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The 1000 Hours Outside Podcast
1KHO 761: The Things a Scalpel Cannot Solve | Dr. Lee Warren, The Life-Changing Art of Self-Brain Surgery
00:57:35
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- [00:00]
A
We have had a lot of conversations on this show about how every child is different and how, especially for kids with ADHD or other learning differences, the world can feel a little overwhelming sometimes. And if you're parenting a child like that, I want to point you to a podcast called Everyone Gets a Juice Box. It's a space where parents are just being really honest with each other about what this journey actually looks like. The questions, the doubts, the small wins, all of it. One part of a recent episode that really stuck with me was this mom who was talking about how she started noticing things early on. Little signals that something might be different. But at the same time, everyone around her was. Was saying, she's fine. And she described that feeling so well, that back and forth between I know something's going on and what if I'm overreacting? I think so many parents have felt that tension. And then when she shared this moment where her daughter said, I can feel it talking about her body not giving her the signals she needed. And it opened up this whole understanding about how some kids experience the world so differently on a sensory level. It was such a powerful reminder that often our kids are having a hard time and the more we understand what's going on beneath the surface, the better we can show up for them. I really appreciated how thoughtful and honest the whole conversation was. So if that sounds like something you need right now, go give it a listen. To listen search for Everyone gets a juice Box in your podcast app. That's Everyone gets a juice Box.
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B
Welcome to the 1000 Hours Outside podcast.
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A
My name is Jenny Urgent, founder of 1000 Hours Outside.
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B
And today there is a neurosurgeon, Dr. Lee Warren. Welcome.
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C
Thank you, Jenny. It's so good to be with you.
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B
A neurosurgeon. And also, I mean your credentials are so far reaching. You've done military like in combat surgeon, doing surgeries there. And then you also are a prolific author. I've got three books of yours here. One came out February 2026.
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A
So this is the newest one, the
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B
Life Changing Art of Self Brain Surgery, which you're like, this is not a metaphor. This is like an actual thing. You can really change your brain. I also have. I've seen the end of you. And neurosurgeons look at faith, doubt and the things we know. And then also I have no Place to Hide, which is about you, your long journey, coming home from the Iraq war. And that's not all. You also have a book called Hope is the First Dose. You also have a self published Book called out A Brain Surgeon Goes to War. And you wrote two novels and you have a podcast. At what point do you decide, I want to be an author?
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C
You know, Jenny, writing for me came out of all those things that I went through, learning how to process what I saw in the war, process losing our son, all those things. So learning to write was really how I learned how to understand the things I was going through and explain them to other people.
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B
Can you talk about the path toward becoming a neurosurgeon? You had said that you fainted the first time you saw blood. And I think it's one of those types of jobs that people know is out there, and you know that people do them. You know that they cut people open. You know that they go in, they remove things, they fix things, but you don't. I would imagine that the majority of people don't ever say, I'm going to choose that for my life path.
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C
Yeah. So I did feel called to medicine from my youth. My parents said I really never talked about anything but being a doctor. But I grew up in a really small town in Oklahoma, and I thought I was going to be Marcus Welby. That'll tell you how old I am. But there was an old TV show in the 80s called Marcus Welby, and he was this family doctor, and he could do everything, and he knew how to take care of babies and adults and surgery and everything. So I thought I was going to go back to my little town in Oklahoma, be a family practice doctor. And then I got to medical school. And in your third year of medical school, you. You basically take a rotation through every specialty. And the very first one I did was family practice, and I hated it. Like, it just wasn't for me at all. I didn't have the attention span, and I needed to do stuff with my hands. I figured out pretty quick I needed to be a surgeon, but I never even thought about neurosurgery, like you said. I mean, most people don't, hey, I'm going to grow up and be a brain surgeon, right? And as it turns out, my son Mitchell, who's the one that passed away in 2013, he was going to be born in February of my third year of medical school. And I wanted to have a little bit of time off to see him. And so they let me change my schedule. And the only thing available for me to take that month in place of what I was supposed to be doing was neurosurgery. And I was like, I never heard of that. It might be fun to just look at it. And my very first day on the service as a student neurosurgeon, they let me drill a hole in a little, a person's head. And I was like, holy cow, this is what I'm supposed to do for a living. And so like, I found my calling that day. All because of my son being born when he was.
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B
So almost happenstance.
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C
Yeah, well, I think it was a, you know, a God thing. He just orchestrated that for me to fall into.
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A
Wow.
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B
And then at what point did you. So obviously you graduate and you become a brain surgeon. What was the connection then going to war?
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C
So I received a scholarship from the Air Force to go to medical school to pay for medical school. So taxpayers pay for med school. Thank you very much, listeners who pay taxes. And so I was, I was serving in the military as part of the four years of payback for having been funded for medical school. And I got out of my training in August or in July of 2001 and showed up for active duty in August of 2001. And then the planes hit the towers on 911 in 2001. We became a wartime military at that point. And so three years after that, in 2004, I was deployed as part of a tent hospital, air force theater hospital in the busiest part of the Iraq war when they were getting mortared every day. And I survived 100 mortar and rocket attacks and did 200 brain surgeries in a tent hospital and all of that. So that was my, my service of, part of paying back that, that scholarship. I ended up getting to go to war and learning how to do real trauma, brain surgery.
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B
I didn't realize that in those situations you are operating on, you know, anyone, you know, you're, you think, okay, well, yeah, there's going to be soldiers, but it's also civilians and also terrorists.
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C
That's right, yeah. So people don't know this. It was never covered by the media. But our medics, when they would go out to the battlefield to land the helicopter and pick up wounded people, they picked up anybody who was hurt. And oftentimes it was the three marines that got blown up and two Iraqi civilians and a baby. And then the terrorist who set the bomb off, everybody was hurt and they brought all to our hospital, we took care of all of them. Was, it was kind of an amazing experience.
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B
Wow. So another thing that would appear to be happenstance, but would, you know, you would say this is God's hand, God's path is that your son in law was working with you.
