Brain Neuroscientist: Do This Daily To Reduce Your Risk Of Cognitive Decline | Dr. Dan Levitin

Dr. Rangan Chatterjee 0:00 I think we all understand that, you know, certainly in the, in the West at least, we're living longer, generally speaking. Um, but living longer doesn't necessarily mean we're living healthier and happier. And you do talk about that, right at the start that you talk about lifespan versus healthspan.

Dr. Dan Levitin 0:19 Yeah. So, uh, I worked at the Salk Institute for, uh, a while on and off over the years, and the, our former, uh, director, Elizabeth Blackburn, who won the Nobel Prize for discovering telomerase, um, she, she makes this distinction, which I really like. It's, it's obvious what your lifespan is. It's the amount of time you have from when you're born to when you die. But she divides it up into your healthspan and your disease span. And so the basic idea is, for most of us, you're born and you're healthy. You, and you run along with some ups and downs. You get the flu or, you know, maybe you get pneumonia, whatever. Uh, but you're basically running along most of your life healthy, and then somewhere near the end, you get really sick, and that kills you. And there's a lot of research and a lot of talk about extending lifespan, not much about extending healthspan, and it's a quality of life issue. So, um, I think everybody needs to make the choice themselves for whether they'd like to live longer or better, and there are often trade-offs. Um, but the, uh, the idea is that I think we should be talking about maximizing healthspan, minimizing disease span, not just purely trying to increase the number of years you're on the planet.

Dr. Rangan Chatterjee 1:37 Yeah. And I think if you ask most people would they like to live longer, generally speaking, people, I think, often say, "I don't wanna live longer," because they associate old age with pain, with disability, with being immobile, with not being able to do the things that they wanna do in their life. And that's why I think lifespan versus healthspan is so interesting because I think the research n- is now supporting that it is quite possible that you might be able to live to 90 or 100 in really good health. And I guess you're trying to share the science, but also tips in your book on how people can do that.

Dr. Dan Levitin 2:14 Exactly.

Dr. Rangan Chatterjee 2:15 And you, you mentioned genetics, so I just wanna sort of get this established right at the start of this conversation. Are some people just lucky? They're born with good genes, so they're gonna age well, or do all of us have the opportunity to do things that are gonna increase the likelihood that we can also age well?

Dr. Dan Levitin 2:36 Well, all is a strong word. Uh, if you've got a genetic, uh, disease that's, uh, that's, is fatal, uh, if, and it, it comes up early, I mean, there's often nothing you can do about that. But for the vast majority of us, uh, genetics is not a prescription. It's not deterministic. It's probabilistic. It's like, uh, quantum physics. It's, it's a, a statistical tendency that you are, might be prone to cancer or alcoholism or, uh, heart disease or living a long, healthy life. And the choices that we make in three areas, uh, can really... There's a whole lot that's still under our control. Genes make up, depending on the trait or quality you're looking at, they make up between 7 and 50% of the variability in outcomes. That leaves a whopping amount that's under our control, and it's basically things like mindset, um, healthy practices, and then luck. You know, if you, if you get hit by a bus and you get a concussion, no matter how careful you were, that could happen and, and that will change things.

Dr. Rangan Chatterjee 3:44 Yeah.

Dr. Dan Levitin 3:44 I'm curious to know what conversations you have with your patients. As you know, I'm not a medical doctor. I, I'm just a simple country neuroscientist. So do you talk about quality of life, and are there trade-offs in your patients where you have to say, "Well, look, you can do this. You'll-- if you do this, it'll make you live happier but maybe not as long"?

Dr. Rangan Chatterjee 4:06 Yeah. Look, it-- I, I talk with my patients about a whole variety of different things. So, you know, typically, people will be in to see me with a specific problem. So I wouldn't say that many people are coming in well, saying, "Hey, Doc, what can I do to enhance and optimize my longevity?" You do get it a couple of times, but it's not that common. So typically, the attention goes to, what is that person suffering from? Now, my bias is that we overmedicate in medicine. We suppress symptoms a lot, and that often if we are qui- often if we're careful with lifestyle interventions, you can make big changes, not just in terms of prevention, in terms of preventing getting sick, but often when people are sick, it can make a massive improvement in their symptoms. And, you know, sometimes, you know, you can reverse things. But I'm talking about giving patients a sense of agency over how they feel-

Dr. Dan Levitin 5:08 Absolutely

Dr. Rangan Chatterjee 5:09 ... which I think is really important. I think certainly in almost 20 years of practice, I'd have to say that when a patient feels as though they can't do anything, like they've just got this condition and there's nothing they can do about it, I, I, I just see, you know, you don't see that good outcomes there. People feel very disengaged in the process. I always wanna give people a feeling that they can do something about it. Even if it's five minutes of meditation a day, it's gonna help change their perception of it. Um, but often what I do is when I talk to them about those lifestyle changes, I'll also explain what that's gonna do for them long term. So yes, it's about helping them in the short term with their symptoms, but also I'll say, "Well, yeah, but this can also..." Like, you know, sleep, for example. Uh, I spoke to Matthew Walker on, on the podcast maybe a year ago or so.

Dr. Dan Levitin 5:54 He's terrific.

Dr. Rangan Chatterjee 5:54 Yeah. He, absolutely fantastic. And, you know, me and Matthew were talking about some of the research that is suggesting that sleep deprivation, chronic sleep deprivation can be causative in the-

Dr. Dan Levitin 6:05 Oh, absolutely

Dr. Rangan Chatterjee 6:06 ... in the development of Alzheimer's.

Dr. Dan Levitin 6:07 Absolutely. And, and, and, and interestingly, there are many misdiagnosed cases of Alzheimer's where somebody's got memory impairment, and it's, they're simply sleep deprived.

Dr. Rangan Chatterjee 6:16 Yeah, exactly. So if I had a patient who was struggling with their sleep And who also had a family member with Alzheimer's, for example, the conversation could very easily be about the things that they can do in the short term to help. But I might also bring up some of that research and say, "Hey, look, you know, Alzheimer's doesn't just start, you know, the six months before you get it. It's probably been going on for 20 or 30 years in your brain beforehand, and chronic sleep deprivation is one of those factors."

Dr. Dan Levitin 6:43 Yeah.

Dr. Rangan Chatterjee 6:44 "So not only will you feel good in the short term, but you're gonna help insulate yourself from potentially going down the path that your family member did." So I guess that's the context of which I might bring it up. Is that what you were getting at?

Dr. Dan Levitin 6:58 Yeah. That's terrific. Yeah, I'm, I'm, I'm really interested in that, and it sounds, it sounds... I, I agree with you completely. If I were a medical doctor, it would be-- I'd be having the same conversations. Um-

Dr. Rangan Chatterjee 7:08 Yeah, because it's, it's... For me, and I wonder if you subscribe to this, Dan, that it's often the things that we can do day to day that are gonna help us feel good day to day are also the sort of things that are gonna help us age well, right?

Dr. Dan Levitin 7:26 Yes. Well, although, there are some funny exceptions. Uh-

Dr. Rangan Chatterjee 7:29 Yeah. So let's-- What are those exceptions?

Dr. Dan Levitin 7:30 Well, w- my favorite example of an exception is jogging.

Dr. Rangan Chatterjee 7:34 Okay.

Dr. Dan Levitin 7:34 There's, there's dozens of studies now that show that for every hour that you jog, you get an extra hour, uh, of life. So if you're jogging five hours a week, you're gonna get five hours, uh, added on to the end of your life. Uh, it's a pretty robust finding. But if you unpack it a bit, if you step back and you say, "I love jogging," well, that's a good trade-off. You're enjoying it in the moment. If you hate jogging, like I do, I like power walking. I can't stand jogging, um, why would I wanna spend an hour a day now to get an hour a day later at the end of my life when I'm, you know, possibly catatonic and drooling all over myself? It doesn't seem like the right trade-off. I'd rather have the hour now. If, if it was a two-to-one ratio, that'd be different, but it's not.

Dr. Rangan Chatterjee 8:22 So I guess your approach is about giving people information and letting them decide w- what they wanna do with that information.

Dr. Dan Levitin 8:31 Absolutely. In fact, that's, that's my whole, uh, thing, uh, for the-- through the last three books is that I, I wouldn't presume to tell anybody what to do about anything. I feel that my job as a scientist, uh, is to just lay out what I know about the science of various issues, whether it's productivity and creativity, as in The Organized Mind, or the science of trying to sort out what's true and what's not in the newspaper and in Facebook posts, A Field Guide to Lies in Statistics. And here, these are the, these are the trade-offs. These are the choices. You have to decide. It's a very personal thing.

Dr. Rangan Chatterjee 9:09 Yeah. And, and, Dan, it's, it's interesting. You're saying that as a neuroscientist, but I would echo that as a medical doctor. I actually don't believe it's my job to tell anyone what to do. Um, in fact-

Dr. Dan Levitin 9:18 Well, I appreciate that because a lot of doctors are, uh, paternalistic.

Dr. Rangan Chatterjee 9:22 They are, and I, I fundamentally believe that you don't really connect and make long-term changes with someone when you are paternalistic and you tell them what to do. I guess going back to the book, because I do think it's, it's really interesting, and there's quite a few-- there's quite a few things in there that I think people listening to this podcast can start thinking about applying into their own life, which is ultimately, I think, the goal of, of you sharing that information with people. It's, yes, to educate them, but

Dr. Rangan Chatterjee 9:52 it's also to hopefully empower them to think, "Hey, I could start doing that," right? So let's actually go into the sort of granular, the nitty-gritty of what it is. What is the number one thing people can do to help ensure that they age well?

Dr. Dan Levitin 10:07 The number one factor that influences how you're going to fare at any age is a personality trait, um, a mindset, uh, you might call it, of conscientiousness. That swamps all other factors, uh, in terms of whether you're gonna be healthy and, uh, and happy at age eight or age 108. Now, th-think about it. Conscientious kids don't cross against the light, so they're less likely to get hit by a lorry. Uh, conscientious teenagers and adults are less likely to end up in prison because they follow some marginal rules. Conscientious adults go see a doctor when something's wrong. They say, "It hurts here," you know? And, and then, well, conscientious adults have a doctor. And they, um, at least in the US, their insurance payments are, are current, and w- when the doctor tells them to do something, they do it. Conscientiousness, which is a cluster of traits relating to stick-to-it-iveness, reliability, dependability, uh, doing what you'll say you'll do, that's the biggest single factor. And although it's unevenly distributed throughout the population, some people have a lot of it, some people have none, and on the one extreme, if you've got too much of it, it becomes obsessive compulsive disorder, uh, you know, compulsive hand washing or things like that. Um, you can change that as well as any personality trait or mindset quality at any age. It's never too early to start, and it's never too late to start.

