← The Mel Robbins Podcast
The Mel Robbins Podcast
This One Episode Will Change How You Think About the World & Your Life (From #1 Cancer Surgeon)
01:20:00
Today, you’re going to learn the life lessons most people learn too late. This episode will teach you exactly what matters most in life. Because in this powerful conversation, Dr. Rahul Jandial, MD, Ph.D. – a world-renowned cancer neurosurgeon and neuroscientist – shares the #1 regret he’s heard from more than 15,000 patients at the end of their lives. Dr. Rahul Jandial is the Medical Director of Neurosurgical Oncology and Skull Base Surgery at City of Hope in Los Angeles, one of the leading cancer centers in the world. He operates on brain cancers and spinal tumors in both adults and children, and he directs a research lab focused on developing cutting-edge neuroscience and cancer treatments. Today, he is going to share what matters most when time is limited: what people wish they’d done sooner, what they wish they’d stopped caring about, and what becomes crystal clear at the end of life - including why so many of us wait too long to start living the life we truly want, ...
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- [00:00]
A
Hey, it's your friend Mel, and welcome to the Mel Robbins Podcast. I just finished recording the episode you're about to listen to and I just, I have to tell you, this is one of the most impactful conversations that I've ever had. What you're about to hear will stay with you long after you're done listening. I mean, I'm personally sharing this with everybody I know because today, Dr. Raul Jandial, a world renowned cancer surgeon and neuroscientist who treats stage four cancer patients every day. I'm talking adults, children. He is here to give you the life lessons most people learn too late. After treating more than 15,000 cancer patients for over 25 years, he's going to share the number one regret he hears from his patients when time is running out, what people wish they had done sooner, especially when it comes to love, taking risks, reconciliation. He's going to tell you what really matters at the end of life and why most of us wait too long to start living the life we truly want. Now. I guarantee you what you're going to learn from people looking back on their lives will change how you live your life starting today. And Dr. John Dial is also going to walk you through a very specific playbook for dealing with difficult moments like a diagnosis, getting laid off, crisis, a breakup that just devastates you, or losing someone you love, how to navigate chaos and the exact mindset you need when receiving heartbreaking news or when life throws you something brutal. After this episode, you're gonna know how to find your power when the path forward feels unclear. And even if you're not in chaos or crisis right now, everything you're about to hear will prepare you for it. And it's also going to be an episode that you're gonna wanna share with absolutely everybody in your life. Because when you really take in what Dr. John Dial is gonna teach you today, and I want you to really take it in, I promise you, you and everyone that you share this episode with, you'll never be the same again. Furniture isn't just how it looks in your home. It's about how it lives in your home. Ashley offers affordable, well crafted pieces designed to handle real life kids, pets, everyday messes, constant use with features like stain resistant performance fabrics that are easy to clean, plus machine washable cushion covers made for daily living. Because when you're investing in your home, you want pieces that look great and are built to last and with fast, reliable delivery right to your room of choice. Ashley makes the entire process simple from start to finish. Visit your local Ashley store or head to Ashley.com to find your style. The Mel Robbins Podcast is proudly sponsored by by Amica Insurance, our exclusive insurance partner. You know when someone finishes your sentence because they already understood what you needed, that's what working with Amica feels like. They don't guess, they don't assume. They take the time to understand what you're trying to protect and why it matters. Most companies talk, talk, talk about putting customers first. Amica really does it. You feel it in the way they listen, the way they follow through, the way they treat you. As a customer owned company, Amica puts your needs first. Visit amica.com and get a quote today. Hey it's your friend Mel. And welcome to the Mel Robbins Podcast. I am so excited for our conversation today. I'm thrilled that you're here. It's such an honor to spend time with you and to be together. And if you're a new listener, I just want to take a moment and personally welcome you to the Mel Robbins Podcast family. I'm so glad that you're here. I cannot wait for you to meet today's guest, the extraordinary Dr. Rahul Jandial. He's here to tell you exactly how to get through life's most difficult situations. Dr. Rahul Jandial is a world renowned cancer surgeon, neurosurgeon and neuroscientist. He has won award after award after award and is one of the most cited and distinguished doctors and surgeons alive today. He is the Medical Director of Neurosurgical Oncology and Skull Day Surgery at City of Hope Medical center in Los Angeles which is one of the top cancer hospitals in the world where Dr. John Dial operates on brain cancer and spinal tumors in adults and children with stage four cancer. He also directs his own research lab, the John Dal Laboratory at the City of Hope Cancer center which focuses on developing cutting edge neuroscience and cancer treatments. He also serves as a Professor within the Division of Neurosurgery at City of Hope where he teaches doctors from around the world, the most innovative cancer surgery techniques and brain tumor research. He received his medical degree from the University of Southern California, his PhD in neuroscience from the University of California, San Diego, and completed a Cancer Surgery specialization at the University of California, San Francisco. He is the author of 10 bestselling books and over 100 academic articles on surgery, neuroscience and cancer biology Biology including his most recent New York Times bestselling book, this Is why youy dream and today, Dr. John Dial is distilling more than 25 years of experience as a cancer surgeon to share with you the lessons about life that most people learn too late. Please help me welcome the remarkable Dr. Rahul Jandial to the Mel Robbins podcast. Dr. John Dial, welcome to the Mel Robbins Podcast.
- [06:04]
B
Pleasure to be here.
- [06:05]
A
I am so excited you're here. And I know that some of the things that we are gonna talk about today you have never talked about in
- [06:13]
B
an interview, written about em, but not had a conversation about.
- [06:17]
A
Well, that makes me even more excited for what you're about to teach us today from your extraordinary life. If you think about some of the major life lessons that you've learned both through your work and your own personal experiences, what could change about my life? If I take to heart everything that you've witnessed, the wisdom you're about to share, and I apply it to my life, what could change?
- [06:45]
B
Well, for me personally, what I want to share are rules for survival that have served me well throughout my life, as well as lessons from my cancer patients that have given me a greater sense of meaning and purpose because I've had the fortune, privilege to share in their lives during their difficult moments. So from there, I've sort of come up with a playbook, if you will, on how to deal with crisis, how to embrace change. It's imperfect, but it's been something I've been shaping and molding for 25 years.
- [07:19]
A
Now you're about to unpack this playbook for an extraordinary life. And if you could go back and speak to the nine year old you. It's a little photo there that I'm passing.
- [07:32]
B
Oh yeah, that was an interesting time. Sometimes I mentioned, like my life started at lax. I don't really remember the first eight years of my life. It was when I arrived and it was an intense kind of thing. Like one day you're at the foothills of the Himalayas and cashmere. It's beautiful, it's violent. You get on a Pan am flight and 24 hours later you land at LAX with my father, with my mother and my brother. And so for me it's always people are like, where are you from? I'm like, I'm from lax. It's sort of birth, rebirth. And I think the suddenness of that, and I could tell there was something intense going on, a lot of tears in the old country and super fortunate to be here. And all this wonderful country has given me the opportunities to sort of so many second chances this country has given me, really. But if I could go back, you know, I think I would say that you will be underestimated. There will be pain There may even be violence, but suffering comes from regret and peace comes from meaning. I would give myself those, those words as a compass because other people gave me that as through mentorship and love.
- [09:01]
A
If you look at that photo of yourself as a nine year old and you think back to landing at lax, what would you want to tell the nine year old version of you in that moment about what's about to happen and how your life's about to change and all of the extraordinary things that your life is going to hold for you.
- [09:24]
B
I would tell them it's going to be wild and it's going to be beautiful and it can't be completely engineered. And you're going to have to go with a lot of things that you don't expect and don't want. And the adversity will reveal your character, but it'll also fortify you and make you the person you're going to be.
- [09:44]
A
Is there any background that you want to share about, like why your parents left, what was happening coming to this country?
