Ep 534 - Outlive (feat. Peter Attia)

Support the D. A. W. G. Z. @ patreon.com/MSsecretpod Read Peter's Book 'Outlive: The Science and Art of Longevity' and Listen to The Drive Podcast @ https://peterattiamd.com/ Go See Matt Live @ mattmccusker.com/dates Go See Shane Live @ shanemgillis.com yo0o00o. Bonus ep for you guys. Surprise. Matt hit the podiums w/ Dr. Peter Attia. Check out his book 'Outlive: The Science and Art of Longevity' and listen to his pod The Drive Podcast. Also say a prayer for Matt's A1Cs (he just got diagnosed with pre-diabetes). Please enjoy. God Bless. Learn more about your ad choices. Visit podcastchoices.com/adchoices

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:00Speaker 00

  Wow, wow, Wes.

• 0:01Matt McCusker?

  Dr. Peter Tia, dude, thank you for coming. Thank you for doing this. Um, thank you for doing this. I'm really, I'm really pumped. I read your book, so I'm kind of familiar with your stuff.

• 0:09Speaker 00

  Thank you so much.

• 0:10Matt McCusker?

  I kind of like what you're about.

• 0:11Speaker 00

  Thanks for having me.

• 0:12Matt McCusker?

  Thanks for doing the podcast. Um, and I guess I'll give you an introduction and correct me if anything, if I'm wrong. You are a medical doctor and you did cancer surgery, right?

• 0:21Speaker 00

  A general surgery with a focus on cancer.

• 0:23Matt McCusker?

  With the focus on cancer. And then you just kind of, I liked your origin story a lot. And so from what I remember in your book, you did this big swim, like rate, it was like a marathon swim or something. And how far did you swim?

• 0:35Speaker 00

  Uh, it was about 21 miles.

• 0:38Matt McCusker?

  That's insane. So you did a 21 mile swim. And then if I remember correctly, you were eating a cheeseburger in celebration.

• 0:44Speaker 00

  And your wife, your wife kind of. That was a slightly longer swim, but yes, yes. Now I know the story you're talking about. Okay.

• 0:49Matt McCusker?

  Yeah, that I that honestly, dude, that made me laugh so hard that you did like a, what?

• 0:53Speaker 00

  I think that was like 25 miles or something.

• 0:55Matt McCusker?

  25 mile swim. You go out to have a cheeseburger and I believe a Coca-Cola?

• 0:59Speaker 00

  Yeah.

• 1:00Matt McCusker?

  And your wife more or less was like, you're fat.

• 1:02Speaker 00

  Yeah.

• 1:03Matt McCusker?

  Dude, that's the best. And then you it launched you and then you just got the ultimate revenge and started like a super successful business. How do you feel about that?

• 1:11Speaker 00

  Very sweet. She said, she just, she didn't say you're fat. She goes, you need to work on being less not thin.

• 1:18Matt McCusker?

  That's worse, though. I'd rather someone be like, you fat ass and be like, you need to be less not thin. But you just swam 25 miles.

• 1:26Speaker 00

  Yeah.

• 1:27Matt McCusker?

  That's wonderful, though. That is good, though, to have a woman to push you to those heights. Cause then that's, is that really like the genesis of you kind of branching out into like?

• 1:34Speaker 00

  Um, I had actually already left medicine at that point. I had been out of medicine for three years. I was working, um, at that time. God, what was I doing? I was working at an energy company, I think, or maybe I was in finance or something. I was, but I was like, I had nothing to do with medicine. Um, but that was right around the time my daughter was born as well. And so I think that was kind of the one-two punch. It was sort of my daughter's born.

• 1:58Speaker 00

  And then I'm realizing, actually, like, I'm not that healthy. Even though I exercise a lot, I'm actually not that healthy. And that, those, those two things were what kind of got me to be pretty obsessed with just trying to figure out how to not die prematurely.

• 2:12Matt McCusker?

  The kids do that. I have a two and a four year old and that really kind of, I, I actually thought, you'll find this interesting. I thought I was healthy. I did all, I was doing the, um, you know, all these apps. Like I did the one where you like mail your poop and all that stuff. And I did that. It came back like, dude, you're like six years younger biologically. I was like, this is awesome. Did I, I had the fucking aura thing. I had that going on. Telling me I'm seven years younger than my age. And then I took a blood panel, dude, I'm like pre-diabetic. I was like, what the fuck, man? It was like, I, I thought I was like killing it and I got it back and it was like, I literally just found out two days ago. So this, this timing couldn't be more perfect. My A, what is it? A1C, I think it was? My A1C is like 5.7, which was like, but I did eat, uh, two bites of a pancake before my blood work, which I'm not, not supposed to do.

• 2:53Speaker 00

  Shouldn't impact the A1C.

• 2:54Matt McCusker?

  Damn it, dude. I was fucking hoping that was the answer. Yeah. So that is kind of crazy because you, and again, I don't, you know, I'm not the definition of fitness, but I'm not like, I wouldn't think, I thought I had the almost type two diabetes.

• 3:06Speaker 00

  Well, it takes a while, like you don't, no one wakes up diabetic, but also most people don't kind of, don't recognize that it's a 10 year journey for most people.

• 3:14Matt McCusker?

  Really?

• 3:15Speaker 00

  To get there, yeah.

• 3:16Matt McCusker?

  So what? I have like four, like four more years of pre-diabetes?

• 3:19Speaker 00

  I mean, I think that's impossible to predict for any one person, but, but we, we definitely know that disease is so much more complicated than people. I think historically have thought of it. People have historically said, well, I mean, type two diabetes is your pancreas can't make enough insulin. You can't get enough glucose out of your blood into the muscles. And eventually we just cut off some arbitrary number. We just say, once you reach a certain level of blood glucose, then you have type two diabetes. But you know, to me, that's just, um, not a great way to think about it. I think of it as a continuum and a spectrum. And pre-diabetes is a step along the way, but we also know that the lower your blood sugar, the better. So 5.7 is better than 5.8 is better than 5.9.

• 4:01Speaker 00

  But even though we would call you quote unquote, normal at 5.6, I would argue five is much better than 5.6.

• 4:07Matt McCusker?

  Gotcha. I see what you're saying.

• 4:08Speaker 00

  Yeah.

• 4:09Matt McCusker?

  Yeah. It was like for real joke because I was like dancing in the end zone on my wife because she's, she is her biological age. And I'm not rubbing it in, but it was like, whatever. And I was like, I'm five years older than her. So I was like her peer biologically. And I was laughing, you know, I was

• 4:22Speaker 00

  These biological clocks things are such a scam. It is incredible. I love it. I love it. It's brilliant marketing.

• 4:30Matt McCusker?

  It is.

• 4:30Speaker 00

  Brilliant marketing.

• 4:31Matt McCusker?

  I woke up one day and I went like I lost half a year of my biological age. I was like, what the fuck did I do? I like went into a panic. But yeah, so the, uh, that was like a real revelation for me. I was like, holy shit, man. Cause my dad has type 2 diabetes. And I was like, yeah, that's on him. He eats ice cream all the time. I'm healthy. And I like got my blood work. And I was like, son of a bitch. By the way, I'm just breaking this right now. I don't, I don't

• 4:51Speaker 00

  This is breaking news.

• 4:52Matt McCusker?

  This is breaking news.

• 4:52Speaker 00

  This is, this is like so timely.

• 4:54Matt McCusker?

  I have free and I was actually, it is very timely. And I have been leveraging it emotionally in my household, which is nice. Anytime my wife bothers me, I'm like, dude, I have pre-diabetes. This cortisol is gonna mess up my insulin. So.

• 5:06Speaker 00

  I, I got a text message literally on the way over here from a buddy who just got a vasectomy yesterday. And, uh, we had recommended the urologist to him, um, who, who was gonna do it. So he goes, look, I just wanted to tell you, man. Literally the best experience ever. The guy was incredible. So funny. You know, he's got me draped like over the table. So like, you know, he's like, there's a drape, like I'm laying on my back.

• 5:27Matt McCusker?

  Like a C-section? They do like, they don't let you see?

• 5:29Speaker 00

  Yeah. It's like you're sterile. They want to keep you sterile, right?

• 5:31Matt McCusker?

  Got you.

• 5:32Speaker 00

  And the guy walks in the room, first time he hasn't seen me, doesn't see my face. He just sees my, my, my schlong and he goes, oh, I remember you. But he was like, but it was just all jokes. And he's, so he says today, he goes, you know, look, honestly, zero pain at all. But don't tell my wife, I am gonna milk this. It's 10 out of 10 pain for another week.