Dr. Rangan Chatterjee 11:38 Yeah. And that, that's super interesting because when you talk about personality, 'cause you're basically saying the number one factor that predicts if you're gonna age well is how conscientious you are.

Dr. Dan Levitin 11:47 Yeah.

Dr. Rangan Chatterjee 11:48 And some people will hear that and think, "Oh my God, uh, I'm not that conscientious a person." So that number one factor that Dan said and Dan, that neuroscientist said, I don't have it. But what you're then saying is that you can change your personality.

Dr. Dan Levitin 12:05 Well, you can. The, the whole field of psychotherapy is based on this idea. And although not all psychotherapeutic techniques work for all people, um, you know, there's a bunch of studies coming out, uh, about behavioral change. Uh, just to take one example, cognitive behavioral therapy, uh, has been shown to be better at improving symptoms of depression and lack of conscientiousness, and it This CBT is, is not you just lying on a couch and talking about your childhood and, you know, your mo- the relationship with your mother. It's practical tools that the therapist gives you to help you reach the goals you said that you wanted to reach, sort of like your patients coming to you. CBT doesn't tell you what to do. They tell you how to do it, and it's been shown to be more effective than drugs, even antidepressants. And interestingly, perhaps counterintuitively, CBT alone is more effective than the combination of drugs and CBT. But it's not just therapies. Uh, meditation, yoga, finding inspiration from literature or art or, or somebody that you've read about in the news who has made a change, uh, maybe somebody in your family, and saying, "You know, I'm inspired by that. I'm gonna do that."

Dr. Rangan Chatterjee 13:23 Super interesting, isn't it, that conscientiousness is that number one trait, uh, and that it's something that you can train or work on certainly.

Dr. Dan Levitin 13:31 At any age.

Dr. Rangan Chatterjee 13:31 At any age, which i- which is very encouraging. Now, when you were describing conscientiousness, I was thinking, okay, so someone who's conscientious, uh, they're not gonna... They're gonna wait for the green man to cross the road. They're gonna go and see the doctor when they're sick. Are you talking about someone then who just follows rules? Because I guess, and I, I've read your previous book, uh, and I know you talk a lot about creativity. And, you know, there's so many benefits to being creative and, uh, I guess challenging a lot of the assumptions that are already there in society and actually, you know, sort of navigating your way around that. I- is there a clash there somewhere? Can you be someone who is highly conscientious but is also very creative and willing to challenge things?

Dr. Dan Levitin 14:19 Well, I believe so. Uh-

Dr. Rangan Chatterjee 14:21 Do you see what I'm getting at?

Dr. Dan Levitin 14:22 I do, yeah. I, I th- C- 'cause conscientiousness, although rule following is a part of it, it's not all of it.

Dr. Rangan Chatterjee 14:28 Yeah.

Dr. Dan Levitin 14:28 And there are cases where you really have to not follow a rule. Um, if, um, if you're starving, and, uh, you see a roll... I mean, really starving. You're about to die, and you see a roll left out on a table in a restaurant that hasn't been picked up yet. I would say you're morally and ethically justified to pick up that roll even th- though you didn't pay for it. Uh, there are all these kinds of thought experiments about ethics. Um, I think that if you had the opportunity to murder Hitler, murder is supposed to be against the rules, but, you know, there's a, an argument to be made that that would've been a good thing to do. So a- and these aren't... I'm not talking about creative acts here. I'm talking about more practical ones. But, uh, I think of the people I know. Joni Mitchell's a good example, one of the most creative people I know, and she's very conscientious, uh, although she breaks all kinds of rules with her songwriting and her painting. She's a wonderful painter. Um, the way the conscientiousness shows up is she finishes what she starts. She'll spend months working on a single line of a song to get it just right. That's a kind of stick-to-it-iveness, and, um, she's happy to break rules in songs. For one thing, she doesn't use standard guitar tunings like everybody else does.

Dr. Rangan Chatterjee 15:47 Yeah.

Dr. Dan Levitin 15:47 She invents her own. Interestingly, she... This is not well known, but the reason she did it is because, uh, she had polio as a child. She doesn't have full... I, I can tell you this 'cause you're a guitarist. She doesn't have the full strength of her left fingers to be able to make conventional chords. For the most part, she can only play two strings at once, kind of like Django Reinhardt. So she invents these tunings that allow her to basically take two fingers and move them up and down the neck. I would say that's an interesting case of rule breaking and conscientiousness.

Dr. Rangan Chatterjee 16:20 Yeah. I mean, that, it's super interesting, that. That reminds me of, um, I don't know if you heard of a band called Crowded House?

Dr. Dan Levitin 16:26 For sure. Neil Finn.

Dr. Rangan Chatterjee 16:27 Yeah, Neil Finn.

Dr. Dan Levitin 16:27 Love Crowded House.

Dr. Rangan Chatterjee 16:28 Yeah. They, they were one of my favorite bands in the '90s.

Dr. Dan Levitin 16:30 Oh, me too. Yeah.

Dr. Rangan Chatterjee 16:31 I, I've seen them a few times play.

Dr. Dan Levitin 16:32 Don't Dream It's Over.

Dr. Rangan Chatterjee 16:33 Yeah.

Dr. Dan Levitin 16:34 There is reason within.

Dr. Rangan Chatterjee 16:35 Yeah, exactly.

Dr. Dan Levitin 16:36 There is reason without.

Dr. Rangan Chatterjee 16:38 It's such a great track.

Dr. Dan Levitin 16:39 Yeah.

Dr. Rangan Chatterjee 16:39 Um, uh-

Dr. Dan Levitin 16:40 My friend Mitchell Froom plays the organ on it, the B3 organ.

Dr. Rangan Chatterjee 16:43 Oh, really?

Dr. Dan Levitin 16:44 Da, da, da, da, da.

Dr. Rangan Chatterjee 16:46 Yeah. Yeah. I know it well.

Dr. Dan Levitin 16:47 It's amazing.

Dr. Rangan Chatterjee 16:47 Oh, my. I mean, w- th- this conversation could fast go down a track of music, which I'm gonna go down for a little bit because I'm super interested. The B3 is one of my favorite sounds, I think, out of all musical sounds. I absolutely love it, and when it's just sitting there in the background, it's, it's just beautiful.

Dr. Dan Levitin 17:04 And I think that Mitchell managed to get it as close to the timbre and the sound of, um, um, Booker T.-

Dr. Rangan Chatterjee 17:15 Yeah

Dr. Dan Levitin 17:15 ... uh, Booker T. Jones. Uh, I think he, he managed to get that sound, the, the Booker T. sound, green onions and all that, and it's hard to do. It's, it's all in the draw bars, and it's in the, the micro adjustments you make with touch.

Dr. Rangan Chatterjee 17:28 Yeah. I mean, he-

Dr. Dan Levitin 17:28 I mean, and he nailed it

Dr. Rangan Chatterjee 17:29 ... it, it's... Yeah. I mean, I mean, but, um, and on, on Crowded House, um, what was relevant in my head based upon what we said about Joni Mitchell is that I remember seeing an interview with Neil Finn once, and he s- uh, he s- uh, you know, not verbatim, but he says something like, "You know, we're a four-piece band, so our limitations become our strength." So he was all... From, from certainly my interpretation of what I heard was that we're gonna only record stuff or play live stuff that we can do, the four of us. So we're gonna have to create around that rather than bringing in extra people to be able to play this part or that part or that part.

Dr. Dan Levitin 18:05 It's the opposite of a la- latter day Beatles or Steely Dan approach.

Dr. Rangan Chatterjee 18:08 Yeah. It's-

Dr. Dan Levitin 18:09 They're a live band like you, too.

Dr. Rangan Chatterjee 18:11 Yeah, exactly, and it's, it's fascinating that Joni also, because she's, she's got a limitation that lends, that, that gives her some new creativity because if she didn't have that, maybe she would play in standard tuning, and therefore she might not be as crazy. Who knows? But it's, it's super interesting. But I guess, Dan, we are talking about aging well and the brain, and you've written a book on music and the brain. Um, so I'm interested. Does music ... play a role

Dr. Rangan Chatterjee 18:41 for us in terms of how we're aging?

Dr. Dan Levitin 18:46 Well, um, yes and no. Um, we now believe that 5% of the population are, uh, sorry for a buzzword, but anhedonic for music, meaning they, they don't get pleasure from music. And, you know, this just due to genetic variation or environmental factors, uh, we see anhedonia, failure to receive pleasure, in many domains. Some people don't like chocolate. Some people don't like sex, uh, or being touched. Some people don't like music. But for the rest of us who do, um, there are some interesting connections between music and aging, uh, some of which are well known. Uh, if you've got Alzheimer's or, uh, extreme dementia and you no longer recognize where you are or who your friends are, you don't recognize yourself in a mirror, in many, many cases you still recognize songs from your youth. They're preserved, and this is not just kind of a, um, a cool fact. It's an essential part of adults living with, uh, cognitive impairment in, um, in relaxing them or causing them to be less agitated. Imagine what it's like if you look in the mirror, you don't recognize who it is, you were put in some home or facility after your memory impairment started, so you don't know where you are. Uh, you don't recognize the caregivers who come in every single day. Um, and often we see in these patients, as you well know, a great deal of agitation and, uh, anger. And of course, they're angry. They don't know where they are. But you put on the headphones, the earbuds, whatever, you play them a song from when they were 14 years old, they suddenly reconnect with themselves. There's home. There's something in their memory that they recognize, and that's who I am. This is, this is something I can get a hold of. And we find that in these cases, the, the patients as well as their families are tremendously relieved. Now, that's sort of an extreme case of music. Um, a less extreme case that's not as well known is that older adults who start to learn an instrument, or if they already play a new instrument, that learning is neuroprotective. One of the many myths that I try to bust in The Changing Mind is that, uh, you can't grow new neurons after a certain age or you can't make new neural connections. Neuroplasticity, the buzzword for making new neural connections, new synapses, that goes on your entire life. And the more you can learn, especially new things, the more neuroprotective it is because you're building up neural and cognitive reserves. So-

Dr. Rangan Chatterjee 21:25 That could be anything though, right? You-- Just learning anything, whether it's music or sport or-

Dr. Dan Levitin 21:30 Absolutely

Dr. Rangan Chatterjee 21:31 ... you know, but is it-

Dr. Dan Levitin 21:32 A new language.

Dr. Rangan Chatterjee 21:33 So this sounds like one of the key things we need to be thinking about as we get older is what? Keep trying new things?

