This One Episode Will Change How You Think About the World & Your Life (From #1 Cancer Surgeon)

24:44Mel Robbins:Well, what's interesting about you is that you are talking about a playbook and what you're describing is not really knowing where it's leading, but paying very close attention to how things feel right now. And those moments when something brings you alive? In your words, that kind of fire inside you lights up. Well, specifically, it was avoid moral injury. And then the step I remember doing was a minus one plus one. What does a minus one plus one mean? That I got rid of one bad habit and then I put myself out to do something like it was a combination of close this box and open up another box.

25:29Not the massive crossroads we're talking about, but on a daily level.

25:32Mel Robbins:So give me an example. So at that time, you know, we were partying too much and I just, I closed that box. It didn't mean I stopped. I just pushed it to the week. I mean, I dampened the indulgences. Yep. And then I started volunteering at San Francisco General Hospital. I take the BART, met some different people in the BART. It was a small, small change this way, small change that way. And at a neuroscience level, you know, your brain is generating this electricity. It's never calm. The measurement is always on. So either it's going to go this way or that way. It's got to be directed. It's not just going to rev down.

26:08I know a lot of people are going to say, no, I feel calm and clarity. But electrically, it's on. So I was just shifting it from indulgences to still something captivating from one habit or practice to another. So that was some knobs I could turn that got me out of that pattern I was in that needed to change, which was a growth mindset really for me.

26:35Mel Robbins:So is there a mindset that the person who's listening right now could start to build or practice that could help them go after more or shift things in their lives? So part of the playbook in my mind is first to be aware of what's going on in your life. So I think there's a lot of good advice out there, but there's like advice and real world scenario mismatch. So you have to know, am I in a storm? Am I in a crisis right now? So there's advice. And Mother Nature is like that. You know, there's a winter and there's a springtime. You got to know where you're at. And so there was a time where I was just like felt like I was drowning.

27:19and if it's a crisis, now I'm in crisis management mode. And my patients have that when they hear the C word, I have that. And so there are some rules around that. So that's a mindset. And then there's a, okay, I'm not in crisis. Now I've got bandwidth and now I wanna take chances. I wanna dare, I wanna grow. I wanna bring in these practices, whatever it is, meditation, taking walks, all those things that I hear about, those are practices. They're not going to help you in a crisis. So this crisis is maneuvers.

27:55Mel Robbins:Amputation. Amputation. What can I get rid of? Survive. Breathing techniques to not freak out. So the mindset is first asking yourself, am I in crisis or am I where I need maneuvers? Or is it springtime where there's some relative stability and I need to come up with some practices that make me better for when the next crisis hits or for the changes I want to make. There's too much like, you know, when the crisis at that time with the neighbor and my mom, that's not a time for me to start taking up a meditation practice. You know, there's or for patients for my patients. It's not when they're diagnosed or the first few weeks of surgery.

28:34It's survivorship. I had cancer a few years ago, but I can't stop thinking about it. So there's a different mindset for survivorship and practices, and there's a different mindset for crisis and maneuvers during that time. I think that's the way to think about mindset is to first know where you're at. Otherwise, that flood of information, you don't know where to apply it.

28:58Mel Robbins:You know, I actually love that because I think a lot of times we skip over that step and don't slow down long enough to just say, well, let me just even ask myself, what am I dealing with right now? Because advice is going to be useless if you have no time to apply it or you are in crisis management mode and you can come back to that. No, there's so many people who live and threaten their own home. We see, you know, when people get hurt, they come to hospital. I don't work in a clinic. I work in a hospital. And I think it would surprise people how many of us live. And you can't tell. It's rich, poor.

29:35You know, it's not like you don't know. And so, again, that person has to identify. It looks like I got it all, but I'm under serious threat right now. And I need to have crisis management techniques, rules for survival rather than rules for self-improvement.

29:53Mel Robbins:Yes, that's very true. And you got to be very careful about what you decide you're going to amputate in those situations. Because it's easy for somebody who's not under threat to say, just get rid of the threat. But it's not so easy at times. Because it won't grow back. I mean, I went back to college, but those amputations lead to changes that are permanent for most people, whether it's relationships or careers and that sort of thing. What would you say to somebody who feels very lost right now? and they're kind of thinking about, well, am I under threat or am I just kind of in this mode where I need to understand I got to make some intentional changes?

30:34I would say if you're feeling lost, I've been there, you know, and not, uh, and not in the distant past, you know, that's not a, that's a place you'll find yourself often in life, especially if you, um, want to engage life fully. I'm 53. I've been working in hospitals since 25, 26. I have felt lost when I have searched for an outcome, like rather than an opportunity. If you hitch your mental health or your self-worth or the story of your life to outcome, it's going to be frustrating. You know, either you're not going to be aiming high enough or you're just going to be constantly looking at it the wrong way.

