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As a strength and conditioning coach 00:01:54.040 --> 00:01:58.140 myself who also trains tactical athletes, dissemination 00:01:58.140 --> 00:02:00.439 of wellness information is one of the biggest 00:02:00.439 --> 00:02:03.700 challenges. Now TeamBuildr is the premier strength 00:02:03.700 --> 00:02:06.239 and conditioning software for tactical athletes, 00:02:06.459 --> 00:02:08.960 and there are several features that really impress 00:02:08.960 --> 00:02:12.520 me. Firstly, there is a full exercise library, 00:02:12.659 --> 00:02:14.960 so you, the personal trainer, does not have to 00:02:14.960 --> 00:02:18.159 create that within your own department. Secondly, 00:02:18.319 --> 00:02:21.620 you can send out programming, but also individualize, 00:02:21.680 --> 00:02:24.460 which I love. So you blanket program for everyone. 00:02:24.659 --> 00:02:27.400 Now you can tweak based on someone's injury, 00:02:27.599 --> 00:02:30.080 someone's need to maybe drop some body composition, 00:02:30.120 --> 00:02:33.039 rather than having to write a program for every 00:02:33.039 --> 00:02:35.810 single person on their own. TeamBuildr also 00:02:35.810 --> 00:02:38.289 allows you to build custom questionnaires to 00:02:38.289 --> 00:02:41.330 collate health and wellness data. It integrates 00:02:41.330 --> 00:02:43.889 with wearables. And I think one of the most important 00:02:43.889 --> 00:02:47.689 things is obviously it tracks. To me, it's imperative 00:02:47.689 --> 00:02:51.169 that we as a profession start tracking our people 00:02:51.169 --> 00:02:55.050 from day one and then over the full span of their 00:02:55.050 --> 00:02:58.270 career, therefore catching potential wellness 00:02:58.270 --> 00:03:01.810 issues and injuries before they happen. Now, 00:03:01.830 --> 00:03:04.030 if you want to try TeamBuildr, they are offering 00:03:04.030 --> 00:03:06.370 you, the audience of the Behind the Shield podcast, 00:03:06.789 --> 00:03:10.969 a free 14 -day trial to experience all of the 00:03:10.969 --> 00:03:13.509 features. And if you want to take a deeper dive 00:03:13.509 --> 00:03:18.050 into TeamBuildr, listen to episode 1032 with 00:03:18.050 --> 00:03:22.069 Melissa Mercado or go to teambuilder .com. And 00:03:22.069 --> 00:03:23.590 I'll spell that to you because it's not as you 00:03:23.590 --> 00:03:30.469 think, T -E -A -M -B -U -I -L -D -R .com. Welcome 00:03:30.469 --> 00:03:32.289 to the Behind the Shield podcast. As always, 00:03:32.330 --> 00:03:34.189 my name is James Gearing, and this week it is 00:03:34.189 --> 00:03:37.169 my absolute honor to welcome on the show former 00:03:37.169 --> 00:03:40.409 Navy flight surgeon and current president and 00:03:40.409 --> 00:03:45.849 CMO of Wave Neuroscience, Dr. Eric Wan. Now, 00:03:45.870 --> 00:03:48.530 in this conversation, we discuss a host of topics, 00:03:48.569 --> 00:03:50.689 from his journey into the world of medicine, 00:03:50.909 --> 00:03:53.930 his perspective of war through a medical lens, 00:03:54.270 --> 00:03:58.569 working with Boeing, The veteran and first responder 00:03:58.569 --> 00:04:02.110 mental health crisis. The breakthrough technologies 00:04:02.110 --> 00:04:05.650 of magnetic e -resonance therapy and synchronized 00:04:05.650 --> 00:04:09.030 transcranial magnetic stimulation they offer 00:04:09.030 --> 00:04:13.289 at WAVE. How Ohio, Florida, and Missouri offer 00:04:13.289 --> 00:04:16.550 this technology to their veterans and first responders 00:04:16.550 --> 00:04:19.689 for free. The application of this technology 00:04:19.689 --> 00:04:22.689 not only on mental health, but also on performance 00:04:22.689 --> 00:04:26.029 and so much more. Now, before we get to this 00:04:26.029 --> 00:04:28.589 incredible conversation, as I say every week, 00:04:28.689 --> 00:04:31.569 please just take a moment. Go to whichever app 00:04:31.569 --> 00:04:34.170 you listen to this on, subscribe to the show, 00:04:34.389 --> 00:04:38.610 leave feedback and leave a rating. Every single 00:04:38.610 --> 00:04:41.889 five -star rating truly does elevate this podcast, 00:04:42.189 --> 00:04:44.670 therefore making it easier for others to find. 00:04:44.850 --> 00:04:49.329 And this is a free library of well over 1 ,000 00:04:49.329 --> 00:04:53.189 episodes now. So all I ask in return is that 00:04:53.189 --> 00:04:56.089 you help share these incredible men and women's 00:04:56.089 --> 00:04:59.750 stories so I can get them to every single person 00:04:59.750 --> 00:05:03.329 on planet Earth who needs to hear them. So with 00:05:03.329 --> 00:05:07.490 that being said, I introduce to you... Dr. Eric 00:05:07.490 --> 00:05:30.250 Wan. Enjoy. Well, Eric, I want to start by saying 00:05:30.250 --> 00:05:32.670 two things. Firstly, thank you to our mutual 00:05:32.670 --> 00:05:35.430 friend, John Doolittle, for making the connection. 00:05:35.649 --> 00:05:37.889 And secondly, I want to welcome you onto the 00:05:37.889 --> 00:05:41.149 Behind the Shield podcast today. Well, thank 00:05:41.149 --> 00:05:43.910 you so much. Yeah, JD is a very dear friend and 00:05:43.910 --> 00:05:47.310 I'm really happy he made the introduction. And 00:05:47.310 --> 00:05:49.769 of course, the honor is mine to be here. I'm 00:05:49.769 --> 00:05:51.930 really excited to be able to talk with you. Absolutely. 00:05:52.129 --> 00:05:57.550 Likewise. Well, we will get to the kind of the 00:05:57.550 --> 00:05:59.509 fusion, how you met John and what you're doing 00:05:59.509 --> 00:06:01.230 with his community and then how that applies 00:06:01.230 --> 00:06:04.490 to the communities listening. But very first 00:06:04.490 --> 00:06:06.569 question, where on planet Earth are we finding 00:06:06.569 --> 00:06:10.569 you today? I'm in Newport Beach, California. 00:06:10.990 --> 00:06:15.350 It's nice and sunny outside. And yeah, this has 00:06:15.350 --> 00:06:17.910 been a home for quite a while for me. Beautiful. 00:06:17.970 --> 00:06:20.750 My little boy, my son was born in Hoag Hospital. 00:06:20.829 --> 00:06:24.050 So just down the road from you. Oh, wonderful. 00:06:24.269 --> 00:06:26.509 Yeah, yeah, I know. Well, yeah, beautiful. All 00:06:26.509 --> 00:06:29.110 right. Well, then very first question. Let's 00:06:29.110 --> 00:06:31.189 go to your origin story. Tell me where you were 00:06:31.189 --> 00:06:33.149 born and tell me a little bit about your family 00:06:33.149 --> 00:06:35.730 dynamic, what your parents did, how many siblings? 00:06:36.970 --> 00:06:41.589 Oh, sure. Yeah, I was born in Oakland, Alameda 00:06:41.589 --> 00:06:45.170 Hospital. My dad at the time was getting his 00:06:45.170 --> 00:06:48.790 PhD at Cal Berkeley. My parents are both first 00:06:48.790 --> 00:06:52.410 -generation Korean -American immigrants. Both 00:06:52.410 --> 00:06:55.970 came over based on academic scholarships. So 00:06:55.970 --> 00:06:59.870 my dad was a chemist, and my mom got her master's 00:06:59.870 --> 00:07:03.230 in librarian sciences and met that way, fell 00:07:03.230 --> 00:07:08.389 in love. And then I was born at the Oakland Alameda 00:07:08.389 --> 00:07:11.889 Hospital. We moved down to Orange County afterwards. 00:07:13.910 --> 00:07:17.069 And growing up, we grew up very much kind of 00:07:17.069 --> 00:07:20.629 a middle class family. They're wonderful parents. 00:07:20.689 --> 00:07:24.350 I think adjusting to life in America, they were 00:07:24.350 --> 00:07:27.509 coming out of the Korean War. So growing up, 00:07:27.509 --> 00:07:30.149 my sister and I, I do have one sibling, an older 00:07:30.149 --> 00:07:33.899 sister, who I'll get to in a moment. we were 00:07:33.899 --> 00:07:36.560 raised very much to have a reverence and respect 00:07:36.560 --> 00:07:39.259 for what america stood for and the opportunities 00:07:39.259 --> 00:07:43.240 that were granted um because many of these things 00:07:43.240 --> 00:07:45.319 you know the poverty that career was going through 00:07:45.319 --> 00:07:47.819 at the time didn't allow for many of the things 00:07:47.819 --> 00:07:51.259 that we were able to achieve here and so we uh 00:07:51.259 --> 00:07:54.040 worked very hard to honor and respect that opportunity 00:07:54.040 --> 00:08:00.620 and um my sister a wonderful human being. She's 00:08:00.620 --> 00:08:05.019 a cardiothoracic surgeon and specializing in 00:08:05.019 --> 00:08:08.300 lung transplants, but she retrained in plastics 00:08:08.300 --> 00:08:11.000 and aesthetics and is now practicing up in Seattle. 00:08:11.319 --> 00:08:14.800 And so I say half jokingly, I was really kind 00:08:14.800 --> 00:08:19.279 of the underachiever in the family, but was really 00:08:19.279 --> 00:08:21.259 appreciative for the opportunities that I had. 00:08:21.639 --> 00:08:25.120 And yeah, so we grew up in Orange County, California, 00:08:25.319 --> 00:08:30.779 predominantly. And I left for college. I went 00:08:30.779 --> 00:08:34.080 to University of Notre Dame and had a wonderful 00:08:34.080 --> 00:08:38.259 experience there. Took a scholarship with the 00:08:38.259 --> 00:08:42.879 Navy to go to medical school and enlisted and 00:08:42.879 --> 00:08:46.919 did an internship in emergency medicine occupation 00:08:46.919 --> 00:08:49.620 or emergency medicine. And they called a transitional 00:08:49.620 --> 00:08:52.860 internship, then did a tour as a flight surgeon 00:08:52.860 --> 00:08:56.820 with the Marines. which we'll get to, I'm sure, 00:08:56.899 --> 00:09:01.440 later, but it was really a great experience. 00:09:01.639 --> 00:09:04.620 And to this day, some of my closest friends. 00:09:04.960 --> 00:09:07.840 And then I finished up my medical training in 00:09:07.840 --> 00:09:11.639 Boston. It was a combined program starting out 00:09:11.639 --> 00:09:14.600 at Harvard Medical School, then Harvard School 00:09:14.600 --> 00:09:17.679 of Public Health, and then many of the hospitals 00:09:17.679 --> 00:09:19.919 there, Mass General, Brigham and Women's, and 00:09:19.919 --> 00:09:22.710 the Cambridge Health Alliance. Finally ended 00:09:22.710 --> 00:09:26.610 up back home in California. I was at the Boeing 00:09:26.610 --> 00:09:29.750 company as their chief physician and took on 00:09:29.750 --> 00:09:32.169 a separate role as their chief technology officer, 00:09:32.429 --> 00:09:34.490 which is how I interface with this technology 00:09:34.490 --> 00:09:38.590 and joined the company about eight years ago. 00:09:38.710 --> 00:09:40.830 It's been been really a full sprint ever since. 00:09:41.009 --> 00:09:43.509 That's an amazing story for an underachiever. 00:09:45.950 --> 00:09:49.019 All right. Well, then. I'd love to go back to 00:09:49.019 --> 00:09:53.759 your parents' immigration, because at certain 00:09:53.759 --> 00:09:57.340 times in recent history, the immigrant has been 00:09:57.340 --> 00:10:00.159 tarnished with a lot of negative connotation. 00:10:00.340 --> 00:10:04.480 But this is the tapestry that this country was 00:10:04.480 --> 00:10:06.480 founded on over and above, of course, the Native 00:10:06.480 --> 00:10:09.779 Americans that were already here. And the incredible 00:10:09.779 --> 00:10:12.539 immigration stories that I've heard and the power 00:10:12.539 --> 00:10:14.639 of some of these conflicts that these people 00:10:14.639 --> 00:10:17.120 were leaving, I think, are stories that need 00:10:17.120 --> 00:10:20.220 to be repeated and need to be heard. So what 00:10:20.220 --> 00:10:22.980 have you heard as far as the conditions in Korea 00:10:22.980 --> 00:10:26.720 and why your parents decided to move to the U 00:10:26.720 --> 00:10:31.279 .S., what they were leaving? Yeah, I always think 00:10:31.279 --> 00:10:34.299 back to the sacrifices that they made to give 00:10:34.299 --> 00:10:39.039 their children an opportunity. Yeah, there was 00:10:39.039 --> 00:10:41.980 quite a bit of hardship at the time where, you 00:10:41.980 --> 00:10:43.559 know, the separation between North Korea and 00:10:43.559 --> 00:10:45.740 South Korea, many families ended up getting separated, 00:10:45.899 --> 00:10:49.620 unfortunately. And that was a little bit of a 00:10:49.620 --> 00:10:52.639 legacy that whenever I went back to Korea, you 00:10:52.639 --> 00:10:55.639 know, I'd hear these stories. And it was really 00:10:55.639 --> 00:10:58.820 only the best students who were able to make 00:10:58.820 --> 00:11:04.570 it across the ocean to study in the U .S. You 00:11:04.570 --> 00:11:07.029 know, I just knew them as my parents. But I know 00:11:07.029 --> 00:11:09.309 when I go back to Korea, they always talk about 00:11:09.309 --> 00:11:12.190 how hard they worked to get this opportunity 00:11:12.190 --> 00:11:17.129 and to make good on it. And that I think I never 00:11:17.129 --> 00:11:21.049 felt it as a burden, but I recognize that I was 00:11:21.049 --> 00:11:23.269 given really a golden opportunity and I didn't 00:11:23.269 --> 00:11:27.070 want to waste it. And so all the things you hear 00:11:27.070 --> 00:11:32.700 about instilling work ethic and. kind of honoring 00:11:32.700 --> 00:11:35.740 the sacrifices that all of our ancestors made, 00:11:35.860 --> 00:11:37.960 you know, that kind of gets instilled in you. 00:11:38.279 --> 00:11:43.279 And I felt very blessed. You know, they gave 00:11:43.279 --> 00:11:46.460 me great opportunities. It wasn't a traditional 00:11:46.460 --> 00:11:49.799 Asian family where, you know, there's a dragon 00:11:49.799 --> 00:11:52.820 mom who was kind of crushing me with expectations. 00:11:53.000 --> 00:11:56.470 It was more of a... kind of a healthy household 00:11:56.470 --> 00:11:59.269 where we were allowed to explore our academic 00:11:59.269 --> 00:12:02.950 curiosity and grow at our own pace. I wasn't 00:12:02.950 --> 00:12:06.350 always a great student, but I did have a natural 00:12:06.350 --> 00:12:11.570 curiosity. So yeah, my dad sadly passed away 00:12:11.570 --> 00:12:15.730 about five years ago. My mom is still alive and 00:12:15.730 --> 00:12:17.629 she lives close to us and so I get to visit with 00:12:17.629 --> 00:12:22.879 her quite often. But yeah, very thankful. for 00:12:22.879 --> 00:12:25.799 their journey and that I was afforded the opportunities 00:12:25.799 --> 00:12:28.200 that I have here. Yeah. Well, that's amazing 00:12:28.200 --> 00:12:31.659 to hear. I just had Dr. Venya on the show and 00:12:31.659 --> 00:12:36.240 he is Mexican -American and his father was a 00:12:36.240 --> 00:12:39.659 mechanic, if I've got this right, in Mexico. 00:12:39.779 --> 00:12:42.580 Then he ended up becoming an engineer in the 00:12:42.580 --> 00:12:45.039 US and then his child becomes a neurosurgeon. 00:12:45.440 --> 00:12:48.220 So, you know, to me, there's some pretty incredible, 00:12:48.299 --> 00:12:50.779 you know, immigration stories. And again, this 00:12:50.779 --> 00:12:52.620 is this beautiful tapestry that is the United 00:12:52.620 --> 00:12:55.980 States. And then also looking at the Korean story, 00:12:56.059 --> 00:12:57.799 and I've got a veteran coming on soon from that 00:12:57.799 --> 00:13:02.179 conflict, how close Korea came, South Korea came 00:13:02.179 --> 00:13:04.679 to being completely dominated by the North Koreans 00:13:04.679 --> 00:13:06.960 and then seeing the impact that the allies had. 00:13:07.080 --> 00:13:09.519 I think that's a very undertold story as well. 00:13:09.539 --> 00:13:11.820 It's the forgotten war. But what those brave 00:13:11.820 --> 00:13:14.500 men and women of that period did to help. you 00:13:14.500 --> 00:13:16.139 know the the korean people at that point the 00:13:16.139 --> 00:13:18.679 southern korean people it needs to be spoken 00:13:18.679 --> 00:13:22.799 about more as well i believe yeah yeah and if 00:13:22.799 --> 00:13:27.000 you know america is viewed in such a um positive 00:13:27.000 --> 00:13:29.100 light in korea even to this day you know now 00:13:29.100 --> 00:13:33.740 that they've um kind of come out of that uh impoverished 00:13:33.740 --> 00:13:36.740 state after the war it's become a fairly affluent 00:13:36.740 --> 00:13:40.039 country but still anything that's american is 00:13:40.039 --> 00:13:42.720 viewed as you know a super premium kind of brand 00:13:42.720 --> 00:13:47.720 and uh there's a lot of um love for for what 00:13:47.720 --> 00:13:52.019 america did for for korea at a time when they 00:13:52.019 --> 00:13:56.000 were being oppressed so um so yeah that was uh 00:13:56.000 --> 00:14:00.730 definitely part of the korean story and um When 00:14:00.730 --> 00:14:02.429 I had the opportunity to give back and join the 00:14:02.429 --> 00:14:04.070 military, I wasn't sure how my parents would 00:14:04.070 --> 00:14:06.529 feel about it. But they were very proud. They 00:14:06.529 --> 00:14:09.129 were excited that we were able to give back in 00:14:09.129 --> 00:14:13.929 any way. And I ended up really enjoying and loving 00:14:13.929 --> 00:14:16.830 that experience. That's sad. I think the career 00:14:16.830 --> 00:14:18.610 at the moment, South Korea is going through the 00:14:18.610 --> 00:14:20.870 most deadly wildfire that they've had in a long, 00:14:20.909 --> 00:14:23.110 long time. I think they've lost 30 plus people 00:14:23.110 --> 00:14:27.889 so far. Yeah. Yeah. It's interesting. And out 00:14:27.889 --> 00:14:31.889 here in California, of course. the fires uh that 00:14:31.889 --> 00:14:34.490 went through it just seems like these are kind 00:14:34.490 --> 00:14:37.970 of unusual times but um but yeah definitely uh 00:14:37.970 --> 00:14:41.509 saying prayers for um our folks in korea as well 00:14:41.509 --> 00:14:44.929 absolutely well what about sports and exercise 00:14:44.929 --> 00:14:46.950 what were you playing when you were a school 00:14:46.950 --> 00:14:51.690 age oh yeah i grew up Mostly playing soccer and 00:14:51.690 --> 00:14:55.490 then played a little bit of volleyball. It was 00:14:55.490 --> 00:14:57.909 very popular in Southern California and then 00:14:57.909 --> 00:15:01.470 kind of found a niche in track and was a runner 00:15:01.470 --> 00:15:05.710 and a jumper and competed at a reasonable level 00:15:05.710 --> 00:15:08.389 in high school and then walked on to the team 00:15:08.389 --> 00:15:11.610 in college. I think the coaches may have just 00:15:11.610 --> 00:15:15.590 been humoring me. My roommate was a thrower and 00:15:15.590 --> 00:15:18.240 he... had me come with him to practice and I 00:15:18.240 --> 00:15:21.620 ran and the coaches said, well, come back tomorrow. 00:15:21.799 --> 00:15:23.419 And I kept going for a couple of years. I got 00:15:23.419 --> 00:15:28.480 to travel with the team and felt very fortunate 00:15:28.480 --> 00:15:31.940 to have that opportunity. But there was a day 00:15:31.940 --> 00:15:34.100 I remember I was feeling pretty good about myself 00:15:34.100 --> 00:15:37.320 training. It got great coaching. There was working 00:15:37.320 --> 00:15:39.659 out with, you know, with at the varsity gym and 00:15:39.659 --> 00:15:42.940 the day the football players joined the track 00:15:42.940 --> 00:15:46.750 team. Some of your audience may know these names, 00:15:46.830 --> 00:15:49.149 but Rocket Ishmael and Tom Carter, who went on 00:15:49.149 --> 00:15:51.769 to have great careers in the NFL, came out and 00:15:51.769 --> 00:15:54.090 they just crushed my PR without any training. 