1 00:00:00,360 --> 00:00:02,440 Speaker 1: Well, good a team. Welcome to another episode of the 2 00:00:02,480 --> 00:00:05,760 Speaker 1: You Project. It's Fatty Harps. It's Craig Anthony Harper's Sunday 3 00:00:05,800 --> 00:00:08,840 Speaker 1: morning in the thriving Metropolis. It's thirteen minutes past nine 4 00:00:09,800 --> 00:00:11,879 Speaker 1: and one of my friends. We're friends now. We used 5 00:00:11,920 --> 00:00:14,960 Speaker 1: to be acquaintances. We knew each other a little bit. 6 00:00:15,000 --> 00:00:17,640 Speaker 1: Now we've hung out a bit, We've we've dined together, 7 00:00:17,800 --> 00:00:21,759 Speaker 1: We've spent time together, We've shared kaffeene together and stories together. 8 00:00:22,680 --> 00:00:26,680 Speaker 1: He helps me and I help him periodically. Doctor Alex, 9 00:00:26,720 --> 00:00:30,160 Speaker 1: welcome back to the show, my friend. How are you great? 10 00:00:30,280 --> 00:00:33,400 Speaker 1: It's really great to see you. It's great to talk again. 11 00:00:34,159 --> 00:00:36,800 Speaker 1: It's good to see you, mate. What's going on? Is 12 00:00:36,800 --> 00:00:38,680 Speaker 1: there anything before we dive in? I want to talk 13 00:00:38,680 --> 00:00:42,000 Speaker 1: to you about. I actually want to have a proper 14 00:00:42,040 --> 00:00:45,960 Speaker 1: grown up podcast today about neurosurgery, the profession and the 15 00:00:46,000 --> 00:00:48,559 Speaker 1: practice and the science and the development of it and 16 00:00:48,600 --> 00:00:52,880 Speaker 1: all that, because I think it's obviously it's interesting fast. 17 00:00:52,880 --> 00:00:54,920 Speaker 1: It's day to day for you, but it's interesting fast. 18 00:00:54,960 --> 00:00:57,560 Speaker 1: But other than that, what's going on? How's marriage? How's 19 00:00:57,600 --> 00:01:00,240 Speaker 1: married life? Be? Still married? By the way, because I 20 00:01:00,280 --> 00:01:02,440 Speaker 1: went to your wedding, I haven't checked in. Still good, 21 00:01:02,480 --> 00:01:05,680 Speaker 1: there's still good there. Yes, I don't know, no one 22 00:01:05,760 --> 00:01:08,880 Speaker 1: would have seen the photos. But you turned up for 23 00:01:08,959 --> 00:01:11,000 Speaker 1: the first time I've seen in a suit and a tie, 24 00:01:11,360 --> 00:01:14,559 Speaker 1: and I didn't recognize you to start off with. In fact, 25 00:01:14,560 --> 00:01:17,560 Speaker 1: you look like the biggest, baddest bouncer I've ever had 26 00:01:17,640 --> 00:01:21,319 Speaker 1: at any wedding or ever seen at any wedding. There's 27 00:01:21,319 --> 00:01:22,040 Speaker 1: a good look for you. 28 00:01:21,920 --> 00:01:24,720 Speaker 2: You look at what the agents out of the matrix. 29 00:01:25,360 --> 00:01:28,160 Speaker 1: Yeah. Well, I do get asked for directions or people 30 00:01:28,200 --> 00:01:30,399 Speaker 1: ask me questions when I turn up at things in 31 00:01:30,440 --> 00:01:33,640 Speaker 1: a suit because they one think I'm on staff in 32 00:01:33,680 --> 00:01:37,240 Speaker 1: some capacity. So that shows you how much you're loved, 33 00:01:37,360 --> 00:01:40,760 Speaker 1: because I'm not putting on a suit for fucking anyone generally, 34 00:01:41,920 --> 00:01:44,360 Speaker 1: especially not for under ten thousand dollars. But I did 35 00:01:44,360 --> 00:01:47,640 Speaker 1: it for you, and you know, so that's a sign 36 00:01:47,680 --> 00:01:48,880 Speaker 1: of my devotion and love. 37 00:01:49,920 --> 00:01:51,960 Speaker 2: It was greatly appreciated. Hups. It was a good day. 38 00:01:52,280 --> 00:01:54,840 Speaker 2: Great and Carlie's great. She's at work at the moment 39 00:01:56,120 --> 00:01:59,800 Speaker 2: at the kids hospital. That's the way it is. That 40 00:02:00,360 --> 00:02:02,280 Speaker 2: we had a wedding yesterday to go to and I 41 00:02:02,400 --> 00:02:05,160 Speaker 2: was there on my own because Carli had a shift 42 00:02:05,920 --> 00:02:09,400 Speaker 2: and so there's a bit of ships in the night 43 00:02:09,800 --> 00:02:14,880 Speaker 2: sort of vibe with everything. But it's also great having 44 00:02:14,880 --> 00:02:20,160 Speaker 2: somebody else who's in the surgical fraternity because the nuances 45 00:02:20,200 --> 00:02:24,960 Speaker 2: of stuff that happens, you don't need to describe the background. 46 00:02:25,240 --> 00:02:29,200 Speaker 2: You can just dive into it and unload and the 47 00:02:29,280 --> 00:02:32,960 Speaker 2: other person will immediately get it. But then again, also 48 00:02:33,000 --> 00:02:35,360 Speaker 2: there's no sympathy. So if Carli's got something on her 49 00:02:35,400 --> 00:02:38,280 Speaker 2: mind and I've been through it like ten times, then 50 00:02:38,360 --> 00:02:41,880 Speaker 2: she gets no sympathy. I'm just like, yeah, that's the 51 00:02:41,919 --> 00:02:44,760 Speaker 2: way it is, get over it. 52 00:02:45,360 --> 00:02:48,119 Speaker 1: Yeah, and that's going to happen and keep happening. Yep, 53 00:02:48,320 --> 00:02:48,640 Speaker 1: move on. 54 00:02:49,240 --> 00:02:51,920 Speaker 2: And then I get no sympathy because she's tired or 55 00:02:51,919 --> 00:02:55,680 Speaker 2: she's been through it ten times. But it's great. It's 56 00:02:55,680 --> 00:03:00,280 Speaker 2: a really interesting dynamic. Obviously, female and pursuing a career 57 00:03:00,919 --> 00:03:04,920 Speaker 2: is it's quite a it's a difficult topic because it's 58 00:03:05,400 --> 00:03:09,600 Speaker 2: a you know, when it comes to family and children, 59 00:03:09,800 --> 00:03:12,560 Speaker 2: females have a different experience than the guy. They've got 60 00:03:12,560 --> 00:03:15,720 Speaker 2: a certain time frame and there's always that pressure, that 61 00:03:15,800 --> 00:03:20,600 Speaker 2: biological pressure about family, and then certainly in recent times 62 00:03:20,639 --> 00:03:23,320 Speaker 2: there's this huge pressure for career as well. I feel 63 00:03:23,480 --> 00:03:26,480 Speaker 2: it really feels like that, and and it's great because 64 00:03:26,520 --> 00:03:30,600 Speaker 2: a career is very stimulating, very fulfilling, engaging, and it 65 00:03:30,639 --> 00:03:33,760 Speaker 2: goes beyond. You know, a kid can leave at the 66 00:03:33,760 --> 00:03:36,040 Speaker 2: age of beteen from home and then what he left with, 67 00:03:36,120 --> 00:03:39,040 Speaker 2: but a career stays with you until the day you retire. 68 00:03:40,080 --> 00:03:42,640 Speaker 2: So that's that's an interesting balancing act. We've had a 69 00:03:42,680 --> 00:03:45,440 Speaker 2: couple of conversations about it, and we haven't resolved it. 70 00:03:46,080 --> 00:03:48,240 Speaker 2: And I have lots of conversations with patients and other 71 00:03:48,960 --> 00:03:52,320 Speaker 2: and other colleagues in the specialty about this. I was 72 00:03:52,320 --> 00:03:54,360 Speaker 2: talking to people at the wedding last night about this 73 00:03:54,480 --> 00:03:58,600 Speaker 2: because it's quite a it's an unresolved and unresolved issue. 74 00:03:58,600 --> 00:04:00,920 Speaker 2: We haven't we haven't worked out but both loving the career, 75 00:04:02,080 --> 00:04:02,960 Speaker 2: highly stimulating. 76 00:04:03,480 --> 00:04:06,120 Speaker 1: What is the issue, like, is the issue we're gonna 77 00:04:06,160 --> 00:04:09,600 Speaker 1: have kids? Or are we? Or when are we? Or 78 00:04:10,680 --> 00:04:13,120 Speaker 1: it's because it's kind of not fair that the women 79 00:04:13,240 --> 00:04:15,520 Speaker 1: have to do that, right, Like, there's no other option, 80 00:04:15,720 --> 00:04:16,000 Speaker 1: is there? 81 00:04:16,279 --> 00:04:19,279 Speaker 2: No? They get that that's a much bigger deal. I mean, 82 00:04:19,320 --> 00:04:21,200 Speaker 2: obviously it has a huge effect on their body and 83 00:04:21,240 --> 00:04:24,000 Speaker 2: their time. You know, they've got to have maternity leave 84 00:04:24,040 --> 00:04:26,000 Speaker 2: and go through all of that, and then that's a 85 00:04:26,000 --> 00:04:28,839 Speaker 2: big chunk out of training like that. You know, take 86 00:04:28,880 --> 00:04:31,839 Speaker 2: three or six months off from a training program to 87 00:04:31,920 --> 00:04:32,240 Speaker 2: do that. 88 00:04:33,120 --> 00:04:35,719 Speaker 1: And when you say you mean medical training, you don't 89 00:04:35,720 --> 00:04:37,760 Speaker 1: mean the gym, right, or do you mean the gym? 90 00:04:38,279 --> 00:04:41,800 Speaker 2: Yeah, like surgical training training to become a surgeon, which 91 00:04:41,800 --> 00:04:44,200 Speaker 2: is you know, six or seven years, so you've got 92 00:04:44,200 --> 00:04:47,159 Speaker 2: to take time off during that. And then you know, 93 00:04:47,360 --> 00:04:49,000 Speaker 2: it's a really tough gig being a mum. How do 94 00:04:49,040 --> 00:04:52,560 Speaker 2: you know, then be a mom to a young child 95 00:04:52,920 --> 00:04:57,560 Speaker 2: and push extremely hard career wise, that that's a really difficult. 96 00:04:57,680 --> 00:05:00,479 Speaker 2: A lot of people have nannies and family around to 97 00:05:00,480 --> 00:05:05,080 Speaker 2: help with that, and I don't know if if you 98 00:05:05,080 --> 00:05:10,240 Speaker 2: can do both perfectly. I actually don't know how somebody balances. 99 00:05:10,240 --> 00:05:13,120 Speaker 2: I know some surgeons you've got several kids and they 100 00:05:13,160 --> 00:05:15,600 Speaker 2: have two or three nannies and that's almost the only 101 00:05:15,640 --> 00:05:18,640 Speaker 2: way that it works, someone there during the day to 102 00:05:18,680 --> 00:05:21,400 Speaker 2: look after the kids. Anyway, haven't We haven't cracked this 103 00:05:21,440 --> 00:05:22,280 Speaker 2: code yet. 104 00:05:22,160 --> 00:05:26,080 Speaker 1: So just tell people what because obviously I don't think 105 00:05:26,080 --> 00:05:28,839 Speaker 1: you tell us specifically what Kylie's doing. So she's a doctor, 106 00:05:28,880 --> 00:05:31,280 Speaker 1: of course, and she's doing her training to become a surgeon. 107 00:05:31,360 --> 00:05:31,760 Speaker 1: Is that it. 108 00:05:32,040 --> 00:05:34,560 Speaker 2: Yeah, she's finished med school, so she's a doctor. She's 109 00:05:34,560 --> 00:05:39,080 Speaker 2: done her required years in the hospital general training you 110 00:05:39,120 --> 00:05:40,800 Speaker 2: have to do before you can apply to get on 111 00:05:40,800 --> 00:05:43,720 Speaker 2: the surgical training program. You have to do the general 112 00:05:43,960 --> 00:05:48,520 Speaker 2: the surgical training program to be a qualified consultant, right, 113 00:05:48,560 --> 00:05:50,479 Speaker 2: And so she's going to apply for that next year. 114 00:05:50,520 --> 00:05:52,680 Speaker 2: So she's at the start of the of the process 115 00:05:53,000 --> 00:05:55,640 Speaker 2: of the actual official training program, which will be six years. 116 00:05:56,560 --> 00:06:00,599 Speaker 2: So and that's in pediatric surgery, which he loves and 117 00:06:00,640 --> 00:06:03,200 Speaker 2: really enjoys a job and is really good at it. 118 00:06:05,160 --> 00:06:12,000 Speaker 2: But there's lots of decisions coming up. Will stand by, 119 00:06:12,160 --> 00:06:15,440 Speaker 2: will stand by, But lots of people were listening, would 120 00:06:15,480 --> 00:06:17,679 Speaker 2: would have you know something similar like if it doesn't 121 00:06:17,720 --> 00:06:20,320 Speaker 2: have to be medicinal surgery. They're having family and all 122 00:06:20,320 --> 00:06:23,920 Speaker 2: sorts of careers in facing the same issues, and it's 123 00:06:23,920 --> 00:06:28,080 Speaker 2: incredibly difficult. But it's an ongoing conversation. 124 00:06:29,360 --> 00:06:36,400 Speaker 1: Is there a particular personality or type that is more 125 00:06:36,640 --> 00:06:41,120 Speaker 1: likely to become a surgeon or is it not at 126 00:06:41,120 --> 00:06:42,000 Speaker 1: all unrelated? 