- [09:52]
B
Northern India was violent at that time. My father's an aerospace engineer. He's passed away seven years ago. And this great country gave us the opportunity to come here. We left crisis and came to a sanctuary where everybody in my family has since thrived. And I've done my best to be appreciative of the people that live in this country. And I, I personally love Los Angeles because it's, it's not just where I landed, it's just the diversity, the creativity has just been, you know, and it's home and it's home now.
- [10:31]
A
Today we look at you. Cancer surgeon, neuroscientist, bestselling author. You have all of these unbelievable accolades and awards. And when you were in high school, did you want to be a doctor?
- [10:46]
B
No, I was, I mean, I don't, I did not like studying. I was like, I set the record in my high school for going to detention and that sort of thing. I was just. That's why everybody's like that guy. I mean, even my mom is like, oh boy, how did this, how do you, how did you get from that to that? And then. So no, it wasn't like that at all. I mean, I just, I just wanted to get out of LA at that time because LA was real intense in the 80s, you know, the crack epidemic and gangs. It was just a lot of, a lot of intensity. And when I had an opportunity to go to the Bay Area, I just like, you know, got into Berkeley, went there without seeing Berkeley. I just needed I needed, I needed a, a physical change. My pops used to have this joke he nicked. He's like, I think you're sort of like the enemy of books. I never. I read Cliff Notes.
- [11:36]
A
Yeah, Remember those? The yellow ones with the black and the outside? The yellow and black things.
- [11:40]
B
I got to Berkeley, I had to take remedial English because I was just like only doing Cliff Notes. Somehow I got, you know, my grades on the SAT and I got in and I got out and I was in. I was in the Bay Area. And frankly, I needed that change. Started partying a little bit too much and a couple of other crises mounted at that time, and I had to amputate something in my life. I mean, there was, there was, there was threat, and then there was. My mom developed breast cancer at that time. She was doing great. I was 19. And I just realized the thing that I had to cut out of my life was school.
- [12:14]
A
That sounds like a weird thing coming from the 53 year old, accomplished version of you that in your 19 year old brain, your mom is going through breast cancer, you're partying a little too much, you've got a whole new chapter in front of you. You're at a really prestigious school, and in your mind, pops, I know what I need to do. I need to amputate school, right?
- [12:38]
B
Because the two things that were, we were dealing with at that time, we had a. A neighbor who slowly became a neo Nazi and later he would end up in, in prison and like in the Aryan brotherhood and that sort of thing. So that was, that was five feet from our front door.
- [12:53]
A
My God.
- [12:54]
B
And then my mom was, you know, dropping hair, she had chemotherapy. And so, like it was that. And then so out of those three, then you could see where every resource was for crisis management. I mean, I think that's the essence of what we're talking about, is you don't know what's around the corner. So I'm trying to share with the world an approach, no matter where you're at, because we don't know what's around the corner. And at that point, I think now you could see out of those three things, if you're exhausted, you've got nothing left. You've got to marshal and deploy all your energy that it's gonna go to those two things dealing with threat. And I think a lot of people deal with threat in their own.
- [13:38]
A
I think everybody does on some level. And I love this. It's a very surgical procedure to take a step back and say, my life isn't working and I need to amputate something because I've gotta be able to pull all my resources to focus on what's important. And if you've got a neo Nazi psychopath living next to you and your mom's going through breast cancer, I can see how that's a very intelligent and strategic decision to say, school can wait. This needs my attention now.
- [14:10]
B
Nobody understood and nobody understood, but I understood that rather than getting these three things kind of right, I need to get these two things 100% right. And that was the first time I noticed where I was like, okay, I'm driving my life. Because that was a bold move. And then for two years, I was working in the cafeteria as a security guard. It was great because those other two priorities,
- [14:41]
A
your mom and your family's safety.
- [14:43]
B
Correct, they were flowing in the right direction. She was getting better. She was getting stronger. When you have breast cancer, they check your lymph nodes to see if it's partially escaped. Those lymph nodes came back negative. So that raised her chance of survival. And then the threat, you know, was dampening. He moved away, you know, later from prison, a decade later, he would write letters that he's getting out. So the threat never went away, but it was I. Then energy returned. And then I took a. And then I said, I got to deal with this remedial English. So I went to. I went to Compton Community College. And that, like, that move. I met my mentor there. And then. So that energy blossomed. And as that energy blossomed and those other things got more in control, the. The sort of. The ecology, the. The harmony of all the pieces in my life started to blossom. But at some point, I just needed to hunker down and deal with some heavy stuff. And school had to go. And only I knew that.
- [15:53]
A
I love this, and I wanna stay right here because I sense that as you're listening, there's somebody in your life that you're already thinking, they need to listen to this episode. And I'm only a couple minutes into this thing because we all have somebody in our life, or we are currently going through a chapter in our life where there's just too much. There's too much going on. And I really resonated with what you said about the fact that all three of these things, I wasn't doing very well. And I realized I had to make a decision. I had to make a decision of what I was going to amputate. And when you put it in that context of it's my family's Safety. It's my mom who needs support because she's going through breast cancer or at school.
- [16:38]
B
And everybody just saw that, like, he's failing, he's dropping out. And I was just bracing through a storm. Right. I wasn't. Only I knew that when I get through this, you know, there's something on the other side for me, but I can't get through these two things. Just half ass, partially.
- [16:55]
A
What I also love that you said is that making the decision that other people judged, oh, he must be, he must be a dropout, he must be failing, he must be this, he must be that. Making that decision, though, you said, felt incredibly empowering because you felt like that difficult decision. Getting out of Berkeley, going back home, working as a security guard. That was one of the first times you actually felt in charge of your life. What do you mean by that?
- [17:22]
B
I feel proud that I took a bold step when the optics weren't right. Because so much when you're a teenager, you're doing it for pressures that aren't internal, they're placed upon you. And that's okay. We need to raise children. I've got three adult sons. I understand putting expectations on children and trying to raise them, but, you know, I mean, I was like, like one week I'm in class with them and the next week I got an apron on. And I didn't feel any shame, you know, because I knew that inside my skull, in, inside the sort of the, the mental workspace of my mind and my imagination, all these things that happen when we close our eyes, all the things that are inside us that we don't share, we don't fully understand things felt right.
- [18:10]
A
I would love to have you talk to the person who's listening who probably had this conversation texted to them by somebody who loves them and they need to amputate something. They need to make a tough decision and get their life back on track. And it's going to go against what people think they should do. Whether it's getting divorced, whether it's living your life a certain way, whether it's converting to a different religion or just going back to school. Something that people are gonna judge you for. I would love to have you talk to that person who has received this conversation and is at that moment that you were at where you're like weighing, I'm half assing all this stuff. Something does not feel right for me. I have got to take control. What do you want that person to know?
- [19:02]
B
The reason it's a difficult choice is because it's an Unclear path. Right. It's not going to make sense to other people. That's why you're at this crossroads. But as long as it makes sense to you and you've given it thought, you know what's important to you in your life and how you're trying to steer this ship slowly, like turning a massive ship, it's not a sudden change is changing. It's a redirection of the journey of your life, that as long as you're peace with what you're doing and you're not hurting somebody else, don't let other people laughing at you change what you're about to do. Go for it.
- [19:40]
A
Well, isn't it funny that if you really think about it, anytime you've been at a crossroads in your life, it's probably because you've been making decisions for other people a lot of the time.
- [19:51]
B
Yeah. For me, sometimes it's been that I've got my head in the wrong place and that. That often is trying to please other people, you know, or doing it for other people. But sometimes, you know, we can fall down a ravine of negative thinking that isn't necessarily placed upon you. So there is responsibility. You know, they're the choices we make with the world outside of us that are constructive and destructive, but they're also choices we make but with the world inside our minds that are constructive and destructive. And I just think, you know, I just think both have to be paid attention to.
- [20:29]
A
So let's go back to you working as a security guard after you drop out of college. You end up enrolling at Compton Community College. And what happens next in your story?
