Whether you end up having Alzheimer's. It begins, we're like, where did I put my keys? We can't tell you which one's going to go to. Ten years later that adult says, I can't find my way home. Since we don't have that answer, everybody should do things to prevent memory neurosurgence and in your biology, Doctor ruhu Jiandiel.

Whether you end up having Alzheimer's. It begins, we're like, where did I put my keys? We can't tell you which one's going to go to. Ten years later that adult says, I can't find my way home. Since we don't have that answer, everybody should do things to prevent memory neurosurgence and in your biology, Doctor ruhu Jiandiel.

Why is it that we feel we can't remember anything anymore?

Why is it that we feel we can't remember anything anymore?

One of the most common questions people ask is when they start forgetting, like where the keys are at? And they say, hey, is this alzheimer or does this need to be fixed? Is this natural?

One of the most common questions people ask is when they start forgetting, like where the keys are at? And they say, hey, is this alzheimer or does this need to be fixed? Is this natural?

What are we doing every day that's distracting and disrupting a working.

What are we doing every day that's distracting and disrupting a working.

Memory too much? Juggling multitasking has its own issues. You want to get away from your thought hijacking your body?

Memory too much? Juggling multitasking has its own issues. You want to get away from your thought hijacking your body?

Why do we replay negative memories? Why is it so easy?

Why do we replay negative memories? Why is it so easy?

So an emotional imprint on a memory requires no focus in the technic. So emotional imprinting of a memory and trauma makes it sometimes too easy to remember, and sometimes it pops up without you even wanting to. When you were able to revisit a memory in a controlled environment, you can dampen your emotional stamp onto that memory. You don't forget the memory, you just disassociate the emotional feelings of the trauma the fear of the physical reaction.

So an emotional imprint on a memory requires no focus in the technic. So emotional imprinting of a memory and trauma makes it sometimes too easy to remember, and sometimes it pops up without you even wanting to. When you were able to revisit a memory in a controlled environment, you can dampen your emotional stamp onto that memory. You don't forget the memory, you just disassociate the emotional feelings of the trauma the fear of the physical reaction.

For anyone concerned that their family member may have early dementia Alzheimer's, what should they be looking out for and how can they help that person?

For anyone concerned that their family member may have early dementia Alzheimer's, what should they be looking out for and how can they help that person?

The number one health and wellness podcast Jay Sheety.

The number one health and wellness podcast Jay Sheety.

Jay Shetty Sez jo. Hey, everyone, welcome back to On Purpose, the place you come to listen, learn and grow. Today's guest is someone that we had on last year and you absolutely loved the episode. The response was incredible. We had to have him back on It is none other than doctor Raoul Johndel, a renowned neurosurgeon, neuroscientist, and author. Doctor John Deal is known for his expertise brain surgery, particularly in areas related to brain tumors, epilepsy, and other brain disorders. Doctor John Delle is also a prominent public speaker and educator, frequently sharing insights into the brain's complexity and health. His work combines clinical practice with research aiming to deepen our understanding of the brain and improve treatments for neurological diseases. Please welcome back, doctor Roll John Dale. It's great to have you back.

Jay Shetty Sez jo. Hey, everyone, welcome back to On Purpose, the place you come to listen, learn and grow. Today's guest is someone that we had on last year and you absolutely loved the episode. The response was incredible. We had to have him back on It is none other than doctor Raoul Johndel, a renowned neurosurgeon, neuroscientist, and author. Doctor John Deal is known for his expertise brain surgery, particularly in areas related to brain tumors, epilepsy, and other brain disorders. Doctor John Delle is also a prominent public speaker and educator, frequently sharing insights into the brain's complexity and health. His work combines clinical practice with research aiming to deepen our understanding of the brain and improve treatments for neurological diseases. Please welcome back, doctor Roll John Dale. It's great to have you back.

I'm stoked to be back, man.

I'm stoked to be back, man.

People loved that episode and the response was so great that we were like, we have to get you back on for part two.

People loved that episode and the response was so great that we were like, we have to get you back on for part two.

I mean, it was hard to tell for me because you know, we're here and it's intimate. I feeling relaxed and I can communicate, but then it's going out to so many people, whereas if you do a you know, live television or you do an audience event, you can feel that energy like a sporting event. But I'm thrilled to be back, man, and I'm I'm ready to just just go off the top and just vibe.

I mean, it was hard to tell for me because you know, we're here and it's intimate. I feeling relaxed and I can communicate, but then it's going out to so many people, whereas if you do a you know, live television or you do an audience event, you can feel that energy like a sporting event. But I'm thrilled to be back, man, and I'm I'm ready to just just go off the top and just vibe.

I love it, man, I love it. I wanted to dive in because I know you've been talking a lot about memory, and that's been something you've been study quite deeply recently. Why is it that we feel we can't remember anything anymore?

I love it, man, I love it. I wanted to dive in because I know you've been talking a lot about memory, and that's been something you've been study quite deeply recently. Why is it that we feel we can't remember anything anymore?

So that was the most common question I would get from my patient. So I'm a brain surgeon. I've taken care of several thousand patients with surgery and the interaction before and after surgery, and then I've met thousands. I was talking to your team, like you know, not everybody you see need surgery or benefits from surgery, or choose a surgery. So there's just a lot of human interaction. I've had thousands of patients. I'm fifty two. I've been doing this since i was twenty five. And one of the most common questions people ask when they start to think about maybe my brain isn't going to be perfect forever is when they start forgetting like where the keys are at, or they stop remembering things, and they say, hey, is this Alzheimer's? Does this need to be fixed? Is this natural? So that the question of my memory is fundamental and I'll zoom out for a little bit. People who don't have memory of who they are are completely lost. Every day they have to invent themselves new. So it's an essential feature that one type of memory called autobiographic memory. It stitches our memories of our childhood, lifetime experiences, and it gives us a sense of identity meaning purpose, like I have been the one in this vehicle of life and those those experiences are connected, right, So memory is essential in that way for identity. On a more practical level, memory is not one word, so like there's a lot of types of memory, and I think that's where today I want to just take it one step deeper, Like I don't have all the answers, but when I'm communicating with patients, if I can take it one step deeper in the explanation and they go, ah, I get it, then they're more likely to implement the guidance they choose. There are many types of memory. Memory is not one word. So let's take one that we rarely lose, procedural memory. Once you learn how to ride a bike, once you learn how to like you know, tie your shoelaces. Patients of mind that have Alzheimer's or even brain injury, or just get eighties and nineties, they still remember that. Procedural memory is not the one we need to be thinking about. Then there's another type of memory called semantic memory, as facts. I don't want to remember my phone number anymore, Matt, I got facts on my phone. I want to connect the dots, so those kind of things aren't as important. Then there's a third type you can call episodic memory. It's a fancy word for episodes. Again, like this happened in my life, this episode, Now that's important. Unfortunately, that type of memory is what's lost with dementia with aging, and people worry about that, like does this mean I'm aging normally or is this the onset of Alzheimer's. We don't have that answer. So whether you end up having Alzheimer's or whether you just have age appropriate subtle loss of memory, it begins we're like, where did I put my keys? Like it all begins that way, we can't tell you which one's going to go to. Ten years later, that adult says, I can't find my way home. So that concept is so tricky that since we don't have that answer, I believe everybody should do things to prevent memory loss. Right, you don't, because if you go down the Alzheimer's path or just a normal cognitive decline, the guidance is still the same. ABC. Eat a certain way, think a certain way, move a certain way. The guidance ABC whether you're about to get Alzheimer's, don't know. If you're bout to have Alzheimer's or normal aging or have been diagnosed with Alzheimer's, the guidance is the same, and that speaks to how the brain and mind works.

