Dr Rahul Jandial: in some ways we've we've become adversarial. I'm proud that there are pills that can help. But people hate pills. But if they become the drivers, they'll see that pills are this option for them. They are, pills are their partner if their own changes and their own modifications to their diet, their wellbeing, their thoughts, their lifestyle, if that's not enough, we can supplement a little bit. If you if you change your diet and your cholesterol doesn't go down as much as we need it to, then we'll bring in pill at a lower dose. That way, they respect the, you know, people respect what docs do, medics do, and medics respect that people need to be treated as individuals who drive their own care.
Voiceover: Welcome to The Doctor's Kitchen podcast with me, Dr Rupy, where we discuss the most important topics and concepts in the medicinal qualities of food and lifestyle. These are some of the things that I've written about in my latest book, Eat to Beat Illness. And today, I'm speaking to Dr Rahul Jandial, an American dual-trained neurosurgeon and scientist at the City of Hope, a research centre, hospital and postgraduate training facility in Los Angeles. He is well known for his cutting-edge approach to brain surgery and neuroscience and has absolutely transformed the lives of his neurosurgical patients by putting them through his specially developed boot camp for restoring brain function. He's written an eye-opening, informative and accessible guide, Life Lessons from a Brain Surgeon, where he uses his years of experience to show how healthy people can rewire their brains to work in a higher gear. And this is what we'll be chatting about on today's show. And when I first thought I'd be getting Dr Rahul on the show, I thought it was going to be quite a technical show, talking a lot about the intricacies of the human brain and how we can do hacks and and tips and tricks and that kind of stuff. But what this podcast really was about, and I think it's so special, is just how humble Dr Rahul is. His his learnings from his practice, how connected he is to his family and genuinely his experience in London. He he's thought of this process of writing a book and being asked to come to London and speak at events as just such a wonderful opportunity, and it really does come across. He has plenty of anecdotes in this podcast, but plenty more in the book, and I absolutely love his writing style. Blending smart brain hacks with case studies and storytelling from his own experience is something that he is truly a master at, and I highly recommend you pick up a copy, Life Lessons from a Brain Surgeon. I really hope you enjoy listening to this episode. The recipe will be on thedoctorskitchen.com, and you can see the video recipe on YouTube as well, thedoctorskitchen.com. There is a lot of evidence-based, safe dietary lifestyle change that we as practitioners can be confidently discussing with our patients. And this is something that Dr Rahul truly resonates with. And it's just so humbling to be able to speak to a super specialist, someone who does brain surgery for brain cancers for a living, and someone who just gets it. And and I I I really hope you listen to the end. I'm going to summarise what we sort of talked about in terms of brain hacks and stuff, but this is more about his journey of maturing into a medical student into someone who wants to specialise and his experiences along the way. I truly hope you enjoy this as much as I love making it. On to the podcast.
Dr Rupy: I'm going to be cooking for you a mushroom, a wild mushroom, tarragon fricassee. It's going to have some walnuts, some broad beans, a little bit of tomatoes, some sort of traditional flavours of shallot, banana shallot and some garlic and courgettes. Sound alright?
Dr Rahul Jandial: That sounds great.
Dr Rupy: Good. We're just going to pop this in a little bit of butter and some extra virgin olive oil. Very low sort of heat cooking, so we're not burning that extra virgin olive oil, which we know has got good brain health benefits. And the sort of overriding flavour is going to be the wild mushroom, but it's going to be kind of mellowed with the tarragon hopefully. So, yeah.
Dr Rahul Jandial: Let's enjoy.
Dr Rupy: Yeah. So, you're in London for 10 days. How's your how's your journey been so far?
Dr Rahul Jandial: It's been fantastic. We were talking about that on the way in. People keep asking me, are you breaking the jet lag and how's it going with that and your techniques for breaking jet lag? And my answer is we're not breaking jet lag at all. We're going hard day and night. So, I'm here with my son. You met him, he's 14. And it's quite a maturation experience for him. Yeah, absolutely. The journey and the places we're going to are not accessible to just people who are here for tourism. So I feel honoured and humbled by the perspective and view I'm getting of Londoners. It's been fantastic. So we did some additional stuff. We went to Stonehenge, as I told you. We did a bike ride for a couple hours. We went to Tate Britain to see Van Gogh. And in all the stuff related to the book as well, and different restaurant every night. We went to a I think it was a tandoor kebab. It was like a tapas tandoor thing. It's excellent.
Dr Rupy: Whereabouts was it? Was it East London or?
Dr Rahul Jandial: It was close to where we're staying by Trafalgar Square. I don't know how to say that just right, but it's been fantastic.
Dr Rupy: Oh, you said it perfectly. That's perfect, yeah.
Dr Rahul Jandial: And then one night we went to Italian restaurant. Last night we went to Bancone. That was phenomenal. I had a recommendation. And so we're we're going for it. We're we're savouring this this week.
Dr Rupy: Yeah. Oh, that's great. And you're going up to Edinburgh as well tomorrow, right?
Dr Rahul Jandial: Tomorrow train to Edinburgh. I want to see, wherever I go with them, we do city. I travel with all my boys and my wife. But I travel with each of my boys once a year to a far-off place alone. The communication is different when it's just me and one boy. When we get all of them together, it's wild. It's great too. But one at a time. And I like to see the city, so we get a pulse of the energy and just the, I can see how they're navigating a busy space. And then I like to see the land right outside of the city because sometimes cities start to blur, you know? They've got similar restaurants and similar subways.
Dr Rupy: Absolutely, yeah.
Dr Rahul Jandial: I think Mexico City might have the same design for the tube as you guys or something like that is borrowed down there. I'm not 100% sure, but you start to see these overlapping similarities. So I like to get out a few hours to, what do the trees look like? What does the land look like? What do the people look like outside the city? So that's where we're, tomorrow is Edinburgh.
Dr Rupy: I've done the same actually with LA. So I've got a few of my friends that live there and we'd go for hikes just outside the city. And it just gives you a real sense of of how real people live in that part of the world, right? Because otherwise you just see, like you said, the sort of same museum and and tube network and and restaurant scene.
Dr Rahul Jandial: Heavy on the garlic and onions.
Dr Rupy: Yeah, yes. I'm all for that. Yeah, so just chopped up this shallot and the garlic and that's going in. So we're getting that the proper French sort of style flavours here. And I'm not scared of using a little bit of butter, even though yes, it has saturated fats and stuff, but you know, in moderation, these kinds of things.
Dr Rahul Jandial: It's not the indulgences, it's the habits. That's an interesting thing, in LA people go on a diet and they say, if, you know, they've stayed on the diet for 24 days and then they have a burger, they think it undoes the value of those 24 days. It doesn't. Indulgences never hurt the body. It's the habits that get us.
Dr Rupy: Absolutely. And so how would how would you describe you growing up and eating food? Like what was your connection with it? Was it something that was important or was it something that you've only recently got into?
Dr Rahul Jandial: You know, I I don't remember food being remarkable when I was young. I don't remember music being remarkable when I was young, even though those are things I love now. I think as a teenager in Los Angeles in the 1980s and 90s, it was such a toxic environment that I almost feel like it was living under just this constant threat. So the the things I enjoy now, either I wasn't exposed to them or I didn't cultivate them. So I don't remember much of food. I do remember the first time thinking about food was in the university when they had the cafeterias. And so then they had all kinds of different food. I think like meatloaf and pasta and that was the first time I noticed there were different cheeses and and um I met my wife, my my wife now, back then I when I met her, she was the first person to take me to sushi. And I'm and now I'm just, I'm not a sushi snob, but I am a sushi connoisseur. I'll eat California roll, it's like French fries. I like it. I'll take it any time. But I've also indulged and gone to Masa in in New York City, which is a Michelin three. I don't get into their ratings. If there is something I like San Pellegrino's ratings more, more young and creative. Their top 50, whatever it is. But I went with my teenage son and it was pricey. We indulged. We we cut the money for the hotel budget and we raised the money for everything else. It was $700 each for Omakase.
Dr Rupy: Wow. Was it, was it $700 worth it?
Dr Rahul Jandial: It was. It was. That's the most important thing, right? We made a we made a couple of jokes. He was 16 then, not my son Kai is here now. Zane went with me to New York. We made a couple of jokes looking at each other where we went, last meal. Meaning like if we were, it's kind of a macabre thing to bring up but, last meal. And we've extended that to, what would be your last bite? The last flavour you want to enjoy in some sort of strange hypothetical situation. For me, I don't know what it is for you, but for me it would be uni.
Dr Rupy: Uni. What, remind me what uni is?
Dr Rahul Jandial: It's sea urchin.
Dr Rupy: Oh, wow, okay.
Dr Rahul Jandial: Sea urchin with seaweed paper just to soften it with a little salt. That is mine.
Dr Rupy: I don't think I've even eaten that.
Dr Rahul Jandial: Yeah, it's, it's a little bit like um, I don't know how to explain it. I think it's got the smokiness of a good scotch, the texture of pâté almost with a bit of like um, it's got, you know, it's briny, an enjoyable briny. It's not fishy. It's the, it's the Japanese have something about that. So sea urchin is and so when you come to LA and if we ever hook up, north of LA to Santa Barbara, 100 kilometres, they actually have great sea urchin in the Santa Barbara pier. You just go to the pier and get it. It doesn't have to be a an exclusive access thing. But so it's been fun bringing food in with the with the kids and you know, what I noticed was, so then jump forward, I've got teenage kids. I do want them to be as robust as they can be, psychologically and physically. And then so we started telling them, don't eat junk food, don't eat that, don't, but we didn't give them an alternative. So, with kids, it's like, all right, you took all the good stuff out of the closet and the pantry, but there's nothing left. So now, I would say in the last um, I prepared my first meal, it was for Mother's Day, this year for my mum.
Dr Rupy: You prepared your first meal?
Dr Rahul Jandial: For like company.
Dr Rupy: Oh okay, fine, yeah. Okay, yeah, yeah, yeah.
Dr Rahul Jandial: And it was just my, you know, my my brother and my mum and that. It was just a gesture to her. Last year my father, her husband, passed away. So it was sort of like, you know, you're we're going to pay a lot of attention to you, mum. We love you. And what I found that I'm good at is um is baking fish.
Dr Rupy: Baking fish, okay.
Dr Rahul Jandial: I can bake a killer salmon.
Dr Rupy: Yeah, yeah. In the in the like baking paper? Is that how you do it or?
Dr Rahul Jandial: I do it in foil in the toaster oven. It's a strange thing. I feel like I can predict, I guess that's the surgical thing in me. I I need I can control the temperature and predict the timing better than the big oven. Sometimes it says it's 350, but I I don't know, it doesn't feel like it and I don't want to put the extra thermometer in there. So, so I do this um, and what I realised was if you get reasonable fish and meat, and I tend not to eat a lot of meat, but it's that's a different topic we'll get into this. I think it's again being a cancer surgeon, I'm trying to, I'm trying to lean away from eating flesh. Something about it is there's some cognitive dissonance I'm going through about operating on patients and eating flesh. Something's not vibing with me as I'm getting older. But for my family, um I put the, you get the salmon, you put it on a long sheet of aluminium foil. It's olive oil and whatever spice you want on top, like a salmon seasoning powder, and just close it like a little envelope and it's 30 minutes at 350.
Dr Rupy: All right, okay, yeah.
Dr Rahul Jandial: It's perfect every time.
Dr Rupy: We've been chatting for food, the whole time, but you're you're here promoting your incredible book, Life Lessons by a Brain Surgeon, from a Brain Surgeon. How's it all going? It's I mean, it's sort of become a best seller in the UK in a couple of weeks.
Dr Rahul Jandial: I I I you know, the funny thing is I have I'm not a, I try not to look at that. Even my own social media, my Instagram, I have somebody else, I give the material to them and say, over the next month, here are some cool images and some interesting thoughts. And I like to walk away from it. For me, the constant connection with social media, rankings, because I'm sort of a, I'm a competitive person. I I I I'm sensitive.
Dr Rupy: You have to be, you're a brain surgeon. You want me to be competitive. Not casual, but so for me, creatively, it helps to look at things once a week. At Sunday, let's see how the week went. So I haven't looked at it, but it has been um, it has been a delight because the publisher, Venetia and her team at Penguin, they suggested the title.
Dr Rupy: Oh, right, okay.
Dr Rahul Jandial: They, it's it's my heart and soul over last 15 years of collecting stories and waiting till I was mature enough in the field, I had enough gravitas to, otherwise it's like, who is this guy telling us about our brains and how dare he speak about something so complex and personal?
Dr Rupy: Because you said that at the start of the book, you've been waiting to write this book for for years.
Dr Rahul Jandial: In the States, we get a lot of quick experts. Self-declared experts, they get some promotion and then you look at the track record and it's lacking. I didn't want to fall into that. And so what she did and what they did is they put the word stories in the subtitle and I really, really am indebted to them for that. Every chapter starts with three or four pages of a standalone gripping story. Can I give you the one about food, since we're on food?
Dr Rupy: Please do, please do, yeah, because that's the one where you go to Ukraine, right? Yeah, it's it's a phenomenal story.
Dr Rahul Jandial: And it's and it's it's decades established. Yet it's considered new. So that's our job, right? Like all the, we are the, how did medicine and surgery become the worst communicators in the world? We're sitting on this giant body of knowledge, we just can't explain it to people. We haven't shared it with people. But um, you know, the brain is an electrical entity. It's flesh that sparks. I like to think of it as 80 billion tiny jellyfish inside an aquarium. And um, and sometimes that electricity is aberrant. Just like you can have a heart arrhythmia and people get that. Like, my heartbeat is off. Well, your brain beat, your brain electricity can be off and it's called having a seizure. And if you have more than one, it's called epilepsy. And if you can't afford medicine as kids or the medicines that they have are not working, they I was on a floor in in Ukraine. And the mums were in the bed with the kids and they had little frying pans in the corner and it's just cooking only fat. And we have known for a long time an all-fat diet can be used to treat epilepsy. So there is the premise that I can start from to say, what what, what can Rahul say about food? And food can heal. That was, that's the, it's it's in all the journals. You might think it's wild now. Just go on and look that up. All-fat diet for intractable epilepsy. And then when I was reading that, I saw this quote by Hippocrates. I said, this is it. And it was, let food be thy medicine. And so how did we get from that to the way we eat and live now in the in the States and here? It's just, and then I would say on the flip side, food can be thy poison.
Dr Rupy: Exactly, yeah.
Dr Rahul Jandial: And so from there, I built this chapter that went into the mind diet and intermittent fasting. But that's, you should ask, why, why can Rahul talk about food? He doesn't cook. Right?
Dr Rupy: I'd love for you to try this. So this is the wild mushroom fricassee with tarragon. You can give me your honest opinion as well because...
Dr Rahul Jandial: No, I mean, that's my flaw.
Dr Rupy: But tell me some of the components because I'm not familiar with them. I know a few items like sushi and grilling, but otherwise I'm quite ignorant about.
Dr Rupy: So we have got broad beans at the moment. This is a seasonal ingredient. I think you guys call it fava beans.
Dr Rahul Jandial: Oh yes, fava beans, I know that.
Dr Rupy: So these are just cooked, lightly steamed and then thrown in afterwards as well. So it's got a lot of fibre, it's a protein source as well. It's very bland. It's sort of like a giant pea, but it's a very bland sort of ingredient. So that's why you've got to use punchy flavours like tarragon, nigella seeds and a little bit of wild mushroom to really bring it out. I've also added some walnuts in there because we know that it's got a good source of short-chain omega-3 fatty acids. Um tarragon, all these different simple herbs that have phenomenal phytochemical properties that can reduce inflammation in the body may have some brain health benefits as well. Just generally looking after your internal ecosystem is what I'm about because the body has this innate amazing ability to look after itself. And that sounds a bit woo-woo, but actually if you put your body in the right environment.
Dr Rahul Jandial: Let me just jump in there. We use the word environment when we talk about the brain. So much so there are words like synaptic pruning. That's like in a neuroscience journal. And that's that's the right way to think of it. It's not as these like modular, compartmentalised things. There is a ecosystem inside us. And to take it into a different direction into a disease direction, because I learned from that, if you have breast cancer, there's a different environment. The cancer is growing in a certain way and looking for certain nutrients and fuel sources. When it swims to other parts of the body like to the brain, which is my, what I, my specialty is, it it it morphs and drinks different kind of juices in the new environment. We speak of the microenvironment inside the brain. And so your suggestion or your, that you posit that our body is an environment and it can be healed and brought to a better homeostasis if you will. These are the kind of words we need to bring out to the public so it's not eat one blueberry and it's a brain food. Change this one thing and you will be skinny and gorgeous and healthy, you know? And that's exactly where we need better, more impeccable language. And so environment is exactly that.
Dr Rupy: Yeah, absolutely. Great.
Dr Rahul Jandial: Um, I love the mushrooms. The walnuts for me are a little bitter, but that's why people do the um, but they're so good for you. What I do with the kids is I sprinkle a few M&Ms in there.
Dr Rupy: Yeah, I know, totally, yeah. They're a little bit more bitter because I've toasted them slightly just to bring out some of these essential oils. But a good um suggestion because it was either going to be walnuts, but if you prefer like a slightly softer nut, pine nuts work brilliantly. Yeah, they're wonderful, so.
Dr Rahul Jandial: I like it.
Dr Rupy: Good. I'm glad.
Dr Rahul Jandial: No, I do, and I love the mushrooms in there. It gives it that fleshy flavour without flesh.
Dr Rupy: Yeah, yeah.
Dr Rupy: it's going to be plant focused, tons of fibre, you know, quality fats, not getting rid of all fats. Fats are super important. Um, and um a ton of different colours. And once you hit those sort of markers, you're looking at a diet that can improve yes, your brain, but also your skin, immunity, your mental health simultaneously. And it's like what we were talking, you know, that internal environment. Um, you know, how the body has this innate mechanism to sort of look after itself. And homeostasis is a concept that just fascinates me. You know, it's something that um we have lost the balance of and I think once we push people towards that state, then it's, yeah, things just seem to click into place.
Dr Rahul Jandial: Yeah, and if diseases could be treated without medicines, you know, that would be a huge advancement for us. It's almost like medicine was made and it helped. I mean, of course there, I give these talks for City of Hope about um inventing medicine, right? Because people, what are you, you do research? I don't know what that means. Do you study where cholera spreads? Do you study car accident research? No, we invent medicine. We manipulate cancer cells and squirt things that kill them and then try to bring them to patients in that process. And so medicine is important before we get to, we have too much of it. Um early 1900s, the top three killers were infection, infection and infection, you know? And then there was penicillin. Changed a lot of things for the better. There's no question that is, that's a medicine you want to keep around. People say, I don't like to take pills. No, you want that one. You don't want to die from an ingrown toenail, like people used to. And then there was um a virus, you know, and then Salk vaccine. And in San Diego where I got my PhD, there's a Salk centre. And uh he never got a patent for it. He just, he's like, I don't want the money with this. I just want it out there.
Dr Rupy: Really? Oh, I didn't even realise that. Wow.
Dr Rahul Jandial: So the Salk vaccine, polio. But there were pictures of children and people who using crutches and these sort of things. That's a powerful thing to, you know, that's legacy. Um and then I was at, how old was I then? I had dropped out of university for two years.
Dr Rupy: I wanted to talk to you about this actually, because this kind of interweaves into the book is um your own experience of kind of losing the passion for what your undergraduate was in and then you were a security guard at cafeteria, you ultimately met your wife. And which is good, yeah, that's.
Dr Rahul Jandial: The other day I was at Stella McCartney, I said, my current wife. I said, I mean, I mean my only wife. And they tore me up. And my son was there and he just, he just covered his eyes. He's like, Dad, what is Dad, Dad is himself at, Dad is actually still thinks he's in his kitchen, talking like he's in his kitchen.
Dr Rupy: I have a friend actually that refers to her husband as her first husband. Like, this is my first husband. He's like, can you stop saying that? It's like, I'm just trying to keep you on your toes.
Dr Rahul Jandial: I like that. I like that. No, we've got to, we have to choose to be married daily. Uh, that's funny. Um, I never liked studying. This is not some, my mum and dad will be my, well, my dad, um in the past, you know, and when you when you get older and you, kids are around they're like, listen, nobody hated studying more than your dad, Rahul. He would tell my kids. So don't, it doesn't, you don't have to love it to realise it's a path to somewhere. And it's an opportunity that many don't have. So it doesn't matter. There was one perspective. They never pushed school a lot. They just said get straight As and we won't push school a lot. We'll leave you alone if you get straight As. So I got straight As. And I didn't, I was the master in my school of getting just 90%. I never tried to get, why get extra? This gets me the little letter, right? Okay, fine. I'm going to go party. So I I had a wild youth. You know, I had some wild friends and um, it makes sense. My hormones were going, my frontal lobes were trying to figure out is, you know, what's what's inhibition and what's disinhibition. We also know a lot of mental health issues spike at that time. So there's something going on that's magical in your late teens and early 20s. When I got to college, it was just to get away from LA, frankly. I went to a university I had never set eyes on. My brother went there and I was like, I'm it's Northern California, I'll just, yeah. I never looked at it. I just wanted to get out of LA. And I was young, I was 17. Um, and I asked my mom, how am I 17 and a senior? Why am I the youngest kid in my class? He's like, well, we had an opportunity to get you to start school early, so we put, we started you early because you were such a nuisance when you were a toddler. So when she, she's she's she's an attractive, not older, but less young woman, she's got a full head of hair, and she'll just sit there just deadpan and say that in a room full of people. Yeah, you were a headache as a toddler, so we got you started early. And that's why, that's why it lands so well. But when I got there, I was young and I had never enjoyed. And San Francisco and Oakland and Berkeley with their version of the tube, I didn't have a car finally. It was great. They had a metro, you know, they had, it's called the BART. And people were different up there. Northern California is very different than Southern California. It wasn't as adversarial when men looked at each other, it wasn't like road rage or are we going to fight? You know? And um I started to realise I needed some personal health and psychological development that this place was providing me. And once again, I wasn't studying and I was getting Bs and Cs. And so I thought, let me take some time. Worst case scenario, I come back and get all Cs and I still get my diploma. I'm not I'm not um I'm not, I don't lack strategy. So I thought, you know, I'll just, I'll finish this because I'm not doing anything and I'm still passing. But maybe I'll take some time off and do something different. That time off, three things happened. Um, San Francisco General was in the middle of the AIDS epidemic. And that was the hub. They have books written about it, San Francisco General Hospital. Um I think the Facebook guys put his name on there and I just, I don't know how I feel about buying sanctuaries if you will. I'll just leave it at that. Putting your name on it. Um I mean how you get buying stadiums? All the stadiums in in in the States are now, you know, Petco Park.
Dr Rupy: But this is very different though, isn't it? Yeah, it's a sanctuary. People go there to die. You get your neon sign up there. I just, that doesn't make sense to me.
Dr Rahul Jandial: Back then, and in my heart, it's still San Francisco General. And I saw um people like, just, I was volunteering and my, all I was doing was wiping blood off gurneys. But it was like, whoa. A lot going on. There's more going on in here than is actually outside in San Francisco. San Francisco is a wild place. So it became this like aquarium and I realised, I don't like studying but I like studying people. And then at the same time, my mum got breast cancer, so at that time, those things were considered, my mom got breast cancer and at that time it was considered terminal. Um but it wasn't. Uh she's around, we live together now. She's with me. My dad passed away last year, so she's living with me and my three sons and my wife, my first wife, my current wife, my only wife.
Dr Rupy: Only wife to be. I dedicated the book to her. All seriously. To the love of my life. So in case she leaves me, the dedication still applies. The love of my life. That's how I would describe this relationship with this woman.
Dr Rahul Jandial: She did, was she quite pivotal in terms of you sticking with medicine or going to medicine?
Dr Rupy: She didn't want me to change. That was an interesting thing too. She, it wasn't like, calm down, be more motivated or, it was just, take, take all that you are, all the heat, all the intensity, all the craziness, the wild, whatever is, just put it to good use. Deliver it with purpose. It was such a, and the word I can say is, because in the States, it's all about, you know, calming down, finding zen, all that. I get that. I like that. It just didn't apply to me. I'm not diminishing other people's narrative, but that's not my narrative. My narrative was be badass. Just put it to good use. Just don't be destructive with it, but hold the energy and redirect it. So I call it sublimation, you know. So the confluence of those three things meant, okay, let's, I'll try to get into medical school because I never thought about law or account. I'm just, you know, I'm not that guy. Um, that was it was going to be either that or become a police detective or a firefighter. It was not going to be, I'll go into law or I'll be an accountant. I'm not again, not diminishing those professions. It's just not my narrative. And uh but my grades sucked, right? Because I was getting all those Cs. So then the climb back was brutal because at that time in the States, the dot-com bubble had burst and all the engineers were trying to pivot to medical school. So the applications went up in a competitive landscape. Gotcha, yeah, yeah. So then next thing you know, I'm in Compton City College. This is the city from the Serena Williams sisters and N.W.A. and now Kendrick Lamar. Uh, and uh I found a professor there, an English professor. And uh he said something to me, I know because he figured out like this guy, you know, you're going to be fine, you know. But he said, I know you'll do well, but I hope you do good. So I held on to that. And later on, I dedicated a textbook to him. I don't even know his first name was Mr. Jet. So all of those things happened because I took the circuitous route, the tangential route, the obliquity. I took some chances. I mean, I didn't take health chances, I didn't take life chances. And so it um it redirected me and then, you know, I had to get straight As for a couple of years and I had borderline, you know, marks and got lucky on a standardised test and got into medical school. The first thing I did when I got into medical school, I took a year off. I said, I'm exhausted. It's time to party again and relax. The partying with a medical school admission in your pocket, that's a good feeling.
Dr Rupy: Yeah, I can imagine, yeah.
Dr Rahul Jandial: Versus I'm partying but I don't know where I'm going. And then medical school happened and I thought I was going to be, you know, I didn't like medical school again, to be frank, because it was classroom work. Once I got to next thing, you know, I'm in LA County General Hospital, 2200 beds, a place where the gangs at that time had actually come in and shot and killed doctors. I mean, it was like, and and I was like, this is metal detectors to go in. And it was this whole ocean of life in there. And I fell in love. I love, I fell in love with people. And um went into surgery because I thought I was going to be a heart surgeon, then uh I didn't actually go directly into neurosurgery. It's a different discipline over there. You have to apply directly into. I didn't have the marks for it. And I didn't have any exposure to it. But when I was in general surgery in uh San Diego, just about 150 kilometres south of Los Angeles, um they had an opening in neurosurgery. And they had seen me one month on their service, if you will. Um and they said, hey, you know, so they picked me up. So it was a again, another random way to get into brain surgery, right?
Dr Rupy: Because you were in to you were doing cardiothoracics before then and then sort of pivoted because someone told you there was an opening and it's very fortuitous at the time.
Dr Rahul Jandial: Before I pivoted, I said, well, can I at least see what brain surgery looks like? I had never seen it. Because in medical school, if you're not going into it or coveting the position potentially, you probably won't even drift through there. I just something to see an open skull. And it's not grey. It's not like cardboard. It's it's opalescent like I wrote in the book. It's like an oyster with these serpentine vessels. I mean, it's something like something. At first I thought I was like, is this possible? Because it's white. It gets 20% of the blood flow and it's white. I don't know how to explain that. It's it's like, huh?
Dr Rupy: I love that section actually because you have pull-outs where you're like, you know, busted, neuro busted, grey matter is not grey. You know, it's this beautiful colour and then underneath the white matter is a pearly white. You describe it as yeah.
Dr Rahul Jandial: And what how we fell into that um misperception is they kept showing the brain once people died. And they held it in their gloved hands. Well, it's not alive anymore. Right? Somebody should have said, let's take some beautiful pictures in the operating room to show you. And it pulsates, not like the heart, but it throbs. And it's it's floating in white, not white, excuse me, clear, odourless fluid, but they still have proteins and diseases in it. Clear fluid, shiny, pearly, opalescent material, undulating ridges. I it was a, it's a sacred space. Um so into neurosurgery, into brain surgery I went and then my wife got pregnant by me. Since we're clarifying, yeah. I mean, she's, you know, that's her choice. Uh just because we're married doesn't mean, you know, she loses any of her freedoms. I want her to choose me daily. Uh, but she's an OBGYN, so I looked at her like, I thought you were, it's not like the birth control was all in your house. So I was like, huh? So another, and so she, and you were in impulse control, so it was a bit of a, it's a collaboration there. Yeah, we we did collaborate for that pregnancy. Yes, we did. Um but um that's funny. But we, she was 26, I was 27, as you know, in training for this stuff, this is not a good time to have a baby, but we're going to go for it. So uh family helped, nannies, different cultures, different foods. We just went for it, travel. Let's not, let's not hold back. Let's not pretend like this is a burden. Let's let's party like rock stars. We got a little kid now. And uh and um I had this opportunity. We're supposed to in that seven-year neurosurgery training, you're supposed to take a year of uh research. Again, I don't know what research means. So most people could just research, you know, like if you do this brain surgery, how many infections do you get out of 100? But San Diego is the highest per capita of neuroscientists. Remember I mentioned Salk is over there? Um there's like five institutes in this bluff in San Diego overlooking the ocean. And when I went there, um I was working at Children's Hospital and for epilepsy, they would cut out parts of the brain, the temporal lobe and we set up the arrangement and the parents agreed and there were no patient identifiers. So I was able to bring human brain tissue to the laboratory where they had been working on like mice brains, mouse brains. And so there was an advantage for me. I was also older. And so during those, I took another additional year and I got enough data to get a PhD out of it. So I started as an MD in residency and I launched at age 36 with an MD and a PhD. And I was like, well, how did that happen? But and then something again, accidental happened. Something I wasn't planning. I thought I was going to be a private practitioner. Um when I interviewed at City of Hope, they said, well, okay, you've got some interesting data right here. It's hot data, it's fresh. Because usually when you get a MD and a PhD, you do it in medical school and then you do your residency or your training and it's old data. So I had hot scientific data, new surgical skills. I went to UCSF again for extra uh cancer training. It was weird to come back to San Francisco General and see that now as somebody who's a participant, not just a spectator. Um and I've been at City of Hope for 10 years. I've got a laboratory there. It looks like CSI that show with the petri dishes and the fog machine and we're trying to invent medicine and and I take, I do only cancer surgery and I I operate on Wednesdays, I see patients on Thursdays and um Monday, Sunday, Fridays, Saturdays, Sundays, Mondays are to myself. That's when I think about science. I'm always thinking about science. I'm always thinking about everything all the time. It's not a, I shall now work on science, as you know. And and uh I've been fortunate enough to take some of those scientific ideas and apply to the US uh United States government, the NIH and uh last year, actually six months ago, we got a grant for one and a half million dollars to study uh cancer. And just to make the circle all the way back to when I had dropped out, there's two types of brain cancer. There's the ones you hear about uh Senator McCain in the United States or Ted Kennedy. It's glioma. It's an, it grows from the substance of the brain. It's the brain tissue going bad, if you will, breaking bad. But there are, more commonly are lung cancers and breast cancers wanting satellite spots and spreading up there. So I study breast cancer spreading to the brain. Um my mom had breast cancer, she's doing fine and back then I got her name tattooed on my arm and it's a, all of that stuff and this book being able to share those stories all the way from San Francisco General to about a year ago is in this book as well. And um it's been deeply satisfying for me to see the traction it's getting here and how Penguin and uh their team have um you know, they saw something in my writing. I never met them in person. They saw something in the writing and they set up all of this. And um you know, they've they've sort of revealed my soul in a light better than I even could myself because I don't know London, I don't know UK. They know you guys and they say, hey, oh, that's interesting and UK will like this and we're going to put it forward in a in a wonderful way more than it has happened in the states. So I am just so grateful.
Dr Rupy: Well, I'm grateful that they that they picked up on it as well because like I said in the first part of this pod, you do have this natural ability to segue. I mean, you've just been doing it now, you know, we've been talking about your personal experiences and how that relates to the kind of research that you're doing right now. Um and that those years where you're partying or like you're just being yourself, it reminds me of a quote in your book where you had the pleasure of meeting Francis Crick at one point, right? And he, there's something that um he said to you is scientists need to be more creative.
Dr Rahul Jandial: He said, well, we all know this in the lab. Geeks make technicians. Scientists are creative. I mean, how dare us try to guess how mother nature works. That's not going to be a 2 + 2 is four and let me uh do data mining to understand mother nature, right? So um but the creativity part um is a is a luxury for me to not only have a career where I can provide for my family, not only have a career that shapes my identity, to I feel good about myself because I, for the most part, I try to help people, you know, that's my, it's never not in my equation when I make decisions going back to Mr. Jett at Compton City College. You'll do well. I hope you do good. And the luxury of I've travelled the world in Ukraine and and um you do some work in Lima as well, right? Yeah, it's been a bunch of places. And that started because I wanted to honour what he said and that started because I wrote about that shit in my personal statement applying to medical school. And even though that will nobody will ever know about that, I didn't want to be a liar to myself. Cuz I was like, I know my grades suck, even though my standardized scores are sky high and that might seduce you, but if I get in and if I have the luxury of getting the privilege of getting into medical school, I will I will give back. So I I work at a in East I work back in LA County, there's an East LA hospital and I speak Spanish so I have a lot of Latino patients there and um and uh so all of those things, there was no wasted time, you know, people feel like especially in academics, oh, you wasted a year. No, no, no, no, this is my fabric. And in many ways, these tangential paths have um have really allowed me to surge forward in a life that's for me was unexpected. I didn't I'm not I don't I didn't expect, I was dropped out of university. I was just, I didn't expect to have this nuanced of a life, the luxury of um creativity in my life. How am I going to, how am I, how am I going to sculpt this, this this heavenly marble? How am I going to three-dimensionally remove this cancer without disrupting the marble as much as possible? Or how does science work? And the things I daydream about and then what am I doing in in your kitchen talking about this and my son is outside watching Kevin Hart on his. It's just this is a, I will never forget this. This has been a very um momentous week in my life, you know. And I've had, you know, I've got some good mileage for 46. I've done some fun stuff. So it's not coming from somebody who doesn't get out and get around.
Dr Rupy: Even the way you talk in terms of like your mind wandering and you know, the fact that you speak a second language and all these, these are all like concepts that come out in your book. And it's kind of just, your book is just like a structured way for you to express yourself. And there are benefits to this, right? There are benefits to to daydreaming, there are benefits to um using your left hand. I must admit something. I've actually started using my left hand to text on my phone, actually use my phone now. Um it's something I started a few years ago, but then I rapidly just forgot about it. And then once I read your book and I was like, okay, now I'm going to do that again because that is actually harnessing those new neural connections, right?
Dr Rahul Jandial: Right, absolutely. And just on a more fundamental way, you don't want to have arthritis just in your right hand, right? You you want to, you've got a lot of phone mileage to go. I don't plan to put my phone away. So it's...
Dr Rupy: And arthritis will start in your thumbs as well, so.
Dr Rahul Jandial: Yeah, absolutely. And um I was talking to somebody and not knowing these things or sharing these things in a overly simplistic way has maybe made us not see our real potential. Children, you're this type of personality, you're left brain. It it it closes us. You know, it um it puts us in a rut. And the key to get out of that rut is inside us, but nobody has explained to us that that is possible. So in the book, we have um extreme examples to show you what I call your top speed. It's up to you if you want to get out of first gear. I'm not here to be preachy and say, do this and do. I'm not that guy. I just I'm not that guy. I actually told, I was talking to somebody the other day, I I want to be allowed to do things that are dangerous or hurtful to myself. I just don't want to be misinformed about them. If I want to have a cigarette, I just want it to know and have known from decades past that it was dangerous. If you want to play American football, we didn't do our generation a favour by lying to them that it was just like boxing. But we knew if you go into boxing, everybody knew for the 100 years, well, you get punch drunk and there's dementia pugilistica. There are all these words that say, you bang your head against the wall or fist too much, it's going to mess up that delicate jellyfish inside. We knew that. And then if you choose it, that's fine. I I love free will and freedom. I just don't like misinformation. So I just want to let people know, for example, on creativity, um some patients with dementia when their frontal lobe withers, the CEO, the boss, the thing behind our forehead, there's two of them, it's a paired brain, it's a left and a right with this bridge. When that wears out, they can have dramatic improvements in their ability to paint. What are you talking about, right? Now I'm not saying get dementia to be, I'm not saying, but that should make people say, so there's something that was tamped down. Then you have these case reports of people being hit with lightning and they can do math. And then you have, you know, savants who might have an intellectual disability, and in America that's how we refer in the most respectful way. So if it isn't here, I just want to qualify that for the listeners. That's my most respectful and articulate and nuanced way to talk about that because I do take care of those patients. They can have certain mathematical abilities released. So there, if the homeostasis in our brains is tilted and it might be not good for you, but there are hidden talents and latent abilities inside us. That is the premise now. Then we talk about how about, well, I'd like to tap into those in my daily life. I'd like to tap into those if I work for Google or if I'm here in London. And then the book goes into what are the things that people can do. So I love the topic of creativity. I know four people that are wildly creative, four types of people, actually five, kids. Kids are, stuff kids. And guess what, their frontal lobe is not fully developed.
Dr Rupy: So that, that's quite interesting, isn't it? The fact that your frontal lobe isn't fully developed and this is where you harness those sorts of um the imagination, right? The um the sort of creativity element. Yet, you give them a box and they will have a whale of a time. Like I'm I'm watching my two godsons who are in America at the moment and just the things they come up with and how happy they are and content they are. That's...
Dr Rahul Jandial: So let me answer that conundrum. The frontal lobe is not developed and the frontal lobe is also the seat of creativity, but it's the part of the frontal lobe, I don't mean anatomically, the capacity of the frontal lobe, I don't mean like corner X, to uh squash down creativity to be able to go to school, check your emails, get on the tube, and check, the checklist part of the CEO component of our frontal lobes hasn't hit maturation. We can also lose that part by getting drunk. I'm not saying get drunk, but that's what alcohol does, it disinhibits. So the inhibition capacity, not location, of the frontal lobe isn't there, so creativity is having its way as a kid. Um some writers like to drink and they feel they write better. Then we're also uh microdosing. People feel like they're more creative. Again, that disrupts the frontal lobe from saying, I got to check my emails, I got to get home. Oh my god, I got bills, I got to all, and it should do that because you don't want to be walking around the park only being creative. You got to, you have to achieve the goals of the day to live, to eat. Um and then the fourth person that has is wildly creative are people with dementia again in front of Lobes now physically injured. And then what I would posit is, so so we know that creativity is, there's greater creativity than we deliver because the homeostasis is tamping it down, okay? Because we've got these examples. But we're all wildly creative in our dreams.
Dr Rupy: I love that term you used by the way in the book where um we are all Dali's of creativity when we sleep. It's incredible.
Dr Rahul Jandial: We are though, right? Wild stuff going on whether we remember it or not.
Dr Rupy: Yeah, yeah.
Dr Rahul Jandial: And so then I was writing this chapter on creativity. I just like, you know, I yes, mind wandering is helpful. Yes, getting out, walking around is helpful, being playful, but I just didn't feel like that was nuanced and sophisticated enough for for everybody. Uh so I do talk about microdosing. I do talk about, you know, a patient that had slow growing benign cancer and he lost his creativity, so just to set the precedent. And then doing just, oh my gosh, just years of like looking up creativity on Google and neuroscience journals and creativity, creativity. I wasn't finding anything fresh. And then I found this thing called, um it's the hypnagogic and hypnopompic period. It's the period where just the 15 minutes before you drift into sleep and the 15 minutes when you wake up. And people are saying that that might be like a portal that where you can access your subconscious. And I thought, this sounds, this sounds over the top. But there's science behind it. Before the science, I actually saw this amazing thing by Salvador Dali, 50 Secrets of Magical Craftsmanship. And he's always talking about using slumber as his as his pond from which he finds all his magic, right? I was like, but look at his stuff, right? And then the science. So if, you know, if, if you're not a child and you don't, I don't encourage you to drink, I don't encourage you to go backwards in time, though some people might want that, but I don't encourage you to have dementia. We've established those precedents. I don't encourage microdosing. But if you can harness sleep for creativity, uh here's an interesting thing. There are um the brain is electric and if you put a sticker on the head, you can detect the electricity. Just like when you put a sticker on the heart, you can detect the heart rhythm. Um and the rhythms that that 15 minutes while you're awake and drifting to sleep, you actually have dual overlapping readouts. One is awake and relaxed, that zen flow state that maybe Tom Brady has when he throws the ball or a ballerina has on that, you're not thinking when you're dancing, you know? That's a, that's an alpha state. And but you also have this light sleep dreaming wave. And those two waves, there's never any two waves. It's either one or the other. There's four waves total. But there, those windows in before you fall asleep and right when you wake up, you actually have dual waves oscillating in your brain. And so to me, that was the science behind, yeah, you're sort of, you're awake but you're drifting and we're widely creative when we're dreaming. And this is the concept of hypnagogic and hypnopompic periods as a way. And on the practical level, what I've done and I have done for a long time, I like to look at the tumours before I go to bed. Once all the checklist stuff is done. You can't be thinking about emails and fighting and, and so then I look at it and just just I just kind of let it float and just all right, man, and wake up and kind of look at it again and I take my notes then before I go to bed. I have a notepad. I use my phone for the notes app and I always have different headings. Um, and so that's the best I can do to talk to you about creativity. And I have been digging for years and years to come up with what is real and uh it's in the book.
Dr Rupy: Yeah, yeah, totally. And I I I love the way you actually um utilise the your sort of own uh ways in which you tap into creativity because um the way you describe the anatomy at the start of the book is actually very uh flow. It it just it just makes total sense to even a layperson. I gave it to a friend of mine and they read it and they were like, oh, yeah, no, I completely understand it now. And it's almost like you've tapped into your own creativity, you've sort of like put someone in your eyes and you know, you're actually describing all the different cortices and...
Dr Rahul Jandial: And that's from the being security guard in in Berkeley for two years and that's from all those patients that talked, talked to me and taught me how to communicate. I learned to communicate from my patients. Um and so all of that is uh is released in the book. It's something that I think uh I actually got my teenage kid reading it which is it was it was the moment. If I could have one billion readers or one, I would take that one. You know, can you imagine your teenage kid? And we were flying to Bolivia when it happened where he and I had done coca leaves to deal with altitude sickness. And I put that in there. Under smart drugs. And I looked over and he was uh, and he had the book open. I was, I was, I was glad to see it was right side up. And uh and uh, and then like, you know, 15 minutes later, he was asleep and the book was on the floor. But still, just that he thought, I'm going to try to read daddy's book. I just, uh it's been good. It's been really good.
Dr Rupy: And um yeah, you're probably expecting us to just talk about food the whole time, but actually, I found some of the most profound bits of the book were uh about you talking about breathing and meditation and how you were trying to debunk the myth that this is all alternative practitioners and actually there's tons of evidence looking at, you know, intervention trials where you can change the the volume of the hippocampus. The the volume and the the connections between the amygdala. Um that, that I found very, very interesting. Would you mind talking about meditation?
Dr Rahul Jandial: I would love to. You tell me when I'm doing too much, saying too much or going too long. I just, I could, I dream about these things. I think about these things. Like all these, I've been privileged to see so many interesting things, nobody's ever connected it in a in a deliverable package. So meditation. I'm not sure I know what meditation means because what happened in Los Angeles, it became mindfulness and it became, then I started seeing these things about the mindfulness of dishwashing. I was like, well, I don't need, I don't need a, and then it's almost like a guilt trip like if you're not happy being stuck in traffic, you're not in the present, you're not understanding mindfulness. And I don't want to be again, I'm not trying to diminish people. I'm just telling you what I looked at. I was like, I can't, it's not like everything has to be proven, but this book, the things I have in there, even if they look, even if they sound wild or they sound like an established principle is being smashed, there is personal stories, scientific references, but not in a way that it's over the top. There's proof in there. Um so meditation, I don't know what that is, but I know a few things. I know Buddhist monks can think down their heart rate. I know my cancer patients after surgery sometimes if they meditate, let's just use the word, but they can, they need less opioids. I know deep divers before they go down for like, how long can I hold my breath? They are, they are grabbing the mind-body connection. They're doing something. And it's not chemicals that are being released. So what is that? Um it's the vagus nerve. I've operated on the vagus nerve. So when a Buddhist monk thinks down his heart rate or her heart rate, but when when somebody meditates down there, it's going through a nerve that's sprouted from the deep parts of their brain and it comes down in the side of our throat. It's the vagus nerve. We're taught about it, it's by the carotid, it's the three things in that area. It's like and when you feel for your pulse in your neck, it's in there. And it goes around your heart and lungs and even into your guts. That's why when you get nervous, you feel it in your gut. You didn't really feel it in your gut. Your your brain felt it and the way the ripples came out, it just went down the vagus nerve which is wrapped around your gut. That's why you get butterflies in your stomach, in your tummy. So I started to understand, okay, the brain is sending signals down. Now that's established, right? We can all agree. Can the signals go in reverse? Can the body affect the brain? Can the body calm the brain? There's a thing called vagal nerve stimulator. People can just look it up after they're listening, so you can see like, wait, these are things that have been around for 20 years. It's a little, it's a little coil, it looks like a spring in a pen that that makes the pen bouncy and it's to a wire and we cut, make a little cut and we wrap it around the vagus nerve. We leave a little generator under the collarbone much like patients have for heart reasons. And it tickles the vagus nerve with electricity and it's a treatment for epilepsy. So again, tickling the vagus nerve with our little surgical device can calm the electricity of your brain. Okay? So now we've got an example that's been around for a while that that the nerve can work in reverse. It's bidirectional. It's two-way highway. And then what happens is breathing. A long, one, two, three breath, hold for one, two, three and then out three, two, one. Just a little bit of that. That's been going on for millennia. Has it been duping people for 3,000 years? But that's not enough of a reason for a sceptic. Some of those patients that have epilepsy and don't have the little coil, we do this bizarre thing. When we can't tell where the epilepsy starts, we can't treat it sometimes. This is when pills fail. This is like at the highest level of specialty centres. Pills fail, everything fails, diet fails, everything fails, right? Because diet can tamp down electricity. They um we actually open up their skull, scalp, skull, we lay a little grid, a thin grid, like like 20 stamps connected to each other, little wires coming off, just plop it right on the surface. So it's not, it's brain surgery, but it's not inside the brain surgery. Um and the wires come out and they live in the hospital for a week. So you got all these patients that we're doing there for a clinical purpose and then come in these grad students, they're 25 to 35 and they're wild and they have these ideas. Can we please, can we please talk to your patients because our patients are bored hanging out with a 24-hour readout of their brain electricity like from the brain, not a sticker on the skull. And so all these San Diego students, all these like, this is, they're just like, this is the best. And they came in and they started doing these deep breathing techniques with them and they recorded the electricity calming down, the electricity going more into that alpha state, the calm but awake state. That's in a publication. That's not my story. That's me putting the whole story together. So before you see your boss or when I pull in on Wednesdays for my operation, pull in at seven, I just take five minutes and do that and I go in there. I'm not saying you shouldn't take Xanax or you should. I'm not going there. I'm just saying you have these abilities that we have not shared with you. It is my fault. It is our fault that we have not shown you with all the powers you are self-equipped.
Dr Rupy: Absolutely.
Dr Rahul Jandial: So before you, during the day, if you do this a couple of times, and if it works for you, to me, that's meditation. And really it's what I call meditative breathing. So that's my whole thing about breath and life.
Dr Rupy: I really appreciate that actually because I think a lot of patients are um told that there isn't much in their locus of control. And I think that that um that sort of uh permission to actually, you know, actually you can do some things that are going to impact your physiology that are going to make you healthful, is really powerful for patients because when you're when you are a patient, and this kind of stems from my experience actually of becoming a patient when I was a junior doctor, it's a very embarrassing and vulnerable state. And when you can't figure out, in my case it was, I've talked about this in the in previous episodes where uh I had atrial fibrillation and going at about 200 beats per minute, there's no reason why I should have had that medical issue. There is no family history, there are no triggers, nothing like that. And yet it was happening to me. So that dysfunction in your body and not being able to understand, particularly as a medic as well, why this is happening. It's very disarming. And when you can actually teach people, okay, you know, we have, we do have medications, we do have interventions, we have surgeries, we have all these different things. Why don't we complement that with a whole arsenal of other safe lifestyle practices that we, that we know can have significant effects on our physiology?
Dr Rahul Jandial: It has to be that way. And even if we don't get the pills gone, at least maybe you'll need less. Even if you need to keep the pills, you'll drive your health, not just I take four in substance and it does something magical. You will be the driver of your care. And when, like my father used to say, you go in there like, take this pill, take that pill. And he's like, uh, no, he wouldn't take them. If you can't explain to me what is wrong, what right looks like, and how we're going to get there, I'm not going to listen to your suggestions. That's why all these listicles and these quick things on TV and different things just, every day it's do this, do this, do this. People are fed up with that. There needs to be explanation, there needs to be empowerment. And then what my feeling is, then people will say, I love pills in the right, if I'm, if I have cancer, I I love that people are trying to make better chemotherapy. I may choose it, I may not. If I have an infection, I love that there's penicillin. And thank that guy for finding it on that piece of bread or whatever he did. So in some ways we've we've become adversarial. I'm proud that there are pills that can help. But people hate pills. But if they become the drivers, they'll see that pills are this option for them. They are, pills are their partner if their own changes and their own modifications to their diet, their wellbeing, their thoughts, their lifestyle, if that's not enough, we can supplement a little bit. If you if you change your diet and your cholesterol doesn't go down as much as we need it to, then we'll bring in pill at a lower dose. That way, they respect the, people respect what docs do, medics do, and medics respect that people need to be treated as individuals who drive their own care.
Dr Rupy: I totally agree and that, you know, that blending of the science behind both of those disciplines, both lifestyle, diet, um all the different sort of meditative techniques as well, integrated with uh pharmaceuticals, with surgical interventions, that's the way. I mean, as someone seeing patients um who sometimes can be quite grievous against pharmaceuticals and I'm a conventionally trained doctor. Yes, I believe in lifestyle and the power of food and everything else, but at the same time, I I dish out antibiotics every time I'm working in an A&E. I dish out a whole bunch of different pills whenever I'm in general practice, but I complement that with all the rest of it as well. And you, I think you hit the nail on the head. An informed patient appreciates what you're doing for them and will therefore appreciate the science and the nuance behind all the different uh treatment modalities that we have.
Dr Rahul Jandial: We have this ridiculous word called compliance. Like compliance is when you send me that uh ridiculous uh training module I have to do more and more all the time. I mean that's corporate compliance, right? Like click, click, click and so, you know, I try to get my wife and kids to do some of them. I hope that doesn't make its way back. But the compliance thing is, patient compliance with medication. How do we turn them into like 66%? No. If if they're not taking the pills, it's because you, not you, I mean, we did not impart upon them why and how. Your blood pressure's up, take this. Well, nobody explained to them, listen, um these arteries you have, if you keep pumping this hard to get the blood to run through these arteries because they're all choked down, your heart is going to wear out. Pumping against high blood pressure. What is high blood pressure? Oh, my blood pressure's high. What does that mean? It means it's like blowing through a narrower straw. You're going to exhaust your heart. Do you want to exhaust your heart? And then it can actually get, the heart gets bigger. And in this case, a big heart is not good. You get hypertrophic, cardio, stuff things you would know better. So they have to understand, and then that also liberates them if they don't take their blood pressure medicine for the weekend, it's not like, oh, I, you know, then you have patients on the other side who have become imprisoned by the pills. But if you understand this is a glacial thing, you don't want to run your blood pressure this high over the next few years because you're going to wear out your heart. So let's start the process of making it, let's let's be, let's befriend your heart a little bit. Why don't you give up the salt a little bit? Why don't you do these things a little bit? We'll check in a little while. If your modifications can bring down your blood pressure, we're in a good spot. We're not going to take pills.
Dr Rupy: Absolutely.
Dr Rahul Jandial: And then if it isn't, then we'll try a little baby pill. But there's no education and information in that way. And because we don't communicate well, we have to be so smart to get into medical school that I actually made this suggestion in medical school that I think they were trying to kick me out. I said everybody should have to work at Taco Bell or Starbucks or Subway for at least one month to know how to talk to people because they, you know, you're just studying all the time. It's that competitive that there's no learning of communication of taking complex things, not dumbing them down, but taking the essence. And each patient is different. The CEO might need a different explanation. The person who I only speak Spanish to, I might use different words, but achieving that effect in the patient, that's real compliance. So whenever I see a patient isn't compliant with something, I think it's my fault.
Dr Rupy: Yeah. Yeah. That's a really good point because like, you know, the number of patients that I've seen with type two diabetes, it's just become another condition that you can take a pill for now. And the gravity of the condition, not to scare patients, but just to make them understand that there are ways around it without medications and it's a stepwise process. If we rely on pharmaceuticals alone and we don't do anything else, it is just a time before that becomes two, becomes three, becomes insulin, becomes all the other micro and macrovascular complications. One of which is dementia, which you talk about in the book as well.
Dr Rahul Jandial: If you mess with the blood vessels in your body, those are the same ones going to your brain. And that flesh needs to be irrigated as much as the rest of your body does. And in fact, it's quite brittle. You don't irrigate it right for three or four minutes, it'll die on you. But the kidney I can take out and put in another person and put in an ice cooler. It's extremely important to have cardiovascular health for your brain. But back to diabetes, um I you know, somebody explained it to me well. I can't remember who it was. He said, well, uh I was, the patient educated me. I was trying to explain it to him and he said, oh, it's like, it's like putting diesel in my car when it is unleaded. I said, exactly. None of us put the, we go to the gas, there's 100% compliance of putting the right fuel in our cars, but we can't explain to people like, hey, having that much sugar flowing around your blood vessels is tearing them up on the inside. And when you tear them up, they clog, they wither, we got to cut off your legs sometimes and you block off the flow to your heart and your brain. You don't want that. You're putting the wrong. Diabetes is corrosive. Because people say, oh, high blood sugar, but that by itself doesn't explain it. High blood sugar is corrosive to your plumbing. And he said, and I had that conversation with him, he was, I was like, I like that, I'm going to use that. I remember telling him, if I ever use it, I'm going to tell, I can't remember the patient's name. I'm going to footnote that I learned that from my patient.
Dr Rupy: Yeah, there's so much that I learn from my patients in terms of the vernacular I should be using, the way I should be describing things to patients. And particularly when it comes to food, you know, instead of me being prescriptive about, okay, you eat this for your brain and you eat this for your skin, you eat this for your immune system. You eat, you eat it for your body and your body has this ability to look after itself. So, you know, looking at sugar, for example, sugar isn't just about diabetes, type two diabetes that we're talking about. It's about brain health, it's about your immune health as well and and different types of fibres and how that impacts your gut microbiota. Um you know, getting into this way of describing things as individual silos is actually quite damaging to the the the real understanding of how our bodies work.
Dr Rahul Jandial: Yeah, I totally agree. And now, what I'd say, so if people think, well, you're against a monumental challenge, I would say, well, we were in the 1900s with infection. We were with polio. We were with AIDS. Now AIDS uh for people who can get the medicine, they can, they can live 20, 30 years. So we made these dents. I'm working on cancer. I think your mission clearly from what you've written, which is great for me because I don't get the liberty to talk like this with my surgical colleagues. We don't really talk like this, but I believe this and because I have kids and...
Dr Rupy: Yeah, absolutely.
Dr Rahul Jandial: So your, you're also liberating me to talk about things in this way and not just in a technical way.
Dr Rupy: Yeah, yeah, totally, yeah.
Dr Rahul Jandial: But it it so the change that we are trying to create now, we may not see for a decade. But we'll definitely won't see in a decade if we don't try now. And that's why I always give that talk about, well, I, you know, my patient, again, a patient said that to me, you know, the patients when they're when they're dying of cancer, they want to, not only take medicines that are on the on the brink of being released to the general population because they've shown promise and current medications aren't enough in in each of those scenarios, let's say, for those individual patient, they want to participate in the development of medicine and science. They are well aware it's not for them only. And they are well aware that half of them are getting a placebo, that they're probably not even getting the active ingredient, and they are passionately dedicated to clinical trials for the generation ahead. So what you're doing and what I'm seeing here in London in a new light, um is that the message, the podcast, the content, everything is so 10, 15 years from now, you see some kids running around and they, they believe these things, these foods are good for them. And it, they take it for granted, this knowledge because it's just, it's inculcated inside them because of the shifts and changes you're trying to make now. So I think it is very powerful. And the, you know, when I was younger, I always sort of put super specialists above everything. And now that I'm less young, getting my 40s, 46 years old, I'm seeing that maybe I do a lot with each patient, but these these global health, these wellbeing messages will change countries, will change generations and nations. And it's very important uh that somebody is doing that. So I just really enjoy talking to you about these kind of things.