- [20:43]
B
I met my mentor there. He was an English professor.
- [20:46]
A
Okay. Oh, yeah, that's right, because you're going
- [20:47]
B
to Compton Community College to address my remedial English.
- [20:51]
A
Brush up on the English. Yes. Okay.
- [20:54]
B
And he just. He wrote, and I still have it. I know you'll do well, but I hope you do good. Oh, w. And so that. And that. That hit me just like that, and I caught fire, so. But that wouldn't have happened unless I went to Compton Community College. So you can't just wait for, like, inspiration and mentorship and things to, like, land on you. You know, you have to put yourself out there. And by. By signing up for Compton Community College and taking that class. And at that time, my mom had cancer, and I remember saying, I just worried about her, you know, feeling pain and all these things. And. And he's like, what if the pain is a welcome reminder that I'm still alive? He would say things like that to me, you know, but later on, that would guide me. And so, so I found my mentor there. And the. The doing good thing would serve me later, as I had many other crossroads on what to do. Plastic surgery, cancer surgery, you know, get in the way of somebody that wasn't doing things that were fair and. Or not. You know, you. You. You're going to hit crossroads, and again, it's going to look like a terrible option. It's going to come with a lot of cost and what my father taught me, as long as it doesn't come with moral injury. Right, because you can succeed. But if you absorb, if you let yourself choose or accept moral injury, you'll never be at peace in the private moments of your life.
- [22:31]
A
So you are now one of the most awarded, renowned and impressive brain surgeons and neuroscientists alive today. How did you go from there to where you are now and what made you want to become a cancer surgeon?
- [22:48]
B
I get that question from my students. And what I would say is, knowing what you want to become is kind of like knowing what's out there, and there's no way to do that. Right, because it's a massive world and you're just a kid, you know? And so I didn't want to be a cancer surgeon. I didn't want to be a neurosurgeon. I didn't even know I wanted to be a physician, you know? But after Compton, when I came back, it felt like I had more firepower. I. I had more potential, and Mr. Jet helped with that. And so I just put my next foot, you know. You know, I just looked at the opportunity in front of me, and that was. That was applying to medical school. And there were these tests and such, and I got lucky on the test, and it opened doors and I wounded up at USC medical school, and. And I hated it because it was classrooms, and I was like, oh, man, this is boring, you know, and then the third and fourth year, you do rotations, and I went to, you know, LA County Hospital. And then I found it, you know, because all of a sudden, the classroom's gone, the nerds are gone, and it's just like the biggest aquarium in which to study humanity. I loved interacting with people of all walks of life, and the hospital gave me that classroom, you know, and then that was something I was like, then I caught fire. And then I saw. And I didn't. I had never seen a surgery. And when I saw my first operation, I was like, wait, this is physical. I can do Physical, So I, you know, I could. Smart and physical I want to do. And, And. And it was such ownership. When somebody trusts you to take you, take them back into a room, make them unconscious, and work inside them for hours. That's. That's a bond that I respected. The surgery thing, it brought me. It woke me up. It wakes me up when I operate. So that's how that evolved.
- [24:40]
A
Well, what's interesting about you is that you are talking about a playbook, and what you're describing is not really knowing where it's leading, but paying very close attention to how things feel right now. And those moments when something brings you alive in your words, that kind of fire inside you lights up.
- [25:06]
B
Well, specifically, it was avoid moral injury. And then the step I remember doing was a minus one plus one.
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A
What does a minus one plus one mean?
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B
That I got rid of one bad habit and then I put myself out to do something. Like it was a combination of close this box and open up another box. Not the massive crossroads we're talking about, but on a daily level.
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A
So give me an example.
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B
So at that time, you know, we were partying too much, and I just. I closed that box. It didn't mean I stopped. I just pushed it to the week. I mean, I. I dampened the indulgences.
- [25:39]
A
Yep.
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B
And then I started volunteering at San Francisco General Hospital. I take the bart, met some different people in the bar. It was a small, small change this way, small change that way. And at a neuroscience level, you know, your brain is generating this electricity. It's never calm. The measurement is always on. So either it's going to go this way or that way. It's got to be directed. You know, it's not, it's not just going to rev down. I know a lot of people are going to say no. I feel calm and clarity and. But electrically it's on. So I was just shifting it from indulgences to still something captivating from one habit or practice to another. So that was some knobs I could turn that got me, you know, out of. Out of that pattern I was in that was. That needed to change, which was, you know, a growth mindset, really, for me.
- [26:32]
A
So is there a mindset that the person who's listening right now could start to build or practice that could help them go after more or shift things in their lives?
- [26:42]
B
So part of the playbook in my mind is first to be aware of what's going on in your life. So I think there's a lot of good advice out there. But there's like advice and real, real world scenario mismatch. So you have to know, am I in a storm? Am I, am I in a crisis right now? So there's advice and Mother Nature is like that. You know, there's a winter and there's a springtime. You got to know where you're at. And so there was a time where I was just like, felt like I was drowning. And if it's a crisis now I'm in crisis management mode. And my patients have that when, when they hear the C word. I had that. And so there are some rules around that. That's. So that's, that's a mindset. And then there's a, okay, I'm not in crisis now. I've got bandwidth. And now I want to take chances, I want to dare, I want to grow. I want to bring in these practices, whatever it is, meditation, taking walks, all about. Those are practices. They're not going to help you in a crisis. So this crisis is maneuvers, amputation, you,
- [27:52]
A
what can I get rid of?
- [27:53]
B
Survival, survive, breathing techniques to not freak out. So the mindset is first asking yourself, am I in crisis? Or am I where I need maneuvers? Or is it springtime where there's some relative stability and I need to come up with some practices that make me better for when the next crisis hits or for the changes I want to make. There's too much like, you know, when the crisis, at that time with the neighbor and my mom, that's not a time for me to start taking up a meditation practice. You know, there's. Or for patients, for my patients, it's not when they're diagnosed or the first few weeks of surgery. It's survivorship. I had cancer a few years ago, but I can't stop thinking about it. So there's a different mindset for survivorship and practices, and there's a different mindset for crisis and maneuvers during that time. I think that's the way to think about mindset is to first know where you're at. Otherwise that flood of information, you don't know where to apply it.
- [28:55]
A
I actually love that because I think a lot of times we skip over that step and don't slow down long enough to just say, well, let me just even ask myself, what am I dealing with right now? Because advice is going to be useless if you have no time to apply it or you are in crisis management mode and you can come back to that.
- [29:16]
B
No, there's so many people who live and threaten their own home. You see, when People get hurt, they come to hospital. I don't work in a clinic, I work in a hospital. And I think it would surprise people how many of us live and you can't tell. It's rich, poor, it's not like you don't know. And so again, that person has to identify. It looks like I got it all, but I'm under serious threat right now. And I need to have crisis management techniques, rules for survival rather than rules for self improvement.
- [29:49]
A
Yes, that's very true. And you gotta be very careful about what you decide you're going to amputate in those situations. Because it's easy for somebody who's not under threat to say, just get rid of the threat. But it's not so easy at times
- [30:04]
B
because it won't grow back. I mean, I went back to college. But those amputations lead to changes that are permanent for most people, whether it's relationships or careers and that sort of thing.
- [30:15]
A
What would you say to somebody who feels very lost right now and they're kind of thinking about, well, am I under threat or am I just kind of in this mode where I need to understand I got to make some intentional changes?
