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Lewis HowesLewis Howes

#1 Neurosurgeon: How To REWIRE Your Mind To Overcome Fear Fast | Dr. Mark McLaughlin

The best in the world don't have high self-esteem. They have none at all. That single idea changes how you think about confidence, pressure, and every story you tell yourself before something hard begins.

Dr. Mark McLaughlinguestLewis Howeshost
Jul 13, 20261h 20mWatch on YouTube

Summaries, chapters, transcripts, and FAQs on this page are made by uListen, not YouTube.

Transcript

  1. 0:00 – 2:22

    Intro: Dismantling Fear

    1. MM

      Fear is the enemy. It's the enemy in performance of anybody's sphere of life. And if we can figure out how to dismantle it, that's when our performance elevates. You can't control your thoughts, but you can be in charge of them. So I'm in charge of my thoughts, and my thoughts generate my feelings, and my feelings generate my actions.

    2. LH

      He's a certified brain surgeon who's done over 8,000 brain and spine surgeries. For over two and a half decades, he's made life and death decisions under extreme pressure in the operating room. Please welcome Dr. Mark McLaughlin.

    3. MM

      Still to this day, sometimes I'll get that nervous edge w- when I'm operating or before I'm operating. I'll say, "You are trained. You are enough." That's it.

    4. LH

      Mm.

    5. MM

      Don't think about the outcome. The outcome doesn't define you.

    6. LH

      How do you not ruminate on all the worst-case scenarios while preparing to overcome the worst-case scenarios?

    7. MM

      What I would say is, you know, what I've learned is...

    8. LH

      Now, you've spent over 25 years as a neurosurgeon making cuts where a single millimeter could be the difference between life and death for some people, and you've said that fear isn't the enemy, but ignorance of fear is. And I'm curious, what did the operating room, for the last 25 years, teach you about fear that most people get wrong?

    9. MM

      What I've learned most about fear is that it's a corrosive force in our lives. Early on, I had teachers that would say things like, "Oh, you know, too much fear will paralyze you, but too little makes you foolhardy." But what I've come to realize is fear is corrosive, and it always impedes our performance.

    10. LH

      Mm.

    11. MM

      So if we think of performance, performance is your potential minus the interference, and interference can be discursive thoughts. It can be thinking about the future, and that's what fear is. I mean, fear is the anticipation of an event that might happen in the future that if that event happens, you're going to feel something you don't wanna feel.

    12. LH

      Mm-hmm.

    13. MM

      So if you can-

    14. LH

      It's the anticipation-

    15. MM

      Exactly

    16. LH

      ... of a, uh, of an uncomfortable feeling in the future.

    17. MM

      Exactly.

    18. LH

      That's fear, essentially.

    19. MM

      It is. So there's two ways to dismantle it, what I've lear- learned, basically, and you can not think about the future, or you can not be afraid to feel what you're going to feel.

    20. LH

      Mm-hmm.

    21. MM

      Now, thinking about the future is probably a valuable thing to do,

  2. 2:22 – 5:54

    Anticipating Worst-Case Scenarios

    1. MM

      um, especially if you're gonna be prudent when you're doing an operation. You, you do wanna think about all the things that can go wrong in an operation. You wanna be prepared for that, but you don't wanna, wanna worry about it. You wanna be prudent about it.

    2. LH

      So how do you... I mean, I think Navy SEALs, even, like, UFC fighters and wrestlers like yourself, like, you have to prepare for all the bad positions you could be in and how to get out of it. As a wrestler, as an athlete, uh, as someone in the Army, as a, as a brain surgeon as well, like, I'm assuming you have to prepare, "Here's the things that could go wrong. What do I do when that happens?" Is that correct?

    3. MM

      Yes, exactly.

    4. LH

      So how do you know that there's a million things that could go wrong and then not go down the rabbit hole of, "Okay, but if that goes down wrong and I can't solve it, then it's life or death, or I lose the game, or I'm embarrassed or humiliated in a s- a social setting"? How do you not ruminate on all the worst-case scenarios while preparing to overcome the worst-case scenarios?

    5. MM

      What I would say is, you know, what I've learned is, you know, A- Anders Ericsson said it takes 10,000 hours to become an expert at something. Takes 50,000 hours to become a neurosurgeon.

    6. LH

      Wow.

    7. MM

      And in my career, I've spent another 50,000 hours practicing, so that's 100,000 hours. And, um, when we talked about how brain surgeons not only do brain surgery, but they do spine surgery, and one of the instruments that we commonly use is this Kerrison rongeur, which is a bone biter. And what this instrument simply does is it removes bone spurs. When we close this trigger, the mouth of this instrument closes, and it removes bone. So-

    8. LH

      Kinda cuts it off or shaves it a little bit.

    9. MM

      Exactly. It shaves it off, so make a canal where a nerve is, is compressed free to relieve pain. And so every time you close this instrument as a neurosurgeon, you need to be watching the edges of this instrument and make sure when you're closing it, you're closing it on the bone spur and not the nerve. And I've closed this instrument probably two million times in my career, and every single time I take a bite, I need to be focused on the bite I'm taking, not the one before, not the one after. You can never be casual. If you're casual, you create a casualty. That's what I say to the West Point, speak to the West Point cadets, is I say, "If you're casual on duty, you're gonna become a casualty." So you be- need to be focused on the moment at hand. And so when you're talking about what could go wrong, yes, before a surgery, I go through my mind, what could go wrong, and what are my plans? What are the steps to go through? If a vessel is bleeding and I can't control the bleeding, what would I need to do next? We'll start with try to control the bleeding, compress it. Order blood. Maybe call in a, a second set of eyes and hands to help me. Boom, boom, boom. I have a set thing I'm, I'm thinking about. If a nerve looks like it's damaged, what am I gonna do? Can I consider repairing it? Can I suture it? All those things need to be in my mind before the surgery, but the second that surgery starts, I am focused on the next step, whatever it is, the next step, the next step, the next step. Nothing before, nothing after.

    10. LH

      But what if something has gone wrong, let's say? Like, it didn't go according to plan. I don't know, a, a blood vessel or you, you clip a nerve on accident or, I don't know, something could go wrong.

    11. MM

      Sure.

    12. LH

      How do you focus on the next thing when you've made a mistake or something has gone out of control-

    13. MM

      Sure

    14. LH

      ... uh, in, in surgery, and how can someone apply that to their life?

  3. 5:54 – 11:45

    IRIS Protocol: Handling Mistakes

    1. MM

      So the first moment, uh, that you realize something has gone wrong or that you made a mistake is reject your first reaction to it, and I talk about that in a protocol called IRIS in, in my book. You wanna reject what your first im- impulse is gonna be 'cause it's almost always self-preservation. So you need to reject that initial thought. I talk about, in the book, I talk about a time when I'm, um, putting a, an, a scope through the hole and into the brain of a child, and we encounter e- severe bleeding.

    2. LH

      So it's, like, coming out of the, the skull or it's-

    3. MM

      It's coming out of the scope that I put in.

