Inside the Mind of a Neurosurgeon with Dr. Randy D’Amico

Today we are joined by Dr. Randy D'Amico, a neurosurgeon who's going to take us inside one of the highest pressure jobs on the planet. I reached out to him after seeing his morning in the life of a neurosurgeon on TikTok, and he generously came on and gave me an hour of his time. In this episode, we talk about what it's really like to perform brain surgery, how he stays calm when someone's life is literally in his hands.

and what happens when things go wrong in the operating room. We recorded this episode in his office at Lenox Hill Hospital. So because it's a real hospital, you're going to hear like alarms and sirens, sirens, not alarms. You're going to hear like sirens and ambulances and a lot going on in the background, some dings from his email. I've never seen a busier person and I actually can't believe he made an hour of his time for me and for you and for this podcast. And I'm really grateful for that.

He shares what years of working on the brain have taught him about handling pressure in life, the new perspectives he's developed and gained because of this job, and the practical advice that everybody listening can apply to their everyday life, including how to protect your brain health, what foods help your brain function, and how alcohol and other substances actually affect your brain.

I absolutely loved this conversation and I think what he's doing to try and demystify the job of neurosurgery and what that job and the pressure is actually like is really, really cool. And I'm so incredibly excited to share this episode with you. Without further ado, please welcome Dr. Randy D'Amico to Geissell.

Josh Felgoise (02:01.518)

dated for a few months then we broke up and then I didn't talk to her for eight years and then I ran into her at the Soho Grand on New Year's Eve in an elevator oh my god and and she was I was like what are you doing here and she's like it's my party what are you doing here it's so totally meant to be yeah and I was like oh well I'm just here I got invited by somebody yeah she's like actually what are you doing here so I went up there they had a hotel room because they were hosting the party she was in a group called the miss shapes or

I guess she is at the Miss Shapes. Okay. Which is a DJ trio. They had a big party on Saturday nights for 10 years in the city. They were a huge part of New York City nightlife. Like in the story of New York City nightlife, it goes like Studio 54, Limelight, like weird shit in the 90s, like Tonal and all these things. And then the Miss Shapes, which was Don Mills and whatever. Yeah. And so from that, she started doing music production. She does a lot of runway music.

She does big corporate events now, a lot of fashion brand collaboration, stuff like that. And yeah, she's still going. How long you guys been married for? Eight years. Wow. Yeah. That's awesome. So, well, I reached out to you after seeing your morning routine on TikTok. I appreciate it. You did like a day in my life as a neurosurgeon. I thought that was incredibly interesting.

So what does a day in your life look like? It's actually, mean, that's funny that you reached out. I was basing it on the Ashton Hall thing. really? Which I saw and I was like, I was like, wow, the production on this is insane. It was. And I was like, but I'm not actually, I do kind of similar stuff. was like, I wonder if people would be interested. Of course they would. And so, yeah, I had no idea that it would actually take off the way it did. But my day basically starts at 4.30 in the morning. I've actually, in that video, I'm not sure it was started at 4.30 or five, because I started going to the gym now.

So 430 in the morning I wake up and when do go to bed? We'll get there. Okay. Okay. Okay. Okay. And by the way, we're recording in his office right now. So if you hear sirens or people in the hospital, yeah, it's real. Yeah, it is real. So yeah, I'm in, I'm in a 430 in morning. I wake up. I am immediately awake. Like actually sometimes I'm awake before my alarm. I like anticipate it and I get up and I get dressed and I'm out the door and I sneak out the house, which I, I just showed you cause my kids are little. I got eight and a four year old.

Josh Felgoise (04:24.628)

And my biggest fear is waking them up in the morning. Not because they're scary, but mainly because I don't want to enrage my wife. Yeah, fair enough. And so I sneak out of the house like a ninja smart man and I get on a bike and I ride to work and I'm here. I'm in this door at five in the morning. Really? Yeah. So you live close by. I live about 10 minutes on a city bike across the upper west side. Helmet.

Yeah, always. It's a nursery. Yeah. 2.2 million views. I wear a helmet. Of course. I don't want those that many people attacking me. But anyway, so I walk in this door, I get a coffee. I actually do all my email work in the morning, first thing in the morning. So people get weird timed emails from me. It's actually funny because I can tell who's really I can tell time zones based on who responds or who doesn't. Yeah, But anyway, I do some emails like I down a cup of coffee. I listen to music here very comfortably.

and at 5.30 the gym opens. so I- In the building? No, it's two avenues over. Okay. So I take a walk over to the gym. I go to the gym for about 40 minutes. And it is regimented. What's the routine? No, I mean I am in at 5.30 and I am out at six whatever- Got it, okay. 6.10 or 6.20 I guess, because I take a shower there. I do Apple Fitness. Okay. Actually, yeah, I'm 43 years old. I designed something-

that I think is good for me functionally and I think Apple fitness is a good job of being very functional. So I do like two days of zone two, I do HIIT, I do some yoga, I do some strength training a couple days a week. But 40 minutes, that's it. I shower there and it's hilarious. I mean, I'm sorry, New York Sports Club, but it's like a homeless shelter. The people at 5.30 in the morning too are special. So my wife did music for Equinox a long time ago.

And I had a one year free Equinox membership and I didn't shower at home for a year. Equinox was like, they're nice showers. It was unreal. And it was back when Kiehl's products were there. So was legit. But anyway, this is different. This is an experience. Yeah. The towels are like this big. I don't even know what they want me to dry off with. Like what they want. But anyway, whatever. I'm back here and I work. I sit down on non-operating days. No one bothers me till eight in the morning. OK. So from

Josh Felgoise (06:41.262)

630 until 8 I crank out work at my desk and that usually involves research or preparation for the day of some sort Sometimes fixing notes from the day before things like that Yeah on an OR day I have to sign in the patient at 7 we're in the operating room by 7 45 so typically what will happen is I'll come back here and Get whatever I can get done signing my patient eat some breakfast and then we have some sort of conference usually in the morning I'll participate with that and then we go up and start the day

On at 8 a.m. On the on the non-operative days my wife my world falls apart at 8 in the morning the minute someone comes to work everything changes just like now where you get a phone call and someone's like I got an emergency I got someone who's got to talk to you and that happens non-stop all day long. I'm sure yeah, and so the day goes on I leave here, know, we're not a trauma center So I don't get a lot of trauma knock on wood. Yeah comes in Which means I'm usually home at least by dinnertime for the kids. Oh, that's great. So I feed

bathe and put my kids to bed five nights a week. Wow. Yeah. And which is amazing. And I wouldn't change that for the world. I go out once a week, usually something industry related or business related, just trying to make connections or tell people the interesting stuff that we're doing. And then and then I go to sleep at like nine thirty, ten o'clock. Yeah, my TV broke two weeks ago, so I haven't even watched TV in two weeks. I'm usually reading until I pass out. Are you reading anything good right now?

