#738: Dr. Gabor Maté and Dr. BJ Miller

Summary

Podcast Summary: The Tim Ferriss Show – Episode #738: Dr. Gabor Maté and Dr. BJ Miller

Release Date: May 17, 2024

---

Introduction

In this insightful episode of The Tim Ferriss Show, host Tim Ferriss sits down with two renowned experts in the fields of trauma and palliative care: Dr. Gabor Maté and Dr. BJ Miller. Celebrating the show's 10th anniversary and over a billion downloads, Tim presents a "Super Combo Episode," featuring these transformative conversations that delve deep into human suffering, healing, and the art of living well.

---

Understanding Trauma

Timestamp: [07:22]

Dr. Gabor Maté introduces the concept of trauma, emphasizing that it's not merely about the traumatic events themselves but the internal impact they have on an individual's emotional and physical state. He distinguishes between trauma of commission (adverse events like abuse or loss) and trauma of omission (lack of necessary emotional support during development).

Dr. Gabor Maté [08:32]: "The trauma is not what happens to you. The trauma is what happens inside you."

This internalization leads to disconnection from emotions and the body, fostering a defensive worldview that persists into adulthood.

---

Compassionate Inquiry and Healing Modalities

Timestamp: [08:24]

Dr. Maté outlines his therapeutic approach, Compassionate Inquiry, which shifts the focus from judging addictive behaviors to understanding the underlying pain that fuels them.

Dr. Gabor Maté [08:24]: "I call it compassionate inquiry. So inquire in a compassionate way, not why did I do this, but why did I do this?"

He discusses various healing modalities that aid in reconnecting individuals with their bodies and emotions, including:

• Somatic Experiencing: Developed by Peter Levine, focuses on bodily sensations to process trauma.
• EMDR (Eye Movement Desensitization and Reprocessing): Combines talk therapy with specific eye movements to reprogram emotional responses.
• Yoga: Emphasizes unity with oneself and the environment through meditative movement.
• Psychedelics: Explored as a potent tool for rapid self-awareness and trauma healing when administered in controlled, supportive settings.

Dr. Gabor Maté [14:43]: "There's a meditational component to it, which is taught by a number of disciplines."

---

The Role of Psychedelics in Trauma Healing

Timestamp: [13:28]

Dr. Maté shares his personal journey with psychedelics, particularly ayahuasca, highlighting its profound impact on his understanding of love and trauma.

Dr. Gabor Maté [17:30]: "In such hands and in such a context, it can be like a superhighway to self-awareness."

He emphasizes the necessity of integrating psychedelic experiences with professional guidance to ensure safety and efficacy.

Dr. Gabor Maté [16:16]: "Inner Engineering, when I recommend it to friends and others, everybody has been only been grateful. So I can highly recommend it."

---

The Impact of Trauma on Perception and Behavior

Timestamp: [28:12]

Through an exercise with Tim Ferriss, Dr. Maté illustrates how trauma shapes our automatic perceptions and reactions. Tim shares an incident where unmet commitments led him to assume disrespect and lack of care from others, a pattern rooted in childhood trauma.

Dr. Gabor Maté [30:52]: "We don't respond to what happens. We respond to our perception of what happens."

This exercise underscores the importance of examining and reframing our perceptions to overcome ingrained trauma responses.

---

Personal Insights and Experiences

Timestamp: [21:05]

Dr. Maté recounts his traumatic childhood experience during World War II, where his mother had to give him up to a stranger to save him from the chaos in Budapest. This event led to a deep-seated sense of abandonment, shaping his future emotional landscape.

Dr. Gabor Maté [22:56]: "So my heart closes against love. And I got all this."

His subsequent psychedelic experience with ayahuasca opened doors to reconnect with emotions and love, catalyzing his therapeutic philosophies.

---

The Importance of Setting Intentions

Timestamp: [24:39]

Both Tim and Dr. Maté discuss the significance of setting intentions in life, particularly during challenging times. Dr. Maté shares a personal anecdote about an intentional holiday that brought harmony and understanding to his relationship with his wife, contrasting it with previous, more chaotic experiences.

Dr. Gabor Maté [26:32]: "We set an intention. What is our intention? And if we have an intention, I've learned from a couple of very wise teachers."

This section highlights how mindful intention-setting can transform personal relationships and enhance overall well-being.

---

Conclusion

The episode culminates without reaching a formal conclusion, as Dr. Maté and Tim delve into practical exercises and personal reflections on trauma, healing, and living with intention. The conversation provides listeners with profound insights into understanding and overcoming trauma, the therapeutic potential of psychedelics, and the transformative power of setting meaningful intentions in life.

---

Notable Quotes

• Dr. Gabor Maté [24:26]: "Your conflicts... are specifically yours. Designed specifically for you by a part of you that loves you more than anything else."

• Dr. Gabor Maté [30:05]: "We don't respond to what happens. We respond to our perception of what happens, to our interpretation of what happens."

• Dr. Gabor Maté [16:44]: "If you allow it, psychedelics can foster a sense of belonging in this sort of cosmic way."

---

Resources Mentioned

• Somatic Experiencing by Peter Levine
• Waking the Tiger: Healing Trauma by Peter Levine
• Inner Engineering by Sadhguru

For more in-depth discussions and therapeutic approaches, listeners are encouraged to explore these resources and consider professional guidance when addressing trauma and seeking healing modalities.

Transcript

[Tim Ferriss]

This episode is brought to you by Vuori Clothing, spelled V U O R I Vuori. I've been wearing Vuori at least one item per day for the last few months and you can use it for everything. It's performance apparel, but it can be used for working out, it can be used for going out to dinner. At least in my case. I feel very comfortable with it. Super comfortable, super stylish. And I just want to read something that one of my employees said. She is an athlete. She is quite technical, although she would never say that. I asked her if she had ever used or heard of Vuori and this was her response. I do love their stuff. Been using them for about a year. I think I found them at rei first for my partner T shirts that are super soft, but somehow last as he's hard on stuff. And then I got into the super soft cotton yoga pants and jogger sweatpants. I live in them and they too have lasted. They're stylish enough, I can wear them out and about. The material is just super soft and durable. I just got their Clementine running shorts for summer and love them. The brand seems pretty popular. Constantly sold out. In closing, and I'm abbreviating here, but in closing, with the exception of when I need technical outdoor gear, they're the only brand I've bought in the last year or so for yoga, running, loungewear that lasts and that I think look good. Also, I like the discreet logo. So that gives you some idea that was not intended for the sponsor. Read. That was just her. Her response via text. Vuori, again spelled V U O R I is designed for maximum comfort and versatility. You can wear it running, you can wear their stuff. Training, doing yoga, lounging, weekend errands, or in my case again, going out to dinner. It really doesn't matter what you're doing. Their clothing is so comfortable and looks so good and it's non offensive that you don't have a huge brand logo in your face. You'll just want to be in them all the time. They're men's core short. K O R E the most comfortable lined athletic short is your one short for every sport. I've been using it for kettlebell swings for runs, you name it. The Banks Short, this is their go to land. To C short is the ultimate in versatility. It's made from recycled plastic bottles. And what I'm wearing right now, which if I had to pick one to recommend to folks out there, or at least to men out there, is the Ponto Performance pant and you'll find these at the link I'm going to give you guys. You can check out what I'm talking about, but I'm wearing them right now their thin performance sweatpants but that doesn't do them justice so you got to check it out. P O N T O ponto Performance Pant for you ladies, the women's performance jogger is the softest jogger you'll ever own. Vuori isn't just an investment in your clothing, it's an investment in your happiness. And for you, my dear listeners, they're offering 20% off your first purchase. So get yourself some of the most comfortable and versatile clothing on the planet. It's super popular. A lot of my friends have now noticed are wearing this and so am I. Vuoriclothing.com Tim that's v u o r I clothing.com Tim not only will you receive 20% off your first purchase, but you'll also enjoy free shipping on any US orders over $75 and free returns. So check it out. Vuoriclothing.com tim that's v u o r I Clothing.com Tim and discover the versatility of of vuoric clothing.

[BJ Miller]

This episode is.

[Tim Ferriss]

Brought to you by Shopify, one of my absolute favorite companies and they make some of my favorite products. Shopify is the commerce platform revolutionizing millions of businesses worldwide and I've known the team since 2008 or 2009, but prior to that I wish I had personally had Shopify in the early 2000s when I was running my own e commerce business. I tell that story in the four hour workweek, but the tools then were absolutely atrocious and I could only dream of of a platform like Shopify. In fact, it was you guys, my dear readers, who introduced me to Shopify when I polled all of you about best e commerce platforms around 2009 and they've only become better and better since. Whether you're a garage entrepreneur or getting ready for your ipo, Shopify is the only tool you need to start, run and grow your business without the struggle. Shopify puts you in control of every sales channel. Doesn't matter if you're selling satin sheets from Shopify's in person POS system or offering organic olive oil on Shopify's all in one e commerce platform platform. However you interact with your customers, you're covered. And once you've reached your audience, Shopify has the Internet's best converting checkout to help you turn browsers into buyers. Shopify powers 10% of all E commerce in the United States and Shopify is truly a global force as the e commerce solution behind Allbirds, Rothy's, Brooklinen and millions of other entrepreneurs of every size across more than 170 countries. Plus Shopify's award winning help is there to support your success every step of the way. If you have questions, this is possibility power, so check it out. Sign up for a $1 per month trial period at Shopify. That's S-H O-P-I-F Y shopify.com Tim Go to shopify.com Tim to take your business to the next level today. One more time, all lowercase shopify.com Tim.

[BJ Miller]

At this altitude I can run flat out for a half mile before my hands start shaking.

[Gabor Maté]

Can I ask you a personal question?

[BJ Miller]

Now it is in a broken time.

[Tim Ferriss]

What if I did the opposite?

[BJ Miller]

I'm a cybernetic organism.

[Tim Ferriss]

Living tissue.

[BJ Miller]

Our Metal Endoscopy Tim Ferriss show hello.

[Tim Ferriss]

Boys and girls, ladies and germs, this is Tim Ferriss. Welcome to another episode of the Tim Ferriss show where it is my job to sit down with world class performers from every field imaginable to tease out the habits, routines, favorite books and so on that you can apply and test in your own lives. This episode is a two for one and that's because the podcast recently hit its 10th year anniversary, which is insane to think about, and passed 1 billion downloads. To celebrate, I've curated some of the best of the best, some of my favorites from more than 700 episodes over the last decade. I could not be more excited to give you these Super Combo Episodes and internally we've been calling these the Super Combo Episodes because my goal is to encourage you to, yes, enjoy the household names, the super famous folks, but to also introduce you to lesser known people I consider stars. These are people who have transformed my life and I feel like they can do the same for many of you. Perhaps they got lost in a busy news cycle, Perhaps you missed an episode. Just trust me on this one. We went to great pains to put these pairings together and for the bios of all guests, you can find that and more at Tim Blog Combo. And now without further ado, please enjoy and thank you for listening.

[BJ Miller]

First up, Dr. Gabor Mate, Twitter, rgabor mate and drgabormate.com Gabor is an addiction and trauma expert and best selling author of in the Realm of Hungry Ghosts, when the Body says no and the Myth of Normal Trauma, Illness and Healing in a Toxic Culture.

[Tim Ferriss]

One of the epiphanies for me in the last very recent year or two, has been looking at my coping mechanisms very differently. And what I mean by that is for a very long time I had certain behaviors, certain defaults that I hated, which of course means I'm hating a part of myself.

[Gabor Maté]

That's right.

[Tim Ferriss]

And that included anger, rage, responses of stimulants, you name it. I always applied this loving kindness meditation to other people. And what was recommended is that I apply that loving kindness to the younger Tim, to the other versions of Tim who had these behaviors that I had grown to hate and resent and to actually thank them for the role they played. For instance, that rage, that anger was the fuel that got me out of Long Island. I just love to hear, and we can take it anywhere we want, of course. But once you have shifted the focus from why the addiction to why the pain and you start to work with someone, what approaches have you found to help? What tools?

[Gabor Maté]

I call it compassionate inquiry. So inquire in a compassionate way, not why did I do this, but why did I do this?

[Tim Ferriss]

Right?

[Gabor Maté]

The first one is not a question, it's a statement. It's a self condemnation. The second one is a question, wonder why I did this? Ah, it soothed my pain. And so what your friend said, that it served you. So thank it, love it, but let go of it. Is absolutely right. I call it the stupid friend. The stupid friend is the one who helped you in a particular way at a certain time. But it can't learn that that way doesn't function anymore. That instead of helping, now it's hurting. So it's a friend because it's really trying to help. But it's stupid because it's not learning that you're no longer that 3 year old or that 5 year old or that 15 year old, you know. So now this leads to the question of trauma. Because it's one thing to recognize that all this originates in childhood pain, it's quite another to transform that pain. And for that we have to understand what trauma is. So people often think that trauma is what happens to you. So trauma is a divorce when you were small and your parents fighting. Trauma is your mother's depression. Trauma is your father's alcoholism. Trauma is your parents argumentation. Trauma is physical or sexual abuse or some loss. Those aren't the traumas, those are traumatic. But the trauma is not what happens to you. The trauma is what happens inside you. And as a result of these traumatic events, what happens inside you is you get disconnected from your emotions and you disconnected from Your body and you have difficulty being in the present moment. And you develop a negative view of your world and a negative view of yourself and a defensive view of other people. And these perspectives keep showing up in your life in the present because they're the stupid friends. And so the issue is not just to recognize what happened 10, 15, 30, however many years ago, but to actually recognize their manifestations in the present moment and to transcend them. And how do you do that? By reconnecting with yourself, by restoring the connection with your body primarily and with your emotions that you lost. And once you do, when you found these things again, then you have what we call recovery. Because what does it mean to recover something? It means to find it again. So what is it that people find when they recover? They find themselves. And the loss of self is the essence of trauma. So the real purpose of addiction treatment, mental health treatment, any kind of healing, is reconnection for people who are listening.