00:15:54.210 --> 00:15:58.429 They just came out and jumped and beat me by 00:15:58.429 --> 00:16:00.830 about three feet. So I realized pretty quickly, 00:16:00.929 --> 00:16:05.269 while this was, I think, fun for me, it certainly 00:16:05.269 --> 00:16:09.049 was not going to be my future. So I ended up 00:16:09.049 --> 00:16:13.700 focusing very much on my studies. gave up my 00:16:13.700 --> 00:16:17.320 running and jumping career pretty early on. My 00:16:17.320 --> 00:16:20.159 son is following the veterinary route at the 00:16:20.159 --> 00:16:24.159 moment, and he's considering doing the veterinary 00:16:24.159 --> 00:16:26.259 actual vet school through the military. He's 00:16:26.259 --> 00:16:29.360 not sure yet. Talk to me about your kind of medical 00:16:29.360 --> 00:16:31.360 journey and why you chose the military route. 00:16:33.139 --> 00:16:36.220 Yeah, it was actually a recruiter that came to 00:16:36.220 --> 00:16:40.750 our medical school. I remember listening to them 00:16:40.750 --> 00:16:42.450 and hearing about the different opportunities 00:16:42.450 --> 00:16:45.929 that it afforded. And that really appealed to 00:16:45.929 --> 00:16:49.450 me that we could have medical school paid for, 00:16:49.629 --> 00:16:53.090 get our medical training, because many doctors 00:16:53.090 --> 00:16:56.210 end up graduating from medical school with loans 00:16:56.210 --> 00:16:59.230 and debt amounting to a quarter to a half million 00:16:59.230 --> 00:17:03.129 dollars. It's just kind of a difficult financial 00:17:03.129 --> 00:17:06.170 situation to dig yourself out of. And so to be 00:17:06.170 --> 00:17:10.160 able to have that scholarship. work with the 00:17:10.160 --> 00:17:12.660 military and lots of other really good men and 00:17:12.660 --> 00:17:17.440 women seemed interesting to me. And it really 00:17:17.440 --> 00:17:23.000 was a great experience. I deployed with the Marines. 00:17:23.079 --> 00:17:25.440 We were HM -268. It's a medium lift rotary wing 00:17:25.440 --> 00:17:30.059 squadron. And we formed what's called a Marine 00:17:30.059 --> 00:17:32.960 Expeditionary Unit. So we deployed to the Persian 00:17:32.960 --> 00:17:35.940 Gulf as the 11th MEU, part of the 1st Marine 00:17:35.940 --> 00:17:40.859 Expeditionary Force. And it's hard to describe, 00:17:41.059 --> 00:17:42.740 and I think your audience probably understands, 00:17:42.960 --> 00:17:45.980 but the camaraderie in that unit is something 00:17:45.980 --> 00:17:49.579 I'll never forget. And, you know, we're all relatively 00:17:49.579 --> 00:17:53.140 young. Most of the people are going to be between 00:17:53.140 --> 00:17:57.500 18 to 30 years old. And you're going to all sorts 00:17:57.500 --> 00:18:00.220 of foreign countries, sometimes difficult environments, 00:18:00.480 --> 00:18:04.440 and ultimately, in our case, some combat environments. 00:18:06.509 --> 00:18:08.990 Part of, I think, the story that's important 00:18:08.990 --> 00:18:12.269 to mention is our unit had some of the first 00:18:12.269 --> 00:18:16.609 casualties of Operation Iraqi Freedom. And that 00:18:16.609 --> 00:18:19.829 was something, of course, that leaves a lasting 00:18:19.829 --> 00:18:23.970 impact. And so we lost four Marines or eight 00:18:23.970 --> 00:18:29.180 British Special Forces on board. The residual 00:18:29.180 --> 00:18:32.900 of that is, you know, the mission changes from 00:18:32.900 --> 00:18:36.680 operational readiness to making sure the men 00:18:36.680 --> 00:18:39.640 and women who are grieving, you know, remain 00:18:39.640 --> 00:18:43.880 kind of in the game, but years afterwards are 00:18:43.880 --> 00:18:48.359 able to manage. And so the signature injuries 00:18:48.359 --> 00:18:51.759 of that conflict were traumatic brain injuries. 00:18:51.859 --> 00:18:54.680 It was a very kinetic conflict and then post 00:18:54.680 --> 00:18:58.829 -traumatic stress disorder. My experience from 00:18:58.829 --> 00:19:03.410 the clinical side was we were deploying every 00:19:03.410 --> 00:19:05.970 modality that we could to try to help, whether 00:19:05.970 --> 00:19:08.650 it was medication management, cognitive behavioral 00:19:08.650 --> 00:19:15.349 therapy, ID sensitization. There's many different 00:19:15.349 --> 00:19:19.269 modalities that we tried and many were helpful. 00:19:19.410 --> 00:19:22.069 I'm not here to diminish the value of any of 00:19:22.069 --> 00:19:25.029 those, but when I came across this technology, 00:19:25.190 --> 00:19:29.750 which We'll walk through. It's called magnetic 00:19:29.750 --> 00:19:33.250 EEG guided resonance therapy. It's a form of 00:19:33.250 --> 00:19:36.089 transcranial magnetic stimulation, TMS for short. 00:19:36.829 --> 00:19:39.970 But what our organization, Wave Neuroscience, 00:19:40.009 --> 00:19:43.049 is doing is offering a personalization component 00:19:43.049 --> 00:19:47.069 to it where we get an EEG brain map and we look 00:19:47.069 --> 00:19:50.029 for some disruptions in activity in terms of 00:19:50.029 --> 00:19:54.109 brain connectivity. And then we administer the 00:19:54.109 --> 00:19:56.670 transcranial magnetic stimulation. in strategic 00:19:56.670 --> 00:19:59.589 areas to try to restore the disruptive networks. 00:19:59.990 --> 00:20:03.589 And we found that to be quite effective for PTSD. 00:20:04.730 --> 00:20:09.049 And we're finishing up an FDA clinical trial. 00:20:09.269 --> 00:20:13.710 We believe that'll complete this year. And we'll 00:20:13.710 --> 00:20:16.410 be lobbying the FDA to get a full clearance for 00:20:16.410 --> 00:20:21.829 that. In the interim, there are some state initiatives 00:20:21.829 --> 00:20:25.549 where... This is being offered to veterans and 00:20:25.549 --> 00:20:28.809 first responders, and we're allowed to do that 00:20:28.809 --> 00:20:30.569 through practice and medicine. I should clarify 00:20:30.569 --> 00:20:33.170 what we're trying to get FDA cleared is an automated 00:20:33.170 --> 00:20:35.390 protocol generator, which will allow us to scale 00:20:35.390 --> 00:20:38.990 very rapidly. We currently design these personalized 00:20:38.990 --> 00:20:42.450 protocols manually through a full -service EEG 00:20:42.450 --> 00:20:46.369 lab we have here in Newport Beach. But these 00:20:46.369 --> 00:20:50.210 initiatives in Ohio, Missouri, and Florida have 00:20:50.210 --> 00:20:53.890 gone spectacularly well. And we're seeing that 00:20:53.890 --> 00:20:59.650 the treatment really we strive to optimize brain 00:20:59.650 --> 00:21:03.349 function. But whether it's a firefighter, law 00:21:03.349 --> 00:21:06.589 enforcement officer or a veteran, it's pretty 00:21:06.589 --> 00:21:09.849 agnostic to your profession. It's really just 00:21:09.849 --> 00:21:12.509 trying to tap into first order principles of 00:21:12.509 --> 00:21:15.089 physics and our natural neurobiology and optimize 00:21:15.089 --> 00:21:17.920 function. Well, let's jump ahead. We'll go back 00:21:17.920 --> 00:21:20.440 to the kind of journey into Boeing and everything. 00:21:20.539 --> 00:21:23.059 But while we're talking about this now, so you've 00:21:23.059 --> 00:21:26.200 got the EEG, you've got the analysis, and then 00:21:26.200 --> 00:21:30.220 you've got the TMS. So kind of walk me through, 00:21:30.440 --> 00:21:32.539 let's say it's a soldier or a firefighter that 00:21:32.539 --> 00:21:34.940 walks through the front door. What would that 00:21:34.940 --> 00:21:38.039 look like as far as what they're actually experiencing 00:21:38.039 --> 00:21:41.640 in each of these units and then the kind of timeline 00:21:41.640 --> 00:21:46.569 that you're seeing? Sure. So the EEG stands for 00:21:46.569 --> 00:21:49.990 electroencephalogram. It's a very simple study. 00:21:50.009 --> 00:21:52.269 It's a neuro image takes about 15 to 30 minutes 00:21:52.269 --> 00:21:55.269 to acquire. It's painless. You sit in a dark 00:21:55.269 --> 00:21:57.349 room and they put kind of a cap on your head. 00:21:57.630 --> 00:22:01.349 And we can see a lot of different things through 00:22:01.349 --> 00:22:06.619 this capability. EEG went through a pretty quantum 00:22:06.619 --> 00:22:09.980 change about 15 years ago when it got fully digitized. 00:22:10.119 --> 00:22:12.200 And we can do very sophisticated discriminant 00:22:12.200 --> 00:22:15.599 analyses now that we could not do before. So 00:22:15.599 --> 00:22:18.839 much in the same way, an electrocardiogram is 00:22:18.839 --> 00:22:20.880 an electrophysiologic picture of the heart. These 00:22:20.880 --> 00:22:23.200 electron encephalograms are electrophysiologic 00:22:23.200 --> 00:22:27.660 pictures of the brain. Our next step doing these 00:22:27.660 --> 00:22:30.259 computational analytics, and there's some AI 00:22:30.259 --> 00:22:33.660 augmentation to this. We can look for disruptions 00:22:33.660 --> 00:22:38.160 in brain activity and show that to not just physicians 00:22:38.160 --> 00:22:40.920 and scientists, but also our patients. And it's 00:22:40.920 --> 00:22:43.279 been very illuminating to see the light go on 00:22:43.279 --> 00:22:46.359 for many of our patients, whether they're veterans 00:22:46.359 --> 00:22:49.359 or law enforcement or firefighters or paramedics. 00:22:50.519 --> 00:22:53.559 Many of them have gotten MRIs and CT scans and 00:22:53.559 --> 00:22:56.700 told everything looks normal. But when you see 00:22:56.700 --> 00:22:59.279 a disruption activity, there's this realization 00:22:59.279 --> 00:23:02.279 that, oh, you know, it's not just... my weakness 00:23:02.279 --> 00:23:05.319 or uh you know it's not a lack of discipline 00:23:05.319 --> 00:23:08.119 or fortitude there's a real neurobiological issue 00:23:08.119 --> 00:23:12.779 that's leading to me um struggling and many of 00:23:12.779 --> 00:23:14.500 them will say you know my healing journey started 00:23:14.500 --> 00:23:18.519 once i could see that and it's been impressive 00:23:18.519 --> 00:23:20.880 to see the kind of behavioral change that that 00:23:20.880 --> 00:23:24.140 can engender people become their own best advocates 00:23:24.140 --> 00:23:27.740 and They start protecting their sleep more. They'll 00:23:27.740 --> 00:23:31.079 exercise more vigorously. They'll have cleaner 00:23:31.079 --> 00:23:34.960 diets, which is all, I think, foundational to 00:23:34.960 --> 00:23:41.680 this healing and human performance journey. But 00:23:41.680 --> 00:23:44.799 we don't just rest on natural holistic methods. 00:23:44.920 --> 00:23:47.980 We can use this transcranial magnetic stimulation 00:23:47.980 --> 00:23:52.740 device to tune those areas and restore the functional 00:23:52.740 --> 00:23:56.400 connectivity of the brain networks. And the way 00:23:56.400 --> 00:23:59.900 that happens is there's a 15 minute session where 00:23:59.900 --> 00:24:02.440 you sit in a comfortable chair. They place this 00:24:02.440 --> 00:24:05.220 coil near the area where they see the disruption. 00:24:06.339 --> 00:24:11.140 And there'll be about a six to 10 second pulse 00:24:11.140 --> 00:24:14.900 train of it feels like a tapping on your forehead. 00:24:15.819 --> 00:24:19.039 And that. process is in training brains and neuron 00:24:19.039 --> 00:24:23.220 activity to become more coherent. And I'll explain 00:24:23.220 --> 00:24:27.039 that more in a moment. But it's not painful. 00:24:27.160 --> 00:24:29.839 You know, this is not like electroconvulsive 00:24:29.839 --> 00:24:33.180 therapy or anything very aggressive. Many of 00:24:33.180 --> 00:24:34.880 our patients say it feels like a brain massage. 00:24:36.099 --> 00:24:39.380 The very first pulse may be catch you off guard 00:24:39.380 --> 00:24:41.000 if you're not ready for it. But by the second, 00:24:41.039 --> 00:24:42.859 third time you do it, it's very comfortable. 00:24:43.660 --> 00:24:45.960 It does not require any anesthesia or anything 00:24:45.960 --> 00:24:50.440 like that. It's completely non -invasive. But 00:24:50.440 --> 00:24:52.720 many of our doctors say, you know, 15 minutes 00:24:52.720 --> 00:24:57.619 a day for four weeks, we're asking for not a 00:24:57.619 --> 00:25:02.420 lot of time to recover a lot of function. And 00:25:02.420 --> 00:25:07.630 so that's fundamentally the process. To take 00:25:07.630 --> 00:25:09.829 a step back in terms of one of the ways we look 00:25:09.829 --> 00:25:13.890 at the EEG, every one of us has a unique signature. 00:25:14.430 --> 00:25:16.950 And one of the dimensions we look at is something 00:25:16.950 --> 00:25:20.990 called the alpha signal. And alpha is the dominant 00:25:20.990 --> 00:25:23.109 rhythm in your brain, how many times per second 00:25:23.109 --> 00:25:26.089 your brain can process information. And it's 00:25:26.089 --> 00:25:29.970 generally between 8 and 13 hertz. And you may 00:25:29.970 --> 00:25:32.890 have a 12 .4 hertz brain, a fast processing brain. 00:25:33.589 --> 00:25:35.990 Other people may have a slower brain. We find 00:25:35.990 --> 00:25:38.190 many people who are more creative may be a little 00:25:38.190 --> 00:25:42.109 bit slower in the 9 .2, 9 .3 range. It doesn't 00:25:42.109 --> 00:25:43.589 matter. It tends to be just where we're born. 00:25:43.970 --> 00:25:46.630 But if we see an area of the brain that's misfiring, 00:25:46.789 --> 00:25:50.630 let's say the prefrontal cortex is at 6 hertz, 00:25:50.769 --> 00:25:54.190 while the rest of your brain is at 11 hertz, 00:25:54.390 --> 00:25:57.029 that information mismatch may manifest as certain 00:25:57.029 --> 00:26:00.559 symptoms to you. And that happens to be one of 00:26:00.559 --> 00:26:03.039 the more common patterns that we see. If you've 00:26:03.039 --> 00:26:07.579 had a mechanical injury, like some blunt force 00:26:07.579 --> 00:26:11.160 trauma to the front, or even an over -pressurization 00:26:11.160 --> 00:26:14.420 blast injury for some veterans, the neuron's 00:26:14.420 --> 00:26:16.779 stereotypical response to injury is to slow down. 00:26:17.259 --> 00:26:19.759 And so if we can start to speed those areas up 00:26:19.759 --> 00:26:23.619 and provide it with the entrainment daily, the 00:26:23.619 --> 00:26:25.779 body does a lot of the heavy lifting for us. 00:26:26.700 --> 00:26:31.500 And that kind of taps into how we've been designed 00:26:31.500 --> 00:26:34.279 as human beings. Whether you believe in Mother 00:26:34.279 --> 00:26:37.500 Nature or God, we're healing organisms. And if 00:26:37.500 --> 00:26:40.000 you put two ends of a broken bone together, it'll 00:26:40.000 --> 00:26:42.220 heal, sometimes grow back stronger. If you put 00:26:42.220 --> 00:26:44.519 two ends of a wound margin together, that will 00:26:44.519 --> 00:26:47.140 also heal. And the brain sometimes just needs 00:26:47.140 --> 00:26:49.859 a gentle nudge as well. And so we're looking 00:26:49.859 --> 00:26:53.440 for these areas of disruption, and we're providing 00:26:53.440 --> 00:26:56.289 a gentle stimulation. It is about a 1 .8 Tesla 00:26:56.289 --> 00:26:59.009 magnetic coil. We provide a much lower intensity 00:26:59.009 --> 00:27:02.750 than that, obviously. And for those who are academically 00:27:02.750 --> 00:27:06.069 curious, the reason an MRI grade coil is used, 00:27:06.190 --> 00:27:09.210 MRIs have unique property of being able to deliver 00:27:09.210 --> 00:27:12.769 energy across a solid object. And so rather than 00:27:12.769 --> 00:27:14.789 having to drill a hole in place, kind of an electrode 00:27:14.789 --> 00:27:18.109 in the brain, we can use these coils. It'll traverse 00:27:18.109 --> 00:27:21.680 the one centimeter piece of skull. between you 00:27:21.680 --> 00:27:24.079 and the outside world. And it can cause an action 00:27:24.079 --> 00:27:25.799 potential within the neurons that lie underneath. 00:27:26.400 --> 00:27:30.339 So it's a beautiful capability. And I can't say 00:27:30.339 --> 00:27:34.440 it's absolutely painless, but it's not, in my 00:27:34.440 --> 00:27:36.240 experience, it wasn't particularly painful or 00:27:36.240 --> 00:27:37.599 anything like that. It was actually a pleasant 00:27:37.599 --> 00:27:42.259 sensation. And so we do that for generally four 00:27:42.259 --> 00:27:44.180 weeks. Some people may take longer. Some people 00:27:44.180 --> 00:27:45.759 can be shorter. It depends on the severity of 00:27:45.759 --> 00:27:49.339 the injury. And we see pretty significant changes 00:27:49.339 --> 00:27:54.880 in symptoms. What are the kind of commonalities 00:27:54.880 --> 00:27:56.559 that you're seeing in the fire service? Because 00:27:56.559 --> 00:27:59.279 when I think about the military, especially obviously 00:27:59.279 --> 00:28:02.880 if they are infantry or some of the other units 00:28:02.880 --> 00:28:04.140 that are going to be front and center, they're 00:28:04.140 --> 00:28:06.220 going to be breaching them. The concussive force 00:28:06.220 --> 00:28:08.859 is quite obvious. When it comes to law enforcement, 00:28:08.980 --> 00:28:11.519 again, going hands -on with people, again, firearms 00:28:11.519 --> 00:28:13.819 training, SWAT breaching, you can see there'd 00:28:13.819 --> 00:28:17.079 be more of that. But with the fire service, We're 00:28:17.079 --> 00:28:20.420 exposed to that less. Now, I was a martial artist 00:28:20.420 --> 00:28:22.980 my whole life, so I've definitely been kicked 00:28:22.980 --> 00:28:25.299 and punched way more than I probably should have 00:28:25.299 --> 00:28:30.039 been. But that aside, you know, when I see my 00:28:30.039 --> 00:28:32.359 profession, I see more damage from the sleep 00:28:32.359 --> 00:28:35.119 deprivation, which what I'm told from many people 00:28:35.119 --> 00:28:38.519 in your world has a similar effect to, you know, 00:28:38.519 --> 00:28:43.119 the kind of traumatic effect as far as the demyelination 00:28:43.119 --> 00:28:47.869 of the myelin sheath. So what are you seeing 00:28:47.869 --> 00:28:50.750 as far as those imbalances in firefighters versus 00:28:50.750 --> 00:28:54.230 maybe some of the other professions? Yeah, you 00:28:54.230 --> 00:28:57.650 touched precisely on maybe the first thing people 00:28:57.650 --> 00:29:00.730 notice is the restoration of deep restorative 00:29:00.730 --> 00:29:04.210 sleep. And that is a common finding between the 00:29:04.210 --> 00:29:06.450 different communities. And it's interesting. 