31:26And so I saw that in Nicaragua where another friend of mine is the head of children's brain surgery at San Diego. We were doing surgery down there. And mom had taken a bus for like 20, like, man, I can't remember, brought a kid with no shoes on. And once she got her child just across like almost like the threshold to the hospital, in a later conversation, she would tell the nurse that she did it. That was the opportunity. it didn't matter what the outcome that kid did well but a lot of kids with cancer don't do well but she wasn't like and if my son lives forever and if my son is cured in her mind that she had brought her to her his her child to a hospital where brain surgeons from america you know america is a light it had come to uh and that her she got her child in managua nicaragua two brain surgeons of America plus the, and then, so what I learned from there is don't, don't count the wins, count the shots, you know?

32:35And so if you want to be unstuck, take some shots, but don't, you know, don't anchor yourself on, on the outcome. If the shot goes in.

32:45Mel Robbins:Dr. John Deale, I am so grateful you're here. And I'm particularly grateful that you are with us right now, listening or watching, whether you're the one going through a difficult time or not, you know somebody who is. This episode is a life-changing resource, a reminder and frameworks for the people that you care about to be using right now. Please, while we take a short break, be generous. Text the link to this conversation to your family group chat. Share this with friends of yours who are going through a difficult time because we all deserve to be reminded that we have within us the ability to use the tools that Dr.

33:25Mel Robbins:John Deall is sharing with us to get through the difficult moments. There is so much more that Dr. John Deall will teach us when we return from this short break. So stay with me.

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36:53Mel Robbins:Welcome back. It's your friend Mel Robbins. Today, you and I are learning frameworks and tools for how to get through some of life's most difficult moments with one of the most renowned cancer surgeons in the world. His name is Dr. John Deall, and I'm so thrilled that he's here, and I'm also excited to talk about some of the things that your patients have taught you about what's important about life. So one of the things that's interesting about your career is you have treated and operated on thousands and thousands of patients with a cancer diagnosis, with a life-ending diagnosis, what are some of the biggest takeaways about how to live a happy, fulfilling life that you've learned from your patients?

37:42Yeah, so just for your, I love what I do. I chose to do this when I had opportunities to take care of less sick people. When you're in medical school, you choose sick or not sick, and then you choose procedure or not procedure. I do big operation. They come to me for operations and they're extremely sick. And I take care of patients who have stage four cancer. And what we're trying to do is land this crashing airplane. And so I don't have patients that I still know because they're gone. And so from what, 2004, I don't know, 25 years, I was younger than them. Then I was the same age as them. Some of them are younger than me.

38:36I was growing up. I was raising three sons. They're in their 20s. And I chose cancer surgery when I had an option of different types of surgery to do. And I know I'm a neurosurgeon or brain surgeon, but in my heart, I'm a cancer surgeon. and most cancer cures begin with surgery and it's just so visceral like he's a well i love for my sons to be like father and cancer surgeon and what you see during that process in the beginning you just try you know you're taking you you want to you want to be the best at what you do and you and you have to realize that this you can never get the risk to zero there will be turbulence on the way to the moon this is not a flight to san francisco on southwest where you expect to land it every time you know i'm saying like so that's i know you're like he just went there no that's that's this but that's that captures you're like there will be turbulence you know and so you want to and so what i realized is that you know i hurt people the least that this this operation will have a three to four percent complication rate and i'm trying to get it to two i can't get it to zero which means you will have complications and that you're still doing a service i had a hard time wrapping my head around that because when you meet somebody and then they wake up and they can't talk they can't move um you know that that this it's been difficult especially with children and it's not an oops moment it's you can't get it to zero if you're going to fly to the moon you know you you will crash and burn sometimes it's not a mistake um and so well the tumor you're trying to remove has done the damage it's right and and the art there is to get as much of the tumor out as you can, but not injure the person.

40:21See, that's the art of surgery is you're reverse sculpting. There are people who can take it all out, but the patient doesn't do well afterwards. And then there are some people who just go in there and don't take enough of it to give them the best lifespan. We call it peak and shriek. They look at it. They're afraid that they pull back and that's okay. So the patient's perfect, but the cancer surgery hasn't been done to the highest level. And some people get all the cancer out, but then the patient wakes up injured. So there's a lot going on there. But complications for me were difficult because, you know, in children particularly, because it felt like a failure.

40:58I didn't have the scale to understand that I'm going to try to help thousands of patients. I've seen 15 ,000 operate on 5 ,000. And I'm trying to be the best I can for that whole group of patients. I can't tell which one's going to have a complication or not. It's not an oops moment. That took me some time to wrap my head around that. And I only removed myself from that, whatever all of that caused me. First, I was overly competitive or I was emotional. It was just a lot there. until I started to see that maybe all of this was an opportunity for me to understand humanity, to understand patience, to understand life, to understand suffering and to write about it.

41:43So this thing that we're doing now in the last five, six years is what has helped me not get PTSD from all these sick people I've been taking care of is that they're sharing their life with me as as part of a fabric I'm stitching to share a story with other people.

