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Speaker 1: Well, good a team. Welcome to another episode of the

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Speaker 1: You Project. It's Fatty Harps. It's Craig Anthony Harper's Sunday

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Speaker 1: morning in the thriving Metropolis. It's thirteen minutes past nine

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Speaker 1: and one of my friends. We're friends now. We used

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Speaker 1: to be acquaintances. We knew each other a little bit.

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Speaker 1: Now we've hung out a bit, We've we've dined together,

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Speaker 1: We've spent time together, We've shared kaffeene together and stories together.

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Speaker 1: He helps me and I help him periodically. Doctor Alex,

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Speaker 1: welcome back to the show, my friend. How are you?

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Speaker 2: I'm great, It's really great to see you. It's great

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Speaker 2: to talk again.

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Speaker 1: It's good to see you, mate. What's going on? Is

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Speaker 1: there anything before we dive in? I want to talk

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Speaker 1: to you about. I actually want to have a proper

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Speaker 1: grown up podcast today about neurosurgery, the profession and the

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Speaker 1: practice and the science and the development of it and

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Speaker 1: all that, because I think it's obviously it's interesting fast.

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Speaker 1: It's day to day for you, but it's interesting fast.

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Speaker 1: But other than that, what's going on? How's marriage? How's

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Speaker 1: married life? Be? Still married? By the way, because I

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Speaker 1: went to your wedding, I haven't checked in. Still good,

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Speaker 1: there's still good there. Yes, I don't know. No one

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Speaker 1: would have seen the photos. But you turned up for

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Speaker 1: the first time I've seen in a suit and a tie,

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Speaker 1: and I didn't recognize you to start off with. In fact,

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Speaker 1: you look like the biggest, baddest bouncer I've ever had

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Speaker 1: at any wedding or ever seen at any wedding. There's

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Speaker 1: a good look for you.

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Speaker 2: You look at what the agents out of the matrix. Yeah.

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Speaker 1: Well, I do get asked for directions or people ask

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Speaker 1: me questions when I turn up at things in a

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Speaker 1: suit because they one think I'm on staff in some capacity.

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Speaker 1: So that shows you how much you're loved, because I'm

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Speaker 1: not putting on a suit for fucking anyone generally, especially

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Speaker 1: not for under ten thousand dollars. But I did it

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Speaker 1: for you, and you know, so that's a sign of

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Speaker 1: my devotion and love.

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Speaker 2: It was greatly appreciated. Hups. It was a good day.

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Speaker 2: Great and Carlie's great. She's at work at the moment

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Speaker 2: at the kids hospital. That's the way it is. That

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Speaker 2: we had a wedding yesterday to go to and I

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Speaker 2: was there on my own because Carli had a shift,

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Speaker 2: and so there's a bit of ships in the night

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Speaker 2: sort of vibe with everything. But it's also great having

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Speaker 2: somebody else who's in the surgical fraternity because the nuances

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Speaker 2: of stuff that happens, you don't need to describe the background.

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Speaker 2: You can just dive into it and unload and the

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Speaker 2: other person will immediately get it. But then again, also

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Speaker 2: there's no sympathy. So if Carli's got something on her

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Speaker 2: mind and I've been through it like ten times, then

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Speaker 2: she gets no sympathy. I'm just like, yeah, that's the

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Speaker 2: way it is, get over it.

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Speaker 1: Yeah, and that's going to happen and keep happening. Yep,

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Speaker 1: move on.

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Speaker 2: And then I get no sympathy because she's tired or

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Speaker 2: she's been through it ten times. But it's great. It's

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Speaker 2: a really interesting dynamic. Obviously, female and pursuing a career

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Speaker 2: is it's quite a it's a difficult topic because it's

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Speaker 2: a you know, when it comes to family and children,

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Speaker 2: females have a different experience than the guy. They've got

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Speaker 2: a certain time frame and there's always that pressure, that

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Speaker 2: biological pressure about family, and then certainly in recent times

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Speaker 2: there's this huge pressure for career as well, I feel

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Speaker 2: it really feels like that, and and it's great because

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Speaker 2: a career is very stimulating, very fulfilling, engaging, and it

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Speaker 2: goes beyond. You know, a kid can leave at the

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Speaker 2: age of beteen from home and then what he left with,

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Speaker 2: but a career stays with you until the day you retire.

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Speaker 2: So's that's an interesting balancing act. We've had a couple

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Speaker 2: of conversations about it, and we haven't resolved it. And

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Speaker 2: I have lots of conversations with patients and other and

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Speaker 2: other colleagues in the specialty about this. I was talking

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Speaker 2: to people at the wedding last night about this because

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Speaker 2: it's quite a it's an unresolved and unresolved issue. We

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Speaker 2: haven't we haven't worked out but both loving the career

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Speaker 2: highly stimulating.

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Speaker 1: What is the issue, like, is the issue we're gonna

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Speaker 1: have kids? Or are we? Or when are we? Or

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Speaker 1: it's because it's kind of not fair that the women

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Speaker 1: have to do that, right, Like, there's no other option,

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Speaker 1: is there? No?

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Speaker 2: They get that that's a much bigger deal. I mean,

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Speaker 2: obviously it has a huge effect on their body and

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Speaker 2: their time. You know, they've got to have maternity leave

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Speaker 2: and go through all of that, and then that's a

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Speaker 2: big chunk out of training like that. You know, take

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Speaker 2: three or six months off from a training program to

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Speaker 2: do that.

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Speaker 1: And when you say you mean medical training, you don't

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Speaker 1: mean the gym, right, or do you mean the gym?

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Speaker 2: Yeah, like surgical training training to become a surgeon, which

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Speaker 2: is you know, six or seven years, so you've got

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Speaker 2: to take time off during that. And then you know,

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Speaker 2: it's a really tough gig being a mum. How do

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Speaker 2: you know, then be a mom to a young child

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Speaker 2: and push extremely hard career wise, that that's a really difficult.

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Speaker 2: A lot of people have nannies and family around to

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Speaker 2: help with that, and I don't know if if you

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Speaker 2: can do both perfectly. I actually don't know how somebody balances.

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Speaker 2: I know some surgeons you've got several kids and they

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Speaker 2: have two or three nannies and that's almost the only

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Speaker 2: way that it works, someone there during the day to

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Speaker 2: look after the kids. Anyway, haven't We haven't cracked this

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Speaker 2: code yet.

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Speaker 1: So just tell people what because obviously I don't think

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Speaker 1: you tell us specifically what Kylie's doing. So she's a doctor,

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Speaker 1: of course, and she's doing her training to become a surgeon.

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Speaker 1: Is that it.

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Speaker 2: Yeah, she's finished med school, so she's a doctor. She's

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Speaker 2: done her required years in the hospital general training you

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Speaker 2: have to do before you can apply to get on

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Speaker 2: the surgical training program. You have to do the general

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Speaker 2: the surgical training program to be a qualified consultant, right,

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Speaker 2: And so she's going to apply for that next year.

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Speaker 2: So she's at the start of the of the process

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Speaker 2: of the actual official training program, which will be six years.

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Speaker 2: So and that's in pediatric surgery, which he loves and

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Speaker 2: really enjoys a job and is really good at it.

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Speaker 2: But there's lots of decisions coming up. Will stand by,

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Speaker 2: will stand by, But lots of people were listening, would

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Speaker 2: would have you know something similar like if it doesn't

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Speaker 2: have to be medicinal surgery. They're having family and all

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Speaker 2: sorts of careers in facing the same issues, and it's

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Speaker 2: incredibly difficult. But it's an ongoing conversation.

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Speaker 1: Is there a particular personality or type that is more

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Speaker 1: likely to become a surgeon or is it not at

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Speaker 1: all unrelated?

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Speaker 2: There's definitely a good aptitude for surgery. You can just

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Speaker 2: look at someone and say they've just got a good

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Speaker 2: aptitude for it. They get the anatomy, they get the

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Speaker 2: physicality of surgery. They're efficient, they're a decision maker. That's

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Speaker 2: really important. They can make a decision. And there's also

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Speaker 2: the attitude of dealing with people. I didn't realize this

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Speaker 2: how important that was, but in a hospital you may

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Speaker 2: not know it, but there are a whole spread of

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Speaker 2: personalities from toxic personality to you know, to someone who's

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Speaker 2: quite pleasant, and that's very, very difficult to deal I mean,

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Speaker 2: you can have an okay day at work and just

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Speaker 2: your day is ruined by toxic personality, a clash with

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Speaker 2: another consultant or someone in ICU or in theater. That

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Speaker 2: was a problem to deal with personality wise. I don't know.

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Speaker 2: I just I always just wanted to do surgery. There

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Speaker 2: was just no there was no plan B. So it

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Speaker 2: was very driven. I guess Klie is very driven, and

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Speaker 2: I don't know. Perhaps why do you do what you do?

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Speaker 2: Do you think you've got a specific personality for talking

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Speaker 2: to people? I don't know. This is a really important

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Speaker 2: issue because selecting surgeons, you have to do. The interview

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Speaker 2: is a big part of the process. You've got a

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Speaker 2: c you've got referees, and then you have to sit

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Speaker 2: down at an interview and for me, there were six

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Speaker 2: spots out of all of Australia. How do you pick

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Speaker 2: six people to get on the training program? And you

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Speaker 2: ask a series of questions and trying to get to

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Speaker 2: know these people, and then you just base it off

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Speaker 2: those responses. So it's actually really tricky to pick the

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Speaker 2: right person. And there's ongoing research and what are the

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Speaker 2: right questions, what's the right way to sort out these

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Speaker 2: people and find who has got the right aptitude or

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Speaker 2: surgery And then often they said that fails and then

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Speaker 2: the surgical training program becomes the screening. So they go

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Speaker 2: through the training and then they are that they will

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Speaker 2: thrive all they'll struggle, and if they're struggling, then that

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Speaker 2: becomes a sign that tough conversations need to be had because.

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Speaker 1: It's I think it's from the outside looking in, it's like,

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Speaker 1: obviously you need you know, you need to be intelligent,

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Speaker 1: you need a great understanding of an anime in physiology

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Speaker 1: and all that, all the skills and all the science

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Speaker 1: or the knowledge. Then you need to be able to

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Speaker 1: have I would think extreme an extreme ability to focus

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Speaker 1: and concentrate and be present and not distracted. Then you

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Speaker 1: need goods social skills to be able to lead a

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Speaker 1: team and communicate and not piss people off and not

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Speaker 1: get pissed off. And then you need to be able

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Speaker 1: to self regulate in the middle of fucking chaos so

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Speaker 1: you're not losing your shit. And then you need to

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Speaker 1: be physically, mentally and emotionally healthy yourself so you know.

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Speaker 1: And then you need to have good leadership skills. And

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Speaker 1: then you need to be a high level problem solver,

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Speaker 1: because surgery in some ways is problem solving in real time,

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Speaker 1: and it's like this fucking collision of a million different

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Speaker 1: variables that all matter.

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Speaker 2: And it's not like sport, where you are great when

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Speaker 2: you're young and you've identified yourself as good at sport,

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Speaker 2: and then you go down this pathway and you just

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Speaker 2: get better and better at what you've already demonstrated you're

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Speaker 2: good at this. You kind of don't really know that

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Speaker 2: you're good at it until you've gone through the whole

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Speaker 2: process and you start, and even not until you're halfway

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Speaker 2: through the process do you realize if you're any good

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Speaker 2: at it.

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Speaker 1: It's so true about how many people study mate and

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Speaker 1: then like even the people that I did one hundred

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Speaker 1: years ago when I did my first degree. People who

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Speaker 1: studied physic or human movement or whatever we want to

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Speaker 1: call it, exercise science, and they go through the whole

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Speaker 1: thing and then at the end of it they go, oh,

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Speaker 1: I want to do this at all. And they never

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Speaker 1: spend one day writing one exercise program or prescribing anything

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Speaker 1: for anyone, but they do the whole thing, and or

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Speaker 1: they go and do a bit of work experience, or

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Speaker 1: they start to work in the industry or with a

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Speaker 1: sporting club. And then the amount of people I've seen

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Speaker 1: that I went to UNI with who are still working

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Speaker 1: in the space of exercise science, it's probably less than

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Speaker 1: five percent twenty years after they did their degree, Like

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Speaker 1: very minimal.

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Speaker 2: It doesn't surprise me. I'll see that in surgery people

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Speaker 2: get halfway through and they decide to go down at

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Speaker 2: a completely different route. They go and do radiology or

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Speaker 2: general practice, or go into business or admin. And that's tough,

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Speaker 2: isn't You did that whole You go through meta school

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Speaker 2: and half of a training program and then decide this

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Speaker 2: is not for you.

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Speaker 1: Do you think that I think for some people that

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Speaker 1: it's just the emotional and psychological cost where you just

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Speaker 1: you get to a point where and I think it's okay.

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Speaker 1: I don't think it's weakness or bad. I don't think

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Speaker 1: it's a flaw. I think it's just a realization. Like,

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Speaker 1: if I'm being honest, there's been twenty six times in

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Speaker 1: my PhD where I've said to myself and that's only

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Speaker 1: a PhD, that's not all the shit that you've done, right,

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Speaker 1: I'm like, is this worth it? Like this is so

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Speaker 1: hard and so much and I go, you know, where

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Speaker 1: you weigh it up? And there's been a bunch of

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Speaker 1: times where I thought I didn't need to do this,

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Speaker 1: you know, and for whatever reason, I keep doing it.