Right now I'm just reading, actually Penguin sent me the great nerve. It's a book by Kevin Tracy, who's a neurosurgeon and he writes about the vagus nerve, all his research, which is actually the timing is incredible because I've had this like new like longevity reawakening in myself. And vagal nerve tone is really important for longevity. And so just reading a little bit of the background of how bioelectric medicine has gotten started and the importance of the vagus nerve in terms of our homeostasis and you know, just

just our inflammation, our constant state of inflammation. It's incredibly fascinating. So in layman's terms, can you like break that? So basically the biggest nerve comes from your brain down your neck on both sides. It's the only nerve on your body. If you cut both of them, you die. It is responsible for all for regulating all of your internal organs. All the things you don't think about all day long is regulated by this nerve. It's like 200,000 fibers on both sides that just go up to your brain and your brain reads how much how much oxygen is in your blood.

Josh Felgoise (09:06.754)

how fast your heart's beating, what you're digesting. If there's an injury somewhere that it needs to launch an immune attack on, this is all controlled by this nerve. And it turns out if you stimulate it, you can increase or decrease its tone in certain ways. they sell these vagal nerve stimulators. Now there's a whole market on this and it ties into longevity. And so it's pretty cool. That is really cool. Yeah. And Kevin Tracy is a neurosurgeon and the guy who wrote the book and he basically retired from neurosurgery because he made so much progress in this and has actually cured people of things like rheumatoid arthritis or IBS.

Or so they claim I mean, you you got to take everything through this with vagus nerve. Yes Wow intervention that's super interesting super interesting So I recommend reading it. It's it's it's an easy read, know, it's written for people Do you have a favorite book?

Something else that you recommend? I just read When Breath Becomes Air. yeah, yeah, Yeah, do you have a book you'd recommend to people? That's sad. So sad. That's a hard book. I cried on the subway reading that when I was a resident. Yeah, cried in bed. Yeah. And it was one of those things where I was like, no. I'm gonna cry. I met his wife. really? Yeah, which is amazing too. So yeah, she was at a conference speaking and very eloquent. The whole thing was incredible. Wow.

Do you mean a favorite neurosurgery book or just a favorite book either? So I go back and forth on these things. I love I I'm kind of in this like self-help motivation phase right now. I mean Dave Langer gave us marcus aurelius's meditations Which you know, he got very in a stoic philosophy. Dave Langer is my boss. He's the chairman here He's the guy on the lenox hill tv show. yeah. Yeah and

I think story philosophy really it's obviously a little bit in vogue right now, but it really resonates. think with what we do. And so that meditations is on my bedside. It's on my end table. And I have any time I just read a couple of passages of that or, you know, a couple of sayings that that Mark's really said. And it's really helpful, I think, to give you perspective on life. I love the writings of Jorge Luis Borges, just like this really romantic, imaginative kind of dreamlike stuff. Yeah.

Josh Felgoise (11:14.446)

I just read actually, I think it's called on all fours or all fours, all fours. It's a book by this. I forget her name, actually. Shit, I'm going to sound stupid, but she's a former riot girl from. don't think you're going to sound stupid. She's a former riot girl. And it's a book about just, you know, perimenopause. It's like it's really, I think, really targeted towards a women readership, but it's a really interesting read. She's an artist. She thinks kind of outside the box and it's good. Cool.

And so yeah, no, I've read I've been reading a lot more since my TV died And then what are you eating throughout the day? are there I don't know are there things like you eat that? Like you you think about how it helps your brain function when you this type of stuff or like yeah, I've gotten obsessed. Okay, tell me all that I'm really interested I start my day With an avocado toast like pretty much every day. Okay, and that's pretty reason it actually and it's it's cost-effective I buy my avocados from Trader Joe's I get my exit Trader Joe's and I get like a really

nice seedy bread that's not gonna be high glucose. And I start my day with that. I put some hot sauce on it. It's actually delicious and it's amazing for you. I eat two Greek yogurts around 10 in the morning, 10 or 11 with chia seeds and hemp seeds just for more protein, minimal carbs. I became obsessed with, I had a glucometer for a period of time. I was just watching my glucose trends and trying to flatten the curve as they say. And then usually lunchtime is where I struggle. I haven't figured out lunchtime yet.

Usually I miss it Usually it's a cup of coffee. I do a lot of green tea now. I kind of limit my coffee Just to the mornings, although it's hard because there's so much data out there Coffee's good for you, right? It's not bad for you, right? And I love coffee, but going back to vagal tone I noticed that my heart rate variability which I check on my watch was like low and I was like shit am I dying? Or is it coffee related? So I started just

kind of fucking with it, just like personal experiments, know, where I can bring things. And it turns out that coffee probably does affect me in that way. It just keeps me ramped up. Me too. Yeah. So I started doing more green tea to kind of help with that around now o'clock, which is what you just saw me do is I'll eat like a peanut butter on again, just some nice toast just for some protein and fats and carbs just to kind of get me through the rest of the day. And then dinner is where we struggle. I've really gone into low glycemic pasta is a lot.

Josh Felgoise (13:32.238)

I'm a vegetarian. I've been vegetarian since 1999. Okay. I started eating fish about 10, 10 or 15 years ago. So I eat fish, but probably once a week. Got it. We don't cook it at home because I don't want the house to smell like salmon the whole time. Yeah. So, um, so I'll do like natural pasta, Durham pastas that are slow burning. They're probably also still bad for you, but they're better than regular shit. Um, a lot of vegetables I've, I've updated. I'll have greens now with everything's spinach. I'll have tomatoes. Um,

And just all as natural and whole as I can possibly make it. So are there any other things like supplements, vitamins that you take that you recommend? I love I love that we're talking about this because this is all stuff I've been obsessed with. I'm obsessed with this. Especially talking to somebody like you who like has the information I feel like. Yeah, but no one really does. Right. Because supplements are tricky because they're not FDA regulated. It's all you have to be really, really careful. The only thing I take is creatine. OK. And I just started. Yeah. And creatine is.

there's enough scientific backing on it. There's the brain health component and the muscle recovery component, especially now that I'm actually actively working out that I think there's enough data to support its benefit. And so I take a really nice, whatever it's called, micro-micronized creatine. It's one spoonful a day. It's super easy. I don't go nuts. Occasionally I'll have a protein powder shake, but I'll buy it somewhere. But those are full of sugar, right? That's why they taste good. So the minute you're putting sugar in your body, you're fucking yourself up anyway.

