S10E63
· 58:39
Good morning, my friend. I'm Dr. Lee Warren, and I'm here with you on Mind Change
Monday for some self-brain surgery.
I'm really honored and excited to be bringing you a very special guest today.
Dr. Joe Maroon is a, without hyperbole, I'll say it this way,
a world-famous, widely regarded as one of the greatest neurosurgeons of his generation.
Dr. Maroon was the chairman of the Department of Neurosurgery,
the founder of the Department of Neurosurgery at Allegheny General Hospital in Pittsburgh.
He's been, at different times, chairman and vice chairman of the University
of Pittsburgh Medical Center's world-famous neurosurgery program,
trained with some of the world leaders, trained many of the world leaders in
neurosurgery, widely published and highly regarded former president of the Congress
of Neurological Surgeons.
Joe Maroon has had an internationally regarded career as one of the best neurosurgeons ever.
Well, the reason he's with us today is because he started the program that trained me.
And in the year that he started it, I was the very first resident that he chose
to train in that program.
So I was the first resident to come out of medical school and go in as a beginning
first year resident at Allegheny General way back in 1995.
So I had the honor of being the very first resident selected and the very first
resident to graduate ever after having having received all of their training at Allegheny General.
So great honor. And I'm a neurosurgeon today.
I say without any doubt, I am the doctor that I am, the type of surgeon that I am.
The good parts of my training came as the result of the influence and mind vision of Joe Maroon,
the hard work and labor of Joe and the incredible team of people around him
that he assembled to train up young neurosurgeons.
The other thing that Joe did, though, is he had an eye on developing our character
and our thought processes and the way we looked at things.
And he spent a lot of time with us. He took me aside personally and mentored me.
And then years later, after my training was long complete, he continued to be
involved in my life and we became friends.
It's hard to imagine becoming friends with someone who is your mentor and your
champion and your teacher and your trainer and your boss and your professor and all those things.
But Joe's become a true friend and he's had an incredible life, not just neurosurgery.
He's the team doctor, the team neurosurgeon for the Pittsburgh Steelers,
Pittsburgh Pirates, Pittsburgh Penguin, professional sports teams for 30 years
or more, still highly involved with the Steelers.
There was a period of time, he is a world-class Ironman triathlete.
The crazy people that run, swim in the ocean, bike a hundred and so miles and
run a whole marathon all in the same day.
Some of us haven't done all that in our whole lifetime, but he does it on the
same day. and he's completed numerous, as he talks about in this episode, numerous Ironmans.
He's won them on different continents for his age group multiple times.
And he was highly involved with a nutrition company called GNC.
And if you used to go buy vitamins from GNC, there was a period of time when Dr.
Maroon's face was on the bottle of many of the vitamins that they sold.
He was a consultant for them.
He's done consulting work for professional boxing and wrestling organizations.
He was highly involved in the concussion program, impact program that's used
in every high school, junior high, college, and professional team ever to test
athletes for concussions before they allow them to continue to harm themselves with head injuries.
He was the first doctor to retire an NFL player because of concussion.
He's a world thought leader on head injuries in sports.
So Joe's had this diverse and eclectic career, but I realized frequently when
I'm operating that a lot of the things that I do and a lot of the ways that
I think have to do with something that Joe Maroon taught me directly or a way
to look at things that he taught me.
And so not long ago, Lisa said, you know what? You should talk about Dr.
Maroon. You should get Dr. Maroon back on the podcast.
He was on the show way back in 2014, not long after we lost Mitch.
We had a great conversation back then. But Lisa said, hey, you should reach
out to Joe and get him on the show because you've You've been talking a lot
about legacy lately and remembering where you came from and those kinds of big ideas.
And I realized that one of the things that's unique about Joe Maroon is he saw
in his mind the value of surgeons using an operating microscope to perform surgery.
And I had this sort of arrogant idea. I think a lot of neurosurgery trainees,
we go to medical school and we get fascinated with brain surgery.
We don't really think about spine surgery as being that important because,
I mean, after After all, orthopedic surgeons, some of them are allowed to do spine surgery.
So we see the separation when we're young that brain surgery is the realm of neurosurgeons.
Spine surgery is a common ground. It turns out Joe had this vision of recognizing,
okay, when we do spine surgery, we work on big nerves.
I mean, your sciatic nerve and the nerves that come off of your spinal cord
in the lower lumbar spine are big.
Orders of magnitude larger than the cranial nerves that we work on in brain surgery.
And so Joe said, you know what, why would you do spine surgery with loops on
these little magnifying glasses that people wear on their eyes when you could
use spine surgery, which is much more common.
There's probably eight or nine spine surgeries that are needed before every
brain surgery that's needed based on demographics of those disease processes.
Why don't we make our Our residents use the operating microscope on every case they do.
So they become masters that's using surgical microscope so that then when they
do brain surgery, the scope's not in their way, but it's an extension of their body.
It's an extension of their skill set and then become masters at using the scope to their advantage.
And that turned into this thought process that dawned on me that really saved
me because I had this arrogant idea.