• 5:48Matt McCusker?

  So important.

• 5:49Speaker 00

  Yeah, yeah, yeah.

• 5:49Matt McCusker?

  So also the vasectomy, you can't ejaculate for like, what? Seven days or something?

• 5:55Speaker 00

  That's a good question. I don't know how many days. I don't know how many days.

• 5:58Matt McCusker?

  I think it's like seven. My friend did it.

• 6:00Speaker 00

  He, uh, He had to hold off, yeah.

• 6:01Matt McCusker?

  Seven whole days. And he said he went a little prematurely and said he had a little bit of pain. So that's not good. But yeah, dude. So that's, that was kinda crazy, man. Cause again, I've been doing all the, the services. Cause I haven't, I haven't like been to a doctor forever. Cause I'm like, you know, I go to, and this is, I think was cool in your book. You have like, was it healthcare 2.0 versus like 3? What was the latest?

• 6:21Speaker 00

  Yeah. Medicine 2.0 versus medicine 3.0. Yeah.

• 6:23Matt McCusker?

  So 3.0 is kind of where you're at. That's kind of more cutting edge. 2.0 is like, what a step up from like medieval humors and.

• 6:30Speaker 00

  Yeah, but, but still important. I mean, we still want medicine 2.0. Medicine 2.0 will take care of a problem when it shows up. And if you, you know, if you, if you're in a car accident, you break your leg, you get pneumonia, you, you want, you want someone who knows how to deal with those problems. But it's a very different system from, hey, how do I? Take a guy who's hemoglobin A1C is 5.5, who no one, everyone thinks is just perfect, but I think he's on the path to actually, you know, being diabetic in 10 years. And why would I wait till he's staring down the door when I could just make the changes now?

• 7:04Matt McCusker?

  And that was kind of my beef with doctors. I would go there and they're like, nice. I don't have anything against them, but I go there and they're just kind of like, yeah, cholesterol is good. And I'm like, this is all we're worried about? Like this is, and then they lowered the window to like, blood pressure. The one day I went in there and they're like, oh, by the way, uh, high blood pressure is lower now. I'm like, oh, okay. I didn't have a blood pressure problem, but it's like, I just feel like you go there and it's like, you're like a car. You go in and they check like two things. You're like, nah, you're good. But so I really liked your book, how you're like, you want to check for more things and try to increase the health span, not just the lifespan, which I like, because a lot of people are very unhealthy. I thought I was a poster child for health, dude. I'm, I'm one of the suffering Americans, just, I need Michelle Obama to come get, make me lunch, dude. I'm fucking all fucked up right now.

• 7:47Matt McCusker?

  So what are you working on right now? Has the book, has anything changed from the book? Cause and again, correct me if I'm wrong, but the summary was like the four horsemen, that's the things that are the four leading causes of death. And there are what? Heart disease?

• 7:57Speaker 00

  Cancer.

• 7:58Matt McCusker?

  Cancer.

• 7:59Speaker 00

  Neurodegenerative diseases and dementing diseases like Alzheimer's disease and metabolic disease.

• 8:05Matt McCusker?

  That's me. That's diabetes, right?

• 8:07Speaker 00

  And they overlap. So when you have type 2 diabetes, your risk of those other diseases goes up by 50%. So that one sort of feeds into the other. And also if you have cardiovascular disease, your risk of dementia goes way up. So.

• 8:21Matt McCusker?

  Oh, really?

• 8:22Speaker 00

  Oh, yeah.

• 8:22Matt McCusker?

  Damn, that sucks. Yeah. And you know what's weird too? Because I don't want to turn this into like a personal doctor visit, but like, I for real had like crazy brain fog. Like I couldn't, I was like messing up recalling words and a lot of my, my mom's side had, um, like dementia stuff when they got older. So I started being like, damn, I might be like, getting like early dementia. And as soon as I learned about the high A1C, and I don't know if that's like high enough to cause brain fog. Like I was like, forget it. I forgot the word croissant. I was like trying to think of that word, couldn't think of that. But I, as soon as I got off all the carbs and now I'm like basically doing like keto, my brain just like came right back to life. It was pretty nuts.

• 8:56Speaker 00

  Yeah. I mean, I don't know that that's related to the A1C per se, but fluctuating levels of blood glucose are, make it just a little more difficult. And, and some people are more sensitive to it than others. Some people. You know, they can eat all the carbs in the world and it doesn't seem to faze them. And a lot of people are like, no, the moment I go to slower carbs, or just no carbs at all, or just more complex carbs, my energy levels normalize and so too does my attention.

• 9:21Matt McCusker?

  Yeah, dude, that's, that happened for me. And I also don't, uh, I don't, you have to eat as much. Like, I was eating so much, man. It would be like four cups of rice. I'd be, I was just picking out.

• 9:30Speaker 00

  Yeah.

• 9:31Matt McCusker?

  And then as soon as I stopped eating that much carbs, I eat like two meals a day and they're pretty sparse. So.

• 9:37Speaker 00

  Tell me about these pictures here.

• 9:39Matt McCusker?

  Oh, thank you, man. Um, this, I just figured it was funny because it's just a kind of like a, um, just an ample naked lady sitting at a picnic. So I like saw, I literally picked the pictures very quickly. I, this one, I just wanted very intense imagery.

• 9:52Speaker 00

  Yeah.

• 9:53Matt McCusker?

  And so this is kind of like, you know, this is pleasant. It's a little complicated. You have.

• 9:56Speaker 00

  What do you think's going on here? Why is she naked? And who, who are these guys?

• 9:59Matt McCusker?

  These guys are up to no good for sure. They, uh, I think these guys, it looks like they just got happened upon. And someone's going, what the hell are you doing with that ample naked lady in the park? And this guy's like.

• 10:10Speaker 00

  But he's like fully dressed.

• 10:12Matt McCusker?

  Yeah.

• 10:12Speaker 00

  Who's, who's, who's the girl in the background?

• 10:14Matt McCusker?

  So to answer your first question, this is a clothed male, naked female. It's a fetish. Uh, that's going on. And I think she's kind of like next. I think they're like, get over here.

• 10:24Speaker 00

  Mm hmm.

• 10:24Matt McCusker?

  Strip down so we can have a naked picnic. This caused a serious uproar back in the day when he, this guy painted this. It was a problem.

• 10:32Speaker 00

  I believe, I mean, I can see why.

• 10:34Matt McCusker?

  They, they were like, if you had someone posed, this lady had to have been a prostitute. And they're like, that's totally scandalous.

• 10:39Speaker 00

  Yeah. What year approximately was this?

• 10:41Matt McCusker?

  I wish I knew. I don't know. If I had to guess, I would say like, maybe the late 1800s? If I had to guess. I could be wrong. And that guy, I don't know what that guy's hat's all about over there, but.

• 10:52Speaker 00

  Yeah. I mean, it's sort of, I don't want to profile him, but, but I have thoughts.

• 10:58Matt McCusker?

  True. It is a hat. I don't recognize that hat and I do have my own suspicions as well.

• 11:02Speaker 00

  Yeah.

• 11:02Matt McCusker?

  But yeah, I don't know. I don't know if he's like, I don't know what's going on. He seems kind of distracted. I think he's being caught. She's just kind of getting caught. There's just a lady in a pond, maybe just kind of floating around.

• 11:12Speaker 00

  Oh, that's interesting. So I, I see that now. I thought she was picking up apples, but maybe she's washing her hands.

• 11:16Matt McCusker?

  Sure. Well.

• 11:17Speaker 00

  In the pond.

• 11:18Matt McCusker?

  You know, one could only guess why. But the, uh. But yeah, so that's, that was cool. I thought that was a fun one. This is very intense. I like this. And then I just, you know, toss a little crucifixion up there.

• 11:27Speaker 00

  Yeah, it's the, the rainbow crucifixion. I don't, I, I'm not, I don't know my, my biblical history well enough to, I, I would embarrass myself if I asked dumb questions, but is there a rainbow after the, after the crucifixion was?

• 11:40Matt McCusker?

  I, I would hope so, you know, God was rising back to heaven two days before, so I'd, I'd hope.

• 11:45Speaker 00

  No, I thought it was three days after this.

• 11:46Matt McCusker?

  Three days, my bad, my bad, three days, three days.

• 11:47Speaker 00

  So the, the, yeah, so that foreshadowed maybe the resurrection.

• 11:52Matt McCusker?

  Could be, yeah, could be.

• 11:53Speaker 00

  Yeah.

• 11:54Matt McCusker?

