Dr. Nadine Burke Harris

[0] Welcome, welcome, welcome to armchair, expert, experts on expert.

[1] Ms. Padman.

[2] I'm here.

[3] You're here.

[4] I see you.

[5] I'm Dan Shepard.

[6] Today we have Nadine Burke Harris, Dr. Nadine Burke Harris, and she is a pediatrician, and she is the first and current Surgeon General of California.

[7] She's the first person ever hold that title in California.

[8] Badass.

[9] She's a badass.

[10] Yeah.

[11] She's incredibly smart, and she focuses on.

[12] a lot on the long -term effects of trauma or which she calls childhood adversity.

[13] She has a new book called The Deepest Well Healing the Long -Term Effects of Childhood Adversity.

[14] I think some of these statistics are going to shock people.

[15] Yes.

[16] Of how impactful the downstream effects of childhood adversity are.

[17] Yeah, it's profound.

[18] And you're going to find yourself as a listener going through this list she gives.

[19] Yeah.

[20] And it's kind of eye -opening.

[21] I think as she said, there's two -thirds of people have several of these, and it's a health crisis.

[22] So please enjoy the brilliant, the beautiful, the talented, Dr. Nadine Burke Harris.

[23] Also, let me add, we added a second show in Nashville on November 2nd.

[24] We're at Andrew Jackson Hall, November 2nd.

[25] So please, if you want to see that second show, there are a few seats left.

[26] You can go to our website, www .orgchairexpertpod .com.

[27] And you can follow a link there to buy some tickies and see Moni, Wabi, and I in Nashville on November 2nd.

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[31] you're going no caffeine for this you know what i'm sensitive to caffeine it messes with my sleep oh okay sure so i tend to be a low -calf person so i too have a hard time sleeping but i've gone the other way have you done a 23 of me i have not my brother did my brother did But I have not.

[32] Did he find out anything really exciting?

[33] So my family, we already know that we have a really interesting background.

[34] And so I think it just kind of confirmed some of the family lore.

[35] Uh -huh.

[36] Well, so often, though, these tests actually debunk family lore.

[37] We have a really good friend who sincerely believed he was 12 .5 % Native American because, in fact, his grandpa was Native American.

[38] then he got a 23 -Me test, and he doesn't have a trace of it.

[39] So that what it exposes is that, oh, that wasn't grandpa's child, really, is what you end up finding it out.

[40] Some family secrets get exposed.

[41] But we did 23Mee, Monica and I, and we cannot stop talking about it because there are genetic markers for, like, sleep, which I felt a relief of guilt because I don't sleep well, and then I go, okay, well, I'm not going to drink caffeine after X time, right?

[42] And then I can't go sleep.

[43] And then I'm mad at myself.

[44] and I should have cut it off at 11, blah, blah, blah, blah.

[45] All the shame, shame, spiral.

[46] And then I got the thing and I'm like, oh, I'm kind of genetically wired to be an insomniac.

[47] That's a little comforting.

[48] Well, cutting down the caffeine is likely to impact your sleep.

[49] So, Nadine, with all due respect, I have gone no caffeine for like a few months at a time.

[50] I didn't see a huge difference.

[51] It's not like I just drifted off to sleep.

[52] No, the racket inside is just, it's loud and pervasive in the evening.

[53] Do you suffer from that?

[54] It's when I go to bed, I think this is one of the things that makes me a really good doctor is that I have all these checklists and I need to make sure that I check all of them.

[55] Yeah.

[56] But I keep a journal next to my bed.

[57] And so one of the things I do to help my sleep, if I really have stuff that my mind is gnawing on, I just write them down and then I meditate.

[58] There you go.

[59] Yeah, that's a good trick.

[60] I do.

[61] Oh, me, me too.

[62] Yeah.

[63] Nadine Burke Harris, you are a pediatrician, among many things you are.

[64] You are our first and current Surgeon General of California.

[65] I know.

[66] That's kind of cool.

[67] It is so exciting.

[68] The smile on your face either said that's cool or it said, I'm the 20th.

[69] You got that wrong.

[70] No, no. I am California's first Surgeon General.

[71] Yeah, so that's really fascinating.

[72] What's the backstory of how Governor Newsom decided we should have a Surgeon General for California?

[73] On his first day in office, one of several executive orders that he signed was an executive order to create the role of Surgeon General for California.

[74] Yeah.

[75] That's awesome.

[76] That's really interesting.

[77] And it is the thought behind it like, well, we have many different municipalities and oversight bodies on a state level.

[78] Why on earth do we not have our own for health?

[79] Was that the premise behind it?

[80] So, yes, I mean, we have a lot of oversight bodies for health.

[81] in California.

[82] I mean, we have a Secretary of Health and Human Services, who is a dear colleague with whom I have the opportunity to work every day.

[83] I think what the governor had in mind was that the role of Surgeon General for California is really someone who has the opportunity to work across sectors, right?

[84] So to work with partners across education and transportation and health and the justice system, for example, to be able to advance things on a public health scale.

[85] And really, in particular, what the governor highlighted in his executive order is that our early social determinants of health are the source of some of our biggest and most expensive health challenges facing California.

[86] And so he really created the role to have someone to target those develop solutions and implement across all these different agents.

[87] Uh -huh.

[88] And so is the simple theory that an ounce of prevention's worth the pound of cure that'll be so much cheaper for us to deal with this in a preventative way than to deal with it downstream when people are in emergency rooms?

[89] Is that kind of the fiscal model?

[90] Pretty much, yes.

[91] Yeah.

[92] It's daunting, I would imagine.

[93] If you don't have a predecessor, you kind of have to create your own, I guess you're like a teacher at a college and they've never taught that course.

[94] you're going to create your own itinerary or your own agenda.

[95] Yeah, that's right.

[96] And I think that it can be daunting, but my disposition is that I can also see that as an opportunity, right?

[97] Because I have the opportunity to shape the role of Surgeon General of California for the people who come after me, right?

[98] Which is pretty amazing.

[99] That's a big load on your shoulders.

[100] You kind of got to figure out how to do it.

[101] Honestly, the biggest hassle is that.

[102] there are no existing protocols, right?

[103] So setting up a budget and hiring a staff and all of that kind of stuff because the department, the role didn't exist before.

[104] But that's kind of my gig.

[105] Like I've always founded things early in my career coming straight out of my residency training.

[106] I founded a clinic in one of San Francisco's most underserved neighborhoods.

[107] Uh -huh.

[108] And then I founded a. center to be able to address childhood adversity as a root cause of major health problems.

[109] So I feel like somehow maybe that's a little bit in my DNA.

[110] I might be a glutton for punishment.

[111] Right.

[112] Okay.

[113] So generally, well, and I will, well, I'll learn about what led you even to being a pediatrician in the first place.

[114] But the work you're doing that brought you to my attention is very tasty.

[115] So I kind of want to, I want to say right now kind of what your work is.

[116] And then I want to go kind of back and figure out how we got there.

[117] Well, what I mentioned in my TED talk was that in my role in my clinical practice, when I started this clinic in this neighborhood in San Francisco, what I quickly discovered was that there was an exposure that dramatically increased my patient's risk of long -term health problems and that we're talking about in very high doses, right?

[118] we're talking about triple the risk of heart disease, triple the risk of lung cancer, and a 20 -year difference in life expectancy.

[119] That's crazy.

[120] So that's significant.

[121] Right?

[122] And so if this were some packaging chemical or some BPA or.

[123] Exactly.

[124] It would be like pulled off the shelves in a minute.

[125] And by the way, it's not only harmful, but it's.

[126] It's something that two -thirds of our population is exposed to.

[127] Two -thirds.

[128] That's the number.

[129] Two -thirds of our population is exposed to, right?

[130] And so, you know, if that were the case, right, you would expect that, like, every mom in America and every advocacy group and every health group would be out there marching in the streets to, like, end this, right?

[131] But it turns out that it's not packaging chemical.

[132] It's childhood adversity.

[133] Which we would, in general, the lay person would just say trauma, yeah?

[134] Is that what we're kind of talking about?

[135] That's right.

[136] Yeah.

[137] So I think a lot of us use the word trauma when we talk about it.

[138] But what's interesting is that part of the reason why I use the word adversity rather than trauma is because I think that for a lot of people, it's so common that they almost kind of don't think about it as trauma.

[139] Right, right.

[140] So first let me say that this research, the science of this came from a huge study from the CDC, right?

[141] We trust them.

[142] And yes, and Kaiser Permanente, these are like big, well -respected health care institutions.

[143] And they did this study in 17 .5 ,000 people.

[144] And they asked them about 10 categories of childhood adversity.

[145] And these include physical, emotional, or sexual abuse, physical or emotional neglect, or growing up in a household where a parent was mentally ill, substance dependent, incarcerated where there was parental separation or divorce or domestic violence.

[146] Girl, I got like seven of those.

[147] You just click through those.

[148] I don't think I'm any.

[149] God bless you.

[150] I know.

[151] That's why you drink so.

[152] So readily and with ease.

[153] With ease and without any pathology.

[154] Yeah, it's true.

[155] I mean, that's really what's going on here.

[156] Yeah.

[157] And so, and that is referred to as ace.

[158] Am I right?

[159] Aces, yeah.

[160] Adverse childhood experience.

[161] And so obviously there's a wide spectrum.

[162] of abuse and level of trauma if we quantified it, right?

[163] Yeah.

[164] I would assume, predictably, the more you have of it than the less chances.

[165] That's right.

[166] We refer to it as cumulative adversity.

[167] Really quick.

[168] I didn't notice racial wasn't in there?

[169] No, it wasn't because this is what happened.

[170] So the head researcher who did this at Kaiser, he did it at Kaiser San Diego.

[171] Oh, a lot of white folks.

[172] And the population that they studied, those 17 .5 ,000 people, 70 % Caucasian, 70 % college educated.

[173] Oh, interesting.

[174] And when they came up with the criteria, what this doctor, Dr. Vince Felitti, what he was seeing was that he was talking to his patients and actually he ended up creating the study by accident.

[175] What happened was he was running an obesity treatment program.

[176] We're aware of that story.

[177] Was it Topal that was telling us about this or was it Yuval Harari?

[178] the doctor was treating people for obesity and at some point he started realizing that like it's 70 or 80 % of them had been abused that's right so this is what happened normally he asked his patients how old were you when you first became sexually active right but he just slipped in his words and what he said was how much did you weigh when you first became sexually active and his patient responded and i don't know if it's because it was you know related to he was doing obesity treatment or what her answer was 40 pounds yeah yeah yeah and she was like i was five years old it was with my dad yeah whether it was total or herrari what one of them was you know it was it was johan harry yeah yeah you've all harari i know lots of names uh but yeah he he was making the case that like part of your regular screening or right physical your annual physical is like the doctor should say like, hey, by the way, have you had any abuse?

[179] You know, that should be like one of the main things we learn about you is along with your allergies and everything else.

[180] Well, that's what's going to happen.

[181] That's what's going to happen.

[182] Oh, good.

[183] Under the new surgeon general.

[184] The new boss is what I hear.

[185] Yeah.

[186] So I can imagine where it's illustrated perfectly in a study about obesity.

[187] I can imagine detractors from this notion going, okay, well, Yes, lung disease, heart disease.

[188] These are probably health -style choices, and it's the bad food and the smoking, the drinking, and all the things which we all would understand as being ways to cope with the trauma.

[189] But does that get murky to people go like, well, it's not the trauma?

[190] It's the life choices resulting from the trauma.

[191] Yeah, so that's what people said when this study came out.

[192] So let me just back up real quick and just say the two things that they found.

[193] was that this was incredibly common.

[194] Two -thirds of folks had at least one of these adverse childhood experiences.

[195] One in eight folks had four or more, right?

[196] The second thing that they found was like the more you have, the greater your health risk, including increased risk for, you know, heart disease and stroke and cancer and all these different things.

[197] And so that's what people said.

[198] People said, oh, well, of course, this is about health behavior.

[199] And this is why I love being a doctor and a science nerd.

[200] because it turns out that some really smart doctors decided, okay, well, let's put that to the test.

[201] And so they did what we call logistic regression analysis.

[202] Like they said, okay, we're going to do all this complicated statistical modeling and pull out the effects of smoking and overeating and inactivity and high -risk behavior and drink, you know, all of that kind of stuff.

[203] Yeah.

[204] All those known health risks.

[205] And what they found is that it only accounted for about half the risk.

[206] Really?

[207] Yeah.

[208] Wow, that's incredible.

[209] Clearly, this is costing billions and billions of dollars downstream.

[210] Yes.

[211] Obviously, it seems like the earlier you could intervene and help little kids, the better your outcome would be.

[212] Yes.

[213] Okay.

[214] And I would imagine there's certain hurdles of getting that information out of a kid.

[215] Like, I have a four and a six -year -old.

[216] So I'm imagining someone trying to glean that from talking to them.

[217] and, well, just a knee -jerk paranoia is like, oh, will it be the 80s, like, pedophilia, a scare and outrage for, like, they're putting words in kids' mouths and whatnot.

[218] But how would the doctors go about assessing whether the kids at a young age are experiencing trauma?

[219] So, I will say that when I read this research as a doctor, as a pediatrician caring for kids, the first thing in my mind was like, oh, we should figure out how to screen.

[220] And so I and my team actually created a clinical protocol for screening.

[221] And it turns out you don't ask the four -year -old.

[222] So for little kids, right, we ask the parents.

[223] You know, we say, hey, we ask everyone, and we now know that these factors can impact a child's health and development.

[224] And so now we screen because early intervention improves outcomes.

[225] So that's the first thing.

[226] But for kids who are adolescents, so 13 and over, we ask the parent and we ask the teenager to do a self -report and those are done separately, right?

[227] And oftentimes the parent report and the teenagers report are different.

[228] Yeah, I would guess that.

[229] And the other thing that we do, which we learned over a decade of doing the screening, is that the protocol developed by me and my team before I came into this role was we actually do what's called a de -identified screen.

[230] So we list the 10 adverse childhood experiences.

[231] And then we ask the parents to report not which ones their child has experienced, but only how many.

[232] Oh, okay.

[233] That's kind of smart.

[234] So you just write, okay, your child is a zero or a five or a 10, you know, or whatever it is.

[235] And what that does is that it gives the doctor as much information.

[236] as they need to be able to act to say, okay, this child is at low risk, intermediate risk, high risk, right?

[237] And just as if I heard a heart murmur, right, I would refer my patient to a cardiologist.

