Doctor Who’s Seen Death Reveals What Really Matters (Dr. Vass)

As someone who has witnessed a lot of people facing their mortality.

Yeah.

What lessons can you pass to us?

It's not your net worth. It's not the car you're driving. It's, it's the people in the room. And sorry, I don't know why I'm getting emotional, but when people are dying, They don't have time for the BS that the rest of us, that all of us fill our lives with most of the time. They speak truth. Dr. Vaz is the co-founder and chief medical officer of Longevity Health, board certified in emergency medicine and trained at Cornell University Medical College and the University of Colorado. After serving in the Peace Corps and working with the WHO, he spent over a decade in traditional healthcare before shifting to functional and regenerative medicine to focus on focus on prevention, optimization, and longevity. Originally from Westchester, New York, he balances his medical mission with a lifelong passion for grappling, winning national and world titles in Brazilian jiu-jitsu, as well as rock and ice climbing and whitewater kayaking. The people there are so much happier than we are, and with so much less. I felt like a sponge that had been wrung completely dry. There's more to life than us. There's more than our egos.

This is exactly the thread I wanted to pull on because, I mean, there's a reason a lot of the ancient wisdom traditions, part of the practice is facing death because death has a way of reminding us how small we are.

Yeah. The people who live the longest have a sense of purpose and a sense of connection. The things that really matter, you can't buy with money.

And what are those things?

I think it's— it's— that's what people regret on their deathbeds.

Welcome to Money Stories, where we have conversations with founders about money, meaning, and what makes a truly rich life. Today I am joined by Dr. Vos Eliopoulos, founder of Longevity Health, a boutique concierge practice for high net worth individuals. Uh, I'm, I'm really excited to dive into this conversation. I, I had the pleasure of listening to you on a panel with, uh, our mutual friend Kevin Dahlstrom at his event. And a lot of what you said really resonated with a lot of what we talk about on the show. So thank you for being here and I'm excited to dive in.

Yeah. Thanks for having me. Yeah, super grateful to be here.

So let's start from the beginning. How did you grow up with money and how did that drive you to become successful?

Love it. I grew up, my parents were artists, so they were, you know, an actor and an actress. Which can sound, sounds really good. But the reality of the starving artist was sort of, that's how I grew up. And, you know, I've never, you know, there are a lot of people who had it worse than me. You know, I never worried about a roof over my head. I never went hungry. My parents were loving. You know, there was no sort of you know, neglect or anything of that sort, but money was tight and it was a sort of a constant presence of scarcity. It was just part of life. And I, growing up, you know, wanted something different and I also wanted to do something that, you know, in some way, shape, or form was helping people. And so, you know, that for me was sort of the natural gravitation towards medicine. 'Cause, you know, it was, I never really, never really had the goal of like, I want to be wealthy or rich. I just wanted to, you know, not have to worry about the next, you know, is there, is there a paycheck? Or, you know, coming. And, um, which is sort of how, you know, how artists and, you know, actors grow up. You know, it might be good for a period of time if you're on a show or in a, you know, on a series, um, and have a recurring role. Like, that could be really great. And then, you know, that could dry up and go away and be gone for, you know, months or years. And so I wanted more regularity in my sort of financial realm, so to speak. And I thought that was sort of like the, a natural way to do it in a way that wasn't, I don't know, at least in a way that felt right to me.

As a child, when did you become aware that maybe money was scarce or that there was inconsistency? When did that start to imprint on you?

It was very early. I, you know, and I'm, I guess I'm kind of a, I see this in my son, so I'm, I'm reflecting through him on how I might have been, I think, to a degree. But I, I'm a pretty sensitive guy. My son's pretty sensitive and I, like, I see myself in him. And so I think I, you know, and my sister who's older than me is too, if, you know, if I'm, you know, able to say that at least based, you know, from my perception. We, we sort of knew early on that, you know, conscious decisions were made around budgeting, you know, when things happened, how to do things to make sure that, you know, we as a family could make it through not month to month, but year to year, but also periods of scarcity. And so even when, you know, my father and my mom were, had a regular sort of, um, paying role, um, they were extremely careful with how they budgeted because there was always this sort of idea of like, well, the show gets canceled, your character, you know, is sort of written outta the script in one, one way or another. Like you, you don't know what's coming next. And so, yeah, I think I, you know, very young, let's put it that way, I guess, is that—

Yeah. And it's, and it's, and I'm getting a sense. It's not just the scarcity. It's not just lack. It's instability, the constant not knowing if it's going to get taken away or if this will be here tomorrow.

Yeah. Yeah. Good, good observation.

And what did that leave you with as you started to grow up and become more successful? How did that story imprint?

I mean, I still struggle with that. Maybe struggle isn't the right word. I still work with that, you know, on— I don't want to say daily, but on a regular basis, you know, because, you know, maybe not want to jumping too far ahead, but, you know, how do you— to, you know, like, how do you really be successful? How do you really embody, like, well, what is embodying success? And maybe we'll get to that. But it's like, how do you be comfortable in your own skin and how do you be comfortable in really anything if, you know, what you've learned and, and, and how you operate is so heavily influenced by this sort of scarcity mindset.

Yeah.

I mean, this is, and so, yeah, it's, it's, um, it's a deep, it's a deep hole that maybe we're, we're about to go down, but yeah, it's, it's a, it's a constant. It's constant work. And I think, you know, for me, it's, it's still present.

Yeah. I mean, I, you know, it's, it really is what I say with clients is the goal is not to eliminate or get rid of these imprints left on us from childhood. It's just learning how to work with them and noticing when they come up so that we're not driven by our subconscious, right? We're bringing it into the light.

I like it.

And, and so, uh, tell me about your, your med school and, and, uh, early career. How did that shape up?

