Concussions, Ozempic and Leadership Through Crisis

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Save $80 with code SPACE80 at talkspace.com. Lifespan, healthspan, joy span. And, and joy span is not just how long and how well you live, but how joyous you, you live, how creative you are, how, um, cognitive, uh, you are of your, uh, uh, horizons and y- and, uh, where you are when you're working. So if you look at, uh, at any of those factors, concussions or not, single most important determinant in all decades of life w- with regard to all-cause mortality, as well as brain health, is VO2 max. And, uh, you know, it's really technical.

No, it's not really. It's really exercise. Are you b- be able, able to get, um, some form of exercise around three hours a week? Doesn't have to be the most intense, doesn't have to be, you know, sprinting, uh, running, cycling, um, climbing a mountain. You know, just walking.

Walking up inclines, walking, uh, at, and, and, and building your cardiovascular strength, um, insulin resistance, uh, importance of, of sugars, as you say. Uh, prediab- not just diabetes, but type 2 diabetes, prediabetes. You know, what's your insulin resistance? Uh, what's your lipid profile? How can you manage that?

So as you might guess, it, it all pulls together in these wonderful ways that s- if someone says, "Well, what's most important?" Uh, the answer is yes. Yes, all of the things that I just mentioned are critically important. And for an audience like yours that are y- you know, entrepreneurial people, uh, whether they're building business ventures, whether they're building a family, whether they're building their own life, their own capability and creativity and ability to think, act, and innovate, as I like to say, in, in creative ways, all those things are, are gonna be fueled by a healthy body, which drives a healthy mind, which drives the ability to think and c- make connections, uh, almost epiphanous moments that you wouldn't see if you weren't able to do that. Plus, as you know, you're, you're an athlete, uh, both a current and former athlete.

You know, you... There's a almost Zen-like, um, state that you get from exercise, um, a reflection, a, an ability to think clearly about what's going on in your surroundings, and how you adapt to your surroundings. So it's, um, mystical, but it's also highly scientific. Like a lot of people who were former at- or were athletes in high school or college, uh, you get into your life, you get into the more sedentary work life, office life, et cetera, whatever your career is, and you start to let the habits slip that kept you in shape during, uh, the times when you were more athletic. And you look in the mirror and you, you start convincing yourself that you're still an athlete or you're still in shape even though what you're seeing in your reflection doesn't necessarily say that that's the case.

And in 2017, I had this moment where I was so riddled with inflammation from eating like crap and drinking too much and not working out enough and traveling without a good plan for, for being on the road and, and all these things, that, uh, on the second day of a conference that I was, that I was putting on, um, I literally couldn't finish. Could not finish the conference. I was the emcee and I, and I couldn't go back out, and it, it changed the entire course of, uh, the, my life since then. This was 2017. Lost 25 pounds, got, got all these things.

Okay. So one of the things that I come across a lot with the clients that I coach, uh, they come to me for business related things, but oftentimes their physical health is so out of whack that s- starting to dial in on some of the mental habits or mental frameworks that I might wanna teach them from a business perspective, um, it, it, it's almost, it's almost irrelevant to talk about some of these items in a business context because their physical health is so, is, is so out of a- alignment When you, when you come across these people, or just your, your best guidance for what this might be, h- how do people get started? How does someone who has let themselves start to fade away, what are some of the small things that they can do? And, and I know you're not necessarily like a health coach or whatever, but obviously dealing, being in the NFL, seeing what, what goes on, and then getting to know so many of these guys after their careers, right? How, how do you, how do you start to get this in alignment, and what are some of the, what are the 20% things that are gonna give you the 80% results for a, for a working professional?

Excellent question. You know, first of all, when I talk about the diff- distinction between leadership and leading, leading being what we do, not what we say. Mm-hmm. Leadership is worthless because it's what you say, and anybody can say anything. Leading is what you do.

So I always tell people, the leader you're looking for is you. The answers are not above us, they're within and among us. And, and the answer is, it's never too late. It's never too late to start. The time to start is now.

The person to start that process is you. And, you know, I always tell my patients, my colleagues, um, treat exercise like a medication, because it is a medication stronger than any medication known to man, s- stronger than lipid-lowering drugs, than hyper- antihypertensive drugs, than, um, GLP-1 agonists, the Ozempics, Rybelsus, those kinds of things. All great medications, but the strongest thing that you have is yourself. And, and begin when? Begin now.

