#879: How to Reinvent Yourself and Make Bold Moves — Decisive Stories from Matthew McConaughey, Steve Young, Samin Nosrat, and More

24:38Next up, Suleika Jawad. Suleika Jawad is an Emmy award-winning journalist, an artist, and the best-selling author of Between Two Kingdoms and The Book of Alchemy.

24:51Tim Ferriss:it's based on some of the reading that that i've done and also in your ted talk you had four hour naps in the middle of some days you still had to make visits or you did make visits at least to the er at points i'm curious to hear how you related to expectations of you perhaps so outside of sort of the physical aspect, did you feel there were certain expectations of you after, let's just call it beating cancer, and then a dissonance between sort of the reality of your experience and what was expected of you? If that question makes any sense. Absolutely. I remember the day I was discharged from the hospital and was finally done with these four years of treatment, getting a slew of text messages congratulating me on being done.

25:49And that seemed to imply an endpoint that I very much wanted, but didn't feel necessarily true or accurate because there were so many unanswered questions that I realized I suddenly needed to figure out, like the ones you just named. How do I hold down a job if I need to nap for four hours in the day? How do you begin to date when you're coming out of an experience like this and you still have a port in your chest? Or do you bring up a cancer diagnosis without potentially scaring somebody away? Is it responsible for me to consider long-term commitments like marriage or children, given my high likelihood of relapse?

26:35Those were the questions I was swimming around in. But the other piece of it that I began to grapple with are the ways in which the hero's journey arc is projected onto survivors. There's this notion that when you emerge from a trial or a big trauma, you are better, braver, stronger for what you've been through. But I didn't feel brave. I didn't feel strong. I felt wrecked by this experience and had no idea who I was or how to find my way forward. And what I'd expected to be the kind of final act of this illness experience, which was being cured, was actually the beginning of a very different kind of healing.

27:32Tim Ferriss:Please say more. I would like to encourage you to continue. What do you mean by that? In that first year after treatment, I was hell-bent on moving on from this experience. I wanted to be a quote-unquote normal young person. And I remember looking to my friends almost with an anthropological sort of eye, thinking to myself, like, what does a normal 27-year-old do in trying to do those things? Almost as if I was kind of play acting. And, you know, I'd go out dancing with friends and then pay for it with three days in bed. I would try to force myself to write about something other than illness, to come up with something new and I just couldn't.

28:23And what I came to understand is that moving on is a myth. You don't get to compartmentalize your most difficult passages and stow them in the past. You don't get to skip over the hard work of healing and grieving and recovering and really uncovering who you are in the wake of that, and that instead I was going to have to learn to move forward with this experience, with these imprints on my body and my mind, and to learn how to integrate them in my present. So I started thinking about the language of ritual and the rules of rites of passage. In these transitional moments, we have birthdays and funerals and weddings and bar mitzvahs.

29:19And mourning periods. Yeah, and mourning periods. These ritualized ceremonies that allow us to shoulder complicated feelings that help us cross the distance between no longer and not yet. And what I realized was that there is no 12-step program. There is no rite of passage for when you survive a trauma like illness and that I was going to have to create one for my own. And so that's what I did.

29:50Tim Ferriss:As Tim takes a long inhale, because there's so many questions I want to ask. I don't want to interrupt your train of thought, but you mentioned no one gets to skip the hard work of grieving, recovering, and or in some senses, uncovering the trauma or the difficulty through which they have passed, I would love to hear what type of work, whether it ended up being hard or otherwise, ended up in retrospect being really valuable. Were there any particular things you did, types of therapy you experimented with, anything at all that really seemed to help with those checkboxes. These are the things that must be done before you can pass go.

30:38Tim Ferriss:You don't get to skip these seven steps. Was there anything that really stood out as valuable or helpful in terms of that work? So the truth is, I didn't do much of that work that first year. I had done therapy while I was sick. I had gone to support groups for young adults with cancer. But in the aftermath of that experience, because of that projection that this was supposed to be done, I didn't have in place those same kinds of support systems and structures. I think when someone gets diagnosed or when someone loses a loved one, if you're lucky to have friends and family, everyone rallies around you in that moment of acute distress.

