Jim Doty: Cure Negative Self-Talk, Be More Mindful & Build Compassion
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I found that when I did this practice where I looked through the lens that everyone was suffering, the world changed. Once I stopped that type of narrative in my head, I realized that people were actually much more kinder and thoughtful, and it changed everything in terms of my interactions. Now, what you're about to hear is an interview between me and Professor Jim Doty. Jim is a professor of neurosurgery at Stanford School of Medicine, and he's also the founder and director of Stanford's

Center for Compassion and Altruism Research and Education, of which the Dalai Lama is in fact the founding benefactor. I was walking through Stanford one day and I got a vision of the Dalai Lama. Met with him. We had a 15-minute appointment and it ended up

going for an hour and a half or so he gave the largest donation at that time he had ever given to a non-tibetan cause jim has had an incredibly illustrious career like starting from very very humble beginnings then getting into medical school he also became an entrepreneur and through that he got ridiculously rich and then also donated tens of millions of dollars to philanthropic causes now jim's interest these days is in the topic of compassion and how can we cultivate a sense of self-compassion as well and remove that negative self-talk that a lot of us have about ourselves and how

How can we also cultivate the feeling of compassion towards others? When you sit there and make statements, I can't, it's not possible, it won't happen, you're starting to encase yourself in a prison. And as the walls get higher, it gets darker. If you're able to understand that and able to deal with your negative self-talk and be kind to yourself and realize everyone is suffering, then you have an extraordinary opportunity to change yourself and actually change the world.

When Dan sent me a voice note saying that you're sort of the compassion guy, I'd never come across like the science of compassion or anything like that. And so I'm just incredibly interested in that because clearly part of a good life is that feeling of outwardness and service and selflessness and compassion. But I didn't realize there was a whole sort of combining neuroscience with that. Well, it's interesting because I'm sure you know about mindfulness. And mindfulness was brought to the West, if you will, by Jon Kabat-Zinn.

And he created a mindfulness practice to deal with people with chronic pain issues primarily. And he's not a physician. He actually, I think, has a PhD in molecular biology or something. I may be wrong. But he created this program and wanted to do research on it and did. And over the course of a few decades, if you looked at the literature,

There was essentially none. And then probably took 20 years to see this huge uptake in the literature on how mindfulness affects your physiology. The interesting aspect about that and why I think it's beneficial is one part of it is, if you will, relaxing the body or what we call a body survey. Because what that does is with intention, you relax your muscles. And a lot of people don't appreciate that they carry stress in their muscles, right?

And then the next part of it is a breathing exercise or technique. And also, when you're doing that, there are all sorts of thoughts that are passing you by when you're doing this practice. And for most people, especially negative self-talk, if it's going on, your mind stops and grabs that and starts trying to deal with it. And what he teaches is to just let that pass.

And so the reality is that it allows you to be much more focused instead of being distracted. And from a physiologic point of view, if you're not attending to this negative self-talk, it allows you to be more present. Yep. And it helps your physiology shift from a stress mode or engagement of your sympathetic nervous system to engagement of your rest and digest system. So like...

What is mindfulness? How would you define it? My uneducated understanding of it is that really it's a series of techniques to be more present in the moment and devote your attention to the thing that you're doing or your surroundings rather than it being on your own. Well, yeah. I mean, you've just reiterated what I've said in your speak. Okay. So you're exactly right. Here is the problem with it.

So, yes, it allows you to be present because you're not distracted by these ongoing negative thoughts in your head. The problem with it is, though, that as an example, if you are a hedge fund manager, it allows you to be very focused on potentially being very ruthless.

right? Because you're focused on that. You're not thinking of potentially the negative consequences you might create for others. You're not thinking about anything else other than your goal to maximize your return. So we can take a person, especially a type A person, and make them more ruthless. And this has nothing to do with compassion at all, either for self or others.

And in fact, in some instances, this is why these types of companies promote people to do mindfulness. Because it does one thing. It shifts you over to this engagement of your parasympathetic nervous system, which calms you. It gives you access to your executive control functions, which are impaired, which

by engagement of your sympathetic nervous system. So in that situation, you are more reactive and you don't have access to information to make better decisions. Right? So there's nothing in it explicit about compassion for self and others. And I've had a number of conversations with John about this. He says, well, it's implicit. But the fact of the matter is that's not necessarily the case.

And what I have done is to create a technique, which I think is now adopted. Uh, and in fact, you probably don't know this, but as I was talking about mindfulness, that became the new buzzword, right now, over the last few years, it's always compassion and mindfulness. Okay. Right. It goes together. Yes. And, and, and I would take some credit for, uh, uh,

making that a reality. And don't get me wrong, there are a number of other people working in the same area. But when I started looking at this at Stanford in 2008,

And I spoke to academics about, you know, I'm interested in understanding the neuroscience of compassion and the psychology behind it. I was told that the study of compassion from an academic perspective was a dead end. Oh, why? Because many people felt that it is weak and weak.

Unlike quantitative science, psychology is qualitative science, right? And some people can dismiss that. So what I did was I gathered a group of academics together simply to explore this and have a discussion. And it turned into sort of a journal club. And

I was fortunate in that I had the resources to fund these guys and pay for some research, which always gets the attention of academics who live for it. How do I survive? And what happened is I gathered a group of people together, and over a period of a few years, they were quite impressed not only with literature that was being published or had been published, but work that we had done.

And in fact, two of them switched their focus to focusing on compassion. So it's very, very powerful. And I mentioned a few years ago, I think in 2017, maybe 2018, I was the senior editor on a book published by Oxford University Press called The Handbook of Compassion Science.

And so, which covers the whole gamut of this field. - How did you get interested in compassion in the first place? 'Cause it seemed to me like, if you're a professor of psychology or even neurology, I might've, okay, you know, reasonable, but like going from neurosurgery to then compassion, like what was the connection for you? - Sure. All of us are manifestations of our past, right?

We're just talking about your background. You, I'm sure, were heavily influenced by your parents or your environment or the people you were around. And I think that's true of everyone. So in my case, there is often an assumption that if you're a neurosurgeon or highly educated, that you come from an affluent background. So that was not the case with me. And it's interesting because, especially if you're white...

And you dress the part, you speak the part, and you act the part, then you get into the club. Yeah. That's just the way. And that was evident to me. So I grew up in poverty. My father was an alcoholic. My mother, when I was young, had a stroke and was partially paralyzed. It was hemiplegic. And...

She had a seizure disorder, and she was chronically depressed and attempted suicide. We were actually evicted from multiple residences. And as you well know, when children grow up in that type of an environment, the likelihood for them to achieve success in what is defined by Western society is quite low. And that's why you have this...

measuring system called adverse childhood experiences, right? Where you, you know, say, was there drug and alcohol abuse? Was there mental illness? Was there poverty? Et cetera, et cetera. And the higher that number,

the less likely you are going to achieve and the more likely you're going to be a drug or alcohol addict or mentally ill or in poverty. So at the age of 12, even though I was reasonably bright, I did not have either parents who had the ability to guide me nor resources nor mentors,

And so I had a feeling of hopelessness and despair for obvious reasons. And what changed was that when things got particularly difficult at my house, I would get on my bicycle and ride as far and as fast as way as I could.

And one time I did that and I ended up at what we call a strip mall in the United States. I don't know. What do you call them here? These sort of collection of shops. Shopping mall or shopping center. Yeah. And so I ended up at one of those and there was a magic shop there. And I had been interested in magic. So I went in and there was a woman there at the counter in her probably mid-50s, early 50s.

And she greeted me with a radiant smile. And she was, you know, I still remember this very well. She was a bit overweight. She was wearing a blue muumuu. Do you know what a muumuu is? It's like a...

It's a sheet that basically hides your curves. But it was very popular in the 60s and 70s. But anyway, and she had this long flowing gray hair and she had these glasses on the end of her nose with a chain in the back and was reading this thick paperback. So she looked up at me and she greeted me with this incredible smile. And I started asking her some questions about magic and she said –

Don't ask me any questions about magic because this is my son's store. He's running an errand and I'm just minding the store. But we ended up chatting and it turned out that she was there for six weeks during the summer. And for somebody like me in that situation, you already appreciate, at least if you have insight and self-awareness, that you're being judged, right? By the way you're dressed, right?

And a whole number of other cues that people use to assess who you are, or at least who they think you are. And it's a shortcutting system that normally allows you to be more efficient in your assessments, right? But it certainly has some shortcuts. But anyway, we began a conversation.

And she was actually feeding me Chips Ahoy chocolate chip cookies, which of course garnered my interest as well. But after a while, she said to me, she said, you know, I really like you. And she had asked some actually penetrating questions, which I would never typically answer for somebody like, where do you live? What do your parents do?