Dr. Dan Levitin 21:42 Yeah. And in particular, there's this new appreciation for what we call embodied cognition. Uh, Barbara Tversky and Scott Grafton both have new books out about this. Scott's is called Physical Intelligence. Uh, fantastic books. The idea is that your body actually helps your mind grow through the experiences you have manipulating your body. So learning a new language is neuroprotective, but learning something that involves eye-hand coordination, um, musical instruments being one, not so much singing, but playing an instrument or, or taking up tennis or, or ping-pong or, you know, anything that involves this kind of body intelligence. Very powerful is simply going for a walk on an uneven trail. As you probably know, some Scottish doctors are now writing prescriptions-

Dr. Rangan Chatterjee 22:32 Yeah

Dr. Dan Levitin 22:32 ... for their patients. Go for a walk outside, you know? Uh, it's because as you're walking on an uneven surface, your foot and your ankle and your legs are ma-- and your vestibular system are making dozens of micro adjustments every minute. Uh, you have to change the pressure and the angle, and you have to get feedback about what's happening so you don't fall over, and it's hugely important.

Dr. Rangan Chatterjee 22:56 So would you say that, you know-- would you therefore not be recommending as people age that they work out in a gym, on a treadmill, or on an exercise bike? Or can you do a bit of both?

Dr. Dan Levitin 23:07 Well, you can certainly do a bit of both. Uh, I've-- I mentioned at the beginning of our conversation, I've ch- changed a few things in my own life. One was I didn't know about sarcopenia. How would I? As I say, I, I basically know about stuff from the chin up, uh, and a little bit of spinal cord. But sarcopenia is to muscle what osteoporosis is to bone. And, um, so I've started doing resistance training. I go to the gym. I'm not trying to bulk up like Arnold Schwarzenegger, but I do a round of 20, uh, sorry, 12 different weight machines just to keep my muscles going. I spend about 40 minutes there four, five times a week. Jane Fonda has started-- told me she started doing the same thing. Um, and I-

Dr. Rangan Chatterjee 23:51 Do you enjoy it?

Dr. Dan Levitin 23:52 I do. I do. I can't-- I couldn't tell you why, but I do. And I also do the elliptical because I'm trying to get my heart rate up, and I do what's called high intensity interval training. But better than both of those really is the difference between sedentarism and moving outdoors. If you only do one thing, you should move outdoors. But yeah, adding the others is great.

Dr. Rangan Chatterjee 24:13 Yeah. I mean, that's, that's great because there's a lot of information we're giving people, and sometimes getting too many things to do, too many things that are great to do can sometimes seem a bit overwhelming.

Dr. Dan Levitin 24:26 You have to prioritize. Now, if you're in a wheelchair, get somebody to take you out. The visual stimulation of being in nature is neuroprotective. Not as much as if you're walking, and if you can push your own wheelchair, even better.

Dr. Rangan Chatterjee 24:38 Yeah.

Dr. Dan Levitin 24:38 Or walker.

Dr. Rangan Chatterjee 24:39 Yeah. But then you've- Got a long history in music, haven't you? You're a music producer as well?

Dr. Dan Levitin 24:44 Yes.

Dr. Rangan Chatterjee 24:45 Yeah. And I heard you on an interview recently talk about you had the opportunity to meet Sting once, and you scanned his brain.

Dr. Dan Levitin 24:52 Yeah.

Dr. Rangan Chatterjee 24:52 So I'm interested. You know, Sting, well, I don't know how old Sting is, but-

Dr. Dan Levitin 24:56 He's a few years older than me. I'm 62. I think he's 67-ish.

Dr. Rangan Chatterjee 25:00 Yeah. So look, I haven't seen or pictured Sting for a while, but the last time I saw him, certainly there's no way I would have guessed that he was in his late 60s. He's clearly someone who seems to be aging very well. So Sting has a lot of practices certainly that come across in the media that we read about. How many of those are true, that I don't know. But when you-

Dr. Dan Levitin 25:19 The tantric sex is not true, for example.

Dr. Rangan Chatterjee 25:21 That's ... It's not true?

Dr. Dan Levitin 25:22 No.

Dr. Rangan Chatterjee 25:22 Okay. Um, do you know what he does health-wise?

Dr. Dan Levitin 25:26 I do. I do. Um, uh, Sting had read This Is Your Brain on Music, and he reached out to me at some point in 2007 or '8 and said he wanted to visit the lab and meet me and talk about the findings. And so he came to Montreal and I said, "You know, while you're here, if you want, we can scan your brain and we can, you know, see what it looks like. Um, it wouldn't be an actual s- study. I guess it- it's a case study, but not a proper experiment." Uh, and he was into it. And, uh, you know, we, we found that his corpus callosum is thicker than most people's. That's the fiber tract that connects the left and the right hemisphere, and we often see thicker corpus callosi in people who are very creative, who are shuttling information from the left to the right hemisphere. Um, we learned some things about how he organizes music in his memory that were quite novel. We published a paper about it, Scott Grafton and I, the embodied cognition guy, in a, a journal called Neurocase. It's available for free on my website, as all my peer review papers are.

Dr. Rangan Chatterjee 26:26 Okay. Great.

Dr. Dan Levitin 26:26 Um-

Dr. Rangan Chatterjee 26:27 And we'll link to all of them-

Dr. Dan Levitin 26:28 Sure

Dr. Rangan Chatterjee 26:28 ... as well in the show net section so people can easily find that.

Dr. Dan Levitin 26:31 Uh, I mean, it is a, a r- article written for other scientists, but I think that the average person could glean, uh, the punchline from it. Uh, and then he, uh, we, we kind of got alo- we got a, we got along well, and he invited me to come and tour with him in The Police reunion tour for a few shows.

Dr. Rangan Chatterjee 26:47 You got to be kidding me. [laughs]

Dr. Dan Levitin 26:48 It was terrific. Um-

Dr. Rangan Chatterjee 26:50 Oh, wow

Dr. Dan Levitin 26:50 ... and so I did get to see what his life is like. Uh, he does yoga every afternoon. He has, uh, you know, for at least a couple of hours, sometimes four. He, uh, earmarks alone time apart from the yoga to either practice something musically or learn a new song or, uh, or write something just to experiment around. He gives himself pla- time to play every day when he's on tour. And then the other extraordinary thing was, we were talking about conscientiousness. I've never met anybody with the work ethic that he has. And, uh, you know, I, I, I'm, uh, I'm a, a professor. I know a number of Nobel Prize winners. Most of the professors I know are workaholics. We work 75, 80 hours a week. That's nothing compared to what Sting does. He is working all the time. He enjoys himself, uh, but he- his work ethic, just to give you an example, I asked him, "How is it that you play bass and sing at the same time?" I'm a bass player. That's very difficult to do because-

Dr. Rangan Chatterjee 27:58 Sure

Dr. Dan Levitin 27:58 ... it's not like strumming guitar or finger picking where everything's in sort of lockstep time. Bass parts tend to be syncopated. You're not, you're not always singing when the bass hits a note. You're sometimes-

Dr. Rangan Chatterjee 28:09 Yeah

Dr. Dan Levitin 28:09 ... singing in between notes and in odd inter- integer ratios. Uh, and so just as, as a demonstration of work ethic, I said, "How do you do it?" He says, "Well," he says, "when I know that I'm gonna go out on tour, and I'm gonna have to play these songs that in the studio-"

Dr. Rangan Chatterjee 28:28 Yeah, you can track it differently.

Dr. Dan Levitin 28:29 Yeah. He played the bass first. He sang second or vice versa. If he's gonna have to do it live, so he writes out on a piece of paper the lyrics and the, the chords or the notes, and he writes a kind of visual map for where the vocal note is versus the bass notes. Sometimes they're synchronized. Sometimes they're anti-phase. And then he'll sit down, and he'll practice one measure at about one-fifth the normal tempo, and he might do that for half an hour, that one measure. And then he'll put it away and go to another song, and the next day he'll come back, and he'll add another measure. And he says it could take him six months to work up a tune at the proper tempo. And I thought-

Dr. Rangan Chatterjee 29:13 Wow

Dr. Dan Levitin 29:14 ... "Oh, my God."

Dr. Rangan Chatterjee 29:15 Is, is it a bit like, you know, some ... Uh, again, I'm not trying to compare the two, but just to sort of make it really relevant for people at home who maybe are not musical or don't play the bass and have never tried to play the bass and sing at the same time. You know, like I'm sure it's the same in America, we have the saying where you have to try and, um, pat your stomach and ... Sorry. You know, uh, put your hand around your stomach and pat your head at the same time, which some people find quite hard to do unless you ... But m- I think most people when they focus on it and practice can s-

Dr. Dan Levitin 29:44 Well, it requires what we call limb independence.

Dr. Rangan Chatterjee 29:47 Yeah. So-

Dr. Dan Levitin 29:47 Yeah

Dr. Rangan Chatterjee 29:47 ... is there something similar to that that's going on with Sting when he's trying to just teach him maybe not limb independence, but, you know, voice and hand independence?

Dr. Dan Levitin 29:58 Yeah. And, and we find this in a lot of activities. Flying an airplane requires limb independence. You're using both feet. You're using both hands. Um, one of the things I did in order to, uh, uh, uh, adopt the in- advice that I gave others i- in the book is that I realized I had to push myself out of my comfort zone, and so I took flying lessons and studied for my private pilot's license 'cause it is very complicated. It's not like playing drums. It's a-

Dr. Rangan Chatterjee 30:25 So, so, uh, you're doing this to help you age better.

Dr. Dan Levitin 30:28 I did. Yeah.

Dr. Rangan Chatterjee 30:29 Yeah.

Dr. Dan Levitin 30:29 Uh, and, um, you know-

Dr. Rangan Chatterjee 30:31 Be- because it's a new skill, and it's, it's sort of taxing your brain, your, and your brain's having to fire up different neurons.

Dr. Dan Levitin 30:37 Yeah.

Dr. Rangan Chatterjee 30:37 Is that in a nutshell what it is?

Dr. Dan Levitin 30:39 It's exactly that. It was taxing my brain in ways I hadn't taxed it before.

Dr. Rangan Chatterjee 30:43 Yeah.

Dr. Dan Levitin 30:43 Not only that, but I'm, I'm terribly afraid of heights.

Dr. Rangan Chatterjee 30:46 Yeah.

Dr. Dan Levitin 30:46 And so it was a way for me to get some agency over my own-

Dr. Rangan Chatterjee 30:51 Yeah

Dr. Dan Levitin 30:51 ... uh, feelings in life.