I wanted to be a brain surgeon. I didn't care too much about spine surgery.
Spine surgery was more labor intensive, and I just didn't like it when I was a trainee.
And Joe said, you know what? If you go into private practice or you do general
neurosurgery, 80% of your work for your whole career is going to be spine surgery.
You're going to relieve pain and restore function and help people and improve their quality of life.
But you also can use spine surgery as a way to master the handling of nerves delicately.
And you can learn to see it in a minimally invasive way and use the microscope
to become a true master of microsurgery.
And what you're going to find is that your spine surgery outcomes are vastly
better than those of corresponding surgeons,
orthopedic surgeons or neurosurgeons who don't use the microscope because when
they can't see as well, when it's not as well lit or well magnified,
they're going to retract and pull on nerves more. They're going to have more
concussive force on the nerves.
They're going to do more damage to the muscles and you're going to see over
the course of your life that using the microscope and thinking of every case
as an opportunity to practice microsurgery and being less invasive,
you're going to see that pay dividends in your outcomes.
And what I didn't know then, even though I thought it was irritating,
is that it turned out to be true.
Now, every time I do an operation, I think of how can I be the least invasive,
least harmful, most delicate, and how can I use this to practice for the next
time when I have a case that's even more difficult?
How can I use this case in front of me, this particular patient and their issue?
How can I try to maximize their outcome and minimize the impact and the imprint
and the footprint of my having been there?
And I began to see the nervous system as holy ground. And I began to see things
with the microscope that I could never see before, little subtle pulsations,
little places where a vein has a nerve tethered.
And if I release that tether, then the patient will move better and feel better
And it's turned into this incredible, vastly better outcome than I ever imagined
for most of my patients. And so if you have the...
Experience of me being your actual doctor, you have Dr. Joe Maroon to thank
for a lot of the ways that I take care of you.
And so that led to a generation and now common idea that all neurosurgeons are
masters of microsurgery and handling using the operating microscope.
And now I've got 3D robotic, fancy technology microscopes. We were the first
ones in the world here in North of Platte, Nebraska, to have the Esculap AOS 3D robotic microscope.
And that interest that I've had in always trying to stay on the leading edge
of surgical microscopy is the result of Joe Maroon.
So I didn't mean to go into a deep dive on the nerd side of neurosurgery.
I just want to tell you, there's somebody in your life whose shoulders you're
standing on when you do the things that you do.
It's somebody. You may not even know who they are, but there's somebody ahead
of you in history and in your life that did things and saw things and thought
of things and developed things.
And that's one of the ways that you can make this switch in your hippocampus
from being anxious and stressed and struggling with this. Why is everything so hard?
And why does my life always feel this way? And why does it always work out this
way for me? You can make that switch and say, you know what?
I'm so grateful that somebody came along before me and I'm not having to literally
dig a hole in the ground every time I need to go find water.
Like somebody thought of wells and somebody thought of sewage and somebody thought
of electricity and all the things that I have that I take for granted.
Somebody thought of quantum physics and that's why I have a cell phone or a
smartphone that I can use to listen to a podcast.
There's always some way, no matter what you're facing, to find a way to look
at this situation and see the shoulders you're standing on, see the reasons
to be grateful for something.
And that little switch, even though it doesn't immediately resolve the issue
that you're frustrated with.
It switches you from hippocampus to frontal lobe instead of hippocampus to amygdala.
And you get out of that fight, flight, freeze, anger, stress,
depression, anxiety mode, and you go up towards executive thinking,
improving your neurochemistry, reducing cortisol, improving the quality of your life.
Is one of those giants on whose shoulders I stand.
So we had a wide-ranging conversation. We talk about faith. We talk about hardship. We talk about struggle.
We talk about his career. We talk about his impact on me and my life.
And I just want you to see this as not just two old friends having a conversation.
But two people talking about an important, critically important concept.
And that is that whatever you're doing in your life, you didn't get here by yourself.
You're made of everybody that came before you. So even if there's some scoundrels
or some people in your past that didn't do things right by you,
you can find some way to be grateful for something around that life or at least
the way that it got you to where you are now.
And so, my friend, I always tell you that you have to change your life by changing your mind.
You can't get your life better until you get your mind better.
And Joe Maroon helped me do that, starting way back when I was just a greenhorn
kid coming out of Oklahoma to Pittsburgh.
To learn how to be a brain surgeon. And what I didn't know was that I was really
gonna become a master of spinal microsurgery and that that would be what I spent
the bulk of my time doing in my life.
And so the tens of thousands of people that I've been able to help in my life
with my hands, all of them owe a thank you and a tip of the hat to Joe Maroon
and the many others that he put around me as my mentors and trainers,
as I became a real life neurosurgeon and not just one that you listen to on the internet every day.
We're going to have a great talk with Joe Maroon today. And before we do,
I have a question for you.
Hey, are you ready to change your life? If the answer is yes, there's only one rule.
You have to change your mind first. And my friend, there's a place where the
neuroscience of how your mind works smashes together with faith and everything
starts to make sense. Are you ready to change your life?
