. That means death. Okay, so stage four is the word terminal is not fair, but stage four is the most advanced cancer. So all my patients live a few years, let's just say that. But that means, you know, after a while, you know, I was like, I've cared for like over a thousand people and they're no longer alive.

Wow.

And it started to mess with my head, man.

And because stage four, there's no way to cure it, is what you're saying.

Stage four, by definition, other than in blood cancers, is not curable. so the question is, can we, can we get out a few?

Extend life. Yes.

And, and quality life during that time.

Oh, my gosh.

That's what I was thinking.

Yeah.

So after a while, I was like, man, I gotta, I gotta, I gotta drawer full of invitations to funerals.

Oh, my gosh.

And I just stood back a little bit, and I was having some struggles with my own, in my own life. And so, so the answer to your question is for those for those who are involved in cancer care to make yourself vulnerable to actually sort of in piecemeal go on their difficult journey with them. It can be hurtful. It was raw. The last five years though, the last three years, I've been able to take that and write about it and see that I have been fortified by letting them teach me and the privilege of them saying, Come along with me in my difficult times. This airplane must crash and you will ride with us. We choose you to ride with us, but you have the parachute at the end. And after a while, I was just telling my kids that, man, I just feel like I'm crashing a lot of planes. And so it went from not noticing it to noticing it and having it mess with me to wait a second, that might have been the biggest gift of my craft, is to learn from the people in their most difficult times and how they remain optimistic in the face of calamity. So I'm in a different space about the last couple of years. But that's probably the best question anybody's asked me in the last couple of years. I appreciate it.

But of course, man.

Wow.

So how do you personally manage your mind and your brain health knowing that I mean is there any I guess survival rate after a few years of any patient that you work on?

Few.

Yeah.

So maybe it's a it's more of a stage three cancer I guess or.

It'S yeah, yeah the earlier stages have cure potential.

Yeah.

When they come to see me youe're at the stage three. It's usually that it's spread to the brain. from a cancer in the body that's broken out.

Gotcha. And is there no way to see to do a surgery on a brain that has less cancer at stage one or two and remove it fully? Is that possible?

Some.

Or is it hard to see that?

Yeah. There's two types of brain cancers. One that grow from the flesh of the brain and they come in different stages and more commonly are those that spread to the brain. Jimmy Carson or Jimmy Carter, president, is 90-something and he's got melanoma that's in the brain, but it was that, you know, so it's not always, but for breast cancer or lung cancer that spreads to the brain, it's sort of the final manifestation of the cancers, right?

Oh man.

Now, but those are heroic stories to me, right? That, oh man, that look you gave me. that was me five, six, seven, eight years ago. Like, man, this is good, you know? But the last couple of years, it's, man, they made it to the graduation. They made it to, you know, moms are always like, I just want to get to where my kid is out of high school. There's something.

It's our kids with it.

No, moms have breast cancer in the 40s.

They got a kid in 15, 15.

Year olds in ninth grade, and they're. Yeah, but. So when you see them, it's, like I said, it's, I don't. It's not sad at all for me anymore. It's actually how rare of a gift that I can see people at their most valiant.

Oh my gosh.

And so now it informs me, but back to your original question, there was about five years where it was just messing with my mind.

How does someone, this is more of a educational question I guess for people, how does someone prevent cancer? And where does most of these cancers come from? random that people just get it? If they're whatever genetics, is it their environment, their levels of stress, their food intake, is it anxiety that they're dealing with, trauma that they're not processing, what is the cause of most cancer?

There are cancers we potentially give ourselves from our bad choices, really.

Give me Smoking. Okay, yeah.

Okay. But not everybody that smoke gets it. And 20% of lung cancer people never smoke.

Really?

Right.

Where do they get lung cancer from if they're not smoking?

So, do you remember I was talking about the brain being this garden and stuff like that? Well, our bodies, they're not an interesting garden in my opinion, you know, but they're their garden too. Their skin is shedding off, liver cells grow. So, when things grow, they can sprout weeds. so parts of the body that don't ever change, strangely, heart never gets cancer. So things that don't change don't sprout. Cancers. It's a byproduct of constantly having cells in our bodies die and regrow and when you do that regrowth process, you're going to spin off something that doesn't behave.

So how do you spin off things that are healthy and flourishing as opposed to little weeds here and there. How do you do your both?

Well, you're doing your both. How do you do your oh, I'm talking about physiologically before we get to the mind. It's an interesting point. Thoughts can be thought of that way too. The body when it is 99% of the time is doing the right thing. We're both here. But when you do it with a sheer volume of a lifespan and you do it over seven billion people, you're gonna sprout some cancers. So you get cancers in the body, cancers in the brain. Can our thoughts become cancerous?

That's a provocative... And can our thoughts heal cancer?

That's a very provocative thought. I have not seen positive thinking. There's no... I'm not saying it's not possible. And I encourage people to do it. But I think positive thinking, meditating, cultivating optimism, all of these things, they do change the global physiology of your body. I think we were not just the.

Brain, but the body.

And that in turn can affect what's going on in the brain. But I don't know if a thought can send an electrical zap to a tumor and hurt the tumor. But a certain way of thinking can make you have a certain physiologic response which there in turn could, you know, get in the way of cancer's progression.

That's why, I mean, I feel like if we're breaking this down from what I'm hearing you say, there's a garden in our brain. There's a garden, right?

And how-- Think of it as a garden.

Think of it as a garden or a school of fish, you know, working harmony, all these different things, right? So if our, if we have a level of thinking that is Let's call it positive. Let's call it beautiful thinking as opposed to suffering-based thinking. Beautiful thoughts, joy, gratitude, happiness, peace, appreciation, acknowledgement, self-love and love for others. Let's say those types of thoughts versus the opposite of suffering type thoughts. If we have those thoughts on a consistent basis in the mind, would those then in fact penetrate the brain to flourish more healthy... To nurture that part of the garden. The 100 billion jellyfish floating in harmony, would they be in more harmony and healthier as opposed to penetrating it with these suffering based thoughts? And then in return, with the brain activated and flowing and not having these breaks and blocks, then it's signaling down to the body to send a more healthy ecosystem throughout the body and then returning the body back to the brain and back to the mind and having.

A more... Let me unpack that for you because that's an enormous question that I think I have a very specific answer. Because I think when we were talking about this earlier, language can be confusing if it's if it's used too casually. But let's take the cancer part out for now.