And I answered them honestly. And she said, so I'm here for another six weeks. If you show up every day, I'll teach you something that I think could really help you. And she didn't define it necessarily. And ultimately, this was fundamentally a mindfulness practice. Oh, okay. So what happened is I ended up showing up every day and she taught me a

mindfulness practice, which initially, as we were actually talking about a little bit earlier, a relaxation technique. And I had never appreciated that I was tense all the time. And what happens when you come from an environment like mine, it's chaotic, right? You never know what's going to happen. You know, your father may break through the door drunk. She may have a seizure. You have to take her to the emergency room.

So you never know. So as a result, you're like in a war zone all the time. And you're sitting there trying to figure out and you can't attend or be present because your mind is always trying to figure out what's going to happen next.

So the first thing she taught me was this relaxation technique. I mean, literally going from your toes to the top of your head to relax your muscles. Then she taught me a breathing exercise. So the standard techniques for mindfulness practice. And you have to remember, though, this was before mindfulness was really discussed anywhere. And it turned out...

And I'm guessing, I don't know this factually, that she probably had some experience with Eastern religious practice. And, you know, it was the time of the Summer of Love and all of that stuff. So I'm sure it had related to that. But anyway, she taught me those two practices.

And I have to say, as a 12-year-old, I mean, to be bluntly honest with you, I initially thought it was just a bunch of BS, right? I've never been exposed. And, you know, imagine sitting in the back room with a woman in her 50s. Yeah, wearing the Momo thing. Yeah, yeah, yeah. No, it's very bizarre. But anyway, I did notice it started to have some effect. I was being more relaxed. I was able not to get lost in my negative thoughts because when you grow up in those types of environments –

You have a lot of negative thoughts. I'm not worthy. I'm not good enough. You have a lot of shame. And I would suggest everyone has that. It's just the degrees to which they have that. But I never appreciated that. And I thought those negative thoughts were truth. And I didn't realize that there was actually an evolutionary basis for it. So when our evolution as a species...

as an example. And remember, our DNA has not changed over the last 200,000 years.

On the savannah in Africa, as an example, if you saw the grass move, you assume there's probably a predator there. What that does is that engages your sympathetic nervous system with all the consequences, increasing your heart rate, increasing your blood pressure, release of catecholamines, increased stress hormones, shifting the blood into your skeletal muscle from your GI tract.

and your pupils dilate, et cetera, et cetera. And you see that, you run off, and if you survive, it worked. And if it didn't, it didn't matter. But anyway, so we are very attuned to negativity because, you see, that puts us at risk if we don't attend to it. The problem is that there's an overlap between that and negativity.

negative self-talk and the negative self-talk sticks to you very much. So as a result, I did not understand that it is a creation. It's not necessarily truth. So she made me aware that I could change the negative self-talk to self-affirmation and positivity. And what this ultimately translates into is

is what Kristen Neff and Chris German, a variety of other people, have studied, which is self-compassion. And so what does that do? Well, when you're overwhelmed with negative self-talk, that stimulates your sympathetic nervous system.

And what does that do? It has the consequence of increasing your heart rate, increasing your blood pressure, releasing catecholamines, releasing stress hormones, depressing your immune system, resulting in the release of inflammatory proteins, which are associated with chronic disease states. And if you respond to the negative self-talk, obviously it has very bad health consequences. Yeah.

So if you're able to be kind to yourself, give yourself words of affirmation, then that shifts you over to engagement of your parasympathetic nervous system. - So I get the kind of relaxing the muscles thing and the breathing exercises bit. When does the, so I'm relaxed, I'm in a parasympathetic state.

Where does the awareness of the self-talk and the negative self-talk come in and where does the sort of over is it overriding that with? Positive affirmation. Yeah. Yeah. Yeah, I mean it comes in when you start so the first step is relaxation The next step is let's say the breathing exercise That's one technique the very nature of doing the breathing exercises help shift you over to the parasympathetic nervous system and it also helps not respond to the negative self-talk and

But you can make it more powerful by, with intention, giving yourself positive affirmations. And once you engage the parasympathetic nervous system, then you look through a different lens. Because the one lens of sympathetic nervous system engagement is the fear state, right? And this flight, fright, or freeze mode. Well, then if you shift, if you will, to the love mode, which is this bifurcation mode,

When you have engaged your parasympathetic nervous system, you're looking through the lens of lack of fear, being open, being generous, being thoughtful. Because you see you're not afraid anymore of your survival and you have an understanding that there are resources for you, right? You're not afraid anymore. And so it changes everything. And what I mean by that is one,

When you are able to be kind to yourself, obviously, as I said, it shifts you into engagement of your parasympathetic nervous system with all the associated positive physiologic effects, but also brain effects where it engages your pleasure and reward systems. So you feel nice, you feel kind. But it has an even more powerful effect because when you stop beating yourself up,

then it allows you to see the world through a different lens. Because if you're negative to yourself, if you're hypercritical to yourself, then you become judgmental and hypercritical of others around you versus having a sense, one, that like you, everyone else is suffering, and two, that everyone is in fear of being judged. So then...

you change sort of the energy you emanate in the world. And, and what I found for myself was, you know, if you're angry and hostile, as I was as a child, you,

that does have a relationship with your relationships with other people, right? Because as humans, we're very in tuned to the emotional states of others. I mean, we're highly attuned. And so if you're putting out that energy, then people respond to you not necessarily in a positive way. You know, it's like, I'm sure you've probably experienced, you're walking down the street and you see somebody and you have this sort of judgment you've made that,

there's something going on there. But now, unfortunately, that can be tempered by

unconscious bias about race or assessment of whether they could potentially be a criminal or something, but also emotional state because they're carrying this anger and tenseness and you subconsciously are tuned to that. And I found that when I did this practice where I was kind to myself, where I looked through the lens that everyone was suffering, then the world changed because once I stopped that type of narrative in my head,

I realized that people were actually much more kinder and thoughtful, and it changed everything in terms of my interactions. But the other more important thing in terms of my parental interaction was I used to have a lot of anger and hostility because my parents weren't always there for me. But what I realized was that they had not been given the tools to help their own pain, right? Because as we talked about earlier,

We are products of our past and if you've suffered been abused had problems And you don't know how to deal with that and then you turn to alcohol or you get depressed It's not your fault, right? Yeah, so I stopped Blaming them and changed how I looked at them and and I realized

That, you know, they wanted to love and give that. They just didn't have the ability. But then that changed how I reacted to them, right? Because it allowed me to not have anger about that anymore, right?

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And you said that initially you thought it was BS. So what was it that made you come around? Well, look, I mean, to be frank with you, I mean, as a 12-year-old, you're not particularly sophisticated, especially from my background. But what came around was, you know, I did give it the benefit of the doubt.

And it started having an effect. I realized I wasn't as tense. I didn't get as agitated anymore. I wasn't constantly elsewhere.

And I could look through a lens that was a kinder, gentler lens. And so I was much happier. Oh. And you noticed those effects like when you were young? Yeah. So, you know, I mean, after a few weeks of doing these exercises, even my parents noticed a difference. What did they say? Well, just that I wasn't as...

angry, that frankly, I was much nicer. Wow. Yeah. So what happened next in the story? Well, so a couple of things. So one, we did this relaxing the body. If you want to talk, call it taming the mind, learning self-compassion, and then learning compassion. So the next thing she taught me was manifestation of intention. Hmm.

And again, this was before we talked about neuroplasticity. And I'm sure you're aware, sports psychologists, they talk about visualizing what you're going to do. And of course, at that time, that did not really exist per se. But what she said was...

I want you to write down the things that you want to think are important in your life, what you want to manifest. And I did. Now, as a 12-year-old, some of them were not realistic. It was like, you know, I wanted to have a Rolex or I wanted to live in a mansion or I wanted to be a millionaire. But the others were, you know, I wanted to be a doctor. Okay. And the reason that was was because when I was in fourth grade –

A doctor came to my class and I was so moved and impressed by him and how he treated me and interacted with me that at that moment I decided to be a doctor. Now, you know, coming from poverty with my background, saying you want to be a doctor and becoming a doctor, far different. But that stayed with me.

And so I made this list and she would say, I want you to read the list multiple times a day. I want you to read it aloud. I want you to read it silently to yourself. I want you to visualize...

each of these things occurring and how you would be in that situation. And I did that, and I did it very religiously. And so it made me believe these things were possible. And so then you're in middle school, high school, and you've got your heart set on being a doctor. Correct. Where did you go to medical school? At Tulane University in New Orleans.

But there's an interesting story related to that because the typical path to have things manifest, that was probably the case in your situation, was you studied really hard. You were very good academically. And you utilized the resources that were available to you. Well, it's a bit different if you've never had those resources, right? I mean, you can be bright, but if you don't know how to take tests—

You're not going to succeed. And if you don't even have knowledge of how to even apply to college because you don't have role models or mentors. So as an example, when I applied to college, here's how it happened. I was in a science class and there was a girl next to me filling out an application.