I try to really kind of, you know, purify or get things down to the basic. We have a nurse here named Hinchu who's amazing, who does kind of alternative kind of functional medicine. And she and I were talking today and she's like, we just had all my labs done. And, and she's like, I think you should do a fast. You know, you should drink these mushroom soups, 800 calories only for the day for a couple of days and it'll clear you out on all your toxins. And I was like, I'm not paying to.

eat mushroom soup. I'll just chill. right. You eat like less shit. Yeah, like that's kind of it. And I'm sure there's a benefit to it. But who who said that there's a benefit to it? Yeah. So I read actually the woman who's just got nominated for Surgeon General. OK, like the podcaster influencer. She was like an ENT who dropped out of the residency to write a book about like longevity. Cool. I forget her name right now, but the book's good. And I read that and then this other thing called.

Josh Felgoise (15:58.06)

Metabolical, which is another good book about these and the glucose revolution. And what's interesting is that they all do kind of say the same thing, though, which is just like we're eating a bunch of poison. Right. We have to get back to kind of whole natural foods. There's probably an order in which we should eat them in terms of like greens, proteins, then sugars. Yeah. For better metabolic health. And if you if you parse it out to like those root things, then I don't think you have to go overboard with all this other shit. Right. Like the NAD. Like, OK, famous people are taking NAD. Sure.

famous people are doing a lot of things. NAD is a precursor to like amino acids basically. It's all over my Instagram. It's like, Kardashians take NAD and it's like, okay, great. Sure, they also pay a lot of money for great plastic surgery. okay. And I don't know if you follow it at all, but I got very into the Brian Johnson, which is also just, it gets fanatical. whenever you're in that realm,

No, it's not. I don't believe the science anymore. Yeah, you know, and I love the idea. Tell me stuff. Right. I'll try it out. Some things I'm not going to stop eating at 11 a.m. Right. That's not going to be me. But like, sure, learn from it. But you got to always you always be judgmental about what you're doing and you got to always do your own homework on it and find what works for you. What are the other things that are good for our brain function and our brain health that we could be doing more of? Use it. OK. Read a book. Yeah. Yeah.

Read a book, reading a book expands your ideas, right? Everything we do is based on our beliefs and our beliefs are built on our experiences. So you believe something to be true because you have experience that reinforces that. And the best way to increase your experiences is to read a goddamn book because it takes you to a place that you are not in, right? And even if you're not super interested in it, you read it a little bit, you know, and you just get the sense of it. Listen to music, think about the music that you're listening to, right? Why is this?

Why do I like this or why don't I like this? Yeah, go listen to something else Look at art. I'll try to understand more. It's not about like I don't understand art It's look at it and just think and think about why you're looking at it and why someone made it and what's going on And if you're using your brain, you're using your brain. That's a good thing. Yeah in terms of supplements I think creatine's got good data behind it Yeah, think again, you just need to make sure you're getting a good variety of essential amino acids and proteins to Sleep is super important. Everyone has proven that

Josh Felgoise (18:23.886)

Yeah, mental health is hard and so like, know, these these are it's all a push and a pull and a balancing act that you got to do There's nothing physical I think exercise sleep Eating healthy and using your brain are the things that you can do every single day to make yourself better Okay. and then what are the things that we should stop doing? Drinking how bad how bad is it actually? I mean look I mean I kind of agree but the the certain general just came out with this big

about it being a leading cause of cancer. really? Yeah and it's a huge issue right? That's a huge, the alcohol industry is a major industry. Yeah. And so you know telling people that alcohol causes cancer is a scary thing to do. You're talking about affecting a lot of people, the entire industry's lives, and you know all these people are involved in that. But it's true. I mean if you look at you know these things like the aura ring gives you a readiness score. Look at people who have one the day after they drink.

and their readiness score just plummet. It just really fucks with you. So I think that there's just negative there. Now look, moderation is moderation. I'm fine with that. Just do what you gotta do. But I think alcohol and chronic alcohol use is definitely something not good for you. Smoking cigarettes obviously don't do. That's been proven. You know, I think it's really hard to make comments on social media and things like that. I think that it's not going away. And so rather than...

be like the movie Footloose and be like, no dancing in my town, no social media in my town, you just sound crazy. I think it's just trying to understand what it's doing to you. And so just when you look at it, pull back a little bit and be like, is this making me feel good or bad or why? And that's not a judgment. That's just identify how it makes you feel. If you understand that, then you can get a better sense of who you are, But I don't know, we live in a weird time.

We do I saw a chart yesterday that was talking about super fascinating graph It's on the on the bottom axis is how old we are okay and on the going up axis y-axis for those non-scientists me It's how happy you are and the graph used to start really high because when we're young We're really happy right and then it drops at like in our middle age like 30s and 40s for whatever reason maybe it's job satisfaction or

Josh Felgoise (20:48.446)

Responsibility that'll fuck you up. Yeah, but then as you go towards retirement and stuff It gets better again because like you got a life you got a family you realize that there's great things in life, right? And I think the New York Times published this Can I turn that off by the way that thing? Oh, yeah, I don't know how but you know what it is. It's probably my computer Oh, then it's fine. Just leave it. It's You're What's super interesting is in the new that is super? in the new graphs in Kids are having our suffering really and the happiness score of children

At like what age like young like teens like in high school and I guarantee it is somehow related to social media to social me it has to be and YouTube culture and Looking at lives that aren't really your life right feeling that like you're nothing or you don't have those opportunities And that's scary. I don't know what to do about it. But like you're not gonna turn it off. It's not going away Yeah, so, you know, how do we fix it or how do we how do we better, you know protect our kids or

kids growing up or young people growing up in these situations. I don't know the answer to that, but it's interesting. It is interesting. What about drugs like weed and shrooms and all of these things that are so I don't know. think I think weed there's no there's no major issues with weed. think anything like that becomes a problem when you become dependent on it. And even though weed is not addictive you can still become very dependent on weed and the rebound is hard in terms of anxiety and things like that.

In terms of things like mushrooms, so Silas Simon has a wealth of literature about the positive benefits of it, right? psychiatrists have been looking at this for years. And I remember a New York Times article probably 15 years ago talking about its effects on depression. And so I think that back when people were like doing a bunch of mushrooms and going in the woods and like getting weird, maybe that's, you know, that was probably okay intermittently, realistically. But, you know, people don't do that like on a daily.

the micro dosing thing may have something to it. You know, I don't know, I don't do it so I don't have a sense of what it would do to people or how it wouldn't, know, but I don't see, I don't see major negative reporting. Vaping is another tough one, Vaping has to be better than a cigarette. But it also has to be bad for you too, right? But it has to be bad for you too. like at the same time. Yeah, nicotine is in general a stimulant. It's actually not that bad for you.