- [30:30]
B
I would say if you're feeling lost, I've been there, you know, and not. And not in the distant past. You know, that's not a, that's a place you'll find yourself often in life, especially if you want to engage life fully. I'm 53, I've been working in hospitals since 25, 26. I have felt lost when I have searched for an outcome like rather than an opportunity. If, if you hitch your mental health or your self worth or the story of your life to outcome, you, it's going to be frustrating, you know, either you're not going to be aiming high enough or you're just going to be constantly looking at it the wrong way. And so I saw that when in Nicaragua, where another friend of mine is the head of children's brain surgery at San Diego. We were doing surgery down there and mom had taken a bus for like 20. Like, man, I can't remember, brought a kid with no shoes on. And once she got her child just across almost like the threshold to the hospital, in a later conversation she would tell the nurse that she did it. That was the opportunity and didn't matter what the outcome. That kid did well. But a lot of kids with cancer don't do well. But she wasn't like, and if my son lives forever and if my son is cured in her mind that she had brought her to her child to a hospital were brain surgeons from America. You know, America is a light it had come to and that her she got her child in Nic Managa, Nicaragua two brain surgeons from America plus the and then so what I learned from there is don't don't count the wins, count the shots. You know, and so if you want to be unstuck, take some shots but don't, you know, don't anchor yourself on on the outcome if the shot goes in.
- [32:41]
A
Dr. John Dal, I am so grateful you're here and I'm particularly grateful that you are with us right now, listening or watching. Whether you're the one going through a difficult time or not, you know somebody who is this episode is a life changing resource. A reminder and frameworks for the people that you care about to be using right now. Please, while we take a short break, be generous. Text the link to this conversation to your family group chat. Share this with friends of yours who are going through a difficult time because we all deserve to be reminded that we have within us the ability to use the tools that Dr. John Dial is sharing with us to get through the difficult moments. There is so much more that Dr. JohnDial will teach us when we return from this short break, so stay with me. You know that feeling when your brain is fried? You have like 12 irritating tasks you don't care about, but you have to do them anyway. That's where I've been lately. The administrative stuff was eating up half my day, so I've been using Microsoft Copilot as my extra set of hands. It's like having your own personal assistant. That's why Microsoft Copilot is my favorite AI tool. Last week I had to send this long, overly complicated email about scheduling and travel, the kind of thing that takes up way too much energy for what it is. I opened Copilot, talked to it out loud while I was walking around my kitchen, and Copilot turned it into a clean professional draft. It was amazing. And because my brain wasn't fried, I had the energy to sit down and eat dinner with Chris without feeling mentally wiped. That's the whole point for me. Microsoft Copilot clears the clutter so I can be more present for the moments that matter. That's why I'm using it. If you want to try it for yourself, visit Microsoft.com Melrobbins to download the Copilot app. Get started with Copilot today for free and see how handing off the small stuff gives you more energy for the moments that matter that's Microsoft.com Melrobbins on TikTok Teens get over 50 built in protections from the start. But for parents, further visibility and control of content can help create the right environment. That's where family pairing comes in. With family pairing, parents can set their own screen time limits or even set restricted times based on what works best for their family. Parents can also link accounts to see their teens followers and who they follow and help restrict content that's not right for them. When safety comes first, discovery can follow. Learn more@TikTok.com guardiansguide so when I was out in Los Angeles for the Golden Globes, I saw this very famous actress wearing this beautiful cashmere puffer vest. It was beautiful. And so I took a photo so I could remember what it looked like. And then you know what I did? I went to Quint's and guess what was on the Quint's website? The Mongolian cashmere puffer vest. It looked exactly like the one this famous actress was wearing. It's the perfect layer. Lightweight, warm and comfortable. I loved it so much I immediately ordered it in a second color. And here's what makes Quince different. They cut out the middle person and work directly with ethical factories, which means you're not paying for a markup, just high quality clothes that last at a reasonable price. And these days I'm all about quality, not quantity. Right now, go to quince.commel for free shipping and 365 day returns. That's a full year to wear it and love it. And you will now available in Canada too. Don't keep settling for clothes that don't last. Go to quince.commel for free shipping and 365 day returns. Quince.commel. Welcome back. It's your friend, Mel Robbins. Today you and I are learning frameworks and tools for how to get through some of life's most difficult moments with one of the most renowned cancer surgeons in the world. His name is Dr. John Dial, and I'm so thrilled that he's here. And I'm also excited to talk about some of the things that your patients have taught you about what's important about life. So one of the things that's interesting about your career is you have treated and operated on thousands and thousands of patients with a cancer diagnosis with a life ending diagnosis. What are some of the biggest takeaways about how to live a happy, fulfilling life that you've learned from your patients?
- [37:29]
B
Yeah, so just, you know, just for your. I love what I do. You know, I chose to do this when I had opportunities to take care of less sick people. You know, when you. When you're in medical school, you choose sick or not sick, and then you choose procedure or not procedure. I do. I do big operation. They come to me for operations, and they're extremely sick. And I take care of patients who have stage four cancer. And what we're trying to do is land this crashing airplane. And so I don't have patients that I still know because they're gone. And so from what, 2004? I don't know, 25 years. I was younger than them then. I was the same age as them. Some of them are younger than me. I was growing up. I was raising three sons. They're in their 20s. And I chose cancer surgery when I had an option of different types of surgery to do. And I know it's. I'm a neurosurgeon or brain surgeon, but in my heart, I'm a cancer surgeon. And most cancer cures begin with surgery. And it's just so visceral. Like, he's a. Well, I love for my sons to be like father and cancer surgeon. And what you see during that process, in the beginning, you just try, you know, you're taking. You. You want to. You want to be the best at what you do. And you. And you have to realize that this. You can never get the risk to zero. There will be turbulence on the way to the moon. This is not a flight to San Francisco on Southwest, where you expect to land it every time. You know what I'm saying? Like, so that's. I know you're like, he just went there. No, that's. That's this. But that's. That captures. You're like, there will be turbulence, you know, and so you want to. And so what I realized is that, you know, I hurt people the least, that this. This operation will have a 3 to 4% complication rate. And I'm trying to get it to 2. I can't get it to 0, which means you will have complications and that you're still doing a service. I had a hard time wrapping my head around that, because when you meet somebody and then they wake up and they can't talk, they can't move, you know, that this. It's been difficult, especially with children. And it's not an oops moment. It's. You can't get it to zero if you're going to fly to the moon, you know, you. You will crash and burn sometimes. It's not a mistake.
- [39:58]
A
And so, well, the Tumor you're trying to remove has done the damage.
- [40:01]
B
It's right. And. And the art there is to get as much of the tumor out as you can, but not injure the person. See, that's the art of surgery is you're reverse sculpting you somebody. There are people who can take it all out, but the patient doesn't do well afterwards. And then there are some people who just go in there and don't take enough of it to give them the best lifespan. We call it peak and shriek. They look at it, they're afraid that they pull back, and that's okay. So the patient's perfect. But the cancer surgery hasn't been done to the. To the highest level. And some people get all the cancer out, but then the patient wakes up injured. So there's a. There's a lot going on there. But complications for me were. Were difficult because, you know, in children particularly, because it felt like a failure. I didn't have the scale to understand that. I'm going to try to help thousands of patients. I've seen 15,000 operate on 5,000. And I'm trying to. I'm trying to. I'm trying to be the best I can for that whole group of patients. I can't tell which one's going to have a complication or not. It's not an oops moment. That took me some time to wrap my head around that. And I. And I only. I only remove myself from that. Whatever all of that caused me. First I was overly competitive or I was emotional. It was just a lot there. I'm sure, until I started to see that, that maybe all of this was an opportunity for me to understand humanity, to understand patience, to understand life, to understand suffering, and to. To write about it. So this. This thing that we're doing now in the last five, six years is. Is what has helped me not get PTSD from all these sick people I've been taking care of, is that they're sharing their life with me as part of a fabric I'm stitching to share a story with other people.