    4. LH

      Oh, you put a, a, a scope to see inside the hole.

    5. MM

      Exactly, and the blood is coming out.

    6. LH

      So when you-

    7. MM

      What's my first in- initial reaction? Pull the scope out, right?

    8. LH

      Ah.

    9. MM

      That's the worst possible thing that you can do. You need to keep the scope in so that the blood comes out of the head and doesn't stay in the head, damaging normal structures.

    10. LH

      Yeah, interesting.

    11. MM

      So the first thing you need to do is reject your first impulse because it's almost always self-preservation.

    12. LH

      Yeah, it's like take it out and put, like, some, a gauze over or something, right?

    13. MM

      Exactly. Exactly.

    14. LH

      Interesting. So you keep it in.

    15. MM

      You keep it in.

    16. LH

      So, so when you do that-

    17. MM

      Yes

    18. LH

      ... you will drill through the top of the head. Is that right?

    19. MM

      That's correct, yes.

    20. LH

      [sighs] That's cra- so you put a scope in first through the top?

    21. MM

      Depending on the type of surgery, sometimes we can do the surgery just with a scope. Um, and so you can see what's going on, and you can do surgery through that tube, through the scope that-

    22. LH

      Uh-huh

    23. MM

      ... you're working on. And so what, going back to your question, is id- identify what's going on, reject your immediate response, inventory what other avenues you have to manage this. What resources do you have around you to talk about, "Okay, I'm having dif- a profuse bleeding. Let's get some blood in the room now. Anesthesia, we're losing blood. We need to control the blood pressure. Um, let's get another do- L- call my partner doctor s- to come into the room to help me manage this," and then basically try to evaluate what other alternatives there are and stabilize in the way that you can so that you can think further.

    24. LH

      So you've done over 1,000 brain surgeries, but over, I think, 8,000 total of the spine surgeries involved as well. Is that correct?

    25. MM

      Yes.

    26. LH

      Which one is harder to do, brain surgery or spine surgery in your mind?

    27. MM

      It really, uh, depends on what your s- what, what your niche is. So a- as you do this over years, you will find what you, uh, f- uh, are trained best to do, and you'll focus on those. So if I see some type of a tumor that I don't operate on, I, I won't do that. I'll hand that off to another person. But in a person that has, like, severe facial pain, when they're having trigeminal neuralgia, which is a, a syndrome where they have severe facial pain, where there's stabbing sensations in their cheek or in their jaw, that's a, a, an operation I've, I trained in Pittsburgh, uh, to do and I feel very comfortable doing, and I'll offer that person surgery. So it's really an assessment.

    28. LH

      Yeah.

    29. MM

      A- as you go along in your career, you'll find that there are, you know, a certain number of operations that you do regularly, and, and that's what you do, and then you'll hand them off to others. If you see something that's not common, uh, you'll hand it off to other doctors.

    30. LH

      Yeah. And so with your... W- is that, would you say that's your specialty, is, like, dealing with, like, a pain in the face?

  4. 11:45 – 16:59

    Shift Focus From Fear to Love

    1. MM

      And I tell a story about when I was, uh... You asked about the frequency of operations. So, um, early on in my career, I was, uh, I was planning to do an operation on a patient that had a brain tumor in the back of their head in, in a location where there was a very tricky vein, um, where you had to really be careful to preserve that vein as you were doing the surgery And it turned out I was doing that surgery on Friday after a long week, and the surgery was, uh, postponed from 11:30 in the morning to 3:00 in the afternoon, which, uh, you know, is not an ideal time to operate. You have ... You still have good, competent staff, but everybody has sh- shifted, and the p- person who set the table for the surgery is leaving, and you're getting a new person there. So I, I'm totally exhausted, um, and I'm thinking, "Wow, I..." You know, I'm trying to get myself psyched up to do the surgery.

    2. LH

      It's the end of the week. It's a long week.

    3. MM

      It's a long week.

    4. LH

      You, you got the weekend coming up. Yeah.

    5. MM

      And it's an operation that I've done many times before, but I hadn't done recently because I had been handing a lot of my tumor patients over to one of my partners. So I'm getting ready to go in, trying to self, psych myself up, and I get a phone call from my father's physician, and my father was, you know, my bi- mentor and h- just a, a, a leader, a huge leader in my life. And the news was bad, that he had, he had cancer and his, his prognosis was really poor. So in my-

    6. LH

      Right before you're about to go into surgery.

    7. MM

      Right before I'm about to go into surgery. And, um, so I'm in my car and I'm, I'm, I'm saying to myself, "I, I don't think I can do this. Like I, I, I don't think that this is a good time to do surgery. You're distracted. Uh, you're, you're, you're, you're not gonna be at your best. What happen- what if something happens and you'll never forgive yourself, right?" So I decided to cancel the surgery, and I walked in the hospital to go talk to the patient. And as I'm walking down the hallway to talk to him, I see it's not just him in his room.

    8. LH

      Ugh.

    9. MM

      It's his wife.

    10. LH

      Ugh.

    11. MM

      And it's his three daughters.

    12. LH

      Ugh. So he's already, like, in, you know, in scrubs or whatever. He's, like, ready to go in. He's-

    13. MM

      He's ready to go. He's ready to go.

    14. LH

      Ugh.

    15. MM

      And as I walk in the room, s- something just shifted in my mind, and I said, "You know what? My dad needs me." I... It was a, such a gut punch. I wanted to go drive and go see him right there and give him a hug. And I said, "My dad needs me, but this guy needs me now."

    16. LH

      Yeah. Mm-hmm.

    17. MM

      What would my father want me to do?

    18. LH

      Yeah. Oh, man.

    19. MM

      And I thought about, you know, uh, he, he loved poetry, and one of the poems I always loved is Rudyard Kipling's If. "If you can meet with Triumph and Disaster, And treat those two impostors just the same." And I said, "You know what? I'm gonna dedicate this operation to my father."

    20. LH

      Oh, yeah.

    21. MM

      "I'm gonna dedicate it." And I shook his hand, and I took him back, and I did what needed to be done at that moment. And I was talking to my coach afterwards and I said, "Yeah, wow, this whole thing happened. I got, I got courageous." And he says, "No, you didn't." And I said, "Yeah, I did. I, I thought of that poem and n- and it made me courageous." And he said, "No, you didn't." He said, uh, "They're just words. They don't, they don't really do anything. They're words on a piece of paper." He said, "What you did was you reminded yourself of who you are."

    22. LH

      Mm.

    23. MM

      "You dismantled fear by reminding yourself of who you are, and you began to love your father more-"

    24. LH

      Mm.

    25. MM

      "... love your patient more, and love what you do more. And when you love what you're doing, you're at your best."

    26. LH

      Wow.

    27. MM

      So that's what I've realized. When I realized, like, fear interferes. When I dismantle fear, I love what I do more-

    28. LH

      Mm

    29. MM

      ... and I'm at my best.

