Revision Surgery: All-In August #13

Good morning, my friend. Dr. Lee Warren here with you, your favorite internet

brain surgeon, maybe real-life brain surgeon, hopefully not.

For you, I'm going to go to the operating room soon and do some real-world physical surgery.

But today I want to help you, guide you into a little bit of all-in August self-brain

surgery that's going to change your mind about one thing.

This is one of those trauma rounds. This is a short little conversation we're

getting ready to have because I want you to see something clearly.

Okay. If all in August is helping you, if you're all in with us,

the number one thing you can do is get people in your world to come in with you.

We want to build a community of people who are saying, Hey, it's time to make a change.

It's time to press in. It's time to go all out.

It's time to go all in for the all in all.

Okay. It's time to get our heads on straight, to change our minds and change

our lives. So share Share this episode with a friend and say,

hey, let's do this together.

There's 12 episodes before today that you can go back and catch up if you haven't

gone all in yet. There's good stuff here, friend.

This stuff will help you change your mind, and it'll help you change your life,

and it'll help you start today.

So let's get after it. Today we're going to talk about revision surgery.

What's revision surgery, you might ask? I'm going to do some in the operating

room today, somebody that's had prior surgery.

And one of the problems with prior surgery is the anatomy is always altered.

There's always scar tissue. There's stuff missing. There's not bone where you

think there's going to be bone. There's not ligament where you think there's going to be ligament.

And you have a hard time at first. It's really difficult sometimes to sort out

where the anatomy is and what you're actually seeing because everything's altered.

I just want to give you one little concept here today, friend.

Your life, when you got to the age where you started having conscious thought

about yourself and about the world around you,

the things that you think and the experiences you have and the emotions you

feel and the way that the tools and the filters and the worldview that you look at everything through.

Were already shaped for you by your heritage, your genetics,

your family of origin, the types of environment that you grew up in.

If it was a calm environment, a threatening environment, if people were fighting

all the time, if there was strife and conflict before you even had language,

if you had pre-verbal trauma, if you had all these things happening in your life, you started.

Or if you had a beautiful, calm, wonderful,

loving family, no matter what, I just want you to recognize that when you started

processing what you think reality is and how you think the world works and all

the things about how you think your life is,

we're sort of shaped for you by a set of things that were out of your control.

Okay? When I get into the operating room today, I'm going to make an incision

in somebody's body, and there's going to be changes in the anatomy compared

to how it normally looks.

Any surgeon that came along in the whole world would expect the spine of a person

or the brain of a person to look when they opened it up.

It's not going to look like that because of the previous history of the patient.

The patient has had surgery before. The anatomy will be altered.

Nothing will look like it's supposed to look. And from my perspective as an

operating surgeon, it's going to be hard for me to sort out what I'm seeing

in order to get to the target and actually do the job for the patient.

What should I do? Should I just give up and say it's too hard and it's too dangerous?

I can't tell where the nerves are.

You know, scar tissue is white and nerves are white. And when they're all bound

up together, I could cut a nerve in half thinking I was just getting scar tissue

out of the way. I could hurt this person.

So did I just give up because it's too hard?

Or do I recognize that this person in front of me has a problem that needs to

be solved and there's a way to do it. There's a path forward.

And I just need to get my eyes on it. I need to get my mind adjusted to the

idea that the anatomy is still there.

It's just different. And I need to think about it in a different way.

And so the self-brain surgery trick for today for trauma rounds is this.

I want you to recognize that the anatomy of your life was altered before you

ever had a chance to think about it.

And what you think of reality, if you said everybody in the world,

if they didn't have any past issues,

if they didn't have the same kind of upbringing I did, if they didn't have the

same set of experiences and problems and issues and decisions and bad marriages

or addictions or traumas or diagnoses or anything else that I've been through,

if a quote-unquote normal person who hadn't been through any of that looked at my life and said, oh,

they just need to alter their perspective here. They just need to change the direction here.

If somebody could come along and say from the outside, they had a drone looking

down on your life, then somebody could say, wait, you're not really in as much

trouble as you think you're in.

It's manageable. It's navigable. Other people have made it through this before.

There's a path forward here. And that's sort of what it was like as a resident.

To do revision surgery because you don't have the experience of having done

a lot of revision surgery before.

So you'd get in there and everything looks like a mess and you don't know what to do.

You can't find your way to something that looks normal.

And I remember my professor Adnan Abla, the spine surgeon, extraordinary spine

surgeon, who taught me a lot about how to do really high quality and less invasive spine surgery.

And Adnan would say, if you want to find your way forward, go find some normal

anatomy and start from there.

Go find some place that hasn't been operated.

Go a little bit higher, go a little bit lower, go a little bit more lateral,

go a little bit to the left or to the right of the operated area and find some

bone or find some ligament or find something that hasn't been altered and then

use that to follow into the scar.