Um, I mean, I guess as I'm talking about scarcity and, and that side, I, I, I'm fortunate in a way that I always found, um, sort of refuge and solace in things that I enjoyed. So, you know, I enjoyed You know, wrestling was, is, still is, you know, grappling's a big part of my life, has been since, you know, from way back. And so I'm going a little bit before med school because I think it's sure.

Yeah. Yeah. Take us back.

You know, I, you know, after college, I, you know, I wanted to travel. I wanted to see the world. I wanted to, you know, at the time I studied French in high school and college and I really wanted to like solidify my French. And so I thought, you know, I ended up ended up looking at a bunch of different options, but going into the Peace Corps and that sort of, you know, felt to me like, man, this is a right, like this felt good. It felt like I can go have a fantastic experience, live abroad, like really, you know, get, get another language really solidly under my belt and do something where I'm giving back and I'm learning in an interesting place. And it didn't work out the way I planned. I went to a country that was non-French speaking and Um, you know, so where did you go? It was in the Solomon Islands in the South Pacific, which—

what did you learn from your time there?

Um, a lot. I mean, there, you know, there are certain pivotal moments in, in, in your life. And for me, the Peace Corps was one of them. I think that one of the through lines is, and another thing that I think is pertinent is, is I'm dyslexic. So I learned early in school that grinding, like the only way to be competitive for me in academics was to work way harder than all of my peers. And so that was sort of deeply ingrained. And then, you know, and then I had these refuges where really things that I did where I really had fun, where I really, you know, was able to sort of let go of that burden, so to speak. And that's where the grappling was. And the Peace Corps, I think, was, was both of those things. I really loved that experience, had a great time. And it was also, you know, you learn a lot about yourself in many ways when, you know, because I guess the way I put it is you could have put me on the moon. That's how different life was there, the way I was living day to day from, you know, I had grown up in, you know, outside of New York City and in Westchester County. And so I learned that there's a completely different way to do things. In essence, a way to think about the world, a way to exist in the world. I learned, 'cause I was teaching, I worked with the World Health Organization and was teaching in a sort of a secondary school, teaching science and math. I learned how language really shapes what and how you think. So, you know, the construct, if the construct of your language doesn't If you don't have vocabulary for something, how do you conceptualize that? And in a country of mainly coral atolls, you know, I'm teaching physics problems of like a barrel comes off the waterfall. If a kid has never seen a waterfall, like, how do you— do you understand what I'm saying?

Like, absolutely.

Like, how do you— it's really difficult to try to explain that. So you have to come up with different analogies like, well, you know, think about a coconut falling off a tree, but you know, it's, if you don't, if you haven't experienced it, if you haven't seen it, and if you don't have a word to explain it in your native language, it creates all sorts of interesting sort of thought constructs and problems that I was dealing with on a regular basis, trying to fulfill my roles, you know, that I was there to fill. Um, so I learned, I learned a lot about the world, about myself. And then there's the other thing that we don't deal with a lot here, which might be pertinent is, you know, when you go to a country and you're living, you know, no electricity, um, you know, running water sometimes because it's what's collected off your roof is what you drink. And when that runs dry, like, you know, then what do you do? Um, but you know, The only distraction is, is radio, you know, so shortwave radio. And you spend a lot of time alone and lonely. And so how do you, what does your mind do? Where does your mind go? How do you, how do you handle that in a, in a country where everything's foreign, smells are foreign, the food's foreign, the language is foreign, even after, you know, 3, 2, 2 and a half, almost 3 years there, it's still foreign. So learning a lot about how to be with yourself in a strange environment at a, you know, in your early 20s.

Yeah. How old were you at this time?

22 through 24-ish, something 25, something like that.

Well, what strikes me is that, you know, we talk about growing up in scarcity in the US. That's a lot different than going to a country where poverty means something totally different. How did that realization hit you?

Fascinating that you brought that up because the people there are so much happier than we are and with so much less. But I think this gets into the foundation of A lot of structurally why we struggle with certain things like anxiety, depression, meaning in our society. There's very solid community connection, clearly, very clearly defined roles. And it's not that, you know, it's not a utopia. There's lots of similar problems, socioeconomic problems, but The connection to nature is so, like I mentioned, the running, like your water. I mean, if it doesn't rain, you don't have drinking water. So then what do you do? Right? I mean, and your personal, like, how important really are you in the face of, man, nature is just so much more powerful and dominant, then, you know, here we have this sort of, I think, fallacy and hallucination that we have control over things. And when you live in a place where, you know, man, a cyclone comes through and levels your house, like, I don't know. And it's somebody, you know, death is in a country like that. Death is, is is right here all the time. And not necessarily— I don't mean that in like a scary, dominating way, but it's, you know, we had a student at our school break his femur playing soccer and he died from that. Like, that doesn't happen here, you know what I mean? So, and it's not that people played soccer scared, they still lived, but I think having an understanding that, um, there's more to life than us. There's, there's, there's more to, um, there's, there's more than our egos. I don't know if that makes sense. And, and that's just in your face, part of your daily life. It, it's, it's an interesting place for an American to go in formative years.

Um, yeah, I don't even know if I answered your question, but yes, this is, uh, This is exactly the thread I wanted to pull on because, I mean, there's a reason a lot of the ancient wisdom traditions, part of the practice is facing death, because death has a way of reminding us how small we are.

Yeah.

And when it's a constant part of life, you know, anxiety means something different.

Yeah.

What a gift to experience that at such a young age. How did that inform your path?