Yes.

But yeah, being in a better frame of mind, exercising, eating right, feeling calm, stress, all of that changes things physiologically that make your whole body better at fighting cancer. That we agree on, that's measured. Now, let's go back to the brain as a garden.

Yes.

So can we cultivate that part of the garden or can we cultivate a garden that lean towards a positive mind frame?

Yes.

Because if bombs are falling, even the most optimistic garden will go into threat response. You don't only want to be chill. You don't only want to be positive.

You want to be aware. Yeah, you want to be flexible. You want to be all these things.

So let's say there is an external stress around Yet you're too jacked up. You're too stressed. That's a common ailment of city life, at least here where we have safety. This is really fascinating. It's one of my favorite things that I love talking about. You remember we talked about the reptilian brain? Uh-huh. You get knocked out and you stay awake. And then we talked about the mushroom canopy. Well, there's another one in the middle called the limbic system, but I call it the emotional brain. Categories are not that simple. But it's got its own little anatomy. Like if there was a slice down the side of my head, you would actually see the mushroom canopy, and you'd see some unique Star Wars looking structures in the middle, and then you'd see the reptilian brain.

The stem. Yeah, the stem. The stem is the reptilian brain, and in the middle is the limbic system.

And on top is the mushroom. Right, that's the cortical. We call it the cortical canopy. We use ecological terms to describe it in journals. So the cortical canopy and that emotional brain, the limbic system, they have branches towards each other, measurable. And so when somebody goes from age 16 to being wild to being 18 and more composed, let's say adolescence, the structure of the brain hasn't changed. It weighs the same, it looks the same on MRIs, but the person's totally different, right? Well, because of the cultivation of thought from the cortical canopy, the mushroom cap, to the emotional brain, as they integrate more, you're able to say, Hey, maybe don't run across that freeway or maybe wear that seatbelt.

It's learning.

But it's interacting with emotions. At the same time, you don't want to be emotionless. So emotion is making a push back to thought. Like, no. Love is an emotion. This pain I'm feeling because mom is sick is an emotion. I don't wanna be spock about it or tamp it down. So that cultivation of thought and emotion is the most lush way to live because then you're adaptive to stress. Like, hey, this is actually something dangerous going on. Thought is coming in.

Be aware.

Emotions going on. But at the same time, you have this internal, what they call emotional regulation. Like, nothing's wrong. and you're just freaked out. And that's where those branches, thought, meditation, therapy, counseling, hugging your puppy, it creates a better balance between thought and emotion. And that tone, not on off. Thanks for asking this question. I love this. The tone is what life is about. you become a new parent, let that emotion run rampant, cry. You're about to go see your boss and you know it's not gonna go well and you're starting to do things that you know is emotion running rampant. Then use thought and breathing exercises.

Turn the volume down.

Just set the tone a little different on that and then go and see your boss or your lover or some conflict situation you're in. That is what we're doing throughout life. And the example of it is adolescence, where it happens for most of us automatically, but then we stop, like we're grown ups. That tone is something you cultivate through the experiences of life. And then when you get older, or when the next trauma comes, you're better braced and positioned for how to cope with this. A little more thought, because I'm running hot on emotion, or like, Man, I'm too cold about this right now. It is a raw situation. I need a safe place to let my emotions run wild.

Right, a safe environment, yeah.

That's the way I approach the intersection of thought and emotion.

Yeah, I think you said it, emotional regulation, I feel like is for me one of the most powerful skills that someone can learn in relationships, in career, in driving, you know, on the street with other people around.

The emotions are dominant, by the way. Yes. Which is great, but let's use the emotional regulation, not thought regulation.

Right, but learning how to have emotional regulation, is such a powerful skill for each individual.

And we're never done, because you don't know what's coming. But it's the tending to the garden. It's the lifelong cultivation.

Because what's happening if we allow our emotions, the limbic part of the brain is the emotion-based part of the brain.

Thought is the... No exact regions, but there is some anatomy relative to this. Yeah, I'm with you.

It's more of the main focus of the brain. Obviously, if it was taken out, it would regulate, but. Emotionally, if the emotion is, if you're always in reaction mode, you see something, ah, you're in freak out mode, you're in scream mode, you're in defensive attack mode, I'm in someone's hurting me mode, if you're always in that space, what happens to the brain physiology? What happens to the actual physical aspect of the brain? and how does that affect the body and the mind if your emotions are always running high?

Oh, I love this question, man. Because when I was reading about, no, I'm not. No, because this is what can empower people is an understanding of how things lean and how things that can be modified. Otherwise it's just, I mean, I can't tell my cancer patients just, Try not to stress out. It's hollow. It's shallow. It's rude actually. So I think there's too much of that advice going on. What I want to show people is how we're sort of designed, our natural inclinations, and then you come up with your approach. I'm telling you, hug my son got a puppy in the pandemic. That man, that's my therapy dog. I didn't even understand the con, I hugged that animal.

And you brought so much peace and love.

I'm telling you my physiology changes. There's aha. Yeah, it just, so everybody's gotta have an individual approach to that. So here's the two things about emotions. There's, we could cut out the thinking, just to put it coarsely, cut out the thinking brain and you'll still be alive. If you somehow were able to take out that middle part of the brain, there is no life left. The consciousness relies on emotions. On emotions.

Consciousness relies on emotions.

Yeah, 'cause they spark through. Right, remember the branches? Frontal lobe, deeper branching, intersecting the global waves of electricity. That's why there's something called deep brain stimulation. Just let me riff on this for a second. Go for it. So, well we want people to not wash their hands 150 times a day or have Tourette's or sometimes depression or sometimes a drive for obesity or certain tremors, we take a little catheter. And just the tip isn't covered in plastic. And we put it into the emotional-- Come on, the limbic brain.

The limbic brain. You stick it down through the top of the mushroom. What do you call the cortical-- Cortical canopy. Yeah.

Cortical canopy.

You can punch through that.

You can punch through that and it doesn't affect you. You guys can look it up, deep brain stimulation, DBS. It's been around for 40 years. Yeah, yeah. So you put it through. So those drives that Tourette's, the precision. We don't tickle the cortical, the thought. You're not just tapping on the top.

It's an emotional job. Oh my gosh. So you're sticking it in through the.