    30. LH

      I love this because you shifted your attention to, to not what is going wrong in my life right now or with my father, what could go wrong, I'm exhausted. You said, "How can I love my father? How can I serve my patient and my client more? And how can I be excited or passionate about my craft?" is what I'm hearing you say. How do you not let the worry of, "Yeah, well, still, what if something goes wrong?" How do you eliminate that, or maybe you don't eliminate it. How do you navigate that worry or fear of like, "Well, I'm not at my best still. You know, I'm not, still not emotionally fully there maybe, or I'm a little off. It's the end of the week." How do you overcome that thought?

  5. 16:59 – 23:41

    Don't Judge Your Outcomes

    1. MM

      have to accept that. I had this one experience very early on in my career where, um, I got called to the ER. Literally a l- within a month of my first, uh, uh, job, I got called to see a patient who had, was, was quadriplegic. They had jumped into a pool, and they broke their neck.

    2. LH

      And this happened r- like recently. They weren't quadriplegic for a long time.

    3. MM

      No, they, they just became quadriplegic.

    4. LH

      Okay.

    5. MM

      A tumor-

    6. LH

      And they were in the hospital.

    7. MM

      Exactly. They were brought by the emergency squad-

    8. LH

      Wow

    9. MM

      ... to the hospital. I met him in the emergency room. He had no movement in his arms and his legs.

    10. LH

      Ugh.

    11. MM

      And we rushed him to the operating room. He had a dislocated spine, and I relocated his spine, and I figured his odds of getting better from being able to move again were still, like, one in 1,000 or more. But miraculously, he started moving his hands and his legs a few days later, and he walked out of the hospital-

    12. LH

      Shut up

    13. MM

      ... like two weeks after the surgery.

    14. LH

      Wow.

    15. MM

      And I, I, I did that. When I, that happened, I, I... There was a picture of me and him walking out of the hospital in the town newspaper, and I put that on my wall, and I was so happy, and I was like, "Wow, this is great. I love being a neurosurgeon." But then a month later, I had a young boy come into the ER, and he had a brain tumor. And I took him to the operating room and did the same- ... perfect operation that I did on this other guy, and he had a terrible outcome.

    16. LH

      Mm.

    17. MM

      And he had every complication that he could possibly have. And, uh, I, I kept asking myself weeks, months after, like, "I must have done something wrong. You know, I must have taken too long to do this surgery. I must... I should have missed, should have picked up some, uh, harbingers of things that were going wrong along the way. I could have done something differently to affect his outcome." And, um, and I carried that with me to the point where I, I stopped doing pediatric neurosurgery because I just, it was too emotionally, uh, wrought with feelings of inadequacy, and I carried that with me for many years. In fact, I ended up n- not really f- following with him 'cause I moved. I, I quit pediatric neurosurgery and I moved to a new town partly because I, I couldn't g- escape these feelings of sadness.

    18. LH

      Really?

    19. MM

      And, um, and, and then fast-forward 15 years later, 16 years later, I'm writing a book and I look at a picture on the wall. I had a picture of, of this, uh, this, uh, young boy, Anthony, on the wall, and I th- you know, I never, never found out what happened to him. I thought he had just passed away 'cause it was a bad tumor and he had bad out- a bad outcome. And, um, so I looked up, his mom and dad had a pizza parlor, and I looked up on Facebook and I saw his mom and dad still had the pizza parlor. And then I scrolled down a little farther and I saw a 20-some-odd-year-old man in a wheelchair with his parents.

    20. LH

      Smile.

    21. MM

      I was, "Oh my God, he's still alive." [laughs] I couldn't believe it. So I called his parents. I said, "I wanna come up and see you. Um, uh, can I come visit Anthony?" And they said sure. So I went back up and I visited them, and I had dinner with them. And at the end of... And I saw Anthony, and Anthony has s- serious neurological challenges still. Um, and he ended up go- leaving the dinner early, and I was with his parents. And at the end of the dinner, I said, "You know, I, I had something I wanted to tell you for, for a long time and I never have told you, and it... I, I wish I could have brought your boy back, you know?"

    22. LH

      Mm.

    23. MM

      And, uh, he, uh, and his mom and dad, they jumped over the table and gave me this big hug, and they said, "What are you talking about? You saved our boy. Like, he's still part of our family. He's still my number one guy." And, um, I, I realized on that moment, like, I had the story all wrong. I kept blaming myself for his bad outcome when, in fact, I, I did, I did the best I could in a very difficult situation, and I kept this family intact. And I was calling my editor and I said, "You're never gonna believe this story about Anthony because, you know, he, he, he's still alive and he's, and he's with his family." And my editor said, "Yeah, well, I think we should put the Anthony story and the, your spinal fracture story in the same chapter." And I said, "Well, that doesn't make any sense. One, one's a really great outcome, one's a terrible outcome. Why would you do that?" And he said, "Well, Mark, you've been telling me this whole time, like, you know, uh, y- y- you take a person who's paralyzed and you help them walk again, and you say you're lucky. And then you have a child who has a bad tumor and he has a bad outcome, and you say it's your fault."

    24. LH

      Mm.

    25. MM

      That's an impossible standard to live up to.

    26. LH

      Yeah.

    27. MM

      And on that day, I recognized, like, I cannot judge myself on my outcomes.

    28. LH

      Mm.

    29. MM

      I gotta show up to work, do what I was trained to do, and the chips fall where they may.

    30. LH

      Wow.

  6. 23:41 – 30:34

    The Self-Esteem Disease

    1. LH

      Mm.

    2. MM

      I don't wanna have high self-esteem. I don't wanna have low self-esteem. I want no esteem. Esteem is a roller coaster that I don't wanna ride.

    3. LH

      Mm.

    4. MM

      It, it, it is, uh-

    5. LH

      You might run out of steam. [laughs]

    6. MM

      Yeah, exactly. It's, it... Self-esteem is not helpful. Connecting with yourself is.

    7. LH

      What's the difference?

    8. MM

      Huge difference. Being who you are, accepting who you are as, as it is, understanding that you're, you're enough. You know, you need to go through this training, whatever training, whatever profession you're in, whatever specialty you're, you're, you're executing in. Train to be the best. I'm, I'm not saying don't do after-action reports when things go wrong. Look at how things could have gone better, but not in a fault or blame way. Just be responsible. Responsible meaning the cause. I am the cause of what's happening. Not in blame, not in fault, but I'm responsible, and I'm gonna continue to get better. I love Ryan Holiday's quote, m- you know, "Mastery is a fluid, continual, never-ending process."

    9. LH

      I love that.

    10. MM

      So just keep getting better and better and better, and don't, don't beat yourself up by saying, "I sh- I should've known better," you know? I mean, that's just, uh, you know, guilt masquerading as self-help. It... Of course, every, every single thing in your life you should've done better in the past, because you know more now than you do then.

    11. LH

      Mm-hmm.

    12. MM

      So I think it's a useless statement. Uh, so getting back to, I, I think the, the key to excellent performance and, and your best performance is connecting with yourself, not going into an operation saying, "I'm a great surgeon. I'm gonna do a great job." Um, because that doesn't last, you know? The, the outcome that didn't go so well, that, that hand's gonna reach up from the graveyard and pull you down later on [laughs] that week or that month.