Well, this is the place, Self-Brain Surgery School. I'm Dr.
Lee Warren, and this is where we go deep into how we're wired,
take control of our thinking, and find real hope.
This is where we learn to become healthier, feel better, and be happier.
This is where we leave the past behind and transform our minds.
This is where we start today. Are you ready? This is your podcast.
This is your place. This is your time, my friend. Let's get after it.
Music.
Ben, we're back, and I am so honored and excited to be reintroducing you today
to an old friend and important, incredibly important figure in my life. I've got Dr.
Joe Maroon with us today from Pittsburgh, Pennsylvania.
Welcome back to the show, Dr. Maroon. Thanks so much, Lee. Great to be with you again.
It's good to see your face. It looks like you get younger every time I see you. I wish.
But, Dr. Maroon, before we get started, and I'm going to call you Joe.
You've told me over the years, call me Joe. It's hard for me to do.
But I'm going to call you Joe today.
And would you start us off with a word of prayer here this morning?
Yeah. Dear Lord, give us the thank you for the grace you've given us to reconnect
with my good friend and student Lee.
Keep us healthy.
Keep us safe. And let us continue to share our word with those who would like
to receive it through your help. Amen.
Amen. Well, Joe, I don't know if the listeners have heard this story before.
It's been a long time since you were on the show. I think seven or eight years or longer.
But the reason I'm a neurosurgeon today is because you started a new program
in Pittsburgh and I was your first resident that you chose in Allegheny General.
Tell the story of how you came to start a residency training program.
Well, I was formerly, I came to Pittsburgh, to the University of Pittsburgh, and I was with Dr.
Peter Giannetta, one of the foremost neurosurgeons at the time.
And after 12 years, I was invited to start the Department of Neurosurgery at
Allegheny Health Network, another hospital here in the city of Pittsburgh.
And we had such a large volume of patients that I thought, educationally,
it would be very beneficial to have neurosurgical residents.
And so we we literally applied and was accepted and started the program.
And at the time, I think it was six years.
Lee, or was it how long was it? Five or six? Six?
A six year program. So we were looking to recruit individuals of the highest
caliber to join the program and to be mentored by some very talented neurosurgeons. we recruited.
And we had, as we do now, there's many, many applicants for neurosurgical spots.
At the University of Pittsburgh now, we have over 300 applicants for four spots a year.
And 28 residents, Lee, we have 28 neurosurgical residents at Pitt now.
But we started with two or one with you? I'm not sure. Maybe it was you.
Just one. So we had many applications for the program.
And looking over applications, we look at,
productivity as a student, character, work ethic,
letters of recommendation, and to this late day, I'm still proud to say,
Lee, that you rose to the very top of the list, and it was our great pleasure to work with you. Wow.
Well, it was an honor to be chosen. I was a left-handed kid from Oklahoma and
had no idea that you were going to say yes to me.
And I just am so thrilled still to think back to that time as a medical student
to have received that letter with your signature on it and Jack Wilberger's
signature on it to say, hey, you're going to be our first resident.
And so here we are, you know, coming on 30 years later.
That was 29 years ago that I got that letter, believe it or not.
And here, 30 years later, I've done, you know, tens of thousands of operations
on three continents and all because you said, hey, we want to train you.
So I'm just so grateful, Joe, to have had that opportunity to train under you.
Well, God works in strange ways, as the cliche goes, and so many things of our lives.
You know, and as I don't like to say get older, Lee, but I say mature.
As I mature, I see how dots get connected in our lives and how things happen
completely we have no control over.
The small determining factors of human existence and how we end up and how you
and I, 30 years later, are now on a Zoom call discussing,
you know, not only the past, but also the present and future and the struggles
that we all have been through.
Through the adversities that we've experienced and fortunately been able to
overcome and how our faith becomes stronger.
With adversity and more humble as we get older.
That's right. You know, I was thinking the other day about this notion that
when I was coming up as a scientist, the research that I had done before I got
to Pittsburgh, which had a lot to do with why you chose me,
and then working around a lot of neurosurgeons, There was a lot of people who
were sort of hardcore materialists and people who may not have thought much
of faith or believed in God or any of that.
But you created an environment really for training where it was okay to be who you were.
You said, hey, it's okay to have faith. It's okay to be the kind of person that you are.
And we want to train you to be a good surgeon and believe what you believe and
live out your faith and live out your worldview.
You never discouraged that. And I think it was a welcoming environment and not
all places were that way.
So it was kind of a good piece of your character, I think, to allow people to
grow up and show up and be who they were.
Well, thank you, Lee. And honestly, I can't tell you how proud I am of the work
that you've done, who you've evolved to become, and the thousands of patients
that you've touched and helped in so many ways.
And the messages that you, you, you've, you're very unique.
I've, I've been in this business for 50 years now as a neurosurgeon,
you know, it's hard to believe that.
But when I look back of all the, probably a hundred or so or more residents.
I, again, I'm not blowing smoke, but the way you've reached out because of your
own difficult experiences and translated that into books, into podcasts, into lectures.