00:29:06.609 --> 00:29:09.670 I sort of thought of all of these professions 00:29:09.670 --> 00:29:14.160 as being slightly different. I feel very privileged 00:29:14.160 --> 00:29:15.980 to be able to help these communities. I realize 00:29:15.980 --> 00:29:19.019 there's so much in common. All of these different 00:29:19.019 --> 00:29:21.000 communities have raised their hand and said, 00:29:21.160 --> 00:29:24.259 I'm going to sacrifice and serve my community 00:29:24.259 --> 00:29:28.160 in this way. And each of them willing to go into 00:29:28.160 --> 00:29:31.000 harm's way to protect and serve, which is kind 00:29:31.000 --> 00:29:33.119 of unique. Not a lot of people are willing to 00:29:33.119 --> 00:29:38.579 do that. But the sleep deprivation, whether it's 00:29:39.210 --> 00:29:41.930 Going overseas, you know, 18 time zones away 00:29:41.930 --> 00:29:44.109 and wearing night vision goggles to have a tactical 00:29:44.109 --> 00:29:47.970 advantage at night. So you're intentionally inducing 00:29:47.970 --> 00:29:50.309 kind of a sleep deprived state or whether you're 00:29:50.309 --> 00:29:55.029 doing shift work in a local community. Sleep 00:29:55.029 --> 00:29:59.029 disruption and circadian rhythm disruption tend 00:29:59.029 --> 00:30:02.589 to be hallmarks of these professions. Although 00:30:02.589 --> 00:30:05.309 we tend to think or assume that we will adapt 00:30:05.309 --> 00:30:10.250 given some time off from a night shift, physiologically, 00:30:10.430 --> 00:30:12.750 it doesn't happen as quickly or easily as we 00:30:12.750 --> 00:30:16.710 might hope. So certainly we can walk through 00:30:16.710 --> 00:30:19.970 all the different sleep hygiene, you know, tactics 00:30:19.970 --> 00:30:22.809 we can use, whether it's kind of exercise and 00:30:22.809 --> 00:30:26.210 at the right times or diet, nutrition, you know, 00:30:26.210 --> 00:30:28.690 blackout curtains, these things. But what this 00:30:28.690 --> 00:30:31.619 treatment is affording. in some ways is a bit 00:30:31.619 --> 00:30:35.380 of a reboot. And we find when we see disruptions 00:30:35.380 --> 00:30:37.259 in activity, because chronic sleep deprivation 00:30:37.259 --> 00:30:40.240 certainly causes slowing in the prefrontal cortex. 00:30:40.799 --> 00:30:43.180 And if you ever wonder, you know, if I'm sleep 00:30:43.180 --> 00:30:46.859 deprived, you know, my emotional resilience goes 00:30:46.859 --> 00:30:50.200 down, my impulsivity goes up. It's not your imagination, 00:30:50.460 --> 00:30:53.119 right? These are things that we can observe in 00:30:53.119 --> 00:30:57.319 an EEG with great predictability. And if we can 00:30:57.319 --> 00:31:01.829 help to restore that activity, Number one, you 00:31:01.829 --> 00:31:04.329 may subjectively feel better, but you're likely 00:31:04.329 --> 00:31:07.390 going to sleep better as well. So one of the 00:31:07.390 --> 00:31:12.190 pieces of feedback we frequently hear is, I just 00:31:12.190 --> 00:31:13.990 had the best night of sleep I've had in 10 years. 00:31:14.690 --> 00:31:16.589 And those are usually the cases where we know, 00:31:16.690 --> 00:31:18.230 okay, this is a person who's going to do well. 00:31:20.380 --> 00:31:22.720 So yeah, sleep is really foundational. There's 00:31:22.720 --> 00:31:24.440 second and third order benefits to sleep that 00:31:24.440 --> 00:31:27.799 are critical in so many different ways. And I've 00:31:27.799 --> 00:31:29.619 heard in some of your other podcasts, this is 00:31:29.619 --> 00:31:33.799 covered in great detail, but chronic sleep deprivation 00:31:33.799 --> 00:31:36.339 predisposes people to cardiovascular disease, 00:31:36.680 --> 00:31:41.339 cerebrovascular disease, cancer, many different 00:31:41.339 --> 00:31:45.839 types of conditions. And I believe now... Thankfully, 00:31:46.059 --> 00:31:48.400 there's beginning to be some recognition and 00:31:48.400 --> 00:31:51.460 proactive movement to try to correct that. Never 00:31:51.460 --> 00:31:53.640 as fast as we want it to be. But I think the 00:31:53.640 --> 00:31:56.299 first step is just to acknowledge this is an 00:31:56.299 --> 00:31:59.099 issue and then work towards finding solutions 00:31:59.099 --> 00:32:02.660 that can help. Well, we talked before we hit 00:32:02.660 --> 00:32:04.180 record because you mentioned about listening 00:32:04.180 --> 00:32:07.799 to some of the episodes prior. And I was explaining 00:32:07.799 --> 00:32:11.000 how. I'm trying to make an industry standard 00:32:11.000 --> 00:32:14.240 where we have at least a 72 hour period between 00:32:14.240 --> 00:32:17.619 shifts. Right now it's a 48 hour period. What 00:32:17.619 --> 00:32:20.079 is your perspective with this unique lens that 00:32:20.079 --> 00:32:23.980 you have on the impact of giving first responders 00:32:23.980 --> 00:32:26.759 more time between shifts to try and get closer 00:32:26.759 --> 00:32:31.759 to that baseline? Yeah, I think it's a brilliant 00:32:31.759 --> 00:32:36.460 idea to be able to make that change. And what 00:32:36.460 --> 00:32:38.799 you're proposing. It's actually quite a simple 00:32:38.799 --> 00:32:42.299 change. And the long -term impact of that, you 00:32:42.299 --> 00:32:45.220 think about adding an extra 24 hours of rest 00:32:45.220 --> 00:32:50.319 between shifts over a career, you know, 10, 15, 00:32:50.339 --> 00:32:55.460 20 years. The amount of benefit that each individual 00:32:55.460 --> 00:32:59.579 would gain not only would help the force of the 00:32:59.579 --> 00:33:03.240 unit, but also the family. You think about how 00:33:03.240 --> 00:33:05.980 that impacts your time at home, your ability 00:33:05.980 --> 00:33:10.440 to be present with children and spouses. I think 00:33:10.440 --> 00:33:12.720 that it would have quite a meaningful, potentially 00:33:12.720 --> 00:33:17.279 profound impact on both an emotional and a physical 00:33:17.279 --> 00:33:23.660 level. So I imagine there are logistical challenges 00:33:23.660 --> 00:33:25.619 with making something like that happen. But I 00:33:25.619 --> 00:33:30.859 think if there's will. To see these changes in 00:33:30.859 --> 00:33:33.140 service to the community that's serving all of 00:33:33.140 --> 00:33:36.460 us, it can be done. It's just a matter of recognizing 00:33:36.460 --> 00:33:40.180 it and probably acquiring some data to demonstrate 00:33:40.180 --> 00:33:42.779 what those benefits are at a quantitative level. 00:33:43.140 --> 00:33:44.740 Yeah, well, it's interesting because, I mean, 00:33:44.759 --> 00:33:48.059 we've got the sadly the reverse data where we 00:33:48.059 --> 00:33:50.019 know what happens if we do it the way we do at 00:33:50.019 --> 00:33:52.440 the moment. And it results in a recruitment crisis 00:33:52.440 --> 00:33:54.960 and, you know, bleeding money through overtime 00:33:54.960 --> 00:33:58.079 and lack of retention and all these things. Ironically, 00:33:58.079 --> 00:34:00.880 the data is in the opposite direction, but it's 00:34:00.880 --> 00:34:04.420 still data. We know this isn't working. Graveyards 00:34:04.420 --> 00:34:06.480 are full of firefighters and other first responders. 00:34:06.839 --> 00:34:09.519 But what's exciting is that money is already 00:34:09.519 --> 00:34:12.769 downstream. So even, you know, financially, you 00:34:12.769 --> 00:34:14.809 can just kind of front load that, invest in your 00:34:14.809 --> 00:34:17.190 people. And then, you know, then you've got the 00:34:17.190 --> 00:34:20.210 capacity to start sending people to all the other 00:34:20.210 --> 00:34:22.750 areas that can help you level up. And obviously, 00:34:22.809 --> 00:34:24.929 wave neuroscience is one of them. But there's 00:34:24.929 --> 00:34:27.989 so many areas that we can get from trying to 00:34:27.989 --> 00:34:30.670 get us not to die all the way to the other side 00:34:30.670 --> 00:34:33.630 of performance. And I think this is what's become 00:34:33.630 --> 00:34:36.150 very clear recently when I talk to nutritionists 00:34:36.150 --> 00:34:38.070 and strength and conditioning coaches and people 00:34:38.070 --> 00:34:42.170 like yourself. When you work with special warfare, 00:34:42.469 --> 00:34:45.269 you're squeezing out performance. Like you said, 00:34:45.309 --> 00:34:48.150 you're also trying to mitigate the impact of 00:34:48.150 --> 00:34:50.349 war on the mental health side, but you're helping 00:34:50.349 --> 00:34:52.369 these operators perform at the highest level. 00:34:52.630 --> 00:34:56.409 In my profession, all the conversations are is 00:34:56.409 --> 00:34:59.230 let's try and get us to die less. So we've got 00:34:59.230 --> 00:35:02.269 a long way to go from where we are now to the 00:35:02.269 --> 00:35:04.670 performance conversation. But it's an exciting 00:35:04.670 --> 00:35:07.550 journey that we can travel because not only will 00:35:07.550 --> 00:35:09.650 we improve our longevity and our relationships 00:35:09.650 --> 00:35:13.889 at home, but we will simply be better paramedics, 00:35:13.889 --> 00:35:18.239 police officers and firefighters. Yeah, I couldn't 00:35:18.239 --> 00:35:20.860 agree with you more. You know, before joining 00:35:20.860 --> 00:35:24.699 the podcast, I was doing some research on the 00:35:24.699 --> 00:35:28.039 literature on shift work really across professions, 00:35:28.239 --> 00:35:30.079 whether it's hospital workers or firefighters, 00:35:30.340 --> 00:35:32.599 law enforcement, you know, long haul pilots. 00:35:34.239 --> 00:35:36.320 And the weight of the evidence is pretty clear 00:35:36.320 --> 00:35:39.480 that shift work, as it's currently administered, 00:35:39.840 --> 00:35:43.119 is pretty harmful to health. And so anything 00:35:43.119 --> 00:35:46.380 we can do to bend that curve. I think would be 00:35:46.380 --> 00:35:50.219 of great service to these communities. So yeah, 00:35:50.380 --> 00:35:56.519 I agree. And I think that your effort to spread 00:35:56.519 --> 00:35:58.639 the knowledge that this is a simple intervention 00:35:58.639 --> 00:36:01.860 that could help. um in many different ways i 00:36:01.860 --> 00:36:04.219 think it is very smart and i hope uh the right 00:36:04.219 --> 00:36:06.360 people will listen and start to make some of 00:36:06.360 --> 00:36:08.460 these changes yeah well i mean it's been this 00:36:08.460 --> 00:36:10.840 it's been people like you over a thousand conversations 00:36:10.840 --> 00:36:12.780 not all of them are specifically about shift 00:36:12.780 --> 00:36:15.119 work but you know it's just layers where i always 00:36:15.119 --> 00:36:17.679 tell people the venn diagram has overlapped so 00:36:17.679 --> 00:36:21.239 clearly that there is no denying because every 00:36:21.239 --> 00:36:24.099 person from all these walks of life from neuroscientists 00:36:24.099 --> 00:36:27.099 to neurosurgery to sports performance to whatever 00:36:27.099 --> 00:36:30.659 it is back injury they all say the same thing. 00:36:30.800 --> 00:36:34.239 So this is a beautiful thing. If you really get 00:36:34.239 --> 00:36:36.420 outside your echo chamber and you challenge these 00:36:36.420 --> 00:36:38.820 concepts and they come back as the truth over 00:36:38.820 --> 00:36:41.780 and over and over again, then it's hard to then 00:36:41.780 --> 00:36:43.619 turn your head. Now it's time to acknowledge 00:36:43.619 --> 00:36:48.199 it and change. Absolutely. And it's probably 00:36:48.199 --> 00:36:51.019 worth mentioning too, it was interesting, we 00:36:51.019 --> 00:36:54.400 had talked before we hit record, some of the 00:36:54.400 --> 00:36:57.170 work that... we were fortunate enough to do with 00:36:57.170 --> 00:37:00.510 U .S. Special Operations Command. And their feedback 00:37:00.510 --> 00:37:04.710 was earlier on, you know, we love what you're 00:37:04.710 --> 00:37:06.269 doing for the men and women who are injured. 00:37:06.750 --> 00:37:10.130 We actually view a lot of this benefit as being 00:37:10.130 --> 00:37:14.250 a human performance benefit. And in fact, Air 00:37:14.250 --> 00:37:16.769 Force Special Operations recently just published 00:37:16.769 --> 00:37:22.840 the first brain optimization program. They measured 00:37:22.840 --> 00:37:25.000 a bunch of different things. Some of the things 00:37:25.000 --> 00:37:27.019 that were interesting and maybe interesting for 00:37:27.019 --> 00:37:31.320 your audience, we saw improvements in reaction 00:37:31.320 --> 00:37:34.219 times, sometimes in the millisecond range, but 00:37:34.219 --> 00:37:38.320 for firefighter law enforcement or a Navy SEAL 00:37:38.320 --> 00:37:41.380 or an Army Green Beret, that can be very important. 00:37:42.099 --> 00:37:44.159 We were able to see quantitatively improvements 00:37:44.159 --> 00:37:48.719 in sleep. um and then you know there's a number 00:37:48.719 --> 00:37:50.760 of other things that were measured force plate 00:37:50.760 --> 00:37:55.639 data that is a proxy for injury risk and it was 00:37:55.639 --> 00:37:57.800 interesting to have a conversation with some 00:37:57.800 --> 00:37:59.940 of the doctors in this area and one of my mentors 00:37:59.940 --> 00:38:03.460 i should mention stephanos kales out of harvard 00:38:03.460 --> 00:38:05.420 most of his research has been on firefighter 00:38:05.420 --> 00:38:07.960 health and the question that was raised is are 00:38:07.960 --> 00:38:11.840 those benefits completely due to the treatment 00:38:11.840 --> 00:38:15.519 or is it a happy byproduct of improving the sleep 00:38:15.519 --> 00:38:18.679 quality of these individuals. And I think an 00:38:18.679 --> 00:38:20.380 argument can be made for both. It's really hard 00:38:20.380 --> 00:38:22.880 to tease out the contribution of one or the other. 00:38:23.260 --> 00:38:28.500 But I do think something that the whole audience 00:38:28.500 --> 00:38:31.300 can learn, I think is probably, if it hasn't 00:38:31.300 --> 00:38:34.159 been learned, can just be reinforced that sleep 00:38:34.159 --> 00:38:37.059 is of paramount importance. And if you look at 00:38:37.059 --> 00:38:40.039 the pillars of health, Diet and nutrition being 00:38:40.039 --> 00:38:43.260 one, exercise activity being a second, but recovery 00:38:43.260 --> 00:38:47.159 and sleep being the third. Strong arguments made 00:38:47.159 --> 00:38:49.800 that recovery is really the foundation for all 00:38:49.800 --> 00:38:52.099 of this. And we do have to give ourselves a time 00:38:52.099 --> 00:38:55.579 to heal and to recover, especially if you have 00:38:55.579 --> 00:39:01.599 a difficult shift. And I really like that three 00:39:01.599 --> 00:39:06.260 -day concept. rather than two, because cumulatively 00:39:06.260 --> 00:39:09.260 over time, the benefit people can get from one 00:39:09.260 --> 00:39:12.840 extra night of good sleep in a four -day cycle 00:39:12.840 --> 00:39:17.519 is quite profound. Absolutely. I had two military 00:39:17.519 --> 00:39:19.619 sleep researchers on the show, Rachel Markwald 00:39:19.619 --> 00:39:21.840 and Alison Brager, and they were talking about 00:39:21.840 --> 00:39:24.579 not only reaction time when it came to sleep, 00:39:24.639 --> 00:39:27.679 but also critical thinking. which is incredibly 00:39:27.679 --> 00:39:29.659 important, you know, to shoot or not to shoot, 00:39:29.739 --> 00:39:32.320 for example, or in my profession, you know, the 00:39:32.320 --> 00:39:34.739 right drug, the right dose, the right part of 00:39:34.739 --> 00:39:38.260 the body. And so, yeah, there was a direct correlation 00:39:38.260 --> 00:39:42.460 between sleep deprivation and poor critical thinking. 00:39:42.559 --> 00:39:44.380 And you look at a lot of these videos of these 00:39:44.380 --> 00:39:46.179 police officers, for example, making the wrong 00:39:46.179 --> 00:39:48.699 decision. No one ever really asked when did they 00:39:48.699 --> 00:39:50.840 sleep? Were they forced to do an extra shift? 00:39:50.920 --> 00:39:53.000 You know, so what was their stress level? So 00:39:53.000 --> 00:39:56.599 I agree. Even when you look at the. The performance 00:39:56.599 --> 00:39:59.679 side, as far as mistakes that we make, there's 00:39:59.679 --> 00:40:01.860 hardly ever a kind of reverse engineering and 00:40:01.860 --> 00:40:03.840 sleep deprivation. But if you look at Chernobyl 00:40:03.840 --> 00:40:07.079 and the naval crash that we had not long ago 00:40:07.079 --> 00:40:10.940 and the Exxon Valdez, sleep deprivation is behind, 00:40:11.099 --> 00:40:17.960 not the sole reason, but a massive contributing 00:40:17.960 --> 00:40:20.599 element when it came to those disasters and the 00:40:20.599 --> 00:40:22.679 massive dollar amount that came along with them. 00:40:25.099 --> 00:40:27.659 Yeah. Absolutely. And these things can actually 00:40:27.659 --> 00:40:30.599 be measured in some creative ways, too. You know, 00:40:30.599 --> 00:40:32.599 we're talking about performance gains, but even 00:40:32.599 --> 00:40:34.840 in there's an interesting study that came out 00:40:34.840 --> 00:40:38.239 of Australia in 2019, where they measured typographical 00:40:38.239 --> 00:40:41.139 errors made by nurses and shift workers. And 00:40:41.139 --> 00:40:43.460 there's a dose response relationship, like the 00:40:43.460 --> 00:40:45.599 more sleep deprived you are, the more errors 00:40:45.599 --> 00:40:48.880 that you make in your typing. And it was statistically 00:40:48.880 --> 00:40:52.199 significant. And so we can see consciously or 00:40:52.199 --> 00:40:54.039 unconsciously the number of mistakes that are 00:40:54.039 --> 00:40:58.639 made. increases quite significantly uh the longer 00:40:58.639 --> 00:41:01.219 and more chronically you're sleep deprived so 00:41:01.219 --> 00:41:04.699 so yeah it's uh pretty clear based on based on 00:41:04.699 --> 00:41:07.159 the data and the evidence well you mentioned 00:41:07.159 --> 00:41:09.880 trauma as one of the the factors creating that 00:41:09.880 --> 00:41:14.039 imbalance in the brain um when you know again 00:41:14.039 --> 00:41:16.280 after all these years of having these conversations 00:41:16.280 --> 00:41:18.400 it became very apparent through being educated 00:41:18.400 --> 00:41:22.070 from a lot of guests how many of us have childhood 00:41:22.070 --> 00:41:24.889 elements that contributed to trauma later in 00:41:24.889 --> 00:41:28.889 our career. So aside from the actual physiological 00:41:28.889 --> 00:41:32.469 trauma, how does it manifest in other ways that 00:41:32.469 --> 00:41:35.449 you can still see in the EEG if it's more of 00:41:35.449 --> 00:41:40.309 a kind of psychological traumatic element? Yeah, 00:41:40.309 --> 00:41:42.929 it's interesting. As we dug into the science 00:41:42.929 --> 00:41:48.210 and as the body of evidence has been growing 00:41:48.210 --> 00:41:51.690 about PTSD, there's a few pretty clear physiologic 00:41:51.690 --> 00:41:54.710 changes that occur, particularly in the adolescent 00:41:54.710 --> 00:41:58.170 pediatric trauma population. We see reductions 00:41:58.170 --> 00:42:00.510 in what's called hippocampal volume. The size 00:42:00.510 --> 00:42:04.329 of the hippocampus decreases in size. Very objective. 00:42:04.550 --> 00:42:07.510 This is not kind of a survey or a questionnaire. 00:42:07.809 --> 00:42:11.050 It's a measurable difference that we see as these 00:42:11.050 --> 00:42:15.369 patients grow. The other area that's pretty uncontroversial 00:42:15.369 --> 00:42:18.610 is we see changes in brain network connectivity. 00:42:19.539 --> 00:42:22.780 And specifically, there is a network that's of 00:42:22.780 --> 00:42:26.619 interest for the PTS community called the Default 00:42:26.619 --> 00:42:30.340 Mode Network, or the DMN. So there is some great 00:42:30.340 --> 00:42:34.099 work being done at Stanford exploring the effectiveness 00:42:34.099 --> 00:42:38.559 of a similar treatment as fMRI -guided for depression. 00:42:39.119 --> 00:42:41.760 And they're studying the salience network. And 00:42:41.760 --> 00:42:44.079 I won't bore your audience with a lot of the 00:42:44.079 --> 00:42:46.079 deep science behind that. It's fascinating to 00:42:46.079 --> 00:42:49.320 me, but I know boring for many. But the salience 00:42:49.320 --> 00:42:51.360 network has been closely correlated with depression. 