So that was the most common question I would get from my patient. So I'm a brain surgeon. I've taken care of several thousand patients with surgery and the interaction before and after surgery, and then I've met thousands. I was talking to your team, like you know, not everybody you see need surgery or benefits from surgery, or choose a surgery. So there's just a lot of human interaction. I've had thousands of patients. I'm fifty two. I've been doing this since i was twenty five. And one of the most common questions people ask when they start to think about maybe my brain isn't going to be perfect forever is when they start forgetting like where the keys are at, or they stop remembering things, and they say, hey, is this Alzheimer's? Does this need to be fixed? Is this natural? So that the question of my memory is fundamental and I'll zoom out for a little bit. People who don't have memory of who they are are completely lost. Every day they have to invent themselves new. So it's an essential feature that one type of memory called autobiographic memory. It stitches our memories of our childhood, lifetime experiences, and it gives us a sense of identity meaning purpose, like I have been the one in this vehicle of life and those those experiences are connected, right, So memory is essential in that way for identity. On a more practical level, memory is not one word, so like there's a lot of types of memory, and I think that's where today I want to just take it one step deeper, Like I don't have all the answers, but when I'm communicating with patients, if I can take it one step deeper in the explanation and they go, ah, I get it, then they're more likely to implement the guidance they choose. There are many types of memory. Memory is not one word. So let's take one that we rarely lose, procedural memory. Once you learn how to ride a bike, once you learn how to like you know, tie your shoelaces. Patients of mind that have Alzheimer's or even brain injury, or just get eighties and nineties, they still remember that. Procedural memory is not the one we need to be thinking about. Then there's another type of memory called semantic memory, as facts. I don't want to remember my phone number anymore, Matt, I got facts on my phone. I want to connect the dots, so those kind of things aren't as important. Then there's a third type you can call episodic memory. It's a fancy word for episodes. Again, like this happened in my life, this episode, Now that's important. Unfortunately, that type of memory is what's lost with dementia with aging, and people worry about that, like does this mean I'm aging normally or is this the onset of Alzheimer's. We don't have that answer. So whether you end up having Alzheimer's or whether you just have age appropriate subtle loss of memory, it begins we're like, where did I put my keys? Like it all begins that way, we can't tell you which one's going to go to. Ten years later, that adult says, I can't find my way home. So that concept is so tricky that since we don't have that answer, I believe everybody should do things to prevent memory loss. Right, you don't, because if you go down the Alzheimer's path or just a normal cognitive decline, the guidance is still the same. ABC. Eat a certain way, think a certain way, move a certain way. The guidance ABC whether you're about to get Alzheimer's, don't know. If you're bout to have Alzheimer's or normal aging or have been diagnosed with Alzheimer's, the guidance is the same, and that speaks to how the brain and mind works.

How bad is it that we can't remember what we had for dinner last night.

How bad is it that we can't remember what we had for dinner last night.

Not a big deal at all, not a big deal, not a big deal. So those glitches are age appropriate. That happens in our thirties, forties, fifties, sixties, as we get less young. I had Patience a long time ago. She was ninety something. I said, well, you're older. She looked at me with the just a scow. She was like, older, I'm less young. So that since that day less young. So as we get less young, that's natural.

Not a big deal at all, not a big deal, not a big deal. So those glitches are age appropriate. That happens in our thirties, forties, fifties, sixties, as we get less young. I had Patience a long time ago. She was ninety something. I said, well, you're older. She looked at me with the just a scow. She was like, older, I'm less young. So that since that day less young. So as we get less young, that's natural.

Why what's happening, Well.

Why what's happening, Well.

The answer is not clear because we don't study that. What we do study is when it starts with age appropriate sort of subtle memory loss. And if you zoom out our whole about our knees age, our heart's age, our mind's age, that's not necessarily a disease, but it's age appropriate. Versus Alzheimer's, Alzheimer's and dementia, and like what Bruce Willis has frontal temporal dimension, there's a lot of different types of dementia. Maybe we should just call it dementia. Is that it starts with a little bit of memory loss that's just normal aging. But then it accelerates and what people think is like, oh, they can't remember things. It's more than that they can't remember their autobiographical memory. They can't remember who they are because they don't remember their stories from their childhood. Then they start forgetting who the loved ones are and why they're loved ones autobiographical memory. Then the injury goes even deeper and it affects their emotional regulation. Like that's a big topic I love, I wrote at a long time ago, Like the ability to say I'm angry, but that's not what I want to feel right now, that's not I don't want to act right now. They lose emotional regulation. So for caregivers it's very challenging. It's like you don't remember me, I'm your child, and then on top of that, you're angry with me all the time. It's a it's an intense experience, of course for the patient. For the person, I wouldn't say, why do can? We can? We never age in a way that's super memory all the way. Let me, I'm gonna get to that. I'm not sure we want perfect memory. That's about facts, that's about procedures the area. The last type of memory that I didn't mentioned is called working memory. This is this is the memory I want, of course, I want out of biographical memory. I'm who, I'm this, I'm that, facts are on my phone. I think I'll be able to, you know, handle a bike and laces for a while. So let's get down to if you want to level up. So the training for Alzheimer's and dementia, the training for me, the training for an NFL quarterbacks, for moving receivers, analysis, judgment, timing. That's called working memory. Too much juggling, multitasking has its own issues, but working memory is the skill I want. I want to be able to run six governmental departments. I want to be able to manage a hospital with sixteen patients on ventilators when I was twenty eight. I want to manage talking to you and having a bunch of ideas popping in the back, and which one do I bring? Right? That's called working memory, and there is guidance and training for that. There is brain training for that type of memory. So you ask me early, like, what's memory? So now we've broken it out of several types, and the one we want is short term juggling, a lot of plates, a lot of thoughts in the sky, and that's where creativity comes from. You're looking at things your working memories, pulling back imagination. Working memory can be trained. Working memory is the digital therapy peutic for Alzheimer's. Working memories like the people I look up to, they're the ones that do things the best because it's not just procedurally like I'm looking at six monitors and able to operate. It's the fact that I have a lot of thoughts in my head and my working memories. Keeping them all immediately accessible. I don't have to like, go, ah, well, where's that? What was that? Now? I've got like eight or nine things I want to talk to you about. My working memory is keeping them afloat. Let it allow me to extract them for you.

The answer is not clear because we don't study that. What we do study is when it starts with age appropriate sort of subtle memory loss. And if you zoom out our whole about our knees age, our heart's age, our mind's age, that's not necessarily a disease, but it's age appropriate. Versus Alzheimer's, Alzheimer's and dementia, and like what Bruce Willis has frontal temporal dimension, there's a lot of different types of dementia. Maybe we should just call it dementia. Is that it starts with a little bit of memory loss that's just normal aging. But then it accelerates and what people think is like, oh, they can't remember things. It's more than that they can't remember their autobiographical memory. They can't remember who they are because they don't remember their stories from their childhood. Then they start forgetting who the loved ones are and why they're loved ones autobiographical memory. Then the injury goes even deeper and it affects their emotional regulation. Like that's a big topic I love, I wrote at a long time ago, Like the ability to say I'm angry, but that's not what I want to feel right now, that's not I don't want to act right now. They lose emotional regulation. So for caregivers it's very challenging. It's like you don't remember me, I'm your child, and then on top of that, you're angry with me all the time. It's a it's an intense experience, of course for the patient. For the person, I wouldn't say, why do can? We can? We never age in a way that's super memory all the way. Let me, I'm gonna get to that. I'm not sure we want perfect memory. That's about facts, that's about procedures the area. The last type of memory that I didn't mentioned is called working memory. This is this is the memory I want, of course, I want out of biographical memory. I'm who, I'm this, I'm that, facts are on my phone. I think I'll be able to, you know, handle a bike and laces for a while. So let's get down to if you want to level up. So the training for Alzheimer's and dementia, the training for me, the training for an NFL quarterbacks, for moving receivers, analysis, judgment, timing. That's called working memory. Too much juggling, multitasking has its own issues, but working memory is the skill I want. I want to be able to run six governmental departments. I want to be able to manage a hospital with sixteen patients on ventilators when I was twenty eight. I want to manage talking to you and having a bunch of ideas popping in the back, and which one do I bring? Right? That's called working memory, and there is guidance and training for that. There is brain training for that type of memory. So you ask me early, like, what's memory? So now we've broken it out of several types, and the one we want is short term juggling, a lot of plates, a lot of thoughts in the sky, and that's where creativity comes from. You're looking at things your working memories, pulling back imagination. Working memory can be trained. Working memory is the digital therapy peutic for Alzheimer's. Working memories like the people I look up to, they're the ones that do things the best because it's not just procedurally like I'm looking at six monitors and able to operate. It's the fact that I have a lot of thoughts in my head and my working memories. Keeping them all immediately accessible. I don't have to like, go, ah, well, where's that? What was that? Now? I've got like eight or nine things I want to talk to you about. My working memory is keeping them afloat. Let it allow me to extract them for you.