And I asked her what it was. And she said, it's my college application. I had no idea it was time to apply to college. So I said to her, I said, well, where are you going to college? And she said, well, I'm going to University of California, Irvine. And I said, oh, well, that's great. I said, you know, I haven't gotten my application yet.

And she asked me, where are you going to college? I had no idea. I said, I'm going to UC Irvine. So she said, well, I have an extra application. And that was my process, too. So I applied to one college and got into one college. Oh, wow. Right.

Okay. Because normally in the US system, you apply to, like most people will apply to lots. Of course, yeah. And so you just happened to sit next to someone applying to UC Irvine. That was it. You filled in the application form and you got in. Yep. And where were you living at the time? Were you in California? Yeah, yeah. In the high desert. So that's how I ended up at college. And now the reality is, if you don't have the academic background in high school,

You don't understand how college works. And I had to leave at different times to go home to attend to, of course, challenging family situations. Getting my father out of jail, dealing with my mother being in the hospital. So I missed a lot of class. And the sad thing is that...

If you tell people, even your friends sometimes, you know, I want to do this. I have this aspiration to this. And instead of saying, that's fantastic. Go do it. What do they say? Well, you'll never do that. Or why would you even think that you could do that? Right. And it's unfortunate. Right. And it's oftentimes because they don't want to see you do it because they can't do it. Yeah. Or they don't want to see you as a competitor to them. And it's just the way human nature is, unfortunately. So anyway, when it comes,

When it came time to apply to med school, which I was attuned to by this time, it was evident I wasn't even going to graduate. Oh, wow. Because I had left several times, right? And there's certain key courses you need. So at UC Irvine at that time, you actually had to get a letter of recommendation from the pre-med committee. So you had to go before them, and then they would ask you a series of questions about

And, uh, depending on how you answered or how they were biased, uh, that determines whether you get a letter that says highly recommended or, uh, recommended with, um, reservation, which tells you that's not a recommendation. So, um, so what happened was I went to, uh, actually make this appointment with the, at the office and, uh,

I go up there and I said, you know, I'd like to make an appointment for the interview committee for med school. And the woman says to me, okay, let me get your file, looks at it, then turns to me and she says, I'm not going to give you an appointment. Oh, wow. And I said, why? And she said, it would be a waste of everyone's time. Because at that time, the average GPA to get into medical school was 3.79. My grade point average was 2.53. And I was not going to graduate.

So I looked at this lady and I said, you know, I appreciate what you're saying, but I'm not leaving here until you give me an appointment. And I said, you know, if you want to call security, that's fine, but I'm not

So she does give me an appointment. And so it comes time for the appointment. Have you seen these pictures with Putin at the end of a long table? Oh, yeah. It's like forever. Anyway, so what happens is I walk into this room and there's one of these long rectangular tables and there are three people at the end and I'm at the other end. And the guy, there are two women on either side of the guy. And then there's this guy at the center who's clearly in charge.

And you know how you walk in a room and people are sitting with their arms crossed, which also is obviously a very bad sign. So I walk in there and the guy in the center has my file and he lifts it up and he throws it on the table and he says, say what you have to say so we can get this over with. So I look at the guy and I said, who gave you the right to destroy people's dreams? And I said, there's not one shred of evidence that...

having a 4.0 makes you a better doctor. And in fact, having simply above average intelligence actually can make somebody a fine doctor. And I said, I'm not going to allow you to objectify me into a grade because you know nothing about me. So I went on this diet trip for about 15 to 20 minutes and they ended up all cried. Oh, wow. Yeah. So then, yeah.

What happened is they ended up giving me the highest letter of recommendation. And then what happened is the woman, the secretary, was not going to give me the appointment. She was actually in the room. And she came to me as I was packing up my stuff to leave. And she said, why don't you take this? And I looked at it. And what it was was it was an application for

actually to a summer enrichment program at Tulane Medical School for socioeconomically disadvantaged students and minority students. And she said, you know, I think this could really be beneficial to you, but I have to tell you the deadline has passed.

But I don't think that'll apply to you. So what happened was I called the lady up and she gave me a position in that summer program. And again, I applied to one medical school in

And they accepted me with that GPA and without a degree. My goodness. Yeah, yeah. Wow. Yeah. So it's not the usual medical school. That's not at all the usual medical school. Right. Now, let me fast forward a little bit. Yeah. First of all, I did fine in medical school. Tulane is in New Orleans, and that was where they were flooding associated with Hurricane Katrina. The medical school closed for two years. They had to go to – they shipped the medical students to –

Baylor University. And actually the dean moved there and he actually got depressed and he resigned. So...

For me, obviously, this is many, many years afterwards. I ended up not only becoming a neurosurgeon, a professor at Stanford, but I also became an entrepreneur. And there may be a company you might be aware of called Accuray. They make something called the CyberKnife. And so I actually ended up helping develop that technology and running the company. Oh, wow. So long story short, though, so they were looking for a new dean.

And he wanted an endowed chair. And I don't know if they have those here, but in the U.S., that's a high academic honor. But endowed chairs are endowed by somebody, a philanthropist. And so I...

Ended up giving several million dollars to endow the Dean's chair. So the present Dean remains the Doty professor And so he's the Dean of the medical school. I'm on the Board of Governors and on the university's presidential council and So what it shows is that? None of us have the ability to predict whether someone will or will not succeed and

And the typical criteria which many people use, because grades are artificial criteria, right? Is say, okay, what's the difference between somebody having a 3.4 and a 3.5? Nothing. But it's an artificial criteria so people don't have to think, right? It's the first cut. And yeah, there are tons of people who are cut who shouldn't be cut because –

The nature of compassion oftentimes is the degree of suffering you've had, right? And, you know, I certainly know individuals from affluent backgrounds who were not nice people at all. And this is not to criticize people from affluent backgrounds. I'm just stating there is a subset of people like that. And I assume probably from poor backgrounds are nice people. But my point is that there's no clear-cut

as to who those people really are. And this is why oftentimes it's much more than just saying, oh, well, he had a really good GPA and that's why he got in. And I guess in a system where that's so oversubscribed like college admissions and medical, they need these very blunt arbitrary instruments to cut people. Exactly. And your 20-minute diatribe moved people sufficiently emotionally to put you on this career path. Yeah. And so this is also to say to people that

You shouldn't misjudge or underjudge or be hypercritical to yourself because when you have this negative self-talk, what it does is it takes your own agency away. And what I mean by that is when you sit there and make statements, I can't, it's not possible, it won't happen.

You're starting to build bricks to encase yourself in a prison. And as the walls get higher, it gets darker. And the reality is once somebody can connect with their own inner power, that can change everything. And yet if you build this prison, you can't see other possibilities.

So, if you're able to understand that and able to deal with your negative self-talk and be kind to yourself and realize everyone is suffering, then you have an extraordinary opportunity to change yourself and actually change the world. Wow. Okay. So, what was your experience in med school like? I guess because…

Your background would have been quite unusual in med school. Mostly people in med school tend to be fairly affluent. So what was that experience like for you? Well, so as I said,

If you're white, typically, if you look the part and you act the part, you're assumed to be the part. And, you know, I was attuned to that very early. And I typically did not share anything about my background with people. And most of the people were, as you described, they're from affluent backgrounds and they

There's a difference between cognitively thinking of people in poverty or people suffering versus actually having lived in those situations in terms of how you react and your sensitivity to that. But no, I didn't have any issues. And, you know, I fit in. And so it wasn't a problem. And so you went for neurosurgery residency? Yes. Okay.

Why neurosurgery? I'm just curious. So, well, you're really going in depth here. Your readers are listeners. Whoa. So what happened was,

I initially thought I was going to be a family practice doctor because I had this naive image that I could deliver babies, be a pediatrician, caring for young couples, heading out all the way to geriatrics. And I had this sort of naive impression I was going to have this office with kids and everybody running around.

And at least in the United States, unless you're living in some remote part of Alaska, that's not going to happen because you're held to the standard of the specialist in whatever you do. And certainly in more modern times, I hate to say it, but oftentimes family physicians simply become referring agents to specialists. And that's not to say they're not some brilliant ones. Right.

But that's very common. And I, uh, first of all, when I realized what that really was, I didn't want to be that per se. And, but the other thing that was probably more important was, uh, I had done a rotation and had been exposed to neurosurgeons. At least the subset I met with were very kind, nice people and encouraging. But the other part was that I had decided my personality was more of a surgeon. Uh, and, uh,

I wanted to do craniofacial surgery in children. And to do that, you have to do a surgery specialty. Then you do a plastic surgery fellowship. Then you do a craniofacial fellowship. And what I didn't mention was because I didn't have the money to pay for medical school, I accepted a scholarship from the Army. Okay. And so they paid my way through medical school, but I owed the Army time.

So I was going to do general surgery.