31:31But in my experience and the experiences of so many other people that I've befriended or interviewed, it's the quieter weeks and months after that are the hardest because you don't have the cavalry running after you and you're left to your own devices. And so all those sources of support that I had created for myself or sought out in treatment, I no longer had in the wake of treatment. And so I really had to invent my own. But this notion of recovery is something that I spent a lot of time reflecting on. The word recovery implies a return to something. And I think in that first year, I was really trying to return to the person I'd been pre-diagnosis and very quickly realized that that person no longer existed.

32:32and that though the word may be implied otherwise, recovering wasn't about a return to the old. It was a kind of brute, terrifying act of discovery. And what was helpful was I met a doctor who I was actually interviewing for a story and we got to talking and I explained to him some of the things I've been struggling with. And he said to me, it sounds like you have post-traumatic stress disorder. You have PTSD. And that was a revelation to me because I thought of PTSD as something that's reserved for veterans returning from war or someone who has experienced a kind of violence. It hadn't occurred to me that it also applied to emerging from a long period of life-threatening illness.

33:25And once I actually understood what it was that I was feeling, once I removed any expectations of what this post-cancer experience was going to be like, and I actually was able to confront the facts of what was happening face forward, then I actually began to create a plan for myself.

33:48Tim Ferriss:What did that plan look like? And was it mostly focused then at that point on the present state awareness of this possible diagnosis of PTSD? So rather than being trapped in the past, trying to revert to this pre-illness version of yourself that no longer existed, did the plan focus then on this diagnosis or possible diagnosis of PTSD? What did it look like? The simplest way for me to say it is that I understood I needed time to heal, which wasn't something that I'd allowed myself. I'd been pushing myself to figure out what I was going to do next and to kind of get back into the motions of living immediately.

34:33But more than that, what I understood was that I needed to learn how to feel safe again in my own body. I write in the book that when the ceiling caves in on you, you no longer assume structural stability. You have to learn to live along fault lines. And so that really became my work. I wanted to feel safe in my body. I wanted to learn to become my own caregiver after years of being dependent on other caregivers. And more than anything, I wanted to carve out the time and space to figure out who I was and what that path forward was going to look like for me. So what I did was I started by confronting a smaller fear, but still a pretty significant fear for me, which was learning how to drive.

35:31And so that's what I did. I learned how to drive. And as I began learning how to drive, I started dreaming of going on a long road trip. And as I began dreaming of that, I began to imagine a solo cross-country road trip. And I didn't just want to go on some kind of touristy boondoggle, but I was really seeking out people who could offer guidance in this strange kind of limbo in between place that I found myself in. And so I ended up making a list of about 22 strangers, all of whom had written to me in response to my column about all kinds of reckonings and interruptions in their own life. And that's what I set out to do.

36:22I had this newly minted driver's license, which I'd had for about a month. I rented out my apartment and used the funds from that to pay for my road trip. and I reached out to all of these different people to let them know I'd love to meet face-to-face and I left home into the unknown next up Samin Nasrat Samin Nasrat is the James Beard award-winning author of the New York Times bestseller salt fat acid heat also the title of her acclaimed Netflix series.

37:02Tim Ferriss:Why was the food market so quickly popular? Or were there any particular reasons that come to mind? I think part of it was timing of it. So what it was, was I was really good at making pasta. That's like, I lived in Italy for two years. I made pasta every day for 10 years. I really love making pasta. And when the restaurant closed, I would sort of bump into people in town and they'd be like, well, we really miss your pasta. And I really enjoy the beautiful sort of manual labor of making it and the folding and the cutting and the whole thing. And so I thought, well, what if I cut out all of the parts of having a restaurant that I hate and I just make the pasta and sell it to people?

37:41Tim Ferriss:So I had these friends who had a commercial kitchen that was empty a lot of evenings. So they let me use it. And I was like, okay, well, how do I sell this pasta to people? So this was, I think it was 2009. So it was before, I think it was before Instagram or certainly before Instagram was really big. And I maybe had a Twitter with like five followers, but like really Facebook was the main thing that I used. And so I think I put on Facebook like, I'm going to sell some pasta. Does anyone buy it? And I made a Google doc and people started buying it. And so I opened a little like Shopify storefront where people would order this stuff online.

