Joy, a Podcast. Hosted by Craig Ferguson - Robert J. Cerfolio, MD

Episode Date: December 19, 2023

Meet Robert J. Cerfolio, MD aka “Cerf”. He is one of the world’s top thoracic surgeons and his peers have voted him one of America’s Best Doctors. He is an author of several books and certainly a very interesting and charismatic human being. This conversation is guaranteed to pique your interest. enJOY! See omnystudio.com/listener for privacy information.

Want to know how to leverage culture to build a successful business? Then Butternomics is the podcast for you. I'm your host, Brandon Butler, founder and CEO of Butter ATL. And on Butternomics, we go deep with today's most influential entrepreneurs, innovators, and business leaders to peel back the layers on how they use culture as a driving force in their business. Butternomics will give you what you need to take your game to the next level. Listen to Butternomics on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts.

For 10 years, I've been obsessed with one of the most bizarre and audacious cons in rock and roll history. We were all facing 20 years and all that good stuff. The lead singer tried to pull off an English accent and they went on the road as the zombies. These guys are not going to get away with it. Zombies are too popular. Listen to the true story of the fake zombies on the iHeart Black Girls podcast, a weekly chat about mental health and personal development, where my expert guests and I discuss the unique challenges and triumphs faced by Black women through the lens of self-care, pop culture, and building the best version of you. So if you're looking for more ways to incorporate wellness into your life, listen to the Therapy for Black Girls podcast on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts.

My name is Craig Ferguson. The name of this podcast is Joy. I talk to interesting people about what brings them happiness. Dr. Robert J. Serfolio. We'll call him Serf because that's what he wants. And once you know about this guy, you'll think, you know what? Give him everything he wants.

He's an amazing character. Listen to this. Serf, before we begin, I do want to say one thing to you, which is I want to apologize because you came in and you recorded an episode of this, and then we checked it back, and we didn't record it. It's like, it's the podcast equivalent of you doing an operation. Leaving the cancer in. Well, at least leaving the keys or something in there, or maybe your wallet or your phone. Like, we got the cancer out, everything's good, but I left my phone there

so we got to go back. It's so funny. You know, I get this a lot from women that I go on dates. They say they accidentally left something back so they have to come back. And I say,

well, you used it, kind of. Now, listen, here's the thing, though. Well, are you single? You're not really single now. No, no, you're just, yes, I do.

That's why that was a joke. Yeah. We make that very clear Yeah, I get it. Totally understand. It's a girlfriend. Yes, I do. That's why that was a joke. Yeah. We make that very clear. Yeah, I get it. Totally understand. It's fine. So listen, I want to talk to you a little bit because I was just saying to you, I got a screening coming up for an endoscopy coming up in about a week. And it's only because they found a little irritation during the last one. So they gave me some PPIs to treat it. They found Barrett's. Barrett's. No, no, it wasn't Barrett's.

It was a lesion, an ulcerated lesion or something like that. Dysplasia? Dysplasia, yeah, yeah, yeah. So, listen, I know that we're not really on your dime here, but is that good or bad, dysplasia? No, it's just a thing. It could be absolutely, and much better than some other things they could find. Oh, sure.

Well, they did a biopsy. They didn't find anything like that. What they might do now is, I don't know if you're going to have an ultrasound done at the same time in multiple quadrant biopsies. Sometimes they do that to get more representative tissue. Oh, yeah. They might do that.

I don't know. You're going to be chilled out on propofol. I don't care what the hell they do. I'm going to be taking the big sleepy time nap, which we've established I love too much. Yes, which we've established I love too much. Yes, well. Yeah, I love too much. And that's why, you know, I would take an endoscopy once or twice a week if I could, just for the propofol.

So listen, tell me this. You are, and we established this before, but you are, to my understanding, the number one robotic surgery guy in the U.S., right? Yeah, so that's just not a measurable metric. Right, okay. It's like saying I've done a lot of robotic thoracic surgery, but I'm a lung surgeon, a thoracic surgeon, so I do lungs. So that's lungs, thoracic, that means lungs? Esophagus.

Okay. And thymus. Anything in the chest that's really not heart related. Although we can take out parts of the heart, but even though we're boarded as cardiothoracic surgeons, we choose to do thoracic, which is the lung, the esophagus, the mediastinum, thymus, stuff like that. So is that specialism or is that a union thing?

We're going all out on strike tomorrow, as a matter of fact. Now that you bring that up, we're going to join the writers and everybody else. The writers are back, and the actors are still out, but I think as long as the doctors stay in, I'll be all right. So talk me through what a robotic surgery is, because it's not you just programming a robot,

and the robot was in it. Tell me what it is. It's so interesting. Even the patient I operated on today who came from very far away and is super educated, when he came in, he looked at the robot. He said, now you're doing it, right? Not that big machine. I'm like, listen, bro, we've talked

all... You've looked at the videos. You've looked at everything. It doesn't even make sense. But yeah, so what the robot does is we're able, instead of making big incisions and spreading the ribs, we're making incisions that are a third of an inch, 8 millimeters. Wow. We'll make three of these.

The old robot actually had 5 millimeter ports. We were making 5 millimeter incisions, not 8, which I think actually had a real benefit. This new one, I would hope that they're going to miniaturize it a little bit. So you put in these metal ports through these tiny incisions in the chest. And then through the port come a series of different instruments. Right. And then they get hooked up to the robot, this great big giant monstrosity. the pore come a series of different instruments. Right. And then they get hooked up to the robot, this great big giant monstrosity, looks like

it's over the patient. Right. Does it have a face on it or anything? It does. He asked me if I named my robot, I'm like, listen, bro, we don't name the robot. That's not something we do. But then we sit in a console remotely. Now I've operated in, I think, 26 countries.

In one country, I was a mile away from the patient, which would never happen in the United States, could never fly. Wow. Right. I was a mile away from the patient, which would never happen in the United States. Could never fly. It was in China. But they wanted a big room of people. They had 800 people there and they wanted me to answer questions

as I was operating. Was that a teaching situation? Yes. Yeah, when I go on, these things are always, you know, for charity and teaching and I'm honored to do it.

I love to do it. So it was like a corporate gig for a comedian then? It's like, hey, I'm very happy to be in China. I'm going to do a little bit of thoracic here for you.

I love you guys. A little bit, except I think they get paid. Yeah, yeah. They pay for our flight, but that's about it. That's it. See?

You know, I knew being a doctor was not the way to go financially. You made a good decision. When you nailed the MCATs, you made a good decision. I tell you, I did not make the decision.

If I had made the decision, it would be something else. I was dealing with the cards. I was dealt. So you go in there, and so you work remotely in the sense that, is it like a video game or something? Yeah, so we are sitting in a console that has an immersive experience. So it's a 3D.

We put our head into a console like this, and there's all ergonomics. You have your own chair, but then there's a giant machine with two hands here, multiple pedals for your left foot, your right foot. There are like six options. It looks complicated, but it's actually very, I mean, I'm doing it. So how hard can it be? No, come on now. You're talking yourself down a little bit.

No, I'm giving it to you straight. It's like an airplane. It looks super complicated, but you know. Once you get to know it. Exactly. Yeah. And so you move your left foot and right foot and in the right chest, you're going to have two left hands.