I mean, the way I've sort of intellectualized this is that, um, you know, both like my, from my learning experience with my sort of learning difference, um, and then in the Peace Corps sort of learning it in a, in the Solomons in a different way. It's like there's, there's no one way to do anything. Right. And, and then this gets into, well, you know, why limits, like what, like what, what are, what are the limits? Why, why, why are there li— you know, what's the limit? The limit's self-imposed. And seeing that, you know, okay, there's certain things that we have limits around what we believe and conceive of here, and it's very different in, in a totally different society. And so then, you know, in a, in a I guess just seeing that for what it was, it was like, man, these limits are arbitrary, right? And I would see it in my students because for them, success was getting to university mainly because none of them had the money. Most of them didn't have the money. The vast majority of them didn't have the money to do it. So it was like they're relying on getting an extremely competitive scholarship. And they're all competing against each other. And, you know, the school system there is, you know, you, you, it's not everybody goes, it's, you, you, it's tested like at every, you know, so there's a primary school through approximately the 6th grade and then there's a national exam in English and math. And then everybody's plotted from basically the highest score to the lowest score. And then the secondary schools are ranked for like the top, you know, 1, 2, 3, 4, 5, 6, 7 on down. And the top, however many spots there are at the best school, the top 200 and some odd kids, they go to the best secondary school. And then the next however many go to the second best ranked and the third best ranked. And I was teaching kids at like the fifth ranked school in the country, which was, I mean, these kids were all, I would tell them like, you're all smarter than I am. And they thought, they were like, oh, Mr. Voss, like, you know, no, of course, like, that's not possible. How, you know, and I'm like, you don't see how, like, I would not have been able to test into the school if I was in your shoes. There's no way I would have, I would have made it to this school at that age with these sorts of requirements. And then again, you know, they, they would do 7th, 8th grade and then, and then another exam and then even fewer spots. And reshuffling. And then again, to get into the 12th grade, the equivalent of the 6th form, the equivalent of the 12th grade, again, a huge— so the kids who made it to the 12th, the equivalent of our 12th grade would all have, you know, scholarships to our best institutions here in the United States. No, no question in my mind. But then all those kids were, were competing for, you know, 1 or 2 or 3 or maybe half dozen scholarships from, you know, the Solomons or from Australia, from New Zealand, from other countries around. Um, and so they had these other, these limits, right, that they're, that are part of their reality. Um, and I always used to think, I was like, man, if I, we could just get you to the US, like if I could just take a group of you, give you 2 years in my high school, like, man, you guys would see like how amazing you are. but they don't, I don't know, they, they couldn't see that because of the limit, whatever the limitations that, that they were working within. So anyway, interest, you know, very interesting sort of like experiences that, um, I've never really thought about in this context of like scarcity, poverty, because I'll tell you, I don't think of the people in the Solomons as poor. I don't, I mean, they don't have a lot of money, but they have what they need. They live happy lives. A lot of them live a long time too. So yeah, this thought of poverty and scarcity is just, takes a very different form there. Now that, now that you bring up the question, I love this thread.

So you, you come back from the Peace Corps. What did that experience leave you with as it came to the next chapter?

I mean, for me, where, uh, practically, um, I guess there were a couple of interesting things that, that I did right when I came home and I, I'd actually didn't even notice it. My, my mother and father sort of pointed them out because I had, I, you know, I'd packed away all this stuff. Childhood sort of knickknacks and memories and stuff from high school and college. And I remember coming back and I was like, I don't need any of this stuff. Maybe there are a couple things that I might want to keep as mementos or whatever. But my mom really commented on like, man, you went into the garage, like our garage at the time where I had boxes of stuff. And I just, I was like, this is just totally unnecessary. All this stuff is absolutely unnecessary. So, so it changed my perspective on things and how to value, like, what's, what's the value of things? Like, what's really of value to me? Um, and, uh, and the reality is, you know, it's in the relationships, it's not in the things. And, and so that was part of, I think, my coming back and, and you know, reassimilating. Um, and you know what they'll tell you when you, when you go into an experience like that, where you're gonna live somewhere for a year or more, the hardest part is coming back for sure. Um, it's very, very hard to sort of come back to this way of living. Um, and, uh, you know, uh, I guess that's there's a lot there, but it's, it's an interesting transition coming back.

What was hard for you in the coming back?

You know, I guess me, this is front of mind. My daughter's senior in high school. She's taking AP Environmental Science. So I'm helping her, you know, with that in, in the way that I can. And, um, one of the things was, uh, this was, you know, early '90s, the environmental movement. You know, I went, I was in med school in New York City, you know, basically, and in, you know, this, so I had to, I had to teach, you know, climate change to my students who were just horrified because they were like, our country's going to be underwater. Like, what can we do?

Yeah. It's an actual existential threat.

And to them it was real. And actually, I mean, literally the textbook, which was sort of a workbook. Was like a Solomon Island man and a woman, like climbing a coconut tree as the, as the tide's like, you know, basically swallowing their, their island and their stuff, you know, like stuff's floating around. And I mean, you know, it's, it's like horrifying. And, and what's even more horrifying was, you know, when they asked like, well, what could we do? And I was like, you know, I, I don't really know. What you can do. You're not the problem. Right. You know, so I go back to, uh, a city that you can see from space. And, um, yeah, that was, that was tough. It was tough because it was really, it was me deciding, you know, like I said, coming back was, is hard. And it's because then the thought is, well, why don't I just go back and stay there? You know, where I could stay. That wasn't a choice that I wanted to make, or that wasn't the right choice for me. Although some people do that. And, you know, so there's a little bit of that internal conflict around, you know, man, I'm making a choice that, you know, if you, you know, depending on how, you know, I know there's different beliefs around climate change and all that kind of thing, but but let's assume like if, if it's real, if the, if, if it is real, um, I'm basically choosing myself and what I'm comfortable with and what I want for my life, um, in a way that's detrimental to the existence of all of us. I mean, this is, and so there's an internal, like, like that, that was tough. And then the way that manifested for me was, um, You know, we'd have, I'll remember dinner with other med students and somebody was, you know, chastising somebody like, don't throw that in that bin, throw it in that bin. You know, it's like, you know, and I'm like, what do you listen? Okay. I get it. Like recite, like we should recycle. And what are you arguing about? Like, that's just, it seemed like, it seemed like kind of like a lie. I'm like, just be honest with yourself. You're, you're living the life that's destroying the planet if you really want to subscribe to that. So, um, decide to live it or not.