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Speaker 1: But I can understand, like the amount of people who

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Speaker 1: start a PhD and drop out is something like eighty percent,

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Speaker 1: Like it's very high number the people who don't complete

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Speaker 1: their PhD. And I'm thinking, with what you do it,

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Speaker 1: that's you know, my experience, yours would be time was

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Speaker 1: twenty five in terms of how difficult it is to

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Speaker 1: get where you got. I just think that people just

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Speaker 1: weigh it up and go, could I get through? Probably? Maybe?

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Speaker 1: But is it worth it? No? Because I'm fucking miserable,

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Speaker 1: I'm anxious, I don't sleep, I'm stressed, my health suffering,

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Speaker 1: So I think that you know that probably eliminates people

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Speaker 1: naturally anyway, that way, it's.

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Speaker 2: One hundred percent through. The drive is really important. You've

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Speaker 2: got to have that inner drive to do surgery because

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Speaker 2: that's what gets you through. You will get you over

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Speaker 2: the hurdles that you inevitably will face. If you're doing

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Speaker 2: it for any other reason than you want to do it,

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Speaker 2: You're going to struggle and probably go in a different

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Speaker 2: direction given enough hurdles. And that certainly was my drive

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Speaker 2: since year ten. That was all I wanted to do,

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Speaker 2: and I had plenty of hurdles, but each hurdle was

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Speaker 2: just an excuse to hit harder and jump higher type thing.

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Speaker 2: And if you didn't have that, you would certainly give up.

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Speaker 2: It's probably a weird question, but could you? And I

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Speaker 2: know there's no typical day, but one of the things

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Speaker 2: I say to my clients or back in the day,

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Speaker 2: especially when someone would come to me, I'd say, walk

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Speaker 2: me through a typical day of you, and by that

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Speaker 2: I mean sleep, food, exercise. You know, are you sitting

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Speaker 2: for four hours a day? So can you walk us

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Speaker 2: through a typical day of being and we don't need

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Speaker 2: your breakfast and your dinner. But the neurosurgery stuff, like

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Speaker 2: what's a typical day, And I know it varies broadly,

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Speaker 2: but of neurosurgery, like on the days that you're working,

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Speaker 2: do you do you do one up a day, four

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Speaker 2: ops a day. I know it varies wildly, but can

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Speaker 2: you give us a snapshot into the day of a neurosurgeon. Yeah,

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Speaker 2: I get up at three thirty, go to the gym,

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Speaker 2: I come home and I meditates and then I read

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Speaker 2: my natomy text.

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Speaker 1: Though you're a fucking idiot. We know that's not true.

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Speaker 2: Mark Woolberg sort of schedule, which I think is day

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Speaker 2: of rubbish. A typical day like Friday is one of

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Speaker 2: my operating days. He's a classic day. So the theaterist

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Speaker 2: starts at eight, and I'm there at ten to eight,

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Speaker 2: and I'm in theater by eight and I've got my

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Speaker 2: walk in there and you can tell it's going to

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Speaker 2: be a great day. The anesiis that I love is there.

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Speaker 2: The scrub nurse that I love is there, the assistant

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Speaker 2: that is my favorite. You've got the whole team there.

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Speaker 2: He's got a good vibe straight away. And then the

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Speaker 2: patients in the anesthetic bay, I go and have a

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Speaker 2: chat with them, they sign their consent form and then

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Speaker 2: we're off. And the first case on Friday was a

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Speaker 2: spinal tumor, and so I sit down and look at

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Speaker 2: the scan and just rehearse what I'm going to do.

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Speaker 2: And I'm looking at the scan in terms of the anatomy,

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Speaker 2: so landmarks that I'll be looking for and what I'm

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Speaker 2: going to try and what I want to recognize when

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Speaker 2: I get in there to guide me where I'm going.

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Speaker 2: And then also looking at the scan for things that

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Speaker 2: are going to trip me or potentially that can cause

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Speaker 2: a complication and how I'm going to avoid that. So

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Speaker 2: that's review that for a good twenty minutes or so,

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Speaker 2: and then a typical day could be anywhere between four

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Speaker 2: and I've done up to seven cases in a day,

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Speaker 2: depending on the anisthetus and the team and hospital beds.

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Speaker 2: And it's I love the efficiency of surgery. And I

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Speaker 2: watched my guy down in Hobart operate and that's where

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Speaker 2: I got that from. Incredibly efficient in terms of all

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Speaker 2: of his movements and starting doing the operation, closing up,

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Speaker 2: wrapping up, and then my aniesthetus is very efficient as well.

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Speaker 2: So the turnover can be quick because don't forget. If

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Speaker 2: you do five cases, that's about you know, that's four

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Speaker 2: turnover times. And so if the anesthas is fast, that's

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Speaker 2: half an hour per turnover time, so that's two hours

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Speaker 2: extra added to the operating time. Or if they're not

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Speaker 2: as quick and it's an hour, that's an extra four

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Speaker 2: hours of the day added just sitting around waiting for

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Speaker 2: the anesthetus to do their things. So there's that element.

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Speaker 2: I think I've got five cases. They will take me

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Speaker 2: forty minutes each, will be done by two o'clock, and

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Speaker 2: then you've got to add in the anesthetic time, which

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Speaker 2: is four hours, so actually we'll be done at eight o'clock. Wow. Yeah.

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Speaker 2: But the theater days, it's the best part of it.

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Speaker 2: I do a lot of consulting, sitting at the desk

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Speaker 2: and talking to patients and that's becoming a more rewarding

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Speaker 2: process as well. And that would typically start at nine

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Speaker 2: o'clock and finish around about round four seeing new patients

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Speaker 2: going and I love the education side of things. I'm

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Speaker 2: talking to them about their problem, trying to identify what

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Speaker 2: their problem is. That's really really key often it's not

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Speaker 2: straight up obvious what it is that they want to

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Speaker 2: talk about. And so finding that getting expectations sorted out

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Speaker 2: that's really really key. Expectations. They need to need to

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Speaker 2: be on the same page otherwise that causes real problem.

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Speaker 2: So finding that I love the education side of things,

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Speaker 2: showing them the scan, showing them what's wrong. People love

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Speaker 2: to see that there is something wrong. It's very common

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Speaker 2: that they say, oh, you know what, I actually thought

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Speaker 2: I was going crazy. There's actually something wrong with me. Yes,

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Speaker 2: very And I take video of surgery. I've got this

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Speaker 2: video app that I've called Surgery TV, which I've developed

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Speaker 2: over the last two years with a colleague, and in fact,

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Speaker 2: we just we just got awarded a government grant for

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Speaker 2: this video app. It was about eighty six thousand dollars,

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Speaker 2: which is just great in terms of us being able

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Speaker 2: to push it further. But essentially, what it does is

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Speaker 2: allow me to record the video of every operation I do,

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Speaker 2: which it always do, but it takes about you can

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Speaker 2: take you about forty minutes to download a video of

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Speaker 2: each operation onto a USB and then you've got to

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Speaker 2: do something with it. With this app that we've designed,

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Speaker 2: it goes from the microscope straight to my iPhone ready

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Speaker 2: to go. So it's an automated process. So now I

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Speaker 2: have a video of everyone's surgery for everyone that I do,

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Speaker 2: and I give it to them to the patient the

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Speaker 2: following morning, and again I've told them about an operation,

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Speaker 2: they've consented for an operation, they've had the operation, and

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Speaker 2: then the following morning, after their operation, I showed them

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Speaker 2: the video of the problem and me fixing the problem.

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Speaker 2: And they still say, oh, that was so good to see.

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Speaker 2: There's actually something wrong with me. I wasn't going crazy.

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Speaker 2: Yes you must have. I mean you're still possibly there

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Speaker 2: was something you thought you were crazy.

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Speaker 1: You know what I love about that? That shows that

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Speaker 1: you have absolute confidence in what you do to be

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Speaker 1: able to record, to record that and then say here's

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Speaker 1: the video. A lot of surgeons would not do that,

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Speaker 1: is my guess.

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Speaker 2: Well, that is a very good point that you raise.

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Speaker 2: Patients say a couple of things about the video, and

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Speaker 2: one of them is exactly that, Well, if you're confident

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Speaker 2: enough to record the operation, then I'm confident in you

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Speaker 2: doing the operation. But I look at it like this,

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Speaker 2: if you don't have a video of surgery, the surgeon

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Speaker 2: stuffed up if you do have a video of surgery,

365
00:19:01,359 --> 00:19:05,120
Speaker 2: it was a difficult case, just say there's a complication.

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Speaker 2: Surgeons say I don't want a complication recorded on video. Well,

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Speaker 2: surgeons are rarely negligent. In fact, they're almost never negligent.

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Speaker 2: It's just bad luck or the case was just very

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Speaker 2: very difficult, And you can't say that. You can't say

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Speaker 2: the case was difficult, or it was bad luck, or

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Speaker 2: there was this you know, this anatomical variation. You can

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Speaker 2: write it at an opropose, but it's just very difficult

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Speaker 2: to communicate that because you're you're contrasting that to an

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Speaker 2: outcome that's not ideal, and that's blank and white. So

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Speaker 2: it's sort of good evidence. So I say, well, you know,

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Speaker 2: without a video, basically people just think that you stuffed up.

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00:19:40,960 --> 00:19:43,359
Speaker 2: With a video, people will see that it was just

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Speaker 2: it was bad luck or it was a difficult case.

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Speaker 2: So the video is actually protective.

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Speaker 1: Amazing. How often do you get in there? And I

381
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Speaker 1: would imagine the answer is not much. But so you've

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Speaker 1: got all the stuff that you need to see and

383
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Speaker 1: analyze beforehand, do you ever get in there and you're surprised, like, oh,

384
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Speaker 1: I didn't think this would be here, or I expect.

385
00:20:05,560 --> 00:20:10,800
Speaker 2: That, not surprised about the location of something. I know

386
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Speaker 2: to a millimeter where something is going to be because

387
00:20:13,280 --> 00:20:15,560
Speaker 2: you can tell on the scan. The MRI scan is

388
00:20:15,640 --> 00:20:18,919
Speaker 2: high resolution imaging, so I know exactly where something is

389
00:20:18,960 --> 00:20:22,800
Speaker 2: going to be. What can be a surprise is what

390
00:20:22,840 --> 00:20:25,959
Speaker 2: that thing is made of, or how stuck it is,

391
00:20:26,800 --> 00:20:29,280
Speaker 2: or how adherent it is to different structures. That's the

392
00:20:29,320 --> 00:20:32,679
Speaker 2: only real surprise. Like the spinal timber, for example, I

393
00:20:32,760 --> 00:20:35,200
Speaker 2: knew to a millimeter where the top of the bottom

394
00:20:35,240 --> 00:20:38,440
Speaker 2: of that, where the lateral the medial margin was. What

395
00:20:38,480 --> 00:20:40,480
Speaker 2: I was unsure about is what it was actually going

396
00:20:40,560 --> 00:20:42,679
Speaker 2: to look and feel like. Was it going to be

397
00:20:42,720 --> 00:20:45,199
Speaker 2: soft and gelatinous and come out easy. Was it going

398
00:20:45,200 --> 00:20:46,760
Speaker 2: to be tough and fibrous where it's going to be

399
00:20:46,760 --> 00:20:49,080
Speaker 2: a bit more difficult to take out. So it's difficult

400
00:20:49,119 --> 00:20:52,800
Speaker 2: to judge what something is going to be. Consistency of

401
00:20:53,160 --> 00:20:55,680
Speaker 2: the stuff is going to be like, which is makes

402
00:20:55,680 --> 00:20:57,879
Speaker 2: a huge impact on how you deal with it. If

403
00:20:57,920 --> 00:21:00,640
Speaker 2: something soft and gelatinous, that's quite easy to remove. If

404
00:21:00,640 --> 00:21:03,159
Speaker 2: it's fibrous and densely adherent to stuff, and that's a

405
00:21:03,200 --> 00:21:05,920
Speaker 2: lot more difficult to remove. So that's the unknown.

406
00:21:06,560 --> 00:21:08,960
Speaker 1: I never thought of that. So when you're cutting out

407
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Speaker 1: something that's soft and gooey versus something that's tougher and

408
00:21:14,040 --> 00:21:18,240
Speaker 1: more fibrous and dense, do you use the exact same tool,

409
00:21:18,520 --> 00:21:21,959
Speaker 1: the exact same scalpel or whatever, or is it? There

410
00:21:22,000 --> 00:21:23,760
Speaker 1: are a bunch of you go no, this is like

411
00:21:23,840 --> 00:21:26,119
Speaker 1: removing an old bit of leather boots.