127 00:06:43,520 --> 00:06:46,599 Speaker 2: There's definitely a good aptitude for surgery. You can just 128 00:06:46,600 --> 00:06:48,120 Speaker 2: look at someone and say they've just got a good 129 00:06:48,120 --> 00:06:51,400 Speaker 2: aptitude for it. They get the anatomy, they get the 130 00:06:51,440 --> 00:06:57,320 Speaker 2: physicality of surgery. They're efficient, they're a decision maker. That's 131 00:06:57,360 --> 00:07:02,200 Speaker 2: really important. They can make a decision. And there's also 132 00:07:02,760 --> 00:07:06,039 Speaker 2: the attitude of dealing with people. I didn't realize this 133 00:07:06,080 --> 00:07:09,159 Speaker 2: how important that was, but in a hospital you may 134 00:07:09,160 --> 00:07:11,080 Speaker 2: not know it, but there are a whole spread of 135 00:07:11,080 --> 00:07:15,040 Speaker 2: personalities from toxic personality to you know, to someone who's 136 00:07:15,080 --> 00:07:19,360 Speaker 2: quite pleasant, and that's very, very difficult to deal I mean, 137 00:07:19,360 --> 00:07:21,120 Speaker 2: you can have an okay day at work and just 138 00:07:21,200 --> 00:07:23,680 Speaker 2: your day is ruined by toxic personality, a clash with 139 00:07:23,720 --> 00:07:27,040 Speaker 2: another consultant or someone in ICU or in theater. That 140 00:07:27,160 --> 00:07:31,880 Speaker 2: was a problem to deal with personality wise. I don't know. 141 00:07:31,960 --> 00:07:34,880 Speaker 2: I just I always just wanted to do surgery. There 142 00:07:34,960 --> 00:07:37,080 Speaker 2: was just no there was no plan B. So it 143 00:07:37,160 --> 00:07:43,320 Speaker 2: was very driven. I guess Klie is very driven, and 144 00:07:45,960 --> 00:07:48,000 Speaker 2: I don't know. Perhaps why do you do what you do? 145 00:07:48,000 --> 00:07:50,720 Speaker 2: Do you think you've got a specific personality for talking 146 00:07:50,720 --> 00:07:53,280 Speaker 2: to people? I don't know. This is a really important 147 00:07:53,320 --> 00:07:56,080 Speaker 2: issue because selecting surgeons, you have to do. The interview 148 00:07:56,120 --> 00:07:57,920 Speaker 2: is a big part of the process. You've got a 149 00:07:58,000 --> 00:07:59,760 Speaker 2: c you've got referees, and then you have to sit 150 00:07:59,800 --> 00:08:02,560 Speaker 2: down at an interview and for me, there were six 151 00:08:02,600 --> 00:08:04,680 Speaker 2: spots out of all of Australia. How do you pick 152 00:08:04,760 --> 00:08:07,200 Speaker 2: six people to get on the training program? And you 153 00:08:07,280 --> 00:08:09,040 Speaker 2: ask a series of questions and trying to get to 154 00:08:09,040 --> 00:08:11,160 Speaker 2: know these people, and then you just base it off 155 00:08:11,200 --> 00:08:14,440 Speaker 2: those responses. So it's actually really tricky to pick the 156 00:08:14,520 --> 00:08:16,880 Speaker 2: right person. And there's ongoing research and what are the 157 00:08:16,960 --> 00:08:20,200 Speaker 2: right questions, what's the right way to sort out these 158 00:08:20,240 --> 00:08:23,360 Speaker 2: people and find who has got the right aptitude or 159 00:08:23,440 --> 00:08:26,640 Speaker 2: surgery And then often they said that fails and then 160 00:08:26,640 --> 00:08:30,200 Speaker 2: the surgical training program becomes the screening. So they go 161 00:08:30,240 --> 00:08:31,880 Speaker 2: through the training and then they are that they will 162 00:08:31,920 --> 00:08:34,840 Speaker 2: thrive all they'll struggle, and if they're struggling, then that 163 00:08:34,880 --> 00:08:38,640 Speaker 2: becomes a sign that tough conversations need to be had because. 164 00:08:38,400 --> 00:08:42,200 Speaker 1: It's I think it's from the outside looking in, it's like, 165 00:08:42,520 --> 00:08:45,679 Speaker 1: obviously you need you know, you need to be intelligent, 166 00:08:45,679 --> 00:08:48,040 Speaker 1: you need a great understanding of an anime in physiology 167 00:08:48,080 --> 00:08:50,280 Speaker 1: and all that, all the skills and all the science 168 00:08:50,920 --> 00:08:52,640 Speaker 1: or the knowledge. Then you need to be able to 169 00:08:52,679 --> 00:08:56,040 Speaker 1: have I would think extreme an extreme ability to focus 170 00:08:56,080 --> 00:08:59,280 Speaker 1: and concentrate and be present and not distracted then you 171 00:08:59,360 --> 00:09:02,280 Speaker 1: need goods social skills to be able to lead a 172 00:09:02,320 --> 00:09:05,000 Speaker 1: team and communicate and not piss people off and not 173 00:09:05,040 --> 00:09:07,840 Speaker 1: get pissed off. And then you need to be able 174 00:09:07,880 --> 00:09:11,480 Speaker 1: to self regulate in the middle of fucking chaos so 175 00:09:11,600 --> 00:09:14,280 Speaker 1: you're not losing your shit. And then you need to 176 00:09:14,320 --> 00:09:18,400 Speaker 1: be physically, mentally and emotionally healthy yourself so you know. 177 00:09:19,320 --> 00:09:21,760 Speaker 1: And then you need to have good leadership skills, and 178 00:09:21,800 --> 00:09:24,280 Speaker 1: then you need to be a high level problem solver, 179 00:09:24,440 --> 00:09:28,520 Speaker 1: because surgery in some ways is problem solving in real time, 180 00:09:28,640 --> 00:09:32,280 Speaker 1: and it's like this fucking collision of a million different 181 00:09:32,400 --> 00:09:33,720 Speaker 1: variables that all matter. 182 00:09:34,480 --> 00:09:37,959 Speaker 2: And it's not like sport, where you are great when 183 00:09:37,960 --> 00:09:40,880 Speaker 2: you're young and you've identified yourself as good at sport, 184 00:09:41,600 --> 00:09:44,120 Speaker 2: and then you go down this pathway and you just 185 00:09:44,160 --> 00:09:47,959 Speaker 2: get better and better at what you've already demonstrated you're 186 00:09:47,960 --> 00:09:50,040 Speaker 2: good at this. You kind of don't really know that 187 00:09:50,080 --> 00:09:51,880 Speaker 2: you're good at it until you've gone through the whole 188 00:09:51,880 --> 00:09:56,040 Speaker 2: process and you start, and even not until you're halfway 189 00:09:56,080 --> 00:09:57,840 Speaker 2: through the process do you realize if you're any good 190 00:09:57,880 --> 00:09:58,199 Speaker 2: at it. 191 00:09:58,880 --> 00:10:02,640 Speaker 1: It's so true about how many people study mate and 192 00:10:02,720 --> 00:10:05,040 Speaker 1: then like even the people that I did one hundred 193 00:10:05,080 --> 00:10:07,120 Speaker 1: years ago when I did my first degree, people who 194 00:10:07,200 --> 00:10:10,040 Speaker 1: studied physic or human movement or whatever we want to 195 00:10:10,080 --> 00:10:12,120 Speaker 1: call it, exercise science, and they go through the whole 196 00:10:12,160 --> 00:10:14,240 Speaker 1: thing and then at the end of it they go, oh, 197 00:10:14,360 --> 00:10:18,080 Speaker 1: I want to do this at all. And they never 198 00:10:18,160 --> 00:10:22,400 Speaker 1: spend one day writing one exercise program or prescribing anything 199 00:10:22,440 --> 00:10:25,000 Speaker 1: for anyone, but they do the whole thing, and or 200 00:10:25,040 --> 00:10:26,920 Speaker 1: they go and do a bit of work experience, or 201 00:10:26,960 --> 00:10:28,800 Speaker 1: they start to work in the industry or with a 202 00:10:28,840 --> 00:10:32,360 Speaker 1: sporting club. And then the amount of people I've seen 203 00:10:32,400 --> 00:10:34,880 Speaker 1: that I went to UNI with who are still working 204 00:10:34,880 --> 00:10:38,600 Speaker 1: in the space of exercise science, it's probably less than 205 00:10:38,640 --> 00:10:42,120 Speaker 1: five percent twenty years after they did their degree, like 206 00:10:42,480 --> 00:10:43,200 Speaker 1: very minimal. 207 00:10:44,440 --> 00:10:46,800 Speaker 2: It doesn't surprise me. I'll see that in surgery people 208 00:10:46,840 --> 00:10:50,040 Speaker 2: get halfway through and they decide to go down at 209 00:10:50,040 --> 00:10:53,040 Speaker 2: a completely different route. They go and do radiology or 210 00:10:53,080 --> 00:10:58,400 Speaker 2: general practice, or go into business or admin. And that's tough, 211 00:10:58,440 --> 00:11:00,520 Speaker 2: isn't You did that whole You go through metic school 212 00:11:00,559 --> 00:11:03,640 Speaker 2: and half of a training program and then decide this 213 00:11:03,800 --> 00:11:05,720 Speaker 2: is not for you. Do you think that? 214 00:11:06,360 --> 00:11:09,560 Speaker 1: I think for some people that it's just the emotional 215 00:11:09,600 --> 00:11:12,440 Speaker 1: and psychological cost where you just you get to a 216 00:11:12,480 --> 00:11:15,560 Speaker 1: point where and I think it's okay. I don't think 217 00:11:15,600 --> 00:11:18,560 Speaker 1: it's weakness or bad. I don't think it's a flaw. 218 00:11:19,000 --> 00:11:22,920 Speaker 1: I think it's just a realization. Like, if I'm being honest, 219 00:11:22,960 --> 00:11:26,080 Speaker 1: there's been twenty six times in my PhD where I've 220 00:11:26,120 --> 00:11:29,240 Speaker 1: said to myself and that's only a PhD, that's not 221 00:11:29,520 --> 00:11:33,360 Speaker 1: all the shit that you've done, right, I'm like, is 222 00:11:33,400 --> 00:11:35,920 Speaker 1: this worth it? Like this is so hard and so 223 00:11:36,160 --> 00:11:38,959 Speaker 1: much and I go, you know, where you weigh it up? 224 00:11:39,200 --> 00:11:41,040 Speaker 1: And there's been a bunch of times where I thought 225 00:11:41,760 --> 00:11:43,679 Speaker 1: I didn't need to do this, you know, and for 226 00:11:43,720 --> 00:11:46,559 Speaker 1: whatever reason, I keep doing it. But I can understand, 227 00:11:46,640 --> 00:11:48,480 Speaker 1: like the amount of people who start a PhD and 228 00:11:48,559 --> 00:11:52,080 Speaker 1: drop out is something like eighty percent. Like it's very 229 00:11:52,160 --> 00:11:55,920 Speaker 1: high number the people who don't complete their PhD. And 230 00:11:55,960 --> 00:11:58,360 Speaker 1: I'm thinking, with what you do it, that's you know, 231 00:11:58,440 --> 00:12:01,400 Speaker 1: my experience, yours would be time was twenty five in 232 00:12:01,520 --> 00:12:04,560 Speaker 1: terms of how difficult it is to get where you got. 233 00:12:05,080 --> 00:12:07,480 Speaker 1: I just think that people just weigh it up and go, 234 00:12:07,960 --> 00:12:12,959 Speaker 1: could I get through? Probably? Maybe? But is it worth it? No? 235 00:12:13,080 --> 00:12:16,840 Speaker 1: Because I'm fucking miserable, I'm anxious. I don't sleep. I'm stressed, 236 00:12:17,280 --> 00:12:20,800 Speaker 1: my health suffering, So I think that you know that 237 00:12:20,880 --> 00:12:24,720 Speaker 1: probably eliminates people naturally anyway, that way, it's. 238 00:12:24,640 --> 00:12:29,480 Speaker 2: One hundred percent through. The drive is really important. You've 239 00:12:29,480 --> 00:12:32,280 Speaker 2: got to have that inner drive to do surgery because 240 00:12:33,080 --> 00:12:35,280 Speaker 2: that's what gets you through. You will get you over 241 00:12:35,320 --> 00:12:38,480 Speaker 2: the hurdles that you inevitably will face. If you're doing 242 00:12:38,480 --> 00:12:41,520 Speaker 2: it for any other reason than you want to do it, 243 00:12:42,360 --> 00:12:45,199 Speaker 2: You're going to struggle and probably go in a different 244 00:12:45,200 --> 00:12:49,680 Speaker 2: direction given enough hurdles. And that certainly was my drive 245 00:12:49,720 --> 00:12:51,640 Speaker 2: since year ten. That was all I wanted to do, 246 00:12:51,679 --> 00:12:54,720 Speaker 2: and I had plenty of hurdles, but each hurdle was 247 00:12:54,840 --> 00:12:58,319 Speaker 2: just an excuse to hit harder and jump higher type thing. 248 00:12:58,360 --> 00:13:02,000 Speaker 2: And if you didn't have that, you would certainly give up. 249 00:13:04,120 --> 00:13:07,440 Speaker 1: It's probably a weird question, but could you And I 250 00:13:07,520 --> 00:13:09,640 Speaker 1: know there's no typical day, but one of the things 251 00:13:09,679 --> 00:13:12,280 Speaker 1: I say to my clients or back in the day, 252 00:13:12,360 --> 00:13:15,240 Speaker 1: especially when someone would come to me, I'd say, walk 253 00:13:15,320 --> 00:13:18,400 Speaker 1: me through a typical day of you, and by that 254 00:13:18,520 --> 00:13:22,880 Speaker 1: I mean sleep, food, exercise. You know, are you sitting 255 00:13:22,920 --> 00:13:25,480 Speaker 1: for four hours a day? So can you walk us 256 00:13:25,480 --> 00:13:27,839 Speaker 1: through a typical day of being and we don't need 257 00:13:27,880 --> 00:13:32,160 Speaker 1: your breakfast and your dinner. But the neurosurgery stuff, like 258 00:13:32,240 --> 00:13:35,160 Speaker 1: what's a typical day, And I know it varies broadly, 259 00:13:35,200 --> 00:13:39,040 Speaker 1: but of neurosurgery, like on the days that you're working, 260 00:13:39,080 --> 00:13:42,320 Speaker 1: do you do you do one up a day, four 261 00:13:42,400 --> 00:13:44,520 Speaker 1: ops a day. I know it varies wildly, but can 262 00:13:44,559 --> 00:13:47,880 Speaker 1: you give us a snapshot into the day of a neurosurgeon. 263 00:13:48,480 --> 00:13:50,200 Speaker 2: Yeah, I get up at three thirty, go to the gym, 264 00:13:50,280 --> 00:13:52,080 Speaker 2: I come home and I meditates and then I read 265 00:13:52,120 --> 00:13:53,000 Speaker 2: my natomy text. 266 00:13:53,040 --> 00:13:55,840 Speaker 1: Though you're a fucking idiot. We know that's not true. 267 00:13:56,120 --> 00:13:59,040 Speaker 2: Mark Woolberg sort of schedule, which I think is day 268 00:13:59,080 --> 00:14:02,960 Speaker 2: of rubbish. A typical day like Friday is one of 269 00:14:03,000 --> 00:14:05,840 Speaker 2: my operating days. He's a classic day. So the theaterist 270 00:14:05,880 --> 00:14:09,160 Speaker 2: starts at eight, and I'm there at ten to eight, 271 00:14:10,480 --> 00:14:13,920 Speaker 2: and I'm in theater by eight and I've got my 272 00:14:14,240 --> 00:14:15,520 Speaker 2: walk in there and you can tell it's going to 273 00:14:15,520 --> 00:14:18,040 Speaker 2: be a great day. The anesiis that I love is there. 274 00:14:18,360 --> 00:14:21,119 Speaker 2: The scrub nurse that I love is there, the assistant 275 00:14:21,160 --> 00:14:23,200 Speaker 2: that is my favorite. You've got the whole team there. 276 00:14:23,200 --> 00:14:26,320 Speaker 2: He's got a good vibe straight away. And then the 277 00:14:26,320 --> 00:14:28,200 Speaker 2: patients in the anesthetic bay, I go and have a 278 00:14:28,240 --> 00:14:33,880 Speaker 2: chat with them, they sign their consent form and then 279 00:14:33,920 --> 00:14:38,400 Speaker 2: we're off. And the first case on Friday was a 280 00:14:38,480 --> 00:14:41,680 Speaker 2: spinal tumor, and so I sit down and look at 281 00:14:41,680 --> 00:14:44,200 Speaker 2: the scan and just rehearse what I'm going to do. 282 00:14:44,560 --> 00:14:47,280 Speaker 2: And I'm looking at the scan in terms of the anatomy, 283 00:14:47,320 --> 00:14:51,600 Speaker 2: so landmarks that I'll be looking for and what I'm 284 00:14:51,600 --> 00:14:54,520 Speaker 2: going to try and what I want to recognize when 285 00:14:54,560 --> 00:14:56,360 Speaker 2: I get in there to guide me where I'm going. 