Yeah, For anyone who's listening right now and they're concerned that their family member may have early dementia Alzheimer's, that direction, what should they be looking out for and how can they help that person?

Yeah, For anyone who's listening right now and they're concerned that their family member may have early dementia Alzheimer's, that direction, what should they be looking out for and how can they help that person?

The story is when humans passed away in our thirties and forties, 're sort of like the heart that we're out and then we live longer. We addressed heart disease. Main you knows, as we live longer and longer, it's the brain that's starting to wear out and if you suspect that your family members having memory issues, the greatest challenge will be, and I don't mean this lightly, is that that person doesn't remember what they don't remember. They're not thinking I forgot that because they don't remember that. It's the loved ones that see it. So if you see that, you have to invite them and say, look, you know, I'm noticing a few different things in our next general visit to the doctor, can we maybe mention it to them? And they'll do a neurocognitive test. It's straightforward, draw this circle backwards and they do like those that like a little test. It's casual, but they can track it. Say hey, can we do this every year? And you track that test every year? And when you see that you're drawing the clock and you're missing numbers. Even the person with dementia will say, yeah, you know something's changing. But if you try to persuade somebody who can't remember, hey you're not remembering? Can you can see how that could just not work right, So you want to get them to somebody early. And what the physician will do is take a look at that and then they say, hey, do you have genetic history? And so certain Almost all dementia is not genetic, but there are some genetic issues that you want to know about. And then this is the best part. Whether it's age appropriate cognitive decline of certain memory, not working memory, the one where fight I'm fine for, or it's early onset Alzheimer's, that we can identify. The interventions are the same. Keep the brain arteries open, eat a certain type of food, the mind diet, and continue to challenge the brain puzzles, socializing, networking, taking a different route home using your left hand. Learning a new language. You have to learn the new language. You just have to try. You might only get like three words. You're like, hey, this language thing is not working. But it's the those those three steps are are there is that's the established thing, and I think that way that's empowering to the patient, to the families. And it's not like pill and medicine dependent, because frankly, there ain't good medicine for it.

The story is when humans passed away in our thirties and forties, 're sort of like the heart that we're out and then we live longer. We addressed heart disease. Main you knows, as we live longer and longer, it's the brain that's starting to wear out and if you suspect that your family members having memory issues, the greatest challenge will be, and I don't mean this lightly, is that that person doesn't remember what they don't remember. They're not thinking I forgot that because they don't remember that. It's the loved ones that see it. So if you see that, you have to invite them and say, look, you know, I'm noticing a few different things in our next general visit to the doctor, can we maybe mention it to them? And they'll do a neurocognitive test. It's straightforward, draw this circle backwards and they do like those that like a little test. It's casual, but they can track it. Say hey, can we do this every year? And you track that test every year? And when you see that you're drawing the clock and you're missing numbers. Even the person with dementia will say, yeah, you know something's changing. But if you try to persuade somebody who can't remember, hey you're not remembering? Can you can see how that could just not work right, So you want to get them to somebody early. And what the physician will do is take a look at that and then they say, hey, do you have genetic history? And so certain Almost all dementia is not genetic, but there are some genetic issues that you want to know about. And then this is the best part. Whether it's age appropriate cognitive decline of certain memory, not working memory, the one where fight I'm fine for, or it's early onset Alzheimer's, that we can identify. The interventions are the same. Keep the brain arteries open, eat a certain type of food, the mind diet, and continue to challenge the brain puzzles, socializing, networking, taking a different route home using your left hand. Learning a new language. You have to learn the new language. You just have to try. You might only get like three words. You're like, hey, this language thing is not working. But it's the those those three steps are are there is that's the established thing, and I think that way that's empowering to the patient, to the families. And it's not like pill and medicine dependent, because frankly, there ain't good medicine for it.

Really.

Really.

Yeah, this is not a There are not great treatments for Alzheimer's. They're out there, people can look at them. They're for early cognitive decline. But when you even if you were to take those medicines, you still got to do the other things. You got to walk to keep your brain arteries open. You got to irrigate the flesh. You got to eat a mind die, which is fatty fish or if you're vegan or plant based, you know they have that. And then you got to like you have to do those brain training and challenge your working memory. The same thing with somebody with Alzheimer's about to get Alzheimer's, worried about Alzheimer's, and you and me, it's the same recipe.

Yeah, this is not a There are not great treatments for Alzheimer's. They're out there, people can look at them. They're for early cognitive decline. But when you even if you were to take those medicines, you still got to do the other things. You got to walk to keep your brain arteries open. You got to irrigate the flesh. You got to eat a mind die, which is fatty fish or if you're vegan or plant based, you know they have that. And then you got to like you have to do those brain training and challenge your working memory. The same thing with somebody with Alzheimer's about to get Alzheimer's, worried about Alzheimer's, and you and me, it's the same recipe.

Let's break down the recipe for people who are listening right now so that we can get into the details of those three steps.

Let's break down the recipe for people who are listening right now so that we can get into the details of those three steps.