So you can toggle your foot and make your left hand the one here or the one behind it and assist yourself. So you have four hands? You have three hands and a camera. So you're driving your own camera, which is a big advantage over laparoscopy or video assistothoroscopy or arthroscopy, which is where they put a scope in the joint and you have to hold it. Here, it's hooked up to a robot. And as I move my hands and feet, the camera moves where I want to go. Gigantic advancement. Because when I did these cases with someone driving the camera, I'm like, listen, could you bring the camera? I don't want to look

at it. Move it over. It's a constant dialogue. If you have great assistants, they know where you want to look. But no one knows where you want to look more than me. So with the robot, I drive the camera. The robot is a slave to my hands. If I don't move my hands, the robot sits still. If I don't move my feet, the robot doesn't move the camera. So it doesn't go, this patient is the odd. It doesn't do anything. At some point, we will get to where parts of the operation, I think, will say to the robot, here's the artery, here's the vein, here's the bronchus. Robot, get around the artery.

Because at some point, it's going to be better than us. I firmly believe that despite despite what my colleagues say. So it's like the benefits of AI, right? Correct. I was in Italy a couple days ago lecturing on this, and the people in the audience, again, were like, you know, sir, if you're pushing this, you're going to get us out of a job. I'm giving, it's about getting patients better care.

Sir, you're crazy. We don't like you. They did say you're crazy. You're crazy. You're crazy. You're going to make the robot. It's bad news.

You wanted the robot. But the tactile approach, you as a surgeon, now, presumably, I would imagine, that as you're training and going through building up, becoming a surgeon.

Right. It's a very tactile thing. You're in there with the sounds and the smells. It is. You are so, boy, you're pretty sharp. You're a pretty smart guy. How'd you know that? Yeah, I used to be a doctor.

In my mind. Before you. Well, I'm not a doctor, but I did a yoga class in L.A., which makes you a doctor. It does in L.A., yeah. Not about New York City. No, it doesn't. So, do you lose anything with that? Such a great question. And again, I hate to go back to experiences, but today

I have a, and I'm very honored because they don't come to see me. They come to see NYU and the NYU team. So I have a doctor from Brazil and two from England who were there today. And the case we did is a metasectomy. I won't detect it, but it means there's little tiny spots in the lung that are very small. Right. That both surgeons said where they are, they would make a big incision, spread their ribs, put their fingers in and feel. I'm like, yeah, you could do it. That's how I did. I've done 18,900 operations.

Right. That's how I did my first 10,000. Now, we can't do that. So with the robot, although you can't feel, you can still take your instrument and rub it over the lung and you can see a little tiny nodule, a four millimeter nodule, like a pop out on the top of the surface or even five to six millimeters under the surface. So we've come up with ways to do this. But you would have to be a surgeon who's experienced the tactile. You've been through that to feel that. I think that's a fallacy. I think to say, hey, you got to open up and do a whole bunch of opens or go to a lab now and operate on animals and do feel that you don't think that's a fallacy i think to say hey you got to open up and do a whole bunch of opens or go to a lab now and operate on animals and do

opens i don't think so i think we've gotten so good with simulation and teaching that we can teach the non-experienced palpator what's that so as young surgeons who have not opened because we do everything robotically everything 100 me and my partners we don't ever open that's why people come from all over the world. And our conversion rate has been essentially zero the last four or five years. Does that cut down on post-op infection as well? Well, we don't get a lot of infections, but the pain. So I'm about to write a paper.

I've operated on 106 surgeons. They've all been back in the OR within seven to ten days. So your recovery, because you have tiny little nicks. That's it. within seven to ten days. So your recovery, because you have tiny little nicks. Right. That's it. And then, you know, now we have to make the one incision bigger because we put the tumor, which is in a lung, in a bag,

and then we're like pulling the bag. I got my foot on the guy's chest trying to pull the bag out. Really? Well, because you want to make the incision as small as you can. So it's kind of like, pulls it out like,

oh my God. And it does make that sound. Does it really? Something like that. That's horrifying and awesome at the same time. Yeah, no, it's cool. Now, listen, because I think about this,

because I've met a couple of surgeons in my life. You seem very like this to me. They're kind of, they're jocks. You know, you guys are, you're competitive, you're sporty. Yep. You're kind of, you know, I've met male and female surgeons. Similar. They're very similar.

There's that real kind of sport mentality. 100%. I played baseball in college, and all three of my boys were captain of their high school baseball teams, and they went on to college and played D1 baseball. Yeah. Are your boys all in medicine? No. Well, they were a little too smart.

They thought I worked too hard, and they were doing things that are maybe a little bit better for society. I don't know. But that kind of driven you. Your father was a doctor, right? He was, yeah. Was your father very sporty and very— He was. He played baseball in college as well that that kind of dream your father was a doctor he was yeah was your father very sporty and very he was he played baseball in college as well what kind of doctor what kind was he a surgeon he was a surgeon a urologist oh man no i've met plenty of them i'm 61 years old i mean that's like i'm 61 too right well you know then yes now you know

as a as a doctor you're probably a terrible patient right i really am i had surgery uh about nine days ago, right before I flew to Italy. Nine days ago? Yeah, and I was back in the OR two days later. Can I ask you what it was? It was, yeah, because I've done so much surgery. It's very common for surgeons.

We look down. I had advancing arthritis in my cervical vertebral bodies, and so they just plucked a little bit of the bone out with a little incision, took a little disc out, and I had a little numbness in my finger, which is scary when you're a surgeon. Like, I kind of need that puppy. I may not be good, but valuable to me.

Sure, like a concert pianist or something. You need that. A hundred percent right. Is it demystified for you then, surgery? Because a lot of people's surgery is like, this is a very big deal. I'm very frightened. I'm very upset. It doesn't make sense.

You're like, nah, I'll go in. I'll get it done. I'll be out. Yeah, because obviously I know the people who are really good. They did a minimally invasive incision in my neck, and I literally was in my office. Now, he told me to take a week off. I finished the operation at 1.

I saw a patient in my office at 5, and then I was back in the operating room Monday, and I flew to Italy the next day. See, you're not listening to your doctor, sir. Well, not 100%, but you asked if we're good patients. I was giving an example to support your claim or not. Oh, just how bad a patient you are. I just think my surgeon was so good that I was able to recover.

Did you ever get, when you were training, right at the start, when you're looking at all the different disasters that can go wrong with a human body, did you get them all? Did you become a hypochondriac as you were studying? No, I never. See, I would have. Even talking to you, I'm thinking, oh, my God, I hope I don't catch something.

I hope he's not got anything on his hand. I don't think so. I did wash my hands. Yeah, no, I know you did. And I washed your card for you, too, by the way, bro. So you're good. But, you know, that's something that I think is maybe something about the mindset. Because if you're a jockey, you're sporty, you're a competitive personality, I think that probably helps going in, right?

Because it's you against the disease, right? It is. It is. But so, you know, now as someone who has an MBA and was an executive VP and COO of a healthcare system and a leader, those are some of the bad things about surgeons. And it has to do with our training. So think about- That's interesting. Why is that bad? Well, because in college, you have to be in the top 1%. So you're kind of hoping a little bit of people around you don't do well. That's terrible as a leader.