  But I honestly don't know. I, I don't have any real, um, knowledge.

• 11:57Speaker 00

  Can you imagine how brutal the world was when we crucified people?

• 12:01Matt McCusker?

  I think about it all the time.

• 12:02Speaker 00

  How lucky are we to live in this candy ass world of softness?

• 12:07Matt McCusker?

  Dude, I try to tell it to people and I have people tell me.

• 12:09Speaker 00

  I'm so grateful.

• 12:10Matt McCusker?

  It's insane because I try to tell people, I'm like, dude, it was way different. And other people are like.

• 12:13Speaker 00

  Like those guys were thieves, right?

• 12:15Matt McCusker?

  Yeah.

• 12:15Speaker 00

  Like that today, you wouldn't even go to jail.

• 12:18Matt McCusker?

  Yeah, they'll kill you.

• 12:19Speaker 00

  Yeah, they'll kill you. And then you get crucified?

• 12:22Matt McCusker?

  Yeah. And it also, the procession was like a pretty nasty part of it too. Just get walked through the streets, spit upon, rocks thrown at you.

• 12:29Speaker 00

  I, I just, I can't, I can't fathom.

• 12:32Matt McCusker?

  Dude, the social anxiety.

• 12:33Speaker 00

  And by the way, that's only 2,000 years ago, which in the arc of human history is yesterday.

• 12:38Matt McCusker?

  Nothing.

• 12:39Speaker 00

  That's nothing.

• 12:40Matt McCusker?

  That's what I try to tell people, man. Cause there, there's a lot of people are like, everything's always been the same. It's just different variations on the same themes. And I'm like, dude, it's gotten so much different from 2,000 years ago. It can still get so much different.

• 12:50Speaker 00

  Think about 500 years ago, right? Think about, if you could be you, or you could be the king of England 500 years ago, with like, you know, no, it sounds great until you get like a dental abscess and you realize there's no AC, there's no heat, the food sucks.

• 13:07Matt McCusker?

  Yeah.

• 13:08Speaker 00

  Like, I, I don't think you're going to be the king of England 500 years ago. I think you.

• 13:11Matt McCusker?

  The food still sucks in England now. Yeah, that's a good point because you could be.

• 13:16Speaker 00

  It's probably pre fish and chips.

• 13:18Matt McCusker?

  Yeah, that would fucking, that would actually suck. I, I didn't ever thought about being like the king of another country. But it would be pretty terrible. There was a king in some medieval time, like longer ago than that, but they thought alcohol was like health stuff back in the day. It was like the spirit.

• 13:33Speaker 00

  It kind of was because water was so contaminated, right?

• 13:36Matt McCusker?

  Yeah.

• 13:36Speaker 00

  So you basically had two broad cultures that emerged from either the fermentation of alcohol, of water, right, and alcohol to make, to get rid of the bacteria, or tea, right? You had sort of the, the rise of the sort of tea culture where you boiled water. But yeah, the idea that you were just gonna go and drink water was like, I mean, the fact that we're sitting here drinking this is incredible.

• 13:58Matt McCusker?

  It's pretty tight, actually. But yeah, they had a king. They, they, they were like, they rubbed him down in like, brandy, maybe? And then they were like, all right, we're gonna like, rub this all over his body and like, a candle got too close and just burnt the guy alive and all the high priest or whatever had to be like, ah, you must have been fucking evil.

• 14:13Speaker 00

  Yeah.

• 14:13Matt McCusker?

  Fucked up.

• 14:14Speaker 00

  No one, no one put two and two together. They didn't understand exothermic chemical reactions.

• 14:20Matt McCusker?

  Damn dude, so, so let me ask you this. What is your, the gist of your book is basically, and again, correct me if I'm wrong, but the gist was basically like, we can pre-screen better and we can kind of promote wellness rather than waiting till somebody has like a horrible, often irreversible disease and like, try to fix it through kind of like nuking the.

• 14:38Speaker 00

  Yeah, and, and, and part of it is like, you know, what gets measured gets managed. And so, medicine 2.0 measures lifespan as the ultimate outcome, which is, that's been productive. That's, that's a good thing to measure. I don't, I'm not suggesting we shouldn't care about lifespan because 150 years ago, lifespan was 40 years. Today it's 80. That's insane. We doubled lifespan. And that's all due to medicine 2.0.

• 15:03Speaker 02

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• 15:05Speaker 03

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• 15:13Speaker 02

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• 15:14Speaker 03

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• 15:18Speaker 02

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• 15:27Speaker 02

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• 15:32Speaker 00

  Basically figuring out how to not kill women when they gave birth to children, how to keep babies alive when they were born, how to fight infections, how to wash our hands, like that, and then a little bit of stuff around trauma and critical care. Like you doubled human lifespan, but we're not managing health span. And so part of the argument is, okay, we've done pretty well on lifespan. We could do better, but we really have to manage health span.

• 15:55Matt McCusker?

  Yeah.

• 15:55Speaker 00

  And so if we think about things that make up health span, it's sort of like, how much muscle mass do you have? How strong are you? How much endurance do you have? How much flexibility and balance do you have? How quick is your cognitive performance? You know, how happy are you? How are your relationships? How much joy do you have in your life? These things are softer and squishier. Some of them are pretty easy to measure, like VO2 max and muscle mass and strength. Some of them are harder to measure, like cognitive performance. But if you don't measure something, there's no chance you're going to manage to it. And I would just argue, we have to, we have to slightly tilt in the direction of doing more on that front.

• 16:32Matt McCusker?

  Yeah, it'd also be cooler to go to the doctor and have them like hit the treadmill. Let's check your VO2 max.

• 16:36Speaker 00

  Yeah, let me see how long you can dead hang for. Let me see your grip strength.

• 16:39Matt McCusker?

  I'd be so much better than sitting there and just being like, basically getting molested and leaving. That's, that's all you do. You go there and they're like, all right, we're gonna, what's, what is the coughing? Why do they do that? Why do they call, hold your?

• 16:49Speaker 00

  It's funny, I thought you were gonna ask me to do it to you earlier when you said this is not an appointment. I literally thought you were gonna whip your junk out and have me check.

• 16:55Matt McCusker?

  I'm just going just for the A, dude. You gotta do the butt.

• 16:58Speaker 00

  It's, they're checking for a hernia.

• 17:00Matt McCusker?

  Is that what it is?

• 17:01Speaker 00

  Yeah, yeah.

• 17:02Matt McCusker?

  But why is that like the top of the pops?

• 17:04Speaker 00

  Yeah, exactly.

• 17:05Matt McCusker?

  There's so much other things to check. It's like, we're not gonna do all this other stuff that'd be useful.

• 17:09Speaker 00

  We're just not going to look at a bunch of things, but I do wanna stick my finger in the inguinal canal.

• 17:14Matt McCusker?

  That's what I'm saying.

• 17:14Speaker 00

  Yeah, and I'm gonna, and make you cough.

• 17:17Matt McCusker?

  And I'm glad, you know, they do that, but it's like, why did that get picked as opposed to all of this other stuff you're talking about? Do you think it has something to do with like, just like institutional, just repressed homosexuality throughout the entire culture? And that was like?

• 17:29Speaker 00

  I don't know. But I will say this, like, I can't tell you how many rectal exams I've done. And then I realized like, I mean, technically, a good, a good urologist will tell you that their finger is good enough to truly feel a prostate cancer that would otherwise not be picked up on a PSA or some other test. And I'll take them at their word, but I think for the rest of us who don't do 20 a day, yeah, I just, I don't think my finger is good enough, you know?

• 17:56Matt McCusker?

  Don't say that.

• 17:57Speaker 00

  I mean, I'll work harder, but.

• 18:00Matt McCusker?

  Yeah, that's crazy. So they're saying they can just feel like it just.

• 18:03Speaker 00

  They've said like, look, man, you know, there's always that one case that slips through the crack where the guy has a normal PSA, no pun intended.

• 18:11Matt McCusker?

  So they can't tell. Yeah.

• 18:13Speaker 00

  But they're like, yep, if you feel a certain type of super hard nodule on the prostate, that would be suspicious.

• 18:18Matt McCusker?

  Damn. Yeah, that is, I do, I think they really could have, you know, if doctors would embrace that, it'd be so much more fun. You go, you kind of run on the treadmill, dead hang, you know, they could talk to you a little bit about, it just seems so kind of sterile.

• 18:30Speaker 00

  Plank. Yeah, there's like a bunch of basic tests. Everybody should be able to, we should be able to see the people do. I completely agree.

• 18:35Matt McCusker?