[238] I'm not going to get in there and fix the heart myself, right?

[239] Like, I'm not going to crack them open and, you know, and sew up the hole in the heart.

[240] I refer them to a specialist to do that.

[241] similarly, based on this risk, then I can connect the family to the resources that they need to be able to support and heal.

[242] Yeah.

[243] The inherent potential issue of this, I would imagine, is that the parent is heavily disincentivized to report stuff that ultimately would incriminate them on some level or at least trigger their fear that child protective service is going to come in.

[244] So even if it's benign and not like that they're molesting their kid, but the mental health issue or substance abuse.

[245] For the parents to say, yeah, I have substance abuse or my wife has substance abuse.

[246] And yeah, we, you could say we've neglected for periods while we're both doing all these jobs.

[247] Whatever the thing is, I think there would be an implicit fear on the parents' part that they're going to lose their child.

[248] So it's almost like, again, this would be so controversial.

[249] But it's like you'd almost want to grant the parent amnesty or something so that they could just be honest.

[250] us so we could get involved with the prevention end of it.

[251] Is there something in place for that?

[252] So I think that's a big part of the reason why we find the de -identified screen to be so effective.

[253] Because when you're a parent and you read this thing and you say, okay, these things could affect my kids' health, right?

[254] That's why the doctor's asking.

[255] Yeah.

[256] Right.

[257] But right at this moment that I'm doing the screen, like, I don't have to say, yes, my child has been sexually abused or they're substance, you know, we substance use in the home, right?

[258] Like, I don't have to say that on this form.

[259] I can just say, okay, my kids are three, right?

[260] Or a four or whatever.

[261] And then the doctor can connect you.

[262] Now, I have to say that doctors are mandated reporters.

[263] Right, right.

[264] So it's not just like, hey, is it cool?

[265] It's like literally we're mandated reporters.

[266] But one of the things, and this is what I feel like I've found over a decade of screening is that parents want what's best for their kids.

[267] Oh, for sure.

[268] Right, yeah.

[269] And I think that for many parents, especially for parents whose kids have high aces, most of the time they themselves have high aces.

[270] And one of the things that we recognize is that they tend to be handed down from generation to generation and to recognize that there's an opportunity for us to break the cycle.

[271] Yes.

[272] And frankly, I think a lot of it comes down to relationship and trust.

[273] Mm -hmm.

[274] Right?

[275] Mm -hmm.

[276] And so typically what I've found in my practice, because one of the interesting things about this, I think doctors often get pretty nervous about it because they're like, great, am I going to be calling child protective services on every other kid?

[277] That's what I'm saying.

[278] you're kind of inadvertently creating a hierarchy by which if I see a broken femur and some bruises on the back, that's clearly child abuse and I need to report that.

[279] But what's ironic probably is the other forms of abuse are probably just as destructive on some level down the line, right?

[280] Absolutely.

[281] And so this is the piece that I think is really important.

[282] I think as we do the screening, what we understand and what we have the opportunity to communicate with families is, listen, we know.

[283] that exposure to these high doses of adversity is harmful for kids' health.

[284] And we know that when we do early identification and provide the supports, right?

[285] Because frankly, the supports, the response is not to snatch the kids out of the home, right?

[286] And I will tell you, even in cases where there is frank, awful child abuse going on, right?

[287] where they're, let's say, you know, more often than not, it's the dad who's abusive, but you know, whatever.

[288] And, and, you know, even in those cases, right?

[289] So typically, from my clinical practice, I have seen so many beautiful examples where in doing that screening, the parent understands, holy crap, you want to know the, frankly, the, frankly, the reason that I'm beating the crap out of my kid is because I have a way overactive stress response, right?

[290] Yeah.

[291] Because what happens when you are exposed to lots of trauma and adversity in your childhood is that you can develop an overactive stress response and helping that parent or caregiver to actually get the tools.

[292] The treatment they also need.

[293] Yes.

[294] Yeah.

[295] But again, Again, how does it, so, you know, a lot of our approaches are so draconian here that I imagine so many people right out of the gate just being like so not open to hearing that there is a cycle of abuse or there is a cycle of trauma and knowing that probably the best course of action to break the cycle is.

[296] And again, this is interesting from my mother who is Acosta who works with kids in foster care.

[297] It's like it is weighted to keep the kids with the parents as it should be, in my opinion, because this.

[298] That then is another level of trauma.

[299] So you're comparing a bunch of terrible decisions, and I just wish we were kind of open -minded and forward -thinking enough to just go like, okay, let's just hang off the punitive nature for one second and try to interrupt this cycle, and let's just try to work on this before we start separating people, incarcerating people, all this stuff.

[300] None of it's leading towards a solution, but I imagine it's a very tough theory to get the public to embrace, or is it not?

[301] Are people cooler than I think?

[302] Are they able to go like, listen, priority number one right now is getting everyone treatment?

[303] So, as I mentioned, I'm an optimist, and I do think that raising public awareness is one of the most important things that we can do.

[304] You should go on a podcast.

[305] What a great idea?

[306] seriously, I think that's step one because I think that the key to addressing anything on a public health level, like, hey, guess what?

[307] Smoking causes cancer.

[308] Yeah, yeah.

[309] Unfortunately.

[310] And step one is raising that awareness because, listen, government, doctors, nobody's going to go into every single person's house, right?

[311] But if we arm people with the knowledge to understand And some of these frameworks, we can talk to our friends and our siblings and our kids and our, you know, nieces and nephews.

[312] And we can not only share that knowledge, but also share the solutions, which is the thing that I'm super excited about.

[313] Yeah, you're right.

[314] Because at no point, I mean, obviously smoking's been on the decline, I believe, for the last 30 years or whatever.

[315] And it was not because some agency went into people's homes and broke up their cigarettes or banned the sale of ashtrays and lighters.

[316] it was solely the educational, the public service announcements, all that is what armed people with making better decisions, I suppose.

[317] The biggest thing was smoking, because this is what I do, like I study what worked, and then I try to do it.

[318] That's like the public health thing.

[319] The biggest thing was smoking was one of the biggest things that came out of the tobacco settlement was a huge initiative to prevent young people from starting smoking.

[320] Because guess what?

[321] Smoking's really, really, really hard to quit.

[322] Yeah, yeah, once you're on, yeah, look at me. I'm 15 years later, I have nicotine lozenges at my mouth.

[323] Yeah.

[324] The dramatic decline in the prevalence of smoking in the U .S. didn't come from like all these people quitting smoking.

[325] Listen, some people did, but smoking is really like, it was from people not starting smoking in the first place, and that was a public education campaign.

[326] Yeah, that makes sense.

[327] It's so true.

[328] And that is why when it comes to, Adverse childhood experiences and the fact that it has over your lifetime, helping to raise awareness and especially of, number one, the younger generation, but number two, parents to recognize, like, hey, guys, we can actually interrupt the transmission and we can do things to not hand it down to our kids, number one.

[329] And number two is that even if our kids have been exposed, we can actually also use the science that shows that like nurturing relationships are healing.

[330] Right?

[331] Like when our kids experience something stressful or scary for most of us as parents like one of the first things that we do, what do we do?

[332] We wrap them up in our arms.

[333] We give them hugs and kisses and love on them.

[334] Right, right.

[335] That releases oxytocin and oxytocin interrupts the biological stress response, right?

[336] And it counteracts almost all of the effects that trauma has on our biology, right?

[337] It literally protects your cells against damage.

[338] Because adrenaline and cortisol, right?

[339] They're damaging.

[340] Are they not?

[341] They're helpful and life -saving.

[342] But at a cost, yeah.

[343] in when they're released occasionally in severe circumstances.

[344] But when the release happens too frequently, yes, they are damaging.

[345] So I want to get into the biology of it because I think it's fascinating.

[346] I do believe there'll also be certain people my age who are getting old and cranky and they'll go like, oh, everyone has trauma.

[347] Oh, everyone has an excuse.

[348] Oh, blah, blah, blah.

[349] Poor me. So I'm, you know, on some levels when I hear millennials can't work at a place unless their boss takes them to lunch four times a week.

[350] I go, oh, my God, guys, what the fuck's happening to us?

[351] But I am not in that camp, and that I do believe in trauma and its biological effects.

[352] Stay tuned for more armchair expert, if you dare.

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[370] Walk me through some of the things that actually happen.

[371] Before you do that, when people have too much fight or flight response in their childhood, does it make it hyper or hypo?

[372] Like, does it fatigue and run out?

[373] Because I interestingly had a blood panel a few years ago and the guy said to me, now I took this as a feather in my cap, but he said, this guy works with like the Navy SEALs with a couple football teams, one of these guys.

[374] And he goes, your adrenal glands are like, they're not making adrenaline.

[375] He goes, and I've really only seen this in the Navy SEAL guys, which they're just in so much shit eventually.

[376] It gets fatigued and it kind of stops working.

[377] You kind of need adrenaline for your mood stabilization.

[378] So anyhow, yeah, does it, does it get fatigued or does it become hyperactive?

[379] Let me start by explaining what the fight or flight response is.

[380] Yeah.

[381] So all of us, the way that we're designed is that when we experience something scary or traumatic, right?

[382] Like imagine you're walking in the forest and you see a bear.

[383] And what happens is that immediately the amygdala in your brain, which is your brain's fear center, activates, and it sends signals to your whole body.

[384] And your body releases stress hormones, including, like you said, adrenaline and cortisol, right?

[385] And these have lots of effects on your body.

[386] So the effects of adrenaline, think about it when the last time you're scared, right?

[387] Like your heart starts to pound.

[388] You're filling your muscles with oxygen.

[389] That's right.

[390] Your pupils dilate.

[391] Your airways open up.

[392] You shunt blood to your big muscles for running and jumping.

[393] Uh -huh.

[394] Away from that itty -bitty muscle that holds your bladder close so you may pee your pants.

[395] Okay.

[396] Okay.

[397] Fingers drop.

[398] And that's awesome.

[399] if you're in a forest and you're going to fight a bear.

[400] But if you were to think about it, fighting a bear wouldn't seem like a good idea, right?

[401] No, right, right.

[402] And so actually, your amygdala fear center sends projections, it sends like neurons, nerve cells, to the part of your brain that's responsible for executive functioning for judgment and impulse control.

[403] It's your prefrontal cortex.

[404] And it turns it way down.

[405] Yeah, yeah, yeah.

[406] Because you don't want judgment to, get in the way of survival.

[407] That's right, yeah.

[408] And instead, what it does, it turns up the part of the brain.

[409] It's called the noradrenergic nucleus of the locuserulius, but...

[410] Hit me with that one more time.

[411] I just, I got a little aroused.

[412] Hit me one more time with that one.

[413] It's called the noradrenergic nucleus of the locus ceruleus.

[414] Wow.

[415] But I like to call it the part of the brain responsible for, I don't know, karate.

[416] But I do no car raising, right?

[417] I'm the James Brown Center.

[418] Yes, this is the within the brain stress response.

[419] And then the other thing that happens when you activate your stress response, that's a little bit less obvious, is that it also activates your immune response.

[420] Because if that bear gets his claws into you, you want your immune system to be primed to bring inflammation to stabilize that wound.

[421] So you can live long enough to beat that bear or get away.

[422] Oh, Jesus.

[423] And I have an autoimmune thing.

[424] You just kind of map that out for me. Yeah.

[425] So just really quick, in a very pragmatic example of what you're talking about, I read this great book on killing.

[426] And in World War I, they found many, many people in the trench warfare who had been shot, who never fired their gun.

[427] And that was so perplexing to all of these people because they thought, why wouldn't, if a Germans running at you, firing at you, why wouldn't your response be to fire back.

[428] And what they later found through all sorts of research is that exactly what you're saying, your frontal lobe goes offline.

[429] So you're not making a rational decision.

[430] What they really found is we had this binary grouping of flight or fight.

[431] And in fact, most traumatic situations in the wild resolve themselves with posturing and submitting.

[432] That's the bulk of how we resolve things.

[433] So a bear growls, most people intuitively will submit.

[434] They'll cower, they'll look down to do all these things.

[435] You've got to be trained almost into running.

[436] And so all these guys were watching posturing, which was a loud gun firing at them.

[437] And they were submitting, like, I surrender, don't shoot me. And they just sat there and got shot.

[438] And so they had to train these people a part of their brain that would act without thinking, basically, to fire no matter what.

[439] Yeah.

[440] And it's actually, we, as a shorthand, I say fight or flight.

[441] But we actually say fight, flight, or freeze.

[442] Uh -huh.

[443] So that's the long and short of like what happens with our.

[444] stress response, it's really good.

[445] I never thought of the autoimmune part.

[446] That's really fascinating.

[447] And I'm actually quite logical.

[448] Folks with high aces are at dramatically increased risk for autoimmune disease.

[449] If you have two or more ACEs, you have double the risk.

[450] Two or more ACEs.

[451] You have double.

[452] Yeah, I told you, I think I have seven of those that you're ready.

[453] Because there was so much inflammation early on getting activated.

[454] The activation of the stress response also activates.

[455] the inflammatory response.

[456] And this is the thing, so this as a doctor, right?

[457] Like this is why this is such an important health issue because when we think about childhood trauma and we think about the effects of it and importantly, when we think about how much it costs, most people think about substance use or mental health issues or incarceration, right?

[458] Heart disease is the number one killer in the United States of America.

[459] Right.

[460] If you have four or more, adverse childhood experiences, you're at twice the risk for heart disease.

[461] We spend $3 trillion a year in our country on health care, 75 % of which is for the treatment of chronic disease.

[462] And what makes me really sad and upset as a doctor when I read this information, I was like, why is no one telling, hey, having ACEs can increase your risk of these health problems?

[463] And why are we not investing in preventing because we're spending trillions of dollars.

[464] Yes.

[465] And by the way, I get the fiscal conservative point of view.

[466] I totally understand it.

[467] But even if you don't give a shit about anybody and all you care about is us dumping money down the toilet, that minimally should get you interested in the preventative route through these trillion dollar fees that we're all paying.

[468] Yes, because here's the thing.

[469] We now know enough to do something about this.

[470] So this is something that we can prevent.

[471] This is something we can heal.

[472] This is something that we can interrupt.

[473] And the amount of money we're spending on health care costs, because having four or more aces increases your risk for eight out of 10 of the leading causes of death in the U .S. That's a big deal.

[474] And I just, again, to give myself as a personal example, I was on Humera.

[475] I forget how much that was a month.