Dr. Rangan Chatterjee 30:52 I mean, I find if we, if we just go back to Sting for a second, what I find really interesting is you started off talking about Sting And saying that he t- he makes sure he does some yoga every afternoon, sometimes for two hours, sometimes for three or four hours. He ensures that he's got some time alone.

Dr. Dan Levitin 31:07 Mm-hmm.

Dr. Rangan Chatterjee 31:08 And then you followed that up by saying he's one of the most, if not the most, productive and conscientious people you've ever had the, had the opportunity to meet.

Dr. Dan Levitin 31:16 Yeah.

Dr. Rangan Chatterjee 31:17 And to a lot of people, that won't make sense. It will be like, hold on a minute. How can he be conscientious and hardworking when he's got time to do yoga in the afternoon, and he's got time to spend an hour by himself each day? Unless, of course, those are things that help him be productive and conscientious.

Dr. Dan Levitin 31:37 Well, it's exactly that. Uh, it's... If, if I don't go to the gym in the morning, um, it, there's always this tension that I, I, like you probably, I'm, oh, I'm way behind in my work. I'll never catch up no matter what I do. And I always feel that if I take 15 minutes off, I'll fall 30 minutes behind. And so when I wake up in the morning, do I go to the gym and, and basically lose 45 minutes? Well, for me anyway, if I do, I gain that back later in the day in terms of productivity. I get more done in an hour of work if I've had that. And Sting must have worked out that these things, um, help keep him on an even emotional keel and help inspire him to, to do his best. You know, the whole Sting story, um, reminds me of something else that maybe your listeners will be interested in. I saw this fantastic magic trick. It was the, um, it was the signature trick of a guy named Glenn Falkenstein, who's passed away, and I saw it several times. And what he does is he goes into a, a, a room, you know, it's usually a, a concert hall or a venue, and, um, he's on the stage and his assistant, uh, puts some, uh, silver dollars over his eyes and then wraps them with, uh, plastic and then puts on, um, some sort of, uh, um, thing to block his, his vision even more. Uh, and, um, then she goes out in the audience, and she asks somebody, um, to, without saying what they're doing, pull something out of their pocket or their purse or off their table and hold it up. Uh, and so I was a, a, I was a participant in this a couple of times. I, I love this trick. Uh, one time I pulled out a credit card, and she says to him, uh, [lips smack] "Okay, uh, you, you know, this person is ready. Do you, do you know what he has?" And, uh, and Glenn says, "Well, it's a credit card." And she says, "Okay. What else can you tell us about it?" And he says, "Well, it's a Visa. It's not a MasterCard or a Diners Club or an Amex." She says, "What else? Uh, can you tell us anything else?" He says, "Well, it's the Chase Bank." And she says, "Okay." Uh, and, um, she says, "And, uh, now I'm wondering if you can read off the numbers, the 16 digits." And he does in groups of four. After each one, she says, "Keep going," or, you know, uh, "That's right. Uh, what's next?" You know, these kinds of things. Um, now I imagined that this was a super high-tech trick, that she's got a hidden camera in her hand, and the reason for all of this stuff around his eye is that he's got some kind of a screen or maybe he's got an earpiece and somebody is, you know, talking into his ear. Um, he can read off the serial number of a dollar bill. People pull out a lipstick. He can tell you it's an Estée Lauder, and it's this color, and it's, it's amazing. And so right before he retired, I asked him how he did the trick. And of course, magicians aren't supposed to tell you, but he had retired. Um, he worked on that trick with his assistant for five years. Everything she says is code. When she says, "This person's ready," that means it's a credit card. She says, "Are you ready to start?" That means it's a bill of some sort. If she says, um, "Okay, let's go," that means it's a piece of silverware. It's the most elaborate code you can imagine, and they memorized it. It took them five years of working on this two hours a day. But in the end, I mean, to me... That, it's a marvel of conscientiousness and, and, and work ethic. But in the end, they had this amazing trick that nobody could figure out.

Dr. Rangan Chatterjee 35:34 I mean, it's incredible to hear that, and it's, it's incredible to hear the capacity of the human brain. Um, it's incredible to hear that story, Sting's story, and just think how hard and how dedicated some people are to mastering their craft. And then I'm always thinking about, how can I bring that back to someone who's out on a run at the moment who's listening to this, who maybe liked the title of the podcast, thought, oh, how I'm gonna age well? And then what can they take from that into their own life? And I guess it's, as you said right at the start, you know, the number one trait that's gonna help you age well is conscientiousness. So I guess, can you finish a task you started? Is that-

Dr. Dan Levitin 36:12 And can you, and can... And not only that, but can you do the best possible job you can? Can you do not just good enough? Can you try to push yourself to do more, to do better? Um, can you, can you grow in whatever it is that you're doing? If it's keeping a garden, um, if it's cooking for yourself and your family, if it's choosing vegetables, learning which ones to choose at the market so you get the most flavorful and healthy ones with the most nutrients. Any area of a human endeavor where you can learn and keep learning is what's neuroprotective. And, um-

Dr. Rangan Chatterjee 36:51 I mean, it's fun

Dr. Dan Levitin 36:53 It is fun. Yeah.

Dr. Rangan Chatterjee 36:54 You know, it-

Dr. Dan Levitin 36:55 It's, it's curiosity really, which is a separate trait. It's number two on the list after conscientiousness.

Dr. Rangan Chatterjee 37:00 Is it really?

Dr. Dan Levitin 37:01 People who are curious do better in life

Dr. Rangan Chatterjee 37:04 So conscientiousness and curiosity, the two Cs-

Dr. Dan Levitin 37:07 Yeah

Dr. Rangan Chatterjee 37:07 ... of aging well.

Dr. Dan Levitin 37:09 Right. And, you know, with this book, like all my other books, the version of it that got published was, uh, roughly, uh, version 52. That is, I wrote the manuscript, I went back over it and rewrote it entirely 52 times. I've never published anything that I, uh, had fewer than 12 revisions on. And those tend to be short articles or scientific papers where it's, uh, you know, there's a formula. But for, you know, for the books or for The New Yorker articles or things like that, it's always 40 or 50 drafts. And I have this friend named Mike Lankford, who is, is I th- the best writer I know. He published a wonderful book that I think you'd like, called Life in Double Time.

Dr. Rangan Chatterjee 37:55 Okay.

Dr. Dan Levitin 37:56 About his, uh, early years as a drummer in a touring band that nobody's ever heard of.

Dr. Rangan Chatterjee 38:02 Oh, wow.

Dr. Dan Levitin 38:02 But it's, it's hilarious and insightful. And then he wrote another book, which is-- both of the-- two of my favorite books of all time. The other one is Becoming Leonardo. It's a biography of da Vinci. It's so much better than Walter Isaacson's, uh, bio, which came out at the same time. And I said to Mike, "Um, your books are so amazing. How many drafts for Becoming Leonardo?" He said, "Seventy-five."

Dr. Rangan Chatterjee 38:32 Yeah.

Dr. Dan Levitin 38:33 He worked on it 10 years. That's a masterpiece. It couldn't be any better. Um, I have much to learn.

Dr. Rangan Chatterjee 38:41 Uh-huh. And I guess all of these stories, whether it's your friends there or yourself, just the act of you writing this book, forget about your other ones for a minute, just this book and doing 52 or so revisions, that is conscientiousness, that is dedication, that is actually, I guess, helping you to age well.

Dr. Dan Levitin 39:00 Well, and it's curiosity. I'm curious to know what I can do to make it better.

Dr. Rangan Chatterjee 39:04 Yeah.

Dr. Dan Levitin 39:04 I'm curious to know if there's a-- uh, you know, after our conversation, I'm gonna go write-- take notes because I get a chance between now and the paperback to do another few revisions.

Dr. Rangan Chatterjee 39:14 Yeah.

Dr. Dan Levitin 39:14 And in stimulating conversations like this, I always think, "Well, there's probably something I can take and change it for the better."

Dr. Rangan Chatterjee 39:22 Yeah. And it's interesting. I mean, as we record this, Dan, I mentioned just before we went on air, my hundredth episode of this podcast has probably gone live whilst we've been chatting.

Dr. Dan Levitin 39:30 Congratulations.

Dr. Rangan Chatterjee 39:31 Yeah. Thank you. It's, uh, it's again something that started off as an idea, um, just over two years ago.

Dr. Dan Levitin 39:37 A hundred?

Dr. Rangan Chatterjee 39:38 Yeah, episode 100 goes out-

Dr. Dan Levitin 39:39 One a week.

Dr. Rangan Chatterjee 39:40 One-- yeah, pretty much one a week. Uh, I have taken August off the last, uh, two years 'cause, you know, for me, I've got two young kids. They're off in August. I wanna just switch off and be able to spend proper quality time with them when they're off school. So, um, you know, I, I've, I've done that the last couple of years. But what's interesting for me is the feedback we get, the way it, it's grown so rapidly. And the fact that people say, "Look, each week it's, it's, there's such varied guests. I'm learning new things. It's making me think about my life in a different way. I can't wait for the next one. I'm really curious for what's coming next." So I guess I'm thinking, or I'm certainly hoping, that actually people who listen to this podcast each week with that curiosity, maybe in some way this is helping them to age well.

Dr. Dan Levitin 40:25 Oh, I hope so. I, I believe so. If, if you can remain curious and learn new things, that's neuroprotective. It doesn't mean that you won't get Alzheimer's or that you can reverse it or slow it down, but it does mean, based on the research, that you may get it and nobody would notice it for years because you've built up this cognitive reserve. Think of it this way. If you go to the gym and you can bench press, uh, 200 kilos, on a bad day, you could still do 50. Uh, I can't, but you've got some muscle reserve. Same thing with the brain. You, you build up this reserve through doing new things, whatever they are. Just to bring this full circle, um, the other, uh, third quality that we can all work on is gratitude.

Dr. Rangan Chatterjee 41:08 Yeah.

Dr. Dan Levitin 41:09 Um, I, as you, as you, as you know, I had the opportunity to meet with the Dalai Lama-

Dr. Rangan Chatterjee 41:15 Yeah

Dr. Dan Levitin 41:15 ... in doing the research for the book, and he meditates on gratitude and compassion two to four hours every day, and he believes the real secret to happiness, not necessarily longevity, but happiness, is to embrace gratitude. If you're happy for what you have, and you're not focused on what you don't have, and feeling slighted or carrying around anger and such, uh, and how come so-and-so has a Tesla and I don't, or, you know, so-and-so got promoted and I didn't, so-and-so's spouse is better looking than mine. All of that stuff, uh, throws our brain into a kind of fear mode. It activates the amygdala. It releases cortisol. But, you know, Warren Buffett agrees-

Dr. Rangan Chatterjee 42:01 Yeah

Dr. Dan Levitin 42:01 ... the idea of experiencing gratitude. My grandmother was a, an immigrant to the United States from Germany, a Holocaust survivor. Uh, she escaped the Nazis, and she had written out on a piece of paper, uh, the things she was grateful for.