Josh Felgoise (23:08.334)

Unless you take a lot of nicotine chronically the problem is it's addictive become dependent right so you don't every day right and you're dependent on this vape and again You know Homemade babes versus commercial babes who knows you just we don't know and there's no long-term data So we don't know what's bad or good about but it has to be better than a cigarette right a hundred percent Okay, so pick your poison MDMA who knows I mean no one I don't think anyone's really doing it like every day now ketamine if you're doing it like party club vibe

It's probably not great for you. Probably not. But if you're doing it for depression treatment where people are charging you seven grand for a week and you're having it and you're getting better. Right. That's OK. Yeah. Right. And people do that. Right. It's FDA approved for treatment, refractory depression, anxiety. And so there are are centers in Tribeca. You can go in, you lay down in a chair, you put on some music, you take some ketamine and really micro dose ketamine and your depression gets better. Yeah. So, you know, there's it.

I think you again if you're gonna embark on a journey like that Which also I'm not even saying like don't experiment because you've got to do your shit, right? You're get your life. The only thing I would say is don't experiment with heroin. Yep, because It's addictive. Yeah, I spoke to a model once a long time ago. She was Beautiful and she was talking about Heroin and the first time she did it and she said doing heroin feels like a thousand orgasms at once huh, and I was like well well

Okay, we'll not do that because I can I understand but that's too much that's too much. Yeah, that's too much No one should experience that much. Yeah, so I think that's a bad idea. Yeah And don't do like weird shit like crocodile those things we I deal with a lot of these complications Really? Yeah, and it's you see that stuff here. Yeah Wow people come in they look like that Marvel movie all their veins are black and necrotic lines going up their arms And they usually come in for whatever

I don't wanna call it luck, because it's definitely not lucky, but I take a lot of call here, and all the brain abscesses, all the infections come my way. And so brain abscess, spine abscess, real neurologic problems from IV drug use. You gotta be careful, it's not worth it. So, yeah. Okay, I wanna get into your job, and how you chose this job. So, what drove you to pick one of the most high-pressured

Josh Felgoise (25:32.626)

life or death jobs of neurosurgery? That's a great question. I don't. I don't fully know, and it's something I think about a lot because you're obviously not the first person asking this. I'm sure I've kind of dialed it down. So I grew up in a nice working class family. My father worked at Citibank early on. My mother was an immigrant. She came here from South America when she was like 10 years old.

And they were in no, they had nothing realistically. My dad had nine brothers and sisters and they lived in a small apartment in Williamsburg and my mother came over with literally like hundred bucks with her mom. Like a new baby or something like that. And I think when I was born and growing up with my family who's all pretty much like this, I'm only like the second person to go to college in my family I think. The idea of a doctor first of all was like the doctor is the best thing you could possibly be.

Right, everyone loves the doctor. The doctors are smart. And neurosurgery was just the greatest doctor of all times, right? It was like you were the best doctor. And I think that just, it just fit my personality where I just wanted to be the best person that they knew. And that was like my drive. And so I went through all of grammar school, you know, and high school being like, well, I just have to be the best person that they know.

This is what's gonna drive me to do this and I mean some people I guess would call it capital T trauma, but I Don't know who to blame for it, but but no it kind of drove me and Yeah, I liked that feeling of like I'm gonna be the best. I'm gonna be the best I never was the best like my grades weren't fantastic. I Got good grades in grammar school, but kind of everyone does right you just show up and they pass you yeah High school I did fine in but I definitely wasn't like

Full like AP everything or whatever And at the end of college, I started kind of changing my mind a little bit. I got very early in high school Sorry, I got very in a skateboarding I got very into punk rock music and when I got to NYU I went to NYU I had good grades. I got into a good school. Yeah Originally, I was pre-med and after my first year like NYU in like 1999 Downtown was about to take off like the strokes Interpol, know punk rock was making this big resurgence

Josh Felgoise (27:48.622)

and I knew everybody and I was like, fuck medicine. No way I'm going to be in a rock and roll band and I'm going to have a recording studio. And so I changed my major out of pre-med. went to I was biology major. I dropped that. I went to neuroscience because at least it's a little more like philosophical. But I the brain. I always like the brain. And so I played music. I took four years off after college. I played music. I had a record label. Whoa. Concerts downtown. I toured around with a

a shitty punk rock band for years, four shitty punk rock bands, different bands. And then and then I came back to this. And when I got to med school, I kind of always loved the brain. I always loved the neurosciences and psychiatry and psychology. And because we were saying before this started, I think about how our brain interprets the world all day, every day. It's my Roman Empire, like, legit. I'm just obsessed with it. And so there was an opportunity to to choose a specialty. And I was like, well, this is the one.

But I was open-minded about it. I tried everything. So CT surgery I loved, but it was kind of the same. Cardiothoracic surgery. So it was the same kind of thing every day. Those guys are real surgeons. They're incredible. They small surgery and big surgery at all times. It's really incredible stuff. But it just didn't appeal to me. It was the same procedure over and over again. The physiology wasn't as interesting to me for whatever reason. I've just got a good gut. I knew what my gut liked. I tried trauma surgery. That was a lot of adrenaline.

Yeah, yeah people come in they're sick. It's fast-paced, but I was also like well I don't want to you know, I gonna want to do that when I'm 50? Like maybe not right and the neurosurgery you get to operate all over the body It's not just the brain. It's the spine. It's peripheral nerves. Literally. I didn't know yeah I can go for I'm operating on a calf next Monday and you know tomorrow I'm doing two big brain surgeries Wow, and so like you really can operate all over the body and you know the

I think your real question is the stakes part of it. And I never, it never dawned on me that there would be a negative to that. Like it was always like, well, these are just the stakes. Because I was so interested in the field that I never once stopped and said, well, how am I gonna process this every day? Or what's it gonna feel like to have to do that or tell people that? And so yeah, it was really primarily just a love and a

Josh Felgoise (30:12.814)

an urge and a push to do it internally that I can't really describe. But I can blame my parents for what I mean, I could go, I feel like in a thousand different directions from what you just said. And I think what you do is really cool. So what have you learned about life and the meaning of life from what you do? Life is a gift. And and none of us are owed anything at all. And

You know, brain tumors and, and spine tumors and any sort of cancers, accidents, they don't give a shit who you are. we treat celebrities, we treat, you know, homeless people. the same disease affects all humans and it does not give a shit. And, and time doesn't matter. You know, it doesn't matter that you're young or you're old, like the world and, and probability and the universe does not care. And so, you know, that

It's the great equalizer, right? It's the great reveler of everything and I think that Gives me perspective every day and I talk about this with my wife all the time where I'm like I just want my kids to come to the ICU and take a walk around but I know they're too young to understand what they're looking at because what they're looking at is mortality, right if they're looking at how easy Everything can go away. Yeah, or change in a major way, right? And I think that's I every single patient story

I think that's why I do this, honestly. It's just every story is so fascinating to me. And I love to watch someone digest what I'm telling them. And then I love to watch their response to it, both, you know, what they say to me, but also their response. Like, how do they live afterwards? Do they fight? Do they, you know, who do they rely on? How do they handle it? Because it's just, it's so fascinating the one million individual stories and the one individual, one million individual responses.