[476] It was thousands.

[477] I was on Zalgians.

[478] That's thousands a month.

[479] So just me personally, I've gobbled up tens of thousands of dollars to deal with an autoimmune thing.

[480] And so that's the medical science behind it in terms of your question around what happens to your stress response.

[481] So what the research shows is that it becomes overactive for a lot of people.

[482] And then in some cases and sometimes in the more severe cases, what you see is essentially burnout of your stress.

[483] response system as you get higher and higher doses of adversity.

[484] And so that may be what they were finding.

[485] And I was just telling Monica this the other day.

[486] I don't know if I accidentally found a backdoor solution to all this.

[487] And it's probably going to make it worse in the long run.

[488] But we used to think of, I remember taking a psychology class early on.

[489] And they basically said the difference between people who can watch the grass grow and risk takers is this MAO chemical in your brain.

[490] And it really creates brain activity.

[491] And so some people who have a lot of MAO, they could stare at a blade of grass, watch it grow, and their brain is on fire.

[492] Other people, low MAO, they got to jump off a bridge or something.

[493] And that was the two categories I kind of thought of that in.

[494] But now as I learn more about this and fatiguing your adrenaline, I was saying, Monica, because I ride a motorcycle most places around L .A., which is an adrenaline -raising experience because you're lane splitting, there's a ton of stuff.

[495] And I was saying, as I, like, the days I drive my motorcycle to or from work, I'm in such a better mood.

[496] And I'm like, I wonder if I'm just, like, squeezing a little bit of adrenaline.

[497] out to help stabilize the mood or something.

[498] So one of the things that's really interesting about this research is that they found that high doses of adversity also affects the pleasure and reward center of your brain, right?

[499] So this is the part of your brain that's stimulated by cocaine, heroin, sex, gambling, right?

[500] All of these things.

[501] Delicious, delicious, delicious.

[502] Yes, it's everything.

[503] And what's interesting, so this is the pleasure center of your brain.

[504] And what they found is that high doses of adversity in childhood affects the structure and the function of the way that part of the brain can develop.

[505] What can happen is that activities that should be pleasurable, actually it's less sensitive, so you need higher doses of the...

[506] So, you know, I think for someone who perhaps has zero aces, they get a little bit, right?

[507] Like they get a little bit of something exciting.

[508] And they're good, right?

[509] They're streaked.

[510] Yeah, yeah, yeah, yeah.

[511] And so this is why for folks with four more aces, right, 10 times it's likely to be substance dependent.

[512] Yes.

[513] And so, okay, so that's an very interesting scientific way to think about it.

[514] But I have to share with you this kind of breakthrough I had recently, and I wonder if this jives with that, which is I've talked to so many people who have tried cocaine that are like, yeah, it was whatever.

[515] cocaine was like whatever I tried it was ever and we're like what are you talking about it was it whatever no you immediately feel optimistic same thing ecstasy I would have just said I would imagine across the board this chemical works on everyone's brain the same and that they they must feel what I feel and then when I talk to people that are like ambivalent about it it's so confusing to me and then again that goes with alcohol that goes to all these stuff and that's always been a little perplexing to me and when I thought of the other day was a good childhood friend of mine who had quadruple what I had I mean And in fact, I think maybe even why some of my stuff I didn't even go on, it's not that bad.

[516] Like, he is living in fucking hell.

[517] You know, one bedroom, trailer, crazy alcoholic that's beating everyone.

[518] Just fucking carnage all day long every single day.

[519] And he and I both fell in love getting fucked up together.

[520] I mean, that was our life.

[521] What I remembered the other day was there was a period for a year where he huffed gas.

[522] He carried a gas can around for a year in eighth grade.

[523] Now, I don't know if you've ever huff gas.

[524] Gasoline.

[525] Gasoline?

[526] Gasoline.

[527] You just, you huff it.

[528] I have done it.

[529] And let me tell you, it's the worst feeling imaginable.

[530] I hate, it's the grossest buzz you could ever have.

[531] It feels terrible, right?

[532] So I did it in eighth grade or ninth grade.

[533] And I'm like, this is terrible.

[534] And I never could make peace with why he enjoyed that.

[535] And what I thought of just a few weeks ago, I was like, man, all that tells you is what his standard feeling was, his standard.

[536] feeling, emotional feeling was so fucking shitty that that terrible high of huffing gas felt better.

[537] And I almost started crying for him.

[538] And I almost started crying for me because I was like, yeah, for a lot of us, when we took that first drink, we were like, oh, my God, relief.

[539] This feels so much better.

[540] And to the point of huffing glue and gas and all this shit, that feels terrible.

[541] So this is something that I talked about with researcher at Stanford, who has done a lot of this work on the impact of childhood diversity on the brain.

[542] And we were sitting down, he's doing all these MRI studies and we're looking that you can, you know, some of the stuff is now evident on MRI and you can see.

[543] We were talking and he was like, so imagine you're a kid and you're experiencing this from the time you're itty -bitty.

[544] Is it any wonder that by the time you get old enough to get access to substances, you're like, bring it on.

[545] Oh, yeah.

[546] Because up until that moment, there's no relief.

[547] And again, I'm not asking for sympathy.

[548] I'm not asking everyone to feel bad for addicts, whatever.

[549] I'm just saying it's fascinating that the thing is as complicated as it is.

[550] You know, and the longer I'm around other addicts, you can't not, not observe these patterns emerging.

[551] So you know a lot of addicts, like how many of the addicts that you know have had some experience of childhood trauma?

[552] Like what percent?

[553] My sponsor, who has over the last 30 years probably sponsored, I mean a thousand guys probably at this point, he told me, you know, your four steps where you write out all these resentments and then you take a personal inventory and then you read it to your sponsor.

[554] And he said that no question 75 % of the people have a sexual abuse thing in their inventory.

[555] That it's like that's dark.

[556] So this is the point.

[557] It's regardless of how you're feeling about the choices that people make in their life, basic science and public health tells us that if we identify early and we intervene early, we can change the odds for people, right?

[558] And that's what it's about, regardless of whether you're on the most progressive side or you're on the most conservative side, changing the odds for people, improving the likelihood that they can be healthy, productive, income, earning, tax -paying citizens is a good thing.

[559] I want to add one more thing about addicts before we move because I really want to hear about what that prevention looks like and what the intervention looks like.

[560] But I do want to add one thing, which is, and again, it would be me. I'm a fucking cynic.

[561] I totally get it.

[562] If I wasn't an addict, I'd be like, fuck you, you just have any willpower or you're choosing not to have willpower.

[563] And the only counter argument I want to make to that is, if you were to have looked at my life on paper, every chance I could be, I was at work making money, saving money, I was going to UCLA, I was getting great grades, I was going through the groundlings, I was making my levels, I was writing as many or more sketches than everyone else.

[564] I didn't have a willpower issue.

[565] If you look at any compartment in my life, you're seeing me exercise a tremendous amount of willpower.

[566] And then you put this fucking thing in my mouth, one drop of it, two pills of it, whatever.

[567] that guy's gone.

[568] I'll disappear for four days.

[569] So I just want to point out, like, there is a difference between willpower and addiction.

[570] I think, I don't know that I ever make that point on here.

[571] And maybe for some people, you know one that someone that's just a lazy piece of shit across the board.

[572] But it's easy to conflate those two things and they're much different.

[573] Part of the reason that raising awareness about this is so important to me is that, okay, so the way that this manifests biologically in different people is different.

[574] It's a common between nature and nurture.

[575] It's a combination between your DNA, your protective factors, you're all these different things.

[576] But the thing that I would say about it is that I think it makes a difference for folks in the way that they view themselves to be able to say, oh, wow, because of what I've experienced, I'm at greater risk.

[577] So we don't necessarily have to play that blame and shame game.

[578] Right.

[579] And I want to be very clear that no one in this conversation is saying, oh, you had these, so you now have a built -in excuse for the rest of your life.

[580] No, now you have an explanation.

[581] And with that explanation comes some semi -proven treatments for it.

[582] That's right.

[583] Yeah.

[584] That's right.

[585] So tell me about how you intervene.

[586] What happens when someone gets identified?

[587] What kind of programs are proving to be successful?

[588] One of the first things is safe, stable, nurturing relationships, right?

[589] So what the research is showing is that oftentimes to really kind of advert the worst outcomes, it can only take just one person, right?

[590] That one trusted, loving support.

[591] The research shows that just one person who is that loving, safe, trusted person in a child's life can make a difference.

[592] That being said, just as the impacts of adversity are cumulative, right, in the body, similarly, the impacts of what we call buffering are cumulative.

[593] So the more sources that you have of safe, nurturing, buffering relationships are really important.

[594] I would say probably the strongest healing power connection is this nurturing, buffering care.

[595] And part of the reason for that, as I think I mentioned earlier, is that when you get a hug from someone that you love, right, like that releases oxytocin in your body, and that oxytocin inhibits the stress response.

[596] And it not only inhibits the stress response, it protects your organs, like it protects your brain and body against the harmful effects of the stress response.

[597] Because biologically, our stress response was designed to save our lives, but we also have this biological response led by oxytocin to be able to recover, right?

[598] And so that piece is really important.

[599] And some other pieces that I talk about in my book, because I wrote a book on this topic, is...

[600] Really quick, the title of that book is the deepest well, healing the long -term effects of childhood adversity, which I have a copy of and cannot wait to read.

[601] So sleep is really important.

[602] So it turns out your stress response resets itself while you're sleeping.

[603] It recalibrates.

[604] And you know how, like, if you don't sleep for a while, you get sick.

[605] Oh, yeah, yeah, yeah.

[606] because not only does your stress response recalibrate itself while you're sleeping, but your immune system recalibrates itself while you're sleeping.

[607] And so one of the things that I talk a lot about is the importance of sleep hygiene, right?

[608] Like kind of going to bed at the same time every night and not sitting in bed with your iPad.

[609] Your blue light emitting device.

[610] Exactly.

[611] And, you know, going to bed and waking up at the same time and avoiding things at a distraction and sleeping in a calm, quiet, cool environment, right?

[612] Like all of these things that really help us get better sleep and that helps our body to have a fighting chance when stress response get overactive.

[613] Another thing is exercise.

[614] So when we exercise, again, that helps to metabolize.

[615] We burn up the stress hormones, right?

[616] It helps to release endorphins.

[617] our body's natural, high -inducing chemicals, which can help to stabilize mood.

[618] It helps your immune system function better.

[619] And it actually, so exercise releases something called BDNF, brain -derived neurotropic factor.

[620] And this is kind of like miracle grow for brain cells.

[621] And so we know that one of the biggest impact.

[622] of the stress responses on the brain.

[623] BDNF helps brain cells be able to make new connections.

[624] And so literally, biologically, exercise helps to reduce stress hormones, reduce inflammation, and enhances the ability of brain cells to make new connections.

[625] So mindfulness, meditation, that's another thing that helps to regulate the stress response.

[626] part of it is through a combination of breathing and awareness and turning off your thinking, it helps to stimulate the parasympathetic nervous system.

[627] We know that we have the fight or flight system.

[628] The opposite of that, our fight or flight is called our sympathetic nervous system.

[629] The opposite of that is the parasympathetic nervous system, and it is in charge of resting and digesting.

[630] Resting and digesting.

[631] And so when we do mindfulness practices, it strengthens the parasympathetic nervous system so that it can fight against our overactive.

[632] Right.

[633] So I talk about sleep, exercise, nutrition, mindfulness, mental health, and healthy relationships as like the six really powerful tools that we have to fight an overactive stress response.

[634] Well, when you say all that, I go, well, that's the difference between why I didn't end up in prison, ultimately, is that my mom was so nurturing and made so much time for nurturing and snuggling and petting my hair and all that.

[635] She was amazing at that.

[636] And then my friend who I was talking about, we at 12, snuggled.

[637] We snuggled all the time.

[638] We were with each other, arms around each other.

[639] Like, we didn't know we needed that, but we found that.

[640] And I do get so sad when I think of kids who are on their own with it because I wasn't.

[641] I was saved by this friend of mine, you know.

[642] Yeah, it's a release of oxytocin.

[643] Yeah.

[644] And you don't know, like, you don't know why it feels right.

[645] You don't know why it works.

[646] Yeah, yeah.

[647] And this is the thing that I love about science, right, is that we take a look and we see, okay, like, how does that stuff work?

[648] And I will tell you one of the things that I would really love to see.

[649] So as a researcher, looking at the effects of oxytocin, interestingly, when we think about the solutions, A lot of the solutions are the things that I talked about, sleep, exercise, nutrition, mindfulness, mental health, and healthy relationships.

[650] But I'd also like to see medical science do more in the term of research to, like, help people out, man. Yeah, yeah.

[651] So there was a researcher at Stanford that I tracked down who actually was doing a randomized control trial.

[652] She was doing it in a population of kids who had autism because, you know, autism communication social deficits can be a big part of the manifestation.

[653] She was using oxytocin nasal spray.

[654] They make such a thing?

[655] Yeah.

[656] Can you mail it to me?

[657] Yeah.

[658] And so this is the thing that I literally, last week I was at the NIH and I was like, have you guys ever thought about like doing some trials about oxytocin nasal spray to treat an overactive stress response?

[659] because, you know what, we spend how many, like, hundreds of million dollars for treatments for cancer and heart disease and all of these other things, right?

[660] And when we think about all of the money and scientific minds and efforts that's put behind it, like, hello to all the, you know, drug manufacturers out there, right?

[661] Like, two -thirds of the population has experienced childhood trauma and the effects are significant.

[662] Like, if we can do something to help people out to block that from happening, right?

[663] And I think that we should use our full arsenal of resources.

[664] We have to.

[665] By the way, there's so much downstream stuff.

[666] You couldn't even imagine what stuff it would clean up downstream, which is you got a bunch of people with trauma running all these countries in the world.

[667] They have people acting out of fear, acting out of terror, at protect.

[668] You know, it's so.

[669] So global and humongous that if people felt good, how many other things would be affected?

[670] So the thing that I would say is that when we're talking about solutions, right?

[671] I've talked about the things that are like for the individual and what we can do in medicine and science.

[672] And that's why here in California, beginning in January 2020, doctors are going to get reimbursed if they screen adults and kids for adverse childhood experiences.

[673] Like, that's the biggest project that I'm working on right now.

[674] And that's for our governor put $40 .8 million into reimbursing doctors to screen.

[675] And that's in our Medicaid system.