Um, there's a lot of theater in the decisions that we make. Yeah. Or, or the things that we place as important. I think recycling, throwing one thing in a bin, you're still creating a massive amount of waste by the, by the way you live.

Yeah. And, um, anyway, so I forgot where, where that came from, but yeah, it was, it was coming to grips with all that, that, you know, yeah, okay, I'm gonna, I'm gonna live an American life. And there's parts of that, that, that are, that are ugly, that aren't pretty. Um, and, um, you know, environmental, you know, impact might be one of them, but, but, but another one is, um, you know, just our reality of we're, uh, we're consumers. That's the reality of our society. And not all societies are consumption societies. And, you know, this is another sort of big point in the Solomons and the traditional sort of the way culture is, the rules around culture that have sort of developed there. The wealthiest person in the village, quote unquote, is not the person who has the most stuff. It's the person who gives away the most stuff. Crazy, right? But so we, like, as Westerners, we can't wrap our heads around it. So you have to like, let me contextualize this for you. The chief of the village is the person who gives away the most food. Generally speaking. Why? Because there's no refrigeration. If you pull it out of the ground or the ocean, it's going to rot in 2 or 3 days. So if you're an excellent fisherman and there are, it's not that there, there weren't women who fish, but culturally it was very rare for women to fish. The men generally fished. And so that's why I'm using fishermen. But if you are an incredible fisherman and you can go out and catch more fish than your family can eat, you don't throw those fish back. Now, there is a choice about how long do I stay out? Do I really need to stay out much longer? I have enough for my family to eat tonight. How much longer am I going to stay? Maybe I'll stay a little bit longer and I'll catch more because I know so-and-so and so-and-so isn't so good at this. And so I'll have a few extra fish that I can give to them. And so it's not all altruistic. Part of that was practical from my perspective. I don't know if this makes sense.

Total.

And so the most prolific producers were also the most prolific givers historically because of the way the culture was set up.

It's absolutely fascinating.

Yeah. And so those people tend to rise in the eyes of other people, like, oh, who do you trust? Who can you go to when you have a problem? Who can help sort of navigate the conflict that arises in these communities, which is inevitable? It tended to be the person who is one of the best producer. And, you know, and I guess, you know, speaking about it in this way right now, it's, you know, there's, there's an altruism in, well, am I going to stay out a little bit longer? Right. Do I really need, because there's other things I could be working in the garden or I could be helping, you know, other people in the family, other, you know, want talk. So it's like, there's, yeah, it was an interesting way of seeing the society and the conflict that that created as that, because it was a British colony. So, you know, it's, there's westernization, they wanted westernization and those two forces were at complete odds. Like how do you become successful in a western society? And the people who did that, one of the things that was really sort of tragic for me to see was the people who were really successful, they go away. They get educated, they get skills, they, they want to come back. But now the, it, there's other things in the culture that, that, um, that are interesting products of this sort of setup, which is it's, it's not just, um, the good thing to do to give. You're actually obligated if you have to give and somebody comes to ask, it's your obligation to give. And so you can see, you start, you know, trying to put a Western culture on top of that. These people who are successful, they go out, they get educated, they come back. Now everybody from their village want, I need school fees for my son or daughter. Can you, you know, and it's not, please, may I have it? Is it in the kindness of your heart? It's your obligation to give it to me.

I mean, you're, you're really setting up this battle between rugged individualism and collectivism. I mean, ultimately, yeah, is, is what, you know, at the deepest roots there. And, um, what strikes me is you're about to come back and then have a clash of your own with the Western medical system. What, yeah, what was that like for you?

It was tough because to sum it up, I think I went into medicine for what I believed was the right, what I still believe the right reasons. I think I changed, I was interested in neuroscience and neurosurgery and the brain and how the brain worked because of my sort of education and background and went into the Peace Corps and like got really worked with the World Health Organization on like malaria, filariasis control, like the parasite that causes elephantiasis. So I was active in their control projects there in the Solomons. And that really took me on a shift towards, you know, more sort of like public health. And then ultimately, you know, I ended up choosing, and I really struggled finding a special, you know, cause you go to med school and you have to pick a, you, you have to pick a specialty to be trained in. And this is what a lot of people don't understand. Like your med school is sort of, your, your background where you get your base knowledge, but where you actually train to be a doctor is in your internship and residency, which comes after. And you have to pick what, what you're going to do. And in our medical society, it's very highly specialized. So, you know, I was still planning on working abroad, going back, working on malaria control and malaria vaccines, which, which I did for a number of years. But, um, there was no specialty that I felt really trained me properly for the type of medical care that's required and given in really in the, in the developing countries. You need a true generalist background. You need some surgical skill, like you need to be able to do C-sections and take out appendixes and like treat all the medical stuff. And so that's not how our systems, like we don't train doctors to do that anymore. The closest space was emergency medicine. And so that's where I sort of landed as like a special, a specialized generalist. I don't know if that makes sense.

Totally.