[Tim Ferriss]

And want to reconnect with themselves, with their bodies, for instance. What recommendations might you have? Whether that's things they can do or resources they can look to, or both or something else. What recommendations? Because I'm sure, I am 100% sure, because I've had people come on and for the very first time on this podcast, talk about sexual abuse that they endured as children and what they did to help recover from that. Many people listening, I am sure, have addictions, both traumatic past experiences and trauma. What recommendations could you make for them?

[Gabor Maté]

So I want to say, first of all, that for trauma, you don't need terribly traumatic events. So there's two ways to look at trauma. One is that bad things happen that shouldn't have. We've talked about those. But the other way to get traumatized is when good things happen that should have happened. Good things didn't happen that should have happened. Look at that.

[Tim Ferriss]

Trauma of omission.

[Gabor Maté]

Trauma of omission where the parents, not that they didn't love you, not that they didn't do their best, but they were too stressed, traumatized, distracted themselves. Then you didn't get the kind of attention and the kind of acceptance and the kind of attuned being with that you needed, that itself can make you disconnect from yourself. The child needs that acceptance, that connection, that attunement. Our brain development requires it, our emotional development demands it. And when we don't get it, not because the parents don't love us, but simply because of their own issues, we can also suffer that disconnection. So that's what I call Developmental trauma. Now, how do we connect? Well, there are many, many forms of therapy. It's very difficult for anybody to do this on their own. Some people do it. I certainly couldn't do it on my own. I've needed a lot of help in terms of therapy that helps you understand what happened to me. And so that there's a reason for it. So that not if there's a reason for it, then it's no longer me. I'm not somebody to be ashamed of. I'm just somebody who developed along certain lines for some very good reasons. But it's not in my deepest character and it's not who I am and I don't have to be that way. That's a relief to know. It's also not that I'm genetically programmed, so I'm doomed to stay that way, number one. Number two, you have to reconnect with the body. There are various body therapies. My friend Peter Levine and his Somatic Experiencing Walking tiger.

[Tim Ferriss]

Is that one of his. Waking the tiger, Waking the tiger.

[Gabor Maté]

Waking the Tiger was his first book and he's written many wonderful books since then. Somatic Experiencing, his method is called, which he develops is brilliant. There is emdr, eye movement desensitization, reprogramming, which is a way of bypassing the conscious mind and getting to the emotional brain and quicker than talk therapy by itself can do. So it's combined with talk therapy, but it takes you past just a conscious defensive, egoic mind. There is emotional freedom tapping that people do. There's various variations on that. There is this motor sensory integration techniques. Then there is the traditional therapies like yoga. Now, yoga was not simply a physical modality when it first developed. Yoga actually means unity. So the very essence of yoga is to regain that unity not just with ourselves, but also with the larger creation. And so yoga, when it's practiced in its intended way, not just the hot yoga, where you get a good workout, that's great. I'm not against it, but I'm talking about intentional yoga with a meditative aspect to it, which is taught by a number of disciplines. Body work of all kinds of.

[Tim Ferriss]

Just going to hit pause for one second. Do you practice yoga? And if so, what type do you practice?

[Gabor Maté]

So I've always said that with my adhd, I'm not a yoga person. I can't do it until a year and a half ago, I met actually a yogi. His name is Sadhguru. He's an Indian yogi with a big following. I was very skeptical, but I Met the guy. I now have a 50 minute daily yoga practice which I did this morning before coming to the interview. And this made an enormous difference in my life with my ADHD mind, I really have trouble just sitting there. When I sit on the meditation cushion, my mind is like all over the place. But with the yoga which is more body based, I can stay much more present. There is a meditational component to it and so the answer is yes. If you had asked me 18 months ago, I would have said no, I support it, but I don't do it. But now I'm actually a very committed practitioner and it really has made a difference.

[Tim Ferriss]

Is it a particular type of yoga that people could Google or learn more about?

[Gabor Maté]

So I'm not a yoga expert and there's many forms of yoga that other people more knowledgeable than I am could recommend. But the one I learned is called Inner engineering and it's taught by either Sadhguru or his followers. And you can look up inner engineering online. Inner Engineering, when I recommend it to France and others, everybody has been only being grateful. So I can highly recommend it. Typically there's to me what seems to be a cult around the guy, which I don't take to particularly, but he's the genuine article in terms of having a deep experience and being able to transmit that experience to others and creating a practical system around it. So it's worked for me. I'm not here to recruit anybody else, but since you're asking.

[Tim Ferriss]

No, no, that's just my fans appreciate. Well, I'm not going to blame it on my fans. I like specifics.

[Gabor Maté]

Yeah. So inner engineering you can look up online and it's taught here in the States and in Canada, internationally actually.

[Tim Ferriss]

But I did interrupt you. You're about to mention, I think, another technique or modality that can help. Talked about, for instance, the somatic experience, emdr, emotional freedom tapping, motor sensory integration technique or techniques, yoga. And then there's something coming up after that.

[Gabor Maté]

Well, about 10 years ago, I began to work with psychedelics. Now if you're 15 years ago, you were to ask me, will I ever be working with psychedelics as a healing modality? I would have said, you're out of your mind. But then through a series of events I became aware of the potential role of psychedelics in healing. And I've been doing work with them now for 10 years. And they're another potent method. They're not for everybody. And I have to emphasize that whatever modality you choose of a psychedelic nature, you have to do it with Adept practitioners with deep integrity and deep knowledge and experience. But in such hands and in such a context, it can be like a superhighway to self awareness. Not in isolation, but it opens doors that otherwise might take years. And so it's not unusual for me to conduct a psychedelic session with somebody or a series of sessions, either in a group or individual setting, and have them say, that was like 10 years of psychotherapy in one day. And I've had the same experience myself. So again, it's not to be isolated from other kinds of work and it has to be integrated, but it's not a potent way of working. And of course, as I know you personally aware, there's an increasing movement amongst psychologists, therapists, psychiatrists, medical doctors, other healers to find ways of incorporating psychedelic healing in the larger therapeutic scheme.

[Tim Ferriss]

So, Gabor, you mentioned a series of events leading you to psychedelics, or to consider psychedelics potentially as a healing or medical modality, if you're able to. Could you describe any of those events?

[Gabor Maté]

Sure. So in 2008, my book on addiction in the Realm of Hungry Ghosts, Close Encounters with Addiction, was published in Canada and very quickly became a number one national bestseller, subsequently published in the States as well. And I was on a book tour and people kept asking me, what do you know about addictions and ayahuasca as a treatment? Ayahuasca being a Peruvian or Amazonian vine that's made into a brew that has psychedelic properties. I knew nothing. The next speech or the next event, somebody else would ask, what do you know about ayahuasca? And the two addiction? I finally started getting annoyed with it. Like, leave me alone. I've just written a book. I've spent years researching it. My life experience and all kinds of scientific exploration went into it. Asked me about something I know about, and then I realized that maybe the universe was knocking on my door. And somebody said, did you know you could experience it here in Vancouver? There was a Peruvian shaman leading some ceremonies up in Vancouver. So who am I to say no? And I jumped right in and I sat in this tent with 50 other people. Yeah, that's how they set it up. It's not what I recommend, but that's how they set it up. They played beautiful music and there was a little baby in the room. Mother and dad were there for the experience. The baby was in the room and the baby was cooing away. And tears started flowing down my face. And these were not tears of sorrow, they were tears of joy. And I got in touch with such profound love That I had never consciously experienced before. And there were tears of love. And it wasn't love for anybody else in particular, it was just love. And then I saw in all the ways that I had closed my heart against love in my life and how I had betrayed love in my personal relationship with my spouse and my children and in other ways. So I just got this experience of love is something profound and universal and life defining, but something from. I've been cut off in so many ways. And I got it because I closed my heart against love. Precisely because when I was vulnerable and small, I'd been so hurt. Owing to my mother's states of mind, she couldn't respond to me where I needed to be responded to. Not her fault, but she couldn't. And then when I was eight year old, she gave me to a stranger to save my life. And I didn't see her for a month, which is a huge.

[Tim Ferriss]

Explain that for a second.

[Gabor Maté]

So again, it's Budapest, Hungary, Second World War, January. The Russians have circled Budapest and are fighting the Germans. The government empire is a right wing fascist, anti Semitic military force. And even though the deportations of Jews have stopped, the Germans had annihilated half a million Hungarian Jews in three or four months. But now the Hungarian fascists were killing Jews in Budapest and including in the house where my mother and I were living. So my mother gave me to a stranger in the street, a Christian woman, because she didn't know if she'd be dead or alive next day.

[Tim Ferriss]

Wow.

[Gabor Maté]

Or that I would be. And I was quite sick. So I didn't see her for a month, which I experienced as a deep abandonment. How else could I experience it? So my heart closes against love. And I got all this. And so I got that. If this plant that, as you say, manifests the mind can show me both the ways in which I've closed off from myself and that I don't need to, because the love is still there. What healing potential it has. Now, I wish I could say that after that experience I became a loving husband and a loving human being. I didn't. It's not that simple, as my wife could tell you. Nevertheless, it opened the door for me and I got right away. Now, however, the thought that I had was that I had no induction, I had no introduction, I had no processing afterwards. Ayahuasca is a medicinal plant that has been used in the Amazon basin for hundreds of years, maybe longer, in a cultural context, in a tribe, in a village where people know each other, where they know the shaman, where they share the same assumptions and the same history. That's not the same as a bunch of westerners, strangers to each other, come together for one night, drinking the stuff and then going their separate ways.

[Tim Ferriss]

Agreed.

[Gabor Maté]

So immediately the question that came up for me was how can we create a setting that at least resembles, as best we can fashion, the original setting. So we came up with the idea of a retreat where a small number of people get together with properly trained shamans who have integrity and experience, deep experience, and with me facilitating people's preparation and their post ceremony integration. And so I've been doing that now for 10 years. A lot of learning involved, we made mistakes, but it evolved. And the essence of it is that people don't come into it cold. They come into the preparation in a safe setting where pretty soon a group becomes a family to each other. Which means that not only do they love each other and support each other, but they also trigger each other. I mean, I mean basically I tell people, guess what? You're back in your family of origin and everything you've hated about your family origin is going to show up here, but in the context where it's safe for that to happen. And so I've seen a lot of great healing. I've had people with multiple suicide attempts heal from depression. I've seen people get much better with their autoimmune diseases. I've seen people deal with all kinds of addictions and life issues, relationship problems come out of it much more themselves, much more able to deal with these issues so long as the proper integration is done afterwards. So that was my personal experience. Well, can I again give you a quote?

[Tim Ferriss]

Yes, please.

[Gabor Maté]

Which I love. It's from one of my favorite teachers and his name is ah Almas. And he says your conflicts, all the difficult things, the problematic situations in your life are not chance or haphazard. They're actually yours. They're specifically yours. Designed specifically for you by a part of you that loves you more than anything else. The part of you that loves you more than anything else has created roadblocks to lead you to yourself. You're not going to go in the right direction unless there's something pricking on the side. Saying, telling you, look here, this way, that part of you loves you so much that it doesn't want you to lose the chance. It will go to extreme measures to wake you up. It will make you suffer greatly if you don't listen. What else can it do? That's its purpose. And I found this to be true of physical illness and Mental problems and everything. You got to see what is the teaching here. So we can look at all these things as problems to get rid of, which is what the personality wants to do, or we can look at them as learning opportunities, which is what your true self wants to do. Now, two things. One is. You talked about intention in life. So my wife and I had a holiday recently in Costa Rica. Partly it was a working holiday, but partly it was just a holiday. Traditionally, we've had terrible times during holidays, partly because my workaholism and once I go into a holiday, I just collapse. And now my wife is dragging a corpse around, you know, because I'm a workaholic, you know, and I hadn't clear space. So this time we actually went into the holiday with intention. This is nothing to do with psychedelics, just to do it. That we set an intention. What is our intention? And if we have an intention, I've learned from a couple of very wise teachers. What structures do we want to set up to support our intention? And how are we going to handle when there's kind of disagreement or conflict? We had a beautiful holiday because it was the first intentional holiday that we've had. So that intention in life in general is absolutely essential. Like every morning, what is my actual intention? So the problems, the upset. So, want to do a bit of an exercise?

[Tim Ferriss]

Sure. Okay.

[Gabor Maté]

And if you don't like it, just tell me. This is something I do in my groups or when I speak or so on. When I teach, I ask people to tell me some recent episode when they're upset with somebody with their lives and something that they're open to sharing. So it doesn't have to be anything sorted or something, but just something whether it's your spouse, partner, the bus driver, I don't care who. A friend.

[Tim Ferriss]

Okay.

[Gabor Maté]

So are you willing to go there?

[Tim Ferriss]

Anything?

[Gabor Maté]

Okay.

[Tim Ferriss]

I can share anything.

[Gabor Maté]

Just. Were you upset with somebody?

[Tim Ferriss]

Okay. Yes.

[Gabor Maté]

Okay. So what happened?

[Tim Ferriss]

Describe it.

[Gabor Maté]

What happened? Yeah.

[Tim Ferriss]

All right. There were a number of issues in my home. Broken aspects of the home, things that were falling apart or needed to be fixed physically.

[Gabor Maté]

Physically, yeah.