Dr. Rangan Chatterjee 42:22 Yeah.

Dr. Dan Levitin 42:22 And she recited them every morning when she woke up and every night before she went to bed. She was not religious, but we were talking about how you could affect change, and we talked about meditation and medication and psychotherapy. Another thing that works is religion. All the world's religions teach you that you can change yourself. You can become more compassionate or generous-

Dr. Rangan Chatterjee 42:43 Yeah

Dr. Dan Levitin 42:43 ... or more tolerant or, uh, express more gratitude. So she had this list, and she told us that every day she woke up, she told me and my, me and my mom, around the time she was 79, that she sang "God Bless America" every morning. "God Bless America," written by another immigrant, by the way, Irving Berlin, another Jewish immigrant, and she felt that it was her purpose to do that. She had to express gratitude that her family was saved. So for her 80th birthday, my mother and I bought her a little $80 electronic keyboard, and I got pieces of masking tape and put them on the keys to play the song, and I put numbers on them-

Dr. Rangan Chatterjee 43:23 Oh, wow

Dr. Dan Levitin 43:24 ... so she'd know what order to play them in, and she loved it. She'd never played an instrument before, so she's going, "One, two, three, four, five, six," you know, [laughs] like this. Uh, and then by the time it was her 81st birthday, she had lifted the masking tape off and was playing it from memory. By her 82nd birthday, she'd worked out a rudimentary harmony with the left hand.

Dr. Rangan Chatterjee 43:48 Oh, wow.

Dr. Dan Levitin 43:49 She kept improving. She did this every single morning and every night before she went to bed until she died at 97, and we found the keyboard on her bed table.

Dr. Rangan Chatterjee 43:59 Wow. You know, it's, it's a, it's an amazing story, that, and I th- if I'm honest, Dan, I'll tell you what pops into my head as you were s- telling me that. Um, my, my mum lives really nearby. She lives by herself since my dad died almost seven years ago. And, um, you know, recently Mum got admitted to hospital literally just about maybe 10 days ago. She had a slip on the side of the bed.

Dr. Dan Levitin 44:21 Oh.

Dr. Rangan Chatterjee 44:21 She couldn't get up herself. She was by herself for seven, eight hours. Um, and she was in for a night. She's come out. I've moved her downstairs. I brought some things down for her, and, you know, helping. I stayed a couple of nights with her, trying to just get her settled into, uh, being back at home. But as you were telling me that story, I thought, you know, Mum's been an amazing singer her whole life. Upstairs, uh, so Mum came over from India. She's a brilliant Indian classical singer. She's got a harmonium upstairs.

Dr. Dan Levitin 44:50 What part of India?

Dr. Rangan Chatterjee 44:51 Uh, Calcutta.

Dr. Dan Levitin 44:52 Oh, yeah.

Dr. Rangan Chatterjee 44:53 So she's got a harmonium, and I'm thinking, Rangan, you should go after this conversation, nip round, get the harmonium, and bring it downstairs and put it in her bedroom.

Dr. Dan Levitin 45:03 Yeah.

Dr. Rangan Chatterjee 45:03 Because ultimately, that's something that gives her joy, gives her pleasure, something she'd be incredibly grateful for, and, uh, I mean, I know we, we're not here to talk about that, but I'm just sort of sharing openly and honestly what that was triggering for me. It's like-

Dr. Dan Levitin 45:17 I love that

Dr. Rangan Chatterjee 45:18 ... I can go and do that literally after this f- after this conversation. I could go and do that, and I wonder what will happen, but I'm pretty sure that will give Mum a sense of meaning and enjoyment and just a, a bit more agency over, oh, you know, this is something I enjoy doing. Do you know what I mean?

Dr. Dan Levitin 45:34 Yeah.

Dr. Rangan Chatterjee 45:34 That's gonna help her age well, right?

Dr. Dan Levitin 45:36 Absolutely. You know, this thing of, about agency is well known in the research community but not so much in care facilities. There was a famous study about this where people in an old folk's home, in inverted quotes, uh, were given a potted plant, and half of them were told, uh, that a staff member would come by and water it and, uh, and trim it, and they didn't need to do anything. The other half were told, "You have to water this, and you have to cut off the leaves. Uh, it's your responsibility." And then they simply waited a couple of years and looked at outcomes. How many people had falls? How many people died? How many people ended up being admitted to the hospital? And, um, the ones who had this sense of responsibility and agency with something as simple and trivial as watering a plant were... did, did twice as well as the ones who didn't.

Dr. Rangan Chatterjee 46:29 That is incredible, and that makes me think for, you know, for some of our elderly population who need help, is there a danger that we sometimes give them too much help? Now-

Dr. Dan Levitin 46:42 Absolutely.

Dr. Rangan Chatterjee 46:43 Because-

Dr. Dan Levitin 46:43 Absolutely

Dr. Rangan Chatterjee 46:44 ... this is something I've been, um... if, if that's... This is literally a, a conversation I had with my mum two mornings ago. I went round to give her breakfast, um, and I actually thought literally five days ago or a week before that, Mum was getting her own breakfast every day. And if I start coming round every morning, or someone does, and start giving her breakfast because I want to help her and care for her, am I potentially conditioning her to needing that care? And actually, I said to... uh, this is exactly what I said. I said, "Mum, I think you can get your own breakfast. I can come and watch you or sit with you whilst you're eating if you want." And actually, the last two mornings she's just gone and done just that. So I think there's something interesting there, isn't there, about our desire to care for people, but sometimes we might be doing them a disservice by doing too much potentially.

Dr. Dan Levitin 47:29 You're absolutely right. It's, it's what's called learned helplessness.

Dr. Rangan Chatterjee 47:32 Yeah.

Dr. Dan Levitin 47:33 Uh, and, um-

Dr. Rangan Chatterjee 47:35 This is interesting. Really interesting.

Dr. Dan Levitin 47:37 Yeah. My aunt, who I write about in the book, my mother's sister, it's a tragic, tragic story. Uh, she had come over from Germany, uh, in 1939, and she married a man who was 15 years older than she. This was back a long time ago. She was, I think, 15, and he was 30. They were from the old country. You did that back then. And he did everything for her. He doted on her, and she never had a checkbook. Uh, she never paid any bills. He made all the decisions for the family, and he pampered her. Well, when he died at age 80 and she was 65, she had no sense of agency, and she very quickly went into a downroad s- downward spiral. And she passed away a month ago at the age of, I think it was 93, having spent from 65 to 93 in a catatonic state. She couldn't communicate. Uh, people were having to do things for her. She, she could not make up her mind about anything because she had learned to be helpless, and no amount of therapy or cajoling could fix it. Uh, it may also be that she was emotionally crushed at losing him. It's-

Dr. Rangan Chatterjee 48:50 Yeah

Dr. Dan Levitin 48:50 ... I'm not... It's hard to say what the factors are. Um- But this, uh, uh, of course, one needs to temper this, uh, allowing people to do things to themselves with reason and prudence.

Dr. Rangan Chatterjee 49:04 Yeah, of course.

Dr. Dan Levitin 49:05 So my grandmother, before we had to put her in a facility, had-- was doing her own cooking, but she would forget to turn the burner off.

Dr. Rangan Chatterjee 49:12 Yeah.

Dr. Dan Levitin 49:12 And she had set fire to the kitchen a couple of times, you know, so... And, and sh- her hands were shaky, and she'd cut herself with a knife, so my mother would go over and cut the vegetables, and then we got her a hot plate with a, a timer on it, so it wouldn't stay on too long.

Dr. Rangan Chatterjee 49:27 Yeah.

Dr. Dan Levitin 49:27 Right? But, you know-

Dr. Rangan Chatterjee 49:29 But there's a balance.

Dr. Dan Levitin 49:29 Yeah.

Dr. Rangan Chatterjee 49:29 And I, I, I'm certainly not at all suggesting that we shouldn't be caring for people and giving them assistance. It's just-

Dr. Dan Levitin 49:34 Right

Dr. Rangan Chatterjee 49:34 ... it's worth us all considering that anyone who is in a caring role, I guess it is worth just considering keeping in the back of your minds, you know, uh, are we doing a little bit too-- You know, are we making sure that they're maintaining independence as much as they can?

Dr. Dan Levitin 49:48 Though there's an interesting overlay here with what I do for a living now, which is that, um, I helped to found a new university in San Francisco called Minerva.

Dr. Rangan Chatterjee 49:59 Right.

Dr. Dan Levitin 49:59 And we run our classrooms very differently than almost any other university program in that our undergraduates, um, we don't teach them anything per se. We don't tell them what books or articles to read. We tell them what questions we're gonna ask in class, and they have to figure out themselves how to teach themselves what they need to know. They work with each other to test their understanding of things, and the teacher becomes kind of a coach or a, um, I guess a conductor. Uh, and they-- because they're helping themselves, we're not giving them everything on a silver platter. They become lifelong learners. They have a sense of agency and curiosity, uh, and, um, responsibility for their own education and knowledge, which has been a huge change in the way people run universities.

Dr. Rangan Chatterjee 50:54 Yeah. I mean, you, you're doing that at a university level. Now, as a father of two young kids, mine are nine and seven, I'm thinking about the education system and thinking, you know, not in every school, of course, but there is a big exam pressure in a lot of schools from a very young age, which is putting a lot of stress on kids. Um, a lot of people are being schooled to do exams, um, so they can get into a certain school. So they're getting trained for the types of questions gonna be asked, how to answer those questions well, so they can a-achieve the right score to get into the right school, and I understand that. But what you're presenting seems to be saying, "Well, hold on a minute. Are we actually potentially doing them a disservice by doing that?" Because if we wanna encourage lifelong learning, lifelong curiosity, is teaching them how to answer things so they get the right mark for that particular paper for that particular school, is that gonna help them in the long term be lifelong learners? A-and, and I, I must be honest, part of me is feeling it's probably not the best thing that we could be doing for them.