00:42:51.619 --> 00:42:55.079 And when they treat these areas, the salience 00:42:55.079 --> 00:42:58.739 network can flip the direction of some of the 00:42:58.739 --> 00:43:02.460 pathways they call anti -correlation. The depression 00:43:02.460 --> 00:43:05.519 remits. And so that's been very exciting to see. 00:43:05.929 --> 00:43:09.110 Our group is very focused on restoring function 00:43:09.110 --> 00:43:12.530 at the default mode network. And the disruption 00:43:12.530 --> 00:43:15.389 in this pattern of connectivity, it's not just 00:43:15.389 --> 00:43:18.789 our data. There's large population -sized epidemiologic 00:43:18.789 --> 00:43:24.269 studies with hundreds of thousands where we can 00:43:24.269 --> 00:43:26.750 see pretty consistently that this area gets disrupted. 00:43:27.210 --> 00:43:30.510 And part of that pathway and part of the way 00:43:30.510 --> 00:43:34.190 we're able to... strive to restore function is 00:43:34.190 --> 00:43:37.309 using this treatment to close that circuit and 00:43:37.309 --> 00:43:40.010 to reactivate neurons that might be firing too 00:43:40.010 --> 00:43:45.909 slowly. There's a paradigm in neuroscience they 00:43:45.909 --> 00:43:47.769 call heavy in learning that as neurons fire, 00:43:47.869 --> 00:43:51.690 they wire. And if we're able to induce these 00:43:51.690 --> 00:43:55.630 neurons to fire at a rate that is consistent 00:43:55.630 --> 00:43:57.869 with how other areas of the brain are working, 00:43:57.969 --> 00:44:01.869 we can cause synchronization of activity. That 00:44:01.869 --> 00:44:03.809 is believed to be one of the elements that allows 00:44:03.809 --> 00:44:07.469 people to get more restorative sleep. There is 00:44:07.469 --> 00:44:11.849 a pattern we see in sleep as we get into deeper 00:44:11.849 --> 00:44:15.210 sleep, stage two sleep, which is the stage prior 00:44:15.210 --> 00:44:18.809 to REM sleep. There's a phenomenon we call sleep 00:44:18.809 --> 00:44:20.769 spindles, where there's these synchronous bursts 00:44:20.769 --> 00:44:23.809 of activity. And that allows you to get into 00:44:23.809 --> 00:44:27.699 your dream states of sleep. And we're seeing, 00:44:27.980 --> 00:44:30.019 and we've had some sleep specialists tell us, 00:44:30.019 --> 00:44:31.559 we're seeing a dramatic increase in the number 00:44:31.559 --> 00:44:34.360 of sleep spindles when we administer this treatment. 00:44:34.800 --> 00:44:38.400 And that aligns in the sense that we are trying 00:44:38.400 --> 00:44:40.420 to restore synchronization of brain activity, 00:44:40.539 --> 00:44:44.039 or something we call alpha coherence. And with 00:44:44.039 --> 00:44:47.000 that, we're starting to tease out and pull the 00:44:47.000 --> 00:44:51.059 curtain back on how are we getting people into... 00:44:51.309 --> 00:44:54.570 more restorative sleep. And this may be one of 00:44:54.570 --> 00:44:57.110 those modalities. We're doing some more research. 00:44:57.170 --> 00:45:00.210 We're working with a group out of Virginia Tech 00:45:00.210 --> 00:45:02.309 called the Frameland Biomedical Institute that 00:45:02.309 --> 00:45:05.369 is doing full in -lab polysomnograms on patients. 00:45:05.510 --> 00:45:08.369 And so I think we'll have a better idea of how 00:45:08.369 --> 00:45:11.989 sleep is changing post -treatment over the next 00:45:11.989 --> 00:45:16.130 six to 12 months. See, I have no problem getting 00:45:16.130 --> 00:45:19.670 to sleep. But I find that I'm not getting that 00:45:19.670 --> 00:45:22.329 deep quality of sleep. I don't wake up feeling 00:45:22.329 --> 00:45:24.789 rested normally. So I do all the right things. 00:45:24.889 --> 00:45:27.829 You know, I usually maybe not the device thing 00:45:27.829 --> 00:45:29.949 or the TV thing, but I have blue blocking glasses. 00:45:30.170 --> 00:45:32.789 I have the air down. I have all the lights, you 00:45:32.789 --> 00:45:36.530 know, muted in the bedroom. And, you know, just 00:45:36.530 --> 00:45:38.630 trying to get that sleep hygiene dialed in. And 00:45:38.630 --> 00:45:41.570 it works to a point. I sleep, but I wake up normally 00:45:41.570 --> 00:45:43.849 with my jaws real tight. My neck is tight because 00:45:43.849 --> 00:45:48.079 I've been clenching the whole night. my fire 00:45:48.079 --> 00:45:50.139 service career and then probably beyond that 00:45:50.139 --> 00:45:51.619 you know i was in a house fire when i was four 00:45:51.619 --> 00:45:53.260 years old that you know that might be one of 00:45:53.260 --> 00:45:57.179 the reasons i almost died um but uh so it's interesting 00:45:57.179 --> 00:45:59.280 because i'm doing the headspace and there's nothing 00:45:59.280 --> 00:46:01.539 like there's not a thing that i feel like i need 00:46:01.539 --> 00:46:05.139 to address um that's haunting in any way so this 00:46:05.139 --> 00:46:07.219 is why this technology is intriguing to me is 00:46:07.219 --> 00:46:09.280 like okay well outside of all the psychological 00:46:09.280 --> 00:46:12.900 things outside of the sleep hygiene What are 00:46:12.900 --> 00:46:15.460 other things that may be that missing link to 00:46:15.460 --> 00:46:18.079 help me actually get a better quality of sleep? 00:46:20.420 --> 00:46:25.599 Yeah, it's interesting. If it's possible, it 00:46:25.599 --> 00:46:28.860 would be great to let you demo the technology 00:46:28.860 --> 00:46:31.679 and see if it might help you to get kind of a 00:46:31.679 --> 00:46:35.619 longer sleep duration and push you through sort 00:46:35.619 --> 00:46:39.760 of those. periods where you may be kind of waking 00:46:39.760 --> 00:46:42.579 up. It may be related to cortisol. That's a hard 00:46:42.579 --> 00:46:44.579 thing to measure throughout the night, but there 00:46:44.579 --> 00:46:47.159 may be some ways to measure that and see if that 00:46:47.159 --> 00:46:50.460 might be one of the areas that could be tuned 00:46:50.460 --> 00:46:54.219 up. But we can talk about it offline, but it 00:46:54.219 --> 00:46:58.360 would be great if you could visit one of our 00:46:58.360 --> 00:47:00.960 centers in either Ohio, Missouri, or Florida. 00:47:01.480 --> 00:47:04.699 We could certainly let you try the technology, 00:47:04.800 --> 00:47:07.920 see if that helps you sleep better. Yeah, I would 00:47:07.920 --> 00:47:10.099 love to. Thank you. Well, you mentioned those 00:47:10.099 --> 00:47:11.880 states. So let's talk about these initiatives. 00:47:12.000 --> 00:47:15.260 Which one was first and how did that kind of 00:47:15.260 --> 00:47:20.360 come about in the first place? Yeah, so. So Senator 00:47:20.360 --> 00:47:23.719 Frank Hoagland was at the time, he's a retired 00:47:23.719 --> 00:47:27.179 Navy SEAL. He saw what this technology could 00:47:27.179 --> 00:47:30.440 do for many of the team guys, and he wanted this 00:47:30.440 --> 00:47:32.559 to be in the state of Ohio. So we worked through 00:47:32.559 --> 00:47:37.940 a group called JLC Services. There's a great 00:47:37.940 --> 00:47:39.960 human being, a patriot named Joe Charles, who 00:47:39.960 --> 00:47:42.860 saw what this technology could do and wanted 00:47:42.860 --> 00:47:47.159 to operationalize it. So that bill passed around, 00:47:47.380 --> 00:47:51.639 I want to say. 2020, 2021. And at that time, 00:47:51.659 --> 00:47:54.820 it was predominantly for veterans. In year two, 00:47:54.940 --> 00:47:58.579 they added first responders. And they've now, 00:47:58.679 --> 00:48:03.159 I believe, treated over 1000 patients. And it's 00:48:03.159 --> 00:48:05.860 been a great success. And we've been able to 00:48:05.860 --> 00:48:09.320 create what's called the dashboard where legislators 00:48:09.320 --> 00:48:13.579 and many of their stakeholders can actually see 00:48:13.579 --> 00:48:16.219 in real time how their taxpayer dollars are returning 00:48:16.219 --> 00:48:18.949 back to the community. And we get eight gold 00:48:18.949 --> 00:48:21.610 standard scales measuring depression, post -traumatic 00:48:21.610 --> 00:48:26.329 stress symptoms. And there were two scales added 00:48:26.329 --> 00:48:28.429 a couple years ago that have been of great interest, 00:48:28.530 --> 00:48:31.070 the opioid craving scale and the pen alcohol 00:48:31.070 --> 00:48:34.530 craving scale. And we saw an interesting signal 00:48:34.530 --> 00:48:38.489 that the same treatment seemed to be helping 00:48:38.489 --> 00:48:42.510 to reduce cravings for substance use disorder. 00:48:42.949 --> 00:48:46.860 And they launched a separate pilot. out of two 00:48:46.860 --> 00:48:50.119 inpatient detox centers, Perry Behavioral Health 00:48:50.119 --> 00:48:52.980 and Meridian Health. And they were able to replicate 00:48:52.980 --> 00:48:56.179 this data. And so the goal being, you know, in 00:48:56.179 --> 00:49:01.099 firefighters, law enforcement, veterans, they 00:49:01.099 --> 00:49:03.659 may identify with different types of issues. 00:49:04.659 --> 00:49:08.219 The number one cause of patients coming in was. 00:49:08.599 --> 00:49:11.099 performance, and then sleep disorder. Whereas 00:49:11.099 --> 00:49:13.019 in these inpatient addiction centers, their number 00:49:13.019 --> 00:49:15.000 one cause for coming in was substance use disorder. 00:49:15.300 --> 00:49:18.920 And so we were able to see these findings again 00:49:18.920 --> 00:49:22.079 in that community, which was interesting. But 00:49:22.079 --> 00:49:27.059 the success that was experienced in Ohio prompted 00:49:27.059 --> 00:49:31.079 legislators in Missouri to replicate that same 00:49:31.079 --> 00:49:34.409 bill. And so we're very excited. They've had 00:49:34.409 --> 00:49:36.449 a very successful program as well. Senator Black 00:49:36.449 --> 00:49:40.929 is leading the effort there. And then Florida 00:49:40.929 --> 00:49:46.869 came online this year and actually the. legislator 00:49:46.869 --> 00:49:49.929 that uh initiated the bill there is actually 00:49:49.929 --> 00:49:51.889 somebody who's on your podcast danny alvarez 00:49:51.889 --> 00:49:55.369 uh who is himself just an amazing guy i've uh 00:49:55.369 --> 00:49:56.949 been fortunate enough to be able to spend some 00:49:56.949 --> 00:50:00.050 time with him and he is the real deal like he 00:50:00.050 --> 00:50:04.239 uh is i think what you would want every senator 00:50:04.239 --> 00:50:08.280 and politician to be. He lives his word and is 00:50:08.280 --> 00:50:10.639 really doing everything he can to help the community. 00:50:11.320 --> 00:50:16.559 So yeah, it's been inspiring to see these initiatives 00:50:16.559 --> 00:50:19.460 move forward and to be able to help these communities 00:50:19.460 --> 00:50:24.340 and collect more insight into what's happening 00:50:24.340 --> 00:50:30.269 has been pretty amazing to see. And so I would 00:50:30.269 --> 00:50:31.969 just mention, too, if anyone in your audience 00:50:31.969 --> 00:50:36.889 is interested, they can go to etmsohio .com or 00:50:36.889 --> 00:50:40.550 etmsmissouri .com or etmsflorida .com. You can 00:50:40.550 --> 00:50:43.050 actually enroll. There's a portal on those websites 00:50:43.050 --> 00:50:46.110 where they can sign up and access the treatment 00:50:46.110 --> 00:50:50.280 really at no cost to them. Thanks to, you know, 00:50:50.280 --> 00:50:52.699 these these lawmakers who found it suitable to 00:50:52.699 --> 00:50:55.340 provide the treatment to those populations. Beautiful. 00:50:55.340 --> 00:50:58.059 So so those states are actually funding the treatments 00:50:58.059 --> 00:51:00.219 for these first responders, military and veterans. 00:51:01.860 --> 00:51:06.840 That's right. That's right. And, you know, paramedics 00:51:06.840 --> 00:51:11.280 are part of that community as well. And yeah, 00:51:11.420 --> 00:51:14.739 the the different it seems like the different 00:51:14.739 --> 00:51:17.940 centers may have sort of different populations 00:51:17.940 --> 00:51:20.840 that come into them. But it's been interesting, 00:51:21.099 --> 00:51:25.079 you know, a tip of the hat to the firefighters 00:51:25.079 --> 00:51:32.239 and law enforcement folks seem to be more, they 00:51:32.239 --> 00:51:34.739 don't just get the treatment. They go out and 00:51:34.739 --> 00:51:37.039 they tell their brothers and sisters that you 00:51:37.039 --> 00:51:38.739 need to come in and get this. And so it's kind 00:51:38.739 --> 00:51:43.619 of caught on in a way that's been really beautiful 00:51:43.619 --> 00:51:47.849 to see. where if they see somebody who is struggling, 00:51:48.110 --> 00:51:52.269 no longer do they have to say, just suck it up 00:51:52.269 --> 00:51:54.969 or it's going to get better. There's an opportunity 00:51:54.969 --> 00:51:58.690 for them. And these were specifically designed. 00:51:59.849 --> 00:52:02.969 We don't necessarily have to diagnose you. There 00:52:02.969 --> 00:52:07.570 are many people who are a badge who do not want 00:52:07.570 --> 00:52:13.099 a diagnosis of major depression or PTSD. Interestingly, 00:52:13.260 --> 00:52:15.579 our treatment, we don't necessarily look for 00:52:15.579 --> 00:52:17.760 that label either. We're just trying to find 00:52:17.760 --> 00:52:22.320 disruptions in connectivity. What a doctor or 00:52:22.320 --> 00:52:26.320 therapist may call it isn't necessarily of primary 00:52:26.320 --> 00:52:28.539 interest to us. We just want to help people. 00:52:28.820 --> 00:52:33.179 And sometimes they come in for, gosh, I really 00:52:33.179 --> 00:52:35.820 just want to get my sleep tuned up. Other people, 00:52:35.860 --> 00:52:39.659 they want a performance bump. And we see that 00:52:39.659 --> 00:52:44.730 in... Most of our clinics, we see CEOs and CFOs 00:52:44.730 --> 00:52:48.409 from Fortune 500 companies. We see U .S. Olympians, 00:52:48.409 --> 00:52:53.030 and we see a lot of elite operators, Navy SEALs, 00:52:53.030 --> 00:52:56.989 Army Deltas. And so the saying is, you don't 00:52:56.989 --> 00:52:59.829 have to be sick to want to be well. And so if 00:52:59.829 --> 00:53:02.750 anyone in those communities is interested in 00:53:02.750 --> 00:53:05.329 the treatment, I just encourage them to look 00:53:05.329 --> 00:53:07.590 through those websites, and there's lots of studies 00:53:07.590 --> 00:53:11.280 listed there. supported by really good, solid 00:53:11.280 --> 00:53:16.300 evidence and science. But for us, the encouraging 00:53:16.300 --> 00:53:20.360 part is just being able to provide access to 00:53:20.360 --> 00:53:22.219 communities that otherwise may not have access 00:53:22.219 --> 00:53:25.320 to it. One thing that's been apparent is just 00:53:25.320 --> 00:53:29.260 how diverse the toolbox is for... someone who's 00:53:29.260 --> 00:53:31.039 struggling you know it could be physically mentally 00:53:31.039 --> 00:53:34.019 i mean those are usually interwoven anyway but 00:53:34.019 --> 00:53:36.519 it used to be well talk therapy and psychiatric 00:53:36.519 --> 00:53:38.980 meds were pretty much all you had to choose from 00:53:38.980 --> 00:53:41.179 and you hear that a lot from the the military 00:53:41.179 --> 00:53:43.460 members that go through the va i mean sadly i'm 00:53:43.460 --> 00:53:45.280 sure there's some great great professionals within 00:53:45.280 --> 00:53:47.440 that service but a lot of them you know probably 00:53:47.440 --> 00:53:49.860 have a tiny window to see each veteran and so 00:53:49.860 --> 00:53:52.260 that tends to be the kind of knee -jerk reaction 00:53:52.260 --> 00:53:55.820 but then you actually learn about what's truly 00:53:55.820 --> 00:53:58.199 out there i mean yes you have all those and emdr 00:53:58.199 --> 00:54:00.260 and you know all these things that are very effective 00:54:00.260 --> 00:54:02.840 and then you have what we're talking about today 00:54:02.840 --> 00:54:05.119 and then you have equine and canine therapy and 00:54:05.119 --> 00:54:07.340 then you have psychedelics and ketamine and mdma 00:54:07.340 --> 00:54:10.059 and all of a sudden you realize how many tools 00:54:10.059 --> 00:54:13.119 there are and so i could see how for example 00:54:13.119 --> 00:54:17.079 using wave would then kind of bring that kind 00:54:17.079 --> 00:54:19.769 of temperature down out of the red zone And now 00:54:19.769 --> 00:54:21.809 maybe that person is able to open up more with 00:54:21.809 --> 00:54:24.429 their counselor or they are able to reflect on 00:54:24.429 --> 00:54:26.670 and even maybe which part of their body is actually 00:54:26.670 --> 00:54:29.869 giving them trouble. So, you know, taking it's 00:54:29.869 --> 00:54:31.849 not just, you know, the one one size fits all, 00:54:31.909 --> 00:54:34.110 but taking all of these little pieces and finding 00:54:34.110 --> 00:54:36.610 out what's best for you. And this seems like 00:54:36.610 --> 00:54:38.969 such a great, you know, first step is like, all 00:54:38.969 --> 00:54:41.949 right, well, let me get my brain to. kind of 00:54:41.949 --> 00:54:45.289 downregulate and balance. And then let me assess 00:54:45.289 --> 00:54:47.289 again and let me see, you know, what else would 00:54:47.289 --> 00:54:51.809 be a great complement to this treatment. Absolutely. 00:54:51.949 --> 00:54:55.969 That is something that we've seen encouragingly 00:54:55.969 --> 00:54:59.610 in the community is when people come in for the 00:54:59.610 --> 00:55:02.050 treatment, many times we'll get an unsolicited 00:55:02.050 --> 00:55:05.309 call from a cognitive behavioral therapist or 00:55:05.309 --> 00:55:07.750 a family member that, you know, whatever you're 00:55:07.750 --> 00:55:10.719 doing. They're able to listen better. They're 00:55:10.719 --> 00:55:12.559 able to talk better. What we're doing is more 00:55:12.559 --> 00:55:16.659 effective. And so I think that's a fundamental 00:55:16.659 --> 00:55:22.360 part of this is we're big believers in, you know, 00:55:22.360 --> 00:55:24.699 it takes a village. So if you're getting benefit 00:55:24.699 --> 00:55:29.699 from CBT or group therapy or art therapy, by 00:55:29.699 --> 00:55:32.099 all means, like, please continue those things. 00:55:32.280 --> 00:55:34.119 You know, it's all part of the healing journey. 00:55:34.719 --> 00:55:40.079 And everyone come from. a different part of you 00:55:40.079 --> 00:55:41.840 know they everyone has different risk tolerances 00:55:41.840 --> 00:55:44.980 and so we see people are very aggressive about 00:55:44.980 --> 00:55:46.659 how they want to treat themselves and we see 00:55:46.659 --> 00:55:49.719 people are very conservative about it and uh 00:55:49.719 --> 00:55:53.179 we're fortunate in that we can really take uh 00:55:53.179 --> 00:55:58.239 just about all comers um but there are so i should 00:55:58.239 --> 00:56:01.650 mention There are some preclusions to the treatment. 