Doesn't matter what shape you're in right now, any exercise is good exercise, as long as you don't overdo it. Sure, you wanna be out of breath. If you have chest pain, then that's a different story altogether. And it can start as simply as, as you get a standup desk. Work standing up instead of sitting down.

You know the old saying, you know, sitting is the new smoking. Mm-hmm. Uh, because for a lot of different reasons. It's bad for our, our posture, it's bad for our muscles, uh, our, our hamstrings tighten up. Most people who complain of back problems, it's not their back, it's their hamstrings and their hip flexors.

Mm-hmm. You know, stretch three to five times a day at work while you're at work. A- and so movement matters. And it doesn't matter when you start it, it matters that you start it, and no one can start it for you. Other people can help you by saying, "Hey, did you get a chance to work out today?

Hey, did you ever get that standup desk?" You know, "Hey, uh, are, are you planning on having healthy snacks when you're at work?" Eh, you know, you don't have to be some kinda psychotic, uh, out there b- trying to, uh, convert the whole world. Yeah. Convert your world.

Yeah. And, and that begins as, as you do very well with your podcast to, you know, Henry Adams said, "A, a teacher affects eternity. He can never tell where his influence ends." Yeah. And I would say that's what you do with your podcast, is you affect eternity.

You don't know how many people you're affecting, but you do it, I presume, um, to help others. Yeah. Yeah. And in hopes that, um, uh, most of your guests, myself probably excluded, are trying to help others. That's why they a- are so passionate about what they do.

So, you know, the, the answer to who is you. Yeah. Yeah. Yeah. Well, I, I will say I started this podcast because I realized about a decade ago, uh, I was having some career, I don't wanna say struggles 'cause I was successful by measurables, but just wasn't feeling satisfied.

I realized that I get more pleasure out of watching the light bulb come on for other people than my own success, and that's why I became basically manic in creating and sharing and trying to take big ideas and break them down and, and, and connect with wonderful people like yourself who are willing to share their expertise. Because it- you said it, man. Like, like one person, one person hears something you say and it clicks over for them, then all the work was worth it. Like, literally all of it. I mean, that's, that's, that's why we do these things, so.

Yeah, it, you know, you can't make this up. I, uh, uh, just finished a book, uh, as you may know, uh- Yeah ... called Leadership is Worthless but Leading is Priceless. Yes. And one of the things I talk about in there is my beautiful and brilliant wife, Maureen, and I had three boys, now young men, and when they were younger, when I used to take them to school, when anytime I was in town I, I drove them to school in the morning, I always said precisely the same thing to them, which is, "One more step in the journey of discovering where your deep joy intersects the world's deep needs." Mm-hmm.

I swear I said this to them. They prefer to take the bus, as you might guess. They don't wanna hear Dad say something like that. But you have to start with your deep joy. Yeah.

Not the world's deep needs, 'cause the world's deep needs are unfathomable, they're infinite. Mm-hmm. And, and I find a lot of people who are unhappy, who are depressed, who are burnt out because they have failed to follow their deep joy. So I get asked, as you do, "What's your deep joy, Doc?" And it's helping other people find and express and live and embrace their deep joy.

Yeah. So I, I think we're saying very, very similar things in terms of, of what drives us to do what we do. I love it. Um, I wanna ask you a very technical question, just 'cause I've been getting asked it a lot. Um, you know, I'm 43 years old, I'm 6'4", uh, 190 pounds, in pretty good shape.

I work out quite a bit, eat, try to eat well. And I get... People ask me if I'm on Ozempic or if I've taken Ozempic, which I have not. Uh, I have friends that are on it. And what I found interesting about Ozempic in general is almost, to a number, every person I know who's on it doesn't really know what it does, doesn't really know why they're on it, but their doctor recommended it or someone recommended it to them.

They somehow got on this thing, and it's, quote-unquote, working, but it's, it's like they- they're not overly informed in it. And, and maybe just because I think it is a hot button item, I think there are a lot of people who are either considering this drug or recommending it and, or being recommended it, and you brought it up, maybe you could just give us a couple minutes on, on Ozempic and, and GL- uh, GLP-1, uh, drugs in general. Yeah. So this is... I don't mean to be on a tirade, but medications are great, and, and GLP-1, glucagon-like, uh, protein or peptide agonists, meaning they act that way, can be very helpful.