412
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Speaker 2: So we use something different. There's something different. This tumor

413
00:21:29,480 --> 00:21:33,040
Speaker 2: on Friday was soft into latinous. So the tumor has

414
00:21:33,080 --> 00:21:36,000
Speaker 2: a capsule which has possibly got nerve fibers running through

415
00:21:36,080 --> 00:21:38,159
Speaker 2: the capsule, so you have to preserve the capsule. So

416
00:21:38,160 --> 00:21:39,960
Speaker 2: I make a linear cut through the capsule, which is

417
00:21:40,000 --> 00:21:42,919
Speaker 2: like half a millimeter thick, and it springs open and

418
00:21:42,960 --> 00:21:45,640
Speaker 2: reveals the sort of soft latinous tumor underneath.

419
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Speaker 1: Sin.

420
00:21:46,080 --> 00:21:48,760
Speaker 2: As I see that, I know this is going to

421
00:21:48,800 --> 00:21:52,879
Speaker 2: go well. And there's a curet that's a bit spoon shaped,

422
00:21:52,920 --> 00:21:55,600
Speaker 2: and I essentially slide it between the tumor and the capsule,

423
00:21:55,840 --> 00:22:00,199
Speaker 2: and it's like scooping out a pee out of a pod, almost,

424
00:22:01,000 --> 00:22:03,399
Speaker 2: and I just gently separate it and gently separated and

425
00:22:03,440 --> 00:22:06,080
Speaker 2: gently free it up. There's a couple of places where

426
00:22:06,080 --> 00:22:08,680
Speaker 2: it's densely adherent, and there's a micro scissor. It's beautiful

427
00:22:08,680 --> 00:22:13,200
Speaker 2: micro scissor and that's used to divide where it's densely

428
00:22:13,200 --> 00:22:16,359
Speaker 2: adherent and then it comes out comes out quite nicely.

429
00:22:16,400 --> 00:22:19,080
Speaker 2: If it's more fibrous. We've got this beautiful machine called

430
00:22:19,080 --> 00:22:26,800
Speaker 2: a CUSA CUSA which stands for Cavetron Ultrasonic aspirator. It's brilliant.

431
00:22:27,000 --> 00:22:31,720
Speaker 2: It's this fine tip and it uses I think it's

432
00:22:31,720 --> 00:22:35,960
Speaker 2: an ultrasonic wave to fracture the tissue at the tip

433
00:22:36,240 --> 00:22:40,080
Speaker 2: and then it asperates the fractured tissue, so in effect,

434
00:22:40,160 --> 00:22:42,919
Speaker 2: it's like having a pencil and at the tip of

435
00:22:42,960 --> 00:22:45,679
Speaker 2: the pencil the tumor just dissolves and goes up the sucker.

436
00:22:45,920 --> 00:22:47,800
Speaker 2: So it can be quite fibrous and dense and it

437
00:22:47,840 --> 00:22:51,159
Speaker 2: will just literally dissolve it and suck it. And the

438
00:22:51,200 --> 00:22:56,080
Speaker 2: beautiful instrument for tumors are a lot more dense. We

439
00:22:56,200 --> 00:22:59,240
Speaker 2: joke that the CUSA actually c USA stands for can't

440
00:22:59,359 --> 00:23:01,600
Speaker 2: use straight up because it takes about forty minutes to

441
00:23:01,640 --> 00:23:02,320
Speaker 2: set the thing up.

442
00:23:02,960 --> 00:23:06,280
Speaker 1: That's hilarious. Is there any I don't know if I

443
00:23:06,280 --> 00:23:08,280
Speaker 1: want to ask this question, but I know you'll answer

444
00:23:08,320 --> 00:23:11,520
Speaker 1: it honestly in general terms, like I think people a

445
00:23:11,520 --> 00:23:14,840
Speaker 1: lot of people have been essentially led to believe that

446
00:23:15,359 --> 00:23:17,400
Speaker 1: if you're going to have surgery, make sure you get

447
00:23:17,440 --> 00:23:20,240
Speaker 1: the surgeon. Make sure you get your surgery in the morning,

448
00:23:20,600 --> 00:23:24,240
Speaker 1: because that's when the surgeon's at his or her best,

449
00:23:25,960 --> 00:23:30,080
Speaker 1: and surgeons are human. I would imagine that that might

450
00:23:30,200 --> 00:23:32,920
Speaker 1: be true, or is that not true, or it depends.

451
00:23:33,920 --> 00:23:35,840
Speaker 2: I see a patient in the anesthetic bay, and it

452
00:23:35,840 --> 00:23:38,639
Speaker 2: doesn't matter where they are on the list. If they're first,

453
00:23:38,720 --> 00:23:41,359
Speaker 2: I say, you're first up, everyone's fresh. You're in the

454
00:23:41,359 --> 00:23:44,040
Speaker 2: best position. If they're fourth on the list, I walk

455
00:23:44,080 --> 00:23:46,600
Speaker 2: in there, I say, we've done three already. Everybody's warmed

456
00:23:46,680 --> 00:23:48,440
Speaker 2: up and got their eye, and you're in the best position.

457
00:23:49,600 --> 00:23:52,080
Speaker 2: It doesn't matter. They all have a laugh and it

458
00:23:52,160 --> 00:23:57,320
Speaker 2: relaxes them. It doesn't matter because every operation, the experience

459
00:23:57,400 --> 00:24:00,800
Speaker 2: is the same, which is a laser focus. Sitting around

460
00:24:01,080 --> 00:24:04,040
Speaker 2: and waiting is different. You've got a bit more energy

461
00:24:04,119 --> 00:24:07,040
Speaker 2: waiting in the morning and the evening, the waiting is

462
00:24:07,080 --> 00:24:10,439
Speaker 2: you know, a bit more painful. But as soon as

463
00:24:10,480 --> 00:24:14,920
Speaker 2: the microscope gets wheeled into place, the brain just switches

464
00:24:15,000 --> 00:24:19,000
Speaker 2: on and it becomes a laser focus and it's like

465
00:24:19,080 --> 00:24:21,560
Speaker 2: nothing has changed. It's like the first case. Wow.

466
00:24:22,320 --> 00:24:25,640
Speaker 1: You spoke before about how the idea that you walk

467
00:24:25,640 --> 00:24:27,360
Speaker 1: and it's going to be a good day because you've

468
00:24:27,359 --> 00:24:31,280
Speaker 1: got the team that you love, You've got your dream team.

469
00:24:32,160 --> 00:24:35,520
Speaker 1: Who organizes that, Like do you go, I want to

470
00:24:35,560 --> 00:24:37,480
Speaker 1: work with these people or do you just show up

471
00:24:37,480 --> 00:24:40,280
Speaker 1: on the day? And it depends who's rostered on.

472
00:24:41,880 --> 00:24:45,560
Speaker 2: The nursing staff are rosted, the anesthetic staff. I have

473
00:24:45,640 --> 00:24:52,200
Speaker 2: relationships with those guys and have essentially elected to work

474
00:24:52,240 --> 00:24:56,440
Speaker 2: with them, and that's the dynamics. Over time, you sort

475
00:24:56,440 --> 00:24:58,119
Speaker 2: of start to get the team that you want to

476
00:24:58,160 --> 00:25:03,320
Speaker 2: have with the nursing staff and the scrub team they're

477
00:25:03,400 --> 00:25:06,080
Speaker 2: rosted that you start to get more and more time

478
00:25:06,119 --> 00:25:07,159
Speaker 2: with the people that you like.

479
00:25:08,920 --> 00:25:12,000
Speaker 1: Do you think over time like racking up all the

480
00:25:12,040 --> 00:25:18,160
Speaker 1: surgeries that you've done and are doing, and of course

481
00:25:18,280 --> 00:25:21,679
Speaker 1: everyone who's doing a job, over time, you know, develop

482
00:25:21,760 --> 00:25:24,399
Speaker 1: skill and competence and all of those things. Do you

483
00:25:24,440 --> 00:25:29,040
Speaker 1: think that you've become calmer? Not that you were probably

484
00:25:29,080 --> 00:25:34,359
Speaker 1: ever chaotic, but like I think most of us doing

485
00:25:35,000 --> 00:25:37,040
Speaker 1: obviously most of us wouldn't do what you do, but

486
00:25:37,160 --> 00:25:42,080
Speaker 1: something where the potential consequences are so big, you know,

487
00:25:42,160 --> 00:25:45,240
Speaker 1: one way or the other. I mean, that's for us

488
00:25:45,280 --> 00:25:51,200
Speaker 1: mere mortals. That's a recipe for fucking overthinking, self doubt, rumination, anxiety.

489
00:25:52,480 --> 00:25:55,320
Speaker 1: But obviously those things don't work being in any of

490
00:25:55,320 --> 00:25:59,040
Speaker 1: those states don't work. When you need so much fine

491
00:25:59,119 --> 00:26:05,640
Speaker 1: motor skill, so much calmness, and so much presence, how

492
00:26:05,680 --> 00:26:09,480
Speaker 1: do you stay calm but also at the same time

493
00:26:09,680 --> 00:26:11,359
Speaker 1: fully alert and switched.

494
00:26:11,000 --> 00:26:16,520
Speaker 2: On watching a mental watching and learning during the training years. Again,

495
00:26:16,840 --> 00:26:20,280
Speaker 2: my guide out in Hobart still the most naturally gifted

496
00:26:20,320 --> 00:26:25,040
Speaker 2: guy I've seen around Australia, and I've been around Australia.

497
00:26:25,320 --> 00:26:30,280
Speaker 2: It was observing him under pressure and how he reacted

498
00:26:30,320 --> 00:26:33,840
Speaker 2: to it. I still remember a pediatric brain tumor case.

499
00:26:34,359 --> 00:26:38,760
Speaker 2: It went for ten hours or something like that, and

500
00:26:38,800 --> 00:26:41,200
Speaker 2: he just stood there with his shoulders down, his elbows

501
00:26:41,200 --> 00:26:45,040
Speaker 2: by his side, risk just moving slowly, slowly for that

502
00:26:45,200 --> 00:26:49,600
Speaker 2: whole time. And at the time I was like, why

503
00:26:49,720 --> 00:26:51,720
Speaker 2: is he taking so long? I'm tired, I want to

504
00:26:51,760 --> 00:26:55,080
Speaker 2: go home, let's wrap this up. Until I had a

505
00:26:55,080 --> 00:26:57,800
Speaker 2: case of a pediatric brain tumor that I was doing

506
00:26:58,280 --> 00:27:01,280
Speaker 2: on my own. I've told this story before. I think

507
00:27:01,480 --> 00:27:03,880
Speaker 2: it was. It started at eight or nine and went

508
00:27:03,880 --> 00:27:09,560
Speaker 2: through to eleven o'clock that night. Difficult pediatric tumor, and

509
00:27:10,000 --> 00:27:13,119
Speaker 2: it was stuck to the brain stem. It was bleeding profusely.

510
00:27:13,480 --> 00:27:16,239
Speaker 2: Progress was super slow. At times, it was hard to

511
00:27:16,240 --> 00:27:19,359
Speaker 2: make out what was tumor and what was normal brain stem.

512
00:27:19,520 --> 00:27:21,800
Speaker 2: And the brain stem is highest priced real estate you

513
00:27:21,800 --> 00:27:24,439
Speaker 2: can get in the brain. I touched that and there

514
00:27:24,440 --> 00:27:30,000
Speaker 2: are huge consequences. So that was extremely incredibly stressful operation.

515
00:27:31,160 --> 00:27:33,760
Speaker 2: And I thought, this is probably what my mentor was feeling.

516
00:27:33,800 --> 00:27:36,400
Speaker 2: This is the emotions he was feeling during that ten

517
00:27:36,440 --> 00:27:38,960
Speaker 2: hour case. He was looking at that structure, going is

518
00:27:39,040 --> 00:27:40,000
Speaker 2: that tumor?

519
00:27:40,080 --> 00:27:40,159
Speaker 1: Or?

520
00:27:40,200 --> 00:27:43,160
Speaker 2: Is that is that I need? I don't know. I

521
00:27:43,160 --> 00:27:45,199
Speaker 2: imagine that that's what was going through his head. And

522
00:27:45,240 --> 00:27:47,399
Speaker 2: I only worked that out when I was doing the case.

523
00:27:48,280 --> 00:27:50,720
Speaker 2: But at the time he was just composed and just

524
00:27:50,760 --> 00:27:53,960
Speaker 2: went millimeter by millimeter. I just remember that, and during

525
00:27:54,000 --> 00:27:57,399
Speaker 2: this pediatric tumor case of mine, I just replicated that.

526
00:27:57,680 --> 00:28:01,000
Speaker 2: I just kipped my head, kept my car and knew

527
00:28:01,040 --> 00:28:05,400
Speaker 2: that it was okay just to proceed slowly. I learned

528
00:28:05,440 --> 00:28:09,520
Speaker 2: a huge amount just watching this guy. The other thing,

529
00:28:09,560 --> 00:28:12,360
Speaker 2: Do I stay calm I think I get I am

530
00:28:12,720 --> 00:28:17,920
Speaker 2: definitely calm and get calmer with time, but I get

531
00:28:18,680 --> 00:28:23,920
Speaker 2: not agitated. But I don't think grumpy is the right

532
00:28:23,960 --> 00:28:29,879
Speaker 2: word either. But it's essentially I get shorter and clearer

533
00:28:30,040 --> 00:28:33,600
Speaker 2: and maybe a little bit blunter with instructions in theater

534
00:28:35,520 --> 00:28:41,440
Speaker 2: because I know more now the value of nipping any

535
00:28:42,280 --> 00:28:46,360
Speaker 2: variable in the bud, any new variable that's introduced during theater.