42:01Mel Robbins:What has your patients who are near the end of their life, who come to you as a cancer surgeon, taught you about living life now? More time with family, pursuing things, reconciling, not reconciling. But what I'm seeing, what I have seen is that all of that is external. And in the end, if they start talking and they say, I wish I had, they're not coping well. And then, but some of my others, they say, I'm glad I did. They're coping well. And I started to see this pattern that some of the ones doing the best in my mind, I'm like, you're doing great compared to some of the other people I'm saying, but their brain was stuck.

42:54Their life story was stuck. with, I wish I had. I wish I had gotten screening earlier. I wish I had gone to a different place. I wish I had not, you know, smoked. I wish I had. And then there were others who weren't doing as well. You would think the people doing well are going to be like, I'm glad I did. But there's a mismatch there. It's a perspective on your life. It's your own, the story you write for yourself.

43:21Mel Robbins:Well, Dr. John Deal, I want to really unpack the mindset you just taught us. And I want to make sure as you're listening or watching that you didn't miss it. And it's the difference between having a mindset where you say, I wish I had versus I'm glad I did. Can you just talk more about the power of that? I'm glad I did and what that means. well what i'm learning um yeah and from my own life too you know that things haven't gone um smoothly for me um but i'm glad i did drop out of college you know i'm glad i did have a marriage i'm glad i did uh go into cancer surgery and and um and it's not because all those decisions went well, man, some of that stuff was painful, but, um, and it took effort because in those, it's not like I'm born with this disposition.

44:22I'm actually, I don't like school. I didn't like reading. And I always took a negative angle on everything. And I was competitive and I felt easily slighted. I didn't begin with this, you know, I'm, I'm no saint. This is not about that. It's that it's been just a dial I'm turning for a quarter century and choosing experiences that built my identity. But what I want people to know is those cancer patients are not falling into like, oh, rosy disposition says I'm glad I did. They're fighting for that. Their fight is not just with the cancer, but the fight is with the way we think about our world, our life, because you don't know what's around the corner.

45:08There is no moment of arrival. There's only being prepared, having some strategies, some coping skills, right? So we're maturing through life. And then having the ultimate, ultimate gift is to write your own story in your own mind and not by other people. And that's what they're doing. Everybody's like, oh, how are you doing? You have cancer. They hate it. They're like, oh, if another person asked me about my cancer, you know, they wear a wigs to hide all of that stuff. But in their mind, when I see them, I can see the wheels turning that they're taking this imperfect life. And they're like 40s and 50s with cancer.

45:45Of course, that feels like the worst luck. But they don't come in depressed. If you went into this, you would think, oh my God, it's got to be the saddest thing in the world. They're heroes. They come in, they come in dressed up. They're telling jokes. They found a way with a cancer diagnosis, through effort, through faith, through spirituality, through friendship, they're directing their life story this way. Because if you don't, you're just going to spiral. And that's the responsibility, I think, that we have in our position is to equip people with that, that there's no shortcut that is possible.

46:28There's no secret steps. Cancer patients have taught me that it's a direction of your psychological energy to write the story of your life as you want it told, and more importantly, as you really embrace inside your own mind.

46:46Mel Robbins:Well, it's also, and I love that phrase, the direction of your psychological energy. Both of the story that you want to be told, but also of the story you want to experience as it is unfolding. Because what you're also teaching us is that when it comes to things that are out of your control, and I think we can all agree, all of the decisions that we have made in the past are over. The cancer is here. The divorce has happened. The school has been dropped out of. The drinking for however many years, whatever it is, you cannot control what has happened, but you can control how you talk about it and how you look at it.

47:32Mel Robbins:And so even the framework that you use through your own life, you could have said, I wish I had never dropped out of college. I wish I had not gotten a divorce. I wish I had this. I wish I had that. Or you can say, I'm glad I did. I'm glad I did. Because in that reframing, I'm glad I did, you have to force yourself to see either the lesson that you learned from it or the experiences that you could have only gained in it. And it's an active process. It is your prayer. It is your cognitive behavioral therapy. It is the argument you must make to yourself. And it's, I'm glad I did, and then populate that with, because of this good thing happened.

48:16Then I met Mr. Jet. Then I met this. Then I did this.

48:19Mel Robbins:Or because I learned this about myself. that, right. So it's not just four or five words or whatever. It's an approach to thinking. And so when you talk about cognitive behavioral therapy and that cognitive restructuring to looking at perceiving and looking at things. So these are consistent things between Marcus Aurelius and meditations and stoicism, where people are talking about, you feel what you allow yourself to feel, or you have Buddha and Eastern philosophy, or you have cognitive behavioral therapy where it's cognitive restructuring and monitoring. It's all the same thing. You're controlling the direction of your psychological energy.