And, and the primary, uh, indication for that is, uh, is insulin resistance. Um, you know, glucose builds up in, in, uh, the blood. Fortunately, we can measure that not just with a fasting glucose, but with, uh, hemoglobin A1C, which is gonna give you a 30-day... You know, a, a blood sugar, fasting blood sugar is a Polaroid. It's a snapshot.

Uh, at that moment, in that time, at that day, your blood sugar was X. But hemoglobin A1C gives us a 30-day shot of, okay, this was what you, it averaged over time. So that's the way to think about it. And, and I know that Ben Greenfield and Peter Attia and, uh, Andrew Huberman and I and others, and I don't put myself at their level in any way, all say the same thing. It's a great medication for the purposes for which it was designed.

And, and what concerns me is y- you know, if somebody's taking, um, saying, "Hey, what about GLP-1s," whether it's Ozempic or anything else, and my first question is: How much do you exercise? You know, what do you eat? How do you eat? You know, uh, inflammation, massive issue. Uh, are you taking B6 and B12 in your diet to help pull, uh, inflammation?

People think of inflammation, probably a whole different episode, as, well, that's just local inflammation. Well, there's no such thing as local inflammation. Yeah. It's all systemic, body-wide inflammation. Mm-hmm.

So for the purp- you know, if, if somebody's taking it strictly for weight loss, what they're going to be able to do is look in the mirror and say, "Wow, I look a lot better, and people tell me I look a lot better." Mm-hmm. And that has a purpose. But what's inside? What is your VO2 max?

What is your cardiovascular health? What is y- your, uh, blood pressure, which is elusive for a lot of people? Uh, what is your insulin resistance? Uh, y- you know, not hemoglobin A1C alone, but, uh, what's your total insulin? And issues like that.

So, you know, fan of the drug in context. Yeah. In the context of movement, of, of cardiovascular, of muscle strength. You know, the older that you get and, and, um, let's just say you told us your age, and I would say I'm not. Uh, I won't say how old I am.

But I'm not. Uh, like you, as an athlete, the longer ago we played, the better we were, you know? Yeah, exactly. For me, I was, uh, was a lot better. But that sense of movement, uh, you know, put it all in context.

What you eat, you know, how you exercise, how you move, what's your muscle strength, are you getting enough protein? And don't just use a mirror tests of, "Boy, I look better. I've lost weight. People tell me I look better." But what's your true, uh, not just cardiovascular health, not just your insulin health, but your, uh, brain health?

Your- Yeah ... ability to move and, and, and feel, uh, productive, uh, the joy span aspect we talked about. Yeah, the journey that I went on in 2017 was all about inflammation. I went and saw a doctor, um, just my, just my, m- my general practitioner at the time, explained to her what had happened at this conference, and we did some blood work and she came back and she's like, "Your inflammation numbers are off the charts." And I can't remember exactly what the number was, but that w- those were the words that she used. Yeah.

And I had had, um... It's not gonna really translate in the, in the video if people are watching, but if you're listening, I'll try to explain it. I had so much scar tissue and built-up inflammation in my right elbow from playing baseball for so long that literally I could only get my right arm to, like, a, to, to, like, a- Sure ... 120-degree angle. I couldn't- Yeah ... straighten it all the way.

So I went and saw a specialist, and we went on a, a, ani- an... I basically just went on a diet that was all about anti-inflammation, removed anything that caused inflammation as much as I possibly could from my diet, uh, except for coffee, 'cause I was unwilling to give that up. But I figured- Yeah ... fairly negligent, uh, impact in general. But, um, and what I f- in a month, I felt like myself. In six months, I felt 10 years younger.

A year later, I felt like I was in my 20s again, and I was bouncing around the house and running and lifting seven days a week and, and, like, my, my brain was, like, on fire. Like, I don't know how to describe it to people. It was like... Uh, when I say on fire, like, it was like when you were a kid. It was like being all the way back to just thoughts connecting, serendipity, creativity, problem-solving, uh, endless energy because I just removed...