286 00:14:56,360 --> 00:14:59,200 Speaker 2: And then also looking at the scan for things that 287 00:14:59,240 --> 00:15:01,560 Speaker 2: are going to trip me or potentially that can cause 288 00:15:01,560 --> 00:15:04,080 Speaker 2: a complication and how I'm going to avoid that. So 289 00:15:04,160 --> 00:15:06,640 Speaker 2: that's review that for a good twenty minutes or so, 290 00:15:07,360 --> 00:15:10,320 Speaker 2: and then a typical day could be anywhere between four 291 00:15:10,360 --> 00:15:12,560 Speaker 2: and I've done up to seven cases in a day, 292 00:15:12,960 --> 00:15:18,320 Speaker 2: depending on the anisthetus and the team and hospital beds. 293 00:15:19,400 --> 00:15:23,120 Speaker 2: And it's I love the efficiency of surgery. And I 294 00:15:23,160 --> 00:15:25,840 Speaker 2: watched my guy down in Hobart operate and that's where 295 00:15:25,840 --> 00:15:29,240 Speaker 2: I got that from. Incredibly efficient in terms of all 296 00:15:29,240 --> 00:15:32,360 Speaker 2: of his movements and starting doing the operation, closing up, 297 00:15:33,200 --> 00:15:36,480 Speaker 2: wrapping up, and then my aniesthetus is very efficient as well. 298 00:15:36,520 --> 00:15:38,400 Speaker 2: So the turnover can be quick because don't forget. If 299 00:15:38,440 --> 00:15:43,280 Speaker 2: you do five cases, that's about you know, that's four 300 00:15:43,320 --> 00:15:46,520 Speaker 2: turnover times. And so if the anesthetas is fast, that's 301 00:15:46,600 --> 00:15:49,040 Speaker 2: half an hour per turnover time, so that's two hours 302 00:15:49,080 --> 00:15:51,480 Speaker 2: extra added to the operating time. Or if they're not 303 00:15:51,520 --> 00:15:53,760 Speaker 2: as quick and it's an hour, that's an extra four 304 00:15:53,800 --> 00:15:56,520 Speaker 2: hours of the day added just sitting around waiting for 305 00:15:56,560 --> 00:15:59,840 Speaker 2: the anesthetus to do their things. So there's that element. 306 00:16:00,160 --> 00:16:02,120 Speaker 2: I think I've got five cases. They will take me 307 00:16:02,160 --> 00:16:05,840 Speaker 2: forty minutes each, will be done by two o'clock, and 308 00:16:05,880 --> 00:16:07,520 Speaker 2: then you've got to add in the anesthetic time, which 309 00:16:07,560 --> 00:16:11,920 Speaker 2: is four hours, so actually we'll be done at eight o'clock. Wow. Yeah. 310 00:16:12,240 --> 00:16:15,680 Speaker 2: But the theater days, it's the best part of it. 311 00:16:16,640 --> 00:16:18,360 Speaker 2: I do a lot of consulting, sitting at the desk 312 00:16:18,400 --> 00:16:21,200 Speaker 2: and talking to patients and that's becoming a more rewarding 313 00:16:21,240 --> 00:16:23,800 Speaker 2: process as well. And that would typically start at nine 314 00:16:23,800 --> 00:16:29,160 Speaker 2: o'clock and finish around about round four seeing new patients going. 315 00:16:29,320 --> 00:16:31,480 Speaker 2: And I love the education side of things. I'm talking 316 00:16:31,480 --> 00:16:33,800 Speaker 2: to them about their problem, trying to identify what their 317 00:16:33,800 --> 00:16:40,640 Speaker 2: problem is. That's really, really key. Often it's not straight 318 00:16:40,720 --> 00:16:42,800 Speaker 2: up obvious what it is that they want to talk about. 319 00:16:43,320 --> 00:16:47,880 Speaker 2: And so finding that getting expectations sorted out, that's really 320 00:16:47,920 --> 00:16:52,080 Speaker 2: really key. Expectations They need to need to be on 321 00:16:52,120 --> 00:16:54,920 Speaker 2: the same page otherwise that causes real problem. So finding 322 00:16:55,000 --> 00:16:57,680 Speaker 2: that I love the education side of things, showing them 323 00:16:57,720 --> 00:17:01,360 Speaker 2: the scan, showing them what's wrong. People love to see 324 00:17:01,400 --> 00:17:04,760 Speaker 2: that there is something wrong. It's very common that they say, oh, 325 00:17:04,960 --> 00:17:06,760 Speaker 2: you know what, I actually thought I was going crazy. 326 00:17:06,760 --> 00:17:10,560 Speaker 2: There's actually something wrong with me, yes, very And I 327 00:17:10,680 --> 00:17:12,960 Speaker 2: take video of surgery. I've got this video app that 328 00:17:13,000 --> 00:17:15,840 Speaker 2: I've called Surgery TV, which I've developed over the last 329 00:17:16,040 --> 00:17:18,119 Speaker 2: two years with a colleague and in fact, we just 330 00:17:18,720 --> 00:17:21,840 Speaker 2: we just got awarded a government grant for this video app. 331 00:17:24,119 --> 00:17:26,399 Speaker 2: It was about eighty six thousand dollars, which is just 332 00:17:26,640 --> 00:17:28,360 Speaker 2: great in terms of us being able to push it further. 333 00:17:28,400 --> 00:17:30,359 Speaker 2: But essentially, what it does is allow me to record 334 00:17:30,359 --> 00:17:33,760 Speaker 2: the video of every operation I do, which it always do, 335 00:17:33,920 --> 00:17:36,960 Speaker 2: but it takes about you can take you about forty 336 00:17:36,960 --> 00:17:40,399 Speaker 2: minutes to download a video of each operation onto a 337 00:17:40,480 --> 00:17:42,040 Speaker 2: USB and then you've got to do something with it. 338 00:17:42,040 --> 00:17:44,760 Speaker 2: With this app that we've designed, it goes from the 339 00:17:44,800 --> 00:17:47,879 Speaker 2: microscope straight to my iPhone ready to go. So it's 340 00:17:47,880 --> 00:17:50,439 Speaker 2: an automated process. So now I have a video of 341 00:17:50,480 --> 00:17:53,040 Speaker 2: everyone's surgery for everyone that I do, and I give 342 00:17:53,080 --> 00:17:55,320 Speaker 2: it to them to the patient the following morning, and 343 00:17:55,359 --> 00:17:58,280 Speaker 2: again I've told them about an operation, they've consented for 344 00:17:58,320 --> 00:18:01,520 Speaker 2: an operation, they've had the operation, and then the following morning, 345 00:18:01,680 --> 00:18:04,639 Speaker 2: after their operation, I showed them the video of the 346 00:18:04,640 --> 00:18:07,680 Speaker 2: problem and me fixing the problem. And they still say, oh, 347 00:18:07,800 --> 00:18:10,600 Speaker 2: that was so good to see. There's actually something wrong 348 00:18:10,640 --> 00:18:14,280 Speaker 2: with me. I wasn't going crazy. Yes you must have. 349 00:18:14,560 --> 00:18:17,560 Speaker 2: I mean you're still possibly there was something you thought 350 00:18:17,560 --> 00:18:18,159 Speaker 2: you were crazy. 351 00:18:18,880 --> 00:18:21,560 Speaker 1: You know what I love about that? That shows that 352 00:18:21,640 --> 00:18:26,800 Speaker 1: you have absolute confidence in what you do to be 353 00:18:26,920 --> 00:18:31,119 Speaker 1: able to record, to record that and then say here's 354 00:18:31,200 --> 00:18:33,959 Speaker 1: the video. A lot of surgeons would not do that, 355 00:18:34,320 --> 00:18:35,040 Speaker 1: is my guess. 356 00:18:36,000 --> 00:18:38,639 Speaker 2: Well, that is a very good point that you raise. 357 00:18:40,560 --> 00:18:42,760 Speaker 2: Patients say a couple of things about the video, and 358 00:18:42,800 --> 00:18:44,919 Speaker 2: one of them is exactly that, Well, if you're confident 359 00:18:45,000 --> 00:18:47,240 Speaker 2: enough to record the operation, then I'm confident in you 360 00:18:47,320 --> 00:18:51,760 Speaker 2: doing the operation. But I look at it like this, 361 00:18:52,800 --> 00:18:56,600 Speaker 2: if you don't have a video of surgery, the surgeon 362 00:18:56,640 --> 00:19:00,399 Speaker 2: stuffed up. If you do have a video of surgery, 363 00:19:01,359 --> 00:19:05,120 Speaker 2: it was a difficult case, just say there's a complication. 364 00:19:05,560 --> 00:19:08,520 Speaker 2: Surgeons say I don't want a complication recorded on video. Well, 365 00:19:08,560 --> 00:19:12,000 Speaker 2: surgeons are rarely negligent. In fact, they're almost never negligent. 366 00:19:12,359 --> 00:19:15,840 Speaker 2: It's just bad luck or the case was just very 367 00:19:15,960 --> 00:19:19,080 Speaker 2: very difficult, And you can't say that. You can't say 368 00:19:19,080 --> 00:19:21,080 Speaker 2: the case was difficult, or it was bad luck, or 369 00:19:21,119 --> 00:19:24,480 Speaker 2: there was this you know, this anatomical variation. You can 370 00:19:24,520 --> 00:19:26,479 Speaker 2: write it at an opropose, but it's just very difficult 371 00:19:26,480 --> 00:19:31,160 Speaker 2: to communicate that because you're you're contrasting that to an 372 00:19:31,160 --> 00:19:34,080 Speaker 2: outcome that's not ideal, and that's blank and white. So 373 00:19:34,160 --> 00:19:37,679 Speaker 2: it's sort of good evidence. So I say, well, you know, 374 00:19:37,720 --> 00:19:40,880 Speaker 2: without a video, basically people just think that you stuffed up. 375 00:19:40,960 --> 00:19:43,359 Speaker 2: With a video, people will see that it was just 376 00:19:43,480 --> 00:19:45,480 Speaker 2: it was bad luck or it was a difficult case. 377 00:19:45,560 --> 00:19:47,200 Speaker 2: So the video is actually protective. 378 00:19:48,000 --> 00:19:51,000 Speaker 1: Amazing. How often do you get in there? And I 379 00:19:51,040 --> 00:19:54,040 Speaker 1: would imagine the answer is not much. But so you've 380 00:19:54,040 --> 00:19:56,439 Speaker 1: got all the stuff that you need to see and 381 00:19:56,480 --> 00:20:03,040 Speaker 1: analyze beforehand, do you ever get in there and you're surprised, like, oh, 382 00:20:03,080 --> 00:20:06,000 Speaker 1: I didn't think this would be here, or I expect. 383 00:20:05,560 --> 00:20:10,800 Speaker 2: That, not surprised about the location of something. I know 384 00:20:10,880 --> 00:20:13,280 Speaker 2: to a millimeter where something is going to be because 385 00:20:13,280 --> 00:20:15,560 Speaker 2: you can tell on the scan. The MRI scan is 386 00:20:15,640 --> 00:20:18,919 Speaker 2: high resolution imaging, so I know exactly where something is 387 00:20:18,960 --> 00:20:22,800 Speaker 2: going to be. What can be a surprise is what 388 00:20:22,840 --> 00:20:25,959 Speaker 2: that thing is made of, or how stuck it is, 389 00:20:26,800 --> 00:20:29,280 Speaker 2: or how adherent it is to different structures. That's the 390 00:20:29,320 --> 00:20:32,679 Speaker 2: only real surprise. Like the spinal timber, for example, I 391 00:20:32,760 --> 00:20:35,200 Speaker 2: knew to a millimeter where the top of the bottom 392 00:20:35,240 --> 00:20:38,440 Speaker 2: of that, where the lateral the medial margin was. What 393 00:20:38,480 --> 00:20:40,440 Speaker 2: I was unsure about is what it was actually going 394 00:20:40,560 --> 00:20:42,679 Speaker 2: to look and feel like. Was it going to be 395 00:20:42,720 --> 00:20:45,199 Speaker 2: soft and gelatinous and come out easy. Was it going 396 00:20:45,200 --> 00:20:46,760 Speaker 2: to be tough and fibrous where it's going to be 397 00:20:46,760 --> 00:20:49,080 Speaker 2: a bit more difficult to take out. So it's difficult 398 00:20:49,119 --> 00:20:52,800 Speaker 2: to judge what something is going to be. Consistency of 399 00:20:53,160 --> 00:20:55,680 Speaker 2: the stuff is going to be like, which is makes 400 00:20:55,680 --> 00:20:57,879 Speaker 2: a huge impact on how you deal with it. If 401 00:20:57,920 --> 00:21:00,640 Speaker 2: something soft and gelatinous, that's quite easy to remove. If 402 00:21:00,640 --> 00:21:03,159 Speaker 2: it's fibrous and densely adherent to stuff, and that's a 403 00:21:03,200 --> 00:21:05,920 Speaker 2: lot more difficult to remove. So that's the unknown. 404 00:21:06,560 --> 00:21:08,960 Speaker 1: I never thought of that. So when you're cutting out 405 00:21:09,000 --> 00:21:14,000 Speaker 1: something that's soft and gooey versus something that's tougher and 406 00:21:14,040 --> 00:21:18,240 Speaker 1: more fibrous and dense, do you use the exact same tool, 407 00:21:18,520 --> 00:21:21,959 Speaker 1: the exact same scalpel or whatever, or is it? There 408 00:21:22,000 --> 00:21:23,760 Speaker 1: are a bunch of you go no, this is like 409 00:21:23,840 --> 00:21:26,119 Speaker 1: removing an old bit of leather boots. 410 00:21:26,160 --> 00:21:29,439 Speaker 2: So we use something different. There's something different. This tumor 411 00:21:29,480 --> 00:21:33,040 Speaker 2: on Friday was soft into latinous. So the tumor has 412 00:21:33,080 --> 00:21:36,000 Speaker 2: a capsule which has possibly got nerve fibers running through 413 00:21:36,080 --> 00:21:38,159 Speaker 2: the capsule, so you have to preserve the capsule. So 414 00:21:38,160 --> 00:21:39,960 Speaker 2: I make a linear cut through the capsule, which is 415 00:21:40,000 --> 00:21:42,919 Speaker 2: like half a millimeter thick, and it springs open and 416 00:21:42,960 --> 00:21:46,199 Speaker 2: reveals the sort of soft latinous tumor underneath. Sin As 417 00:21:46,240 --> 00:21:49,200 Speaker 2: I see that, I know this is going to go well. 418 00:21:50,119 --> 00:21:53,000 Speaker 2: And there's a curet that's a bit spoon shaped, and 419 00:21:53,040 --> 00:21:55,600 Speaker 2: I essentially slide it between the tumor and the capsule, 420 00:21:55,840 --> 00:21:58,679 Speaker 2: and it's like scooping out a pee out of a 421 00:21:58,720 --> 00:22:02,840 Speaker 2: pod almost, and I just gently separate it and gently 422 00:22:02,880 --> 00:22:05,600 Speaker 2: separated and gently free it up. There's a couple of 423 00:22:05,600 --> 00:22:08,000 Speaker 2: places where it's densely adherent, and there's a micro scissor. 