Middle of the brain and what happens? And then the tip, with just a little pulse, like the brain's pacemaker, and it changes the electric, it's not brand new.

I understand, but why would it work? You can pulse the limbic brain.

How long do you do this for? Five minutes, an hour? What is this process? They wear it under their clavicle, like.

Grandma with a pacemaker.

You're keeping in all the time. It's you were right here. What do you do?

I mean, do you just push a button when you're freaking out and it.

Kind of relaxes you? So, the waves on that lake?

Yeah.

If I also jumped in on the other side, when those waves come towards each other, sometimes they negate each other, right? Similarly, the right electrical pulse can reset the electrical waves in your brain that we were talking about earlier. That's how deep brain stimulation has worked for 40 years.

So how do we create Deep brain stimulation on our own?

Oh, that's a good question. Let me answer the first one. I'll get back to that. Deep brain stimulation on our own is through paced breathing. Let's get back to that one.

Breathing, meditation, and I'll show you the anatomy for that.

Because as we talked about, I need somebody to explain it to me. I can't just say do this. Emotional regulation is tricky in two ways. Hot emotions lead to high heart rate, surging blood pressure, lots of things being released. We've already heard about them. So you're running your body in overdrive for no reason, you're wearing yourself out. That makes sense to people, okay? That's a good reason to be physiologically not stressed if you can and you come up with your coping maneuvers. What's more interesting is the intersection of the frontal lobes of the thinking brain and the emotional brain is that emotions are, they're coming in favored. They're always hot. The thinking brain has to do more of the work. And at some point, if you are not able to cultivate emotional regulation, it becomes a feed forward thing because the connections start to sever and then you start having this emotional brain that's no longer being tamped down or paced or controlled by the thinking brain. So emotional regulation is the life skill to deal with the trauma coming up. to rev your body down, but if you don't try to cultivate it, you'll actually lose control of it. And as you get older, you'll have more rampant uncontrolled emotions and not be approaching life the way you want to. So that's the answer about emotional regulation.

Do emotions have more power over thoughts or thoughts have more power over emotions?

We start off with the emotions are generally on overdrive compared to thought. So thinking through emotions, thinking which emotions have earned the right to be there is that lifelong process. And people are like, what does that mean? Well, take adolescence. Teenager goes from 15 to 19, very different person. And that's all emotional regulation, right? Thought was losing. Teenagers, I miss it actually, it was a wild time. But then thought comes into balance emotion.

Your reflection and thinking and So take.

That thing that you know happens, take my explanations if they're of value to you, and then say, now let me take the wheel of that thing that happened without me actually choosing or driving. That maturity happens on its own. Now let me take the wheel of that process and try to do it for the rest of my life, every year, every moment, and not just say, Hey, whatever I got at 18-19 is who I am. Going back to your first thing, you're new every day. So it's a responsibility to cultivate that emotional regulation through thought and through certain behaviors for our whole life because you never know what's gonna happen, pandemic, war.

And.

You want to be best braced for that and not approach that as a 15-year-old.

You want to have more awareness and I don't know if you want to call it control, but I think you want to have control over your emotions and not let your emotions control you. To do the same thing.

Control the ride a little bit, control the roller curves a little bit, trim the sails.

So that the emotions are mostly based in the limbic part of the brain, right? Obviously it's all connected in certain areas, but if you're talking about an area, and so what's the best way to train the emotional part of the brain? So that we are in, we have a personal power over it.

That we're in control.

That we have Or more, it depends on the situation. We can turn it up or turn it down and we are-- Depending on.

The, depending on what's going on.

Yeah, maybe we need to be a more emotional in a moment and not.

Be chill and relax when there's an attack. Yeah, maybe the moment is so big, man. It's, of course you're just emotionally over the top. And we know that's what's been going on the last couple of years and even today. So, but that leaves you a flexibility. And it also leaves you without feeling bad, like, oh, I was emotional then, now I'm not a person that-- has emotional regulation. You don't have this brain the same forever. It's a constant trimming of the sales, modulating tone. To me, it's a little bit of work if you're in a good spot, like, hey, this ain't guaranteed, but it's also so much power and opportunity that if you're not in a good spot, like tomorrow can be better, and if not tomorrow, then the month or the year after, right? Emotional regulation, the shortcut. So now we're getting to like, is there a tip? 'Cause I hope people feel like, wait a second, everything is possible, but it's gonna take a lot of work. That's really what I was trying to get at for the first part. But are there shortcuts? 'Cause I love shortcuts. LA Freeways or whatever.

Right, ways is good.

But there is one that has stood the test of time. and that I can now explain to you based on things that we do as surgeons. And that's, I refer to as meditative breathing in my first book, but really it's pacing your breath. And so what is that something you.

Study with actual scans or... No, no, no.

It's even wild to study that. If you have aberrant brain electricity and we check a scan and there's some funky marble type tough to brain tissue. That doesn't look right. We know, like, that's the epicenter. That's where the electricity is sprouting from. But some people, they have it, some kids, they have it, some adults, they have it. There isn't anything wrong with the scan, right? The scan looks pretty. Brain looks perfect. But the electricity's off, right? That's what epilepsy is. All right, that's yet another proof. Seizures. One seizure, two seizures is epilepsy. Then you get the diagnosis. But, yes, seizures. is aberrant electrical activity of the brain, the same things we've been talking about. So when we don't know where it's sprouting, because if it's from a small space, we can dissect it out and take away the epicenter, right?

You can take it out. You mean you can cut it out?

We can cut it out and the patients are seizure free.

Really? Yeah.

Now, but what if there isn't a spot that we find and their seizures are horrible? and it's well before thinking about removing half the brain. So what they would do is we make a reverse question mark incision. It's a scalp. It's not very tender. That's what they tell me. Ribs are more tender, is what they say. Patients. Then we make our little ice fishing hole. Are they numb when they're taking this out?

For this one, they're asleep.

There's others. They're awake.

Do you numb the skull, the skin? You just cut through the skin.

No numbing. They're fully asleep.

Oh, but when they're awake.

At the very end, I inject the cut. So the numbing lasts the longest.

With numbing, gotcha.

Yeah.

You're not just sitting there awake, they're.

Just cutting it off. That is an operation we do, but that's a different story. So you take the skull off. The brain has a covering, you don't see the brain right away.

There's like a sheath.

