Jocko Podcast - 397: Your Body Is Not a Rental Car. With Dr. Matthew Provencher, Naval Special Warfare Doctor

Episode Date: August 2, 2023

>Join Jocko Underground< Dr. Matthew Provencher is one of the nation’s leading orthopedic surgeons specializing in the surgical treatment and rehabilitation of injuries to the knee and shoulder.Captain Matthew T. Provencher, MD MBA MC USNR (Ret.), a native of Barrington, New Hampshire attended Oyster River High School in Durham, New Hampshire and then the United States Naval Academy, where he was appointed the Deputy Brigade Commander (Second in command), graduated with Distinction (Highest Honors) with a Major in Electrical Engineering, and was designated as Secretary of the Navy Distinguished Graduate. He was also inducted into Phi Kappa Phi (The National Honor Society), Tau Beta Pi (The National Engineering Honor Society), and Sigma Pi Sigma (The National Physics Honor Society). During his undergraduate years, Dr. Provencher was also a 4-year varsity oarsman and First-Team All-American at Navy and named Most Valuable Oarsman. He completed his medical education at Dartmouth Medical School where he graduated with Honors and was elected to the Alpha Omega Alpha Honor Society.Support this podcast at — https://redcircle.com/jocko-podcast/exclusive-content

This is the Jocko podcast number 397 with Echo Charles and me Jocko willing good evening echo good evening The president of the United States takes pleasure in presenting the legion of merit to Captain Matthew T Preventure Medical Corps United States Navy for exceptionally meritorious conduct in the performance of outstanding service as the command medical officer at four sea air and land seal team 17 from June 2013 to June 2022. Captain Proventure displayed extraordinary leadership, world-class professional

expertise and provided unmatched care and treatment for the service members within his command and throughout the Naval Special Warfare Community. He was instrumental in the implementation of policy, processes, and procedures that optimize the operational readiness of both reserve and

active force seal operators. A world-renowned orthopedic surgeon and educator, he delivered databases to track treatment efficacy, wearable devices that provided remote assessment of individual motion patterns, and leading-edge science that will improve human performance and longevity. His contributions extend far beyond the Naval Special Warfare medical community to programs and cutting-edge science treatments that have been adopted by the Navy and Department of Defense. Captain Preventures, superior performance of duties culminated in his 27 years.

years of honorable and dedicated military service. By his dynamic direction, keen judgment, and loyal dedication to duty, Captain Proventure reflected great credit upon himself and upheld the highest traditions of the United States Naval Service. And that is an award. That's actually an understatement. It's an understatement for someone that had a huge impact on the SEAL teams, putting broken seals back together. I had one of my friends tell me about Doc and he said he repaired both my

left and right shoulders my left one after a vehicle roll over in Iraq 2008 he's been a huge reason I've been able to keep pushing my body so hard him and others like him are the unsung heroes of the seal teams helping hurt and damaged guys come back and operate again I and so many other seals appreciate him with the greatest sincerity and that is the truth guys in the SEAL teams get broken it's a rough job it is a rough job and guys like doc preventer put us back together again and on top of that this group that he headed up spearheaded injury prevention optimal human performance including strength and conditioning, nutrition, brain health, mental wellness. And they do this with experience, knowledge, and patriotic passion and an unmitigated commitment to the SEAL teams. After being the

lead medical officer for the SEAL teams for almost a decade and then working at Mass General in Boston and being the head team physician and medical doctor for the New England Patriots, Doc Proventure certainly has some incredible knowledge on all these different topics. And it's an honor to have him here tonight to pass on his experiences and lessons learned from this vast experience. Doc, thanks for joining us. Jocko, Echo Charles, it's a great pleasure. Thank you.

Truly honored to be here tonight. So we have to recap something here because once again, you are another witness. and I believe the first time I remember interacting with you was to check my bicep which had been injured. I was doing jiu-jitsu and my my bicep had popped, made a noise and I came in to the, what do we call it, the human performance center? What was it called? Yeah, medical.