    13. LH

      Right.

    14. MM

      As opposed to saying, "You know what? I'm a servant. I'm gonna do whatever I need to to this day to be a good servant."

    15. LH

      Mm-hmm. But it sounds like with Anthony, um, you know, what the individual that didn't recover as well as you would have liked in your mind, it weighed you down for many years. 15, 16 years I think you said, right?

    16. MM

      Yes.

    17. LH

      So when did you learn to not let the trauma of the past or an undesirable outcome of your performance of the past to not rob you of your joy or your ability to show up as your full self in the present or in the future?

    18. MM

      I mean, I think that lands squarely in the concept of acceptance, you know? Um, healing is acceptance. Um, w- you know, i- in the book I talk about, uh, this concept called terrible knowledge, and terrible knowledge is a term that was described by a psychologist in Chicago by the name of Jeffrey Jay. And what terrible knowledge is, is, um, these horrific experiences that we all have in our lives that, um, that make us realize that, wow, the world can be so incredibly capricious and so harsh.

    19. LH

      Yeah.

    20. MM

      And yet you, you have to go on and live your life. When I was thinking all, all these ti- and sad times about Anthony, I was looking around, seeing people who were happy and going, "How can they be happy? Like, h- this poor family, they, their life got turned upside down. How... All these people are naive. They don't realize how-"

    21. LH

      Mm

    22. MM

      ... harsh the world is. So we're all carriers of some terrible knowledge. It's, it's just a fact of life. Li- um, uh, I love the quote by a philosopher, "Life fires at you point blank." It just fires at you. And so we have these experiences. We weren't trained for them. We weren't ready for them. Nobody asked if you were, you know, prepared for them. They just happen, and, and even if you think about them... I talked to state troopers in New Jersey about these experiences. Even if you train for them, they don't, they don't really play out the way you expected them to.

    23. LH

      No.

    24. MM

      And they're never gonna be desirable or good experiences for you. They're gonna be awful experiences. So how do you carry your terrible knowledge? Well, you can let it, uh, you know, pull you by the, the string, the puppet strings, and, and feel terrible, or you can turn it into useful knowledge. And the only way to turn it into useful knowledge is to share it with others in a way that it's useful for them.

    25. LH

      Mm-hmm.

    26. MM

      And what I say about that is then, then that knowledge, then the, the st- the, the knowledge, terrible knowledge of Anthony not going back to be the normal eight-year-old boy that he was, that knowledge, um, doesn't use me anymore. I use it. And that's... You put a frame around it. You put it on your wall and you say, "That was a time I s- I experienced this sadness. You may be going through another experience questioning yourself, holding yourself to an impossible standard. Maybe my story will give you a different perspective, and you'll realize that it, it's, it is what it is, and it's not what it's not."

    27. LH

      Right.

    28. MM

      That's acceptance.

    29. LH

      And it sounds like the more you reflect on it and put self-blame or anger, resentment, frustration, questions around it, it's only gonna hurt you emotionally and mentally. Instead of transforming that wisdom into, "How can I serve? How can I improve?" H- uh, and you hear this with widows or people who have been through divorce or other challenges like that, or lost someone close to them. It seems devastating for a period of time until they meet someone else who's been through a similar experience, and they can share that information and kind of create community and connection and support through, "How did you get over this, and how did I overcome this?" And it's, when you use it to serve another person, that's when it's really helpful, I think.

    30. MM

      Of course. And, and you mentioned h- you have to express it. Self-expression is extremely healing. If I hadn't shared my story-

  7. 30:34 – 37:41

    How Language Rewires the Brain

    1. MM

      language. I think that, um, we underestimate how powerful our language is-

    2. LH

      Mm

    3. MM

      ... and our choice of words. So I used to think I would be, I would worry about something bad happening in operation, and I changed that word to prudent. I wanna be prudent. I wanna know where this vessel is, and then what happens if, uh, there's a tear in it and how I'm gonna repair it. Um, luck- am I lucky or grateful? I say to the West Point cadets, I say, "Some people, you'd say, 'I'm lucky to be here.'" I would say that denigrates everything you did to get here, okay? Yes, there's some luck involved. We were born in the genetic lottery to be in the United St- to live in the United States, be born in the United States, but it takes a lot to get into West Point.

    4. LH

      Mm-hmm.

    5. MM

      And I think a better word would be grateful. Grateful. Um, how about, you know, is something hard or challenging? Nobody likes to do something hard, but challenging, I love doing challenging things. So I think that our words, um, our language not only reveals what we're thinking, it creates our reality.

    6. LH

      Mm-hmm.

    7. MM

      And we, we see that. I mean, look at Muhammad Ali talking about affirmations and how affirmations repeated over and over become beliefs, and beliefs become action and become reality. So I think that, um, our, our brain is, has neuroplasticity. It has the ability to rewire itself. And, you know, unfortunately, w- we're all steeped in, in a, in a culture that, that has some things wrong about it. All the things we learned as kids w- aren't helpful to us, you know?

    8. LH

      Mm-hmm.

    9. MM

      I talk about, um, in this, uh, another book I'm working on with Joe De Sena, Why We Quit. You know, one of the things our parents used to say is, "If you start something, you gotta finish it." Well, that's not great advice. Like, not everything you start you should finish.

    10. LH

      Mm-hmm.

    11. MM

      There's plenty of things you should stop immediately. [laughs] So I think that we, we get steeped in a culture that talks about self, you know, we wanna have high self-esteem. You wanna go into this, you know, event or, um, as I'm the best and nobody's gonna beat me. No, I wanna go into the event as I'm me, and I am gonna be the best me I can possibly be.

    12. LH

      Mm-hmm.

    13. MM

      And I'm in a competition where a, a competition, if you really look at the Latin root of competition, it, it is, um, to bring out the best in each other. It's not about winning or losing. It's, it's a non-zero sum concept. Competere means to bring out the best in each other.

    14. LH

      Mm.

    15. MM

      So you're competing with someone else who loves what they do, and you're bringing the best out in each other. So it's a, it's a part- partly language. Language affects our thoughts.

    16. LH

      Mm.

    17. MM

      And again, like I said, thoughts, um, your, your, your brain is a thought generator, continuously generating thoughts. It's like, uh, you know, the, the ticker tape on the old, uh, Times Square newsreel. But not all those thoughts are real-

    18. LH

      Mm

    19. MM

      ... and not all those thoughts are facts. Some of them are. Some of them are extremely valuable. Some of them are just garbage, and you need to get rid of them. So it's slowing it down, I think slowing it down, uh, so that we really have a menu of choices-

    20. LH

      Mm

    21. MM

      ... when, when we're, when we're challenged. We wanna go with a menu of choices. I say, like as a doctor, I, I hit the reflex hammer and a knee-jerk. We don't want our brains to be like that when we're challenged by something. We wanna have a menu of options to choose, and then choose the one that's most fitting and, and, and serves the most people.