[Tim Ferriss]

Right. And I had hired someone to do these things while I was gone.

[Gabor Maté]

Okay.

[Tim Ferriss]

And I came back and none of them were fixed.

[Gabor Maté]

Okay. And your emotional reaction was Anger. Rage. Anger. Okay. Anything else besides anger?

[Tim Ferriss]

I think they're close cousins. Frustration.

[Gabor Maté]

Frustration is anger. Yeah.

[Tim Ferriss]

Yeah. I was disappointed.

[Gabor Maté]

Disappointed is sadness.

[Tim Ferriss]

Yeah. It's a different feeling. So I was disappointed in myself also because I started to look at how maybe.

[Gabor Maté]

Well, disappointed is not so much an emotion as A state of mind. I'm asking what the emotions were. What's inside? Disappointment. Something didn't happen I wanted to happen. How do I feel? Isn't there sadness there?

[Tim Ferriss]

Sure, yeah, there's sadness.

[Gabor Maté]

I'm not talking into it, I'm just asking.

[Tim Ferriss]

Well, I suppose I might be confusing state of mind and states of mind and emotions. I'm not sure how to deal with that.

[Gabor Maté]

I'm looking at the raw emotion.

[Tim Ferriss]

Yeah. Sadness.

[Gabor Maté]

So there's anger and sadness. Those are the emotions.

[Tim Ferriss]

Let's go with that.

[Gabor Maté]

Okay, so I'm going to ask you a silly question. What were you sad and angry about?

[Tim Ferriss]

Well, I suppose the answer, which is not the right answer I'm expecting, was I was angry that someone had made commitments to me and not fulfilled those commitments.

[Gabor Maté]

Okay, well, that's what happened. They had made the commitment in the phone. But that doesn't tell me what you were sad or angry about. What does that mean? That they didn't fulfill their commitments meant.

[Tim Ferriss]

That they didn't care about me. They didn't respect me.

[Gabor Maté]

So they didn't care about you and didn't respect you. What kind of person doesn't get cared or respected?

[Tim Ferriss]

I might need a lifeline here. Don't know. Someone who doesn't deserve to be cared for or respected.

[Gabor Maté]

Exactly. Somebody unworthy. Right, sure. Of respect and care. Okay. Now, if there are other people here, which there usually are when I do this exercise, I would ask them. Okay. We just listened to Tim tell us about this experience. Are there other reasons why this other person might not have done the work? That has nothing to do with him or her not caring about him or not respecting him. So what other reasons might there be?

[Tim Ferriss]

A million and one Million.

[Gabor Maté]

One.

[Tim Ferriss]

Yeah. He could be in the hospital.

[Gabor Maté]

He could be in the hospital.

[Tim Ferriss]

His partner cared. One could have been in a car accident.

[Gabor Maté]

Exactly.

[Tim Ferriss]

He had a flight delay and got caught on Puerto Rico during a hurricane.

[Gabor Maté]

Yeah. He's got adhd.

[Tim Ferriss]

Yeah.

[Gabor Maté]

Follow through. He's under stress and he couldn't.

[Tim Ferriss]

Right. The email that I was supposed to send is sitting in drafts. And I thought I'd sent it, but in fact he never received it. I mean.

[Gabor Maté]

Okay. And any number of possibilities. Now, of all the possibilities that you've just outlined, including they don't care about you or respect you, which is the.

[Tim Ferriss]

Worst one, the one I immediately defaulted to.

[Gabor Maté]

Right.

[Tim Ferriss]

Well, I mean, the worst. If the guy's dead, then it's bad.

[Gabor Maté]

No, no. But internally.

[Tim Ferriss]

Yeah, internally, the worst assumption is the one that I immediately made.

[Gabor Maté]

So let's notice something a you. I should say we because we're all like this. We don't respond to what happens. We respond to our perception of what happens.

[Tim Ferriss]

Right?

[Gabor Maté]

Okay. That's what the Buddha said. It's with our minds who create the world. So that if you'd found out he had ADHD or he was stressed or, you know, you might have been sad for him, but we would not have been angry and you would not have been sad. So first of all, we don't respond to what happens. We respond to our perception of what happens, to our interpretation of what happens, number one. Number two, of all the possible interpretations, we choose the worst one, the two. Thirdly, what I just said isn't true. We didn't choose it. It's not like you went through all these possibilities and you said it was a multiple choice.

[Tim Ferriss]

I chose option D. Oh no, he.

[Gabor Maté]

Doesn'T care about me. He doesn't respect me. You didn't do that. Your brain jumped there automatically. Right? The question is why? Now here's the learning first time in your life that you felt hurt and angry, that when you perceived somebody didn't care about you or didn't respect you, or has it happened before?

[Tim Ferriss]

This is where the exercise might go sideways. I'm going to hit pause on that. I think that's probably for more of a conversation over wine.

[Gabor Maté]

But you'd probably agree it's not the first time.

[Tim Ferriss]

It's not the first time.

[Gabor Maté]

Very good. And most people I talk to, it goes back. Way back. Yeah, this goes way back into childhood.

[Tim Ferriss]

Just a quick thanks to one of our sponsors and we'll be right back to the show. This episode is brought to you by LinkedIn ads. As a business to business marketer, your needs are unique, the B2B buying cycles are long and your customers face incredibly complex decisions. Isn't it time you had a marketing platform that was built specifically for you and your needs? LinkedIn ads allows you to build the right relationships, drive results and reach your customers in a respectful environment. You'll have direct access to and build relationships with decision makers. One billion members, 180 million senior level executives and 10 million C level executives. You'll be able to drive results with targeting and measurement tools built specifically for B2B in technology. Specifically, LinkedIn generated a 2 to 5x higher return on ad spend than other social media platforms. Based on an assessment by Analytic Partners, 79% of B2B content marketers said LinkedIn produces the best results for paid media. So make B2B marketing everything it can be. And get a $100 credit on your next campaign. Check it out. Go to LinkedIn.comtfs to claim your credit. That is LinkedIn.comtfs as in Tim Ferriss show one more time. LinkedIn.comtfs terms and conditions apply.

[BJ Miller]

And now Dr. BJ Miller. Twitter jmillermd a hospice and palliative care specialist, author and speaker whose TED Talk, what really Matters at the End of Life, has been viewed more than 17 million times.

[Tim Ferriss]

BJ welcome to the show.

[BJ Miller]

Thank you, Tim. It's nice to be here.

[Tim Ferriss]

I have been wanting to talk to you, or I should say I have wanted to talk to you for years now and to give a few examples and illustrate that the first was an article that I came across in the Princeton Alumni magazine, Princeton Alumni Weekly, about your work. And then the next was a profile in a magazine here in San Francisco, following on the tales of that Adam Ghazali, who is just an incredible neuroscientist at UCSF who's been on the podcast, reached out to me and that was related to a I think it's a senior partner at IDEO who had also reached out to him to suggest that you be on the podcast. So I feel like this was fated to be and I've been increasingly over the last few years thinking about death and the value of meditating on death, among other things. But before we get there, and I suppose we'll get there rather quickly, when people ask you what do you do? How do you answer that?

[BJ Miller]

I guess I generally say, you know, generically, I'll say, oh, I'm a physician. And if people seem like they actually really want to talk things out, I'll say, well, I'm a palliative care doc. And then people won't talk out from there. I'll say I work at a remarkable place called the Zen Hospice Project and do some work at UCSF and do increasing amounts of speaking and beating the drum. I like to say, so depending on how interested the the person asking the question is, that's what they might hear from me.

[Tim Ferriss]

Let's say they're very interested. I don't know if you drink, but let's say the the other person's had two drinks, so pleasantly, drunkenly curious. And they say, what drum are you beating? I'm really interested to hear more. What is, what is the drum?

[BJ Miller]

Well, the drum, I suppose, is really is getting society to pay attention to the inevitables in life, helping each other look at hard stuff, helping each other to live with Hard truths. I'm trying to get people to pay attention to the fact that we all die and that the way we die could be a lot better than it is in general.

[Tim Ferriss]

Let's dig into that because I really enjoyed, for instance, your TED Talk. And maybe you've given multiple, but at least the one that I saw.

[BJ Miller]

Just one. Yeah.

[Tim Ferriss]

Which is. And one is enough, by the way.

[BJ Miller]

No kidding.

[Tim Ferriss]

But let's look at a sample experience. So you have a new patient come into your facility. What does the first meeting look like? And what does that first day look like for them?

[BJ Miller]

Let me pre answer your question because it, it so depends. So, for example, at Zen Hospice Project, by virtue of coming to our place, by virtue of enrolling in hospice, many corners will have been turned just to get to that place. So when we're meeting folks for the folks for the first time in Zen Hospice, they for the most part, are aware that time is short, are aware that they're dying soon, are aware that there's really not much more to beat back their disease to be done, and there's plenty of work to be done, even, you know, on the far side of turning that corner. Another way of answering your question is really, you know, upstream of hospice, when folks are struggling, gone to war with their disease, engaged in that fight, whether it's chemotherapy or whatever, that's the kind of person I'll meet in clinic at ucsf. So part of my job is on faculty at ucsf and I work in a clinic that's called the Symptom Management Service. It's about 10 years old, and that's just basically a euphemism for palliative care. The cancer center wanted us to call it the Symptom Management Service because it felt that the palliative care phrase had too much baggage around it.

[Tim Ferriss]

And is palliative care. I'm just going to plead ignorance here. Is that synonymous with hospice care or is are those different things?

[BJ Miller]

They are. They're related, but different. And thank you for asking that question, Tim. I mean, this is part of the drumbeat. So hospice is that portion of palliative care that's at the end of the road. And hospice is an insurance designation as much as it is a philosophy of care. So hospice is by definition, end of life care. Time is not an issue in palliative care. You just have to be suffering. You can see folks in palliative care for many, many years, far in advance of their death. So, yeah, all hospice is palliative care, but not all palliative care. Is hospice.

[Tim Ferriss]

Got it.

[BJ Miller]

All right. So palliative care, just to kind of make it is basically the, you know, within the context of dealing with illness, palliative care is the pursuit of quality of life, period. That's it. So the fulcrum in palliative care is suffering, you know, are you suffering in some intractable way more than you struggling more than you need to? And if so, then, you know, come see us in palliative care we'll help. And in palliative care you can receive our support and continue on with your more aggressive, invasive, life sustaining interventions as well. You don't have to give up one type of care to add palliative care to the mix. Whereas once rendering hospice because of its insurance details and vagaries, you do have to in general, you have to give up curative intended care to qualify for hospice. And we can spend a lot of time on this. There are a lot of wonky details. But does that sort of make sense to you in the.

[Tim Ferriss]

It totally makes sense. And the first thing that leapt to mind for me, and that will lead to a lot of tangents, I apologize in advance, but was that the way that you define palliative care would seem to include almost everyone on the planet in some respect suffering more than they need to. And we'll dig into the learnings and philosophies and so on that you've cultivated. So let's say they have gone through the paperwork and the process to get to the Zen hospice project. What does their first day look like?

[BJ Miller]

So first day of Zen hospice is usually there's always the folks by almost by definition are pretty fragile state. So just the ride getting to the house and into the house is often plenty overwhelming. So very often the resident will just sleep much of the first day. But as soon as they're beyond the logistics of the trip over, the first day is generally our nurses, our volunteers, the kitchen crew sort of swarming around that resident and their family and just getting to know them. That's where all the potency comes. It's inherently a relationship. So there's some details around medications etc, but most of the early work is just getting to know people and making them feel that this is their home now, this is they've come to live here. Yeah, they're going to be dying soon, but they're here to live until they die. So it's a very non medical establishment. And the first day doesn't feel anything like being in a hot admitted to a hospital, you know, and pretty soon you as you get to know someone within the first day. You invariably questions get asked like, you know, tell us what's most important to you. Now, you know, you want something neat, we can whip you up something in the kitchen or we'll tend to the family. It's very casual, it's meant to be. Feel like you're entering a warm and bright familiar setting. And what does the.

[Tim Ferriss]

Just to highlight also the, the differences can you describe upon the patients death what happens in Zen Hospice Project versus in a conventional hospital setting? And you can present either first?

[BJ Miller]

Yeah, well, so in hospice and palliative care in general, but certainly places like Zen Hospice Project, in many ways they were created as antidotes to the hospital. So in some ways they're, they're really. You'll feel like opposites. That's to some degree by design. But a death at a place like Zen Hospice Project is usually very peaceful because we've gotten to know that person, we've been living with that person, we know what they want, what their idiosyncrasies are. And we work with, you know, local teams of hospice agencies who come in and provide the medical care. So for the most part people can enjoy and expect a much more comfortable and peaceful death. At Zen Hospice Project and places like it. That's what the, all the expertise is geared towards. You're not distracted by beeping machines and other things and other agendas happening, research agendas, whatever it is. And to your question, Tim, you know, so when the person dies, invariably the mortuary needs to come and retrieve the body. And we have this ritual that we offer people which is on their way out the building. You know, the mortuary guys have picked up the body and if there are family or friends around and certainly staff and nurses and volunteers will gather around and we'll all, we'll all gather on the porch and we will do this, our flower ceremony, which is basically we gather around and the mortuary guys pause for a moment and we maybe say a few words or sing a song or whatever it is, just reflect on our time and remember the person who is just leaving us. And then we'll sprinkle the body with flower petals. It's just this very simple, gorgeous moment. And then the body bag is zipped up as it has to be by law, and the body heads out the door. But you know, it's, it's, it's this very stunning, poignant, gorgeous, simple moment. And you can feel everyone entering into this sort of grieving phase more fully. Especially of course the family. And you can watch folks have this little bit of closure, perhaps, but more the point is you watch them swarmed with warmth and love and easing into the grief process because there's space for it and there's this sweet segue and you can just feel that something's been completed there. And then the family now have to live on, but can do so with some imagery that's sweet and beautiful to remember rather than traumatic. So counter that with the typical hospital death. And by the way, Tim, and we can talk about all sorts of things together. I hope we do. But, you know, no knock on hospitals. They're incredible places. They're just not really designed to have a beautiful experience per se, and they're not really designed to help you die well, and you feel that mismatch. So I've worked on a lot of work in hospitals as a patient, but also as a physician. And, you know, a typical hospital death is. Is in a more sterile room, usually lined with a bunch of machinery and all the sounds and lights emitted. And it's very cold. I mean, the second the person dies, you can feel the cleaning crew waiting to descend on the room and they need to get the body out of the room because someone invariably is waiting for the room. And there's no ushering in of grief. There's a sort of a snuffing of it. And it's very disorienting for everybody involved, including the clinicians, because there's no pause moment to reflect on the experience you've just had with this person. It's just kind of on to the next. And it's a stark, stark contrast.