Like you know, uh, the brain is flesh. I remember the first time I saw it when I was twenty six and they opened the skull and I was like watching the professors and I was like, what is this even possible? And it gets twenty percent of the blood from your heart with these four raging arteries that come up, and it's like three pounds or five kilograms or whatever it is, That three four pound organ gets twenty percent of our blood flow. It is an energy hog. And you think it's and then it's white opal lesson, it's shimmering under the operating room lights. I mean, it's not gray matter. Great matters when they when the patients passed away and they've for mountain no no, and it's heat with every breath that heaves a little bit. It's got fluid chambers on it. It's like, it's the way to imagine it is like one hundred billion ish jellyfish in an aquarium, but there's fluid in there and they're shooting electricity and chemicals at it. You mentioned something about when I said sleep entry, and you said, yeah, versus falling asleep. Language is important for our concepts. That's what I try to do. Before I came on today, it was like, how do I describe this in a way where it's not like lebrain. I'd say the same thing. I'm not throwing shade on anybody, but take your imagination away that it's one hundred billion jellyfish packed together in clusters, floating in an aquarium inside her skull. Our brain doesn't sit on the inside of her skull. It's buoyant and it's spring electricity, and it's not in left and right directions. It's like Aurora borealis, or a school of birds that rolls back onto each other. Right, it's a there's an electrical flow that's shivering through those through those jellyfish, right, Like, that's how you got to imagine it. So when you look at it, the first thing you need to know is those four arteries that come and feed this garden. Right, And the neurons are like roses. You get what you get. You're not really growing neurons. It's a mild exception with stem cells. And then there's all the supporting cells what I call like shrubs, like extracites. Like you want to keep that garden irrigated, you sprinkle the lawn, right, You got to sprinkle blood to that flesh because that activity in those neurons is relying on the glucose coming up, and glucose is the fuel to keep those little molecular jellyfish alive. So people say, well, what do I do to keep my brain shot? Well, keep those arteries open. How do you keep those arteries open? You know that take the lipiatore walk exercise. That's not just to look good. It's to keep the main arteries and all those fine branching arteries going into those crevices open because if you start losing swaths of brain tissue. You're gonna have issues, not always. But that's the first thing. Is heart health is also brain health. That's the easiest thing. Okay. Number two is what you eat, not today or tomorrow, but over a decade. And this is well established. This isn't like one study globally the Mediterranean diet, which is mostly plants, fatty fish, beans, nuts. Those people, if you just look at like thousands and thousands over a decade or two, they have lower rates of dementia. And that's the only difference that they're having. That's the recommendation we give to people. So you say, well, why is that that kind of diet? Why does that work? And look, love have a burger, I love it. I mean, it's not the indulgences, it's that baseline habit with fish. Those neurons, the neurons, if you think of it as a jellyfish, all these tentacles ten you know, they rough numbers ten thousand, hundred or whatever. But the electrical signals that flow between our neurons, they're wrapped with something insulation. The insulation lets the electricity fire faster. That insulation is literally made of omega three fat. The brain is fatty. The fat that the brain uses to keep insulated comes from fatty fish and those kinds of things. So there's a reason to eat that way. And the last thing we've been talking about all you know all morning is focus on untentioned, on your next level of not somebody else's right, Because if I told you, hey, you want bigger biceps, we would say we need it. But this is a thinking flesh, This is a feeling flesh. This is an interconnected flesh. So vibe, think, read, whatever that is for you. But the combination of those three things is well established and there is no shortcut.

Like you know, uh, the brain is flesh. I remember the first time I saw it when I was twenty six and they opened the skull and I was like watching the professors and I was like, what is this even possible? And it gets twenty percent of the blood from your heart with these four raging arteries that come up, and it's like three pounds or five kilograms or whatever it is, That three four pound organ gets twenty percent of our blood flow. It is an energy hog. And you think it's and then it's white opal lesson, it's shimmering under the operating room lights. I mean, it's not gray matter. Great matters when they when the patients passed away and they've for mountain no no, and it's heat with every breath that heaves a little bit. It's got fluid chambers on it. It's like, it's the way to imagine it is like one hundred billion ish jellyfish in an aquarium, but there's fluid in there and they're shooting electricity and chemicals at it. You mentioned something about when I said sleep entry, and you said, yeah, versus falling asleep. Language is important for our concepts. That's what I try to do. Before I came on today, it was like, how do I describe this in a way where it's not like lebrain. I'd say the same thing. I'm not throwing shade on anybody, but take your imagination away that it's one hundred billion jellyfish packed together in clusters, floating in an aquarium inside her skull. Our brain doesn't sit on the inside of her skull. It's buoyant and it's spring electricity, and it's not in left and right directions. It's like Aurora borealis, or a school of birds that rolls back onto each other. Right, it's a there's an electrical flow that's shivering through those through those jellyfish, right, Like, that's how you got to imagine it. So when you look at it, the first thing you need to know is those four arteries that come and feed this garden. Right, And the neurons are like roses. You get what you get. You're not really growing neurons. It's a mild exception with stem cells. And then there's all the supporting cells what I call like shrubs, like extracites. Like you want to keep that garden irrigated, you sprinkle the lawn, right, You got to sprinkle blood to that flesh because that activity in those neurons is relying on the glucose coming up, and glucose is the fuel to keep those little molecular jellyfish alive. So people say, well, what do I do to keep my brain shot? Well, keep those arteries open. How do you keep those arteries open? You know that take the lipiatore walk exercise. That's not just to look good. It's to keep the main arteries and all those fine branching arteries going into those crevices open because if you start losing swaths of brain tissue. You're gonna have issues, not always. But that's the first thing. Is heart health is also brain health. That's the easiest thing. Okay. Number two is what you eat, not today or tomorrow, but over a decade. And this is well established. This isn't like one study globally the Mediterranean diet, which is mostly plants, fatty fish, beans, nuts. Those people, if you just look at like thousands and thousands over a decade or two, they have lower rates of dementia. And that's the only difference that they're having. That's the recommendation we give to people. So you say, well, why is that that kind of diet? Why does that work? And look, love have a burger, I love it. I mean, it's not the indulgences, it's that baseline habit with fish. Those neurons, the neurons, if you think of it as a jellyfish, all these tentacles ten you know, they rough numbers ten thousand, hundred or whatever. But the electrical signals that flow between our neurons, they're wrapped with something insulation. The insulation lets the electricity fire faster. That insulation is literally made of omega three fat. The brain is fatty. The fat that the brain uses to keep insulated comes from fatty fish and those kinds of things. So there's a reason to eat that way. And the last thing we've been talking about all you know all morning is focus on untentioned, on your next level of not somebody else's right, Because if I told you, hey, you want bigger biceps, we would say we need it. But this is a thinking flesh, This is a feeling flesh. This is an interconnected flesh. So vibe, think, read, whatever that is for you. But the combination of those three things is well established and there is no shortcut.

Before we dive into the next moment. Let's hear from our sponsors. Thanks for taking a moment for that. Now back to the discussion. I love the way you've broken down the different memories. I had no idea that there were so many different words for memory, and I love that because it helps us really compartmentalize how we think about this really big topic. But when I'm listening to you, I'm wondering what are we doing every day that's distracting and disrupting our working memory.

Before we dive into the next moment. Let's hear from our sponsors. Thanks for taking a moment for that. Now back to the discussion. I love the way you've broken down the different memories. I had no idea that there were so many different words for memory, and I love that because it helps us really compartmentalize how we think about this really big topic. But when I'm listening to you, I'm wondering what are we doing every day that's distracting and disrupting our working memory.

So what I try to do is I try to take my patient stories I try to look at the neurons in a Petrie dish. I read a lot. I read a lot of random things, and I try to think about how to answer that. What's the right How do you thread the needle between juggling enough to where you're holding on to and cultivating your working memory or you're just like just numb by this like blitz of things coming at you. Yeah, I think it's very individual. I would say it's different for children because, as we discussed last time, we're learning to move and walk, and the brain is learning to have a sense of self. There's a psychological cultivation that mirrors our physical cultivation. You don't want to flood that mind with too much. I'll let others comment on at which age they should be on social media or not. But the concept I think we can all agree on based on science and this conversation is in the developing mind. It doesn't have the filter and it doesn't have the maturity of that working memory. You don't want a kid. Our raised three sons, they're nineteen, twenty and twenty three, so I'm talking from the perspective a parent. I always try to see where are they at, and then add one more thing. But sometimes when I see families with their patients in the waiting room, I mean the kids just look down at their phones for like one hundred hours. You know. It's like you look at their you know, the they've been on there, and you ask her how long you've been on there, like a lot of them. It's just it feels excessive for that age. And then it's also the content at the later range of life. You want certain brain training games for elderly they have shown like it's FDA proved. That means you brought a lot of evidence in it. It's not just one study. I'm not throwing shade on anybody. But the game is it's a racer game where like grandma's like racing a car and there's distractions coming up and she has to avoid them. Same thing for NFL quarterbacks. I think it was Atlanta. He's a broadcaster, now he's a quarterback. That a game where they're looking at something but different lights are popping up and they have to identify them in their peripheral vision. That speed of processing, that working memory is an important skill. The question is when are you stunting its development and when are you cultivating I think it's age specific. I think it's individual specific. I think when we know we're just doing some something to shut down versus doing it as training, so that portal can be both. It can mess you up, it can hold you back, but if you have the right digital diet man, it can open up the world for you. So I think that's the way I look at it.