I, it was just inflammation. I went back. My inflammation numbers were, like, down at the bottom, you know, like 95th percentile, I think. And, and that alone was this enormous game changer. Um, I wanna ask you one more health question, and then I have one more question about leadership, so I'm gonna- Sure ... change.

That, that, just the inflammation piece and, and to give people, just backing up what you just said, I, I lived that. The other things, I've never tried Ozempic, I haven't focused too much on, uh, glucose levels or anything. That hasn't really been a problem for me. But just that simple thing you were talking about with inflammation changed my life. I recently found out, uh, over the winter, um, that I just wasn't feeling like myself, and I had some things happen with work and life and, you know, all these messy things.

And I was like- Yeah ... it's wintertime, I live in Upstate New York, like, you know, we're all vitamin D deficient during that time and miserable anyways, and, uh, you know, whatever. But man, I just... I've lived this, you know, I've done this cycle 43 times, and this one was different. So I, uh, did some blood work. Actually, I was listening to Huberman on uh, I think it was Rogan, and he was talking about the impact of testosterone on male bodies post age 40.

And he recommended this service called, uh, uh, Maximus. I'm not recommending them for anyone at home, he just, that, he mentioned that name. So at home blood test, whatever. I was in the 6th percentile for testosterone for men my age. I had what, I had sev- I don't know what the, what the thing was, right?

But I had- Yeah ... 77 micrograms, 77- That's way low. Yeah. Way, way low. Yeah.

So I started taking, uh, an oral that they recommend before you do any kind of like, uh, supplementation, um, in terms of like injections or anything. You know, this is kinda step one in their process. They don't like to go right to injections. And four months later, I, I'm not all the way back, but it's insane how much better I feel, workouts, the whole thing. So I, I would love if you could helps, you know, 'cause a, 'cause a lotta our audience tends to be 35 to 55 is like our primary range.

We tend to skew a little towards men, but a lot of women as well that listen to this show. But for that group, particularly for men, I think, I've talked to a lot of my friends since this happened, and I found this out, and none of them know what their testosterone level is. They don't track it, they don't work on it. They don't even think about it. They just assume they have it, right? 'Cause they're guys.

Sure. And like maybe just talk a little bit about the importance of it, how we can track it, how we can, how we can keep t- you know, keep our testosterone levels up or at least at a healthy range. Because I feel like this is something that just from what I've read, just from what I've heard, it feels like a bit of a, I'll use the word pandemic, for men in particular, that we're just operating at low testosterone levels and we don't even realize. Yeah, there's no question about it. And, and, you know, but I will say it's both men and women.

Yep. Uh, and so let me start with women first, uh, strangely enough. Yeah. You know, you don't have to be a post-menopausal woman to, to ha- understand endogenously what the effects of hormone imbalance is like. And the, the s- uh, well-meaning studies on hormone replacement therapy in, in women, post-menopausal women, uh, did a huge disservice to them.

You know, there are a lot of them that had depression, a lot of them had, uh, uh, y- you know, anger issues, uh, had physical issues. Um, and when I see a woman in the emergency department, I'm an emergency physician in addition to sports medicine, and she's got frozen shoulder, you know, she's a pens- post-menopausal woman who, yes, I can give her a steroid or PRP injection and just open her shoulder up like that. But what caused it was hormonal imbalance. So whether it's testosterone creams, you know, there's a whole, uh, suite of solutions and, and forward-thinking physicians. Uh, yours must be very good because she was interested in inf- your inflammasome- Yeah ... for lack of a better term, but also, uh, the, the hormonal balance that you're in, because as you say, most people don't even test it in the first place.

Yeah. So there's a m- uh, all these things are opening up and more and more physicians, primary care and otherwise, are beginning to say, "Oh yeah, this is, uh, uh, there's a real need." I mean, you and, people look at you and I, we're quintessentially male-looking guys. Yeah. That you would just assume, well, our testosterone must be fine.

Uh, well, no. Let's measure it, and then let's see, okay, how do we, how do we get there? So i- i- you know, I was not just a linebacker football player, but I was a theology major. Mm. And so, which is a pretty interesting combination- Yeah, yeah, yeah ... for sure.