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C
Yeah. So long before he was, my son in law, Nate, who was just a 19 year old kid at the time, was assigned to. He was deployed to Iraq. He was Air Force and I didn't know him, but we were. He was assigned as my scrub tech in the war and was assigned to me. So we were working together in Iraq and when the war, when it was time for us to come home, he had done such a good job that I said, hey, if you ever need a job, you know, look me up. When you're out of the Air Force someday, come find me. And several years later, he did. He called and said, hey Doc, I'm getting out of the Air Force. You still have that job for me? And I said, sure, yeah, come move to Alabama and I'll be happy to have you work for me. And, and so we scheduled a dinner for him to meet and meet my wife and all of that. And our daughter Katie, who was a young teenager at the time, looked up in the restaurant and saw him coming in, didn't know who he was. And she said, I'm going to marry that man someday. And I said, no, you're not. He works for me. And then years later, she actually did marry that man and now we have three grandkids from them. So it's amazing.
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B
What a story. I loved what you wrote about him. You said you've been to war together, we've been in bunkers in Iraq together while mortars landed around us, and we've saved and lost a lot of lives side by side. There's no one I trust more than Nate in the operating room. So you see God's hand in your story so clearly. Yeah, but then you also are grappling with. And we'll talk about this maybe more toward the end. We'll talk about your new book first. But you know, I've seen the end of you sort of grappling with unanswered. You know what seems to be unanswered? Prayers. And where is the intersection of faith and science? But in this new book, which is called the Life Changing Art of Self Brain Surgery, this is not a metaphor. It is a mechanism by which your mind physically changes your brain and enables you to flourish. And a lot of this is coming out of losing your son, Mitch. You lose your son, he's 19 years old. And well, first of all, you have to get back to work because you have this family practice and your accountant or, you know, whoever runs the books. It's like you're going to have to eventually, you know, your, your staff can't keep going. You're going to have to get back to work. And you and your wife are trying to figure out, how do we manage this? And what you said is, is that you can actually see changes in the brain by changing your mind. You, like, you can physically see what's happening with the blood flow. Can you talk about that part of it? Like what you saw when we change what we're thinking about?
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C
Yeah. So it turns out, so most of us. Most of us believe, Jenny, that most of what we are is how our brain works. Like your hopes, your dreams, your fears, your potential, your talents, all that stuff comes from how your brain works. All of us are kind of taught to believe that. But especially if you're a Christian, there's already a part of you that believes that something about you lives after your body dies. Right? Like, okay, if you're going to go to heaven, you have a soul. Something about me persists after my brain is not there anymore. So you already have this sort of idea that there's a difference between you and your body, but most of us haven't really ever thought about it because traditional neuroscience is that everything about you is related to how your brain works. But as the 21st century has played out and we've developed something called functional imaging, which is a type of MRI scanning where you can put someone in a scanner and you can actually see what their brain is doing. Not just what it looks like, but you can see what activity is happening inside the brain. Neurotransmitters and parts of the brain and blood flow and all those things. Functional imaging has shown pretty clearly that there's a difference between things that you're thinking about and things that your brain is doing. Again, reinforces this idea that Christians have had all along, that. That there's a soul, mind, heart. Bible. Bible uses all these different terms, mind, soul, heart, that really mean the same thing. It's you, the part of you that's not your brain. And so as you said, we. We lost Mitch, and we're in this state of utter despair. And if anybody listening has lost a child or lost somebody close to you, I'm sorry, but you know what that feels like. That. That devastation that you feel and this hopelessness. And your brain is doing all these terrible things to you. It's telling you you'll never be okay again. Your family's gonna fall apart, your wife's gonna lose you. You know all the statistics about marriages that break up after they lose a kid and all that stuff, and you're Hearing all these negative thoughts and you're feeling this. This horrible chemical environment in your brain that feels like despair. And. And so a few weeks after Mitch dies, we literally. Our practice is not going to be able to go on if we don't go back to work. And at the time, our office was in Auburn, Alabama, on the campus of Auburn University. And it just turned out Lisa and my wife ran our practice. And our office was on the third floor of a building where on the first floor they were doing this functional MRI research. And so we go back to work and we get invited to this meeting that where they're going to put somebody in the scanner and show everybody what they've been able to demonstrate with how the mind and the brain aren't the same thing. And so I'm this Christian, but I'm also a practicing neurosurgeon and I'm now a bereaved parent, right? And I'm. And I have never really thought about the fact that what my science has taught me is that my brain is everything about me and that my faith says I'm not just my brain. I've never really reconciled those two things. I don't think most people who ever spent two seconds thinking about that, but I hadn't really. And then I'm down there in that scanner and hopeless and angry at God and shaking my fist at him and in despair and really only there because I was invited and somebody forgot to take it off our calendar. So we didn't want to be rude, so we went down to this meeting and they put this woman in the scanner and they had headphones on her like you have on, so they could communicate with her. And they said, okay, just. Just relax for a minute. Don't think about anything in particular. Let's calibrate the scanner so we can see what your brain's doing when you're not thinking about anything in particular. And we see all these sort baseline metabolic activity in the brain. Different parts are kind of percolating a little bit, but nothing really happening. And then they say, okay, Mrs. Johnson, think about the worst thing you've ever felt in your life. Your worst memory, the scariest thing, the worst day, whatever it was. Think about that for a minute. And we saw her kind of wrinkle up her forehead and you could tell she was recalling a memory and her brain was kind of bubbling along. And then all of a sudden, the part of her brain that's related to fear and anxiety, the amygdala, this little part over here in your limbic system lit up like a. Like a fireball, like, got really active. And shortly after that, her blood pressure monitor started to change, and her heart rate went up and her blood pressure went up, and her respiratory rate went up. And we saw her think about something, and then her brain do something, and then her body react to that. We saw this clear sequence of thought became brain activity, became body activity. And then they said, okay, Mrs. Johnson, stop thinking about that and think about the happiest thing you can think of. Your best day. The day your kid was born, the day your husband proposed, whatever it was. The day you got to be on Jenny's podcast, whatever your best day. Remember that? And so you saw her again, kind of. Her brain kind of go back to a baseline state, and you saw her kind of wrinkle up her brow. And then you saw the frontal lobes and the. The cingulate gyrus and the insula, the parts that are related to sort of processing happy stuff and. And all that good stuff, start lighting up, and her amygdala calms down like the fire went out in it. And then her blood pressure came down, and her heart rate came down, her respiratory rate came down. We saw this sequence again. Thought became brain activity became body activity. And my wife, who's super brilliant, said, that reminds me of this passage in the Bible, Philippians 4. And I said, what do you mean? And she said, well, Philippians 4 says, don't be anxious about anything, but be grateful, and the peace of God will guard your heart. Like. Like, think about different stuff and you'll feel better.
