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- [00:00]
Podcast Host
Foreign. Welcome to the thriving Kids podcast. Our guest this week, Dr. Brian Heflinger, Brain surgeon. I will also say, like, you know, we were, we're talking about just as we were about to start filming, like, how I can refer to why our team got so excited about this interview with you today. You know, for our listeners. We, we do a review of new guests with our, our team here at the Child Mind Institute. And oftentimes our, our production team looks for people who are experts, are good communicators. And then there's just an aspect, and I know no one's heard your voice yet of your communication that we were looking at as we were looking at your messaging, where you have such an incredible tenderness and ability to communicate about really difficult and complex topics. We're like, we have to talk to him. So anyway, thank you for being here.
- [00:53]
Dr. Brian Heflinger
Oh, you're welcome. My pleasure.
- [00:54]
Podcast Host
Glad to be here and to give our listeners the walk across as an intro here that, you know, we talked about this and we said to ourselves, and Also, you know, Dr. Brian, you asked this question as well. You know, we said to ourselves, okay, what is it that makes, you know, having a brain surgeon on a walk across for the thriving kids, parenting and mental health audience? And really, the way that I think about it is that we in psychology are a young science, one that knows a lot about the brain, and I think you'll agree with me on this, also knows very little. And so given that we're at this kind of early stage of understanding our brains, the overlap between medical and mental health, the brain as it has to do with the mind and its health in general, you know, there's so many questions that people generally have with their brains and so often spots where when you're discussing mental health, people want to talk about what's going on in the brain and what that means. So to begin with, to get our listeners to know you a little bit, what would you say is your kind of trajectory to becoming a neurosurgeon? How did that career become your work?
- [01:57]
Dr. Brian Heflinger
Yeah, well, that's a simple story, but it's a personal story. So I was actually in high school, finished high school, was signed up to go into marine biology. I love scuba diving. I love the outdoors in the water. And my mother called me. I lived in Florida with my grandparents at the time. And my mom called me and told me that my brother Eric, who was 21 at the time, was a senior in college, had been in a horrible accident and had emergency brain surgery in the middle of the night. So I had never been on a plane. I booked a plane that day. I'm all upset. I fly up to. Back home to Toledo, and when I first saw my brother, I mean, he's lying there basically naked in the ICU with a little towel over his privates, and he's got a white wrap around his head with a big metal bolt coming out of his head. And his eyes and head, his face are all swollen. He doesn't look like my brother. He's got a breathing tube in, a tube in his nose, two chest tubes, tube in his bladder. And, you know, we were told by the neurosurgeon who would come around typically once a day for a few minutes to talk to us that he was going to die. The first three days, they said, you know, we've done everything we can. He had surgery, had a bad brain injury, thought he was going to die. And then eventually he lived. And he was in a coma for six months and then came out of the coma about a year later, but could never walk or talk again. But just those few weeks I was up there every day we spent there, and I got to see the environment and talked to the neurosurgeon, and I just became fascinated with it. And I just said, there's so much that can be done for people like my brother who's never going to be normal again. And I just wanted to be part of that. I wanted to be in that world. I immediately went back down to Florida. I dropped out of my classes, which I already had signed up for at South Florida, and I moved back home, and I started college with the intent of becoming a neurosurgeon at the University of Toledo. And I just followed through on it. I never gave up.
- [03:41]
Podcast Host
So you were already enrolled in taking classes in Florida in marine biology?
- [03:47]
Dr. Brian Heflinger
Well, yeah, I hadn't started. I was signed. It was the middle of summer, so I was. My classes were signed up. I had them all enrolled. Yep, I was enrolled.
- [03:53]
Podcast Host
And in a perfect place to study marine biology, of course.
- [03:56]
Dr. Brian Heflinger
Yeah.
- [03:57]
Podcast Host
And then just that experience alone just kind of called to you.
- [04:02]
Dr. Brian Heflinger
Yeah. It just shows you how life experiences so much shape what we do and who we become. And I'm sure everybody out there has a life experience that's done something to change their trajectory. But that was a big part of my. Why I became a neurosurgeon.
- [04:15]
Podcast Host
Yeah. So given that you've obviously gotten into such a kind of very challenging part, as well as your personal history, that kind of got you into this. I mean, one other thing that I've heard you speak about a few times is that in becoming a neurosurgeon you'd struggled significantly with anxiety and panic as a kid. Right?
- [04:35]
Dr. Brian Heflinger
Yeah, yeah. When I. Go ahead.
- [04:38]
Podcast Host
Yeah, no, no, I was going to say, tell us more about that.
- [04:40]
Dr. Brian Heflinger
Yeah, yeah. You know, it affects so many people in the. In the world. And I was embarrassed by it for so long because when I was in seventh grade, up until then, I was very, very sociable. I was president of student council. I used to give speeches in front of the. The whole schools and stuff. And then in seventh grade, I was in English class. You know how you go around the room and they were asking people to read a little part of each book. And all of a sudden I just froze and I. I couldn't talk. I was sweating, my heart was racing. I panicked. I felt like I was gonna die. And I left the room, I couldn't be there. And I went home and I really didn't know what happened to me. And this is back in the 70s, you know. So then I. Next day I go back and it's the same situation. Here we go. They're counting, you know, going around the room. You got to read it, like eight people in front of me. I realized my turn was coming up and I had that horrible panic attack. And it's for anybody out there who's ever had one, you know what I'm talking about? I mean, I just felt ill. I was sweating, my hands are trembling, my heart's racing, I can't breathe. I feel this dread like I'm going to die if I don't get out of there. And I. And I just left again. And I didn't come back. And that's when my whole life changed. I became very quiet, private. I skipped class a lot. I would stay home, tell my mom I'm sick. I'm surprised my mom never questioned me because I didn't miss a day of school from fourth grade to sixth grade. I. Some award for that. And now I'm missing school all the time. And so it's just one of those things that back then nobody paid attention to it. And my parents didn't do anything. My teachers never said anything, but people could see I was different. I didn't talk. I didn't. I avoided talking. I. But it affected my whole life. I mean, it controlled my life for. For 20 years.
- [06:17]
Podcast Host
And as a kid, was the panic mainly about public speaking.