The way you've helped people is not just with your hands.
You know, the French word for surgery is chirurgie, hands, work with your hands.
But there's a saying that laborers are individuals who work with their hands.
Craftsmen are individuals who work with their hands and their head.
Artists are those who work
with their hands their head and their
heart yeah and lee you you're
a true artist because you do
this podcast it's it's out of your heart and your brain that we're discussing
this and hopefully there can be a message or two that will relate with others
that may help them in a time of need or a time of trouble.
And God only knows that the world we're in, the stuff we're seeing daily at our universities,
and the riots, the protests, the anti-Semitism that we're seeing now.
We need we need a higher power. We need faith. We need good works.
We need gratitude for the gifts we've been given.
You know, I write two blocks from me is a veterans hospital,
hundreds of patients, their veterans.
And I take I've taken care of like you. You know, I've taken care of hundreds
of veterans with PTSD, with amputations.
And if you want a humbling experience, visit Walter Reed Hospital,
the amputee section, where you see individuals with their arms, their legs.
There was one individual, no arms and no legs.
And then not to mention the mental issues, the devastating PTSD that completely
destroys their lives and individuals.
And then to see the horrible burning of flags and the kinds of protests that
are going on now, no appreciation of history,
no appreciation of the freedom that these these young individuals have and how
it was earned and bought by blood, sweat and tears of the people who have gone before them.
So anyway, I'm getting a little carried away.
Excuse me. I love it. I recently had a conversation with Ben Carson about these
very similar things. Dr. Carson has a new book.
What's that? I mean, you've been there. You've taken care of the same people.
You've seen the broken, not only broken bodies, but broken brains.
That's right. Dr. Carson has a new book coming out called The Perilous Fight,
and it's about how we get back to the notion that family and faith and those
big things like that are what made America great in the first place.
And it's really a great conversation with another brain surgeon.
Yeah, I know Ben and I just utmost respect for how he's maintained his principles
and his character, despite, again, an awful lot of criticism and adversity.
That's right. Speaking of adversity, you tangentially mentioned it a moment
ago, but how do you, you've walked through some big things in your life.
And we told this story before the last time you were on the show about how when
your father passed, you were kind of thrown into a part and a place in your
life that you weren't expecting. Maybe tell a little bit of that story and how
you navigated through that.
And that's how you found your way to running and maybe found your way back to faith.
And ironically, maybe to some of your success as a neurosurgeon.
No question about it. Completely changed my life, Lee. Well,
initially when I came to Pittsburgh, I finished my residency at the University
of Indiana and Oxford University in Georgetown, University of Vermont.
Came here and worked. I was very dedicated to be a very successful neurosurgeon.
And I was. I had all the amulets of success.
I had a good title and a position, enough money to live on and doing good research.
And then in the course of a week, my father died of a massive heart attack at age 60.
My family broke up because I was so successfully.
I had all the amulets of success, but I wasn't successful in my marriage and in my home.
And those two things happened the same week, and I had to quit neurosurgery.
So one day I was chief of neurosurgery in this hospital that I'm talking to you from right now.
Now, the next week, because of depression and success, I moved into a farmhouse
in Wheeling, West Virginia, 60 miles from here.
My father bequeathed to my mother a dilapidated truck stop that was heavily mortgaged.
And we had to pay off the mortgage. And one day I was doing awake brain surgery
on patients with tumors in eloquent parts of their brain.
The next week I was literally flipping hamburgers and filling up 18 wheelers in a truck.
Wondering, you know, how and how did this happen?
Well, it happened because I was totally unaware and unmindful of what the pursuit
of success could lead to if it's not accompanied by a balanced square,
which is the title of my book, Square One, A Simple Guide to a Balanced Life.
I, my spiritual, so very quickly, anyone listening to this, draw a square.
And at the top of the square put work, family, spiritual and physical.
Now draw a square somewhat with how much effort you put on each one of these.
My work line was this flat line EKG. There was no family, there was no spirituality and no physical.
And the banker one day called me and said, Joe, I think he wanted to see if
I'd be around long enough to pay off the mortgage. He said, we need to go for a run.
And I found a pair of scrubs and tennis shoes and went down to the high school
track, went around four times and said never again. Totally exhausted.
But that night was the first night I slept in about four months.
So I went back the next day and I did a mile and a half. Then two, then three.
And then I was like Forrest Gump running through Wheeling, West Virginia.
They said, there he goes.
And I read about triathlons, cross training, learned to swim,
got a bike, entered in a small sprint triathlon.
Subsequently, over the course of the next several years, build up to eight Ironman
distance triathlons, which is 2.4 miles swim, 112 mile bike and a marathon.
And, but what, I'm not being boastful because it's what I do to save my life.
As you know, Lee, the brain can make the body very sick.
Depression, anxiety, fear, causes heart attacks, irritable bowel syndrome, and ulcers.
What's so critical to realize is that the body can heal the brain.
And what happened to me, by running around that track and biking and swimming,
I was resetting my neurotransmitters.