536
00:28:47,000 --> 00:28:49,840
Speaker 2: If you allow too many new variables to accumulate, that's

537
00:28:49,880 --> 00:28:54,920
Speaker 2: when you start getting complications. So my instructions are crystal clear,

538
00:28:55,000 --> 00:28:57,680
Speaker 2: and I'm actually quite blunt, and if there is a

539
00:28:57,720 --> 00:29:03,760
Speaker 2: minor variation to that, I stop, corrected and then move forward.

540
00:29:04,200 --> 00:29:06,520
Speaker 2: And it can be the simplest thing. The screen needs

541
00:29:06,520 --> 00:29:09,720
Speaker 2: to be facing this particular way, the drape needs to

542
00:29:09,760 --> 00:29:12,800
Speaker 2: be on a certain way, The instrument needs to always

543
00:29:12,840 --> 00:29:15,840
Speaker 2: be the same. Told the story of the hammer they

544
00:29:15,840 --> 00:29:18,640
Speaker 2: handed me during a spine operation, a hammer that I

545
00:29:18,720 --> 00:29:21,800
Speaker 2: was not expecting. It was a slightly smaller one. They

546
00:29:21,840 --> 00:29:26,000
Speaker 2: had a laugh, and I was quite short and blunt

547
00:29:26,040 --> 00:29:30,120
Speaker 2: back at them, Not because I'm just a toxic, a

548
00:29:30,160 --> 00:29:33,360
Speaker 2: difficult personality, but I was nipping a variable in the bud.

549
00:29:33,520 --> 00:29:35,640
Speaker 2: They don't understand that variable, but if you have enough

550
00:29:35,680 --> 00:29:39,440
Speaker 2: of them, it just disorientates you. And then once you

551
00:29:39,440 --> 00:29:45,959
Speaker 2: start getting disorientated, that's where complications occur. Every time, almost invariably,

552
00:29:45,960 --> 00:29:48,080
Speaker 2: if there's a complication, you can trace it back to

553
00:29:48,440 --> 00:29:52,360
Speaker 2: a root pause. It's when this step wasn't normal, but

554
00:29:52,480 --> 00:29:54,320
Speaker 2: you accepted it and thought, oh, that's okay. We'll just

555
00:29:54,360 --> 00:29:58,200
Speaker 2: get on with the case and move forward. And so again,

556
00:29:58,560 --> 00:30:02,360
Speaker 2: my guy down in Hobart, he had white line fever.

557
00:30:02,800 --> 00:30:06,120
Speaker 2: If anything change in theater, he would just he would

558
00:30:06,200 --> 00:30:08,280
Speaker 2: just get so angry. And I couldn't understand it at

559
00:30:08,280 --> 00:30:11,040
Speaker 2: the time, and I don't condone that sort of behavior,

560
00:30:11,040 --> 00:30:15,320
Speaker 2: but I understand the concept of of what he was,

561
00:30:15,560 --> 00:30:18,160
Speaker 2: what his philosophy was, don't give me a new variable.

562
00:30:18,160 --> 00:30:20,680
Speaker 2: It's the same time every time, because if I do that,

563
00:30:21,280 --> 00:30:26,240
Speaker 2: then I'm least likely to have a complication and I'm

564
00:30:26,240 --> 00:30:27,320
Speaker 2: going to do my best work.

565
00:30:28,200 --> 00:30:31,360
Speaker 1: And I think, also, that's amazing, thank you for that.

566
00:30:32,000 --> 00:30:37,080
Speaker 1: Like dealing with people like every every day, you're dealing

567
00:30:37,120 --> 00:30:41,000
Speaker 1: literally with life and death, like literally like and so

568
00:30:42,040 --> 00:30:42,840
Speaker 1: you don't really.

569
00:30:42,640 --> 00:30:44,800
Speaker 2: Happen in hups. It's worse than that. It's not life

570
00:30:44,800 --> 00:30:50,400
Speaker 2: and death, it's it's life and life with a morbidity.

571
00:30:51,280 --> 00:30:54,000
Speaker 2: The worst thing is for someone to I mean, obviously

572
00:30:54,040 --> 00:30:57,360
Speaker 2: death is bad, but that really happens. The bad thing

573
00:30:57,400 --> 00:31:01,080
Speaker 2: if someone goes in and they're normal and they come

574
00:31:01,120 --> 00:31:04,440
Speaker 2: out with a neurological deficit, they have to live the

575
00:31:04,480 --> 00:31:08,120
Speaker 2: rest of their life with that neurological deficit. Right, That's

576
00:31:08,440 --> 00:31:11,000
Speaker 2: that's the worst outcome. You go in there and you're

577
00:31:11,000 --> 00:31:12,840
Speaker 2: able to speak, and you come out and you can't speak,

578
00:31:13,400 --> 00:31:15,360
Speaker 2: Or you go in there and your foot is working

579
00:31:15,400 --> 00:31:17,160
Speaker 2: and you come out with a foot drop. It's a

580
00:31:17,280 --> 00:31:24,040
Speaker 2: huge burden on your quality of life. That's that's really that. Yes,

581
00:31:24,120 --> 00:31:26,760
Speaker 2: death is bad, but it really happens. It's causing a

582
00:31:27,200 --> 00:31:29,920
Speaker 2: irreversible problem that they then have to live with for

583
00:31:29,920 --> 00:31:31,760
Speaker 2: the rest of their life. That's the thing we really fear.

584
00:31:32,680 --> 00:31:37,320
Speaker 1: Yeah, I had not thought of that. That is fucking terrifying.

585
00:31:37,640 --> 00:31:40,600
Speaker 1: And I guess also when you're under that pressure and

586
00:31:40,640 --> 00:31:45,960
Speaker 1: you're making decisions and doing the thing that you don't

587
00:31:46,800 --> 00:31:49,080
Speaker 1: you don't really in that moment have the bandwidth to

588
00:31:49,120 --> 00:31:52,520
Speaker 1: be able to want to or have to cater to

589
00:31:52,600 --> 00:31:58,800
Speaker 1: people's individual emotions and to keep everyone you know happy

590
00:31:59,040 --> 00:32:02,000
Speaker 1: in because you're just doing your thing. So it's not

591
00:32:02,120 --> 00:32:05,760
Speaker 1: your job to take or to be responsible for how

592
00:32:05,840 --> 00:32:09,960
Speaker 1: everyone's feeling in the middle of that surgical reality.

593
00:32:10,920 --> 00:32:14,400
Speaker 2: I don't even think about it. Teamwork is really important.

594
00:32:15,360 --> 00:32:20,040
Speaker 2: And when a scrub nurse hands me something that is perfect,

595
00:32:20,080 --> 00:32:22,920
Speaker 2: which means I'm looking down the microscope, I hand out

596
00:32:22,920 --> 00:32:26,120
Speaker 2: my hand and they put the instrument in my hand

597
00:32:26,680 --> 00:32:28,040
Speaker 2: in such a way. I just got to close my

598
00:32:28,120 --> 00:32:30,280
Speaker 2: hand and put it back in. And if they do that,

599
00:32:30,360 --> 00:32:36,280
Speaker 2: I say, perfect, that was perfect, thank you. And if

600
00:32:36,320 --> 00:32:39,400
Speaker 2: I hold my hand out and then they give it

601
00:32:39,440 --> 00:32:41,560
Speaker 2: to me as if what's easy for them, Like they

602
00:32:41,600 --> 00:32:43,320
Speaker 2: grab the instrument in their hand and they hand it

603
00:32:43,360 --> 00:32:45,000
Speaker 2: to me, so it's pointing the wrong way. I've got

604
00:32:45,000 --> 00:32:48,840
Speaker 2: to move my hand then to grasp that. I don't

605
00:32:48,840 --> 00:32:50,480
Speaker 2: even do that anyway. I say give it to me properly.

606
00:32:50,480 --> 00:32:51,720
Speaker 2: I actually give it back to them. Say give it

607
00:32:51,760 --> 00:32:58,400
Speaker 2: to me properly. And because it's teamwork, you know, they

608
00:32:58,400 --> 00:32:59,720
Speaker 2: get the best out of me when I get the

609
00:32:59,720 --> 00:33:06,200
Speaker 2: best out of them. So I reinforce great behavior and

610
00:33:06,520 --> 00:33:09,360
Speaker 2: I ask for it in return. We have something called

611
00:33:09,360 --> 00:33:12,800
Speaker 2: the Mayo table, which is a It sounds fancy, but

612
00:33:12,960 --> 00:33:14,920
Speaker 2: essentially it's just a tray that sits on top of

613
00:33:14,920 --> 00:33:17,120
Speaker 2: the bed, but it's got some legs onto the floor.

614
00:33:17,120 --> 00:33:20,840
Speaker 2: It's called basically sit instruments on this on this mayo table.

615
00:33:21,800 --> 00:33:23,880
Speaker 2: And when that mayo table, it's got a lot of

616
00:33:23,920 --> 00:33:26,120
Speaker 2: instruments that the scrub nurse is using. It's the stuff

617
00:33:26,120 --> 00:33:28,480
Speaker 2: that I'm using is going on and off, back and forwards.

618
00:33:28,600 --> 00:33:32,200
Speaker 2: When that mayo is organized, all the instruments are lined up, dunk.

619
00:33:33,120 --> 00:33:36,200
Speaker 2: I say that the mayo is a is a glimpse

620
00:33:36,200 --> 00:33:39,280
Speaker 2: into the scrub nurse's mind. The mayo is a reflection

621
00:33:39,400 --> 00:33:43,880
Speaker 2: of the mind. When that mayo is organized, I feel organized.

622
00:33:43,920 --> 00:33:46,960
Speaker 2: I feel they are organized, and I'm confident in them.

623
00:33:47,000 --> 00:33:48,640
Speaker 2: And I say that, I actually say that. I said

624
00:33:48,640 --> 00:33:52,040
Speaker 2: that your mayo is very clean and tidy. Clearly, your

625
00:33:52,040 --> 00:33:54,920
Speaker 2: mind is very clear clear at the moment, I appreciate that.

626
00:33:55,760 --> 00:34:05,480
Speaker 1: Yeah, how quickly or slowly does neurosurgery evolve? I feel

627
00:34:05,720 --> 00:34:08,960
Speaker 1: it's probably not linear. It's probably on an incline at

628
00:34:09,000 --> 00:34:12,600
Speaker 1: the moment. With tech or what the fuck do I know?

629
00:34:14,520 --> 00:34:17,880
Speaker 2: Give usked a fascinating question, And I've written an article

630
00:34:17,920 --> 00:34:21,960
Speaker 2: on this. There is some technology at the moment, like

631
00:34:22,000 --> 00:34:27,759
Speaker 2: a robot or the endoscope for spine surgery quite a

632
00:34:27,760 --> 00:34:31,080
Speaker 2: bit of tech at the moment where it's a huge

633
00:34:31,120 --> 00:34:37,800
Speaker 2: expenditure to develop that tech, massive expenditure and the price

634
00:34:37,880 --> 00:34:41,880
Speaker 2: to purchase this equipment is phenomenal, the million dollars for

635
00:34:41,880 --> 00:34:46,480
Speaker 2: a piece of equipment, and the benefit to the patient

636
00:34:47,760 --> 00:34:52,799
Speaker 2: is extremely marginal. And the reason I say that you

637
00:34:52,920 --> 00:34:57,240
Speaker 2: just wind back the clock not far at all. CT

638
00:34:57,440 --> 00:35:01,320
Speaker 2: scan which revolutionize medicine. I mean Planet Earth probably stopped

639
00:35:01,360 --> 00:35:04,520
Speaker 2: spinning for about two seconds when the CT scan arrived

640
00:35:04,920 --> 00:35:08,680
Speaker 2: at address Planet Earth. That was developed on a shoe

641
00:35:08,680 --> 00:35:11,960
Speaker 2: string budget by a guy from the Second World War

642
00:35:12,000 --> 00:35:16,520
Speaker 2: who is working with radar, and over three years persevered

643
00:35:17,040 --> 00:35:24,440
Speaker 2: and against expectations, came up with the CT scanner. Minimal expenditure,

644
00:35:25,120 --> 00:35:32,480
Speaker 2: exponential effect on medicine and patient outcomes. The same with

645
00:35:32,640 --> 00:35:37,240
Speaker 2: MRI scan and in eurosurgery. There's some beings, some texts.