No two people do everything the same way and you just it's just like I was saying about reading right? It's you know, your beliefs are based on your experiences and I get to experience every single life that I operate on At the end of their life, you know if it's cancer, yeah, not always fortunately I do other stuff too. Sometimes we actually help, know, we not sometimes we often help people Of course, of course, but because my specialty is oncology. I do deal with a lot of terminal illnesses

Josh Felgoise (32:40.332)

And so that is, yeah, think if anyone was ever given the opportunity to go and just watch, don't say just watch, just watch kind of the interactions. The doctors don't matter, right? Look at Grey's Anatomy, right? Grey's Anatomy, guess they did some people development, character development, right? But if you look at the documentaries that have come out about medicine that have been successful, you need...

Or look at SVU. No one cares about the characters in SVU. You care about Mariska Hard-to-take because it's been on for 40 years, right? But like the story is what gets you. the story is the people. It's their interpretation of life. It's their response to adverse events. And it's their ability to either overcome or succumb to those things. you watch that every day. That's all I watch that.

I spoke to 11 patients this morning. I watched that 11 times today, right? And that's just my morning. So like it's a truly fascinating and indescribable thing. And you and I were talking about it before too about what is it like to save someone's life? Because we do, right? If someone comes in with a big brain bleed, we take out the blood and they get better. Or I've got the people I'm operating on tomorrow, They have a big tumor pushing on their brain. I'm gonna take it out and they're gonna get better.

that their brain's gonna function better, because we're gonna remove that pressure and remove everything. That is, it's not something I can easily describe. And actually after this, I'm probably gonna think a little bit about it, so that the next time I'm asked this question, I can give a better response. This is a great response. But it's just, it's, you know, it just gives you so much perspective. I imagine that this is what childbirth is like. But like.

I'm probably gonna get a lot of hate for that. No, no. Because you're bringing an actual life into the world and it's perfect and wonderful. But yeah, waking someone up as just like a part of your day is wild. Yeah. This is wild. Yeah. How do you deal with those 11 conversations you had this morning? Like, I'm assuming not all of them were good conversations, right? Yeah. No, it, you go back and forth. think it depends on the type of day it is, you know?

Josh Felgoise (34:58.414)

I think the way to process delivering bad news is to tell the truth Because the truth is the truth. It's fact and you're not at fault for fact You are you know, you should be thanked for fact realistically And so that protects you so you tell the truth when you start to sugarcoat things or bullshit people all of a sudden now You're treading, you know, you're on thin ice because you can quickly become a bad guy

Right of you. Well, you didn't say that right or you didn't tell me that or I didn't think it was gonna be this bad or whatever But you also never want to destroy someone's So, you know a lot of it is about managing expectations when you talk to people But truth is the foundation of that you build everything on the truth. And so Yeah, I think you know it It's a lot of up and down always especially when you're with oncology. Yeah

And you I do a lot of listening more than anything, you know I deliver something and I you know Just wait. Yeah and see what people say. What are their questions? You have to make sure you hit the major points and then you just pause and let like let life happen, know Yeah, yeah a lot of times the questions come later because there's a processing time, right? Yeah, how do you as Randy like how do you come back to your desk and like resume normal day or like go back to your kids and wife?

after all of that and just like resume life. Yeah, it's they're separate. mean, ultimately, this is this is career, this job. I mean, I treat I think that I treat patients like family. But it's ultimately, I can draw a line. And I've learned that. And a lot of that is just repetition, right? You know, we don't always have we have complications. If you if you're, know, if you do surgery long enough, you're going to have a complication, right?

And I've had bad complications. had, I had a young guy last year who had just a terrible tumor that was neglected for a long time. And he came to me and it was terrible and it was hard. And we designed a surgery and it just, it just didn't work. And he died from his tumor. And, that was a super hard case. He was, he was not old. had kids. but I was honest the whole time and it affected me. Cause that's also, it's a, it's a, that's a technical thing, right? When, if my surgery hurts someone, like I can easily say, look, I didn't put the cancer there.

Josh Felgoise (37:22.912)

Right, I can back away right right, but if my surgery negatively affects someone that's a me thing Yeah, how many people have you injured or maimed in your life? None none right? Yeah, it's a weird. I haven't saved any well Yeah, but it's true, but it's not trust me You probably have more than you know, know, maybe someone listened to this and change their you know outset in life I hope that right and we can talk about the effects of things like that You were asking an interesting question before that we can get back to you but

Processing internally when you physically hurt someone is really tough. Even though you're trying to do the right thing and you're trying to help people. Because it's just, it's a crush to your ego, to your confidence. And you have to process it. You have to learn to process that. And you start by watching. So I've had great mentors and I've seen complications and I've learned to deal and I've watched how they deal with it. That's part of training. And then you have great partners.

And so when those things happen, I go next door and I'm like, look, this is what I did, this is what I did, this is what I did, this is what happened. And I get a, you you did your best or we could have done this differently and this is how to process it and this is what you should think about or a different perspective, because it pulls you out of your hole, you know? But no, have to be able to leave it, you don't leave it at the door. Like I said, you take the lessons home with you. And so what I often do is I go home and I just, you know, I'll sit with the kids and I'll have dinner and that's it.

You know, they have no concept of this stuff. They're just like, they're just little people who are happy. And you can at least, you know, put it in the back of your mind until they go to bed and then you can ruminate a little bit more. Yeah. Yeah. Yeah. But at least, you know, that's kind of, find, you find your sources of, um, of comfort, uh, and your support systems, you build that and you get used to it. So when there is a complication or something does go wrong in surgery, how do you remain calm? Like, do you have any techniques or tips that you can share that?

There's an old saying, check your own pulse first, because you have to be calm. So if you panic, everyone panics. And I may not be the leader of this ship, this enterprise, but in that room, that's my room. Everyone there has to choreograph and we have to work all together. But at the end of the day, I'm kind of captain of that ship because my hands are the ones in there. And if you lose your head, everyone loses their head.

