Speaker 1: My name is Craig Ferguson. The name of this podcast
Speaker 1: is Joy. I talked to interest in people about what
Speaker 1: brings them happiness. Doctor Robert J. Serfolio. We'll call him
Speaker 1: Surf because that's what he wants. And once you know
Speaker 1: about this guy, you'll think, you know what, give him
Speaker 1: everything he wants.
Speaker 2: He's an amazing character, wasn't it, this.
Speaker 1: Surf? Before we begin, I do want to say one
Speaker 1: thing to you, which is I want to apologize because
Speaker 1: you come in and you recorded in an episode of
Speaker 1: this and then we checked it back and we didn't
Speaker 1: record it. It's like it's the podcast equivalent of like
Speaker 1: you doing an operation and cancer leave at least leaving
Speaker 1: the key, your keys or.
Speaker 2: Something in there, or maybe your wallet or your phone.
Speaker 1: Like we got the cancer out, everything's good, but I
Speaker 1: left my phone there, so we got to go back.
Speaker 3: You know, I get this a lot from women that
Speaker 3: I go on dates. They say they accidentally left something
Speaker 3: back so they have to come back.
Speaker 2: You know.
Speaker 1: Listen, here's the thing, though, You're just saying, well, are
Speaker 1: you single? You're not really single? Now you got to
Speaker 1: go yes. I yeah, that's why that was a joke. Yeah,
Speaker 1: I like that very Yeah, I get totally understand. It's vibe.
Speaker 1: So listen, I want to talk to you a little
Speaker 1: bit because I was just saying to you, I got
Speaker 1: a screening coming up for an en dusky coming up
Speaker 1: in about a week, and it's only because they find
Speaker 1: a little irritation during the last ones. They gave me
Speaker 1: some PPIs to to treat it.
Speaker 2: They found Barrett's spirits.
Speaker 1: No, no, it wasn't barrets it was it was it
Speaker 1: was a lesion, an ulcerated lesion or something like blasia displas.
Speaker 2: Yes, right, so listen, I know that.
Speaker 1: We're not really on on your dime here, but is
Speaker 1: that good or bad displays?
Speaker 3: It's just a thing could be could be absolutely much
Speaker 3: better than some other things.
Speaker 1: They sure, well they did a biop so you didn't
Speaker 1: find anything right now.
Speaker 3: But they might do now is I don't know if
Speaker 3: you gonna have an ultrasound done at the same time
Speaker 3: in multiple quadrant biopsies. Sometimes they do that they get
Speaker 3: more representative tissue.
Speaker 2: Oh yeah, you might do that.
Speaker 1: I don't know.
Speaker 2: You're going to be chilled down on propofilo.
Speaker 1: I'm going to be taking the big sleepy time, which
Speaker 1: we've established I love too much.
Speaker 2: Yes, well, yeah, I love too much.
Speaker 1: And that's why you know, I would take an endoscopy
Speaker 1: once or twice a week if I could, just just
Speaker 1: for the propofall. So listen, tell me this dude. You are,
Speaker 1: and we established this before, but you are, to my understanding,
Speaker 1: the number one robotic surgery guy in the US. Right.
Speaker 3: Yes, So that that's just not a measurable metric role,
Speaker 3: is it, really? You know, it's like saying, I'm I mean,
Speaker 3: I've done a lot of robotic thoracic surgery, but there
Speaker 3: are I'm I'm a lung certain of thoracic surgery. I
Speaker 3: do long lungs, esophagus and thymus, anything in the chest
Speaker 3: that's really not heart related, though we we can take.
Speaker 2: Our parts of the heart.
Speaker 3: But we're you know, even though we're boarded as cardio
Speaker 3: thoracic surgeons, we choose to do thoracic, which is the
Speaker 3: long the esophagus, the media stye, and the thymus stuff
Speaker 3: like that.
Speaker 2: So is that specialism or is a union? We're going
Speaker 2: all on. I'll strike tomorrow. It's a matter right now.
Speaker 2: You big that up could have joined the writers. The
Speaker 2: writers are.
Speaker 1: And the actors are still. But you know, I think
Speaker 1: as long as the doctor stay in, I'll be all right.
Speaker 1: So talk me through what a robotic surgery is, because
Speaker 1: it's not you just programming in a robot, and the
Speaker 1: ruleboat was ended well to tell me what it is.
Speaker 2: It's so interesting.
Speaker 3: Even the patient I operated on today, who came from
Speaker 3: very far away and is super educated, when he came
Speaker 3: in he looked at the robot.
Speaker 2: He said, now you're you're doing it right, not that
Speaker 2: big machine.
Speaker 1: I'm like, listen, bro, we've talked, you've looked at the videos,
Speaker 1: you've looked.
Speaker 2: At everything doesn't even make sense.
Speaker 3: But yeah, so what the robot does is we're able
Speaker 3: instead of making big incisions and spreading the ribs, we're
Speaker 3: making incisions that are a third of an inch eight millimeters.
Speaker 2: We will make three of these.
Speaker 3: The old robot actually had five millimeters reports we were
Speaker 3: making five millimeter incisions, not eight, which I think actually
Speaker 3: had a real benefit. This new one, I would hope
Speaker 3: that they're going to miniaturize it a little bit. So
Speaker 3: you put in these metal ports through these tiny incisions
Speaker 3: in the chest, and then through the poor come a
Speaker 3: series of different instruments right, and then they get hooked
Speaker 3: up to the robot. This great, big, giant mostrosity look
Speaker 3: like it's over the patient.
Speaker 1: Right. Does that have a face on itth it does?
Speaker 3: He asked me if I name my robot, I'm like, listen, bro,
Speaker 3: we don't name the robot. That's not something we do.
Speaker 3: But then we sit in a console remotely. Now you know,
Speaker 3: I've operated and I think twenty six countries. In one country,
Speaker 3: I was a mile away from the patient, which would
Speaker 3: never happen in the United States. Could never fly in China, right,
Speaker 3: But they wanted a big room of people. They had
Speaker 3: eight hundred people, and they wanted me to answer questions
Speaker 3: as I was operating.
Speaker 1: We teaching situation.
Speaker 3: Yeah, when I go on these things are always you know,
Speaker 3: for charity and teaching and a honor to do it.
Speaker 1: I love to do it. So it was like a
Speaker 1: corporate gig for a comedian. Then it's like, hey, I'm
Speaker 1: very happy to be in China. I'm going to do
Speaker 1: a little bit of thoracic here for you. I love
Speaker 1: you guys a little bit. I think they get paid, Yeah,
Speaker 1: they pay for our flight.
Speaker 2: But that's a that's it.
Speaker 1: See, you know, I knew being a doctor who was
Speaker 1: the way to go finance.
Speaker 3: You made a good decision when you nail the MCATs,
Speaker 3: you made a good I.
Speaker 1: Tell you I did not make the decision. If I
Speaker 1: had made the decision, it would be something else. I
Speaker 1: was dealing with the cards. I was deal So you
Speaker 1: go in there and you so you work remotely in
Speaker 1: the sense that is it like a video gamer.
Speaker 3: Yes, so we are sitting in a console that has
Speaker 3: an immersive experience. So it's a three D We put
Speaker 3: our head into a console like this, and there's all ergonomics.
Speaker 3: You have your own chair, but there's a giant machine
Speaker 3: with two hands here, multiple pedals for your left foot,
Speaker 3: your right foot.
Speaker 2: There like six options.
Speaker 3: It looks complicated, but it's actually very I mean, I'm
Speaker 3: doing it, so how hard can it?
Speaker 2: Come on? You're trusting yourself.
Speaker 1: Done.
Speaker 3: No, I'm giving it to you straight. It's it's like
Speaker 3: an airplane. It looks super complicated, but you know once
Speaker 3: you get to know it exactly. Yeah, And so you
Speaker 3: move your left foot and the right foot and in
Speaker 3: the right chest. You're going to have two left hands,
Speaker 3: so you can toggle your foot and make your left
Speaker 3: hand the one here or the one behind it, and.
Speaker 2: Assist yourself, so you're like your four hands.
Speaker 3: You have three hands and a camera, so you're driving
Speaker 3: your own camera, which is a big advantage over laparoscopy
Speaker 3: or video assist a throoscopy or arthroscopy, which where they
Speaker 3: put a scope into joint and you have to hold
Speaker 3: it here it hooked up to a robot, and as
Speaker 3: I move my hands and feet, the camera moves where
Speaker 3: I want to go. Gigantic advancement because when I did
Speaker 3: these cases with someone driving the camera, I'm like, listen,
Speaker 3: did you bring the camera?
Speaker 2: I don't want to look at it? Move it up.
Speaker 1: You know, it's a constant dialogue. If you have great assistance, they.
Speaker 3: Know where you want to look, but no one knows
Speaker 3: where you want to look more than me. So with
Speaker 3: the robot, I drive the camera. The robot is a
Speaker 3: slave to my hands. If I don't move my hands
Speaker 3: to robots, it's still right. If I don't move my feet,
Speaker 3: the robot doesn't move too. So it doesn't go this
Speaker 3: patient is It.