49:00Either you are focusing on something and focus, like holding your breath is a skill that you can learn, or you are learning to be non-judgmental and let all these experiences pass you like little boats on a river and not biting on everything. For me, it was both. I was biting on too much when I was young, wilding out, reactive, impulsive. So I had to learn that there's a temporal nature. Like I know something's coming up that I can't deal with and I need to brace myself for it. So there are strategies directing your focus. I wish I did and filling that bucket and then also using that focus to actively monitor but not judge.

49:42These are Buddhist and behavioral therapy techniques. So what I'm seeing is all of these different things that the people are hearing in the wellness community on a practical level, my cancer patients are doing it and it all comes down to the direction of your psychological energy. And amputating something from your life is another tool because if you are filling your life with too many things. Absolutely.

50:10Mel Robbins:I always say if everything's important, nothing is. Well, that's what we talked about. Yes. Amputating something pulls the direction of your psychological energy toward the things that matter. Because your psychological energy is limited. It's not infinite. And it has to be matched to your real world scenario. you know if everything's good distribute all of that juice to all the good stuff but sometimes you got a brace for the storm when i operate sometimes i'll come around a corner on a tumor and there'll be a blood vessel and i know there's four more hours of work that just kicked up and there's a risk for the patient and i gotta i gotta i gotta go into uh escape the free fall mode so this is a very practical thing whether you are a navy seal or complex surgeon or you get that email that says we have layoffs and I need to see you tomorrow.

51:01You know, when it hits you, the best thing you can do is control your breathing. And what you want is at that time just to pace your breathing, okay? So that's what I do in surgery. That's what Navy SEALs do. That's what deep divers do. And that's what people, that's the built-in resource. The simplest way that I had somebody explain to me He was raised like, oh, so you don't hyperventilate and panic because hyperventilation leads to panic. So at that time when you want to panic. And what you're doing is first you're directing your psychological energy to controlling a reflex that's called breathing.

51:45And so you're practicing your focus, your ability to focus. It's a skill. Attentional power is what I call it. And then number two, what you're doing is you're relying on a physiological mechanism that prevents hyperventilating and those slow, deep breaths. There's a whole science that I can explain is going to keep you from having hyper excitability of your limbic system. The point is, do not let yourself breathe too fast. When you blow off the carbon dioxide, you will panic. Then you will not be able to deliver your maneuvers. So for me in surgery or whenever you're about to go into a difficult situation, maybe you got in a fight, you know, you got to talk to a lover about breaking up or whatever.

52:31Just coming with pace breathing and it's a few seconds in, it's a few seconds hold and it's a few seconds out. Now, what I will tell you is if you think you're going to do that when you get rocked, it's not there for you because you haven't been rehearsing it. You haven't made that ritual. So when I park my car in my spot, and so that's the mindset, that's the playbook for when the crisis hits.

52:56Mel Robbins:Well, Dr. John Deale, what I like a lot about what you said, there's a lot to unpack, is this concept of controlling the direction of your psychological energy and attentional power. Attentional power. And the power that you have, even in the storm around you, whether that's a patient that comes to you and gets a terrifying diagnosis, or it's the email that you get that layoffs are coming and there's a meeting tomorrow, or the sound of somebody saying, I don't love you anymore, this is over. like so many moments what I really appreciated about what you said was just simplifying it down to slow down your breathing don't worry about technique or seconds or just in slowly out slowly and I also loved that you are suggesting that there are moments throughout your day that you can leverage attentional power and settle yourself and calm yourself or even create an intentional transition, whether it's before you get out of the car, you're just gonna breathe in and breathe in.

54:09Mel Robbins:And there's nothing going on. Five minutes. Yeah, that's it. There's nothing going on before you walk into the house. Before you walk into the room, you're just gonna breathe in and breathe out. And what you're saying is, if you start to leverage this little tool in your life before it's going sideways. It'll be there for you when shit goes sideways for real. Yes, because we all know the more emotional and reactive we get, the more screwed we are. Yeah, you got to practice. Game time is not going to be the only time, right, that you want to run those drills. So it's practical. And again, cancer patients are doing it, Navy SEALs, and it's there, it's free, it's universal, it's for all of us.

54:48And there is a, just briefly, you know, there's an anatomical connection that sort of mediates all of that. It's not woo-woo. I mean, we - What's happening?

54:57Mel Robbins:Like at the highest level, what's happening when you breathe in and you intentionally like control the direction of your psychological energy by suddenly? You're releasing your own, the pharmacy in your mind. You're releasing your own volume and you're, it's an anxiolytic. It's so we always hear about, just to get a little science here, we hear about a lot of neurotransmitters, but it's a big cocktail up there. And a lot of neurotransmitters will actually depress the electrical energy of your mind a bit. You know, they're excitatory, but there are also some that depress it, and that's called GABA.

55:31It's used in Valium to actually break seizures, out-of-control brain electricity. And so what is clearly demonstrated out there, whether you tickle the vagus nerve here or you control it naturally with pace breathing, you're increasing the release of GABA that's sitting there already in your brain and mind. That's the science behind it. It's not even exotic. It just hasn't been explained.