Like a skin? No, it's like almost a nylon material. You can pick it up and stitch it. that's what keeps the water inside the skull. It's not the bone sack. Yeah, brain sack. There you go.

It's a brain sack, right?

It's like a nylon. It's pretty. And we cut it and then the clear water pours out.

You can see the surface of the brain.

And water's coming out.

Yeah.

Because the brain is floating in an aquarium, right? It's crazy.

Yeah.

It's buoyant.

Your brain doesn't sit on bone.

It's.

It's floating again. Jellyfish in water.

So when you're hitting. When you're having a lot of.

Fast actions and you're hitting something, is it hitting?

Yeah, your skull stops and then inside it sloshes into the inside.

That can't be good for you, is it?

That's where all the CTE and football stuff is the issue. It's a sudden stops, repeated sudden stops with the brain sloshing and hitting the.

Inside surface of your skull.

That can't be good, can it? Well, people are pretty, people get by, but we're seeing that if you do it too much, that's with kids and NFL people, but So you got it open, then there's a little, it's the size of a deck of a card. It's got a little 96 or different electrodes on it. You put the deck of the card on the naked brain. You take those wires, you pop them out with little needles through the back, almost like, like, yeah. And then you put the bone back on and you stitch up the scalp, and then you put some numbing medicine and you put on a head wrap and they hang out in the hospital for weeks.

'Cause you're waiting for the seizure to happen.

So you've got a pad on the brain A grid, so when the seizure sparks, we can see it was like in Connect 4 or Battleship, was that board game? Battleship? Yeah, it's in two.

You know where it's at?

Yeah, you know where it's at. 2-6.

'Cause that way you know where you're gonna, that's the key. So there's a mesh pad, electromagnetic pad or something that can track with wires that are coming out of the back of this.

Connected to the monitor. That are connected to the monitor at all times. And they're there for a couple weeks.

It's insanity. Because they're trying to find. They're happy, they're fine. They're like us. Hanging out, let's give me some ice.

Cream, play some video games, watch some TV. So what happened was a bunch of wires coming out of their necks. Yeah, but the scalp, yeah, but we have things, people, you know, you'd be surprised with what we can. You wrapped it up. What kind of devices we put in and dangle from people.

You know, from broken legs that come up with those little metal grids and they move around.

So then after a few weeks, you.

Wait till a seizure happens.

And then we know under that grid where it's sparked, we found the epicenter.

And then from that, you track the data, you have the recording of the data, and then you can go in and then tweak it or you remove that little part. And then they're done, they don't have seizures anymore.

Sometimes, or they're reduced. Now here's something that's more interesting for you and your audience. Well, that's a boring couple of weeks. So a bunch of cognitive science students and brain students and all, They come in and they started hanging out with them. And they said, Hey, can we go through these lessons of paced breathing and meditative breathing?

Can we do this without removing it? Yeah.

Well, completely unrelated to the clinical work, where we're hanging, I've got a direct feed of the true electricity from the surface of your naked body. While they're breathing. Yeah, while they're sitting there. So they do something new with them. They teach them meditative breathing.

Come on. What are you seeing on the brain activity recordings?

The same thing that we see when we give Valium, which is an anxiolytic, their anxiety level goes down, their electricity goes from fast to medium. Remember we started this and we're talking about athletes not wanting to be in fast, we want to be in the flow state. Meditative breathing led to direct changes in the electricity of their brain as measured not with a sticker on the forehead, but with a grid on the surface of the naked brain.

It's true. On the brain.

It's true measurable changes in the electricity there for the mind. So meditative breathing that for thousands of years people have said can help you chill out is an anxiolytic and break anxiety. Well, we have proof of that now. And I think that's important for people to know that it's not just some It's just not a concept that's being thrown around too casually that through awake, direct electrophysiological recording of seizure planning surgery at elite centers while looking for the seizures, there's a lot of data coming out about let's play video games, let's do meditative breathing, let's read, and then what changes. That's what I love in book one that I shared was that's raw data. That's real data. And there's an explanation behind how that happens. And so what I would say to people is that's something you have that's free, because I'm not selling anything.

Breathing.

And the pace of breathing.

And what's some pace that works best? I mean, there's lots of different techniques of meditative breathing.

They found, you know, it doesn't, you know, people say through your nose or mouth, and that's kind of the confusing stuff that's out there. Well, the nose and the mouth connect before they get to the trachea and it goes to your lungs. So it doesn't matter how, but it's about slowing the cadence and making the cadence more methodical. A deep breath in and a deep breath out. It's no different than what we do in surgery when you feel the case getting a little out of your control.

What do you do?

Well, the first thing is I just slow my breathing down. and that doesn't mean the solution will arise, but I know that puts me in my most calm and focused state to find the solution for the problem in front of me. Likely that's what athletes at Thrive do as well.

You don't want your brain surgeon to be like, well, exactly.

That's what stress does. It makes you hyperventilate, right? Absolutely. But if you, that's a great point. If you just hyperventilate just 'cause you're just doing it as just whatever, for whatever reason, you'll get physically jittery. you will give yourself anxiety by just doing that. Yeah, I felt that just for a second. I'm showing you the proof on the other side. Do the opposite of hyperventilation and you'll make yourself less frenetic. Will that solve your relationship problems? I'm not sure. Will that make you not want to get in a fight with your boss? I'm not sure. But you should know that that puts you at your most in command of your emotions, your emotional regulation.

That's a great, great question for that. The emotional regulation, it sounds like, A big part of the health or the lack of health of our brain and our bodies is what I'm hearing you say. The emotional regulation is at the center of our potential, let's call it sprouting of healthy brain activity and connections and also healthy cells throughout the body and organs, or a lack of emotional regulation could potentially damage the brain activity or could have it so up and down as opposed to a calmer activity and the body as well to create potentially more, I don't want to call it cancerous cells, but... You wear yourself out.

Yeah, if you let the most... Exhaustion.

Stress, anxiety, depression, all these different things. You wear yourself out. What I'm hearing you say is emotional regulation is at the core of these things.

I think so. And... And it's the rarest skill to cultivate and the most important one. and it's in your control. But it's not easy.

It's not easy. It's taken me a long time to learn this process. So we've got thoughts. Do thoughts come from the brain or from the mind?

That's a deep question.

And is the mind, but the mind is only activated when the brain is activated.