424 00:22:08,040 --> 00:22:12,680 Speaker 2: It's beautiful micro scissor and that's used to divide where 425 00:22:12,680 --> 00:22:15,760 Speaker 2: it's densely adherent and then it comes out comes out 426 00:22:15,800 --> 00:22:18,520 Speaker 2: quite nicely. If it's more fibrous. We've got this beautiful 427 00:22:18,520 --> 00:22:25,440 Speaker 2: machine called a CUSA CUSA which stands for Cavetron Ultrasonic aspirator. 428 00:22:26,040 --> 00:22:31,359 Speaker 2: It's brilliant. It's this fine tip and it uses I 429 00:22:31,400 --> 00:22:35,560 Speaker 2: think it's an ultrasonic wave to fracture the tissue at 430 00:22:35,560 --> 00:22:38,960 Speaker 2: the tip and then it asperates the fractured tissue, so 431 00:22:39,440 --> 00:22:42,560 Speaker 2: in effect, it's like having a pencil and at the 432 00:22:42,600 --> 00:22:45,080 Speaker 2: tip of the pencil the tumor just dissolves and goes 433 00:22:45,119 --> 00:22:47,280 Speaker 2: up the sucker. So it can be quite fibrous and 434 00:22:47,320 --> 00:22:49,760 Speaker 2: dense and it will just literally dissolve it and suck it. 435 00:22:49,800 --> 00:22:53,960 Speaker 2: And the beautiful instrument for tumors are a lot more dense. 436 00:22:56,000 --> 00:22:58,879 Speaker 2: We joke that the cuser actually c USA stands for 437 00:22:58,960 --> 00:23:01,520 Speaker 2: can't use straight up because it takes about forty minutes 438 00:23:01,560 --> 00:23:02,320 Speaker 2: to set the thing up. 439 00:23:02,960 --> 00:23:06,280 Speaker 1: That's hilarious. Is there any I don't know if I 440 00:23:06,320 --> 00:23:08,280 Speaker 1: want to ask this question, but I know you'll answer 441 00:23:08,320 --> 00:23:11,520 Speaker 1: it honestly in general terms, like I think people a 442 00:23:11,520 --> 00:23:14,840 Speaker 1: lot of people have been essentially led to believe that 443 00:23:15,359 --> 00:23:17,400 Speaker 1: if you're going to have surgery, make sure you get 444 00:23:17,440 --> 00:23:20,240 Speaker 1: the surgeon. Make sure you get your surgery in the morning, 445 00:23:20,600 --> 00:23:24,240 Speaker 1: because that's when the surgeon's at his or her best, 446 00:23:25,960 --> 00:23:30,080 Speaker 1: and surgeons are human. I would imagine that that might 447 00:23:30,200 --> 00:23:32,920 Speaker 1: be true, or is that not true, or it depends. 448 00:23:33,920 --> 00:23:35,840 Speaker 2: I see a patient in the anesthetic bay, and it 449 00:23:35,840 --> 00:23:38,639 Speaker 2: doesn't matter where they are on the list. If they're first, 450 00:23:38,720 --> 00:23:41,359 Speaker 2: I say, you're first up, everyone's fresh, You're in the 451 00:23:41,359 --> 00:23:44,040 Speaker 2: best position. If they're fourth on the list, I walk 452 00:23:44,080 --> 00:23:46,600 Speaker 2: in there, I say, we've done three already. Everybody's warmed 453 00:23:46,680 --> 00:23:48,440 Speaker 2: up and got their eye, and you're in the best position. 454 00:23:49,600 --> 00:23:52,080 Speaker 2: It doesn't matter. They all have a laugh and it 455 00:23:52,160 --> 00:23:57,320 Speaker 2: relaxes them. It doesn't matter because every operation, the experience 456 00:23:57,400 --> 00:24:00,800 Speaker 2: is the same, which is a laser focus. Sitting around 457 00:24:01,080 --> 00:24:04,040 Speaker 2: and waiting is different. You've got a bit more energy 458 00:24:04,119 --> 00:24:07,040 Speaker 2: waiting in the morning, and the evening. The waiting is 459 00:24:07,080 --> 00:24:10,439 Speaker 2: you know, a bit more painful. But as soon as 460 00:24:10,480 --> 00:24:14,920 Speaker 2: the microscope gets wheeled into place, the brain just switches 461 00:24:15,000 --> 00:24:19,000 Speaker 2: on and it becomes a laser focus and it's like 462 00:24:19,080 --> 00:24:20,720 Speaker 2: nothing has changed. It's like the first case. 463 00:24:21,280 --> 00:24:25,320 Speaker 1: Wow, you spoke before about how the idea that you 464 00:24:25,400 --> 00:24:27,159 Speaker 1: walk and it's going to be a good day because 465 00:24:27,160 --> 00:24:29,080 Speaker 1: you've got the team that you love, You've got your 466 00:24:29,160 --> 00:24:35,240 Speaker 1: dream team. Who organizes that, Like do you go, I 467 00:24:35,280 --> 00:24:37,000 Speaker 1: want to work with these people or do you just 468 00:24:37,040 --> 00:24:40,280 Speaker 1: show up on the day? And it depends who's rostered on. 469 00:24:41,880 --> 00:24:45,560 Speaker 2: The nursing staff are rosted, the anesthetic staff. I have 470 00:24:45,640 --> 00:24:52,200 Speaker 2: relationships with those guys and have essentially elected to work 471 00:24:52,240 --> 00:24:56,440 Speaker 2: with them, And that's the dynamics. Over time, you sort 472 00:24:56,440 --> 00:24:58,119 Speaker 2: of start to get the team that you want to 473 00:24:58,160 --> 00:25:03,880 Speaker 2: have with the nursing staff and the scrub team they're rosted. 474 00:25:04,280 --> 00:25:06,199 Speaker 2: That you start to get more and more time with 475 00:25:06,240 --> 00:25:07,159 Speaker 2: the people that you like. 476 00:25:08,920 --> 00:25:12,000 Speaker 1: Do you think over time like racking up all the 477 00:25:12,040 --> 00:25:18,160 Speaker 1: surgeries that you've done and are doing, and of course 478 00:25:18,280 --> 00:25:21,679 Speaker 1: everyone who's doing a job, over time, you know, develop 479 00:25:21,760 --> 00:25:24,399 Speaker 1: skill and competence and all of those things. Do you 480 00:25:24,440 --> 00:25:29,040 Speaker 1: think that you've become calmer? Not that you were probably 481 00:25:29,080 --> 00:25:34,359 Speaker 1: ever chaotic, but like I think most of us doing 482 00:25:35,000 --> 00:25:37,040 Speaker 1: obviously most of us wouldn't do what you do, but 483 00:25:37,160 --> 00:25:42,080 Speaker 1: something where the potential consequences are so big, you know 484 00:25:42,160 --> 00:25:45,240 Speaker 1: one way or the other. I mean, that's for us 485 00:25:45,280 --> 00:25:51,200 Speaker 1: mere mortals. That's a recipe for fucking overthinking, self doubt, rumination, anxiety. 486 00:25:52,480 --> 00:25:55,320 Speaker 1: But obviously those things don't work being in any of 487 00:25:55,320 --> 00:25:59,040 Speaker 1: those states don't work. When you need so much fine 488 00:25:59,119 --> 00:26:05,640 Speaker 1: motor skill, so much calmness, and so much presence, how 489 00:26:05,680 --> 00:26:09,480 Speaker 1: do you stay calm but also at the same time 490 00:26:09,680 --> 00:26:11,359 Speaker 1: fully alert and switched. 491 00:26:11,000 --> 00:26:16,520 Speaker 2: On watching a mental watching and learning during the training years. Again, 492 00:26:16,840 --> 00:26:20,280 Speaker 2: my guide out in Hobart still the most naturally gifted 493 00:26:20,320 --> 00:26:25,040 Speaker 2: guy I've seen around Australia, and I've been around Australia. 494 00:26:25,320 --> 00:26:30,280 Speaker 2: It was observing him under pressure and how he reacted 495 00:26:30,320 --> 00:26:33,840 Speaker 2: to it. I still remember a pediatric brain tumor case. 496 00:26:34,359 --> 00:26:38,760 Speaker 2: It went for ten hours or something like that, and 497 00:26:38,800 --> 00:26:41,200 Speaker 2: he just stood there with his shoulders down, his elbows 498 00:26:41,200 --> 00:26:45,040 Speaker 2: by his side, risk just moving slowly, slowly for that 499 00:26:45,200 --> 00:26:49,600 Speaker 2: whole time. And at the time I was like, why 500 00:26:49,720 --> 00:26:51,720 Speaker 2: is he taking so long? I'm tired, I want to 501 00:26:51,760 --> 00:26:55,080 Speaker 2: go home, let's wrap this up. Until I had a 502 00:26:55,080 --> 00:26:57,800 Speaker 2: case of a pediatric brain tumor that I was doing 503 00:26:58,280 --> 00:27:01,280 Speaker 2: on my own. I've told this story before I think 504 00:27:01,480 --> 00:27:03,880 Speaker 2: it was. It started at eight or nine and went 505 00:27:03,880 --> 00:27:09,560 Speaker 2: through to eleven o'clock that night. Difficult pediatric tumor, and 506 00:27:10,000 --> 00:27:13,119 Speaker 2: it was stuck to the brain stem. It was bleeding profusely. 507 00:27:13,480 --> 00:27:16,239 Speaker 2: Progress was super slow. At times. It was hard to 508 00:27:16,240 --> 00:27:19,359 Speaker 2: make out what was tumor and what was normal brain stem. 509 00:27:19,520 --> 00:27:21,800 Speaker 2: And the brain stem is highest priced real estate you 510 00:27:21,800 --> 00:27:24,439 Speaker 2: can get in the brain. I touched that and there 511 00:27:24,440 --> 00:27:30,000 Speaker 2: are huge consequences. So that was extremely incredibly stressful operation. 512 00:27:31,160 --> 00:27:33,760 Speaker 2: And I thought, this is probably what my mentor was feeling. 513 00:27:33,800 --> 00:27:36,400 Speaker 2: This is the emotions he was feeling during that ten 514 00:27:36,440 --> 00:27:38,960 Speaker 2: hour case. He was looking at that structure, going is 515 00:27:39,040 --> 00:27:41,639 Speaker 2: that tumor or? Is that is that I need? I 516 00:27:41,640 --> 00:27:44,640 Speaker 2: don't know. I imagine that that's what was going through 517 00:27:44,640 --> 00:27:46,600 Speaker 2: his head. And I only worked that out when I 518 00:27:46,640 --> 00:27:49,480 Speaker 2: was doing the case, But at the time he was 519 00:27:49,520 --> 00:27:52,359 Speaker 2: just composed and just went millimeter by millimeter. I just 520 00:27:52,440 --> 00:27:55,680 Speaker 2: remember that, and during this pediatric tumor case of mine, 521 00:27:56,359 --> 00:27:59,520 Speaker 2: I just replicated that. I just kipped my head, kept 522 00:27:59,560 --> 00:28:02,760 Speaker 2: my car and knew that it was okay just to 523 00:28:02,840 --> 00:28:07,480 Speaker 2: proceed slowly. I learned a huge amount just watching this guy. 524 00:28:09,040 --> 00:28:11,280 Speaker 2: The other thing. Do I stay calm, I think I get. 525 00:28:12,040 --> 00:28:17,240 Speaker 2: I am definitely calm and get calmer with time, but 526 00:28:17,359 --> 00:28:23,639 Speaker 2: I get not agitated. But I don't think grumpy is 527 00:28:23,640 --> 00:28:28,359 Speaker 2: the right word either. But it's essentially I get shorter 528 00:28:29,040 --> 00:28:33,080 Speaker 2: and clearer and maybe a little bit blunter with instructions 529 00:28:33,119 --> 00:28:40,440 Speaker 2: in theater because I know more now the value of 530 00:28:40,680 --> 00:28:45,040 Speaker 2: nipping any variable in the bud, any new variable that's 531 00:28:45,080 --> 00:28:48,680 Speaker 2: introduced during theater. If you allow too many new variables 532 00:28:48,680 --> 00:28:52,680 Speaker 2: to accumulate, that's when you start getting complications. So my 533 00:28:53,400 --> 00:28:56,800 Speaker 2: instructions are crystal clear, and I'm actually quite blunt, and 534 00:28:56,880 --> 00:29:01,160 Speaker 2: if there is a minor variation to that, I stop, 535 00:29:01,760 --> 00:29:04,840 Speaker 2: corrected and then move forward. And it can be the 536 00:29:04,880 --> 00:29:08,080 Speaker 2: simplest thing. The screen needs to be facing this particular way, 537 00:29:08,880 --> 00:29:11,440 Speaker 2: the drape needs to be on a certain way, The 538 00:29:11,520 --> 00:29:15,200 Speaker 2: instrument needs to always be the same. Told the story 539 00:29:15,200 --> 00:29:17,400 Speaker 2: of the hammer they handed me during a spine operation, 540 00:29:18,040 --> 00:29:19,720 Speaker 2: a hammer that I was not expecting. It was a 541 00:29:19,720 --> 00:29:24,800 Speaker 2: slightly smaller one. They had a laugh, and I was 542 00:29:24,880 --> 00:29:29,120 Speaker 2: quite short and blunt back at them, not because I'm 543 00:29:29,160 --> 00:29:32,360 Speaker 2: just a toxic a difficult personality, but I was nipping 544 00:29:32,400 --> 00:29:34,960 Speaker 2: a variable in the bud. They don't understand that variable, 545 00:29:34,960 --> 00:29:38,400 Speaker 2: but if you have enough of them, it just disorientates you. 546 00:29:38,520 --> 00:29:42,800 Speaker 2: And then once you start getting disorientated, that's where complications occur. 547 00:29:43,800 --> 00:29:47,280 Speaker 2: Every time, almost invariably, if there's a complication, you can 548 00:29:47,320 --> 00:29:50,760 Speaker 2: trace it back to a root pause. It's when this 549 00:29:50,840 --> 00:29:53,600 Speaker 2: step wasn't normal, but you accepted it and thought, oh, 550 00:29:53,600 --> 00:29:55,240 Speaker 2: that's okay, we'll just get on with the case and 551 00:29:55,280 --> 00:30:00,000 Speaker 2: move forward. And so again, my guy down in Hobart, 552 00:30:00,560 --> 00:30:04,640 Speaker 2: he had white line fever. If anything change in theater, 553 00:30:04,720 --> 00:30:07,240 Speaker 2: he would just he would just get so angry. And 554 00:30:07,240 --> 00:30:09,760 Speaker 2: I couldn't understand it at the time, and I don't 555 00:30:09,800 --> 00:30:13,560 Speaker 2: condone that sort of behavior, but I understand the concept 556 00:30:13,600 --> 00:30:17,120 Speaker 2: of of what he was, what his philosophy was. Don't 557 00:30:17,160 --> 00:30:19,680 Speaker 2: give me a new variable. It's the same time every time, 558 00:30:19,720 --> 00:30:24,520 Speaker 2: because if I do that, then I'm least likely to 559 00:30:24,560 --> 00:30:27,320 Speaker 2: have a complication, and I'm going to do my best work. 560 00:30:28,200 --> 00:30:31,360 Speaker 1: And I think, also, that's amazing, thank you for that. 561 00:30:32,000 --> 00:30:37,080 Speaker 1: Like dealing with people like every every day, you're dealing 562 00:30:37,120 --> 00:30:41,000 Speaker 1: literally with life and death, like literally like and so 563 00:30:42,040 --> 00:30:42,840 Speaker 1: you don't really. 