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B
Yeah.
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C
And I was like, wow, that's exactly what we're seeing here. She's changing what she thinks about, and her brain's doing something different. Her body's doing something different. And. And I'm not a. I'm not at all a person who goes around saying, oh, God told me this, or God spoke to me. I don't. I'm from a pretty conservative tradition, so I don't go around saying that God spoke to me. But in that moment, Jenny, like, as. As loud as I'm talking to you, I heard this crystal clear connection that said, lee, when you perform brain surgery, you are intentionally making a structural change in your patient's brain for the purpose of improving their life. And when you think about one thing and not another thing, you are intentionally making a structural change in your brain for the purpose of improving your life. It's surgery. It's exactly like you do in the operating room. I'm. I'm changing. I'VE given people a mechanism by which they can change how their brain works when they think about different things. And it's surgery. And that's where the, the first time I ever thought about the phrase self brain surgery came. And I had this, this crystal clear insight. If I want to feel different than I feel after losing my son, because right now that feels like it's going to be how I feel the rest of my life. If I want to feel different, I have to think about that in a different way. I have to change what I'm thinking about, the set of things that I'm ruminating on about having lost my son. If I want to be different than that. Because it'll always be true that I've lost my son. But if I want to feel different, I'm going to have to think differently about it. And I saw that just in that amount of time. And from then on I began to really dig into trying to integrate those two things I told you about before. My faith and my science and how they came together. And it was that day in Auburn when all of this started happening and I started to feel something that turned out to be a little bit like hope again.
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B
There's so many turning points in your story that just could have happened differently. Like you said, you had agreed to go to the meeting. It's in the first floor of your building. You know, you don't even totally want to go. You show up anyway. And it just is this light bulb moment you wrote in this book. I could choose to see myself switch positions from the suffering, sad father to the one who gratefully remembered the joy Mitch had brought me. I could watch the blood flow changes as my brain reacted to the top down control of my mind.
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A
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B
So this is a really powerful book. You related it. I thought this was a good tie into this podcast. You related it to trees. You say we're not all that different from trees. I love this part about how we can make changes you use. I've actually never even said the word dendrologist before. I'm not even sure if I knew beforehand what that was. But you say we're. We're not all that different from trees. Dendologists know that to withstand high winds and erosion, healthy trees develop reaction or stress wood within their trunks and branches so they will not crack or break during extreme weather events. But it's only developed by being buffeted over time by wind gusts. So you talk about how when we can withstand stress that it will build strength and flexibility that we need. You are the same is true for you, my friend. So just so many hope filled messages in here. And you have this book called Hope is the First Dose. Like that's where you have to start with. So I wanted to talk about some of the commandments you have in here. 10 Commandments of Self Brain Surgery. We'll talk about one or two and then people can find the rest of them in the book. It's called the Life Changing Art of Self Brain Surgery. So one of the ones that you talk about is the. It's about the tomorrow tax.
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C
Yeah.
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B
Which I love that phrase. So the commandment is I must love tomorrow more than I hate how I feel right now. Can you talk about the tomorrow tax?
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C
Yeah. So when I perform surgery in the operating room, I rely on my anesthesia colleagues to make sure my patient's not going to move and they can't feel pain and all that. So anesthesia is really important. Important in surgery, in brain surgery. But in self brain surgery, anesthesia is not allowed. And the reason it's not allowed is because when we feel bad, when we're hurting, when we're suffering, when we're under great stress, it's so tempting to numb ourselves to what we're feeling. And we'll use alcohol or we'll use Netflix or we'll use Instagram or use shopping or sex or a number of other things that people use to sort of not feel what they're feeling right now. But the problem is that if you anesthetize yourself from the pain that you're feeling, you anesthetize yourself from everything else too. So you can't feel anything. You can't selectively numb a part of your life and still feel everything else. You become less available and less present to your kids and your family and all of that. That's part of why marriages break up. Because somebody decides to anesthetize themselves against it. They can't feel anything. They can't steward their relationship anymore. But then the other thing that happens is the next day you still have the problem. You still feel all the things that you were feeling that you didn't want to feel the night before. And now you have a new problem too, because you're hungover or you've spent a bunch of money or you said something you shouldn't have said to your wife or your. Your husband. And so now you're paying a tax on tomorrow because you treated a bad feeling with a bad operation. The night before, you made a. You made a choice to not feel something, and now you're having to feel it and all the other stuff that you had to deal with. And you're in a worse position to do so because your neurochemistry's off or you broke or something else is happening. So it's just this. It's a reminder that we should love tomorrow more than we hate how we feel right now. Because guess what? Tomorrow you got a bunch of stuff on your plate that you're going to need to deal with. And if you're in this moment right now, the time to deal with what you're feeling right now is right now. Because Jesus said this thing, don't worry about tomorrow. Tomorrow's got enough trouble of its own. And I made this corollary of, you know, tomorrow's got enough stuff to deal with without you dragging today into it. Too, like so. So don't pay the tomorrow tax. That's just one of the commandments that'll help you flourish if you're suffering.