It's like saying, does the roar come from the person in the stadium, you know, or is its own thing. You need the neurons to roar, to connect with electricity to have the mind. The mind is that roar outside of the stadium. Interestingly, they did this experiment again with direct, like, I need hard science. I don't want fluffy language. Somebody says, In the next five minutes, decide on your own, at your own, whatever you want, then you're gonna move, you're gonna grab this coffee cup. And then they're measuring me. The electricity pops before I report wanting to move this coffee cup.

What do you mean?

Meaning that the electricity happens before... You make a move. Before... I think I'm ready to make a move. The ambition comes from the electricity. It's not like, I'm gonna grab this coffee cup and then electricity. It's the electricity. I think I'm gonna grab this coffee cup. Really? So this is something you can't explain.

It comes first.

You've scanned this, you've seen this. More than scan, right? Because a lot of brain scans going on these days. Everybody in a car accident with a headache is getting a brain scan.

I'm talking about direct electrical measurements. you mean with on the brain? Yeah, yeah.

Yeah. So the electricity is the thought.

So before I move my hand to grab this coffee cup, there's an electric.

I can measure. I can measure a little flick like your light bulb. I can measure something before without you telling me when.

So.

So you can tell me when I'm gonna move for it based on.

I can tell you when electricity changes. I can't tell you your intentions. I can't read your mind.

Gotcha.

But electricity pops before you actually think I'm having a thought. The electricity is you having the thought.

What does that mean? It's crazy.

But that's measurement that we can, you know, it's, that's why it's fascinating, the inner, you know, let me tell you something about this, man. We are electrical beings, like eels. Right, you can the nerves to your legs, you can put electrode in there. You know, we're electric. We're flesh. We have chemistry, right? Electrochemistry. There's a battery and you separate these little ions and what's a battery? We are batteries. Those neurons are essentially batteries. They're things that are separated that currents can run through. And people say, oh, man, that sounds so... I know. We're measuring it. Seizures are aberrant electrical activity without any changes in brain anatomy. I'm trying to get people out of flesh, people out of being wired to electrical flows. And then think about this. In bipolar disorder, when you can be really manic or really depressed, the treatment is an ion, lithium.

Exactly. For bipolar.

Wow. And for decades, it's on the periodic table next to all the other ones like hydrogen. It's an ion, it's stardust. Stardust, lithium, is cheap. It's a pill and it can bring down your mania and it can lift your depression. Really? So I'm seeing a lot of different things that point to that we are electrical flows, our thoughts, our feelings, our emotions, behaviors, because that's what we're talking about today, right? Like the bigger stuff, not how do I move an arm or how do I move my body? Right, right, right. And again, if you see your thoughts as billowing through your skull, if you see them moving like Aurora Borealis, like a school of fish or birds, that leaves us with potential that we can think differently, we can feel differently.

Yeah.

That we can transform. That takeaway is for you to make, but I'm trying to give you a lot of evidence that the world of neuroscience is starting to see things that way and not about gears or wires.

So how do we train our brains and our minds to live a more abundant life?

You know, everybody's got their own drive. I mean, I've got people who don't like to be on lithium because they think they're more creative when they're manic. you know, so I'm not, I can't, I don't judge, I inform, it's up to people what they want to do.

But if it's abundant and peaceful, loving life, you know, it's like all that.

Well, I mean, if that's your ambition, I think you would, you know, because it isn't for some, actually, they want a wildlife or they want to, you know, they're, you know, they take risks, they climb mountains, they're, they like the thrill, you know, I don't, that's up to you, but, To optimize brain function, I think, whichever direction you want to steer it, is to first look at the flesh, because it is flesh. And so keeping the arteries open and irrigating that garden, that flesh is important. So things good for your heart, keep the arteries open in your brain, you know, you want blood flow going. You want water going in your garden. That's easy enough.

And you get that through how?

The same things that keep your heart or arteries open.

Exercise.

Exercise has double benefit, but yeah, but if you're my age, 49, cholesterol pills, you've got to keep the plumbing open. Exercise eating right, keeping your cholesterol down. All those things they tell you so you don't get a heart attack, well, keeping those arteries open on the surface of your heart also keep these arteries open into the garden of your brain. So that's easy for people to get, like, okay, heart health is good for brain health. Well, heart health is good for brain flesh. We are more than flesh, right? And so then you have to leave the world of heart behind and come more into sort of the mind.

Then there's thinking thoughts, not just brain health, but thinking health.

Yeah, I like that. Exactly. Because it's not a pump, you know?

Right, it's thought health.

Yeah, I like that. And now, before we get to the electricity up here that we've touched on a lot, We've talked about now heart health is good for brain flesh health. Yes. There's something in between that we haven't touched and that's the chemical that there are chemicals, neurotransmitters often used. I hate the word, you know, but dope. It's a dopamine hit. It's not that simple. So now there's chemicals there too. So in this garden, the piece that I didn't tell you about is that those hundred billion neurons, when they are trying to branch with each other, when successful, they never actually touch. There's always gonna be a gap. And in that gap, they spray chemicals at each other. So you have electricity coming down this neuron and to get across this cleft to the other neuron, it sprays dopamine, it sprays serotonin, it sprays other things, GABA. And so you are electrochemical. And that's why things like Prozac as an antidepressant is out there. that's where lithium works. You can change the global electrical pattern and flows of your brain by modifying the chemistry in those little cliffs. So we're going to give you a specific example, selective serotonin reuptake inhibitor. A lot of people are antidepressants. When serotonin is sprayed, the reuptake inhibitor is a little vacuum and it doesn't clear the cleft of serotonin as much. You're messing with the vacuum so there's more serotonin in the cleft that tends to work as an antidepressant. So chemicals have to be thought about also. There's the flesh, there's the chemistry, and then there's the electricity. What seems to help everything, and people aren't gonna like this answer, but it is exercise.

Right, yeah, of course.

And exercise on, in a way where you're also thinking there are these cool things like they had people running on a treadmill and and dodging wild game and like a video, like thought, you know, thought and movement together. So like a, I mean like a racket sport where you're like hand-eye coordination.

You have to move ping pong, tennis, pickleball is amazing. I just started playing last year. I've only played like five times. I'm like, this is an incredible sport. I played with my sons.

We were dropping them off in San Francisco for Berkeley and they got it. I hadn't played.

Dude.