Um, but, but how wonderful that, that the more you know about science, the more you realize these things are all tied, uh, together in serendipitous ways, to use a term- Mm ... that you used. Thomas Walpole wrote that original story. And, uh, a- and yet logically they make sense. They may be epiphanous in the way they come to us, but once you absorb them and think about them and see how your life changes as a result of changing those hor- hormonal balances, you begin to say, "I, I look better, I feel better, I move better, I think better." Mm-hmm.

"Joy span. I'm making connections that I didn't see before or wouldn't have seen before." Uh, even in, I grew up in the Midwest, so like you, I know that Persephone is the goddess not just of winter, but death as well. Mm-hmm. So, you know, understanding that, uh, seasonal affective disorder, so-called SAD, red light therapy, all kinds of, of pieces.

And I'm, I realize to some, probably a, a minority of your audience, they may say, "That, this guy's kinda wacky. He's got all this, you know, broad, uh, medical, trying to pull in all these things that traditional medicine doesn't think of." Well, bad on traditional medicine for not thinking of these connections and how they affect how we view life. Um, so we, I think we're, we're ... Thank God medicine's changing.

Yeah People have become much more forward-thinking in terms of how these connections, uh, interconnect and what they mean. Well, Doc, I thank God for people like you, Huberman, Attia, these medical professionals who 20 years ago, we'd never hear from you guys, ever. Yeah. You guys would not be out front on podcasts, in media, sharing these ideas. I mean, people love to take shots at Huberman, but the number of people that he has at least exposed to ideas that have helped them, you know what I mean?

Like, I, I, I think it's, it is a, it is, you know, the, the internet, the, the broadness and, and massiveness of information can be overwhelming, but at the same time, uh, it has helped me in so many ways personally be able to find things, get exposed to ideas, and particularly why I love having individuals like yourself who are more health and fitness related on the show is 'cause I have told my clients, I've told every team I've managed, your health is a competitive advantage in business. Now, obviously it's incredibly important, uh, what you said, joy span, health span, et cetera. But if you're simply just a pure capitalist- Yeah ... type A driven, make money at all costs type of person, which I have no problem with that either, your health is a competitive advantage in that space. And you know, I look at, I ... When I sit down at a business meeting and I look across the table, if I'm negotiating with someone and I see that they're out of shape, they're sweaty, I know I can outlast them.

I simply know that I can outlast them in that meeting, and there will come a point when they become tired, frustrated, irritable because they're not in good shape, their fitness is not together, their mind is foggy, maybe they're hungover, et cetera, that I can just beat them in that place because I know I can, I can just be more present and more focused longer than they can be. And for that reason alone, guys, take everything that Dr. Tom is saying incredibly seriously. We, we, we can't leave our health simply to our physicians. I think physicians are amazing, and I am not knocking them in any way, but I think we need to take more ownership as well.

Um- Yeah, yeah, to be clear, I mean, my father used to say, my dad was a World War II veteran, um, and, and a, you know, not a traditionally educated man, but full of wisdom. And he used to say, "Son, you can teach Sunday school and make money. There's no reason you can't do both. There's nothing wrong with either one of those." Yeah.

So I do believe in, in purpose, in, in joy span, and a sense of a deep joy to which we connect our lives. But I've been, I've had multiple, uh, entrepreneurial businesses, both in, in healthcare, in ambulance companies. I continue to invest in opportunities that I think will help broaden horizons for other people. And, and so it's, you used the term competitive advantage appropriately, uh, it's ROI. Yeah.

It's return on investment. You know, uh, build into your schedule the exercise and the eating habits we're talking about, the testing to determine what is really your baseline, because it is competitive advantage and it's a return on investment. It's a way of being able to say, "I can't" ... Uh, uh, one of the things that's most important is, first of all, I always tell people, number one, every person is a leader. Lead yourself, lead your team.

Number two, every person is a performance athlete, no different than my 2,500 athletes in the NFL, involved in a cycle of performance, rest, and recovery. Performance, rest, and recovery. And we have badly neglected rest and recovery. Yeah. And then third, the work begins within.

If we're gonna reform our systems, we have to reform ourselves to have the energy, the wherewithal, the joy span, the brain health to be able to come up with those creative solutions because the way we're working isn't working. Yeah. Or it isn't working well enough. Could work better. All right.