So what I try to do is I try to take my patient stories I try to look at the neurons in a Petrie dish. I read a lot. I read a lot of random things, and I try to think about how to answer that. What's the right How do you thread the needle between juggling enough to where you're holding on to and cultivating your working memory or you're just like just numb by this like blitz of things coming at you. Yeah, I think it's very individual. I would say it's different for children because, as we discussed last time, we're learning to move and walk, and the brain is learning to have a sense of self. There's a psychological cultivation that mirrors our physical cultivation. You don't want to flood that mind with too much. I'll let others comment on at which age they should be on social media or not. But the concept I think we can all agree on based on science and this conversation is in the developing mind. It doesn't have the filter and it doesn't have the maturity of that working memory. You don't want a kid. Our raised three sons, they're nineteen, twenty and twenty three, so I'm talking from the perspective a parent. I always try to see where are they at, and then add one more thing. But sometimes when I see families with their patients in the waiting room, I mean the kids just look down at their phones for like one hundred hours. You know. It's like you look at their you know, the they've been on there, and you ask her how long you've been on there, like a lot of them. It's just it feels excessive for that age. And then it's also the content at the later range of life. You want certain brain training games for elderly they have shown like it's FDA proved. That means you brought a lot of evidence in it. It's not just one study. I'm not throwing shade on anybody. But the game is it's a racer game where like grandma's like racing a car and there's distractions coming up and she has to avoid them. Same thing for NFL quarterbacks. I think it was Atlanta. He's a broadcaster, now he's a quarterback. That a game where they're looking at something but different lights are popping up and they have to identify them in their peripheral vision. That speed of processing, that working memory is an important skill. The question is when are you stunting its development and when are you cultivating I think it's age specific. I think it's individual specific. I think when we know we're just doing some something to shut down versus doing it as training, so that portal can be both. It can mess you up, it can hold you back, but if you have the right digital diet man, it can open up the world for you. So I think that's the way I look at it.

Yeah, I always think about it like an elastic band, and it's this idea that an elastic band is useless if it's not being stretched, but at the same time, there's a point at which it will snap. Yeah, and I've seen that with my own memory or my ability, my working memories. You describe it where I used to think I was doing everything I could, and then I stretched and I was like, oh wow, I could do more than I believe. And then I stretched, and then I stretched, and I started to realize that my capacity and capability was far larger than I ever imagined.

Yeah, I always think about it like an elastic band, and it's this idea that an elastic band is useless if it's not being stretched, but at the same time, there's a point at which it will snap. Yeah, and I've seen that with my own memory or my ability, my working memories. You describe it where I used to think I was doing everything I could, and then I stretched and I was like, oh wow, I could do more than I believe. And then I stretched, and then I stretched, and I started to realize that my capacity and capability was far larger than I ever imagined.

And you were developing it with each stretch exactly.

And you were developing it with each stretch exactly.

But if I accepted where I was that, oh this is the most I can do, actually, I would never have known. And you're saying that in some ways that's unhealthy, unhealthy that you you don't stretch and challenge. You say, video kids, you're always adding, oh yeah.

But if I accepted where I was that, oh this is the most I can do, actually, I would never have known. And you're saying that in some ways that's unhealthy, unhealthy that you you don't stretch and challenge. You say, video kids, you're always adding, oh yeah.

So many flies to space. They don't have gravitational force, they come back. Their bones are brittle. You need certain amount of stress at the bone, at the osteocyte level. Like physiologically we need gravity. So some stress makes us grow. Too much stress fractures that bone. Okay, take that physiologic concept and apply that same to the mind. Now what I would say is that elastic band, I love that. And if you leave it idle and that elastic band gets dry, then the stretching is too late. And then the last thing I would add to that is when my sons and others they play video games is a very well studied thing. If you give them multiple levels, they'll compete to level up. But if you just present them the fifth level, they'll just say, nah, that's too hard. And if you make it too easy, then won't hold their at tension. So the nuance is exactly is to find where am Where am I at? Not that person's advice, not that person's life, but from everything that I've taken in where am I at? Where the appropriate next stress challenge? Stretch of the rubber band, next level on the video game is there that's enticing enough achievable with some effort, and then I get there, and then I get there, and then I get there and then I get knocked down, because life is going to knock you down. That's part of its struggle and its beauty. And then you might find yourself not at those same levels, not with those same coping mechanisms, but remembering that it's an incremental crawl out of that ditch that your mind can fall into. I've seen it in my cancer pati of their heroes. And so if the lesson there is that our working memory, our memory, everything from bones to biology to trees, we need stress and pressure. It's a thermostat. Stress isn't all bad, A stress isn't all good, And it's individual stress for you might be different than stress for me. In the hospital. There are stresses that certain friends of mine can handle. It's a massive stress. Yes, you're operating the middle of the night, you're handling fifteen patients for them, they're right at that. For other people that might inundate them, and that's not appropriate. So it has to be an individual thing. But biologically, physiologically, psychologically, I think knowing thyself is to know what's that next challenge for me that's enticing, that's achievable with effort, that's not too easy, so I don't give it down, or just there's no way I can get there, so I'm not even going to try.

So many flies to space. They don't have gravitational force, they come back. Their bones are brittle. You need certain amount of stress at the bone, at the osteocyte level. Like physiologically we need gravity. So some stress makes us grow. Too much stress fractures that bone. Okay, take that physiologic concept and apply that same to the mind. Now what I would say is that elastic band, I love that. And if you leave it idle and that elastic band gets dry, then the stretching is too late. And then the last thing I would add to that is when my sons and others they play video games is a very well studied thing. If you give them multiple levels, they'll compete to level up. But if you just present them the fifth level, they'll just say, nah, that's too hard. And if you make it too easy, then won't hold their at tension. So the nuance is exactly is to find where am Where am I at? Not that person's advice, not that person's life, but from everything that I've taken in where am I at? Where the appropriate next stress challenge? Stretch of the rubber band, next level on the video game is there that's enticing enough achievable with some effort, and then I get there, and then I get there, and then I get there and then I get knocked down, because life is going to knock you down. That's part of its struggle and its beauty. And then you might find yourself not at those same levels, not with those same coping mechanisms, but remembering that it's an incremental crawl out of that ditch that your mind can fall into. I've seen it in my cancer pati of their heroes. And so if the lesson there is that our working memory, our memory, everything from bones to biology to trees, we need stress and pressure. It's a thermostat. Stress isn't all bad, A stress isn't all good, And it's individual stress for you might be different than stress for me. In the hospital. There are stresses that certain friends of mine can handle. It's a massive stress. Yes, you're operating the middle of the night, you're handling fifteen patients for them, they're right at that. For other people that might inundate them, and that's not appropriate. So it has to be an individual thing. But biologically, physiologically, psychologically, I think knowing thyself is to know what's that next challenge for me that's enticing, that's achievable with effort, that's not too easy, so I don't give it down, or just there's no way I can get there, so I'm not even going to try.

Yeah, there's a brilliant book called flow State by Mihai Cheek said me Hi if I'm saying his surname right, that explains this so brilliantly. He talks about the need for having your skills meet your challenge. And so he talks about this idea that either what most of us experience is our challenge is above our skills, So we get frustrated, right, we get really disappointed. You might even get depressed because your challenge is so high and your skills are so low. Or you have the opposite where your skills are really high but your challenge is low. Now you're bored. Now you're disconnected. Now you're disengaged because you can practically do everything with these And so he talks about flow state, which is what we see athletes, musicians, singers. These people are in their moments or in the zone is when their experiences and their skills meet their challenge. And while we're talking about this, the part that I was thinking about is why do we get so stressed when we can't remember something right? When we're like, oh, man, I wanted to tell you about that movie, and I want to tell you about that Oh what was the actor's name? Oh gosh? You know, we get so frustrated when we're we almost feel that glitch.