[676] I'm working on trying to get the private payers to pay for it as well.

[677] And also put $50 million over the next three years for me to work with our Department of Healthcare Services to train doctors on how to screen and how to respond with trauma.

[678] unformed care.

[679] So that's like the medical response.

[680] But to be clear, I see childhood adversity.

[681] It's like germ theory, right?

[682] Like once you understand it that this is the source of so many of health, social, mental health outcomes, there are things you can do in medicine and science in medicine.

[683] It's kind of the equivalent of developing antibiotics.

[684] We can do these advance our pharmacotherapy and we can do practices like sleep exercise, nutrition, mindfulness, mental health, and healthy relationships.

[685] But we also have to like change the way our society works.

[686] This is what I would say to the folks who are like, oh, well, everyone has trauma.

[687] Yeah.

[688] And you're also covered head to toe with bacteria.

[689] There's a trillion bacteria living in your gut.

[690] The point is when we have this information, it doesn't mean like we have to eliminate every bacteria.

[691] Right.

[692] That's dumb.

[693] But you can figure out it doesn't have to cause disease and early death.

[694] Yeah, right, yeah.

[695] You can nurture the good bacteria and you can minimize the things that feed the bad bacteria.

[696] Exactly.

[697] Yeah.

[698] And, you know, I think it's a really interesting and intriguing inroad to adults recognizing their own trauma in that I was on a TV show for six years that dealt a lot with autism.

[699] So I met over those years, many, many different parents of autistic kids.

[700] And many of them had discovered their own place on the spectrum by going through the questions with their kid and going, oh, wow, I guess I would have answered yes to that.

[701] So it's almost like a Trojan horse if you're there to just help your kid and then you kind of accidentally find out, oh, shit, I probably have some things that, you know, those are great things and there are things people can do.

[702] People can aim to sleep better.

[703] People can aim to get some exercise.

[704] Outside of that, what kind of like, is there a cognitive behavioral therapy aspect?

[705] Is there any kind of therapy or is?

[706] Yeah, absolutely.

[707] So trauma -focused cognitive behavioral therapy is one of the treatments that's recommended.

[708] There are more and more mental health interventions that are proving to be effective in helping to address an overactive stress response.

[709] I'm not a mental health professional.

[710] Yet.

[711] And so I, cautious as I say that, but some of the ones that we hear about are, for example, EMDR is one that a lot of people are talking more and more about eye movement desensitization.

[712] But trauma -focused cognitive behavioral therapy, particularly for kids, there's child parent psychotherapy developed by Dr. Alicia Lieberman, a research.

[713] at UCSF.

[714] The most important thing about the mental health treatment is that it be trauma focused.

[715] Because this is one of the things that we see that actually still happens to this day is that someone has a challenge, whether they, you know, whether they have an addiction or they're having anger management issues or they're depressed.

[716] And they go and see a therapist.

[717] And this therapist spends the whole time trying to treat their substance dependence and never.

[718] treats the trauma.

[719] Sure.

[720] Right?

[721] That's underlying.

[722] Right?

[723] Exactly.

[724] And so that's the trauma focus nature is important.

[725] Yeah.

[726] I feel like it's important in the same sentence when you say these things can cause this that we all say and you can stop it.

[727] Because otherwise my fear is and I think what maybe a lot of people might think when they hear it is like, could this cause some sort of self -fulfilling prophecy where it's like, oh, I have four aces.

[728] So I'm going to have this and I'm going to to have the, so yeah, I could see people being like, well, do you want to find out?

[729] Because if you find out, then you know you're susceptible to all these things.

[730] And not that I agree with that, but I have reactions like that.

[731] And it's funny because it all boils on to like, I have a very low assessment of people's true good nature.

[732] I'm like, oh, any way someone can game the system, they're going to game the system.

[733] You know, like this knee jerk, again, having grown up around a lot of wolves that were gaming the system, I'm on high alert for people to your point going like, well, I have five.

[734] So tough shit.

[735] I'm checking out.

[736] And I don't even mean consciously like that.

[737] Not like even to game the system, but just like knowing that, okay, I'm probably going to have a substance abuse.

[738] Like it, you know, I don't know.

[739] But again, I think it would be, look, I pretty much knew I was going to have one.

[740] I'm third generation.

[741] I've known people having it.

[742] And yet I was like, well, I'm still going to, I'm going to find out.

[743] Right.

[744] You know, I wonder, but I guess it's.

[745] But I guess if you catch it, Earl, if you know these things early, then you can start early with some of these.

[746] Some service, I think.

[747] Stay tuned for more armchair experts, if you dare.

[748] So my experience as a doctor is that what my hope would be and what I see, and this is for like the experience I have over and over and over again.

[749] Because when you write a book about this topic and you do a national book tour, what happens is that everyone in line who's there for you to sign their book, They also tell you they're a score, right?

[750] Like, this is real.

[751] I did it right away.

[752] I'm so cliche.

[753] And one of the things about it is, I think especially for adults, is to recognize, oh, dang, okay, I might have an overactive stress response, right?

[754] And so when something stressful is going on in my life, let me actually be proactive and do the things that are going to make a difference so that I actually don't have that negative.

[755] outcome.

[756] Right.

[757] I want to give an example of this because, I mean, I'm looking at you guys.

[758] You guys know that when I came into my clinical practice, it's not an accident that this is the work that I found.

[759] Well, that's where I was going to end.

[760] Yeah.

[761] Yeah.

[762] Yeah.

[763] I mean, for myself, I grew up in a household where my mom was paranoid schizophrenic.

[764] And the there were a lot of scary moments.

[765] Yeah.

[766] And I think that informed my medical practice in ways that were really powerful.

[767] The thing that I want to remember to say, because I think this is so important, is that I think our aces can be a vulnerability, but I also think they're the source of our superpowers.

[768] Oh, absolutely.

[769] Yes.

[770] For real.

[771] My wife will say, you know, it's hard to deal with some of your shit.

[772] But when the shit hits the fan, which over the last 12 years, the shit's hit in the fan a couple times.

[773] Yeah.

[774] And it's chaos.

[775] I'm as cool as a cucumber.

[776] I make the right decisions.

[777] I'm not very affected.

[778] And she's like, oh, my God.

[779] I'm boggling how there was a huge accident.

[780] People were screaming.

[781] And you were like, all right, let's party.

[782] We got to do this, this and this.

[783] So yeah, that's the kind of other side of the sword that I like having.

[784] That's right.

[785] And it's actually, I actually think there's a lot of people.

[786] I truly think I'm a big X -man fan.

[787] Okay.

[788] I read the comics when I was a kid, watched cartoons when I was little.

[789] I watched the movies now, but...

[790] And they're all mutants, right?

[791] Yeah, yeah, yeah, they're mutants.

[792] Yeah.

[793] And so the part of the reason I love the X -Men series, right, is because they're these young people who blow stuff up, right?

[794] They have these mutations.

[795] They blow stuff up and, you know, eventually Professor X, who's like the head teacher, right?

[796] He finds them.

[797] And instead of, again, like blaming and shaming them, he has his professor X's, school for gifted youngsters, and he teaches them how to use their gifts, right?

[798] And instead of blowing stuff up, how to use it for good.

[799] Right.

[800] Right.

[801] And in my own experience in my medical practice, from the experience of having a mom who's mentally ill, I kind of learn how to read nonverbal cues, like really well.

[802] Or you have to because your life is threatened if you don't have those spidey senses where shit's about to go sideways.

[803] Right.

[804] That's exactly right.

[805] And so when I'm caring for a patient.

[806] And if there's something kind of going on beneath the surface, it's very easy for me to read that.

[807] And it makes me a way better doctor.

[808] Uh -huh.

[809] Right?

[810] And then similarly, when stuff is going sideways, I am.

[811] At your best, probably.

[812] Yeah.

[813] Yeah.

[814] But a couple years ago, 2014, my husband and I had the experience of losing a child.

[815] Oh, my God.

[816] Oh, we, yeah.

[817] Yeah, we were, six months pregnant and our son came early and he lived for 14 minutes oh god is that that's the worst thing sorry yeah and you want to talk about stressor and I will tell you I'm gonna I'm gonna say I really feel like this science probably saved my life and did some really good things for our kids because this is not an absolute extract exercise to that question of how do people use this information.

[818] I knew for myself because of my own history, the likelihood that my brain and body are stress sensitized, and that I'm more vulnerable to subsequent trauma.

[819] It was definitely the worst moment of my life ever when we lost our son.

[820] And it took some doing, even me, like, scientists, researchers, this is what I do for a living stress physiology and all this stuff.

[821] I was a hot, hot mess.

[822] And it wasn't until my brother was like, dude, are you okay?

[823] And I was like, oh my God, I'm really not okay.

[824] I'm that person that you see.

[825] I'm the impaired parent.

[826] I can't take care of my kids right now.

[827] Yeah, yeah.

[828] And I literally, I was like, well, what do you do?

[829] I literally, and I'm like, oh, sleep, exercise, nutrition, mind well, it's, health, and healthy.

[830] Yeah.

[831] Okay.

[832] Yeah.

[833] I literally, like, did the thing.

[834] Religiously.

[835] Just made a huge difference.

[836] I say that to dudes I work with in the program all the time, which is like, know your list.

[837] You got to have your list.

[838] Mine is journaling, exercise, being observed as someone I don't want to be.

[839] You know, I have my thing.

[840] And I'm not allowed to get scared until I've done everything on that list.

[841] And I still feel pessimistic and terrified and all those things.

[842] And so, yeah, I mean, you got to know your list.

[843] And you got to run through it even when you're miserable.

[844] That's exactly right.

[845] That's one of the things that I tell my patients all the time is I say, make a list of what works for you.

[846] Right?

[847] and hopefully it's informed by, you know, some of the science and some of the research, but really it's about what works for you.

[848] And that list can include, like, who your people are.

[849] Yeah.

[850] Like, and who your people aren't?

[851] Like, who is like, you know what?

[852] Let's touch base another time.

[853] Yes, yes.

[854] And just the same way that my youngest son has a peanut allergy.

[855] We literally have a thing, an emergency care plan on our fridge.

[856] Like, if he eats peanuts, this is what you got to do.

[857] do.

[858] This is the medicine you've got to give.

[859] This is the dosage.

[860] It's literally like if you're triggered or if you are having that stress or that trauma, even if you just feel yourself kind of tipping over, right?

[861] Get that plan.

[862] Yeah, yeah.

[863] Right.

[864] The sad thing and the problem with mental health issues in general is that you're at your worst to be making those decisions.

[865] It's very much a self -accelerating thing where it snowballs because you're making bad decisions.

[866] You're, so you decide to eat a shittier meal to comfort yourself and now you feel even shittier, so you decide to do this, you know, and you're getting further and further away from the list.

[867] Yeah.

[868] And it's so easy.

[869] I just want to go back to one thing, Monica, the one thing I was going to add to what you said about the self -filling prophecy is the one thing it can do is alleviate some of the shame, I think.

[870] And for me, shame is such a driving force of all the other isms that are destructive, that just to cut myself a little slack and go, yeah, what you're doing is a little.

[871] bit predictable.

[872] It doesn't mean you're not responsible for it, but it does help that I'm not a failed human being unworthy of love and all these things and good feelings.

[873] It's just helpful to know like, oh, yeah, no, these are, again, if you had diabetes and you were like, yeah, I don't make insulin.

[874] There ain't no shame in that.

[875] No one's sitting around, you know, beating themselves up over it.

[876] Do you think knowing that like the subjects were all similar in race, do you think there's more research to be done with different types of people?

[877] Yeah.

[878] So the 10 criteria that were in the ACE study, the 10 adverse childhood experiences, they kind of set the scientific foundation for us to understand there's cumulative adversity.

[879] If someone is threatening you or oppressing you because of your race, it activates the same biology.

[880] Right.

[881] Or because of your sexual expression or whatever, it activates the same biology.

[882] The point is it's about basic biology, right?

[883] And that actually, for me, it's been a real eye -opener because I actually came into this research from the standpoint of addressing health disparities.

[884] Like, why do certain communities have worse health outcomes?

[885] And initially it was about access to health care.

[886] Yeah, that's right.

[887] I did my master's in public health at Harvard, and that was a big part of the research.

[888] Monica, she residenced at, where unifiles, she residencied at Stanford, she went to Harvard, she went to Harvard.

[889] Berkeley.

[890] Don't forget about UC Davis, man. Go at ease.

[891] Well, they're not, listen, I'm from the UC system that UC Davis did not make our unifile cut.

[892] I'm so sorry.

[893] Everyone that was UC Davis is great, but, you know, I'm not even putting UCLA in there.

[894] So I'm taking one as well.

[895] But Berkeley makes it.

[896] Yeah, okay.

[897] But yeah, so this is to say as like a black person living in America, I've definitely felt that little flutter of my fight or flight response.

[898] Oh, yeah.

[899] When I'm like, am I at risk here?

[900] Is there a threat to me or my kids?

[901] Crazy story.

[902] So this is something I put in the book.

[903] So spoiler alert.

[904] So my husband and I have four boys.

[905] Two we baked in the oven to gift with purchase.

[906] So we have four black boys.

[907] Sure.

[908] Three at the time because our youngest hadn't been born.

[909] We're up in Tahoe.

[910] And you know, some places around Tahoe get real rural.

[911] Oh, when you're on the Nevada side heading towards Reno.

[912] Yeah.

[913] Yeah, so that's where we are.

[914] And our boys are sitting on a bench acting like rowdy little boys.

[915] And two guys walk up behind them.

[916] And I describe them in the book as like shaved heads, steel toe boots, real, like, you know, tattoos on their neck.

[917] White nationalist look.

[918] And they're looking at our kids crazy.

[919] Like, what the heck are these kids doing?

[920] Like, really.

[921] And I had been in the restroom and I walk around the corner and I see my husband, he's looking at the kids and he's looking at these guys and his fists are clenched and he looks like he's ready to brawl.

[922] Yeah, yeah.

[923] And the point I'm making the book is that my husband is white.

[924] Oh, dang.

[925] Okay.

[926] But because he has four black kids, right?

[927] The impacts of racism in America.

[928] Because he's like, I'm about to die today.

[929] Because of race.

[930] Because of race.

[931] Monica, this proves my point about Wabiwob.

[932] Wabi Wob is half Asian.

[933] God, we fight about this.

[934] Rob's wife is Filipino.

[935] She's actually half Filipino.

[936] And his son then is quarter Filipino.