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B
Yeah. So one of that's one of the ten commandments of self brain surgery, which is, I must love tomorrow more than I hate how I feel right now. Let's do one more, and then people can pick up the book to read the other eight. I must believe that most of my automatic thoughts are untrue. It's kind of shocking.
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C
It is kind of shocking, especially in the culture right now, because we're so encouraged to follow your heart, live your truth. You do you. I heard a sitting United States congressperson say in an interview that your feelings, your perceptions are more important than objective reality, that you should. You should focus on what you feel. And that's fine, but it just turns out from really good neuroscience research that an alarming percentage of what we think and feel automatically, the things that pop into our heads, the voice that sounds like you, that speaks to you a lot, and this automatic feeling of anxiety that you might have, or some feeling that pops into your. Into your head, an alarming percentage of them, some people say up to 80%, turns out not to be true.
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B
Wow.
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C
And so that means. That means we're reacting to things that are not true. And if you react to things that aren't true, you end up making mistakes or choosing the wrong path. And a good example of that is, how many times have you looked at a text message from your spouse or from one of your kids or from a friend quickly, while you were in a bad mood and you misdiagnosed it and you fired off some angry response or you're such a jerk, and why would you say that to me? And then they write back and say, that's not what I said. And then you read it again. You're like, oh, no, I made a mistake. Now I'm in trouble. And now I'm trying to undo something because I reacted to a feeling that wasn't true. And so we all do that. We all think that the voice that's in our head that sounds like us is reliable, but it just turns out it's not very reliable. And so it will set you free, and it will set you on a path to flourishing in your life. If you can just become aware of. Of the fact that the voice in your head isn't particularly trustworthy and that it's wise to take a second to investigate what you think and feel before you react to what you think and feel. And if it isn't true, then it's not going to help you to react to it. You should choose a different thought to react to. Yeah.
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B
I think if you're listening and you're a parent, you could see how helpful this would be in your family.
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C
Yeah.
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B
The life changing art of self brain surgery and you even have one of the, your appendixes is that people say,
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C
I really need to learn appendices.
- [26:46]
B
Appendices that I really need. I'm like, I need to make myself a note. There are five appendices in this book. They're. They're the best I've ever seen.
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C
Thank you.
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B
These are fantastic. One of them is specifically for kids. It's the pediatric. This is the third appendix. It's about pediatric self brain surgery. Every generation faces challenges never experienced by those who came before. But today's children and young people are under immense and unprecedented pressure with constant comparisons and this safety first environment that implies they are inherently fragile. Can you talk about like selling this to the parent? I mean, this is a really good resource for parents to have, especially for today's kids.
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C
Yeah. So it's another one of these things that we're being taught right now that kids are easily broken, that our brains are fragile, that trauma and tragedy and hardship can mess us up and create all these adverse childhood experiences. That we're going to have a hard time with our life if we go through certain things. And that has produced a culture where we want to shelter our children and not allow them to experience anything that's uncomfortable. And the result of that, the last 20 years or so of that being common in parenting is that we're now seeing kids who can't go on dates because they're too scared. They don't get their driver's licenses when they're 16. We're seeing in business. It's common now for people to go on job interviews and bring a parent with them because they're afraid. And so what we're seeing is a generation of children who are afraid to make a mistake and fail in some way because they've never been shown that they can fail and survive it. And what it turns out to be is that humans are not actually inherently fragile. You're not, most of us think, I think, that we're either genetically superior and robust and we're strong, or we're kind of fragile and weak and it's one or the other. But it turns out that you can't really be a strong, robust person unless you have suffered a little bit or sometimes Even greatly and neurologically, we know that's true. Now, again, from functional imaging, we've seen that this part of your brain called the anterior cingulate gyrus is the part that's related to what willpower and emotional resilience. And it's related to how you shift from one emotional state into another. And it turns out that the way to get your cingulate gyrus to be really good at willpower and inertia and all those things that you need to have to be a good adult is to make yourself do something that seems hard or like you don't want to do it. Like you need to. You need to face something where you're initial thought is, oh, goodness, I don't want to do that. That seems scary to me. But if you tell your brain, hey, I'm going to do that anyway, and it can be something simple like, I don't feel like making my bed, but I'm going to make it anyway, or I don't feel like trying out for the baseball team, but I'm going to anyway. Your cingulate learns that you're the kind of person who can do things that you don't seem to want to do. And then it begins to lay down new wiring to make it easier for you to do something hard the next time. So that's the way God wired you neurologically, to be prepared for hard things later in your life is by having gone through hard things earlier in your life. And so while it's safe for your kids to fail, while it's safe for them to struggle, let them be on a team with kids they don't like. Let them be picked last once in a while without writing a letter to the coach. Let them be seated behind a child in class that they. That they don't get along with, or let them have a. A class where their best friend isn't in it. Don't try to manipulate everything in your child's life to remove all the stress from them, because they need that stress for their brains to develop the resilience and hardship that they're going to need when they're adults. And it's interesting if you want to tie it back to scripture again. So I think it's. I keep finding all these places where Scripture wrote a prescription for how humans best flourish. And neuroscience eventually shows us how that thing works. So there's this verse In Romans, chapter 5, verse 3 through 5 that says, suffering produces endurance, and endurance produces character, and character produces hope. And so now we can put you in a scanner. And we can show that if you're willing to press through suffering, you become a person who can endure. And then if you press through that, you develop the type of character of a person who's willing to go through hard things. And that kind of person can be hopeful and even when they face something hard because they know that they're okay to get through it. And can I tell you a little story about that? I've got the best story ever about this. My Grandson George is 10 years old and the first time I told this story, I didn't use his name because I hadn't asked my daughter, but she said it's okay. So I'm allowed to use George's name in this. George was falling dramatically behind when he was in third grade and the other kids were passing him up. And he's a brilliant little kid, problem solver, brilliant kid. And figured out that he could not read. And we got him diagnosed and it turned out he was dyslexic and George was struggling mildly to learn how to read. Now, Katie, our daughter, and Nate, my son in law that we talked about, they could have chosen to blame the teacher. They could have demanded he move, be moved to a different class and get a new teacher. They're not doing a good job. They're not teaching my kid how to read all that stuff. They didn't do that. Instead they hired a coach, a woman who's a dyslexia specialist to come and work with George. And George dug in and did the work. And over the course of about four months, he made up two grade levels in reading. And he figured it out. And this kid became a kid who's a. He called me on the phone, he said, I'm going to cry when I say this. Said, pop, I'm a reader. I just read my first chapter book. I did it, you know. And so here's the thing we've seen now two years later with George. That kid's not afraid of anything, Jenny. George knows that he can go through something hard because he learned how to read.
