Team,
I just sat down with one of the most accomplished neurosurgeons alive.
He runs one of the top brain institutes in the world. He takes the cases no other surgeon will touch. He has clipped over 5,000 brain aneurysms and performed more than 10,000 operations. He works with Neuralink, putting chips into the brains of paralyzed patients and watching them move a cursor with a thought. He has held living, thinking human brain tissue in his hands more times than almost anyone on earth.
So near the end, I asked him the question I most wanted answered.
What do you do to protect your brain?
Here is exactly what he said.
“I don’t take a single supplement. I don’t do any of that.”
Let that land for a second. The man who has seen more of the human brain than you or I ever will, who could take anything, who has access to everything, takes nothing from a bottle.
What he does instead is almost boring.
He sleeps seven hours, without fail, every night. He exercises first thing every morning, before the day can steal the time. He is careful about what he eats. And he protects the people and relationships around him.
That is it. Sleep, movement, food, connection. The four things you already know, done by the one person who has the most authority on earth to tell you they are not enough. And he is telling you they are.
I have been saying a version of this for years, and it still hits differently coming from a man with his hands inside people’s skulls three days a week. There is no secret. There is no supplement he knows about that you don’t. The people with the most knowledge are doing the simplest things, relentlessly.
He also said something that stopped me.
He believes that in twenty years, we will look at alcohol the way we started looking at cigarettes in the 1960s. Something we all did socially, without much thought, that turns out to be quietly damaging the organ we most want to protect. Coming from him, that is not a wellness opinion. That is a warning from someone who sees the damage up close.
And then there is the part that sounds like science fiction and is already real. He walked me through the patients who cannot move their arms or legs, who now control a computer with their thoughts alone. One of them races a cursor across a screen faster than a healthy person can. He thinks we are at the beginning of treating things we never thought neurosurgery could touch. Depression. Addiction. One day, maybe, Alzheimer’s.
This was one of the most remarkable conversations I have had on the show. It moved between the far future and the simplest possible truth, and both were coming from the same pair of hands.
If you want the future of the brain and the four things the best in the world actually does to protect his, this is the episode.
TOPICS DISCUSSED
00:00 Intro: The Brain Surgeon at Neuralink's First Hospital
00:39 The Guy Who Does the Cases Nobody Else Wants
02:17 A Day in the Life: 5:30am Starts and Three Surgeries
03:20 "Game Tape": Reviewing Every Operation Like an Athlete
04:24 The Surgeon Athlete and Why Surgery Is a Physical Skill
05:32 Fifty Years From Now: What Happens to Neurosurgery
06:11 The ROSA Robot and Mapping a Seizure Focus
08:16 Deep Brain Stimulation and Hitting an Exact Target
08:52 Will We All Be Operated On by Robots?
10:02 The Brain AVM: The One Case a Robot Can't Take
11:18 Why Bleeding Breaks a Robot: The Waymo Problem
13:15 What a Brain-Computer Interface Actually Does
14:49 The Hand Knob: 108 Electrodes in One Small Spot
15:50 Cursor Control at World Record Speed
16:31 Inside the Implant: Threads a Tenth the Width of a Hair
17:27 "No, the Chip Cannot Read Your Thoughts"
17:58 What the Device Really Reads: A Train of Spikes
19:18 From Movement to Sensation: What Comes Next
19:48 Why Restoring Sight Is So Much Harder
20:58 The 1943 Paper That Predicted All of This
22:37 Elon, Telepathy, and What's Actually Possible
23:00 Boosting Creativity and Intelligence in 50 Years
25:10 "When I Retire, We'll Be Treating Depression and Addiction"
26:04 Alzheimer's: Light Therapy and the Blood-Brain Barrier
27:11 Treating the Disease vs Preventing It
28:25 10,000 Operations: How He Feels About Robots Taking Over
29:54 Neuroplasticity: How Nolan's Brain Learned the Device
31:34 What Actually Changes at the Neuron Level
32:04 Patient Two and the Robotic Arm
32:42 5,500 Aneurysms: The Cases That Stay With Him
33:16 Cardiac Standstill: Cooling a Brain to 15 Degrees
35:46 What Separates a Great Surgeon From an Average One
36:17 Traits of Greatness: The Formula Nobody Has Cracked
37:21 The Phone Call in the Middle of a 16-Hour Surgery
39:35 "I Must Have Been Born for This"
41:26 Can You Tell How Old a Brain Is Just by Looking?
43:12 Why Alzheimer's Is Invisible in a Living Brain
44:14 What a Neurosurgeon Does to Protect His Own Brain
44:40 "Alcohol Will Be Viewed Like Cigarettes in the 60s"
45:13 Peptides, Injectables, and Zero Supplements
46:52 The Last Generation to Operate With Open Hands
48:10 How Louisa Found Him on Twitter in 2021
48:53 The Six Mysteries of the Mind
49:14 Which One Gets Solved First, and Which May Never
50:03 Is Consciousness in the Tissue?
51:39 Memory: The Circuitry We Still Can't Explain
53:18 Why Consciousness Is Harder Than Memory
55:12 Louisa's Father's Stroke
56:02 Advice for Anyone Watching a Parent Decline
56:21 His Sister's Brain Tumor and How He Carries It
57:38 A World Where Stroke Is an Outpatient Repair
58:40 Forty Years On, Finally at the Dawn
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