[Tim Ferriss]

Since you began your work with palliative care and hospice care, how many deaths have you witnessed or experienced? Even in the periphery, not necessarily watching someone die, but under your care or in your periphery, how many deaths have you experienced?

[BJ Miller]

You know, my guess now, I mean, I finished my final bits of training and then there's all the deaths during residency and fellowship, of course, but I've been out of my final training now for 10 years. If it's not a thousand people, it's approaching a thousand. I don't know that for sure, but it's certainly many, many hundreds.

[Tim Ferriss]

What. And this is a huge question, so we can certainly find. Slice it and feel free to tackle it any way you like. But what has observing that many deaths and the march towards death taught you about living and specifically your own life?

[BJ Miller]

Well, that's the perfect question, man. I mean, you know, there's like a. Those of us who work in the Field of hospice and palliative care. You know, we. It can feel like you're sitting on a secret because I think the assumption is that, oh, wow, that's got to be very morbid. You know, it is. I mean, it's got to be very morbid work or very depressing work. And sure, it is loaded. I mean, it is emotionally laden work, without a doubt. I don't mean to make it sound easy, but those of us who work in the field, you pretty quickly get a real sweet hit that paying attention to this zone of life is very. There's a lot, it's very nurturing. This sort of. The sort of secret is that paying attention to the fact that you die can help you live a lot better. So a lot of my colleagues and I are very, you know, aware of the clock. You know, I'm sure that can make you anxious as well. But we, you know, we know, we're aware of our finitude. And so we're just a little more likely to be kind to ourselves and others, and we're a little less likely to squander that time because we have all these sort of remarkable vicarious deathbed moments with our patients and their families. And you can learn a lot. And one of the things I love thinking about, a real organizing theme for me is, is avoiding regret, essentially. And we avoid regret by again, paying attention to our decisions, paying attention to how precious things are, and getting very good at forgiveness and reconciliation. And these are themes that play out in this work all the time. So in a sense, we're exercising these muscles on behalf of others that all of us need to exercise on behalf of ourselves at some point. We just get pretty well practiced at it. So this is where the work gets extremely beautiful and really nurturing and can help you live better. And I guess that's part of the drumbeat. Why do we want to talk about this? Well, there. There's some systems issues or some economic issues, but there's these, these beautiful civil issues on behalf of kindness, on behalf of justice and equality. The fact that we all die. Well, paying attention to this has all this potential for this to be a bond among human beings. The fact that we die and the fact that we're cognizant that we die, that's part of this drumbeat.

[Tim Ferriss]

And in the case of paying attention to decisions, what would be examples of some specific decisions you've made or habits you've developed that have been impacted by this work?

[BJ Miller]

One thing caveat is I, like anybody else, flawed and I'm A work in progress. And I forget all the lessons that I've learned a million. I have to learn them over and over again. So, you know, I got all sorts of work to do on myself.

[Tim Ferriss]

But I think, as we all do.

[BJ Miller]

Yeah, yeah. Amen, brother. So. But I do think I've gotten a lot better at. I'm pretty good as a hyper educated person at rationalizing all sorts of things and behaviors. And I can convince myself to stay in relationships or in situations that don't necessarily feed me or that aren't working very well. And I. I think I've gotten a lot better at calling that for everybody's sake, you know, So I might be. I think I'm a little bit better these days at not squandering my time and in terms of friendships and relationships, navigating them, not taking them seriously so that we're just not wasting each other's time. So I feel that in my relationships, I feel these lessons in my relationship to nature. So that's a great salve for me is being out on Mount Tam, out here in Marin county, or just about anywhere and feeling letting myself really delight and bask in the. The crazy grandeur of being alive at all. And I get thrilled that I can feel anything, sometimes even pain. I can. If way I deal with my own pain is I'm just remind myself that I'm glad to. To feel anything at all. So my relationships, I think are impacted. My sort of orientation to Mother Nature's impacted. I've got a lot better at forgiveness. So not holding grudges. You know how we walk around with anger at others and ourselves and it's just unnecessary. It doesn't help anybody. So I've got a lot better, I think, of letting go of certain things.

[Tim Ferriss]

So to. To drill into that. I apologize for interrupting, but yeah, yeah, because this is a particular Achilles heel of mine and I proved. I think I'm trending in the right direction over the last few years. But I have always had a lot of difficulty letting go of grudges and those loops that we tend to repeat, or at least I tend to repeat and reinforce, like a groove in a record that can just create this bitterness might be a strong word, but it's not totally out of place. When you find yourself. When you catch yourself angry with someone or not letting go, what is the internal dialogue? What do you say to yourself? How do you ameliorate that?

[BJ Miller]

Well, this is where, you know, meditation, mindfulness, self awareness, whatever you want to call it, can be so helpful because One thing to. Is to just get better at. At realizing you're doing it in the first place, you know, even before you're able to change it at all, is there's great, great potency and just being aware that you're doing it. I used to be much more. I could walk around for months with grudges and chips on and bitternesses etc before I really even realized it. I would just be really moody or whatever else. So, you know, job one, I guess, is just paying attention to yourself and seeing it for what it is. And then the next steps. Actually, that's the hard part, I think, at least for me. I mean, the next step is actually kind of easy because then as you watch yourself spinning out, then you can kind of call it the silly useless thing that it is and you kind of take the wind out of its sails, you know, you disempower the anger. And for me, you know, my life, man, I. The absurdity, the being in touch with absurdity has been very, very helpful.

[Tim Ferriss]

Yeah.

[BJ Miller]

So that's my next step. So the awareness and then is sort of watching the silliness of it all and then that anger and maybe with some deep breaths or whatever else or a walk to sort of bleed off the physical anxieties of it, but then I can sort of unspool, unwind, and maybe even quickly kind of laugh at myself. And that's great because A, you've let go of the junk, and B, it's an exercise in humility and forgiveness, which is always pretty dang useful.

[Tim Ferriss]

And for those people listening who might have these same issues, and a lot of us do, of course, there's a book with a very bland title called Radical Acceptance by Tara Brock that I found very, very particularly helpful to me. In this instance, you mentioned mindfulness meditation. Do you have a regular meditation or mindfulness practice?

[BJ Miller]

You know, not really.

[Tim Ferriss]

Well, I guess your whole job, in a way, is a mindfulness practice. So I. That perhaps might be overkill. They'll just add another session on top of everything else you're doing.

[BJ Miller]

Thank you for that way out, brother man.

[Tim Ferriss]

You're welcome.

[BJ Miller]

But yeah, I mean, it's. You know, there is some truth in it. Actually, this is where it's another reason why this work is so potent and fun is your personal and professional lives are deeply entwined, almost necessarily because so much of this work is just being aware, is listening, is paying attention and bearing witness and come to terms with all the stuff you can't control. Whether it's on my. For my own sake, or my patient's sake. So there is some real truth that I. I kind of feel like doing this job well. And so empathy is job one in this work. And so I do feel that much of my daily life, the daily grind for me is itself sort of meditative. I also want to be clear. I mean, I do. I have my own relationship. For me, it's a bike ride, or it's time with my dog, or it's time sitting in my backyard just looking out at the hills. And it feels to me like in meditation, I like movement. There's something. Ever since I became disabled, you know, I think I'm particularly primed to appreciate movement. So I like a walking or bike ride, and it feels like meditation, but so I feel like I'm doing it a lot, in a way. But I also want to honor those folks in the audience and elsewhere who truly have a meditation practice, and that is really its own discipline. So I. I don't really have that, but I got those other things.

[Tim Ferriss]

Well, I think they're all present state mindfulness practices. Right. And if you're riding a bike. Now, you mentioned something we haven't covered, and I didn't cover it very deliberately, but it makes sense, I think, at this point to rewind the clock. Could you tell us about the Dinky?

[BJ Miller]

Yeah, I'm sorry, I love. Speaking of absurdity, you know, the Dinky. This. What a. I mean, I lost three limbs to a thing called the Dinky.

[Tim Ferriss]

Sorry, I'm laughing, but your shirt.

[BJ Miller]

Laugh. I mean, this. I laugh. No, please laugh. I mean, it is kind of silly, but anyway, so as you know, I love Tiger. Yeah. There's this commuter train that runs on the campus of Princeton University, although I guess it doesn't run on campus anymore, but. And it's a commuter train, you know, it's called the Dinky. With affection to some. And the. The Dinky runs from Princeton to Princeton Junction. And commuters can take the trains into Philly or New York or whatever else. So that's what the dinky is. The why it's significant in my life in particular is, you know, one night, it was November. It was just after Thanksgiving vacation, sophomore year, November 27, 1990. A couple friends of mine and I were out just hanging out, having fun. Not a crazy night, but we were walking. Well, you remember the Wawa Market, Tim?

[Tim Ferriss]

I do. I was at Forbes, so I walked by the Dinky and the Wawa every single day, multiple times.

[BJ Miller]

Right. So, you know, so a late night visit to the Wawa Market was Pretty common. And so we were heading over to get a sandwich or whatever, you know. So when we were just walking by the dinky, it was just parked there. This is not operating hours. And, you know, it has a ladder on the back. And we just walked by it and just decided to climb it, you know, like you would climb a tree. We really did not think we were doing anything that daring. But put it this way, we'd done a lot stupider things besides that, at least we thought. But I just happened to be the first one up on top of the train and that those trains run like the buses in San Francisco, wires that run overhead. And then there's this metal thing called the pantograph, I think it's what it's called. And that connects the train itself to the power source. It's this big metal pole. So when I stood up on top of the train, I had a metal watch on and I happened to be close enough to the power source and the electricity arced to the watch and. Yeah, entered my arm and then blew down the feet. How was that?

[Tim Ferriss]

So what happened at that point?

[BJ Miller]

Well, I should say I don't really remember anything about that night, but my friends who were with me pieced it back together. But there's, you know, it's a big explosion and I was thrown some distance and one friend came up on top of the train while the other friend ran and called 911. And if you can imagine, I mean, both my friends were freaking out and right into action mode and, you know, getting up on top of the train that had just in ways they couldn't have possibly understood and just electrified their friend. And yet they got up on top of the train to help me. I mean, just ever a daily shout out to my friends Jonathan and Pete and Tommy too, for all they did for me that night and. Oh, God, and so many nights. But, yeah, so Pete held me down because I guess I. I guess at some point I. I came to and I was just thrashing about and you have. Electricity enters your body and so you've got all this heat. You burn from the inside out. And apparently it's very common and people wake with extreme energy. I mean, you are. You are electrified. So I mean, I'm just flailing, punching him through. I'm just a wild tear, apparently. So Pete, who was a very particularly large, strong and sturdy, heroic friend of mine, held me down. So I did roll off the top of the train and make things worse. And then the ambulance came and I don't blame them. One Bit. But the ambulance drivers refused to get on top of the train as they should have. But between my friends and a Princeton police officer by the name of Officer Dawson, I believe his name was, who went on to become. Who was promoted, I think after that to Sergeant Dawson. But anyway, Sergeant Dawson got up on the train with Pete and together with Jonathan, they got me into the stretcher and handed me down to the ambulance guys. And the ambulance whisked me off to the local hospital. And the local hospital did these things where they basically just slice open the skin to allow the heat out. It's called this fasciotomy, so that you stop burning yourself, essentially. And then I was flown to the a burn unit at St. Barnabas Hospital in Livingston, New Jersey, which is New Jersey's one and only burn unit, at least it was at the time. And that was that.

[Tim Ferriss]

And flash forward to when you became fully cognizant of what had happened. You open your eyes. What does the scene look like?

[BJ Miller]

It's interesting. It's like I was conscious, I was awake throughout the. The ordeal. And it's just more the. The sleepiness of memory. So there really. It's not. It was not like coming out of a coma where I was asleep and then awake. So there was not a sort of a singular moment reprisal, you know. But I tell you, the first memory, which I actually. Some freakish reason I love this story, just. I don't know why. I do like the story. So I will tell it to you anyway.

[Tim Ferriss]

Please do so.