I was reconstituting my serotonin without drugs, my cannabinoid system, my dopamine,
so that I subsequently got back on a healthy diet. it.
And diet, exercise, avoiding environmental toxins like drugs,
alcohol, and then controlling stress.
So what's the best way to control stress? You know, your book on hope is so powerful.
And if you look at the areas of the world where they have the most centenarians,
the people who live look greater than
100 what's what's the secret well one
of the secrets besides diet exercise and avoid
avoiding environmental toxins are strong family units that's right and prayer
and spirituality why is that important because it reduces stress what happens with With stress,
as you so eloquently describe in your work and podcast,
it reduces cortisol,
the stress hormone that's neurotoxic to the human brain.
It literally destroys the cells in the hippocampus that subserve memory.
So, by a strong family unit, it reduces the cortisol,
resets your neurotransmitters, and enables you to get back in homeostasis or balance.
So, prayer is a, prayer, faith, Faith is a key part of health.
You know, it's like diet. It's like avoiding toxins. It's like exercise.
Faith is one of those qualities that permeates everything else we do.
That's right. And again, I come back to your work, Lee.
You know, of all the, you're a unique neurosurgeon, my friend, and you know that.
But your books called out your experience in Iraq.
It's so heart-wrenching what you've experienced, what your eyes have seen,
what your hands have experienced, and what your heart has felt.
You've walked the walk and talked the talk.
I mean, you do it. And I just, I just, I'm so proud for you and of you. Thank you.
Thank you. Well, you know, I was thinking the other day about this concept of
how do we get to the place that we are in our life.
And I'll go back in a minute to the difference between mind and brain,
and I want to pick your brain about those things.
But I was thinking about this the other day because I remembered a case.
I don't think I ever told you this story. The very first surgery that I performed
as an attending neurosurgeon, I graduated my training program at Allegheny in
2001 in June, and then had to do a little bit of military training.
And I ended up at Wilford Hall Air Force Medical Center in San Antonio, August 1st of 2001.
So this was a month before 9-11, right? So I show up as an attending neurosurgeon
and I walk in and I'm looking for the chief of neurosurgery,
whose name is David Garrett.
And I was told that there was another neurosurgeon coming out of training at
NYU, turned out to be a guy named Mike Leonard, but he was on vacation for two
weeks, so it was gonna be me and Dr. Garrett.
So I walked into the neurosurgery clinic, now found Dr.
Garrett, and he saw me, introduced himself to me, handed me his beeper, and went on vacation.
So he was gone. So I was by myself in a 1200 bed level one trauma center as
a first day neurosurgeon.
And Joe, five minutes later, the pager went off, and it was the ER,
and it was a three year old little boy.
With blown pupils and had a posterior
fossa mass, a big tumor in his cerebellum, and he was herniating.
And both of his parents worked in the hospital.
So my first day, I was dealing with a pediatric brain tumor emergency.
And I called John Maceros. Do you remember John?
So John Maceros is a pediatric neurosurgeon that you brought to Pittsburgh.
And John trained me in handling pediatric brain tumors.
And so while they were preparing this child for surgery, I called John and said, I don't know what to do.
He said, yes, you do. He said, yes, you do. You know how to handle intracranial pressure.
You know how to put a drain in and relieve emergency pressure.
You know how to get the child positioned safely.
And you know how to administer mannitol and reduce intracranial pressure.
And you know how to resect this
tumor. It's going to be a polycytic gastrocytoma and you know what to do.
And he just reminded me that he had trained me and you had trained me and Jack
Wilberger and Parvus Bagai and all these guys had prepared me for that moment.
And so I performed the surgery and the kid did great. And it was,
you know, a resectable tumor and he did fine.
But I was able to navigate that moment because I was standing on John Maceros'
shoulders and your shoulders.
And I was finding myself not having to rise to some occasion of being somebody
that I wasn't, but able to fall back to the training I had been given and the
preparation that I'd spent the previous six years in Pittsburgh doing.
So maybe talk for a minute about this idea that we are the people and the training
and the moments that came before us, because I recognize that my career is built
on your career and your career is built on somebody else's.
Neurosurgery is only about 100 years old, so it doesn't take that far back to
get to Harvey Cushing, right?
No, that's exactly. That's exactly right. And, you know, it stimulates a in
the book or in the poem Ulysses.
The author writes, I'm a part of all that I have met.
And when we really think about that, you know, it begins it really begins in
utero with the connection with our mother.
I mean we know that mothers who say abuse alcohol or drugs uh.
The baby is affected negatively in utero from the mother.
So we're part of all we've met beginning very early on.
If there's healthy nutrition and exercise, it helps our brain as we're forming and developing.
But after that, you know, we talk about epigenetic factors. Those we're all
familiar with genetics.
We have the same genes and this and that from our mother and father.
Epigenetics is that science 20, 30 years old now that reflects the environmental
factors and how they affect our brain,
meaning individuals that we meet early on in our lives, how we're nurtured, the examples we see,
the lessons we learned early on in
those first five to 10 years that get wired into our brain and and as you so
again i i love watching you and listening to your podcast you know you talk
about the connectome which is the wiring diagram of the brain and how.