Dr. Dan Levitin 52:03 I'm with you. Uh, and you know, I, I won kind of a lottery in terms of genetics and culture and opportunity and family in that I was raised in a household where my parents valued reading and learning, and they taught me to learn at a young age. And my grandfather, who was an MD, starting when I was six, he would bring over these little science experiments that he had gotten in the mail, uh, where I'd learn about magnetism or optics or gears. And, you know, you can tell somebody, uh, to memorize what, you know, if you have a small gear versus a large gear, which one do you wanna turn to move a heavy object? But if you experiment with it yourself-

Dr. Rangan Chatterjee 52:46 Yeah

Dr. Dan Levitin 52:48 ... you, you, you quickly learn it's the large gear. Or, you know, optics, magnetism, all these things. He taught me to taught myself, to teach myself. And I have to say, I, I, I'm, I'm... I, I don't consider myself to be particularly intelligent. I've just had all these great mentors and experiences that unfortunately other people may not have had, and I'm all for figuring out how to give everybody-

Dr. Rangan Chatterjee 53:15 Yeah

Dr. Dan Levitin 53:15 ... these kinds of experiences.

Dr. Rangan Chatterjee 53:17 Yeah. Dan, I would, I would absolutely echo that myself. And it's a, it's a theme that's come up before on this podcast is this whole idea of, you know, often what we're exposed to as kids is what we deem is possible in the world, what we think we might be able to achieve. You know, I've said before that, you know, I was surrounded by doctors. My dad was a doctor. All my mom and dad's friends were doctors. There was at least one doctor in that family. And so I grew up around that, so I don't think it's any huge credit to me that I actually went to medical school and became a doctor because that was my norm. And I've become acutely aware of this. You know, I've worked in some very deprived areas of the country, uh, as a doctor. Um, when I was making this BBC documentary series called Doctor in the House, I went and lived alongside people all over the country with very different, um, you know, in, in very different areas from where I live. And yeah, I, I really would, would see that actually depending on where you live, depending on what you're exposed to, that absolutely plays a huge role in determining where you end up in life. Of course, it's not like a... It's not, it's not definitive. You can absolutely break out of that. You know, you can have people with great upbringings and great opportunities who can-

Dr. Dan Levitin 54:28 And they become serial killers.

Dr. Rangan Chatterjee 54:29 Yeah. Or they don't take advantage of it, and they flunk out or for whatever reason or, and vice versa. People can break out of poverty, let's say, and go and achieve amazing things, so.

Dr. Dan Levitin 54:38 Well, that's the, that's the interesting thing. At Minerva, we decided that-- I mean, we realized that intellect and ability is not confined to the wealthy. And so our-

Dr. Rangan Chatterjee 54:48 Yeah

Dr. Dan Levitin 54:48 ... policy is to admit anybody who, uh, meets our requirements, and we pay 100% of their tuition and living expenses if they can't afford to or their families can't afford to. And one of my favorite stories about a Minerva student is a girl, well, a woman now, who came from rural China. Uh, her parents, uh- It was the one child per family law, and her parents did not want a girl, and they let her know from the very beginning that she was not wanted. Uh, they were farmers. They, uh, they didn't have access to anything like a good education. Uh, but she somehow had the bug to read and learn, and she managed by the time she was in, uh, secondary school, uh, to get to a, a, you know... I think she had to take a, a mule or something to this school that was 20 miles away every day. Was-- Nobody from her village was going there except she. And then she got admitted to Minerva, and she graduated, uh, last year and now has a job at, um, o-one of the big, uh, creative companies in the US. Uh, the, um... She's working for, um, Uber.

Dr. Rangan Chatterjee 56:08 Oh.

Dr. Dan Levitin 56:08 And she had done internships at Google. I mean, that-

Dr. Rangan Chatterjee 56:10 Wow

Dr. Dan Levitin 56:11 ... that's somebody who rewrote the course of her life through these kinds of things we're talking about, generally mindset. It's not conscientiousness. It's not curiosity. It's another factor that I call resilience. It's the ability to, um, make lemonade when you get lemons, to, to not feel easily defeated.

Dr. Rangan Chatterjee 56:32 I mean, that really is an incredible story. Um, yeah, where does that come from? Where is that, um, desire, that resilience that you, you just mentioned that's such an important trait? Look, Dan, we, we've spoken about all kinds of different things. There's all kinds of stories. We've, we've touched on some music, but there's some really concrete things so far that people can think about. Conscientiousness, uh, mindset, l- you know, trying new things, getting outside and being active as much as possible. You mentioned resilience there, which I think is super important. And I have-- I've highlighted, um, this little passage in your book which I just loved. I mean, I think one of the reasons I love your work so much, A, it's brilliant. Uh, B, it's very consistent also with the things that I've been writing about as well. There's, there's a lot of similar themes.

Dr. Dan Levitin 57:20 There is. We have a similar outlook.

Dr. Rangan Chatterjee 57:22 Yeah, which of course, you know, my bias is, of course I'm gonna like that because it's helped support the narrative that I'm saying. Um, but I've really liked, uh, these four lines. "Reducing stress and increasing resilience, the ability to bounce back from adversity can be coached and taught through specialized psychotherapy, strengthening of social networks, physical exercise, and programs that help people find meaningful and purposeful activities in their lives." I absolutely love that because it just encompasses so much of what I also stand for. Um, and I think it's inspiring for people to listen to because, you know, you can, you can coa-- you can, you can increase your ability to be resilient.

Dr. Dan Levitin 58:05 Yes.

Dr. Rangan Chatterjee 58:05 So someone listening to this might be thinking, "I'm not that resilient," or, "I get battered down." No, no, hold on a minute. You can change that, right?

Dr. Dan Levitin 58:11 Right.

Dr. Rangan Chatterjee 58:11 And that's what we're trying to say. Doesn't matter how old you are, doesn't matter where you are in life, you can change that. So a few things we've not covered yet, which I'd really love, uh, to discuss with you are... Well, in that you mentioned social networks, strengthening of social networks. Now, this is something, again, I, I've, I've, I've touched on in many conversations on this podcast before. But why are social networks so important?

Dr. Dan Levitin 58:36 Well, uh, there's-- I have a lot to say about this, but I'll, um, try to say less. Um, what you and I are doing right now, Rangan, is the most complicated thing for the brain that we know of, having a conversation with somebody you don't know. It activates more regions of the brain than anything else that we know of. Um, it's re-requires turn-taking. Uh, we can't be both talking at once. Uh, it requires, uh, empathy and compassion. I have to read your body language, so if you say to me, "That's interesting," and you're looking right in the eye, that's different than if you say, "That's interesting," and you roll your eyes on the top of your head. I've gotta be keeping track of all these signals. Um, it... Talking to somebody on the phone or through texting or through social networking is not the same. Actually talking to somebody is very, very important. Um, and, you know, we talk about changing your life and, uh, becoming more resilient or m-more of anything that you want. Many of us, uh, don't need psychotherapy or meditation or drugs. We need it, uh, simply to have friends and family who are spurring us on. And, uh, you know, my wife will say to me every once in a while, "You haven't been to the gym in a couple of days." And I, I don't feel like she's nagging me. We sh- we don't have that kind of relationship. But she's spurring me on, um, helping me to remember the things that I wanna do, and I hope I do the same for her. Social support networks. The other thing is that, um, one of the biggest killers in old age is loneliness, which is not the same as solitude, because you can feel lonely in a crowded room, and you can feel not lonely when you're by yourself. But loneliness, uh, is, uh, the biggest predictor of, of fatalities.

Dr. Rangan Chatterjee 1:00:35 Yeah.

Dr. Dan Levitin 1:00:36 And an interesting way to not get lonely is perhaps counterintuitive. It's to have what Barb Fredrickson from Stanford, uh, now at University of, uh, North Carolina. Uh, she and I were Stanford students together. Again, y- serendipity. I had this great education, and I learned about her work back then. She finds that micro communications, just conversations with people on a bus or in the checkout line at the store, just a little 15-second, "Hi, how are you? How, how, how's the weather? I see you bought these, uh, new cookies. Uh, I've never tried them. Do you like them?" Having a few of these micro conversations-

Dr. Rangan Chatterjee 1:01:14 Yeah

Dr. Dan Levitin 1:01:14 ... throughout the day is a real cure for loneliness, even for people who say, "I could never do that."

Dr. Rangan Chatterjee 1:01:20 Yeah. No, I, I love that. And, and this whole thing about loneliness, I mean, you mentioned the elderly. It's, you know, the, the... If you look at the research in the UK, yes, the elderly, loneliness is a big problem. Men between the age of 30 and 45 in this country are one of the loneliest groups in society, which absolutely is a, a big contributing factor to the growing tide of mental health problems in that age group and the growing rates of suicide. And I, I, I sort of can't help thinking about the digital world is in some way, for all its benefits, is contributing to this problem. And you mentioned that, that digital communication is not the same as human connection. Do you know why that is?

Dr. Dan Levitin 1:01:59 No. We don't know why it is, but it keeps showing up.

Dr. Rangan Chatterjee 1:02:02 Yeah.

Dr. Dan Levitin 1:02:03 Um, I th- it may have to do with attention. Um, I d- I don't know of any work on the blind, uh, or the deaf, which is, uh... which would be helpful to have if to sort this out. But if you and I are in the same room, I can tell whether you're checking Facebook on the side-

Dr. Rangan Chatterjee 1:02:21 Yeah

Dr. Dan Levitin 1:02:21 ... or if you're texting somebody. Uh, and, you know, if we're just, um, communicating digitally in some fashion, it's different. There's different requirements.

Dr. Rangan Chatterjee 1:02:32 Yeah. That non-verbal communication, I mean, I, I don't... Depending on which stat you read, and you may know the, uh, you know, some more current research than me, but, uh, something like 60, 70% of communication is non-verbal.

Dr. Dan Levitin 1:02:43 Right. Right.

Dr. Rangan Chatterjee 1:02:44 So it's, it's all that body language-

Dr. Dan Levitin 1:02:47 Yeah

Dr. Rangan Chatterjee 1:02:47 ... um, that obviously you can't pick up over a computer or over your phone. Um, and I love that thing about micro communication. It's something I've written about, uh, quite a lot. And in m- in my latest book, which is all about five-minute things that people can do, um, there's a section all on heart, what I call heart, which is not really about the physical structure of the heart. It's about human connection.

Dr. Dan Levitin 1:03:09 Yes.

Dr. Rangan Chatterjee 1:03:09 And I... There's so many suggestions I make, but one of them is, look, if you're... If, if you drink coffee every day and you go to a café and pick it up and you, you're in a rush and you get it in a takeaway, okay, if you have to get it in a takeaway, say something nice to the barista. You know, just say, "Hey, I really appreciate that" or, or, you know, "Hey, the latte you made me yesterday was amazing. I hope this one's as good today," or whatever. It's amazing. When you strike up this little micro... What, what did you call it? Micro communications.