    22. LH

      As a neurosurgeon that's done over 1,000 brain surgeries, what is the greatest skill that you've developed to master your own mind?

    23. MM

      Focus. It truly is focusing on what is the most important matter at hand. I had one, um, terrible Christmas morning where I took care of a young boy who was hit by a car and, um, and he-- we lost him on the table.

    24. LH

      Mm.

    25. MM

      And it was just-- it's just still to this day, I'm very upset about it. Um, and I thought like, "What can I do?" Like and, and I call these all is lost moments in, in, uh, in our life, which we all have, where we, we have something objectively that's terrible and something that's subjectively that's terrible, and I thought, "What can I do?" I can go and deliver this news to the family as the best, in the best possible way that I can, in the, the best setting with the right people around them, with their clergy, with nurses w- in the right area, delivered the right way, and that's the only thing I can do today to, to move up a little bit on the subjective scale of what do I do?

    26. LH

      Yeah.

    27. MM

      And by doing that, that's how you live your life. It's a constant challenge. You s- sometimes we're in flow. Sometimes we're in something I call calm before the storm, where something good happens to us, but there's also something subjectively not good about it. We get a job promotion, but our new boss is toxic, okay? I call that the calm before the storm. All is lost. That's where, you know, you get a diagnosis of cancer, and you have to stop your job and focus on your health. And then there's the birthing a new skill set, where you, you lose your job, but you get an opportunity to write the book you always wanted to write. And we're constantly in this circle of flow and all the way around, and that's the heroic journey of life.

    28. LH

      Mm-hmm.

    29. MM

      So that's really how I would say what I've learned from operations is focusing on where you are and what's the next step to serve what your goal in your life is. I learned very early that I'm a servant, and so when I, when I, um, and dis- have a, a, an, an awful experience, I say, "What can I do to make the world a little bit of a better place?"

    30. LH

      Yeah. How much of your studies did you study the mind versus studying the matter inside of the brain?

  8. 37:41 – 42:17

    Brain Machinery vs. The Mind

    1. MM

      The brain has machinery to, um, to do I think whatever the mind asks it to.

    2. LH

      Really?

    3. MM

      Yes. Uh, so the brain has a machinery to develop habits, okay? The brain has a machinery to, uh, experience emotions. The brain has a machinery to-

    4. LH

      Mm

    5. MM

      ... sense danger in ways you don't even know. Like, you can smell danger actually, and most people don't realize that. But there's a smell of danger when, uh, the pheromones of a, of a, of a nefarious character who's cha- walking down the street near you. There is something there-

    6. LH

      Really?

    7. MM

      ... that we don't, we're not even aware of.

    8. LH

      Your brain creates that mechanism for you to feel it.

    9. MM

      Exactly.

    10. LH

      You smell it, and then it triggers, like, fear, danger, something's off.

    11. MM

      Exactly.

    12. LH

      And now you interpret it through feeling.

    13. MM

      Yes.

    14. LH

      And it, it what? Sends a signal through your immune system, nervous system? What is this?

    15. MM

      Your, it's, well, your limbic system, which is your amygdala and your hippocampus and the areas of your brain which are your alarm system. Um-

    16. LH

      But sometimes that, like, goes to your stomach or, like, makes you f- like, clenched in the chest or, like, gives other feelings and sensations, right?

    17. MM

      Yes. There's a whole neuroadrenergic or chemical storm that happens in your body-

    18. LH

      Wow

    19. MM

      ... that gets you ready for fight, flight, or freeze. Now we have to understand that many times that's not helpful, um, in, in terms of when we're in the boardroom or when we're being challenged by somebody. But, but somebody says, you know, even, even if people say like, "Well, fear is good if, like, a, a bear's chasing you," my answer is, "No, fear's not good." You gotta, you gotta remember, like, if it's brown, lay down. If it's black, fight back. You've gotta be thinking. The more fear you have, the less you're gonna think.

    20. LH

      You need to focus more.

    21. MM

      So- exactly.

    22. LH

      Yeah.

    23. MM

      So I think that, uh, the brain has the machinery, uh, t- for, for the mind to do really whatever it wants, and I think that we're just starting to scratch the surface on the capabilities of the mind. And we're seeing... We used to think the brain doesn't really grow as we get older and we lose cells, but the number of connections can increase and increase and increase based upon what, ba- based upon what we're doing, what we're thinking.

    24. LH

      Really?

    25. MM

      Yes. And even learning new skills creates new proteins within the brain and the way the neurotransmitters. So there clearly is the mind's ability to kind of guide the brain's growth. There's definitely, like, some hard wiring there, but the mind can generate brain growth.

    26. LH

      Have you ever studied your own brain?

    27. MM

      I haven't.

    28. LH

      Well, that'd be int- have you ever scanned your own brain or, like-

    29. MM

      I have not. I've never, never, uh-

    30. LH

      That's interesting. I wonder if, like, there's a documentation of a, a brain surgeon who's, like, scanned it every five years and seen, like, their own development. I wonder what that'd be like, but-

  9. 42:17 – 48:23

    A Surgeon's Black Swan Event

    1. MM

      Yes. Actually, um, I had a, a transformational moment, um, um, about maybe four years into my career where I was operating on a gentleman who presented to the hospital with some confusion and some sleepiness, and the, the scan that we got showed that he had a small cyst in the center of his brain that was clogging the fluid pathways. So, uh, I took him to the operating room, and I got the microscope in, and I've got my, uh... These things are like retractors. They're like basically metallic, um, tongue depressors that are separating the brain tissue to get down to where this cyst is. And I bring the microscope in, and I come down. I'm coming right down where this cyst is, and there's no cyst.

    2. LH

      No way.

    3. MM

      There's no cyst.

    4. LH

      Come on. And on the scan-

    5. MM

      I'm looking

    6. LH

      ... the scan, you see the cyst, but when you open it, there's no cyst.

    7. MM

      There's no cyst. I take a step back. Am I operating on the right patient?

    8. LH

      Oh, no.

    9. MM

      Am I operating on the right side?

    10. LH

      Oh, no. And you don't wanna like just dig around inside the brain [laughs]

    11. MM

      No

    12. LH

      ... That's not good.

    13. MM

      That's, that's frowned upon.

    14. LH

      Oh my gosh.

    15. MM

      No. So, uh, I took a step back. I looked at the scan. Could this cyst have disappeared? No, the scan was done two days ago. Um, we're, we're on, w- we're with the-- We're operating on the right patient. We're operating on the right side of the head. Um, okay, so I, I call one of my senior partners. I say, "Can you come in and help me?" He says, "I, I can't. I'm not available."

    16. LH

      No.

    17. MM

      So-

    18. LH

      So you're like, "Uh, I'm not 20 years in. I'm four years in still." It's like, yeah.