I'm going to take a tangent about heraclitus a greek philosopher who 400 500
years of correction 2500 years ago said you can never put your foot into the same river twice.
Think about that. Why can't you put your foot into the same river twice?
Because the river is constantly flowing. It's a different river every second, virtually.
Our brains, that's the definition of neuroplasticity.
The olfactory, visual, auditory, sensory, gustatory sensations.
That are going by the cranial nerves into our cerebral cortex is constantly
making new synaptic connections on a minute by second, second by second basis.
So those people listening to this podcast are going to be different in their
brains when this is finished.
They're going to have new Synaptic connections.
And so as we're maturing, those synaptic connections get hardwired,
so to speak, until about age 25, plus or minus,
when the brain is then fully developed.
But what happens to the adolescent, the adolescent who smokes marijuana that
has now been legalized in 33 states and nationally as of a couple of days ago?
What does marijuana do to the adolescent brain?
It messes it up. It predisposes the connections to addiction,
to psychosis, to manic depression.
So, you know, people say, well, it's like alcohol. Well, alcohol is neurotoxic
also, but it's marijuana to the adolescent brain is so bad and so harmful.
And we know one out of four kids in a high school today will be smoking marijuana
and four to five times this month.
It's epidemic. epidemic it's now euphemistically referred to as self-medication
yeah uh but i you know but the point is the you're standing on the shoulders
there's so much of what we are and who we are,
is acquired non-consciously, non-voluntarily. It's living.
It's the experiences we have, the good, the bad, the ugly, that molds our brain.
And as you so eloquently discuss in Frontal Lobe Friday.
You know, what's happened in our frontal lobes?
What do they do? They control impulsivity, planning, and our memory,
our judgment, decision making.
All of these things are in the frontal lobes.
And as you say, how do you rewire this once it does get hardwired? It ain't easy.
It ain't easy. Shakespeare and Macbeth had a great quote.
You know after they they killed king duncan
and the blood was on the hands of lady macbeth and she said out damn spot out
damn spot well macbeth went to the physician because his wife suffered from
a severe ptsd because of the murder that was committed and and he asked he asked
the doctor He said, Doctor,
how does one pluck from memory some rooted sorrow,
erase the written troubles of the mind, and with some sweet,
oblivious antidote, cleanse the bosom of that perilous stuff that weighs so heavy upon the heart?
Wow. And the doctor looked at Macbeth
and said, in this, the patient must minister to himself or herself.
And what you do, Lee, is you give all of us, all of us who are patients,
suggestions and tools to minister to ourselves with the help of a higher power.
That's right. You cannot do it alone. That's right. It doesn't work.
That's right. I was reading a book recently about art, and a guy named Russ
Ramsey wrote a book, Rembrandt is in the Wind.
And it was talking about a Dutch painter named Vermeer.
I don't know if you're familiar with Vermeer's work, but when you look at a
Vermeer painting, something kind of unsettling happens because the color and
the detail are so intense compared to other artists of his era.
And Ramsey was describing how they finally figured out what Vermeer did was
he used the first version of a device called a camera obscura,
which basically was like a projector which could project
onto the canvas an image that he
could then paint in greater detail with and it it turned out that his next door
neighbor was Anton von Leeuwenhoek who was the guy that invented the microscope
right and so Leeuwenhoek made him this device to help him be a better painter
so you've got Vermeer this great Dutch artist benefiting
from a guy who was into optics and studying cameras and lenses and all of that.
And when I read that, I thought, Joe Maroon insisted that we used a microscope
in the operating room for even simple procedures.
Like you said, you guys need to learn how to be master utilitarians of the operating
microscopes. It'll help you
be better spine surgeons, and that'll help you be better brain surgeons.
And so I thought, gosh, we were the beneficiaries of van Leeuwenhoek all those
years, centuries later, on a different path than Vermeer was.
But isn't that fascinating?
Well, it is. And it takes me back to when I finished my residency.
I never used a microscope. It wasn't even being used.
But Dr. R.M. Pearden Donaghy was the chair at the University of Vermont.
And I met him at a neurosurgical meeting at Colby College.
And he offered me a fellowship after finishing six years of neurosurgery to take another year,
six months, to go to his lab and learn how to use a microscope to do minimally
invasive surgery. Changed my life.
And Dr. Ghazi Yassergil, who is known as the neurosurgeon of the century,
was a teacher of mine and learned in Donaghy's lab.
So when I came to the University of Pittsburgh and then subsequently Allegheny,
I was carrying on that same tradition of Donaghy, Yassergil, Janetta, Lee Warren.
Aren't that's right that's exactly what
i was going to get out here today like we we learned from
the those who came before us and and we don't even know
sometimes the people that were influential in that like like von lebenhook all
the way back there in in the netherlands you know hundreds of years ago doing
that work resulted in us being able to that's exactly right what we do today
fascinating it's really interesting to me and here's a little pivot but i've been reading a lot,
Joe, about this sort of mind-brain problem.