And, and it fit because, um, you know, emergency medicine is the one specialty where now the system functions differently, but, um, we're the one specialty that doesn't screen our patients based on the ability ability to pay. And now that creates a whole nother set of problems afterwards. And then the cost of that care. And I'm not saying that I agree with how all that's done, but there was sort of an altruistic component of like, man, if somebody really needs help, like I want to be like, I'll help them. I want to be there to help people who need help. And so, yeah, I think that, you know, my choice of specialty was pretty heavily influenced by my time abroad, what I wanted to, you know, where that pointed me sort of professionally and, and what I wanted to do. And then in the skills that I wanted to have. But also sort of fundamentally in what was important to me was yeah, that, that component of medicine, which is You know, we're here, we're here to help people who are in need. The conflict that that creates, of course, is that, um, well, one, there's the system, you know, which functions very differently. And then two, there's the, for me, what it became was I felt like when I left emergency medicine, I felt like a sponge that had been run, run completely dry. I dunno if that makes sense.

Yeah. Like I just, let's dive in there because, you know, I, I'm just feeling this deep sense of service, even, you know, from your early, earliest years, you, you had this bent towards service and I think it's no surprise that the Western medical system sort of wrings out doctors like a sponge. What was that experience like for you?

Um, it was tough because, you know, I'd finally, well, first of all, like with my educational background, like I didn't know if I was going to get into med school. Like that was a big question mark. Right. And then, and then I finally do it and, and I, and I actually, you know, did it in a big way, at least from like, I got to my like dream school. Right. And, um, and then. I got my choice of resident, you know, go to the top ER program, you know, top 1 or 2 ER program in the country. Still is here in Denver. Most people don't know that, but like the textbook for emergency medicine was written at Denver Health. It's still one of the top ER programs anyway. So, so I sort of like was able to hit, you know, achievements that even I like question, like, am I really going to be able to do that? Like, how am I going to compete with with all these other people who are just like, have intellectual capabilities that are very different from mine, can smash these tests without like, from the, from the way I look at, without even having to lift a finger to try, you know, they can roll out of bed and get hundreds on these things. And for me, it, you know, you have to scrape and claw. But, um, anyway, so, so I did it and and then the reality is like, this is really what I was like trying so hard and aspiring to do, because this isn't what I like. This isn't what I thought it was going to be at all. And I shouldn't say at all, but, but in many ways it's not what I think the altruistic sort of naive, young, service-oriented, sensitive physician, right? Doctor now. It's not what I expected. I mean, it's the reality of the system we have. I think it's, there's always a give and take, right? Like you can't give unless you're taking care of yourself. And part of giving is drawing the limits and knowing where the boundaries are. And I think that's something I still have to work on actively and probably will forever. But I had a really hard time learning where to draw the boundary. And so I was always, I was always the guy who was there like 3 hours after their shift was over, like taking care of people because the thought I would like sign out, you know, someone who's really in pain or need or dying. And it's just like, oh, shifts up. Like, oh yeah, hey, Dr. John, yeah, here are my patients. Like, so-and-so's like dying from whatever. These are the tests that are pending, and when they come back, like, I need you to find out, figure out what to do with them. Like, it— that was just very hard for me to do. Um, and sometimes the cases would work out where you could get a clean break, but usually I was, I was just I was overextending myself because of that sort of sense of, call it whatever it is, this desire for service or to want to help. And it led to a couple of hard realizations. It's like, well, one, I can't keep doing this.

Was there a moment? Was there a specific point when it sort of came crashing down for you?

Yeah. Well, there were a few because it was a transition. So I went initially into academic medicine, which when you come from like a, an academic program, there's biases and, you know, it's like, well, the real doctors are the academic doctor, right? Like they're doing the research and they're, they're, they're not making as much money and they're really dedicated to their craft and and the patients. And I think there's, there's fallacy to all of these, you know, sort of, sort of biases. But, you know, I quickly, like, I hit that limit there and I was like, man, I'm, I gotta teach residents, I gotta teach students, I gotta do research, I gotta take care of patients. This is just like too much. I gotta simplify, go to, you know, like make the move to private practice. Right. But then it's the same thing. In a different form if you let it be that. And for me, ultimately, what drove me out of the system was a combination of two things. One was my own sort of personal health journey. The other was, you know, sort of my realizations around this boundary setting. And, um, and ultimately the control, really it was the control of my medical practice. Um, so I was part of a medical practice that had gotten bigger. Um, we were very successful and we, we ended up merging. We got too big to be physician-owned and managed, and the practice kind of realized that. And there we were like, physician-owned democratic practice sounds good. but it's like, I mean, uh, not, it's a herd of cats. I mean, literally trying to make decisions and, and figure out the business of medicine. And we knew, um, we needed, we, we needed help and we merged with a private equity backed big national group and we thought there'd be negotiation power and intelligence that we, you know, as a small, smaller group weren't privy to. But the second that transition happened, um, the, you know, the words I've used in sort of other forums describing this, it suddenly felt like at least with that, like I had, we had control. There were a lot of things we didn't control in the system, but we could control our practice. We could control the hours we worked, the expectation for productivity. Um, uh, we, we controlled, you know, how much how much money we spent trying to capture our billing. You know, we controlled a lot, a lot of things. And then the second that merger happened, it felt like I was suddenly in a cubicle at some big company in the medical sense. And, and that for me was like, that was, that was it. I was like, I can't do this anymore. Because there were enough other things about the system of medicine that I didn't like. But when I had enough control, like it was always just good enough. And it wasn't until I, like, I had that sense like, man, I'm in a cubicle now. And even though I'm a shareholder and reaping the benefits, the economic benefits of what this is producing, like, I can't, like, I can't do this anymore. And that's when I left.

What was the journey like into longevity?