Josh Felgoise (39:47.95)

then you're barking orders, you're yelling at people, they're hurt, everyone's hurt. know, everything's gonna get screwed up. So you learn through watching. Again, you have good mentors who teach you this stuff. And you have to have that inside your heart and inside your brain that if something's going wrong, you have to stop and pause. And you have to think back to your training, because you've done this. And if it's something new, you better find something analogous quickly. And you need to just pause. And that's step one.

And then once you regain a little bit of composure, you get control. And that's it. And then it's very, very, you do this. I need you to do this. I will do this. And then we will regroup in a couple of minutes and then you reorganize. Got it. And actually, it's funny. I'm a high octane guy. But in the operating room, especially in those situations, I am middle of ground. That's it. I am just, I'm there. I'm zoned in.

In complications, the same exact way, I do not panic. It is a, what are we gonna do, how are gonna fix this? And a lot of that's internal, and the external part is, you're gonna do this, you're gonna do this, and this is how we're gonna fix this. How do you prepare for surgery? I get nervous when I have something big tomorrow, like a presentation. You have two huge surgeries tomorrow. big surgeries tomorrow. How do you go to bed tonight? Do you think about that? And then tomorrow morning, how do you prepare? How do you keep your nerves low? All of it.

Yeah, I mean I take it pretty easy. You know I I get good sleep That's like it's become a priority for me without a doubt. I won't eat too much bad stuff tonight You know like I said, I'm reading a book that'll be peaceful I think about the cases actually and I think that there's a lot to be said for rehearsal And so I will spend time You know at the end of the day today probably just going in my head kind of what the incision is gonna look like How the bones gonna come off? do I expect to see based on stuff? I've done in the past you know

What is it gonna look like when I'm done? Yeah, what is it gonna look what and and? Doing that helps you make it that way in a weird way, know Because you've rehearsed it, know what you're gonna see and you know, you're gonna find And so I'll do I'll do that Kind of chronically and I've probably been doing it for two days already because I know these cases are coming up Yeah, I use this thing behind me here is that augmented reality system?

Josh Felgoise (42:06.702)

I'll actually probably later today or tomorrow morning I'll plug it in and I'll rotate the heads around and I'll get it even more rehearsal. I'll in three dimensions at what this looks like and what it's going to look like in the actual operating room. I have the brain networks on an MRI scan that I will review before the case or in the case even on the screen and we'll see this is a no-fly zone, this is a fly zone, this is where we're going to see this, this is what we're going to expect. And then it's just reps, you you become a lot more confident, becomes a lot more comfortable. I will tell you that

You know when when problems happen it's because you didn't take that time and go over it and as long as you start as long as you You do a little prep work things go fine. Yeah in the morning tomorrow. I guess what what time of the surgery is that? Tomorrow's the first case of 7 45 so like tomorrow morning. You'll do your same like workout routine 4 30 in the morning Everything I'm gonna hit the gym tomorrow's a zone to cycle. All right, I'll cycle for 30 minutes I'll do 10 minutes of core. I think also

Nice. I'll be back here. I'll have an avocado toast with some chia seeds and hemp seeds on it. and a second cup of coffee and then I'll go upstairs and I'll sign in my patient. and that's it. I'll come back down and I'll probably listen to some music and yeah. In, in the surgery, do you listen to music? Like, what do you do? What's the whole time? What, are your songs? Like what's, what's on the playlist right now? So I have, I have actually curated a playlist. you can search my name on Spotify. It's Randy D'Amico.

It's called great songs. Okay, and it's a personally curated Playlist of only songs that I've deemed are great. I'm good. Great. I love that It's about five days of music at this point. It spans the 50s 60s 70s 80s 90s It I'm very hesitant about the early 2000s, even though there are like a lot of stroke stuff on there And the 20 and the newer stuff you have to be really good to get in. Yeah, it's to be like But because it's great songs, I can't be

Extremely niche about it. So I throw in a few gems for me and I have like a punk rock background So there's definitely like Misfits on there and there's definitely like Dead Kennedy's on there And then weird pop punk stuff like Newfound Glory that just great songs. They have to be great And Blink-182 is on there too. think what are the new songs that have made it on? So Audrey Hobart sue me which we were listening to before when you came in great Tom Actually, the Romy Mars a-lister is on there immediately and it's hard for a song that just came out to jump right in Friday Yeah, but I'm like

Josh Felgoise (44:34.102)

You can just tell when a song hits. you can. And that song just hits. Other new ones, I had a big moment like a week ago. Actually, I went to Jamaica with my family and I realized that there was no Bob Marley on this mix. And Bob Marley writes some great songs. Right. And everyone loves Bob Marley. So a bunch of Bob Marley songs made it on there. Love it. Recently. I'll go through phases where I'm like, you know, it's I'm in like a like a what's his name? The guy who the 1950s girl

girl group producer who like murdered everybody. What? What's his name? I'll come. when I come to you. The Supremes and like, Rondelles and things like that. They'll get on there. Charlie XCX is on there from recently also. Love Charlie. The 1975, huge 1975 fan. So good. So they have a bunch of stuff on there. That's more of modern stuff, but it's tricky. You know, I'm not.

And I apologize to your viewers. I'm not a big Lady Gaga fan. That's okay. I think they'll be okay. Yeah. And and so none of that stuff gets on there. don't know. Leave it up. Ninety seventy five is great. I've had a big resurgence with them recently. It's like my fit because they're a band and like I'm a musician and I like. Yeah. But I like that they incorporate electronic stuff too. So good. But what else? What else is actually brand new that I really I don't think I've put much on there. Audrey Hover jumped right in. Gracie's on there. Gracie Abrams also great. I'm a

The whole department's a big Taylor Swift fan. So we'll her on. So like there's just like pop music going on while you're doing brain surgery. A a lot of punk, and a lot of like soul and R &B. went through, I mean, there's a lot of like 90s hip hop in there too. It depends on the song. That's like crazy. When NWA comes on, gets a little rough. Holiday in Cambodia by the Dead Kennedys, typically I'll fast forward nowadays. Okay. And then I'm big New Wave fan, so there's a lot of New Order and

know, Joy Division on there and like, you know, I joke around with the staff all the time where I'm like, oh man, you guys can tell what kind of mood I was in when I put this on. We're like, oh, it's got about to get real romantic in here, So you should listen to it. It's will. I'm going to search right after this. What is the longest surgery you've Probably around, probably around 15 hours, 14 or 15. Whoa.

Josh Felgoise (46:56.302)

How do your hands stay stable the whole time? take breaks. You have to. So my partners, if I know something, you know when something's going to be that complicated. So I'll say like, Dave, can you come in for a little bit? And you know, when you go to the bathroom, you grab something to eat because you can't, your sugar levels dip, you know, you're so focused and it's hard to explain. Cause you might think, well, 15 hours you're sitting in a chair just doing micro movements with your hands, but you have to think about the entire human physiology while you're there.