  Yeah. I don't, it's, so I did really like your book for that reason. Hopefully that kind of stuff takes. So what is, so if that's the scope of the book, where do you stand now? Is anything changing that time? Or is there anything that's like latest and greatest that's kind of like blowing your mind right now?

• 18:47Speaker 00

  I think my thinking is always evolving. I would say, if I were writing that book today, I would actually kind of add a fifth horseman, which is anything that pertains to a weakened immune system. So I'm just getting over a cold because I have three kids and two of them are young. So basically I'm always in the, I'm always in the face of like some virus, right?

• 19:08Matt McCusker?

  Yeah.

• 19:08Speaker 00

  So twice a year, I always get some stupid cold and it's no big deal. You know, I, it starts in my throat, blah, blah, blah. It gets into my lungs. I hack up a bunch of junk and then I'm fine. But, you know, anyone who's been around older folks realizes that that's the kind of thing that can tip them over the edge when they're 80 years old.

• 19:26Matt McCusker?

  Yeah.

• 19:26Speaker 00

  You know, a really bad infection of flu, COVID, things that us, you know, 50 year olds laugh at can become deadly. And so from a, from a, from a research perspective, this is something I'm super interested in is how do we regenerate the immune system? So, you know, I'm in my 50s, my immune system is also in its 50s. Would it be amazing if when I'm in my eighties, I could still have an immune system? That's maybe like in my fifties or forties. The, the effect that that would have against, you know, mitigating the risk of fatal pneumonias, infections, and even cancers is huge because the immune system is the first line of defense against cancer.

• 20:04Matt McCusker?

  Oh, really?

• 20:05Speaker 00

  Yep.

• 20:05Matt McCusker?

  Is that, didn't they used to use like fevers for that too? They would induce fevers to try to kill certain types of cancer?

• 20:10Speaker 00

  Yeah, and it wasn't very successful because it's so non-specific.

• 20:14Matt McCusker?

  Oh, okay.

• 20:14Speaker 00

  Cancer is, the only way for the immune system to eradicate cancer is it has to, you have to get the very, very, very specific T-cell that recognizes exactly that cancer, and you have to figure out a way to make enough of them that it, you know, wins that war. And that rarely happens spontaneously. I mean, the cases are, you know, documented in the literature, they're so rare. But we now have drugs that can make that happen in about 10% of cases. Which is huge.

• 20:41Matt McCusker?

  Yeah, that's pretty crazy. So how, how would you, how would you, what's your research yielded? How, how do you think you can bolster the immune system or like?

• 20:47Speaker 00

  I mean, it depends how, I don't know how technical the, the audience wants to get into this stuff, but, um, so, so stop me when this has become unbearable.

• 20:55Matt McCusker?

  For sure.

• 20:55Speaker 00

  So the, you know, we have DNA.

• 20:57Matt McCusker?

  Okay.

• 20:58Speaker 00

  Okay, so everyone's sort of DNA. DNA is the code that tells every cell how to make a protein. So, um, what tells DNA to turn on and off are something called methylations, little carbons that stick on the backbone or something called the epigenome. So DNA is regulated through this methylation pattern. And as we age, that changes.

• 21:26Matt McCusker?

  Gotcha.

• 21:26Speaker 00

  So we can look at a T-cell, which is the type of cell that fights a cancer or an infection, and we can say, that's what an old one looks like, that's what a new one looks like. Even though the DNA is the same, the epigenome above the genome, this methylation pattern looks different. And so the question is, what if we took the methylation pattern of an old T-cell and made it look like a young T-cell? Would it revert into a young T-cell? So to me, that's.

• 21:56Speaker 00

  Certainly top two or three most interesting questions in aging research today.

• 22:01Matt McCusker?

  That's pretty cool. And that makes sense because it's like the DNA, you're born with it. And then the epilayer, that's like the kind of like pattern that's affected through the environment.

• 22:09Speaker 00

  That's what regulates it. Exactly.

• 22:11Matt McCusker?

  Yeah. And then, so if you can kind of get into that and then so you could, and it was stress too. Cause I noticed that was a big thing, your book. So, and you can stress yourself to the point where your epigenome will just start being like,

• 22:22Speaker 00

  Every, everything in the environment can affect that. So it's affected just naturally through aging. So the passage of time affects it, but so does anything in the environment. So whether you exercise, whether you smoke, whether you have diabetes or not, all of those things, good sleep, bad sleep, high stress, low stress, anything can tweak that in the right or wrong direction.

• 22:40Matt McCusker?

  Damn. Okay. That's pretty cool. So you're saying.

• 22:42Speaker 00

  But the gravitational pull of age is huge. And that's the one I'm most interested in is like, how would you? Cause even the healthiest 80 year old has nowhere near the immune system of an unhealthy 30 year old.

• 22:55Matt McCusker?

  Yeah. Yeah. And we also, we saw that everyone was hoping against hope that Mike Tyson would just knock out, Jake Paul. And that was kind of like a bitter moment for a lot of people.

• 23:03Speaker 00

  Yeah. You can't like age, age is not.

• 23:05Matt McCusker?

  You just can't do it.

• 23:06Speaker 00

  Yeah. As father time is undefeated, as everybody said.

• 23:08Matt McCusker?

  Yeah. Even with the, even with like the TRT, what are your thoughts on that? Like in terms of like, you know, what age to kind of smash the glass and just go full upgrade.

• 23:16Speaker 00

  I don't know that there's an age I would do it. I mean, I think the things that I would, you know, I had a long talk with a patient yesterday about this exact question and he's pretty young. He's like 36, does not have kids, but wants to have kids. So that's a huge consideration. So in his situation, I would say like TRT is not a good idea. I, I suggested that he bank sperm and if he wants to go down that rabbit hole. And by the way, I don't think he needs to, because I don't think his level, his levels are like kind of 50th percentile. He's not terribly symptomatic. I would kind of eke out a bit more time, but I would, I would rely on hormones that are going to ramp up his body's production of testosterone as opposed to just giving him testosterone, which will shut off his body's supply.

• 23:59Matt McCusker?

  Forever?

• 24:00Speaker 00

  No. And it also, it's not something that happens overnight. Like, you know, he, he'd have to be on testosterone for a while before he would shut down his own production.

• 24:08Matt McCusker?

  Yeah. So what are your thoughts on that? On like that whole thing of especially for 30 year olds? Do you think it's like good to kind of have that? Or you think it like should be kind of a long road?

• 24:15Speaker 00

  I think you gotta, I think you gotta, you know, take every case individually, but. If a 30 year old has testosterone that is so low that it's impacting him, I think you have to start by asking why.

• 24:27Matt McCusker?

  Right.

• 24:27Speaker 00

  Like, how bad is his sleep? How bad is his stress? How bad is every other factor going on? I mean, when I finished, um, God, when I was, you know, leaving my residency, my testosterone was 227, I think, which is insanely low. That's, you know, that's only two and a half times higher than a woman.

• 24:51Matt McCusker?

  What?

• 24:51Speaker 00

  Yeah.

• 24:52Matt McCusker?

  Is that why doctors' hands are so soft every time you shake them?

• 24:57Speaker 00

  No, that's, that's for the rectal exam. So you just don't get the...

• 25:00Matt McCusker?

  That's true, that's true. You wouldn't want to like my dad's finger.

• 25:01Speaker 00

  No, the, um, and, and, but the reason is pretty clear, right? Cause I was sleeping 28 to 30 hours a week.

• 25:10Matt McCusker?

  Damn.

• 25:10Speaker 00

  Right? So, you know, horrible sleep deprivation is going to make it really difficult to make appropriate levels of testosterone.

• 25:17Matt McCusker?

  And that makes it harder for you to sleep too when your testosterone gets lower?

• 25:21Speaker 00

  Uh, I think probably a little bit, but the causality is much more in the opposite direction. Meaning the, the horrible sleep is destroying

• 25:28Matt McCusker?

  Ah, I see, I see, I see.

• 25:29Speaker 00

  The, the, the production of testosterone and growth hormone.

• 25:34Speaker 00

  So, but of course, at the time, it never occurred to me to do anything about it, you know? And once I, you know, was in a job where I could actually sleep each night, lo and behold, my testosterone kind of normalized.

• 25:45Matt McCusker?

  It peaked up.

• 25:47Speaker 00

  Yeah.

• 25:47Matt McCusker?

  Well, do you think that's a good thing for people to actually look at? Cause I, I always get the feeling that like, if you even go into one of those places, they're going to hard sell you and you'll be on the T like before you know it.