Um, I had to, I had to learn, uh, how to practice a different kind of medicine and a kind of medicine where we don't have and still don't have a formalized training program for better or for worse. Cause there's some really good things about that in my perspective, but I had to retrain. I had to go learn a lot of conferences, finding other doctors who I really respected and trusted to ask questions. When I came up against things that I didn't have, you know, answers or the background to deal with. And, but I credit my experiences, right? Like there's a different, there's a different way to do this. There's a different way to do medicine. And, and then I would say, you know, the real mission at even, well, when I left, you know, I, I didn't know what I was doing and going into a pure cash-based sort of medical practice. Now, a lot of people like question, they're like, well, that doesn't seem to like follow the through line. That seems very like, um, capitalistic, not altruistic. I mean, the pay cut that I took. Making that transition was gargantuan. And still to this day, financially, I would've been much better off staying in the cubicle, much better off financially. Now, personally, for my professional development, for my relationship with my wife, for my relationship with myself and my relationship with my children, the best things I ever did.

One of the questions I often ask on this podcast is, is What does wealth mean to you now? It sounds like you had some semblance of financial wealth working in the system, but, and I don't want to put words in your mouth, but fundamentally unhappy and that was not working for you. So what does wealth mean to you now?

I think, you know, wealth to me, financial wealth, because I guess there's many different ways we could look at that. Term really boils down to it's your choice. It's financial wealth. What does money give you? It gives you more choices in my perspective, right? And so if you're comfortable with fewer choices, you know, there's no issue there if this is tracking.

Yeah.

But what we forget and what I think our society and culture is not good at self-examining is that the things that really matter, you can't buy with money.

And what are those things?

I think it's, um, it's connection. It's peace, inner peace. Are you, are you comfortable with yourself? Um, are you comfortable with, um, and actually let me take a step back. I, I have a cheat sheet here and the cheat sheet is when you work in the ER, I've been with a lot of people as they face their mortality and, um, and I've learned a lot from them. Sorry, I don't know why I'm getting emotional, but when, when people are dying, they don't have time for the BS that the rest of us, that all of us fill our lives with most of the time. They speak truth. And, um, I learned from those people, it's not your net worth, it's not, um, some deal you made or didn't make. It's not your name on some university somewhere for, on a building or, or whatever. It's not the car you're driving. It's, it's the people you love. And the quality of those relationships. That's what people regret on their deathbeds. And that's what they talk about with a complete stranger. And yeah, being the doctor and having, you know, an air of authority, like there's, you know, um, people are, I think, are able to be a little bit more open, um, to the doctor if, if they fill the right shoes. Have the right, you know, sort of interaction with their clients, with their patients. But that's what matters. Everything else is stuff we decide to fill our time with. So yeah, I think true wealth is how you feel about yourself and then the relationships and the quality of those relationships with the people you care about. That's it.

And as someone who has witnessed a lot of people facing their mortality, yeah, what, what lessons can you pass to us and the audience for how to maybe mitigate some of those deathbed regrets?

Um, I don't know. I mean, um, you know, how, how do you, it's easy to say The quality of the, you know, the quality of your relationship with yourself. Like, what does that even mean? You know, because I'll tell you personally, like, that's actually something that I'm working really hard on for myself. Um, so the reality is you have to, you have to, I believe, or at least for me, maybe Maybe you don't, you don't have to actually do anything, right? You don't have to do anything. What, what, what I have had to do is to ask myself the hard questions, the questions that, that I'm not even necessarily aware that I need to ask myself. And if this makes any sense, and, and get comfortable with what your answers are to those questions.

Like what?

Well, this one's going to sound too obvious, but, but I think particularly for, for men in our society, like, how do you feel? How? No, not, oh, I'm good. I'm okay. How do you feel right now? How do you feel? What are you feeling? Most of us can't answer that question, really answer that question. And I don't know if that— I think this is probably going over a lot of people's heads because I would have heard this maybe 20 years ago and thought, I know exactly how I feel.

My sense is people listening to this podcast are starting to wake up to these questions.

I would challenge you to ask yourself how you feel and do you really under— understand how you feel and are you comfortable with how you feel? It's a way harder question for me to answer than I think, like I would've thought 10, 20, 30 years ago.

Well, now I have a cheat sheet because I've heard you speak on stage before, but how do you bring some of these questions or thoughts into your practice? How are they intertwined with longevity?

I think longevity is, is the great, um, catchphrase of the moment. And I love it. I like it. My current practice is called Longevity Health. Um, the question And then how, for sort of the purposes of your podcast, right? Like longevity is, I think in many ways monetized as we're fantastic at doing. And it's amazing about, you know, what we do. We're fantastic at monetizing it. I would then sort of layer wellbeing, right? Because longevity is one thing and there's an image of like, I'm going to live to 140 and I'm going to do all this stuff and run marathon, right? Like, and that's what some of these talking heads are sort of like promoting, have goals of doing. And I think there's nothing wrong with those goals, right? I think those for the right person, like fantastic, awesome. Good for you. What's the well-being of, of your humanity, your spirituality, your, your true inner self? I think a lot of this longevity stuff and performance stuff are the masks that we put over that, that, that sort of deeper level of the well-being. And I think a lot of people Their longevity might look pretty good on paper, but if you got into their wellbeing, it probably doesn't look so good. And so for me, it's really, how do you bridge that? How do you bridge that? I don't want to call it gap or divide or maybe misunderstanding around like, what is real longevity? Longevity isn't living to 140 if you're not fulfilled, if you don't have quality relationships, and if you don't have a sense of purpose. And I think these are ways that we can articulate like, well, what is true wellbeing? But true wellbeing is being comfortable with yourself.

I like red light therapy and sauna as much as the next guy. But, but yeah, kind of what I hear you pointing to is that a lot of times those are majoring in the minors.

Yes.