The medical. I go into the medical and I go in there and I see Jason who's who, who, who, who, Help me with some little tweaks here and there to look at my bicep. You did an assessment of my bicep. What was your assessment of my bicep? Joccoe, and what I recall was you were in some kind of hold. And, you know, you felt this pop pretty classic at the elbow.

It's almost always a rupture of the biceps tendon. Where it attaches into your forearm. And it's pretty important for someone like you and what you want to do, be able to move the forearm right and also biceps hold. and looked at torn your biceps. And in general, for someone like you, that's something we take to surgery to fix because you need to have that right.

So you said to me, hey, look, Jocko, here's this situation. You got a torn bicep, and this won't heal. This is, you need to get surgery. And you scheduled the surgery right there. You had the little computer system. You scheduled the surgery, and it was maybe three, four weeks away.

And you said, okay, in, Whatever this date come back in here for your pre-operation check. I said, Roger that you know, I'm one of those people if I got a problem and you tell me how I'm gonna fix it I'm ready to go like I'm not gonna wait around. Let's do it. So I come back three weeks later for my pre-operation tests checkup and you're there and you look at my bicep and what had happened I couldn't believe it, but it actually healed. I mean, he had no strength deficit You had complete restoration of function. I don't know what happened. I mean, you knew something was wrong a couple weeks prior. And it's kind of the first time we could get you in for surgery. We knew we had to get you in a couple weeks before this tendon got, the muscle got too atrophied and it was harder to repair.

But I said, what the heck is going on here? This thing is, I've done, I'm testing. And I'm like, Jason Jagged who's there. And I'm like, Jason, what's going on? He's like, I don't know. It's healed. got full strength. He's ready to go back in the fight. So there you go, Echo Charles. So Echo has, he told me when I first explained this, because he's had both biceps torn, both bicep

tendons torn. He's had surgery on both arms. And I told him after his first one or maybe after a second one, I said, you know, when that happened to me, I just healed it. And he did not believe me. He did not believe it. It wasn't until we had Doc Parsley on here and confirmed. And now We've got the second witness. Yeah. Echo, do you accept now that Wolverine blood is a real thing? So when Doc Parsley came on, I was like, he was like saying it. I was like, this something you guys are missing here.

I know that already, but I was 50% convinced. So I was like, okay, maybe, you know, he's a doctor after all. So whatever. And then yes, yes, sir, I believe it now. The other 50% right now has been confirmed. And I think I remember talking to Parsley about that as well. And I was like, what's going on with the system here? This is almost always something we fix.

There's no tendon there. It's like one of the easier diagnoses we make. I feel like I'm pretty lucky. I've been, you know, actually, Echo, you described to me one time as being durable. Yeah. And I would say I'm not, I'm definitely not the strongest person. I'm not the fastest person. I'm not the smartest person.

But my durability level seems to be good. Very good. We're appreciative of that. So, Doc, seriously, all the guys know. know what you've done in the SEAL teams and how many people you've helped. And it's not just the SEAL teams because you were working on everybody in the military and we'll get into that. But let's start off with the beginning.

Let's start off about how you became who you are. Let's go. Where did you start? Born in New Hampshire, is that right? Yeah, born in a really small town, Jocco in New Hampshire. It's maybe 2,500 people, a place where the general store is the post office, didn't have a traffic light. We didn't have cable TV.

We had a channel or two maybe on the television with the antenna. that you had to, my dad and I had to get up there and fix all the time. And you had a little dial that couldn't point the antenna to get the better signal on this motor. We got that motor. It was great. We didn't have to go out and rotate it manually. Yep. And then the ice and the snow and everything would jack it all up. So we grew up in the woods and we were close enough to the beach that we took care of advantage of, took advantage of everything out in New England and New Hampshire.