646
00:35:37,360 --> 00:35:40,479
Speaker 2: The big one for us is stereotactic. That is using

647
00:35:40,480 --> 00:35:43,000
Speaker 2: a computer to be able to decide where something is

648
00:35:43,080 --> 00:35:47,959
Speaker 2: inside the brain or the spine that's mainly inside the brain,

649
00:35:49,160 --> 00:35:50,640
Speaker 2: and so we use it all the time. If there's

650
00:35:50,640 --> 00:35:53,439
Speaker 2: a tumor that's three centimeters blow the surface of the brain,

651
00:35:53,520 --> 00:35:55,799
Speaker 2: this computer can tell us on the skin where that

652
00:35:55,840 --> 00:35:57,880
Speaker 2: projection is, so we can get the cut on the

653
00:35:57,880 --> 00:36:04,520
Speaker 2: scalp in the perfect position. Stereotactic surgery revolutionize the game,

654
00:36:05,600 --> 00:36:12,440
Speaker 2: and now it feels like industry brings out technology for

655
00:36:12,520 --> 00:36:17,000
Speaker 2: the purposes of maintaining earnings for the quarter, and in

656
00:36:17,040 --> 00:36:20,000
Speaker 2: a way, without being cynical, in a way, a lot

657
00:36:20,000 --> 00:36:24,440
Speaker 2: of tech at the moment gives whoever's got that tech

658
00:36:24,719 --> 00:36:28,440
Speaker 2: a commercial advantage. If this hospital has got a robot

659
00:36:28,680 --> 00:36:31,720
Speaker 2: and this hospital does not have a robot, then obviously

660
00:36:31,760 --> 00:36:34,520
Speaker 2: this hospital is better and that's where people should go.

661
00:36:36,239 --> 00:36:38,160
Speaker 2: And that's a big part of a landscape at the moment.

662
00:36:39,160 --> 00:36:43,759
Speaker 2: So hospitals are forced to buy this equipment because another

663
00:36:43,800 --> 00:36:46,480
Speaker 2: hospital has got it without it at a disadvantage in

664
00:36:46,560 --> 00:36:48,640
Speaker 2: terms of their quality of care. But really the quality

665
00:36:48,640 --> 00:36:52,880
Speaker 2: of care is almost unchanged. And it's a really dangerous

666
00:36:52,960 --> 00:36:55,560
Speaker 2: landscape that we're entering where there's becoming more and more

667
00:36:55,560 --> 00:37:00,319
Speaker 2: of a push by industry to adopt this technology for

668
00:37:00,400 --> 00:37:05,800
Speaker 2: their shareholders and less so for actual patient outcomes. Huge

669
00:37:05,840 --> 00:37:10,440
Speaker 2: expenditure for very very marginal outcome, but it's a really

670
00:37:10,560 --> 00:37:14,520
Speaker 2: easy sell to the patient. I use a robot. How

671
00:37:14,520 --> 00:37:18,920
Speaker 2: could you resist that I use an endoscope for spine surgery.

672
00:37:20,160 --> 00:37:24,359
Speaker 2: It's truly keyhole surgery. How do you say no to that?

673
00:37:24,920 --> 00:37:25,200
Speaker 1: Yes?

674
00:37:26,000 --> 00:37:30,759
Speaker 2: Yes, the reality behind the scenes is slightly different, and

675
00:37:30,800 --> 00:37:33,640
Speaker 2: it's much harder to sell the fact that perhaps that

676
00:37:33,760 --> 00:37:37,279
Speaker 2: robot doesn't actually change very much at all, and there's

677
00:37:37,280 --> 00:37:40,040
Speaker 2: a different reason that hospital has a robot. That's a

678
00:37:40,040 --> 00:37:42,880
Speaker 2: hard sell. But just to say we have a robot

679
00:37:43,520 --> 00:37:44,560
Speaker 2: is a very easy cell.

680
00:37:45,320 --> 00:37:49,440
Speaker 1: Yeah. Yeah, What about I don't even know if this

681
00:37:49,600 --> 00:37:51,879
Speaker 1: is a good question, So if it's dumb, I'll take

682
00:37:51,920 --> 00:37:59,120
Speaker 1: it out. What about current or future surgical treatments for

683
00:37:59,239 --> 00:38:05,960
Speaker 1: neurological diseases like Alzheimer's, Parkinson's and so on? Is there

684
00:38:06,080 --> 00:38:07,759
Speaker 1: do you ever do? Is that a thing?

685
00:38:08,800 --> 00:38:15,960
Speaker 2: Alzheimer's No, Parkinson's, Yes, Parkinson's disease. The surgical treatment for

686
00:38:16,000 --> 00:38:20,080
Speaker 2: that is phenomenal. The fuck has three parts of the rigidity,

687
00:38:20,160 --> 00:38:23,640
Speaker 2: the hand tremor, and then they walk really stiff and slow,

688
00:38:24,480 --> 00:38:27,759
Speaker 2: and it can be completely debilitating. There are drugs for it.

689
00:38:28,160 --> 00:38:31,760
Speaker 2: But there's an operation called deep brain stimulation. The target

690
00:38:31,880 --> 00:38:34,279
Speaker 2: is a few millimeters wide, deep in the center of

691
00:38:34,320 --> 00:38:36,960
Speaker 2: the brain, and the target was discovered by accident. A

692
00:38:37,040 --> 00:38:39,640
Speaker 2: number of years ago, but now we've got the target

693
00:38:39,680 --> 00:38:41,440
Speaker 2: and we can put a probe into that target and

694
00:38:41,520 --> 00:38:45,680
Speaker 2: stimulate or cause a lesion in that target. The effect

695
00:38:45,880 --> 00:38:51,520
Speaker 2: is phenomenal. A patient can be completely immobilized and incapacitated

696
00:38:51,520 --> 00:38:58,759
Speaker 2: by their Parkinson's symptoms and then post surgery getting towards

697
00:38:58,840 --> 00:39:02,879
Speaker 2: barely recognizable, almost back to normal. There's another condition called

698
00:39:02,880 --> 00:39:08,440
Speaker 2: a central tremor, which again is a type of neurodegenerative condition. Essentially,

699
00:39:08,480 --> 00:39:10,319
Speaker 2: when their hand is at rest, it's fine, but when

700
00:39:10,320 --> 00:39:12,840
Speaker 2: they go out to reach something, the hand starts shaking violently.

701
00:39:12,880 --> 00:39:14,439
Speaker 2: You may have seen it. They reach out to grab

702
00:39:14,480 --> 00:39:16,840
Speaker 2: a glass of water, and the closer you get to

703
00:39:16,840 --> 00:39:20,520
Speaker 2: the glass of water, the hand just starts just shaking uncontrollably.

704
00:39:20,800 --> 00:39:22,640
Speaker 2: It's obviously they can't use their hand for anything because

705
00:39:22,640 --> 00:39:24,480
Speaker 2: as soon as they go to do something, it's called

706
00:39:24,480 --> 00:39:26,480
Speaker 2: an action tremor. As soon as they use the hand

707
00:39:26,520 --> 00:39:30,560
Speaker 2: for anything, the hand just completely starts flailing around. And

708
00:39:30,600 --> 00:39:33,960
Speaker 2: then after deep brain stimulation the hand works completely normally

709
00:39:34,040 --> 00:39:37,919
Speaker 2: like it's a phenomenal before and after video. So that's

710
00:39:37,960 --> 00:39:44,040
Speaker 2: been around for a while. The accuracy is what's improved

711
00:39:45,000 --> 00:39:48,000
Speaker 2: exactly where that probe goes in what location and ensuring

712
00:39:48,040 --> 00:39:52,000
Speaker 2: the accuracy. That is certainly improved. The instruments we have

713
00:39:52,080 --> 00:39:54,880
Speaker 2: to do the surgery have improved, making it easier to

714
00:39:54,920 --> 00:39:58,640
Speaker 2: manipulate tissues and do things safely. But for lo the

715
00:39:58,640 --> 00:40:02,640
Speaker 2: philosophy is the same. Surgery is a game of physicality.

716
00:40:02,960 --> 00:40:05,479
Speaker 2: It's removing something that shouldn't be there, or putting something

717
00:40:05,520 --> 00:40:09,360
Speaker 2: back in its normal place, or fixing something that's physically broken.

718
00:40:09,400 --> 00:40:12,719
Speaker 2: That's essentially the name of the game. If it comes

719
00:40:12,719 --> 00:40:15,120
Speaker 2: to brain tumors, the outcomes for a lot of them

720
00:40:15,120 --> 00:40:18,600
Speaker 2: haven't changed in fifty years. Surgery hasn't changed. The only

721
00:40:18,640 --> 00:40:20,760
Speaker 2: thing that's really going to change that is drugs.

722
00:40:21,920 --> 00:40:25,279
Speaker 1: So a friend of mine's got an essential tremor. I

723
00:40:25,360 --> 00:40:28,120
Speaker 1: did not know what you just told me, So I'm

724
00:40:28,120 --> 00:40:31,759
Speaker 1: going to ring him after this. How long?

725
00:40:32,920 --> 00:40:36,440
Speaker 2: How long does that procedure take? Give or take not

726
00:40:36,520 --> 00:40:38,880
Speaker 2: long at all? The planning takes a while going to

727
00:40:38,880 --> 00:40:41,000
Speaker 2: do a scan of the brain and identify that target

728
00:40:41,080 --> 00:40:43,880
Speaker 2: and his minuscule harps. It's a tiny target deep in

729
00:40:43,920 --> 00:40:46,439
Speaker 2: the brain. Planning is a big part of that. Doing

730
00:40:46,440 --> 00:40:48,200
Speaker 2: the operation, they'll do it in under an hour.

731
00:40:48,880 --> 00:40:53,360
Speaker 1: Wow, And what's the chances of a good outcome.

732
00:40:53,640 --> 00:40:55,600
Speaker 2: In someone who's experience, who knows how to do the

733
00:40:55,640 --> 00:40:58,440
Speaker 2: planning and to minimize risk, and has experience in minimizing

734
00:40:58,440 --> 00:41:01,360
Speaker 2: the risk and the one of the big challenges is

735
00:41:01,360 --> 00:41:03,920
Speaker 2: that the brain moves, so it moves with each heartbeat,

736
00:41:04,280 --> 00:41:06,200
Speaker 2: so you kind of have a moving target. You have

737
00:41:06,239 --> 00:41:08,440
Speaker 2: a moving target when you put it in, but also

738
00:41:08,520 --> 00:41:10,960
Speaker 2: when it's actually in the brain's still moving, so it's

739
00:41:10,960 --> 00:41:13,960
Speaker 2: still like a moving target for the stationary tip. People

740
00:41:14,080 --> 00:41:18,560
Speaker 2: have experienced doing that and know how to work around that,

741
00:41:19,280 --> 00:41:21,719
Speaker 2: their chances of success are high.

742
00:41:22,080 --> 00:41:24,439
Speaker 1: What's the bit of the brain called where you said,

743
00:41:24,480 --> 00:41:27,160
Speaker 1: we accidentally found this out and it's like a bit

744
00:41:27,200 --> 00:41:29,360
Speaker 1: of the brain that's a few millimeters what's it called.

745
00:41:30,239 --> 00:41:32,359
Speaker 2: One of them is called the VIM which I think

746
00:41:32,440 --> 00:41:37,520
Speaker 2: is the ventral intermediary something. I'll have to look that up.

747
00:41:37,560 --> 00:41:41,839
Speaker 2: I can't remember. V im is is the acronym. There's

748
00:41:41,840 --> 00:41:44,560
Speaker 2: a couple of targets. There's a subthallomic target. I'm not

749
00:41:44,600 --> 00:41:47,640
Speaker 2: an expert in this, but there's a subfalloming target. There's

750
00:41:47,640 --> 00:41:50,840
Speaker 2: a couple of other targets. It was absolutely discovered that

751
00:41:50,880 --> 00:41:54,319
Speaker 2: the story goes. I think it was. I think it

752
00:41:54,360 --> 00:41:57,000
Speaker 2: was last century. A guy was doing a blood vessel

753
00:41:57,040 --> 00:42:01,480
Speaker 2: operation like in ancient times, and he clipped the wrong

754
00:42:01,520 --> 00:42:05,400
Speaker 2: blood vessel as he would do because he didn't have

755
00:42:05,480 --> 00:42:08,160
Speaker 2: microscopes and modern instruments. He clipped the wrong blood vessel

756
00:42:09,040 --> 00:42:12,160
Speaker 2: and the patient woke up and their tremor was gone.

757
00:42:13,200 --> 00:42:15,680
Speaker 2: He hadn't fixed the original blood vessel problem that he'd

758
00:42:15,719 --> 00:42:18,840
Speaker 2: set out to fix, but he couldn't help but notice

759
00:42:18,840 --> 00:42:24,200
Speaker 2: the patient's tremor had completely disappeared. And I think that

760
00:42:24,280 --> 00:42:26,640
Speaker 2: they did. They didn't even have a scan of that time.

761
00:42:26,640 --> 00:42:28,879
Speaker 2: I think they did a post mortem and worked out

762
00:42:28,920 --> 00:42:32,000
Speaker 2: where that stroke was in the brain and then started

763
00:42:32,000 --> 00:42:33,400
Speaker 2: putting two and two together.

764
00:42:33,920 --> 00:42:36,279
Speaker 1: So they had to kind of reverse engineer it to

765
00:42:36,280 --> 00:42:39,160
Speaker 1: figure out how that fucking fixed it correct.

766
00:42:40,760 --> 00:42:44,000
Speaker 2: That is, that is the one I wound up understanding

767
00:42:44,040 --> 00:42:47,640
Speaker 2: the human brain. The only way that we have gathered

768
00:42:47,719 --> 00:42:50,719
Speaker 2: any valuable information about the function of human brain is

769
00:42:50,760 --> 00:42:52,920
Speaker 2: to observe the broken and work backwards.