00:56:02.590 --> 00:56:07.269 If there's any ferromagnetic metallic shrapnel 00:56:07.269 --> 00:56:11.849 or other types of forms of metal inside the brain, 00:56:11.869 --> 00:56:16.329 intracranially, that would be an absolute contraindication 00:56:16.329 --> 00:56:20.369 to treatment. Some people, whether they have 00:56:20.369 --> 00:56:23.730 a shunt or a surgical clip in their brain, they 00:56:23.730 --> 00:56:27.880 wouldn't be candidates for treatment. A history 00:56:27.880 --> 00:56:30.139 of seizures can also be a preclusion. It's what 00:56:30.139 --> 00:56:33.699 they call a relative contraindication. The doctor 00:56:33.699 --> 00:56:37.139 can do an assessment and decide whether the patient 00:56:37.139 --> 00:56:40.440 is a candidate for treatment or not. The most 00:56:40.440 --> 00:56:45.300 common side effect is a transient headache, usually 00:56:45.300 --> 00:56:47.800 relatively mild, alleviated by over -the -counter 00:56:47.800 --> 00:56:53.639 ibuprofen or Tylenol. Roughly 15 % to 20 % of 00:56:53.639 --> 00:56:55.760 people may experience a headache in the first 00:56:55.760 --> 00:56:58.659 couple of treatments. Typically, then it goes 00:56:58.659 --> 00:57:01.380 away. But we always try to be very transparent 00:57:01.380 --> 00:57:05.320 about any of those risks. We do kind of a full 00:57:05.320 --> 00:57:08.880 informed consent where everyone who comes in 00:57:08.880 --> 00:57:11.519 knows what all the risks, side effects, and potential 00:57:11.519 --> 00:57:16.380 adverse events would be. But compared to many 00:57:16.380 --> 00:57:21.050 other modalities, such as psychopharma, This 00:57:21.050 --> 00:57:25.949 has a more desirable safety profile. Beautiful. 00:57:26.190 --> 00:57:29.989 Well, I want to circle back to med school because 00:57:29.989 --> 00:57:31.789 this has been always an interesting conversation 00:57:31.789 --> 00:57:35.889 with anyone who's gone through that system. As 00:57:35.889 --> 00:57:38.550 we are talking now, we're having this 2025 conversation. 00:57:38.949 --> 00:57:40.710 We're talking about sleep. We're talking about 00:57:40.710 --> 00:57:42.670 nutrition. We're talking about exercise, talking 00:57:42.670 --> 00:57:46.130 about TMS and all these other therapies. How 00:57:46.130 --> 00:57:49.780 much of that, obviously not the current. technology 00:57:49.780 --> 00:57:51.679 that you're working with. But when it comes to 00:57:51.679 --> 00:57:54.619 the holistic human, how much education did you 00:57:54.619 --> 00:57:57.219 get on that side as you progress through medical 00:57:57.219 --> 00:58:00.539 school? Oh, wow. That's a great question. Very 00:58:00.539 --> 00:58:04.719 little. Yeah. And, you know, I went to med school 00:58:04.719 --> 00:58:07.800 at a time where it was a bit more barbaric in 00:58:07.800 --> 00:58:13.960 terms of the type of hours that you worked. So 00:58:13.960 --> 00:58:18.500 I remember our trauma surgery rotation. And I 00:58:18.500 --> 00:58:22.840 had to do trauma again before I deployed. The 00:58:22.840 --> 00:58:25.000 typical schedule, it's not supposed to be this 00:58:25.000 --> 00:58:27.719 way, but the typical schedule was 36 on, 12 off, 00:58:27.820 --> 00:58:31.039 36 on, 12 off. And we would do that for two months. 00:58:31.599 --> 00:58:36.320 And it's a bit of a crucible in terms of the 00:58:36.320 --> 00:58:40.800 pressure because you're literally many times 00:58:40.800 --> 00:58:42.659 on the cutting edge between life and death for 00:58:42.659 --> 00:58:49.320 a patient. And you're so sleep deprived. you're 00:58:49.320 --> 00:58:51.079 really worried about making a mistake. And there's 00:58:51.079 --> 00:58:53.300 always these stories about the resident who fell 00:58:53.300 --> 00:58:55.239 asleep driving home and got into an accident. 00:58:55.780 --> 00:58:58.780 So it is something we should have better understood. 00:58:59.360 --> 00:59:01.699 I would say sleep science has come such a long 00:59:01.699 --> 00:59:05.539 way over the last 30 years. It's been interesting 00:59:05.539 --> 00:59:10.460 to see how it evolves. And, you know, early in 00:59:10.460 --> 00:59:13.780 my career, I got to meet two of the legendary 00:59:13.780 --> 00:59:17.019 sleep scientists, William Dement. and Christian 00:59:17.019 --> 00:59:19.000 Gelmanow. They started one of the first sleep 00:59:19.000 --> 00:59:23.159 labs at Stanford. And then my mentor, Stephanos 00:59:23.159 --> 00:59:26.000 Kales, his dad's name is Anthony Kales, was a 00:59:26.000 --> 00:59:28.079 preeminent sleep researcher at Penn State University. 00:59:28.920 --> 00:59:31.780 And I just think about how exciting it must have 00:59:31.780 --> 00:59:34.559 been to have discovered these sleep stages, how 00:59:34.559 --> 00:59:39.780 humans as a species needed to sleep. But yeah, 00:59:40.039 --> 00:59:42.719 when I was going through, I don't think we really 00:59:42.719 --> 00:59:46.679 knew. too much about sleep and sleep architecture 00:59:46.679 --> 00:59:52.300 and how important it was uh to us and we're right 00:59:52.300 --> 00:59:54.619 around the same age but you know our generation 00:59:54.619 --> 00:59:59.320 was when uh kind of bravado when it came to you 00:59:59.320 --> 01:00:02.019 know i'll sleep when i'm dead uh was very much 01:00:02.019 --> 01:00:05.500 uh the call you know ronald reagan and margaret 01:00:05.500 --> 01:00:09.340 thatcher sadly they talked about how well they 01:00:09.340 --> 01:00:11.900 could function without sleep, and both of them 01:00:11.900 --> 01:00:15.559 passed away of Alzheimer's disease. So yeah, 01:00:16.219 --> 01:00:20.320 to answer your question, we had almost no coursework 01:00:20.320 --> 01:00:25.260 on sleep or sleep architecture. There's a slide 01:00:25.260 --> 01:00:28.039 that I have on this presentation I do on the 01:00:28.039 --> 01:00:30.079 2472, and it's not something I normally talk 01:00:30.079 --> 01:00:32.059 about. I don't normally present, but I've helped 01:00:32.059 --> 01:00:35.239 a couple of departments recently, you know, kind 01:00:35.239 --> 01:00:37.960 of... help make the move in their area, hopefully 01:00:37.960 --> 01:00:41.199 make the move. And there's this one photo, and 01:00:41.199 --> 01:00:42.659 I said, does anyone know who it is? And I can't 01:00:42.659 --> 01:00:46.960 remember his name now, but it is that the surgeon 01:00:46.960 --> 01:00:51.480 from about, I think he was like early 1900s or 01:00:51.480 --> 01:00:55.099 late 1800s, but he was the one that really created 01:00:55.099 --> 01:00:58.699 up this insane residency week that you were just 01:00:58.699 --> 01:01:01.780 talking about. And when they dove deeper into 01:01:01.780 --> 01:01:04.380 who he was, he was a cocaine and heroin addict. 01:01:04.889 --> 01:01:07.269 So, of course, he was able to stay up for days 01:01:07.269 --> 01:01:09.710 on end. But that's really the origin story on 01:01:09.710 --> 01:01:13.010 the medical side of why these residency weeks 01:01:13.010 --> 01:01:15.969 were so long. And just like you said, how dangerous 01:01:15.969 --> 01:01:20.449 in neurosurgery, surgery and ER to have a, you 01:01:20.449 --> 01:01:23.909 know, a woefully sleep deprived physician working 01:01:23.909 --> 01:01:29.719 under those conditions. Yeah, yeah, it's. And 01:01:29.719 --> 01:01:31.820 they've actually instituted some regulations 01:01:31.820 --> 01:01:34.500 where that kind of schedule is no longer permitted. 01:01:34.840 --> 01:01:37.519 And so it's interesting to see the old school, 01:01:37.639 --> 01:01:40.159 new school type approach where a lot of the doctors 01:01:40.159 --> 01:01:43.340 who went through that pressure cooker feel like, 01:01:43.360 --> 01:01:45.159 oh, you know, it's a rite of passage. They should 01:01:45.159 --> 01:01:49.039 be required to go through that to prove themselves. 01:01:49.179 --> 01:01:53.440 And I think other more common sense folks realize 01:01:53.440 --> 01:01:56.000 that that's a very positive thing, that not only 01:01:56.000 --> 01:02:00.130 are we jeopardizing. the young resident, but 01:02:00.130 --> 01:02:02.250 patient care can be compromised as well. So I 01:02:02.250 --> 01:02:04.510 think overall, those changes are real positive. 01:02:05.010 --> 01:02:08.010 And to your point about trying to see this change 01:02:08.010 --> 01:02:11.190 in the firefighter community, it always feels 01:02:11.190 --> 01:02:14.710 impossible until it's not. And so sometimes it 01:02:14.710 --> 01:02:16.510 feels like, are they going to adopt this? Are 01:02:16.510 --> 01:02:19.670 we going to do the right thing? And I just encourage 01:02:19.670 --> 01:02:23.730 you and others, because you clearly have the 01:02:23.730 --> 01:02:29.099 conviction, these things are possible. If it's 01:02:29.099 --> 01:02:35.099 serving the community in that way, eventually, 01:02:35.260 --> 01:02:38.159 I think the right thing usually happens, not 01:02:38.159 --> 01:02:42.559 always. But science converges on the truth. And 01:02:42.559 --> 01:02:47.360 this is one where I think a pretty simple study 01:02:47.360 --> 01:02:50.639 could illustrate that quite simply. But it's 01:02:50.639 --> 01:02:52.199 common sense enough where maybe you don't even 01:02:52.199 --> 01:02:56.000 need that. And I do hope that change comes about 01:02:56.000 --> 01:02:58.780 sooner rather than later. Yeah, I've made that 01:02:58.780 --> 01:03:01.199 very point. If we need to study to show that 01:03:01.199 --> 01:03:05.000 56 hours a week is worse than 42, then do we 01:03:05.000 --> 01:03:07.039 need to study for getting hit by a bus is going 01:03:07.039 --> 01:03:08.840 to hurt? There's certain things that you know 01:03:08.840 --> 01:03:12.260 you just don't need to study for. Well, as you 01:03:12.260 --> 01:03:14.699 touched on, the holistic education, and I've 01:03:14.699 --> 01:03:17.260 heard this so often from physicians either side 01:03:17.260 --> 01:03:22.000 of your generation, being such a tiny, tiny part 01:03:22.000 --> 01:03:25.710 of medical school education. If you were king 01:03:25.710 --> 01:03:28.869 for a day and you could kind of rewrite the syllabus 01:03:28.869 --> 01:03:32.269 for our young physicians that are entering schools 01:03:32.269 --> 01:03:35.869 now, what would you change as far as the kind 01:03:35.869 --> 01:03:39.429 of proactive, holistic health element of a physician 01:03:39.429 --> 01:03:44.130 skill set? That's a brilliant question. You know, 01:03:44.150 --> 01:03:46.110 I would require there to be some instruction 01:03:46.110 --> 01:03:50.650 and study on circadian rhythm and just kind of 01:03:50.650 --> 01:03:53.389 our natural biology that may be already incorporated. 01:03:54.190 --> 01:03:56.849 There are two Nobel Prizes awarded for the discovery 01:03:56.849 --> 01:04:00.110 of blue light. And so your audience may already 01:04:00.110 --> 01:04:03.710 know, but just to walk through it, blue light 01:04:03.710 --> 01:04:06.550 is 450 to 500 nanometer light. That's richest 01:04:06.550 --> 01:04:10.449 in natural sunlight in the early morning. The 01:04:10.449 --> 01:04:13.289 reason it's important is when blue light hits 01:04:13.289 --> 01:04:15.190 your retina, there are specific receptors called 01:04:15.190 --> 01:04:18.010 melanopsins that activate. And that is your first 01:04:18.010 --> 01:04:20.849 biological cue to wake up. And so you think about 01:04:20.849 --> 01:04:24.320 our ancestors thousands of years ago. They didn't 01:04:24.320 --> 01:04:27.219 have smartphones or tablets or artificial light. 01:04:27.420 --> 01:04:30.920 Their first biological cue to wake up was natural 01:04:30.920 --> 01:04:34.860 sunlight. So what they call low -angle solar 01:04:34.860 --> 01:04:39.519 light will activate this biological cascade, 01:04:39.780 --> 01:04:42.539 where when the melanopsins are activated, it 01:04:42.539 --> 01:04:44.679 sends a message to the suprachiasmatic nucleus 01:04:44.679 --> 01:04:48.860 and ultimately the pineal gland to release melatonin 01:04:48.860 --> 01:04:53.159 roughly 14 to 16 hours later. So the first bit 01:04:53.159 --> 01:04:56.579 of advice would be get blue light in the morning, 01:04:56.639 --> 01:04:59.280 at least 30 minutes. You can have a bowl of cereal 01:04:59.280 --> 01:05:01.199 outside. You can walk the dog outside. Whatever 01:05:01.199 --> 01:05:04.179 you need to do, just be outside without sunglasses. 01:05:06.539 --> 01:05:10.719 Throughout the day, just common sense. Limit 01:05:10.719 --> 01:05:16.469 your caffeine until maybe lunchtime. bit of data 01:05:16.469 --> 01:05:19.690 that i found interesting is there's some research 01:05:19.690 --> 01:05:21.570 that's suggesting there's a ceiling effect to 01:05:21.570 --> 01:05:25.550 caffeine at right around 200 milligrams and you 01:05:25.550 --> 01:05:27.349 can titrate that throughout the day but i see 01:05:27.349 --> 01:05:29.610 some of these energy during swiss like 300 milligrams 01:05:29.610 --> 01:05:31.849 of caffeine it's just overkill you really don't 01:05:31.849 --> 01:05:35.510 need that amount um and there's some variants 01:05:35.510 --> 01:05:37.610 like if you're a larger person you may need a 01:05:37.610 --> 01:05:40.070 little bit more but just to be sensible about 01:05:40.070 --> 01:05:44.929 stimulant and caffeine intake Last meal should 01:05:44.929 --> 01:05:48.530 be around 6 or 7 p .m., ideally without too much 01:05:48.530 --> 01:05:51.969 sugar. And then you begin the wind -down process. 01:05:52.590 --> 01:05:55.170 This is the part that's tricky for people. I'm 01:05:55.170 --> 01:05:57.449 guilty of it. It's very hard to put away your 01:05:57.449 --> 01:06:00.690 phone and to put away your work. But your body 01:06:00.690 --> 01:06:05.409 needs a ramp -down period, cool, dark environment 01:06:05.409 --> 01:06:12.320 for sleep. The ideal time to sleep for most people 01:06:12.320 --> 01:06:15.019 is between 9 and 10 p .m. And there's some people 01:06:15.019 --> 01:06:17.239 who will say I'm a night owl. And there are some 01:06:17.239 --> 01:06:19.139 people, there's different chronotypes, there's 01:06:19.139 --> 01:06:22.559 no doubt. But for the vast majority of people, 01:06:22.739 --> 01:06:24.820 they will get the deepest, most restorative sleep 01:06:24.820 --> 01:06:28.219 between 9 and 10 p .m. And that is the closed 01:06:28.219 --> 01:06:30.079 loop that starts in the morning with a blue light 01:06:30.079 --> 01:06:32.960 exposure. There will be about a 30 to 40 minute 01:06:32.960 --> 01:06:35.800 window of evening somnolence where you start 01:06:35.800 --> 01:06:38.239 to feel very tired, usually signaled by a deep 01:06:38.239 --> 01:06:41.300 yawn. that should be your biological cue that 01:06:41.300 --> 01:06:44.199 I need to go to bed. And if you go to bed within 01:06:44.199 --> 01:06:46.599 that window where your melatonin is spiking based 01:06:46.599 --> 01:06:49.400 on the biological cue of having blue light exposure 01:06:49.400 --> 01:06:51.980 in the morning, you should get deep restorative 01:06:51.980 --> 01:06:55.380 sleep. Hopefully your cortisol levels will remain 01:06:55.380 --> 01:06:58.280 low and you'll be able to sleep through the night. 01:06:58.940 --> 01:07:01.500 And it doesn't always happen, you know, in the 01:07:01.500 --> 01:07:05.469 fifth and sixth decade. the prostate starts to 01:07:05.469 --> 01:07:07.550 enlarge, something we call benign prostatic hypertrophy 01:07:07.550 --> 01:07:09.369 for men. Many times people have to get up at 01:07:09.369 --> 01:07:13.750 night to use the bathroom. So we recommend don't 01:07:13.750 --> 01:07:17.710 overhydrate right before sleep. There are some 01:07:17.710 --> 01:07:21.650 good interventions for that. But fundamentally, 01:07:22.050 --> 01:07:26.929 if I could construct the curriculum for medical 01:07:26.929 --> 01:07:29.610 school, I would say that's a critical piece everyone 01:07:29.610 --> 01:07:33.670 should know. And just one more anecdote I would 01:07:33.670 --> 01:07:38.250 share. There was a subway stop in Tokyo that 01:07:38.250 --> 01:07:42.130 sadly many people were committing suicide on. 01:07:42.510 --> 01:07:45.869 And they actually installed blue lights in that 01:07:45.869 --> 01:07:49.670 particular subway station. And almost miraculously, 01:07:49.769 --> 01:07:52.409 they saw those suicide rates go down within the 01:07:52.409 --> 01:07:55.829 first month. There's a publication on this. And 01:07:55.829 --> 01:07:58.789 we don't always get that blue light exposure 01:07:58.789 --> 01:08:03.099 as we should. And I'll admit for myself, I was 01:08:03.099 --> 01:08:05.420 going from, because windows actually filter out 01:08:05.420 --> 01:08:09.179 blue light. And for myself, I'd go from my bedroom 01:08:09.179 --> 01:08:12.400 in an enclosed space into my garage, into a car 01:08:12.400 --> 01:08:14.920 where I'm getting closed in glass. And I walk 01:08:14.920 --> 01:08:17.159 about 10 feet into my office and I was getting 01:08:17.159 --> 01:08:19.260 no blue light exposure. And it wasn't a surprise 01:08:19.260 --> 01:08:21.779 that my sleep was terrible. And once I learned 01:08:21.779 --> 01:08:24.039 these simple things, like these are simple, free, 01:08:24.220 --> 01:08:27.640 available to everyone types of techniques that 01:08:27.640 --> 01:08:31.300 can really encourage better sleep quality. And 01:08:31.300 --> 01:08:33.260 that's the type of thing I think everyone should 01:08:33.260 --> 01:08:38.260 know. Absolutely. I actually had Professor Russell 01:08:38.260 --> 01:08:40.979 Foster on the show. He ironically had worked 01:08:40.979 --> 01:08:42.859 with my dad. My dad's a veterinary surgeon, retired, 01:08:43.140 --> 01:08:45.420 but they had crossed paths in, I think it was 01:08:45.420 --> 01:08:48.579 King's College, one of those colleges in London. 01:08:50.380 --> 01:08:53.359 he was actually the one who found the chronoreceptors 01:08:53.359 --> 01:08:55.359 in the first place. And it's so interesting because 01:08:55.359 --> 01:08:58.079 again, as I sit here getting a lot of resistance 01:08:58.079 --> 01:09:00.300 from my profession and trying to make proactive 01:09:00.300 --> 01:09:03.760 changes, he was laughed at by the ophthalmology 01:09:03.760 --> 01:09:08.319 careers for suggesting there was another receptor. 01:09:08.340 --> 01:09:10.840 They had rods, they had cones, that was it. But 01:09:10.840 --> 01:09:14.060 it's a real kind of, you know, disruptor story 01:09:14.060 --> 01:09:16.500 because he ended up proving it on rats. And now 01:09:16.500 --> 01:09:18.500 it's all we hear about is, you know, when you 01:09:18.500 --> 01:09:20.739 wake up and I get daylight on your eyes, reset 01:09:20.739 --> 01:09:25.880 your chrono in a rhythm. And, you know, so still 01:09:25.880 --> 01:09:28.640 relying on the way we did it, as you touched 01:09:28.640 --> 01:09:31.779 on, you know, 30, 40, 50 years ago. is insanity 01:09:31.779 --> 01:09:34.500 when you see technology and you watch science 01:09:34.500 --> 01:09:36.939 constantly evolving we can't stay stuck back 01:09:36.939 --> 01:09:39.020 then because we understand things completely 01:09:39.020 --> 01:09:42.840 differently now so you know a 2025 medical school 01:09:42.840 --> 01:09:45.659 i would hope would be talking about sleep and 01:09:45.659 --> 01:09:48.579 nutrition and exercise and the importance of 01:09:48.579 --> 01:09:51.859 community and some of these you know things outside 01:09:51.859 --> 01:09:54.359 of pharmacology that i think would would forge 01:09:54.359 --> 01:09:56.800 a lot more physical mental health in this country 01:09:56.800 --> 01:10:03.069 absolutely One other similar discovery to that, 01:10:03.289 --> 01:10:06.930 we used to believe the deeper stages of sleep 01:10:06.930 --> 01:10:09.890 when brainwaves slowed down was just a time for 01:10:09.890 --> 01:10:15.569 these neurons to restore their energy. Adenosine, 01:10:15.609 --> 01:10:18.630 diphosphate, and monophosphate would rephosphorylate 01:10:18.630 --> 01:10:22.350 and you'd get ATP again. But it turns out there's 01:10:22.350 --> 01:10:24.090 a much more important activity that's happening 01:10:24.090 --> 01:10:26.029 that we didn't even know about until probably 01:10:26.029 --> 01:10:29.199 about a decade ago. And there was a researcher 01:10:29.199 --> 01:10:32.479 named Megan Nettergaard who used a technique 01:10:32.479 --> 01:10:34.479 called two -photon microscopy where they could 01:10:34.479 --> 01:10:38.000 look at neurons in real time. And there's structural 01:10:38.000 --> 01:10:40.180 scaffolding in the brain that was thought to 01:10:40.180 --> 01:10:44.300 be just a support structure and not really have 01:10:44.300 --> 01:10:47.100 any type of activity. They're called glial cells. 