Dr. Dan Levitin 1:03:36 Yeah. Micro contacts, whatever.

Dr. Rangan Chatterjee 1:03:38 I've always liked doing things like that. And, you know, if you, if you work at... Like, sometimes if I'm getting an early train to London, I'm up early. Sometimes I'm feeling a bit tired, and you, you grab a drink on the way and you do that. You, you, you feel different, right? It change... You've had a p- a bit of meaningful human interaction, and it changes the way you feel. You don't feel quite as insular or stuck inside your heads.

Dr. Dan Levitin 1:04:00 Right. In, in a big city, um, like Manchester or London or any big city, um, generally our experience is we see all these people, and we don't know any of them.

Dr. Rangan Chatterjee 1:04:10 Yeah.

Dr. Dan Levitin 1:04:10 And we feel like we're on the outs. We're not part of the fabric of this community. Uh, and so just having a couple of quick conversations with somebody in the street, you now feel like you're an insider. You're, you're, you-

Dr. Rangan Chatterjee 1:04:23 Yeah

Dr. Dan Levitin 1:04:23 ... you're part of the community. And people who know the names of their neighbors and chat with them a few times a week are happier than people who don't. Now, people always say, "Well, I could never do that. I'm too shy," or, "I'm too nervous," or, "People won't like me," or, you know.

Dr. Rangan Chatterjee 1:04:37 Yeah.

Dr. Dan Levitin 1:04:37 But what we find is that if they can get over that, could be through therapy or just willpower or inspiration or going out with a friend and letting the friend start the talking and then you ease yourself into it, uh, that makes a huge difference.

Dr. Rangan Chatterjee 1:04:54 Yeah. Yeah. Absolutely. And I think once people get over that hump and start, it's actually a lot easier than you think.

Dr. Dan Levitin 1:05:01 Yeah.

Dr. Rangan Chatterjee 1:05:01 You know? 'Cause w- we're wired for that social connection. The, the other human you interact with also is highly likely to want and crave that human interaction as well. 'Cause we're all walking around, you know, pretty lonely, c- certainly compared to how we used to be as a society. Of course, there's individual differences, and I think once you start, you find actually people want that. They, they really do. So I think that's another key takeaway for people. Social connections are important. I want to also talk to you about memory, and I think there's a certain societal

Dr. Rangan Chatterjee 1:05:32 narrative, which I know you're keen to challenge, about what happens as we get older. You know, is it true that our memory declines as we get older?

Dr. Dan Levitin 1:05:44 Well, you know, I think that globally, the, the societal narrative is that after you're born, you begin acquiring skills and abilities. You know, when you're an infant, you begin to learn to talk, and then when you're a toddler, you begin to crawl and walk, and, um, you learn to share when you're a young child. And y- you know, it's, it's a matter... You go to university or trade school, and you pick up a bunch of skills. Uh, and the idea is that you keep adding and adding, and then at some point you start to fall off a precipice. Maybe it's 50, 60, 70, but, you know, depending on your own, um, story that you hold in your head, that aging is accompanied by inevitable decline, and that's not true. Uh, the, the brain does slow down. It can take longer to solve problems or retrieve a word, but there's no evidence that most of us will experience a real memory deficit. Now, of course, memory deficit is a hallmark of Alzheimer's, but Alzheimer's is rarer than we appreciate or realize. Um, you can go through your 80s and 90s with no, with no memory decrement, um, apart from the fact that it might take you a little while longer to retrieve a memory. But if it was a memory impairment, you'd never get it. It would be lost. It just takes a little longer because of demyelination and other factors.

Dr. Rangan Chatterjee 1:07:03 So why is it then that so many of us think and take as fact that our memory declines as we get older?

Dr. Dan Levitin 1:07:12 Well, I, I don't know. I think- Um, part of it is that the story was developed for the way we lived maybe 40 years ago. We're living longer and healthier than ever before. When my grandfather was 65 in 1966, he wasn't particularly healthy. Uh-

Dr. Rangan Chatterjee 1:07:31 Right

Dr. Dan Levitin 1:07:31 ... a 65-year-old today is, in general, much healthier. Uh, he had ma- um, he, everybody he knew, he was a doctor, they all smoked. Uh, I mean, in fact, you know, at least in the US, there were ads that doctors would s- recommend smoking-

Dr. Rangan Chatterjee 1:07:46 Yeah

Dr. Dan Levitin 1:07:46 ... that they were good for your brain, you know?

Dr. Rangan Chatterjee 1:07:49 It's just, it is so crazy to think of that now, isn't it? I mean-

Dr. Dan Levitin 1:07:52 Yeah

Dr. Rangan Chatterjee 1:07:52 ... that wasn't that long ago, really.

Dr. Dan Levitin 1:07:54 No, it wasn't. Um, and I think that, you know, the way that older adults are portrayed in, um, in movies and in jokes is that they're doddering and that they are losing their memories and-

Dr. Rangan Chatterjee 1:08:06 It, it almost becomes a self-fulfilling prophecy, doesn't it? In the sense that if that's what the movies are telling you and that's what media's telling you, and then let's say you're in your late 40s or early 50s and you forget something, you then will say to yourself, won't you, "Oh, that's 'cause I'm getting older." And it almost is reinforcing that belief, and is that part of the problem? Like, rather than actually, I think there's an example you use either in the book or in an interview I've heard you say before that we just create a different narrative around it when we're older.

Dr. Dan Levitin 1:08:38 Yeah. So I, you know, I, I, I teach college students, and 19-year-olds are, uh, very forgetful. They lose their cell phones and their keys. They forget their computer passwords. This happens to 79-year-olds, too. Uh, but the story's different. When a 19-year-old, you know, has one of these memory lapses, lost my cell phone, can't find it, they just say, "Oh, I, I've gotta get more sleep," or, uh, "I've got too much on my plate." The 79-year-old or even 59-year-old says, "It's Alzheimer's. I know it. Thing, it's, it's downhill from here." Part of the problem is that, um, if you forget something and you, uh, obsess about it or stress about it, that's gonna release cortisol and adrenaline, which are gonna shut your memory down, and they make it even worse. So if you're trying to find a word, and you're just beating yourself up and say, "Oh, I, I have it here. It's, you know," uh, that's the worst thing you can do. It's better to let go. Now, we, we do know that when older adults have this memory lapse or delay in getting a word or a name, it's not actually the concept that they've forgotten. It's what's called the, um, the phonological word form, that peculiar set of vowels and consonants that represent the word. That's what you lose, and there's a very particular area of the brain that, um, is a little bit decremented as we get older. So, um, you might know that you're thinking of a flower, and you can picture it, and you know its use, but you can't get the name gladiola, but sooner or later you'll get it. It's that, and you might even know it starts with G. It's, uh, four syllables. I mean, we've had this tip-of-the-tongue kind of a phenomenon. Uh, but the, uh, the proof that it's not really a memory deficit per se is that you get it eventually and, and, you know, just don't stress out about it. Let it, let it go.

Dr. Rangan Chatterjee 1:10:32 I mean, can we train that to be better? Let's say we, we're thinking of that flower. We can't think of gladiola. Is there something we can do to make it more likely that we can think of the word?

Dr. Dan Levitin 1:10:43 Uh, w- we don't know, uh, other than just letting go, uh-

Dr. Rangan Chatterjee 1:10:47 Yeah

Dr. Dan Levitin 1:10:47 ... and, and moving on. It's not that, most of the time it's not that important that you get exactly the right word.

Dr. Rangan Chatterjee 1:10:52 Yeah. And I think that's important, isn't it? That whole idea that, that really circles back to something you said right at the start of this conversation about, um, you know, as long as you... I think you said something about diet. You don't, don't stress about it too much. And you're saying now when you stress about it and you release cortisol, cortisol in itself when, you know, too much of it for too long a period of time will be detrimental to your memory. So chronic stress is detrimental to your brain, right?

Dr. Dan Levitin 1:11:19 Absolutely. It's, it's, it's an, um, I mean, we've been listing big killers. Chronic stress, uh, is, is a huge killer. Uh-

Dr. Rangan Chatterjee 1:11:26 Yeah

Dr. Dan Levitin 1:11:26 ... um, the, the fact is, though, you do need a little bit of stress.

Dr. Rangan Chatterjee 1:11:31 Yeah.

Dr. Dan Levitin 1:11:32 Um, stress is actually neuroprotective, and it kickstarts the immune system. Um, the, this is why I say, you know, if you, if you retire from something, you should retire to something else. You need the modicum of stress that requires you to get up out of bed in the morning and groom yourself and go be with other people and make some work product that's got a deadline. All these things are important as long as they're not stressing you out completely. Uh, without that small amount of stress, we often see a, a great decline in mental and physical health. But yes, chronic is, it's like with everything in the body. There's this Goldilocks zone.

Dr. Rangan Chatterjee 1:12:14 Yeah.

Dr. Dan Levitin 1:12:15 You, you know, too little is no good. Too much is no good. You've gotta come right-

Dr. Rangan Chatterjee 1:12:19 Yeah

Dr. Dan Levitin 1:12:19 ... just right in the middle.

Dr. Rangan Chatterjee 1:12:19 You know what? I, I teach, um, a course I created with, with, uh, some colleagues of mine called Prescribing Lifestyle Medicine, a credited course that we teach to, you know, GPs and specialists and other healthcare professionals about the science of various lifestyle factors and how we can use them to help our patients. And I, I show this graph, uh, I think it's from a 2015 journal. I can't remember the name. The Learning Memory. I, I can't remember the name of the journal, but again-

Dr. Dan Levitin 1:12:46 Well, there is a, a Journal of Learning and Memory-

Dr. Rangan Chatterjee 1:12:48 I think it, I think-

Dr. Dan Levitin 1:12:48 ... is one of our big journals

Dr. Rangan Chatterjee 1:12:49 ... I think it's that one. And there's this beautiful graph showing stress' impact on the brain and how, again, it's that, you know, you start off, little, uh, stress increases. Your brain function is improved. Um, but then you start to get diminishing returns, and then it, it starts to become detrimental. And we know that, you know, chronic stress, you know, kills nerve cells in the hippocampus, the memory center of the brain. So as you say, it is that Goldilocks zone. You need enough to get you engaged in life, but not so much that you're worrying about every little thing. I think you, you, you actually mention in the book, don't you, people who ruminate a lot, that go over and over things and worry and, and, um, become anxious about it. You're saying that actually makes your body awash with those stress hormones that can actually be detrimental to aging well.