770
00:42:53,400 --> 00:42:57,239
Speaker 1: It wasn't that the way that they discovered viagra as well.

771
00:42:57,360 --> 00:43:01,680
Speaker 1: Wasn't that meant to be like some kind of vasil

772
00:43:02,200 --> 00:43:05,080
Speaker 1: vaso dilator or something for blood pressure and it ended

773
00:43:05,160 --> 00:43:06,720
Speaker 1: up giving blokes hard cocks?

774
00:43:07,640 --> 00:43:12,600
Speaker 2: Yep. It was for pulmary hypertension and this side effect.

775
00:43:14,760 --> 00:43:17,680
Speaker 1: And then they're like, hey, we invented this, We've we've

776
00:43:17,760 --> 00:43:21,200
Speaker 1: solved one of the biggest problems for men of all time.

777
00:43:21,560 --> 00:43:23,880
Speaker 1: You're welcome. And then nobody solved it at all. They

778
00:43:24,000 --> 00:43:25,480
Speaker 1: just fucking stumbled across it.

779
00:43:26,120 --> 00:43:29,279
Speaker 2: Yeah, that's a phenomenal story is at Viagra and with

780
00:43:29,360 --> 00:43:31,880
Speaker 2: the tie. It's a great name, it's a great product

781
00:43:32,320 --> 00:43:34,680
Speaker 2: that that will be if if that was your project

782
00:43:35,239 --> 00:43:37,680
Speaker 2: that fires or whoever made that, that's that's a legacy

783
00:43:37,719 --> 00:43:39,600
Speaker 2: that is that's a game changer.

784
00:43:40,080 --> 00:43:45,120
Speaker 1: One hundred percent. Yeah. Yeah. Have you ever have you

785
00:43:45,280 --> 00:43:48,840
Speaker 1: ever encountered a case of been involved in a case

786
00:43:49,640 --> 00:43:56,600
Speaker 1: that fundamentally changed how you viewed the brain or consciousness

787
00:43:56,719 --> 00:43:59,360
Speaker 1: or the way that you just looked at it in general,

788
00:44:00,320 --> 00:44:03,800
Speaker 1: or perhaps you heard of a case or you reviewed

789
00:44:03,840 --> 00:44:10,160
Speaker 1: a case or something, or there's been no real surprises, but.

790
00:44:10,120 --> 00:44:13,960
Speaker 2: There was one central case that changed the way I

791
00:44:14,000 --> 00:44:18,200
Speaker 2: looked at the human brain. Awake Cranny oto me patients

792
00:44:18,239 --> 00:44:21,960
Speaker 2: awake during surgery. And I've done it many times before.

793
00:44:23,080 --> 00:44:24,520
Speaker 2: This was the first time I was doing it as

794
00:44:24,560 --> 00:44:29,319
Speaker 2: a consultant, so fully qualified. And the thing that rattled me.

795
00:44:29,760 --> 00:44:32,000
Speaker 2: The thing that I realized for the first time in

796
00:44:32,040 --> 00:44:36,799
Speaker 2: my career was essentially the mystery of the physical and

797
00:44:36,840 --> 00:44:39,360
Speaker 2: the non physical, that gap between the physical and non physical.

798
00:44:39,520 --> 00:44:41,759
Speaker 2: So what I mean is I could see the human brain,

799
00:44:41,800 --> 00:44:44,439
Speaker 2: and I'd seen it a thousand times before, and because

800
00:44:44,480 --> 00:44:48,480
Speaker 2: the patients awake under the drape, I could see them

801
00:44:48,520 --> 00:44:51,720
Speaker 2: having a conscious experience, and I understood for the first

802
00:44:51,800 --> 00:44:54,919
Speaker 2: time what people were talking about between that gap between

803
00:44:54,960 --> 00:44:59,279
Speaker 2: the physical brain and this non physical thing that is experience,

804
00:45:00,920 --> 00:45:04,800
Speaker 2: you know, feelings, seeing, hearing, all that sort of stuff.

805
00:45:06,360 --> 00:45:08,000
Speaker 2: And it was it was, it was. It was a

806
00:45:08,040 --> 00:45:10,840
Speaker 2: game changer for me to see that played out in

807
00:45:10,920 --> 00:45:15,279
Speaker 2: theater and there was what was really was. I don't

808
00:45:15,320 --> 00:45:17,960
Speaker 2: know why I only thought about it at that particular time.

809
00:45:17,960 --> 00:45:20,960
Speaker 2: I remember the day that it happened and I just sort

810
00:45:21,000 --> 00:45:23,799
Speaker 2: of started thinking deeply about it. I just never thought

811
00:45:23,800 --> 00:45:25,120
Speaker 2: about it, and all of a sudden it did a

812
00:45:25,160 --> 00:45:30,280
Speaker 2: deep dive in theater in that moment exploring the topic.

813
00:45:30,640 --> 00:45:33,480
Speaker 2: During the operation, there was no clue on the surface

814
00:45:33,520 --> 00:45:37,600
Speaker 2: of the brain of how that physical brain was connecting

815
00:45:37,640 --> 00:45:40,520
Speaker 2: with the non physical world. There was just no clue.

816
00:45:40,880 --> 00:45:44,120
Speaker 2: It was just pulsating with a heartbeat, but it wasn't

817
00:45:44,160 --> 00:45:46,640
Speaker 2: glowing green, and there was no sparkles and no distortion

818
00:45:46,760 --> 00:45:51,680
Speaker 2: in the atmosphere, which there should have been, because it's

819
00:45:52,200 --> 00:45:55,799
Speaker 2: still the greatest mystery known to man how the human

820
00:45:55,840 --> 00:45:59,320
Speaker 2: brain does that. It's a complete void, how that physical

821
00:45:59,320 --> 00:46:03,880
Speaker 2: brain creates the non physical phenomena of experience. There should

822
00:46:03,920 --> 00:46:11,880
Speaker 2: be some supernatural evidence of how it's doing that, and

823
00:46:11,920 --> 00:46:14,440
Speaker 2: it's and there just isn't. It's just a white brain pulsating.

824
00:46:14,440 --> 00:46:16,960
Speaker 2: It's as physical as your arm or your delt muscle

825
00:46:17,120 --> 00:46:19,680
Speaker 2: or you know, your heart. It's as physical as everything else,

826
00:46:20,120 --> 00:46:23,120
Speaker 2: yet it's got this magical quality of creating consciousness. And

827
00:46:23,160 --> 00:46:27,000
Speaker 2: looking at the brain, I realize what everybody was talking about.

828
00:46:27,040 --> 00:46:30,040
Speaker 2: There's just no evidence about how it's doing that. I

829
00:46:30,040 --> 00:46:32,759
Speaker 2: couldn't hear any voices from heaven. I couldn't. There was

830
00:46:32,840 --> 00:46:35,440
Speaker 2: just nothing. And it was a unique situation because the

831
00:46:35,440 --> 00:46:38,279
Speaker 2: patient was actually awake, having a conscious experience, where usually

832
00:46:38,280 --> 00:46:41,719
Speaker 2: there are sleeps of general anisex bond them out, but

833
00:46:41,760 --> 00:46:45,160
Speaker 2: they're having the actual non physical experience and I can

834
00:46:45,200 --> 00:46:47,080
Speaker 2: see the physicals, I can see the physical, and I

835
00:46:47,080 --> 00:46:49,600
Speaker 2: can see the evidence of the non physical in the

836
00:46:49,680 --> 00:46:53,919
Speaker 2: same person. And no link between the two of them.

837
00:46:54,560 --> 00:46:56,640
Speaker 2: And I thought, that is that is a cool mystery.

838
00:46:56,680 --> 00:46:59,359
Speaker 2: Like I get what people are talking about when they

839
00:46:59,360 --> 00:47:02,400
Speaker 2: say that's the thing they really want to understand before

840
00:47:02,440 --> 00:47:06,120
Speaker 2: they die. I mean, that is that's a that's a

841
00:47:06,120 --> 00:47:09,600
Speaker 2: brain breaker. That is I remember that day. I was like,

842
00:47:09,680 --> 00:47:11,920
Speaker 2: I get it. That is that actually is very cool.

843
00:47:12,360 --> 00:47:14,919
Speaker 2: That is that is the greatest mystery known to man

844
00:47:15,160 --> 00:47:17,080
Speaker 2: playing out right in front of me. It's like a

845
00:47:17,080 --> 00:47:22,160
Speaker 2: front row seat, no answers, but you know, I kind

846
00:47:22,160 --> 00:47:24,440
Speaker 2: of like the mystery. I like it hasn't been solved,

847
00:47:25,080 --> 00:47:27,600
Speaker 2: but as a found moment to see it actually played

848
00:47:27,680 --> 00:47:29,880
Speaker 2: out in front of you, it'd be like, are you're

849
00:47:29,920 --> 00:47:32,959
Speaker 2: visiting a black hole? Like that's just imagine if Eli

850
00:47:33,040 --> 00:47:34,520
Speaker 2: Must said I can fly you to a black hole.

851
00:47:35,000 --> 00:47:36,279
Speaker 2: Not only can you stand on the edge of the

852
00:47:36,320 --> 00:47:38,160
Speaker 2: black hole, I'll let you go in for five seconds

853
00:47:38,200 --> 00:47:41,880
Speaker 2: just to see what it's like. You'd be like, oh, yeah.

854
00:47:41,040 --> 00:47:44,480
Speaker 1: Well, I mean it's funny because my job kind of

855
00:47:44,560 --> 00:47:46,480
Speaker 1: is the mind and your job is the brain, and

856
00:47:46,520 --> 00:47:48,880
Speaker 1: we know they're related, but we kind of don't really

857
00:47:48,920 --> 00:47:52,640
Speaker 1: know how you know, and that the truth is, we

858
00:47:52,640 --> 00:47:55,080
Speaker 1: don't really have evidence of a mind only evidence of

859
00:47:55,120 --> 00:47:58,279
Speaker 1: a brain, you know, and we know that there's consciousness,

860
00:47:58,280 --> 00:48:00,880
Speaker 1: and we know that there's a brain, but we don't

861
00:48:00,880 --> 00:48:04,880
Speaker 1: know how one arises from the other. And neuroscience is

862
00:48:04,880 --> 00:48:07,440
Speaker 1: having a big crack at it. But I don't know

863
00:48:07,480 --> 00:48:09,759
Speaker 1: that we're going to understand that anytime soon. And maybe

864
00:48:09,760 --> 00:48:13,120
Speaker 1: it's good that we don't. Maybe that is that spiritual part,

865
00:48:14,239 --> 00:48:17,600
Speaker 1: maybe there is, maybe there's you know, well, there's definitely

866
00:48:17,960 --> 00:48:20,960
Speaker 1: stuff that we you know. I think that when we

867
00:48:21,120 --> 00:48:27,839
Speaker 1: can't understand or explain something in science, we're very uncomfortable

868
00:48:27,880 --> 00:48:32,880
Speaker 1: to go, well, it exists, but we don't get it.

869
00:48:33,160 --> 00:48:35,160
Speaker 1: And I think sometimes we've just got to say, you know,

870
00:48:35,640 --> 00:48:38,560
Speaker 1: on our current level of with our current level of

871
00:48:38,640 --> 00:48:43,360
Speaker 1: knowledge science, you know, ability to examine whatever we don't know,

872
00:48:43,480 --> 00:48:46,719
Speaker 1: and it's okay that we don't know, you know. And

873
00:48:46,760 --> 00:48:48,600
Speaker 1: even some of the things we think we do know,

874
00:48:49,120 --> 00:48:51,040
Speaker 1: we find out in ten years, oh, we didn't know

875
00:48:51,120 --> 00:48:52,759
Speaker 1: that at all. We only thought we knew.

876
00:48:53,760 --> 00:48:55,120
Speaker 2: Yeah, there's two things I want to say about that.

877
00:48:55,160 --> 00:48:57,759
Speaker 2: It's interesting. Number One, I feel like technology will be

878
00:48:57,800 --> 00:48:59,839
Speaker 2: the antsick because it has been the answer up till date.

879
00:48:59,840 --> 00:49:03,600
Speaker 2: If you'd said to Caesar Julius Caesar, DNA, Show me DNA,

880
00:49:03,760 --> 00:49:05,440
Speaker 2: tell me about it, what does it look like, how

881
00:49:05,440 --> 00:49:08,160
Speaker 2: does it work? He would just lock you up in

882
00:49:08,160 --> 00:49:12,120
Speaker 2: an asylum. You think you're crazy. He's got no chance

883
00:49:12,160 --> 00:49:15,360
Speaker 2: of understanding an atom or what it looks like, or

884
00:49:15,719 --> 00:49:19,799
Speaker 2: what DNA is, And just that's completely ethereal concept, not

885
00:49:19,800 --> 00:49:25,080
Speaker 2: even a concept, and technology, through X ray technology and

886
00:49:25,160 --> 00:49:29,120
Speaker 2: mathematics was able to uncover that. So I feel like

887
00:49:29,280 --> 00:49:33,160
Speaker 2: consciousness today is much of a bizarre concept as DNA

888
00:49:33,160 --> 00:49:37,600
Speaker 2: would have been to Julius Caesar, solved by technology, and

889
00:49:37,640 --> 00:49:39,560
Speaker 2: so there's a lot who feel that probably will be

890
00:49:39,600 --> 00:49:42,680
Speaker 2: the answer for this as well. But there is an interesting,

891
00:49:43,440 --> 00:49:48,319
Speaker 2: interesting catch with the mind, as you know, it's called

892
00:49:48,320 --> 00:49:52,360
Speaker 2: the other minds problem, meaning I can never examine I

893
00:49:52,400 --> 00:49:55,920
Speaker 2: can never experience someone else's mind. I can only experience

894
00:49:55,960 --> 00:49:59,080
Speaker 2: my own mind. I can only examine my own mind.