Right. And then as you're in medical school, you got to be AOA in the top 2% to get a surgical residency. And then to become a cardiothoracic surgeon, which is one of the hardest besides neurosurgery or ortho. So again, you sort of take resources and can become, I always say you can kind of sometimes tell who's going to be the surgeon, who's going to be an internist by looking at people playing the playground at six or seven. That's really interesting. But I think if you're going to lead, it's just the opposite.

You have to give all the resources to everybody else. You have to be humble and listen and to be able to make fast, quick, definitive decisions, which you have to do in the OR when someone's coding, is exactly the wrong skill set. Explain to me what that is, coding. So a patient is dying. So they come in, you know, when you're a surgical resident, you get called once a day, twice a day to a floor and a patient is coding and dying. You have to come in immediately, take charge, tell everybody to shut up. You say, do this, start epinephrine. We're going to do CPR. And you're barking out orders.

So that's a great leadership style for that particular moment. Do you kind of get a rush out of that? Oh, my God, yes. Anyone who says you don't, well, if the patient does well. Yeah, if the patient does well, of course. Well, let me ask you because that kind of leads me into what I wanted to talk to you about a little bit, is the emotional impact of what you do. Because you're facing literally death as your profession. You face death.

It's what you do. Correct. And you try and head it off of the past. Is there a point where it's too much, where you can't take it? It may be because how my father treated me, how he trained me. Well, how did he train you? Well, so I think he made us really tough. His dad was an immigrant from Italy who came over, was a farmer, second grade education, the concept of hard work.

And I do think in resilience and toughness. And I love when people say the kids don't have it. The kids have that today, too. And they're going to be better doctors, better fathers and husbands and daughters and wives and granddaughters and grandsons than we are. They're going to be. Sure. They're definitely getting better. No doubt about it.

And they're going to be more resilient. But it's our job as older people to say kids are terrible. Things were better when I was a kid. But they weren't. You and I both know it. They weren't better. They were awful. But I heard that today from one of our visitors from England.

And I said, listen, I politely disagree with you. These doctors are going to get better outcomes than us because each generation gets better. And they may not have the same experience because we spent 120 hours in the hospital a week. Now they can only do 80 hours a week. And it's tough to get good at anything with 80 hours a week. I'm trying to get my boy to learn to play the guitar. 20 minutes a day is bad enough. He's 12. It'll get better. Well, that's pretty guitar. 20 minutes a day is bad enough. He's 12.

It'll get better. Well, that's pretty good. If he's committed to it, he'll do it. But, I mean, there's your 10,000-hour rules. It takes time. So they may have a little delayed gratification, but they're more balanced. They're better in their roles at home.

And at the end of the day, that may make them a better doctor and a better leader that has a different leadership style besides authoritative. They're more affiliative. Now. The leadership thing is interesting to me because you go back to your dad your dad was clearly an alpha and a leader and and you clearly have that too. It's like a leader. I mean you've written books about how to you know succeed and how to do your best and how to get the best out of things. Correct. Super results or super achiever. Super performing.

Super performing. Thank you for plugging about it. Well, look, it's my job. It's just like, you know, I make the incision, I do a little work. But here's the thing. It seems to me that it is such a competitive environment. Competitive personalities are so drawn to it that at the at the core of it i wonder if there is if there is a point whenever you lose because

you're gonna lose we would get humbled i tell every resident who thinks they're so good the good lord is going to humble you at some point so just Just, you know, if we're doing well, go home and just look in the mirror and don't, don't look at your navel. Don't navel gaze too much because bad outcomes are coming. So I totally agree with you. And then, you know, as a leader of a department or a division where you may have 20 of those guys, and then a COO of a healthcare system where we had 6,000 doctors and maybe I think a thousand or surgeons, you have to manage those egos like a manager in a dugout with all these superstars and tell them, really, it's about the team. What work did you do on your own ego for that?

Because if you're a young man, you need a little bit of that kind of, you know, I'm the cat's pajamas. You're right. You're right. And I've shared this with you before, but, you know, my wife, who I was married with 21 years, got cancer, and then she got a chemotherapy for this breast cancer that was, should have been cured. And that chemo caused the leukemia. So I felt incredibly guilty and humble about that because I participated in the decision to give her the chemo. And then for six months, I would

operate every day. We had people come from all over the world because we could take their tumors out because we were so good. And I got humbled because i would round the last person i rounded on was my wife i guess at my team home and i would spend the night there and sleep and i took my kids were in high school and one was at yale in college and i'm like you guys are on your own and i became so humbled i watched her die i could do nothing for it but hold her hand and watch Jeopardy. That's a cataclysmic result. The irony on top of the immense emotional pain of watching the woman you love die, of what you fight against all the time. Correct.

Very humbling. So that was a humility check. And I don't think I was that bad. Could you work at that point? Yeah, I operated the day she passed away, I operated. And then that was really on a Friday. And then we had to actually, she had a terrible brain bleed. We had to end up together.

I flew my kids all in. My son had just pitched at Harvard that day. They flew in Saturday and she was declared brain dead. We pulled the ventilator off on Sunday, which was terrible. And I had people from China coming in to watch surgery. I didn't do, they didn't operate Monday or Tuesday, but Wednesday I went back and operated eight cases on Wednesday. Do you think that helped? So, you know, people criticize me for this, but I think it's, you know, no one, everyone has lost. Everyone has, and everyone mourns in their own way. My sister's a psychiatrist and said, you know, we didn't do it right.

I don't think there's a right or a wrong way. It helped me because I got immersed in my work and my world, literally my world stopped spinning. I don't know how else, if that's how I felt. I remember that night going, it's a terrible story. No, no, no. You're bringing everybody down. No, no, no, no. It's a story.

It's the, so it's the, And she hadn't even passed away yet. It was Saturday because that night I spent in the hospital. So I knew in the next day we were going to be pulling the plug because every neurosurgeon said she's not recoverable. Right. And so I came home and said, I'm not going to sleep in the hospital. Nothing's going to happen. And I sat under her clothes and the smell of the clothes man just set me off and I just was like sobbing and no one had really seen me

cry because right you don't want to cry in front of it's ridiculous sure but that was that night I just remember saying it was like a surreal thing like is this really happening our family everyone kind of called us like you know we had this magic aura that my kids all did well and my wife was beautiful. And I mean, I'm not beautiful like she is, but we had all, you know, it was a camel. They call us like a little camelot. And it's very funny, the humility, no camelot when your wife gets a chemotherapy induced cancer called leukemia, and then all the chemo in the world couldn't help her. And then she has a massive brain bleed.

And, you know, she was the love of my life, and their kids, my three boys who I drove and drove lost their mom, and so they're all dealing with that now. It's 10 years, and we still talk about it. Yeah, of course you will, and you'll always talk about it. I feel like sometimes, whenever I've experienced loss, I mean, everyone experiences it in their life, I feel like it's kind of like a scar, maybe even from an operation. It's like the scar's never going to go away.