- [41:49]
A
What has your patients who are near the end of their life, who come to you as a cancer surgeon, taught you about living life now more time
- [42:02]
B
with family, pursuing things, reconciling, not reconciling, but what I'm seeing, what I have seen, is that all of that is external. And in the end, if they start talking and they say, I wish I had, then they're not coping well. And then. But some of my others, they say, I'M glad I did. They're coping well. And I started to see this pattern that some of the ones doing the best in my mind, I'm like, look, you're doing great compared to some of the other people I'm seeing. But their brain was stuck. Their life story was stuck with, I wish I had. I wish I had gotten screening earlier. I wish I had gone to a different place. I wish I had not, you know, smoked. I wish I had. And then there were others who weren't doing as well. You would think the people doing well are going to be like, I'm glad I did. But there's a mismatch there. It's a perspective on your life. It's your own. The story you write for yourself.
- [43:08]
A
Well, Dr. John D', Al, I want to really unpack the mindset you just taught us. And I want to make sure as you're listening or watching that you didn't miss it. And it's the difference between having a mindset where you say I wish I had versus I'm glad I did. Can you just talk more about the power of that? I'm glad I did and what that means.
- [43:34]
B
Well, what I'm learning. Yeah. And from my own life, too. You know, things haven't gone smoothly for me, but I'm glad I did drop out of college. You know, I'm glad I did have a marriage. I'm glad I did. Going to cancer surgery and, and, and it's not because all those decisions went well. Man, some of that stuff was painful, but. And it took effort because in those. It's not like I'm born with this disposition. I'm actually, I don't like school. I don't like. I didn't like reading. And I always took a negative angle on everything. And I was competitive and I felt easily slighted. I didn't begin with this, you know, I'm no saint. This is not about that. It's that it's been a just a dial I'm turning for quarter century and choosing experiences that built my identity. But what I want people to know is those cancer patients are not falling into like, oh, positive, rosy disposition says I'm glad I did. They're fighting for that. Their fight is not just with the cancer, but the fight is with the way we think about our world, our life, because you don't know what's around the corner. There is no moment of arrival. There's only being prepared, having some strategies, some coping skills. So we're maturing through life and then having the ultimate gift is to write your own story in your own mind and not by other people. And that's what they're doing. Everybody's like, oh, how are you doing? You have cancer? They hate it. They're like, oh, if another person asked me about my cancer, you know, they. They wear wigs to hide all of that stuff. But in their mind, when I see them, I can see the wheels turning, that they're taking this imperfect life and they're like 40s and 50s with cancer. Of course, that's. That. That's. That feels like the worst look. But they don't. They don't come in depressed. If you went into this, you would think, oh, my God, it's got to be the saddest thing in the world. They're heroes. They come in. They come in dressed up, they're telling jokes. They found a way with a cancer diagnosis through effort, through faith, through spirituality, through friendship. They're directing their life story this way because if you don't, you're just going to spiral. And that's the responsibility, I think, that we have in our position is to equip people with that, that there's no shortcut that is possible. There's no secret steps. Cancer patients have taught me that it's a direction of your psychological energy to write the story of your life as you want it told, and more importantly, as you really embrace inside your own mind.
- [46:34]
A
Well, it's also, and I love that phrase, the direction of your psychological energy, both of the story that you want to be told, but also of the story you want to experience as it is unfolding. Because what you're also teaching us is that when it comes to things that are out of your control, and I think we can all agree all of the decisions that we have made in the past are over. The cancer is here. The divorce has happened, the school has been dropped out of, the drinking for however many years. Whatever it is, you cannot control what has happened, but you can control how you talk about it and how you look at it. And so even the framework that you use through your own life, you could have said, I wish I had never dropped out of college. I wish I had not gotten a divorce. I wish I had this, I wish I had that. Or you can say, I'm glad I did, I'm glad I did. Because in that reframing, I'm glad I did. You have to force yourself to see either the lesson that you learned from it or the experiences that you could have only gained in it.
- [47:48]
B
And it's an active process. It is your prayer, it is your cognitive behavioral therapy. It is the argument you must make to yourself. And it, it's, it's, I'm glad I did. And then populate that with. Because of this good thing happened. Then I met Mr. Jet, then I met this, then I did this or
- [48:07]
A
because I learned this, this or I learned that.
- [48:09]
B
Right?
- [48:09]
A
Yes.
- [48:10]
B
You know, so it's not just four or five words or whatever. It's like, it's, it's an approach to thinking. And so when you talk about cognitive behavioral therapy and that, you know, cognitive restructuring to looking at perceiving and looking at things. So these, these are consistent things between Marcus Aurelius and meditations and stoicism, where people are talking about, you know, you feel what you allow yourself to feel, or you have Buddha and Eastern philosophy, or you have cognitive behavioral therapy where, where it's cognitive restructuring and monitoring, it's all the same thing. You're controlling the direction of your psychological energy. Either you are focusing on something and focus, like holding your breath is a skill that you can learn, or you are learning to be non judgmental and let all these experiences pass you like little boats on a river. And not biting on everything. For me, it was both. I was biting on too much when I was young, wilding out, reactive, impulsive. So I had to learn that there's a temporal nature. Like I know something's coming up that I can't deal with and I need to brace myself for it. So there are strategies. Directing your focus. I wish I did. And filling that bucket and then also using that focus to actively monitor but not judge. These are Buddhist and behavioral therapy techniques. This is so all what I'm seeing is all of these different things that the people are hearing in the wellness community. On a practical level, my cancer patients are doing it. And it all comes down to the direction of your psychological energy.
- [49:47]
A
And amputating something from your life is another tool. Because if you are filling your life with too many things.
- [49:57]
B
Absolutely.
- [49:57]
A
I always say if everything's important, nothing is.
- [50:00]
B
Well, that's what we talked about.
- [50:01]
A
Yes. Amputating something pulls the direction of your psychological energy toward the things that matter.
- [50:08]
B
Because your psychological energy is limited, it's not infinite, and it has to be matched to your real world scenario. If everything's good, distribute all of that juice to all the good stuff. But sometimes you gotta brace for the storm. When I operate, sometimes I'll come around a corner on a tumor and there'll be a blood vessel and I know there's four more hours of work that just kicked up and there's a risk for the patient and I gotta, I gotta, I gotta go into escape the freefall mode. So this is a very practical thing. Whether you are a Navy SEAL or complex surgeon, or you get that email that says we have layoffs and I need to see you tomorrow, you know that when it hits you, the best thing you can do is control your breathing. And what you want is at that time just to pace your breathing. Okay? So that, that's what I do in surgery. That's what Navy seals do, that's what deep divers do, and that's what people, that's the built in resource. The simplest way that I had somebody explain to me is great, like, oh, so you, so you don't hypervent. So you don't hyperventilate and panic. Because hyperventilation leads to panic. So at that time when you want to panic,
- [51:26]
A
just.
- [51:26]
B
And what you're doing is first you're directing your psychological energy to controlling a reflex. That's called breathing. And so you're practicing your focus, your ability to focus. It's a skill. Attentional power is what I call it. And then number two, what you're doing is you're relying on a physiological mechanism that prevents hyperventilating and those slow, deep breaths. There's a whole science that I can explain is, is going to keep you from having hyperexcitability of your limbic system. The point is, do not let yourself breathe too fast. When you blow off the carbon dioxide, you will panic. Then you will not be able to deliver your maneuvers. So for me, in surgery or whenever you're about to go into a difficult situation, maybe you got in a fight, you know, you got to talk to a lover about breaking up or whatever, just come in with pace breathing. And it's a few seconds in, it's a few seconds hold, and it's a few seconds out. Now what I will tell you is if you think you're going to do that, when you get rocked, it's not there for you because you haven't been rehearsing it, you haven't made that ritual. So when I park my car in my spot, and so that's, that's the mindset, that's the playbook for when the crisis hits.