Right. So what are the major factors in, in your view for the longevity, you know, stacking that pyramid that we—

yeah, yeah. So the longevity pyramid that I guess you saw that, yeah. Um, I mean, it's really— and, and the data, this is what's so fascinating. Which is we can intellectualize all we want, right? And there are certain things that are easier to measure than others. And therefore there's sort of a preponderance of, of data, like, and maybe the spotlight's pointing over in this direction just because we can measure it. But if you're willing to actually take a step back and look at the real fundamentals, the people who live the longest have, have a sense of purpose and a sense of connection. And it doesn't mean like smiley, happy, joy, joy. It's they're happy with who they are and how they're being in the world. That is the longest lived people, the common thread that, you know, underlies all the other stuff because yes, I'm not trying to minimize diet and exercise and medical care and all, all these other things play a role. But the longest-lived people have connection, they have purpose, and they're comfortable in their own skin. And really, that's all you need to live a long, fulfilled life. So, um, when I, um, you know, when I speak, I think it resonates with people because I do my best to try to connect the fancy things that we can do medically to, um, to these deeper, more meaningful subjects and, and really try to, um, really just bring awareness to that fact. Let it, let it into the room, acknowledge the importance of it. Can be incredibly powerful for people because in my day-to-day medical practice, you know, I guess I'm not sure how that shows up other than I want to be true to myself and I want to be true to the person I'm working with. And so, you know, one of the things I'll say is you know, I'm not dogmatic about any, any medical therapy or recommendation because I might, and this I've learned, you know, from, you know, my clients and my patients in the ER over the years, I might think in the medical data and the system, the algorithms might say, this is the right thing to do. All the research could say, you have, you're in this scenario and you have these options. This is clearly the right way to go. And I can't tell you how many times I've had conversations with either patients or their families and their gut sense is no, like we're not, we, that's not something I'm, that's not right for me. This is what's right for me. And I'll go to bed thinking, well, they're going to be gone before the morning, you know, and lo and behold that the science is not always right. And you have to trust that, that gut sensation. Like as a clinician, I've learned that. And, and as a patient, if, if, if your deeper inner sense is to go a different direction, trust that, trust it. It's, it's more informed and more knowledgeable than like our frontal cortex and our data could ever be. And so just acknowledging that and bringing that in the room, I think is, is sort of an important step because it's not, it's not how our system operates, not how any of it's set up to work. And I think, you know, bringing this back to, you know, the broader mission of the medical practices is, is how do we bring, how do we bring that, how do we swing that pendulum? You know, how do we get that back into how we take care of people? How we take care of each other in our medical system.

Yeah. I mean, if, if, if I can summarize, what I'm hearing is at the, at the base of everything, before we get into medical intervention or, or diet or exercise or sleep, which is wildly important, you're saying relationship with yourself.

Yeah.

Relationship with others.

Yeah.

And relationship with source, essentially.

Yeah. Yeah.

As the most fundamental piece of what creates well-being.

Yeah, absolutely. No question. And this is where we're so well conditioned to go to data and frontal court, these rational, linear, logical thinkings. And so, it's hard to sometimes, um, yeah, I'm not trying to convince anybody. And at the same time, um, it's hard to sometimes debate or have what some would consider a true intellectual evidence-based conversation around this. Um, and yet I, I can't tell you how many times, um, in my personal clinical medical experience that when you trust that intuition, even when it flies in the face of the data, um, you're more likely to be right than wrong. And so, um, there's real-world practicality and application for that, that we don't allow space for academically. I think in medicine or in other sort of professions and realms in our Western sort of trained minds and culture, if that makes sense at all.

But yeah, something else that I heard on this panel where we met, there was, there was 4 very educated folks in this space. And the question was asked, you know, if you had to do one thing, one activity, or, you know, practice, what would it be? All of you, to the person, said a contemplative practice or meditation. Yeah, some sort.

Yeah.

Talk to me about your experience there and how that ties into longevity and health.

Yeah, I think, um, for me, you know, looking back, this is what wrestling was and then rock climbing and then kayaking. So I found activities that hooked me into a flow state. And I know that's different than I think some other meditative practices, but, but I believe it's a type of meditative practice that un— being able to disconnect from the chat, the brain chatter and, and the peace that that brings. I think, you know, all of us look for it and crave it and find it in different ways, whether it's, you know, video games or running or, you know, art or whatever. We're all sort of looking this sort of hypnotic sort of flow state where we disconnect. So my first, and really where I'm best at that is in wrestling and the grappling arts. 'Cause it's, you can't grapple and be thinking about something else or even thinking about wrestling. You can't, it won't work. You have to just be. And that has evolved over many years now into a more intentional meditate, you know, meditation practice. And I have certain forms of certain techniques of meditation techniques that I've been fortunate enough to be taught that I, that I practice on a daily basis. That's newer for me. More recent, you know, more recent years, but yeah, incredibly, incredibly incredibly powerful, incredibly potent. And there are datasets that exist that, you know, can compare people who engage in these types of practices. And I don't know that any of them have been peer-reviewed and published, but the little that I know of them and have experienced or seen of them, you know, seem to demonstrate that it can be as powerful as any medical intervention depending on what, you know, variables you're looking at.

So now working with high net worth individuals on, on health and longevity and recognizing that's primarily the audience of this podcast, what are you seeing that, you know, as sort of a meta experience that makes a great life?

I think recognizing that we all have great lives, right? In some way, shape, or form. And it's not that there isn't pain and suffering, you know, built in there because, you know, that's, it's got to be, it's part of it. You know, there's no yin without the yang, right? So, we all have great lives. I think what is truly like, what's going to boil down to, you know, on my deathbed, am I going to have a regret? Right. That's again, I don't think there's any easy answer to that. You have to ask yourself, you have to start to try to ask yourself the hard problem, the hard questions. And in my experience, that usually begins with, with doing, doing the work, whether it's, you know, therapy or some form of contemplative practice or some form of spiritual practice where you really get grounded in who you are, how you exist in, in, in this, you know, brief life that we have and, and how, what we do, how we feel about what we do in in this time that we have. And I think that, that, that understanding that we're all a part of something bigger than ourselves. And I think this manifests for a lot of people is like, well, what's my legacy going to be? I think I hear people ask that question. And, you know, I would, if you're, if you're debating that or wondering that, I would challenge you to try to take the step deeper or ask the question that goes a level below that. Because that's the legacy question, I think, is just another— maybe it's called— it's another distraction. Because if you really get if you solidify around the deeper questions, the simple questions, the legacy becomes easy. I don't know if that makes any sense.