38:17Tim Ferriss:So I would know exactly how much to make because a big thing in food is it's already so hard to make money. And really, if you're not efficient in terms of every decision of how much labor and ingredient, you'll really lose money. So by sort of taking my orders in advance, I knew exactly how much to make. Nothing was going to go to waste. And then people would come pick up their stuff. And so then very quickly, it grew from just pasta to pasta and sausages to pasta and sausages and cookies because everyone else that I knew who was an unemployed cook who maybe wanted to start their own food business also wanted to do these things.

38:51Tim Ferriss:So we started doing this and all of a sudden it became this like online marketplace where you could pre-order and prepay for your food and then come and pick up your stuff like a week later. It was sort of this way to get beautiful restaurant quality stuff at home. But it was before, it was certainly before caviar. It was certainly before like a lot of these internet food things. And it was also before Good Eggs, which is like a food tech startup that was sort of born out of this thing. And so it was definitely like one of the first online order your food thing. I don't know. It was just a weird time.

39:26Tim Ferriss:And so then we had a mailing list from the restaurant and I started sending it out to that. And very quickly, because the press sort of was like very interested in this weird way that I was operating this thing, the mailing list grew to like many, many tens of thousands of people, way more than I could support. And so it was just, it was a whole thing that grew out of control beyond the resources I had very quickly. And so I was always struggling to keep up and that became such a source of stress. All I had wanted to do was to make some pasta. You know, like... Yeah, it's funny how things... And all of a sudden I'm like managing like 9 ,000 business licenses and permits and health department and, you know, taxes and sales tax.

40:08Tim Ferriss:There was just like... vendors and vendor infighting and people wanting their beans vegan or whatever. Like it was so much more than I ever wanted to do. And it took so much energy and I couldn't do it anymore. I knew I couldn't do it anymore. So you have this feeling, I can't do this anymore, which I think a lot of people have. And yet they keep doing it, right? For a long time and maybe forever to a certain extent. Now, while this is happening, you have these maternal instincts kicking in, which make you feel obligated on some level to help these people who, at least in your head at some point and in their heads, depend on this income.

40:51Tim Ferriss:Do you remember the meal, the drinks you had with a friend, the walk you took where you're just like, you know what? Fuck it. I have to close this down. When you went from thinking about winding it down to like, okay, tomorrow morning, that's it. I'm doing it. I'm pretty sure it was therapy. Yeah. Okay. All right. I'm pretty sure it was therapy. And I'm pretty sure I realized, I think the like thought that sort of like really hit my body that I realized it was that I had by that point spent 10 years cooking. I had been wanting to be a writer for, you know, since I was 15 years old. I finally had a chance to make the time to be a writer I even had an office that I had that I shared with other writers like I had everything in place but because this thing was ruining my life and making me miserable I couldn't do the thing that I always had wanted to do and was like basically ready to do and not that it was some easy thing to just go be a writer because like what I was going to write I ended up writing blog posts for yogajournal.com for$25 like it wasn't so much income or anything.

41:59Tim Ferriss:It was just this, I knew that this thing was making me like emotionally and almost physically ill. I just had to stop. And I think now I'm just so much more attuned to that moment, to that feeling of knowing like this thing is bad for me. And no matter how many other people it's good for, it's making me sick and it's making me feel really bad. So I think I try to be a lot more aware of that. And sometimes now I get into situations or projects or jobs where like that feeling comes up again, but I'm already in it. And often now a lot of the work that I do is temporary. I do one project, I do one article, I do one story, I do one whatever.

42:39Tim Ferriss:So now for me, it's more about learning and being really attuned to what's happening. Even just for example, in the process of making the show, like I had never made a show before. This was this incredible opportunity that came to me. I was so excited and felt so lucky to go make it and go do it. And I still feel so lucky and so excited. But a lot of things happened throughout the making of the show that I was like, oh, this doesn't feel very good or this doesn't feel very fair or I don't ever want to be in a situation like this again. And so now that I know what's possible, like I know that one negatively and also positively, I know what to ask for and I know how to articulate that.