[BJ Miller]

Your blood pressure is unstable. You're just a hot mess. So surgery can't happen until you're more stable if it can be avoided. And so it's common to wait several days before surgical amputation of the dead tissue. And it's also, in part because it's not totally clear what tissue's viable and what tissue's not. So anyway, it was maybe day five or day six before the first amputations, and I woke up the night before. I remember this very, very well. You know that feeling where you wake up from a dream and it's been a bad dream and you. There's a moment of sort of panic and then you sort of orient yourself, you look around you or yourself and you realize, oh, thank God, that was. That was just a dream, you know, that sensation. And it's an incredible somatic. You know, it's a beautiful feeling of relief that washes over you. So anyway, I somehow I looked around a burn unit which is a particular environment. It's not like Our guest house that I was just describing a moment ago at Zen Hospice. It's a very technical, sterile, intense environment. And somehow in my stupor, I looked around and saw all these machines and still managed to think, oh, thank God, that was just a dream. And so I had the sensation I had to use the bathroom. I said, oh, well, get out of bed and go to the bathroom. And in this state, I ex. I was intubated on a ventilator. I extubated myself.

[Tim Ferriss]

Jesus.

[BJ Miller]

Not easy to do by shoe stretch. So I extubate myself. I pull out. I have all these lines running into my jugular, veins in my neck. I pull those out. I just decouple myself from all these machines and get out of bed on my crispy little feet and start heading for the door to go to the bathroom. You know, I just. Obviously out of it, but in my mind, very clear, everything's fine. And then the. You know what a Foley catheter is, Tim?

[Tim Ferriss]

I don't know what a Foley catheter is, but a catheter I would understand is something. It's probably in your urethra.

[BJ Miller]

There you go, pal. You got it. So, yeah, that's right. And the way it stays in there is there's a little balloon on the tip of it. So the tip is fed through your urethra into your bladder. And the catheter just is there to spontaneously drain your bladder. But the way that thing stays in there is they in. There's a little balloon that gets inflated once it's in your bladder so that it doesn't slip out of your bladder. So there's this, you know, small ping pong ball at the end of it. It's now inflated. So I'm walking the door, and they usually clip the catheter in the bag onto the side of the. So you know. You know where this is going. So anyways, I'm walking to the door and the thing runs out of slack and it yanks the dang catheter, of course, and it comes not all the way out, but like, partially out. Sorry to you and all you.

[Tim Ferriss]

Oh, this is like a. Wait, are we talking like a small python that ate a golf ball kind of situation? No, no offense. I mean large pythons that ate a golf ball.

[BJ Miller]

Yeah, so. No, that's right, man. So, I mean, this is hot, pleasant, and the total reverse, that total warm bath of relief that you experienced thinking it was a dream. So that just goes totally in reverse. And in a millisecond, I realized that all of this was Not a dream. I fall down to the floor because all of a sudden I really can't walk either. I just fall on the floor and I'm screaming and I'm pulling on the. I'm trying to break the rubber tubing of the catheter, which is no way I could to somehow relieve the pain. And anyway, finally a nurse comes running in and gets me back in bed and that was that. But so anyway, that's my first real memory.

[Tim Ferriss]

Oh my God. I can see why it's vivid.

[BJ Miller]

Oh yeah. I'm. I'm sort of bent over as I'm talking to you.

[Tim Ferriss]

Let's contrast that with one that I've heard you tell, but I don't recall the details. And this is snowball. Am I getting this right? Could you tell the snowball story?

[BJ Miller]

So a burn unit is, like I said earlier, a particular place. They're gruesome places. They're very difficult environments. The pain that the patients are going through is gut wrenching. And so working in a burn unit is very difficult. People often don't last in a Bern unit very long. As a clinician, it's incredibly difficult work and we learn from wars over time. Is my understanding of certain medical history that, that the way burns often kill people is indirectly through infection. So once you've disrupted the integrity of your skin, you're much more vulnerable to infection. And so the thing that often kills burn victims after they've survived the initial trauma is infection. So burning. It's our incredibly sterile environments. So everyone's gowned up, masked, gloved. For the first maybe several weeks, I could only have one person in my room at a time. You know, it's just like you're in a bubble, in other words, and therefore you're cut off from everything. There's no day, night, runs together. There was no window in my room. There's no, you know, you're in a little cell. And even when people are at your bedside there, there's all this garb in between you and them. So there's no relationship to the natural world. You can touch nothing. And also you're in a fair amount of pain, of course, which does not necessarily reward your paying attention to anything. So it's just, just. It's not fun. So this was November at some point in December, maybe it was early January. And honestly, I can't remember who brought me the dang snowball. I can't remember. There were two nurses in particular I was felt very close to, and it may have been one of them. And I Think it was. It may have been her. Her name was Joy Varcarta Pone, and it may have been Joy. But anyway, it was snowing outside, and I didn't know that. I didn't know if it was night or day. And. And she had the bright idea of just smuggling in a snowball to me so I could hold. So I could feel snow. And, man, it was so. Oh, man, it was just stunning, you know, What a simple little thing, right? But to put it in my hand and just feeling the contrast of that cold snow on my sort of crisp, like, you know, the burnt skin, the obnoxious inflamed skin, and also watching it melt and watching the snow become water, and just the simple miracle of it was just a stunner for me. And it really made it so palpable that we as human beings, as long as we're in this body, we are feeling machines. And if we're cut off, we can't take. If our senses are choked off, we are choked off. And it was the most therapeutic moment I can imagine, and I would never have guessed this, but just holding that snowball, first of all, the sensation, but also the implied inherent perspective that it helped me make, right, that everything changes. Snow becomes water. It's beautiful because it changes. Things are fleeting. And it just felt so beautiful to be part of this weird world in that moment, you know, I just felt part of the world again rather than removed from it. It was potent.

[Tim Ferriss]

Bj, what did you study undergrad? Or what were you planning on studying or studying at the time? I always forget when people make decisions in undergrad. Even though I went through it, my.

[BJ Miller]

Yeah, well, like you, I mean, I started out, you know, 10. I started. I was at Princeton 89 and 93. And I started out, I went there really high on the idea of learning things that. That were foreign to me, you know, totally seeing a different worldview and really delighting in the liberal arts education. So with that, Tiananmen Square had just happened before freshman year, and I was so China was on my mind. I started studying Chinese language and was heading for a major in East Asian studies. But when I was out with this injury, art, which I'd always been interested in, especially music, I became much more interested in art. Not just listening to it or looking at it, but the idea of art. So I switched my major to art history, and that's what I ended up studying.

[Tim Ferriss]

What do you mean by the idea of art?

[BJ Miller]

What is this art stuff, right? I mean, why do humans, we seem to be unique As a species that we reflect on our lives, we reflect on our mortality, we reflect on our experiences, and we, one way or another, we reproduce them. We use them as creative grist. So either in our sort of daily lives or those of us who make art, you know, we use it to make art. You know, what's the purpose of making art? Art is inherently kind of useless, and that seems to be part of its charm. The fact that we as a species make art and care about it seemed to me really important because I was trying to figure out, well, who am I now? Like, my less human because I have less. Fewer body parts, you know, and, like, is that the measure of what it means to be a human being? Or no? But I couldn't really answer the question, what was my humanity? What did it mean to be a human being? Why was I happy to be still alive? Those are the kinds of questions I was trying to kind of wade through. Like, essentially questions of identity. So studying art, the hunch was, well, this seems to be a peculiar. The situation I'm in was sort of peculiar to being a human being, that one could survive injuries like that and go back out into the world in this damaged way and make their way again and return ostensibly to some sense of wholeness in themselves. And it seemed to me rightly placed to focus on something like art as a guide to help me get creative with the reality I was now facing. In a way, it was the thing I was trying to learn how to do, was make perspective. And that's what art really helps. You exercise that muscle. It helps you learn how to see, how to listen. And that was really empowering because I. There's so much I would have loved to change about what I was seeing, you know, when I looked at my body. I would have loved to change so much about it, but I couldn't. Well, I could change with this knowledge. I could change my perspective. I could change how I saw myself. That's what art helped me learn and where to focus my energies. And it, you know, it really paid off. I had to say it's very helpful.

[Tim Ferriss]

I'd love to explore that some more because I've been in the last few months in particular, asking myself over and over again, why do humans care about music? Create music like a compulsion and dance every. Every group of humans on the planet. And it just seems so peculiar, yet unsurprising if you look at, say, birdsong and animal mating calls and mating dances and all this, that and the other thing. But there seems to be many layers. How did it pay off? I mean you gave one example already in terms of changing perspective. But were there any particular classes, teachers, books, pieces of art that really influenced.

[BJ Miller]

You really so much of, I mean art history, the way the curriculum was set at the time, it really didn't actually dig in so much around why humans make art. It just presuppose that we do and that that's interesting and went from there, which was cool. Basically put me in front of a lot of art and helped me tweak my eye and my ear and that was great. But on this sort of identity, sort of philosophical front, like the existential, like why do we do this? What's the meaning of this? That was actually kind of left up to me as an individual and in my relationships. And there was one of my dearest friends, a guy named Justin Burke, who is, he is a philosopher and art historian. I mean that's what he studied to his doctorate. And frankly a lot of stuff we're talking about right now, Tim. And the benefits I reaped from it was really from conversations with Justin fed in the backdrop by this pounds of artwork that I got to spend time with. But working through this philosophical stuff was really with my buddy Justin. So that's one point. And there was no particular work of art. Again, it was more the idea of art than it was any particular piece of art. That was so potent for me. And even this day I love going to museums, but I just like being around art. Sometimes I don't even look at it. I just like that it exists and I like to reward places to help it exist. So there's no one work I could point to. Although I would say probably the painting of Mark Rothko has proven to be very poignant and potent for me. I just. Any chance I get to stand in front of a Rothko, I will, I will do.

[Tim Ferriss]

How do you spell that last name? I'm an ignorant when it comes to this type of thing.

[BJ Miller]

Oh, Rothko. R O T H, K O. Mark rothko, abstract expressionist, mid 20th century guy made these big beautiful color form paintings.

[Tim Ferriss]

Non representational, quick random anecdote that might be entertaining. So I grew up on eastern Long island where Jackson Pollock basically turned himself into one of his paintings by driving a car into a tree. And he actually used to show up at one of my relatives homes completely shit face drunk all the time. And he would bring his poor dogs in the car and he'd show up at like 9 o' clock and this man and his wife would say to themselves, oh, no, it's Jackson again. And they would pretend to be going out to dinner no matter what time it was. And they'd go, oh, we're so sorry, we can't stay. We're just on our way to dinner. Because what would happen is he would stay. He would forget about the dogs. They would all over the car. He would take the dogs home, leaving the intact in the car, and then blame it on my relatives to his wife, who then had to contend with the whole mess. So, anyway, related, but totally unrelated. But if we're talking about abstract, the if you were, this is an awkward transition, but here we go. That's kind of my mo. If you were brought in as a physician slash, let's just say mentor, guide to someone who had just suffered nearly identical injuries to yourself, 20 some years old, what would your conversation be like with them or what resources or reading or otherwise would you point them to?

[BJ Miller]

You know, I find myself every once in a while I'll get called by friends in the hospital, come visit with someone who is in similar shoes, you know, and actually, I wish I remembered his name, but someone did that for me when I was in the burn unit. He'd had a similar accident. I think he lost two legs, below the knee, I should say both legs anyway. And I learned a lot from how I gained from his visits to me. I have just sort of reproduced, which is basically walking in these rooms with almost no agenda, almost no plan to advise in any way. The potency, especially early on, was just seeing someone in similar shoes. My early questions when I was in the bed was like, what am I gonna look like? What's it gonna feel like to walk on prostheses? And that's kind of what, you know, it was that nuts and boltsy kind of stuff. Will. Will anyone want to date me again? You know, I mean, I don't know. It. It was on that level. And so when this guy would come visit me, he was just seeing him, just seeing him upright, just knowing that by virtue of the fact that he'd entered my room, he came from somewhere else. He was out in the world, knowing he was a functioning human being out in the world, then just seeing him look me in the eye with some kinship, that was the therapy of it. I think I've gotten in trouble when I've tried to come in with some predetermined idea of advice giving. Oftentimes that's not really what's needed. It is more just the camaraderie and the bearing witness. And so to Answer your question. When I do go into folks room, I'm there and I'll avail myself to any questions they have. But I think most of the power of visit is just visiting, just being together and sharing this awkward body.

[Tim Ferriss]

From what I've heard and read of yours, one of the recurring themes appears to be, and please correct me if I'm getting this off at all, is how powerful simple things can be or maybe are, and that our tendency is to perhaps undervalue the things that are not expensive or difficult to obtain. The snowball. Could you talk about the things you've noticed that most help people in hospice care? And the reason I ask is specifically related to cookies, which maybe you could talk about, but I'd be curious to hear sort of what really brings the most peace to these people.

[BJ Miller]

So you're right. I mean, I think one of the joys about. One of the upshots or silver linings about the end of life is that if you want it to, if you let it, you can let a lot of the rules that govern our daily lives fly out the window. Because you realize that we're walking around in systems and society and much of what consumes most of our days is not some natural order. We're all navigating some superstructure that we humans created. That is the work day, the work week, whatever it is. I think part of the trick is if when you're dealing with serious illness or some natural trauma or are facing the end of your life, oftentimes that becomes crystal clear. Like where you've been hanging out and spending so much your time and energy and worry is like living in someone else's dream. You know, it's not sure. I mean, society and what we've structured, there's a lot of importance to it. I don't mean to dismiss it, but we inherit that we don't spend a lot of time creating our realities in a cop. You know, most of us don't in a sort of. In a clear or intentional way. And so when you have this excuse to forget all that, it can be really liberating. A little bit scary too, because a lot of people then invariably realize that they feel like they've been wasting so much of their time on things that actually weren't that important.

[Tim Ferriss]

Right.