895
00:49:59,120 --> 00:50:01,080
Speaker 2: I could never I mean I can do it through

896
00:50:01,120 --> 00:50:03,879
Speaker 2: some surrogate Marcus, asking some questions and things like that,

897
00:50:04,160 --> 00:50:07,960
Speaker 2: that I can never enter your mind to experiment on

898
00:50:08,040 --> 00:50:10,279
Speaker 2: it and try and study it.

899
00:50:11,880 --> 00:50:14,120
Speaker 1: Yeah, well that there's a whole area of research in

900
00:50:14,200 --> 00:50:18,000
Speaker 1: psych called theory of mind, which is that which is

901
00:50:18,040 --> 00:50:21,520
Speaker 1: trying to understand the mind of somebody else, and then

902
00:50:22,680 --> 00:50:26,040
Speaker 1: you know, but again, it's it's really just high level guessing,

903
00:50:26,120 --> 00:50:30,520
Speaker 1: or in some instances low level guessing, trying to understand

904
00:50:30,640 --> 00:50:33,920
Speaker 1: somebody else's version. And you and I have spoken about

905
00:50:33,920 --> 00:50:36,960
Speaker 1: this between ourselves. But you know, when we go, all right, well,

906
00:50:37,040 --> 00:50:40,760
Speaker 1: let's say ten thousand people listen to this chat, nobody's

907
00:50:40,800 --> 00:50:43,399
Speaker 1: going to have an identical experience. There might be some

908
00:50:43,600 --> 00:50:48,040
Speaker 1: very similar experiences, but that's it's it's likely now that

909
00:50:48,120 --> 00:50:50,480
Speaker 1: some people have already tuned out and gone, fuck this,

910
00:50:50,480 --> 00:50:53,960
Speaker 1: this is bullshit, And there's it's likely also that some

911
00:50:54,000 --> 00:50:56,480
Speaker 1: people are going, this is ace. I hope it keeps

912
00:50:56,480 --> 00:50:59,759
Speaker 1: going for as long as possible. Some people are this

913
00:50:59,840 --> 00:51:02,440
Speaker 1: is in enlightening some people. This is boring some people,

914
00:51:02,480 --> 00:51:06,160
Speaker 1: this is confusing. And you know, so there's the stimulus

915
00:51:06,200 --> 00:51:12,839
Speaker 1: and then there's the individual's reaction cognitive, emotional, psychological reaction. Yeah,

916
00:51:12,960 --> 00:51:16,520
Speaker 1: and trying to have an insight into like me, trying

917
00:51:16,520 --> 00:51:19,000
Speaker 1: to have an insight into in real time, into how

918
00:51:19,040 --> 00:51:21,640
Speaker 1: you think or how you're feeling, or how this is

919
00:51:21,719 --> 00:51:26,360
Speaker 1: going for you as a conversation, but also simultaneously me

920
00:51:26,600 --> 00:51:30,319
Speaker 1: having a greater than me awareness of the listening experience

921
00:51:30,719 --> 00:51:34,160
Speaker 1: for thousands of people. And so when I ask a question,

922
00:51:34,400 --> 00:51:37,880
Speaker 1: I'm like, what's the best question that I can ask,

923
00:51:38,600 --> 00:51:44,880
Speaker 1: which hopefully will be broadly interesting to the biggest percentage

924
00:51:44,920 --> 00:51:47,800
Speaker 1: of people that I can, you know, rather than I

925
00:51:48,440 --> 00:51:51,080
Speaker 1: want to know things that I'm fascinated in as well.

926
00:51:51,320 --> 00:51:53,839
Speaker 1: But if I think I'm the only one fascinated by

927
00:51:53,840 --> 00:51:57,360
Speaker 1: this question, I'm not asking it, not in this context anyway.

928
00:51:57,760 --> 00:51:58,719
Speaker 2: Does it frustrate you?

929
00:51:59,640 --> 00:52:03,960
Speaker 1: No, I'm fascinated by I mean, ergo my PhD. Right,

930
00:52:04,040 --> 00:52:09,440
Speaker 1: But I'm fascinated with how others think and how others see.

931
00:52:10,200 --> 00:52:13,480
Speaker 1: You know, And then you think about, like, where does

932
00:52:13,520 --> 00:52:19,000
Speaker 1: your version of right, where does your personal experience come from? Well,

933
00:52:19,040 --> 00:52:21,880
Speaker 1: part of it comes from part of it is genetic,

934
00:52:21,920 --> 00:52:23,799
Speaker 1: and part of it comes from the brain and the

935
00:52:23,800 --> 00:52:26,760
Speaker 1: biochemistry of the brain. Correct me if I fuck anything

936
00:52:26,840 --> 00:52:29,320
Speaker 1: up from your end. But part of it is about

937
00:52:29,840 --> 00:52:34,879
Speaker 1: your interpretation of what's going on. You know, some people

938
00:52:34,920 --> 00:52:38,239
Speaker 1: are interpreting this as interesting, and therefore they're in the

939
00:52:38,320 --> 00:52:42,440
Speaker 1: moment experience is that they are interested, that they are fascinated.

940
00:52:43,120 --> 00:52:47,359
Speaker 1: Somebody else's interpretation of the exact same stimulus could be

941
00:52:47,719 --> 00:52:51,719
Speaker 1: this is boring, and their literal experience is boredom. But

942
00:52:52,520 --> 00:52:56,680
Speaker 1: either way, those experience are self created. They're stimulated by you,

943
00:52:56,760 --> 00:52:59,880
Speaker 1: and I bet they're created by the interpreter of the

944
00:53:00,120 --> 00:53:01,200
Speaker 1: data or the stimuli.

945
00:53:02,320 --> 00:53:06,799
Speaker 2: It's interesting what you say, and it fascinates me how

946
00:53:06,880 --> 00:53:11,640
Speaker 2: little control we actually have, how easily an external stimulus

947
00:53:11,719 --> 00:53:14,520
Speaker 2: can change the way we feel, think, or what we say.

948
00:53:16,680 --> 00:53:20,200
Speaker 2: And it's almost like we don't have any real control.

949
00:53:21,360 --> 00:53:25,640
Speaker 2: I'm a product of my genetics, shore and my biochemistry,

950
00:53:26,600 --> 00:53:29,960
Speaker 2: but it doesn't take much for me to change the

951
00:53:29,960 --> 00:53:34,719
Speaker 2: way I view the world on a particular day. So

952
00:53:34,760 --> 00:53:37,200
Speaker 2: who am I really? I feel like I'm just a

953
00:53:37,239 --> 00:53:39,520
Speaker 2: complicated stimulus response machine.

954
00:53:40,600 --> 00:53:43,640
Speaker 1: You in some ways you are in some ways we

955
00:53:43,800 --> 00:53:46,759
Speaker 1: all are. And you made a good point, and that

956
00:53:46,920 --> 00:53:50,640
Speaker 1: is that nine am Alex might be quite different to

957
00:53:50,800 --> 00:53:55,480
Speaker 1: seven pm alex, depending on you know, whether or not

958
00:53:55,520 --> 00:53:57,640
Speaker 1: you've eaten, how tired you are, whether or not you

959
00:53:57,719 --> 00:54:00,840
Speaker 1: had a blue with Karli, you know, whether not it's raining,

960
00:54:01,400 --> 00:54:03,480
Speaker 1: whether or not one of the dogs did away in

961
00:54:03,520 --> 00:54:07,400
Speaker 1: the house, you know, like that in the moment version

962
00:54:07,440 --> 00:54:11,960
Speaker 1: of you. Sometimes I said this to Melissa yesterday. I said,

963
00:54:12,000 --> 00:54:14,080
Speaker 1: I don't want to jinx it, but I'm not even

964
00:54:14,120 --> 00:54:18,960
Speaker 1: sure why, but lately I feel fucking amazing, and I've

965
00:54:19,000 --> 00:54:22,000
Speaker 1: been trying to figure out what I'm doing that makes

966
00:54:22,040 --> 00:54:24,839
Speaker 1: me feel I'm not saying I am amazing, but I

967
00:54:24,880 --> 00:54:29,800
Speaker 1: feel amazing, you know, like mentally, emotionally, cognitively, I feel sharp,

968
00:54:29,880 --> 00:54:34,399
Speaker 1: I feel physically strong. I'm strong in the gym. I'm

969
00:54:34,760 --> 00:54:38,880
Speaker 1: fucking solving problems like a motherfucker. I'm like everything is

970
00:54:39,000 --> 00:54:41,840
Speaker 1: just and I'm trying to I'm trying to reverse engineer

971
00:54:42,280 --> 00:54:46,280
Speaker 1: what am I doing that is making this this state

972
00:54:46,400 --> 00:54:49,879
Speaker 1: that I'm in because it's not psychological, because it's been a.

973
00:54:49,880 --> 00:54:53,279
Speaker 2: Surprise I was about to finish their PhD to me.

974
00:54:54,400 --> 00:54:57,879
Speaker 1: Maybe that's it. Maybe I can just see the light

975
00:54:57,920 --> 00:55:01,520
Speaker 1: at the end of the academic tunnel. Maybe this all right.

976
00:55:01,560 --> 00:55:03,960
Speaker 1: Let's wind up with one or two questions. Right, this

977
00:55:04,080 --> 00:55:07,799
Speaker 1: is not really your field or your area of expertise,

978
00:55:07,880 --> 00:55:11,040
Speaker 1: but it's in your area of kind of and I

979
00:55:11,080 --> 00:55:13,960
Speaker 1: can chime in on this, but we're not interested in me.

980
00:55:17,200 --> 00:55:20,560
Speaker 1: What advice do you have for people who want to

981
00:55:20,600 --> 00:55:24,480
Speaker 1: look after their brain? And I know that you're not

982
00:55:24,560 --> 00:55:27,920
Speaker 1: really the lifestyle guy or the you know, but I mean,

983
00:55:27,960 --> 00:55:30,800
Speaker 1: you work with brains. And therefore you must have advice

984
00:55:30,880 --> 00:55:34,160
Speaker 1: for people on you know how to best look after

985
00:55:34,239 --> 00:55:39,040
Speaker 1: their brain so that in terms of their choices and behaviors,

986
00:55:40,120 --> 00:55:44,759
Speaker 1: they can keep it working whatever optimally is for them.

987
00:55:45,120 --> 00:55:49,200
Speaker 2: Great question, it's quite simple. Don't stuff it up because

988
00:55:49,200 --> 00:55:53,200
Speaker 2: you've only got one. Basically there reason I say that quickly.

989
00:55:53,800 --> 00:55:57,560
Speaker 2: Story eighteen year old guy drunk got into a fight.

990
00:55:57,840 --> 00:55:59,719
Speaker 2: This was in Perth when I was training, got into

991
00:55:59,719 --> 00:56:03,120
Speaker 2: a fight, got king hit. During the fight. King hit

992
00:56:03,200 --> 00:56:05,560
Speaker 2: for those who don't know, that's being punched in the

993
00:56:05,560 --> 00:56:08,400
Speaker 2: back of the head, so you don't see the assailant coming,

994
00:56:08,520 --> 00:56:10,960
Speaker 2: so you haven't got any of your defenses up, so

995
00:56:11,120 --> 00:56:13,720
Speaker 2: your arm's down by your side. You don't see it coming.

996
00:56:14,280 --> 00:56:15,959
Speaker 2: And when you get punched in the back of the head,

997
00:56:16,080 --> 00:56:19,200
Speaker 2: it knocks you out cold. So you hit the deck,

998
00:56:19,640 --> 00:56:22,560
Speaker 2: which means because you're out cold again, none of your

999
00:56:22,640 --> 00:56:25,319
Speaker 2: defenses are mobilized, your hands don't reach out to break

1000
00:56:25,360 --> 00:56:28,239
Speaker 2: your fall or anything like that. So the skull hits

1001
00:56:28,280 --> 00:56:34,120
Speaker 2: the concrete flush and it causes a catastrophic brain injury.

1002
00:56:34,960 --> 00:56:41,160
Speaker 2: And this guy had several operations permanent brain damage. Basically

1003
00:56:41,160 --> 00:56:45,640
Speaker 2: a vegetable and there was one day that really struck

1004
00:56:45,680 --> 00:56:48,720
Speaker 2: me and rattled me. I remember the day clearly, walking

1005
00:56:48,760 --> 00:56:51,239
Speaker 2: into his room. We're talking three or four months down

1006
00:56:51,280 --> 00:56:53,360
Speaker 2: the track, and he's in a hospital bed. He's on

1007
00:56:53,440 --> 00:56:57,400
Speaker 2: a ventilator, he's rigid, he's staring into space. Lights are on,

1008
00:56:57,400 --> 00:57:00,880
Speaker 2: there's no one home. It's a severe brain injury. His

1009
00:57:01,000 --> 00:57:03,319
Speaker 2: parents are there. He's got sweat on him, he's got

1010
00:57:03,320 --> 00:57:06,880
Speaker 2: a fan on, his brain, stems misfiring, he can't regulate.