- [06:21]
Dr. Brian Heflinger
It was. That was my choice, public speaking. So anything I had to do where there's a chance I Had to speak. Even in college, I would avoid it, you know, until a point I had that I had to confront it at some point. I knew if I was going to become a neurosurgeon, I had to change that. And so I worked at it really hard a long time and had a lot of failures. Sometimes I'd still leave class, but sometimes I could do it. And just with those successes, gradual successes, I overcame. Overcame it.
- [06:47]
Podcast Host
Well, I was going to say that you. I mean, you just told us right as we're sitting down that you spoke with 36 patients earlier today. Obviously, that's, you know, just a typical day in the office in. In talking to folks. I'm sure that. I mean, even an experience like this. I know you speak to a wide range of audiences. I know you record a lot of, you know, public education, you know, kind of content. How nervous does it make you to do something like that today?
- [07:15]
Dr. Brian Heflinger
It doesn't. I can't. I can't tell you why. It just doesn't. And, and in the past days, the past years, I could never do it. And it never affected me. Like, I never had a panic attack, operating or anything like that. It's always just public speaking, you know, but it just. Especially after my son Brian died, I, you know, he was. He was drunk. He was a drunk driver, and he died. Thank God he only killed himself. But the news attacked us and attacked him when he died 13 years ago. And I told my wife, Cindy, I was still kind of scared of public speaking a little bit at that point. I said, I just can't let this happen. I called the local news anchor, got to know her. She came over to her house, did an interview, and then we just were very outspoken about drunk driving and all this stuff. And then we got on national television. But there's just. There's things in your life that just change you. And I. I don't know, I just. It gradually got better. And then that my son dying was the final thing that just kind of kicked me into speaking out loud about things, you know.
- [08:11]
Podcast Host
And, I mean, this is like a. A mental health professional question, of course, where I'm just like, as a psychologist looking through all of the events you've experienced, my heart breaks for some, you know, your brother, for your son, for, you know, the. The kid who's struggling and thinks that something is wrong and is avoiding class and not going because he's scared he might be called upon. It's like, did you ever meet anyone in the mental health side of the field, meet with Someone, you know?
- [08:38]
Dr. Brian Heflinger
No. And I was always. I don't know, I was always embarrassed by it. Like, it was very humiliating to have to leave class. I could see my friends could see me get nervous and scared, you know, and that's kind of. It makes you feel less of a person embarrassed and. And I would avoid social situations so I wouldn't look like that. And so it's just back in an era where no one really recognized it, I guess. I. I don't know if my mom or dad ever noticed it or the teachers, but no one ever did anything. And I was too embarrassed to even tell my parents. My parents never knew about it. The only person in my life that ever knew about that was my wife. When we first got married, I knew I had it Teller. And I told her. Yeah. But no one ever knew. I just couldn't tell anybody. I mean, I.
- [09:19]
Podcast Host
And now you speak up about it fairly often in kind of disclosing and letting people know what kinds of things you've. You've struggled with.
- [09:26]
Dr. Brian Heflinger
Well, because nowadays I think people should seek. I mean, it's so stupid that I didn't get on a medication like a beta blocker or, you know, seek somebody to talk to and get it out and let them know that it's normal that you're not abnormal. I just never had that opportunity. But I think for now, people should really seek treatment that's there.
- [09:43]
Podcast Host
When I think about what we. Like, if we got young Dr. Brian in the office here, it's like the treatment for this now is so predictable in the sense that what we do is we take those kids who can finally disclose with some bravery to us that they get these panic attacks, and we do two things. You know, we sit there and first of all, we do exposures to tolerate all the physical symptoms that come along with the panic attacks to make you not feel like you're so out of control, which I know you've. I remember you made a video online on your Instagram about. It was the Yosemite metaphor, where I thought you described it so perfectly. And I was just kind of like, okay, you know, he's definitely. Then of course, at the end of the video, you disclose about panic attacks. And I was like, this makes so much sense for why he could describe it. But we'll do those exposures, which are interoceptive exposures, and then we'll do exposures like, we'll gather staff at the Child Mind Institute around, and we'll have kids practice public speaking opportunities in front of our staff while they're in the midst of feeling those panic symptoms all the way up to the point where they can kind of go back to class and get them into school. And it's like, I just. Anytime I hear about a kid struggling with that in a day, before treatment was fairly accessible around this or we necessarily knew what to do, it's like, it's miraculous that you got to where you were, that you figured out how to triumph. I mean, so you. You were becoming a neurosurgeon before your son's death, knew you had to begin to be, you know, engaging in this. This kind of thing was supposed to
- [11:09]
Dr. Brian Heflinger
be, well, because, like, when you're in residence. So in medical school, I was still having panic attacks, but I struggled through medical school. You know, you have to present patients to people, to groups of people. It was really hard. But then I knew in residency, I was going to have to present in front of, you know, 50, 100 people on grand rounds and things like that. And I just knew I had to do something. So my wife forced me to take the Dale Carnegie course, which was good. So we did it together.
- [11:33]
Podcast Host
Oh, my gosh.
- [11:34]
Dr. Brian Heflinger
Well, I had to. She. She said, you have to, Brian. I knew I had to, so I did that. And then. And then I just practiced. And, you know, I. I was still nervous. I could do it. People could probably tell, but at least I could do it, you know?
- [11:44]
Podcast Host
Yeah. And were the folks that you were taking the Dale Carnegie course with also prone to any anxiety about public speaking? Were they just trying to look for better?
- [11:54]
Dr. Brian Heflinger
A lot of people are business people who are. Yeah, they already have to give presentations. So a lot of people are just adults who want to.
- [12:00]
Podcast Host
They want to win friends.
- [12:00]
Dr. Brian Heflinger
They want to bone up on their public speaking. I needed to learn how to talk in front of people.
- [12:05]
Podcast Host
But from a psychological perspective, you structured a course that was basically a set of graduate exposures for yourself, in the sense that, like, you went and took the Dale Carnegie course, which most of us therapists were trying to get people to do those things, and you just kind of, like, flooded yourself and jumped in the deep end of the pool.