[937] And I keep telling Monica that now Rob is half Filipino and she hates it.

[938] So anyways, you just kind of stumbled into a long time joke of, yeah.

[939] So look at that.

[940] Her husband is now half black.

[941] Do you see what happened?

[942] Okay.

[943] Okay, great.

[944] He now has the stress responses to the black person.

[945] But would you say he's half -flare?

[946] Yeah, she would.

[947] Probably not.

[948] I'm joking about that.

[949] You're on Team Monica.

[950] But no, that's for real.

[951] That's wild.

[952] Yeah, yeah, that is wild.

[953] Yeah, and I guess if you're white and you've had a black friend and you've been places and you've felt that too by proxy or you've dated someone over a, you get to not nearly on the same level, but you can.

[954] witness it in a brand new way, which you're just largely unaware of.

[955] Or, you know, just imagine that every time you see a cop in your rear, it's the feeling that you had when you were drunk driving.

[956] Like, oh, fuck, I'm fucked.

[957] I'm going to jail.

[958] Literally, if every time you saw a cop, you were like, am I drunk driving?

[959] You know, that's...

[960] Yeah, DWB.

[961] Yeah, yeah.

[962] Yeah, you get, cops get behind you a lot.

[963] And if every single time...

[964] Well, I think the worry is, and I think that for many people, It's, and I, listen, I'm the Surgeon General of California, and I have the experience of, is this person going to have a bias that's going to put my life at risk?

[965] Yeah, yeah.

[966] Yeah.

[967] It's all coming to the surface, I think, thank God, because I'm fucking blind.

[968] I grew up, you know, I lived in downtown Detroit, it's 92 % black.

[969] And I'm still at 44 having things explained to me in a way.

[970] I'm like, oh, my God, yeah.

[971] I was totally blind to that.

[972] You know, I'm trapped in my own perspective at all times, pretty much.

[973] Okay, I do want to just introduce an idea I had, and it's not to make you defend what you've been saying, but I did have this thought the other day.

[974] I've watched a million documentaries about baboons, chimpanzees, orangutans, gorillas.

[975] And if you watch any of these videos, they witness almost daily physical abuse from an outranking male or female, sexual trauma, orangutan's race.

[976] rape each other.

[977] There are interspecies wars that happen where they witness homicides.

[978] Well, not homicides.

[979] They're not hominids.

[980] But when I look at that, part of me goes, bullshit, we are so hardwired to deal with this stuff.

[981] We have to have been.

[982] There's no reason that we are also great apes.

[983] And I can look at all the other great apes.

[984] And they're dealing with just daily trauma by all definitions, and we must have the mechanisms, and we couldn't have just evolved to lose them.

[985] So there is a voice in my head that goes, horseshit, we're designed to deal with trauma.

[986] Have you read the research on cortisol in primates?

[987] Is it off the charts?

[988] Rob Zabolsky.

[989] This is actually how we know a lot of this stuff.

[990] Okay.

[991] Because, yeah, monkey do the same thing.

[992] Primates do the same thing.

[993] So Rob Zipolsky, he's at Stanford.

[994] he like went out and lived in the bush and tracked monkeys and not monkeys gorillas right you can tell him not a primatologist yeah that's all right yeah yeah i'm a pediatric yeah so so tracked gorillas and he measured cortisol levels i guess what the lower ranking you are oh i spite the higher your cortisol level except in one condition this is fascinating is that when you have the highest ranking gorilla, and then something happens that shuffles it up, where there's a threat of losing their privilege.

[995] Yeah.

[996] In that instance, the gorilla that has the most privilege to lose, their cortisol levels spike.

[997] Oh, boy, this is a circle right back to race.

[998] Yes.

[999] Fascinating.

[1000] But this is what they see.

[1001] The ones that are lower ranking, they have the highest cortisol, they have the highest inflammation, they have the highest level of illness.

[1002] They live shorter.

[1003] Are they all of the above?

[1004] Oh, they do have, okay, okay, that makes sense.

[1005] Read Why Zebras Don't Get Ulcers by Rob Spolsky.

[1006] Oh, why zebras don't get ulcers?

[1007] Yeah.

[1008] I will.

[1009] Okay, another thing, and you and I talked about this a little bit before we started, which I think is interesting.

[1010] So we're starting to hear more and more about generational trauma in kind of inheriting trauma, and most frequently it's brought up in reference to the black experience in America, which makes a ton of sense.

[1011] I, of course, was a little bit like, well, hold on, you can't change your DNA.

[1012] No part of your experience is going to alter your DNA.

[1013] You're going to pass on that.

[1014] And so I brought that up to you, and then you explained to me in artful detail what actually changes and how that can be transmitted generationally.

[1015] Yeah.

[1016] So it doesn't change your genetic code, right?

[1017] Your DNA, the ATGC.

[1018] What researchers found is that on our DNA, there are markers.

[1019] They're called epigenetic markers because epigenetic means above the genome.

[1020] And these markers tell us how our DNA should be read.

[1021] They put markers on sequences of DNA, which essentially say, skip this next segment.

[1022] Don't bother to read this next segment of DNA.

[1023] Or, hey, you know this segment right here that processes how much inflammation you have in your body?

[1024] Read that twice.

[1025] Make some extra copies of that.

[1026] Right?

[1027] So it's this epigenetic regulation.

[1028] Right.

[1029] So one of the things I say, it's like if the DNA are the musical notes, they're like the musical notations, which tells your body how to play that segment of DNA, right?

[1030] And it's kind of also like a computer program that it can go, go back to line 20, read line 30.

[1031] That's exactly right.

[1032] So our epigenetic regulation is very strongly shaped by our environment.

[1033] And that actually can be handed down from one generation to the next.

[1034] So, for example, part of the way that we know this and understand this, they've done research in the children and grandchildren of Holocaust survivors using naturally occurring circumstances of severe trauma and seen changes in their epigenetic markers, right?

[1035] that also coincided with increased risk of health and mental health and behavioral problems.

[1036] Right.

[1037] But again, we also see this across species.

[1038] But here's what's totally dope, right?

[1039] So this is what we were talking about.

[1040] So we used to say which is more important nature or nurture, and now we know that it's actually your environment shapes how your biology manifests, right?

[1041] And here's what's really dope about it, is that some of this research about nurturing relationships, there's evidence to show that these nurturing relationships can actually change epigenetic regulation.

[1042] So we've literally seen this in rats where when they take baby rats and they stress them out and then the moms either do lots of nurturing care or some rat moms kind of naturally did a little bit less nurturing care.

[1043] and the rat pups whose moms did a lot of nurturing care, they had better executive functioning, right?

[1044] Like they performed better on tests.

[1045] They actually had a more normally functioning stress response that turned itself off normally after the stressor was done.

[1046] And what they found was that that was associated with the changes in these epigenetic markers and that they handed it down to the next generation.

[1047] And the crazy thing is that in these experiments, when they took the next generation of rats and they stressed them out again but this time instead of giving them to their biological mom they switched them and they gave the pups that were biologically from a mom who didn't do a lot of nurturing care to a mom who did do a lot of nurturing care those pups then better executive functioning more normal stress response and they had the epigenetic markers of the mom who raised them not their biological mom.

[1048] So this is what the science is showing us, is that nurturing care really can change us all the way down to our DNA, which I think is really cool.

[1049] Yeah, it's incredibly cool.

[1050] Yeah, that's fascinating.

[1051] It's got me to buy in.

[1052] Yeah, I love it.

[1053] I'm officially bought in.

[1054] I recall, again, 20 years ago in a psychology class learning, that schizophrenia is a genetic, right?

[1055] So you generally can pass that on.

[1056] And as it was explained to us, again, it probably changed in 20 years.

[1057] But there were people who, when identified as having the genetic marker for it, were encouraged to not do anything stressful between the ages of like 18 and 24.

[1058] That's kind of when it generally sets on if you carry the marker.

[1059] Is that still how we think of schizophrenia?

[1060] And if so, were you terrified to also become schizophrenic?

[1061] Oh, yeah.

[1062] Was I terrified?

[1063] Yes.

[1064] Yes, absolutely.

[1065] I was.

[1066] And I think some of the research shows that even, for example, again, like we're understanding a lot now, this combination of nature and nurture.

[1067] So even, for example, identical twins where one develops schizophrenia, I think the other one, don't quote me on this, but I think it's like 50 % chance.

[1068] Okay.

[1069] So, so again, even though they have the identical DNA, they don't just necessarily both get it.

[1070] So it's a combination between genes and environment.

[1071] And, yeah, I had a mom who had parentage schizophrenia, and I also had a very stressful environment, right?

[1072] Right, right.

[1073] Which was really challenging.

[1074] One of my four brothers ended up developing schizophrenia.

[1075] And did he have a traumatic event significantly more profound than any of you guys did in that window?

[1076] Honestly, I think he was more sensitive.

[1077] Uh -huh.

[1078] But I also think, like, one of the things that research also shows is that you can have five kids growing up.

[1079] in the same family who have different experiences.

[1080] And part of this is around buffering care.

[1081] Part of the work is increasing the, you know, as I say, the cumulative dose of buffering in the community.

[1082] Because it could be like your soccer coach who's at buffering care.

[1083] Or it could be, you know, your pastor or your rabbi or your imam.

[1084] Or it could be whoever, you know, your next door neighbor or whoever is that person who is able to be that nurturing care.

[1085] and the more sources you have, the better, right?

[1086] For me, my dad was a huge buffer for me. So my dad is a biochemistry, he has a PhD in organic chemistry.

[1087] Oh, wow.

[1088] And we - People hate that class, organic chemistry.

[1089] That's why everyone fails.

[1090] It's a hard class.

[1091] But it was a really interesting experience in my family because of all of my brothers, none of them were really scientifically inclined.

[1092] None of them have gone into the sciences.

[1093] Yeah.

[1094] And I, like, out the gate just loved science.

[1095] And that was something that my dad and I totally bonded over.

[1096] Like, we were like the nerd father and daughter, like doing natural experiments in the kitchen, right?

[1097] Yeah.

[1098] And that was a big source of buffering for me. Yeah.

[1099] This is so off topic, but I'm just going to ask you any.

[1100] Anyways, we recently heard a different podcast and there was a woman on there talking about that so many folks, this is so dangerous, I'm going to repeat what they said, so many folks that get into these Ivy League colleges that are African American, that have had some kind of weighted admissions through affirmative action, go with the intention of exploring some kind of STEM pursuit.

[1101] And they gave Michelle Obama even as an example in her book, she talks about having gone there to get into medicine and then being kind of redirected towards something else.

[1102] Did you feel pressured to drop that pursuit?

[1103] Or what do you think of that situation in general?

[1104] I don't know the stats on it.

[1105] I'm not, I wouldn't be surprised if I heard it.

[1106] Right.

[1107] I mean, I would say, I know a lot of people who were premed in college.

[1108] That's what I said when I heard it.

[1109] But African American doctors, right?

[1110] So let's just say you went through college.

[1111] You were premed.

[1112] You go through medical school and you go the whole way are five times as likely to serve underserved communities, right?

[1113] Where I'm going to tell you, you don't make it much money.

[1114] Right, right, yeah, yeah.

[1115] As Caucasian.

[1116] You can say monkey, yeah.

[1117] But seriously, listen, I think that just as, you know, you're a parent, right?

[1118] Yeah.

[1119] If you saw a dad in the park and he had two little girls and something was going on and he was kind of struggling, right?

[1120] You'd be like, man, I've got to help him out.

[1121] Yeah, yeah, yeah.

[1122] Yeah, yeah.

[1123] Similarly, I think because people of color, we do, we walk through the world and we see the experiences.

[1124] And I will tell you that I, when I was in college, I would spend all my summers doing like these pre -med training programs and the, MCAT, that horrible test that people had to take, like MCAT training programs.

[1125] And I remember I went to do this MCAT training program.

[1126] It was in Chicago.

[1127] And the woman who's leading this for students of color, she's like, don't worry about trying to study too hard because, you know, the average black person who gets into medical school, they have lower MCAT scores anyways.

[1128] And I was like, what?

[1129] Are you encouraging me to lower my standard?

[1130] Yeah.

[1131] Right?

[1132] Like, and this is the program for students of color.

[1133] That's insane.

[1134] Right, right.

[1135] That's, I fortunately for me, I feel like my parents taught me the opposite, and it was really wonderful that, you know, my dad's a PhD in organic chemistry, my mom's a nurse, and they always told me like, hey, you have to, like, get your education.

[1136] They had very, very high expectations.

[1137] Yeah.

[1138] And for me, that was actually ultimately.

[1139] one of the reasons why it was really important for me to open this clinic in this really underserved neighborhood in San Francisco because I just felt like, you know what, this community that is mostly low -income African -American, Latino, and Pacific Islander, they need a doctor who went to Harvard and Stanford and Berkeley.

[1140] Yeah, yeah, and you see Davis.

[1141] All right, yeah.

[1142] Yeah.

[1143] Well, Dr. Harris, what a pleasure to talk to you.

[1144] Really, really fun.

[1145] One of my favorite topics.

[1146] I'm so happy for you.

[1147] You made it.

[1148] I know.

[1149] They had high expectations and you delivered.

[1150] Yeah.

[1151] Are you sure they weren't Indian parents?

[1152] Listen, Jamaican parents are no joke.

[1153] Oh, they're no joke.

[1154] Yeah.

[1155] Yeah.

[1156] This is my dream job.

[1157] I have to say, I love science and I love people and I love using science to help people be healthier.

[1158] And so I'm just grateful.

[1159] I think you're wearing the hat well.

[1160] I think they picked well.

[1161] Yeah.

[1162] Really good job.

[1163] Yeah.

[1164] All right.

[1165] Great.

[1166] Thank you.

[1167] And now my favorite part of the show, the fact check with my soulmate, Monica Padman.

[1168] So Rob has nice handwriting, you were just saying.

[1169] Yeah.

[1170] He wrote a note, and I think he has nice handwriting.

[1171] To be fair, I'm a little far away, and I'm not wearing my glasses.

[1172] So the compliment is only so strong.

[1173] You and I wasted, I don't know, 40 minutes last night looking at shark teeth because you didn't have your glasses.

[1174] And I was like, the teeth are serrated.

[1175] And you're like, I don't know.

[1176] If they were serrated, you couldn't wear more on your neck that cut you.

[1177] I'm like, no, that's the soft part lays.

[1178] And no, I still feel like if you're wearing a sharp shark tooth that's serrated on your body.