I've got a scar on my hand from where I punched a window when I was drunk, when I was 21 years old. I left a big scar. But now you can hardly see it, and when I look at it, I kind of half smile because I go, geez, what an asshole. But you remember, it reminds you. It reminds me. And it is an evolution. So I've used the same analogy. I call it a wound instead of a scar. The wound goes through different layers of healing. There's five layers, but it's never fully

healed. And it's obviously much better now than it was ten years ago. Right, but it's changed you. It changes how you are. Want to know how to leverage culture to build a successful business? Then Butternomics is the podcast for you. I'm your host, Brandon Butler, founder and CEO of Butter ATL. Over my career, I've built and helped run multiple seven-figure businesses that leverage culture and built successful brands. Now I want to share what I've learned with you. And on Butternomics, we go deep with today's most influential entrepreneurs, innovators, and business leaders to peel back the layers on how they use culture as a driving force in their business. On every episode, we get the inside scoop on how these leaders tap into culture to build something amazing.

we get the inside scoop on how these leaders tap into culture to build something amazing. From exclusive interviews to business breakdowns, we'll explore the journey of turning passion for culture into business. Whether you're just getting started or an established business owner, Butternomics will give you what you need to take your game to the next level. This is Butternomics. Listen to Butternomics on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. Meet the real woman behind the tabloid headlines in a personal podcast that delves into the life of the notorious Tori Spelling, as she takes us through the ups and downs of her sometimes glamorous, sometimes chaotic life and marriage. I don't think he knew how big it would be, how big the life I was given and live is. I think he was like, oh yeah, things come and go. But with me, it never came and went.

Is she Donna Martin or a down and out divorcee? Is she living in Beverly Hills or a trailer park? In a town where the lines are blurred, Tori is finally going to clear the air in the podcast Misspelling. When a woman has nothing to lose, she has everything to gain. I just filed for divorce. Whoa. I said the words that I've said like in my head for like 16 years. Wild. Listen to Misspelling on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. I'm Angie Martinez. Check out my podcast where I talk to some of the biggest athletes, musicians, actors in the world. We go beyond the headlines and the soundbites to have real conversations about real life, death, love, and everything in between. This life right here, just finding myself, just relaxation, just not feeling stressed,

just not feeling pressed. This is what I'm most proud of. I'm proud of Mary because I've been through hell and some horrible things. That feeling that I had of inadequacy is gone. You're going to die being you. So you got to constantly work on who you are to make sure that the stars align correctly. Life ain't easy and it's getting harder and harder. So if you have

a story to tell, if you've come through some trials, you need to share it because you're going to inspire someone. You're going to give somebody the motivation to not give up, to not quit. Listen to Angie Martinez IRL on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. Your experience with your wife, does that change you as a doctor when you're dealing with someone who's looking at a tough diagnosis or a bad outcome? I share it all the time. And it's funny. It's made me a much more, I think, empathetic. I think I was empathetic before, but it's made me much more empathetic when I say to the patient,

oh, go home. You're going to get three cycles of chemo. We call it neoadjuvant. Then we're going to resect you robotically. Now I know what they're living through at home. Right. It made me much more sympathetic and much more understanding. And then it's an instant connection.

About a week ago, I had a patient say, well, you don't know what I said. Well, actually I do. My wife and I went through it and she lost her battle to cancer. So you're going to do, people, it really connects you. So. Battle is a word that I've heard before with cancer and it is something which I find the idea kind of terrifying because I hate getting into fights. I've lost a lot of them. And so when they say, you know, I'm having a fight or a battle, I feel like I would hate to hear that. I would hear like, I'm not prepared. I don't know.

This thing is big. You are prepared, though. I mean, I think everything you've been through in your life has prepared you and your experience has prepared you and your value system your culture and you have a beautiful family to support you there's some people don't have any of that and even they find some resilience in ways and how does that manifest itself so that if you're in a battle is it about a positive attitude is about changing the way you live is it about a spiritual thing is it finding a church or a belief system what is it it's a great question i think it's a combination of all those things. And I think it's an individual journey.

It's like your own journey to find happiness. It's your journey through a leadership. And it's your journey how you go through grieving, as I explained to my sister, or through adversity. And I think all of us have our own way. So it's not my job to adjudicate if it's right or wrong. It's my job to support that patient. And I give every patient my cell phone.judicate if it's right or wrong. It's my job to support that patient. And I give every patient my cell phone.

I've done this for a long time. But it paid dividends. Never really drove my wife too crazy, though it's gotten a little bit crazy now because people in New York use it more than when I was in Alabama. Well, cell phones are much more a thing now as well. Correct. Like back in the day, there was a big box in your car and you leave your car,

you're on your own. Now it's everywhere. That's when I was a medical student. We had cell phones in Alabama. They have running water and all that. No, are you kidding me? In Alabama? Just in the last few years.

Okay. It's very progressive now. But that's a good hospital down there. University of Alabama is fantastic. Incredible people, great doctors, and a great culture at UAB. Yeah, I've always had a good time down there. I like it. I like it down there. Incredible people, great doctors, and a great culture at UAB. Yeah, I've always had a good time down there.

I like it. I like it down there. So listen, you have this situation where you've dealt with it personally. You deal with it professionally. You know, the ultimate reality for all of us, you look at that all the time. So I got to ask, is there a religious or spiritual side to you? Is there something that, because clearly if you're, if you're giving someone a diagnosis and it's hurting you emotionally, you need to have a place to go, don't you?

So it's very interesting. So I will tell you how I share my own belief is dramatically different in New York than it was in Alabama. So I do personally have a deep faith in something superior to what there is. I do think there's some life after this. I do think, and my kids call me crazy because I'm so evidence-based and so metricized in everything I do, but I do believe that my wife can see me now. I do believe she sees every little thing I do. I do believe my dad and my girlfriend and everyone and my kids can see everything I do. I firmly believe that. Now, maybe that's a mechanism to keep me straight. I don't know. But I think I'm going to see her after this.

So I share that a lot now. What are you going to say to her about your girlfriend? I'm going to say, well, listen, honey. No, I think she'll understand. It's been 10 years. And also, you know what? I think if it's moving on from the physical realm, I think you're okay. I hope you're right. Yeah, no, I think you'll be all right. I mean, anyway. I'm a little worried about it, actually.

You know, I understand. I feel like... She could light me up, so I don't know. Well, you know, I just don't know, and that's a family affair, and you guys will deal with it when the time comes. For the record, Craig said affair. Just want that for the record because there's no affair. No, no affair. We were just good friends.

No, no. So let me ask you this then. You have a situation where you're a younger surgeon, right? Yeah. And you lose your first patient. Yeah, terrible. You remember that? Oh, my God, yes.

I remember the patient like it was yesterday. I remember her name, her husband's name. She had three children. I remember it all. Jesus, terrible story. Isn't that funny? Because I've done 19,000 operations, and the only ones you remember are the ones that don't do well.

And that's true of every surgeon. That's not true of me. That's true of almost every surgeon I know. We lament our failures and rarely toast our successes. That's very interesting. Because I think that maybe you expect to win. Oh, my God. Sure, we're all, I don't want to say egocentric, but we're all very well trained.