    19. MM

      So I, um, I said, "All right. We're gonna take this slow." And actually it's funny, I shared this with Sanjay Gupta, and he said he does this a lot. Uh, I said I, I took the retractor blades out. I took a step back, and I said, "All right. We're gonna go very slowly here. This is Ed, who has a cyst in his brain. This is his scalp. Uh, this is his skull. This is the covering of the brain, the dura. This is the cortex. Okay, I'm gonna put the blades in again." I put the blades in. "Okay, I'm retracting the blades." I put the, open up to the area. I come down a little bit more, and just in the upper left-hand field on the microscope, I saw this little wisp of whiteness. I'm, "Oh, there it is. There it..." So I, I angled up a little bit more. I came up, and what had happened was the cyst was like on a, it was like a cherry on a stem, and it had moved away-

    20. LH

      Ah, so that made-

    21. MM

      ... from where it was supposed to be

    22. LH

      ... everything.

    23. MM

      And it was smaller than my brain had thought it was. I looked at the scan, and my brain thought it was a certain size, but it was actually smaller than that. Second I saw it, a few, a few expletives.

    24. LH

      Ah.

    25. MM

      And then I said, "Got it." 30 minutes later, I took it out, and it was gone, and I was closed. And the thing about that day was I got back into my car, and I thought, "Wow." Like, "The surgeon today is very different than the surgeon who came in in the morning." I didn't think I could get myself out of trouble. I knew I could. Another transformation, another experience where the world was the same, neurosurgery was the same. Everything was the same but me. I was different.

    26. LH

      Wow.

    27. MM

      And so, yes. And could-- Does that still happen sometimes? It can happen sometimes, and that's where I sort of go through my IRIS protocol of identify that there's a black swan happening, reject your first impulse, because it's almost always self-preservation, inventory other opera- op- operatives that... other things that you can do, stabilize, and then reevaluate.

    28. LH

      Mm.

    29. MM

      And so that's my sort of process that I go through when I, when I experience a black swan.

    30. LH

      Wow. So when you're, when you're opening the skull and then going through the brain matter with metal tongs, essentially, you're kind of... You're piercing through all these neurons and connectors, correct?

  10. 48:23 – 54:21

    Daily Habits for Brain Health

    1. MM

      I'll start with we can stop insulting our brains, okay? There are many ways that we insult our brains: alcohol, tobacco, not taking our blood pressure medicines, not having good oral hygiene, um, keeping a, a, a, a healthy exercise regimen to keep blood flowing-

    2. LH

      Mm, mm-hmm

    3. MM

      ... diet. Those are all insults to our nervous system. So, uh, also wearing a helmet when we're skiing, wearing a helmet when we're bicycle riding, um- Avoiding sports that damage the brain, um, striking, head strikes in, in sports. All of those things will dramatically improve brain health.

    4. LH

      Mm.

    5. MM

      So those are actions that people can take. What are some other, um, healthy things they can do? Well, certainly, uh, exercise is great. You know, the exercise s- gives bone strength, gives muscle mass, gives blood flow to the brain. Um, clearly it gets us stimulated, uh, it helps us learn. Exercise helps you learn and remember, uh, what you, what you study. So those are all actions that can be done. As far as thoughts go, I think it's really curating your thoughts and curating your language to, um, to move you to where you wanna go, and identify, uh, thoughts that, uh, that, and habits that hinder us from getting where we wanna go.

    6. LH

      Well-

    7. MM

      So I used to have this one habit after I would... If I got called in for an emergency craniotomy at, in the middle of the night, I'd walk out and there'd be the vending machine on the way out, and I would always be starving. It'd be like 2:00, 3:00 in the morning, and I would get myself two bags of Cheetos.

    8. LH

      Ooh.

    9. MM

      The extra large bag.

    10. LH

      [laughs]

    11. MM

      And they tasted so good in the car.

    12. LH

      So good at 2:00 AM also.

    13. MM

      And I'm like, "You know, you did a good job. You went in. Go have the Cheetos." And, like, and then I finally just said like, "You know, you feel like crap when you wake up in the morning 'cause you're tired, and then you feel more like crap because you're eating two bags of Cheetos, and you're putting some weight on. Like, just don't do that."

    14. LH

      Yeah.

    15. MM

      "Get a glass of water. Get a cup of water and get in your car and go home and go to bed."

    16. LH

      Yeah.

    17. MM

      So, so there are, you know, breaking habits, knowing that you're capable of weakening habits and then breaking them. I love that Epictetus quote, you know. "For habits must first be weakened before they can be destroyed."

    18. LH

      Mm.

    19. MM

      And then as far as thoughts to get a, have a healthy brain, I think that you talked about judgmental, being judgmental of yourself. One of the things I found, especially with Anthony, I was being judgmental of myself. I was saying I wasn't good enough. I was saying I should have picked something up sooner. I should have operated more slickly. I could have retracted on his brain less. Whatever, whatever caused him to have this bad outcome must have been my fault.

    20. LH

      Mm.

    21. MM

      When I became less judgmental of myself 16 years later, I became much j- less judgmental of others.

    22. LH

      Sure.

    23. MM

      And I became a much more effective leader because I, I just, I eliminated... Now, I'm not, I'm not, I haven't eliminated all judgmental from this. When somebody cuts me off on the highway, I'm still wanna...

    24. LH

      Mm.

    25. MM

      Judgment is important. Judgment is good. You know, knowing n- not to cross the street during rush hour, that's judgment. That's important. But judgmentalness, when you have an assessment of somebody-

    26. LH

      Mm

    27. MM

      ... uh, where your affinity, your respect, your admiration for them, uh, uh, di- diminishes, that's not healthy for you, and that's not health- healthy for your brain.

    28. LH

      Really? What is that, when you're judgmental of someone else, how does that affect you and your brain?

    29. MM

      Well, it, it, it reflects that you are judgmental of yourself, too.

    30. LH

      Mm.

  11. 54:21 – 1:03:18

    The 4-Part Fear Framework

    1. LH

      Uh, in your book you talk about this as well. You, you map fear into four types using something you call the fear framework. Can you break down what those four quadrants are and how we can u- uh, understand it so someone can know how to overcome fear as well?

    2. MM

      Sure. So one of the things we're steeped in in this universe is that our current experience is less desirable than our future experience. We're all on a path of going from presently less desirable to future more desirable. And along on that path, what happens is events happen in our lives, and I call those events PHERs, P-H-E-R-E-S. And what that means is these are events that come in and they're unexpected. You know, so I give an example of I'm a medical student and I wanna become a doctor, and along the way- Uh, something drops into my life. Um, a, a teacher becomes, uh, very critical of what I'm doing, and I im- immediately see this person as an obstacle to my attainment of my final medical degree and graduation. Or, um, I have a stroke of good luck, and this event is a tool for me to get to where I am. So we're looking at all these events that come into our lives either as obstacles or tools. When they're-- when they come in, they generate this experience of, "Oh, my gosh, am I gonna be able to succeed in this?" And so we need to dissect that event out, because many times that event can happen, and it can really, uh, impede our performance. It can cause us to have what I call in the book a fear freak-out, where you're like, "Oh, my gosh, what am I gonna do here? What am I-- what am I-- I can't-- I don't see the cyst. What am I gonna do? Uh, everybody's gonna think I'm a bad surgeon. What am I gonna do? What is the patient gonna say? What is the family gonna say? What is the hospital gonna say?" So, uh, we're immediately-- this drops into our life, okay? I've, I've, I've gone to an operation, and now I've-- the thing I was looking for is not here. Okay, that's my fear event that's dropped in. Okay, I need to dissect this. All right. So what I say is we dissect it by what are the objective components of it, and what are the subjective components of it? And you can literally put it on an XY axis, like a De- a, a Cartesian or Descartes formula, okay?