564 00:30:42,640 --> 00:30:44,800 Speaker 2: Happen in hups. It's worse than that. It's not life 565 00:30:44,800 --> 00:30:50,400 Speaker 2: and death. It's it's life and life with a morbidity. 566 00:30:51,280 --> 00:30:54,000 Speaker 2: The worst thing is for someone to I mean, obviously 567 00:30:54,040 --> 00:30:57,360 Speaker 2: death is bad, but that really happens. The bad thing 568 00:30:57,400 --> 00:31:01,080 Speaker 2: if someone goes in and they're normal and they come 569 00:31:01,120 --> 00:31:04,440 Speaker 2: out with a neurological deficit. They have to live the 570 00:31:04,480 --> 00:31:08,120 Speaker 2: rest of their life with that neurological deficit. Right, That's 571 00:31:08,440 --> 00:31:11,000 Speaker 2: that's the worst outcome. You go in there and you're 572 00:31:11,000 --> 00:31:12,840 Speaker 2: able to speak, and you come out and you can't speak, 573 00:31:13,400 --> 00:31:15,360 Speaker 2: Or you go in there and your foot is working 574 00:31:15,400 --> 00:31:17,160 Speaker 2: and you come out with a foot drop. It's a 575 00:31:17,280 --> 00:31:24,040 Speaker 2: huge burden on your quality of life. That's that's really that. Yes, 576 00:31:24,120 --> 00:31:26,760 Speaker 2: death is bad, but it really happens. It's causing a 577 00:31:27,200 --> 00:31:29,920 Speaker 2: irreversible problem that they then have to live with for 578 00:31:29,920 --> 00:31:31,760 Speaker 2: the rest of their life. That's the thing we really fear. 579 00:31:32,680 --> 00:31:37,320 Speaker 1: Yeah, I had not thought of that. That is fucking terrifying. 580 00:31:37,640 --> 00:31:40,600 Speaker 1: And I guess also when you're under that pressure and 581 00:31:40,640 --> 00:31:45,960 Speaker 1: you're making decisions and doing the thing that you don't 582 00:31:46,800 --> 00:31:49,080 Speaker 1: you don't really in that moment have the bandwidth to 583 00:31:49,120 --> 00:31:52,520 Speaker 1: be able to want to or have to cater to 584 00:31:52,600 --> 00:31:58,800 Speaker 1: people's individual emotions and to keep everyone you know happy 585 00:31:59,040 --> 00:32:02,000 Speaker 1: in because you're just doing your thing, so it's not 586 00:32:02,120 --> 00:32:05,760 Speaker 1: your job to take or to be responsible for how 587 00:32:05,840 --> 00:32:09,960 Speaker 1: everyone's feeling in the middle of that surgical reality. 588 00:32:10,920 --> 00:32:14,400 Speaker 2: I don't even think about it. Teamwork is really important. 589 00:32:15,360 --> 00:32:20,040 Speaker 2: And when a scrub nurse hands me something that is perfect, 590 00:32:20,080 --> 00:32:22,920 Speaker 2: which means I'm looking down the microscope, I hand out 591 00:32:22,920 --> 00:32:26,120 Speaker 2: my hand and they put the instrument in my hand 592 00:32:26,680 --> 00:32:28,040 Speaker 2: in such a way. I just got to close my 593 00:32:28,120 --> 00:32:30,280 Speaker 2: hand and put it back in. And if they do that, 594 00:32:30,360 --> 00:32:36,280 Speaker 2: I say, perfect, that was perfect, thank you. And if 595 00:32:36,320 --> 00:32:39,400 Speaker 2: I hold my hand out and then they give it 596 00:32:39,440 --> 00:32:41,560 Speaker 2: to me as if what's easy for them, Like they 597 00:32:41,600 --> 00:32:43,320 Speaker 2: grab the instrument in their hand and they hand it 598 00:32:43,360 --> 00:32:45,000 Speaker 2: to me, so it's pointing the wrong way. I've got 599 00:32:45,000 --> 00:32:48,840 Speaker 2: to move my hand then to grasp that. I don't 600 00:32:48,840 --> 00:32:50,480 Speaker 2: even do that anyway. I say give it to me properly. 601 00:32:50,480 --> 00:32:51,720 Speaker 2: I actually give it back to them. Say give it 602 00:32:51,760 --> 00:32:58,400 Speaker 2: to me properly. And because it's teamwork, you know, they 603 00:32:58,400 --> 00:32:59,720 Speaker 2: get the best out of me when I get the 604 00:32:59,720 --> 00:33:06,200 Speaker 2: best out of them. So I reinforce great behavior and 605 00:33:06,520 --> 00:33:09,360 Speaker 2: I ask for it in return. We have something called 606 00:33:09,360 --> 00:33:12,800 Speaker 2: the Mayo table, which is a It sounds fancy, but 607 00:33:12,960 --> 00:33:14,920 Speaker 2: essentially it's just a tray that sits on top of 608 00:33:14,920 --> 00:33:17,120 Speaker 2: the bed, but it's got some legs onto the floor. 609 00:33:17,120 --> 00:33:20,840 Speaker 2: It's called basically sit instruments on this on this mayo table. 610 00:33:21,800 --> 00:33:23,880 Speaker 2: And when that mayo table, it's got a lot of 611 00:33:23,920 --> 00:33:26,120 Speaker 2: instruments that the scrub nurse is using. It's the stuff 612 00:33:26,120 --> 00:33:28,480 Speaker 2: that I'm using is going on and off, backward and forwards. 613 00:33:28,600 --> 00:33:32,200 Speaker 2: When that mayo is organized, all the instruments are lined up, dunk. 614 00:33:33,120 --> 00:33:36,200 Speaker 2: I say that the mayo is a is a glimpse 615 00:33:36,200 --> 00:33:39,280 Speaker 2: into the scrub nurse's mind. The mayo is a reflection 616 00:33:39,400 --> 00:33:43,880 Speaker 2: of the mind. When that mayo is organized, I feel organized. 617 00:33:43,920 --> 00:33:46,960 Speaker 2: I feel they are organized, and I'm confident in them. 618 00:33:47,000 --> 00:33:48,640 Speaker 2: And I say that, I actually say that. I said 619 00:33:48,640 --> 00:33:52,040 Speaker 2: that your mayo is very clean and tidy. Clearly, your 620 00:33:52,040 --> 00:33:54,920 Speaker 2: mind is very clear clear at the moment, I appreciate that. 621 00:33:55,760 --> 00:34:05,480 Speaker 1: Yeah, how quickly or slowly does neurosurgery evolve? I feel 622 00:34:05,720 --> 00:34:08,960 Speaker 1: it's probably not linear. It's probably on an incline at 623 00:34:09,000 --> 00:34:12,600 Speaker 1: the moment. With tech or what the fuck do I know? 624 00:34:14,520 --> 00:34:17,880 Speaker 2: Give us a fascinating question. And I've written an article 625 00:34:17,920 --> 00:34:21,960 Speaker 2: on this. There is some technology at the moment, like 626 00:34:22,000 --> 00:34:27,759 Speaker 2: a robot or the endoscope for spine surgery quite a 627 00:34:27,760 --> 00:34:31,080 Speaker 2: bit of tech at the moment where it's a huge 628 00:34:31,120 --> 00:34:37,800 Speaker 2: expenditure to develop that tech, massive expenditure and the price 629 00:34:37,880 --> 00:34:41,880 Speaker 2: to purchase this equipment is phenomenal, the million dollars for 630 00:34:41,880 --> 00:34:46,480 Speaker 2: a piece of equipment, and the benefit to the patient 631 00:34:47,760 --> 00:34:52,799 Speaker 2: is extremely marginal. And the reason I say that you 632 00:34:52,920 --> 00:34:57,240 Speaker 2: just wind back the clock not far at all. CT 633 00:34:57,440 --> 00:35:01,320 Speaker 2: scan which revolutionize medicine. I mean Planet Earth probably stopped 634 00:35:01,360 --> 00:35:04,520 Speaker 2: spinning for about two seconds when the CT scan arrived 635 00:35:04,920 --> 00:35:08,680 Speaker 2: at address Planet Earth. That was developed on a shoe 636 00:35:08,680 --> 00:35:11,960 Speaker 2: string budget by a guy from the Second World War 637 00:35:12,000 --> 00:35:16,520 Speaker 2: who is working with radar, and over three years persevered 638 00:35:17,040 --> 00:35:24,440 Speaker 2: and against expectations, came up with the CT scanner. Minimal expenditure, 639 00:35:25,120 --> 00:35:32,480 Speaker 2: exponential effect on medicine and patient outcomes. The same with 640 00:35:32,640 --> 00:35:37,240 Speaker 2: MRI scan and in eurosurgery. There's some beans and texts. 641 00:35:37,360 --> 00:35:40,479 Speaker 2: The big one for us is stereotactic. That is using 642 00:35:40,480 --> 00:35:43,000 Speaker 2: a computer to be able to decide where something is 643 00:35:43,080 --> 00:35:47,959 Speaker 2: inside the brain or the spine that's mainly inside the brain, 644 00:35:49,160 --> 00:35:50,640 Speaker 2: and so we use it all the time. If there's 645 00:35:50,640 --> 00:35:53,479 Speaker 2: a tumor that's three centimeters below the surface of the brain, 646 00:35:53,520 --> 00:35:55,799 Speaker 2: this computer can tell us on the skin where that 647 00:35:55,840 --> 00:35:57,880 Speaker 2: projection is, so we can get the cut on the 648 00:35:57,880 --> 00:36:04,520 Speaker 2: scalp in the perfect position. Stereotactic surgery revolutionize the game, 649 00:36:05,600 --> 00:36:12,440 Speaker 2: and now it feels like industry brings out technology for 650 00:36:12,520 --> 00:36:17,000 Speaker 2: the purposes of maintaining earnings for the quarter, and in 651 00:36:17,040 --> 00:36:20,000 Speaker 2: a way without being cynical, in a way, a lot 652 00:36:20,000 --> 00:36:24,440 Speaker 2: of tech at the moment gives whoever's got that tech 653 00:36:24,719 --> 00:36:28,440 Speaker 2: a commercial advantage. If this hospital has got a robot 654 00:36:28,680 --> 00:36:31,720 Speaker 2: and this hospital does not have a robot, then obviously 655 00:36:31,760 --> 00:36:34,520 Speaker 2: this hospital is better and that's where people should go. 656 00:36:36,239 --> 00:36:38,160 Speaker 2: And that's a big part of a landscape at the moment. 657 00:36:39,160 --> 00:36:43,759 Speaker 2: So hospitals are forced to buy this equipment because another 658 00:36:43,800 --> 00:36:46,480 Speaker 2: hospital has got it without it at a disadvantage in 659 00:36:46,560 --> 00:36:48,640 Speaker 2: terms of their quality of care. But really the quality 660 00:36:48,640 --> 00:36:52,880 Speaker 2: of care is almost unchanged. And it's a really dangerous 661 00:36:52,960 --> 00:36:55,560 Speaker 2: landscape that we're entering where there's becoming more and more 662 00:36:55,560 --> 00:37:00,319 Speaker 2: of a push by industry to adopt this technology for 663 00:37:00,400 --> 00:37:05,800 Speaker 2: their shareholders and less so for actual patient outcomes. Huge 664 00:37:05,840 --> 00:37:10,440 Speaker 2: expenditure for very very marginal outcome, But it's a really 665 00:37:10,560 --> 00:37:14,520 Speaker 2: easy sell to the patient. I use a robot, How 666 00:37:14,520 --> 00:37:18,920 Speaker 2: could you resist that I use an endoscope for spine surgery. 667 00:37:20,160 --> 00:37:24,359 Speaker 2: It's truly keyhole surgery. How do you say no to that? 668 00:37:24,920 --> 00:37:25,200 Speaker 1: Yes? 669 00:37:26,000 --> 00:37:30,759 Speaker 2: Yes, the reality behind the scenes is slightly different, and 670 00:37:30,800 --> 00:37:33,640 Speaker 2: it's much harder to sell the fact that perhaps that 671 00:37:33,760 --> 00:37:37,279 Speaker 2: robot doesn't actually change very much at all, and there's 672 00:37:37,280 --> 00:37:40,040 Speaker 2: a different reason that hospital has a robot. That's a 673 00:37:40,040 --> 00:37:42,880 Speaker 2: hard sell. But just to say we have a robot 674 00:37:43,520 --> 00:37:44,560 Speaker 2: is a very easy cell. 675 00:37:45,320 --> 00:37:49,440 Speaker 1: Yeah. Yeah, What about I don't even know if this 676 00:37:49,600 --> 00:37:51,879 Speaker 1: is a good question, So if it's dumb, I'll take 677 00:37:51,920 --> 00:37:59,120 Speaker 1: it out. What about current or future surgical treatments for 678 00:37:59,239 --> 00:38:05,960 Speaker 1: neurological diseases like Alzheimer's, Parkinson's and so on? Is there 679 00:38:06,080 --> 00:38:07,759 Speaker 1: do you ever do? Is that a thing? 680 00:38:08,800 --> 00:38:15,960 Speaker 2: Alzheimer's No, Parkinson's, Yes, Parkinson's disease. The surgical treatment for 681 00:38:16,000 --> 00:38:20,080 Speaker 2: that is phenomenal. The fuck has three parts of the rigidity, 682 00:38:20,160 --> 00:38:23,640 Speaker 2: the hand tremor, and then they walk really stiff and slow, 683 00:38:24,480 --> 00:38:27,759 Speaker 2: and it can be completely debilitating. There are drugs for it, 684 00:38:28,160 --> 00:38:31,760 Speaker 2: but there's an operation called deep brain stimulation. The target 685 00:38:31,880 --> 00:38:34,279 Speaker 2: is a few millimeters wide, deep in the center of 686 00:38:34,320 --> 00:38:36,960 Speaker 2: the brain, and the target was discovered by accident. A 687 00:38:37,040 --> 00:38:39,640 Speaker 2: number of years ago. But now we've got the target 688 00:38:39,680 --> 00:38:41,440 Speaker 2: and we can put a probe into that target and 689 00:38:41,520 --> 00:38:45,680 Speaker 2: stimulate or cause a lesion in that target. The effect 690 00:38:45,880 --> 00:38:51,520 Speaker 2: is phenomenal. A patient can be completely immobilized and incapacitated 691 00:38:51,520 --> 00:38:58,759 Speaker 2: by their Parkinson's symptoms and then post surgery getting towards 692 00:38:58,840 --> 00:39:02,879 Speaker 2: barely recognizable, almost back to normal. There's another condition called 693 00:39:02,880 --> 00:39:08,440 Speaker 2: a central tremor, which again is a type of neurodegenerative condition. Essentially, 694 00:39:08,480 --> 00:39:10,319 Speaker 2: when their hand is at rest, it's fine, but when 695 00:39:10,320 --> 00:39:12,840 Speaker 2: they go out to reach something, the hand starts shaking violently. 696 00:39:12,880 --> 00:39:14,439 Speaker 2: You may have seen it. They reach out to grab 697 00:39:14,480 --> 00:39:16,840 Speaker 2: a glass of water, and the closer you get to 698 00:39:16,840 --> 00:39:20,520 Speaker 2: the glass of water, the hand just starts just shaking uncontrollably. 