So you're listening to the monitoring device. You're listening to the heart and lungs breathing. Those are audible things. You're looking at your anatomy. Your hands are exactly where they need to be. When you're applying pressure, you can't put too much or too little. You're watching your car. You're just so zoned in that it is exhausting. Yeah. But not while you're there. While you're there, you're just going. And the minute it ends, you just sit and you're just like, holy shit. Yeah. Wow. It just like hits you how fucking tired you are. I'm sure.

But 15 hours, that was a big, a big benign tumor at the base of a skull. Um, in a young woman, she was, had actually just given birth and they found it. And so we took her and we had to take this thing out. It was a long day and they've actually helped me out at home. did, we did a great job. She's amazing. Um, thankfully it was benign. Um, and then the, that guy who I told you about, the one who had the complication, he, that was a very difficult case and then we're very low. I think it was probably a 13 hour, 13, 14 hours.

And so it's just, I try to avoid those, honestly. That's not my specialty. I want to be in and out of there in like three or four hours tops. Is that what tomorrow's will take? Tomorrow's will both take about three or four hours each. And that's kind of like, that's ideal because you're zoned in for about two hours of that time. There's parts that you can kind of like when you're opening this, I joke, I'm not a bone surgeon. I'm not a skin surgeon. I'm a brain surgeon. Get me into the brain and then we'll talk.

So the first parts you there so you've done them so many times that they're you're not thinking so much about those you're thinking about the brain got it You're thinking about the mapping you're thinking about how do I get this patient to be the same human being after this surgery? Yeah Because that's the priority. Have you ever done surgery on somebody awake? That's like my specialty really. Yeah, I love awake surgery. How crazy is that? It's so first of all young men are the worst young women are the best Without a doubt probably for most things. Yeah, it's unreal

Josh Felgoise (49:20.302)

The first time you do it is like a mind blowing experience. And I recommend that everyone, well guess that's not, it's an impossible recommendation, but everyone should see an awake surgery at some point in life. Yeah, I was like, well how could I actually see that? But when you actually do it yourself, it's a really kind of intimate thing. That's okay, that's okay. Because your patient does remember it a lot of times. And so you get this opportunity to like,

talk to someone and then every time you see that person you're like, hey, remember when you said that? Hey, remember when you said that? Oh yeah, remember? And I was I was looking at your brain or pieces of it. Which is a wild experience. But yeah, no, they're not actually fully awake the whole time. It's a misnomer. So you go to sleep. And then once we have everything exposed and ready to go, we wake you up and we map. And you only get about four hours to do it because the local anesthetic wears off. So no one would be awake for 23 hours. Or 18 hours.

You're awake for at most about four. And they scared? No, no, they're not. And I think it's because, you how many times have you woken up and been like, where the hell am I? It like takes you a minute, you know? Like what's going on or something. And that's what happens. You go to sleep. No control over going to sleep. And then you wake up and it's weird without a doubt. but you're, wake up and you get control of your bearings and you see people and then you remember what you're there for.

Usually it's a pretty high stakes situation and people, like I said, the stories are incredible. People rise up. They meet you. How much time do you have left? I'm good. Okay, okay. What has looking at a brain every day or every week taught you about life? We were talking about this earlier before we started recording and perspective and how you think about your life differently after working with all of these patients. Yeah, I mean, think it's, like I said before,

Life is a gift, without a doubt. Every single thing that we do is not just performed by or I guess choreographed by or marionetted by, I don't know what the term for marionetting is, is that a verb? I'm not sure. By our brain. It's also sensed by our brain. So everything that you see, as objective as it may seem, is subjective. Every experience you encounter is completely interpreted, analyzed, and

Josh Felgoise (51:43.372)

and fabricated by a big mushy piece of yellow tofu. That's it. And it's fucking wild. So everything that you see, every conversation that you have, the fact that you can understand the sounds that are coming out of my mouth and they mean something to you, it's just a piece of mushy, like medium tofu. honestly, if it was exposed and like there was a strong rainstorm, it would be injured by.

Wow. a delicate structure. And that's everything that we do. And so I think that there's no way that you can do what we do. And especially when you get into things like like, know, you couldn't move your arm and now you can move your arm because we took that thing out. It's really crazy. There's no way to do what we do without gaining some perspective on everything that happens around you and how fragile it all is and how little it all is. And, you know, I've seen things where like

You know, you can look at the universe, those pictures of like every point of light in this picture is a galaxy with a million stars and bullshit. And that can make you feel really tiny and significant. And then I've heard the other argument that that actually should make you feel even bigger and stronger because you get this life and you get this opportunity to look at these things. And I don't know which one's right. I think it kind of depends on the weather, probably, or the day. But. But it's just no, if you're if you don't do what we do and gain some perspective on life like you're.

you're in it for the wrong reasons, know? Without a doubt. So do you like think about things differently in your life? Like if you get in a fight with your wife or something goes wrong with a kid or just whatever, like do you drop things quicker because you know all of this stuff or how does that apply to your like actual relationships in real life? I think so, I'd like to think so, probably not, but I'd like to think so. I think in general I'm a pretty moderate.

So I don't think I get like I don't fly into fits of rage or anger things like that. Yeah, I definitely do Hold a standard and that is because I'm accustomed to working with very high-performing individuals and so when things don't meet that standard or what I expect or what I want I definitely I definitely can be easily disappointed I would say but I'm also very

Josh Felgoise (54:02.574)

careful, especially after you have taken tons of courses on leadership and I've done tons of surgery. I've dealt with so many people. I've definitely learned to tone that back. Yeah. You what you you said this before we were talking and you said, you know, do you ever feel like your job is more important than other jobs? And I think that's where this is kind of headed. And I ask question for you. Yeah. And it's it's not. And once you realize that because you are trained and you're brought up through all of this to think that this is the epitome of medical training and surgical training.

and this is the most complicated thing in the world. But once you realize that actually it's just a job and actually, you know, the plumber for the building helps a lot more people than you probably help on a daily basis, right? It puts that in perspective and I think that you can bring that home with you and that's what pulls me back and, you know, allows me to not, hopefully anyway, you know, be too, I guess, disrespectful or...

Like pompous. Pompous, yeah, insincere. It keeps you humble. Yeah, I well, I asked you that question with the utmost respect because I think that there's so many times in my life or in my job or in my day that I get stressed over these really small things. And I think so many young people do at work. And I'm reminded all the time of how insignificant all of that is in the grand scheme of things. So I'm assuming that is at a much...