Yeah, there's a brilliant book called flow State by Mihai Cheek said me Hi if I'm saying his surname right, that explains this so brilliantly. He talks about the need for having your skills meet your challenge. And so he talks about this idea that either what most of us experience is our challenge is above our skills, So we get frustrated, right, we get really disappointed. You might even get depressed because your challenge is so high and your skills are so low. Or you have the opposite where your skills are really high but your challenge is low. Now you're bored. Now you're disconnected. Now you're disengaged because you can practically do everything with these And so he talks about flow state, which is what we see athletes, musicians, singers. These people are in their moments or in the zone is when their experiences and their skills meet their challenge. And while we're talking about this, the part that I was thinking about is why do we get so stressed when we can't remember something right? When we're like, oh, man, I wanted to tell you about that movie, and I want to tell you about that Oh what was the actor's name? Oh gosh? You know, we get so frustrated when we're we almost feel that glitch.

I think that's because we assume that we're slowing down or shutting down. And know what I'm trying to tell people is that memory outsource that to your phone. There are people who forget their keys, forget other people's names. That's appropriate as we get less young, but older people can still have high working memory, fight for working memory and stay with that. Back to the flow state. I love that, man. I mean, I wrote about it a little bit. I'm familiar with the book, and I think the insight that he provided is that one it's individual. You can be in a flow state driving, you could be in a flow state sewing, you can be a flow state holding your kid. It's not only for high level people. I think you know as described that it's again individual, it's personal, but it takes knowing not what other people's ambitions and desires are not what other people's goals are. It takes knowing like this is something I want to get better at, this is something I want to cultivate myself. I think that's what I liked about his book was that it wasn't about the skill. It was at your skill level. Yes, it's brain searchers are in flow state. I think it's are in flow state. He studied them to understand that. The second thing that I liked about it often there's a physical component and a thinking component. And I love that because there have been times where I don't know, I mean people think like people think like brain surgery is like fixing a car. You do these twenty steps. It's every tissue, every cancer is reverse sculpting. There's at some point you have to just you have to let the maneuvers go where like it's a dance. When I've seen it done with finesse at the highest level, and in those occasions where I'm feeling that, I just remember feeling so good about what was happening without every thought being engineered and structured, like there was a I felt proud that there was a skill being released. And I think that's a flow state for me during surgery. Sometimes when I grew up in La so when the freeways are open, I took a long, fast drive through all the open roads. I had my white coat. I'm a surgeon, so we were allowed to be on there. But for driving, some people they just describe it. It's again, it's both paying attention externally and then doing something physically. I think the combination the physical move move physical activity I think should not be underestimated. Let me give you a specific example, the overlap of wanting and desire those circuits. When you talk about flow state, it's not just a psychological thing. The most times I felt that it's a mind body thing.

I think that's because we assume that we're slowing down or shutting down. And know what I'm trying to tell people is that memory outsource that to your phone. There are people who forget their keys, forget other people's names. That's appropriate as we get less young, but older people can still have high working memory, fight for working memory and stay with that. Back to the flow state. I love that, man. I mean, I wrote about it a little bit. I'm familiar with the book, and I think the insight that he provided is that one it's individual. You can be in a flow state driving, you could be in a flow state sewing, you can be a flow state holding your kid. It's not only for high level people. I think you know as described that it's again individual, it's personal, but it takes knowing not what other people's ambitions and desires are not what other people's goals are. It takes knowing like this is something I want to get better at, this is something I want to cultivate myself. I think that's what I liked about his book was that it wasn't about the skill. It was at your skill level. Yes, it's brain searchers are in flow state. I think it's are in flow state. He studied them to understand that. The second thing that I liked about it often there's a physical component and a thinking component. And I love that because there have been times where I don't know, I mean people think like people think like brain surgery is like fixing a car. You do these twenty steps. It's every tissue, every cancer is reverse sculpting. There's at some point you have to just you have to let the maneuvers go where like it's a dance. When I've seen it done with finesse at the highest level, and in those occasions where I'm feeling that, I just remember feeling so good about what was happening without every thought being engineered and structured, like there was a I felt proud that there was a skill being released. And I think that's a flow state for me during surgery. Sometimes when I grew up in La so when the freeways are open, I took a long, fast drive through all the open roads. I had my white coat. I'm a surgeon, so we were allowed to be on there. But for driving, some people they just describe it. It's again, it's both paying attention externally and then doing something physically. I think the combination the physical move move physical activity I think should not be underestimated. Let me give you a specific example, the overlap of wanting and desire those circuits. When you talk about flow state, it's not just a psychological thing. The most times I felt that it's a mind body thing.

What's the connection between you mentioned their focus and attention, what's the connection with memory? Because I think a lot of us are trying to be more present. Okay, we see it as valuable. When we meet someone you forget their name instantly. You're right, the facts will be there. But there's a part of us that feel like we're almost looking through people, We're not really there. How much does focus and attention actually impact memory or are they not connected?

What's the connection between you mentioned their focus and attention, what's the connection with memory? Because I think a lot of us are trying to be more present. Okay, we see it as valuable. When we meet someone you forget their name instantly. You're right, the facts will be there. But there's a part of us that feel like we're almost looking through people, We're not really there. How much does focus and attention actually impact memory or are they not connected?

You know, that's a good question. I don't think I have a specific answer about that. I haven't read about that, but I will tell I will tell you that memory to retrieve it is a reconstruction. There's no rolodex or a filing cabinet. You pull it out. Memory is built.

You know, that's a good question. I don't think I have a specific answer about that. I haven't read about that, but I will tell I will tell you that memory to retrieve it is a reconstruction. There's no rolodex or a filing cabinet. You pull it out. Memory is built.

What do you mean by that.

What do you mean by that.

Let's think of the brain as an ecosystem, right, the general electricity that you can record electric is like an atmosphere. Then we have the flesh, the lobes. We can talk about that. Then we have networks and circuits like things that work in ensembles. They go up and down together. They never turn off. It's always like fifty one to forty nine. There's no part of the brain that shuts off. And then there's individual neurons. You can think of them as like each tree in a forest. When we talk about memory, it is not a filing cabinet. It's a hub and so it pulls. Like I want to remember something. The easiest way for me to remember something and sometimes unavoidable, like you can't even forget it, is when the emotional structures and regions of your brain have put a stamp on it. So emotional imprinting of a memory and trauma makes it sometimes too easy to remember, and sometimes it pops up without even wanting to write. So that's one type of focus attention. Emotional stamping. I don't amygdala is not positive, it's not negative stamping. It's just emotional stamping, both positive and negative. So an emotional imprint on a memory requires no focus and attention. It's just churning back there. It's activated. The smell can pop it open. You don't want to think about it, and it's coming up. I think we all know that, right, Like things we don't want to think about feelings, We don't have memories of the past blended with imagination, so you don't require attention and focus for some types of memory, usually the ones with emotional stamps. We can get into trauma and that sort of thing for the right for the rest of it, if we're engaging people. Then on the other side is there's all this like you don't want to remember all of this. It's not really relevant, right, it's a habit, you're driving, you make that exit. There's a memory, there's a procedural memory I don't want to think about, like tying my shoelad. So somewhere in between is the attention to I should remember this. I want to remember this. So memories, emotionally imprinted memories you don't need. You're just driving on the freeway and in between. The emotional memory is easy. The attention and focus to memory is hard because it's a decremental process. Meaning bandwidth is a casual word, but it takes effort. The emotional thing, oh, it just strikes you. The other one you don't want. So attention and focus requires effort. And so when you have people you're talking to you want to remember something where you want to remember them or their names, that attention and focus is something you have to dial up. And there's a couple of ways to dial it up. Removing distractions. When I talk to Lebron James, it's like it's about not thinking about it. There's one way is to remove distractions or increase attention, and that's individual focus. Is if you haven't slept, your energy towards attention is less. It's decremental. They call it decremental vigilance. Like if you're on guard in a military situation, like after a certain amount of hours or long surgery or a long shift to the hospital, it fades. If you're in the middle. Just look I want to have more focus and attention to this. The natural answers lessen the distraction, be rested, and you know, make it a priority. But that's within each of our minds based on what we're looking at.