699 00:39:20,800 --> 00:39:22,640 Speaker 2: It's obviously they can't use their hand for anything because 700 00:39:22,640 --> 00:39:24,480 Speaker 2: as soon as they go to do something, it's called 701 00:39:24,480 --> 00:39:26,480 Speaker 2: an action tremor. As soon as they use the hand 702 00:39:26,520 --> 00:39:30,560 Speaker 2: for anything, the hand just completely starts flailing around. And 703 00:39:30,600 --> 00:39:33,960 Speaker 2: then after deep brain stimulation, the hand works completely normally 704 00:39:34,040 --> 00:39:37,919 Speaker 2: like it's a phenomenal before and after video. So that's 705 00:39:37,960 --> 00:39:44,040 Speaker 2: been around for a while. The accuracy is what's improved, 706 00:39:45,000 --> 00:39:48,000 Speaker 2: exactly where that probe goes in what location and ensuring 707 00:39:48,040 --> 00:39:52,000 Speaker 2: the accuracy. That is certainly improved. The instruments we have 708 00:39:52,080 --> 00:39:54,880 Speaker 2: to do the surgery have improved, making it easier to 709 00:39:54,920 --> 00:39:58,640 Speaker 2: manipulate tissues and do things safely. But for lo the 710 00:39:58,640 --> 00:40:02,640 Speaker 2: philosophy is the same. Surgery is a game of physicality. 711 00:40:02,960 --> 00:40:05,479 Speaker 2: It's removing something that shouldn't be there, or putting something 712 00:40:05,520 --> 00:40:09,360 Speaker 2: back in its normal place, or fixing something that's physically broken. 713 00:40:09,400 --> 00:40:12,719 Speaker 2: That's essentially the name of the game. If it comes 714 00:40:12,719 --> 00:40:15,120 Speaker 2: to brain tumors, the outcomes for a lot of them 715 00:40:15,120 --> 00:40:18,600 Speaker 2: haven't changed in fifty years. Surgery hasn't changed. The only 716 00:40:18,640 --> 00:40:20,760 Speaker 2: thing that's really going to change that is drugs. 717 00:40:21,920 --> 00:40:25,279 Speaker 1: So a friend of mine's got an essential tremor. I 718 00:40:25,360 --> 00:40:28,120 Speaker 1: did not know what you just told me, So I'm 719 00:40:28,120 --> 00:40:31,759 Speaker 1: going to ring him after this. How long? 720 00:40:32,920 --> 00:40:36,440 Speaker 2: How long does that procedure take? Give or take not 721 00:40:36,520 --> 00:40:38,880 Speaker 2: long at all? The planning takes a while going to 722 00:40:38,880 --> 00:40:41,000 Speaker 2: do a scan of the brain and identify that target 723 00:40:41,080 --> 00:40:43,880 Speaker 2: and his minuscule harps. It's a tiny target deep in 724 00:40:43,920 --> 00:40:46,439 Speaker 2: the brain. Planning is a big part of that. Doing 725 00:40:46,440 --> 00:40:48,200 Speaker 2: the operation, they'll do it in under an hour. 726 00:40:48,880 --> 00:40:53,360 Speaker 1: Wow, And what's the chances of a good outcome. 727 00:40:53,640 --> 00:40:55,600 Speaker 2: In someone who's experience, who knows how to do the 728 00:40:55,640 --> 00:40:58,440 Speaker 2: planning and to minimize risk, and has experience in minimizing 729 00:40:58,440 --> 00:41:01,360 Speaker 2: the risk and the one of the big challenges is 730 00:41:01,360 --> 00:41:03,920 Speaker 2: that the brain moves, so it moves with each heartbeat, 731 00:41:04,280 --> 00:41:06,200 Speaker 2: so you kind of have a moving target. You have 732 00:41:06,239 --> 00:41:08,440 Speaker 2: a moving target when you put it in, but also 733 00:41:08,520 --> 00:41:10,960 Speaker 2: when it's actually in the brain's still moving, so it's 734 00:41:10,960 --> 00:41:13,960 Speaker 2: still like a moving target for the stationary tip. People 735 00:41:14,080 --> 00:41:18,560 Speaker 2: have experienced doing that and know how to work around that, 736 00:41:19,280 --> 00:41:21,719 Speaker 2: their chances of success are high. 737 00:41:22,080 --> 00:41:24,439 Speaker 1: What's the bit of the brain called where you said, 738 00:41:24,480 --> 00:41:27,160 Speaker 1: we accidentally found this out and it's like a bit 739 00:41:27,200 --> 00:41:29,360 Speaker 1: of the brain that's a few millimeters what's it called. 740 00:41:30,239 --> 00:41:32,359 Speaker 2: One of them is called the VIM which I think 741 00:41:32,440 --> 00:41:37,520 Speaker 2: is the ventral intermediary something. I'll have to look that up. 742 00:41:37,560 --> 00:41:41,839 Speaker 2: I can't remember. V im is is the acronym. There's 743 00:41:41,840 --> 00:41:44,560 Speaker 2: a couple of targets. There's a subthallomic target. I'm not 744 00:41:44,600 --> 00:41:47,640 Speaker 2: an expert in this, but there's a subfalloming target. There's 745 00:41:47,640 --> 00:41:50,840 Speaker 2: a couple of other targets. It was absolutely discovered that 746 00:41:50,880 --> 00:41:54,319 Speaker 2: the story goes. I think it was. I think it 747 00:41:54,360 --> 00:41:57,000 Speaker 2: was last century. A guy was doing a blood vessel 748 00:41:57,040 --> 00:42:01,480 Speaker 2: operation like in ancient times, and he clipped the wrong 749 00:42:01,520 --> 00:42:05,400 Speaker 2: blood vessel as he would do because he didn't have 750 00:42:05,480 --> 00:42:08,160 Speaker 2: microscopes and modern instruments. He clipped the wrong blood vessel 751 00:42:09,040 --> 00:42:12,160 Speaker 2: and the patient woke up and their tremor was gone. 752 00:42:13,200 --> 00:42:15,680 Speaker 2: He hadn't fixed the original blood vessel problem that he'd 753 00:42:15,719 --> 00:42:18,840 Speaker 2: set out to fix, but he couldn't help but notice 754 00:42:18,840 --> 00:42:24,200 Speaker 2: the patient's tremor had completely disappeared. And I think that 755 00:42:24,280 --> 00:42:26,640 Speaker 2: they did. They didn't even have a scan of that time. 756 00:42:26,640 --> 00:42:28,879 Speaker 2: I think they did a post mortem and worked out 757 00:42:28,920 --> 00:42:32,000 Speaker 2: where that stroke was in the brain and then started 758 00:42:32,000 --> 00:42:33,400 Speaker 2: putting two and two together. 759 00:42:33,920 --> 00:42:36,279 Speaker 1: So they had to kind of reverse engineer it to 760 00:42:36,280 --> 00:42:39,160 Speaker 1: figure out how that fucking fixed it correct. 761 00:42:40,760 --> 00:42:44,000 Speaker 2: That is, that is the one I wound up understanding 762 00:42:44,040 --> 00:42:47,640 Speaker 2: the human brain. The only way that we have gathered 763 00:42:47,719 --> 00:42:50,719 Speaker 2: any valuable information about the function of human brain is 764 00:42:50,760 --> 00:42:52,920 Speaker 2: to observe the broken and work backwards. 765 00:42:53,400 --> 00:42:57,239 Speaker 1: It wasn't that the way that they discovered viagra as well. 766 00:42:57,360 --> 00:43:01,680 Speaker 1: Wasn't that meant to be like some kind of vasil 767 00:43:02,200 --> 00:43:05,120 Speaker 1: vaso dilator or something for blood pressure and it ended 768 00:43:05,160 --> 00:43:06,720 Speaker 1: up giving blokes hard cocks? 769 00:43:07,640 --> 00:43:12,600 Speaker 2: Yep. It was for pulmary hypertension and this side effect. 770 00:43:14,760 --> 00:43:17,680 Speaker 1: And then they're like, hey, we invented this, We've we've 771 00:43:17,760 --> 00:43:21,200 Speaker 1: solved one of the biggest problems for men of all time. 772 00:43:21,560 --> 00:43:23,880 Speaker 1: You're welcome. And then nobody solved it at all. They 773 00:43:24,000 --> 00:43:25,480 Speaker 1: just fucking stumbled across it. 774 00:43:26,120 --> 00:43:29,400 Speaker 2: Yeah, that's a phenomenal story, isn't viagra? And with the 775 00:43:29,440 --> 00:43:32,600 Speaker 2: tie it's a great name, it's a great product that 776 00:43:32,600 --> 00:43:35,279 Speaker 2: that will be if if that was your project that 777 00:43:35,440 --> 00:43:38,040 Speaker 2: fires or whoever made that, that's that's a legacy, that is 778 00:43:38,360 --> 00:43:39,600 Speaker 2: that's a game changer. 779 00:43:40,080 --> 00:43:45,120 Speaker 1: One hundred percent. Yeah. Yeah. Have you ever have you 780 00:43:45,280 --> 00:43:48,800 Speaker 1: ever encountered a case of been involved in a case 781 00:43:49,640 --> 00:43:56,600 Speaker 1: that fundamentally changed how you viewed the brain or consciousness 782 00:43:56,719 --> 00:43:59,360 Speaker 1: or the way that you just looked at it in general, 783 00:44:00,320 --> 00:44:03,800 Speaker 1: or perhaps you heard of a case or you reviewed 784 00:44:03,840 --> 00:44:10,160 Speaker 1: a case or something, or there's been no real surprises, but. 785 00:44:10,120 --> 00:44:13,960 Speaker 2: There was one central case that changed the way I 786 00:44:14,000 --> 00:44:18,200 Speaker 2: looked at the human brain. Awake Cranny oto me patients 787 00:44:18,239 --> 00:44:21,960 Speaker 2: awake during surgery. And I've done it many times before. 788 00:44:23,080 --> 00:44:24,520 Speaker 2: This was the first time I was doing it as 789 00:44:24,560 --> 00:44:29,319 Speaker 2: a consultant, so fully qualified, and the thing that rattled me. 790 00:44:29,760 --> 00:44:32,000 Speaker 2: The thing that I realized for the first time in 791 00:44:32,040 --> 00:44:36,799 Speaker 2: my career was essentially the mystery of the physical and 792 00:44:36,840 --> 00:44:39,360 Speaker 2: the non physical, that gap between the physical and non physical. 793 00:44:39,520 --> 00:44:41,759 Speaker 2: So what I mean is I could see the human brain, 794 00:44:41,800 --> 00:44:44,439 Speaker 2: and I'd seen it a thousand times before, and because 795 00:44:44,480 --> 00:44:48,480 Speaker 2: the patients awake under the drape, I could see them 796 00:44:48,520 --> 00:44:51,720 Speaker 2: having a conscious experience, and I understood for the first 797 00:44:51,800 --> 00:44:54,919 Speaker 2: time what people were talking about between that gap between 798 00:44:54,960 --> 00:44:59,279 Speaker 2: the physical brain and this non physical thing that is experience, 799 00:45:00,920 --> 00:45:04,800 Speaker 2: you know, feelings, seeing, hearing, all that sort of stuff. 800 00:45:06,360 --> 00:45:08,000 Speaker 2: And it was it was, it was. It was a 801 00:45:08,040 --> 00:45:10,840 Speaker 2: game changer for me to see that played out in 802 00:45:10,920 --> 00:45:15,279 Speaker 2: theater and there was what was really was. I don't 803 00:45:15,320 --> 00:45:17,960 Speaker 2: know why I only thought about it at that particular time. 804 00:45:17,960 --> 00:45:20,960 Speaker 2: I remember the day that it happened and I just sort 805 00:45:21,000 --> 00:45:23,799 Speaker 2: of started thinking deeply about it. I just never thought 806 00:45:23,800 --> 00:45:25,120 Speaker 2: about it, and all of a sudden it did a 807 00:45:25,160 --> 00:45:30,280 Speaker 2: deep dive in theater in that moment exploring the topic. 808 00:45:30,640 --> 00:45:33,480 Speaker 2: During the operation, there was no clue on the surface 809 00:45:33,520 --> 00:45:37,600 Speaker 2: of the brain of how that physical brain was connecting 810 00:45:37,640 --> 00:45:40,520 Speaker 2: with the non physical world. There was just no clue. 811 00:45:40,880 --> 00:45:44,120 Speaker 2: It was just pulsating with a heartbeat, but it wasn't 812 00:45:44,160 --> 00:45:46,640 Speaker 2: glowing green, and there was no sparkles and no distortion 813 00:45:46,760 --> 00:45:51,680 Speaker 2: in the atmosphere, which there should have been, because it's 814 00:45:52,200 --> 00:45:55,840 Speaker 2: still the greatest mystery known to man how the human 815 00:45:55,840 --> 00:45:59,320 Speaker 2: brain does that. It's a complete void, how that physical 816 00:45:59,320 --> 00:46:03,880 Speaker 2: brain creates the non physical phenomena of experience. There should 817 00:46:03,920 --> 00:46:11,880 Speaker 2: be some supernatural evidence of how it's doing that, and 818 00:46:11,920 --> 00:46:14,440 Speaker 2: it's and there just isn't. It's just a white brain pulsating. 819 00:46:14,440 --> 00:46:16,960 Speaker 2: It's as physical as your arm or your delt muscle 820 00:46:17,120 --> 00:46:19,680 Speaker 2: or you know, your heart. It's as physical as everything else, 821 00:46:20,120 --> 00:46:23,120 Speaker 2: yet it's got this magical quality of creating consciousness. And 822 00:46:23,160 --> 00:46:27,000 Speaker 2: looking at the brain, I realize what everybody was talking about. 823 00:46:27,040 --> 00:46:30,040 Speaker 2: There's just no evidence about how it's doing that. I 824 00:46:30,040 --> 00:46:32,759 Speaker 2: couldn't hear any voices from heaven. I couldn't. There was 825 00:46:32,840 --> 00:46:35,440 Speaker 2: just nothing. And it was a unique situation because the 826 00:46:35,440 --> 00:46:38,279 Speaker 2: patient was actually awake, having a conscious experience, where usually 827 00:46:38,280 --> 00:46:41,719 Speaker 2: there are sleeps of general anisex bond them mount but 828 00:46:41,760 --> 00:46:45,160 Speaker 2: they're having the actual non physical experience and I can 829 00:46:45,200 --> 00:46:47,080 Speaker 2: see the physicals, I can see the physical, and I 830 00:46:47,080 --> 00:46:49,600 Speaker 2: can see the evidence of the non physical in the 831 00:46:49,680 --> 00:46:53,919 Speaker 2: same person and no link between the two of them. 832 00:46:54,560 --> 00:46:56,640 Speaker 2: And I thought, that is that is a cool mystery. 