Speaker 1: Doesn't It doesn't do anything that at some point we
Speaker 1: will get to where parts of the operation.
Speaker 3: I think we'll say to the robot, here's the artery.
Speaker 3: Here's the vey and here's the Broncus robot. Get around
Speaker 3: the artery because at some point it's going to be
Speaker 3: better than us. I firmly believe that, despite what my
Speaker 3: colleagues say it.
Speaker 2: So that's it's like the benefits of AI right that correct.
Speaker 3: I was in Italy a couple of days ago lecturing
Speaker 3: on this, and the people in the audience again were like,
Speaker 3: you know, sir, if you're you're pushing this, you're gonna
Speaker 3: get us out of a job.
Speaker 2: And I'm giving it's about getting patients better care.
Speaker 1: If you're crazy, we know we're not like they did
Speaker 1: say you're crazy, you're grazez.
Speaker 2: You make it the roll. Boy, it's about news one
Speaker 2: of the role.
Speaker 1: But so let me so. But the tack title approach
Speaker 1: you as a as a surgeon. Now, presumably I would
Speaker 1: imagine that as you're training and going through building up
Speaker 1: becoming a surgeon. Right, it's a very tac tale thing.
Speaker 1: You ran there with the sounds and the smells and
Speaker 1: you are so boy, you are You're pretty sure you're
Speaker 1: a pretty smart guy. How did you know that? Yeah?
Speaker 1: I used to be a doctor used in my mind
Speaker 1: before ye, well, I'm not a doctor, but I did
Speaker 1: a yoga class in LA which makes you a doctor.
Speaker 1: Yeah about New York City. So do you lose anything
Speaker 1: with that?
Speaker 3: Such a great question, And again I hate to go
Speaker 3: back to experiences, but today I have and I'm very
Speaker 3: honored because they don't come to see me. They come
Speaker 3: to see NYU and the NYU team. So I have
Speaker 3: a doctor from Brazil and two from England who were
Speaker 3: there today. And the case we did is a metasectomy.
Speaker 3: I won't de technical, but it means there's little tiny
Speaker 3: spots in the lung that are very small that both
Speaker 3: surgeons said where they are they would make a big incision,
Speaker 3: spread through it is, put their fingers in and feel.
Speaker 3: I'm like, yeah, you could do it. That's how I did.
Speaker 3: I've done eighteen thousand, nine hundred operations. That's how I
Speaker 3: did my first ten thousand. Now we can't do that.
Speaker 3: So with the robot, although you can't feel, you can
Speaker 3: still take your instrument and rub it over the lung.
Speaker 3: Then you can see a little tiny nodule, a four
Speaker 3: millimeure nodule like a pop out on the top of
Speaker 3: the surface, or even five to six millimeters under the surface.
Speaker 2: So we've come up.
Speaker 1: With ways so you do this, But you would have
Speaker 1: to be a surgeon who's experienced the tag tile, you've
Speaker 1: been through that to feel that.
Speaker 2: I don't think that's a fallacy.
Speaker 3: I think to say, hey, you got to open up
Speaker 3: and do a whole bunch of opens, or go to
Speaker 3: a lab now and operate on animals and do opens,
Speaker 3: I don't think so. I think we've gotten so good
Speaker 3: with simulation and teaching that we can teach the non
Speaker 3: experience palpader with the tactile so young surgeons who have
Speaker 3: not opened, because we do everything robotically, everything one hundred percent,
Speaker 3: me and my partners, we don't ever open. That's why
Speaker 3: people come from all over the world, and our conversion
Speaker 3: rate has been essentially zero the last four or five years.
Speaker 3: Does that cut down on a post off infection as well?
Speaker 2: Well, it's not.
Speaker 3: Well, don't get a lot of infections, but the pain.
Speaker 3: So I'm not about to write a paper. I've operated
Speaker 3: on one hundred and six surgeons. They've all been back
Speaker 3: in the o R within seven to ten days. So
Speaker 3: your recovery, because you have tiny little nicks, that's it.
Speaker 3: And then you know, we we have now we have
Speaker 3: to make the one incision bigger because we put the
Speaker 3: tumor which is in a lung and a bag, and
Speaker 3: then we're like pulling the bag. I got my foot
Speaker 3: on the guy's chest trying to pull the bag out, really,
Speaker 3: because you want to make the decisions as small as
Speaker 3: you can.
Speaker 1: And it does make that sound? Does it really something
Speaker 1: like that? That's horrifying and awesome at the same time. Now, listen,
Speaker 1: because I think about this, because I've made a couple
Speaker 1: of surgeons in my life. You seem very like this
Speaker 1: to me. They're kind of their jobs, you know. You
Speaker 1: guys are your competitive, you're sporty. Yep, you're kind of
Speaker 1: you know. I've met male and female surgeons and they're
Speaker 1: very similar. There's that real kind of sport mentality.
Speaker 3: I played baseball in college, and all three of my
Speaker 3: boys were captain of their high school baseball teams. And
Speaker 3: they went on to college and played D one baseball.
Speaker 2: Yeah, well, are you boys own medicine?
Speaker 1: No?
Speaker 2: Well, they were a little too smart.
Speaker 3: They thought I worked too hard, and they're doing things
Speaker 3: that are may be a little bit better for society.
Speaker 1: I don't know, but that that kind of drive your
Speaker 1: father was a doctor. He was, Yeah, it was your father.
Speaker 1: Very sporty and very he was. He played baseball in
Speaker 1: college as well. What kind of doctor? What kind was he?
Speaker 1: A surgeon? Was a surgeony urologist? Oh plenty of I'm
Speaker 1: fifty one years old. I mean it's like I'm sixty
Speaker 1: one too, right, Well you know then, yes, now you
Speaker 1: know as a as a doctor, you're probably a terrible patient, right.
Speaker 2: I really am.
Speaker 3: I had surgery about nine days ago, right before I
Speaker 3: flew to Italy days ago, and I was back in
Speaker 3: the o R two days later.
Speaker 1: Can I see what it was?
Speaker 2: It was? Yeah?
Speaker 3: Because I've done so much surgery, it's a very common
Speaker 3: for surgeon. As we looked down, I had advancing arthritis
Speaker 3: in my cervical proteinebro bodies, and so they just pucked
Speaker 3: a little bit of the bone out with a little incision,
Speaker 3: took a little the disc out, and I had a
Speaker 3: little numbus in my finger, which is scary when you're
Speaker 3: a surgeon, like I kind of need that puppy.
Speaker 2: I may not be good, but I'm valuable to me.
Speaker 1: Sure. It was like a concert penist or something, and
Speaker 1: you need that one hundred percent is it demystified for you?
Speaker 1: Then surgery is like because a lot of people, surgery
Speaker 1: is like, this is a very big deal.
Speaker 2: I'm very frightened. I'm very upset. Doesn't you're like, nah,
Speaker 2: go ahead, I'll get it done.
Speaker 1: I'll bet it's.
Speaker 3: Yeah, because I I obviously I know the people who
Speaker 3: are really good. They did a minimally invasive incision in
Speaker 3: my neck and I literally was in my office.
Speaker 2: Now he told me to take a week off.
Speaker 3: I was in my the finished the operation at one,
Speaker 3: I saw a patient in my office at five, and
Speaker 3: then I was back in the operating Monday, and I
Speaker 3: flew to Italy the next day.
Speaker 1: See that's see, that's just you know, listening to your dog. Well,
Speaker 1: it's the amount one hundred percent. But you asked if
Speaker 1: we're good patients. I was giving an example to Supper.
Speaker 1: You're just you are.
Speaker 2: I just think that my surgeon was so good that
Speaker 2: you did.
Speaker 1: You ever get when you were training right at the start,
Speaker 1: when you're looking at you know, all the different disasters
Speaker 1: that can go wrong with the young body, Yeah, did
Speaker 1: you get them all? Did you become a hypochondriac because
Speaker 1: you were still? See I would have like even talking
Speaker 1: to you, I'm thinking, oh my god, I hope i'm catch.
Speaker 2: So I hope he's not got anything on his end.
Speaker 3: So I did wash my hands and I washed your
Speaker 3: card for you too, by the way, so you're good.
Speaker 1: But you know, that's something that I think is maybe
Speaker 1: something about the mindset. Because if you're a jockey, you're sporty,
Speaker 1: you're a competitive personality. I think that probably helps going
Speaker 1: in right, because you against the disease.
Speaker 2: Right, it is it is.
Speaker 3: But uh so you know now, as someone who has
Speaker 3: an MBA and was of executive VP and COO of
Speaker 3: a healthcare system and a leader, those are some of
Speaker 3: the bad things about surgeons. And it has to do
Speaker 3: with our training. So that's interesting because in college you
Speaker 3: have to be in the top one percent, so you're
Speaker 3: kind of hoping a little bit of people around you
Speaker 3: don't do well.