In my, my son's like, this is why dad, you don't play board games with us or sports with us, 'cause you're insanely competitive. Oh man, yeah. I always just, they're like, okay, dad, it's, it's a fun game. Yeah, yeah. But, so, but that's powerful, right? Because people sitting at home don't want to hear, man, get on your treadmill, get active, get engaged, go out and do stuff.

Yeah.

Board games, moving, thought. So, The thought cultivation is really important. So, brain, you know, keeping the flesh going. But once you get out of thinking just about the flesh, it's about engagement, it's about stimulation, it's about, you know, the results don't happen the next day. It's a life pattern, right? It's not knowing how to play the violin, but trying to learn how to play the violin. It's not, you don't have to learn the next language. You just gotta try. You just gotta try to pull from all the corners of that garden as a habit. I'm not saying all day, every day, but that nobody told us those habits should also be introduced. Nobody told us the cultivate our thought is something kids should learn, something we should have dedicated time to. We learned a lot about heart health, you know, and now it's time to get on to brain and mind health, especially with the pandemic, especially with other things that are going on, is that So I think when I was in medical school, it was just heart, heart, heart all the time, right? In fact, heart surgery was one of the second most competitive along with brain surgery. In the last three decades, as they've gotten better with catheters and stents and the pills have been better, heart surgeons have significantly been reduced because there isn't the need for it. And I think when you look at the dent that has been made in cardiac health through a couple of decades of messaging. And, I mean, you go in there, they check your blood pressure, they check all this stuff for your heart, but nobody asks you how you're doing.

Right.

The emotional, right. Therapeutic side of things.

Mind health, yes.

And so, so emotions is mind health.

Well, I think it depends. So some people, let's stay with that for a second, because for some people, the lack of emotional regulation is leading them to suffer. or not have the mind health they want.

But they're feeling it in their body, the emotion. When you think of emotions, you feel.

Like that book is continuing to do well. The Body Keeps Score, it's a title that's amazing. Yeah, especially in these times. It's number two on the best seller list in New York Times best seller list. But that space is true, but there's also other people whose mind health is a lack of focus or attention. Like they feel good, they just can't get the words out. And so my cancer patients that have chemo, they can sometimes develop chemo fog. There's things like COVID brain fog. So yes, mind health and emotional regulation, likely the most important thing, but also other things like concentration and attention is all under the umbrella of mind health. So if I had an attention coach when I was younger, I could have done better in school. I see my boys, one of them, I'm just like, You're the sharpest tool in the shed. You just can't look at a problem for longer than 20 seconds.

Right, and then you're distracted.

So stay in the striking distance when that naturally comes to you in your 20s, you're gonna be the boss, man. And so realizing attention and focus is one part of mind health. Realizing emotional regulation is one part of mind health. Realizing that if they eat a certain way, and you teach them to eat a certain way, there is a proven mind diet. It's Mediterranean, mostly plants, fish. If you put these habits in them now, think about where they will be at age 49. Having the tools, some of the tricks, having had the diet that has preserved their flesh the best, likely to have staved off dementia a little bit, like those things We do now, in my opinion, as a lesson for the pandemic. Let's not wait to see how this pandemic has just rocked kids' minds. Let's put this stuff in now. Let's front-load this and then let them develop and see how this generation happens after this cataclysmic event.

As a parent of three boys.

Three boys.

And after all the information you've learned, Personally, from life experience, but also as a surgeon, brain surgeon and neuroscientist, if you could only share three pieces of wisdom for parents today to raise their kids to have an optimal life, what would you say were the three things they should do?

The answers I give, I want to back it with even now saying the sciences doesn't mean as much as it used to.

Science is fluid. It's like always evolving and changing.

I want to back it with an explanation that you can understand and take home and grasp. The third thing is just what we talked about. I'd love to equip them with mind health tools. So, that would be a certain type of diet, good food. I'm not talking about being skinny or fat or heavy or obese or underweight. I'm not talking about any of those things. The things you eat, regardless of your weight, can help preserve the flesh of your brain. And that's the Mediterranean diet. So I would have added salmon a couple of times. And if you're vegan, there are vegetables that add that sort of omega-3s in there. I would have said, look, this has to be a part of what you eat, even if you're eating french fries every day. I'm not telling you what not to eat.

Right?

What makes you have this at least?

This vitamin is nature's true vitamins for your brain. I would have taught him that and sort of the emotional coping skills. And then we've gone over why that's important. For these things to work, they're a multi-decade, they're a glacial process. It's not, what can we take tomorrow? Can I take this pill and it'll fix everything? If there was one, I'd be taking it, I'd share it with you. I'm not against it, actually. There isn't one. And when you think of the brain and the ways we've tried to conceptualize them today, you can imagine one pill ain't gonna fix all of that. The other thing that I find interesting is when they're born, they actually have more neurons than they hold on to. And that was one, you know, when you said in surgery, there was an aha moment. I was like, can you do that? Well, in neuroscience, there was this one aha moment for me. It's like they have more of those neurons, those jellyfish, when they're young than when they're older. So you're born with the biggest block of marble.

Wow.

And you shave off what you don't use because the brain is an energy hug, right? So it wants to be efficient. So if you see that there will be a pruning of the diversity of neurons. And then certain things will be have better connections and stay in there. If you know there's a culling coming for the diversity of neurons, the most broad types of neurons, I think it's important to let them have the most broad types of life experiences. So they hold on to those as they get older and then they can choose what they want to do. shave off a few they ain't using anymore, right?

Right.

So that it's called pruning.

Okay.

The human brain in kids will go through pruning. And people are like, what does that mean? Well, you know, we're born and we can't walk and then we learn to walk, so some changes are going on. The changes are also going on up here. You're born with a lot and you're shaving certain things down. Diversity of experiences, I think, are very important. So I took them traveling with me all around the world, like, each of them, eight trips around the world, each.

Wow.

And that's when we did all our vibing, bonding, talking, hanging. Of course, took them to all the practices and games and stuff like that, you know, but the diversity of experiences was important to me. That could be with grandma, cookies, different cookies. I'm not, it doesn't have to be.

All that helps tune the brain and optimize the brain.

Yeah, so that helps. A diversity of experiences will keep, will let them have the widest repertoire of neurons.

As opposed to what? Limiting their experience.

Yeah, because then the brain will shave off the stuff it doesn't do. If you tie one hand behind the back, certain neurons will fall away.