01:10:47.380 --> 01:10:51.060 And what she discovered was that during the deep 01:10:51.060 --> 01:10:54.260 stages of sleep the structural scaffolding would 01:10:54.260 --> 01:10:57.100 change and it would contract and open up wide 01:10:57.100 --> 01:10:59.500 channels in the brain that would allow cerebral 01:10:59.500 --> 01:11:02.300 spinal fluid to rush through and wash away the 01:11:02.300 --> 01:11:04.779 metabolic oxidative stress that accumulates throughout 01:11:04.779 --> 01:11:08.079 the day so it's functionally many people call 01:11:08.079 --> 01:11:11.960 this the sanitation system it's called the glymphatic 01:11:11.960 --> 01:11:16.029 system And there was a separate study that was 01:11:16.029 --> 01:11:18.329 done where, and we probably would not be able 01:11:18.329 --> 01:11:21.810 to do these studies anymore because they actually 01:11:21.810 --> 01:11:24.390 sleep deprived patients for a night or two and 01:11:24.390 --> 01:11:26.729 they would lumbar puncture them and they'd measure 01:11:26.729 --> 01:11:31.789 the amount of kind of metabolites in the cerebral 01:11:31.789 --> 01:11:34.550 spinal fluid. And what they found was even after 01:11:34.550 --> 01:11:37.029 just one night of sleep deprivation, they find 01:11:37.029 --> 01:11:40.890 increased concentrations of tau proteins and 01:11:40.890 --> 01:11:44.420 beta amyloid. And if those sound familiar, those 01:11:44.420 --> 01:11:46.460 are the proteins that phosphorylate in your brain 01:11:46.460 --> 01:11:48.779 and can lead to cognitive decline and Alzheimer's 01:11:48.779 --> 01:11:52.159 disease called neurofibrillatory tangles. And 01:11:52.159 --> 01:11:57.720 there is now emerging evidence that sleep may 01:11:57.720 --> 01:12:00.020 be one of the causal agents, specifically sleep 01:12:00.020 --> 01:12:02.119 deprivation, that may lead to cognitive decline. 01:12:02.800 --> 01:12:05.140 And so if the audience didn't have enough of 01:12:05.140 --> 01:12:07.359 a reason to want to protect their sleep from 01:12:07.359 --> 01:12:13.289 a performance and. you know, kind of health and 01:12:13.289 --> 01:12:17.109 energy and longevity perspective, cognitive decline 01:12:17.109 --> 01:12:19.109 and Alzheimer's really strikes fear into a lot 01:12:19.109 --> 01:12:23.510 of people. And if this is a simple step that 01:12:23.510 --> 01:12:26.590 can be taken to ward off those effects and the 01:12:26.590 --> 01:12:30.689 accumulation of these proteins, that should provide 01:12:30.689 --> 01:12:35.010 some extra incentive and motivation. On the other 01:12:35.010 --> 01:12:36.810 side of that, I don't want the audience to walk 01:12:36.810 --> 01:12:39.130 away in fear that one night sleep deprivation 01:12:39.130 --> 01:12:41.149 is going to cause them to get very sick. It's 01:12:41.149 --> 01:12:43.829 not like that. But chronically over years, this 01:12:43.829 --> 01:12:48.250 can be a concern. It's interesting because one 01:12:48.250 --> 01:12:51.350 of my guests pointed out a while ago, he was 01:12:51.350 --> 01:12:54.550 like, if you truly wanted to do a study that 01:12:54.550 --> 01:12:58.329 actually replicates a firefighter shift in 2025, 01:12:58.710 --> 01:13:01.909 which would be again, 24 hours with no sleep 01:13:01.909 --> 01:13:05.340 or disruptive sleep. a 48 hour period, but every 01:13:05.340 --> 01:13:07.939 week or two would be a forced overtime. So that 01:13:07.939 --> 01:13:11.439 would be a 48 hour period with no sleep. He said, 01:13:11.479 --> 01:13:14.619 ethically, no college would allow that. No research 01:13:14.619 --> 01:13:18.239 facility would allow you to provide sleep deprivation 01:13:18.239 --> 01:13:21.699 to the subjects for that amount of time. So when 01:13:21.699 --> 01:13:23.260 people say, well, where's the data? It's like, 01:13:23.319 --> 01:13:26.159 well, if you actually look at it, I don't think 01:13:26.159 --> 01:13:28.399 any ethics committee would allow you to even 01:13:28.399 --> 01:13:30.579 do that study in the first place, just like you 01:13:30.579 --> 01:13:35.109 pointed out. Yeah, absolutely. And that's where 01:13:35.109 --> 01:13:38.130 I think, as you mentioned earlier, you know, 01:13:38.130 --> 01:13:40.729 science is not sort of a static process. It's 01:13:40.729 --> 01:13:43.069 always evolving. We're always learning more, 01:13:43.189 --> 01:13:48.369 some old paradigms end up being incorrect. And 01:13:48.369 --> 01:13:51.270 we have to move in the direction of, you know, 01:13:51.270 --> 01:13:54.329 what is arc of truth and where is it leading 01:13:54.329 --> 01:13:57.130 us? And so that's where, you know, some of these 01:13:57.130 --> 01:14:02.260 discoveries of brain function and neuroscience 01:14:02.260 --> 01:14:06.260 should alter the way in real time of how we conduct 01:14:06.260 --> 01:14:09.380 our daily lives. And part of that is information 01:14:09.380 --> 01:14:13.180 transfer from the lab and from research into 01:14:13.180 --> 01:14:18.159 kind of wider audiences like this. And so I think 01:14:18.159 --> 01:14:21.409 it's important. to both understand that and to 01:14:21.409 --> 01:14:24.350 track it and follow it because things we held 01:14:24.350 --> 01:14:27.689 on to as truth 10, 20 years ago are no longer 01:14:27.689 --> 01:14:31.109 valid. It's been a fascinating process to watch 01:14:31.109 --> 01:14:35.090 and observe. When you talk about, for example, 01:14:35.510 --> 01:14:38.810 cardiovascular disease and inflammation, if you 01:14:38.810 --> 01:14:42.060 talk about diabetes, Again, old school was it 01:14:42.060 --> 01:14:44.539 was irreversible. Now we know that many, many 01:14:44.539 --> 01:14:47.520 cases, if you change your diet, if you change 01:14:47.520 --> 01:14:49.779 your exercise level, your stress levels, that 01:14:49.779 --> 01:14:52.739 we can reverse a lot of these. What about the 01:14:52.739 --> 01:14:56.800 neurodegeneration side? Is the brain given a 01:14:56.800 --> 01:14:59.699 good environment now, good hydration, good exercise, 01:14:59.819 --> 01:15:02.939 good nutrition and solid sleep? Are you seeing 01:15:02.939 --> 01:15:05.880 reverse of damage in some of these neurodegenerative 01:15:05.880 --> 01:15:10.289 diseases? That's a great question. I don't think 01:15:10.289 --> 01:15:12.949 we know the answer to that yet. I think there's 01:15:12.949 --> 01:15:17.729 some studies that are being either planned or 01:15:17.729 --> 01:15:20.630 launched that will give us some answers, but 01:15:20.630 --> 01:15:24.890 that's going to be a bit down the road. In particular, 01:15:25.210 --> 01:15:28.350 I'm aware of there being some initiatives in 01:15:28.350 --> 01:15:29.930 the Department of Defense where they're looking 01:15:29.930 --> 01:15:33.510 at... medical devices that may encourage activity 01:15:33.510 --> 01:15:35.689 of the glymphatic system that we're talking about 01:15:35.689 --> 01:15:39.710 to encourage clearance of some of the metabolic 01:15:39.710 --> 01:15:41.710 debris that's accumulated throughout the day. 01:15:42.930 --> 01:15:45.829 So I think this knowledge base, as we learn new 01:15:45.829 --> 01:15:49.630 things, interventions can be innovated to try 01:15:49.630 --> 01:15:53.130 to help the long -term health of all these different 01:15:53.130 --> 01:15:58.850 communities. The goal, of course, would be to 01:15:58.850 --> 01:16:04.710 be able to either arrest or reverse neurodegenerative 01:16:04.710 --> 01:16:07.489 disease. I'm not aware of there being that intervention 01:16:07.489 --> 01:16:12.130 at the moment. But given the option, of course, 01:16:12.149 --> 01:16:15.710 we would encourage people, you know, if we believe 01:16:15.710 --> 01:16:18.710 sleep may be one of the causal agents of cognitive 01:16:18.710 --> 01:16:21.649 decline, it then follows that protecting your 01:16:21.649 --> 01:16:23.729 sleep and making sure you're getting good restorative 01:16:23.729 --> 01:16:26.680 sleep. may have some preventative capabilities. 01:16:28.100 --> 01:16:31.060 Absolutely. I mean, one would think that if you 01:16:31.060 --> 01:16:34.239 were able to get that glial activity during a 01:16:34.239 --> 01:16:36.600 deep sleep and you haven't got that deep sleep, 01:16:36.659 --> 01:16:39.060 so for example, you take fire service right now 01:16:39.060 --> 01:16:43.260 and they're working these shorter rest periods, 01:16:43.380 --> 01:16:45.640 the 48 hours, and they're getting forced to work 01:16:45.640 --> 01:16:49.920 more. Now we progress to a 72 -hour period and 01:16:49.920 --> 01:16:52.880 a fully staffed fire service because now people 01:16:52.880 --> 01:16:55.800 are coming back. I would assume that that's more 01:16:55.800 --> 01:16:58.520 baths for their brain. And so maybe every good 01:16:58.520 --> 01:17:00.960 solid night's sleep using Wave and all these 01:17:00.960 --> 01:17:03.020 other tools that we've talked about, there's 01:17:03.020 --> 01:17:05.140 an opportunity for that brain to slowly start 01:17:05.140 --> 01:17:07.300 taking out some of that trash that's been left 01:17:07.300 --> 01:17:11.020 there from our career before. Yeah, absolutely. 01:17:11.560 --> 01:17:15.119 I mean, really, you're talking about a 33 % improvement 01:17:15.119 --> 01:17:19.340 in sleep quantity. What's harder to measure that 01:17:19.340 --> 01:17:22.420 third day, I'd be willing to bet the sleep quality 01:17:22.420 --> 01:17:25.310 will also be significantly better. Um, it takes 01:17:25.310 --> 01:17:28.289 some time to sort of, uh, uh, restore function 01:17:28.289 --> 01:17:31.609 after you've had, um, you know, pull an all nighter 01:17:31.609 --> 01:17:35.029 or are significantly sleep deprived. So, um, 01:17:35.149 --> 01:17:38.010 so yeah, I think there'd be multiple levels of 01:17:38.010 --> 01:17:41.810 benefit there. One more area that I want to revisit 01:17:41.810 --> 01:17:44.409 wave before we kind of go some closing questions. 01:17:45.430 --> 01:17:48.529 I've heard Alzheimer's referred to type 3 diabetes 01:17:48.529 --> 01:17:51.130 many, many times now. And so if we're talking 01:17:51.130 --> 01:17:53.869 about an opportunity to hopefully either minimize 01:17:53.869 --> 01:17:56.229 further damage or even reverse disease, that 01:17:56.229 --> 01:17:58.750 seems to be another one that we can get to. The 01:17:58.750 --> 01:18:00.869 Parkinson's side sounds like it's more trauma 01:18:00.869 --> 01:18:04.109 and chemical insults. But what have you learned 01:18:04.109 --> 01:18:06.649 as far as diet and Alzheimer's specifically? 01:18:08.149 --> 01:18:10.890 Yeah. And this is another area of the science 01:18:10.890 --> 01:18:13.430 that's rapidly emerging. Insulin sensitivity 01:18:13.430 --> 01:18:16.829 clearly has a role to play in global health, 01:18:16.890 --> 01:18:20.449 overall health. It can be a profoundly inflammatory 01:18:20.449 --> 01:18:26.270 issue. And it sort of compounds upon itself where 01:18:26.270 --> 01:18:31.270 you can have more adiposity, like increased belly 01:18:31.270 --> 01:18:34.569 fat, which is itself inflammatory and cortisol 01:18:34.569 --> 01:18:40.279 inducing. Part of, I think, the strategies that 01:18:40.279 --> 01:18:42.720 are going to be interesting, especially when 01:18:42.720 --> 01:18:46.640 it comes to diabetes and even this area, it's 01:18:46.640 --> 01:18:49.800 emerging as a controversial area, but these GLP 01:18:49.800 --> 01:18:55.840 -1s, Ozempic, Zetban, Manjaro, some of Glutide, 01:18:56.000 --> 01:19:02.619 they're very good at improving weight loss. The 01:19:02.619 --> 01:19:05.159 controversial area was, it seemed that it was 01:19:05.159 --> 01:19:08.890 not. predominantly fat loss, we also saw some 01:19:08.890 --> 01:19:11.750 lean muscle mass diminishing as weight was going 01:19:11.750 --> 01:19:16.010 down. And the current advice is to, number one, 01:19:16.050 --> 01:19:18.329 increase your protein intake on these GLP -1s, 01:19:18.350 --> 01:19:21.369 but also to increase resistance training and 01:19:21.369 --> 01:19:23.590 weightlifting. For your audience, that's probably 01:19:23.590 --> 01:19:26.329 built in into their DNA. There's probably a fair 01:19:26.329 --> 01:19:28.130 amount of resistance training. I know you're 01:19:28.130 --> 01:19:32.590 carrying these heavy dummies and doing very physical 01:19:32.590 --> 01:19:37.699 activity. But there's a next generation GLP coming 01:19:37.699 --> 01:19:40.479 out that looks really interesting called retatrutide 01:19:40.479 --> 01:19:44.939 that appears to preserve lean muscle mass in 01:19:44.939 --> 01:19:47.279 a different way than the two earlier generations 01:19:47.279 --> 01:19:52.140 of the medication. So I'm not a GLP -1 evangelist. 01:19:52.239 --> 01:19:55.579 I think it definitely has a place, particularly 01:19:55.579 --> 01:19:57.880 for type 2 diabetes. A lot of the studies are 01:19:57.880 --> 01:20:00.300 very encouraging in terms of being able to reverse 01:20:00.300 --> 01:20:07.560 type 2 diabetes. A few cases, people that I know 01:20:07.560 --> 01:20:10.319 well, one in particular I'm thinking lost 100 01:20:10.319 --> 01:20:14.979 pounds. And completely dramatic shift for this 01:20:14.979 --> 01:20:18.039 individual where he's able to enjoy life in a 01:20:18.039 --> 01:20:19.840 different way than he could have just a year 01:20:19.840 --> 01:20:26.899 and a half ago. And so I'm neither a proponent 01:20:26.899 --> 01:20:30.560 or enemy of GLPs. I think they just need to be 01:20:30.560 --> 01:20:34.090 used responsibly. And I think that with proper 01:20:34.090 --> 01:20:37.890 supervision and coaching, they can be very powerful 01:20:37.890 --> 01:20:41.770 adjuncts to other more holistic methods. I will 01:20:41.770 --> 01:20:43.649 say one thing that's interesting is listening 01:20:43.649 --> 01:20:49.930 to some of these exercise athletic fitness podcasts. 01:20:50.270 --> 01:20:52.890 It seems to really be proliferating the bodybuilding 01:20:52.890 --> 01:20:55.069 world, which was not something I'd anticipate. 01:20:55.350 --> 01:20:58.630 But it does make sense if somebody is entering 01:20:58.630 --> 01:21:02.369 a cut. cutting phase to be able to reduce their 01:21:02.369 --> 01:21:08.090 appetite would make sense. But again, to our 01:21:08.090 --> 01:21:11.729 earlier discussion, it's a rapidly evolving area 01:21:11.729 --> 01:21:15.529 of science. And I think how that plays out is 01:21:15.529 --> 01:21:19.909 still to be seen. I had Johan Hari on the show. 01:21:19.949 --> 01:21:23.829 He wrote a book about that. And to me, one of 01:21:23.829 --> 01:21:28.850 the most exciting applications is obesity like 01:21:28.850 --> 01:21:31.529 true obesity because i've lost two friends to 01:21:31.529 --> 01:21:34.810 gastric bypass and you know again but the answer 01:21:34.810 --> 01:21:38.670 obviously ideally is diet and exercise and clearly 01:21:38.670 --> 01:21:41.130 some you know some mental health work too because 01:21:41.130 --> 01:21:43.930 i think behind every you know any person who's 01:21:43.930 --> 01:21:45.670 truly struggling physically there's going to 01:21:45.670 --> 01:21:48.409 be a kind of origin story in in their their timeline 01:21:48.409 --> 01:21:50.529 as well so we miss that piece a lot of times 01:21:50.529 --> 01:21:53.529 the psychological piece but if you are already 01:21:53.529 --> 01:21:56.060 at that point And you, the A, are going to have, 01:21:56.060 --> 01:21:58.319 you know, parts of your digestive system clamped 01:21:58.319 --> 01:22:01.640 and cut. Or you can take, you know, an azempic 01:22:01.640 --> 01:22:03.380 -like drug for a while. I think that's a much 01:22:03.380 --> 01:22:05.979 healthier alternative for that population. Do 01:22:05.979 --> 01:22:07.760 I think that bodybuilders should be using it? 01:22:07.840 --> 01:22:10.579 I mean, we keep losing influencers at the moment, 01:22:10.619 --> 01:22:13.159 fitness influencers. And I'm sure, you know, 01:22:13.159 --> 01:22:16.340 that's probably behind a lot of that too. Like 01:22:16.340 --> 01:22:18.460 every drug, it can be abused. But just to underline 01:22:18.460 --> 01:22:20.060 what you said, I think there is an application 01:22:20.060 --> 01:22:22.319 for certain populations that it can just get 01:22:22.319 --> 01:22:25.680 them back to a more healthy state. And then hopefully 01:22:25.680 --> 01:22:28.520 then that will allow them to actually take a 01:22:28.520 --> 01:22:30.840 deeper dive into their nutrition and their fitness. 01:22:31.020 --> 01:22:33.520 And that will then allow them to sustain and 01:22:33.520 --> 01:22:37.319 come off these drugs. Yeah. Yeah. It's interesting 01:22:37.319 --> 01:22:40.840 to see sort of these off -label uses of different 01:22:40.840 --> 01:22:44.289 compounds. We haven't even talked about peptides 01:22:44.289 --> 01:22:48.590 yet. And I know that's its own area of interest 01:22:48.590 --> 01:22:53.909 and controversy. But the GLP -1s, I think, to 01:22:53.909 --> 01:22:55.750 have something that's genuinely effective for 01:22:55.750 --> 01:22:57.869 obesity, I think, is really encouraging. And 01:22:57.869 --> 01:22:59.569 certainly compared to a surgical intervention 01:22:59.569 --> 01:23:04.810 like a gastric bypass, much safer. Any side effects, 01:23:05.050 --> 01:23:07.170 you know, there are, you know, nausea is pretty 01:23:07.170 --> 01:23:11.050 common. There is what's called gastric paresis 01:23:11.050 --> 01:23:15.949 where your stomach can stop moving the bowels. 01:23:15.949 --> 01:23:18.689 But my experience has been that's a relatively 01:23:18.689 --> 01:23:23.670 rare side effect. So, yeah, compared to, you 01:23:23.670 --> 01:23:26.310 know, an invasive surgical intervention, although 01:23:26.310 --> 01:23:28.310 these can be minimally invasive now, they can 01:23:28.310 --> 01:23:33.560 be done endoscopically. I think the GLP -1s are 01:23:33.560 --> 01:23:36.279 a great option to consider before moving into 01:23:36.279 --> 01:23:39.140 something more aggressive like that. What is 01:23:39.140 --> 01:23:42.699 your perspective of peptides? I'm still taking 01:23:42.699 --> 01:23:45.779 one at the moment, eclomiphene, which helps your 01:23:45.779 --> 01:23:48.199 body make a little bit more of its own testosterone. 