- [12:21]
Dr. Brian Heflinger
What was I going to do? There's no way I can be a neurosurgeon if I didn't do something I couldn't. My life had taken a turn to where I never wanted to be. Like, I'm this. When I was a kid, I'm this outgoing person. I wanted to be this personality and all this stuff, you know? And then all of a sudden, I'm this person who can't even speak. And it's like, this isn't me. And I said, I can't live like this. I can't give up on everything in my life. And I just knew something had to change and I had to. So I just. It was. It's terrible. I mean, it was terrible all those years trying to do this, but you win some, you lose some. But the more. The more you win, the better it is. And the more times, the more you win, the more you're going to win in the future. I just learned that. And then finally, like you said, I got over. I was able to somewhat control those autonomic responses of my heart racing and my breathing and my sweating and trying that. That feeling of dread, like you're going to die. I was able to gradually overcome it with time.
- [13:10]
Podcast Host
It also sounds like the experience of grief at some level after the loss of your son also became a sort of like, I won't swear on the podcast, but a sort of give no Fs era for you, where you kind of like, said, like, all right, at this point, you know, this is for him. I. I'm going to just call up the news stations and start talking.
- [13:28]
Dr. Brian Heflinger
And I think some of us try. I think there's something about that incident. It's the. It's the worst thing that's ever happened in my life. I just can't describe it to you, but it's the trauma of what happened. Something happened in my brain, like it rewired my brain or kicked my brain forward to. To just move on. I don't know how to explain it. I told my wife by. I said, this is something about when he died. I knew something changed in me, and it just changed. And I knew I was going to be a different person.
- [13:54]
Podcast Host
I don't.
- [13:55]
Dr. Brian Heflinger
With.
- [13:56]
Podcast Host
I mean, God, I just. So the thing is, I bet you get this with. With many people, but it's just. I can't imagine. I mean, you know, and really having sat with many patients who've gone through losses, somewhat similar. The way that you talk about your process of getting through it, it is very clear that you've done an incredible amount of work and grieving to get to even where you are now. And having been changed by that experience, pivoting for a second to just the way that you're. Your mental constitution affects your profession. What's the typical length of a brain surgery you might be doing? How long are you in the. Or, you know.
- [14:41]
Dr. Brian Heflinger
Yeah, so it just. It depends. So in my younger days, I did Lots and lots of brain surgeries. As I've gotten older, I'm doing more spine surgeries. But you know, typical brain surgery, if you had a, a smaller brain tumor that's near the surface of the brain, that might only take, you know, three or four hours to do. If you have a big brain tumor that's bloody, that's deep in the brain, it can take, you know, 912 hours. My partner did a 22 hour surgery not too long ago on a big brain tumor. So it just, it varies on how big the tumor is, how easy it comes out, how much bleeding there is. All those things factor into it. But, you know, a typical brain surgery is probably three to six hours on average, I'm guessing.
- [15:21]
Podcast Host
And this is always something I find quite interesting about just panic and anxiety in general. I don't get any anxiety at public speaking, which is fantastic given the anxiety I had as a child. But I get panic attacks on planes, which is why, you know, it's been really helpful for me to know the interventions I have. You are in one of, I think, what people would consider to be one of the more anxiety provoking situations that any human can encounter where someone's brain and life are in your hands for a matter of hours. Do you get nervous to that time? Do you lose, you know, do you ever worry about losing focus? Does, do you ever feel any symptoms of panic in the room? Or are you just.
- [16:01]
Dr. Brian Heflinger
So we're, I mean, you have to realize when you, when you become a neurosurgeon, you're, you're there for seven years and you're, you're trained, you're trained in those situations. Right? I mean, your gradual exposure year after year until you're a chief resident, where you're doing the surgeries all by yourself. Yeah. You just learn to deal with things. And the number one thing is you learn not to panic. Right? I mean, if someone's got excessive bleeding, you have to just let it bleed, take your time, stop the bleeding gradually. If they need blood, give them a blood transfusion. But you don't go doing things that you shouldn't be doing because you're in a panic. So it's just one of those things. And you know, compared to when I was a first, when I first got out of residency, compared to now 27 years later, I mean, things don't faze me nearly as much. I mean, I take my time. If there's bleeding, I just take my time and stop it. But it's a learned, it's a learned attribute. I Think, you know, and everybody's different. I just don't. I mean, I'm. Stay pretty calm, cool and collected, because I know I can work my way out of things. Like, no matter how bad it seems, if you take your time and slow down, take a breath and just work your way through it, it's going to be fine. And it always is. It's that fact where you. If you think too far ahead, like you're thinking, oh, my God, the patient's going to die. Well, you're not even that close to that stage. But then you get panicked, then your mind, then you're doing crazy things. You can't do that. You know, you just have to stop for a minute, let it bleed for a minute, just gather your thoughts, and then slowly proceed on in a. In a logical, methodical way. And it works just fine. You know, I. The.
- [17:25]
Podcast Host
The five sentences you just uttered are perhaps such a solid bunch of nuggets of wisdom that comes clearly from anybody who's been listening for the last few minutes, from both your life experience and your profession, that, you know, my producer, our producer, Chad, who's sitting by a desk, has been like, pumping his fist and nodding at the wisdom of those last few statements as we've been talking, just because I think he feels like, okay, yeah, like, you know, just gotta slow down. I mean, you know, our. Our producer had. His dog, had an incident recently that he was dealing with in the midst of crisis. And, you know, I think, like, we're all drawing in our own crisis moments from what you're saying as you're sitting there in an or in a situation that very few of us could handle.
- [18:08]
Dr. Brian Heflinger
So let me put it first. I'm trained to handle it. You could handle it if you were trained.
- [18:13]
Podcast Host
And I'm identifying with it, too, because I think it's also one of these things where, as a psychologist, I'm constantly faced with patients who say, look, you've never seen a kid with these kind of challenges before. And my answer after a couple decades in is, yeah, I have. The matrix of human behavior is not so large that you haven't seen, you know, behaviors, not necessarily in each combination or in the individual presentation that comes with each person, but not something that's going to, like, surprise you to a point where it upends you.
- [18:43]
Dr. Brian Heflinger
But it's all. But it's all experience. I mean, you've learned that by sitting with a child like that. You've seen so many of them. You've learned what worked this time, what didn't work. That time and then you've learned, now this is what I need to do. And then you could just take it very calmly. But I'm sure when you first start out and you get a kid like that, it's like, oh my God, I don't know.