And when I started to deal with bowel, I did not like that. Yeah, it bit you off. Yeah. I mean, you know, I was very aesthetically oriented, you know, dealing with people's colons and stuff like that. So I decided that that wasn't for me. And again, I was in the army. So you wanted to go as far away from the bowel as possible. Yes, yes. And I'd rotate on neurosurgery and the guys were nice. And so they encouraged me to apply to neurosurgery.

Now, the interesting thing about that was that the Army at that time trained one neurosurgeon a year in the entire Army. So it's a highly competitive application. And I actually...

to do it after the applications were in. Oh, okay. Because that's when I rotate on neurosurgery. Yeah. So what I did was I took a month, my month vacation and actually went to Walter Reed where they trained the neurosurgeon and spent a month on the service. And then at the end, I met with the chief or chairman and he said, you know, Jimmy did a great job, et cetera, et cetera. He said, we have a three-year wait and we're

So I'm happy to consider you in three years and you can go off as a general medical officer. So I looked at him, I said, well, that's unacceptable. That's the bullsy. So what happened was, uh, uh, uh, I applied for the program for the next year. And he, like I said, told me that was already filled for three years. And, um,

In the interval, interestingly enough, the guy who was slotted for that position was working in a general infirmary there. And he was dating the nurse who headed the neurosurgery ward. And they had a falling out. Okay. And I don't know what exactly happened, but she complained to the chairman of neurosurgery.

And he fired the guy. And he got sent off to South Korea as a general medical officer for the rest of his time. And so then he called me up. He said, well, you know, we have a Senate opening. The power of manifestation. Yeah, exactly. So I took that position and there you have it. And so you trained in neurosurgery residency, but like with the army? Yeah.

So does that mean you rotate through army hospitals? Yeah. Well, Walter Reed, you stay at Walter Reed for six years. Oh, of course. Yeah. Because once you, yeah. Yeah. You're rotating all over the place. And now it's interesting because at that time, if you did your residency in the army, you did not owe any further time.

beyond your, them paid for medical school, right? Well, if you went outside of the army for neurosurgery residency, you owed one year for every year they supported you. So imagine, yeah, so you could have seven years and then you owe seven years. So you're forced 14 years. And by that time you might as well retire from the army as a neurosurgeon. So I was fortunate in that I didn't know any time other than that they paid three years of medical school for me. So, uh, uh, so, uh,

Was it mostly like traumatic brain injury that you were dealing with, like from people in the army? Or are army hospitals kind of like normal hospitals that you might get an old person with a fall or something? Yeah, because the military provides care for not only the soldiers, but for their families, right? Okay, so you're dealing with all sorts. Yeah, you did everything. And so it wasn't trauma. In fact, that was probably the lowest amount of stuff that we did, right? Because there's no war going on in the United States. Yeah, quite, yeah.

You know, certainly with the Iraq war, they took neurosurgeons and sent them out in the field. But in general, most neurosurgeons did standard neurosurgery. Were you ever sent out into the field? No. You managed to avoid that. I...

The only close call, if you will, was there was a—I don't know if you remember this, but there was an invasion of Grenada, the island. Oh, right. And what happened was that there were some Americans who—

were going to the medical school in Grenada. And so what happened was they called forth doctors to go to Grenada, but it was like one week and it wasn't neurosurgeons. But that event occurred while I was... Now, the interesting thing is though, as my time ended, the Kuwait-Iraq thing happened and I was like literally supposed to

I was signing out of the military, right? I was done. Well, like a week before, they reactivated everyone and kept me in the military. And the thing was, you know, I'd already bought a home. I accepted a job. And, you know, you can imagine how after I spent my time and I was literally leaving the army. Like a week before. Yeah, that they called me back. Now, I was fortunate in that I knew the Surgeon General.

And I called him directly and they let me go. And it wasn't because I had any problem doing it, but I had served my time and we were done and I, you know, it would have been catastrophic, right? I bought a house. I accepted a job. And what am I going to do? Because, you know, the difference they pay you in the army versus private practice, it's 90% less in the army. Yeah.

Fair play. Yeah. This episode is very kindly brought to you by WeWork. Now, this is particularly exciting for me because I have been a full-paying customer of WeWork for the last two years now. I discovered it during, you know, when the pandemic was on the verge of being lifted and I'd spent like the whole year just sort of sitting in my room making YouTube videos. But then I discovered WeWork and

I was a member, me and Angus, my team members, we were members of the WeWork in Cambridge and they have like hundreds of other locations worldwide as well. And it was incredible because we had this fantastic, beautifully designed office space to go to, to work. And we found ourselves like every day, just at nine o'clock in the morning, just going to WeWork because it was a way nicer experience working from the coworking space than it was just sitting at home working. These days, what me and everyone on my team has is the all access pass, which means you're not tied to a specific WeWork location, but it means you can use any of their several hundred coworking spaces around London, around the UK, and also around the world.

And one of the things I really love about the coworking setup is that it's fantastic as a bit of a change of scenery. So these days I work from home, I've got the studio at home, but if I need to get some focused writing work done and I'm feeling a bit drained just sitting at my desk all day, I'll just pop over to the local WeWork, which is about a 10 minute walk from where I am. I'll take my laptop with me, I'll get some free coffee from there, I'll get a few snacks. And it's just such a great vibe and you get to meet cool people. I made a few friends through meeting them at WeWork and it's just really nice being in an environment almost like a library, but kind of nicer because there's like

a little bit of soft music in the background and there's other kind of startup bros and creators and stuff in there as well. And it's just my absolute favorite co-working space of all time. It's super easy to book a desk or book a conference room using the app. And it's a great place to meet up with team members if you're going to collaborate and you'll live in different places. They've got unlimited tea and coffee and herbal teas and drinks on tap. And they've also got various kind of after work events that happen like happy hours and yoga and a few other exercise type things. And you can also take in guests. So often when guests will come over to visit,

I'll say, hey, let's pop into WeWork and we'll just work from there for the whole day and then we'll go out for dinner sometime in the evening. Anyway, if you're looking for a co-working space for you or your team, then I'd 100% recommend WeWork. Like I said, I've been a paying customer for theirs for the last two years, which is why it's particularly exciting that they're now sponsoring this episode. And if you want to get 50% off your first booking, then do head over to we.co forward slash Ali. And you can use the coupon code Ali at checkout ALI to get 50% off your first booking. So thank you so much WeWork for sponsoring this episode. Did you ever go to Grenada for... No.

Because I ended up visiting that medical school in Grenada a few years ago, like in the middle of my own like surgery placement in med school, because my mom was teaching some stuff there and she had a plus one. So I happened to visit St. George's University in Grenada and hang out with some students there. Yeah.

So at this point, you're fully specialized into neurosurgery. Having stalked your Wikipedia page, there's a bunch of stuff that happened then. You became a professor of neurosurgery, you started the companies. I'd love to fast forward to the Compassion stuff, which I understand started around about 2007-ish. Yeah.

So at that point, were you like retiring from clinical practice? Like what, what did that look like and how did you get into the compassion stuff? So, you know, the nature of my story and interaction with this woman and sort of what I had gone through, I always wondered what motivates people to do good or not. And, uh, what had happened was I, uh,

I'd been at Stanford since 97 on and off. And I think I had left in 2000, maybe 2001 to... Maybe it was earlier. I can't remember. But anyway, somewhere around that time, I started an entrepreneurial endeavor. And as that was... And then the dot-com crisis came and everything collapsed. But what happened was then...

I started another company and I would intermittently work at Stanford. And then I used to consult for developing neuroscience centers of excellence.

And I went down to Mississippi, actually, on the Gulf Coast. And they asked me to set up a plan for them, which I did. And it was unfortunate because here you have this very nice indigent hospital, unfortunately. And the local doctors didn't want to work there because there's a lot of indigent patients. And unfortunately, the sad part is, you know, they'll abrogate their responsibility to care for people there.

For money. Yeah, and so the people who need them the most they won't care for them So there was no neurosurgery. There was no neurology. There's no orthopedic surgery There is no pain management There is no neuro ICU there is so I laid out a four or five year plan for them and Said here's how much it's going to cost. Here's what you have to do. You can't recruit doctors to

And saying, oh, come cover our emergency room. I mean, that's the worst recruiting vehicle. I said, what you have to do is you have to create a narrative that you're creating a center of excellence and that call is part of it. But the overlying theme is to create a very high quality program with specialists you interact with who are very competent. Right.

And so that was the narrative that was created because, you know, if you use the come to our ER, especially in Southern Mississippi, well, you get one of three types of people or they have all these attributes. It's either somebody recovering from drug and alcohol abuse

It's a personality disorder or it's somebody who's gone through a horrific divorce. Oh, okay. So it's not the sort of thing people, doctors would be signing up to. No, no, no, no. This isn't like being in Newport beach, Southern California, overlooking the ocean and highly affluent of it in the background. So anyway, we were able to recruit some excellent people, but the thing was though, that they wanted me to run it because I was the inspiration for doing it. So I agreed to do it.