55:55Mel Robbins:That's super cool. Thank you for sharing that. And I want to thank you for spending time listening or watching this right now, because I know that everything that Dr. John Deall is sharing with you and me has the ability to change your life. So thank you for being here. Thank you for sharing this with the people in your mind that keep popping up and don't go anywhere. We have so much more to dig into after this short break, so stay with me.

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57:09Mel Robbins:It was amazing. And because my brain wasn't fried, I had the energy to sit down and eat dinner with Chris without feeling mentally wiped. That's the whole point for me. Microsoft Copilot clears the clutter so I can be more present for the moments that matter. That's why I'm using it. If you want to try it for yourself, visit Microsoft.com backslash Mel Robbins to download the Copilot app. Get started with Copilot today for free. And see how handing off the small stuff gives you more energy for the moments that matter. That's Microsoft.com backslash Mel Robbins. Let me tell you something. No one wakes up fearless.

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1:01:23Mel Robbins:welcome back it's your friend mel robbins today you and i have the extraordinary honor of spending time learning from dr john deal and he's teaching us all of these frameworks that he's learned as a cancer surgeon about getting through some of life's most difficult situations and really leveraging the power of your attention to focus on what truly matters. So Dr. John Deall, I would love to have you share what you have heard your patients talk about in terms of what matters most about life when time is limited and what kind of comes into focus that people wish they had prioritized more. They're on a mission.

1:02:07Many of them have children. They're not even thinking about a cure. They have said to me, and this has been my experience. I understand a lot of cancer surgeons out there, doctors, a lot of patients. I'm just telling you what I'm seeing. Their prayer is just that they make it to where the kids finish high school and get out of the home because they don't want their children to see their mom pass away while they're in high school. It's a specific finish line that they're going for. You would think, no, they want a cure. They're Just like, this is what I really need. The older ones, when the kids have moved on and they've got their own lives and, you know, they forget to call on Mother's Day or Father's Day and you have that fuss, whatever.

1:02:47Their perspective is more that, again, when it didn't hurt anybody, that they wish they would have been more bold with their hunches and their instinct. That maybe I should change my direction. Maybe this isn't working for me. Maybe, maybe, all those maybes that were like, you know, that were almost like a 50-50 or a 60-40. Not the, it's a choice because it's unclear. Do you want to win the lottery? Not, no choice. Thanks, I'll take it. You know, it's not, choices are because it's a crossroads and it was unclear. So it's not so much the amputation I talked about, because that's more of crisis choices.

1:03:27Mel Robbins:Yeah. It's more of the subtle meandering through life, you know. Maybe I should have lived here rather than there. Maybe I should have done this rather than that. They felt like they weren't, they could have been more bold in pursuing their hunches and their instincts. They never say, whew, I'm glad I was practical and conservative. I mean, maybe not never, but you know what I'm saying, though. I know what you're saying. Because then they look back and they say, it's a short run. I should have taken a few more chances. As long as they're not like, you know, hurting other people or, you know, gambling it all the way.

1:04:02But it's the subtle navigation in their life. They wish they were that all the pivots. They wish they would have been a little bit more emphatic and bold. That's my that's what I'm seeing.

1:04:12Mel Robbins:So I would love to have you speak directly to a family member who may be listening or a loved one who has somebody in their life who is dealing with an illness. What do you want the person who's the caretaker to know, Dr. John Deall? That if you find yourself in the most trying and difficult situation, you're not alone. The person next to you may not have been there, but they will in the future. And the person next to you might look like they're coping, but they could have endured that in the past. and that our struggles and our triumph at the level of the brain are quite similar. So you're not alone and there are resources for you to get through this with support, with love, with direction.

1:05:11But ultimately, it's those private moments in your life that you only share with yourself that you need to prioritize.

1:05:18Mel Robbins:I would imagine that given how much surgery you do, how many patients you've treated with cancer, that you've just seen extraordinary resilience. What have you learned about resilience and that human beings are so many times just so much stronger than they think they are? So it's a word that's been bugging me for a long time because it's not what's thrown off. It's just thrown around like I don't even know what it means anymore, you know, but. What does resilience mean to you? Well, there's an engineering definition, which is the ability to return from deformation or like a bridge shifts and it comes back.

1:06:01Then there's a psychological definition that's more appropriate. And that's resilience doesn't mean just coming back to what you were. It means coming back stronger, more fortified. And so in the psychological sense, there are two types of resilience, and they're systemic and processive. Systemic means what you're bringing to the fight because of all the cyclical nature of crisis and springtime, crisis and growth, struggle and growth that you banked, that you've rehearsed your skills on. So now you're bringing something to the next fight, the next struggle. But then there is also a processive resilience, which is what the fight brings out in you.