[BJ Miller]

And that's part of the trick of checking yourself and you know, over time, you know, on a daily way, am I doing things that I really care about, etc. So. So back to your question to this point about simple things. I mean, the simple things, the Small things ain't so small. You know, actually like I was saying about the snowball, just the joy of feeling anything, of having a body at all, of being capable of movement at all, that is so profound and so potent and yet I think most of us take that for granted, you know. So as a clinician and as a person, I love looking for moments where the rules get to go out the window. I love when I have, you know, I love having residents at the guest house at Zen Hospice who smoke frankly, you know, or you know, anything that just kind of gets to, that kind of reorients us and puts things in proper proportion relationship to the natural world and rejiggers our priorities. I, I love that. I love that reorienting feeling. And, and again, it does seem to be one of the silver linings for folks in this zone. Like, I think about this most nights, every night, depending on where you are, of course, but you can look up and usually find a star. I mean, I feel like, you know, when, when any of us is struggling with just about anything, look up, just ponder the night sky for a minute, just to realize that we're all on the same planet at the same time. And as far as we can tell, we're the only life, only planet with life like ours on it anywhere nearby. And, and then you start looking at the stars. You realize that the lights that hitting your eye is ancient and that the stars that you're seeing may no longer exist by the time the light gets to you. And just, just sort of mulling the, the bare naked facts of the cosmos for me is enough to just thrill me, awe me, freak me out and kind of put all my neurotic anxieties in their proper place. No. Right. So, yeah, and a lot of people, when you're standing at the edge of your horizon on death's door, you know, you're can be much more in tune with that cosmos than you are with what the body is doing in a, you know, in a day to day kind of way. Does that make sense, Tim?

[Tim Ferriss]

No, it makes perfect sense. So just because I brought it up and I don't want people to be harassing me about it on the Internet. The cookies can you mention.

[BJ Miller]

Yeah, yeah. Well, do you know, I mean, the smell of, of fresh bread or for most of us the smell of a chocolate chip cookie does magical things. You know, first of all, food is primal. You know, our sense of smell, I mean, the shortest, I mean it is an. It is one of our oldest senses. It is primal. You know, you can walk by someone who may be wearing a cologne or perfume of someone you knew 30 years ago. Like, I. I still. Wow. There's. It's been maybe a few years, but there's a perfume that I would smell that my babysitter wore when I lived in St. Louis when I was in preschool, and it would throw me back there instantaneously. Sense of smell is potent, and food is primal and potent. I mean, it's nourishment, it's nutrition. It's how we live in some ways, right? So there's all this symbolic stuff happening too, but there's also just a basic joy of smelling a cookie. It smells frigging great. And it's like the snowball. Like, in that moment, I am rewarded for being alive and in the moment. Smelling the cookie is not on behalf of some future state. It's great in the moment by itself, on behalf of nothing, you know, and this is another thing. Back to art. Art for its own sake. Art as part of its poignancy in music and dance is its purposelessness and just delighting in the wacky fact of perhaps a meaningless universe. And how remarkable that is. That's kind of what I'm shooting for. And that's a way for all of us to live until we're really dead. Until we're actually dead is to prize those. Those little moments.

[Tim Ferriss]

You guys, I might be fabricating this, but make cookies at the Zen Hospice center for this precise reason.

[BJ Miller]

Right.

[Tim Ferriss]

And so you mentioned absurdity a few times. This is something I've been thinking about a lot. I mean, and for reasons that may inferentially become super clear in a second, but just the being able to try to laugh at the cosmic joke, so to speak. I mean, like the meaninglessness, if it is in fact meaningless, of things, as opposed to taking all things so damn seriously, which in a way prevents you from doing a lot of the serious work you'd like to do. But the question I was going to ask is to get your opinion on a modality, we'll call it, or a tool. And I'm going to explain this vis a vis a friend I'll keep anonymous. So this is a female young woman who used to work in hospice care. And she found, just as you alluded to earlier, that she felt like she was sitting on a secret. It gave her incredible joy and presence to do that work. She really loved the work. At some point became very frustrated with the insurance policies and vagaries of our healthcare system, and now does something that is illegal. But I Think should not be, which is guided work with psilocybin. And she said, now I get to experience people dying every weekend. The only difference is they come back to life. And many people listening to this will have read or should read an article that was titled the Trip Treatment by Michael Pollan in the New York book about the use of, I believe, specifically psilocybin for those people not familiar, which is extract or the psychoactive compound in magic mushrooms for end of life care in terminal cancer patients. I'd just love to hear your opinion on the use of compounds such as those in end of life care or otherwise.

[BJ Miller]

Yeah, well, I'm so glad you're asking this question. So there's all sorts of stuff coming out of the closet these days, and it's really wonderful. And there's a movement afoot to revisit psychedelics from a therapeutic perspective. And I don't pretend to know the full history of how psychedelics went from considered therapeutic to considered, you know, toxic and the devil's work. But here we are, there's a. There's a revisiting happening with fresh eyes and serious eyes. So it's not folks who are just with a wink trying to justify their own recreational use of these.

[Tim Ferriss]

Ucsf, ucla, Johns Hopkins.

[BJ Miller]

Johns Hopkins. You got it right. NYU friends at the River Styx foundation have been funding some of this work. The people I know who are involved in this work are deeply thoughtful, caring, loving people. Anyway, so that's a sort of a preamble. But, you know, to get to your question, I am thrilled for this for a number of reasons. One is just the counterculture, fun kind of things coming out of the closet. Another is a whole generation, I. E. The baby boomers who are now the focus of so much of our efforts in healthcare and the aging population. How do we cater to this population? Well, a lot of folks of that generation have experience with these compounds and now they get to sort of be above board potentially. So anyway, I love the subject for many reasons. As a clinician, you know, I'm particularly excited because we're pretty good at treating nausea, treating pain as a rule, and where things get very difficult. And in palliative care, we talk about this, we call it existential distress. And basically, existential distress is a. Is a crisis of. Of meaning in some way or another. So it's particularly potent at the end of life when people don't have much time left to make meaning and they realize they haven't been making living a very meaningful life or haven't thought much about can be really traumatizing to realize, oh gosh, to take all of a sudden to take that seriously and then realize you don't have much time to do much with it. So anyway, this idea of existential distress is huge in medicine and palliative care. It's very nascent. I mean, the way we treat it now is, well, if someone comes to us and they're miserable, well, we rule out and. Or treat pain, nausea, other anxiety, depression. We look for a diagnosis that we can treat and then we treat it. And if folks after all that are still miserable and shut down, then we'll sort of invoke this phrase existential suffering or existential distress. This is what we call medicine, a diagnosis of exclusion. So. And no one knows what the hell to do about this.

[Tim Ferriss]

So diagnosis of exclusion.

[BJ Miller]

Yeah, so you just rule out everything else that you understand. And if you're. Then, then whatever you're left with, you just call it this bucket term. And in this case, that bucket term is existential suffering. It's not, not a particularly inspired right. But this is where it also gets thrilling. This is my favorite thing about my field, which is palliative care. First of all, organizing around the human condition and suffering and what it means to suffer this highly subjective state that we all have some experience with in our lives. So that's total ubiquity. Absolutely un esoteric field, absolutely relevant. You know, no one I know has not suffered. It seems to be elemental to being a human being. And this is our fulcrum in palliative care. And what's more, we have named this thing existential suffering, which is so mysterious, right? And there's so much, it's so ripe to invite the arts into this mix, philosophy into this mix. Like we've already talked a little bit. So this is, this is my favorite sort of strategic zone to upload into healthcare all these otherwise non medical issues. So there's a ton of reasons why I love this space. And I'm getting around to an answer to your question, which is we have named.

[Tim Ferriss]

I'm not in any rush, man. This is a long podcast. Always is.

[BJ Miller]

Good, good. Because I love this subject. So, so we have the leverage now that palliative care is accepted and part of healthcare and has, has called out the nature of suffering and has called out this thing, existential suffering. We have this portal to upload all these other fields and interests and to keep them, to make them relevant. So this is where it gets thrilling.

[Tim Ferriss]

Meaning you have a channel because you've wedged Your foot in the door with palliative care. Yeah, through which you can insert other things that wouldn't otherwise have an easy gateway.

[BJ Miller]

Exactly. You got it. Right. So now enter the relevance of the arts, philosophy, design, you name it. There's, I mean, what field isn't relevant in some way or another to the human condition? Right. So all of a sudden there's this huge invitation, or at least possible invitation to the rest of the world besides the medical, that sort of narrow medical sciences per se. That's really exciting. So back to psychedelics. Well, so we can call out this existential suffering, but today as clinicians we don't really have much to offer it. We're aware that we've talked as we talk, like bearing witness and non abandonment. Accompanying people in their struggles is itself a great salve. And that's beautiful work. But what else can we do? Well, I often find myself prescribing people for their existential suffering, you know, to remember what it is that they love to keep an eye out for. Aesthetic moments in their days where they feel something, anything and just whether it's that snowball or sun on your skin, some just to note when you feel happy to be alive. And there's our little toehold to work from. So there's a lot to build around this. But what we haven't had is we certainly haven't had any chemicals to offer people to help in this way. And it seems the data to date seem really robust that it may be that compounds like mdma, psilocybin and other things may be radically helpful in fostering a meaning making moment for someone of fostering a sense of belonging in this sort of cosmic way. And so in other words, we have potentially with these compounds a way to respond to this wacky thing called existential suffering. So this is just thrilling for all those reasons.

[Tim Ferriss]

Yeah, I couldn't agree more. And for people who want to dig into this, and I would encourage everyone listening to take a closer look at this, there's a great organization, I think they're really well organized and comprised of very good MDs and PhDs called the Hefter Research Institute. H E F F T E r it's just hefter.org and they do some incredible work with not only patient focused studies, but also research studies using things like fmris and different types of neuroimaging to look at the specific effects of different types of psychedelics, whether you call them entheogens or psychoactive psychotropics, whatever it might be. So it's a very, very, a lot of interesting work. And you can learn a lot about how these compounds function just by looking at, at, for instance, some of these studies and examining sort of the methodology. Right. The protocols that they use. So if we look at and by.

[BJ Miller]

The way, Tim, can I just interject, I've also had some really fascinating conversations with other folks in this space. And another organization to point your listeners to is a group called Compass.

[Tim Ferriss]

Compass.

[BJ Miller]

I think they're Compass. And they are beginning to also support research in this vein and also starting to try to align healthcare systems and other institutions to participate in this work one way or another and to sort of pull this stuff again out of the closet. I'm not sure where they are in their development, but it's another group to be aware of. And I think their website is compasspathways.org so just another group in this space that's doing cool stuff.

[Tim Ferriss]

Cool. And you know what? I'll throw one more in there. Maps.

[BJ Miller]

Yeah.

[Tim Ferriss]

Which is doing a lot of investigation, interesting work related to policy and the legal side of things as well. And that's worth checking out. And for people wondering, these will all be links to all these things will be in the show [e-mail] podcast all spelled out. But coming back to your story and your life, I mean, I really have so much I would love to ask and we'll dig into some of them, but we're not going to have time for all of them, which is fine. The question that I'd love to ask next is what you feel you do on a daily or weekly basis that is different from most people. Routine, wise thinking, wise self talk, wise.

[BJ Miller]

Anything different from other physicians or just people in general.

[Tim Ferriss]

People in general, because I don't want to make it exclusively professional. This is because I'm looking for what I'm fishing for are practices that you've adopted or developed habits, whatever it might be that people listening might be able to test drive for themselves.

[BJ Miller]

Well, let's see here, my friend. I have two, I have two answers to that question. So the one is, you know, we've touched on a little bit, but I find myself increasingly interested in the aesthetic domain. And by aesthetic I mean just the life of the senses, not just beauty, but just the felt environment at all. That is the world of the aesthetic domain. And one of the reasons I'm particularly interested in the aesthetic domain, besides just delighting and having a body to feel anything like we've talked, is it's how it prizes purposelessness. So I am all for meaning. I see human beings as meaning making machines. And we talked about this a little bit, like, whether there is some grander meaning in the universe, I don't really know. And frankly, I'm fine not knowing. I enjoy the mystery of it. And I'm okay if there's meaning on a grand scale or not, frankly. But meanwhile, I am aware of our talent as a species to make meaning for ourselves and to string together narratives and stories and to make sense of our lives. I think it's a profound impulse and a lot of good comes from it. And I also just increasingly want to carve out a space for meaninglessness, purposelessness. So like, again, like the snowball or anything that makes us feel, in our bones, feel happy to be alive in that moment on behalf of nothing else but that moment. And that is, I think we could all benefit from letting ourselves delight in things that don't necessarily have any meaning, but just feel good, that don't, you know, and don't hurt anybody else, but just give ourselves a space to delight. Delight in purposelessness. That, to me is. Is a huge deal. And I see it's therapeutic relevance for my patients very often who are beyond their life of purpose. They can no longer do that job they loved or their role in their family has changed. And they're so crestfallen because they don't have that reason to get out of bed. So let's find new reasons to get out of bed. Let's repurpose ourselves. Yes, yes, yes. And let's get really good at honoring just the joy of smelling a cookie. And that can be enough. Watching a ball game, that can be enough. It doesn't have to be big. It doesn't have to be a means to an end. So anyway, I think that's. So that's one answer to your question. I don't know how many of us are out there prizing purposelessness, but I do.