Speaker 2: That's terrible as a leader. And then as you're in.
Speaker 3: Medical school, you got to be AOA in the top
Speaker 3: two percent to get a surgical residency, and then to
Speaker 3: become a cardiothoracic surgeon, which is one of the hardest
Speaker 3: besides neurosurgery or ortho. So again you you sort of
Speaker 3: take resources and can become I always say you can
Speaker 3: kind of sometimes tell who's going to be the surgeon,
Speaker 3: who's going to be an interness by looking at people
Speaker 3: play in the playground at six or seven. And that's
Speaker 3: but I think if you're going to lead, it's just
Speaker 3: the opposite. You have to give all the resources to
Speaker 3: everybody else. You have to be humble and listen and
Speaker 3: to be able to make fast, quick, definitive decisions, which
Speaker 3: you have to do in the oar when someone's coding
Speaker 3: is exactly what wrong?
Speaker 2: So patient is dying, so come in.
Speaker 3: You know, when you're a surgical resident you get called
Speaker 3: once a day, twice a day to a floor and
Speaker 3: a patient is coding and dying. You have to come
Speaker 3: and immediately take charge to everybody to shut up. You say,
Speaker 3: do this, start up in nefferin, we're going to do CPR,
Speaker 3: and you're barking out orders. Right, So that's a great
Speaker 3: leadership style for that particular moment.
Speaker 1: Do you kind of you kind of get a Russia?
Speaker 3: Oh my god, yes, anyone who says you don't you
Speaker 3: well if the patient does.
Speaker 1: Well, yeah, well let me ask you, because that that's
Speaker 1: that kind of leads me into What I wanted to
Speaker 1: talk to you about a little bit is the emotional
Speaker 1: impact of what you do because you're facing literally dead
Speaker 1: as as your profession, you you face death. It's what
Speaker 1: you do correct and and you try and head it
Speaker 1: off of the past or or is there a point
Speaker 1: where it's too much, where you can't take it.
Speaker 3: Maybe because how my father treated me, how he trained me,
Speaker 3: I saw it well, so I think he made us
Speaker 3: really tough. His dad was a immigrant from Italy, came over,
Speaker 3: was a farmer, second grade education, the concept of hard work,
Speaker 3: and I do think and resilience and toughness and and
Speaker 3: I love when people say the kids don't have it.
Speaker 2: The kids have that cost too.
Speaker 3: They're going to and they're gonna be better doctors, better
Speaker 3: fathers and husbands and daughters and wives and granddaughters and
Speaker 3: grandsons than we are.
Speaker 1: They're going to be sure. The definitely getting better, and
Speaker 1: they're going to be more resilient. But it's her job
Speaker 1: as older people to say kids are terrible. There they
Speaker 1: were better when I was a kid, but they weren't.
Speaker 1: You and I both know it. They weren't better, awful.
Speaker 1: But I heard that today.
Speaker 3: From the one of our visitors from England and I
Speaker 3: and I said, listen, I politely disagree with you. These
Speaker 3: doctors are going to get better outcomes than us because
Speaker 3: each generation gets better and they may not have the
Speaker 3: same experience because we spent one hundred and twenty hours
Speaker 3: in the hospital now a week. Now they can only
Speaker 3: do eighty hours a week. And it's tough to get
Speaker 3: good at anything with eighty hours a week. But it
Speaker 3: would just help. I'll try to give my boy I
Speaker 3: learned to play the guitar in twenty minutes.
Speaker 1: A day is better enough. He's twelve.
Speaker 2: It'll get it's pretty good. Yeah, he's committed to it.
Speaker 2: It'll do. But I mean there's you know, your ten
Speaker 2: thousand hour rules. It takes time.
Speaker 3: So they may have a little delayed gratification, but they're
Speaker 3: more balanced, they're better in their roles at home and
Speaker 3: at the end of the day, that may make them
Speaker 3: a better doctor and a better leader. That has a
Speaker 3: different leadership style besides authoritative.
Speaker 1: So the leadership thing is interesting me because you go
Speaker 1: back to your dad. Your dad was clearly a now
Speaker 1: lead oh yeah, and you clearly have that too.
Speaker 2: It's like unfortunately.
Speaker 1: Leader, I mean you've written books about how to you know,
Speaker 1: succeed and how to do your best and how to
Speaker 1: get the best out the things correct, super results, are
Speaker 1: super achieved for performing.
Speaker 2: Thank you for plugging it about. Well, look, it's my job.
Speaker 1: It's just like you know, I make the incision. I
Speaker 1: do a little work. But here's the thing. It seems
Speaker 1: to me that it is such a competitive environment that
Speaker 1: is drawing competitive personalities are so drawn to it that
Speaker 1: at the at the core of it, I wonder if
Speaker 1: there is if there is a point whenever you lose,
Speaker 1: because you're going to lose, we will get humbled.
Speaker 3: I tell every resident who thinks they're so good, the
Speaker 3: good Lord is going to humble you at some point.
Speaker 2: So just be quiet.
Speaker 3: You know, if we're doing well, go home and just
Speaker 3: look in the mirror and don't don't look at your navel,
Speaker 3: don't navel gaze too much because bad outcomes are coming.
Speaker 3: So I totally agree with you. And then you know,
Speaker 3: as a leader of a department or a division where
Speaker 3: you may have twenty of those guys, and then a
Speaker 3: COO of a healthcare system where we had six thousand
Speaker 3: doctors and maybe I think a thousand or surgeons. You
Speaker 3: have to manage those egos like a manager and a
Speaker 3: dugout with all these superstars and tell them, really, it's
Speaker 3: about the team and.
Speaker 1: What work did you do on your own ego for that,
Speaker 1: because if you're a young man, you need a little
Speaker 1: bit of that kind of you know, I'm the cat's pajamas.
Speaker 1: You're right, you know, you're right.
Speaker 3: So, and I've shared this with you before, but you know,
Speaker 3: my wife, who I was married with twenty one years,
Speaker 3: got cancer, and then she got a chemotherapy for this
Speaker 3: breast cancer that should have been cured, and that chemo
Speaker 3: caused the leukemia. So I felt incredibly guilty and humble
Speaker 3: about that because I participate in the decision to give
Speaker 3: her the chemo.
Speaker 2: And then for six months I would operate every day.
Speaker 3: We had people come from all over the world because
Speaker 3: we could take their tumors out because we were so good. Yeah,
Speaker 3: and I got humbled because I would round The last
Speaker 3: person I round it on was my wife. I I
Speaker 3: sent my team home and I was spend the night
Speaker 3: there and sleep. And my kids were in high school
Speaker 3: and one was at Yale in college, and I'm like,
Speaker 3: you guys are on your own and I became so humbled.
Speaker 3: I watched her die. I could do nothing for it
Speaker 3: but hold her hand and watch Jeopardy.
Speaker 2: That's that humbles you.
Speaker 1: Fort a clesmic and the the irony on top of
Speaker 1: the on top of the immense emotional pain of watching
Speaker 1: some the woman you loved of you fight against all
Speaker 1: the time.
Speaker 3: Correct very humbling. So that was a that was a
Speaker 3: humility check. And I don't think I was Could.
Speaker 1: You work at that point?
Speaker 2: Yeah?
Speaker 1: I was.
Speaker 2: I operated the day she passed away.
Speaker 1: I operated, and then that was on really on a Friday,
Speaker 1: and then we had to actually she had a terrible
Speaker 1: brain bleed.
Speaker 2: We had to end up together.
Speaker 3: I flew my kids all in, my son, I just
Speaker 3: pitched at Harvard that day. They flew on Saturday, and
Speaker 3: she was declared brain dead. We pulled the ventilator off
Speaker 3: on Sunday, which was terrible, and I had people from
Speaker 3: China coming in to watch surgery. I didn't do not
Speaker 3: break Monday or Tuesday, but Wednesday I went back and
Speaker 3: operated eight cases on Wednesday.
Speaker 2: Didn't you think that helped?
Speaker 1: So?
Speaker 3: You know, people criticized me for this, but I think
Speaker 3: it's you know, no one, everyone has lost. Everyone has,
Speaker 3: and everyone mourns in their own way. My sister's a
Speaker 3: psychiatrist and said, you know, we didn't do it right.
Speaker 3: I don't think there's a right or wrong way. It
Speaker 3: helped me because I got immersed in my work and
Speaker 3: my world literally my world stopped spinning. I don't know
Speaker 3: how I'll say if that's how I felt. I remember
Speaker 3: that night going, it's a terrible story. I bring it.
Speaker 2: Everybody down. No, no, no, no, it's a story.
Speaker 3: Yeah, it's the So it's the And she hadn't even
Speaker 3: passed away yet. It was it was Saturday, because that
Speaker 3: night I spent in the hospital, so I knew in
Speaker 3: the next day we were going to be pulling the
Speaker 3: pulling the plug, because it was every neurosurgeon say, she's
Speaker 3: not recoverable, right, And so I came home and sai,
Speaker 3: I'm not going to sleep in the hospital.