It was a great place to grow up as a kid. Love being outside. What did your dad do? My dad, so my dad was a naval academy grad. Okay. He was in the Navy for a while. I was born in Newport, Rhode Island, actually. And then we moved up to New Hampshire, and he was by trade and engineer for a number of different companies.

Was he a surface warfare officer in the Navy? He was. And you know, it's interesting, Junko. He had USMC inscribed in his Naval Academy ring. But at the last minute, switched. Interesting. What year was that? That was 1969.

He graduated. What made him make that decision? I don't know. I mean, I think it was different times then. I mean, you didn't remember Vietnam War. I was going to say it's 1969. Exactly. So I think there were some changes there and, you know, mindset. And, you know, when I was at the Naval Academy with some many of your great colleagues in the SEAL teams, we, it was a great place to be. And I know it was very good when he was there, but the political climate made it sometimes a challenge to be at a place like Annapolis. So how long did he do in the Navy? So he did just over five years and got out of Newport, Rhode Island,

and they moved up to New Hampshire and after I was born. And my brother also was born a few years after me. He's three years younger. And he also went to the Naval Academy. And he got the much better genetics, as I say, because he's the F-18 pilot. I wanted to fly F-18s at the Naval Academy. That's why I went.

Top Gun first one had just come out. I mean, it was great. You're like, oh, this is awesome. I want to be able to fly a jet or be a seal or, But while I went to the academy, my eyes went down to like 2050. Yeah. And you didn't have any recourse. And so that's sort of how I defaulted into medicine.

But my brother got the good eye, so he's the F-18 pilot. Now, guys get LASIC, I know now for the teams. Can you get LASIC for flying too? You can, yeah. Yeah. So you can get PRK, LASIC. They had a bunch of different rules and what you can and can't do because of the Gs and the pressure and the dive and the unique seal requirements.

So it's definitely open it up. to more people that just because of eyesight couldn't go before. So before you got there, before you went to the Naval Academy, you're going up in high school. What sports did you play? So we did a lot of team sports, basketball, baseball, the usual stuff around there. Did a lot of skiing. Did a lot of backcountry. Did a lot of backpacking.

Did a lot of, I work for the Forest Service, actually. And it was with their kind of mountain patrol, mountain rescue. So we're always, I guess it was probably my first introduction of medicine. I know when my family was in medicine. So I had no idea what this was, you know, career was going to take me or what I was going to do. We knew Navy. We knew military in my family, but didn't know medicine. Did you, so did you know from basically this time you started looking at colleges that you were going to try and go to the Naval Academy?

I had looked at a bunch of different colleges, but it was definitely high on the list. Definitely because of top gun, because I wanted to fly because I wanted to be a seal because I wanted to do these things. Was it hard to get in? How hard was it to get in? It was hard. Yeah. There's a lot of, you know, there's a lot of extra things. got to do, but you know, you go through the process, you know what to do, you know how to do the interviews with your congressional folks, your senators in the state, and then you do the, you know, just like another college application. There's a few more hoops you got to jump through. But you were getting good grades this whole time? I was doing fine during high school and we had

a really good high school as a public school that we went to. My parents actually, I mean, an amazing sacrifice. They had to drive my brother and I to high school about, you know, 20, 25, 30 minutes every day. And sometimes we got rides with folks. But I mean, there was no bus service to the high school we went to. So we had to kind of figure that out and after school things. And now I'm forever indebted and thankful for them to give me that opportunity. And you, but you get into the Naval Academy and you show up to, uh, Pleeve Summer. How's that go?

Uh, miserable. It was awful. Chuck was freaking awful. I was like, why? Because this guy does not do well in heat. I go to Annapolis, Maryland. It's like 99 degrees, 100% humidity, and I was like, this is going to put me over the edge. I'm like, I'm going to be out here in a week.