Well, that's good. I want a guy like that operating on me. I don't want a guy who thinks, well, I hope I win. I don't know, I'm scared. I'm going to fucking fix this. I'm going to fucking fix this. I'm going to fucking fix this. So what I say is when I step between that line, no one is better than me. We have a line of the red line when you get in the OR.

And the second I step out of that, I'm going home. I'm taking out the garbage. I'm no different than anybody else. And actually, it's a big chapter in my book. It's called Staying in the Zone. And the zone means, yeah, I want you to be confident, have a big ego. But the second you walk out of the operating room, you're no different than anybody else.

You're going to go home and get yelled at. You're going to walk the dog or whatever it is. You're just a person. But one of the reasons why I enjoy talking to you is that, and I'm fascinated by the fact that you have such a sense of joy, a joie de vivre, a life force, and yet you deal with pretty much the hardest thing that people are dealing with, which is...

Lung cancer, yeah. Yeah, it's a real... I mean, lung cancer, I mean, it's not what it was 30 years ago. No, but dramatically. Yeah. And I want to give a shout-out to the oncologist, because really the oncologist sees the patient with stage four, stage three

advanced cancer, and more of their patients pass away. It's one of the reasons I went into surgery. Is that true? I probably wasn't secure enough in my own skill or my own that I didn't want to deal with nihilism. I didn't want to deal with bad outcomes. I wanted to feel great about myself and look in the mirror and say, boy, you cured that guy.

So I picked surgery because it fit more to my personality of always trying to win. I like that. Now, that comes from, I'm guessing that comes from your dad, right? That is you and your dad. A little bit. Because he got you into like, your first surgical procedure was with your father, right? Wasn't it? You remember that.

Yeah, I remember. But our dog in the basement, it's freaking kooky. It was the dog in the basement, right? It was kooky. Who would do that? So my dad had done a year or two of research on animals. He was a surgeon anyway, right? Yeah, he was a surgeon.

But who says, I don't want the vet doing my dog's hysterectomy? I'm better than him. Now, granted, he operates there every day. But when I think about it now, you know, I was 11 years old. I'm not much smarter now, but a little bit, but he did his own anesthetic. We made a, we made a board with little Velcros. We did it in the basement. He cut it out. He made the whole thing. He brought home an endotracheal to me, brought home the anesthetic. Who the hell was managing the airway and giving the dog anesthetic while we were doing the hysterectomy? He did. The dog did, the dog lived

eight years after that. It. Like he said, that dog was more important to him than any of you kids. But it's crazy to operate on your own dog in your basement. But I was assisting him and I said, this is the coolest thing in the world. I have to be able to learn how to do this. It's fascinating to me because you've got a beloved family

pet. You knock out this lovely dog. Beagle. Spot the beagle. This little beagle, and she's going to have the hysterectomy. And suddenly you're seeing the insides of... And see my father navigate the moguls and the ureter and all these other anatomy, which I really didn't know what it was. And the dog was pregnant. So there were little tiny puppies in the uterus at the time. And that actually upset me a little bit. And my mom was like, you shouldn't have had him down there. I'm like, because you saw these things were, they look

like little tiny puppies. They were, you know, maybe an inch, but it was there was like six of them, or five or six of them in her uterus at the time. And that, you had to clean all of that out because... Sure, yeah, he took the uterus out and they all expired. But he very quickly covered that up. That was a surprise. Oh, so he didn't know that until he was in there? No, no, we didn't know.

He didn't do a pre-op pregnancy test like we do with our female patients now. You do that with me, just in case. If you're pregnant, I'm very worried. Well, that's a different operation. But is there ever, does that happen with a frequency that you go in? Because you're not going to get that same, if you're going to go in the keyhole robotic surgery, you're not creating that landscape and going, hey, there's a tumor over here. I didn't even see that thing.

Well, no, but you can pull back. I call it stadium view. You pull your camera back and you look all around. And every time we enter the chest for a cancer, we look at what's called the pleura, the diaphragm, the lining of the heart, the pericardium, make sure there's no metastatic disease. So we could pull the camera back, even though it's 10 times 3D.

You can pull back and get a global view of the whole chest. That's crazy. And then you get so zoomed in. Like today, I had to tell the resident, pull back a little, let's pull back. Because she was trying to find the nodule in the lung, which I thought was pretty obvious. And it wasn't until she could pull it out.

Oh, there it is. She was too zoomed in. Wow. This can happen. So you go in there and you find something that you weren't expecting. Do you make the decision on the spot? Well, get it out. No, I'm not going to talk to anybody.

Get it out. So I'll tell you what I do. I could show you my phone, but I talk to the patient's family. Because when you're on a robot, you're not sterile. You're sitting in a console. Oh, right. And when they bring a new instrument in or something's happening, I have maybe a 20-second delay. I'll text them and say, hey, we're doing this, we're doing that.

Everything's going well. He's asleep. We've painted the skin. The instruments are in. We've just taken the lymph nodes. If I sign something abnormal now, what I do is I will call the doctor's oncologist, and I will call the family member. And I have them often participate.

So you can get a next of kin to say, yeah, go ahead. I'll say, listen, here's what I think we should do. They usually say, what do you recommend? But I've had some people say, no, I don't want you to stop. And I said, well, we're probably, we want you to, and that's fine. But it allows them to participate in the conversation. And then now you can even use the oncologist

and give them information. Just last week, I had a very unusual finding of giant lymph nodes or a metastatic because this patient came from another country. The scan was only three weeks old. Maybe it wasn't perfect quality. Lymph nodes had cancer, and that flipped us out. So I called the oncologist and said, here's what I would do. What do you want me to do?

He said, yeah, I want you to stop, and we'll give chemo. And I involved the family member. The patient's family member was a doctor, so it made it easier. Chemo must be a kind of a mixed bag a little bit, given your own experience. Because, you know, obviously your late wife's story with the chemo. Caused her cancer. Right. And then caused her to bleed into her brain because she had thrombocytopenia, low platelets and bled.

So the chemo caused her cancer, her leukemia, and then caused her to bleed into her brain because she had thrombocytopenia, low platelets and blood. So the chemo caused her cancer, her leukemia, and then caused her to die. And yet, I tell every patient this, this is my own bias, but we recommend chemo all the time to people, adjuvantly. And adjuvantly means after surgery and neoadjuvantly before surgery. My mother, my late mother, about 20 years ago, actually, no, more, 30 years ago, she got non-Hodgkin's lymphoma. And she had been receiving experimental treatment

for arthritis. Because she had very bad arthritis. That can make that take off like wildfire. So she had non-Hodgkin's lymphoma. She was getting some weird gold treatment. I don't know what it was for arthritis. And she had a very compromised immune system. And they started giving her chemo.

So at a certain point, we're in the intensive care unit. And the doctor, who was a lovely woman, came up and said, look, the outcome here is not going to be good. And I think that you guys should say goodbye. How old were you at the time? I was 30. Yeah, it's tough. Yeah, it's bad.

But here's the thing, because this is an important part of it. I'm sorry you went through that. That is really tough. I'm sorry you went through that. But here's, the end of the story is very different, because they say it's time to say goodbye. Okay, so we all say goodbye. And my go, okay, so we all say goodbye.