- [32:44]
B
Yeah.
- [32:44]
C
And he knows that he can survive any, any kind of hardship that's going to come. Because the scariest thing for him was opening a book and not. And having to be called on in class to read out loud. And now he's not afraid of that anymore. So you're, you're neurologically wired to improve in the face of suffering and so don't shield your kids from that. That's why I wrote that part of the book.
- [33:07]
B
Wow. And people can just see what a phenomenal resource this book, the Life Changing Art of Self Brain Surgery is for parents.
- [33:13]
C
Thank you.
- [33:14]
B
I love that story. I'm a reader. One of my very first interviews I did was with a man. His name's John Muir Laws and he's a prolific nature journaler. He teaches it all over the world. And he is also dyslexic. And he talked about how in his childhood it was something he really mightily struggled with and that nature journaling was a solace for him. And then he said, you know, as he grew, he really learned that it was a superpower, he said, because everybody goes in the front door, but I learned how to go in through the window or the back door. You know, I like, like your grandson, you know, it becomes something that you have this unique perspective. And he said, now I'm an adult. And he's like, you know, someone else can edit my book, you know, or he's got these phenomenal books and he's like, it just, it. It allows me to have a different perspective and to look at things from vantage points and viewpoints that most don't. And he said, it's just such an asset. So what a story that is for. And hopefully a hopeful message for parents who are listening or kids who are listening in if they're struggling with their reading. So this book also includes specific microsurgeries. Let me tell people some examples so they'll know what to expect. A microsurgery for your mood. It's great, right? You know, especially if you're, you know, like a mom, you got little kids at home. A microsurgery for if you're suffering. What if you're having a panic or anxiety attack? What if you feel lonely? I mean, this is really covering so many parts of the human experience. What if you have chronic pain? So there's a lot of specific microsurgeries, 15 of them actually, in particular. Then there's a pediatric self brain surgery that we talked about. There's an incredible library of resources that you list in this book. You also tie. There's six of these extra things at the end. Self brain surgery in the Bible. And you end this one. I just thought this was so beautiful. You end this book when in your acknowledgments and you say finally, to the God who saved me from my sin, from the bombs falling in Iraq, from the bombs life has thrown through PTSD and the loss of our son, and who taught me to change my mind and thereby my brain and My life. Thank you. Praise be to God, the great physician. I mean, this is a phenomenal, phenomenal book. So you talk a lot about tragedy, and I love how you kick it off with talking about the person who took out their own appendix.
- [35:30]
C
Yeah.
- [35:30]
B
You know, you're like, there's that situation, but there's this. And you don't. You know, you don't think about your brain because you can't see it, and you can't see the changes. And so what a gift for you to be able to explain to people that you can make physical changes and that thoughts become things, and you can really have an impact on the quality of your life. You can teach this to your children. And I wanted to talk a little bit about. I've seen the end of you as well.
- [35:52]
C
Yeah.
- [35:53]
B
Because this is a book about a question that a lot of people have, which is, why does it seem sometimes like God does not answer prayers? This is a very deep read. So can you talk to people about this type of tumor that is pretty much a hundred percent fatal? And you say, you know, you don't like it doesn't seem to be genetic. They don't seem to know what causes it. There can be identical twins, and one gets it and one doesn't. And so it's called glioblastoma multiform. Yeah, I think I said that right.
- [36:29]
C
Yeah.
- [36:30]
B
And so this has really been challenging for you in your own faith. And I think a lot of people have the same questions. Like you wrote, I feel stuck in the crossfire between my faith, God can heal, and also my knowledge that this disease is 100 fatal.