833 00:46:56,680 --> 00:46:59,359 Speaker 2: Like I get what people are talking about when they 834 00:46:59,360 --> 00:47:02,400 Speaker 2: say that's the thing they really want to understand before 835 00:47:02,440 --> 00:47:06,120 Speaker 2: they die. I mean, that is that's a that's a 836 00:47:06,120 --> 00:47:09,600 Speaker 2: brain breaker. That is I remember that day. I was like, 837 00:47:09,680 --> 00:47:11,920 Speaker 2: I get it. That is that actually is very cool. 838 00:47:12,360 --> 00:47:14,919 Speaker 2: That is that is the greatest mystery known to man 839 00:47:15,160 --> 00:47:17,080 Speaker 2: playing out right in front of me. It's like a 840 00:47:17,080 --> 00:47:22,160 Speaker 2: front row seat, no answers, but you know, I kind 841 00:47:22,160 --> 00:47:24,440 Speaker 2: of like the mystery. I like it hasn't been solved, 842 00:47:25,080 --> 00:47:27,600 Speaker 2: but as a found moment to see it actually played 843 00:47:27,680 --> 00:47:29,880 Speaker 2: out in front of you, it'd be like, are you're 844 00:47:29,920 --> 00:47:32,919 Speaker 2: visiting a black hole? Like that's just imagine if Eli 845 00:47:33,040 --> 00:47:34,520 Speaker 2: Must said I can fly you to a black hole. 846 00:47:35,000 --> 00:47:36,279 Speaker 2: Not only can you stand on the edge of the 847 00:47:36,320 --> 00:47:38,160 Speaker 2: black hole, I'll let you go in for five seconds 848 00:47:38,200 --> 00:47:41,880 Speaker 2: just to see what it's like. You'd be like, oh, yeah. 849 00:47:41,040 --> 00:47:44,480 Speaker 1: Well, I mean it's funny because my job kind of 850 00:47:44,560 --> 00:47:46,480 Speaker 1: is the mind and your job is the brain, and 851 00:47:46,520 --> 00:47:48,880 Speaker 1: we know they're related, but we kind of don't really 852 00:47:48,920 --> 00:47:52,640 Speaker 1: know how you know, and that the truth is we 853 00:47:52,640 --> 00:47:55,080 Speaker 1: don't really have evidence of a mind only evidence of 854 00:47:55,120 --> 00:47:58,279 Speaker 1: a brain, you know, and we know that there's consciousness 855 00:47:58,280 --> 00:48:00,880 Speaker 1: and we know that there's a brain, but we don't 856 00:48:00,880 --> 00:48:04,880 Speaker 1: know how one arises from the other. And neuroscience is 857 00:48:04,880 --> 00:48:07,440 Speaker 1: having a big crack at it. But I don't know 858 00:48:07,480 --> 00:48:09,759 Speaker 1: that we're going to understand that anytime soon. And maybe 859 00:48:09,760 --> 00:48:13,120 Speaker 1: it's good that we don't. Maybe that is that spiritual part, 860 00:48:14,239 --> 00:48:17,600 Speaker 1: Maybe there is, maybe there's you know, well, there's definitely 861 00:48:17,960 --> 00:48:20,960 Speaker 1: stuff that we you know. I think that when we 862 00:48:21,120 --> 00:48:27,839 Speaker 1: can't understand or explain something in science, we're very uncomfortable 863 00:48:27,880 --> 00:48:32,880 Speaker 1: to go, well, it exists, but we don't get it. 864 00:48:33,160 --> 00:48:35,160 Speaker 1: And I think sometimes we've just got to say, you know, 865 00:48:35,640 --> 00:48:38,560 Speaker 1: on our current level of with our current level of 866 00:48:38,640 --> 00:48:43,360 Speaker 1: knowledge science, you know, ability to examine whatever we don't know, 867 00:48:43,480 --> 00:48:46,719 Speaker 1: and it's okay that we don't know, you know. And 868 00:48:46,760 --> 00:48:48,600 Speaker 1: even some of the things we think we do know, 869 00:48:49,120 --> 00:48:51,040 Speaker 1: we find out in ten years, oh, we didn't know 870 00:48:51,120 --> 00:48:52,759 Speaker 1: that at all. We only thought we knew. 871 00:48:53,760 --> 00:48:55,120 Speaker 2: Yeah, there's two things I want to say about that. 872 00:48:55,160 --> 00:48:57,759 Speaker 2: It's interesting. Number One, I feel like technology will be 873 00:48:57,800 --> 00:48:59,839 Speaker 2: the antsick because it has been the answer up till date. 874 00:48:59,840 --> 00:49:03,600 Speaker 2: If you'd said to Caesar Julius Caesar, DNA, Show me DNA, 875 00:49:03,760 --> 00:49:05,440 Speaker 2: tell me about it, what does it look like, how 876 00:49:05,440 --> 00:49:08,160 Speaker 2: does it work? He would just lock you up in 877 00:49:08,160 --> 00:49:12,120 Speaker 2: an asylum. You think you're crazy. He's got no chance 878 00:49:12,160 --> 00:49:15,360 Speaker 2: of understanding an atom or what it looks like, or 879 00:49:15,719 --> 00:49:19,799 Speaker 2: what DNA is, And just that's completely ethereal concept, not 880 00:49:19,800 --> 00:49:25,080 Speaker 2: even a concept, and technology, through X ray technology and 881 00:49:25,160 --> 00:49:29,120 Speaker 2: mathematics was able to uncover that. So I feel like 882 00:49:29,280 --> 00:49:33,160 Speaker 2: consciousness today is much of a bizarre concept as DNA 883 00:49:33,160 --> 00:49:37,600 Speaker 2: would have been to Julius Caesar, solved by technology, and 884 00:49:37,640 --> 00:49:39,560 Speaker 2: so there's a lot who feel that probably will be 885 00:49:39,600 --> 00:49:42,680 Speaker 2: the answer for this as well. But there is an interesting, 886 00:49:43,440 --> 00:49:48,319 Speaker 2: interesting catch with the mind, as you know, it's called 887 00:49:48,320 --> 00:49:52,360 Speaker 2: the other minds problem, meaning I can never examine I 888 00:49:52,400 --> 00:49:55,920 Speaker 2: can never experience someone else's mind. I can only experience 889 00:49:55,960 --> 00:49:59,080 Speaker 2: my own mind. I can only examine my own mind. 890 00:49:59,120 --> 00:50:01,080 Speaker 2: I could never I mean I can do it through 891 00:50:01,120 --> 00:50:03,879 Speaker 2: some surrogate Marcus, asking some questions and things like that, 892 00:50:04,160 --> 00:50:07,960 Speaker 2: that I can never enter your mind to experiment on 893 00:50:08,040 --> 00:50:10,279 Speaker 2: it and try and study it. 894 00:50:11,880 --> 00:50:14,120 Speaker 1: Yeah, well that there's a whole area of research in 895 00:50:14,200 --> 00:50:18,000 Speaker 1: psych called theory of mind, which is that which is 896 00:50:18,040 --> 00:50:21,520 Speaker 1: trying to understand the mind of somebody else. And then 897 00:50:22,680 --> 00:50:26,040 Speaker 1: you know, but again it's it's really just high level guessing, 898 00:50:26,120 --> 00:50:30,520 Speaker 1: or in some instances low level guessing, trying to understand 899 00:50:30,640 --> 00:50:33,920 Speaker 1: somebody else's version. And you and I have spoken about 900 00:50:33,920 --> 00:50:36,960 Speaker 1: this between ourselves. But you know, when we go, all right, well, 901 00:50:37,040 --> 00:50:40,760 Speaker 1: let's say ten thousand people listen to this chat, nobody's 902 00:50:40,800 --> 00:50:43,399 Speaker 1: going to have an identical experience. There might be some 903 00:50:43,600 --> 00:50:48,040 Speaker 1: very similar experiences, but that's it's it's likely now that 904 00:50:48,120 --> 00:50:50,480 Speaker 1: some people have already tuned out and gone, fuck this, 905 00:50:50,480 --> 00:50:53,960 Speaker 1: this is bullshit, And there's it's likely also that some 906 00:50:54,000 --> 00:50:56,480 Speaker 1: people are going, this is ace. I hope it keeps 907 00:50:56,480 --> 00:50:59,759 Speaker 1: going for as long as possible. Some people are this 908 00:50:59,840 --> 00:51:02,440 Speaker 1: is in enlightening some people. This is boring some people, 909 00:51:02,480 --> 00:51:06,160 Speaker 1: this is confusing. And you know, so there's the stimulus, 910 00:51:06,200 --> 00:51:12,839 Speaker 1: and then there's the individual's reaction cognitive, emotional, psychological reaction. Yeah, 911 00:51:12,960 --> 00:51:16,520 Speaker 1: and trying to have an insight into like me, trying 912 00:51:16,520 --> 00:51:19,000 Speaker 1: to have an insight into in real time into how 913 00:51:19,040 --> 00:51:21,640 Speaker 1: you think or how you're feeling, or how this is 914 00:51:21,719 --> 00:51:26,360 Speaker 1: going for you as a conversation, but also simultaneously me 915 00:51:26,600 --> 00:51:30,319 Speaker 1: having a greater than me awareness of the listening experience 916 00:51:30,719 --> 00:51:34,160 Speaker 1: for thousands of people, And so when I ask a question, 917 00:51:34,400 --> 00:51:37,880 Speaker 1: I'm like, what's the best question that I can ask, 918 00:51:38,600 --> 00:51:44,880 Speaker 1: which hopefully will be broadly interesting to the biggest percentage 919 00:51:44,920 --> 00:51:47,800 Speaker 1: of people that I can, you know, rather than I 920 00:51:48,440 --> 00:51:51,080 Speaker 1: want to know things that I'm fascinated in as well. 921 00:51:51,320 --> 00:51:53,839 Speaker 1: But if I think I'm the only one fascinated by 922 00:51:53,840 --> 00:51:57,360 Speaker 1: this question, I'm not asking it, not in this context anyway. 923 00:51:57,760 --> 00:51:58,719 Speaker 2: Does it frustrate you? 924 00:51:59,640 --> 00:52:03,960 Speaker 1: No, I'm fascinated by I mean ergo my PhD. Right, 925 00:52:04,040 --> 00:52:09,440 Speaker 1: But I'm fascinated with how others think and how others see. 926 00:52:10,200 --> 00:52:13,480 Speaker 1: You know, And then you think about, like, where does 927 00:52:13,520 --> 00:52:19,000 Speaker 1: your version of right, where does your personal experience come from? Well, 928 00:52:19,040 --> 00:52:21,880 Speaker 1: part of it comes from part of it is genetic, 929 00:52:21,920 --> 00:52:23,799 Speaker 1: and part of it comes from the brain and the 930 00:52:23,800 --> 00:52:26,760 Speaker 1: biochemistry of the brain. Correct me if I fuck anything 931 00:52:26,840 --> 00:52:29,320 Speaker 1: up from your end. But part of it is about 932 00:52:29,840 --> 00:52:34,879 Speaker 1: your interpretation of what's going on. You know, some people 933 00:52:34,920 --> 00:52:38,239 Speaker 1: are interpreting this as interesting, and therefore they're in the 934 00:52:38,320 --> 00:52:42,440 Speaker 1: moment experience is that they are interested, that they are fascinated. 935 00:52:43,120 --> 00:52:47,359 Speaker 1: Somebody else's interpretation of the exact same stimulus could be 936 00:52:47,719 --> 00:52:51,719 Speaker 1: this is boring, and their literal experience is boredom. But 937 00:52:52,520 --> 00:52:56,680 Speaker 1: either way, those experience are self created. They're stimulated by you, 938 00:52:56,760 --> 00:52:59,880 Speaker 1: and I bet they're created by the interpreter of the 939 00:53:00,120 --> 00:53:01,200 Speaker 1: data or the stimuli. 940 00:53:02,320 --> 00:53:06,799 Speaker 2: It's interesting what you say, and it fascinates me how 941 00:53:06,880 --> 00:53:11,640 Speaker 2: little control we actually have, how easily an external stimulus 942 00:53:11,719 --> 00:53:14,520 Speaker 2: can change the way we feel, think or what we say. 943 00:53:16,680 --> 00:53:20,200 Speaker 2: And it's almost like we don't have any real control. 944 00:53:21,360 --> 00:53:25,640 Speaker 2: I'm a product of my genetics, shore and my biochemistry, 945 00:53:26,600 --> 00:53:29,960 Speaker 2: but it doesn't take much for me to change the 946 00:53:29,960 --> 00:53:34,719 Speaker 2: way I view the world on a particular day. So 947 00:53:34,760 --> 00:53:37,200 Speaker 2: who am I really? I feel like I'm just a 948 00:53:37,239 --> 00:53:39,520 Speaker 2: complicated stimulus response machine. 949 00:53:40,600 --> 00:53:43,640 Speaker 1: You in some ways you are in some ways we 950 00:53:43,800 --> 00:53:46,759 Speaker 1: all are. And you made a good point, and that 951 00:53:46,920 --> 00:53:50,640 Speaker 1: is that nine am Alex might be quite different to 952 00:53:50,800 --> 00:53:55,480 Speaker 1: seven pm alex, depending on you know, whether or not 953 00:53:55,520 --> 00:53:57,640 Speaker 1: you've eaten, how tired you are, whether or not you 954 00:53:57,719 --> 00:54:00,840 Speaker 1: had a blue with Karli, you know whether not it's raining, 955 00:54:01,400 --> 00:54:03,480 Speaker 1: whether or not one of the dogs did away in 956 00:54:03,520 --> 00:54:07,400 Speaker 1: the house, you know, like that in the moment version 957 00:54:07,440 --> 00:54:11,960 Speaker 1: of you. Sometimes I said this to Melissa yesterday. I said, 958 00:54:12,000 --> 00:54:14,080 Speaker 1: I don't want to jinx it, but I'm not even 959 00:54:14,120 --> 00:54:18,960 Speaker 1: sure why. But lately I feel fucking amazing, and I've 960 00:54:19,000 --> 00:54:22,000 Speaker 1: been trying to figure out what I'm doing that makes 961 00:54:22,040 --> 00:54:24,839 Speaker 1: me feel I'm not saying I am amazing, but I 962 00:54:24,880 --> 00:54:29,800 Speaker 1: feel amazing, you know, like mentally, emotionally, cognitively, I feel sharp, 963 00:54:29,880 --> 00:54:34,399 Speaker 1: I feel physically strong. I'm strong in the gym. I'm 964 00:54:34,760 --> 00:54:38,880 Speaker 1: fucking solving problems like a motherfucker. I'm like everything is 965 00:54:39,000 --> 00:54:41,840 Speaker 1: just and I'm trying to I'm trying to reverse engineer 966 00:54:42,280 --> 00:54:46,280 Speaker 1: what am I doing that is making this this state 967 00:54:46,400 --> 00:54:49,879 Speaker 1: that I'm in because it's not psychological, because it's been a. 968 00:54:49,880 --> 00:54:53,279 Speaker 2: Surprise I was about to finish their PhD to me. 969 00:54:54,400 --> 00:54:57,879 Speaker 1: Maybe that's it. Maybe I can just see the light 970 00:54:57,920 --> 00:55:01,520 Speaker 1: at the end of the academic tunnel. Maybe this all right. 971 00:55:01,560 --> 00:55:03,960 Speaker 1: Let's wind up with one or two questions. Right, this 972 00:55:04,080 --> 00:55:07,799 Speaker 1: is not really your field or your area of expertise, 973 00:55:07,880 --> 00:55:11,040 Speaker 1: but it's in your area of kind of and I 974 00:55:11,080 --> 00:55:13,960 Speaker 1: can chime in on this, but we're not interested in me. 975 00:55:17,200 --> 00:55:20,560 Speaker 1: What advice do you have for people who want to 976 00:55:20,600 --> 00:55:24,480 Speaker 1: look after their brain? And I know that you're not 977 00:55:24,560 --> 00:55:27,719 Speaker 1: really the lifestyle guy or the you know, but I 978 00:55:27,760 --> 00:55:30,239 Speaker 1: mean you work with brains, and therefore you must have 979 00:55:30,360 --> 00:55:33,799 Speaker 1: advice for people on you know how to best look 980 00:55:33,880 --> 00:55:38,120 Speaker 1: after their brain so that in terms of their choices 981 00:55:38,200 --> 00:55:43,799 Speaker 1: and behaviors, they can keep it working whatever optimally is 982 00:55:43,880 --> 00:55:44,759 Speaker 1: for them. 983 00:55:45,120 --> 00:55:49,200 Speaker 2: Great question, it's quite simple. Don't stuff it up because 984 00:55:49,200 --> 00:55:53,200 Speaker 2: you've only got one. Basically, there reason I say that quickly. 