Let's think of the brain as an ecosystem, right, the general electricity that you can record electric is like an atmosphere. Then we have the flesh, the lobes. We can talk about that. Then we have networks and circuits like things that work in ensembles. They go up and down together. They never turn off. It's always like fifty one to forty nine. There's no part of the brain that shuts off. And then there's individual neurons. You can think of them as like each tree in a forest. When we talk about memory, it is not a filing cabinet. It's a hub and so it pulls. Like I want to remember something. The easiest way for me to remember something and sometimes unavoidable, like you can't even forget it, is when the emotional structures and regions of your brain have put a stamp on it. So emotional imprinting of a memory and trauma makes it sometimes too easy to remember, and sometimes it pops up without even wanting to write. So that's one type of focus attention. Emotional stamping. I don't amygdala is not positive, it's not negative stamping. It's just emotional stamping, both positive and negative. So an emotional imprint on a memory requires no focus and attention. It's just churning back there. It's activated. The smell can pop it open. You don't want to think about it, and it's coming up. I think we all know that, right, Like things we don't want to think about feelings, We don't have memories of the past blended with imagination, so you don't require attention and focus for some types of memory, usually the ones with emotional stamps. We can get into trauma and that sort of thing for the right for the rest of it, if we're engaging people. Then on the other side is there's all this like you don't want to remember all of this. It's not really relevant, right, it's a habit, you're driving, you make that exit. There's a memory, there's a procedural memory I don't want to think about, like tying my shoelad. So somewhere in between is the attention to I should remember this. I want to remember this. So memories, emotionally imprinted memories you don't need. You're just driving on the freeway and in between. The emotional memory is easy. The attention and focus to memory is hard because it's a decremental process. Meaning bandwidth is a casual word, but it takes effort. The emotional thing, oh, it just strikes you. The other one you don't want. So attention and focus requires effort. And so when you have people you're talking to you want to remember something where you want to remember them or their names, that attention and focus is something you have to dial up. And there's a couple of ways to dial it up. Removing distractions. When I talk to Lebron James, it's like it's about not thinking about it. There's one way is to remove distractions or increase attention, and that's individual focus. Is if you haven't slept, your energy towards attention is less. It's decremental. They call it decremental vigilance. Like if you're on guard in a military situation, like after a certain amount of hours or long surgery or a long shift to the hospital, it fades. If you're in the middle. Just look I want to have more focus and attention to this. The natural answers lessen the distraction, be rested, and you know, make it a priority. But that's within each of our minds based on what we're looking at.

So when you just told me before we started that you're doing brain surgery at three am today, how do you maintain a level of attention? Obviously there's no distractions.

So when you just told me before we started that you're doing brain surgery at three am today, how do you maintain a level of attention? Obviously there's no distractions.

Distructions people walking around, things are going wrong, are going off. You got to tell somebody, hey know my music today.

Distructions people walking around, things are going wrong, are going off. You got to tell somebody, hey know my music today.

So walk me through that. How are you that focused with something that sensitive in that moment? How do you prepare for that type of surgery?

So walk me through that. How are you that focused with something that sensitive in that moment? How do you prepare for that type of surgery?

So the skill, the cultivation is to know when this task can be performed casually, going to the cafeteria, talking to a patient. Your emotional intensity is there, but you you learn to dial up and dial down as the situation requires. It's the fancy word is ecological validity, Like you got you got a game plan, but it's got to be tested. And so that long training in those long hours was partly because they needed labor, partly because you know, they justified it. Like if you go work in a small town or you do an operation, then the Parasi has to go back because something went wrong. You can't call somebody else. You got to run it. You got to handle it. And so what you learn is so for example, the operation went late last night, That's not a big deal to me because before that, I wasn't trying to wear myself out with drama with somebody, you know, wearing myself out with like looking at things that were distracted. I went into sort of what I call a zen mode to prevent distractions. You know, I go to a zenmo before and it's not like you can tell. And then I save that tension and focus because I know my vigilance is acremental. It fades, and then we get the patient set up and we do all of that. I'm still just whatever, you know, and until there's like a there's a physical cue for me, and then it lifts. There's attention to focus, and then there's the craft and then there's a release, and then after that there's you know, there's a crash, and then I make the decision I'm going to uber home or drive home. You know, I know the freeway, so I drove home. But that goes back to your original question, is realize attention to focus for memory for anything is a resource. Some things will grab your attention, some things don't warrant your attention. It's it's it's that middle zone, right, That's what we're trying to finesse at an individual level, you know, and a collective level.

So the skill, the cultivation is to know when this task can be performed casually, going to the cafeteria, talking to a patient. Your emotional intensity is there, but you you learn to dial up and dial down as the situation requires. It's the fancy word is ecological validity, Like you got you got a game plan, but it's got to be tested. And so that long training in those long hours was partly because they needed labor, partly because you know, they justified it. Like if you go work in a small town or you do an operation, then the Parasi has to go back because something went wrong. You can't call somebody else. You got to run it. You got to handle it. And so what you learn is so for example, the operation went late last night, That's not a big deal to me because before that, I wasn't trying to wear myself out with drama with somebody, you know, wearing myself out with like looking at things that were distracted. I went into sort of what I call a zen mode to prevent distractions. You know, I go to a zenmo before and it's not like you can tell. And then I save that tension and focus because I know my vigilance is acremental. It fades, and then we get the patient set up and we do all of that. I'm still just whatever, you know, and until there's like a there's a physical cue for me, and then it lifts. There's attention to focus, and then there's the craft and then there's a release, and then after that there's you know, there's a crash, and then I make the decision I'm going to uber home or drive home. You know, I know the freeway, so I drove home. But that goes back to your original question, is realize attention to focus for memory for anything is a resource. Some things will grab your attention, some things don't warrant your attention. It's it's it's that middle zone, right, That's what we're trying to finesse at an individual level, you know, and a collective level.

Well, I appreciate what you're saying because I remember reading about it in a book by Daniel Leviton called The Organized Mind, and he talked about this idea of how when Warren Buffett is deciding where to invest, he takes milk and cookies, rents an apartment in New York City, and lives in that apartment for five days. So basically he's doing very little when it comes to his daily require ments of food. He's cleared out his space, so he's in a new environment that's empty, and then he's sitting there making decisions. And he talked about how this was his way of removing decision fatigue. This idea that when we're making lots of insignificant decisions in the morning when we wake up, by the time it comes to a big decision at the end of the day the middle of the day, we have no energy left to make it. So most of us are stressing out going. What do I eat today? What do I wear today? Which route do I take to work today? Oh my gosh, what am I going to say to that person today? Now, by the time you get into the office, you've already made so many insignificant decisions that you're exhausted, and now you can't dial it up when you actually need.

Well, I appreciate what you're saying because I remember reading about it in a book by Daniel Leviton called The Organized Mind, and he talked about this idea of how when Warren Buffett is deciding where to invest, he takes milk and cookies, rents an apartment in New York City, and lives in that apartment for five days. So basically he's doing very little when it comes to his daily require ments of food. He's cleared out his space, so he's in a new environment that's empty, and then he's sitting there making decisions. And he talked about how this was his way of removing decision fatigue. This idea that when we're making lots of insignificant decisions in the morning when we wake up, by the time it comes to a big decision at the end of the day the middle of the day, we have no energy left to make it. So most of us are stressing out going. What do I eat today? What do I wear today? Which route do I take to work today? Oh my gosh, what am I going to say to that person today? Now, by the time you get into the office, you've already made so many insignificant decisions that you're exhausted, and now you can't dial it up when you actually need.