Speaker 2: Nothing's going to happen.
Speaker 3: And I sat under her clothes and the smell of
Speaker 3: the clothes man just set me off and I just
Speaker 3: was like sobbing.
Speaker 2: And no one had really seen me cry, because right,
Speaker 2: you don't want to cry for it. It's ridiculous, sure,
Speaker 2: but that was that night.
Speaker 3: I just remember saying it was like a surreal thing,
Speaker 3: like is this really happened our family? Everyone kind of
Speaker 3: called us like, you know, we had this magic aura
Speaker 3: that my kids all did well, and my wife was beautiful,
Speaker 3: and yeah, I mean I'm not beautiful like she is,
Speaker 3: but we all know.
Speaker 1: Yeah.
Speaker 3: They called it like a little camelot and it's very
Speaker 3: funny the humility no camelot when your wife gets a
Speaker 3: chemotherapy induced cancer called leukemia and then all the chemo
Speaker 3: on the world couldn't help her, and then she has
Speaker 3: a massive brain bleed and you know, she was the
Speaker 3: love of my life. And their kids, my three boys
Speaker 3: who I drove and drove, lost their mom and so
Speaker 3: they're all dealing with that nuts ten years and we
Speaker 3: still talk about it.
Speaker 1: Yeah, of course, yeah, and you'll always talk about it.
Speaker 1: I feel like sometimes whenever I've experienced loss, I mean
Speaker 1: everyone experiences in their life, I feel like it's kind
Speaker 1: of like a scar, maybe even from an operation. It's
Speaker 1: like it's never the scar's never going to go away.
Speaker 1: I've got a scar on my hand from where I
Speaker 1: punched a window when I was drunk when I was
Speaker 1: twenty one years old, and I left a big scar,
Speaker 1: but now you can hardly see it. When I look
Speaker 1: at it, I kind of half smile because I go, geez,
Speaker 1: what an asshole.
Speaker 3: But you remember, it reminds you, it reminds me, and
Speaker 3: it is an evolution. So I've used the same analogy.
Speaker 3: I call it a wound instead of a scar, and
Speaker 3: so the wound goes through different layers of healing. There's
Speaker 3: five layers, but it's never fully healed. And it's obviously
Speaker 3: much better now than it was ten years.
Speaker 1: Right, it's but it's changed you. It changes how you
Speaker 1: are your experience with your wife. Does that change you
Speaker 1: as a doctor when you're dealing with someone who's looking
Speaker 1: at a tough diagnosis or a bad outcome.
Speaker 3: I share it all the time, and it's funny. It's
Speaker 3: made me a much more I think empathize. I think
Speaker 3: I was empathetic before, but it's made me much more empathetic.
Speaker 3: When I say to that patient alcohol, you're going to
Speaker 3: get three cycles of chemo. We call it neo ajumant.
Speaker 3: Then we're going to resect you robotically. Now I know
Speaker 3: what they're living through at home. It made me much
Speaker 3: more sympathetic and much more understanding. And then it's an
Speaker 3: instant connection. About a week ago, had of patients say, well,
Speaker 3: you don't know what I said, Well, actually I do.
Speaker 3: My wife and I went through it and she lost
Speaker 3: her battle to cancer. So you're going to people that
Speaker 3: really connects you. So the battle is.
Speaker 1: A ward that I've had before with cancer, and it
Speaker 1: is something which I find the idea kind of terrifying
Speaker 1: because I hate again in the fights.
Speaker 2: I've lost a lot of them.
Speaker 1: And so when they say, you know, I'm having a
Speaker 1: fight or a battle, I feel like I would hate
Speaker 1: to hear that. I would like I'm not prepared. I
Speaker 1: don't know. This thing is big.
Speaker 3: Well you are prepared, though, I mean I think everything
Speaker 3: you've been through in your life has prepared you, and
Speaker 3: your experience has prepared you, and your value system, your culture,
Speaker 3: and you have a beautiful family to support you. There's
Speaker 3: some people don't have any of that, and even they
Speaker 3: find some resilience in wasting.
Speaker 1: What does that manifest itself? So if you're in a bell,
Speaker 1: is it about a positive attitude? Is it about changing
Speaker 1: the way you live? Is about a spiritual anegement, finding
Speaker 1: a church or a belief system? What is it?
Speaker 3: It's a great question I think it's a combination of
Speaker 3: all those things. And I think it's an individual journey.
Speaker 3: It's like your own journey to find happiness. It's your
Speaker 3: journey through a leadership, and it's your journey how you
Speaker 3: go through grieving, as I explained to my sister, or
Speaker 3: through adversity. And I think all of us have our
Speaker 3: own way. So it's not my job to adjudicate if
Speaker 3: it's right or wrong. It's my job to support that patient.
Speaker 3: And I gave every patient my cell phone. And I've
Speaker 3: done this for a long time, but it paid dividends.
Speaker 3: Never really drove my wife too crazy, though it's gotten
Speaker 3: a little bit crazy now because people in New York
Speaker 3: use it more than when I was in Alabama.
Speaker 1: Both cell phones are as much more a thing though
Speaker 1: as well, like correct like back in the day, there
Speaker 1: was a big bux in your car and you.
Speaker 2: Leave your car, you're on your own.
Speaker 1: That's everywhere. That's when I was a medical student. Yeah,
Speaker 1: they had cell phones in Alabama. They have running water
Speaker 1: and all that getting in Alabama just in the last
Speaker 1: few years. Okay, it's very progressive, but that's a good
Speaker 1: hospital down there is your universe.
Speaker 3: Alabama's fantastic, incredible people, great doctors, and the great culture
Speaker 3: at UAB.
Speaker 1: Yeah, I've always had a good time down there. I
Speaker 1: like it. I like it down there. So listen, you
Speaker 1: have the situation where you've dealt with it personally. Yep,
Speaker 1: you deal with it professionally. You know, the the ultimate
Speaker 1: reality for all of us. You look at that all
Speaker 1: the time. So I gotta ask, is there a religious
Speaker 1: or spiritual site to you? Is there something that because clearly,
Speaker 1: if you were if you were given someone a diagnosis
Speaker 1: and it's hearten you emotionally, you need to have a
Speaker 1: place to go, don't you.
Speaker 3: So it's very interesting, So I will tell you how
Speaker 3: I share. My own belief is dramatically different in New
Speaker 3: York that it was in Alabama. So I do personally
Speaker 3: have a deep faith in something superior to what there is.
Speaker 2: I do think there's some life after this. I do think.
Speaker 3: And my kids call me crazy because I'm so evidence
Speaker 3: based and so metric size and everything I do. But
Speaker 3: I do believe that my wife can see me.
Speaker 2: Now. I do believe she sees every little thing I do.
Speaker 1: I do believe my dad and my girlfriend and everyone
Speaker 1: can and my kids can see everything I do.
Speaker 3: I firmly believe that. Now, maybe that's a mechanism to
Speaker 3: keep me straight. I don't know, but I think I'm
Speaker 3: going to see her after this. So I shared that
Speaker 3: a lot. Now you go, friend, I'm going to say, well, listen, no,
Speaker 3: I think I spent ten years.
Speaker 1: Yeah. And also, you know what I think I think
Speaker 1: if it's moving on from the physical realm, I think
Speaker 1: I think you're okay, you know, you're right.
Speaker 2: Yeah, No, I think it'll be all right. I mean, anyway,
Speaker 2: I'm a little worried about it. Actually, I understand. I
Speaker 2: feel like she could light me up. So you know,
Speaker 2: I you know, I just don't know.
Speaker 1: And that's a family affair. You guys will do with it.
Speaker 1: But the time comes.
Speaker 2: But for the record, Craig's an affair. Just what that's
Speaker 2: for the record, because there's no affair. No, no, we
Speaker 2: were just good friends. No no, So let me so
Speaker 2: let me ask you this.
Speaker 1: Then you you have a situation where you're a younger surgeon, right, yea,
Speaker 1: and you lose your first patient.
Speaker 2: Yeah, terrible.
Speaker 1: You remember that?
Speaker 3: Oh my god, Yes, I remember the patient like it
Speaker 3: was yesterday. I remember her name, her husband's name, she
Speaker 3: had three children. I remember it all terrible.
Speaker 1: It isn't that.
Speaker 3: Funny because I've done, you know, nineteen thousand operations, and
Speaker 3: the only ones you remember the ones that don't do them.
Speaker 3: That's true of every surgeon. That's not true of me,
Speaker 3: that's true of almost every surgeon I know. We lament
Speaker 3: our failures and rarely toast our successes.
Speaker 1: That's very interesting because it I think that maybe you
Speaker 1: expect to win. Oh my god.
Speaker 3: Sure we're all I don't want to say, uh, egocentric,
Speaker 3: but we're all very well trained.