Dr. Dan Levitin 1:13:39 Yes. That's exactly right.

Dr. Rangan Chatterjee 1:13:40 Yeah. I mean, super, super interesting. I mean-

Dr. Dan Levitin 1:13:43 And, and, and the, um, the stress hormones not only, uh, damage cells in the hippocampus, they damage your microbiota in the gut. They get it out of balance, and you know, your microbiome is, is creating 95% of the serotonin that ends up in your brain and doing all other kinds of things in terms of immune function

Dr. Rangan Chatterjee 1:14:03 Yeah. I mean, it's incredible. Um, I mean, Dan, there is so much that we could talk about. Going back to, before, before we close it off, um, with some really practical tips for people, um, you know, one thing I, I really was absorbed with in your book was the, was the stuff on pain. And I think you quote a statistic saying that pain is the source of 80% of doctor visits in the US or something like that-

Dr. Dan Levitin 1:14:33 Yeah, yeah

Dr. Rangan Chatterjee 1:14:34 ... which, which was really staggering.

Dr. Dan Levitin 1:14:36 And it's interesting also that the way we treat pain today is basically the same way we've treated it for 2,000 years, with the bark of a tree, aspirin, or its, its synthetic equivalents, or the seed of a poppy-

Dr. Rangan Chatterjee 1:14:49 Yeah

Dr. Dan Levitin 1:14:49 ... opiates and their synthetic equivalents. We, we have not made advances in 2,000 years.

Dr. Rangan Chatterjee 1:14:55 Well, I wonder if that's 'cause we're looking at it maybe through the wrong lens. And what I mean by that is, um, you say in your book that pain... And, uh, and why this is so important is we're talking about healthspan versus lifespan. Sure, you can live to 100, but if your last 10 years are in chronic pain, you know, that is gonna influence the quality of your life and how much enjoyment you get and what you're gonna get out of that life. And you say that pain is influenced by cultural, environmental, historical, and cognitive factors.

Dr. Dan Levitin 1:15:24 Isn't that interesting?

Dr. Rangan Chatterjee 1:15:25 Yes.

Dr. Dan Levitin 1:15:25 So in the US, doctors all know, especially ER doctors, uh, emergency room doctors, uh, you call them something else here, I think.

Dr. Rangan Chatterjee 1:15:32 Yeah. Well, A&E or-

Dr. Dan Levitin 1:15:33 A&E

Dr. Rangan Chatterjee 1:15:33 ... emergency departments.

Dr. Dan Levitin 1:15:35 Yeah. All of them know that if you're a member of a certain cultural or, uh, ethnic group, on the standard pain scale of one to 10, if you say that, that your pain is three, and you remember this particular group, they prepare the operating table. These are people who, uh, are not, um, accustomed to expressing pain. We- you know, zero is no pain, 10 is a lot of pain. If they say three, it's time to prep the operating room. There are other people who they'll say they have a nine, and it means you can, you know, just let them sit in the waiting room for a few hours.

Dr. Rangan Chatterjee 1:16:06 Yeah.

Dr. Dan Levitin 1:16:07 There are these different ways we have of being in the world that are cultural.

Dr. Rangan Chatterjee 1:16:12 And, and I guess in many levels, pain... Well, not many levels. Pain is subjective, right? So-

Dr. Dan Levitin 1:16:17 Oh, it's absolutely that. Yeah

Dr. Rangan Chatterjee 1:16:18 So, so therefore, if we're using a subjective scale, naught to 10, to tell the doctor in front of us or the healthcare professional how much pain we're in, of course my three may be different from your three.

Dr. Dan Levitin 1:16:29 Uh, absolutely. And, you know, a- and, and it, it's, it's a matter of, uh, context. So if I'm hiking and I've got a rock in my shoe and it keeps pressing on this part of my foot, I'm really annoyed, and I'll, I'll stop and take the rock out. Uh, but I might pay 40 quid to go to a massage therapist to press on exactly that part of my foot.

Dr. Rangan Chatterjee 1:16:48 And give you the same level of pain. So it could be at, let's say, a seven with a rock. It could be a seven with a, with a, with a vigorous and strong massage. But you, you will interpret that differently, won't you? "Oh, this is good for me because there's tension here that the massage therapist is releasing," as opposed to, "Oh, something's there." And I guess in a nutshell, and we could do two hours on just pain alone, it's, it's that complex because there is... It's very clear now, isn't it? It's, it's not just [laughs] it's certainly not just mechanical at all. There are emotional, uh, stress, psychosocial components-

Dr. Dan Levitin 1:17:20 Absolutely

Dr. Rangan Chatterjee 1:17:20 ... to do with pain, which makes it very challenging to treat, um, for some people. But it's interesting. At quite a lot of my talks, um, both for doctors and the public, I've had chronic pain consultants come along, and I've often had chats with them afterwards, and they've said to me, you know, "Rangan, we really like, um, a lot of your work and a lot of the books because we can use these tools with our patients with chronic pain. 'Cause ultimately we realize that the medications, often they don't work." Um, we-- Sometimes they do, of course, as well, but it's really fascinating, this whole idea of pain. Um, you know, how come you wrote a chapter on pain?

Dr. Dan Levitin 1:17:54 Well, um, again, I think part of it was that, um, a lot of what we know about pain hasn't trickled down to the average person.

Dr. Rangan Chatterjee 1:18:03 Yeah.

Dr. Dan Levitin 1:18:03 A lot of it came out of McGill, where I, uh, ran a lab for 20 years.

Dr. Rangan Chatterjee 1:18:07 Yeah.

Dr. Dan Levitin 1:18:08 From Ron Melzack. And in fact, I include the Melzack Pain Scale in the book because if people can refer to it before they go to see their doctor or go to the A&E, um, they're using the terms that doctors might be expecting them to use. Uh, for example, is the pain stabbing or is it dull? Is it-

Dr. Rangan Chatterjee 1:18:27 Yeah

Dr. Dan Levitin 1:18:28 ... uh, focused, or is it, um, is it based on pressure or based on, uh, on laceration? These kinds of things. But the other reason I wrote about it is that, again, part of this m- societal narrative is that as we age, we're gonna be miserable and in pain. And actually, the available evidence is that, yes, we do get aches and pains, and they get worse and worse, and then they start getting better. There's a point of inflection. It depends on the person. But around 75 or 80, our, our, the aches and pains somehow disappear for many of us or become manageable.

Dr. Rangan Chatterjee 1:19:05 Yeah. And that's, that's a very optimistic note, um, which is a, it's a great way to start ending this conversation that I've really, really enjoyed, and I wish we did have another two hours.

Dr. Dan Levitin 1:19:15 Me too.

Dr. Rangan Chatterjee 1:19:16 Um, you mentioned, I think, another, another very exciting statistic is that 82 is the happiest age statistically. That's what I read in your book.

Dr. Dan Levitin 1:19:25 Yeah.

Dr. Rangan Chatterjee 1:19:25 Incredible. I mean, so that gives us, for anyone who's listening to this podcast or watching on YouTube right now who is under the age of 82, which is probably many, if-- the majority certainly I wo- I would guess. Um, that's pretty exciting. It means our, our happiest days are still to come, right?

Dr. Dan Levitin 1:19:44 And I think we can push that out another 10 or 20 years if we can get rid of ageism and treat older adults with more dignity and respect, not allow them to fall into complacency and learned helplessness.

Dr. Rangan Chatterjee 1:19:56 Yeah.

Dr. Dan Levitin 1:19:56 I think 82 is, is movable.

Dr. Rangan Chatterjee 1:19:59 Yeah. Well, I love that, Dan. I absolutely love that. And, um, you know, I always like to close off the conversations with tips for people. So, um, the podcast is called Feel Better Live More. When we feel better in ourselves, we get more out of life. And I think the tips that you are You know, the habits you're talking to people about in your book, yes, it's gonna help them age better, but it's also gonna help them feel better today.

Dr. Dan Levitin 1:20:27 Yeah. Agreed.

Dr. Rangan Chatterjee 1:20:28 And that's what's really exciting. So I wonder, you know, you've done a lot of talks. You've been on a book tour for over two months now. Um, from everything that you have put into this book, from all the feedback you've had at events, you know, what are some of your top four or five tips that people can think about applying into their everyday lives immediately to improve the way that they feel?

Dr. Dan Levitin 1:20:48 Well, follow healthy practices. A, a moderate diet. There's no one diet that's been clearly shown superior to the others. The Mediterranean diet, the keto, the paleo, none of them have panned out s- you know, statistically or research-wise.

Dr. Rangan Chatterjee 1:21:03 And, and actually, as you say, and we didn't get a chance to cover this, but you say, as I absolutely agree with, that often it's more important what you don't eat than what you do eat.

Dr. Dan Levitin 1:21:13 Right. Uh, don't eat heavily processed foods, and it's also more important than we realized when you eat.

Dr. Rangan Chatterjee 1:21:19 Yeah.

Dr. Dan Levitin 1:21:20 Uh, your metabolism is linked to your biological clock, that funnily named suprachiasmatic nucleus, and if you eat at the same time every day, you're gonna digest the food and draw the nutrients out of it more completely.

Dr. Rangan Chatterjee 1:21:34 Yeah.

Dr. Dan Levitin 1:21:34 Um, so moderated lifestyle in terms of diet. Eat more plants than you usually do probably, but a varied diet, uh, and, um, get a good night's sleep, um, and movement, which I see as the imprisoned corollary of exercise. It's not about whether you get an extra 20 minutes on the treadmill. It's about whether you actually get outside and move your whole body-

Dr. Rangan Chatterjee 1:22:00 Yeah

Dr. Dan Levitin 1:22:00 ... uh, especially in nature. So that's three things, uh, the healthy practices of diet, exercise, and sleep.

Dr. Rangan Chatterjee 1:22:06 Yeah.

Dr. Dan Levitin 1:22:07 And then I would, uh, talk about mindset.

Dr. Rangan Chatterjee 1:22:10 Yeah.

Dr. Dan Levitin 1:22:10 Trying to cultivate curiosity, openness to new experience, conscientiousness, and resilience. And then the final thing, number five, is to associate with new people, especially younger people, as you get older. Keep your social networks, and I don't mean your digital ones, I mean your in-person ones, going because that is really an important part of, uh, brain health and brain happiness.

Dr. Rangan Chatterjee 1:22:37 If that conversation resonated with you, here is another incredibly powerful conversation that I really think you're gonna enjoy.

Cameo 1:22:43 Digestive issues, mental focus issues, depression, anxiety, exacerbation of every major psychiatric disorder from OCD to ADHD is closely associated with disruptions in circadian clock function