43:18Tim Ferriss:And so I will forever insist on working with a lot more people of color in the future. Like I'm going to insist on making sure that I have a lot more power creatively in anything that I do. I realized I became very frustrated when I didn't have as much power as I needed or wanted. So there are just things like it's a constant learning thing. Nothing's perfect. We figure things out as we go. And like we try to do our best. And like what is failure? I don't know. I mean, it's not that big of a deal, especially if there's some sort of positive takeaway that you have. And maybe my therapist would be really proud of me.

43:54Tim Ferriss:Maybe it's really bad for me to even say that my therapist would be proud of me. But I do feel like all of these stories and all of these experiences really always come back to me sort of paying attention to my feelings. Yeah, here, here. That's something that I've also personally been working on because I think I muted my feelings or viewed them as a liability for so long. And I've realized, holy shit, you cannot spreadsheet your way out of everything. No, me too. Nor into everything. You really have to pay attention to that. I mean, I think about that all the time. I came from a culture that's very much about sort of appearances and not very touchy-feely in a lot of ways.

44:36Tim Ferriss:I came from a family that wasn't super touchy-feely. So what did I learn to do? I learned to shut down all of my own feelings. And then I made my way into a profession who literally tells you to shut down your feelings. Like when you're a cook in a restaurant, you don't have time or room or space for feelings. Not only emotional feelings, but if you actually burn or cut yourself, there's not time or space to address that. You just sort of wrap your hand up and keep going. Next up, Dr. Martine Rothblatt. Dr. Martine Rothblatt is the founder, chairperson, and CEO of United Therapeutics, a biotechnology company she started to save the life of one of her daughters, and a pioneer of satellite radio.

45:22Tim Ferriss:you seem to be good at many things of course just based on the bio alone but what strikes me is how quickly you are able to develop expertise in new fields and i'd like to use this as an opportunity to bring up what was mentioned at the very beginning of your bio and that is united therapeutics, a biotechnology company. She started to save the life of one of her daughters. I'd love for you to provide some context for this and tell a bit of the story, just because people will want to hear it. And then the follow-up, just to plant the seed for it, is how you learned biology. Because my understanding is you didn't have much in terms of background in biology.

46:15Tim Ferriss:That's a huge mouthful of a question, but if you could give us a bit of the background, that would be extremely helpful, and we can use that as a jumping-off point. Sure. So, it's kind of funny that you can go all the way through undergraduate at a great place like UCLA and never be required to take a life science course, but that was the case. So the last biology class I had was in high school. And here, suddenly, I was faced with a situation as an adult while running SiriusXM that our youngest daughter is diagnosed with a fatal illness. She can't even walk up a couple of stairs to the front door.

46:59And there are no medicines approved for it. I finally got her to the best doctor one could find, the head of pediatric cardiology at Children's National Medical Center in the middle of Washington, D.C. And the doctor said, you know, this is an extremely rare disease. No one knows why it arises. All the patients die within two to three years. He had only seen two or three other kids with it, and they both died. And all you can do is hope for a lung transplant. So Tim, I was completely crushed. I just saw black. I didn't know what to do. And the only thing I could think of doing while she was in the intensive care ward night after night and myself and Bina would tag team staying there with her was once she fell asleep to go down into the library and to just begin learning about what was this illness she had, which they told me was called pulmonary arterial hypertension.

48:01And why were there no treatments available for it? So I just began reading and reading and reading. Most of the time I read things, I didn't understand what they were talking about because there were these long medical words and chemical words that I never learned in law school or we never had to deal with in electrical engineering. But of course, there were dictionaries, and I looked up the words in a dictionary. And they had college-level anatomy textbooks. So what I didn't know, I just kept going backwards in academia, I guess you would say, backwards in learning or pedagogia, until I would even get to a high school-level textbook that would explain something.

48:45And I said, okay, I get that. And I kept taking notes and just educated myself night after night until I learned everything I needed to know.