- [18:59]
Podcast Host
Exactly. And to your wisdom, you take a deep breath and you start working the problem and you start working through the various aspects of the pyramid. You know that, you know, you start working on the kids relationships, you start working with the techniques you have. And in general, you know, as long as you keep working at it, you see improvement fairly quickly. But it's in psychology, it's more like watching hair grow where you don't notice it over the course of, say, two weeks. You may start to notice it at four, and at six weeks you're like, oh my God, everything's changed. But like, it's hard for people to wait on that level of time. So pivoting for a second and with the, you know, advantage of having a brain expert on this show coming from like your perspective, your side of the field. Because we talk about brain health on the mental health side a lot on this podcast, you know, to you, if you've got patients, others who ask you what makes a brain healthier, what makes you concerned about a brain in your line of work? How do you answer that question?
- [19:56]
Dr. Brian Heflinger
I don't know. I think I'm not an expert on brain health, but I mean, there's just general things that stay healthy, I think, you know, and so you, you see all this stuff on social media about do this and that. I mean, obviously eating healthy is important. You know, you eat a bunch of fatty processed foods, it's not good for your body as opposed to eating fruits and vegetables. So that's just a, a cliche thing that people say, but it's true. I mean, eating healthy is important and I think, you know, getting sleep is so important. I, I try to get as much sleep as I can now. It's crazy the, the days I would go on a row without sleeping, how bad it probably was for me. And so I prioritize my sleep. And even like our little three year old grandson Arch that lives with us, I mean, it's so hard to get him, for his parents to get him to sleep, but it's so important for their brain because that's when their brain's rewiring itself. It's, it's developing and they, and they need their sleep, you know, and so I think brain sleep is very important. I'm big on Exercise. I've always done a lot of exercise, and I've done an ironman. I've climbed Mount Kilimanjaro with my son two years ago. And I believe that exercising in general is very good because it gets blood flow to your body, blood flow to your brain. I mean, you know, you need oxygen, you need nutrients. But it's true. I mean, it seems stupid, but moving around just a little bit a day makes a big difference in your brain health. And then I think for me, it's mental health. I mean, everybody talks about all the physical things. Eat healthy and sleep and take your vitamins and all this stuff. But what about just feeling good? I mean, if you, if you enjoy doing something, but somebody says it's not healthy, if it helps, if it makes you feel better. I think there's such a good effect of feeling good about things, you know, I mean, we don't know everything about the brain and we don't know. I like to have a doctor diet, a Diet Pepper every day. It makes me feel good. It does. After surgery, it makes me feel good, it gives me a kick. And is it bad for me? I don't know. Maybe it is, maybe it's not. But I'm pretty healthy and I'm 61 years old. But I'm not going to give that up because it makes me feel good. And I think that's more important for my mental health than worrying about what ingredient it has.
- [21:55]
Podcast Host
Honestly, I only laugh because I love that piece. And I plan on forwarding this to some members of our Chalman Institute team, because our chief science officer has a diet Dr. Pepper basically on the desk at all times during the workday. He also, I would consider to be one of the major experts on the brain within the field. And you know, I don't think anybody's trying to say the diet Dr. Pepper is necessarily the most healthy thing that one could drink. I know, but to your point, it kind of brings you joy. And, and you're in Ohio, right? And, and you, and you love scuba diving. Do you still get to do that and have that bring you joy these days at all since you were originally going to be?
- [22:33]
Dr. Brian Heflinger
Not much when, when Brian was al to do family, all the kids, we got certified. My wife scuba dive. So when he was alive, my son, we did scuba diving trips as a family. But since he's died, a lot of things I don't do as much anymore. So we don't scuba dive much anymore. But I do enjoy it. But I don't do anymore. But there's other things I. I enjoy social media. I mean, I. I enjoy talking, teaching people, you know, and you don't never know who's watching and who's not watching, but it's something I enjoy. It's different than neurosurgery. So there's other things I like doing. I like to go golf once in a while.
- [23:04]
Podcast Host
Well, completely. And also I would say that with what you do on social media, one thing that I'm struck by related to kind of how you do videos is that they're either kind of incredibly wholesome or incredibly informative in the sense that, like, it'll be you after you've taken a walk with a weighted vest or something like that. I've seen that. And. And like, you know, you're talking about, like, you know, your own wellness habits or something, or you're just explaining a medical condition to people that men understand. You know, how nerves and vertebra, like, you know, necessarily fit together or something like that.
- [23:36]
Dr. Brian Heflinger
I mean.
- [23:37]
Podcast Host
Well, on that note of just kind of information, this. This goes back to, like, my other question on kind of brain health. For the people that you see in your office, if there were certain lifestyle habits or things that one does in life that would give someone the best chance of not ending up on your operating table, what would you recommend?
- [23:56]
Dr. Brian Heflinger
Quit smoking, number one.
- [23:58]
Podcast Host
Okay, that's actually not something I necessarily.
- [24:01]
Dr. Brian Heflinger
Smoking is the worst thing you can do for your body all the way around. I think it's just the worst thing. I think sedentary lifestyle. I mean, so many people are overweight in the country, and it's, It's. It's just eating habits and general health. And I think, you know, exercising is so important.
- [24:18]
Podcast Host
Right?
- [24:19]
Dr. Brian Heflinger
I don't know. I mean, I'm not an absolute guy. Like, if somebody, if somebody wants to smoke, I mean, it's their prerogative. It's not good for them. They may not live as long. But if it made them happy and they lived a happier life than I did and they smoked, so be it. Alcohol. I still go out and have some drinks with friends and stuff. It's not. To me, it's not like cancer. It's not like. It's just, you know, there's people who live till. My grandfather had a cock there too, every single night, and he lived till he's 95. I think a lot of it is genetics.
- [24:46]
Podcast Host
It's a range of predictive capability and combined factors.
- [24:49]
Dr. Brian Heflinger
Everything in moderation. I think I tell my. I tell my patients everything in moderation. You don't have to go do an iron man, but I don't think you should sit on the couch eating chips, watching TV all day. I don't think, you know, smoking's not good for you, but you know, if that's what you need to do, I mean, you know, do something else healthy to help.
- [25:07]
Podcast Host
And so this, the smoking. Can you just walk us the. What does the smoking do that ends up with someone on the operating table in front of you?