    3. LH

      Mm-hmm.

    4. MM

      So on the X axis is the material objective. Is it objectively positive? Is it objectively negative? On the Y axis, it's subjective. Subjective, is it materially good for-- towards what my goal is in life? Is it materially bad for what I'm doing and what I wanna be in my life? And the X axis is kind of like your left brain. It's the, it's the acquisition, and the Y axis is kind of like your right brain. It's the subjective comprehend.

    5. LH

      Mm-hmm.

    6. MM

      So when we have an event that drops in our life, we have to ask ourselves, is this a tool or an obstacle? Is it positive and negative, subjectively and objectively? Okay, I got a raise. That monetarily is good. Okay, my boss is a real problem.

    7. LH

      Mm-hmm.

    8. MM

      I don't think I can work here. That's subjectively negative. That puts me in the bottom quadrant of the Descartes XY. Okay, that's the calm before the storm. Something's gonna happen.

    9. LH

      Mm.

    10. MM

      Okay? Or I talk about an experience when I had a person that had this facial pain, uh, and they came in, and it was, um, uh, one of the first times I did the entire operation myself during my training, where we had to make an incision behind their ear, drill a hole about the size of a fifty-cent piece, retract the brain, and come down to the nerve that causes the pain and move a blood vessel away from the nerve and put some padding between it. It's called a microvascular decompression, and it relieves the pain. It cures them. And in my training, I, I did the whole operation myself with my teacher just watching.

    11. LH

      Watching. Wow.

    12. MM

      And it was a flow experience, 'cause objectively, I was materially having my boss see me, knowing that I was competent, and subjectively, it was getting me towards my goal. That's the flow quadrant.

    13. LH

      Mm-hmm.

    14. MM

      So flow, and then below that is the calm before the storm. And then if something is objectively negative and subjectively negative, then you're in the negative-negative quadrant of Descartes.

    15. LH

      That's the-- yeah.

    16. MM

      And that's the all is lost situation. And then birthing a new skill set is when objectively on the X axis, you, you, you had something that's monetarily or acquisitionally bad, like you lose your job, so you're not getting paid, but you have free time to create, and that's subjectively positive.

    17. LH

      Mm-hmm.

    18. MM

      And we're constantly going through this quadrant system in our lives. Um, it's the heroic journey that Joseph Campbell talks about. And ideally, we're getting better and better at getting out of these things, because if you learn how to dissect them and break them down-

    19. LH

      Mm

    20. MM

      ... that's the first step towards dismantling fear.

    21. LH

      Yeah.

    22. MM

      And when we dismantle fear, what happens? Love shows up.

    23. LH

      Mm.

    24. MM

      Some people say courage shows up. I say love shows up. If you ask a Congressional Medal of Honor winner why they ran up the hill to that bunker under machine gun fire to kill that guy that was-

    25. LH

      Sure

    26. MM

      ... firing the gun, he doesn't say, "Because I believe in freedom." He says, "Because he was killing my friends."

    27. LH

      Right.

    28. MM

      That's why they do it. That's, that's love.

    29. LH

      Wow.

    30. MM

      It's an act of love.

  12. 1:03:18 – 1:09:55

    Let Go of Others' Opinions

    1. LH

      It's one of the reasons why people never act on their dreams, or they never start their book, or they never ask the person out, is 'cause they're afraid of what other people are gonna think about them. So with the fear of other people's opinions being one of the biggest fears that most people have, what has 25 years of brain surgery taught you about letting go of the opinions of others when there's so much at stake?

    2. MM

      Well, my answer was if you wanna get rid of worrying about other people's opinions, get rid of your own opinions, you know? Um, um, another Epictetus quote, you know. "What, what somebody else thinks of me is none of my business." So I think that, um, as we become less judgmental of others, as we have, uh, you know, l- let go of our opinions of others, we let go of our opinions of ourselves. I think that's the, that's the, that's the path to greatness.

    3. LH

      Hmm.

    4. MM

      It's challenging. Um, I haven't mastered it.

    5. LH

      Hmm.

    6. MM

      I'm a, hopefully an advanced student and imperfect practitioner, but, uh, I think that's the key-

    7. LH

      Yeah

    8. MM

      ... to greatness.

    9. LH

      Yeah. Most people think that skills are built through repetition, but I've heard you talk about skills being built through pressure. What's the difference, and why does it matter?

    10. MM

      Well, I think skills need to be learned from deliberate repetition, and, um, pressure... Uh, uh, you know, I've learned a lot even since I've written this book. I, I would probably say that pressure is, again, something that we need to eliminate from our lives because pressure is what other people think. Pressure is what other people would say. So if I... And I, I will rewrite, uh, uh, uh, this book. I'm working on another one now called Why We Quit, but I, I've learned even from this book that pressure is probably something that's not going to be the most productive thing. Um, having simulations of what needs to be done, I think, is helpful, so you, you know, when you... if you're gonna do a debate, going to the room where the debate-

    11. LH

      Mm-hmm

    12. MM

      ... is gonna be and imagining the people there, all that, I think, is very helpful, um, uh, i- in terms of, uh, teaching somebody a skill. If you can replicate the environment, you know, we see... It's i- interesting when I w- when we work out in the Princeton University wrestling room, sometimes the coach will have the s- the crowd playing really loud to have the wrestlers experience the, the, what it's like to be in a big crowd.

    13. LH

      Yeah, rehearsing what could happen.

    14. MM

      Exactly. I think, I would say rehearsing, uh, deliberately and, and, and multiple times is very helpful, but thinking about pressure, probably not helpful in getting better.

    15. LH

      As a brain surgeon, do you feel pressure, or do you feel something else when you're about to operate?

    16. MM

      Every once in a while, it will creep in. You know, if I'm operating on a celebrity or somebody like that, it will... And then I'll... Again, you have to recognize it. Again, you ha- you, you can't control your thoughts, that it's gonna pop in there.

    17. LH

      Mm-hmm.

    18. MM

      But you can be in charge of them. And so I, I say, "Look, I need to work on this person like they're a clock and like they're a person, and integrate the two of those together. It's a person, and it's a clock. Now get to work."

    19. LH

      Why operate on someone like they're a clock as well? What does that mean?

    20. MM

      Because, you know, this is... Surgery is a mechanical, um, alteration of some pathology that's happened in somebody's body. So you need to go in there, and you need to get the job done, either, um, dredge out a channel-

    21. LH

      Mm-hmm

    22. MM

      ... so that a nerve is free or remove, uh, um, a piece of material that's herniated, and it's pressing on a nerve or take a tumor out. So there's a mechanical part of it, and our bodies are a machine. They... It is very much like a clock. It works in a certain way.