And I was there for, and I, listen, I talked to my wife about this and visited six times. And so I decided to do it. And then, you know, my family moved there. And about a few weeks after this, my wife says, I can't live. Oh, wow. Can't live in Mississippi. Yeah. And, you know, look, I've committed to this. And then Hurricane Katrina happens. And I can't like just leave. Right.

And this was after I was there about two years. So my wife said, I'm not living here anymore. So she moved back to California and then I continued to work there. And then what happened, I would progressively take longer and longer breaks to go to California. And then I recruited some other people there.

And at the end of it, you know, here we have full neurosurgery, full neurology, full orthopedics, full pain management. We created a neuro-IC with neuroflora. We created a brain and spine and brain injury, spine stroke rehabilitation center. The only one certified in the state of Mississippi, actually. And so it was an incredible accomplishment to do that. And they, in fact, obviously wanted me to stay.

But I said, you know, I'll be divorced. And they said, well, we'll offer you. But anyway, I ultimately left. And it was at that point that I decided to go back to Stanford. And they were kind enough to offer me a position. And then, so it was during this period where I was reflecting on, you know, what causes people to do good, not good. And so I decided when I got back to Stanford, I was going to explore this. So it initially started out as something called Project Compassion. Yeah.

And I just gathered these people together, these scientists, and we started doing some research. And then what happened was that obviously the results were very positive. And this will sound strange because I'm an atheist. And I was walking through Stanford one day, and I got a vision of the Dalai Lama. And it persisted.

And to the point where I couldn't get it out of my head, right? And I was not a fan of or follower of the Dalai Lama. Clearly, though, he represents compassion. And in fact, my wife was a big follower. And he had been at Stanford doing some programs in the local area a few years before. And my wife actually bought tickets and I refused to go. Oh, wow. Yeah.

So anyway, I had this vision and I said, geez, you know, I need to invite the Dalai Lama to Stanford and do a program on compassion. And long story short, I was able to get access to him and get an appointment and met with him. And we had a 15 minute appointment and it ended up going for an hour and a half or so. And he immediately agreed to come to Stanford.

Sorry, just a question on that front. What was it like meeting him in person? From accounts I've read of this, Michael Singersberg, it says there's sort of this energy that you can just sort of feel and is like palpable. Did you get any of that kind of vibe? No, I think that's true. And you get a sense of unconditional love, which is all of us want, right? And it is very powerful. And this is why so many people love the Dalai Lama and want to have proximity to him.

So we had this meeting, and near the end of it, and he speaks perfect English, but he always has an English translator for subtleties of the English language, idioms and things like this. So at the end of it, his translator turns to me and says, Jim, His Holiness is so moved by this endeavor, he wants to make a donation to your work. And so he gave the largest donation at that time he had ever given to a non-Tibetan cause.

And then what happened was two other individuals each gave a million dollars. And of course, now I have the significant amount of money.

So then I met with the medical school dean and said, look, I've got this mind. I'd like to set up the center. And it was sort of interesting. He says, well, what expertise do you have in this area? I said, none. Other than intuitive. And so what he did was he pulled in the director of the Neuroscience Institute, who was a friend of mine, and my chairman, a neurosurgeon. They said, look, I'll support this creation of the center here.

but, um, if it doesn't work out, you two guys are the guys. So anyway, it worked out perfectly fine. And, uh, and so that's how the center, uh, was created as a formal center in the school of medicine. And then what happened was I became friends with the Dalai Lama and, um, I ultimately became chairman of the Dalai Lama foundation for a number of years. And he and I grew very close and I spent a relatively significant amount of time with him. And, um,

Yeah, there you have it. What does it mean to create a center? Well, I'm sure if you've been at Cambridge, there are

There's probably a center for AI and there's a center for bioinformatics. Yeah, there's centers for a bunch of different- Yes, it's the exact same thing. So like a building with some people who are trying to research a thing? Yes, exactly. Exactly, yeah. Okay. And so you recruit the academics and the postdocs and PhDs and fund research on the theme of compassion? Basically, yes. Now, I would say, since I don't have a PhD, we collaborated with a number of people who have postdocs and stuff like that. But yeah, that's how it works. Okay.

And so that was roundabout 2007. So what's been...

What did you, I guess, find out about compassion, which ended up in the book, I'm sure? Yeah. Well, I mean, basically, I've shared a lot of it just in our conversation about its effects on the brain and how the brain responds to threat and how it affects certain centers in your brain or stimulates reward centers or things like that. And so, you know, we've published a number of studies basically in that domain. And then...

Additionally, we've done a few other things. One is we created two academic lectures, one for senior investigator, one for junior investigator, where they come and talk about their research on compassion. We created something called Conversations on Compassion.

And actually, this is a very selfish thing. I just sit on stage with somebody I think is interesting. And that's why I do this podcast. Yeah, exactly. And talk about compassion. And so, you know, I've had the Dalai Lama, Thich Nhat Hanh, Amma, the Hugging Saint, Sri Sri Ravi Shankar, and a variety of folks like that. Eckhart Tolle, Byron Katie.

And then also other people are interesting, people in the corporate space, people who are teachers in the context of certain types of compassion practices. Scientists, Paul Ekman, who's studying emotion and a whole variety of other people like that. So then we've created different training programs. So as you know, there's a training program for mindfulness.

As I mentioned to you, though, I think that type of training, though, goes beyond that. It should include self-compassion and compassion for others. So we created an eight-week program called Compassion Cultivation Training, of which there have been thousands of people trained all over the world. And that's still an ongoing program. More recently, we created something called Cultivating the Heart, which is a similar type of eight-week program.

And now we have something called the Applied Compassion Training Program, which is an 11-month long certificate program with people from the corporate environment, health care, sort of the mind-body wellness space. And they spend 11 months. It's all online now for obvious reasons. And then we help them or mentor them in the development of a capstone project.

Which then they take back to their organization and implement. And typically we train about 500 a year from, I think, 60 different countries. And so it gets spread all over the world. And so with the aim of helping people become more compassionate towards themselves and towards others. Yeah.

Nice. What does a study on compassion look like? What is an archetypal study that you might do at the center? As an example, let's say with compassion cultivation training, we recruit a group of people who, part of them, we do the compassion cultivation training. Part of them, we do...

a different type of training, actually like an improvisational workshop. And the others just don't do anything. And then we monitor different effects. So one is self-report.

One is biological markers like cortisol levels. One is imaging studies like functional MRI where we look at areas of increased metabolism. And then we compare the different groups. And not surprisingly, compassion has some very strong positive effects. So the people that you specifically take through the compassion training program...

presumably feel more compassionate and self-compassionate. And also the biomarkers, like cortisol goes down and blood pressure goes down and stuff. FMRI shows what? Increased metabolism in areas associated with reward. And none of this is particularly surprising, right? And in fact, that's why people, they'll sit there and they'll say,

Why do you need to study this when it's intuitively obvious? The problem is that if you're going to teach things, especially in a secular world, they want evidence to demonstrate it, even though intuitively...

You know, that's the case. Yeah. So when I was in my third year of med school, we have this thing where you can do a degree in whatever else you want. And so I did psychology and did a lot of fMRI type stuff. And I always found that there was always that thing. And one of our essay questions was, why is fMRI trying to show things that we all know are intuitively obvious?

But I always found it interesting because it shows that there is actually something here. And especially with, I found, whenever I dabble with meditation and mindfulness or anything vaguely resembling anything Eastern, there's always a little bit of skepticism in me. But if there's some biomarkers, some fMRI stuff, even with all the caveats of fMRI, it's like, okay, cool. There is something here. I can switch off the skeptical part of my brain and actually just go all in and take this seriously.

Yeah, no, and I think that's how most people feel. But the interesting thing, of course, is if you look at the classic –

studies in psychology and we're talking about there's qualitative and quantitative you know 50 of them you can't repeat this study so there are some flaws uh that you have to be aware of but in general if you look at the totality of the evidence yeah i think there's no question that uh yeah so okay so let's say there's someone listening to this or or even me where i'm like okay i'm i'm sold that i that compassion is a is a great thing i feel like for me personally i

I don't think I'm a particularly compassionate person. I could sense that when I met you. Okay, interesting. It's a dead giveaway. I feel like when I was in med school and certainly doing clinical communication skills and stuff, I had friends who seemed very genuinely compassionate. Whereas for me, it felt more like...