But, you know, fortunately, just I was able to find ways around it, find a way to adapt, and you sort of get used to it. I mean, you know, you deployed forever in different environments and weather and condition and everything. And the stress of weather can't be overestimated in our field, you know, in the military. It's amazing. And so just plebe summer was part of that package for six, seven, eight weeks. I thought I was going to, like, be out of there in a week. What about just like all the, you know, shock and awe of people yelling and screaming?

You just prepared for that mentally and you knew what was coming. Yeah, I did. And you know, it's not personal. You know, but it's hard. You're starting, you know, you're 18 years old. You're starting freshman year. And you're like, oh, what's going on with this? And why are they after me?

Why are they singling me out? And anyway, you know, you're just like, what did I do wrong? I didn't make my turn right. didn't make my bed right, couldn't bounce the right quarter off it. My t-shirts weren't lined up right. There was always something they would find. There was a speck of dust here. There was a speck of dust there.

But what was amazing about that process when you look back, the attention to detail, the ability to quickly memorize facts, figures, information was just amazing. And my brain sort of worked that way a little bit, but it certainly got fine-tuned there to be able to memorize stuff really quickly. Michigan Proventure, noon meal, go. What is it? And it changes every noon.

Okay, menu for you a meal, go. And we all know that from the Nail Academy. You're like just all these facts and everything you got to memorize there again and again and again. But you're like, why are we doing this stuff? When you walk away, you're like, that really trained my brain incredibly well. So when I went to medical school, it was like easy. I don't want to say easy, but yeah, I was ready. Yeah.

So you are going through the Naval Academy now. And what was your major? Yeah, so I still wanted to fly. I didn't know. You do your medical junior year. It's called your pre-commissioning physical. And so I didn't really know my eyes. It was kind of squinting a little bit to see the board.

I did have some glasses. But it wasn't that bad. You know, I think it was fixable enough that I could do it. So I studied engineering, and it was actually electrical engineering. And of all things. And so not biology, not oceanography, not some of these other major. that could be a little bit more leaning to doing medical as a career. So I was probably the anti-none-medical.

And, you know, with that, we also did some, you know, leadership positions and other things that, you know, all of my mentors there, you know, thought I was going into the regular fleet. I was not, I was going to be a line officer. I wasn't going to be a staff corps, medical staff corps. And you're doing, you were a rower, right? I was, Jocko, yeah. And then how did you get into that?

So I had done a little bit in New Hampshire growing up, and then during PLEB summer, they rotate you around through every sport. They make you play squash and go out to do football and baseball, and they take you out to the rowing facility. So everyone sort of goes through all these sports every afternoon part of Pleeve Summer. It's like it wasn't Pleebs Summer. It would be a great camp because you could do every sport at the Naval Academy. The facilities are amazing. I was like, nah, this is pretty cool.

Boathouse is a good spot. I like the people here. I like the workout. I like the ethic. I like the erg machine. I like the weights and staying in shape and getting in shape. And I liked also just being out in the water. I'm the water guy.

I like the water. That's probably why I picked the Navy over something like Air Force or West Point, which I also applied to. Did you get into West Point? I did. Yeah. I did. And I think I,

I know, Air Force might have weightlisted me or something, but I wasn't going to go there. So you're doing rowing, but you end up being a pretty good rower, is that correct? Well, I mean, joggers, you know, rowing's a team sport, a team, team effort, but there's always all these individual tests, what they assess you on the erg, and all these bench pulls and things like that. And, you know, did okay. But we, you know, it was a team sport and kind of the ultimate team sport that,

as I think of it, and, you know, certainly others will disagree with me. But the amount of precision required to get, you know, the oar in exactly the right, point something milliseconds and it just makes the boat go better. It almost lifts and takes off and it's effortless. And so to have that precision, the strength, the application of force at the right time, to know the right technique is really, it just appealed to me. I love row. My brother also rode and he was a very good rover much better than I was and he did some,