So we want to keep those neurons as long as we can.

And that's my second point. I got a buddy who's an Olympian in in England. He's a decapentathlete, Greg White. And he made a great point.

I was a decathlete in college.

Oh, yeah. Yeah. Just fascinating to see.

It was amazing, man.

It's great. I like the. I've always tried to be sort of.

A decathlete in life.

In life, me too.

Yeah.

I want to be. I want to enjoy. It's not that I want to be good at a lot of different things.

I wanna. I want to see what it looks.

Like when you get to be good at. Yeah, exactly. Because you get into different worlds like this one.

I. But.

The other thing is that proprioception, which should be cultivated in my mind, which is knowing your arm is up or down. And so Greg and I, we talked about it. It would be fun for everybody should play as much as to their capacity, because I know people have children with intellectual or physical disabilities. But similarly, getting them physically is teaching them how to do somersaults, putting them in a not that they're gonna be gymnasts, but.

Dance, dance, and backflips.

Some sort of sporting, they call it sporting over there, like exposure, so they're fully coordinated with their bodies. I think that's an important, whether that translates to Les Falls as grandma when they become grandparents, I don't know. But the full integration of brain to physical coordination, I think would be an interesting one, you know, using the mouse with their left hand. using the fork with their left hand, forcing those neurons to stay relevant. So that's in experiences and that's number two, I would say, in movement. And then number three is what we talked about is teaching them what should be eaten. I think it's easy to say, I had this conversation with one of my sons, the other day, I was like, try to eat this regardless of what else you eat. because there are things in fatty fish, certain vegetables and plants that's separate from the junk foods, separate from all the other bad stuff you might eat or good. I mean it's delicious man, happiness supporting. I eat some junk food, but I have tried hard since I learned about.

This to be on the Mediterranean diet.

Yeah, or to add plants and omega-3s and however you want to do that.

Wow.

As not to lose weight, not for all of that, but to preserve the flesh of my brain. So I think, you know, diversity experiences to keep your neurons around, lots of movement and coordination training to keep those neurons engaged and then eat plants.

Yeah.

To keep the flesh going.

What do you feel like is, I've heard from one, I've heard from different neuroscientists that, tell me if this is accurate, that the bigger your body gets, the more obese it gets, the smaller your brain becomes. It shrinks the brain. Or there's a correlation there with obesity and brain size. Is that?

I haven't heard of that.

Okay.

And just on a regular level, I operate on patients who are obese and when I open their skull, They're fine. There's not. I haven't seen that.

You haven't seen smaller or bigger?

Yeah.

And actually, that can be, you know, I have seen withered brains work perfectly. Really? And I have seen juicy brains have issues with epilepsy or autism. So the flesh is the starting point, but it's the mind and the function that's so fascinating. So trying to go, if you're heavy and your brain is smaller, Brain smaller, bigger, this spot, that spot, hardwired, not hardwired. I'm geared for this.

I just-- But if you have a perfect looking juicy brain, let's say, right? That you're like, wow, that's a beautiful.

Looking-- it looks healthy. And that's what epilepsy is. Most people, it's just beautiful looking brain, but the electricity that is sparking is off. And sometimes they pass out, sometimes they smell certain things, sometimes they have visions. It's all from the electricity, right? Like, that's a real life-- Gotcha. I mean, there's stuff about there, like, authors and writers that in their before having the seizures, when they felt most connected to God. So that's an electrical thing. Their brain MRI looks the same as this brain MRI.

I love this three pieces of advice you'd give to parents, which is physical optimizing the physical body with coordination type activities and doing that. The second one, diversity of experiences in life, just providing a range of opportunities to experience life. at its fullest. And then nutrition, there for mind health. Mind health tools including nutrition and emotional coping skills, emotional regulation skills. I feel like I could go for a few more hours with you. This stuff's fascinating to me. What do you feel like you're gonna be shocked to learn over the next five years as a surgeon and a neuroscientist with the capabilities of where you see the brain, mind, emotional connection heading.

The thing that has fascinated me recently, a bit out of my wheelhouse, because it doesn't require a surgeon, which is good. I'd love for my career to be obsolete. You know, if we can help people without having to cut them open, that's prevention.

Yeah, yeah.

Or non-invasive treatments. Like, I'm trying to invent those. I'm trying to make myself obsolete. But right now, the stuff that some of the stuff, you know, the patients are, they come looking for surgeons. I don't do the type of surgery where I try to offer you improved something. People come to me with a scan or a feeling that say, can you help me? And I have to decide if I can and I guide through that. So I enjoy my craft but I also want there to be a time when opening a skull is no longer needed. That said, NPR did so out of Stanford or Karolinska? I'm not sure but I love the way science communicates. You can see the work but the transcranial and again, These words can be easily manipulated, so I'm trying to give you the explanation. So when you read it some other time, you could say, I remember he was talking about the electricity of the brain. They have figured out the thing looks like the size of a camera, and they put it on a frame on the outside of your skull, and they pulse mild electrical currents. Not the sky-high ones from shock therapy like Jack Nicholson's in One Flew Over the Cuckoo's Nest, but the fact that if you understand that we are electric, the same deep brain stimulation, the little pulse, the heavy pulse of many electrodes of shock therapy, electroconvulsive therapy, that they can do it at more, they can turn the voltage down. and they can direct it more. And recently in a rigorous journal, they were able to get it down to five, most of the day sessions, and they had an 80% reduction in refractory depression. So you're depressed, you've taken all the pills, things are difficult, you've considered suicidal thoughts or yeah. Well, that's an interesting one. Let me get on that one just for a second. When people have suicidal thoughts and they go into a hospital, they can't wait six weeks for the pills to work. If they work.

They need relief now.

Or in five days, like with this kind of little, just the softest shock therapy. The patient's report feels like a wood picker.

On the brain.

On the brain. That's not something a neurosurgeon will do. But to me, that is where things are headed.

Wow.

I would caution, don't buy the stuff from Amazon with the gizmo. There's always a, There's always a dark side of being manipulated by some of these smart five technologies.

They've already been doing studies on this, where 80% reduction on depression.

Yeah, powerful.

From just the electronic shock, a gentle, for what?

Shock therapy is for severe depression.

For what, 30 minutes or five minutes? Is this an hour?

10 minute episode spaced by time over most of the day. But you know, you gotta spend some time. But five days. Powerful.