- [36:46]
C
Yeah. So I had this. This thing that kept happening as I was young in my practice, where. So I'm a surgeon again and a man of faith, and. And this is before my epiphany in Auburn years later. But I kept understanding that people do better. Whatever they're going through, they do better if they hold on to hope. Right. If they fight and they stay in the game. And that's clear from all the research, that people who have hope, they live longer, they take less medicine, they have, you know, better outcomes overall. They don't necessarily beat their disease at a higher rate, but they have better lives while they're doing it. So it's important to have hope. So it's one of my jobs as a doctor, is to always try to give people hope and tell them to fight. But I would see the scan, like, if you come into my office, and before you came, I would review your MRI scan or your CT scan, and I would see that tumor, and I would know what it was going to be. I would see it, and in my mind, I would see this whole thing playing out. Like, I'm going to have this conversation with you. I'm going to tell you it looks like cancer. I'm going to biopsy. That's going to be a glioblastoma. I know when the tumor is going to come back. I know when you're going to fail chemo. You know, I know what's going to happen. And I would just say to myself, I've seen the end of this person. I know exactly how this is going to play out. That's where the title came from. I've seen the end of you. Because I would say that to myself, and then I would beat myself up. I'd be like, wait a minute. Do you believe in prayer? You believe? Do you believe all the things you say? You believe? And I would have this sort of metaphysical, you know, crisis, existential crisis. And. And then I would go in and talk to the patient, and I would say, hey, you really need to have hope, and you need to go through this surgery. You need to have your chemotherapy. You need to do all these things that's important. And in my mind, I'd be like, but I know what's going to happen. You know, 15 months from now, you're going to be dead. And so I was struggling with. With how to do that thing of being a faithful Christian and a. A good doctor when I already thought I knew the outcome. And so I started studying that. I started kind of studying how do people progress through something that seems to be the end of them. And I started noticing these patterns of how people navigate hardship. And. And the one is, I call them crashers. And I wrote the book Hope is the First Dose. I elucidated this even further. But the crashers are people who, like, they seem to be okay. They might even be people of faith or whatever, and they seem like their life squared away, and then something bad happens to them, and it just wipes them out. And some of those people, surprisingly, survive their cancer, but they never come back alive again. And all of us know somebody like this. Like, you bump into somebody on the street corner and you say, how's it going? And they say, oh, you know, ever since I lost my kid 20 years ago, it just hasn't been the same. You know, they're just still stuck in that place where they're bitter, they're angry, they're broken, even though they made it through the thing. And so I started seeing some of those people. And then there was this group of people who seemed like nothing that happened to them could ever change who they were, what they believed, that they were just untouchable. They were just, you know, perfect. I'm not one of those people. And then there were people, really ironically, who were kind of down and out, and their lives had been terrible, and maybe they never believed in God or never had any kind of hope. And then they got sick. And somehow that catalyzed them to come alive for the first time in their life. And even if they died of their disease, they were happier on the day they died than the day they found out they were sick. Like, somehow going through that hard thing brought them back to life. And I tell the story of a guy named Joey. This a real patient of mine who found out he had brain cancer because he was cooking meth in a drug lab. And the DEA raided them, and he got hit in the head with a billy club by a DEA agent and knocked it out. He had a skull fracture. And when I took him to surgery to fix his skull fracture, his brain didn't look right. So I took a little biopsy of his brain, and it turned out he had a glioblastoma, and he didn't know he had it yet. And I was like, well, you know, this is really good. It's. It's young. It's a small tumor. There's a chance we might have gotten all of it. There's a chance you might survive, you know? And he was like, of course I have brain cancer. My whole life's been miserable. Why would I not have brain cancer? He was down and out guy. But then this chaplain befriended him, and he. And he reconnected with some of his family members, and he decided to go back to school and get his ged. And he ended up being the first person in his whole family that ever graduated high school. And he met a girl at night school and fell in love. Like, all this stuff happened while he was dying of his brain cancer. And on the last day of Joey's life, he said to me, doc, this has been the best year of my life. And so I saw that group of people, and it was just all these different responses to suffering. And so I started trying to write about that. And while I was writing that book is when Mitch died, our son. And so I went from studying how people handle suffering to being one of those suffering people. And I think it was one of those things that God did to prepare me to say, hey, remember all those lessons you were learning about how people suffer? Like. Like some people encounter this hard thing and it defines the rest of their life. And that shouldn't be you. Like, you shouldn't let this define. You've got to find a way to find hope and purpose again. And I think the big punchline from that book is that the things we struggle the most with. The subtitle is the things we think we know. The neurosurgeons look at faith and doubt and the things we think we know. And. And we. We struggle when we thought we knew something. Like, you thought your. Your kids were going to outlive you.
- [42:03]
B
Yeah.
- [42:03]
C
And then that doesn't turn out to be true. That's when you really start questioning who you are, what you believe, where God is, all that stuff. So that's what that book is.
- [42:10]
B
Yeah, it's quite a powerful book. It's very deep. I think it. You know, it addresses. There's not much that addresses that. Is a fundamental question about why does it seem like God answers some prayers and not others, or for some people and not others? And I love this part of the book where you said, the Bible is the only religious book in which people are honest when they doubt and God says it's okay.
- [42:34]
C
That's right.
- [42:36]
B
It's big. It's big. So this is a book about how can I pray for God to heal someone of something that no one ever really survives? How do I ask God for something he never seems to do? You know, should we pray to a God who already knows everything? It's sort of addressing, like, is there a futility to prayer? But then you have, like. It is a really interestingly powerful book, I think, in part because it is told through stories.
- [43:02]
C
Yeah.
- [43:03]
B
And different people's stories, and in all of their different circumstances as they come to see you during this time. One of the stories that really stuck with me was the story about the Chang family. Family?
- [43:14]
C
Yeah.
- [43:14]
B
And I was wondering if you'd be willing to share that story about Rupert Chang and when the family came back.
- [43:21]
C
Yeah. So Rupert turns out to be one of those guys that I told you about that was kind of untouchable. He. He was a man who had a tumor that, on the scan, I was sure was going to be this variant of glioblastoma that's even worse, if you can believe it. There's a worse variant called gliomatosis cerebra, where sort of your whole brain turns into cancer all at once. It's like everything. Every Part of your brain just becomes malignant. And took Rupert to surgery to biopsy the tumor because it wasn't one that we could remove. Like I said, his whole brain was cancer. And I just took this little piece of brain, and it started bleeding. And it turned out that all the blood vessels in his brain had kind of coalesced together in this tumor, and it just started bleeding like crazy. And they were all diseased, and I couldn't get the bleeding stopped and ended up finally getting everything stopped. But he had this tremendous brain swelling afterwards, and he ended up dying of the brain swelling months before the cancer would have killed him. And I felt so bad because it was like he went to surgery and didn't ever really, you know, wake back up again afterwards. And then a little while after he died, his family contacted me and wanted to meet. And I thought, oh, boy, they're going to be mad at me. They're going to be upset with me. And it turns out that he had written them a letter before he had his surgery that he's like, you guys, don't worry about me. I think. Think. I'm not sure how this is going to play out, but I'm okay. Like, I know what I believe. I know what I'm. Where I'm going after I die, and it's going to be okay. Like, whatever happens, it's going to be all right. God's got this. And he wasn't scared. And his wife read me that letter and then thanked me for having taken care of him. And he had told her that he hoped if it turned out to be cancer, that he wouldn't survive the surgery because he was not looking forward to going through the process of declining. And so the family felt like it was a gift from God that he didn't make it, and that just. It kind of. They hugged me and prayed over me and forgave me, you know, for the things I was scared about and worried about. And it just turned out to be this really healing moment for me as a surgeon to know that. That I can't control everything, and that how I think people are going to respond to things isn't how they respond. They respond of their own accord, with their own agenda. And Rupert was this amazing person who just had this indeterminable faith, that indeterable faith that wasn't gonna give up and also wasn't scared. And that was. That was beautiful.