1011
00:57:07,080 --> 00:57:08,080
Speaker 1: It's just a.

1012
00:57:08,080 --> 00:57:14,759
Speaker 2: Total disaster physiologically and everything. And the thing that got

1013
00:57:14,800 --> 00:57:17,480
Speaker 2: me with the photos up on the wall, and there

1014
00:57:17,560 --> 00:57:21,360
Speaker 2: was the eighteen year old kid with his dad and

1015
00:57:21,840 --> 00:57:25,160
Speaker 2: holding a fish for memory, and then there was another

1016
00:57:25,160 --> 00:57:27,440
Speaker 2: photo of his eighteen year old kid smiling with his

1017
00:57:27,480 --> 00:57:31,040
Speaker 2: girlfriend at I presume end of view, end of school

1018
00:57:31,440 --> 00:57:37,120
Speaker 2: formal smiling pull a potential, a perfectly firing brain, eighteen

1019
00:57:37,160 --> 00:57:40,000
Speaker 2: year old kid's brain, all the potential in the world,

1020
00:57:40,480 --> 00:57:43,840
Speaker 2: can think clearly, can do anything. It's his number one

1021
00:57:44,440 --> 00:57:47,560
Speaker 2: asset is his brain. And then there's another photo with

1022
00:57:47,640 --> 00:57:49,680
Speaker 2: him and his mates doing something up on the wall

1023
00:57:49,720 --> 00:57:54,000
Speaker 2: as well. And then I look at him lung in

1024
00:57:54,040 --> 00:57:59,280
Speaker 2: the bed and he's lost all of that. And the

1025
00:57:59,320 --> 00:58:02,560
Speaker 2: message is very clear. It's you know, people say, what

1026
00:58:02,600 --> 00:58:06,200
Speaker 2: can I do to look after my brain? Well, quite

1027
00:58:06,280 --> 00:58:09,480
Speaker 2: literally that just look after it. It's the best asset

1028
00:58:09,520 --> 00:58:13,040
Speaker 2: you ever have. And it doesn't matter what knock to

1029
00:58:13,040 --> 00:58:16,840
Speaker 2: the head you have, what insults your brain has, you

1030
00:58:16,920 --> 00:58:19,000
Speaker 2: will pay the price for that. You may lose one

1031
00:58:19,120 --> 00:58:22,640
Speaker 2: or two IQ points, or you may lose your entire future.

1032
00:58:23,960 --> 00:58:26,280
Speaker 2: Just don't stuff it up. Is quite literally as simple

1033
00:58:26,320 --> 00:58:29,600
Speaker 2: as that. You don't get a second chance with the brain.

1034
00:58:30,560 --> 00:58:34,320
Speaker 2: Sometimes the effects are not immediately obvious, but the effects

1035
00:58:34,320 --> 00:58:37,680
Speaker 2: are certainly there, and it doesn't repair itself. You've got

1036
00:58:37,720 --> 00:58:41,680
Speaker 2: one look after it, use it. Just don't stuff it up.

1037
00:58:42,520 --> 00:58:44,440
Speaker 2: Beer yep.

1038
00:58:45,200 --> 00:58:48,040
Speaker 1: So I'm guessing the UFC is not high on your

1039
00:58:48,040 --> 00:58:51,840
Speaker 1: list of career options for now.

1040
00:58:51,880 --> 00:58:55,600
Speaker 2: What's UFC? Absolutely enthralled by it and then I cringe

1041
00:58:55,640 --> 00:58:58,040
Speaker 2: out at the same time. It's like this dichotomy of

1042
00:58:58,120 --> 00:59:01,800
Speaker 2: experiences when watching it. I love the I mean, it's

1043
00:59:01,840 --> 00:59:05,560
Speaker 2: just it's visceral to see combat. I'm sure that's why

1044
00:59:05,560 --> 00:59:09,160
Speaker 2: the Romans loved it. Build a Coliseum, because there's something

1045
00:59:09,280 --> 00:59:13,960
Speaker 2: natural about seeing a blood sport and two people in combat.

1046
00:59:14,040 --> 00:59:15,760
Speaker 2: It just it just gets you in a way that

1047
00:59:15,760 --> 00:59:20,040
Speaker 2: you can't really explain. But then I see the slow

1048
00:59:20,080 --> 00:59:22,520
Speaker 2: mods of the punch to the head, and I know

1049
00:59:22,640 --> 00:59:24,880
Speaker 2: what that means in terms of brain function. I know

1050
00:59:24,960 --> 00:59:29,480
Speaker 2: what that will look like on a CT scan. But

1051
00:59:29,520 --> 00:59:31,480
Speaker 2: the context is different, isn't harps. They're getting paid to

1052
00:59:31,520 --> 00:59:33,840
Speaker 2: take damage. Basically, that is their career. That's what they've

1053
00:59:33,880 --> 00:59:36,040
Speaker 2: signed up for. I guess so, and.

1054
00:59:35,960 --> 00:59:38,880
Speaker 1: They know, and you know what. So yeah, I'm it's

1055
00:59:38,920 --> 00:59:41,720
Speaker 1: funny you say that. I've said essentially what you said.

1056
00:59:41,720 --> 00:59:44,040
Speaker 1: It's for me. It's a dichotomy because on the one hand,

1057
00:59:44,760 --> 00:59:48,960
Speaker 1: I'm an excise scientist. I love I love athleticism and

1058
00:59:49,040 --> 00:59:52,600
Speaker 1: power and speed and skill and those guys and girls

1059
00:59:52,640 --> 00:59:55,920
Speaker 1: in the UFC and more broadly, you know, mixed martial

1060
00:59:56,000 --> 01:00:01,040
Speaker 1: arts across the spectrum. You know, there's so many great things.

1061
01:00:01,640 --> 01:00:06,400
Speaker 1: There's that unavoidable thing, which is you are going to

1062
01:00:06,640 --> 01:00:09,640
Speaker 1: at the very least damage your brain a bit, if

1063
01:00:09,720 --> 01:00:12,600
Speaker 1: not completely fuck it up. Like nobody gets out of

1064
01:00:13,280 --> 01:00:17,640
Speaker 1: full contact sport. Nobody, zero people with zero damage. Nobody

1065
01:00:17,640 --> 01:00:22,440
Speaker 1: has no damage. But I don't know, if you're across this,

1066
01:00:22,440 --> 01:00:25,720
Speaker 1: this is going to make you shudder. So Dana White,

1067
01:00:25,800 --> 01:00:29,680
Speaker 1: who who is the boss of the UFC who you know,

1068
01:00:29,760 --> 01:00:30,440
Speaker 1: you know who he is?

1069
01:00:30,520 --> 01:00:32,080
Speaker 2: Right? Yeah?

1070
01:00:32,120 --> 01:00:35,880
Speaker 1: So also, I mean people hate him. I fucking I

1071
01:00:36,040 --> 01:00:38,880
Speaker 1: find him hilarious. I don't agree with everything he says,

1072
01:00:38,920 --> 01:00:42,040
Speaker 1: but here's what I do love about Dana White. You

1073
01:00:42,080 --> 01:00:45,720
Speaker 1: will never not know what he thinks.

1074
01:00:45,920 --> 01:00:49,080
Speaker 2: I was going to say. He has a very clear mind.

1075
01:00:49,680 --> 01:00:52,880
Speaker 1: He has no filter, and he gives no fucks if

1076
01:00:52,880 --> 01:00:55,760
Speaker 1: people agree or disagree, and he's not doing it to

1077
01:00:55,840 --> 01:01:00,680
Speaker 1: be controversial or for attention. And he's built this fucking

1078
01:01:00,760 --> 01:01:04,880
Speaker 1: incredible brand from nothing to this multi billion dollar thing.

1079
01:01:06,320 --> 01:01:08,840
Speaker 1: And he's just a knock about bloke who's a visionary.

1080
01:01:08,920 --> 01:01:11,360
Speaker 1: And yeah, he's got all these flaws and all these

1081
01:01:11,440 --> 01:01:13,880
Speaker 1: chinks in his art and all that shit, but he's

1082
01:01:13,960 --> 01:01:17,760
Speaker 1: just take he saw I think it was two years ago.

1083
01:01:18,000 --> 01:01:22,520
Speaker 1: There's this thing there's face slapping competition, right, which happens

1084
01:01:22,560 --> 01:01:27,080
Speaker 1: in lots of countries around the world. But he took

1085
01:01:27,160 --> 01:01:31,160
Speaker 1: this idea and he turned it into power slap. So

1086
01:01:31,320 --> 01:01:34,840
Speaker 1: these I think it's I don't know if women are involved.

1087
01:01:34,880 --> 01:01:38,880
Speaker 1: Maybe women are, fuck but all the ones I've seen

1088
01:01:38,920 --> 01:01:42,080
Speaker 1: the men where they literally stand with their hands behind

1089
01:01:42,120 --> 01:01:46,040
Speaker 1: their back. It's almost like they're leaning over a bench.

1090
01:01:46,120 --> 01:01:50,240
Speaker 1: Which is for arm wrestling. But they just they just

1091
01:01:50,320 --> 01:01:53,600
Speaker 1: stand there and this bloke on the other side just

1092
01:01:53,720 --> 01:01:57,160
Speaker 1: winds up and smacks them with an open hand across

1093
01:01:57,160 --> 01:02:03,160
Speaker 1: the face with like ridiculous force. So they're just getting

1094
01:02:03,640 --> 01:02:07,280
Speaker 1: struck in the head. And this has gone from nothing

1095
01:02:07,360 --> 01:02:10,840
Speaker 1: to now being it's it's like I heard him talking

1096
01:02:10,880 --> 01:02:14,200
Speaker 1: about it the other day, where it's it's becoming this

1097
01:02:14,400 --> 01:02:18,520
Speaker 1: big spectator sport. Clearly not for everyone. I don't I

1098
01:02:18,560 --> 01:02:21,000
Speaker 1: don't watch it. I've just seen some reels. I can't

1099
01:02:21,000 --> 01:02:23,320
Speaker 1: watch it. I can't get on board. I can get

1100
01:02:23,320 --> 01:02:25,680
Speaker 1: on board the UFC, but I can't get board this.

1101
01:02:26,520 --> 01:02:29,600
Speaker 1: But I'll send you. I'll send you a clip and

1102
01:02:29,640 --> 01:02:33,320
Speaker 1: you as a you as a neurosurgeon, mate, you're just

1103
01:02:33,360 --> 01:02:35,920
Speaker 1: gonna fucking shake your head.

1104
01:02:36,240 --> 01:02:39,320
Speaker 2: I've seen his clips from India, the slap competitions from India.

1105
01:02:39,400 --> 01:02:43,760
Speaker 2: These Begindian guys. It's it's bizarre. I've got like this,

1106
01:02:43,760 --> 01:02:47,560
Speaker 2: this respect of each other and this courtesy and then

1107
01:02:47,600 --> 01:02:50,280
Speaker 2: they wind up and fucking so bang.

1108
01:02:51,000 --> 01:02:54,320
Speaker 1: That's not good. All right, mate, I love chatting with you.

1109
01:02:54,520 --> 01:02:56,520
Speaker 1: This has been one of my favorite chats. I feel

1110
01:02:56,560 --> 01:02:59,000
Speaker 1: like there was a lot of great information and a

1111
01:02:59,000 --> 01:03:01,680
Speaker 1: lot of great insight in there. We'll chat off here.

1112
01:03:02,160 --> 01:03:04,480
Speaker 1: Is there anything you don't want to got nothing to sell?

1113
01:03:04,520 --> 01:03:06,520
Speaker 1: I always say to my guests, where do you want

1114
01:03:06,520 --> 01:03:10,280
Speaker 1: to send our listeners? We are There is some news

1115
01:03:10,320 --> 01:03:13,120
Speaker 1: coming from Alex next year. There's going to be some

1116
01:03:13,240 --> 01:03:16,000
Speaker 1: big shit. I'm going to be involved in a little bit.

1117
01:03:16,600 --> 01:03:19,520
Speaker 1: I'm the one percent, he's the ninety nine. But I'm

1118
01:03:19,560 --> 01:03:21,640
Speaker 1: gonna I'm going to have my toe in the in

1119
01:03:21,680 --> 01:03:24,200
Speaker 1: the Alex door next year to help him do a

1120
01:03:24,240 --> 01:03:26,760
Speaker 1: couple of things. But we'll let you know more about

1121
01:03:26,800 --> 01:03:28,760
Speaker 1: that in the future. But for the moment, mate, love

1122
01:03:28,840 --> 01:03:31,840
Speaker 1: talking to you, Appreciate you and thanks for being on

1123
01:03:31,840 --> 01:03:33,040
Speaker 1: the new project yet again.

1124
01:03:33,520 --> 01:03:35,520
Speaker 2: Thanks Harts, really enjoyed it. Great to see you.