48:55Tim Ferriss:How did you, and I know this is a story you've told before, but ultimately in searching for possible solutions, as we were chatting about before recording, there's a lot of luck involved. and it doesn't mean that your path is replicable by any set of parents who are caught in a tragic situation similar to what you experienced. But nonetheless, you were able to ultimately track down, I suppose it's fair to say, a molecule, a drug of some type. Would you mind describing for listeners the process then of attempting to secure the ability to utilize in any fashion this drug or to license it? If you could describe that, I have a number of questions that will stem off of it.

49:43There are a gazillion articles published on every type of medical research you could imagine. I mean, it's just a bottomless well. There are literally hundreds of different types of medical journals, and each of those journals have, you know, every year thousands of articles published across them. So it's difficult to find the information that you need. But in law school, we learn a very useful skill. This skill goes by the name of shepherdizing after this type of index that they have in law school called shepherds. So what shepherdizing involves is when a judge writes a decision, like the Supreme Court issues a decision, they drop a lot of footnotes.

50:31And of course, one thing lawyers love to do is make footnotes and references. And then what you're supposed to do as a good lawyer is to look up all of the footnotes and the references that that Supreme Court or lower court case referred to. And then the shepherdizing process is after you get all of those references to then look up all of the references in those other articles. And ultimately, you get to a point of diminishing returns where three, four, five levels down, the references are all circling back around on themselves. So I applied that shepherdizing process to these medical articles.

51:13And somewhat like doctors, whenever a researcher publishes an article, they make footnotes and citations to other people's research who they relied upon. So I would get all of those articles and read those, and then I would follow up on all of the references in those. Finally, I read about a molecule that a researcher at GlaxoWelcome had written in which they described testing this molecule for congestive heart failure, and it failed in its test of congestive heart failure. It did not work. But in the article, they had charts of what the molecule did. And the one thing that the molecule did that grabbed my attention was that it reduced the pressure between the lung and the heart, which is called the pulmonary artery.

52:03It reduced the pulmonary artery pressure while leaving the pressures in all of the rest of the body perfectly fine. Well, that's exactly the problem with pulmonary arterial hypertension, the people who have this disease. I'll make a quick footnote that when my daughter was diagnosed, 2 ,000 people in the U.S. had the disease because medicines have become so much better and because we've been able to, like you mentioned in the introduction, get all these approvals. There are now 50 ,000 people in America alone living with it. So it's likely that people listening to your podcast will know somebody or another who has pulmonary arterial hypertension.

52:47I read this article and I said, wow, just when I need this tiny stretch of artery, just between the heart and the lungs, this molecule somehow talks to that tiny stretch of artery and leaves the whole rest of the body alone. That was the holy grail that I was looking for. So I looked at where the author of the article was from. He was from GlaxoWelcome in Research Triangle Park, North Carolina. And I made a beeline down to him and asked him if he could develop this molecule that he'd found for my daughter's disease.

53:22Tim Ferriss:Was it an immediate handing over of the keys to the kingdom? A big all-caps yes? No, it was actually a big all-caps no. So, unfortunately, the individual who had written the article had actually retired a few months earlier. And the person that I ended up meeting with who was in charge of research and development said that this was just one article. It was an incidental finding. In any event, this disease afflicted so few people, it was completely unrealistic to expect Glaxo-Welcome to develop this molecule. for my daughter and other people with that disease. And I asked him, his name's Bob Bell, he's now a venture capitalist and very successful gentleman.

54:10I asked Dr. Bell, I said, what would it take for you to develop this medicine? He said, well, it probably would take, you couldn't do it. We only develop medicines if they have more than a billion dollars a year in revenue potential. He said, but it's possible you could buy it from us If you had a real pharmaceutical company with real pharmaceutical expertise, I could then introduce you to the business development people at GlaxoWelcome. So over the course of the next several months, I created a brand new biotechnology company. I was able to have a Nobel laureate who was formerly associated with GlaxoWelcome become head of a scientific advisory board.

54:55and I re-approached Glaxo Welcome and I said, I have all the things that you asked for. Can you sell me this drug and we'll develop it ourselves? Well, Tim, it turns out that everybody I asked said, well, you have to get somebody else in the company to agree. And that's how it is in a big bureaucracy. It turned out that we had to have 15 different executives sign the same piece of paper to agree to license this drug to me. Finally, it happened. And all they wanted really was$25 ,000 and a promise of 10 % of any money that I would ever get from this molecule. I think they agreed to that only because I kept bugging them.