• 25:56Speaker 00

  I think you should not go to, um,

• 26:01Speaker 00

  I'm trying to think of the right analogy.

• 26:04Speaker 00

  If you, if you walk into a store that, uh, only sells hammers, everything's a nail.

• 26:10Matt McCusker?

  Yeah.

• 26:10Speaker 00

  Right? So, so I, I think if you walk into a tea shop and all they do is male hormone optimization, I would say buyer beware.

• 26:18Matt McCusker?

  Yeah.

• 26:18Speaker 00

  Cause they, even if they internally have the best of intentions, like I just don't think they can get out of their own way. I, I, I also think you should be very wary of... Going to a place for any sort of therapy where they're selling you the therapy.

• 26:34Matt McCusker?

  True.

• 26:35Speaker 00

  If, if, if my whole shtick is, I'm here to, you know, give you the best hormones or supplements or whatever. And oh, by the way, on your way out, we'll sell them to you. It's just such a conflict of interest.

• 26:45Matt McCusker?

  Yeah, yeah.

• 26:45Speaker 00

  So.

• 26:46Matt McCusker?

  So what do you, what do you think about the, like, even like the internet companies that are like, like I did one, I don't know if it's nice to like name it or not, but like the ones that like you mail like stool sample, blood, saliva, and they're like, here's precision supplements for you and you alone. How, do you think they're like, how much of that is kind of generic? And do you think some of those companies are really dialed in or like?

• 27:07Speaker 00

  I don't doubt that there are ways to kind of sort of optimize supplements around biomarkers.

• 27:14Speaker 00

  I just, I'm not sure that it's as precise as people want to believe. I certainly don't think that. I actually think you can do a lot of supplement optimization off really basic blood work. Like, I don't think, certainly, you know, a stool sample is not necessary because most probiotics can't even provide the bacteria you need to impact it. I mean, your diet has a far greater role. Your fiber content has a far greater role on your gut biome and things that you'd be measuring in stool. And obviously saliva, blood, urine can measure things that are relevant and interesting. There aren't that many things that I think are worth taking. Like, I think, yeah, if you're low in vitamin D and you're not getting enough sunlight, that makes sense, but that's a pretty simple blood test. If

• 27:59Speaker 00

  your homocysteine is elevated, yeah, you probably should take some methylated B vitamins. And if you drop it by more than five or six points, you're probably doing a lot. If your omega levels are low, fish oil probably helps if you're not willing to eat three servings of fish a week.

• 28:14Matt McCusker?

  Right.

• 28:14Speaker 00

  But the, the true basics of this are really simple. And then there's other supplements that probably make sense for most people. And you don't even need to test for them. Like, anybody who's active could probably justify taking creatine.

• 28:26Matt McCusker?

  Yeah.

• 28:27Speaker 00

  And there's no blood test that's going to tell you whether or not you need it. We just know that, you know, to, to fill and saturate total body stores, you're going to need three to five grams per day. So.

• 28:37Matt McCusker?

  Really? That's yeah, that was surprising. That was like something I heard like in college, like, you know, years ago when I'd lift weights, it was like creatine was almost like you just like a serious kind of like bodybuilder supplement. Now, everything I read is like, no, everyone needs a ton of creatine.

• 28:49Speaker 00

  Yeah, I mean, again, it's just if you're playing the game of optimizing, you're going to get a benefit, probably about a 10% boost in performance for intensity and like super short intensity, i.e. the creatine phosphate energy system. So kind of like high bursts of, you know, 10 second work and then anaerobic stuff. It's not going to improve much aerobically, but and you'll also get a little hypertrophy benefit because the muscles will get bigger. Would they bring more water?

• 29:18Matt McCusker?

  That makes sense. Yeah, if like my kids are like seven feet away and they're not listening, I could just fucking run at them.

• 29:23Speaker 00

  Easy.

• 29:25Speaker 00

  Easy.

• 29:27Matt McCusker?

  Just hulk them down. Yeah, that's and that's my thing with fitness. A lot of people, and I'm sure you, I mean, I don't know if you've heard this, you're kind of a, I'm sure your like listenership is very health oriented, but a lot of people get very like, I don't know, like very kind of scoffed. They kind of scoff a lot of the stuff where they're like, who gives a shit? And it's like, and I feel bad because like I do get it. If you're like in a job you hate, you're just totally crushed down by like your life circumstance, having somebody be like, dude, eat a banana and do jumping jacks. You're gonna be like, dude, fuck you. I don't want to think about this. But it also will make your life better. Like I always like, whenever I lose sight of that, whenever, whenever I get too into my own like just stuff where I'm like, this isn't going well. I gotta, I don't have time. If I just take like an hour, any even a half an hour and just like run as fast as I can,

• 30:09Matt McCusker?

  it's like, I feel like amazing. And I always say that's like a nice dimension you can add to your life where it's like, everyone's like, you know, like, I want to get better in my job. It's like just adding that like time yourself running 100 meters and then try to get a better time next week. It is like it gives you something. You're kind of making progress and and then also you feel great as a result.

• 30:28Speaker 00

  Yeah, I think this is where kind of social media really distorts reality. And the example you give is a great one, right? So if you're, if you're. Health sucks and you, you know, you're trying to figure out where you're going to find an extra two hours a week to do some form of self-care. The last thing you need is some idiot influencer telling you to spend more time in the sauna and cold plunging. Like, I can promise you that is not the first, second, third, fourth, or fifth best use of your time if you only have two hours a week.

• 31:02Matt McCusker?

  How would you break it down then?

• 31:03Speaker 00

  If you've only got, so, you know, I would start with, what's the, let's do the absolute basics of blocking and tackling. So first thing I want to know is, are you getting at least seven hours of sleep a night? Because if you're not getting at least seven hours of sleep a night, it's going to be very difficult for you to do anything at your best.

• 31:19Matt McCusker?

  So, me, I didn't, I don't want to interrupt you. My, my question with that is, say like, you know, say you are tracking your sleep and you only get like 43 hours of deep sleep every night, even though you go to bed at like a proper time. Does that matter as much of like REM versus deep sleep or like?

• 31:31Speaker 00

  I'd assume you're in 43 minutes, but.

• 31:33Matt McCusker?

  Forty-three minutes, I wish, fucking forty-three.

• 31:35Speaker 00

  I only get 43 hours of deep sleep a year. I'm doing the math quickly.

• 31:41Speaker 00

  I don't know. If you feel, if a person says, I feel really well, and there are these, I link to them in the book, there are a whole bunch of surveys you can get for free that just have you do like, you know, there, these are validated surveys that kind of go through daytime drowsiness and stuff like that. If you're in bed, seven to seven and a half hours a night, ideally eight, and you're, you know, your little sleep tracker says you're sleeping seven, but you're not happy with your stages, I wouldn't put a lot of stock into that unless you feel that there is a problem.

• 32:08Matt McCusker?

  Got you.

• 32:09Speaker 00

  But if you're like, no, I feel fine, and I fill out all the two surveys and they said I'm doing fine, ignore the data.

• 32:14Matt McCusker?

  That makes sense.

• 32:14Speaker 00

  And stop wearing the tracker.

• 32:16Matt McCusker?

  I know.

• 32:17Speaker 00

  Done with the tracker. So.

• 32:19Matt McCusker?

  I was checking every day, I'm like, forty-three fucking minutes.

• 32:21Speaker 00

  Yeah, like it just creates more anxiety.

• 32:22Matt McCusker?

  It's just red. I see red numbers.

• 32:24Speaker 00

  Yeah, yeah, yeah.

• 32:25Matt McCusker?

  Fuck.

• 32:25Speaker 00

  I, I haven't used, I haven't used one of those in a longer time than I can remember.

• 32:30Matt McCusker?

  Yeah, yeah.

• 32:30Speaker 00

  So.

• 32:31Matt McCusker?

  So just do the basics.

• 32:32Speaker 00

  The next bucket, yeah, so then the next bucket I want to know is, what are, you know, what's your physical activity level? So let's say this is a person who's got none, they're doing none. And they say, look, I've only got two extra hours. I'm putting that entire two hours into exercise. So I'm going to say, we're going to do four 30 minute workouts a week. And, you know, again, I'd have to know more about the person, but it could easily end up being, we're going to do two cardio sessions a week. We're going to do two strength sessions a week. One of those cardio sessions per week is going to be kind of aerobic base training, where you're going at the same intensity the whole time. It's not that high. You can still sort of almost carry out a conversation. It's a little hard to talk, but you could.