Speaker 1: That's good.
Speaker 2: I want a guy like that.
Speaker 1: You on me.
Speaker 2: I don't want the guy thinks, well, I hope, I
Speaker 2: want to know.
Speaker 1: I'm scared. I was like, right, I'm going to fucking
Speaker 1: fix this, exactly right, fucking fix this.
Speaker 3: So what I say is, when I step between that line,
Speaker 3: no one is better than me. We have a line
Speaker 3: of the red line when you get in the O R.
Speaker 3: And the second I step back that I'm going home.
Speaker 3: I'm taking out the garbage. I'm you know, no different
Speaker 3: anybody else. And actually it's a big chapter in my book.
Speaker 3: It's called staying in the zone. And the zone means yeah,
Speaker 3: I want you to be confident, have a big ego.
Speaker 3: But the second you walk out of the operatunom you
Speaker 3: know no different than anybody else. You know, you're gonna
Speaker 3: go home and get yelled at, You're gonna walk the
Speaker 3: dog or whatever it is.
Speaker 2: You're just the person.
Speaker 1: But one of the reasons why I enjoy talking to
Speaker 1: you is that. And I am fascinated by the fact
Speaker 1: that you have such a sense of joy as revive
Speaker 1: a life force, you know, and yet you deal with
Speaker 1: pretty much the hardest thing that people are dealing with,
Speaker 1: which lung cancer. Yeah, it's a real I mean lung cancer.
Speaker 1: I mean it's not what it was thirty years ago.
Speaker 2: Dramatically.
Speaker 3: Yeah, And I want to give a shout out to
Speaker 3: the oncologist because really the oncologist sees the patient was
Speaker 3: Staged four stage three advanced cancer, and more of their
Speaker 3: patients passed away. It's one of the reasons I went
Speaker 3: into surgery. Probably wasn't secure enough in my own own
Speaker 3: skill on my own that I didn't want to deal
Speaker 3: with nihilism. I didn't want to deal with bad outcomes.
Speaker 3: I wanted to feel great about myself and look at
Speaker 3: the mer and said, boy, you cured that guy. So
Speaker 3: I picked surgery because it fit more to my personality
Speaker 3: of always trying to win.
Speaker 1: I like that. No, that that comes from guess that
Speaker 1: comes from your dad, right, That is you and your
Speaker 1: dad a little bit, because he got you into like
Speaker 1: your Your first surgical procedure was with your father, right.
Speaker 2: You remember that?
Speaker 3: Yes?
Speaker 1: Remember?
Speaker 3: But our dog in the basement, it's it's freaking kookie.
Speaker 3: It was the dog in the basement, it's Cookie. Who
Speaker 3: would do that? So my dad had done a year
Speaker 3: or two of research on animals.
Speaker 2: Well, let's me. He was a surgeon anyway, right, Yeah,
Speaker 2: he was a surgeon.
Speaker 3: But who says, I don't want to vet doing My
Speaker 3: dog's just directed me. I'm better than him now, credit
Speaker 3: he operates there every day. But when I think about it, now,
Speaker 3: you know, I was eleven years old. I'm not much
Speaker 3: smarter now, but a little bit. But he did his
Speaker 3: own anesthetic made We made a board with little velkros.
Speaker 3: We did it in the basement. He cut it out,
Speaker 3: he made the whole thing. He brought home an end
Speaker 3: to traych you to me, brought home the anesthetic. Who
Speaker 3: the hell was managing the airway and giving the dog
Speaker 3: the anesthetic while we were doing the hysterectomy, he did
Speaker 3: the dog. The dog lived eight years after that. It
Speaker 3: was like he said, that dog was more important in
Speaker 3: than any of you kids, So you know, but it's
Speaker 3: crazy to operate in your own dog in your basement.
Speaker 3: But I was assisting him and I said, this is
Speaker 3: the coolest thing in the world.
Speaker 2: I have to be able to learn how to do. Now.
Speaker 1: It's fascinating to me because you get beloved family pet. Yeah,
Speaker 1: you know, knock out this lovely dog, eagle spot to
Speaker 1: be because this little bagle and she's gonna have the hysterectomy.
Speaker 1: And suddenly you're seeing the inside of and.
Speaker 3: See my father navigate the moguls and the eurydor and
Speaker 3: all these other anatomy which I really didn't know what
Speaker 3: it was. And the dog was pregnant, so there were
Speaker 3: little tiny puppies in the uterus at the time, and
Speaker 3: that actually upset me a little bit. And my mom
Speaker 3: was like, you shouldn't have had him down there. I'm like,
Speaker 3: because you saw these things were they look like little
Speaker 3: tiny puppy. They were, you know, maybe an inch, but
Speaker 3: it was there was like six of them, five or
Speaker 3: six of them in her uterus at the.
Speaker 2: Time, and that you had to clean all of that
Speaker 2: out because.
Speaker 3: Sure, yeah, he took the uterus out and they all expired,
Speaker 3: but he carey quickly covered that off.
Speaker 2: You know, that was a surprise. Oh so he didn't
Speaker 2: know that until he was in there. You No, we didn't.
Speaker 2: He didn't. He didn't do a pre op pregnancy test like.
Speaker 1: We do, Like you do that with me, just in
Speaker 1: case if you're pregnant. I'm very worthy. Well that's a
Speaker 1: different operation. But what is there ever? Does that happen
Speaker 1: with frequency that you go in, because you're not going
Speaker 1: to get that same if you're going to like good
Speaker 1: in the keyhole robotic surgery. Yeah, you know, creating that
Speaker 1: landscape and going, hey there's a tumer over here. I
Speaker 1: didn't even see that thing. Well no, but you can
Speaker 1: pull back. I call it stadium view. You pull your
Speaker 1: camera back and you look all around. And every time
Speaker 1: we entered the chest for a cancer, we.
Speaker 3: Look at what's called the plural of the diaphragm, the
Speaker 3: lining of the heart to pair of card and make
Speaker 3: sure there's no metastatic disease. So we could pull the
Speaker 3: camera back even though it's ten times three D. You
Speaker 3: can pull back and get a global view of the
Speaker 3: just easy, and then you get so zoomed in. I'll
Speaker 3: like tell you I how to tell the resident pull
Speaker 3: back a little. Let's pull back because she was trying
Speaker 3: to find a noge in the lung, which I thought
Speaker 3: was pretty obvious, and it wasn't until she could pull
Speaker 3: say oh, there it is.
Speaker 2: She was too zoomed in.
Speaker 1: That's gonna happen. Yeah, So you go in there and
Speaker 1: you find something that you weren't expecting get do you
Speaker 1: make the decision on the spot. We'll get it out. No,
Speaker 1: I'm not going to talk to anybody. Get it out.
Speaker 2: So I'll tell you what I did.
Speaker 3: I could show you my phone, but I talked to
Speaker 3: the patient's family. Because when you're on a robot, you're
Speaker 3: not sterile. You're sitting in a console.
Speaker 1: Right.
Speaker 3: You want to bring a new instrument in, or something's happening.
Speaker 3: I have maybe a twenty second to lay. I'll text
Speaker 3: him and say, hey, we're doing this, we're doing that.
Speaker 3: Everything's going well. He's asleep, We've painted the skin, the
Speaker 3: instruments are in. We're just taken the lymph notes. If
Speaker 3: I signed something abnormal. Now what I do is I
Speaker 3: will call the doctors and cologists, and I will call
Speaker 3: the family member and I have them often participate.
Speaker 1: Now you can get next to ken to say yeah,
Speaker 1: go ahead, I'll say, listen, here's what I think we
Speaker 1: should do.
Speaker 3: They usually say, what do you recommend? But I've had
Speaker 3: some people, so now I want you to stop. And
Speaker 3: I said, well, we'll probably we want you and that's fine,
Speaker 3: but it allows them to participate in the conversation. And
Speaker 3: then now you can even use the oncologist and give
Speaker 3: them information. Just last week, I had a very unusual
Speaker 3: finding of giant lymph notes or a metastatic because this
Speaker 3: patient came from another country, the scan was only three
Speaker 3: weeks old. Maybe it wasn't perfect quality. Lymph notes had
Speaker 3: cancer and that flipped us out. So I called the
Speaker 3: oncologist and said, here's what.
Speaker 2: I would do. What do you want me to do?
Speaker 3: He said, yeah, I want you to stop and we'll
Speaker 3: give chemo. And I involved the family man the patients failure.
Speaker 3: Mam was a doctor, so it made it easier chemo.
Speaker 1: It must be a kind of a mixed bag a
Speaker 1: little bit. We're giving your own experience because you know
Speaker 1: obviously your late wife's story with the chemo, I mean.
Speaker 3: Caused her cancer, right, and then caused her to bleed
Speaker 3: into her brain because she had thrombocytepedia low platelets and bled.