Uh, I have, I have one more topic that I wanna hit with you. I appreciate your time so much. This has been amazing. Uh, slight pivot, but, uh, you were part of the crisis response team for, uh, the anthrax attack back in 2001, and y- you can go into that detail as much as you think is necessary. What I'm really interested in are your thoughts, particularly around leadership in crisis, right?

These moments in which something happens, a black swan event that we did not see coming that has drastic, severe, and urgent, um, or requires urgent response. How, how do we approach this? What, what ... How do we make sure that we are present in the moment, we do not become overwhelmed? How do we handle these crisises? 'Cause you see them on TV, and we all armchair quarterback the decisions people make, but for anyone who's ever been involved in one, and, and thankfully I've never been involved in anything quite so dire as what, as, as that situation, but to me it just doesn't seem rational to think that we would all make these perfect decisions afterwards.

And, and so how do you approach these things? How do we be the, the, the leader, uh, that, that you recommend in your book in, in these moments of severe and urgent crisis? Well, it's a great question. Um, starting maybe 10,000 feet and coming down, leadership is worthless because it's what you say, and anybody can say anything they want. Leading is priceless because it's what you do all day, every day.

Everyone is a leader. Every business owner, every entrepreneur, every CEO, but also every person within that organization, within that team. Every single mother, every mother and father within a family, uh, are leading the team of their family, and their actions matter a deep, a great deal. Figure out your deep joy and attach our, our confined, constrained, uh, uh, years of life and, and the health that we are, we are investing in, as we talked about before, in feeding that deep joy. Because we should all be leaping for joy going into work, not just going home from work.

Mm-hmm. Leading from the time we wake up in the morning and swing our legs out to say, "How will I lead today? How will we lead our team today?" So it's very much in the active voice. The Boss, and I always capitalize that, is someone who's quite convinced that he's the most important person in the room.

But the leader is someone who knows that her job is to make everyone else feel that they're the most important person in the room, that they have agency for their lives, and how they act will determine the ROI, the return on investment, in their life, whether it's a business, whether it's a interpersonal relationship, uh, whatever it is that they happen to be doing. A- and I would say there's no ... I happened to have dinner w- uh, my wife and I had dinner with, uh, uh, uh, Sully Sullenberger and his wife. She asked, you know, "What's your philosophy on this? You've been leading in times of crisis your whole life."

And my answer was, "I don't think there's any leading except in times of crisis." And she laughed and turned to Sully and said, "You guys have been talking." I had no idea what they were talking about. Mm. Sully s- laughed and said, "Well, I've always said you're not really a pilot until the engines go silent."

Mm-hmm. "Well, what are you until then?" I said. "Just a driver. Just a, a very expensive, very well-trained driver."

And that's true in our lives, you know? What are we when, before we're leading in times of crisis? We're just drivers, and that's no place to be. You know, where we wanna be ... But you don't have to live the life I've lived.

You don't have to have been at the Pentagon on 9/11, led the bioterrorism attack, um, the concussion crisis, the COVID crisis, going to Ukraine. Uh, next week I'm, uh, helping escort, uh, 60 D-Day veterans back to Normandy for the 80th anniversary. Wow. Just blessings. Yeah.

Everyone faces crisis. We live in times of crisis. We're in what I would call the perpetual white water of change. We go from change to change to change to change to change. And the question is, are you going to be the author of the change in your life, or are you gonna let somebody else be the author of that change?

Are you going, uh, to proactively say, "These are the changes made"? Because innovation does not occur at the speed of intelligence, creativity, or genius. It occurs at the speed of trust, the ability to trust others. Because if you're serious about innovation, and we all should be, you innovated your life when you learned what your testosterone levels were, what your inflammation levels were, and you chose to make changes. You chose to innovate within that in the midst of that crisis.

That crisis is no different, maybe in, in location. I would say it's not actually in magnitude. The stage is different. But, you know, lots of folks, as you know, just keep doing what they've been doing, and, and that's not gonna work. We've gotta be able, uh, to understand that most people don't mind change, they mind being changed.

And that's why I say the answers are not above us, they're within and among us. And so that, um, imprimatur to be able to say, uh, "Who's the leader you're looking for?" The leader you're looking for is you. One follow-up question to that. I'm gonna use the both positive and negative response to Jordan Peterson as a, a benchmark for this.

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