01:23:48.579 --> 01:23:51.319 I think I've said this a lot on the show. The 01:23:51.319 --> 01:23:54.079 old school, again, mentality was if you were 01:23:54.079 --> 01:23:57.020 within that range. then you were fine. And you 01:23:57.020 --> 01:23:59.720 had 30 -year -old tactical athletes being told 01:23:59.720 --> 01:24:02.420 that their testosterone being at 251 was perfectly 01:24:02.420 --> 01:24:05.239 within normal limits. Now we know that's not 01:24:05.239 --> 01:24:07.779 the case. But then I think the pendulum swung 01:24:07.779 --> 01:24:09.819 the other way where all these men's clinics are 01:24:09.819 --> 01:24:12.079 opening up and they're giving young firefighters 01:24:12.079 --> 01:24:15.000 TRT, not educating them the fact that they're 01:24:15.000 --> 01:24:16.560 going to have all these side effects and they're 01:24:16.560 --> 01:24:18.579 going to be on it the rest of their life. So 01:24:18.579 --> 01:24:21.000 I think peptides are a good, happy medium for 01:24:21.000 --> 01:24:23.529 this population when it comes to that. I know 01:24:23.529 --> 01:24:25.350 you've got dihexa, which is supposed to be a 01:24:25.350 --> 01:24:28.850 good nootropic. What is your perception, without 01:24:28.850 --> 01:24:30.510 loading the question, what is your perception 01:24:30.510 --> 01:24:32.590 of the world of peptides that we're seeing now? 01:24:33.689 --> 01:24:36.569 It's a great question. So I should preface this 01:24:36.569 --> 01:24:39.109 by saying I don't know a lot about peptides. 01:24:39.109 --> 01:24:43.489 I haven't prescribed them or used them. But I 01:24:43.489 --> 01:24:46.649 find myself having to be somewhat knowledgeable 01:24:46.649 --> 01:24:49.069 because so many of my patients come into the 01:24:49.069 --> 01:24:52.810 discussion using these, and they'll ask me, is 01:24:52.810 --> 01:24:56.550 it safe to proceed, whether it's in clomiphene 01:24:56.550 --> 01:25:01.289 or PPC -157, or I'm having to learn these acronyms. 01:25:02.449 --> 01:25:04.210 SLUPP332, I think, is a new one. It's supposed 01:25:04.210 --> 01:25:09.229 to be a good anti -inflammatory. And so I don't 01:25:09.229 --> 01:25:13.489 have enough background on the science. Certainly 01:25:13.489 --> 01:25:16.850 to recommend or endorse them, but I see them 01:25:16.850 --> 01:25:19.630 enough and people have told me enough that at 01:25:19.630 --> 01:25:22.229 least anecdotally, they seem to hold some promise 01:25:22.229 --> 01:25:27.750 without as many of the side effects that may 01:25:27.750 --> 01:25:31.430 be common with other interventions. But my encouragement 01:25:31.430 --> 01:25:34.569 is always wait until there's more data. I recognize 01:25:34.569 --> 01:25:38.850 I'm probably more risk averse than others, but 01:25:38.850 --> 01:25:43.520 I still like to see. you know, hard science and 01:25:43.520 --> 01:25:46.279 empirical evidence before recommending a lot 01:25:46.279 --> 01:25:49.460 of these things. But, you know, I've seen these 01:25:49.460 --> 01:25:53.239 become much more common and ubiquitous, particularly 01:25:53.239 --> 01:25:55.500 in like the high performance world. I'm seeing 01:25:55.500 --> 01:26:00.079 a lot of people using these. So yeah, it's certainly 01:26:00.079 --> 01:26:04.340 a rapidly emerging area. And yeah, I'd be interested. 01:26:04.939 --> 01:26:06.600 You've had, it sounds like a pretty good response 01:26:06.600 --> 01:26:09.140 on the enclomaphene. Yeah, well, it's interesting 01:26:09.140 --> 01:26:11.460 because they gave me a bunch and I naturally 01:26:11.460 --> 01:26:15.020 had at 50, almost 50, I had a testosterone of 01:26:15.020 --> 01:26:17.979 around 700 after all that shift work, which is, 01:26:17.979 --> 01:26:20.979 you know, but I just felt, you know, very drained. 01:26:21.020 --> 01:26:22.819 I was like, well, if that's after 14 years of 01:26:22.819 --> 01:26:25.460 not sleeping, because I did the 24 -72 for most 01:26:25.460 --> 01:26:28.520 of my career, I had the mandatory overtime, you 01:26:28.520 --> 01:26:31.199 know, can I take a little tweak? Well, what they 01:26:31.199 --> 01:26:34.390 gave me. I'm sure was probably more for the person 01:26:34.390 --> 01:26:37.090 with the 300, you know? And so I went through 01:26:37.090 --> 01:26:39.270 the roof and I, my nipples hurt and I started 01:26:39.270 --> 01:26:41.069 crying and I'm like, okay, this is too much. 01:26:41.649 --> 01:26:44.229 So I've been tapering off ever since. And the 01:26:44.229 --> 01:26:47.189 clomiphene has been good, but again, I just have 01:26:47.189 --> 01:26:49.329 my bloods taken and I'm on, you know, the lowest 01:26:49.329 --> 01:26:51.829 dose I've got just to the single peptide. And 01:26:51.829 --> 01:26:53.890 again, my testosterone was like a thousand. I'm 01:26:53.890 --> 01:26:56.250 like, okay, this is still probably too much. 01:26:56.250 --> 01:26:58.510 So now I'm in the process of actually coming 01:26:58.510 --> 01:27:00.720 off everything. Cause this is my whole thing 01:27:00.720 --> 01:27:03.159 is like a bolus might be good for a while to 01:27:03.159 --> 01:27:04.840 help you kind of get back on your feet. Just 01:27:04.840 --> 01:27:07.380 like the, maybe the Zen pick is for someone, 01:27:07.420 --> 01:27:10.119 but then how can you sustain without any of it? 01:27:10.140 --> 01:27:12.359 Because your body is a miracle and it should 01:27:12.359 --> 01:27:15.359 be able to perform at a higher level. Um, but 01:27:15.359 --> 01:27:17.439 now I'm not on shift, you know, and I'm, I'm 01:27:17.439 --> 01:27:19.880 doing a lot of things, right? So this is always 01:27:19.880 --> 01:27:22.359 my, my ethos, whether you're on blood pressure 01:27:22.359 --> 01:27:25.880 medication or a peptide. Is there an exit strategy? 01:27:26.279 --> 01:27:28.079 It's getting you to a certain point, but then 01:27:28.079 --> 01:27:29.340 when are you going to come off? Are you going 01:27:29.340 --> 01:27:31.140 to take this for the rest of your life? And I 01:27:31.140 --> 01:27:33.779 don't think that is the right answer. So I think 01:27:33.779 --> 01:27:37.500 for me, as a crutch, when you're in a hole, then 01:27:37.500 --> 01:27:39.819 absolutely, I think they're fantastic. But for 01:27:39.819 --> 01:27:41.979 example, the anti -inflammatories are right. 01:27:42.060 --> 01:27:44.760 You've got the pain to stop hurting in your joint. 01:27:44.859 --> 01:27:46.640 Well, now what are you doing to PT it? What are 01:27:46.640 --> 01:27:48.680 you doing to reduce the inflammation so you don't 01:27:48.680 --> 01:27:51.890 need to take BPC -157? the rest of your life 01:27:51.890 --> 01:27:54.449 either so i think just again it's that if there's 01:27:54.449 --> 01:27:58.270 an application but um you know the further you 01:27:58.270 --> 01:28:02.989 get away from the the holistic um way that man 01:28:02.989 --> 01:28:05.130 has existed for the longest time and thrived 01:28:05.130 --> 01:28:07.970 on this planet i think you know that you ask 01:28:07.970 --> 01:28:10.489 yourself why do you need this pill this potion 01:28:10.489 --> 01:28:12.989 you know the rest of your life so that's that's 01:28:12.989 --> 01:28:16.090 kind of my my philosophy i've kind of self -experimented 01:28:16.090 --> 01:28:18.850 i've titrated to effect and that effect is literally 01:28:19.520 --> 01:28:21.960 Now it's going to be zero. I'm like every other 01:28:21.960 --> 01:28:23.340 day and I'm going to be off it probably in a 01:28:23.340 --> 01:28:25.520 couple of weeks. So it'll be interesting to see. 01:28:25.640 --> 01:28:27.880 But it's had a great effect up to this point. 01:28:27.960 --> 01:28:29.920 But you got to be careful because too much is 01:28:29.920 --> 01:28:33.600 bad too. No, that's brilliant. Especially I like 01:28:33.600 --> 01:28:36.079 your comment about there should be an exit strategy. 01:28:36.640 --> 01:28:41.060 And I think that's probably where the GLP -1s 01:28:41.060 --> 01:28:44.439 will emerge. And I think the paradigm that I'm 01:28:44.439 --> 01:28:47.340 seeing... more and more. And this particular 01:28:47.340 --> 01:28:50.039 case I was talking about that lost 100 pounds, 01:28:50.279 --> 01:28:54.300 part of the goal should not just be, I mean, 01:28:54.359 --> 01:28:59.100 a principal goal, of course, is to maintain insulin 01:28:59.100 --> 01:29:02.840 sensitivity and hopefully reverse some of the 01:29:02.840 --> 01:29:05.260 type 2 diabetes. But if the goal is weight loss, 01:29:05.859 --> 01:29:08.680 I would try to reframe that discussion as being 01:29:08.680 --> 01:29:11.800 something along the lines of changing body composition. 01:29:12.760 --> 01:29:14.859 Because if you're reducing, let's just say somebody 01:29:14.859 --> 01:29:18.619 starts with a body fat percent of 28%, if you 01:29:18.619 --> 01:29:21.300 can get that below 20%, there's a concordant 01:29:21.300 --> 01:29:24.659 increase in basal metabolic rate where they can 01:29:24.659 --> 01:29:27.119 maintain that weight loss and do it in a healthy, 01:29:27.199 --> 01:29:30.819 naturalistic way and not take GLP -1s indefinitely. 01:29:31.699 --> 01:29:34.340 Where I start to get worried is when people enter, 01:29:34.579 --> 01:29:38.260 particularly as it relates to TRT, a scenario 01:29:38.260 --> 01:29:40.739 where they may not realize it's indefinite consumption. 01:29:41.739 --> 01:29:45.239 Um, because TRT unopposed, uh, over a long period 01:29:45.239 --> 01:29:49.279 of time, uh, can cause a destruction of the endogenous 01:29:49.279 --> 01:29:51.600 production of testosterone. And you end up needing 01:29:51.600 --> 01:29:55.619 that long -term. Um, my understanding is N -clomphene, 01:29:55.760 --> 01:29:59.000 uh, is the opposite effect of that is you do 01:29:59.000 --> 01:30:01.920 maintain your natural production, uh, of testosterone. 01:30:02.039 --> 01:30:06.239 So a much safer, um, and, uh, natural way of 01:30:06.239 --> 01:30:09.079 approaching it. Yeah, absolutely. That's what 01:30:09.079 --> 01:30:11.859 I found myself. All right. Well, then let's go 01:30:11.859 --> 01:30:15.479 back to WAVE. So just kind of underline if someone 01:30:15.479 --> 01:30:18.600 listening wants to find a place to experience 01:30:18.600 --> 01:30:21.239 this themselves, what is the best way? And then 01:30:21.239 --> 01:30:24.239 also, if someone's in a state other than Missouri, 01:30:24.560 --> 01:30:27.739 Ohio and Florida, what moves can they make to 01:30:27.739 --> 01:30:30.020 try and get this a statewide initiative in their 01:30:30.020 --> 01:30:34.020 home? Yeah, so the websites that I mentioned, 01:30:34.340 --> 01:30:38.199 etmsohio .com, etmsflorida .com, and etmsmissouri 01:30:38.199 --> 01:30:43.500 .com are probably the easiest way to engage those 01:30:43.500 --> 01:30:46.020 initiatives. And you should get a call within 01:30:46.020 --> 01:30:52.039 24 hours typically. We also have other clinics 01:30:52.039 --> 01:30:55.239 around the country. If you look up, I believe, 01:30:55.300 --> 01:30:57.640 braintreatmentcenter .com slash locations, it'll 01:30:57.640 --> 01:31:00.319 give you a list of, we have over 100 centers 01:31:00.319 --> 01:31:05.430 nationwide. And those centers can certainly take 01:31:05.430 --> 01:31:07.869 you in, get an EEG, and get you started on all 01:31:07.869 --> 01:31:11.609 of this. If there are other people who are interested 01:31:11.609 --> 01:31:14.369 in just standard TMS, it's more of a one -size 01:31:14.369 --> 01:31:17.949 -fits -all approach without the EEG. Those are 01:31:17.949 --> 01:31:20.130 locations, too. You can really just do an internet 01:31:20.130 --> 01:31:22.750 search and find some of those locations. It's 01:31:22.750 --> 01:31:25.250 become a fairly common mainstream procedure. 01:31:26.649 --> 01:31:30.210 And so they can look into all those different... 01:31:30.819 --> 01:31:34.739 access points and clinics. Many people will focus 01:31:34.739 --> 01:31:36.380 on the quality of the doctor at the different 01:31:36.380 --> 01:31:39.600 sites. I've been impressed with the quality of 01:31:39.600 --> 01:31:41.239 the physicians who are going into the space. 01:31:42.859 --> 01:31:45.479 Many psychiatrists, others, kind of functional 01:31:45.479 --> 01:31:49.159 medicine doctors or primary care doctors. But 01:31:49.159 --> 01:31:52.380 generally speaking, we've seen pretty good quality 01:31:52.380 --> 01:31:56.199 of medical care being delivered through these 01:31:56.199 --> 01:31:59.859 different locations. Beautiful. And then what 01:31:59.859 --> 01:32:01.939 about if someone wants to try and get it as a 01:32:01.939 --> 01:32:04.899 statewide initiative? How would you suggest they 01:32:04.899 --> 01:32:07.619 go about it? Have you heard of how Florida, Ohio, 01:32:07.800 --> 01:32:11.479 and Missouri made it happen? There's quite a 01:32:11.479 --> 01:32:17.819 process to go through. And so I don't know that 01:32:17.819 --> 01:32:22.199 it happens simply. But in the cases that I've 01:32:22.199 --> 01:32:27.239 seen, usually there are a handful of people who... 01:32:27.760 --> 01:32:30.619 are lobbying the state to provide access to this 01:32:30.619 --> 01:32:34.699 treatment. There should be a handful of legislators 01:32:34.699 --> 01:32:37.819 who want to carry the flag and provide access 01:32:37.819 --> 01:32:40.920 to the treatment. You can either go through a 01:32:40.920 --> 01:32:45.319 bill process or a direct appropriation. It is 01:32:45.319 --> 01:32:48.859 lengthy. This is not a quick cycle, usually over 01:32:48.859 --> 01:32:55.659 months and years rather than weeks. But yeah, 01:32:55.739 --> 01:32:58.989 for us, Part of our goal and objective is to 01:32:58.989 --> 01:33:04.270 help as many people as possible. When I saw what 01:33:04.270 --> 01:33:07.670 this could do for my friends and the people that 01:33:07.670 --> 01:33:12.069 I deployed with, it reminds us of all the good 01:33:12.069 --> 01:33:15.890 reasons we go into medicine. I haven't seen something 01:33:15.890 --> 01:33:18.970 that could really move the needle in terms of 01:33:18.970 --> 01:33:22.609 how somebody felt and how they are engaging with 01:33:22.609 --> 01:33:24.750 their communities and society quite like I saw 01:33:24.750 --> 01:33:28.699 with this treatment. And that's part of why I 01:33:28.699 --> 01:33:32.979 joined the cause is, you know, for the people 01:33:32.979 --> 01:33:35.100 who are struggling and don't have good interventions 01:33:35.100 --> 01:33:38.579 available, this can be life -changing. And so, 01:33:38.579 --> 01:33:40.460 you know, in the military community, we talk 01:33:40.460 --> 01:33:43.000 a lot about mission and purpose, and this really 01:33:43.000 --> 01:33:47.680 checked the box in terms of that. So, yeah, I 01:33:47.680 --> 01:33:52.039 can share lots of stories about, you know, people 01:33:52.039 --> 01:33:55.619 who... benefited from the treatment. But ultimately, 01:33:55.779 --> 01:33:58.619 I know data speaks the loudest. And so we're 01:33:58.619 --> 01:34:01.859 engaging in all kinds of clinical trials, both 01:34:01.859 --> 01:34:04.739 looking at this treatment versus sham placebo. 01:34:05.239 --> 01:34:07.720 And there's another study that was funded by 01:34:07.720 --> 01:34:11.039 Special Operations Care Fund and Tomahawk Charitable 01:34:11.039 --> 01:34:13.239 Solutions, where some veterans were getting, 01:34:13.479 --> 01:34:16.859 they called the trifecta study, where some veterans 01:34:16.859 --> 01:34:20.479 were getting hormone management through a functional 01:34:20.479 --> 01:34:24.039 medicine specialist. And then they would either 01:34:24.039 --> 01:34:26.380 come to our center in San Diego to get our treatment, 01:34:26.460 --> 01:34:31.699 or they'd go to Mexico to get a Ibogaine 5 -MeO 01:34:31.699 --> 01:34:33.800 -DMT session, and then they would come to our 01:34:33.800 --> 01:34:36.199 center in San Diego and get treatment. And the 01:34:36.199 --> 01:34:39.020 goal of this study was to see whether it was 01:34:39.020 --> 01:34:42.000 preferred to get the psychedelic session before 01:34:42.000 --> 01:34:46.279 or after our treatment. And so we're still blind 01:34:46.279 --> 01:34:48.840 to that data. I don't have the answers yet. But 01:34:48.840 --> 01:34:52.770 I think perhaps one thing to mention is This 01:34:52.770 --> 01:34:55.489 is a pretty unique time in history where there's 01:34:55.489 --> 01:34:58.930 so much emerging science that should give vulnerable 01:34:58.930 --> 01:35:01.869 communities hope that there's going to be really 01:35:01.869 --> 01:35:04.010 meaningful interventions coming on the horizon. 01:35:04.590 --> 01:35:07.850 And what we've seen initially from this trifecta 01:35:07.850 --> 01:35:11.609 study, the feedback has been, this is not a case 01:35:11.609 --> 01:35:14.210 of one plus one plus one equals three. These 01:35:14.210 --> 01:35:15.949 people are saying it's like an eight or a 10. 01:35:16.449 --> 01:35:19.640 And they really feel like. This kind of stacked 01:35:19.640 --> 01:35:23.140 therapy where you're combining modalities may 01:35:23.140 --> 01:35:26.260 be the future. And I think there's a lot of science 01:35:26.260 --> 01:35:29.199 to do before we can endorse or recommend one 01:35:29.199 --> 01:35:31.819 or the other. But it's encouraging to see some 01:35:31.819 --> 01:35:34.720 of these studies starting to happen. I just returned 01:35:34.720 --> 01:35:38.279 from a trip from UT Austin and met with some 01:35:38.279 --> 01:35:41.859 brilliant scientists. Greg Fonzo and Chuck Nemiroff 01:35:41.859 --> 01:35:43.460 were talking about some of the studies being 01:35:43.460 --> 01:35:46.800 conducted there where they're doing a TMS psilocybin 01:35:46.800 --> 01:35:51.279 study. And again, the data is very early, but 01:35:51.279 --> 01:35:52.859 it's encouraging to see this kind of science 01:35:52.859 --> 01:35:56.640 starting to emerge. So if there are people out 01:35:56.640 --> 01:36:02.760 there who feel like there's no hope or that nothing 01:36:02.760 --> 01:36:09.579 is working, my encouragement would be just wait. 01:36:09.819 --> 01:36:14.399 I think that the next decade is going to be just 01:36:14.399 --> 01:36:17.529 a fascinating time where new therapeutics. are 01:36:17.529 --> 01:36:20.329 going to get their FDA clearances and there'll 01:36:20.329 --> 01:36:22.750 be new interventions that can really help in 01:36:22.750 --> 01:36:25.810 a profound and meaningful way. Well, it's so 01:36:25.810 --> 01:36:27.390 beautiful because we've talked about, you know, 01:36:27.390 --> 01:36:29.329 evolving with the science, but there's also, 01:36:29.470 --> 01:36:31.750 you know, at least this is my personal opinion, 01:36:31.810 --> 01:36:33.649 there's been a lot of arrogance in science and 01:36:33.649 --> 01:36:35.789 medicine when you reflect on certain areas. And 01:36:35.789 --> 01:36:38.010 sadly, some of that obviously is coming from, 01:36:38.010 --> 01:36:41.149 you know, professions that make a lot of money 01:36:41.149 --> 01:36:44.170 on the stasis, you know, the way it is with chronic 01:36:44.170 --> 01:36:48.260 disease. But now you look at this kind of revisiting 01:36:48.260 --> 01:36:50.840 of ancient, you know, medicine and plant medicine 01:36:50.840 --> 01:36:53.840 and, you know, therapeutics, and now it's marrying. 