And then it stays or it's for a period of time.

Very good question. Some of the patients found it to be durable. Maybe in that time the pills come in, maybe that time the therapy comes in. Interesting. But the point is, and they can do with magnets too, so be careful on YouTube with magnets can do, but it's electromagnetic, so.

It'S fascinating.

Yeah, and it's not completely in my space, that's why I'm also more fast. I'm a surgeon, I stimulate the brain, I use electric Wands, I put electric pulses. But the whole space of doing it from outside the skull is a non-surgical space, but to me it's very fascinating. It reinforces a concept that our highest levels of thinking, feeling and emotions are all sort of electrical flows.

Oh my gosh, this is my jam. I love this stuff, man. I'm so excited.

But there's a lot of room for exploitation when you use language like that, because it's easier to say gears and wired, but it's not. Otherwise, you know, Dostoevsky wouldn't report writing his best work the moments preceding his epilepsy. You're talking about art and literature. Otherwise, you wouldn't put a little battery in the controlled medical environment and break depression. And otherwise, you wouldn't being shock therapy, it's still some of these centers and it can be useful where you literally shock the skull and people wake up non-suicidal. Even if it happens once, all three of these things from ancient literature and the world of epilepsy to new study.

Out-- To modern science.

To modern-- It's a lot-- the theme that connects it all is all juicy brains But all different people because the electricity that sprouts from those juicy berries.

Oh man.

So it's a bit to wrap your head around, but that's our current understanding. It'd be easier for me to come in there and say, you,'re wired this way, you're wired that way. Change your wiring by eating a blueberry. Look, it's just not where our understanding is.

This is fascinating, man. We're gonna have to have you come back on for part two sometime, but I wanna ask you a couple final questions. This is a question, well actually before I do ask you a couple of final questions, I want people to check out your work. You've got a new book called Life on a Knife's Edge: A Brain Surgeon's Reflections on Life, Loss and Survival. You've got a number of books but people can check out that one, it's the recent one, if they go to your website is, what's your website where they can learn more about it all?

I would say just, I would just You know, just Google because you see a lot of different things like that.

Yeah.

You know, my website isn't really a conduit, but I'm a cancer surgeon at City of Hope. Yes.

And there's different stuff I've been doing.

Are you on social media at all? I am on Instagram actually.

That's where I put my good stuff.

Okay, cool.

So, we'll follow that. That's Dr. John Diel. John Diel. Yes. J-A-N-D-I-A-L. So, go check you out over there. And the books on Amazon and everywhere else, but again, check out the book Life on a Knife's Edge. This stuff's fascinating, man. I'm so intrigued by this. I feel like in another life I would have been a neuroscientist. Probably not a surgeon, but a neuroscientist. Because I just think, yeah, surgery for me, that might be a little too much, but I don't know how you do it, man. Every week, that's got to be intense. But really fascinating stuff that you've been studying and practicing, and I want people to get the book and learn more about you. How else can we best be supportive of you and what you're up to right now?

I mean, this is, I never take it lightly to have a voice and to share my opinions. So that right away you've, you know, you've already done me a tremendous favor to invite me on your show. So we're all good. And I think, you know, I don't, you know, I don't ask for it. There's nothing I'm selling. I don't have anything like that. But I'm turning 50 this year, and, you know, my pops and other people I've seen, you know, this run ain't forever. And I think. I think I'm just super happy that I'm still. I'm exploring and investigating. and tearing myself apart, putting my soul work in this book, and just to have the opportunity to have that as a component of my life, I never expected that. And so by being given that opportunity, that's support enough, brother.

That's cool, man. I'm excited. I'm excited for people to get the book. This question is called the Three Truths. It's a question I ask everyone at the end of the interviews. Hypothetical scenario. Imagine you live as long as you want to live, but it's your last day on earth. You've accomplished everything, you've done the stuff you want to do, you have happy, healthy life, family, all that stuff. But for whatever reason, you've got to take all of your message with you to the next place. It's your last day, you've got to turn the lights off, there's no more electricity in the brain, and you move on to the next place. You take all of your work with you, all the message, the content, anything you've shared, your lessons, no one has access to anymore. But you get to leave behind three things you know to be true, three lessons you would leave with the world. And that's all that we would have to remember you by are these three lessons. What would you say are yours?

I think the first one would be that life is short, but art is long. I never fully understood that, but through the last few years where I've become an author, I've realized I can impact a lot of people and that the words in this book and the soul work in this book can actually last onward.

Yeah, that's cool.

So life is short, but art is long and having an opportunity to leave a bit of art has been a tremendous opportunity and that would be a message I would leave the world. The second thing I would say is it really touched me. I think people think he was being facetious, but Kafka said, I think, and I learned about these authors and stuff later. I never read, I didn't read much at all when I was young. I was just rocking out. But in the last four or five years of trying to put this, trying to talk about the human brain in mind, you have to bring in artists and literature. He said the meaning of life is that it ends. My cancer patients have shown me that is when you get that feeling of mortality that it can be fuel for you to live.

Absolutely.

So, and the third thing is if you can, this one's more mine. If you're fortunate enough to find true.

Love.

Take care of it so you don't lose it. That's on an interpersonal level between friends and lovers and parents even, you know, the children. That's what I got, baby.

Man, I want to acknowledge you for a moment for putting your message out there in a way that we can understand it. 'Cause I think it's confusing to understand the brain and the mind, the emotions and how it all is connected. And I think people are communicating in a way of rewiring. I've said these things. And it's understanding how do we.

Start.

To change the language around this and understand the brain and the mind and the emotions and the body and the flesh and the electricity of it all. And so you doing the practical work as a surgeon and a neuroscientist and bringing both fields together to then educate in more simplified ways of something that's extremely complex that will probably never fully understand how it all works is really helpful. And for me, this has just been really inspiring. So I appreciate and acknowledge your work and your ability to want to continue to grow as a human and serve people with your message. It's really inspiring, man. My final question is, what's your definition of greatness?

That elusive goal that no one achieves but keeps us striving for more.

My man. Thanks, sir.

We have to change our narrative. We have to forget what the world said about all these scary words and see those as very helpful. It's a complete 90 degree or 360 degree change. Despair, anxiety, shame, thinking I am shamed, thinking I have no self-esteem, thinking I can't do this.

That's okay.