And my mother's not, her brain isn't gone. They're just there, so look, there's nothing. This is going to be bad. When we take the breathing tube out, it's going to be bad. They take the breathing tube out. She lived another 15 years. That's a twist, right? 15 years.

15 years. She recovered because they stopped the chemo. I hope you beat the hell out of that doctor. Well, see, what it was was, I think, they never really quite understood what they did. But in a socialized medicine environment, people are not suing each other. People are not, you know, so.

It's better. Is it? I don't know. There's good and bad everywhere. Sustained. I would say maybe they stopped your immunocompromising gold therapy that led to her immune system to kick in because most people don't have that many problems with Hodgkin's lymphoma.

Right. That's right. When the chemo started, that's when it got really bad. They stopped the chemo and stopped her arthritic medicine, which immunocompromised her and allowed her own immune system to check. Right. She never really had full mobility again because of the arthritis, because they couldn't treat it.

That's tough. She was mentally with it. She was mentally fine. She got around in a wheelchair. She did what she did. She got to watch your career. She got to watch my career. She got to see her grandkids be born.

I mean, she saw that. Can't beat that. No, it was good. But I think that the thing that terrifies me about it is I think there comes a point in life when you realize doctors are human oh my god yes I see I could have told you that with the second I walked in the door and tripped on the uh yeah but carpet but you've known that for a while I mean for a lot of us and particularly I think my parents generation maybe your parents generation

too yeah the doctor knew everything and the doctor was going to make it all okay. I'm very proud to be in a profession that still has the highest respect from the public doctors. And I do think it's well-earned. Having said that, we're knuckleheads and we make mistakes all the time and we're human. And I think that keeps our ego in check. And it's that desire to get better, which is so ingrained in me. Every day,

I kind of wake up, what are we going to do today that's better than tomorrow? We're always innovating and getting better. And I think most physicians, most people out of the way, but especially physicians, we really want to learn from our colleagues and get better. Want to know how to leverage culture to build a successful business. And Butternomics is the podcast for you. I'm your host, Brandon Butler, founder and CEO of Butter ATL. Over my career, I've built and helped run multiple seven figure businesses that leverage culture and built successful brands. Now I want to share what I've learned with you. And now I want to share what I've learned with you.

And on Butternomics, we go deep with today's most influential entrepreneurs, innovators and business leaders to peel back the layers on how they use culture as a driving force in their business. On every episode, we get the inside scoop on how these leaders tap into culture to build something amazing. From exclusive interviews to business breakdowns, we'll explore the journey of turning passion for culture into business. Whether you're just getting started or an established business owner, Butternomics will give you what you need to take your game to the next level. This is Butternomics. Listen to Butternomics on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. Meet the real woman behind the tabloid headlines in a personal podcast that delves into the life of the notorious Tori Spelling as she takes us through the ups and downs of her sometimes glamorous, sometimes chaotic life and marriage. I don't think he knew how big it would be,

how big the life I was given and live is. I think he was like, oh yeah, things come and go, but with me, it never came and went. Is she Donna Martin or a down and out divorcee? Is she living in Beverly Hills or a trailer park? In a town where the lines are blurred, Tori is finally going to clear the air in the podcast Misspelling. When a woman has nothing to lose, she has everything to gain. I just filed for divorce. Whoa. I said the words that I've said like in my head for like 16 years. Wild.

Listen to Miss Spelling on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. I'm Angie Martinez. Check out my podcast where I talk to some of the biggest athletes musicians actors in the world we go beyond the headlines

and the sound bites to have real conversations about real life death love and everything in between this life right here just finding myself

just just relaxation just not feeling stressed just not feeling pressed this is what I'm most proud of. I'm proud of Mary because I've been through hell and some horrible things. That feeling that I had of inadequacy is gone. You're going to die being you. So you got to constantly work on who you are to make sure that the stars align correctly. Life ain't easy and it's getting harder and harder. So if you have a story

to tell, if you've come through some trials, you need to share it because you're going to inspire someone. You're going to, you're going to give somebody the motivation to not give up, to not quit. Listen to Angie Martinez IRL on the iHeartRadio app, Apple podcasts, or wherever you get your podcasts. or wherever you get your podcasts. So in the extremely advanced technological world that you're in now, where you're looking at a situation where you can get to, is there a future where you say,

well, it looks like we have some cancer here, so I'll put in an E43 program, slide them in the door, and it should be fine. So when you mean slide them in the door? Well, you know, put them in the machine, and you go and say, the little robot does all the work for you, and you just... So I do, but I'm the exception to that. And I think the reason, and this came up a little bit in Italy,

I mean, I've just seen what's happened in my lifetime, and there's no question that artificial intelligence and robotics is going to give our patients better care. The doctors should not worry about protecting their trade. What we should do is wake up every day and say, how can the patient get better experience and a better care? NYU has really done that. NYU Langone Hospital with Dr. Grossman and all the other people there, we wake up every day, how can we give the patient better quality and better experience? And I think we use AI all the time, so it's going to do that. At some point, they will slide into a machine, but I don't know if it'll be surgical. I think it'll be more molecular. They'll be able to rearrange that. It's not just, it may

be prevention, it may be very early detection of tumors and then just changing that cell's physiology, preventing it from populating and spreading and metastasizing. That's my hope. What are the cancers right now you think we're just not getting anywhere with this? Well, so, you know, cancer is such a diverse thing. Look at lung cancer. It's such a big, a big thing. It's a big subject, isn't it?

Someone asked me, I was doing this show. They said, we're going to cure cancer. I'm like, hang on, hang on a minute, man. I'll talk about adenocarcinoma of the lung. You want to talk about squamous cell, carcinoid, small cell. What do you want to talk about? It's like saying, when will we cure illness? It's exactly, it doesn't even make sense.

So I think all, and there's new cancers coming and there's some that are going away. So I mean, I think all together, if you look at the results of what we've done in the improved survival of lung cancer, of breast cancer, of colon cancer, and prostate cancer, those are the most common cancers. Now, lung cancer takes the life of more Americans and the other next three combined, colon, prostate, and breast. I had no idea. Lung cancer takes more Americans and those three combined.

It's finally coming down, but that was still true a few no idea. Lung cancer takes more Americans than those three combined. It's finally coming down, but that was still true a few years ago. What is that, smoking? Like 25% of the women I operate on never touched a cigarette, and 15% of men never touch a cigarette. It has to do with genetics, and maybe pollution,

maybe environmental, I don't know. Wow. But that number's growing, and malignancy in non-smokers. So what do you do in your own little tabernacle, like your body? No tabernacle. So I'm a certified personal trainer. I work out. Are you really? Yeah, I lifted weights. I'm a big believer in that. The guy told me I couldn't lift. How good do you sleep, man? But I'm eight days post-op, so I lifted a little bit. I hope my

neurosurgeon's not listening. It was only 20 pounds, bro. Don't worry. No, I sleep like everybody else, and we're very efficient. And so I'm very rigorous like most surgeons, like I'm sure you are. Most successful people are rigorous, and they fit time in. So I love to work out. I love the feeling of having worked out. Yes. I feel like having worked out is one of the greatest feelings in the world. But before working out, I'm like, I don't want to do this.