- [25:14]
Dr. Brian Heflinger
Well, smoking. So smoking is a. Can be a. Nicotine is a vasoconstrictor. So it constricts your blood vessels. So smoking can lead to poor circulation to the end organs like your brain, your heart, your kidneys, your lungs. And so it can lead to problems with those organs. And smoking has so many other things, you know, it has like how many carcinogenic factors. And sure, it's obviously predisposing to lung cancer. I see so many people who come in with brain tumors that are metastatic, right. They've got, here's my typical scenario when I'm a call, patient comes in, they have a. Find a brain tumor because they came in, they're weak in their arm or something, do a metastatic work of CAT scans of the body. They've got lung cancer, newly diagnosed, now they got one or multiple brain tumors. And by the way, I smoke two packs per of cigarettes for the past 30 years. So in my world, you know, smoking can lead to tumors that end up in your spine and your brain, you know, lead to paralysis and things like that. It can lead to. I think there's been a link with smoking in the early dementias just because of the vascular perspective from it. It's just not, it's horrible for your body. I mean, my mom and dad smoked till they died. And I mean, that's probably why they died. But I, you know, it's a different world.
- [26:28]
Podcast Host
Grandfather who died of lung cancer and is the main reason why I've avoided the stuff myself because.
- [26:32]
Dr. Brian Heflinger
And none of us, not one of us smoke in the family. My mom and dad smoke like chimneys, but none of us smoke.
- [26:38]
Podcast Host
Yeah, well, also, if you've kind of seen it now, are there certain kinds of traumas that end up more likely to be on the operating table in front of you? Like I just think about the fact that we get so many questions, especially with kind of mental health differentials of like kids who've been riding motorized scooter and have had.
- [26:55]
Dr. Brian Heflinger
Well, here I got the great example. So I was just operating yesterday and the nurse was Talking to me, talking to us at the operating table. And they were asking, one other nurse has asked, how's your daughter? And I didn't know about it. So this is a little girl who's 11 years old. I don't remember if she had her helmet or not. I'm guessing she probably did not have her helmet on. So she fell off her bike. And at first she was okay. Then she had a bad headache. They took her to the emergency department, started getting sleepy. They did the CAT a CAT scan. She had an epidural hematoma, blood clot over her brain. And she was going downhill, you know, slipping into a coma rapidly. So she ended up at a different hospital in town and had emergency brain surgery. And she's doing really well right now. But, you know, if that mom would have just observed overnight, she may have not been alive the next day. And I had a little girl who was on one of those things at school that you go around, and she fell off and hit her head, went into. The nurse called the mom because she had a headache. Mom took her home. They were gonna keep her and just watch her at night. And mom said, because I did a thing on this. Mom's intuition, but moms know best. She took her to the emergency department. She had a big epidural hematoma. She was slipping into coma. I took her to surgery. She would have died without surgery. I took her to surgery, like within an hour of her getting there. Took the blood clot off and then she left like two days later, normal. But, you know, that's the kind of stuff that, you know, always have your kids wear your helmet. You just have to. I know it's a struggle. I know I had four kids myself. They fight with you. But I'm telling you, if you're that one person that has that happen, you can lose your child very quickly.
- [28:25]
Podcast Host
So, I mean, I also just feel so validated. Like, look, helmet thing, I get you. But like the spinny things at playgrounds for kids, like, I definitely think that American culture, when you visit playgrounds across the world, our playgrounds have become a little bit, I would say, like, overcorrected for childhood in the sense of like, there's nothing high, there's nothing you climb, everything's soft. Like, all that kind of stuff. Which, having a nine and six year old, sometimes I'm like, I think they can handle a little bit more challenge. But I see these spinny things where it's like the kids start going really fast. I think to myself, this is a head Trauma waiting to happen. Like, somebody's going to either fall off of this, knock their head against another toy, that kind of thing.
- [29:04]
Dr. Brian Heflinger
But they're kids. The kids are kids, you know.
- [29:06]
Podcast Host
Yeah. Of course.
- [29:07]
Dr. Brian Heflinger
They like the experience.
- [29:08]
Podcast Host
It's also going to happen.
- [29:09]
Dr. Brian Heflinger
Yeah. So.
- [29:10]
Podcast Host
All right, so while we have you here, one of the things that I have prepared as we get into your expertise in the brain, is that there are a number of things that we at the Child Mind Institute hear patients reflect back to us about kind of like brain facts, like out there in the zeitgeist, that I just thought to myself, if we get a neurosurgeon on, I would really love to get their reaction to these facts.
- [29:32]
Dr. Brian Heflinger
Okay.
- [29:33]
Podcast Host
When you hear people say. First one. When you hear people say, well, we as humans only use 10% of our brain, it's like that movie Limitless with Bradley Cooper, you know, if only we could use more. Or that movie with Scarlett Johansson where she suddenly can do all kinds of cool stuff with her brain. How do you react when people throw out that fact?
- [29:53]
Dr. Brian Heflinger
Well, it's wrong, because your brain, you're using a majority of your brain all the time. Because remember, you have two parts, your two halves of your brain, the right and left brain. Right. And there's something called the corpus callosum. And so your brain is communicating back and forth constantly with different parts of the brain all the time, front to back, side to side, because all your brain cells are communicating with one another. So you're using a lot of your brain, a majority of brain, all the time, because of that communication between different lobes of the brain. When people say 10%, I think they're talking about, like, capacity. Like, what capacity of your brain do you use? Well, I don't know. I mean, is there more capacity? There probably is. But as far as using your brain, you're using most of your brain all the time because there's stuff going back and forth. You know, you got billions and billions of neurons, brain cells, communicating all the time.
- [30:39]
Podcast Host
Right?
- [30:39]
Dr. Brian Heflinger
Yeah.
- [30:40]
Podcast Host
So in general, just on this note, you don't think that there's necessarily a technological advance in our future in which we suddenly can use so much more of our brain and communicate. Television, like access.
