Episode 573 Changing Life Circumstances With Dr Iyer

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Show Summary

This source presents a podcast interview with Dr. Iyer, a physician with over four decades of experience, discussing various aspects of health, medicine, and life-changing circumstances. The conversation spans topics such as the importance of narrative in personal experience, the challenges of motivating patients to make healthy choices, and the impact of societal factors and lifestyle on well-being. Dr. Iyer shares personal insights into his medical practice, emphasizing the significance of human connection, community engagement, and sustainable habits like walking, while also reflecting on complex medical issues such as cancer and multi-drug resistant infections. The host, Rob Cairns, also shares his personal experiences and opinions, creating a dynamic and informative dialogue about navigating life’s inevitable changes and maintaining health.

Show Notes

Key Discussion Points:

• Dr. Iyer’s Background and Journey:
  • Growing up in Jamshedpur, India, a steel town, and his early education.
  • His “Tom Sawyer” like medical school experience by the Ganges River.
  • Transitioning from a metallurgical family background to a career in medicine.
  • His 42-year career as an internist, caring for patients from 14 to 114.
  • The enduring nature of a medical career when cognitive and physical functions remain sharp.
• The Unasked Question in Healthcare:
  • The critical role of identifying and addressing the patient’s deepest, often unspoken, fears.
  • How skilled doctors build trust by gently guiding patients to confront underlying anxieties (e.g., “Am I having a brain tumor?” vs. “I have a headache”).
  • Creating a “sheltered space” for patients to face uncertainties, akin to a leader guiding their tribe.
• Understanding Life-Changing Circumstances:
  • Distinguishing between circumstances monumental in scope versus those monumental in impact.
  • The crucial role of our narrative in shaping the impact of circumstances.
  • How an objective awareness of our personal narrative can empower positive change, rather than being a “victim” of circumstance.
• The Intertwined Nature of Physical and Mental Health:
  • Rob’s personal commitment to mental health, including couple’s therapy, as a vital part of overall well-being.
  • The importance of addressing the “brain and head” alongside physical ailments.
• Challenges in Patient Behavior Change:
  • The shocking truth: 99% of disease is self-created by lifestyle choices.
  • The difficulty of enabling patients to make different choices when those choices are tied to their “reward structures” and definition of happiness.
  • Ozempic and GLP-1 drugs: Not just about weight loss, but revealing the fundamental role of gratification.
  • How these medications impact addictive and compulsive behaviors by satisfying reward mechanisms.
• The Power of Human Connection and Community:
  • The profound impact of human connection on emotional gratification and diminishing toxic self-gratifying behaviors.
  • The concept of “trim tabs” (from Buckminster Fuller): Small, non-glamorous social behaviors that yield monumental, lasting health benefits.
  • COVID-19’s impact on social isolation and the subsequent mental and physical health setbacks.
  • The pandemic as a “global experiment” in isolation, prompting a re-evaluation of priorities worldwide.
• The Importance of Sustainable Habits:
  • Walking as the ultimate sustainable exercise: accessible for all ages, requiring no special equipment.
  • The philosophy of walking for the experience, not just the benefit, by paying attention to sights, sounds, and feelings.
  • Rob’s personal journey with walking for mental clarity and incidental weight loss.
• Aging, Cognition, and End-of-Life:
  • The increasing prevalence of dementia and Alzheimer’s: factors like greater isolation in nuclear families, inflammatory diets, and environmental pollution.
  • The concept of “experiential memory” in advanced cognitive decline.
  • Cancer as a multi-faceted disease: significant improvements in 5-year survival rates, but “cure” is statistically defined by 10-year remission.
  • Dr. Iyer’s perspective on focusing on living in the present moment rather than dwelling on the inevitability of death when facing a cancer diagnosis.
  • The ongoing “fight” with multi-drug-resistant hospital infections.
  • The philosophical view of “exit ramps” in life (heart attack, stroke, infection) and the ultimate goal of medicine: providing functionality, not just longevity.

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Notable Quotes:

• “99% of the time it is our narrative that determines how monumental its impact is rather than the circumstance itself.” – Dr. Iyer
• “The really good doctors know how to make the unasked question asked… and in this manner they actually win the patient’s trust.” – Dr. Iyer
• “99% of disease is self-created by the patient by the choices they make and how they live their life.” – Dr. Iyer
• “Human connection causes satisfaction. People getting together with people and engaging with people in a touchy-feely way will produce an emotional gratification that will negate a lot of toxic self-gratifying behavior.” – Dr. Iyer
• “Exercise for me is not an activity, it is a habit, and it needs to be a sustainable habit.” – Dr. Iyer
• “I will give you functionality. You ask for longevity with your maker. Don’t come to me for your longevity.” – Dr. Iyer

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Call to Action/Question for Listeners:

What “unasked question” have you been avoiding in your own life or health journey? Share your thoughts and reflections with us!