- [52:44]
A
Well, Dr. John Dal, what I like a lot about what you said, there's a lot to unpack is this concept of controlling the direction of your psychological energy and attentional power and the power that you have even in the storm around you. Whether that's a patient that comes to you and gets a terrifying diagnosis, or it's the email that you get that layoffs are coming and there's a meeting tomorrow, or the sound of somebody saying, I don't love you anymore, this is over. Like so many moments. What I really appreciated about what you said was just simplifying it down to slow down your breathing. Don't worry about technique or seconds or just in slowly, out slowly. And I also loved that you are suggesting that there are moments throughout your day that you can leverage attentional power and settle yourself and calm yourself or even create an intentional transition. Whether it's before you get out of the car, you're just going to breathe in and breathe and there's nothing going on.
- [53:58]
B
Five minutes.
- [53:58]
A
Yeah, that's it. There's nothing going on. Before you walk into the house, before you walk into the room, you're just going to breathe in and breathe out. And what you're saying is if you start to leverage this little tool in your life before it's going sideways, it'll
- [54:13]
B
be there for you when shit goes sideways. For real.
- [54:15]
A
Yes. Because we all know the more emotional and reactive we get, the more screwed we are.
- [54:20]
B
Yeah, you gotta practice. Game time is not gonna be the only time. Right. That you wanna.
- [54:25]
A
Yes.
- [54:25]
B
You wanna run those drills. So it's practical. And again, cancer patients are doing it. Navy seals. And it's there, it's free, it's universal, it's for all of us. And there is a, just briefly, you know, there is an anatomical connection that sort of mediates all of that. It's not, it's not. Woo, woo.
- [54:43]
A
I mean, what's happening like at the highest level? What's happening when you breathe in and you intentionally like control the direction of your psychological energy?
- [54:53]
B
You're releasing your own, the pharmacy in your mind, you're releasing your own volume and your, your. It's an anxiolytic. It's. So we always hear about, just to get a little science, you. Right. We hear about a lot of neurotransmitters, but it's a big cocktail up of neurotransmitters will actually depress the electrical energy of your mind a bit. They're excitatory. But there are also some that depress it and that's called gaba. It's used in Valium to actually break seizures out of control, brain electricity. And so what is clearly demonstrated out there, whether you tickle the vagus nerve here or you control it naturally with pace breathing, you're increasing the release of GABA that's sitting there already in your brain and mind. That's the science behind it. It's not even exotic, it just hasn't been explained.
- [55:43]
A
That's super cool. Thank you for sharing that. And I want to thank you for spending time listening or watching this right now, because I know that everything that Dr. John Dal is sharing with you and me has the ability to change your life. So thank you for being here. Thank you for sharing this with the people in your mind that keep popping up and don't go anywhere. We have so much more to dig into after this short break, so stay with me. With Target, filling every basket with Easter magic has never been easier. That means fun and festive finds starting at just $3. From tasty favorite day treats to the softest Gigglescape plush toys, we've got everything you need to make their day, so find all the Easter basket goodies they'll love at Target. Are you ready to make a change in your life? If you're thinking about going back to school, let me tell you about Southern New Hampshire University. They have more than 200 online degree programs with affordable tuition and industry leading academic support. At snhu, you're not just another student, you're part of an entire community that cares about your success. So what are you waiting for? Visit snhu. Edu Mel to learn more support for
- [56:58]
C
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- [57:31]
A
the last year I've been working so hard on my first ever product. I am so proud of it. It's personal. It's something I needed in my own life and I couldn't find it. So I helped create it. What is it? It's called Pure Genius protein. It's a 23 gram complete protein shot. It's the easiest way to get high quality, delicious protein on the go. And you may be wondering, Mel, why are you getting involved in protein? Well, I'll tell you why. Because of this podcast. For two years I kept hearing every medical and nutritional expert on this show talk about how important protein is that it's critical for Strength, healthy aging, energy, weight loss, hormone balance. And yet most women were under eating protein by 50%. That was me. So I took the advice. I tried to get more protein, but it was really hard. That's why I co founded Pure Genius Protein. It is an incredibly delicious 23 gram protein shot. It's designed for busy schedules, travel, long shifts, low appetite days, fueling workouts and everything in between. We developed it with a team of leading doctors, medical researchers and scientists. Pure genius protein shots are only 100 calories. They have zero sugar, zero fat, no artificial flavors or sweeteners or dyes. It's amazing and I can't wait for you to try it this week. Save 20% off on your first order at PureGenisProtein.com when you use code MEL+ there's a 30 day money back guarantee. Welcome back. It's your friend, Mel Robbins. Today you and I have the extraordinary honor of spending time learning from Dr. John Dial. And he's teaching us all of these frameworks that he's learned as a cancer surgeon about getting through some of life's most difficult situations and, and really leveraging the power of your attention to focus on what truly matters. So, Dr. John Dial, I would love to have you share what you have heard your patients talk about in terms of what matters most about life when time is limited and what kind of comes into focus that people wish they had prioritized more.
- [59:45]
B
They're on a mission. Many of them have children. They're not even thinking about a cure. They have said to me, and it's been my experience, I understand a lot of cancer surgeons out there, doctors, a lot of patients. I'm just telling you what I'm seeing. Their prayer is just that they make it to where the kids finish high school and get out of the home because they don't want their children to see their mom pass away while they're in high school. It's a specific finish line that they're going for. You would think, no, they want to cure. They're just like, this is what I really need. The older ones, when the kids have moved on and they're, they've had, they got their own lives and you know, they forget to call on mother's day or Father's day and you have that fuss. Whatever their perspective is more that again, when it didn't hurt anybody that they would, they wish they would have been more bold with their hunches and their instinct that maybe I should change my direction, maybe I should. This isn't working for me. Maybe. May. All those maybes that were like in, you know, that were almost like a 50, 50 or a 60, 40. Not the. It's a choice because it's. It's unclear. Do you want to win the lottery? Not. No choice. Thanks, I'll take it. You know, it's not. Choices are. Because it's a crossroads and it was unclear. So it's not so much the amputation I talked about, because that's more of crisis choices.
- [61:06]
A
Yeah.
- [61:06]
B
It's more of the subtle meandering through life. You know, maybe I should have lived here rather than there. Maybe I should have done this rather than that. They felt like they weren't. They could have been more bold in pursuing their hunches and their instincts. They never say, I'm glad I was practical and conservative. I mean, maybe not never, but you know what I'm saying, though.
- [61:28]
A
I know what you're saying.
- [61:30]
B
Because then they look back and they say, it's a short run. I should have taken a few more chances. As long as they're not like, you know, yes. Hurting other people or, you know, gambling it all the way. But it's the subtle navigation, their life. They wish they were at all the pivots. They wish they would have been a little bit more emphatic and bold. That's my. That's what I'm seeing.
- [61:50]
A
So I would love to have you speak directly to a family member who may be listening or a loved one who has somebody in their life who is dealing with an illness. What do you want the person who's the caretaker to know, Dr. John D. Al.
- [62:12]
B
That if you find yourself in the most trying and difficult situation, you're not alone. The person next to you may not have been there, but they will in the future. And the person next to you might look like they're coping, but they could have endured that in the past, and that our struggles and our triumph at the level of the brain are quite similar. So you're not alone. And there are resources for you to get through this with support, with love, with direction. But ultimately is those private moments in your life that you only share with yourself, that you need to prioritize.
- [62:58]
A
I would imagine that given how much surgery you do, how many patients you've treated with cancer, that you've just seen extraordinary resilience. What have you learned about resilience? And that human beings are so many times just so much stronger than they think they are.
- [63:20]
B
So it's. It's. It's a word that's been bugging me for A long. Bugging me for a long time because it's. Now it's thrown off, this is just throwing around like I don't even know what it means anymore, you know.
- [63:29]
A
But what does resilience mean to you?