you know, Olympic team tryout stuff in and out. But I did a little bit of national team try out stuff in and out for the a couple years after the naval academy and and for a couple years after so you know they sort of test you and look at how you do on the erg and see how you move the boat what can you row 500 in to be competitive for that 500 meters yeah so you probably looking at 1 30 or under 125 so 120 now I am not the biggest row I was in an out of a lightweight heavy weight we have a lightweight category. So, you know, my brother would make fun of me because he's 6.5 and 225. He's not a lightweight. So he would crush the erg. But for the, my body class was a

pretty good, pretty good time. You go to the world rolling, the world erg championships in Boston they had every year, and you compete against all these people from Denmark. And so those were, I mean, those are kind of fun to see. And it was a great existence for me while I was there at the Naval Academy. I made it a great, great team. great sport and just really completed the package for me there. Are you doing that sport year round? We are. At the Naval Academy?

Yeah, we are. Really consumed your life, but in a good way. So you said in junior year is when you get your medical. And how long after you get your medical do they look at you and say, hey, you can't see well enough to have any of these jobs that you want to have? Right away. They're like, here's your list. And they just hand you the list and, okay, where, what ship do you want? Do you want to go Marines?

Do you want to do these other things? Surface Warfare Officer, et cetera. And I said, well, I mean, those are all great. I'm not against my dad of surface warfare officers, we discussed, but I didn't know where, I didn't know really where I wanted to go. And I had a couple great mentors, one of them being this guy, Dean Kelly. My dad, I don't know what to do. I got disqualified for flight, disqualified for seal, all these other things.

He's like, all right, go see my chemistry professor there. His name was Dean John Kelly. And he was actually, my dad's chemistry professor, but he had kind of fleeted up to Dean of the entire academic side, civilian, dean, not the military side. And they have two sides. A military and a civilian side. And I go in and see Dean John Kelly in his classic meeting.

I go in there and Michigan, Proventure, do, do, do, do, do, reporting. And so, oh, get in here, Professor. I'll talk to you. Yeah, you got some pretty good grades here. You're electrical engineer. Okay, here's the deal. I pulled your dad's folder. Hold on. He rips his classic professor, books everywhere, dust, stacks of files and folders and

open it up in the folders. My dad's, he's like, oh, I tried to get your dad to go to medicine, but he wanted to go be a Marine or something written down. He had my dad's folder from 1967 or eight or something like that before he graduated. He's like, he ever thought about medicine? And he's like, well, my dad's something here to talk to you. You got a great connection with him. and it's amazing you're still here. And he's like, well, I run the medical program here at Naval Academy. We allow 15 graduates a year to service select medical. And I said, tell me more about that, sir.

I'm very interested. What was it that was in your mind because they couldn't have sold me on the medical program? So did you have some like nascent thought about being a doctor at some point? Only that we did some ski patrol stuff. We did some of that mountain patrol, the Forest Service. We took some of these wilderness, you know, first aid courses they had to do to be able to do that. That was really my only introduction. I had no idea, like, even how long medical school was, what it was, or how to do it or what, even a residency.

I had no clue about any of this stuff. And they take 15 people. 15 out of about 1,200-ish or so we graduate. Yeah. So you decide at that point, like that's what it took? Did you, that was it? I did, but, you know, to be honest, I was a little nervous about it because I had a couple jobs. I had a leadership job.

I was a deputy brigade commander, the second in command of the, at the time, we're trying to sort through it. And had this guy, Colonel Terry Murray, who was very well known. He went on to become a general, but he was colonel of the time. He was the deputy commandant and the commandant of the chivin and the superintendent. And you get to know these folks. through all these leadership events and you go and have, you know, just incredible opportunities at that place. You know, like, Preventure, get over. You need to go to dinner at the superintendent.

So I'm like, oh, what's going on? I got to go study. I just tired. I'm just worked out. Just finished rowing. They're like, well, it's Margaret Thatcher. You got to go hang out. You know, so you get like some really cool experiences looking back when you're at a 15-person dinner and, you know, a couple of midshipmen there and they yanked you to go.