1:06:51They're not tough until they get hit. They're not tough and resilient until they face the cancer diagnosis. And I've seen that. You think people are like, oh, they're going to fall apart inside your mind. and the crisis brings out something in them. I like to feel like that's what happened in my life at age 19. And that's a tricky thing to say because I don't want cancer. I don't want these things. None of my patients do, but it's what you bring the fight. But if you're not doing well, this fight is training you. So you're not lost no matter how you're dealing with your life. Either you're practicing and feeling good about coping or, hey, this is rocking your world and teaching you a lot that's going to prepare you for what's coming up.

1:07:38Mel Robbins:Dr. John Deal, what are the best recoveries that you've seen in terms of like the things that they have in common or even if it's not a recovery, the best meeting of the moment? So sometimes cancers and injury will paralyze, like Christopher Reeve will paralyze patients are sometimes their legs are paralyzed but they have their arms the injuries like around their belly button and the brain can't talk to the legs and the legs can't send sensation up to the brain and and some of those injuries are either total and there's no chance uh and or some are partial they've got flicker of movement and the the lesson there for for for patients and people is it's in the first three months that they get the bulk of their function back.

1:08:28The ones that get it back the most are the ones that are sitting there trying to move their leg and the leg isn't moving. They are sending electrical signals through the damaged spinal cord, landing on the muscles ready to go. It's just not getting the spark. So they are directing their psychological energy towards moving a leg that won't listen. And they do it and they do it and they do it and there's nobody there. It's not when physical therapy comes in and then I, because I see them in gaps and all of a sudden they're coming back with movement. And it's all of that work they did when they saw no result.

1:09:03Just imagine just trying to flicker your foot and it doesn't move. And you're still trying, you're still trying, you're still trying. So the recoveries that impress me are not biological. It's, and I always tell them, You're training for the Olympics. This is boot camp. This is the window to go for it. Things won't look like they're moving. But the continued effort is the only way you will spring back to life in your legs. And so those are the kind of things I wish people would know is there's a lot out there. And the inspiring thing is if the injured brain can heal, and I don't mean heal like some magical thing.

1:09:45I mean, and it doesn't regrow. It's not liver. You don't pop up a new part of your brain. But if the injured brain can recover, what about our healthy brain?

1:09:55Mel Robbins:So, Dr. John Deall, after watching people recover, like you just described, from a devastating brain trauma, what do you wish everybody understood about how change truly happens in life, in the brain, in general? Well, I think we can go backwards. We can talk about it in the brain. and they're for life. Sometimes the children will have seizures so ferocious from both sides that they have to be on a ventilator. Otherwise they can't live. And the only option exhausted through everything else is to remove nearly half of their brain. It's called, people can look it up. It's a hemispherectomy. And usually it's on the right side because language is on the left.

1:10:40So you take the right side, the surgery is done. They're able to wake up because you took the right side, the left arm and left leg is, is, is out. It's paralyzed. And, and then, you know, it's a large part of the brain that you've removed, removing a hemisphere. It's like, and this has been going on for a long time. So I'm bringing insights from all different facets of my life and things that I'm reading. Then a couple of years later, there's an extreme example to set the precedent. They'll come back walking. It happens in children, more difficult in adults. Um, and what's interesting there is when you take a brain scan, it's hollow.

1:11:21The part that you cut out, it just filled with brain fluid. It didn't grow back. The leftover neurons, uh, repurposed the, the dancer became the soldier. It's the neuron. You didn't grow. So I always get thrown off when people are like rewire plastic. I don't understand what that means because these kids, they don't regrow that part we took out. It stays hollow. What's left over does a new job, takes on new functions and such. And the way that happens is with this thing called myelination. So when we're going to get into that, how change happens is if you have a sudden, if you do something once, the way it works is why change for that?

1:12:07Because it's unlikely to happen again. But the constant direction of psychological and energy will make the original effort not have to be as strong once you deposit myelin. So just stay with me for a little bit. So the neurons are like molecular microscopic jellyfish. You're spraying electricity at each other. and the way once you think a certain way, once you behave a certain way to reduce the energy usage, they'll start wrapping omega-3s as fatty sheets, like insulation around the tentacles. Okay, so think of it as like, if you keep going down the same groove from the top of a mountain, you tend to fall down that groove.

1:12:58Well, there's a cellular basis for that. And the brain will do that as a response because it wants to now, you know, have this action occur without using up so much fuel, efficiency, neural efficiency. Otherwise, well, we're using up so much fuel just to tie our shoelaces. At some point, you want to tie your shoelaces. Not really think about it. And when people get Alzheimer's, they can still tie their shoelaces. They can still ride a bike because it was efficiently deposited. So change takes constant but moderate effort. It's not like one big effort. It's not 10 hours to throw on the baseball to learn it.

1:13:40It's better to do 15 minutes a day. And those are the molecular cues for the omega-3 fatty acids that we all want to eat from salmon and brain diet to take the positive habits that you built and make them more likely to occur, to shift from the bad grooves down the mountain to the new grooves that you've made. That shift takes effort, but it's not lifelong effort. You put in a hard couple of months to make that change. Now that change gets easier to do. Then you take on another change. You do another minus one plus one, like we talked about incrementally.