• 33:13Speaker 00

  And then the other cardio session I would do, say, three days off of that would be more interval, kind of like what you were describing. So let's get on a, you know, if you, if you're at a gym and they have one of those like, you know, air bikes, do something there, be on a treadmill, be outside. It doesn't really matter. Like the goal, like this person will get so much benefit from two hours a week of exercise, that it almost doesn't matter what they do. And then the other two days a week, I'd have them do two 30 minute whole body workouts at a gym, where they never stop moving.

• 33:42Matt McCusker?

  Okay.

• 33:42Speaker 00

  So if you're doing it at home, it might be pushups, pullups, wall sits, something like that. If you're at the luxury of being at a gym, you might just rotate machine to machine to machine and never stop. And that would, I mean, that would just bring huge dividends. And then the last thing I'd do is in addition to that is just do a quick audit of their diet.

• 33:59Matt McCusker?

  Yeah.

• 33:59Speaker 00

  You know, are you overweight? Are you adequate weight? Are you underweight? That determines whether you need to eat more or less. And then are you getting enough protein? And, and honestly, like, I wouldn't make it much more detailed than that. And so, look, with, with just a little bit of that insight, you've made better use of two hours a week. You've got them to stop worrying about their sleep. You've maybe changed three little things in their diet. I promise you, that person in three months is going to feel significantly better. And then maybe, by the way, at that point, they're like, you know what? I wouldn't mind doing three hours a week of this exercise thing because I'm feeling kind of good. And you know what? I kind of want to dial the diet in a little bit more.

• 34:37Speaker 00

  But again, the problem is too many people are consuming information that says, oh, my God, you need to be on this supplement. You need to be on this supplement. You need to be doing 30 minutes of this type of sauna and 20 minutes of this type of cold plunge. And people are like, shut up.

• 34:51Matt McCusker?

  Yeah. I can't do that.

• 34:53Speaker 00

  Yeah. I mean, and to be clear, I love sauna and I love cold plunge.

• 34:57Matt McCusker?

  Sure.

• 34:57Speaker 00

  But it is like the 20th thing on my list of 21 things that is a part of my routine.

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• 36:04Matt McCusker?

  Yeah, that makes sense, man. That's actually cool to hear because it is like, the solution is pretty basic and simple. And that's a thing that gets me bummed out when like, you know, because I do think we live, and I could just be wrong, but I feel like we live in a pretty nihilistic kind of age. And it's like, it does suck when that spreads. It's like a physical nihilism. Like, what the fuck's the point of even? It's like, dude, you'll feel so much better. If I don't work out, I get depressed. It's like A to B, easily. If I don't do it for like two weeks, I'm just like depressed and sad. And it's like, if you don't do it, it's just, yeah, you feel terrible. And I always, I always like to try to, you know, like just get up and move your fucking body, man. There's so much, it's so much better than just...

• 36:36Speaker 00

  We were meant to move.

• 36:38Matt McCusker?

  We were.

• 36:38Speaker 00

  And meant to be outside. That might be the other thing I would add is, figure out a way to do something outdoors, like whether it's a quick walk or incorporate some of that exercise outdoors.

• 36:48Matt McCusker?

  You know what I started doing? Skateboarding. At my ripe old age of 38, I started skateboarding. I just took it back. I'd been doing it when I was little and I just started it. And it's weird doing it. That's a, that's a real eye opener when you take it, an activity you did in childhood effortlessly. And like, let me try this again at 38. Dude, I swear I burnt 900 something calories. I skateboarded for an hour and 20 minutes and I was, I was dying.

• 37:09Speaker 00

  That's awesome.

• 37:10Matt McCusker?

  Cardio wise, I was, I was just doing like a little pump track where you kind of just like ride up on a wall. Dude, I thought I was gonna die. I used to do this all day when I was younger. Now I'm like, it's like a real eye opener to be like, alright, where am I at? Cause I do feel like especially, uh, I guess men and maybe women do it too, but men specifically over index like, I'm good. And it's like, try something that you did when you were younger and you're like, holy shit, I'm gonna, my heart rate was at like 170 the whole time. Just skateboarding. And I wasn't even, I was barely pushing. I just had to like balance myself on this track. It was, it was amazing though. I, I agree with you. It's like find something, you know, to do and just kind of, I don't know. I feel like, uh, I do feel like we get too tunnel visioned into like the career stuff and it's like, we need to, you need to do that to survive.

• 37:51Matt McCusker?

  But it's like the sacrifice of hours of time, like the quote unquote rest time into like physical activity, just pay dividends and all the other things you're trying to do anyway. But yeah, I always sound like a broken record, but I'm like, dude, it's so important, man. It really is. So yeah, skateboarding is awesome. We should go one time.

• 38:08Matt McCusker?

  You skate?

• 38:09Speaker 00

  Nope. I do not at all.

• 38:11Matt McCusker?

  Have you ever?

• 38:12Speaker 00

  Nope. And it's funny. I mean, growing up, I was certainly of that age when a lot of, a lot of kids were skateboarding. I don't know why it just never appealed to me.

• 38:18Matt McCusker?

  Yeah.

• 38:20Speaker 00

  I was sort of busy in my own little world. Um, my daughter did for a little bit. She's 16 now, but she did probably like when she was 12, 10, 11, 12, she was pretty into it.

• 38:30Speaker 00

  The coolest thing I've picked up recently, though it's not a physical activity, but it's, I'm freaking obsessed with it is chess.

• 38:38Matt McCusker?

  Really?

• 38:38Speaker 00

  Holy cow.

• 38:40Matt McCusker?

  How do you, how are you pretty good?

• 38:41Speaker 00

  No, I'm horrible. I mean, I'm just learning, but, but I love it. Like I can't stop playing. I just can't stop.

• 38:47Matt McCusker?

  Who do you, who are you playing against?

• 38:48Speaker 00

  I'm just playing my boys.

• 38:49Matt McCusker?

  Really?

• 38:50Speaker 00

  Literally just the three of us.

• 38:51Matt McCusker?

  Phone chess or physical chess?

• 38:52Speaker 00

  On the board.

• 38:53Matt McCusker?

  That's good.

• 38:53Speaker 00

  Writing down every move, studying our moves after.

• 38:56Matt McCusker?

  Really?

• 38:57Speaker 00

  Like nerding out, watching YouTube videos. I'm obsessed with this guy, Magnus Carlsen, who's the best chess player in the world.

• 39:03Matt McCusker?

  Actually, yeah.

• 39:04Speaker 00

  Dude, I, I can't stop watching chess porn.

• 39:08Matt McCusker?

  Really?

• 39:08Speaker 00

  Can't stop.

• 39:09Matt McCusker?

  That's awesome.

• 39:10Speaker 00

  Can't stop. You know how YouTube figures out what you're about? Like my videographer for our podcast, he comes, he pulls me aside like three weeks ago, he goes, Are you getting into chess? I'm like, how do you know? He goes, because like I'm managing our YouTube channel and like it only populates just it's just like pushing chess stuff all day.

• 39:28Matt McCusker?

  That's awesome.

• 39:29Speaker 00

  Idiot, I can't stop.

• 39:30Matt McCusker?

  It is good for your brain.

• 39:31Speaker 00

  I stay up at night like watching chess videos.

• 39:32Matt McCusker?

  Do you really?

• 39:33Speaker 00

  Oh, it's awful. I'm like, it's 9:30, I should go to bed.

• 39:35Matt McCusker?

  What's the open, what's your opening move? What do you go with?

• 39:37Speaker 00

  Oh, I'm typically like E4, you know, I, but I like to, I like to castle really early. So I'm going to try to castle within about three, within four or five moves. If I, if I'm doing a king side castle.

• 39:48Matt McCusker?

  Really?

• 39:48Speaker 00

  Yeah.

• 39:49Matt McCusker?

  I like the, the first move, the horse just over your pawns. Be like, what's up?

• 39:53Speaker 00

  Yeah.

• 39:53Matt McCusker?

  It's called, there's a name for it. I forget what it's called. It's like the English or something, but I like the horse, I just fucking bang. Here's my motherfucking horse.

• 39:59Speaker 00

  Yeah. No, the knight's cool because again, he can, he can, he can, he can hop over people.

• 40:04Matt McCusker?

  You move in that fucked up L shaped pattern. Oh yeah, I love chess, dude. That is fun. I, I just say, yeah, it's, I don't have anyone to play with. That's the thing. It's like, I don't, and I know it's, it's, how long does a chess game take?

• 40:15Speaker 00

  One of my boys is super aggressive, so the games are quick. Cause he just comes out swinging.

• 40:20Matt McCusker?