I couldn't quite relate to a lot of the experiences patients had, especially the bad ones, because I've lived a very privileged life, haven't really had anything bad happen to me. And so it was a lot of kind of knowing how to respond in situations rather than genuinely feeling compassion. Correct. So basically you understand the cognitive components of compassion, but not the affective components. Absolutely. So how do I become more...

affectively compassionate? Well, you could take the Compassion Cultivation Training Program. I can just do that online? Yeah, or our Cultivating the Heart Program. We have a lot of people in England who take that. But I think getting insights and doing specific practices is

can help you gain more insight and self-awareness. Now, you know, is it gonna get you to the point where you're bleeding hard? You go, "Oh my God." Probably not, but it can more connect you, if you will, with your heart. - Yeah. - And actually not only sort of cognitively analyze and say, "Well, this is a good thing to do, "and if I do it, the patient will feel better," but more of, you know, you want to do it because you know it will have a positive effect on people at a heart level. - Two things on this.

I've recently become somewhat involved with the effective altruism community. And that's a lot of like within that trying to rationally and cognitively evaluate what are the best cost effective ways to spend your time and your money and resources and stuff.

And again, I have some friends who seem very affectively altruistic in that, you know, my sister-in-law, for example, will genuinely be kept up at night at the thought of kids dying in Africa. Whereas a lot of other people, including me, is more like, hey, I recognize rationally that this is a thing. I recognize that I probably should value all lives fairly similarly. And therefore, okay, cool. I can donate money to the Against Malaria Foundation or something like that. And your question is? And the question is...

Is there a way to feel, presumably this compassion stuff, and if I went through the training, I'd be able to feel that sense of altruism more affectively rather than just cognitively?

I would say so, but you have to be careful because this is the argument for effective altruism, right? You respond to, as an example, you know, there's a charity advertisement that shows one child suffering. You go, oh my God, versus, you know, showing, you know, thousands of children suffering. You go, gosh, I can't do anything, right? Yeah.

So you have to, again, and I think we talked about biases briefly, you have to be aware of the biases that all of us carry, right? Here's my argument against effective altruism. And I know Sam Harris is a big proponent and who's the guy, the philosopher. Will McCaskill. Yeah, exactly. I had him on the podcast a couple of months ago. Oh, really? Maybe you can connect me with him. Oh, absolutely. So here's my argument. It's great for people...

to do that. In an ideal world, that would work great. But let me give you two examples and you tell me who we save. Okay. Wonderful. Okay. So as you probably are aware, if we were to look at India or Pakistan, there are a ton of people who come from very challenging backgrounds and for whatever reason have

the intellectual capability, or at least the orientation from family or whatever that will allow them to succeed in terms of education and ultimately by the normal measures of success in society. Then you have Africa here, which is complete opposite. Okay. So, and let's say we have X amount of dollars, where are we going to spend them? Do you sit there and completely disregard

the African nation or people and say, well, yes, there are a whole variety of reasons, sort of the negative aspects of colonialism, the fracturing of tribal culture, which have destroyed, you know, how they interact, complete corruption, blah, blah, blah. Or should we take this group of Indians who, you know, nominally have performed and give them every resource to make sure they

do better. Then you could look at this and say, historically, is this actually really a manifestation of these people are really black, these people are less dark, and then there's the white people. Okay. Then the encounter to this next is, okay, we take the Indian group, now let's see what's happening in America. Well, instead of focusing...

Why don't these people focus on changing a system that's fundamentally corrupt and benefits privileged people versus looking for projects that in many ways are just the bias of the individual who are funding them? And I know there's the argument, well, the person gives them money and we look at it and we do all this analysis. Frankly, I would say a lot of that's complete bullshit. And

If you have a person of the billionaire class looking at it, I will assure you if he puts his money there and you do something that disagrees with his natural biases, that will not be the most effective altruistic act that you'll do. Does that make sense? So is your argument that... I don't think we have the...

algorithms. Yeah, we can't quite perfectly predict the effect of stuff, and therefore we shouldn't try? This is probably what Will would say when I posed this exact question to him. He was like, well, to be honest, most charitable donation is still done to

sort of the person in the street who asks you for money. So even if we can just do it, even within an order of magnitude, rough approximation, say that, hey, $5,000 would literally save the life of a child in Africa versus would allow 0.1 of a person to get through med school. You should probably save the child in Africa. Well, but then we would, as an example, first of all, what's the value of a life is...

giving mosquito nets to people in Africa that allow them to survive without the other resources that are necessary to thrive as a human being, is that actually a good expenditure of resources? Yeah, that's big philosophical dilemma. Yeah. So, I mean, you see, what I'm saying is there are a whole set of biases that you have that are making these decisions which perhaps they're not aware of and which are self-serving.

And that's my point. I don't know the answer to that. I mean, why not? It's like, as an example, people say, you know, there's a disaster somewhere. We need to send orthopedists and neurosurgeons and all these people there. Well, frankly, the fucking thing that will save the most people is sanitation. Yeah. Right. Right. Don't send any of those people there. It's a waste of money because, you know, for doing what I do.

I need an immense amount of resources. I need subspecialists. I need an ICU. I need imaging stuff. I need equipment." Well, that's a complete waste of time in the face of a disaster. I would love to connect you to Will. I think you and him would have a fantastic conversation. He's much more prepared to- But you see my- I see your point, yeah. Yeah. And so it's like saying, as an example, why don't we let AI run the world?

Right. Because they theoretically have, they're not, although they are, but we would presumably say they're not biased and they will make the best decisions to get the best result. Because as an example, even with imaging studies, they find underlying...

uh, uh, connections between things that we cannot see. Yeah. And then they would actually be the best arbiters in a, I hate to say completely unemotional way. Now, of course, the thing is they'll, they may say, okay, let's let everyone starve at Africa and India. Yeah. And let's put all of our resources into the most educated countries because that's a group of people who ultimately are going to give the best benefit to society. Yeah.

So I think on that point, what the effective altruists would probably say is that let's not worry about the extreme cases. Let's focus on there's so much poverty and stuff that we can solve right now by just diverting even some of the funds that we put towards, I don't know,

things into slightly more cost-effective charities let's actually you know like just like we make investments and we you know there's always some like level of bias that hedge funds will have when making decisions about investments but there is at least an attempt at calculating what the roi of investment would be let's do the same thing for charities and for effective causes and put at least some of the money there

Yeah. And, you know, I think impact investing and all of that is fine, but here's another counter. Yeah. This is a great lead. So the thing that would benefit the world the most is to remove 90% of the monies that have been taken from the population into the hands of eight families in the world or 12 families in the world. And if you redistributed those funds- Yeah.

to alleviate poverty, to give education, to give housing, you would solve a huge, huge number of problems in the world. Now, of course, the problem is, and it's like looking at Davos, right? Here you have a group of self-interested individuals making decisions, economic decisions about the world. And there's a wonderful quote by Tolstoy that I'm paraphrasing it. It says, there is a man on your back choking you.

He acknowledges he's on your back choking you, but never does he offer to get off your back and stop choking you. Right, yeah. And that's what we see here. These individuals have access to information that unlike perhaps, and I'm in the top 1%, and maybe you are as well. Even in the face of that, I can only make 5% on my money maybe, sometimes 10% maybe.

These are individuals who have access to information that is allowing them to make 20%, 30%, 50%, 100% on their money. I mean, look at some of these individuals who, you know, five or 10 years ago was worth a billion, and today they're worth $150 billion. It's not because they're just invested like you or I. They have access to information that allows them to make...

insane profits at the expense of the average person. Right? And it's not fair. Yeah. And so the best thing you could do to be an effective altruist is to, if you're in the billionaire class, to give 90% of your money away to

things that are actually going to change versus I'll get $5,000 here, I'll get $5,000 there. I mean, literally, as an example, look at the military budget in the United States. We spend more, and I think this is a correct number, it's something like we spend more, like six times more than the other nine top industrialized countries in the world on the military, right? Yeah.

Six times more, maybe even nine times more, but it's a huge multiple of what the other nine top industrialized countries in the world spent on the military. If we took three days of that budget, we could give, as an example, free education, free health care, alleviate poverty in the United States, deal with the homeless problem. Yeah.

Absolutely. Yeah. And I think effective altruists would be very full, fully on board with that if that were possible. Well, but here they have this cadre of billionaires who are pontificating. Let's make it happen. You see, there has to be the political will actually to confront these horrible inequalities that are negatively affecting the vast majority of humanity. And until that class of people gain self-awareness, I mean, tell me,

How does having a 500-foot yacht help anybody? How does having 10 homes that each cost between $15 and $25 million that sit empty 90% of the time benefit anybody, right? I mean, this is wretched excess that is worthless, and it creates a class of entitled people who think that's how they deserve to live.

at the expense of all of these other people. As an example, it's fascinating.

I'm sure you recall when we started talking about not allowing smoking in bars and restaurants. What was the outcry from all these people? You're going to bankrupt our business. We're not going to make any money. Oh, my God. Surprisingly, it didn't affect anybody. Now you look at the minimum wage. There's this argument. If we raise it beyond the minimum wage in the United States, all the restaurants are going to go bankrupt. Well, look what the pandemic has done. Nobody wants to be paid shit. Right.