[1179] Right.

[1180] And, you know, you're jumping around and it cuts you.

[1181] You're dead.

[1182] Well, hold on, though.

[1183] I don't think it could cut you because.

[1184] There's got to be some opposite force on the opposite end of the tooth, but it's just jiggling around.

[1185] You know what I'm saying?

[1186] There's no hand pushing it down.

[1187] But if you don't know, what if someone pushes you?

[1188] Okay, well, now you're putting it in different circumstance altogether.

[1189] But that's my point is in life, shit happens.

[1190] You fall down, people push you.

[1191] You're jumping and something.

[1192] Yeah, that's what I mean.

[1193] It's too dangerous.

[1194] Well, I wonder, Rob at it.

[1195] Has anyone died from owning a shark tooth necklace?

[1196] Oh, maybe listeners, you can tell us if you know someone who's passed.

[1197] Or if you've died.

[1198] Yeah.

[1199] Now, let me ask you something.

[1200] Close your eyes.

[1201] Close them tight.

[1202] And what does it sound like?

[1203] Sounds like you're, I'm wrestling around in your nose with the napkin.

[1204] Oh, okay.

[1205] Well, I am.

[1206] But I thought it sounded like someone rolling around in their brook linens.

[1207] Oh, okay.

[1208] That is a big stretch.

[1209] I would have never thought about that.

[1210] But you'd already seen the tissue in my hand in my big nose.

[1211] And you taught me bringing the tissue up to my big nose.

[1212] So your brain did the rest.

[1213] Yeah, my brain works pretty well.

[1214] You got a dang good brain.

[1215] I really liked Nadine.

[1216] I know.

[1217] You know, my friend Lizzie, one of my smartest friends, Lizzie, who's also the person I turned to for all the Jewish questions.

[1218] Oh, great.

[1219] She's your ambassador.

[1220] Yes.

[1221] She was like, hey, you guys should think about having this person on.

[1222] She had read about her or something.

[1223] And then I put two and two together that that was the person that, was involved in these aces that we had heard about a while ago.

[1224] So then, yeah, so I didn't even know at that point she was a Surgeon General of California.

[1225] And so I just reached out.

[1226] You know, my favorite kinds of episodes are ones where, like, as soon as we finish recording them, I'll, like, reach out to my mom going like, oh, my God, we just recorded when you have to hear.

[1227] Yeah.

[1228] And I think I've already told, like, three or four people that they have to listen to Dr. Harris.

[1229] Yeah, it's a great episode.

[1230] Not to be confused with Dr. Sam Harris.

[1231] Is he a doctor?

[1232] Yeah, he's a doctor.

[1233] I guess he is because he has Ph .D., yes.

[1234] P .J. P .J. Pote.

[1235] I kind of wish medical doctors had a different...

[1236] I do, too.

[1237] I still don't.

[1238] Well, don't they have MD.

[1239] Yeah, but you don't say that.

[1240] Right.

[1241] Ph .D .M .D .M .D. Yeah.

[1242] You don't differentiate.

[1243] You just say doctor.

[1244] Ph .D .M .D .M. Although I shouldn't say that because I love professors.

[1245] Yeah, you do.

[1246] So I think they should be called doctors.

[1247] Actually, I don't think he was a doctor at that point.

[1248] Oh, he probably wasn't.

[1249] Too hot.

[1250] Yeah, too hot.

[1251] And then she, I don't think she would be mad that I say this, but she sent a follow -up email to just see if I was okay.

[1252] Uh -huh.

[1253] Which was very, you know, remember, I don't know, two months ago, I was saying nothing to feel bad about, but just when you stake out a certain identity, some of the costs of that are sometimes people aren't too worried about you.

[1254] Yes.

[1255] So it felt very nice that she was like, are you okay?

[1256] Yeah.

[1257] And then I said, I don't know.

[1258] I think I am.

[1259] How does one know if they're okay?

[1260] Well, yeah.

[1261] Are you functioning?

[1262] Are you happy?

[1263] I show up to work relatively on time.

[1264] Yeah.

[1265] I'm present with my family.

[1266] Do you feel happy most days?

[1267] Yeah.

[1268] I think you're doing pretty good.

[1269] Oh, okay, good.

[1270] I guess you're right.

[1271] Yeah.

[1272] But you know what I'm saying?

[1273] Of course.

[1274] If she goes like, oh, well, you have all these aces.

[1275] Yeah.

[1276] But then it made me wonder like, oh, is there a specific treat?

[1277] for aces.

[1278] Well, she was giving those, like, mainly personal relationships, positive personal relationships, and...

[1279] And I have quite a few of those.

[1280] Meditation, which you do sometimes.

[1281] And, uh, um, um, sleep is a big one.

[1282] Yeah, I'm pretty good about that.

[1283] So, yeah, I think you...

[1284] I'm good.

[1285] Yeah.

[1286] I'll live, I won't live 20 or shorter.

[1287] I hope you don't.

[1288] You know, I was just at the doctor.

[1289] And I was like, you know, I raced over to Glendale and I raced over here.

[1290] And then I did, I had a little fantasy about this probably total illusion.

[1291] So I'm probably just this way and I'll be this way even in retirement.

[1292] But I had this notion of being retired and just dilly -dailing my way everywhere.

[1293] Uh -huh.

[1294] And I imagine that's going to be good for my body.

[1295] I don't think that's going to happen.

[1296] Oh, you don't?

[1297] No. Okay.

[1298] I don't think that would happen for me either.

[1299] I don't, I don't think I have a. Dillie -dele gear.

[1300] No. Uh -huh.

[1301] And I'm fine with that.

[1302] Kind of.

[1303] When I was mainly doing assistant work for Kristen, that specific kind of work, I was manic.

[1304] Yeah.

[1305] Like I know.

[1306] And I could tell.

[1307] And at the end of the day, I would like recognize that I was in a state, I was in a brain state that wasn't healthy.

[1308] Right.

[1309] Because of the trillion balls in the air?

[1310] Yes.

[1311] Was it just a volume of things?

[1312] It was the amount of balls in the air at once, not for me, for somebody else.

[1313] Yes.

[1314] So it was, it felt like pressure mixed with this like.

[1315] Why do I have to deal with this?

[1316] No, no, no, no. I didn't have any evaluation of it.

[1317] I just had, my brain was just working at a hundred miles an hour all day.

[1318] Trying to hold like eight things you're supposed to be remembering.

[1319] Yeah.

[1320] But, but it was weird because I was recognizing, I was like, I'm in this.

[1321] sort of manic state and I could tell when I was in it.

[1322] But I also kind of liked it.

[1323] Sure.

[1324] Well, people who have manic spells, they enjoy the manic spells.

[1325] Well, it feels really productive.

[1326] Uh -huh.

[1327] And probably you're a little high.

[1328] You're, yeah.

[1329] Yeah.

[1330] But I think it's, you're a high on your ability to be able to do it.

[1331] To manage it.

[1332] Yeah.

[1333] Uh -huh.

[1334] Yeah.

[1335] Well, also just I imagine chemically, things are like adrenalineizing you and getting you extra yeah probably taking an extra oxygen and stuff maybe but I was just saying that because but you do good on vacation I think you and I both do good on vacation yeah we're not the type of people that need to like be busy on vacation I will sit down in a chair on vacation and stay in it for 12 hours yeah you know that's changed for me what has because I used to like go on vacation and I had a list of things that I had to restaurants I had to go to places, yes, itinerary.

[1336] And I told you once I went with my family to New York and I really wanted to go to Serendipity and then we went and the line was like three hours and they said no and I was furious.

[1337] You would have waited for three hours.

[1338] Oh yeah.

[1339] You are amazing that way.

[1340] You know, back to the premiere in London.

[1341] Oh, sure.

[1342] You have a great patience for lines when you want to do the thing.

[1343] For things that I really need to have.

[1344] Oh yeah.

[1345] Yeah.

[1346] I'll wait.

[1347] Like I was walking down the street and there was a billboard that said free oral sex with Scarlett Johanson and there's more than 10 people on the line I'm going to keep moving that's so weird is that I wouldn't wait yeah yeah because I don't I don't know that I enjoy anything in life as much as I dislike waiting that's interesting yeah like I'll go to a restaurant I'm like I got my mindset on it I'm already eating it on the car ride get there there's like seven people mingling in the doorway and I'll just keep driving past the place.

[1348] What?

[1349] Yeah.

[1350] Even though there's so many ways to distract yourself now, like podcasts and stuff, I just Well, maybe if I were with like you and Bell and Jess and whatever, right, and I knew we were going to cut up and have fun and make fart noises in line.

[1351] Oh, my God.

[1352] Oh, my God.

[1353] You've got to tell it.

[1354] Oh, my goodness.

[1355] Oh, my goodness.

[1356] That just came up so naturally.

[1357] Yeah, we have a story to tell.

[1358] Oh, boy.

[1359] So embarrassing.

[1360] We interviewed someone yesterday, and I'll add that it was a pretty female.

[1361] I feel like that compounds it for me. Sure.

[1362] And I had eaten these new bars, you know, I'm generally, mostly paleo, and so they fit into that zone.

[1363] Yeah.

[1364] So I'd pounded like two or three of those bars in the morning, and then throughout the whole interview, I found that I was getting very gaseous.

[1365] And I was really holding them, obviously, we're in a small space.

[1366] and that was its own discomfort, blah, blah, blah, poor me. We go outside to take the photograph as we do at the end of the interview.

[1367] And it was a great interview and it was really fun and we got along with her really well.

[1368] Loved her.

[1369] And then we're taking the pictures and Wobby Wob changed his focal length at one point or his aperture or something.

[1370] And I was about to comment on that.

[1371] And right as I was about to speak, I did a real loud fart.

[1372] I mean, it came out of nowhere.

[1373] I had no warning.

[1374] It was as big of a surprise to me as it was to wabiwob and this poor woman.

[1375] It was longer than that.

[1376] Was it?

[1377] It was long.

[1378] Yeah, you're more objective than me. You do what you think of.

[1379] Oh, my God.

[1380] Hold on.

[1381] No, no, no, no, no. I am going to push back a little bit because maybe that length was correct, but that your sounded It was such a good farts out.

[1382] It was.

[1383] But his sounded wet.

[1384] And mine was in no way did anyone think I needed to go like check myself or wipe or change my miandis.

[1385] Wow.

[1386] It was a lot drier than that.

[1387] But I can see that it might have been that length and that volume.

[1388] It was so loud.

[1389] Oh, and Monica had had, you had to run to an audition in this one hour break we had.

[1390] I did.

[1391] So I miss this moment.

[1392] You miss this moment.

[1393] And there was no missing it.

[1394] If you were within 12 or 15 feet of us, you heard that fart.

[1395] What if I was driving?

[1396] I called you.

[1397] Did someone just fart back at the attic?

[1398] And it was so obvious and unavoidable that I immediately just go, oh, my God, I farted.

[1399] I'm sorry.

[1400] I can't believe that happened.

[1401] And then God bless her.

[1402] She was like, oh, my God, I love that you just farted.

[1403] I mean, she was clearly just being nice to me because you and I really, we really hammered this out last What are the different levels that go on?

[1404] Yes.

[1405] And you were like, well, that's fine.

[1406] If she said she thought it was funny.

[1407] And then we were playing this game like, hypothetical, what if we had Scarlett Johansson on?

[1408] Okay.

[1409] And she tooted during the pictures.

[1410] Right.

[1411] I said you'd like that.

[1412] And you're right.

[1413] Like, first I was like, no, but then I really put myself in that situation.

[1414] And yeah, what I decided was I would either be neutral of it or even maybe think it was cute.

[1415] Yeah.

[1416] But I would also be overcome with the codependent, of course.

[1417] Secondhand embarrassment that I know she's feeling and I would take that on.

[1418] I agree.

[1419] So however cool this gal was yesterday, she had to have been like, oh my God, he's so embarrassed.

[1420] Now I've got a comfort.

[1421] This is like the race thing where you have to comfort people who are apologizing for being racist.

[1422] But that's different.

[1423] You farted.

[1424] You couldn't help it.

[1425] And I did not choose.

[1426] You did not.

[1427] No, no, no, no, no. I was a passenger in this fart.

[1428] It's a mixture of feeling like, oh, no, he's embarrassed, but also the, probably the mirror neurons of like, oh, if that.

[1429] That's what it is.

[1430] It's the mirror neurons.

[1431] Even if you think it's cute, you go right to how you would feel and you'd feel terrible.

[1432] Yeah.

[1433] And then I was saying, I like jogged my memory.

[1434] And it has been 16 years since I farted in front of someone on accident.

[1435] Right.

[1436] This is a very kid affliction.

[1437] It is.

[1438] It is.

[1439] Before you get control of your self.

[1440] sphincter in your anus parts.

[1441] Well, I was, there's a scene with how to paddle to the very beginning of the movie where I climb a very tall rope up to a tree fort.

[1442] And something about, you know, exerting myself in this manner.

[1443] I was climbing.

[1444] And the whole crew is staring at me climbing the rope.

[1445] There's like 80 people in a moon shape around the rope.

[1446] And I get about midway up.

[1447] So I'm virtually, my butt is just maybe a foot of everyone's head.

[1448] and I just one just rips out and I just got to keep climbing you know.

[1449] Do you everyone laugh?

[1450] No, here's what happened.

[1451] Well, because we were rolling.

[1452] We were filming me and I'm like, oh my God, well, that's being in the movie.

[1453] I don't know much about movies at that point.

[1454] I don't even know that they can drop the sound for a second.

[1455] Whatever.

[1456] Point is I get to the top of the tree house and it was maybe 20 feet off the ground.

[1457] I get up, I stand, I say whatever I'm supposed to say.

[1458] And then immediately after I go, guys, I know.

[1459] I farted.

[1460] And then everyone started laughing because everyone did in fact hear it.

[1461] Yeah, the first movie.

[1462] Oh my God.

[1463] This is awful.

[1464] This is making me cringe so much.

[1465] To me, that's way worse than what happened yesterday.

[1466] No, I would argue it's not because because those 80 people could share it.

[1467] It's like so public that it's almost like they were protected in their, you know what I'm saying?

[1468] In their numbers.

[1469] Then it's a lot of people laughing at you.

[1470] But that's not even what I mean.

[1471] It's worse because there's something about like someone exerting a lot of energy, like really focused and then farting.

[1472] That's so embarrassing.

[1473] Sure, sure.