  Does he really?

• 40:21Speaker 00

  Oh, he swings.

• 40:22Matt McCusker?

  I like that.

• 40:22Speaker 00

  He goes for the fences. And then the other one is so conservative and so thoughtful that the games take like so long. And I got us a little timer too. So I'm like, buddy, you have two hours to make the first 40 moves or you're disqualified.

• 40:37Matt McCusker?

  That's good.

• 40:38Speaker 00

  Yeah, yeah, yeah.

• 40:38Matt McCusker?

  That's good. Yeah, you gotta think on your feet.

• 40:40Speaker 00

  And the younger one, the one who's super aggressive is so competitive. Like if any one in our family ever makes it and becomes like great, it's him. Cause the, you can't like hit the fire is insane.

• 40:52Matt McCusker?

  Really?

• 40:52Speaker 00

  When he loses, he tears up his sheets and I'm like, buddy, you shake my hand and we had a good game. He's like, he's just losing his mind that he lost a game of chess.

• 41:02Matt McCusker?

  It's war, yeah, it's war. Is it true that the possibilities of the chessboard are kind of infinite in a way?

• 41:07Speaker 00

  They are truly infinite.

• 41:08Matt McCusker?

  That's crazy.

• 41:08Speaker 00

  Yeah, it's a computationally infinite problem.

• 41:11Matt McCusker?

  Damn.

• 41:12Speaker 00

  Or as close to, I mean, I shouldn't say infinite, right? In that AI can.

• 41:16Matt McCusker?

  Yeah.

• 41:17Speaker 00

  But, but it's from a, from a practical perspective, I think it's infinite.

• 41:21Matt McCusker?

  Damn, that's awesome. That is cool. How, how, I, I'm, I'm gonna try it. My kids are too young for that. I, we and my daughter did a, like.

• 41:27Speaker 00

  Your oldest is six?

• 41:28Matt McCusker?

  Four.

• 41:29Speaker 00

  Oh, four, okay.

• 41:29Matt McCusker?

  Four, six could be, six is doable.

• 41:31Speaker 00

  Six is totally doable.

• 41:32Matt McCusker?

  I did chess. We did one of those big ones. We're on vacation. We did one of those like, you know, those like huge outdoor chess boards, the big pieces?

• 41:38Speaker 00

  Yeah, yeah.

• 41:39Matt McCusker?

  We did it and I tried with my four year old and by the end of it, it was like the mommy and daddy were, the queen and king were mommy and daddy and the pawns were all of our babies. And I was like, all right, man. That always sucks.

• 41:51Matt McCusker?

  But yeah, man, that is amazing.

• 41:53Speaker 00

  I once made the mistake of, in a game, like, one of, one of my, my older one, the one who's more conservative, like he had, you know, he had a rook, knight, bishop in the back that hadn't moved. And it was like 25 moves in and I'm like, buddy, those guys over there are standing there like they got their thumbs up their butts. And now those two boys cannot stop saying that. They just walk around every, anytime someone's not moving, why do you have your thumb up your butt? And my wife's like, why do you say this stuff to them? Like, you can't say anything like that. They're just gonna say whatever you say.

• 42:29Matt McCusker?

  It's weird. It's weird because my four year old is like language police in our house. She like will learn that something's bad and then she's just like horrified of the idea of saying it. And she's like, if we, if she hears us saying anything like, like we even say the word hate. I don't know where, we didn't, this wasn't a rule for us. My, oh, I hate that. She'll be like, don't say that. She like polices our language. And we say like, but we said, my wife said freaking the other day. She's like, mom, that's a bad word.

• 42:51Speaker 00

  It's a bad word, yeah.

• 42:52Matt McCusker?

  Like, no, it's not. And she's like, and I was like, I was arguing. My wife's like, no, just, just give her that one. She's like, it's, it's pretty nuts. But yeah, that is true. They do parrot everything. I, you really do gotta watch what you say. Cause you can say whatever you want around them for the longest time and eventually you're like, oh shit, you can. Talking shit on my neighbors. You can hear this, you can hear this right now.

• 43:11Speaker 00

  Our youngest one, when he would, this is the super aggressive ones. It was not surprising. I think when he was like three, we get a call from the preschool and they're like, yeah, you gotta come and get him. My wife's like, what's going on? They're like, uh, he said the F word.

• 43:25Matt McCusker?

  Whoa.

• 43:26Speaker 00

  My wife's like, oh, I. I'll be right there, but I

• 43:30Matt McCusker?

  They made you get him for that?

• 43:31Speaker 00

  Yeah, I'm like, this is a misunderstanding. And my wife's like, first of all, the kid is obsessed with rhyming. So he almost assuredly was like, truck, truck, fuck, or something like that. And the woman is like, no, no, he's actually the first kid we've ever heard use it properly.

• 43:46Matt McCusker?

  Oh, no.

• 43:47Speaker 00

  They're like, what was the situation? And they're like, well, he was in circle time and we were telling all the kids they had to be quiet. And he wasn't being quiet. And we're like, hey, if you're not quiet, you're gonna have to get up and leave. And he wouldn't be quiet. So we got up and made him leave and he stood up apparently and just goes, fuck it. And then walked and got out of the corner.

• 44:09Matt McCusker?

  That's a coincidence.

• 44:09Speaker 00

  Yeah, I'm like, I don't, I think he learned that from his mom.

• 44:15Matt McCusker?

  Yeah, my daughter nailed a, she dropped something one time when she was really little and she was like, shit. I was like, ah, damn it, that's, that was right on the money.

• 44:22Speaker 00

  That's on me.

• 44:22Matt McCusker?

  Yeah, I was like, that was right on the money. So that made you, what are you like, it was like a one day suspension?

• 44:27Speaker 00

  Yeah, it was like, he's on probation now.

• 44:32Speaker 00

  We ended up finding another preschool forum that he did great in.

• 44:35Matt McCusker?

  Oh, that's cool. Yeah, that's insane to like, be like, you gotta come get this kid.

• 44:38Speaker 00

  Yeah.

• 44:38Matt McCusker?

  Although that could spread like wildfire amongst other people.

• 44:42Speaker 00

  Yeah, I guess I can see it from your point as well.

• 44:44Matt McCusker?

  No, that's lame. That's crazy to be like, he must leave right now. But I think they gotta let that kind of stuff go. That is, that is tricky though, man, because especially at that age, it's like kids hit other kids and like, you know, some people are like, this is, this is like, it's like, but I don't know. I treat it like the dog park. It's like, they'll figure it out, man. If it's really bad, you can intervene.

• 45:02Speaker 00

  There's gotta be enough discomfort in the situation for the kids to evolve.

• 45:06Matt McCusker?

  Yeah, exactly what I'm saying. Yeah, cuz it's like, dude, you gotta let, they're gonna do that, man. It's like, you know, me and my cousin got separated and we were in kindergarten together. And then we went to the same school the next year and they were like, AM class, BM class. They can't be, they can't be with each other at all. But I thought it turned out all right. All right. So before you get out of here, as we are, we're coming up on, what are we, where are we at right now, Josh? I don't wanna keep you too long. Huh? Perfect. The, um, the one thing that I feel like was in the book a lot, you talked about how, and again, always correct me if I'm wrong, cuz I'm always have stuff in my head. Stress was something you was really on the back burner that you kind of put to kind of like the forefront of your thinking from like the day to day and the health perspective. How, where do you kind of stand on that? And like, what's like, do you have any, give any thoughts on that at all?

• 45:52Speaker 00

  When I think about like, what is the, what is the thing that's gonna kill me fastest? I think it's undoubtedly stress. I just think it's, you know, I think it's the most insidious killer in a way because it's the hardest thing to measure directly. You can sort of measure some of its indirect actions like on blood pressure and blood sugar, which both go in the wrong direction when stress is high. But I think there's even components of it that just, even when blood sugar and blood pressure are normal, I still think it's just doing something to your brain, probably and to your heart. And again, I don't think anybody would feel good living in a zero-stress environment. So it's mostly just about kind of managing how one responds to it.

• 46:36Speaker 00

  And I think it goes beyond just stress. I think it's sort of like just overall, like satisfaction in life and contentment and, you know, enjoying your relationships with people. You know, I interviewed this guy on my podcast, Bill Perkins, who wrote this incredible book. It's one of my favorite books. It's called Die With Zero. And he writes about how you have basically, like, you know, you have time, you have money, and you have experiences. And, sorry, he talks about it through health. So health, time, and money.

• 47:07Matt McCusker?

  Okay.