I think the key is to remember, I always tell my kids, put this feeling in a bottle, and then you just sprinkle it over your head. Because if you come home from work and sit in the couch, you are dead meat. It's over. So you got to sprinkle that little bottle. How does it feel? Let's go. Don't even get comfortable. And that's what that's really so you'll come over of a surgery a long day and you'll do, how long would you do at the gym or then?

Yeah, so an hour and 12 minutes or 15 minutes. You do a little program on your phone and you do all the little lifts and then beep and then do it again.

Yeah, lift three days a week and then do cardio and then, you know, I told you I'm in this singles pickleball thing and I've gotten really into that.

I've got to let my neck heal up from this operation but in another week or two I'm back playing golf and pickleball. What I've gotten really into that. I've got to let my neck heal up from this operation, but in another week or two, I'm back playing golf and pickleball. What would you say, if you were standing in front of a bunch of people, say we go to Denny's in Alabama, right? We go to Denny's in Alabama,

and everybody's in there, and everybody's having their stuff, and we all decide, we want to talk to Seraph about how we can avoid cancer. What would be the first thing you would say to just a random group of people? Not surgeons,

not personal trainers. The first thing I would do is keep my mouth shut. You've been asked. It comes down to one of two things. It's either you stop smoking or you stop drinking or you lose weight. Those three things would predominate. I'd have to pick one.

In China, I'd say stop smoking. I was just there 50% in Italy. I was there a few days ago, 40%. People still smoking in Italy? There were doctors, cardiothoracic surgeons coming out of the damn meeting at the break smoking outside. That's crazy to me. It's absurdity. How can you be a leader? So I might put smoking, although I don't know now. It might be drinking. It might be obesity, although with a Zempik, that is going to change the landscape. Talk to me about a Zempik. Because people are taking it for chronic obesity. People are taking it just for the hell of it.

Yeah. I think that's what I might be asking you. So listen, the professorial answer is we don't have long-term follow-up. The reality is I know two or three people have been on it for two, three years, and they have lost 15, 20 pounds. They love it. Now, those people, I think they inject themselves. I don't think they don't take it by mouth.

I think they inject it. The patient told me she injects it subcutaneously maybe once every two weeks or maybe once a week. And it's expensive but somehow she gets it because they're rich. But she loves it and has had no problems with it. That's the majority of most patients. What does it do by the way? So it's a glucogen

inhibitor but the reality is it will reduce your level of glucose and maybe lets food stay more in your GI tract. It causes constip lets food stay more in your GI tract. It causes constipation. It slows down your GI tract. You're absorbing less food. If I want to slow down my GI tract,

I'm taking fucking heroin. I'm going to get something enjoyable. So, you know, it makes you constipated and you don't even feel the base? No, thank you. Don't share that with your anesthesiologist just before your endoscopy next week. I'm just saying.

Might leave that out. Yeah. You know, it's funny. Like, I'm very free with the fact I know that I have. I mean, I've been sober for 31 years. Which is incredible. Thank you. And it is an interesting thing because sobriety, I feel like,

is largely misunderstood by your profession. I think you're right. You give everybody perseverance and credit and you have a different view. I do a little bit in the sense that, you know, people say, you know, why, well, why can't you just stop? And you go, well, if I could just stop, it wouldn't be a problem, would it? Of course. And then the whole idea of it having a spiritual component. Now, I think with you, sir, if I don't think that's a problem, you are a spiritual human being. I am. You happen to be, you know, a doctor, a surgeon, a very good one, but you're a spiritual human being.

And I think for a lot of your colleagues, that feels a little, you know, airy-fairy and a little strange. It does. And I don't share it with them, and they're going to hear it now. But I don't wear that on my sleeve or discuss it because it's not really admissible in what we do. We're evidence-based. We're a meritocracy, and it's not there. Then let me give you some evidence.

Okay, great. Until I dealt with the spiritual nature of it, it's physical and mental, no doubt, but until I embraced the spiritual nature of the malady I had, I couldn't stop drinking. That's interesting. That's the evidence of it. It is.

And I know a lot of people with similar experiences. Right. And it's kind of, you know, well, I mean, obviously it's anecdotal because it's one guy, but I think at the same time I find it fascinating. Did you ever look at Carl Jung's work at all? I can't imagine it would enter your world much. But it's just that Jung, a very, you know, one of the founding fathers of your sister's profession, it was very much, you know, about religion, religious symbols, religious symbolism, and I think was very involved at the beginning of what is now, I guess, the sobriety movement.

At the beginning of AA, he was very connected to all of that. And I wonder if there is a time coming when someone who's as accomplished as you and you in the field comes out and says, look, we got to look at the God thing here. Yeah. Well, and I have seen things that you cannot explain. We've seen tumors. Oh my goodness. We've seen tumors regress, spontaneous regression of melanomas and lung cancers. And there's a thing called an escopal effect that I can give you all the medical explanations, but some of these things you just can't explain. And I just don't think we're that smart. I have great humility and know there are things and powers much smarter and more important than me that I don't fully understand that have influence in our world. But I think that's interesting to me.

And I don't want to push it on you, but I think it's partially, and it's why I'm so taken with you and your story, is about your humility. Because I don't think humility is, I don't know. I think humility is, I understand where I am in the universe. Right. I know where I am. Right. And really how incredibly small that I am.

Right. And I've gotten to so many, I've been invited to so many places to operate and to teach. And I always learn a little bit more than I teach. I don't really always say that because they're inviting me, but there's always something to learn. Every culture doing something better than us. Like, for instance, the first time I went to Italy, I went to operate. I got there at 7 a.m.

I go in there, and there's a guy going, hey, what are you doing? What the fuck are you doing? He's smoking a cigarette. There's oxygen tanks. Oh, my God. He goes, well, who are you? And I said, I'm the visiting professor. He goes, they won't be here for two hours.

So it's okay. Two hours. They didn't start on the aura until nine o'clock. And so everyone criticizes them. But you know what? Maybe they're happier that way. Maybe they don't mind working from nine to four or five and being inefficient because that would drive, it drives me crazy.

Is stress carcinogenic? Oh, unequivocally, I think it is. Yes. Yeah. Yeah. So, I mean, I wonder if that's a thing that, you know, if you look at the idea that someone in your position would say, there are things that we can't

explain. Right. I think that that is beautiful. I think it's beautiful that you will say, well, I like AI. I'm thinking, if it makes people better, why not? You know, it's kind of interesting. But do you ever, like, say you're in Italy, right? And you go out for dinner with a bunch of professors afterwards,

and you all go to, because Italy, you know you're going to eat beautiful food. You're going to have some wine. We're going to have some fun, and we did. And so do you ever think, I can't have that wine. I can't have that pasta because I'm going to get fat. I do. Oh, you do, and you're careful? 100%. I have one drink, and that's it.