Speaker 3: So the chemo caused her cancer, her leukemia, and then
Speaker 3: caused her to die. And yet I tell every patient
Speaker 3: this about this my own bias, but we recommend chemo
Speaker 3: all the time to people adjuvantly and agually means after
Speaker 3: surgery and neo adjuvantly.
Speaker 1: Before sir, My mother, my late mother about twenty years
Speaker 1: ago got actually no more thirty years ago. She got
Speaker 1: non Hodgkins lymphoma. And she had been receiving experimental treatment
Speaker 1: for arthritis because she had very bad at right that.
Speaker 2: Could make that take off like wildfire.
Speaker 1: So she had non Hodgeglimbs lymphuona. She was getting some
Speaker 1: weird gold treatment I don't know what it was for
Speaker 1: us writis and she had a very compromised immune system
Speaker 1: and they started giving her chemo. So at a certain
Speaker 1: point we're in the intensive care in it, and the
Speaker 1: doctor who was lovely women come up and said, look,
Speaker 1: the outcoming here is not going to be good. Yeah,
Speaker 1: and I think you guys should say goodbye.
Speaker 2: How old were you at the time. I was thirty.
Speaker 1: It's tough. Yeah, it's bad. But here's the thing, because
Speaker 1: this is an important part. Sorry you went through that,
Speaker 1: but that that is really tough. I'm sorry you went
Speaker 1: through that. But here's the end of the story. Is
Speaker 1: very different because they say it's time as say goodbye.
Speaker 1: I know, okay, so we all say goodbye, and my
Speaker 1: mother's not a brand. Isn't gone right, They're just the look,
Speaker 1: there's nothing. You know, this is going to be bad
Speaker 1: when you take the breathing and two boat, it's going
Speaker 1: to be bad. They take the breath and she lived
Speaker 1: another fifteen years.
Speaker 2: That's a twisting. Yeah, fifteen years. Fifteen years she recovered
Speaker 2: because they stopped. I hope you ke the hell out
Speaker 2: of that.
Speaker 1: But see, you see what it was? Was it?
Speaker 2: I think they never really quite understood what they did.
Speaker 1: But in a socialized mandisine environment, there's no people are
Speaker 1: not suing each other, people are not you know, so.
Speaker 2: Better better is it?
Speaker 1: I don't know.
Speaker 2: It's there's good and bad everywhere. Sustained.
Speaker 3: I would say, maybe they stopped your immuneo compromising gold therapy.
Speaker 3: That letter her immune system to kick in, because most
Speaker 3: people don't have that many problems with not hod film right, Yeah,
Speaker 3: that's right. It was when when the chemo started. It
Speaker 3: when really stop the chemost and stop her arthritic medicine
Speaker 3: which immuno compromised her about her own immune system to
Speaker 3: check right.
Speaker 1: She never really had film mobility again because of the aarthritis,
Speaker 1: because he couldn't treat. It's tough, but she was mentally
Speaker 1: with us. She was mainly fining. She got around the wheelchair.
Speaker 1: She did, she did what she did.
Speaker 2: Had to watch your career.
Speaker 1: She got to watch me career. She got to see
Speaker 1: her grandkidsy born. I mean she she saw that.
Speaker 3: You know.
Speaker 2: No, it was it was, It was good.
Speaker 1: But I think that the thing that terrifies me about
Speaker 1: it is I think there comes a point in life
Speaker 1: when you realize doctors are human. Oh my god, yes,
Speaker 1: I see.
Speaker 2: I could have told you that with the second I
Speaker 2: walked in the door and tripped.
Speaker 1: On the Yeah. But garbet you, But you know not
Speaker 1: for what I mean, for a lot of us, and
Speaker 1: particularly I think my parents' generation, maybe your parents' generation too.
Speaker 2: The doctor knew everything, and the doctor was going to
Speaker 2: make it all.
Speaker 3: Okay, I'm very proud to be in a refreshion that
Speaker 3: still has the highest respect from the public, you know, doctors.
Speaker 2: And I didn't it. I do think it's well earned.
Speaker 3: Having said that, you know, we're knuckleheads and we make
Speaker 3: mistakes all the time, and we're human, and I think
Speaker 3: that keeps our ego in checking. And it's that desire
Speaker 3: to get better, which is so ingrained me. Every day
Speaker 3: I kind of wake up, what are we going to
Speaker 3: do today that's better than tomorrow.
Speaker 2: We're always innovating and getting better.
Speaker 3: And I think most physicians, most people out of the way,
Speaker 3: but especially physicians, we really want to learn from our
Speaker 3: colleagues and get better.
Speaker 1: So in the extremely advanced technological world that you're in,
Speaker 1: where you're looking at a situation where you can get
Speaker 1: is there a future where you say, well, it looks
Speaker 1: like we have some cancer here, so I'll put in
Speaker 1: an E forty three program, slide them in the door,
Speaker 1: and it should be fine.
Speaker 2: So when you mean slide them in the door, well,
Speaker 2: you know, put them in the machine and you go
Speaker 2: and say down the little rowboat does all the work
Speaker 2: for you, and you just so I do.
Speaker 3: But I'm the exception to that. And I think the
Speaker 3: reason and this came up a little bit in Italy.
Speaker 3: I mean, I just seen what's happened in my lifetime,
Speaker 3: and there's no question that artificial intelligence and robotics is
Speaker 3: going to give our patients better care. And the doctors
Speaker 3: should not worry about protecting their trade. What we should
Speaker 3: do is wake up every day and say how can
Speaker 3: the patient get better experience and a better care?
Speaker 2: And you know NYU has really done that.
Speaker 3: I mean Nyu Langone hospital with doctor Grossman and all
Speaker 3: the other people there have We wake up every day,
Speaker 3: how can we give the patient better quality and better experience?
Speaker 3: And I think we use AI all the time, so
Speaker 3: it's going to do that. At some point they will
Speaker 3: slide into a machine. But I don't know if it'll
Speaker 3: be surgical. I think it'll be more molecular. They'll be
Speaker 3: able to ree it's not just it may be prevention.
Speaker 3: It may be very early detection of tumors and then
Speaker 3: just changing that cells physiology, preventing it from populating and
Speaker 3: spreading and metastasizing.
Speaker 1: That's my hope. What are the cancers right now? You
Speaker 1: think we're just not getting anywhere with us.
Speaker 3: Well, so your cancer is such a diverse thing. Look
Speaker 3: at lung cancer. That's a big, big, seven different subjects.
Speaker 3: Someone asked me I was doing this this show, they said,
Speaker 3: we're going to cure cancer. I'm like, hang on, hang
Speaker 3: on a minute, man, you want, I'll talk about add
Speaker 3: no carcinoma.
Speaker 1: The long you talk about squam and s old carcinoid small,
Speaker 1: So what do you want to talk about. It's like saying,
Speaker 1: when will we cure illness? Yeah, it's exactly doesn't even
Speaker 1: make sense.
Speaker 3: So I think, all yeah, and there's there's new cancers
Speaker 3: coming and there's some that are going away. So I mean,
Speaker 3: I think all together, if you look at the results
Speaker 3: of what we've done in the improved survival of lung cancer,
Speaker 3: of breast cancer, of colon cancer, and you know though,
Speaker 3: and prostate cancer, those are the most common cancers. Now,
Speaker 3: lung cancer takes the life of more Americans, and the
Speaker 3: other next three combined, colon, prostate and breast lung cancer
Speaker 3: takes more Americans, and those trees combined.
Speaker 2: It's finally coming down. But that was still true a
Speaker 2: few years.
Speaker 1: What is that smoking?
Speaker 3: Like twenty five percent of the women I operate and
Speaker 3: never touched a cigarette, and fifteen percent of men never
Speaker 3: touch a cigarette.
Speaker 2: It's uh, has to.
Speaker 3: Do with genetics and maybe pollution, maybe environmental I don't know, Wow,
Speaker 3: but that number is growing and malignancy and non smokers.
Speaker 1: So what do you do in your own little tabernacle
Speaker 1: like your body?
Speaker 3: No tabernacle. So I'm you know, I'm a certified personal trainer.
Speaker 2: I work really. Yeah, I lifted weights. I'm a big
Speaker 2: believer in that.
Speaker 3: The guy I couldn't sleep man, but I'm eight days postop,
Speaker 3: so I lifted a little bit. I hope by neurosurgeon's
Speaker 3: not listening. It's only twenty pounds.
Speaker 2: Pro don't work.
Speaker 3: No, I sleep like everybody else, and we're very efficient
Speaker 3: and so I'm very, very rigorous like most surgeons, like,
Speaker 3: I'm sure you are most extensive. People are rigorous and
Speaker 3: they fit time in. So I love to work out.
Speaker 2: I love the feeling of having worked out.
Speaker 1: Yes, I feel like having worked is one of the
Speaker 1: greatest feelings in the world.
Speaker 2: Before working, I'm like, I want to do this. I
Speaker 2: think the key is to remember.