- [30:53]
Dr. Brian Heflinger
Can you access. I don't know, that kind of stuff. I think there probably is maybe a drug out there someday that could increase your capacity to learn and make new connections. I mean, by making more connections, you'll increase your capacity to do things like a computer. Right. Like, if we could, if we had room to triple our connections in our brain and more brain cells could communicate with each other. I think our capacity to, to interpret things like a computer would, would increase. But yeah, you know, that could happen, I guess. Right. But I don't know, who knows? But I don't think we're going to, I don't think we're going to magically teleport ourselves or do something like they did in that show. You know, I don't think, I mean,
- [31:33]
Podcast Host
look, as a science, as a science fiction fan and also I'm married to a neuroscientist, this is always very disappointing when you guys tell me I'm not going to be telepathic or teleporting at some point soon by unlocking the powers of my brain. And at the same time, well, they
- [31:45]
Dr. Brian Heflinger
did it in the chocolate factory, right?
- [31:46]
Podcast Host
So that's it. I mean, and as a scientist, I, I, these things are things that I unfortunately have to, you know, accept but still want my science fiction youth to, you know, have things come true. Okay, the next one. You, you mentioned the, the left and the right side of the brain. When people talk to you about the notion that someone might be left brained or right brained or that certain parts of their personality are based around the hemispheres, how do you normal normally react or handle that question, say at cocktail hour?
- [32:17]
Dr. Brian Heflinger
Well, so 95 to 100% of people are left brain dominant. Right. So when we talk about brain dominance, right. So as I'm speaking to you and understanding what you're saying, those are my dominant centers in my brain and they're on the left. But 70 to 80% of the people who are right handed, I mean are left handed, they use their other hand. They still have a right brain dominance. So that question, I don't think, yes, we say, sometimes we say that the mathematical skills are more so on our left side of our brain and maybe our artistic things are more on our right. But I don't think that doesn't hold specifically true because you have to realize again, the brain is communicating back and forth. So people aren't really that dominant one side and the other because the two brains are always communicating with each other. We have regions of our brain that are dominant but.
- [33:10]
Podcast Host
Right. And what you also grounded in is that it's handedness more so than personality in the sense that this is just an opposite kind of thing.
- [33:17]
Dr. Brian Heflinger
Yeah, like a personality. I don't know. I don't think your personality, if you're right brain dominant, what you would call right brain dominant, left brain dominant, makes a difference. I Don't know. I don't think so.
- [33:27]
Podcast Host
Well, and this, this relates to a more open.
- [33:29]
Dr. Brian Heflinger
What do you think? Because you deal cry more depth than I do. I mean, what do you.
- [33:32]
Podcast Host
No, I mean, look, what, what I always go back to is that I, what I feel like I, I go back to is the notion that like, you know, we'll see research that'll show that anytime that mental or medical health professionals start talking about what's going on in the brain, people immediately kind of increase their estimate of that person's credibility, even if what they're saying about the brain is total bs. And so, you know, and it also, I think it relates to this notion that like people like knowing their love language, people like knowing, you know, their Myers Briggs subtype, people like knowing these things that are not evidence based constructs. They don't hold up. You know, they're, you could take this test but it's not like, you know, we can necessarily link these things with predictive validity to people's success in relationships or necessarily things like that. But there's, there's this sense of kind of like wanting to have a non pathologized answer that lets you understand more about yourself as a horoscope. And I always say to people like, as much as I want to believe that I am like a Leo, you know, in astrology, astrological terms, which whenever I say that to anybody who's into astrology, they're like, of course you're a Leo. And I'm like, yes, I know, but there's kind of a confirmation bias and I get back to this kind of thing of being like, look, I, and this relates to kind of like I want to go with what we know about the brain. I also don't want to naysay something that we don't necessarily know yet. Because this gets also to an open ended question I know you've talked about in other spaces where it's kind of like with all that we know about the brain, like, you know, my, my wife studies emotion regulation circuitry in the brain and prefrontal downregulation of, you know, the amygdala and, and limbic structures. And so there's so much that, that she and her colleagues know about the development of emotion regulation circuitry over time.
- [35:14]
Dr. Brian Heflinger
Right.
- [35:15]
Podcast Host
At the same time as you've, I think talked about previously, you know, my question is sort of like what is thought? Where does it come from? Like how do we, how do we become in any way self aware of particular emotions prefrontally and begin to Engage in that top down process of downregulation a conscious way and where does that come from? And I will, I'll throw that question back to you. You got any ideas?
- [35:41]
Dr. Brian Heflinger
I don't know. I think so. All our brain activity is electrical in nature, right? And if the electricity stops, your brain stops. But as far as why do we know who we are and we look in the mirror and say, hey, this is. I'm Brian. I think there's gotta be some electrical pathways in there that we just don't know. I mean, because there's two thoughts, right? We talk about this, it's either gonna be something that you're, you have a soul, it's your soul and that's your, you got a soul and you're living. That soul is living in this body and when the electricity stops, the soul leaves the body. Or, or it's all electrically related. And I mean, I have to go back to like when you talk to enough people who have had an out of body experience and I've talked to a few people now when they die and they go to that and they, Everybody sees the light, Everybody sees the light. They have the very similar experience. And yet we're all human. So I wonder when, when your brain stops, when the blood flow stops, your brain as the cells are dying, do we just have the same electrical sequence of events that leads to these vivid visions of light and going to heaven and feeling peaceful and feeling loved? Or is it, or did they go to heaven and really see that or wherever. I'm just saying. But is it an electrical thing that all humans are just innate, their brain is set up to do that when it's dying? Or is it something more than that? I don't know how we would ever know that, Smbi, you know, but it's,
- [37:09]
Podcast Host
it's such an interesting question because look, you know, I, I wrestle back and forth with a particular dialectic and my own philosophy, which is just that, you know, and I say it's philosophy because I don't, I don't believe this necessarily. Science based in the sense that like there are days when I'm very much on the side of, you know, anything that's unexplained is just where science has not yet shown the light. There are also days where I come face to face with a more spiritual kind of aspect of myself that says I can't possibly believe I'm the most powerful force in the universe. And so, you know, when I, when I come face to face with that particular dialectic, you know, Talk about thinking. I really believe that between folks like you, folks like my wife, others who study the brain, our chief science officer, who loves diet Dr. Pepper as much as you do, you know, his colleague Dr. DiMartino, you know, others, that at some point, maybe some of these folks might be able to help me understand how the electrical impulses in our brain become or get translated into a perceptive experience in which our brain somehow fills in gaps that electrical impulses themselves cannot manifest.