Larger scale for somebody like you I think there may be a component of that but no I think I think honestly it's just time in life that fixes that problem You learn also with you with young people especially people in school You know, there are endpoints that you have to there are deadlines. You have to achieve things by deadlines, right in real life There's no deadline at all your deadline. The only thing that's that's happening The only thing you're racing towards is death. And so and sometimes that can show up real fast

Yeah, and so once you learn that then the little things first of all There's nothing you can't fix. So once you realize that You know, I think that gives you a lot of kind of freedom to say okay, well I'll fix this There's also I I would look at neurosurgery definitely and getting things done in a hospital treating, you know doing two surgeries Responding to patients answering emails doing research all in a day definitely

Josh Felgoise (56:29.87)

certain things a lot easier to deal with like the fridge is broken. It's like, okay, we'll fix the fridge. Yeah. Yeah. Yeah. Yeah. Yeah, we'll deal with that. but I think that, you know, the, the, the bottom line is that there's no race. There's no rush. There's no timeline. the little irksome things are just part of the story and, it's actually a stoic philosophy thing. You know, what, what is in the way becomes the way it just, it becomes part of the story. You have to deal with these things. and that can

your story, it becomes part of it. And so, yeah, no, those, just, you get better at dealing with that, I think, once you, think, honestly, I think it's just an age thing. Yeah. Yeah. What is your advice for somebody starting med school? Work hard, be kind. Love Don't burn bridges. Love that. I think, you know, yeah, that's kind of it. Once you're in medical school, you're gonna be a doctor, you know?

So I think that's fine. You got to set your goals on what you want to do and you got to make sure that you absolutely love the physiology of it, like everything. When I went through med school, even though I knew I kind of wanted to do this early on, I told you I went back and forth a lot. I made sure that I learned everything, every organ system, because all of it was going to make you a better doctor. And so what you want to be is a good doctor. And to be a good doctor, you have to understand what you're dealing with because it's all intertwined. Right.

And so I think that's it. And then don't burn bridges with anyone because you never know when you're going to need someone's help or when someone can help you in the future or who's going to be the head of a hospital somewhere or whose family member is going to need help and they're going to need you. What do you think makes you a good doctor? I don't know. I hope I'm a good doctor. I take this stuff very seriously. I play around on social media and

And I definitely enjoy like culture and activity. And when you when you do things like that, you become visible. I think people can look at it and say, you're not genuine about your craft. You just want to be seen or sue me. I want to be wanted. Right. But I think that. I think that that's not necessarily the case with myself, or at least I hope it's not. I really care about I think I do a good job. I'm not perfect without a doubt.

Josh Felgoise (58:56.984)

But I think I do a really good job and I think I really, really care. And the reason I do those things is more because part of doing a really good job is I need patients to trust me. And if these ways help me get patients to trust me, then I get better. And so it's all a way of making sure I'm treating patients better. I'm getting better at my craft and it's all part of the journey, right? All of these things, again, they fill that history, that experience library to just, you

to make you more complete individual. So what is the biggest misconception about your job? I don't know. Probably something to do with Grey's Anatomy. That that's right. Yeah. I have no idea. What do people think about neurosurgeons that they're all brilliant? We're just human beings. I think that is true. Yeah. Like I think we're all just we're all just human beings trying to do a job. And I think I told you before, I think I think that rocket science is way harder. I think programming A.I. is way harder. We

You we have to learn a map and we have to be willing to go in and do something to that map, right? But that map is only like this much of the body. Right, right. So it's not really that complicated to learn when we can learn lots of other things. What do you wish everyone knew about protecting brain health or making your brain better? Like what would you tell everybody about that? I think that, you have to you have to just put what you're doing in the context of humanity.

Right? Evolution created us from something and we are evolving and we have all these cool toys and we're going to have to live and use them. But at the bottom line is what is natural? If you're doing what's natural and it's, it's probably not wrong. Right? Yeah. And that's it. And think about how humans evolved from, you know, nomadic tribes wandering and what they were eating and how they were sleeping and what their communities or social structures looked like. Anything anti that is probably wrong.

because nature is perfect. That's it. That's really good answer. It's a great answer. Is there anything else young guys or young people can be doing to protect their brain health or make our brains stronger? Well, obviously, I told you, you got to use it or lose it without a doubt. Challenge yourself. Yeah. I think young men in particular right now are in a really it's a tough time without a doubt, because even if you are

Josh Felgoise (01:01:22.222)

the most genuine person, your history has put you under the scope in harm's way, in a weird way. And it's for a reason, right? Men have done fucked up shit. And so I think shut up and listen to the other opinions and look at the other viewpoint and especially look at the viewpoints that aren't shoved down your throat.

in a masculine, like, I'm a man fashion, right? You know, be open-minded to that because the truth is, that that's real life, right? Like this other bullshit is just, it's painted, it's fabricated and it was created by men for men. And so you will be a better man, a better human if you just appreciate that, if you appreciate humanity for being this diverse thing and that's it. I love that.

And then what is your advice to your younger self?

do more drugs. What a perfect way to end this. Thank you so much. This was an incredibly interesting conversation. Seriously. Sorry, I have sweaty hands. Don't worry about it. Great to meet you. I appreciate the time. I loved this. This was really cool. And I think you have an incredibly interesting perspective that I think a of people are going to learn from. I hope so. Yeah. And reach out if anyone has questions or they're interested in medicine or neurosurgery or doing research or if they have ideas and they just want to share.

Share your email and your handle your social media social media is just my name Randy D'Amico. Yeah, I'll put it below in the email find me on social I'll give you my email. Okay that ambitious you'll get it. Okay. All right. Thank you so much. Thanks That is the episode thank you so much listen to guys set a guy's guide to what should be talked about I'm Josh. I'm 25 years old 25 now. Yeah. Oh my god. It's crazy Fuck what I was gonna say

Josh Felgoise (01:03:15.822)

I'm Josh, breaking my result and I'm here every single week, every single Tuesday to talk about what should we talk about for guys in their twenties. If you liked this episode, I really hope you did. Please like, subscribe, give this podcast five stars. Let me review that's one, two, three, four, five stars, not four, not three, not ten, one, it's five stars. Thank you so much for that. I really, really appreciate that. If you have anything to talk about that should be talked about for guys. There are 20 sent to my email or my DMs. The DMs are at the guys at thgguiset on all social media platforms, Instagram, TikTok, YouTube, whatever. And my email is josh at guyset.com, josh at guiset.com.

or you can also leave a note on my website guys.com. There's a little box you can leave right there and I'll be sure to talk about it. Thank you so much. Listen to guys said a guy's guide to what should be talked about and I will see you guys next Tuesday. See you guys.