It because it's limited and is decremental over time. I love that. What I would say is again, you have to know yourself a little bit, like that's coming and it could be I'm about to have a hot conversation my lover, and this is not. This is a tense situation. I don't want to walk in that with my mind already in a fuss. I got a big case. It's going late. There was an emergency before I'm gonna start this at eleven o'clock. It needs to go tonight. That's not when I'm trying to get into a fuss. I don't know what the example will be for your viewers and other people, but if everybody can walk away with like, your attention and focus or wherever level and stage you're at is precious, is limited. You want to control your environment. You don't want to talk to certain people. Maybe you do want to talk to certain people, Maybe you want to listen to certain music, maybe you don't want to listen to Those examples are all around US athletes walking in with their bo's headphones on. They're doing the same thing. But we can explain it with neuroscience that attention is decremental. You cannot maintain one hundred sustained external focus. So in those forty hour shifts, I never did a forty hour operation and I just learned to work with my attention and focus. That was the real skill that I learned. And the buffet.

It because it's limited and is decremental over time. I love that. What I would say is again, you have to know yourself a little bit, like that's coming and it could be I'm about to have a hot conversation my lover, and this is not. This is a tense situation. I don't want to walk in that with my mind already in a fuss. I got a big case. It's going late. There was an emergency before I'm gonna start this at eleven o'clock. It needs to go tonight. That's not when I'm trying to get into a fuss. I don't know what the example will be for your viewers and other people, but if everybody can walk away with like, your attention and focus or wherever level and stage you're at is precious, is limited. You want to control your environment. You don't want to talk to certain people. Maybe you do want to talk to certain people, Maybe you want to listen to certain music, maybe you don't want to listen to Those examples are all around US athletes walking in with their bo's headphones on. They're doing the same thing. But we can explain it with neuroscience that attention is decremental. You cannot maintain one hundred sustained external focus. So in those forty hour shifts, I never did a forty hour operation and I just learned to work with my attention and focus. That was the real skill that I learned. And the buffet.

You know.

You know.

He's also changing his physical environment. Yeah, I do that too, Like I'm going to London next next week, and I'm just people are like, oh, you like to stay in the same place, Like, no, I'm coming here to like get lost, my phone's not working, look at this, where's this? Like I need to change physical environments to have new thoughts because I'm working on something in my mind. And so I think part maybe part of what he does is is not just to get rid of the fuss and to avoid decision fatigue or decremental vigilance because of decrimental vigilants. I prefer that one is broader. I'm not telling you what to pay attention to. I'm not trying to tell you, but you're about to make a decision. Just realize this focus. This external they're catchy calling it action network and action brain network. These fountains and continents that rev up a little bit on the inside our brain for outward attention versus dreaming where it's all imaginative, Like you can't rev that up for sixteen hours. See, there's a cadence to the day. You're setting yourself up for success, individual success, fighting with somebody, dealing with a kid driving you crazy, whatever it is that's yours. I want people to walk away with like get it. You know my day is My day is a dance.

He's also changing his physical environment. Yeah, I do that too, Like I'm going to London next next week, and I'm just people are like, oh, you like to stay in the same place, Like, no, I'm coming here to like get lost, my phone's not working, look at this, where's this? Like I need to change physical environments to have new thoughts because I'm working on something in my mind. And so I think part maybe part of what he does is is not just to get rid of the fuss and to avoid decision fatigue or decremental vigilance because of decrimental vigilants. I prefer that one is broader. I'm not telling you what to pay attention to. I'm not trying to tell you, but you're about to make a decision. Just realize this focus. This external they're catchy calling it action network and action brain network. These fountains and continents that rev up a little bit on the inside our brain for outward attention versus dreaming where it's all imaginative, Like you can't rev that up for sixteen hours. See, there's a cadence to the day. You're setting yourself up for success, individual success, fighting with somebody, dealing with a kid driving you crazy, whatever it is that's yours. I want people to walk away with like get it. You know my day is My day is a dance.

Yeah. I really like that, man. I think that's such great advice, and it resonates so strongly with me even when I look at my days. So, for example, I only do two interviews per day, so you're my first one. I have another one in the afternoon. And I can only do two interviews per day because for me, these interviews require one hundred percent focus, and if you ask me to do another one on top of that, I just don't think I could be at one hundred percent, but I know that for you, I can be at one hundred percent. I then have a couple of meetings in between which are requiring a different part of me that don't require this exclusive focus. And you're so right. I think we put so much pressure on ourselves that we expect this level of focus in every conversation, every meeting, throughout the whole day.

Yeah. I really like that, man. I think that's such great advice, and it resonates so strongly with me even when I look at my days. So, for example, I only do two interviews per day, so you're my first one. I have another one in the afternoon. And I can only do two interviews per day because for me, these interviews require one hundred percent focus, and if you ask me to do another one on top of that, I just don't think I could be at one hundred percent, but I know that for you, I can be at one hundred percent. I then have a couple of meetings in between which are requiring a different part of me that don't require this exclusive focus. And you're so right. I think we put so much pressure on ourselves that we expect this level of focus in every conversation, every meeting, throughout the whole day.

In every situation you get some bad news, you got to know, I mean, not even gonna pull off too. You got to crunch you might be a But that's exactly that's again ecological validity in your environment. If I can a car crash, I can't go into my zen and pre surgery zen mode. I call my partner. I got to know where I'm at, and so there is no final guidance. It's just that your attention and focus, you know what I mean. It's great because people think like like he's a robot. Now, man, I've been through a lot. I go through a lot, I feel a lot, but I've just realized that to deliver as a surgeon, here's the dance I do with my own mind to bring it for that patient. Because that patient trusted me on a journey that's sacred, and at that moment, that's all I'm about.

In every situation you get some bad news, you got to know, I mean, not even gonna pull off too. You got to crunch you might be a But that's exactly that's again ecological validity in your environment. If I can a car crash, I can't go into my zen and pre surgery zen mode. I call my partner. I got to know where I'm at, and so there is no final guidance. It's just that your attention and focus, you know what I mean. It's great because people think like like he's a robot. Now, man, I've been through a lot. I go through a lot, I feel a lot, but I've just realized that to deliver as a surgeon, here's the dance I do with my own mind to bring it for that patient. Because that patient trusted me on a journey that's sacred, and at that moment, that's all I'm about.

Before we dive into the next moment, let's hear from our sponsors and back to our episode. I want to ask you by something you've mentioned before. You talked about this idea of this emotional memory that almost comes immediately, this idea that if and I often lead this meditation. It's one of my favorite ones to lead when I'm sharing it with my audience or community. And technically it's called a loving kindness medita, and what it means is I'll often ask people before we share love with the world, I edited it slightly for people to really experience love within themselves. So I'll ask people to close their eyes and get into that zone. But I'll ask them to go back to a memory where they felt the most joyful, the most happy, and the most love. Who was there, How did it smell, what could they see, what could they hear, what could they taste? And immediately people will have a vision. People think of their wedding day. People have even thought of their dog passing away because it was a really important transition point for them. It could be the first time they celebrated their parent or bought their parent a home or whatever it was. The ability to take care of someone. Yeah, it's really beautiful. It's different, but it's really interesting. What you said is for most of us, it's actually the opposite that we do more of. So it's more common for us to replay a negative memory again and again and again and again. Then it is for us to remember what we did last weekend, even if it was positive. Why do we do that? Why do we replay negative memories? Why is it so easy? And what do we do about it?