985 00:55:53,800 --> 00:55:57,560 Speaker 2: Story eighteen year old guy drunk got into a fight. 986 00:55:57,840 --> 00:55:59,719 Speaker 2: This was in Perth when I was training, got into 987 00:55:59,719 --> 00:56:03,120 Speaker 2: a fight, got king hit. During the fight. King hit. 988 00:56:03,200 --> 00:56:05,560 Speaker 2: For those who don't know, that's being punched in the 989 00:56:05,560 --> 00:56:08,400 Speaker 2: back of the head, so you don't see the assailant coming, 990 00:56:08,520 --> 00:56:10,960 Speaker 2: so you haven't got any of your defenses up, so 991 00:56:11,120 --> 00:56:13,720 Speaker 2: your arm's down by your side. You don't see it coming. 992 00:56:14,280 --> 00:56:15,959 Speaker 2: And when you get punched in the back of the head, 993 00:56:16,080 --> 00:56:19,200 Speaker 2: it knocks you out cold. So you hit the deck, 994 00:56:19,640 --> 00:56:22,560 Speaker 2: which means because you're out cold again, none of your 995 00:56:22,640 --> 00:56:25,319 Speaker 2: defenses are mobilized, your hands don't reach out to break 996 00:56:25,360 --> 00:56:28,239 Speaker 2: your fall or anything like that. So the skull hits 997 00:56:28,280 --> 00:56:34,120 Speaker 2: the concrete flush and it causes a catastrophic brain injury. 998 00:56:34,960 --> 00:56:41,160 Speaker 2: And this guy had several operations permanent brain damage. Basically 999 00:56:41,160 --> 00:56:45,640 Speaker 2: a vegetable and there was one day that really struck 1000 00:56:45,680 --> 00:56:48,720 Speaker 2: me and rattled me. I remember the day clearly, walking 1001 00:56:48,760 --> 00:56:51,239 Speaker 2: into his room. We're talking three or four months down 1002 00:56:51,280 --> 00:56:53,360 Speaker 2: the track, and he's in a hospital bed. He's on 1003 00:56:53,440 --> 00:56:57,400 Speaker 2: a ventilator, he's rigid, he's staring into space. Lights are on, 1004 00:56:57,400 --> 00:57:00,880 Speaker 2: there's no one home. It's a severe brain injury. His 1005 00:57:01,000 --> 00:57:03,319 Speaker 2: parents are there. He's got sweat on him, he's got 1006 00:57:03,320 --> 00:57:06,880 Speaker 2: a fan on his brain, stems misfiring, he can't regulate. 1007 00:57:07,080 --> 00:57:08,080 Speaker 1: It's just a. 1008 00:57:08,080 --> 00:57:14,759 Speaker 2: Total disaster physiologically and everything. And the thing that got 1009 00:57:14,800 --> 00:57:17,480 Speaker 2: me with the photos up on the wall, and there 1010 00:57:17,560 --> 00:57:21,360 Speaker 2: was the eighteen year old kid with his dad and 1011 00:57:21,840 --> 00:57:25,160 Speaker 2: holding a fish for memory. And then there was another 1012 00:57:25,160 --> 00:57:27,440 Speaker 2: photo of his eighteen year old kid smiling with his 1013 00:57:27,480 --> 00:57:31,040 Speaker 2: girlfriend at I presume end of view, end of school 1014 00:57:31,440 --> 00:57:37,120 Speaker 2: formal smiling pull a potential, a perfectly firing brain, eighteen 1015 00:57:37,160 --> 00:57:40,000 Speaker 2: year old kid's brain, all the potential in the world, 1016 00:57:40,480 --> 00:57:43,840 Speaker 2: can think, clearly, can do anything. It's his number one 1017 00:57:44,440 --> 00:57:47,560 Speaker 2: asset is his brain. And then there's another photo with 1018 00:57:47,640 --> 00:57:49,680 Speaker 2: him and his mates doing something up on the wall 1019 00:57:49,720 --> 00:57:54,000 Speaker 2: as well. And then I look at him lung in 1020 00:57:54,040 --> 00:57:59,280 Speaker 2: the bed and he's lost all of that and The 1021 00:57:59,320 --> 00:58:02,560 Speaker 2: message is very clear. It's you know, people say, what 1022 00:58:02,600 --> 00:58:06,200 Speaker 2: can I do to look after my brain? Well, quite 1023 00:58:06,280 --> 00:58:09,480 Speaker 2: literally that just look after it. It's the best asset 1024 00:58:09,520 --> 00:58:13,040 Speaker 2: you ever have. And it doesn't matter what knock to 1025 00:58:13,040 --> 00:58:16,840 Speaker 2: the head you have, what insults your brain has, you 1026 00:58:16,920 --> 00:58:19,000 Speaker 2: will pay the price for that. You may lose one 1027 00:58:19,120 --> 00:58:22,640 Speaker 2: or two IQ points, or you may lose your entire future. 1028 00:58:23,960 --> 00:58:26,280 Speaker 2: Just don't stuff it up. Is quite literally as simple 1029 00:58:26,320 --> 00:58:29,600 Speaker 2: as that. You don't get a second chance with the brain. 1030 00:58:30,560 --> 00:58:34,320 Speaker 2: Sometimes the effects are not immediately obvious, but the effects 1031 00:58:34,320 --> 00:58:37,680 Speaker 2: are certainly there, and it doesn't repair itself. You've got 1032 00:58:37,720 --> 00:58:41,680 Speaker 2: one look after it, use it. Just don't stuff it up. 1033 00:58:42,520 --> 00:58:44,440 Speaker 2: Beer Yep. 1034 00:58:45,200 --> 00:58:48,040 Speaker 1: So I'm guessing the UFC is not high on your 1035 00:58:48,040 --> 00:58:51,840 Speaker 1: list of career options for now. 1036 00:58:51,880 --> 00:58:55,600 Speaker 2: What's UFC? Absolutely enthralled by it and then I cringe 1037 00:58:55,640 --> 00:58:58,040 Speaker 2: out at the same time. It's like this dichotomy of 1038 00:58:58,120 --> 00:59:01,800 Speaker 2: experiences when watching it. I love the I mean, it's 1039 00:59:01,840 --> 00:59:05,560 Speaker 2: just it's visceral to see combat. I'm sure that's why 1040 00:59:05,560 --> 00:59:09,160 Speaker 2: the Romans loved it. Build a Coliseum, because there's something 1041 00:59:09,280 --> 00:59:13,960 Speaker 2: natural about seeing a blood sport and two people in combat. 1042 00:59:14,040 --> 00:59:15,760 Speaker 2: It just it just gets you in a way that 1043 00:59:15,760 --> 00:59:20,040 Speaker 2: you can't really explain. But then I see the slow 1044 00:59:20,080 --> 00:59:22,520 Speaker 2: mods of the punch to the head and I know 1045 00:59:22,640 --> 00:59:24,880 Speaker 2: what that means in terms of brain function. I know 1046 00:59:24,960 --> 00:59:29,480 Speaker 2: what that will look like on a CT scan. But 1047 00:59:29,520 --> 00:59:31,480 Speaker 2: the context is different, isn't harps. They're getting paid to 1048 00:59:31,520 --> 00:59:33,840 Speaker 2: take damage. Basically, that is their career. That's what they've 1049 00:59:33,880 --> 00:59:36,040 Speaker 2: signed up for. I guess so, and. 1050 00:59:35,960 --> 00:59:38,880 Speaker 1: They know, and you know what. So yeah, I'm it's 1051 00:59:38,920 --> 00:59:41,720 Speaker 1: funny you say that. I've said essentially what you said. 1052 00:59:41,720 --> 00:59:44,040 Speaker 1: It's for me. It's a dichotomy because on the one hand, 1053 00:59:44,760 --> 00:59:48,960 Speaker 1: I'm an excise scientist. I love I love athleticism and 1054 00:59:49,040 --> 00:59:52,600 Speaker 1: power and speed and skill and those guys and girls 1055 00:59:52,640 --> 00:59:55,920 Speaker 1: in the UFC and more broadly, you know, mixed martial 1056 00:59:56,000 --> 01:00:01,040 Speaker 1: arts across the spectrum. You know, there's so many great things. 1057 01:00:01,640 --> 01:00:06,400 Speaker 1: There's that unavoidable thing, which is you are going to 1058 01:00:06,640 --> 01:00:09,640 Speaker 1: at the very least damage your brain a bit, if 1059 01:00:09,720 --> 01:00:12,600 Speaker 1: not completely fuck it up. Like nobody gets out of 1060 01:00:13,280 --> 01:00:17,640 Speaker 1: full contact sport. Nobody, zero people with zero damage. Nobody 1061 01:00:17,640 --> 01:00:22,440 Speaker 1: has no damage. But I don't know, if you're across this, 1062 01:00:22,440 --> 01:00:25,720 Speaker 1: this is going to make you shudder. So Dana White, 1063 01:00:25,800 --> 01:00:29,680 Speaker 1: who who is the boss of the UFC, who you know, 1064 01:00:29,760 --> 01:00:30,440 Speaker 1: you know who he is? 1065 01:00:30,520 --> 01:00:32,080 Speaker 2: Right? Yeah? 1066 01:00:32,120 --> 01:00:35,880 Speaker 1: So also, I mean people hate him. I fucking I 1067 01:00:36,040 --> 01:00:38,880 Speaker 1: find him hilarious. I don't agree with everything he says, 1068 01:00:38,920 --> 01:00:42,040 Speaker 1: but here's what I do love about Dana White. You 1069 01:00:42,080 --> 01:00:45,720 Speaker 1: will never not know what he thinks. 1070 01:00:45,920 --> 01:00:49,080 Speaker 2: I was going to say. He has a very clear mind. 1071 01:00:49,680 --> 01:00:52,880 Speaker 1: He has no filter, and he gives no fucks if 1072 01:00:52,880 --> 01:00:55,760 Speaker 1: people agree or disagree, and he's not doing it to 1073 01:00:55,840 --> 01:01:00,680 Speaker 1: be controversial or for attention. And he's built this fucking 1074 01:01:00,760 --> 01:01:04,880 Speaker 1: incredible brand from nothing to this multi billion dollar thing. 1075 01:01:06,320 --> 01:01:08,840 Speaker 1: And he's just a knock about bloke who's a visionary. 1076 01:01:08,920 --> 01:01:11,360 Speaker 1: And yeah, he's got all these flaws and all these 1077 01:01:11,440 --> 01:01:13,880 Speaker 1: chinks in his art and all that shit, but he's 1078 01:01:13,960 --> 01:01:17,760 Speaker 1: just take he saw I think it was two years ago. 1079 01:01:18,000 --> 01:01:22,520 Speaker 1: There's this thing there's face slapping competition, right, which happens 1080 01:01:22,560 --> 01:01:27,080 Speaker 1: in lots of countries around the world. But he took 1081 01:01:27,160 --> 01:01:31,160 Speaker 1: this idea and he turned it into power slap. So 1082 01:01:31,320 --> 01:01:34,840 Speaker 1: these I think it's I don't know if women are involved. 1083 01:01:34,880 --> 01:01:38,880 Speaker 1: Maybe women are, fuck but all the ones I've seen 1084 01:01:38,920 --> 01:01:42,080 Speaker 1: the men where they literally stand with their hands behind 1085 01:01:42,120 --> 01:01:46,040 Speaker 1: their back. It's almost like they're leaning over a bench, 1086 01:01:46,120 --> 01:01:50,240 Speaker 1: which is for arm wrestling, but they just they just 1087 01:01:50,320 --> 01:01:53,600 Speaker 1: stand there and this bloke on the other side just 1088 01:01:53,720 --> 01:01:57,160 Speaker 1: winds up and smacks them with an open hand across 1089 01:01:57,160 --> 01:02:03,160 Speaker 1: the face with like ridiculous force. So they're just getting 1090 01:02:03,640 --> 01:02:07,280 Speaker 1: struck in the head. And this has gone from nothing 1091 01:02:07,360 --> 01:02:10,840 Speaker 1: to now being it's it's like I heard him talking 1092 01:02:10,880 --> 01:02:14,200 Speaker 1: about it the other day, where it's it's becoming this 1093 01:02:14,400 --> 01:02:18,520 Speaker 1: big spectator sport. Clearly not for everyone. I don't I 1094 01:02:18,560 --> 01:02:21,000 Speaker 1: don't watch it. I've just seen some reels. I can't 1095 01:02:21,000 --> 01:02:23,320 Speaker 1: watch it. I can't get on board. I can get 1096 01:02:23,320 --> 01:02:25,680 Speaker 1: on board the UFC, but I can't get board this. 1097 01:02:26,520 --> 01:02:29,600 Speaker 1: But I'll send you. I'll send you a clip and 1098 01:02:29,640 --> 01:02:33,320 Speaker 1: you as a you as a neurosurgeon, mate, you're just 1099 01:02:33,360 --> 01:02:35,920 Speaker 1: gonna fucking shake your head. 1100 01:02:36,240 --> 01:02:39,320 Speaker 2: I've seen his clips from India, the slap competitions from India. 1101 01:02:39,400 --> 01:02:43,760 Speaker 2: These Begindian guys. It's it's bizarre. I've got like this, 1102 01:02:43,760 --> 01:02:47,560 Speaker 2: this respect of each other and this courtesy and then 1103 01:02:47,600 --> 01:02:50,280 Speaker 2: they wind up and fucking so bang. 1104 01:02:51,000 --> 01:02:54,320 Speaker 1: That's not good. All right, mate, I love chatting with you. 1105 01:02:54,520 --> 01:02:56,520 Speaker 1: This has been one of my favorite chats. I feel 1106 01:02:56,560 --> 01:02:59,000 Speaker 1: like there was a lot of great information and a 1107 01:02:59,000 --> 01:03:02,240 Speaker 1: lot of great insight in we'll chat off here. Is 1108 01:03:02,240 --> 01:03:04,480 Speaker 1: there anything you don't want to got nothing to sell? 1109 01:03:04,520 --> 01:03:06,520 Speaker 1: I always say to my guests, where do you want 1110 01:03:06,520 --> 01:03:10,280 Speaker 1: to send our listeners? We are There is some news 1111 01:03:10,320 --> 01:03:13,120 Speaker 1: coming from Alex next year. There's going to be some 1112 01:03:13,240 --> 01:03:16,000 Speaker 1: big shit. I'm going to be involved in a little bit. 1113 01:03:16,600 --> 01:03:19,520 Speaker 1: I'm the one percent, he's the ninety nine. But I'm 1114 01:03:19,560 --> 01:03:21,640 Speaker 1: gonna I'm going to have my toe in the in 1115 01:03:21,680 --> 01:03:24,200 Speaker 1: the Alex door next year to help him do a 1116 01:03:24,240 --> 01:03:26,760 Speaker 1: couple of things. But we'll let you know more about 1117 01:03:26,800 --> 01:03:28,760 Speaker 1: that in the future. But for the moment, mate, love 1118 01:03:28,840 --> 01:03:31,840 Speaker 1: talking to you, Appreciate you and thanks for being on 1119 01:03:31,840 --> 01:03:33,040 Speaker 1: the new project yet again. 1120 01:03:33,520 --> 01:03:35,520 Speaker 2: Thanks Harts, really enjoyed it. Great to see you.