55:39I was in their face all the time. Also because I believe a serendipitous factor was that Dr. Bell's sister had contracted a form of pulmonary hypertension from the time I first met him toward the end of this process. And he became a product champion for me within Glaxo Welcome. I mean, that was just purest luck or serendipity, whatever you want to say. And then they really didn't think this molecule had any chance at all. And they were really just doing it to get rid of me, I think. But still, all 15 people had to sign After we successfully developed this molecule, we have over time paid more than a billion dollars just in royalties to Glaxo Welcome because that molecule has saved thousands of people's lives.

56:28It has produced a billion dollars a year in revenue year after year after year for us. and Bob Bell, when I invited him to our 15th anniversary, he came with his sister who was still alive and on our medicine and he said this was the absolute best transaction that Glaxo Welcome had ever done. Last but not least, a conversation from 2017 with Debbie Millman. Debbie Millman is one of the most influential designers working today, according to Graphic Design USA, an author, an educator, and the host of the pioneering podcast, Design Matters, now celebrating its 21st year. The exercise that I do now with my students, because they're quite a bit younger than I was when I was doing this five-year plan, I asked them to do a 10-year plan.

57:22And so this gives them a chance to really mature into who they are in their 20s and into their early 30s. And it's this 10-year plan for what I call a remarkable life. And it's about imagining what your life could be if you could do anything you wanted without any fear of failure. And they are the most life-affirming essays. They are so full of hope and optimism and well-being and goodness that it gives me a sense that humanity can be saved. and so I've borrowed that exercise from Milton and now use that both in my graduate program and

58:09Tim Ferriss:the undergraduate classes that I teach this is going to seem nerdy but I'm a nerd so I'll run with it and that is do you have any parameters for people at home who might want to try this or recommendations ways to start is it bullets or is it prose and full no it's so it's how does it And any recommendations for people who would like to give this a stab? So let's say it is winter 2027. What does your life look like? What are you doing? Where are you living? Who are you living with? Do you have pets? What kind of house are you in? Is it an apartment? Are you in the city? Are you in the country?

58:52What does your furniture look like? What is your bed like? What are your sheets like? What kind of clothes do you wear? What kind of hair do you have? Tell me about your pets. Tell me about your significant other. Do you have children? Do you have a car? Do you have a boat? Do you have, talk about your career. What do you want? What are you reading? What are you making? What excites you? What is your health like? And write this day, this one day, 10 years from now. So one day in the winter of 2027, what does your whole day look like? Start from the minute you wake up, brush your teeth, have your coffee or tea, all the way through to when you tuck yourself in at night.

59:35What is that day like for you? Dream big. Dream without any fear. Write it all down. You don't have to share it with anyone other than yourself. Put your whole heart into it. And write like there's no tomorrow. right? Like your life depends on it because it does. And then read it once a year. See what happens.

1:00:03Tim Ferriss:It's magic. It's magic. Hey guys, this is Tim again. Just one more thing before you take off. And that is five bullet Friday. Would you enjoy getting a short email from me every Friday that provides a little fun before the weekend between one and a half and 2 million people subscribe to my free newsletter, my super short newsletter called Five Bullet Friday. Easy to sign up, easy to cancel. It is basically a half page that I send out every Friday to share the coolest things I've found or discovered or have started exploring over that week. It's kind of like my diary of cool things. It often includes articles I'm reading, books I'm reading, albums, perhaps, gadgets, gizmos, all sorts of tech tricks and so on that get sent to me by my friends, including a lot of podcast guests.

1:00:49Tim Ferriss:And these strange esoteric things end up in my field, and then I test them, and then I share them with you. So if that sounds fun, again, it's very short, a little tiny bite of goodness before you head off for the weekend, something to think about. If you'd like to try it out, just go to tim.blog.friday. Type that into your browser, tim.blog.friday. Drop in your email, and you'll get the very next one. Thanks for listening.

1:01:18Thank you.