- [63:31]
B
Well, there's a engineering definition which is the ability to return from deformation or like, like a bridge shifts and it comes back. Then there's a psychological definition that is, that's more appropriate, and that's resilience doesn't mean just coming back to what you were. It means coming back stronger, more fortified. And so in the psychological sense, there are two types of resilience, and they're systemic and processive. Systemic means what you're bringing to the fight because of all those. The cyclical nature of crisis and springtime crisis and growth, struggle and growth that you've. That you banked, that you've rehearsed your skills on. So now you, you're bringing something to the next fight, the next struggle. But then there is also a processive resilience, which is what the fight brings out in you. They're not tough until they get hit. They're not tough and resilient until they face the cancer diagnosis. And I've seen that you think people are like, oh, they're going to fall apart inside your mind, and the crisis brings out something in them. I like to feel like that's what happened in my life at age 19. And that's a tricky thing to say because I don't want cancer. I don't want these things. None of my patients do. But the, it's what you bring the fight. But if you're not doing well, this fight is training you so you're, you're not lost. No matter how you're dealing with your life, either you're practicing and feeling good about coping, or, hey, this is rocking your world and teaching you a lot that's going to prepare you for what's coming up.
- [65:16]
A
Dr. John Deal, what are the best recoveries that you've seen in terms of, like, the things that they have in common or even if it's not a recovery, the best meeting of the moment.
- [65:30]
B
So sometimes cancers and injury will paralyze. Like Christopher Reeve, they'll paralyze patients. Or sometimes their legs are paralyzed, but they have their arms, the injuries, like around their belly button. And the brain can't talk to the legs, and the legs can't send sensation up to the brain. And some of those injuries are either total and there's no chance, or some are partial. They've got Flicker of movement. And the, the lesson there for, for, for patients and people is it's. It's in the first three months that they get the bulk of their. Their function back. The ones that get it back the most are the ones that are sitting there trying to move their leg, and the leg isn't moving. They are sending electrical signals through the damaged spinal cord, landing on the muscles ready to go. It's just not getting the spark. So they are directing their psychological energy towards moving a leg that won't listen. And they do it, and they do it and they do it, and there's nobody there. It's not when physical therapy comes in and then I. Because I see them in gaps and all of a sudden they're coming back with movement. And it's all of that work they did when they saw no result. Just imagine just trying to flicker your foot, and it doesn't. It doesn't move. And you're still trying. You're still trying. You're still trying to. So the, the recoveries that impress me are not biological. It's. And I always tell them, you're training for the Olympics. This is boot camp. This is the window to go for it. Things won't look like they're moving, but the continued effort is the only way you will spring back to life in your legs. And so those are the kind of things I wish people would know is there's a lot out there. And the inspiring thing is if the injured brain can heal, and I don't mean heal like some magical thing, I mean, and it doesn't regrow, it's not liver, you don't pop up a new part of your brain. But if the injured brain can recover, well, what about our healthy brain?
- [67:34]
A
So, Dr. John D', Al, after watching people recover like you just described from a devastating brain trauma, what do you wish everybody understood about how change truly happens in life, in the brain in general?
- [67:53]
B
Well, I think we can go backwards. We can talk about it in the brain and there for life. Sometimes children will have seizures so ferocious from both sides that they have to be on a ventilator, otherwise they can't live. And the only option, exhausted through everything else, is to remove nearly half of their brain. It's called. People can look it up. It's a hemispherectomy. And usually it's on the right side because language is on the left. So you take the right side. The surgery is done. They're able to wake up because you took the right side. The. The left arm and left leg is. Is is out, it's paralyzed. And. And then, you know, it's a large part of the brain that you've removed. Removing a hemisphere, it's like. And this has been going on for a long time. So I'm bringing insights from all different facets of my life and things that I'm reading. Then a couple of years later, this is an extreme example to set the precedent, they'll come back walking. It happens in children, more difficult in adults. And what's interesting there is when you take a brain scan, it's hollow. The part that you cut out just filled with brain fluid. It didn't grow back. The leftover neurons repurposed. The, the dancer became the soldier. It's the neuron. You didn't grow. So I always get thrown off when people are like, rewire. Plus, I don't understand what that means because these, these kids, they don't regrow. That part we took out. It stays hollow. What's left over doesn't. Does a new job, does. Takes on new functions and such. And the way that happens is with this thing called myelination. So the, when we're going to get into that, why, how change happens is if you have a sudden, if you do something once, you know, the way it works is, you know, why change for that? Because it's unlikely to happen again. But the constant direction of psychological and energy will make the original effort not have to, will, Will not have to be as strong once you deposit myelin. So just, just stay with me for a little bit. So the neurons are like microscope, molecular, microscopic jellyfish. You're spraying electricity at each other. And the way once you, once you think a certain way, once you behave a certain way to reduce the energy usage, they'll start wrapping Omega 3s as fatty sheets, like insulation around the tentacles. Okay, so think of it as like, if you keep going down the same groove from the top of a mountain, you tend to fall down that groove. Well, there's a cellular basis for that. And the, and the brain will do that as a response because it wants to now, you know, have this action occur without using up so much fuel, my efficiency, neural efficiency. Otherwise we're using up so much fuel just to tie our shoelaces. At some point. You want to tie your shoelaces.
- [71:00]
A
Not really. Think about it.
- [71:01]
B
And when people get Alzheimer's, they can still tie their shoelaces. They can still ride a bike. Right, because it was efficiently deposited. So change takes constant but moderate effort. It's not like one big effort. It's not 10 hours of throwing the baseball to learn it. It's better to do 15 minutes a day. And those are the molecular cues for the omega 3 fatty acids that we all want to eat from salmon and brain diet to take the positive habits that you built and make them more likely to occur. To shift from the bad grooves down the mountain to the new grooves that you've made. That shift takes effort, but it's not lifelong effort. You put in a hard couple of months to make that change. Now that change gets easier to do. Then you take on another change. You do another minus one plus one like we talked about incrementally.
- [71:56]
A
What's one like Big epiphany from all the brain surgeries that you've done that has changed the way you see human possibility.
- [72:05]
B
I will tell you the recently, it's not. It's not from brain surgery. You know what? When your heart stops beating, there's still another couple of minutes where your brain is sparking electricity, spraying neur. Spraying neurotransmitters. It's still going. That last surge gives it enough glucose and oxygen. And when your heart stops after cardiac death, there is not electrical silence in the brain. And those one or two minutes, the brain isn't like whimpering, like it's the. The last thing the brain will do is launch all of its electricity and chemicals in a giant salvo fireworks and then stop. So it's not like other organs where they go down decor. There's not like a. It's not like decremental. Slowly the heart stops beating. Slowly the liver turns, changes color. The brain, when it gets its last pulse of blood, will just fire off. And a lot of that electricity looks like dreaming and expansive memories and that sort of thing. And that might explain why if those people come back, they all share the same film strip of their life. That's cool. And that's a measurement that's not my opinion.
- [73:24]
A
That's super cool. Yeah, that's super cool. I would love to talk more about some of the things that you personally do every single day. You know, you are a cancer surgeon. You are a father of three adult boys. You've had so many, like, just unbelievable twists and turns to your life. You're one of the most decorated cancer surgeons around. What are the most important daily rituals to you that really help you? Or what's the single most important daily ritual that you have?
- [74:03]
B
The single most important daily ritual I have is that at several times in the day, I rehearse my attentional focus by pacing my breathing. It trains My mind to focus, and it trains me to get ready for that, what's around the corner. Because when it arrives, when crisis arrives, it's not when you really want to pull something out of your rusty toolkit. You want to. You want to have that sharpened. And what's. Why I think that's important is when I can cultivate my attentional power, then that attentional power is useful for other things, and I'm able to shift it. Like when I'm driving, I'm like, okay, I'm thinking about my next book. I'm gonna listen to music and a rock out a little bit. I'm gonna deliver attention to this. So that five minutes of directing my attention, pacing my breathing, you know, keeps the reins on where my mind is headed. And that way I can deploy it in a strategic fashion.
- [75:01]
A
I want to have you walk me and the person that's listening or watching right now through how we could start this five minute practice ourselves. Because it makes a lot of sense to me that I think most of us go through life probably on autopilot, feeling super distracted, our attention pulled all over the place, putting fires up. How do we implement this today? What do we do?