- [38:22]
Dr. Brian Heflinger
But.
- [38:22]
Podcast Host
But that there is. Is some scientific explanation for the way.
- [38:26]
Dr. Brian Heflinger
I'll give you. So, yeah, just give me three minutes here. So this is a story so easily. So when my son died, it was within the year of him dying. I kept a boat on lake area at the place called Cedar Point. It's a big amusement park. It's got the most roller coaster, huge roller coaster. So anyways, my friend and I went up there and we were on the boat. We decided to go into the park. So we walked by three separate things. I think the first one was called the Magnum, and then the second was something else, and the third one was a millennium. But each time we walk by a roller coaster, you know, we were talking about Brian's death and obviously was fresh on my mind, and I was. We were just talking about how would he communicate? Like, how would do people. Can they communicate after they die? And how would he communicate? So we went that first roller coaster, and the line was like two hours long. We said, you know, we're not going to wait two hours. So we walked to the back of the park. We're still having this conversation all about afterlife death. Brian, my son dying. Get to that next one. And it was broken down. The ride. It's a really good ride. It was broken down. So then we move on to the third one, the millennium, and we're still talking about this whole concept. And that's like an hour and a half wait. We said, screw it. Let's just go back to the boat. So we walk out of the park, right up by the marina, and all of a sudden, I get a message on my phone that alerted me of a new Facebook text. And it said, this is a. This is a friend of Brian, of my son. My son was in golf, heavy into golf, and this guy played golf with him. And I've seen this kid for a long time, and he's texting his girlfriend saying, let's go to Cedar Point, and I want to ride those three roller coasters in that order. So he said, the Magnum, whatever. The other one was in the Millennium in that order. And what are the chances that. What are the chances I'll get that text right? When we got done with that discussion out of the park of this kid who knew Brian, a Facebook alert goes off on my phone. I look at it. He says, I want to go to Cedar Point and ride this ride this ride. And in that sequence that we walk by him, and we're having that whole conversation about how would Brian communicate with us if he were going to. Now, that could be an exceedingly rare, you know, coincidence, which it could be, but it could be something else. And I don't know what it is. A lot of people will think either way, but I have to believe that was so weird. That's. That's 100% true story. And I've had. My wife and I have had several things similar to that that have happened, and I. You could say I wished it, but I can't wish somebody Facebooking me fricking. And why did it even go off? Why did I get notified at that moment about a Facebook thing? It was just the weirdest thing. And Bill swear by. He's right there with me, my friend. But I think there's things out there that we just can't explain yet. I really do.
- [40:57]
Podcast Host
And for those of our listeners who are listening rather than watching us on video. My eyes are tearing up. My skin's getting cold. But I'm like, I think about this a lot in terms of how I can open myself up to experience, because what I just got a vision of was, you know, this notion of, like, have you seen the movie Interstellar?
- [41:14]
Dr. Brian Heflinger
Yeah, I love that movie.
- [41:15]
Podcast Host
You know, there's. There's this moment where he's in the Tesseract, and, you know, Matthew McConaughey's character is, you know, touching on this gravity, you know, kind of manifestation that allows him to communicate back across time, you know, with his daughter Murph's bookshelf. And I just had this image of, like, you know, a Brian. Granted, I've never met your son, but a Brian, somewhere in the universe, saying, like, I'm gonna just knock an electrical impulse that just, you know, lets my dad know and his friend Bill that, like, you know, we're. I'm watching. And. And I'd like to ride those roller coasters, too, by virtue of my friend's message here to his girlfriend. Because, I mean, to your question of, like, how would one communicate and make it clear that they are. It's gonna be nonlinear. It's not gonna be something we can fully Understand, but, but think of all
- [42:01]
Dr. Brian Heflinger
the things that had to line up in that little sequence of events. Thinking of all things that line up those three things in a row. They, you know, there's, there's like 15 roller coasters there. So that person picked those three in a row that we went by. We're talking about my son Brian dying. It's just, it's. What are the chances? They're astronomical. Those things are all line up and then I get a text from a friend of Brian who golf with them. It's like, it's the weirdest thing.
- [42:25]
Podcast Host
Well, this, this gets back to, to, I think also as we're discussing so much, the value of experience and wisdom across this discussion. You know, in my 20s, I suffered very much from a kind of smart kid syndrome of believing that like, you know, everything was going to be discoverable. Science will discover all, and if we just continue to apply that particular tool, I will know all things and be so much smarter even by the end of life. Whereas becoming at peace with the unknowable and yet the mysterious and fantastic, something I think you get a little bit more appreciation for over the course of life. I'll just say that one thing that also makes me think of is that, you know, my, my six year old daughter's a great believer in unicorns and fantastical animals. I talk a lot with my 9 year old son about Cryptids because I want to believe the Loch Ness Monster and Bigfoot, you know, exist at some level. And my daughter's very aware that. My wife and I are very science focused. We are very focused on kind of like facts and things we can see and like, you know, hypothesis generation and proving things. My sister, on the other hand, is a very spiritual free spirit. She is a reincarnation of a Celtic faith spirit, Morgana, mixed with a number of other faith backgrounds. And we've got, we got lots of stuff going on. When my daughter asked me if unicorns were real, I said, honey, I have no proof that unicorns exist or have existed on Earth. That was literally the answer that I gave her. And my wife kind of frowned at me for being so concrete. When my sister visited my daughter for the first time and my daughter said, do you believe in unicorns and fairies? My sister said, I am one and I can help you talk with the fairy world. And you know, and I think about just like the notion that at that moment I was transformed into kind of thinking like, well, who am I to necessarily say that my sister hasn't discovered, you know, some ability to move through that particular place.
- [44:12]
Dr. Brian Heflinger
But isn't that true? I mean, think about it. Just because you can't see something, does it not exist? There's so many things in our world that you can't see, but they're there. I mean it's like, you know, there's just things that we don't know yet, we don't understand. And I mean, I think there's. My wife and I have come to the conclusion, especially after Brian, that there's just more, there's more out there that we don't know about. And if we're that narrow minded to think that we're the all be know it all here, I mean that's. I think you're short sighted in that.