You know, we're brain surgeons and we deal with the brain all the time.
And we recognize, though, I think good neurosurgeons at some point recognize,
that there's a difference between the mind and the structure of the brain.
And as I was doing all this research and reading about this,
preparing my next book, which is going to be called The Handbook of Self-Brain Surgery, by the way.
But the self-brain surgery book is about neuroplasticity
right and how you can direct what happens in your brain
structurally by the things that you think about and to my
shock and fascination i found one of the
first really impactful writings about the mind and the brain being separate
came from a neurosurgeon named wilder penfield who you probably met did you
ever meet dr penfield no but i did meet uh in fact one One of his protégés gave me my boards,
but I still knew of Penfield very well.
And he wrote a little book called The Mystery of the Mind. And stimulated their
brain who had epilepsy to see major contributions in neuroanatomy. No question.
That's right. And what Penfield realized is when he had people anesthetized
and when they were awake and doing craniotomies, he would stimulate the motor
cortex where they could not move.
And he would ask them later what they were thinking about when they couldn't
move. And they recognized that there was a difference between the will that
they had to do something and the ability that they had to do it.
So they had intention and desire and drive, mental processes that wanted to
do certain things that were not just about their physiology and the mechanics
of whether or not they could move.
And that's when Penfield realized that mind and brain are not the same thing. It was fascinating.
Well, it is. And you alluded to something earlier, Lee, that simulated Proverbs.
I think it was Proverbs 14. I'm not sure.
But as a man thinketh, so he shall be. Yep.
Profound statement, 3,000 years B.C.
That's right. and and
as a man thinketh so he
shall be our thoughts are literally converted into who we are and what we are
our thoughts and cause heart attacks irritable bowel syndrome it can cause anxiety
depression and all the mental diseases that.
Can occur and it's again it's
that struggle how do we control
our minds how do we control our thoughts
in a positive in a positive way and it's uh it's a philosophical struggle that
goes back as probably as far back as we can think from the african savannah
that's right all the way back So let's pivot for just a few minutes we have left here, Joe.
I promised you about 45 minutes. We're getting close to it.
But you, like me, have faced significant hardship and strife in your life.
There's been some moments that were devastating to you.
So give us, for the person out there who may be going through something like that now,
like what does Joe Maroon, not only an accomplished, world-renowned brain surgeon,
but also professional, almost professional athlete and world thought leader,
but also a dad and a husband and a father, grandfather,
how do you advise people to handle major adversity and land on hope?
And land on hope. Well, I think, Lee, it's a deep question.
First of all, honest to God, I swear I'm telling you the truth.
A friend of mine is in need, and I sent the individual a copy of your book.
Thank you. Which that's the first thing I would recommend to people,
you know, read this book.
But I think it's usually when things happen, a death of a child,
the death of a parent, firing from a job.
It's a very humbling experience where we realize, like like they say,
there's no there's no atheist in a foxhole. Yeah.
The things that seem important to us, we get back to the very basics.
And when you start thinking of the very basics, you think of,
again, I think of a higher power, faith, God, you know, who else do you reach out to?
Yeah. There are three most important things in life. I've given a lot of thought to this.
Number one is mental and physical health. yeah
number two is relationships with god
family friends and
colleagues like you number three is
carpe diem seize the day we know not the day nor the hour when we will be called
that's right and be aware in pittsburgh it's a beautiful sunshiny day yeah unlike
the usual cloudy days that you were used to and accompanied to.
But it's carpe diem. Seize the day.
And don't be hesitant to reach out to family, friends, and God when,
not only when you're hurting, but also when things are good.
You know, the so-called attitude of gratitude.
Gratitude uh we've been given so much we've
been blessed with so many good things in terms
of our health our families and jobs and work
and food in a great country um you the the buddhists talk about mindfulness
and awareness being aware of what you're going through be mindful of where your
mind is and the level of tension or stress in your body.
Every day when I get in my car, I look at my tachometer.
And as you know, there's a red zone in your tachometer when your engine's overheating.
It's very important to be mindful of when your own engine is overheating by
stress, by anxiety, by the cares of the world.
And then take those steps to decrease
the rpms to decrease the stress
and and and and look
towards your square you know
if it's all work think about working
out your physicality think about your diet
and spirituality spirituality for
me infuses all areas of of what we do that's right lee i was i i took care of
father ephraim who was head of the greek church here for monasteries give me one second one second.
And I actually operated on him for a spinal condition, was able to help him.
And he gave me this prayer rope.
Wow. Many years ago.
Beautiful. There's a beautiful hand-woven prayer rope that I literally wear in surgery. Wow.
To the operating room to have their brain or spine operated upon so what do
you think their adrenaline level their cortisol level is it's sky high yeah so what i'll do,
and i don't try to convert anybody but i say you know would you like to say
a little do you believe in a higher power and would you like to say a prayer
90 of patients say yes that's right i I always reach down, take their hand and touch them.
Touch is healing. And then I'll have them touch this prayer rope.
And I'll say, do you mind if I say a little prayer?