01:36:54.000 --> 01:36:56.659 So you've got, as you said, psilocybin and TMS 01:36:56.659 --> 01:37:00.300 side by side now. And I think this is this beautiful 01:37:00.300 --> 01:37:03.000 kind of full circle that we're coming, of course. 01:37:03.600 --> 01:37:05.720 Medicine is incredible. And as people always 01:37:05.720 --> 01:37:07.859 point out, yes, I would like anesthesia, please. 01:37:08.079 --> 01:37:10.399 And I would like a sharp scalpel. So I'm all 01:37:10.399 --> 01:37:13.720 for modern technology. But when you bring that 01:37:13.720 --> 01:37:16.920 in with the holistic, not only proactive solutions 01:37:16.920 --> 01:37:19.340 to obesity and some of these other things, but 01:37:19.340 --> 01:37:21.119 the plant medicines and some of these other. 01:37:22.320 --> 01:37:24.039 therapeutics that have been shown to work for 01:37:24.039 --> 01:37:26.479 a long time. I'm seeing a lot more leaning back 01:37:26.479 --> 01:37:29.460 into Chinese medicine and herbs and all kinds 01:37:29.460 --> 01:37:32.159 of things. So the marriage of modern technology 01:37:32.159 --> 01:37:34.460 with the humility of still acknowledging the 01:37:34.460 --> 01:37:36.840 wisdom of our forefathers, I think, is the superpower 01:37:36.840 --> 01:37:38.619 that we're going to see, as you said, the next 01:37:38.619 --> 01:37:42.220 few decades. Yeah, it's been fascinating to see 01:37:42.220 --> 01:37:45.460 that area emerge. And I have to admit, I'm by 01:37:45.460 --> 01:37:47.680 no means an expert on psychedelics. You know, 01:37:47.699 --> 01:37:50.770 we're involved in this one study. But trying 01:37:50.770 --> 01:37:56.130 to learn about them, we can make sense of certain 01:37:56.130 --> 01:37:58.970 neuronal circuits and restoring brain function 01:37:58.970 --> 01:38:05.510 with electrophysiologic interventions. But many 01:38:05.510 --> 01:38:08.670 of these operators who are coming back. Talk 01:38:08.670 --> 01:38:10.550 about something very different, you know, rather 01:38:10.550 --> 01:38:12.529 than, you know, in the science world, you know, 01:38:12.529 --> 01:38:14.869 we can talk about the default bone network. We 01:38:14.869 --> 01:38:17.850 can talk about the 5 -HT2A receptor and GABA 01:38:17.850 --> 01:38:20.909 receptors when we talk about some of these psychedelic 01:38:20.909 --> 01:38:25.770 compounds. But the manifestation of that, the 01:38:25.770 --> 01:38:28.350 phenotypic expression of patients who are coming 01:38:28.350 --> 01:38:35.350 back, I hear repeatedly that they feel the ability 01:38:35.350 --> 01:38:38.729 to love again or they feel. the ability to have 01:38:38.729 --> 01:38:42.390 self -love again. So they classify these in pathogens 01:38:42.390 --> 01:38:44.970 and theogens. Some people will find their faith 01:38:44.970 --> 01:38:47.949 and belief in God again. And that's something 01:38:47.949 --> 01:38:50.310 that's very hard to explain with hard neuroscience. 01:38:50.590 --> 01:38:54.670 It's just something that sometimes you take a 01:38:54.670 --> 01:38:56.670 step back and you have to feel a sense of wonder 01:38:56.670 --> 01:39:02.229 and awe at the types of therapeutics that are 01:39:02.229 --> 01:39:04.149 starting to emerge and that these existed for 01:39:04.149 --> 01:39:06.850 100 years and that we didn't have access to them. 01:39:07.880 --> 01:39:09.640 There's a whole separate conversation we could 01:39:09.640 --> 01:39:12.159 talk for hours about, you know, about the journey 01:39:12.159 --> 01:39:14.720 of many of these compounds. And I think back 01:39:14.720 --> 01:39:18.180 to, I had the good fortune of meeting Rick Doblin, 01:39:18.279 --> 01:39:20.279 who's the founder of this MAPS institution. They 01:39:20.279 --> 01:39:23.659 were doing MDMA -assisted psychotherapy. They 01:39:23.659 --> 01:39:25.680 met the primary endpoint, but sadly, they didn't 01:39:25.680 --> 01:39:29.579 get their FDA clearance. That made me very sad 01:39:29.579 --> 01:39:32.140 for humanity. Looking at some of the critique, 01:39:32.300 --> 01:39:34.079 there were some valid criticisms of the trial 01:39:34.079 --> 01:39:37.140 design. But I don't think that's going to stop 01:39:37.140 --> 01:39:39.239 the wave of therapeutics that are coming through. 01:39:39.399 --> 01:39:40.779 You know, there's a trial called the COMPASS 01:39:40.779 --> 01:39:43.939 trial that's looking at psilocybin. You know, 01:39:44.000 --> 01:39:46.439 I'm seeing a lot of really promising data with 01:39:46.439 --> 01:39:52.220 both psilocybin, ibogaine, and ayahuasca. And, 01:39:52.279 --> 01:39:56.819 you know, the only current psychedelic that's 01:39:56.819 --> 01:40:00.119 available is ketamine. And I've talked to a number 01:40:00.119 --> 01:40:01.619 of people who had a really good benefit from 01:40:01.619 --> 01:40:05.720 that as well. But this sort of plant -based therapeutic, 01:40:06.020 --> 01:40:10.000 the emergence of these class of compounds, I 01:40:10.000 --> 01:40:13.180 think is really exciting. And to your point, 01:40:13.300 --> 01:40:17.060 I think that many people who get entrenched in 01:40:17.060 --> 01:40:19.939 a certain way of practicing medicine can be very 01:40:19.939 --> 01:40:25.220 resistant to innovation. And I sort of view things 01:40:25.220 --> 01:40:27.279 a different way. Like if we're really in service 01:40:27.279 --> 01:40:31.180 to our patients. We have to be open -minded to 01:40:31.180 --> 01:40:34.920 the evolution of science. And ultimately, there's 01:40:34.920 --> 01:40:36.500 going to be winners and losers. It's just the 01:40:36.500 --> 01:40:41.359 nature of academically rigorous science and this 01:40:41.359 --> 01:40:48.100 endeavor. But for humanity and for these markets, 01:40:48.460 --> 01:40:52.119 there are going to be winners. And so that's 01:40:52.119 --> 01:40:55.119 what makes me excited to see not just what is 01:40:55.119 --> 01:40:57.300 coming, but how the different combination of 01:40:57.300 --> 01:41:01.859 modalities might be effective. Absolutely. All 01:41:01.859 --> 01:41:03.840 right. Well, I want to be mindful of your time. 01:41:03.920 --> 01:41:05.500 So I'm going to throw some quick questions at 01:41:05.500 --> 01:41:06.939 you, if that's okay. Quick closing questions. 01:41:07.699 --> 01:41:10.020 Yeah, of course. Brilliant. All right. The first 01:41:10.020 --> 01:41:12.220 one I'd love to ask, is there a book or are there 01:41:12.220 --> 01:41:14.920 books that you love to recommend? It can be related 01:41:14.920 --> 01:41:17.180 to our discussion today or completely unrelated. 01:41:19.260 --> 01:41:23.000 It's a great question. It's just a book that 01:41:23.000 --> 01:41:25.220 I've read recently called Tribe by Sebastian 01:41:25.220 --> 01:41:28.680 Junger. And it's really... a little bit about 01:41:28.680 --> 01:41:30.659 the military well a lot about the military experience 01:41:30.659 --> 01:41:37.260 but um how you know being in um a highly effective 01:41:37.260 --> 01:41:41.159 unit in the military and then coming back you 01:41:41.159 --> 01:41:43.079 know this is your tribe and then coming back 01:41:43.079 --> 01:41:46.699 to a society in america that maybe is a bit divided 01:41:46.699 --> 01:41:52.670 um has led to you know a lot of um you know when 01:41:52.670 --> 01:41:54.550 once you leave that unit and you're a bit more 01:41:54.550 --> 01:41:57.489 isolated to not have the camaraderie of that 01:41:57.489 --> 01:42:01.770 tribe can lead to a lot of um mental health challenges 01:42:01.770 --> 01:42:04.090 so i strongly recommend the book i'm not doing 01:42:04.090 --> 01:42:07.609 it justice uh but that's an excellent book one 01:42:07.609 --> 01:42:12.010 of my favorites um is dated now but uh there's 01:42:12.010 --> 01:42:13.569 a book called the road less traveled by scott 01:42:13.569 --> 01:42:17.090 peck um where he talks about the psychology just 01:42:17.090 --> 01:42:19.189 really kind of there's building blocks where 01:42:19.189 --> 01:42:23.840 um He talks about the first building block for 01:42:23.840 --> 01:42:27.260 our human experience is discipline. And through 01:42:27.260 --> 01:42:31.739 discipline, we can achieve so many things. And 01:42:31.739 --> 01:42:34.880 it ends with love and spirituality, that through 01:42:34.880 --> 01:42:37.420 discipline, we can both love ourselves but love 01:42:37.420 --> 01:42:40.199 others. And then the spirituality comes after. 01:42:40.619 --> 01:42:45.359 But I bought that book for probably 100 different 01:42:45.359 --> 01:42:48.979 people because I think that it's... very well 01:42:48.979 --> 01:42:51.539 expressed so but those are the two books that 01:42:51.539 --> 01:42:54.720 really come to mind brilliant yeah i can't agree 01:42:54.720 --> 01:42:57.000 more about tribe especially i've had sebastian 01:42:57.000 --> 01:43:00.020 on four or five times now i mean when i read 01:43:00.020 --> 01:43:02.760 tribe i was like this is this is what we all 01:43:02.760 --> 01:43:04.960 struggle with in uniform you know understanding 01:43:04.960 --> 01:43:08.130 that cohesion that you have when you are you 01:43:08.130 --> 01:43:10.489 know in this kind of selfless unit and then yeah 01:43:10.489 --> 01:43:12.970 you find yourself on the outside whether you're 01:43:12.970 --> 01:43:16.229 fired retired whatever the story was and why 01:43:16.229 --> 01:43:18.829 you feel this suffering because you know as a 01:43:18.829 --> 01:43:21.670 species you know we're a tribal species and you 01:43:21.670 --> 01:43:24.850 know that meant death in ancient tribes so understanding 01:43:24.850 --> 01:43:27.149 that you can have other tribes outside of what 01:43:27.149 --> 01:43:29.770 you do and not to put your entire identity into 01:43:29.770 --> 01:43:32.949 this particular calling i think it's again you 01:43:32.949 --> 01:43:34.670 know a lesson that we need to be taught day one 01:43:36.449 --> 01:43:40.630 Absolutely. All right. What about films and or 01:43:40.630 --> 01:43:47.770 documentaries? Oh, boy. It's been a while since 01:43:47.770 --> 01:43:52.829 I watched a film or a documentary for that matter. 01:43:55.460 --> 01:43:57.619 Gosh, I don't want to leave a question unanswered. 01:43:57.619 --> 01:43:59.800 I'm just kind of drawing a blank at the moment. 01:44:00.020 --> 01:44:01.880 Well, let me ask you a question. Have you seen 01:44:01.880 --> 01:44:05.060 that show? It's called The Pit. It's on HBO Max 01:44:05.060 --> 01:44:09.779 at the moment. I have not. OK, so it's set. It's 01:44:09.779 --> 01:44:13.300 actually one of the actors from ER, the old show. 01:44:13.720 --> 01:44:17.729 But it's a very, very well. Well -written, well 01:44:17.729 --> 01:44:21.729 -acted, very gritty ER show. So very different 01:44:21.729 --> 01:44:24.989 than the other one. But every episode is an hour 01:44:24.989 --> 01:44:28.310 in the ER. And so it's incredibly well done. 01:44:28.390 --> 01:44:31.090 The technical advisors they've had are absolutely 01:44:31.090 --> 01:44:33.010 amazing. So I always tell people they haven't 01:44:33.010 --> 01:44:35.069 heard of it and they're in the medical field 01:44:35.069 --> 01:44:37.310 that it's definitely worth watching because I 01:44:37.310 --> 01:44:40.109 haven't seen a show like that before. And from 01:44:40.109 --> 01:44:43.560 a technical point of view. They're as close as 01:44:43.560 --> 01:44:45.579 they can be. Obviously, compressions on a live 01:44:45.579 --> 01:44:47.939 person in one scene, they can't be just crushing 01:44:47.939 --> 01:44:50.539 the chest. But aside from that, it's very well 01:44:50.539 --> 01:44:53.479 done. Oh, great. I'm going to have to go and 01:44:53.479 --> 01:44:55.300 watch that. You've got me very interested now. 01:44:56.380 --> 01:44:58.340 All right. Well, the next question, is there 01:44:58.340 --> 01:45:00.319 a person that you'd recommend to come on this 01:45:00.319 --> 01:45:03.300 podcast as a guest to speak to the first responders, 01:45:03.579 --> 01:45:05.859 military and associated professions of the world? 01:45:07.159 --> 01:45:11.060 Ooh. That's a great question. Actually, when 01:45:11.060 --> 01:45:15.340 I was coming on, I was thinking there are probably 01:45:15.340 --> 01:45:20.640 quite a few. One of my mentors, Stephanos Kales, 01:45:20.880 --> 01:45:22.640 I think would be a great one. He's a Harvard 01:45:22.640 --> 01:45:26.000 professor who spent a career researching firefighter 01:45:26.000 --> 01:45:30.199 health. And he's a brilliant guy and a wonderful 01:45:30.199 --> 01:45:32.939 human being. I think that he'd be a good guy 01:45:32.939 --> 01:45:36.550 to have on the podcast. I didn't look through 01:45:36.550 --> 01:45:38.390 all of your episodes, but just, you know, we 01:45:38.390 --> 01:45:42.109 talked about sleep a lot. Matthew Walker, I think, 01:45:42.109 --> 01:45:44.770 is a brilliant guy to have on the podcast. He 01:45:44.770 --> 01:45:48.130 spent his career researching sleep. And I would 01:45:48.130 --> 01:45:50.069 say he's one of the real thought leaders in the 01:45:50.069 --> 01:45:53.010 space. So he's another one that would come to 01:45:53.010 --> 01:45:56.279 mind. Yeah, absolutely. I kind of connected pseudo 01:45:56.279 --> 01:45:58.859 connected with him through one of my mutual friends 01:45:58.859 --> 01:46:00.840 a while ago. And I think he's become quite busy 01:46:00.840 --> 01:46:02.939 at the moment. But that was a few months ago. 01:46:02.979 --> 01:46:06.239 So I need to circle around and see if I can bring 01:46:06.239 --> 01:46:07.920 his attention again. Because I mean, that that 01:46:07.920 --> 01:46:09.619 book obviously is the one when you mentioned 01:46:09.619 --> 01:46:11.899 sleep, why we sleep is the one that most people 01:46:11.899 --> 01:46:15.720 think of. Absolutely. All right. Well, then the 01:46:15.720 --> 01:46:17.420 last question before we make sure everyone knows 01:46:17.420 --> 01:46:20.279 where to find you, what do you do to decompress? 01:46:23.159 --> 01:46:25.479 That's a good question. I still enjoy running. 01:46:27.000 --> 01:46:32.539 I'm not as efficient as I used to be in terms 01:46:32.539 --> 01:46:35.960 of kind of my times and whatnot. I enjoy exercise. 01:46:36.159 --> 01:46:38.760 I've tried to take up swimming. Swimming has 01:46:38.760 --> 01:46:41.359 always been a weakness of mine. Even in flight 01:46:41.359 --> 01:46:43.319 school where you have to do survival swimming, 01:46:43.539 --> 01:46:45.539 you have to tread water in boots and a flight 01:46:45.539 --> 01:46:50.060 suit. I almost drowned when I was doing that. 01:46:50.119 --> 01:46:51.800 But I've tried to get better at swimming. I have 01:46:51.800 --> 01:46:54.579 a friend, Rich Hoagland, who's kind of given 01:46:54.579 --> 01:46:56.579 me some tips on how to become a better swimmer. 01:46:56.720 --> 01:47:00.939 So I've tried to take that up. For me, most of 01:47:00.939 --> 01:47:03.680 my leisure time, I try to dedicate to my kids. 01:47:04.579 --> 01:47:08.239 I have a beautiful wife and five amazing children, 01:47:08.520 --> 01:47:11.420 two who are in college now, three who are at 01:47:11.420 --> 01:47:15.000 home. And so a lot of my time is spent watching 01:47:15.000 --> 01:47:19.560 them. play soccer or, you know, my number four, 01:47:19.579 --> 01:47:23.060 her name's Emma. She's a ballet dancer. So some 01:47:23.060 --> 01:47:24.859 of my time is spent watching her competitions. 01:47:25.359 --> 01:47:29.479 But yeah, when you asked me about a documentary 01:47:29.479 --> 01:47:32.579 or movie, I felt very sad that I haven't really 01:47:32.579 --> 01:47:38.319 indulged in a lot of that lately. But maybe I 01:47:38.319 --> 01:47:40.199 take some solace in that I'm investing a lot 01:47:40.199 --> 01:47:43.170 of time in my kids and my family. I'd say so. 01:47:43.329 --> 01:47:45.149 Absolutely. You get more value from that. You 01:47:45.149 --> 01:47:47.170 can always watch movies when they left the home. 01:47:49.289 --> 01:47:51.090 All right. Well, then the very last question 01:47:51.090 --> 01:47:54.649 then, where are the best places to connect with 01:47:54.649 --> 01:47:59.869 you, learn more about you? So Wave Neuroscience 01:47:59.869 --> 01:48:03.250 has, we both have our website, waveneuro .com, 01:48:03.289 --> 01:48:07.600 W -A -V -E -N -E -U -R -O .com. You can find 01:48:07.600 --> 01:48:09.779 many of our publications in the National Library 01:48:09.779 --> 01:48:14.460 of Medicine. And if people are interested in 01:48:14.460 --> 01:48:17.479 those ETMS initiatives, you can find their websites 01:48:17.479 --> 01:48:20.680 as well. And I can send you that and maybe it 01:48:20.680 --> 01:48:25.300 can be in the show notes. I am on LinkedIn if 01:48:25.300 --> 01:48:28.239 people want to reach out and we can connect that 01:48:28.239 --> 01:48:34.050 way as well. Those are the predominant ways. 01:48:34.130 --> 01:48:36.090 I think WaveNur also has a presence on Instagram 01:48:36.090 --> 01:48:43.189 and what used to be Twitter X. There's lots of 01:48:43.189 --> 01:48:46.810 different ways where people can learn and take 01:48:46.810 --> 01:48:50.649 a bit of a deeper dive into what we do. Beautiful. 01:48:50.909 --> 01:48:52.750 Well, I want to say thank you. Firstly, thank 01:48:52.750 --> 01:48:55.109 you to John for facilitating this in the first 01:48:55.109 --> 01:48:58.369 place. It's funny. I found you on LinkedIn and 01:48:58.369 --> 01:49:01.800 sent you a connection. Some of the mutual friends. 01:49:01.840 --> 01:49:04.819 There's Brant McCarthy, who lost his brother 01:49:04.819 --> 01:49:08.340 to suicide. He has a nonprofit now. There's Brian 01:49:08.340 --> 01:49:10.439 Hillard, who's a friend of mine that I'm working 01:49:10.439 --> 01:49:14.920 with to make my latest book into a film. And 01:49:14.920 --> 01:49:17.180 yeah, so it's funny how these circles overlap, 01:49:17.340 --> 01:49:20.899 but it's been such an amazing conversation. I 01:49:20.899 --> 01:49:23.140 mean, your background and your military service 01:49:23.140 --> 01:49:25.880 and then all these comparisons as far as, you 01:49:25.880 --> 01:49:27.539 know, what you're seeing in the special forces 01:49:27.539 --> 01:49:29.380 and what you're seeing in first responders and 01:49:29.380 --> 01:49:31.579 just that hope, as you touched on, the ability 01:49:31.579 --> 01:49:34.170 to tell people. You haven't tried this. This 01:49:34.170 --> 01:49:37.489 may well make a difference in your journey, I 01:49:37.489 --> 01:49:39.649 think is imperative. And I'm sure the people 01:49:39.649 --> 01:49:41.510 listening in those three states are really excited 01:49:41.510 --> 01:49:43.989 now knowing that they can sign up and get this 01:49:43.989 --> 01:49:47.789 for little to no money at all. So I want to thank 01:49:47.789 --> 01:49:49.890 you so, so much for being so generous with your 01:49:49.890 --> 01:49:51.850 time and coming on the Behind the Shield podcast 01:49:51.850 --> 01:49:55.350 today. Absolutely. Really a pleasure of mine. 01:49:55.529 --> 01:49:57.109 And it's an honor to be able to spend the time 01:49:57.109 --> 01:49:58.789 with you. Thank you so much.