So I'm very, very thankful for that. But at the end of the day, I still had no idea what the hell I was getting into. So then what's the application process like to get into the medical program? Yeah, so I finished up at the Naval Academy, not to bore you with too many details, but I didn't have all the requirements. I was going to say, did they make you start taking other classes on biology or whatever? Yeah, but I didn't have enough time. And so Dean Kelly was like, Preventure, you got to graduate electrical engineering. We need, you know, we got to keep our electoral engineering graduate numbers up.

We've got some site visits from whatever academic organization follows call and whatever. And we'd love for you to stay and graduate double E. And then we'll find a way to make it happen that you can finish up your requirements and take biology and organic chemistry and a couple of others. Actually, I had most of them. You know, the well-roundedness of the education in the ABLE Academy is amazing. So I had almost all of them, but I needed a couple. And so it actually worked out that I was going to be trying out rowing, working with the U.S. national team. out of Boston in Philadelphia, Princeton, San Diego.

We had a couple different setups going on, but mostly based out of Boston. And that's where I started taking my classes after I graduated and worked there. I was in the Navy. So they gave you some kind of a normal job, some kind of a gap-filled job, and then you could go to school.

Where were you going to school? I went to Boston College, Boston University, just took these classes with a bunch of freshmen and sophomores. It was great. And in the meantime, you're applying to medical school. Mean time applying to medical school. And then you get into medical school. I do get into medical school.

I was a little worried because I was taking all these, you have to take this ridiculously long, like seven-hour test called the MedCat, which is the medical college emission test. And it's, I look back on that now and I was like, I didn't have really biology when I took the test. So I kind of learned it on my own. And I did, I didn't blow it out of the water, but it did okay to get some looks at schools.

And then I ended up getting in several places, not a lot. I got rejected it a bunch, and I was like, oh, this sucks, what am I going to do? And the navies, the Navy's calling me, and they're like, hey, we need to get a, we need to see a letter of admission from a medical school, or we've got a ship for you waiting Ensign Preventure down here in Newport, Rhode Island. You're going to go to Swas. The USS Never, Doc. You got it.

I was like, dang it, I got to get this letter. And so I finally got into a couple schools and was able to get them the letter. And then where did you end up going, you know, going to Dartmouth? I did, Jock. Yeah, I went back up to my roots up in New Hampshire, up at Dartmouth. and I was four years of medical school up there and I loved every minute. How crazy was that? You go from being a plebe and then a midshipment at the Naval Academy.

You got people yelling at you and all these uniforms you got to wear all day. Did you have to do any of that at Dartmouth? No. Zero. No, in fact, well, actually, the only thing I did was kind of fun stuff. They made you do like 45 days of active duty training because I was on a four-year deferment for medical school. So didn't wear the uniform.

I think I... Are you getting your name? Navy pay? You get an ensign pay? No, no, not at all. Now, if I had gone to the military medical school, EUSS in Bethesda, you would be active duty during that time. So I was not active duty for four years. So they basically, and it's a great deal. It's called HPSP, but it's a scholarship. For those lists out there, it's a great deal. I mean, they, I get out of, you know, undergrad and med school with no debt, zero. And they, you're not getting paid a lot. I mean, you get a few bucks a month but they're covering tuition books and fees which ain't cheap what about

housing no just they give you a stipend per a month check it's a little bit different when I was reading your bio I was like oh he was going there with a big fat paycheck I didn't know that you they took your pay away from you that's rough yeah it was a little it was a little rough I took a small loan you know which obviously since paid off but just just to get through Dartmouth but it was a great four years there I didn't I didn't have to get my hair cut every, you know, 10, 14 days down at the midshipman barber shop. I, you know, maybe cut it every three to six months and just did a lot of other stuff

and focused on med school and living back up in New Hampshire. How far from, like, where you grew up, what, were you at Dartmouth? It was about two hours. Oh, so you were going home for Christmas and Thanksgiving or whatever? Yeah, probably more often than that, like, like mom's cooking. And how hard is medical school for you? It must have seemed like a little bit of a breeze. I mean, honestly, I know it's hard and all that.