[1474] That aspect for sure.

[1475] But I'm more going into like, let's put it this way.

[1476] What would be more embarrassing?

[1477] You're in an elevator.

[1478] It's just two of you.

[1479] And you let out a. Versus you're like in line to get an Apple product.

[1480] and like 40 people hear you fart That is way worse to me Oh, okay And they all hear it Yeah, that's way worse I just think they can all look at each other And share it And then they're alleviated of some of it They're not shouldering that whole experience By themselves There's numbers Yeah I think you're now thinking of it From the perspective of The recipient Yeah, yeah, I am Yeah, for sure No, but I'm talking about the person who farted And you said you can't remember one in adulthood, and you're inclined to think it hasn't been since you were a kid.

[1481] I don't think so.

[1482] Oh, my God.

[1483] Now it's going to happen all this talking about.

[1484] I pray I'm there.

[1485] You must be so upset.

[1486] You weren't there.

[1487] I am.

[1488] Of course I am.

[1489] God, sorry, Nadine.

[1490] Well, we hijacked your fact check with a fart check.

[1491] Boy, that was a fart check.

[1492] It's good, though.

[1493] It's good to be, it's good to me humiliated occasionally.

[1494] Because we were saying there is no, there is no embarrassment.

[1495] like that one.

[1496] That is the ultimate.

[1497] I was saying I would rather have walked through a plate glass window or spilled like a whole smoothie on my shirt.

[1498] Yeah.

[1499] It is so embarrassing.

[1500] Losing control of your butthole is.

[1501] Well, also mainly because it could come with a smell.

[1502] Oh, right.

[1503] Which yours did not.

[1504] Oh, my gosh.

[1505] Thank God.

[1506] Thank God.

[1507] There was no smell.

[1508] I didn't smell.

[1509] Okay.

[1510] Okay.

[1511] Yeah, because there's all this conversation.

[1512] It's like, oh, my, I go, oh, oops.

[1513] I farted.

[1514] Oh, boy, sorry.

[1515] And she's like, oh, my God, that's so cute.

[1516] Blah, blah, blah.

[1517] And then I'm like, now it's that the clock is ticking.

[1518] I'm like, okay, it's we'll know shortly if there's a second wave of embarrassment coming.

[1519] Oh, we were standing so close.

[1520] Oh, my God.

[1521] You go, well, it would have been worse if it were silent, but deadly.

[1522] And then I said, no, no, no, because what I would have done is gotten her email and said, hey, sorry, Rob, farted.

[1523] in a picture session.

[1524] He does that sometimes.

[1525] Like, I kind of just...

[1526] But, like, the only reason this is kind of extra bad, if it's a stranger that you just had an experience with, they have some opinion of you now and some judgment of you.

[1527] And, like, now part of it is, like, I think he farts a lot.

[1528] Exactly.

[1529] Well, that's definitely what our guest thinks.

[1530] There's no way she thinks that that was...

[1531] An anomaly.

[1532] It had been 16 years since that last happened.

[1533] Yeah.

[1534] She's like, oh, this guy's loose.

[1535] triggered it?

[1536] Oh, wow.

[1537] What a good question.

[1538] No, I think it was those bars.

[1539] Sure.

[1540] And then just a total lack of warning.

[1541] Normally, I can feel some activity down there, and I know to clinch my bottom cheeks or do what you got to do.

[1542] But this came, I was broadsided by this.

[1543] We've all been there.

[1544] I mean, everyone knows exactly what you're talking about.

[1545] That's also what's so funny about it.

[1546] She was hugging you.

[1547] Did she squeeze you at that time?

[1548] No, no, no. But if you recall, like, we had our arms around each other looking at your camera.

[1549] We were, like, facing out.

[1550] But I didn't know if she had like a, she tight.

[1551] Oh, oh, like around my waist area.

[1552] No, no, I think it was in my latissomis.

[1553] Maybe she was holding me. Oh, wow.

[1554] Oh, anyway.

[1555] Well, that happened.

[1556] That really did.

[1557] Yeah.

[1558] Okay.

[1559] Anyway, Aces.

[1560] Sishing back.

[1561] I want to read them to people.

[1562] Oh, please do.

[1563] Okay.

[1564] So there's 10.

[1565] Oh, can I, I'm going to, um, I'm going to check when you.

[1566] Okay.

[1567] Okay.

[1568] Okay.

[1569] Wob, you do it too.

[1570] Count yours.

[1571] And you don't have to say which ones you said yes to.

[1572] I in the interview said that I had zero, but I have one.

[1573] Oh, you do?

[1574] Yeah.

[1575] Okay.

[1576] She said most people have one.

[1577] Okay.

[1578] Anyway.

[1579] Okay.

[1580] First one.

[1581] Before your 18th birthday, did a parent or other adult in the household often or very often swear at you, insult you, put you down, or humiliate you?

[1582] or act in a way that made you afraid that you might be physically hurt.

[1583] Number two.

[1584] Before your 18th birthday did a parent or other adult in the household often or very often, push, grab, slap, or throw something at you, or ever hit you so hard that you had marks or were injured.

[1585] Three, before your 18th birthday, did an adult or person at least five years older than you ever touch or fondle you or have you touch their body in a sexual way, or attempt or actually have oral, anal, or.

[1586] or vaginal intercourse with you.

[1587] Before your 18th birthday, did you often or very often feel that no one in your family loved you or thought you were important or special?

[1588] Or your family didn't look out for each other, feel close to each other, or support each other.

[1589] Before your 18th birthday, did you often or very often feel that you didn't have enough to eat, had to wear dirty clothes, and had no one to protect you?

[1590] Or your parents were too drunk or high to take care of you or take you to the doctor if you needed it.

[1591] Hmm.

[1592] This is weird for me as we go through these because a lot of these I would say no to my primary living situation with my mom.

[1593] Yeah.

[1594] But then, you know, we had weekends with dad.

[1595] But I guess that counts.

[1596] It's not like, yeah, yeah, yeah.

[1597] It either happened or didn't.

[1598] Okay.

[1599] Before your 18th birthday was a biological parent ever lost to you through divorce, abandonment, or other reason?

[1600] Before your 18th birthday was your mother or stepmother often or very often pushed, grab.

[1601] slapped or had something thrown at her or sometimes often or very often kicked bitten hit with the fist or hit with something hard or ever repeatedly hit over at least a few minutes or threatened with a gun or knife.

[1602] Before your 18th birthday did you live with anyone who was a problem drinker or alcoholic or used street drugs?

[1603] Before your 18th birthday was a household member depressed or mentally ill or did a household member attempt suicide?

[1604] Before your 18th birthday did a household member go to prison.

[1605] Okay.

[1606] That's all.

[1607] I might have to.

[1608] It's hard.

[1609] Answering these feels hard.

[1610] It does feel hard.

[1611] Because what you, I think you try to minimize.

[1612] You're like, well, you know, one time.

[1613] Yeah.

[1614] And you're like, is this supposed to be a consistent pattern?

[1615] Well, I guess it says often, more often, somewhat.

[1616] Yeah.

[1617] And like, especially with the one about physical fear of getting fit, whatever.

[1618] But it's like also at that time, kids were getting hit, like as punishment, which is, in my opinion, different than just getting hit.

[1619] Well, I think the difference in my mind would be, was your parent administering a consequence?

[1620] Right.

[1621] Or was your parent enraged in hitting you?

[1622] Right.

[1623] But I think that to me would be how you would delineate me. Between that.

[1624] Yeah.

[1625] Your parents lost control and started hitting you or did they go, I told you four times.

[1626] Now you're going to get a spanking and you get two spanks and that's it.

[1627] They're not enraged or making you feel completely unsafe.

[1628] Like you probably didn't feel unsafe when you were getting spanked.

[1629] You probably just didn't like it.

[1630] Yeah.

[1631] I don't think so.

[1632] Who knows?

[1633] I don't think people feel safe when they're getting spanked, which is why spanking has now gone the way of the dodo.

[1634] Well, my grandmother used to spank me, and she would do it with a yardstick sometimes or a paintster paddle.

[1635] But I just, I wasn't scared she was going to lose control.

[1636] Yeah.

[1637] Like I felt like she was in control.

[1638] And then I had other situations.

[1639] There were never moments where they were so angry that it was still a consequence, but it was like, but it came with anger.

[1640] Yeah, well, I guess in that situation, I would be scared.

[1641] Like, where is this going?

[1642] Right.

[1643] You can see when someone doesn't have control of themselves.

[1644] And if a big adult is hitting you and you can see they don't have control, then naturally you're like, how far is this going to go?

[1645] Yeah.

[1646] Like, I remember, like, my brother and I used to fight nonstop.

[1647] Yeah.

[1648] Totally normal.

[1649] And he would beat me up and that was fine.

[1650] But there was one incident, one incident where we were fighting at my dad's house.

[1651] And he was now a teenager.

[1652] So he had so many hormones and everything.

[1653] And I'm sure I was driving him insane.

[1654] And it got to the point where we fought and he got on top of me. And I used to have these carrying cases for my Hot Wheels cars.

[1655] And inside the case, they have these plastic, hard plastic grids that each car would go in.

[1656] And he took that and he pushed it on my face.

[1657] And he was pushing it with this whole body weight.

[1658] And it cut my nose and I was staring up at him.

[1659] And I really was thinking, oh gosh, he's lost complete control.

[1660] I don't know how bad he's going to hurt me. I guess that's how that's how I would, you know.

[1661] Yeah.

[1662] Define it as maybe trauma.

[1663] Yeah.

[1664] By the way, I don't blame him at all.

[1665] He was in a crazy chaotic situation with a very alcoholic father and we were bouncing around to houses and beds.

[1666] Yeah.

[1667] Stap dads, I absolve him of all guilt and wrongdoing.

[1668] Yeah.

[1669] So you had one, you think?

[1670] I don't know.

[1671] I definitely had one.

[1672] At least one.

[1673] Wobby Wob?

[1674] I had two or three.

[1675] Yeah.

[1676] I think I have between one and three.

[1677] Yeah.

[1678] It's also hard when you have good parents.

[1679] Uh -huh.

[1680] To think about them in that way.

[1681] And to like really start evaluating and think like, huh.

[1682] Yeah.

[1683] But you could have a good parent who's incredibly loving, who's a fucking addict who nods out on the couch and would have missed you needing a trip to the hospital.

[1684] So it's like, it doesn't necessarily mean they were bad or evil or...

[1685] Yeah, I mean, I guess I would probably say that that's not a good parent.

[1686] That doesn't mean you love them.

[1687] Right.

[1688] That's not good parenting, but it's not, to me, that's different than choosing to injure your child because you're...

[1689] I know those aren't, for me, binary.

[1690] Like, I think there's a whole spectrum of parenting and what's healthy and what's not healthy.

[1691] And I also think loving your child is mutually exclusive, can be mutually exclusive from even hitting them, yeah.

[1692] From hitting them, from neglecting them, from all of those things.

[1693] Like I don't, I think most parents love their kids.

[1694] Yeah.

[1695] I think biologically they do.

[1696] But I think you can still be a not.

[1697] Although some parents, and understandably, they resent that kid.

[1698] They resent that that kid has changed their life in a way.

[1699] they're not enjoying, and they're stuck with this kid.

[1700] I think you're right, but I think that's rare.

[1701] And she said that.

[1702] She was like, most parents want their kids to be healthy.

[1703] Yeah.

[1704] Even when they're guilty of a lot of these things.

[1705] But, yeah.

[1706] Well, I had eight.

[1707] You had eight.

[1708] Yeah.

[1709] And maybe a couple of those, like you guys, I don't, maybe it's not one.

[1710] I don't know.

[1711] Definitely six are black and white for me, but yeah.

[1712] I think eight.

[1713] I mean, I guess something.

[1714] A takeaway is, even without the screening, it's like, I guess why don't you just teach kids early regardless to build personal relationships, to meditate, to sleep, what, like, sleep training.

[1715] Like, why don't we just do that for every person?

[1716] Right, as a preventative measure.

[1717] Because why not do that forever?

[1718] It's never going to hurt you to do any of those things.

[1719] That's true.

[1720] It's only going to help every kid.

[1721] And so if you're saying, like, we're going to leave them in the house.

[1722] then everyone should just be given those tools from the beginning instead of evaluating who needs these tools who doesn't need these tools.

[1723] Oh.

[1724] What was that?

[1725] That was a throat noise.

[1726] Oh, wow.

[1727] Anyway, it's...

[1728] I'm unraveling.

[1729] I'm losing all control of keeping sounds in my body.

[1730] All right.

[1731] So, yeah, so she was talking about the Vince Valletti study on obesity.

[1732] From San Diego.

[1733] Yes, that's what sort of started this.

[1734] research he he was doing this obesity trial and everyone was dropping out and he couldn't understand why people were dropping out because they were losing weight so it was like a 50 % dropout rate and he was like what is going on it's working it's working why would they leave and then so so then he went and started talking to those people who dropped out right and that's how he found so then he accidentally said how much did you weigh when you had your first sexual experience but that was literally just like a slip of the tongue yeah he was asking all these questions 40 pounds i know oh i hate that that's what my girls weigh so so upsetting that's what i weigh soaking wet out of the shower 40 pounds if you if you um got breast reduction surgery you might be able to get yourself under 80.

[1735] I don't think they weigh 15 pounds.

[1736] You don't think so?

[1737] No. Well, get them on a scale.

[1738] How would I test that?

[1739] I like to test it.

[1740] Oh, I guess I could.

[1741] Set them on a scale.

[1742] But then the rest of my body's attached.

[1743] I know, so you double whatever the number is.

[1744] No. We'll get a physicist to give us a calculation.

[1745] Maybe we'll get Eric Topal to come in.

[1746] I'm sure he has a new scan.

[1747] Oh, he could figure that out.

[1748] Like the known density of boobs and volume times.

[1749] mass equals e he told me i could ask him any questions i need so we love him i know i love him so much um he's so busy but i'd love to i'd love to um hire him as a resident doctor like we just at any moment eric could pop out of the bathroom oh and just set us straight and answer questions oh that's great yeah anyway so you said which you've said this a few times now in the past this week oh boy you've said yeah millennials You know, they, when I hear that they can't work out a place unless their boss takes them to lunch four times a week, you've said that exact phrase a couple times.

[1750] So it's like, I don't know if he heard that.

[1751] Well, you know where that's coming from?

[1752] Where?

[1753] One of the evergreen complaints was that the student had never been to her professor's house for dinner.