Then you'll be able to separate the scar from the normal and you'll start being

able to make progress. Hey, I hope you're staying with me on the metaphor here, okay?

When your life feels scarred up, when your life feels tied down,

when nothing looks right or feels right, it might be because your worldview,

the lens through which you're looking at your life, can only focus on the scar tissue,

can only focus on the trouble, can only focus on the problem.

Maybe you need to go Go find something normal in your life.

T.S. Eliot, in his famous poem, The Four Quartets, for which he won the Nobel

Prize, towards the end, said two things that are relevant to this discussion.

Here's the first one. What we call the beginning is often the end.

And to make an end is to make a beginning. The end is where we start from.

He also said, We shall not cease from exploration.

At the end of all our exploring will be to arrive where we started and to know

the place for the first time.

When I get in the operating room and there's all kinds of scar tissue and everything

seems hard and everything feels difficult, I have to remember Dr.

Abla's words. Go find something normal.

Go back to the beginning, right? The scar tissue is the end.

It's the big mess and it came from somewhere, came from prior surgery,

but there's still some anatomy down there that's normal somewhere.

And sometimes I have to get Damon, and my PA to give me a hand.

We have to change the angle of the microscope.

And I say, Damon, look as hard as you can at that white stuff there.

Look for any evidence that is pulsating. There might be a nerve.

Look for anything you can see and help me focus my eyes here because we need

to be sure before we cut this that it's not a nerve in there.

And I'll get Damon to help me get another perspective, another person to look

at it and say, hey, is this as scarred up as I think it is? Or is this something more normal here?

Go back a little further lateral, and I'll find a bony edge.

And once I find that bone, I can drill into the normal bone a little bit and

drill deeper and find some ligament that hasn't been removed.

And I can get a curette in there and separate that from the scar tissue.

And then I can get deep to the scar, and I can find some normal disc,

and I can go through the disc and then find a plane between the disc and the

nerve. And before that, I found the beginning.

I found the starting point from which I can proceed and do the rest of the surgery.

And it turns out that the secret, the path forward when you're dealing with

scar tissue is to go out and find something that's not scarred up,

to find something that's more normal.

And I'm just here to tell you, my friend, no matter what you've been through,

no matter what your life feels like to you, the truth is you've got a lot of

things that are still good in your life.

You've got a lot of tools and a lot of abilities that you might not even realize that you have.

The Bible says it plain in Ephesians chapter 1, starting in verse 17.

I keep asking that the God of our Lord Jesus Christ, the glorious Father,

will give you the spirit of wisdom and revelation so that you may know Him better.

I pray that the eyes of your heart may be enlightened in order that you may

know the hope to which He has called you, the riches of His glorious.

Listen,

friend, I'm praying that today in the operating room of your own life,

that your eyes will be opened, that you can zoom the microscope in,

that you can work out to a little bit different spot where you can find some

tissue that's not so damaged, and you can recognize that you still have tools

and power and talent and opportunity and you've got a wise professor,

the Holy Spirit and your friend Dr.

Lee Warren here in your ear reminding you that there is a path forward.

There's a place where that nerve isn't as stuck as you think it is.

There's a way that you can make progress today.

The way out, the way through, is to find something, some ground where you can

put your foot down and say, okay, I know for sure that this spot is something

I can hold on to. This way I'm looking at this is right.

Even if I have to get a friend or therapist or pastor, a counselor,

some scriptures, somebody to look at it from a different way and say,

yeah, you can trust that. You can take that step.

That Nicholas Wolterstorff in his amazing book, Lament for a Son After He Lost

His Son, said, faith is a footbridge that you don't know will hold you up until

you put your weight on it, until you step out on it.

And I'm just praying today for you, friend. If you'll go all in,

you keep looking for that place where you can put your foot down and the ground holds.

Remember Mark Rogab said, the floor of your suffering was bought with Jesus' blood.

There's a floor, there's a place that you can put your foot down and faith and hope will hold.

Okay? The neuroscience is on your side here. When you dig in,

when you filter for things that are true, your brain will start noticing those

little footholds, those little handholds, and you'll start making progress.

And the word hope, every time it shows up in the Old Testament,

has this connotation of holding on to a rope that's under tension,

that you're not going to fall.

That hope will allow you to pull and climb and keep going, and it might not be easy.

It probably won't be easy, but you can hold on. and you can know that the way

out is through to look farther lateral, to dig deeper, to find something that's

true, to change your perspective, to use your tools and your people around you

to help you look differently.

And you can change your mind and you can change your life and you can get that operation done.

And my friend, it's time to go all in. It's time to change our mind.

It's time to change our life. It's time for some revision surgery.

And remember that you weren't responsible for the way that you started seeing

the world when you started thinking about it.

But now you've got to find some other way to look at it Because what got you

here won't get you there and if you want to make progress you got to change

your perspective You got to dig in and you got to get after it and the good

news is you can start today.