Speaker 3: I always tell my kids, put this feeling in a
Speaker 3: bottle and then you just sprinkle over your head, because
Speaker 3: if you come home from wor can sit in the couch,
Speaker 3: you are dead meat.
Speaker 2: It's over. So you got to sprinkle that little bottle.
Speaker 2: How does it feel?
Speaker 3: Let's go, don't even get comfortable, and that's what that's really.
Speaker 1: So you you'll come out of a surgery a long
Speaker 1: day and you'll do it. How long would you do
Speaker 1: with the gym or then? Yeah, so an hour and
Speaker 1: twelve minutes a little program on your phone and you
Speaker 1: do all the little lifts and I deep and.
Speaker 3: Then do it again, and I lift three days a week,
Speaker 3: and then you cardio and then you know, I told
Speaker 3: you I'm in this singles pickleball thing. Now gotten really
Speaker 3: into that. I gotta let my neck heel up from
Speaker 3: this operation. But in another week or two, I'm back
Speaker 3: playing golf and pickleball.
Speaker 1: What would you say, like if you were stand in
Speaker 1: front of a bunch of people, say, we go to
Speaker 1: Danny's in Alabama, right, And we go to Danny's and
Speaker 1: Alabama and everybody's in there and everybody's having the stuff,
Speaker 1: and we all decide, look, we want to talk to
Speaker 1: Sarah about how we can avoid hands. What would be
Speaker 1: the first thing you would say to it just a
Speaker 1: random group of people, no surgeons, no personal trainers.
Speaker 3: The first thing I'd do is keep my mouth shut.
Speaker 3: Is so we come down to one of two things. Right,
Speaker 3: It's either you stop smoking, or you stop drinking, or
Speaker 3: you lose weight. Those I said two, but those three
Speaker 3: things would predominantly I have to pick one, and Chinea,
Speaker 3: I'd say stop smoking. I was just there fifty percent
Speaker 3: in Italy. I was there a few days ago, forty
Speaker 3: pers everywhere.
Speaker 2: There were people still smoking.
Speaker 1: In Italy.
Speaker 3: There were doctors, cardiothoracic surgeons coming out of the damn
Speaker 3: meeting at the break smoking outside. It's crazy to me,
Speaker 3: It's absurdity. How could you be a leader? So I
Speaker 3: might put smoking, although I don't know now. It might
Speaker 3: be out, it might be drinking, it might be obesity.
Speaker 3: Although with a zempic that is going to change the landscape.
Speaker 1: Talk to me about the zampick. Is that is that
Speaker 1: because people are taking it for you know, chronicle vicity
Speaker 1: and that I mean, okay, taking it just for the
Speaker 1: hell of it. Yeah, I think that's what I might
Speaker 1: be asking you, So listen.
Speaker 3: The professorial answer is we don't have long term follow up.
Speaker 2: We don't.
Speaker 3: The reality is I know two or three people banana
Speaker 3: for two three years and they have lost fifteen twenty
Speaker 3: pounds day love it. They now those people, I think
Speaker 3: they inject themselves. I don't think they don't take it
Speaker 3: by mouth. I think they injected. The patient told me
Speaker 3: she injects it subcutaneously, maybe once every two weeks or
Speaker 3: maybe once a week, and it's expensive, but somehow she
Speaker 3: gets it because they're rich.
Speaker 2: But she loves it and has had no problem. That's
Speaker 2: the majority of most patients. What does it do?
Speaker 1: By the way, so it's a.
Speaker 3: Lucagen inhibitor, but the reality is it will reduce your
Speaker 3: level of glucose and amazing, maybe lets food stay more
Speaker 3: in your GI track and cause constipation.
Speaker 1: It slows down your GI track. You're absorbing less time.
Speaker 1: I want to slow down my GI track. I'm taking
Speaker 1: fucking heroin.
Speaker 2: I'm going to get something enjoyable.
Speaker 1: It takes so you know, it makes you constipated and
Speaker 1: you don't even feel the base. No, no, thank you.
Speaker 3: Don't share that with your endessties just before your dscopy
Speaker 3: next yek, I just.
Speaker 1: Say that out. Yeah, you know, it's funny, like I'm
Speaker 1: very free with the fact I know that I have.
Speaker 1: I mean, I've been sober for thirty one years, which
Speaker 1: is incredible, thank you and I And it is an
Speaker 1: interesting thing because sobriety, I feel like is largely misunderstood
Speaker 1: by your profession. I think you're right.
Speaker 3: You give everybody perseverance. Yeah, and you have a different view.
Speaker 1: I do a little bit in the sense that you know,
Speaker 1: people say, you know, why, well, why can't you just stop?
Speaker 1: You go, Well, if I could just stop, it wouldn't
Speaker 1: be a problem, would it, of course? And then the
Speaker 1: whole idea of it having a spiritual component. Now, I
Speaker 1: think with you, sir, if I don't think it's a problem.
Speaker 1: You are a spiritual human being. You happen to be,
Speaker 1: you know, a doctor, a surgeon, a very good one,
Speaker 1: but you're a spiritual human being. And I think for
Speaker 1: a law of your colleagues that feels a little you know,
Speaker 1: airy fairy and a little strange. It does.
Speaker 3: And I don't share it with them, and they're going
Speaker 3: to hear it now. But I don't wear that on
Speaker 3: my sleeve or discuss it because it's not really admissible
Speaker 3: in what we do. We're evidence based. We're a meritocracy
Speaker 3: and it's not there.
Speaker 1: Then let me give you some evidence. Okay, right, until
Speaker 1: I dealt with the spiritual nature of the its physical
Speaker 1: and mental, no doubt. But until I embraced the spiritual
Speaker 1: nature of the malady I had, I couldn't stop drink.
Speaker 2: That's interesting, that's the evidence of it. It is, and
Speaker 2: I know a lot of people with similar experiences.
Speaker 1: And it's kind of you know, well, I mean, obviously
Speaker 1: he's had a goodal because it's one guy. But but
Speaker 1: I think at the same time, I find it fascinating.
Speaker 2: Do you ever look at Carl Jung's work at all?
Speaker 1: I can't imagine it would enter your world much, but
Speaker 1: just a young, very you know, as one of the
Speaker 1: founding fathers of your sister's profession. It was very much
Speaker 1: you know about religion, religious symbols, religious symbolism, and I
Speaker 1: think was very involved at the beginning of what is
Speaker 1: now I guess the sobriety movement, at the beginning of
Speaker 1: AA he was very you know, he was very connected
Speaker 1: to all of that. And I wonder if if there
Speaker 1: is a time coming when someone who's has accomplished you
Speaker 1: and you in the field comes out, Yeah, and says, look,
Speaker 1: we got to look at We've got to look at
Speaker 1: the god thing here.
Speaker 2: Yeah.
Speaker 3: Well, and I have seen things that you cannot explain.
Speaker 3: We've seen tumors, oh my goodness. We've seen tumors regress,
Speaker 3: spontaneous regression of melanomas and lung cancers. And there's there's
Speaker 3: a thing called a scopeull the fact that I can
Speaker 3: give you all the medical explanations, but some of these
Speaker 3: things you just can't explain.
Speaker 2: And I just don't think we're that smart. I have
Speaker 2: great humility.
Speaker 3: I know there's there are things and powers much smarter
Speaker 3: and more important than me that I don't fully understand
Speaker 3: that have influence in our world.
Speaker 1: But I think that's interesting to men. And I don't
Speaker 1: want to Yeah, I don't want to push it on you,
Speaker 1: but I think it's partially and it's why I'm so
Speaker 1: taken with you and your story is about your humility,
Speaker 1: because I don't think humility is I don't know. I
Speaker 1: think humility is I understand where I am in the universe, right,
Speaker 1: I know where.
Speaker 3: I am, right, you know, and really how incredibly small
Speaker 3: that I am. And I've gotten so many kinds of
Speaker 3: and invited to so many places to operate and to teach,
Speaker 3: and I always learn a little bit more than I teach.
Speaker 2: I don't really want to say that because they're inviting me.
Speaker 3: But there's always something to learn, every culture doing something
Speaker 3: better than us. Like, for instance, the first time I
Speaker 3: went to Italy, he went to operate. I got there
Speaker 3: at seven am. I go in there and I go
Speaker 3: in there and this guy going, hey, what are you doing?
Speaker 2: What are you doing?
Speaker 3: And he's smoking a cigarette. There's oxygen tanks. Oh my god.
Speaker 3: He goes, who are you? And I said, I'm the
Speaker 3: visiting PREFSS. He goes, they won't be here for two hours.
Speaker 3: So it's two hours. They didn't start in the hour
Speaker 3: till nine o'clock.
Speaker 1: And so everyone criticizes that, but you know what, maybe
Speaker 1: they're happier that way. Maybe they don't mind working from
Speaker 1: nine to four or five and being inefficient because that
Speaker 1: would drive it drives me crazy.
Speaker 2: Is stressed carcinogenic?
Speaker 3: Uh?
Speaker 2: I think? Oh, equivocally, I think it is.