I'm on one drink. They all want it. And I say, listen, I'm not an alcoholic. Just this is what I do because I'm going to get fat. I do. Oh, you do, and you're careful? 100%. I have one drink, and that's it. I'm on one drink. They all want it. And I say, listen, I'm not an alcoholic. This is what I do because I'm working out. I've had a little more pasta, and I weigh myself every morning like a nut. So I'm very regimented. That's interesting. Do you have the, what's that little band that people have, like a watch thing?

There it is. Whoop. What's it called? Whoop. I got it. Now, what does that do? What does it tell you? My phone's an airplane.

It's on your phone? Yeah, but I can show you my workout that I did, and I can show you how well I slept right here. Take a look. All right, so I'm looking at your phone, and it says that you're... What does strain mean? So my strain for the day is what I do with my exercise,

or just the amount of stress that you're under. So you can see, you can go to my activity here today, and you can see I did a high-intensity workout and lifted today. You see the exact time. My strain was 7.3, and then during that time, you can click into, well, I'm not on an earthquake, but give you your heart rate, your blood pressure, all these other things, and it looks how well you sleep. It gives you your blood pressure from that little thing on your wrist?

Not exactly your blood pressure, but close enough. Right. And you see, that's when I sleep. I only slept five hours. I needed nine, but that's my usual life. So you had 52% of what you needed.

Usually that's all I need during the week. If I'm looking at an app and it says you only had 52% of it, I'm like, hey, I'm going back to bed. Or if I can't sleep, I'm going to walk around feeling ashamed all day. It's so funny.

So I'm in three groups of this, and of course I've got a lot of the, I have a place up at Silo Ridge, which is a discovery land in upstate New York, and they're very wonderful people. So I've got some of the younger 30-year-old men wearing the whoop, and we compare, and they're like, well, Surf's going to see my, and I've had a wife come up to me and say, listen, you're killing my sex life. You're killing how much fun I'm having and she made the guy

get rid of the whoop because he wouldn't drink because you don't sleep as well if you have just one drink. Well, that I know. Yeah. That I know.

Like, if I have one drink, I don't do anything so well for a while. It's an interest. Let me talk to you just a little bit. I mean,

we're almost done and I know you're a busy man but because I'm fascinated by my own pathology, I'm let me talk to you just a little bit I mean we're almost done and I know you're a busy man but because I'm fascinated by my own pathology I'm going to talk to you a little bit about

my pathology is worse so we're on the same page I don't know but I as an alcoholic right as a recovering alcoholic as an alcoholic in recovery or a sober alcoholic

or however you want to phrase it very much believe in the theory that it's the first drink that gets you drunk. People like me. That if I take a drink, it kicks off in me something akin to an allergy,

akin to like if I was allergic to strawberries. Interesting. You know, and it forces me into a state, it removes the resistance that I have to stay away from the next one and the next one and all the consequences. I'm impressed in how well you understand yourself. It's been a while. Well, I haven't heard too many alcoholics ever say that, like an allergy. And I think you're exactly right.

It does set off a cascade of events that you can no longer control. That's right. You're not driving. And the key is you're not driving. There it is. And the key is not to get behind the wheel in the first place. Right. You just don't start. I mean, that's why I'm a one-drink guy.

It was put across. But that's the thing. You can be a one-drink guy. I think the difference between an alcoholic and a non-alcoholic is a non-alcoholic can be a one-drink guy. I have to be a no-drink guy. That's probably right. It was put forward, to be fair, I think it

was Jelly Neck in the 19th century came up with the idea of the allergy, or certainly William Silkworth. I was going to give it to you. No, it's not me. It was a dog. Those guys are gone. We don't know who the hell they are. Silkworth? What was it, Silkworm? Silkworth.

Silkworth at the Towns Hospital in New York City in the 1930s he said you know he's looking at alcoholics and he said to Bill Wilson who eventually

founded Alcoholics Anonymous or co-founded that name I know yeah and William Silkworth was working at Towns Hospital and

and he eventually incredible yeah it's an incredible story because what happens is that Bill Wilson is in there right and William Silkworth says to his wife Lois he says Eventually, yeah, it's an incredible story because what happens is that Bill Wilson is in there, right? And William Silkworth says to his wife, Lois, he says, look, I don't know.

His wife's name was Lois? Lois. Lois, okay, I just want to clear that up. Lois, look, that's not, it wouldn't matter if it was Lois. That could do anything wrong with that. Exactly. But he says to Lois, he says, look, I don't think there's anything I can do.

I think he's just, we're going to have to put him in a straitjacket and keep him in here. And Bill Wilson has a God shot. He has a profound experience. Epiphany. Right. Now, he thinks that it is maybe delirium tremens or something like that. That's what Bill thinks. And he asks William Silkworth, and this conversation,

this is why I love this doctor. This is great. It's an amazing conversation because he goes to the doctor. This is why William Silkworth was a genius. He goes to William Silkworth, who's been treating alcoholics, and he says,

am I mad? Yeah. Am I having, is this delirious? Have I gone insane? Yeah. And William Silkworth said this. He said,

I don't know, but you're better than you were half an hour ago. So maybe whatever it is, keep doing that. Yeah. And rather than saying you're crazy. A good way to look at it. Yeah. That's the positive feedback of coaching,

which is what you have. Something's working, you know. And I'm fascinated by that. I believe that you have that spirit. I believe you have that spirit. And I'm fascinated by that. I believe that you have that spirit. I believe you have that spirit. And I know you hate compliments. I see you squirming with it. I see you squirming with it.

Because it's baloney. Yeah, but you know what? There's so many incredible people that I work with every day. I know, but fuck those guys. I don't know them. Well, they're much better looking and smarter. Stop it. Stop it.

It's a joy to talk to you, man. Thank you. I'm so happy you're here. My honor. Continues happiness, continues success, and whatever you're doing, Jesus Christ, keep doing it. We're enjoying it, and my honor to spend time with you again. Let's do it once a year. Let's do it once a year.

Have dinner or something. Yeah, that's even better. I'm all in. All right. And I'll have the wine. You can't. You have the wine. You can have all the wine. And I'll have the wine. You can't. You have the wine. You can have all the wine.

And I'll have a lot of pasta and then go for a big long walk. I love to walk after dinner. Yeah. All right. Thank you. Thank you. Want to know how to leverage culture to build a successful business? Then Butternomics is the podcast for you.

I'm your host, Brandon Butler, founder and CEO of Butter ATL. And on Butternomics, we go deep with today's most influential entrepreneurs, innovators, and business leaders to peel back the layers on how they use culture as a driving force in their business. Butternomics will give you what you need to take your game to the next level. Listen to Butternomics on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. For 10 years, I've been obsessed with one of the most bizarre and audacious cons in rock and roll history. We were all facing 20 years and all that good stuff. The lead singer tried to pull off an English accent and they went on the road as the zombies. These guys are not going to get away with it.

Zombies are too popular. Listen to the true story of the fake zombies on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. Hey, y'all. Dr. Joy here. I invite you to join me every Wednesday on the Therapy for Black Girls podcast, a weekly chat about mental health and personal development, where my expert guests and I discuss the unique challenges and triumphs faced by Black women through the lens of self-care, pop culture, and building the best version of you.

So if you're looking for more ways to incorporate wellness into your life, listen to the Therapy for Black Girls podcast on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts.