Latest / The You Project / #2238 What Happens In The Brain As We Die? - Prof. Tarvez Tucker

Transcript

#2238 What Happens In The Brain As We Die? - Prof. Tarvez Tucker · The You Project

• 0:00
  Speaker 1: G'day team. It's Harps. It's the You Project. It's Dr.
• 0:03
  Speaker 1: Tarvez Tucker, who we'll meet in a moment. It's a
• 0:06
  Speaker 1: bloody wet day here in the thriving metropolis of Hampton.
• 0:11
  Speaker 1: It's Friday. It's the end of the week. We're stumbling
• 0:13
  Speaker 1: towards the weekend. I'm very excited. I'm going to go
• 0:15
  Speaker 1: and see the old Darl, who you may or may
• 0:19
  Speaker 1: not have seen this week on social media. I posted
• 0:21
  Speaker 1: my gorgeous 87-year-old mum has got a job. in the
• 0:26
  Speaker 1: aged care facility that she really doesn't need, but she
• 0:30
  Speaker 1: wants to stay busy because she doesn't want to be
• 0:32
  Speaker 1: like the old people in there, failing to recognise that
• 0:35
  Speaker 1: she's 87, but that's okay. God bless her. Dr. Tarbes
• 0:40
  Speaker 1: Tucker joins me all the way from the States. Hi, Doc.
• 0:43
  Speaker 1: How are you? Thank you for being here. I'm terrific.
• 0:46
  Speaker 2: Thank you. I'm terrific.
• 0:47
  Speaker 1: What do you think about my mum? She's 87. So
• 0:50
  Speaker 1: speaking of all the things that we're going to speak about,
• 0:53
  Speaker 1: I was super interested. I didn't tell you this in
• 0:55
  Speaker 1: our preamble, Taves, but my dad passed away six or
• 1:00
  Speaker 1: seven weeks ago. And so it's been a tumultuous and
• 1:05
  Speaker 1: interesting time and managing my mum and looking after mum.
• 1:10
  Speaker 1: And so she's gone from independent living-ish into a care
• 1:14
  Speaker 1: facility where she's still quite functional and operational, but she's
• 1:18
  Speaker 1: got a lot of love and support and people and
• 1:21
  Speaker 1: mayhem and action, which I like because she's not isolated.
• 1:25
  Speaker 1: But yeah, she said to me, not yesterday, but the
• 1:29
  Speaker 1: day before on the phone, I rang and I said,
• 1:31
  Speaker 1: how are you? And she said, oh, I'm good. I've
• 1:33
  Speaker 1: got a job. I'm like, do you reckon you need
• 1:38
  Speaker 1: a job, mum?
• 1:40
  Speaker 2: Is she paid?
• 1:41
  Speaker 1: Yeah. Well, no, she's volunteering.
• 1:44
  Speaker 2: Perfect.
• 1:45
  Speaker 1: But she's working in the cafe there. There's a cafe there.
• 1:48
  Speaker 1: I said, and what are you doing in the cafe? Oh,
• 1:50
  Speaker 1: I'm just taking people coffee and I'm wiping the tables.
• 1:54
  Speaker 1: And I'm like, and do you enjoy it? Oh, yeah,
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  Speaker 1: it's good to keep busy, she said. I don't want
• 1:59
  Speaker 1: to end up like the oldies, she said. Oh, dear.
• 2:04
  Speaker 1: But there's something to be said for having a focus
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  Speaker 1: and a purpose. Yeah. And, you know, as we get older,
• 2:10
  Speaker 1: isn't there, even if it's just doing something like that,
• 2:13
  Speaker 1: I think sometimes.
• 2:15
  Speaker 2: Absolutely.
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  Speaker 3: And it occupies your mind and it actually, our mind
• 2:20
  Speaker 3: is plastic, so it can grow at 87 years of age.
• 2:23
  Speaker 2: And I love that.
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  Speaker 3: We used to think that we were born with all
• 2:27
  Speaker 3: the neurons, the nerve cells that we have had. And
• 2:29
  Speaker 3: I was taught that in medical school. But no, your
• 2:33
  Speaker 3: mom still has brain plasticity. She can create new synapses,
• 2:37
  Speaker 3: which are connections between nerve cells, and she can create
• 2:41
  Speaker 3: new neuronal circuits, and she probably does it in the cafe.
• 2:45
  Speaker 1: Yes, yes. That is so interesting, isn't it? I mean,
• 2:49
  Speaker 1: we're going to dive more specifically, but just broadly, I
• 2:53
  Speaker 1: feel like people think that once they get to a
• 2:55
  Speaker 1: certain age, maybe it's not a conscious but a subconscious thing,
• 2:59
  Speaker 1: whether it's 50 or 60, it's way young. I mean,
• 3:02
  Speaker 1: I turned 63 the other day. I know you're only 38,
• 3:06
  Speaker 1: but I'm old.
• 3:07
  Speaker 2: No, I'm 39, actually.
• 3:09
  Speaker 3: Thank you.
• 3:09
  Speaker 1: You're 39. Well, well done. You look great.
• 3:11
  Speaker 2: Thank you so much. Yeah, you're welcome. Never mind.
• 3:16
  Speaker 1: But it's almost like we go, oh, what is age-appropriate behavior?
• 3:21
  Speaker 1: I'm like, excuse my language, Doc, but fuck age-appropriate behavior.
• 3:25
  Speaker 1: It's like, well, what can you do? Can you go
• 3:28
  Speaker 1: to the gym and lift weights? Can you stretch? Can
• 3:30
  Speaker 1: you walk? Can you paint the room? Can you start
• 3:33
  Speaker 1: a new business? Can you like, can you build a project?
• 3:36
  Speaker 1: It's like, I don't ever reconcile what I'm doing back
• 3:40
  Speaker 1: to my age. You know, like I said to you
• 3:44
  Speaker 1: before we went live, just, you know, the last few
• 3:46
  Speaker 1: years I've been doing a PhD and all of this,
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  Speaker 1: I didn't start till I was 56, but nothing in
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  Speaker 1: me really thought, oh, I probably shouldn't do this because
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  Speaker 1: of my age. And I feel like as objective as
• 4:00
  Speaker 1: I can be, which is not very because I am me,
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  Speaker 1: but as objective as I can be, I feel like
• 4:06
  Speaker 1: my brain and my energy and my cognitive capacity in
• 4:10
  Speaker 1: general and my strength and all of those other kind
• 4:13
  Speaker 1: of indicators of health, I feel like I'm in the
• 4:17
  Speaker 1: same shape or better than when I was 40 or 45,
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  Speaker 1: especially from a kind of cognitive perspective because I use
• 4:25
  Speaker 1: my brain more than ever.
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  Speaker 3: And it's also experiential. You know, you're using your experiences
• 4:32
  Speaker 3: that you have between 40 and how old you are now.
• 4:35
  Speaker 2: You said 60? 63, yeah.
• 4:39
  Speaker 1: 63.
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  Speaker 3: So you have that time that you've accrued memories, which
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  Speaker 3: I'm sure we're going to talk about, the memories that
• 4:45
  Speaker 3: people remember at the end, such as before your dad died. But, yes,
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  Speaker 3: I think that brain plasticity, I think, and I know
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  Speaker 3: you were involved with exercise physiology. The brain is also
• 4:56
  Speaker 3: a muscle. particularly the hippocampus, which is our memory center.
• 5:00
  Speaker 3: And the hippocampus actually grows as it encodes memories. So
• 5:06
  Speaker 3: as you learn new things. So in your 60s and
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  Speaker 3: your mother at 87 should probably pick up the viola.
• 5:14
  Speaker 1: Wow.
• 5:15
  Speaker 3: Or learn Portuguese because you want to challenge your brain
• 5:19
  Speaker 3: in older age or middle age or actually any age
• 5:23
  Speaker 3: with something with which it's unfamiliar. Yes.
• 5:27
  Speaker 2: So if you love reading history.
• 5:29
  Speaker 3: Books, don't read history, read romance novels, or I don't know,
• 5:34
  Speaker 3: maybe you do that.
• 5:35
  Speaker 1: Yeah. I mean, I try to keep that quiet. It's
• 5:38
  Speaker 1: mainly a weekend thing.
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  Speaker 2: No, that's how I researched you.
• 5:45
  Speaker 1: Yeah. Yeah. Thank you. But you know what? That is
• 5:47
  Speaker 1: very analogous to, for example, if we talk just about
• 5:52
  Speaker 1: fitness or strength or gym type stuff, like you could
• 5:56
  Speaker 1: be quite strong. Like I'm reasonably strong because I do
• 5:59
  Speaker 1: a lot of strength training. But if we just move
• 6:01
  Speaker 1: slightly to the left and we take me to a
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  Speaker 1: yoga class, I'm completely inept because my flexibility is a
• 6:09
  Speaker 1: one out of 10, but my strength for my age
• 6:12
  Speaker 1: is probably a nine out of 10. So it's like, yes,
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  Speaker 1: it's do the thing that you don't normally do. I
• 6:19
  Speaker 1: always say, go to the room where you're the dumbest. Like,
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  Speaker 1: I don't want to be the smarter. I want to
• 6:23
  Speaker 1: be the dumbest in the room so that I can
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  Speaker 1: only grow, learn, evolve, hang out with people who drag
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  Speaker 1: me up.
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  Speaker 3: So you need to go to that yoga and Tai
• 6:32
  Speaker 3: Chi class and not where you're comfortable lifting weights, bench pressing.
• 6:40
  Speaker 1: You know me very well. But we are creatures of
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  Speaker 1: habit and we like predictability. We like comfort. We like certainty.
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  Speaker 1: We like to know what's coming. But the irony is
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  Speaker 1: I think that it's like when we choose the path
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  Speaker 1: of least resistance, we're kind of handicapping ourselves, but we
• 6:59
  Speaker 1: think we're doing ourselves a favor. It's like when we
• 7:02
  Speaker 1: do hard things, our body and our brain have got
• 7:05
  Speaker 1: to adapt, you know? And so that's that development stuff.
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  Speaker 3: And it's not just adapt, but we actually can structurally
• 7:14
  Speaker 3: change our brain by new experiences, like picking up the
• 7:18
  Speaker 3: Viola or you're doing a Tai Chi or yoga class.
• 7:22
  Speaker 3: Because when neurons fire so when nerve cells fire and
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  Speaker 3: they make connections with other nerve cells and that's what
• 7:29
  Speaker 3: plasticity is when you're older you don't necessarily create new
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  Speaker 3: neurons you can do somewhat do that somewhat but mostly
• 7:36
  Speaker 3: what you create is new neuronal circuits and by practice
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  Speaker 3: and by repetition and this is why memories that are
• 7:45
  Speaker 3: encoded from childhood are are so much, they persevere, they're preserved,
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  Speaker 3: as opposed to what you just had for dinner last night,
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  Speaker 3: which may go out of your mind. But memories, and
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  Speaker 3: particularly memories, and this is an aside perhaps, that are
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  Speaker 3: associated with emotions. So your mother's memories of her father,
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  Speaker 3: of your father, are probably most deeply poignant at those
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  Speaker 3: times when she was feeling something like.
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  Speaker 2: Love or ecstasy or sorrow.
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  Speaker 3: Because those are encoded like music in the brain in
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  Speaker 3: deeper pathways within the limbic system. And the hippocampus, our
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  Speaker 3: memory center, is in the limbic system.
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  Speaker 1: So there's a guy, yes, thank you. That makes total sense.
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  Speaker 1: There's a guy that gets a lot of attention on
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  Speaker 1: the internet. He's a neuroscientist called Andrew Huberman. Have you
• 8:39
  Speaker 1: heard of him?
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  Speaker 2: Absolutely, yes.
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  Speaker 1: I'm sure you have. So he talks about the anterior
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  Speaker 1: mid-singulate cortex. I don't know if this is true, but
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  Speaker 1: how when we do hard stuff, I don't know if
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  Speaker 1: it physically grows or it becomes more dense, but he
• 8:54
  Speaker 1: talks about basically the value of doing stuff that's hard,
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  Speaker 1: whether or not that's cleaning out the spare room or
• 9:02
  Speaker 1: going for a run or having a difficult conversation, but
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  Speaker 1: you consciously choosing to do something which for you is hard.
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  Speaker 1: He talks about this benefit.
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  Speaker 3: It's not only hard, and I absolutely agree, but also unfamiliar.
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  Speaker 3: And that's what we kind of talked about. You're going
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  Speaker 3: to the yoga because you feel comfortable lifting weights, but
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  Speaker 3: you're going to actually create new synapses, new connections between
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  Speaker 3: nerve cells by doing something that you consider unfamiliar. So
• 9:32
  Speaker 3: when your iPhone goes off as a text message and
• 9:37
  Speaker 3: you're concentrating on a work project, Your brain pays attention
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  Speaker 3: to the unexpected, and it's curious. So you've got to
• 9:44
  Speaker 3: leave your attention to that work project and answer your iPhone,
• 9:49
  Speaker 3: which is a distraction. So I think the brain actually
• 9:53
  Speaker 3: wants to grow when it's surprised, when it's unfamiliar and excited.
• 10:00
  Speaker 3: as Andrew Humerman says, when it's hard. That's when it grows,
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  Speaker 3: and that's our plasticity.
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  Speaker 1: And I think it's like I don't know. I feel
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  Speaker 1: like as someone who's just interested, I'm really interested in
• 10:14
  Speaker 1: human potential and what we can do. And I'm interested
• 10:16
  Speaker 1: in what my mum can do at 87. Can my
• 10:19
  Speaker 1: mum get stronger? Can she build cognitive capacity? Can she
• 10:23
  Speaker 1: learn new skills? And the answer is yes to all
• 10:25
  Speaker 1: those questions, as you pointed out already. But there seems
• 10:30
  Speaker 1: to be a very prevailing attitude that I need to
• 10:35
  Speaker 1: be careful what I say, but sometimes when I see
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  Speaker 1: a bunch of older people in a room and they're
• 10:40
  Speaker 1: sitting in a circle kicking a balloon, I'm like, oh
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  Speaker 1: my God, can we get rid of the balloons and
• 10:46
  Speaker 1: get them in a gym and give them some dumbbells
• 10:48
  Speaker 1: for God's sake? Can we actually do something that's... I
• 10:51
  Speaker 1: understand the balloon option, but I'm like, do you know
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  Speaker 1: how much how much potential they actually have. One of
• 10:58
  Speaker 1: my first major research projects was in a thing called sarcopenia,
• 11:02
  Speaker 1: which is just muscle wasting in the elderly. When I
• 11:05
  Speaker 1: did my first degree, as you would well know, and
• 11:08
  Speaker 1: it's like, people don't understand just one improvement. Like if
• 11:13
  Speaker 1: we could have everyone who's 60 or older, just 50% stronger,
• 11:19
  Speaker 1: just doing some conscious strength training for obviously some muscle,
• 11:23
  Speaker 1: for some function, for some balance, for some movement, for
• 11:27
  Speaker 1: some safety, for some bone density. And it's very, very,
• 11:31
  Speaker 1: because as you said earlier, 87 year old bodies can
• 11:35
  Speaker 1: still adapt as can the brains. They can improve. They
• 11:38
  Speaker 1: can Become more functional, but I don't think that the
• 11:42
  Speaker 1: majority of people actually understand that potential.
• 11:47
  Speaker 3: So now we have a way of looking at the
• 11:49
  Speaker 3: brain your mom's brain your brain Actually as it's being
• 11:54
  Speaker 3: used as it's actually thinking feeling experiencing and it's called
• 11:58
  Speaker 3: functional MRI so with your reference to exercise physiology, which
• 12:04
  Speaker 3: was part of your career in the beginning and The hippocampus,
• 12:08
  Speaker 3: the center of our memories and the strength of our
• 12:11
  Speaker 3: ability to learn, actually shrinks in two situations. One is
• 12:15
  Speaker 3: Alzheimer's disease or neurodegenerative disease, but the other is lack
• 12:20
  Speaker 3: of exercise. So what you're saying is that you can
• 12:23
  Speaker 3: actually enlarge your hippocampus by going to the gym. Or
• 12:28
  Speaker 3: in your mom's case, she just lifts free weights in
• 12:31
  Speaker 3: her bedroom.
• 12:31
  Speaker 1: Yeah. Yeah. A hundred percent. It's so interesting. All right.
• 12:37
  Speaker 1: I feel like we jumped a few important things. So
• 12:39
  Speaker 1: I'm going to backtrack. First, let me tell everyone who
• 12:43
  Speaker 1: you are. Correct anything I get wrong. Dr. Tarvez Tucker
• 12:48
  Speaker 1: is a neurologist, neurointensivist, and professor of neurology at Oregon
• 12:53
  Speaker 1: Health and Science University, where she leads neurocritical care section
• 12:57
  Speaker 1: and fellowship, The clinical work includes catastrophic brain injury, traumatic
• 13:03
  Speaker 1: brain injury and neurological intensive care. She spent decades caring
• 13:07
  Speaker 1: for critically ill patients and their families and is the
• 13:10
  Speaker 1: author of the forthcoming, I'm excited about this, The Brain
• 13:14
  Speaker 1: at Twilight, the neuroscience of our last words and moments,
• 13:17
  Speaker 1: which I'm incredibly interested to talk about. A little bit scared,
• 13:20
  Speaker 1: I'm going to be honest, but also interested, exploring consciousness, death, dying,
• 13:25
  Speaker 1: and what happens in the brain during our final moments. Now,
• 13:31
  Speaker 1: before we jump into, because I want to learn about that,
• 13:33
  Speaker 1: but When did you realize that you wanted to do
• 13:37
  Speaker 1: this kind of work? Was it early, early? Or was
• 13:39
  Speaker 1: it as your study and research progressed that you realized
• 13:43
  Speaker 1: that this is where you want to kind of land?
• 13:47
  Speaker 3: I was actually the opposite of a critical care physician
• 13:50
  Speaker 3: for most of my career.
• 13:51
  Speaker 2: I was a headache doctor. So I was part of the.
• 13:54
  Speaker 3: I don't know if you've ever had headaches, migraines or
• 13:57
  Speaker 3: tension headaches. Many, many... especially women do, one in five
• 14:01
  Speaker 3: women in America, and I think probably in Australia as well,
• 14:04
  Speaker 3: have migraine. That was my career. It was mostly an outpatient,
• 14:08
  Speaker 3: very calm career. And I got a little bit bored,
• 14:11
  Speaker 3: I think, after a decade or two and decided to
• 14:15
  Speaker 3: be challenged with critical care medicine, which is a completely
• 14:18
  Speaker 3: different world.
• 14:20
  Speaker 1: Yes. So once you went right of kind of I've
• 14:25
  Speaker 1: done this enough or I want to, was that because
• 14:28
  Speaker 1: you wanted to expand? Do you want to learn more?
• 14:30
  Speaker 1: You want to evolve? Yes. Right.
• 14:33
  Speaker 3: I just wanted something else that was very, very different.
• 14:36
  Speaker 3: We were talking about exposing your brain to something different.
• 14:40
  Speaker 3: And that's, I think what motivated me, but I also,
• 14:44
  Speaker 3: there was also a very personal motivation because my aunt Margaret,
• 14:47
  Speaker 3: who is a medical missionary in China and India for
• 14:50
  Speaker 3: many years, worked at the Cleveland VA hospital and, And
• 14:54
  Speaker 3: as she was walking home one night, she worked very
• 14:57
  Speaker 3: late because she was deliberate and slow. She was a radiologist,
• 15:00
  Speaker 3: very slow, very accurate, very precise. She was shot in
• 15:05
  Speaker 3: the neck and jaw by someone who stole just $ 40
• 15:10
  Speaker 3: from her wallet. So she laid in intensive care for
• 15:14
  Speaker 3: 144 days, quadriplegic. But the reason I tell you the
• 15:18
  Speaker 3: story is that the day I was accepted to medical
• 15:21
  Speaker 3: school and I went to tell her because I was
• 15:24
  Speaker 3: there in Cleveland. I went to Case Western Reserve Med
• 15:26
  Speaker 3: School and I went to tell her that I got
• 15:28
  Speaker 3: in and this was the beginning.
• 15:29
  Speaker 2: Of my career.
• 15:30
  Speaker 3: And she was unable to speak, but she looked at
• 15:34
  Speaker 3: me and I didn't really, I couldn't tell whether her
• 15:38
  Speaker 3: eyes were showing joy at my success or sorrow that
• 15:42
  Speaker 3: she wouldn't be able to share my medical journey with me.
• 15:45
  Speaker 3: And then she That day closed her eyes and died.
• 15:49
  Speaker 3: So my link with critical care medicine, I think, began
• 15:53
  Speaker 3: with my Aunt Margaret.
• 15:57
  Speaker 1: We are, when I say we, not everyone, but a
• 16:01
  Speaker 1: lot of us are. somewhere between a little bit interested in,
• 16:06
  Speaker 1: curious about, or obsessed with near-death experiences and what's going
• 16:12
  Speaker 1: on in the brain. Like, is this biochemical? Is this spiritual?
• 16:17
  Speaker 1: Is this like, what is this? You know, so I'll
• 16:21
  Speaker 1: tell you the story and then you can interpret this
• 16:25
  Speaker 1: as best. So when dad was passing away, So we
• 16:29
  Speaker 1: are now, uh, October two in Australia. So probably October
• 16:34
  Speaker 1: one over there in the evening, I'm assuming. And dad
• 16:38
  Speaker 1: passed away on August four. And so that's nearly, uh,
• 16:43
  Speaker 1: it's about eight weeks ish today. And the, he was with, um,
• 16:50
  Speaker 1: a family friend. So I, I, because he, as you know,
• 16:54
  Speaker 1: quite often they're hovering around death for days.
• 16:57
  Speaker 3: Right.
• 16:57
  Speaker 1: And, I'd been sitting with him many times where he
• 17:00
  Speaker 1: would stop breathing for 40 seconds and I'm like, well,
• 17:03
  Speaker 1: that's it. It's all over. We're done and dusted. And
• 17:05
  Speaker 1: then he'd take a big gulp and then, you know,
• 17:08
  Speaker 1: he was like that for days. And then one day
• 17:12
  Speaker 1: I came in and he was literally like the night
• 17:15
  Speaker 1: before at death's door, then the next day sitting up
• 17:18
  Speaker 1: in bed asking for an orange juice and a cheese sandwich.
• 17:21
  Speaker 1: I'm like, as you know, right? I'm like, who are you?
• 17:26
  Speaker 1: Who are you sitting up in that bed? Like, anyway,
• 17:31
  Speaker 1: so a few days later he passed away, but I'd
• 17:34
  Speaker 1: gone home and a family friend was sitting with him
• 17:38
  Speaker 1: and she said to him something like, my dad's name
• 17:44
  Speaker 1: was Ron. It's okay, Ron. Like everyone loves you. You're loved.
• 17:47
  Speaker 1: It's all good. You know, and everyone that's gone before
• 17:52
  Speaker 1: you and loved you, they're there waiting for you. Now,
• 17:54
  Speaker 1: he was basically in a coma. He was out. He
• 17:57
  Speaker 1: couldn't communicate or he was any. When she said everyone's
• 18:01
  Speaker 1: waiting for you, he sat up and looked at her
• 18:03
  Speaker 1: and said, I know I can see them. Right.
• 18:08
  Speaker 3: So he wasn't in a deep coma. He actually was
• 18:11
  Speaker 3: in what we call covert consciousness.
• 18:15
  Speaker 1: Right. Right, incredible.
• 18:18
  Speaker 2: It is.
• 18:19
  Speaker 1: I mean, all right, and then I'll tell you one
• 18:21
  Speaker 1: last bit and then you kind of break that down
• 18:24
  Speaker 1: for me. And then an hour or so later, and
• 18:28
  Speaker 1: he was in that state where he seemed out of it,
• 18:30
  Speaker 1: out of it, and she said, okay, Ron, I love you,
• 18:36
  Speaker 1: you know, I've got to go now. And he looked
• 18:38
  Speaker 1: up and said, me too, and that was it, right? Yeah.
• 18:42
  Speaker 1: Tell me about that. Tell me what might be going
• 18:46
  Speaker 1: on there.
• 18:48
  Speaker 3: I'd love to tell you because this is what makes
• 18:50
  Speaker 3: neurocritical care so fascinating for me and you and all
• 18:53
  Speaker 3: of us, I think. So you mentioned near-death experiences. The
• 18:58
  Speaker 3: only glimpse we have of the afterlife is patients that
• 19:02
  Speaker 3: tell us what they experience after cardiac arrest. So this
• 19:07
  Speaker 3: is after the EKG goes flatlined. and the EEG, this
• 19:12
  Speaker 3: is the electroencephalogram. So this is kind of the analogy
• 19:17
  Speaker 3: to the heart's rhythm recording. It's the brain's electrical recording.
• 19:22
  Speaker 3: Both of those go flatline. So patients are dead. But
• 19:27
  Speaker 3: we do CPR, we shock them and they recover and
• 19:30
  Speaker 3: they tell us what they experienced. And what your father
• 19:33
  Speaker 3: has said, there are three experiences that occur in near
• 19:38
  Speaker 3: death experiences. The first, and I love to talk to
• 19:42
  Speaker 3: you about it, is this sense that you.
• 19:47
  Speaker 2: See the light at the end of the tunnel.
• 19:48
  Speaker 3: So there's a supreme light. light that actually is very
• 19:52
  Speaker 3: bright and sometimes draws you to it. The second thing
• 19:56
  Speaker 3: that happens is that you feel, as I think your
• 19:58
  Speaker 3: dad did, in the presence of someone they have loved
• 20:02
  Speaker 3: and lost. And this is fascinating because they're not in
• 20:05
  Speaker 3: the presence of people that they love that are still alive,
• 20:08
  Speaker 3: like you. He probably wasn't thinking of you. He was
• 20:12
  Speaker 3: probably thinking of people that he actually had lost because
• 20:18
  Speaker 3: they were deceased before him. And the third thing that
• 20:21
  Speaker 3: happens is, and this has to do with the hippocampus,
• 20:24
  Speaker 3: which is our memory center that we were talking about before.
• 20:27
  Speaker 3: They experience a reel of their life from early childhood
• 20:31
  Speaker 3: onward or just portions of it. And it kind of
• 20:33
  Speaker 3: puts their life in perspective. So those are the three things.
• 20:36
  Speaker 3: But my favorite of those is what your father experienced.
• 20:40
  Speaker 3: And that was he felt as though he was with somebody.
• 20:43
  Speaker 3: And this is the bridge to the afterlife, which we
• 20:47
  Speaker 3: don't have a scientific explanation of. But whatever's next, that's
• 20:51
  Speaker 3: the bridge that your dad was traversing.
• 20:55
  Speaker 1: And I know you have to be totally scientific. Do
• 20:59
  Speaker 1: you think there's one that is fascinating? Thank you. Two,
• 21:03
  Speaker 1: do you think.
• 21:05
  Speaker 1: But what do you think there is? Do you think
• 21:07
  Speaker 1: there's anything beyond? I know this is the $ 64 million question,
• 21:11
  Speaker 1: I know. But do you think there's anything that happens
• 21:15
  Speaker 1: beyond what we call death?
• 21:19
  Speaker 3: I do because the small glimpse, the small window that
• 21:23
  Speaker 3: we have, and we only have just the beginning of
• 21:27
  Speaker 3: those moments. The small window tells me that there is consciousness,
• 21:31
  Speaker 3: and we call it covert consciousness. But let me explain
• 21:34
  Speaker 3: from a scientific aspect, as a neuroscientist, what's happening that
• 21:39
  Speaker 3: allows me to answer yes to your question.
• 21:42
  Speaker 2: And that is... gamma waves on EEG.
• 21:45
  Speaker 3: So you know what an EEG is, or can I
• 21:48
  Speaker 3: define that better for you?
• 21:49
  Speaker 2: So it's just... For our audience.
• 21:52
  Speaker 1: Yeah, great.
• 21:53
  Speaker 2: Yes.
• 21:54
  Speaker 3: So it's just picking up the electrical activity of neurons.
• 21:57
  Speaker 3: So the depolarization in the membranes of neurons as they're
• 22:01
  Speaker 3: communicating with each other and the synapses that we talked about.
• 22:05
  Speaker 3: And an EG are just scalp electrodes that pick up
• 22:09
  Speaker 3: those signals and they transform them into a recording, waves
• 22:13
  Speaker 3: that we can measure. They vary from slow waves, which
• 22:18
  Speaker 3: occur during sleep, to very fast waves called gamma waves,
• 22:23
  Speaker 3: which are associated with consciousness. And here's the key. After death,
• 22:30
  Speaker 3: after cardiac and brain death, The patients that return after
• 22:35
  Speaker 3: being resuscitated have evidence, and this is rare, but it's
• 22:39
  Speaker 3: been recorded in about four patients of gamma activity on
• 22:45
  Speaker 3: their EEGs after their EEGs flatlined and their EKGs flatlined.
• 22:50
  Speaker 3: So they may be having a perception, a consciousness that
• 22:55
  Speaker 3: they're not able to communicate, and that consciousness tells me
• 22:59
  Speaker 3: that this may be the boundary between life and death,
• 23:01
  Speaker 3: and one of the one of the reasons that they
• 23:04
  Speaker 3: may be experiencing feeling in the presence of other people
• 23:07
  Speaker 3: because they're still covertly conscious. I don't know how long
• 23:11
  Speaker 3: it lasts and it doesn't happen to everybody. I don't
• 23:15
  Speaker 3: know how many people it happened to because we only
• 23:18
  Speaker 3: have it when we study those patients who have long-term
• 23:21
  Speaker 3: EEGs on as they die.
• 23:23
  Speaker 1: So what do you think, what's your best guess, Taves,
• 23:30
  Speaker 1: in terms of when people have what they... and I'm
• 23:33
  Speaker 1: not being in any way disrespectful to anyone because I
• 23:38
  Speaker 1: actually had, oh, it was about 1,000 episodes ago, a
• 23:42
  Speaker 1: guy who had a near-death experience who'll come to me.
• 23:44
  Speaker 1: He was a doctor. Anyway, but he was talking, oh,
• 23:49
  Speaker 1: I started with B. Anyway, he was talking about, you know,
• 23:53
  Speaker 1: after he died, you know, this wonderland of spiritual experience
• 23:59
  Speaker 1: and all of these things, and Eden someone, his name was,
• 24:04
  Speaker 1: what's your, what is your explanation for, what's your theory?
• 24:09
  Speaker 1: And all of this stuff is so hard because I'll
• 24:12
  Speaker 1: tell you another story in a moment. My training partner
• 24:14
  Speaker 1: at the gym died in front of me for 17 minutes, right?
• 24:20
  Speaker 1: So we'll talk about that. But what's your theory about
• 24:22
  Speaker 1: near death experiences? What people report as I died and
• 24:28
  Speaker 1: all of this stuff happened and then I came back.
• 24:31
  Speaker 3: So it's really not just a theory. And I'm glad
• 24:34
  Speaker 3: you asked me that because this is not a hallucination.
• 24:37
  Speaker 3: This is our window into what happens. This is actually
• 24:40
  Speaker 3: what patients experience, what people experience. And what we see,
• 24:44
  Speaker 3: the correlate on EEG, which is our map of the
• 24:47
  Speaker 3: brain after death, is light up at high energy. Gamma activity,
• 24:54
  Speaker 3: fast activity, conscious activity in the visual cortex and our
• 25:00
  Speaker 3: memory centers. I talked about the limbic system and the hippocampus.
• 25:04
  Speaker 3: So those two places correlate, probably, we can't prove this,
• 25:08
  Speaker 3: but it makes sense that they correlate with the bright
• 25:10
  Speaker 3: light at the end of the tunnel and the memory
• 25:14
  Speaker 3: reel that people experience and their feeling of being in
• 25:19
  Speaker 3: memory and with somebody at their side who has died before.
• 25:23
  Speaker 3: So see, we have electrographic correlate with what patients experience
• 25:29
  Speaker 3: after death.
• 25:31
  Speaker 2: Very hopeful.
• 25:33
  Speaker 1: Yeah, it is. It's so interesting. So my training partner,
• 25:37
  Speaker 1: we're in the gym. It was Friday night. It was 1705.
• 25:43
  Speaker 1: And as per the ambulance report or the paramedic report,
• 25:48
  Speaker 1: So he died at 1705. He did a set of chin-ups.
• 25:52
  Speaker 1: I'm sure you know what chin-ups are. He held his
• 25:54
  Speaker 1: breath because he's an idiot. So he didn't have a
• 25:57
  Speaker 1: heart attack because he's an idiot. He didn't have a
• 26:00
  Speaker 1: heart attack. He just had an arrest. Well, just. So
• 26:04
  Speaker 1: his heart stopped and his heart was stopped for 17 minutes.
• 26:09
  Speaker 1: So I started working on him straight away and then
• 26:12
  Speaker 1: the paramedics got there 11 minutes later and And then
• 26:17
  Speaker 1: they worked on him for another six minutes and then
• 26:19
  Speaker 1: eventually he came back. But when after... And also, amazingly,
• 26:24
  Speaker 1: I do not know how, but no brain damage. Like no...
• 26:29
  Speaker 1: You know, like for a week or so, he was
• 26:31
  Speaker 1: a bit like Dory the goldfish swimming around in the
• 26:35
  Speaker 1: bloody jar or whatever. But he... But ultimately... Like, fine.
• 26:41
  Speaker 2: Fine.
• 26:41
  Speaker 1: I'm like, how on earth are you even somewhat operational? Like,
• 26:46
  Speaker 1: you were dead for over a quarter of an hour.
• 26:48
  Speaker 1: I know. I was on top of you trying to
• 26:50
  Speaker 1: bloody save you. And then once we'd gotten through all
• 26:55
  Speaker 1: of that, it was a week or so later, you know,
• 26:58
  Speaker 1: and because he's obviously he's got kids, all that. And
• 27:01
  Speaker 1: I was just with him.
• 27:02
  Speaker 3: I go, all right.
• 27:03
  Speaker 1: So when you were dead, when you were dead, what
• 27:07
  Speaker 1: was going on? What did you see? Anything? Originally, he
• 27:12
  Speaker 1: just initially just said like nothing. He said, but, but
• 27:17
  Speaker 1: he had, he said, I just had a sense of
• 27:21
  Speaker 1: complete peace. Now, I don't know whether or not that, that.
• 27:27
  Speaker 1: I don't know what that means. It's like, do you
• 27:29
  Speaker 1: have that when in those 17 minutes when you're offline
• 27:32
  Speaker 1: or did you have that when you came back online?
• 27:35
  Speaker 1: I like, I'm not, but his best recollection was in
• 27:39
  Speaker 1: those minutes. Like he just felt complete tranquility, but then
• 27:42
  Speaker 1: you don't know, you don't know is, is that so yeah, it,
• 27:46
  Speaker 1: it for me poses more questions than it answers, but nonetheless,
• 27:51
  Speaker 1: super interested.
• 27:53
  Speaker 3: No, but actually what you say and what he describes,
• 27:56
  Speaker 3: a sense of peace and bliss, actually is what most
• 28:01
  Speaker 3: of my patients, because I've been at their bedside so
• 28:03
  Speaker 3: often as they die, there's very little of that. I
• 28:07
  Speaker 3: don't know if you know Dylan Thomas in Australia, whether
• 28:10
  Speaker 3: you have that poet in your repertoire, but he wrote,
• 28:14
  Speaker 3: as he watched his father die, he wrote, rage, rage
• 28:18
  Speaker 3: against the dying of the light. And I don't see
• 28:21
  Speaker 3: that in my patients. I see much more peace, this
• 28:25
  Speaker 3: sense of belonging to the next world, whatever that is,
• 28:30
  Speaker 3: and also a sense of acceptance. And I do find
• 28:33
  Speaker 3: that comforting. So being at the bedside of my patients
• 28:37
  Speaker 3: dying has actually reduced my own personal fear of death.
• 28:41
  Speaker 1: This is a weird question, but I'm interested in, like
• 28:45
  Speaker 1: we all have, it's probably not the right expression to, Tavis,
• 28:50
  Speaker 1: but you get it. We all have a relationship with death.
• 28:53
  Speaker 1: Some people are okay-ish with death. Some people have been
• 28:56
  Speaker 1: around it a bit. Some people have never seen a
• 28:58
  Speaker 1: dead person. Some people are looking forward to it because
• 29:03
  Speaker 1: they believe they're going to be in a better place, right,
• 29:05
  Speaker 1: and so on.
• 29:06
  Speaker 3: Right.
• 29:07
  Speaker 1: What's your relationship with death? How do you feel about
• 29:10
  Speaker 1: it personally, not as a clinician or a doctor or
• 29:15
  Speaker 1: an observer of death, but for you?
• 29:17
  Speaker 3: For me personally, death itself is less frightening than the
• 29:22
  Speaker 3: process that precedes it. And that's why when we're, and
• 29:26
  Speaker 3: my life is in the ICU, our goal is not
• 29:29
  Speaker 3: to prolong life, which in many cases is just prolonging death,
• 29:34
  Speaker 3: but our goal is for comfort, for the relief of anxiety.
• 29:38
  Speaker 3: I don't know if your dad was short of breath
• 29:40
  Speaker 3: or had a sense that he couldn't get enough air.
• 29:43
  Speaker 3: What we do at the end of life for our
• 29:45
  Speaker 3: patients is provide pain relief that's paramount and also reduce
• 29:51
  Speaker 3: anxiety and that's what i think we as physicians fear
• 29:54
  Speaker 3: the most there is not a single doctor respiratory therapist
• 29:58
  Speaker 3: nurse i know that doesn't have a dnr order Because
• 30:03
  Speaker 3: they do not want to be resuscitated and live in
• 30:06
  Speaker 3: a vegetative, that's actually the proper term for that is
• 30:10
  Speaker 3: now unresponsive state, not vegetative, unresponsive wakefulness. So we all
• 30:16
  Speaker 3: don't want that painful process of prolongation of death. But
• 30:21
  Speaker 3: I hope that answers your question.
• 30:23
  Speaker 1: Yeah, yeah. Sorry, I was going to say. No, go ahead.
• 30:28
  Speaker 1: I'm just like, I'm fascinated by this topic. So I'm
• 30:31
  Speaker 1: going to ask you things that you may or may
• 30:32
  Speaker 1: not know, which you may or may not be like
• 30:35
  Speaker 1: it's out of your wheelhouse. But I feel like culturally
• 30:39
  Speaker 1: across the world, there are different people, different countries and
• 30:43
  Speaker 1: cultures deal with death for one of a better term differently.
• 30:48
  Speaker 1: Like when my dad, for example, when my dad passed away,
• 30:54
  Speaker 1: So the funeral was like whatever, six or seven weeks ago.
• 30:57
  Speaker 1: I had a few friends come that had never been to,
• 31:01
  Speaker 1: for want of a better term, a Christian funeral, right?
• 31:04
  Speaker 1: And it was quite a celebration and there was tears
• 31:06
  Speaker 1: and stuff, but there was also laughter. Like there was actually–
• 31:10
  Speaker 1: and one of my friends who's actually my senior supervisor
• 31:14
  Speaker 1: from university who grew up in Russia and– I guess
• 31:20
  Speaker 1: maybe Russian Orthodox or whatever. I'm not sure. But they're like,
• 31:24
  Speaker 1: him and his wife are like, and Mongolia too. They're like,
• 31:28
  Speaker 1: oh my, like we've never been to anything like this.
• 31:31
  Speaker 1: Like the funerals, we go to a dark and like
• 31:35
  Speaker 1: morbid and heavy and everyone's in black and no one's
• 31:39
  Speaker 1: smiling and there is no fun. There is no joy.
• 31:42
  Speaker 1: And I'm like, oh God, it's already bad enough. Do
• 31:45
  Speaker 1: we have to do that? I'm like, I want to
• 31:47
  Speaker 1: laugh at like, you know, Yeah. So is that have
• 31:52
  Speaker 1: you noticed any of that, the way that different cultures
• 31:55
  Speaker 1: approach death and dying and even after death? Yes.
• 32:00
  Speaker 3: I mean, I think our modern culture in America and
• 32:04
  Speaker 3: probably in Australia and New Zealand as well has a
• 32:06
  Speaker 3: greater fear of death than other civilizations and countries do.
• 32:11
  Speaker 3: Some celebrate it. It's a transition. And there's less fear
• 32:15
  Speaker 3: because they're looking forward to whatever they think is next.
• 32:18
  Speaker 3: But it's also a way to make life meaningful. And
• 32:22
  Speaker 3: that's kind of existentialism and phenomenology. But knowing that you're finite...
• 32:28
  Speaker 3: That your days have a number. Actually, otherwise, if you
• 32:32
  Speaker 3: lived forever, what meaning would your early Sunday morning be
• 32:36
  Speaker 3: in brunch? What friendships mean to you? What the love
• 32:41
  Speaker 3: of your son or daughter means? It all is so
• 32:44
  Speaker 3: much more meaningful because you know it's transient.
• 32:48
  Speaker 2: And finite.
• 32:49
  Speaker 1: Yes.
• 32:51
  Speaker 3: And death, I think, it should be a celebration. I
• 32:54
  Speaker 3: believe you interviewed somebody, Dr. Morgan, this year, who talked
• 32:59
  Speaker 3: about he actually created his own funeral and had a
• 33:04
  Speaker 3: wonderful time at his own funeral. So that kind of
• 33:07
  Speaker 3: celebration other cultures have, we're a little bit shy about that,
• 33:11
  Speaker 3: but it was kind of an intriguing idea. After that podcast,
• 33:16
  Speaker 3: have you designed your own funeral yet?
• 33:18
  Speaker 1: I haven't. No, the answer, the honest answer is no. No,
• 33:23
  Speaker 1: but I've thought about it and I'm like... I, yeah,
• 33:28
  Speaker 1: I don't know. I think he did.
• 33:29
  Speaker 3: Yeah.
• 33:30
  Speaker 1: He did a living funeral. So he did. Right. Why? Yeah.
• 33:34
  Speaker 1: Which is a fascinating thing. All right. So, so much
• 33:36
  Speaker 1: stuff I want to tell you or ask you so
• 33:38
  Speaker 1: little time. All right. My next question is, what is
• 33:42
  Speaker 1: something that you have learned, you know, on this journey
• 33:46
  Speaker 1: of working with people in this capacity at the coalface
• 33:49
  Speaker 1: of death and dying and that blew your mind? You went, oh,
• 33:54
  Speaker 1: my God, or either maybe even changed your mind. Like
• 33:59
  Speaker 1: what was like a revelation that you thought, I never
• 34:03
  Speaker 1: thought this would happen or I would understand this or
• 34:06
  Speaker 1: experience this?
• 34:08
  Speaker 3: So I knew scientifically that when people return from, quote, death,
• 34:13
  Speaker 3: cardiac or brain death, they do feel in the presence
• 34:17
  Speaker 3: of those they've loved and lost. But there was a
• 34:20
  Speaker 3: nurse who one night, the ICU is really uncharacteristically very quiet,
• 34:24
  Speaker 3: and she told me the story of her six-year-old niece.
• 34:27
  Speaker 3: She was born with a congenital anomaly, a congenital cardiac
• 34:34
  Speaker 3: problem that would be fatal within years. But she had
• 34:37
  Speaker 3: a twin who was born just before her and died immediately.
• 34:42
  Speaker 3: She never knew him. But as she died, and she
• 34:45
  Speaker 3: wasn't afraid to die because she was six, but she
• 34:48
  Speaker 3: also had been taught or understood that she would die
• 34:53
  Speaker 3: very soon, and she lived longer than expected. But as
• 34:56
  Speaker 3: she died, her mom was with her, and she said,
• 35:00
  Speaker 3: I took his hand, and she was referring to her brother,
• 35:05
  Speaker 3: whom she saw, felt in the presence of, and she
• 35:08
  Speaker 3: lifted her hand up, said his name, and died. Now,
• 35:12
  Speaker 3: if a six-year-old can experience that, having never known her brother,
• 35:17
  Speaker 3: then your 87-year-old mom and your father and you and
• 35:22
  Speaker 3: I may sometime also have that experience. And for me,
• 35:26
  Speaker 3: that's very comforting.
• 35:27
  Speaker 1: Wow. So the book is The Brain at Twilight, the
• 35:31
  Speaker 1: neuroscience of our last words and moments. Yes. So The
• 35:33
  Speaker 1: Brain at Twilight, that's just your kind of metaphor for
• 35:39
  Speaker 1: as it's going from life to death? Is that in between? Yes.
• 35:45
  Speaker 2: Yes, and it's not a finite moment.
• 35:47
  Speaker 3: As we've been talking about, there's this activity, gamma activity,
• 35:52
  Speaker 3: consciousness that we're now knowing that people experience.
• 35:56
  Speaker 2: So it's a continuum. And twilight is too.
• 35:59
  Speaker 3: You don't go from bright daylight to darkness. There's this continuum,
• 36:05
  Speaker 3: this bridge, this boundary between life and death.
• 36:08
  Speaker 1: Yes, yes. So as we begin to shut down, or
• 36:12
  Speaker 1: our brain does, consciousness just goes offline. Is that our
• 36:17
  Speaker 1: working theory?
• 36:19
  Speaker 3: Well, like twilight, there are, as you're looking at the
• 36:22
  Speaker 3: sky at twilight, there are planets that emerge brighter than
• 36:26
  Speaker 3: those around them. And we think there are these little
• 36:30
  Speaker 3: islands of consciousness, what we call covert consciousness that occur
• 36:34
  Speaker 3: in the dying process. Dying takes a while. It doesn't
• 36:38
  Speaker 3: happen from 1001 to 1002. It's a process. It may
• 36:43
  Speaker 3: take minutes. In some cases, it takes hours. And during
• 36:46
  Speaker 3: this time, even if our patients before us or our
• 36:49
  Speaker 3: family members can't convey it, they are experiencing consciousness and
• 36:53
  Speaker 3: the presence of others. And that's what I find fascinating.
• 36:58
  Speaker 1: Can I ask also as, you know, you're 38 heading
• 37:03
  Speaker 1: towards 40 soon.
• 37:04
  Speaker 2: Yes, tomorrow.
• 37:06
  Speaker 1: Yes, of course you are. Of course you are. You're welcome.
• 37:09
  Speaker 1: So are there certain things like I don't drink, I
• 37:13
  Speaker 1: don't smoke, I've never drunk, I've never had booze, I've
• 37:15
  Speaker 1: never been high, I've never had cigarettes, like I exercise
• 37:18
  Speaker 1: every day. I'm extremely boring, let's be honest, right? But
• 37:22
  Speaker 1: in terms of the things that are in my control, yeah, Taves,
• 37:28
  Speaker 1: and the factors and variables that I can somewhat manipulate
• 37:32
  Speaker 1: for good or bad, right? I do everything pretty much
• 37:37
  Speaker 1: that I can. I don't get too stressed. I sleep
• 37:39
  Speaker 1: pretty well. I try to be a good human, all
• 37:43
  Speaker 1: that stuff. What about you? What are the things that
• 37:45
  Speaker 1: you do for you to optimize, you know, all of
• 37:51
  Speaker 1: that stuff, physical, mental, emotional, cognitive function, you know, immune system,
• 37:56
  Speaker 1: all of that as you head towards your 40s. What's
• 38:02
  Speaker 1: the stuff that you do for you?
• 38:03
  Speaker 3: Well, I just, I want you to know that you
• 38:07
  Speaker 3: had said at one time that you were, you thought
• 38:10
  Speaker 3: maybe one of the oldest PhD candidates in the world.
• 38:14
  Speaker 3: But I've got competition with you because I was one
• 38:17
  Speaker 3: of the oldest neurocritical care fellows in the world. And
• 38:21
  Speaker 3: I had attending physicians that were half my age, and
• 38:25
  Speaker 3: they were teaching me and asking me to bring them
• 38:28
  Speaker 3: coffee and things like that.
• 38:29
  Speaker 2: So you don't get that title, okay?
• 38:31
  Speaker 3: You're not the sole 60-year-old. But what I do, because
• 38:37
  Speaker 3: the brain at Twilight actually is a series of stories
• 38:40
  Speaker 3: about patients.
• 38:42
  Speaker 2: Last words.
• 38:43
  Speaker 3: And I don't know, have you thought of your own
• 38:45
  Speaker 3: last words? But that's often asked of me. What do
• 38:48
  Speaker 3: I think my own last words would be? Women tend
• 38:52
  Speaker 3: to speak to and about their children as they're dying.
• 38:57
  Speaker 3: And it's different for men. They tend to speak more
• 39:00
  Speaker 3: of their partners or spouses. And interestingly, of their own
• 39:04
  Speaker 3: mothers as they're dying. Because there's a mother-son bond with
• 39:09
  Speaker 3: oxytocin release in the brain. So what I do, you
• 39:13
  Speaker 3: asked what I do. I do exercise, not as often
• 39:16
  Speaker 3: as you do, I don't think. You're there in the
• 39:17
  Speaker 3: gym every day, right?
• 39:18
  Speaker 1: Yeah, mostly.
• 39:20
  Speaker 3: Okay.
• 39:21
  Speaker 1: But I'm also insecure, you know, body image issues. I
• 39:24
  Speaker 1: need a lot of attention, you know, so there's that
• 39:27
  Speaker 1: on top of it.
• 39:29
  Speaker 3: Okay. What I do, though, is on every Sunday morning,
• 39:32
  Speaker 3: I wake up and think of what I might say
• 39:36
  Speaker 3: if I were in an ICU. Remember, one in six
• 39:38
  Speaker 3: Americans will die in an ICU. Nobody wants to die
• 39:42
  Speaker 3: in an ICU. They want to die at home. But
• 39:44
  Speaker 3: I think on Sunday morning, what would I like to say?
• 39:46
  Speaker 3: I have four sons to each of them on my deathbed.
• 39:51
  Speaker 3: And instead of waiting until I'm at that point, I
• 39:54
  Speaker 3: call them up Sunday midday.
• 39:56
  Speaker 2: And I tell them one at a time.
• 39:59
  Speaker 1: Wow.
• 40:00
  Speaker 2: And so every Sunday is kind of Mother's Day for me.
• 40:03
  Speaker 1: That's gorgeous. And are they like, Mom, enough? I know.
• 40:08
  Speaker 3: Yeah, and also I call it 7 in the morning.
• 40:11
  Speaker 3: And they really don't appreciate that.
• 40:14
  Speaker 2: I don't know why.
• 40:15
  Speaker 1: Yeah, so selfish of them.
• 40:17
  Speaker 2: They're having brunch.
• 40:19
  Speaker 1: Now, without destroying– you know, the book, can you tell
• 40:25
  Speaker 1: us a story? You already told us one great one.
• 40:27
  Speaker 1: I love that about the six-year-old girl. Can you tell
• 40:30
  Speaker 1: us one more story just to let Howard know it?
• 40:34
  Speaker 2: I will.
• 40:35
  Speaker 3: And actually, it has to do with something you said
• 40:38
  Speaker 3: when I think it was with Dr. Morgan. You said,
• 40:40
  Speaker 3: you know, in my doctor, I want somebody, of course,
• 40:43
  Speaker 3: who's competent, but I also want somebody who I like.
• 40:48
  Speaker 3: And who I empathize with. And in your field, your PhD,
• 40:52
  Speaker 3: that's where you are. You're trying to understand empathy between
• 40:56
  Speaker 3: humans and pets, hopefully as well. So Jennifer was one
• 41:01
  Speaker 3: of our trauma surgeons. Do you know what a trauma
• 41:04
  Speaker 3: surgery residency is like? It was at Boston City Hospital.
• 41:08
  Speaker 2: Do you have any?
• 41:08
  Speaker 3: It was 12 years. A level one trauma center. Do
• 41:12
  Speaker 3: you know what she would have seen? A lot of
• 41:16
  Speaker 3: chaos and a lot of death and dying.
• 41:19
  Speaker 2: And a lot of blood.
• 41:19
  Speaker 3: And she opened chest and does open chest cardiac massage
• 41:24
  Speaker 3: with just her gloves in somebody who's got a gunshot
• 41:27
  Speaker 3: wound to the heart. So that was Jennifer. But she
• 41:29
  Speaker 3: was beautiful. I think about age 40. Tall, slender, never
• 41:34
  Speaker 3: left the hospital. We don't know that she ever had.
• 41:37
  Speaker 1: A home life.
• 41:38
  Speaker 3: And she asked me to see one day one of
• 41:40
  Speaker 3: her patients because she wasn't waking up after she had
• 41:44
  Speaker 3: done an emergency tracheostomy. So putting in a breathing tube
• 41:48
  Speaker 3: when the woman was unable to get oxygen at all,
• 41:52
  Speaker 3: was at risk for anoxic brain injury. And she said,
• 41:55
  Speaker 3: go see her. And I said, I'm happy to. And
• 41:57
  Speaker 3: I did. And it struck me as odd that the
• 42:00
  Speaker 3: patients had a pillowcase over her head. And when I
• 42:04
  Speaker 3: lifted the pillowcase, there was no face left, very little face.
• 42:10
  Speaker 3: So just kind of the orbits and the tissue was gone.
• 42:13
  Speaker 3: The reason I'm telling you is that Jennifer, so she
• 42:16
  Speaker 3: had been, her face had been eaten by a dog.
• 42:21
  Speaker 3: And that was why we were having difficulty understanding why
• 42:26
  Speaker 3: she wouldn't wake up. It was because during the time
• 42:28
  Speaker 3: she was unconscious, She had had an anoxic brain injury.
• 42:31
  Speaker 3: But what struck me about Jennifer was that she never
• 42:34
  Speaker 3: thought to tell me that, to warn me about what
• 42:39
  Speaker 3: I was going to see visually. And you had said
• 42:42
  Speaker 3: you wanted a doctor that was empathetic. Jennifer wasn't empathetic
• 42:46
  Speaker 3: at all, but technologically, technically without peer. And all that
• 42:51
  Speaker 3: mattered to her was that she was able to put
• 42:53
  Speaker 3: in a breathing tube and save this woman's life.
• 42:56
  Speaker 2: And to me, I was.
• 42:58
  Speaker 3: devastated by what I saw. It didn't matter to Jennifer.
• 43:01
  Speaker 3: She saved her life. So if I'm in that situation,
• 43:06
  Speaker 3: I really would like to have Jennifer there instead of
• 43:09
  Speaker 3: somebody who had a good bedside manner. That kind of
• 43:11
  Speaker 3: was the bottom line for that story.
• 43:14
  Speaker 2: Yeah.
• 43:15
  Speaker 1: It was a little bit morbid. Do you think, not
• 43:18
  Speaker 1: in a bad way, but perhaps she was... you know,
• 43:22
  Speaker 1: a sociopath, like not in a, not in a psych,
• 43:27
  Speaker 1: not in a, no, but as in like she doesn't
• 43:30
  Speaker 1: feel what you and I would feel.
• 43:32
  Speaker 3: But I don't think after a 12 year residency in
• 43:35
  Speaker 3: Boston City Hospital, you can feel. If you felt that
• 43:38
  Speaker 3: and you took it home with you, you'd be devastated.
• 43:41
  Speaker 3: How would you survive?
• 43:43
  Speaker 1: So you'd be constantly devastated on a daily basis.
• 43:47
  Speaker 2: You'd be torn apart inside.
• 43:49
  Speaker 1: You have to totally desensitize.
• 43:53
  Speaker 2: So she wore an armor to work every day.
• 43:56
  Speaker 1: Yes.
• 43:56
  Speaker 3: So it's tough to blend empathy and concern for your
• 44:03
  Speaker 3: patients with being technically superb.
• 44:06
  Speaker 1: I think in that environment, I mean, that is like,
• 44:09
  Speaker 1: I don't think anyone could, to me, that's just like,
• 44:14
  Speaker 1: a soldier being in the middle of like a war zone,
• 44:17
  Speaker 1: like that, that is just daily trauma, isn't it? I mean,
• 44:20
  Speaker 1: that's just, it is. You're at the cold face of
• 44:24
  Speaker 1: like a regular person off the street would walk in
• 44:27
  Speaker 1: and see one thing. They'd be scarred for the rest
• 44:29
  Speaker 1: of their life. Maybe. Right.
• 44:31
  Speaker 2: Like I was. Yeah.
• 44:32
  Speaker 3: Even just to look at a face that wasn't there,
• 44:35
  Speaker 3: but to Jennifer, it wasn't a face.
• 44:36
  Speaker 2: It didn't matter.
• 44:37
  Speaker 3: All that mattered was that she could provide an airway and,
• 44:41
  Speaker 3: a working airway so she could save this woman's life.
• 44:45
  Speaker 1: Yes.
• 44:46
  Speaker 3: Wowza. Wowza.
• 44:47
  Speaker 1: Are you excited about the book? So the book comes
• 44:50
  Speaker 1: out December 8th. Is this your first kind of general
• 44:54
  Speaker 1: public book? Yes, it is. Not an academic book, right?
• 44:58
  Speaker 1: And what was the genesis? How did it happen? Did
• 45:02
  Speaker 1: you get approached? Did you go, you know what, I
• 45:04
  Speaker 1: wouldn't mind downloading some of this and sharing it with
• 45:07
  Speaker 1: the world?
• 45:09
  Speaker 3: No, during my fellowship, again, as you know now, happened
• 45:13
  Speaker 3: quite late in my career. I just started, I had
• 45:16
  Speaker 3: a white coat and I had a notebook. And as
• 45:19
  Speaker 3: patients died, I kind of wrote down their last words.
• 45:23
  Speaker 3: And I thought, this tells me what's important to a
• 45:27
  Speaker 3: human at the end of his or her life. And
• 45:30
  Speaker 3: then they just evolved because the story.
• 45:34
  Speaker 3: Medicine is a, is a series of stories. And so
• 45:37
  Speaker 3: these stories evolved out of my lab coat, my notebook,
• 45:41
  Speaker 3: and then just became a book. But what augmented the
• 45:45
  Speaker 3: book was the neuroscience that correlates to whatever those people,
• 45:49
  Speaker 3: my patients were telling me in words, like what's happening
• 45:52
  Speaker 3: in the brain when you're thinking goodbye and forgive me.
• 45:59
  Speaker 1: And have you had to, or have you gone through
• 46:05
  Speaker 1: this process with family and or friends where, you know,
• 46:09
  Speaker 1: somebody that you were close to is passing away and
• 46:14
  Speaker 1: you're there with them. Does that shift it for you
• 46:17
  Speaker 1: when it's not just a patient, not just like another
• 46:20
  Speaker 1: responsibility as part of your job, but somebody that you
• 46:23
  Speaker 1: are intimate with?
• 46:26
  Speaker 3: I think we do, much like Jennifer, I think we
• 46:29
  Speaker 3: do have to have a shift. Even when we're at
• 46:31
  Speaker 3: the bedside of somebody that we love and is either
• 46:35
  Speaker 3: a friend or family member, we shift between doctorhood and humanhood.
• 46:40
  Speaker 2: And that's been.
• 46:42
  Speaker 3: kind of my challenge being a mom and a doctor.
• 46:45
  Speaker 3: And I often think that if I'd been one or
• 46:47
  Speaker 3: the other, I would have been better at each one.
• 46:49
  Speaker 3: But at the bedside of somebody I love, I still
• 46:52
  Speaker 3: have to be a physician and I have to bring
• 46:54
  Speaker 3: science to what they're experiencing.
• 46:57
  Speaker 1: When you look at, this is a deep, weird philosophical question,
• 47:00
  Speaker 1: but I think about this a lot, like, and even
• 47:03
  Speaker 1: after sitting with dad recently, and I've had a few
• 47:07
  Speaker 1: good friends pass away and you know, we spend so
• 47:11
  Speaker 1: much time and I'm not saying this is bad, but
• 47:14
  Speaker 1: like I work in the high performance space, you know,
• 47:17
  Speaker 1: with teams and athletes and companies and, you know, Victoria
• 47:21
  Speaker 1: police where we live, that's the state Victoria and, you know,
• 47:24
  Speaker 1: do lots of cool things. We're talking about high performance,
• 47:27
  Speaker 1: think better, do better, create better, produce better outcomes, more resilient,
• 47:30
  Speaker 1: more adaptable, more of this, all these human high performance things, right? Yeah.
• 47:36
  Speaker 1: And then sometimes a little bit of me is like,
• 47:38
  Speaker 1: when I'm like sitting with dad, I'm like, what's all
• 47:40
  Speaker 1: that about? What's all that about? Like, what does it matter?
• 47:43
  Speaker 1: What does it matter where we live or what we drive?
• 47:45
  Speaker 1: And like, it's this juxtaposition of, yeah, you've got to
• 47:48
  Speaker 1: have a, you've got to have a job and you've
• 47:50
  Speaker 1: got to pay the bills and you've got to, but
• 47:52
  Speaker 1: I feel like as we get closer to death, we
• 47:54
  Speaker 1: reassess what is meaningful and what is not. I don't know.
• 47:57
  Speaker 1: This sounds like an old person just reflecting, which probably is,
• 48:00
  Speaker 1: but even now I go, how much money do I need?
• 48:05
  Speaker 1: How much like what, you know, it's like, well, I
• 48:08
  Speaker 1: don't like I'm not rich, but I'm comfortable. I'm fine.
• 48:11
  Speaker 1: I don't I don't need to be stressing about putting
• 48:14
  Speaker 1: food on the table tomorrow. But that that gap between
• 48:18
  Speaker 1: how we think when we're all young and healthy and
• 48:21
  Speaker 1: as we near the end of our life, there's a
• 48:23
  Speaker 1: total paradigm shift, I think.
• 48:26
  Speaker 3: It is.
• 48:26
  Speaker 2: It's very true.
• 48:27
  Speaker 3: And I think if I could just summarize it into
• 48:30
  Speaker 3: what you asked me was about final words is I
• 48:33
  Speaker 3: would say if I were sitting with your dad and
• 48:36
  Speaker 3: I were you or his wife at the time, your mom,
• 48:39
  Speaker 3: I would say, remember a story that we had together.
• 48:43
  Speaker 3: And I'd like for that to be his last thought.
• 48:45
  Speaker 3: It doesn't have to be a funny story or even
• 48:48
  Speaker 3: a good story, just something that meant something to you
• 48:50
  Speaker 3: and him. And that was what he may take with
• 48:52
  Speaker 3: him into the next phase, whatever that is.
• 48:55
  Speaker 1: Yeah, yeah, yeah. Wow. I love talking to you. You're great.
• 49:01
  Speaker 1: Let's just plug the book, everyone.
• 49:03
  Speaker 2: Oh, thank you.
• 49:04
  Speaker 1: Is it available, Taves, on audio as well?
• 49:08
  Speaker 2: Yes, it is.
• 49:09
  Speaker 3: Penguin Random House has the audio. It won't be out
• 49:12
  Speaker 3: until December, but it's available for pre-order at Amazon. And
• 49:17
  Speaker 3: I am proud of it, and I'm excited to have
• 49:20
  Speaker 3: it come out, just to hold it in my hand.
• 49:22
  Speaker 3: It's a bit of a legacy, you know?
• 49:24
  Speaker 1: Congrats. It's amazing. Writing a book, getting it published by
• 49:27
  Speaker 1: a big publisher, getting what's in your head out into
• 49:31
  Speaker 1: the world. It's such a good achievement.
• 49:33
  Speaker 3: It is.
• 49:33
  Speaker 1: It's like there's this theoretical kind of And now it
• 49:37
  Speaker 1: becomes a real thing. It becomes like a physical thing
• 49:40
  Speaker 1: in people's hands that they can share and read and
• 49:43
  Speaker 1: buy for someone. And yeah, I've, it's, it's such, I've
• 49:47
  Speaker 1: done it a couple of times and it is, it is, yeah,
• 49:50
  Speaker 1: it's a real, apart from the fact that hopefully it's
• 49:53
  Speaker 1: going to help people. It's also such an achievement to
• 49:56
  Speaker 1: take it from the concept to the real thing in
• 49:58
  Speaker 1: the world. Okay. For the last time, everybody, the book
• 50:00
  Speaker 1: is called The Brain at Twilight, The Neuroscience of Our
• 50:03
  Speaker 1: Last Words and Moments. The author is Dr. Tarvez Tucker.
• 50:07
  Speaker 1: She's a ripper. That's a compliment in Australia. She's a ripper.
• 50:10
  Speaker 1: That means amazing. Thanks. Now, if people want to connect
• 50:14
  Speaker 1: with you, Tarvez, like, I don't know, are you on
• 50:17
  Speaker 1: social media? Do you have a website?
• 50:20
  Speaker 2: Yeah, I do.
• 50:20
  Speaker 3: TarvezTucker.com and I'm on I just am on TikTok recently.
• 50:25
  Speaker 2: Are you on TikTok?
• 50:26
  Speaker 1: Wow.
• 50:26
  Speaker 3: So you've got a, okay, a personal question. So actually
• 50:31
  Speaker 3: everything else, LinkedIn and Instagram for sure.
• 50:36
  Speaker 2: And Substack.
• 50:38
  Speaker 1: Look at you. I'm on Insta and I'm on Facebook.
• 50:41
  Speaker 3: TikTok.
• 50:42
  Speaker 1: I don't even get TikTok. You might have to give
• 50:44
  Speaker 1: me a lesson once we. I will. Yeah, because you're 38,
• 50:48
  Speaker 1: you can do that.
• 50:50
  Speaker 3: Because I'm 40 and you're, you know, what, 55.
• 50:53
  Speaker 2: So, yep. Yeah. We can train together.
• 50:57
  Speaker 1: Yeah, I'm a T-Rex, dude. I'm a dinosaur. We'll say
• 51:00
  Speaker 1: goodbye for now, but we'll say goodbye. Tavez, thank you
• 51:04
  Speaker 1: so much for being on the You Project.
• 51:06
  Speaker 2: Thanks for having me.