• 47:08Speaker 00

  And you're not optimizing for the most of any one of those. You're optimizing for the net of fulfillment.

• 47:15Matt McCusker?

  Okay.

• 47:15Speaker 00

  So too many people miss that, right? They're just like working, working really, really hard to get as much money as possible or as much fame as possible. Or they're like maniacally focused on their health and that's the only thing they think about.

• 47:25Matt McCusker?

  Right.

• 47:26Speaker 00

  Or they're just trying to, you know, live as long as possible or make as much time for certain things. But it's kind of like how you put all those things together to optimize around fulfillment. So in this book, he writes about this idea of like, people aren't doing the equation correctly. They're deferring too many experiences when they're young to do when they're old, but then they don't realize when they're old, their health is actually not, they're not actually able to do it when they have all the money in the world.

• 47:49Matt McCusker?

  Yeah.

• 47:49Speaker 00

  They can't go and take the incredible vacation. Or if they can, their kids aren't with them or their kids aren't young. So I think it's just kind of reframed a lot in my mind and made me realize that, you know, when our kids are young and we are Incredibly healthy, that should be the time that we invest more in fulfillment and experiences as a family. Which has just been a, you know, a completely different mindset for me from where I was most of my life.

• 48:14Matt McCusker?

  Yeah, just going kind of like full blast, make as much money as possible.

• 48:17Speaker 00

  Sleep when I'm dead.

• 48:18Matt McCusker?

  Yeah, that's, yeah, that's a big one. Sorry about that bug, dude. That bug won't leave you alone. Hasn't even come over to me at all.

• 48:24Speaker 00

  I mean, I must stink.

• 48:26Matt McCusker?

  Yeah, that is, that is kind of a cool thing too, man. Do, uh, cause you don't really, it's also something you don't really learn. Like, nobody really tells you how to manage your stress. You kind of mostly, from what I gather, you kind of just like watch your parents deal with stress and you're like, alright. And you just kind of like, take those patterns and just apply them to your life. And it's like, it really does like. I don't, what I've been trying to do recently is like, just take one day out of the week. Usually it's Sunday, cause like, we're all off, everyone's hanging out. And I just try to focus on like, being as calm and at ease. That's like top priority of my day. Usually it's like, I gotta get this done, I gotta this done. And on one day a week, I'll be like, I'm only focused today. My number one goal is to try to like, stay in a state of like ease and kind of contentment.

• 49:06Matt McCusker?

  If I get out of it, I like, before I'm like, you know, like, well, I just try to zero in on that. And that's been kind of like, for me, that's been like, a bit of a revelation to be like, oh, I can move through like multiple days. Without completely spinning myself the fuck out. And you know, it's been, I don't know, it's been kind of nice.

• 49:20Speaker 00

  And what, what do you think spins you out? Is it just, uh, busy, it's too much?

• 49:26Matt McCusker?

  Yeah, it's too much.

• 49:27Speaker 00

  Particular thing?

• 49:28Matt McCusker?

  Yeah, I mean, it could be anything. Maybe my kids not listening kind of spins me out. If I'm like trying to get up the steps and it takes 40 minutes and I'm kind of like, alright, let's, let's go. Could be anything. Could be like overwhelmed, like just like situations at work I gotta deal with that are just completely overwhelming, stuff in the house, you know, it's just like, lack of sleep. Our kids are still so little that like our sleep gets fucked up. Um, but yeah, it is. It's that, it's usually like relational stress. Or just like work stuff. Those are the two, the two main things I could, that kind of like can really spin me out.

• 49:55Speaker 00

  And I would argue that most work stress is relational as well. So I, I kind of agree. I think relationships are both the best part of life and the most stressful part of life.

• 50:04Matt McCusker?

  Yeah, I agree. So that's been kind of, that's been my.

• 50:06Speaker 00

  That's what's going on here, by the way. A lot of relational stress in that. I can tell you right now.

• 50:12Matt McCusker?

  That is true. But yeah, that, uh, that is, that's kind of the thing, man. It's like, well, this is my whole point is like, you do have some say in how much a thing can like, like you can, it can, everything can floor you. Things come out of nowhere and you're like, you get caught in it. But just learning how to be like. All right. Something got me. It's like laser tag. Like my thing's beeping. I can kind of walk myself through this without like going on like a Godzilla path. You know what I mean?

• 50:36Speaker 00

  Yeah.

• 50:37Matt McCusker?

  It's like, I don't know. That's been pretty helpful for me. Before I get caught. That's, that's my ultimate fate. She's like, babe, babe, I'm having a naked victim with a prostitute.

• 50:48Matt McCusker?

  She's right there and they're coming out of the water just hawking me.

• 50:53Speaker 00

  It's not what it looks like.

• 50:54Matt McCusker?

  But yeah, that is, that is the number one, man. It's like, dude, it's a, you know, like managing stress. Keep yourself physically fit. Cause you, you can't like, otherwise like what, what the fuck are we doing, man? It's like, you know, it's like, unless you, I mean, some people are just surviving, which is, which is kind of, that sucks, but I don't know. I feel like you can even, I feel like people, there's other countries where people are just surviving. They still do cool stuff. They like big ornate jugs of water and they carried around. They like dance and stuff. I don't know. It's kind of sick. I'm just trying to make people happy. I don't know how to do it.

• 51:23Matt McCusker?

  Well, dude, I mean, is, is there anything else that's kicking in your mind?

• 51:27Speaker 00

  I don't think so.

• 51:29Matt McCusker?

  Well, I think you did it. Thank you for coming and doing this. I apologize for the strange format, but how do you feel about standing in podcasting?

• 51:34Speaker 00

  I think it's hilarious. I think it is. This is the first standing podcast I've ever done.

• 51:37Matt McCusker?

  Bro, it's not bad. I, how do you feel about it? Honestly, you can, you can hurt my feelings.

• 51:42Speaker 00

  Honestly, I think I have better posture than I normally do.

• 51:44Matt McCusker?

  That's what I'm saying. When you're sitting on a podcast, you, I get kind of like slouching forward. Standing keeps you on your feet. It keeps the mind sharper.

• 51:52Speaker 00

  Like, I feel like we're doing a political debate the way they're angled at each other too. You know what I mean? Like, I feel like I need a moderator to ask me a question. That's the only thing that, it would have been a little better if it was moderated.

• 52:02Matt McCusker?

  Moderated.

• 52:02Speaker 00

  This discussion was moderated and more heated.

• 52:04Matt McCusker?

  That's true. That is true. I gotta, I want to work on being.

• 52:07Speaker 00

  I wouldn't mind a teleprompter next time, if you wouldn't mind.

• 52:10Matt McCusker?

  Teleprompter is nice.

• 52:10Speaker 00

  I want a teleprompter there, moderator there, a little more.

• 52:15Matt McCusker?

  For sure.

• 52:16Speaker 00

  Yeah.

• 52:16Matt McCusker?

  I mean, we could bring some heat. We could bring some heat. If you want the heat, I can, I have some burning hot questions I didn't ask them. They're about a lawsuit. So I was like, I don't, why can't everyone, you can't talk about lawsuits. No one can ever talk about them.

• 52:27Speaker 00

  I know the lawyers say no.

• 52:29Matt McCusker?

  Yeah. You, why? What's the point? Bring awareness. Yeah, I did. I actually, I was researching this, you know, when you have someone on, I'm just saying, I saw you're embroiled in a lawsuit and I said, hell yeah, dude. That's what's up. So, but we won't, I mean, the lawyers won't like that.

• 52:44Matt McCusker?

  That is bullshit. You can't talk. I mean, dude, don't do it. Like, why? What the fuck's the problem? It's, I don't know, whatever. Anyway.

• 52:54Matt McCusker?

  Well, dude, thank you. I, dude, is there anything you want to plug? Is there any, the book, obviously, read the book, dude.

• 52:59Speaker 00

  Read the book, listen to the podcast.

• 53:00Matt McCusker?

  Peter, thank you so much.

• 53:02Speaker 00

  Thanks for having me.

• 53:02Matt McCusker?

  You're the man.

• 53:14Speaker 02

  Now streaming on Paramount Plus.

• 53:16Speaker 03

  I'm Dexter Morgan. I've been killing killers for half my life. It gets to you. You're having a midlife crisis. I'm not ready for that.

• 53:24Speaker 02

  He's back.

• 53:25Speaker 03

  I'm older. I'm wiser.

• 53:29Speaker 02

  And sharper than ever.

• 53:30Speaker 03

  Things are gonna get messy. But if I can't believe in myself, I can't believe in anything.

• 53:38Speaker 02

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