But compared to being at the Naval Academy where you had these tests and uniforms and inspections and all this other stuff going on and you're rowing. Like you had a lot of stuff going on at the Naval Academy. Now they're like, oh, no, all you have to do is study. Yeah, well, Jaguarial the most interesting thing for me was, you know, at the Naval Academy, you've got no choice. You've got to go to class. You don't go, the only reason can get out of class is if you have a movement order where you're going on a rowing race. You've got a varsity rowing competition up at Princeton or San Diego or whatever. That's the only way you're getting out of it.

So I get to Dartmouth and they're like, hey, are you even going to go to class? Are you going to show up? I'm like, what? I don't know what this means. Anyway, I went to a lot of the classes, but not all my classmates did. I just learned well that way. I was engaged. You're locked in.

You're falling in the process. You're with the professors and learning alongside them. So I didn't go to everything, though, which is kind of nice. I didn't have to sign all these movement order things. things to get out of stuff. Do they have like fraternities up there? They do for undergrads. I wanted to join one, you know, somehow because I didn't have it as an undergrad.

But they rejected you because you were a postgrad? Too old, yeah, yeah. It looked to me kind of funny. Now, while you're there, is that when you picked orthopedics? I did, yeah. And so this is interesting. You meet these great people that help steer your career along the way. And I know you've had that jocco and you make decisions and you don't know like going to see John Kelly and going to medical school.

Well, I got injured, you know, rowing. It's not like, it's like being a seal and all the injuries you get or an NFL player, but we're playing football in college. But I had a couple of injuries that took me out for a little bit of time in rowing and during some critical times. And so I went to see one of my first mentors who I learned was. this guy, Captain Eddie McDevitt, he was the head orthopedic surgeon at the Naval Academy, and took care of all the sports injuries, and I learned, what is this? This is kind of cool. And so what I didn't tell you is, you know, it was a little easier for me to select medicine because I had Dr. McDavitt there to help say, this is a pretty cool career. You know, you can do this

and be a part of, you know, great community and give back and do orthopedics and serve the Navy in other ways. And so it was really good to have that mentor. but he helped me see what sort of sports medicine and orthopedics was. And I said, this is really cool. Now, of course, I dated a bunch of other specialties like dermatology and plastic surgery. Echo Charles, we talked about that for your biceps. Sir, bicep implants over there. Other things, ENT and ophthalmology.

But I wanted to use my hands. I wanted to use my hands in a craft. whether if I couldn't be using my hands to be a sealers, I couldn't do it because I couldn't be a pilot to use my hands. I wanted to use my hands. And that's the weird thing about orthopedics is you're basically a carpenter or a welder. Yeah. Like you have a job to piece things back together.

Carpentry class 101. And that's so full circle. And you don't realize these things. You put them together in your life. Take a step back and take a 30,000 foot view. life and like how your passion and your energy and your drive sort of leads you to these things. This was a no-brainer for me because I was an engineer. I love trying to figure things out. I love trying to put stuff together to figure out metal-on-metal interactions, implant strengths,

the strength of the anchor we were going to use to fix your biceps jocco. We know the exact newtons and the strength and the suture and the material and what it's made out of. and I was able to walk to walk and talk to talk because I knew the language of engineering. And so for me, orthopedics was kind of this full circle I've arrived. Now, in the civilian world, you'd go when you get done, and correct me if I'm wrong, because I don't know. But in a civilian world, you'd get done with medical school

and then you go do your residency, right? Correct. That's right, pattern? So that's basically what you do at this junction in your career. You get done with Dartmouth, you graduate, you get your degree and then you go to do your is it your do they call it your residency when you go to because you went to belboa right they do yeah i did i went so babbo is in san diego uh it's one of the largest naval hospitals uh in the world there's really three big teaching hospitals

there's belboa san diego uh there's bethesta and then portsmouth virginia and in essence i was going to go to one of those three and one thing you do at the naval account is after your freshman year, you have to go do 30, 60 days on a ship. And so in the summer cruise, you got it. Yeah, exactly. So sophomore summer cruise, youngster cruise. That's a youngster, a sophomore at the academy. And so you go on youngster cruise and guess where they sent me?