    23. LH

      Mm-hmm. If you have too much emotions tied to it of, like, the mom is crying to me right before, or this is a celebrity, or this is a child, or whatever it might be, and, and their life is at stake, if you have too much of that, it sounds like you probably won't deliver your best if you're thinking of the emotions as well.

    24. MM

      Absolutely correct.

    25. LH

      Really?

    26. MM

      Yes, absolutely correct. So the, the emotion is, um... A- a- and all that kind-... comes before the incision. You know, uh, there's a lot of that. There's a lot of chatter that can go on in your mind before an incision. But once the incision-

    27. LH

      Yeah

    28. MM

      ... you- it's step by step by step, and, um, and then you, you just, you just do what needs to get done. And y- you're still thinking of this person as a person, but, but there's no big operation, there's no small operation.

    29. LH

      Really?

    30. MM

      There's just an operation.

  13. 1:09:55 – 1:15:26

    Operating on Friends & Family

    1. MM

      Again, that was another thing-

    2. LH

      Really?

    3. MM

      ... was another thing that I was taught.

    4. LH

      [laughs]

    5. MM

      I was given conventional wisdom by my grandfather, who was a surgeon, and my uncles, who are surgeons. Never operate on your friends, because-

    6. LH

      What if something goes wrong?

    7. MM

      What if something goes wrong?

    8. LH

      Oh my gosh.

    9. MM

      Okay?

    10. LH

      That's scary.

    11. MM

      So here's the thing, though. What if something goes wrong? Well, who's the person who cares about them-

    12. LH

      You

    13. MM

      ... most-

    14. LH

      Yeah, you

    15. MM

      ... who would do whatever needs to happen-

    16. LH

      Oh

    17. MM

      ... to get it done right?

    18. LH

      That's true.

    19. MM

      So I'm getting a little older now, and a lot of my friends are getting degenerative spine diseases.

    20. LH

      Really?

    21. MM

      And they're, they're needing surgery.

    22. LH

      How many friends have you operated on?

    23. MM

      Mm, probably about 10 or 15.

    24. LH

      Really?

    25. MM

      It's only happened recently.

    26. LH

      Oh my goodness.

    27. MM

      But my, you know, I, my coach helped me. I have a coach, and he helped me. He asked me, he said like, "Wait a minute, you don't, you, you love this person? They're your friend?" That, one of them was my, one of my coaches. "Do you love this coach?" I said, "Yeah." He said, "And you, this is an operation that you can do better than anybody else, or as, as good as anybody else?"

    28. LH

      Oh, yeah.

    29. MM

      I said, "Yes, absolutely." He said-

    30. LH

      [laughs]

  14. 1:15:26 – 1:20:18

    Three Truths & Greatness

    1. LH

      your first day on the job 25 years ago after you graduated, after residency, after all the learning was done in terms of schooling, and now you've officially become a brain surgeon, and you could go back and you could face yourself before that first operation or that first surgery as a doctor, what piece of advice would you give yourself, your younger self now?

    2. MM

      It's great, 'cause I, I, I love this question, and I, I give it to talks to, to neurosurgery departments because I, I give, write a message in a bottle and send it back.

    3. LH

      Uh-huh.

    4. MM

      It re- it really is about outcomes. I mean, you're in a, you're in a performance-based profession. Y- you've chosen something very challenging that has, um, it, it's a, i- in some respects, it's a very unfriendly in- learning environment. And, um, and you're gonna have desirable outcomes and undesirable outcomes. Do the best job that you can. Analyze when things go wrong, and continually focus on getting better, and don't judge yourself by your outcomes.

    5. LH

      Mm.

    6. MM

      That would be it.

    7. LH

      That's great. I've got a couple final questions for you, but I wanna make sure people check out your book. It's called Cognitive Dominance: A Brain Surgeon's Quest to Outthink Fear. Uh, I think everyone's gonna get a lot of great information, a lot of great frameworks from this, and some amazing stories as well from your experience. Wanna make sure people get this book. If you're trying to master fear and overcome fear, um, a great book to, to, to jump in and dive into. You're also the co-founder and president of a nonprofit organization called Trenton Youth Wrestling and Learning Center that provides free wrestling instruction and mentoring for underserved boys and girls in third through eighth grade through your community, which is really cool, and if people are interested in that, they can go to trentonyouthwrestling.org. You're also on social media, uh, mmclaughlinmd on Instagram, LinkedIn, and X. Where else can we follow or support your journey?

    8. MM

      Uh, if, if people are interested in more, my website markmclaughlinmd. Um, I have a cognitive dominance questionnaire and a, a questionnaire about quitting, uh, is, which is a new book that I'm working on, and I have a newsletter that, uh, comes out monthly for anybody to interested.

    9. LH

      Okay, cool, and that's all on your website, right?

    10. MM

      Yes.

    11. LH

      Okay, a couple final questions for you, Dr. Mark. This has been really powerful, so I, I wanna thank you again for being here-

    12. MM

      Thank you

    13. LH

      ... and sharing your, sharing your wisdom, and I acknowledge you for the big heart that you have. I know that working on human beings has gotta be the most sacred thing that anyone can do, so the fact that you care deeply about humans' healing and about sharing this knowledge is such a gift to the world. So I appreciate all that you do.

    14. MM

      Thank you.

    15. LH

      And, um-

    16. MM

      It's a privilege, privilege

    17. LH

      ... yeah, and I'm excited to, uh, get this message out there to people. This is a question I ask everyone towards the end of my conversation. It's called the Three Truths. So it's a hypothetical question. Imagine you get to live as long as you wanna live, and you get to create and accomplish all the things you wanna do in this life, but on the last day far in the future, all of your work has to go with you, the books, the content, this conversation. No one else has access to it in this hypothetical scenario, but on your last day on Earth, you get to leave behind three lessons. I call it the Three Truths. And we would have access to that. What would those three truths be for you?

    18. MM

      It would be gratitude for the past. If you like where you are now, then everything in your life has led you to where you are.

    19. LH

      Mm-hmm.

    20. MM

      So be grateful for it. It would be acceptance of the present. It is what it is. It's not what it's not. It's perfect just the way it is. And lastly, responsibility for the future, not in a blame or a fault-finding, but that you are the cause, the creator, and the source for all your thoughts and who you are and what you do. And if you wanna be less frightened in the world, if you wanna be a better leader, um, and you wanna be more effective, stop denying responsibility.

    21. LH

      Mm. Good truths. And the final question, Dr. Mark, what's your definition of greatness?

    22. MM

      One authentic human connection and contribution at a time.

    23. LH

      Mm. Mark, thank you so much. Appreciate you.

    24. MM

      Thank you.

    25. LH

      Powerful, man.

    26. MM

      So people that fundamentally commit their lives towards any aim, and the word is fundamentally commit, have a chance of knowing how good or extraordinary they can be in any endeavor, and if your endeavor is handball, you have to fundamentally commit. If your endeavor is joy and-

Episode duration: 1:20:18

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