And suddenly the wage is $15, $18, $20 an hour and nobody's going bankrupt. Or maybe some are, but there are tons of jobs available for servers who actually get paid what they deserve. So there are all these politically sensitive problems. Yeah.

That should be dealt with and not get into this argument that could be very difficult to pick what is the best cause. These are like things that are just sitting there in front of you that nobody wants to touch. And it's because, as they always say, when you take a privileged class of people and you take their privilege away, they feel oppressed. Right.

Let's say someone's listening to this. Coming back to the topic of compassion. So one action point, I guess, that someone can take away is, and we'll put links to all this stuff in the video description, in the show notes, take the programs that you guys have set up on cultivating compassion. Are there any sort of things that someone listening to this could apply to their life, like right now, to cultivate more of a sense of compassion? Sure. So, you know, I mentioned my med school experience, right?

And people ask me, geez, what is your practice for your own cultivation of compassion? So I was asked, and I don't know if you have it in the UK, something, we call it the white coat ceremony. So prior to medical school, you get a white coat, you take the oath of Hippocrates, and then you have an inspirational speaker. And I was very honored because I was that person at my med school one year. And I wanted to impart with these students, um,

An easy way to look at how to walk in the world. Okay. Okay. And it came down to a mnemonic because, of course, mnemonics are very helpful for medical students. So it was 10 letters of the alphabet. And it starts with C and ends in L. So C, compassion for self and others. D, recognizing the dignity of every person.

And what that is, of course, oftentimes we look at people with pity, which is you looking down from a perceived superior position, looking at the other person in a way which is not that you're equal. E is practicing equanimity. This is this idea of evenness of temperament. One of the things that causes suffering is attachment to outcome or craving, right?

It is wonderful to achieve and you get this lift from accomplishing something or being acknowledged for that. But the nature of that is always transitory. It doesn't last. So if you're always attached to having this feeling, you're going to be unhappy at the end of the day. But of course, the other aspect is a down event where you're actually suffering on some level from some negative outcome of whatever.

Well, it is also transitory. Yet people in their mental state get into a feeling that this is sort of permanently the way it is with all the negative consequences versus understanding that is transitory itself. So if you're able to appreciate the ups as well as the downs because the down experiences often give you the greatest insight and wisdom about yourself and the world.

And you appreciate the extremes at both ends, but you're not lost in them. As an example, I like Ferraris and Porsches and fast cars. I like living well, but I don't need them. And if they're gone tomorrow, I'm perfectly fine. Okay? So it's not getting lost in the nature of how life has its ups and downs, but seeing it through the lens of, yes, that's there.

And it's all okay anyway. So equanimity. F is forgiveness. I mean, one of the greatest challenges is you carry anger and hostility towards another person. And what does that do?

Well, it negatively affects your physiology, right? It stimulates your sympathetic nervous system. When you see that person, when you think about that person, you have all these negative effects going through you. And it's like somehow drinking poison and thinking it's going to have an effect on the other person. And it doesn't. So being able to forgive, and it's not to forget, it's not to protect yourself from these types of individuals, but it's not for...

You don't allow them to take away from your calm nature. Okay? So forgiveness is very, very important. And then another incredibly important thing is gratitude.

The nature of you and I sitting here today, we are incredibly blessed. Half of the world's population lives on $2.50 a day. Well, if you simply think about that, oh my God, I am so blessed. I have had such opportunities. And if you take the time to write down three things a day about what you're grateful for, that in and of itself has a huge positive effect on your physiology. Mm-hmm.

Humility. You know, I can always tell good doctors. And the way I can tell good doctors is they walk on the floor, they know the nurses, they call them by name, they greet the people who sweep the floors, who change the bedpans.

Because they recognize those people are critical to their success. That they may be, if you will, the head of the ship or the captain of the ship, but the ship will sink without the input of these other people. So they are humble about their importance. I is having integrity or values that bound your behavior and determine how you act and walk in the world.

K is simply being kind, which has nothing to do with suffering. J is justice, and this is our responsibility for those who are vulnerable. And of course, all of this is contained by love. So that was the statement I made to those students. And I think looking through the lens of your life, through that lens, it makes you realize that

First of all, we were talking about some of this. Success is not an outward event, okay? Your happiness doesn't occur because you've accomplished something. You determine your happiness. It is an internal event that you decide. And yet, what will make you happy, though, interestingly and paradoxically, is when all of your actions happen

Yeah.

then that changes everything. It changes your life. It changes how you see the world. You know, one of the classic things that people say is, you know, I don't have the position, the power, the resources to help anybody.

But the fact of the matter is if you walk in the world simply sitting down with a stranger and talking to somebody who's lonely, opening a door for somebody, carrying somebody's groceries, buying a poor person a meal, these have a profound, profound effect on your physiology. If you look at your life in total, first of all, almost everyone has had an event or been in a situation where

you were not able to achieve something you dearly wanted. Now, whether it was reasonable to expect it or it was something that's really necessary, but everyone has been in a position where you've so dearly wanted something and it was not going to happen. And, you know, when that happens, how do you feel? You know, it's like the sun's no longer shining. You no longer believe in God. Yet when somebody comes and saves you,

Suddenly, there is a God at such height. Oh my God, I'm so blessed. Thank you so much. And that's something that will sit with you. But the thing that will sit with you even more and resonate you when you think about it is when you've been able to reach out and save someone. Unlike buying a car or something, right?

Which transiently gives you a sense of happiness or good feeling, which is, of course, hedonic happiness, if you will. When you do something like that, that will sit with you when you think about it, give you warmth throughout your body, which is this eudaimonic sense, that's what's really important. And that will create a meaningful life, a purposeful life, and at the end of the day, a happy life.

And I would also close by saying one of the hardest things for people is to know when enough is enough, right? Because what happens for so many people is it's almost like they're always competing to keep up with the Joneses, right? And you can never keep up with the Joneses. And the thing is, in fact, do you remember this actor?

What's the name? Young Fat or something. He was in, what, Flying Tiger or something. So here's a guy who's worth $750 million. And he lives on $100 a month. And he's very happy. Yeah.

Now, I'm not sure I could live $100,000 and be completely happy. But the point of the story is he knows when enough is enough. He doesn't need six $30 million homes. He doesn't need a massive yacht. He doesn't need to be with the most pretty woman in the world, although I'm sure whoever he's with, he feels that way about. But it's the people who are constantly trying to show off, to pretend they're something important, to pretend.

to give the impression they're more important than you, they are not people to be emulated, I don't believe. How do you think of this balance between ambition and satisfaction? To me, it's always felt a bit like they're two ends of a spectrum, where on one hand, you can be very goal-oriented, very outcome-driven, and on the other hand, you can sort of be fully content with what you have, and actually, life is good. And

Of course, there is the idea of sort of holding both ideas and sort of striving for goals, but at the same time being fully content. But it's always struck me like this is something I'm sort of struggling with right now in terms of this business, the YouTube channel, the podcast. To what extent do we want to try and go bigger, like get twice as many subscribers or twice as much revenue or twice as much whatever versus actually life is great right now. And I just want to make the videos that can be of service to the world.

Well, I'm sure you know this guy. What's he called? The Beast? He's a podcaster who gives money away to people. Oh, Mr. Beast. Yeah. Mr. Beast. Yeah, my children are related. Well, my sense is I don't know him at all. He's not doing this for the money, right? And he's doing it to, in some ways, be of service in his own way. I don't think there is anything wrong with

necessarily either of these except with the following caveats. There's a difference between having enough versus, you know,

intentionally somehow starving yourself to prove you have enough, right? Where you actually say, you know, I'm happy where I live. I'm happy with my family. We have the resources and I don't need to spend 90% of my free time chasing after more because that's what happens, right? If you're on the spectrum of, I want to do X and you have a goal, then it's going to take a lot of your time. And that's,

The choice then is, and I don't know anyone who's been that successful at, oh, I can have my career. I can travel the world. I can take care of my family. Everyone's going to be happy. I don't think that's possible necessarily. Are there instances where seemingly that's the case? I'm sure there are. But the question has to be, what is driving you to achieve? Is it

insecurity because you want people from an external validation perspective make your parents happy is that why you're doing it and if that's why you're doing it you're never going to be happy is it to say i have the best podcast in the world and look at me and i have you know 16 million or 20 million followers and i'm important next year i'm gonna have 25 million uh

Then what you have to do is then you have to analyze what stuff do I have to do to make this podcast more sticky, right? And then that causes you to compromise, right? Because stickiness often comes from you doing stuff that's inauthentic.

for the sole purpose of getting numbers. You know, that's why you see all these quote-unquote influencers who'll drive a car off a cliff and watch it, you know, be destroyed. Or they'll blow something up. Or they'll even injure themselves. You know, I got more viewers. I got a thousand viewers this week. Well, that doesn't help anybody. Except, again, you wanting to fill this void that makes you feel that you...