1:14:17Mel Robbins:What's one like big epiphany from all the brain surgeries that you've done that has changed the way you see human possibility? I will tell you the recently it's not it's not from brain surgery. You know what? When your heart stops beating, there's still another couple of minutes where your brain is sparking electricity, spraying or spraying neurotransmitters. it's still going that last surge gives it enough glucose and oxygen and when your heart stops after cardiac death there is not electrical silence in the brain and those one or two minutes um the brain isn't like whimpering like it's the the last thing the brain will do is launch all of its electricity and chemicals in a giant salvo of fireworks and then stop.

1:15:16So it's not like other organs where they go down. There's not like a it's not like decremental. Slowly, the heart stops beating. Slowly, the liver turns, changes color. The brain, when it gets its last pulse of blood, will just fire off. And a lot of that electricity looks like dreaming and expansive memories and that sort of things. And that might explain why if those people come back, they all share the same film strip of their life. That's cool. And that's a measurement. That's not my opinion.

1:15:45Mel Robbins:That's super cool. Yeah. That's super cool. I would love to talk more about some of the things that you personally do every single day. You know, you are a cancer surgeon. You're a father of three adult boys. You've had so many just unbelievable twists and turns to your life. You're one of the most decorated cancer surgeons around. What are the most important daily rituals to you that really help you? Or what's the single most important daily ritual that you have? The single most important daily ritual I have is that several times in the day, I rehearse my attentional focus by pacing my breathing.

1:16:32It trains my mind to focus and it trains me to get ready for that what's around the corner. Because when it arrives, when crisis arrives, it's not when you really want to pull something out of your rusty toolkit. You want to have that sharpened. And why I think that's important is when I can cultivate my attentional power, then that attentional power is useful for other things. And I'm able to shift it. Like when I'm driving, I'm like, okay, I'm thinking about my next book. I'm going to listen to some music and I rock out a little bit. I'm going to deliver attention to this. So that five minutes of directing my attention, pacing my breathing, you know, keeps the reins on where my mind is headed.

1:17:19And that way I can deploy it in a strategic fashion.

1:17:22Mel Robbins:I want to have you walk me and the person that's listening or watching right now through how we could start this five-minute practice ourselves. Because it makes a lot of sense to me that I think most of us go through life probably on autopilot, feeling super distracted, our attention pulled all over the place, putting fires up. How do we implement this today? What do we do? Step one, try. you know step two it doesn't have to be some private place because a lot of your crises and a lot of your attention is is is stolen uh when things are wild right it's not going to be in a yoga studio or in a quiet room so randomly at times during the day where you think you're stressed out or about to be stressed out or walking into a stressful situation just sort of set a timer in your mind it could be a song like i like to go for there's a certain song i use or it could be a timer on your phone.

1:18:17And just through your nose, it doesn't have to be one nostril. I mean, all of that, it's all going to the same place. And through your nose, just try to breathe in for three, four seconds. Hold. Hold for a few seconds and then slowly exhale. And then pause for something and then do that again. Let's see if you can get 10 of those. See if you get 20 of those. And if you're in public and stuff and you don't want people to know you're doing that, of like in surgery, like because my mask, my mask will fog up if I use my mouth. I wrote about that. Like in the beginning when I was learning, I was like, I was like, and we wear these glasses that are magnifying glass.

1:18:55It's like fogging up and the nurses would tease me. They're like, hey, you're freaking out over there. I was like, no, I'm not. So I, you know, I only use my nose. And what I'm trying to tell you is this overlaps with Buddhist meditation, pace breathing, directing. You have to try. You're directing your attention to do this. You're pulling your attention from something that's been spiraling and driving you crazy. So already you're redirecting your psychological energy to something positive. And so the attentional power is really a skill you can cultivate. People can learn to hold their breath.

1:19:30You can learn to hold your attention.

1:19:32Mel Robbins:I want to make sure that you got that. And so I'm going to translate it. And if I miss something, you tell me, okay? Okay, so basically it's as simple as it sounds. Practicing and building the skill of attentional power is simply at any moment, and you could do it right now. You could do it sitting in your car. You could do it lying in bed in the morning. You could do it sitting at your desk. You could do it before you walk into a room. Attentional power is bringing your attention to your breathing. And you just recommend in through the nose. Out through the nose. Out through the nose. It's not as easy as you think.

1:20:12When I first started, like four breaths later, I was like, hmm, do something. So that is what -

1:20:17Mel Robbins:Try 10. Try 10, you're saying. Try to do it 10 times. Like you could do it standing in line at the grocery store. Yeah, especially standing in line at the grocery store or whatever it is. But here's what you're going to notice is that as you're standing in line at the grocery store and like, okay, I'm going to practice attentional power since I just heard this. And I'm not going to look at my phone. I'm just going to practice attentional power. you can only pay attention to one thing at a time. And so by focusing on your breathing in, pause, out, pause, in, pause, this is how you build the skill.