Speaker 1: Yesh. Yeah, So I mean I wonder if if that's
Speaker 1: a thing that you know, if you look at the idea,
Speaker 1: the idea that someone in your position will say, there
Speaker 1: are things that we can't explain, right, I think that
Speaker 1: that is beautiful. I think it's beautiful that you will say, well,
Speaker 1: I like AI. I'm thinking if it makes people better
Speaker 1: right now? You know it's kind of interesting. But do
Speaker 1: you ever like, say, you're in Italy, right and you
Speaker 1: go out for dinner with a bunch of professors afterwards
Speaker 1: and you don't go to because Italy you know you're
Speaker 1: gonna eat beautiful food.
Speaker 2: You're gonna have some wine, we're gonna have some fun,
Speaker 2: and we did.
Speaker 1: Do you ever think I can'd of that wine? I
Speaker 1: kind of that pasta because I'm gonna get fat, and.
Speaker 3: I do You're careful hundred percent. I have one drink
Speaker 3: and that's it. I'm the one drink they all wanted.
Speaker 3: And I just listen, I'm not an alcoholic. Just this
Speaker 3: is what I do because I'm working out. I had
Speaker 3: a little more pasta than I weigh myself every morning
Speaker 3: like a nut.
Speaker 2: So I'm very regiment.
Speaker 1: That's interesting. Do you have the the what's that little
Speaker 1: band of people that was like a watch thing?
Speaker 2: Woop? What's it called?
Speaker 1: The Whoop?
Speaker 2: I got it?
Speaker 1: Now?
Speaker 2: What does that do? What does it it tell you?
Speaker 3: It's so it's like, yeah, but I can show you
Speaker 3: my workout that I did, and I can show you
Speaker 3: how well I slept right here, take a look, and
Speaker 3: it says that, so my strain for the day is
Speaker 3: what I did with my exercise or just the amount
Speaker 3: of stress that you're under.
Speaker 2: So you can see.
Speaker 3: You can go to my activity here today and you
Speaker 3: can see I did a high intensity workout and lifted today.
Speaker 3: You see the exact time my strain was seven point
Speaker 3: three and then during that time, you can click into well,
Speaker 3: I'm not on an airqua to give you your heart rate,
Speaker 3: your blood pressure, all these other things, and it looks
Speaker 3: how well you see your blood pressure from that little
Speaker 3: thing on your wrist, not exactly your blood pressure, but
Speaker 3: close enough. Right, and you see as when I sleep,
Speaker 3: I only slept five hours.
Speaker 2: I needed nine. But that's my usual what you need
Speaker 2: it it's usually that's all I need during.
Speaker 1: If if I if I feel like if I'm looking
Speaker 1: at an app and it says you only had fifty
Speaker 1: two percent of I'm like, hey, I'm going back to bed,
Speaker 1: or if I know if I can't sleep, I'm going
Speaker 1: to woke around feeling ashamed all day.
Speaker 3: So funny so I'm in three groups of this and
Speaker 3: and of course I got a lot of the I
Speaker 3: have a place up at Silo Ridge, which a discovery
Speaker 3: land in upstate New York and very wonder for people.
Speaker 3: So I've got some of the younger thirty year old
Speaker 3: men wearing the whoop and we compare and they're like, well,
Speaker 3: stuff's going to see my chair. And I've had a
Speaker 3: wife from up to me and say, listen, you're killing
Speaker 3: my sex life.
Speaker 2: You're killing how much fun I've had.
Speaker 3: And she made the guy get rid of the whoop
Speaker 3: because it would drink, because you don't sleep as.
Speaker 1: Well if you have just one drink. Well that I know, Yeah,
Speaker 1: that I know. I like if I have one drink,
Speaker 1: I don't do anything. So well, yeah, correct for a while,
Speaker 1: it's an interest. Let me talk to you just a
Speaker 1: little bit. I mean, we're almost done, and I know
Speaker 1: you're a busy man, but because I'm fascinated by my
Speaker 1: own pathology, I'm going to talk to you a little
Speaker 1: bit about my pathology is worse on the same I
Speaker 1: don't know. Yeah, but that is an alcoholic right, as
Speaker 1: a recovering alcoholic, as an alcoholic in recovery or a
Speaker 1: sober alcoholic or whatever you want to phrase it. Very
Speaker 1: much believe in the theory that it's the first drink
Speaker 1: that guess you're drawing people like me, that if I
Speaker 1: take a drink, it kicks off in me something akin
Speaker 1: to analogy, akin to like if I was allergic to
Speaker 1: strawberries or you know, and it forces me into us say,
Speaker 1: it removes the resistance that I have to stay away
Speaker 1: from the next one and the next one and all
Speaker 1: the consequences of that.
Speaker 2: I'm impressed on how well you understand yourself. I haven't
Speaker 2: heard it a while.
Speaker 3: Well, I haven't heard too many alcoholics ever say that
Speaker 3: like an allergy, and I think you're exactly right. It
Speaker 3: does set off a cascade of events that you can
Speaker 3: no longer control.
Speaker 1: Drive.
Speaker 3: And the key is you're not driving there it is.
Speaker 3: And the key is not to get behind wheel in
Speaker 3: the first place. You just don't start. I mean, it
Speaker 3: was actually drink guy.
Speaker 2: It was poor crust. But that's the thing.
Speaker 1: You can be a one drink I have to be
Speaker 1: a I think the difference between an alcoholic and a
Speaker 1: non alcoholic, it's a non alcoholic can be a one
Speaker 1: drink guy.
Speaker 2: I have to be a no drink. That's probably right.
Speaker 1: It was poer forward to be fair. I think it
Speaker 1: was jelly Neck in the nineteenth century came up with
Speaker 1: the idea of the allergy, or certainly William Silkworth. I
Speaker 1: was going to give it to you.
Speaker 2: Those guys are gone. Yeah, word still where was the silkworm?
Speaker 1: Silkworm Silkworth at the Town's Hospital at New York City
Speaker 1: in the nineteen thirties, you know, he said, you know,
Speaker 1: he's looking at alcoholics. And he said to Bill Wilson,
Speaker 1: who eventually founded Alcoholics Anonymous or co founded that name
Speaker 1: right now, Yeah, and Bill William Silkworth was working at
Speaker 1: Town's Hospital and and he eventually Yeah, it's an incredible
Speaker 1: story because whats is that Bill Wilson is in there,
Speaker 1: right And William Silkworth says to his wife Lewis, he says, look.
Speaker 2: His wife's name was Lewis, Lewis Lewis, Okay.
Speaker 1: Lewis, that's not it wouldn't matter if it was Lewis,
Speaker 1: that there's anything wrong with that exactly. But he says
Speaker 1: to Lewis, he says, look, I don't think there's that
Speaker 1: I can do. I think he's just We're going to
Speaker 1: have to put him in a straight jacket, keep him
Speaker 1: in here. And Bill Wilson has a god show. He
Speaker 1: has a he has a profound experience epiphany right now.
Speaker 1: He thinks that it is maybe delirium tremens or something,
Speaker 1: and that's what that's what Bill thinks. And he asks
Speaker 1: William Siltworth, and this is this conversation. This is why
Speaker 1: I love this door, this amazing conversation because he goes
Speaker 1: to the doctor. This is why William Silkworth was a genius.
Speaker 1: He goes to William Siltworth, who's been treating alcoholics, and
Speaker 1: he says, am I, mad am, I having is this delier?
Speaker 1: Have I gone insane? And William Siltworth said that, He said,
Speaker 1: I don't know, but you're better than you were half
Speaker 1: an hour ago. So maybe whatever it is, keep doing
Speaker 1: that and rather than saying you're crazy, you're a good
Speaker 1: way to look at it. That's the positive feedback, which
Speaker 1: is why something's working, you know. And I am fascinated
Speaker 1: by that. I believe that you have that spirit. I
Speaker 1: believe you have that spirit. And I know you hate compliments.
Speaker 1: I see you, I see you score. Yeah, but you know,
Speaker 1: any incredible people that I work with every day. Then
Speaker 1: I know. But those guys I don't know that well,
Speaker 1: they're much better looking.
Speaker 2: Stop and stuff. It's a joy to talk to you.
Speaker 1: Man.
Speaker 2: I'm so happy you're here.
Speaker 1: And I continues happiness, continue success, and whatever you're doing,
Speaker 1: Jesus Christ, keep doing it.
Speaker 3: We're enjoying my honor to spend time with you again.
Speaker 3: And uh, let's let's do once you let's do once
Speaker 3: you have dinner or something. Yeah, that's what even, all right,
Speaker 3: I'll have the wine.
Speaker 1: You can't.
Speaker 2: You have the one.
Speaker 1: You can have all the wine, and I'll have I'll
Speaker 1: have a lot of past that I didn't go for
Speaker 1: a big long walk.
Speaker 2: That's I love to walk after different paper. All right,
Speaker 2: thank you, thank you,