[1754] Okay.

[1755] And I'm like, so that's, okay.

[1756] Are you fucking kidding me?

[1757] Sure.

[1758] That's crazy.

[1759] That's one person.

[1760] And then also, you know, there's these, this whole new.

[1761] employment approach employed by Google and all these tech companies that rely on young people and they have to play games for X amount of the day and they have you know there's there is yeah but that's not about being millennial that's these tech companies they are recognizing like the brain stimulation that happens in those activities is then going to create some creativity and it's not no it's not just that it's that turnover they can't afford turnover and millennials unlike my generation and then even more so the generation before me, most people got a job and that job became their career and they stayed there 20, 30, 40 years.

[1762] That's not the paradigm anymore.

[1763] People will have 11 different employers by the time they're 30.

[1764] So just knowing that they're already in a situation where they have no intention of being there for more than two years, you have to now start heading off any grievance they might have that would cause this turnover.

[1765] So they are coddling these tech, which I have no ethical, judgment about it the market's demanding that they act this way as the market will do maybe i mean yes all that's true but i don't i don't know if like the playing games is because of that i mean the google campus is supposed to be awesome sure you're supposed to take like a three -hour walk in the middle of the day you can like do whatever yeah hook up with people on the on the jungle gym but but i think that's an extreme thing that you're saying that's not true i'm using an extreme wanted to illustrate a point.

[1766] I know, but you're saying it as if, like, you heard that somewhere.

[1767] Well, it kind of did.

[1768] No, you did not.

[1769] Because this woman was furious that her professor had never had her over to dinner.

[1770] Okay, but you don't say that.

[1771] You say millennials aren't, their bosses aren't taking them out to lunch four times a week.

[1772] You've made an entire.

[1773] I'm exaggerating.

[1774] But don't when you're making a point like that because then you're making the sweeping judgment about a guru.

[1775] Well, let me just ask you, this doesn't, I'm not making any point if I go, well, here's the thing about millennials.

[1776] One millennial wanted to go to dinner at her professor's house.

[1777] And you're like, okay, well, that's just...

[1778] That's what's happened.

[1779] You've made a judgment of an entire group of people based on one thing that you heard.

[1780] Well, I'm coupling it with what I know about the tech industry and how they have to prevent these young adults from leaving and going to another company.

[1781] But look, not every millennial's in tech.

[1782] That's a tiny portion of all of us.

[1783] I think 100 % of them.

[1784] No. And, yeah, it might be about retention, but it's probably because these people are hard to come by who are really good.

[1785] Sure, but even, let me back up.

[1786] Henry Ford was one of the first people to kind of overpay his employees.

[1787] And he overpaid his employees because he had done the math.

[1788] And he found out what the price of turnover was.

[1789] And he figured out that it would be cheaper to pay them more than to have turnover because the period of training them and all this shit.

[1790] So I'm just saying the market forced him to pay people more to deal with turnover.

[1791] And I think that's currently happening still.

[1792] And to me, being from a different generation, it seems a little coddling.

[1793] But if it's happening in Henry Ford's generation, it's not millennials.

[1794] It's something that has been happening forever.

[1795] Yes.

[1796] Yes.

[1797] I'm saying that this always has happened.

[1798] But whereas it used to be pay them twice what the going rate was an hour.

[1799] Now it's have a masseuse on staff, go on a jungle gym and make out with your coworkers, five -star buffet, you know, it's great.

[1800] It's like working at a health club.

[1801] It's made up.

[1802] It's made up.

[1803] Everything you just said is completely made up.

[1804] I don't think they have a masseuse on staff.

[1805] Maybe they do.

[1806] I guarantee you.

[1807] I guarantee you one of these tech companies has a masseuse on staff.

[1808] Part of the main reason that that is also happening is because these.

[1809] people are working 20 hours a day.

[1810] Oh, they're hard, great workers.

[1811] No, but the point is the reason there's like a bed to maybe take a nap is because they expect you to constantly be on and working.

[1812] That's new.

[1813] Yeah, well, that is the rationale behind the free dining room because then it'll encourage coworkers to sit at a table and eat this free food and then they'll end up talking about the project and get.

[1814] So, yes, I can see that that's...

[1815] So like, because Cali works at Netflix.

[1816] Which is great.

[1817] Like every time you tell me something that they do at Netflix, I'm like, that's amazing.

[1818] I know.

[1819] Freeze your eggs.

[1820] They'll pay to freeze your eggs, which we will too.

[1821] They pay for Uber's.

[1822] Right.

[1823] To and from work.

[1824] Which is all like on the surface, you're taking that in as like, oh, yeah, they're giving them all this stuff to retain.

[1825] But it's not to retain.

[1826] They want to pay for Uber so that in the morning they can work in the car.

[1827] They are paying for the egg freezing.

[1828] that you don't feel like you have to leave your job and have a baby.

[1829] It's all for the sake of working more and longer and all the time.

[1830] So I don't think it's that...

[1831] Do they have a jungle jam at Netflix?

[1832] Or co -workers are having a mall and...

[1833] I'll ask.

[1834] Google did have a part -time masseuse who got stock and now she's a millionaire.

[1835] Oh, multi -millionaire.

[1836] But for everyone?

[1837] She was just a part one.

[1838] It started up with 40 employees.

[1839] She had a part -time job.

[1840] 40 employees.

[1841] She was rubbing down 40 people.

[1842] In 1999.

[1843] Oh, Jesus.

[1844] 20 years ago.

[1845] 20 years ago.

[1846] Before millennials were working.

[1847] That's a strong argument.

[1848] I think it's more likely that they hire masseuses to come in.

[1849] As opposed to keeping one on staff.

[1850] Yeah, my old company.

[1851] Well, right.

[1852] Because I'll tell you why they want to pay them as an independent contractor and I'd have to give them health care and retirement and stock options.

[1853] Although it sounds like they gave us stock options.

[1854] Yeah.

[1855] But so when I Googled this, I googled it because I was like, I'm sure he's talking about something he read, which I was wrong.

[1856] But the only thing I could find about millennials and lunch and then there was a ton.

[1857] Millennials and lunch.

[1858] It's going to be about avocado toast.

[1859] No. There was a ton of articles on this exact thing, which is.

[1860] Millennials want lunch breaks but feel like they can't take them, which goes to my point where they feel like they have to work all the time.

[1861] And I'm saying they, but I'm one of them.

[1862] So I...

[1863] Yeah, and you always have to have dinner with your boss.

[1864] My boss makes me have dinner.

[1865] It's the opposite.

[1866] Yeah.

[1867] Anyway, anyway, um...

[1868] Let's see.

[1869] You've had a masseuse.

[1870] Well, not at work.

[1871] I mean, I guess at work.

[1872] Again, I, but I am there.

[1873] This is to my point, if we're really going to talk about it, I don't leave.

[1874] I literally don't leave.

[1875] I leave for five hours.

[1876] I mean, I physically don't leave that environment.

[1877] I would say I'm at my house.

[1878] Let's, by the way, I'm grateful for this.

[1879] I'd love to be at your house.

[1880] Okay.

[1881] But I probably go home at 10.

[1882] 10, most nights.

[1883] Right, right, right.

[1884] And then I'm back at seven.

[1885] I mean, eight.

[1886] Yeah, so 10 hours at home.

[1887] But I love it.

[1888] That's also, also, this is not the same situation.

[1889] This is not the same situation.

[1890] What do we watch Silicon Valley last night?

[1891] The masseuse is part of the social thing.

[1892] We're all.

[1893] We're all on a team.

[1894] We're all on team.

[1895] And we're blowing money sometimes with massages and vacations is what's happening.

[1896] Yeah.

[1897] But the vacations aren't for work.

[1898] No. But they're a. product of the work.

[1899] We can afford to go on vacation because we all do this work together.

[1900] Oh, yeah, yeah.

[1901] Anyway, so, millennials, don't be upset that Dax keeps talking about you be.

[1902] How much you want to go to lunch with your boss?

[1903] I guarantee you one arm cherry's like, shit, that's me. I want to go to.

[1904] I don't even know why I'm saying it, because in reality, who wants to go to lunch with their balls?

[1905] Exactly.

[1906] Exactly.

[1907] Who wants that?

[1908] But look, I'm sorry.

[1909] you have to fill a fun archetype for the sake of fun conversation, just as my generous answer to fill an archetype.

[1910] No, I know, because...

[1911] You think the greatest generation was really?

[1912] They were all great.

[1913] No, no, the greatest generation wasn't all great, but we gave them that archetype, and I'm sticking with it.

[1914] Do you know what I'm talking about?

[1915] You think you're the greatest generation?

[1916] No, dingus, the generation who fought in World War II.

[1917] That's the greatest generation.

[1918] Now, clearly, a lot of those people were scumbags, but we call it.

[1919] it's the greatest generation because it's easy and it's fun and then we tell stories and we only think in stories and there are heroes.

[1920] They're the greatest generation.

[1921] Okay, I disagree.

[1922] I'm going to call them a mediocre generation.

[1923] You think millennials are the greatest generation?

[1924] Yeah.

[1925] Oh, wow.

[1926] I actually, look, I'll be honest.

[1927] I think millennials are one of the best generations, not Gen X, Z or whatever the one is under millennials.

[1928] Millennials are not.

[1929] Not.

[1930] Gen. X, Z, or whatever, the one is under millennials.

[1931] fucking.

[1932] No. That is not true.

[1933] You're talking about Jen, you are talking about the one below millennial.

[1934] I'm a millennial.

[1935] I know you're a millennial.

[1936] Oh.

[1937] Congratulations.

[1938] What I'm saying is we had many people in here say that millennials are having less sex.

[1939] I don't think so.

[1940] They didn't say Jen, whatever you just said, OZ.

[1941] That is the generation that is totally isolated and on their phone.

[1942] And that's the, the millennials have half and half.

[1943] They have lived half a life without all that technology in half width.

[1944] So they are not the ones that are, even Jonathan Haidt when he came on, he made the distinction.

[1945] Distinction.

[1946] He said it's not millennials.

[1947] Well, you know what's frustrating is you shouldn't be a millennial.

[1948] I think millennials should be anyone born after 2000, the new millennia.

[1949] That's, I know.

[1950] Okay, so you get cut up in the semantics, okay?

[1951] I mean, why even call them, why don't I call him the fucking 1900s?

[1952] I agree.

[1953] I don't really get why.

[1954] Okay.

[1955] Rob's got some.

[1956] It's 181.

[1957] to 1996 is millennial.

[1958] Right.

[1959] That's so stupid.

[1960] But I think maybe it's because I know.

[1961] It's because when the millennium changed over, this group was young -ish.

[1962] That's actually right.

[1963] Thank you.

[1964] They reached adulthood around the turn of the 21st century.

[1965] They did it.

[1966] Okay.

[1967] I am at the top end.

[1968] Don't you like the idea of the ones that were born after the new millennium?

[1969] Yeah, I mean, what I don't like is technically my brother and I are in the same group, and I don't like that.

[1970] That's what I thought too.

[1971] Yeah, my brother's 96.

[1972] Will you look up Gen X?

[1973] I wonder if my brother and I are...

[1974] 65 to 79.

[1975] Boom.

[1976] I'm Gen X. And my brother is.

[1977] He's 69.

[1978] I'm 75.

[1979] Cool.

[1980] Cool, cool, cool, cool.

[1981] Anyway, millennials, you're doing great.

[1982] Yeah, good job.

[1983] And you work really hard.

[1984] Oh, and then before Gen X is the baby boom?

[1985] Yeah.

[1986] That's my mom.

[1987] My mom, too.

[1988] And then the silent.

[1989] generation is 20s to the 40s.

[1990] That was a long time ago.

[1991] We don't know any of those people anymore.

[1992] That's my dad.

[1993] 20s?

[1994] 28 to 45.

[1995] You're, that was 45.

[1996] Oh, right on the cusp.

[1997] That's how my brother is too.

[1998] He's on the cusp.

[1999] Yeah, but he mainly is on the other one.

[2000] You were talking about your adrenal glands.

[2001] You said that your doctor said it was important for mood stabilization.

[2002] Norepinephrine, adrenaline, improves energy and attentiveness.

[2003] So that would be the mood part that you're talking about.

[2004] But it's both the hormone and a brain neurotransmitter or chemical.

[2005] It's mainly stored in the neurons, nerve cells of the sympathetic nervous system with small amounts also stored in adrenal tissue, which lay on top of your kidneys.

[2006] So maybe you have some in other places.

[2007] But I don't think I want for attention.

[2008] I don't feel like I'm unfocused or...

[2009] Yeah.

[2010] And you have energy.

[2011] Yeah.

[2012] I mean, I'm on a lot of caffeine and nicotine.

[2013] Maybe that's supplementing.

[2014] Anyway, that's all.

[2015] That's all?

[2016] Yeah.

[2017] Have you ever had a blood panel done to see what's happening in your body?

[2018] I mean, I get a blood work done at the doctor every year.

[2019] Because you get a full physical.

[2020] I do.

[2021] I should be better at that.

[2022] Everyone should do that.

[2023] Mm -hmm.

[2024] I think that's really important.

[2025] to do.

[2026] Maybe we should make that part of the employee package here that we bring a doctor in so we don't have to go anywhere.

[2027] Eric Topol, yeah, he can give us a full body scan.

[2028] Yeah, take our blood.

[2029] He'll spit in a cup, peepee, cough, cough, do some coughing.

[2030] All of it.

[2031] He'll hold wabiwob and I's nuts, have us turn to the left cough.

[2032] Well, if he's going to be weighing my boobs.

[2033] Sure, he better hold our test.

[2034] Yeah, it's only fair.

[2035] If I had to bet, like if I had to give a really, real bet.

[2036] I bet you Wabiwob's testicles way more than mine.

[2037] Okay.

[2038] Well, based on what info?

[2039] You know, I'm not positive why I think that.

[2040] But you, he's got youth on his side.

[2041] Okay.

[2042] Actually, I would say youth would make it less dense.

[2043] No, I think it's full of genetic material.

[2044] Yeah.

[2045] Oh.

[2046] Yeah.

[2047] Interesting.

[2048] Very interesting.

[2049] All right.

[2050] Well, I love you.

[2051] I love you.

[2052] And I really, really liked Nadine.

[2053] I would love to talk.

[2054] to her again.

[2055] Me too.

[2056] She's a nice person.

[2057] Yeah.

[2058] Okay, good night.

[2059] Good night.

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