- [45:41]
B
I want to read it. It's such a powerful section of this book that. This book is called I've Seen the End of you. They said, we believe God prepared those blood vessels and orchestrated this event in order to take Rupert home with no pain or suffering. And we are most grateful for this mercy. For them, it was an answer to prayer, his as well as theirs. A merciful thing, a blessing. And they saw it as part of God's plan. And then they said, we'd like to pray for you, that you will be blessed in the difficult work you do, that the pain of losing a few patients will be balanced by the joy of seeing many saved, and that you would always be reminded that God is operating according to his plans, even when he's using your hands. They prayed for your family, your children, your health. What a powerful thing was. Yeah, I thought this was so beautiful. And then they said that he wanted everyone to celebrate who he was and not perpetually mourn the brevity of his time with them. So, I mean, this is just a really deep book, too. I'm excited to read no Place to Hide because I have fallen in love with your books and the way that you write. I was curious about this situation where you have to go in and have these really hard conversations, the hardest of the hard. And obviously, now, like you said, with your son passing, you've had to deal with, you know, the phone call that says something has happened. Is that something that you're taught to do at all? Like, how do you learn that?
- [47:09]
C
Yeah, it's kind of a progressive thing. As you go through medical school and your residency training, you just. You get to be in the room when a lot of other doctors are having that conversation long before you have to have it. And so, for me, I was. I was blessed to see it done very well by a few people and see it done very poorly by a few people. And so I had this sense of the place, this sort of holy place that you get to be in, of being there when people are receiving news that's going to change the rest of their life and how important that is. And so, for me, it became this really missional thing where I saw that as part of my calling as a physician was to be, in that moment, a person who would help the rest of their life have a feel that was better than it would be if I didn't deliver that message well. And we had an experience of a friend whose little girl needed a heart transplant, and we went with them to the surgery that night, and we were all rejoicing that she'd finally gotten a heart. And after hours and hours and hours, the heart surgeon came out and he had this look on his face like you could tell things were not going to be okay. And he came in and set them down and said the words that came out of his mouth were, she's not going to make it. And then his phone rang and he reached into his pocket and he said, excuse me, I have to take this. And he walked out and took a cell phone call and never came back. And their daughter ended up dying. And I was just like, this is kind of my point about the holy place that you're in when you're delivering that kind of a message to somebody. And so I'm grateful that I got to see it done well. I'm grateful that I got to see it kind of botched and not taken seriously. And it's just a, it's an important part of what I do.
- [48:58]
B
One of the things that comes up in this book is the mentorship piece, like where you talk. Well, I guess it's probably in both books, but I'm talking about the story where the person was like, they didn't fit right on the table, they were too big. And you have to like change last minute or maybe last minute it's a child or you know, like they, there's not enough time to fly them to the pediatric unit, so you have to be the one that steps in to help. And you talked a lot about the mentors and how their voices almost like became a part of you. And so this part is from the life changing art of self brain surgery. Can you talk about like your mentor John or Dr. Janita where they like, their influence was so long lasting?
- [49:47]
C
Yeah, I think it's, it's a great testament to mentors that, that especially in surgical training, you spent so many years in the hospital doing so many surgeries and when you have somebody sort of take you under their wing and take a special interest in you and guide you and give you principles, not just tell you what to do, but teach you the principle of why and alternative ways to think about it and things like that. Then I find, at least for me, when I'm under stress, I'll often hear one of their voices of, hey, you remember we've done this before. Like I showed you three different ways to do this or solve this problem. And younger in my career, I would actually call those guys sometimes and say, hey, I'm getting ready to do this case. Can you give me some insight or some help? And they would say, hey, you know how to do this, you know it's going to be okay. And, and so Now, I sort of equate that on a human level to what Christians believe the Holy Spirit does for us. You know, kind of whisper in your ear, constantly, be inside, guiding you and helping you and leading you, even though you have to be the ones with your hands on the patient. Like the good mentor serves almost in that role of sort of divine guide sometimes.
- [50:53]
B
Yeah, I was just so beautiful. This was a text message, like you're texting with your mentor, John, and he says, take a. Take a breath and slow down. You know how to remove this certain type of tumor. I've seen you do it well dozens of times before. Don't let the setting or the intensity of the situation make you forget what you know. You can do this. And you talked about the power of reaching out. I thought this was good advice for anybody in any stage. The power of reaching out to steady yourself with something true. And that circles back to one of the commandments, right? Which is that you have to believe that many of your automatic thoughts are untrue. So you're reaching out to steady yourself with something true. Can we wrap it up with this family slogan that you have, this legacy of Mitch? The family slogan is, you start today.
- [51:43]
C
Yeah. Yeah. So one thing that happened after we lost Mitch, Lisa and I had a lot of conversations, and. And we realized that there were many things that we took for granted. You know, you think you'll get to be at your kid's wedding someday or see their kids born, and you know that they'll be at your funeral someday. All those things. And there were lots of things that we put off that, oh, we'll do this. We'll take the kids on this trip later. We'll do. We'll do Disneyland next year. You know, all those things. And after somebody dies like that, especially somebody young that you don't expect, all of the things that you thought were important become crystal clear, and some of them are not important. And a lot of the things that you thought weren't big deals or that you would be able to deal with later, now you realize they were big deals, and I can't do them now because he's gone. And so we just developed this motto in our family. You know, there's stuff that's got to get done today because you don't know. Like, that was a Tuesday night in August of 2013, and you don't know that Tuesday night's not about to happen in your life. Like, you just don't. And so if there's something important, say it, do it, send it Text it. Make sure your kids hear you say it. Like. Like, don't wait. Start today. And that became the tagline of my podcast. Like, every episode of my podcast, I end with a, you start today. Like, get after it.