[Tim Ferriss]

Well, it made me think of this might be a strange connection, but made me think of Kurt Vonnegut, the writer, who I actually consider a fantastic philosopher in a lot of ways, if you read his fiction. But one of his quotes that I've always loved is, I tell you we are here on Earth to fart around and don't let anyone tell you. Don't let anyone tell you different. And there's a story, I think it's actually in a dialogue with another writer at some type of event. And I'm sure someone will be able to find it. I'll try to put it in the show notes. But it might be tricky to find where he talks about this long walk that he takes to mail something at the post office. And his wife doesn't scold him, but just laughs and asks him why he wasted so much time. And he's like, no, no, no, no, you don't get it. I didn't waste time because. And he runs through all of these seemingly meaningless, seemingly trivial, but to him, very important kind of absurd interactions with multiple people along the way. And it's just a very good meditative exercise because I feel like it's extremely easy to think that the big overarching abstract things are the important things and the small tangible things with sensory inputs are the unimportant things. And I am not convinced at all that that is the case. In fact, it might be quite the opposite. And if you had a patient come in, they are finally getting comfortable at zen hospice project. Very introverted. And they say to you, I'm going to want to talk to everybody and get to know them, But I'm not quite ready. I just want to read. What one to three books would you suggest I read?

[BJ Miller]

So funny. Because, I mean, I'm laughing because I am probably the least well read person you will ever meet. And especially one with like degrees, college and stuff. I, I, if I, I am all right.

[Tim Ferriss]

If they said give me one to three things that I can watch, do, absorb, look at, et cetera, without human interaction, what would your answer be?

[BJ Miller]

Thank you. That's better for me. I mean, hey, I'm all for books too. Those apparently are cool. But for me, you know, I love film, I love music, I love art, I love doing nothing. I love being outside. So that's for me to lit me. But I would put big picture books in front of people and I mentioned Mark Rothko. Staring at Mark rothko work is just a gorgeous splendor. But it, you know, suit your taste. So for me, I guess I put some. A picture book of Mark rothko paintings in front of them. I would put probably any music from Beethoven into their ears. And I probably would reserve that third thing for staring into space before they stared into space.

[Tim Ferriss]

If they wanted to watch a movie, what would you put in front of them?

[BJ Miller]

Man, there's so many good ones.

[Tim Ferriss]

Ratatouille? No.

[BJ Miller]

I think, you know, I have a real soft spot for waiting for guffman. Not that it has this great meaning per se, but by speaking of absurdity, I just think it's hilarious.

[Tim Ferriss]

Waiting for guffman. I've never even heard of it.

[BJ Miller]

We've never heard of Waiting for Guffman.

[Tim Ferriss]

No.

[BJ Miller]

Wow.

[Tim Ferriss]

Just a string of ignorance on my part in this conversation. Although you don't read books, so I feel that evens us out, so.

[BJ Miller]

Oh yeah, but this is good news because, man, you have so much to look forward to. I mean, so this, this movie is by Christopher Guest and company, the guys who did Spinal Tap and.

[Tim Ferriss]

Oh, wow.

[BJ Miller]

You know, best in show.

[Tim Ferriss]

Sure, sure. How do you say guffman? Or how do you spell guffman?

[BJ Miller]

I think it's G U, F, F, M A N. Okay, got it.

[Tim Ferriss]

I'm on it.

[BJ Miller]

It's freaking hilarious. So that I just. Always a long term favorite. I mean, as a kid growing up, Kentucky Fried movie.

[Tim Ferriss]

Oh my God, I haven't thought about that in decades.

[BJ Miller]

Yeah. Wow. That was like really an important movie in my childhood. We watched it probably, I don't know, a hundred times. I mean every day. I mean that and Groove Tube. I mean it was, you know, formative for us. And I heard that you asked another question specifically about documentary film of other guests. And I was thinking about that and you know, one that leaps to mind. I. I don't know if you'd really even consider it a documentary, but I guess it is. It's, you know, the movie Grizzly.

[Tim Ferriss]

Man, oh man, oh man. Yeah, that's. I consider that a documentary.

[BJ Miller]

Yeah, sure, let's call it a documentary. So. Yeah, of course it is. I mean it. And. And it is. I find any piece of art where I simultaneously or I'm not sure whether to sob or laugh hysterically that I love that feeling where you just can go either direction. You're not even sure which is the correct emotion. You're simultaneously attracted and repulsed to something. That was my experience watching that film. And so I just. I think it's a beautiful, like an amazing piece of filmmaking. And I also particularly like its poignancy around our humans. Silly dance around nature and how we humans think of ourselves and somehow opposed to nature. And yet when we try to reinsert ourselves into the wild, it doesn't necessarily go very well. How we romanticize mother Nature can coddle us and you know, I spent a lot of time in the desert in southern Utah, as much time as I can. I just love that landscape. And speaking of perspective making, you know, and thinking on geologic times and making myself feel very, very small and inconsequential is. Is really deeply therapeutic for me. When I go out in Utah, I've gotten lost twice walking around this particular area. And it's the same feeling I had watching Grizzly man, which is Mother Nature, as far as I can tell, is pretty indifferent to us, you know.

[Tim Ferriss]

Yeah, I would say so.

[BJ Miller]

So anyway, there. There's my answer for you.

[Tim Ferriss]

So that brings to my two things. The first is you mentioned that that feeling, which is two sides of the same coin, almost that of being simultaneously repulsed but wanting to laugh and unsure of which way to go, that seems to me to be a very primal emotion, like a singular emotion in a way. When, for instance, I've watched nature footage of chimpanzee troops when one of them is torn to pieces by a jaguar or some such on the ground, and the response tends to be breaking out into what would be considered by primal dermatologists, hysterical laughter. And this seems to be something very, very hardwired. So returning to that in some way and it being therapeutic doesn't surprise me. The second is just to tie together a few things you've said related to sort of the meaninglessness, which may be too loaded a term for some people. It might come off as very negative, but seeming inconsequential or small, and meditating on that, or not even meditating on experiencing it in a very visceral way by in the desert or looking up at the sky. I think it's very compatible with something that struck me, which was told to me by Tony Robbins, who's also been on the podcast. And he said that, and I'm paraphrasing, but that most human suffering comes from a focus on me, like a self focus. And if that is true, it makes perfect sense that focusing on this expansive geological timeline which. Which puts our, like, shitty week into a just hilariously diminutive perspective, it makes a lot of sense. This is unrelated, but what do you think of, or who do you think of when you hear the word successful?

[BJ Miller]

I think of, well, you know, you just pointed to something, the relationship of self and the silliness of self and the power of the self. And I think we do ourselves disservices by playing into polemics around, you know, selfishness or selflessness. So there's a lot to say about that. But to segue to your question about success, on one hand, I sort of think of it in terms. I guess I think of it as a sort of a self actualization. Someone who has realized has played themselves all the way out and that might be seen and appreciated by practically no one and therefore not make the measure of some external success, but someone who has sort of become themselves, delighted in themselves, including their quirks and awkwardness and played that self out, you know, insisted on itself all the way to the end. To me, that may be a version of success. So I guess one part of my answer your question is I think of it as really an internal process, but then beyond that too, I guess I'm a little torn here because I agree that, that what I just said sort of focuses us and success back into the self. And I suppose the second half of the question really has to do with orienting oneself to the other, to everyone but oneself, and to the relational dynamics between the self and the other. And so I think probably success may be, or the second half of it has to do with anyway maybe seeing yourself in others and others in yourself and realizing the unseen connections between us all. And this is another reason I love our mortality is it has the potential to be this equalizing, uniting force. So success may be this sort of self actualized piece, but part of that self actualizing is, is exploding the sense of self and feeling part of everything around you and vice versa, consonants with the world around you. That seems like a great success.

[Tim Ferriss]

Is there anyone who embodies that for you or comes closest?

[BJ Miller]

Well, I recently had the joy of sitting with Oprah Winfrey and watching her make use of her life and now point and, and, and also point her energies to promoting and helping others is this is a very, I mean, a remarkable life's work.

[Tim Ferriss]

Work.

[BJ Miller]

And it's just a name we all know and wow. But you know, I'm also interested in all the gazillion successful people we walk by every day and don't even know it. You know, this kind of happiness, this kind of success doesn't necessarily brag about itself. And I love presuming it when I'm unaware of it and assuming it exists in others that I walk by on the street. In a way, you find yourself kind of imbuing others with an idea of success and it changes how you look at them and how you treat them. And that's a sort of a sweet favorite daily exercise of mine. So no, it's hard for me to say a single person that I would point to is embodying all this.

[Tim Ferriss]

So let's. You actually touched on a much more interesting answer or point than my question deserved, which is your morning practice. So could you elaborate on that, please? When do you do it and how do you do it? So you're walking just to take us through this morning exercise.

[BJ Miller]

How I get up in the day to start the day.

[Tim Ferriss]

No, what you just talked about sort of assuming the presence of this type of success. You said it's morning exercise of yours. Oh, I'd love to just hear you elaborate on that.

[BJ Miller]

Oh, I don't know. I. I didn't remember saying morning. That's what tripped me out.

[Tim Ferriss]

Sorry.

[BJ Miller]

Sort of a daily. Daily exercise, perhaps.

[Tim Ferriss]

Oh, there we go. Yeah. I could have made up the morning part.

[BJ Miller]

Who knows? But. Sure. But it's sort of any time of day or night this is useful. You know, it's kind of like just the power of mean of. Of. Of meaning well, of. Of wanting well of others. And when there's a choice in the matter to see. To choose to see good. And. And if you can't know, assume good. And this kind of builds an argument to your day of gratitude and happiness and some amount of comfort. So I'll catch myself being bitter or I get kind of road ragey. I'm very aggressive on my motorcycle and car. And actually just today I was really annoying someone by. And whatever I get, I get in my bullshit zone pretty quickly. But when I'll catch myself and then. So when I walk by, you know, particularly here, the Bay Area, the homeless epidemic is enormous. And it's just. I'm particularly acutely aware of this exercise when walking by someone who otherwise the world would assume in a sense that they are failures in one way or another. I like to invert that whenever possible. So I'll just fill in the blanks whenever I see a homeless person, that I'll assume that whatever they're going through is vital to them. And that may be whatever junk we project onto them, that inside, maybe they're all right with who they are. Maybe they're way more all right with who they are than a lot of people I see striving and otherwise looking successful. So it's really just simply that I actually learned this. My mother took me to a Deepak Chopra conference when I was pretty young. It was a long, long time ago. And the one thing I heard that stuck, that was really interesting to me was is. Is getting in the habit of saying, you know, and when anyone. When you hear anyone sneeze, either say it out loud or to yourself. Say, bless you. It's just a. It's like a nerve, like a neural loop of goodness. And it just means in that quick second you meant well towards somebody. And even if you don't say it out loud, even if you don't share it, say it to yourself. And I gotta believe that that resonates and registers somewhere, you know, that that lands somewhere that. That lends itself to a vibe. So that's the kind of stuff you walk around and you see people and you just project, well, wishing onto them.

[Tim Ferriss]

Now, I hate to focus on something maybe superficial, but you said riding your motorcycle. Now, I apologize if this sounds like a weird question, but you have three limbs that have been damaged. How do you ride a motorcycle?

[BJ Miller]

Cycle. So, yeah. So, you know, this is. This was a sort of long dream that recently came true.

[Tim Ferriss]

Congratulations. I mean, it's awesome. I'm just so curious about the logistics.

[BJ Miller]

Thank you. Well, it's interesting you ask because right now, there's the man who helped make this dream come true, Randy. He ended up being my patient and our resident at Zen Hospice project. Not long after he converted my motorcycle. So there's a lot to this story, my friend. Friend. So cheers to Randy and his family and his wife, I mean, and his mother, Melanie, who I'm going to be seeing next week, actually. So that's one piece of this story, but the other is this. I'd always. I love two wheels. I love gyroscopic. Gyroscopic lifestyle. I love the feeling of it. So I've always loved riding bicycles. And then I'd always wanted to get on a motorcycle, but I kept going to shops and, you know, people would sort of look at me. And no one got into it. No. I could never find a mechanic who was willing to take it on and try to help make it happen. A fellow named Mert Law Will, who's an old motorcycle racer champion, sort of legendary in that world. He happens to live around here. He lives in Timberland, and he built a prosthetic component. I don't know what the story that inspired Mert to do this, but he's a machinist himself and a handy fellow. And in his retirement, he got into this business of building this prosthetic component that lends itself very well to mounting an arm onto a bicycle or a motorcycle. So the first piece of this puzzle was discovering Mertz invention and getting a hold of it myself, which allowed me to get my prosthetic arm attached to a handlebar in a very functional way.

[Tim Ferriss]

So you have throttle, rear brake, and then typically front brake on the left. How are those controls modified?

[BJ Miller]

Okay, so Randy, what he figured out. So first was to get the arm piece. And then what Randy figured out was, well, then Aprilia and I know Honda had made a version of this as well, but Aprilia makes a model, the Mana M A N A that is clutchless. So that was A huge to get out of the way. So this is essentially an automatic transmission so that do away with the clutch and gear changes. So that's a huge piece of the puzzle. Out of the way. And then Randy figured out a way to splice the brakes, front and rear in a certain ratio into a single lever. So I'm doing nothing with my prosthetic feet except to hold onto the bike. I'm doing nothing with my prosthetic arm except for holding onto the bike. So all the actions in my right hand breaks into one lever. Then Randy built this box and moved all the controls, the turn signals, horn, and all that stuff over to the right side of the bike and good distance for my thumb to reach them. So I have throttle, brake lever, and then the turn signal box all going with one hand.

[Tim Ferriss]

And that's so awesome.

[BJ Miller]

That's it, you know, that's. That's a way. Away you go.

[Tim Ferriss]

Okay, I just have to pause here for a second and just ask everyone listening. What excuses do you have for not going after whatever it is that you want? Like, please write in, tell us on social media why these are real excuses with hashtag afterwards. Oh, my God, man. That's such a great story. I'm so glad I asked about it. And what a really fantastic workaround, man. Congrats. That's awesome.