- [75:24]
B
Step one, try, you know, step two. It doesn't have to be some private place because a lot of your crises and a lot of your attention is, is. Is stolen when things are wild, right? It's not going to be in a yoga studio or in a quiet room. So randomly at times during the day where you think you're stressed out or about to be stressed out or walking into a stressful situation, just sort of set a timer in your mind. It could be a song like, I like to go for. There's a certain song I use. Or it could be a timer on your phone and just through your nose. It doesn't have to be one nostril. I mean, all of that, it's all going the same place and through your nose. Just try to breathe in for 3, 4 seconds.
- [76:04]
A
Hold.
- [76:06]
B
Hold for a few seconds, and then slowly exhale and then pause for a second and then do that again. Let's see if you can get 10 of those. See if you get 20 of those. And if you're in public and stuff, and you don't want people to know you're doing that. Like in surgery, like, because my mask. My mask will fog up if I use my mouth. I wrote about that. Like, in the beginning when I was learning, I was like. I was like. And the. We wear these glasses that are magnifying glass it's like fogging up. And the nurses would tease me. They're like, hey, you freaking out over there? I was like, no, I'm not. So I, you know, I only use my nose. And what I'm trying to tell you is this overlaps with Buddhist meditation. Pace, breathing, directing. You have to try. You're directing your attention to do this. You're pulling your attention from something that's been spiraling and driving you crazy. So already you're redirecting your psychological energy to something positive. And so the attentional power is really a skill you can cultivate. People can learn to hold their breath, you can learn to hold your attention.
- [77:11]
A
I want to make sure that you got that. And so I'm going to translate it and if I miss something, you tell me. Okay? So basically, it's as simple as it sounds. Practicing and building the skill of attentional power is simply at any moment, and you could do it right now, you could do it sitting in your car, you could do it lying in bed in the morning, you could do it sitting at your desk, you could do it before you walk into a room. Attentional power is bringing your attention to your breathing. And you just recommend in through the
- [77:44]
B
nose, out through, hold out through the
- [77:47]
A
nose, out through the nose.
- [77:49]
B
It's not as easy as you think. When I first started, like four breaths later, I'm like, do something.
- [77:54]
A
So that is try 10, try 10. You're saying try to do it 10 times. Like you could do it standing in line at the grocery store.
- [78:01]
B
Yeah, especially standing in line in the grocery store or whatever it is.
- [78:04]
A
But here's what you're going to notice is that as you're standing in line at the grocery store and like, okay, I'm going to practice attentional power. Since I just heard this and I'm not going to look at my phone, I'm just going to practice attentional power. You can only pay attention to one thing at a time. And so by focusing on your breathing in pause, out pause, in pause, this is how you build the skill.
- [78:28]
B
This is how you. And controlling your attention is a part of meditative practices from Eastern philosophy. It's a part of when people say get therapy. When you see your therapist and they talk about cognitive behavioral therapy, you know, you have to divert your attention to argue against the life narrative you're writing. You have to divert your attention to do non judgmental monitoring. They call it don't react, don't react. All of it takes attention. And so this skill, push ups will help you open A heavy door. Focusing on your breathing like this and your private moments during the day will help you with all of the other things you're trying to do because it harnesses your attention.
- [79:07]
A
Could you speak directly to the person who's with us right now who's going through an extraordinarily difficult moment? So they're in the crisis mode. Dr. John Dal. What do you want them to know?
- [79:22]
B
You're not alone. Crisis hits our brains and minds in a similar way. And there are approaches to dealing with crisis that we've talked about today, in the moment as well as when you go home, set your guardrails, don't make a decision tonight in crisis that you can't take back. And then the next day is when you have to sort of turn to others to come up with a plan to get through this difficult moment.
- [79:52]
A
How has what you do for a living and the patients that you've treated changed you?
- [80:02]
B
I'm a lot less judgmental, you know, I just, you know, when you're younger, you place your emotions on other people. You, you think you know what other people are thinking, or you feel underestimated and all of that stuff. And it just feels foolish and immature to me now because after this many patients and all these, oh, you know, all of their stories, what I've seen is that don't judge the rich, don't judge the poor. You don't know what they're going through. You don't know what's, what's happening in their lives. They're in line with you, next to you. You don't know. Cancer patients have taught me that it's not what you think when you, when you care for them, because a lot of times they don't share. A lot of times they keep it inside. I just think somebody on the freeway is probably short with them or something. They have no idea. They just driving home right now after hearing they got cancer.
- [81:00]
A
If you had to just distill everything that you've shared with us today from this playbook, the mindset frameworks, the attentional power, directing your psychological energy, some of the real truths about life into the most important takeaway for the person who's listening, what would it be that you
- [81:26]
B
know that there is no final moment of arrival. This life is not linear, it's cyclical. And you know, in the springtime of your day or your life, relish it, enjoy it. And during the difficult times, there are strategies and approaches that can help you cope and help you survive. It's not you alone in the Dark, you know, trying to grab for. For a life vest. People have been here and they've left their mark by guiding us on how to deal with that as best as we can.
- [82:07]
A
Well, I really appreciate you leaving your mark. Thank you, Mel. And guiding us in an extraordinary way. Dr. John Dal, what are your parting words?
- [82:20]
B
Life is beautiful because it's difficult. There's nothing guaranteed, nothing promised. Make the run. You can relish the good times, too. That's also a life skill.
- [82:34]
A
Yes, well, the good times are the average Tuesday. Like, if you can't enjoy an average Tuesday, then you miss the good times.
- [82:41]
B
Yeah. Yeah.
- [82:43]
A
Well, this was extraordinary. And I'm gonna borrow from one of your really powerful frameworks and say I am glad you did get on a plane and you did come here and you shared all this, because I know that my life will be forever changed. And I know that I speak on behalf of the person that's with us and everybody they share it with. Their lives will be changed too.
- [83:10]
B
Yeah, I'm glad I did too. Thank you, Mel.
- [83:12]
A
Thank you. And thank you for taking the time you put your attentional power to something that is gonna help you create a better life. There is no doubt if you take anything from this and apply it, and I hope you share it with people that you care about, you will be able to. To manage the very difficult seasons of your life. And you will be glad that you did. Alrighty. In case nobody else tells you, I want to be sure to tell you as your friend, that I love you and I believe in you. And I believe in your ability to create a better life. And when you do, I know you'll be glad that you did. I'll welcome you into the very next episode. The moment you hit play. I'll see you there. God, it's amazing how dirty they get because I don't ever recall touching them.
- [84:04]
B
It's like they're snaring it.
- [84:06]
A
It's wild. Just like. Where did that slip come from? I didn't touch the lens. Is that what I'm walking through the air into? Svendrift is colored. I didn't know that. Yeah, I guess I always drink it out of the can. I've never poured it in a glass. I don't mean to stare at you in a creepy. I'm trying to, like, hold so they have a little more room to cut. Trying to do my job, Cameron.
- [84:27]
B
Thank you, Mel.
- [84:28]
A
You're welcome.
- [84:29]
B
If our paths don't cross again. Are really valuable in the last hour and a half.
- [84:34]
A
Well, I. They're gonna cross again. What do you mean if? Oh, and one more thing. And no, this is not a blooper. This is the legal language. You know what the lawyers write and what I need to read to you. This podcast is presented solely for educational and entertainment purposes. I'm just your friend. I am not a licensed therapist and this podcast is not intended as a substitute for the advice of a physician, professional coach, psychotherapist, or other qualified professional. Got it? Good. I'll see you in the next episode.
- [85:18]
B
SiriusXM podcasts.
- [85:26]
C
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- [85:56]
A
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B
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- [86:11]
A
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- [86:14]
B
I think we should call a doctor.
- [86:16]
A
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