1:20:49This is how you, and controlling your attention is a part of meditative practices from Eastern philosophy. It's a part of when people say get therapy, when you see your therapist and they talk about cognitive behavioral therapy, you know, you have to divert your attention to argue against the life narrative you're writing. You have to divert your attention to do nonjudgmental monitoring, they call it. Don't react, don't react. All of it takes attention. And so this skill, push-ups will help you open a heavy door. Focusing on your breathing like this and your private moments during the day will help you with all of the other things you're trying to do because it harnesses your attention.

1:21:28Mel Robbins:Could you speak directly to the person who's with us right now who's going through an extraordinarily difficult moment? So they're in the crisis mode. Dr. John Deall, what do you want them to know? You're not alone. Crisis hits our brains and minds in a similar way. And there are approaches to dealing with crisis that we've talked about today in the moment, as well as when you go home. Set your guardrails. don't make a decision tonight in crisis that you can't take back. And then the next day is when you have to sort of turn to others to come up with a plan to get through this difficult moment.

1:22:13Mel Robbins:How has what you do for a living and the patients that you've treated changed you?

1:22:23um i'm a lot less judgmental you know i just um well you know when you're younger you place your emotions on other people you um you think you know what other people are thinking or you feel underestimated and all of that stuff and it just feels foolish and immature to me now because after this many patients and all these, you know, all of their stories, what I've seen is that don't judge the rich, don't judge the poor. You don't know what they're going through. You don't know what's happening in their lives. They're in line with you next to you. You don't know. Cancer patients have taught me that.

1:23:03It's not what you think when you care for them because Because a lot of times they don't share. A lot of times they keep it inside. I just think, you know, somebody on the freeway is probably short with them or something. They have no idea they're just driving home right now after hearing they got cancer.

1:23:21Mel Robbins:If you had to just distill everything that you've shared with us today from this playbook, the mindset frameworks, the attentional power, directing your psychological energy. some of the real truths about life into the most important takeaway for the person who's listening, what would it be? That, you know, that there is no final moment of arrival. This life is not linear. It's cyclical. And, you know, in the springtime of your day or your life, relish it. Enjoy it. and during the difficult times, there are strategies and approaches that can help you cope and help you survive. It's not you alone in the dark, you know, trying to grab for a life vest.

1:24:22People have been here and they've left their mark by guiding us on how to deal with that as best as we can.

1:24:28Mel Robbins:Well, I really appreciate you leaving your mark and guiding us. in an extraordinary way. Dr. John Deall, what are your parting words? Life is beautiful because it's difficult. There's nothing guaranteed, nothing promised. Make the run you can. Relish the good times too. That's also a life skill. Yes. Well, the good times are the average Tuesday. Like if you can't enjoy an average Tuesday, then you miss the good times. Yeah, yeah. Well, this was extraordinary. And I'm going to borrow from one of your really powerful frameworks and say, I am glad you did get on a plane and you did come here and you shared all this because I know that my life will be forever changed.

1:25:24Mel Robbins:And I know that I speak on behalf of the person that's with us and everybody they share it with, their lives will be changed too. Yeah, I'm glad I did too. Thank you, Mel. Thank you. And thank you for taking the time. You put your attentional power to something that is going to help you create a better life. There is no doubt if you take anything from this and apply it, and I hope you share it with people that you care about, you will be able to manage the very difficult seasons of your life and you will be glad that you did. All righty. In case nobody else tells you, I want to be sure to tell you as your friend that I love you and I believe in you and I believe in your ability to create a better life.

1:26:06And when you do, I know you'll be glad that you did.

1:26:09Mel Robbins:I'll welcome you into the very next episode the moment you hit play. I'll see you there.

1:26:19Mel Robbins:It's amazing how dirty I get. Because I don't ever recall touching them. it's like they're snaring it it's wild just like where did that slick come from i i didn't i didn't touch the lens is that what i'm walking through the air into like spenderift is colored i didn't know that yeah i guess i always drink it out of the can i've never poured it in glass i don't mean to stare at you in a creepy way i'm trying to like hold so they have a little more room to cut trying to do my job cameron thank you mel you're welcome if our paths don't cross again a really valuable in the last hour and a half. Well, they're going to cross again.

1:26:57Mel Robbins:What do you mean, if?

1:27:04Mel Robbins:Oh, and one more thing. And no, this is not a blooper. This is the legal language. You know, what the lawyers write and what I need to read to you. This podcast is presented solely for educational and entertainment purposes. I'm just your friend. I am not a licensed therapist, and this podcast is not intended as a substitute for the advice of a physician, professional coach, psychotherapist, or other qualified professional. Got it? Good. I'll see you in the next episode.

1:27:39Mel Robbins:Sirius XM Podcasts.

1:27:47Wow.

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