[BJ Miller]

Thank you. And thanks, Randy. And thanks to the folks at Scuderia, the bike shop in the city. I mean, I. A lot of people helped me make this come true, and it took a long, long time of trying to find the right folks to make it happen. So. Amen.

[Tim Ferriss]

Amen to that.

[BJ Miller]

So just.

[Tim Ferriss]

Just a few more questions. I want to be respectful of your time, but I'm having a blast here. What $100 or less purchase has most positively impacted your life in recent memory? I'm guessing not the motorcycle.

[BJ Miller]

No, that was a little more than 100 bucks. Holy cow, man. Wow. You know, I would probably point us to a beautiful Pinot Noir from Joseph Swan up in Sonoma county, me. It's like the artwork of Andy Goldsworthy. Or anyone who delights in anything ephemeral. The charm in a bottle of wine, the craft, all the work that goes into it. And actually delighting in the fact that it's perishable and goes away, I find really helpful. So I've gotten a lot of miles out of a beautiful bottle of wine. Not just for the taste and the buzz, but the symbolism of delighting in something that goes away.

[Tim Ferriss]

Hear, hear. I have a practice that some folks might Enjoy. Which I didn't come up with. I'm pretty sure I borrowed it from some past girlfriend. But I have a small glass jar, and I keep the corks from bottles that I finished with friends at home. And I have each of them write something on the cork. So I have this collection. The bottles are gone. The wine is long gone, but there's this vestige. The right one. Maybe that's not the right word. I'm trying to GRE to sound intelligent. But the corks in this sit. I'm looking at it right now. It's on this floating shelf on the wall. And so I see it as I walk by it. So no matter how sort of lonely I might feel at times, I think we all do at moments. It's sort of a reminder of how close by, how within reach sort of friends and that type of experience are. If you could put one billboard anywhere with anything on it, what would it say?

[BJ Miller]

Oh, boy, that's a doozy. Let's see here, man. Well, you know, it makes me think of. As big as billboards are, you cannot. You can only put so much on them. And it makes me think of the. My favorite bumper sticker. And I guess. And it seems like such a potent. I just love. I love it. And so I would love to see it on a billboard, which. And the basic bumper sticker I'm sure you've seen it is don't believe everything you think.

[Tim Ferriss]

I've actually never seen that. That's a really good one.

[BJ Miller]

Oh, it's so good. I think this is a sweet, hilarious, true reminder to not take ourselves so dang seriously, you know? So anyway, that's. That's probably my choice. Don't believe everything you think.

[Tim Ferriss]

Don't believe everything you think. I was really waiting for what this was going to be.

[BJ Miller]

I was.

[Tim Ferriss]

I was really wondering. I saw one. This is. I'm really going to lose any shred of respect that people have for me by saying this, but I saw one recently that was a. It was not a bumper sticker. It was surround finding the license plate. I'm not sure what the license plate casing. I guess it said, if you're on my ass, you better be pulling my hair. That was pretty clever. But it shows you where my level of emotional maturity is in any case.

[BJ Miller]

Paul, don't. You're. I.

[Tim Ferriss]

You know, I thought I might. I might lose you with that one. That's okay. I'll try to really reel you back in with the next few questions. So.

[BJ Miller]

Yeah.

[Tim Ferriss]

Don't believe everything you think that's awesome? I'm. I'm astonished I've never seen that dude. What advice would you give your 30 year old self? And if you could place us with where you were, what you were doing, that'd be helpful also.

[BJ Miller]

Oh, wow. That was a particularly poignant time for me actually. So there's a lot going. I was deep in med school. It was my last year of med school. Boy, I had a really sort of experimental tour of my 20s and I was sort of settling into a new rhythm. I had finally let go of a fair amount of guilt around my own accident and the effect on my friends and I was pretty neurotic at that time and my sister had just died. So it's. This may not be the intention of your question, but 30 happened to be a really sort of heady, heavy time for me. But I'll still roll with the question and I think, I guess I would have of help myself get. You know, I. This sounds way too tidy, but I might have said something like, hey man, don't believe everything you think. Don't, you know, let it go, don't take it all. Don't, you know, I do mean to take life very seriously, but I mean to take things like playfulness and purposelessness very seriously. So I want to take, so I don't mean this, this is not meant to be light, but I think I would have somehow encouraged myself to let go a little bit more and, and hang in there and don't pretend to know where this is all going. And you don't need to know where it's all going.

[Tim Ferriss]

Yeah, you don't need to know where it's all going.

[BJ Miller]

And you can't.

[Tim Ferriss]

And you can't. What have you changed your mind about in the last few years?

[BJ Miller]

Well, for all my talk of purposelessness and all this stuff, you know, I have in the last several years allowed myself to feel that I have a true vocation in this work around palliative care and helping us as a species deal with our. And dance with our mortality. I had convinced myself that, you know, hey man, I had gotten to very loose and I was. Whatever. I didn't feel the need to accomplish so much per se. But in these last few years I've let myself, I think, in a way, man, I think I've let myself get more ambitious in a way and to take my work even extra seriously, more seriously than perhaps I, I had been. And letting myself feel like this could all work and letting myself feel like actually the healthcare system could be Fixed. So in other words, I guess in a word, is to reacquaint myself with something I talked myself out of, which was ambition. I still think of that word in negative with negative connotations. I see bad behavior on behalf of ambition a lot. And I'm sure you have too, in around where we live and places like Princeton and people stepping all over each other to get ahead. And that's not what I'm talking about.

[Tim Ferriss]

But maybe it's aspiration.

[BJ Miller]

Yeah, yeah, yeah, I think that's right.

[Tim Ferriss]

Well, on that point, do you have any. Any last requests, asks, suggestions or otherwise for the people listening?

[BJ Miller]

Oh, thanks, man. That's such a great invitation. I mean, one is, folks. Hey, everyone. Everyone. I would hope we could start seeing the remarkable amount that we all have in common by virtue of being the same species on the same planet, et cetera, and mortal beings at that. And I guess I would ask that we start looking to make. Make that real. I would ask that we prize kindness. I would ask that we learn to forgive in a daily way. But more strategic, I would ask you guys, if you're so moved, to get involved reifying and supporting hospice and palliative care. If you're in and around the Bay Area or just so moved, we would love your support at Zen Hospice Project. These places rely heavily on philanthropy. So if you're moved, please come check us out. Zenhospice.org Otherwise, think about what's going on in your own geography. Support hospice and palliative care. It's work that needs to be developed and built. Yeah, I'll leave it at that. That's. That's plenty.

[Tim Ferriss]

And I really, I've been so excited to chat with you for so long and I. I've had so much fun, in part because it's exciting to me to think that in studying and refining how to die, we can study and refine how to live. And that, like you said with the foot in the door, the wedge that is palliative care, you have the ability in this laboratory called Zen Hospice Project to do a lot of experimentation that could actually translate much more broadly to life, not just at the end of life, but throughout life. And I find that very, very inspiring and exciting. So I think it's a real tremendous opportunity and a potential point of leverage that you have and so people can find you at zenhospice.org z e n h o s zenhospice.org zenhospice doppelgang Facebook is Zen Hospice Project. Twitter nhospice and I'll put all this in the show notes, of course, for everybody listening.

[BJ Miller]

Can I also on that note, Tim, can I just give a shout out to the work that's also the great work that's being done at ucsf?

[Tim Ferriss]

Absolutely.

[BJ Miller]

Of course, the Symptom Management service in the UCSF Cancer center, the outpatient palliative care program there, Mike Rabo and all the work going on around there is gorgeous. And that's another thing to consider supporting. But that's not a place to find my work too.

[Tim Ferriss]

Definitely. Yeah. UCSF is just spectacular. And I've done. I've also been involved with the Ghazali Lab and other folks at ucsf. I'm just continually impressed. BJ hopefully we'll get to do a round two, maybe with some wine sometime. But I really appreciate, number one, first and foremost, the work that you're doing and how you've dedicated your life. It's tremendously important and tremendously impactful. And also on a smaller level, of course, the time that you carved out today for this.

[BJ Miller]

It's such a pleasure, Tim. And that went really fast, man. And thank you so much for having me on the show. It's such a joy.

[Tim Ferriss]

And to everyone listening, you can find the show notes, links to everything we [e-mail] podcast all spelled out. Or just search Tim Ferriss and podcast. And as always and until next time, thank you for listening. Hey guys, this is Tim again. Just one more thing before you take off and that is five Bullet Friday. Would you enjoy getting a short email from me every Friday that provides a little fun before the weekend? Between 1 and a half and 2 million people subscribe to my free newsletter, my super short newsletter called five Bullet Friday. Easy to sign up, easy to cancel. Cancel. It is basically a half page that I send out every Friday to share the coolest things I've found or discovered or have started exploring over that week? It's kind of like my diary of cool things. It often includes articles I'm reading, books I'm reading, albums, perhaps gadgets, gizmos, all sorts of tech tricks and so on that get sent to me by my friends, including a lot of podcast guests. And these strange, esoteric things end up in my field. And then I test them and then I share them with you. So if that sounds fun, again, it's very short. A little tiny bite of goodness before you head off for the weekend. Something to think about. If you'd like to try it out, just go to Tim Blog Friday. Type that into your browser. Tim blog Friday. Drop in your email and you'll get the very next one. Thanks for listening. This episode is brought to you by Shadow Shopify, one of my absolute favorite companies and they make some of my favorite products. Shopify is the commerce platform revolutionizing millions of businesses worldwide and I've known the team since 2008 or 2009. But prior to that I wish I had personally had Shopify in the early 2000s when I was running my own e commerce business. I tell that story in the four hour workweek, but the tools then were absolutely atrocious and I could only dream of a platform like Shopify. In fact, it was you guys, my dear readers, who introduced me to Shopify when I polled all of you about best e commerce platforms around 2009 and they've only become better and better since. Whether you're a garage entrepreneur or getting ready for your ipo, Shopify is the only tool you need to start, run and grow your business without the struggle. Shopify puts you in control of every sales channel. Doesn't matter if you're selling satisfaction sheets from Shopify's in person POS system or offering organic olive oil on Shopify's all in one e commerce platform. However you interact with your customers, you're covered. And once you've reached your audience, Shopify has the Internet's best converting checkout to help you turn browsers into buyers. Shopify powers 10% of all E commerce in the United States and Shopify is truly a global force as the e commerce solution behind Allbirds, Rothys, Brooklinen and millions of other entrepreneurs of every size across more than 170 countries. Plus Shopify's award winning help is there to support your success every step of the way. If you have questions, this is possibility powered by Shopify, so check it out. Sign up for a $1 per month trial period at Shopify. That's S H O P I f y shopify.com Tim go to shopify.com Tim to take your business to the next level today. One more time. All lowercase shopify.com Tim this episode is brought to you by VUORICLOTHING spelled V U O R I Vuori I've been wearing Vuori at least one item per day for the last few months and you can use it for everything. It's performance apparel, but it can be used for working out. It can be used for or going out to dinner. At least in my case. I feel very comfortable with it. Super comfortable, super stylish and I just want to read Something that one of my employees said. She is an athlete, she is quite technical, although she would never say that. I asked her if she had ever used or heard of Vuori and this was her response. I do love their stuff. Been using them for about a year. I think I found them at rei. First for my partner T shirt shirts that are super soft, but somehow last as he's hard on stuff. And then I got into the super soft cotton yoga pants and jogger sweatpants. I live in them and they too have lasted. They're stylish enough I can wear them out and about. The material is just super soft and durable. I just got their Clementine running shorts for summer and love them. The brand seems pretty popular. Constantly sold out. In closing and I'm abbreviating here, but in closing, with the exception of when I need technical outdoor gear, they're the only brand I've bought in the last year or so for yoga, running, loungewear that lasts and that I think look good. Also, I like the discreet logo, so that gives you some idea that was not intended for the sponsor.

[BJ Miller]

Read.

[Tim Ferriss]

That was just her response via text. Vuori, again spelled V U O R I is designed for maximum comfort and versatility. You can wear it running, you can wear their stuff. Training, doing yoga, lounging weekend, every errands, or in my case again, going out to dinner. It really doesn't matter what you're doing. Their clothing is so comfortable and looks so good and it's. It's not offensive that you don't have a huge brand logo on your face. You'll just want to be in them all the time. They're men's core short. K O R E. The most comfortable lined athletic short is your one short for every sport. I've been using it. Kettlebell swings for runs, you name it. The body banks short. This is their go to land to see. Short is the ultimate in versatility. It's made from recycled plastic bottles. And what I'm wearing right now, which I had to pick one to recommend to folks out there, or at least to men out there, is the Ponto performance pants. And you'll find these at the link I'm going to give you guys, you can check out what I'm talking about, but I'm wearing them right now. They're thin performance sweatpants, but that doesn't do them justice. So you got to check it out. P O N T O Ponto Performance pant for you ladies. The women's performance jogger is the softest jogger you'll ever own. Vuori isn't just an investment in your clothing, it's an investment in your happiness. And for you, my dear listeners, they're offering 20% off your first purchase. So get yourself some of the most comfortable and versatile clothing on the planet. It's super popular. A lot of my friends have now noticed are wearing this and and so am I. Bioriclothing.com Tim that's b u o r I clothing.com Tim not only will you receive 20% off your first purchase, but you'll also enjoy free shipping on any US orders over $75 and free returns. So check it out. Vuoriclothing.com Tim that's v u o r I clothing.com TIM and discovery versatility of Biore Clothing.