If you get that, it'll mean something. It'll validate who you are. But if you're saying, look, we focus on effective altruism and talk about that. We focus on overcoming poverty. I get these incredible thought leaders who give me insights, and I share those with people, and that helps them in their own lives.

well, that is a worthy thing to do. And being able to find those people and inspire other people to be versions of their best selves, then that is a worthy thing to spend time and energy on. But it's again, it's, you know, I had a conversation with the Dalai Lama one time and I said, well, is it important what somebody's intentions are? And he said,

And I said, if they're doing good in some way. And he said, no, their intentions are not important if the effect is good. He said, unless you're a Buddhist, then your intentions are really important. Because, of course, you have karma, right? Which I'm not a believer in, but I simply say that. So...

And just one more statement. You know, I've had the privilege, and I mentioned some of the spiritual and religious leaders I've had the opportunity to spend time with. And, you know, again, while there is dogma with every religion, at the core of these elevated individuals is a reality that life is about caring, compassion, and love.

And in some ways, the experiential nature that religion has had over thousands of years validates this truth. And it is only through science that we have had the tools to understand how these types of behaviors affect individuals.

So in some ways, the dogma is irrelevant. It's at the core of these things that define our humanity and give us the opportunity to be our best selves. Yeah, that's really great. As you were speaking, it kind of struck me this thing I've had floating around in my mind for a while, just on this topic of striving for goals, that there's almost sort of two different

Two sorts of goals you could strive for. There's like a selfish goal and there's like a service goal. A selfish goal of I want X million subscribers because it boosts my own ego. But a service goal of I want to help X million people. And I feel like

This is, I guess, why companies have mission statements where even though the subtext is we generate value for our shareholders, they never say that in the mission statement unless it's like a hedge fund. They would say, we help people think differently. We help dot, dot, dot. It's a very service-oriented goal. And my instinct is that there's something about that that helps people get bought into doing this thing compared to if it was like, the reason we exist is to make money for our shareholders.

I sometimes think about this. I was having this conversation with Will McCaskill, the philosopher as well, around how there are some goals in life where they're satisficing goals. Having way more money doesn't make you way more happier. There's a point of enough. Having way more fun doesn't make you happier. There's a point of enough. But impacting way more people

There's no upper limit to that. And so if that is the goal, like an impact goal or service goal, that feels like a good way of having your cake and eating it too in terms of you're striving for something which gives meaning to life. And you're doing it in a way that makes you happy and fulfilled by providing service to others. Well, I think that's just reiterated what I've said. That's how I roll. Yeah.

But I think the danger is as follows. Again, the thing that causes the greatest amount of suffering is craving and attachment. So if you're so involved in sort of doing this thing to help others...

And you do it so much that it harms yourself. Yeah. And that being able to say, you know, I helped 10, like effective altruism. I helped 10,000 people today. The ROI here is incredible. Yet, you know, you've been up for days at a time. You're exhausted. You have no relationship with anybody. That's not a healthy thing.

thing. And if you don't make it to whatever that goal is, then you start all these self recriminations saying, you know, I knew I, you know, it wasn't real. I couldn't really do it. I tried, but you know, I wasn't good enough and I wasn't worthy and I don't really deserve this. And I'm an imposter by telling people that I'm trying to do this and you beat yourself up. Well, that's only causing you suffering. So if you sit there and say, you know, my goal is to, let's say, help 10,000 people, whatever it is,

And you sit there and you help 8,000. You go, you know, I did an incredible job. Was it exactly what I want to know? But I'm okay. Because at the end of the day, I did an incredible job. And, you know, even for some of the stuff I do, do I have dreams and aspirations about helping people? Of course. And a zillion times I've not been able to do what I wanted. And I failed. And I made mistakes. And it's...

painful for myself but i'm still a worthy person deserving of love right one thing i want to ask you so you've had like by any sort of definitions of success like stupidly large amounts of success um a lot of books i've read from people from people who are very successful um

they often lament that they didn't spend enough time on their relationships when they were sort of on the road to that success. I wonder if you can speak to that at all, maybe in your life, or if you were to give advice for other people who are all sort of aiming for success, this balance between taking care of your personal relationships alongside the climbing the mountain. So let me give some information that correlates or relates to our conversation on compassion.

I'm sure you're aware of the blue zones in the world. Butner's work, I think it is, Butner. So these are places in the world, and I'm sure many of your listeners have heard of this, where people live routinely over a century. And why is that? And this is substantiated by a number of studies. So one part of it, which people will claim, is these are people who eat a Mediterranean diet.

who exercise, who are at their ideal body weight, who don't drink alcohol. And there's no question that is a significant contributor. But by far, far, multitudes more important is depth of relationships and human connection. That is the secret sauce. All the other stuff can be a benefit, but the secret sauce of actually longevity is

is human relationships and connecting with others. And what does that involve? It involves having generosity, being nonjudgmental, being accepting. And of course, those are the fundamentals of how to develop relationships. And you're right, there are some people who are so goal-oriented, and in fact, they have no problem stepping on other people to get what they want because they want some external validation.

And probably there's some degree of insecurity that they want to hold that over other people. But, you know, that's not going to create happiness or longevity. And I'm sure you know a number of – and I hate to beat up the hedge fund business. But, you know, there are people who are, you know, in that –

business of making money for the sole purpose of making money at whatever cost. And, you know, they work ridiculously hard. And is it great to live in a big penthouse and drive sports cars and hang out with supermodels?

I suppose I've been in that position on some level. And frankly, at the end of the day, my whole life I felt was completely empty. I had tons of external people going, man, dude, you're living this incredible life. You've got this penthouse and you've got this Ferrari and you're dating so-and-so. Man, you should be so happy. And I was never happy in that situation. I was miserable, actually. And to the point where I couldn't understand because I did all of this stuff.

And I was miserable when all my friends would say, "God, if I was in your position, I would be so happy right now." But again, if it's all about the money or all about killing yourself to get some external validation, you're going to be unhappy. At least that's been my personal experience and my observation. Final thing I wanted to ask, have there been any books that have had a big impact on your life that you would recommend to me or to our listeners?

No. The Oxford Handbook of Compassion Science. Yeah. Only the ones I've written. You know, it's interesting you say that because I get asked this question and I never have an answer because I forget them and I have the worst memory. You know, there are a number of books that have impacted how I see the world and

Some of them, you know, by the Dalai Lama or people who've written for him. Others about sort of the religions of the world. Others about psychology and how we don't have necessarily awareness of who we are in the world. There's a group of books about...

economics and how to look at the world from a lens of revising the economic realities to be a more benefit to the people. And in fact, if you want, I can make a list of 10 books that you could put in your show notes that I think might be helpful for people. But, you know, I've certainly read a lot of books by different spiritual and religious leaders and philosophers. So, yeah.

All right, Jim, thank you so much for coming on the podcast. It's amazingly generous of you to just agree to sort of meeting a complete stranger in the morning while you're in the UK for a few days. Thank you so much. This has been wonderful. And I know that compassion science is a thing and I'll be checking your book out and doing this, the online resources, because I'm genuinely interested in trying to cultivate more self-compassion and also compassion towards others. Well, no, thanks for having me. I appreciate it. And again, I think...

Otherwise, I would just be drinking alone in my room. Glad to be of service. Thank you so much. Yes. Now, look, if I can spread my message that benefits one person,

I'm happy to do so. Thank you so much. And also for just to do another self pitch here. So my book, I should have brought it for you, is called Into the Magic Shop, Neurosurgeon's Quest to Discover the Mysteries of the Brain and the Secrets of the Heart. And it's

It's in, I think, 40 languages and it's an international bestseller, New York Times bestseller. I'm not saying this to promote the book necessarily, but I think that for a lot of people, this has certain messages that resonate with the questions that all of us have as human beings. Amazing.

youtube channel separately to the podcast we often do like book reviews and book summaries and stuff so we'll definitely check that out and yeah no i think you would enjoy it right up my street and evidence-based stuff perfect around living a good life yes well thank you thank you so much

All right, so that's it for this week's episode of Deep Dive. Thank you so much for watching or listening. All the links and resources that we mentioned in the podcast are gonna be linked down in the video description or in the show notes, depending on where you're watching or listening to this. If you're listening to this on a podcast platform, then do please leave us a review on the iTunes store. It really helps other people discover the podcast. Or if you're watching this in full HD or 4K on YouTube, then you can leave a comment down below and ask any questions or any insights or any thoughts about the episode. That would be awesome. And if you enjoyed this episode, you might like to check out this episode here as well, which links in with some of the stuff that we talked about in the episode.

So thanks for watching. Do hit the subscribe button if you want already, and I'll see you next time. Bye-bye.