Makes total sense. I am quite anti-legacy because legacy is what happens after we die.

Yeah.

And impact is how we live while we're here.

Yeah.

And I always want to optimize for impact over legacy.

Said it better than me. Yeah, yeah, amazing.

What, you know, again, being in the business of watching people face mortality and now helping, um, successful high achievers, yeah, uh, from a, from a medical perspective, but really you're looking at a holistic picture. What, what piece of advice or, or what would you want to pass on to listeners that maybe is not obvious for in what you do?

Yeah, I'm not sure. I think maybe one way to answer this is, you know, in this longevity space, which is very sort of à la mode right now, I think what people are craving is um, exactly what is— it can't be monetized. And so if you're looking for help in the space or guidance in the space, a lot of people are, you know, like, who's the expert, who's the talking head, who's published more? Don't worry about that. Find someone who you connect with. That, and, and I would argue that from your primary care doctor to your surgeon, you know, cuz there's this myth of like, well, I don't need to ha— you know, I'm never having lunch with my surgeon. They could be a total asshole. I just want them to be good at what they do. And if, if you are going to, so, you know, interesting, I'll, I'll jump out for a second side note. When I, when I was in med school, um, my surgical a rotation where, you know, you spend 2 months doing, working with the surgery, one of the surgery teams, the medical school. And I went to a pretty high-powered, you know, academically oriented med school. And we were all looking at, you know, the chairperson, the chairman of the surgery department, the vice chair. These people were publishing a lot of papers who, you know, they were a force. Academic force to be reckoned with, right? And then there were the community surgeons and one of the community surgeons in particular, um, who was a little aloof, like read a book, you know, wait, you know, at the, in the, um, you know, sort of the, the waiting area of the ORs when you're in your scrubs and, um, where a lot of people would eat and take a break between procedures and would spend time with his patients. Never published and had a good medical pedigree. I really respect, I liked working with him cuz he liked to teach. He like, and I never really got close with him per se, but he was somebody who I was sort of drawn to. Like I'd rather go scrubbing with that surgeon than these other people who, who I definitely looked up to. Um, and towards the end of my, uh, rotation, I started asking surgery residents, it's like, if you or your mom or your dad needed to have X, Y, or Z procedure performed, who would you rather Who would you go to to do it? Would you go to Dr. So-and-so, the chairman, or would you go to this guy who I'm describing? And, um, almost guess 100% of the people, guess, guess who they said, said this guy, why he cared.

Yeah.

And it came through in the interaction. So when you're choosing your doctor, your whomever, be less worried about the credentials. Now, it's nice to have both, but go with the person who you connect with.

Yeah.

And so I don't know if that answers the question, but Yeah, there's, and if you connect with the talking head, awesome. Right. If you connect with somebody with a little, you know, hung up a shingle and is starting fresh the way I did way back when, like, awesome. Um, you know, cause that's how, like, I mean, that's how I met Kevin. Um, and that's how I, you know, have been able to build what what I'm currently building now. It's, it's those connections are, are sort of the most important thing.

Tell us a little bit about what you're building now, where we can find you if people are interested in, in what you said resonates.

Yeah. I mean, Longevity Health, longevityhealth.clinic. I think it's Dr. Vasily on Instagram. I mean, I do all the content. I make sure I'm comfortable with what we put out there, but other people manage it. So fortunately for me, I don't have to like interface with the technicalities of it. But yeah, we're, you know, I guess what, what our vision is, is this is, you know, when I left the system, all I knew how to do was like be the change you want to see. And, and You know, we did okay at that and that practice is still in existence. And that being the change I wanted to see, I learned a couple of really important lessons. Like I do not know how to manage the business as well as people who know how to manage the business. I don't know how to market the way people who know how to market can market. I stay in, you know, this practice is really one that has, was an evolution out of, you know, just trying my best to be the change I wanted to see. And I believe that this practice in its current form is, you know, catering to a particular set of people. Has a pretty, it has a high price tag, I think is worth every penny. And this is phase one of a broader mission to change the way we deliver healthcare in this country. And so it goes, it goes much deeper than having a successful boutique concierge longevity practice. We know that there's structural change. Me and my business partner are 100% aligned that needs to happen. In our healthcare space. And unfortunately, the narrative there is stuck. Everybody thinks, oh, the problem's too big. It can't be solved. All that's BS. We could solve it tomorrow. And what we're doing at Longevity Health is working towards that goal. And it's not a takeover. I think, you know, we could get in, get into that. I think we need the system we have. The system we have should not go away. But there, there needs to be a parallel system for preventative care. Primary, what we think of as primary care, it needs to be taught differently, needs to be administered differently, needs to be a lot more like the old doctor in the small town who knew people. And that doesn't work well for treating acute where you need highly technical, proficient technicians to do things, um, which is what we're really good at in the system. So that I think should never go away and we need to build sort of a, a different parallel system that administers the preventative care. And so that like longevity, like health and the way this practice is currently structured is sort of phase one of that, that broader mission.

Well, it's amazing. I'm a huge fan. Thank you for sharing all of your wisdom with us. This is, it's been a great conversation and really appreciate you coming on.

Thank you so much.

Cheers.

Yeah.