- [52:58]
B
Yeah. Can you talk about what to say to someone who's going through immense grief? Like you said, this was a time when you learned the platitudes and what were the things that some people would say that were offensive. But then you also gave an example of something that someone might say that. I mean, it's pro. It's not helpful, but maybe it's not awful.
- [53:19]
C
Yeah. The first thing is presence is more important than words. And so just being there, just letting somebody see your face and know that you care enough to show up, that's immensely valuable. There's a guy named Zane who is one of my operating room nurses, and Zane showed up at my house within two hours of the word getting out about Mitch dying. He was one of the first people that showed up. And he literally said, he hugged us. He hugged me, and he hugged Lacey. He was crying. He loved Mitch. And he said, I'm going to go sit over there in that chair, and if you need something, I'll go do it. And that is all he said. Like, literally. And for the next several days, first person there, last person to leave was Zane Kirkland. And multiple times, somebody would say, hey, we're out of ice. And Zane would be like, I'm on it. He'd go get ice. Hey, somebody needs to get picked up from the airport in Atlanta, which was two hours away. I got it. Text me the flight number. And he would go do it. Like, so that turned out to be more of a blessing than anything anybody said. Like, I can't remember most of the things anybody said. So just showing up and being willing to serve, that's a huge thing. But also one of the things that moved me the most, and I can still remember his face. There was a surgeon who was kind of a. He wasn't a friend or a colleague. He was almost a. Almost a frenemy. Like, we didn't really get along very well, and we did sort of tangentially related things. So we competed a little bit in that small town for some. We both did spine surgery, and he did orthopedics, and I did neurosurgery. But we kind of competed a little bit for the same patients. And so we were never friends, and we didn't really talk very often. And I saw him in the hallway shortly after Mitch died, and I'D gone back to work. And he walked right up to, like, didn't some people kind of avert their eyes and act like they didn't see or don't say something? He walked right up to me, Jenny, and he put his hands on my shoulders. He's a big man, big jock, kind of athlete guy like most orthopedic surgeons. Big guy. Neurosurgeons are kind of, you know, we're. We're academics. I'm a mathlete. He's this big, bulky, orthopedic guy. And he braced my shoulders. Like, kind of hurt a little bit. And just. And he looked right in my eyes, and he got tears in his eyes. And he said, lee, I don't even know what to say to you, but I care. And then he walked away. That's all he said. And that meant more. I remember it 13 years later. Like, I'm like. I'm like, it's happening right now. And so I think presence, communicating that you care and being willing to. To just show up and shut up. As my friend who's a hospital chaplain says, just show up and shut up like Zane did. That's way more important than anything you can say. Okay? So remember that. And if you're going to speak and Christians listening, I implore you, please, if you're going to speak on behalf of God, make sure that you say something that he would say. And one thing God wouldn't say is something ridiculous, like, I guess God needed your kid more than you did, or something like that. Because if God needed my son, he could have just made another person. He didn't have to take Mitch, right? Or God must have needed another angel. Well, that means you don't read the Bible because people don't turn into angels. That's bad theology. So, like, don't say something just because you feel like you need to say something that's not accurate or helpful. And then don't quote scripture about future blessings or ways God's going to use this for good or things like that at the funeral, because those things may be true and there will come a time when they might be helpful, but it's not today. Like, so what you say today is, I'm praying for you. I know this is hard. I'm so sorry. What can I do to help? Like, those are fine. They're helpful. But don't feel obligated to say anything other than, I'm really sorry, because that matters. That helps. And. And I guess one more thing a little bit later is say the person's name if you know it. Like you as a parent, you get this fear that people are going to forget that your person ever existed. And it's so powerful when somebody a year later comes up and says, you know, I remember Mitch and he told me this joke one time and it was hilarious and he was such a good kid. And they say they're name and you go, hey, somebody didn't forget my son. It just matters. So say the name.
- [57:37]
B
Yeah, that's so helpful, Lee, thanks for sharing that you wrote in this book. This one's from. I've seen the end of you. Everyone dies. Every life ends. So don't get so caught up in the tragedy that you forget to live while you can. You're here to make things, to help make things better, to shine a light, heal. When you can help people, this is for you. Deal with the diseases and the inquiries that they can't handle on their own. But it's a charge. It's a charge to remember that like the, like it says in the scripture that when we number our days that we have a heart of wisdom. Teach us to number our days that we may have a heart of wisdom. What an honor, Lee, to get a chance to talk to an actual neurosurgeon. This has been so informative, so helpful. I cannot recommend the books more highly. I think that the life changing art of self brain surgery is a great addition to any home to help you as you're raising your kids. We, we always end our show with the same question. What's a favorite memory from your childhood?
- [58:34]
A
That was outside.
- [58:36]
C
Oh, hunting with my dad. We would go, he would take me hunting. We never, hardly ever saw any animals because I was so noisy and clumsy as a kid. But we were outside together and it just, he would always point out, look at God made that rainbow. Look at God made that tree. Look, look at the beauty of the things God made in us. Do that now. And, and that's a treasured memory.
- [58:59]
B
I love it. I love it. Can you tell people where they can find you? You have a substack, a newsletter. I'll link to all the books. You also have your own podcast.
- [59:06]
C
Yeah. DrLee warren.com D R L E E W A R r e n Dr. Lee warren.com and find everything there.
- [59:12]
B
Find it all there. Thank you so much for your time. The book is fantastic. Huge. Congratulations.
- [59:16]
C
What a great talk. Thank you. Wow. Jenny, thank you so much.