No problems. Today is the day the Lord hath made. Let us rejoice and be glad in it.
And with your help, get Mary or John back to their home and their family.
How long did that take me? Five seconds?
10 seconds. I get more thank you notes for taking that time to say a prayer and connect,
with the patient at a spiritual and physical level than anything else.
Thank you for taking the time to say a little prayer with me. So what happens?
It's documented. The average length of stay goes down, the incidence of infections
is less, and the healing power is better.
That's right. Because the cortisol is a physiological basis for all of those things. That's right.
Uh, you know, that's, that's what I relate to people.
Amen. Well, friend, Joe Maroon is a legend. And I say that without hyperbole,
a legend in neurosurgery.
And if you have had the fortune or misfortune, hopefully fortune of having been
one of my patients in real life, that is built on the back of Joe Maroon, the legacy of him.
And a thousand conversations like the one that you've heard us had today.
I remember rounding in Pittsburgh hundreds of
times and you would say things like that sit at the bedside take
a second sit down put your hand on people talk to them use
you know break down that barrier between doctor and patient and
and get on the same level with them and and all
those things that I do every day in my practice and on this podcast and the
writings that I do they're all built on the shoulders of Joe Maroon so Joe thank
you so much for not only training me and and accepting me inviting me into this
incredible profession But being my friend and and for the last 10 years or so,
really coming alongside me as a as a friend and not just a professor.
I love you and I'm so thankful for you and proud of you. And thank you for the
time that you've spent with us today.
I'm so proud of your work and you.
And it's really an honor to be with you again, talking with you and and again,
keep up your phenomenal work.
Yes, sir. God bless you, Joe. Thank you. OK, I know.
Wasn't that incredible? Joe Maroon, one of the giants on whose shoulders I stand.
And you've got them too, friend. So just take a moment today to find a way to
be grateful, to switch whatever you're going through from frustration to gratitude.
That'll change your mindset. It will change your life. It will help you to reframe
whatever experience you're in. Remember the quantum physicists have taught us.
That the way we pay attention to things and the things we choose to pay attention
to become more real over time.
And so if you're frustrated, if you're sad, sick, stressed, stuck,
or out of options in some way, start looking at your situation from a different perspective.
Change the position like I did from thinking about spine surgery as boring stuff
that they allow orthopedic surgeons to do and actually switching to this is
practice for cranial microsurgery.
I'm getting better as a brain surgeon by learning how to become a master of spine surgery.
And that turned me in to a much better surgeon, a much more compassionate,
thoughtful, careful surgeon.
And now that's how I spend the bulk of my time, and I love it.
I absolutely love the way I spend my time in minimally invasive spine surgery
because I realize what an impact I can have on an individual person's life.
And that thought process, that mindset shift is what turned me in to the Dr.
Lee Warren that is there now. in the world, taking care of people.
And that came from Joe Maroon and Parvash Bagai and Jack Wilberger,
Adnan Abla and a dozen other guys that he put around me that turned me in from
this left-handed kid from Oklahoma
to a highly regarded cranial and spinal microsurgeon that I am today.
And I'm so grateful. And I just wanted to have this conversation with Joe so
that you could see that there are places in your life where you can make the
similar mindset shift and recognize whose shoulders you're standing on,
all the way back to the fact that you have a great physician.
Who ultimately is the designer and creator of everything, including your life.
And you can take that idea and say, wait a minute, I need to stop feeling so
frustrated all the time because I'm actually the recipient of an incredible gift.
I've got a mission and a purpose. I've got appropriate training.
I'm getting some of it today with this podcast.
And I can make a difference in somebody else's life if I learn how to change
my mind and changed my life.
I'm so grateful for Dr. Maroon taking the time to be with us today.
And I just want you to remember that no matter what you're facing, my friend,
You can learn to biopsy your thought, change your perspective,
recognize that there are multiple things to be grateful for here.
Take the high ground of your own neurochemistry and remember that you're standing
on shoulders of those who came before you that enabled and empowered you to
be here in this moment so that you can change your mind and you can change your life.
And the good news is you can start today.
Music.
Hey, thanks for listening. The Dr. Lee Warren Podcast is brought to you by my
brand new book, Hope is the First Dose.
It's a treatment plan for recovering from trauma, tragedy, and other massive things.
It's available everywhere books are sold. And I narrated the audio books.
Hey, the theme music for the show is Get Up by my friend Tommy Walker,
available for free at TommyWalkerMinistries.org.
They are supplying worship resources for worshipers all over the world to worship
the Most High God. And if you're interested in learning more,
check out TommyWalkerMinistries.org.
If you need prayer, go to the prayer wall at WLeeWarrenMD.com slash prayer,
WLeeWarrenMD.com slash prayer.
And go to my website and sign up for the newsletter, Self-Brain Surgery,
every Sunday since 2014, helping people in all 50 states and 60-plus countries
around the world. I'm Dr.
Lee Warren, and I'll talk to you soon. Remember, friend, you can't change your
life until you change your mind. And the good news is you can start today.
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