- [44:40]
Podcast Host
Well, what this gets into. And then I promise I'm going to bring us in for a landing here. What this also gets into is I wonder your perspective on this when, I mean you did a. You have a great video I think on, on Instagram where you're teaching about the lobes of the brain. And one thought that I always have when, you know, we're talking about this, it's kind of like, you know, we have this somatosensory cortex. We have these different sensory inputs into the brain and you know, all kinds of ways of processing sensory stimuli. What if none of it is necessarily comprehensive to the sensory stimuli that we could have? Like, do we ever think about whether or not our brain is constructed only for the sensory stimuli that it is constructed for or whether that's even a complete. You know, I don't know if I'm saying this right.
- [45:24]
Dr. Brian Heflinger
What are we missing? Well, just like in the movie Interstellar, I mean, we're not picking up on that. You know, what are we missing? What senses don't we have? I mean, look at, look like a dog. I mean, what is it, 10,000 times the amount they can smell than us? Think of all the stuff that they sense that we have no idea of. So I, and that notion that there
- [45:42]
Podcast Host
could be other senses in a brain that's differently evolved as a different life form because I think the limits of perception are hearing, taste, seeing, smelling, you know, and that's, that's all input.
- [45:56]
Dr. Brian Heflinger
I can feel tangibly.
- [45:57]
Podcast Host
Yeah, right, absolutely. And my brain's constructed to construct my reality that way and to believe that's kind of the limit. But then is there the possibility that, you know, in fact I am not perceiving and completely ignoring all kinds of other input that could have evolved differently as a brain?
- [46:15]
Dr. Brian Heflinger
But how do you explain People like, what about a kid? You can say, you know, 8,765 times 10,225 and they can instantaneously tell you what it is. Now 99.999% of the world could have no idea even what that number could be. But how do those people. What's different about their brain? You know, there's things that we just don't understand. I mean, what are the connections in their brain that allow them to do that? You talk about access. So they've accessed some, they've created some pathway in their brain or access something that allows them to do that that we can't. I'm assuming you can. I don't, I shouldn't speak for you, but I can.
- [46:49]
Podcast Host
Oh, of course, I don't mind, but that's what I'm saying. It's like this is, this is always so fascinating me and this, this is also a point that I emphasize in almost every talk to parents, educators or policymakers is that like, you know, to believe that we are at the pinnacle of all science is complete fallacy that, you know, we, we still don't know so much and like, you know, we're, we're talking and it's like, you know so much about the brain, you literally save lives every day. Related to how what you know about the biology of this organ and how you can, you know, work on this. You know, I, I'm sitting here trying to read everything I possibly can to understand things like sensation, perception, thinking, you know, all kinds of things that are medical and mental health overlaps. And yet still, it is astounding how much we still have as a gap in our understanding and our conscience.
- [47:33]
Dr. Brian Heflinger
Yeah, well, I think it's, it's like Star Trek, right? You know, how they operate on people and scan them. But I think we're going to be there someday. Someday, I think. You know, there's so much going on right now just with all the technology we have in medicine that's so advanced. I mean, but it's, it's stuff 100 years ago, no one could even fathom the stuff that we have now. It's just because you can't see it or think of it doesn't mean it's not going to happen. So I, there's so much promise for the future and things. It's going to get there eventually.
- [47:59]
Podcast Host
This is where it comes full circle. Star Trek is my favorite television show and interestingly, two things about that show that help us come full circle. Our producer Chad, who's been pumping his fist at your wisdom. The entire podcast just turned me on to a podcast that is done by Star the Next Generation's Number two and Data. Oh, you know, talking about sci fi things just earlier this week. And when I start to experience symptoms of panic on planes, one of the first things I do is hum the theme to Star Trek Deep Space Nine. Because it is such a comfort show from my childhood that I still hear that theme in my head when I start to get a little bit nervous, you know, on a plane in the midst of a job that I love, that I get to travel a lot for.
- [48:47]
Dr. Brian Heflinger
And does it work?
- [48:48]
Podcast Host
Just have to fly?
- [48:49]
Dr. Brian Heflinger
Does it work?
- [48:52]
Podcast Host
What works for me is radical acceptance. It is the notion that I am on the plane already. I have made the choice to be here. And so at some level, my job. And I think you hit on this in your videos about panic attacks. My job is to take a deep breath and decide how I would like to have this experience. Because at the end of the day, I can watch Star Trek or Game of Thrones or I can panic, but I'm in a situation that does not involve danger. And so I'm going to take some.
- [49:21]
Dr. Brian Heflinger
But it's so hard to control your emotions and your autonomic nervous system. Like, once it kicks in, you can't just stop it. That's the problem. Yeah.
- [49:28]
Podcast Host
And that's what I'm having trouble with. Right. And it's a journey. It's one of those things that, you know, earlier on, when I was a younger man, I'd be looking for signs of distress and flight attendants and signs of distress in the pilot's updates and, you know, turbulence forecasts and all kinds of things like that. And over time, I got to a point where I realized I'm getting on the plane anyway. Whether the pilot's distressed with a nurse is distressed, whether I think I heard a problem on the wing or whether there's a turbulence. Plane's getting there.
- [49:56]
Dr. Brian Heflinger
Yeah.
- [49:56]
Podcast Host
And I'm at more risk when I'm driving the car to the airport. So, yeah, I'm going to go ahead and watch House of the Drag.
- [50:01]
Dr. Brian Heflinger
Yeah.
- [50:01]
Podcast Host
Yeah. All right. Well, look, on that note and on the note of bringing us full circle on how we deal with panic, it's been wonderful to have you join us. The way that you share about the interwoven aspects of your expertise, your personal history, the kind of, I mean, for any of our listeners, if you're looking for more of this and you're sitting here thinking like, oh, my God, Dr. Brian was so wonderful to listen to, rest assured. There are. First of all, there's a podcast that's four hours and 17 minutes that you did with Dalton. I forget his last name on YouTube.
- [50:31]
Dr. Brian Heflinger
Yeah, right.
- [50:31]
Podcast Host
That we get. That we can find that talks about even more of this stuff in more detail. Not to mention that you're putting out Instagram videos at a great clip that include a lot more of your wisdom and kind of, you know, experience here. So thank you so much for joining us.
- [50:45]
Dr. Brian Heflinger
Yeah. Well, thank you. I totally enjoyed it. It's fun talking to you. And thanks for having me on.