The kid from New Hampshire, they brought them all the way out west to San Diego. And I thought I had died and gone to heaven. I mean, this is unbelievable. You got surfing. You got good water. not freezing. I can go in the water year round. It's not just three months a year. And New Hampshire when the water's cold. And I was like, this is amazing. And so that sort of guided my way to get to San Diego after. Because they were going to, just like I got the letter,

you're either going to med school or we got a ship for you, Ensign Prevention. Now I'm lieutenant prevention and you're going to be either going to San Diego, but those are a Portsmouth. You let us know your choices. You don't always get your first choice. Fortunately, I did and just all worked out. So that's where this is 1998 when you get out here for the first time? It's 98, Chaco, yep. And now you're just, you check into Balboa. Is this the residency like my friend, Dr. Peter Attia, who did his residency at Johns Hopkins

and it was, he tells the stories of just no sleep, you know, working 36 and 48-hour shifts. Was it like that at Balboa for your residency? Was there some kind of control? No, so what's interesting is there are quite a few controls now. And we call it the quote unquote 80 hour work week, which you're supposed to adhere to as a 10 hour work week. You're supposed to adhere to an 80 hour work week. But I can tell you, oh, during my entire training, we had none of those roles. We had no 80 hour work week.

We had 110, 120 hours. You're on the call night after night, maybe a day off. We were busy. And it was a significant, I know, burden on, you know, the family of burden on, you know, just being away and just time and on your body. And we do it so much better now in what we call graduate medical education, GME. It's done so much better now in the United States than what we did. But it certainly taught you the craft really well. And, but sometimes function, I mean, as you know, in your

field jocko, it's not always the best to be functioning on, you know, zero sleep and you're on your 55th hour. It's just not the best. It's pretty disturbing actually when you think about these young doctors and they're awake for 55 hours and they're making a decision on what they're going to do cutting you open, right? That doesn't seem like the best plan. Was that just like a cultural thing? Was that a cultural thing where that's how it was for me and that's how it's going to be for you too? Yeah, I mean, I think that certainly is a part of it. Unfortunately, you know, the wake up call came where we're now able to really regulate it. You can only be on call so much. If you're on call, you got to go home by a certain time the next day, which is basically late morning.

So that rest and recovery, which we know is so important in sleep, talk to Parsley, is so important. And you're just better at your craft at the end of the day. So what's your job like when you get to Balboa? And this is, so this is 1998, 1999. There's no war going on. You're dealing with kind of normal injuries like family injuries. People, you know, accidentally, you know, cut themselves with a knife and they come in or they break their leg on the playground or playing basketball. That's what you're dealing with at this point.

All the above, yeah, for sure. And the first you are, I mean, you're at the very bottom of the rung. I mean, you're the intern. So your first year of internship. And there's a little bit of uncertainty in the Navy. If the Navy taught me anything, it was certainly patience. And you don't have to rush into everything. And I've got a lot of, you know, folks who are able to mentor now.

They're like, oh, I want this. I got this. get done a resident I'm like calm down it's okay we're gonna get there and after my internship year the Navy sent me to Okinawa in Japan for a year and I went kicking and screaming because guess what all my friends of Dartmouth they're going straight through into residency it's five years of orthopedic training I want to get through this I've done this I do you know I want to get done with it but it ended up being one of the best years of the maturity and the PPO meat and taking care of the what were you doing in Japan you're a general medical

officer you're you could be a flight surgeon you could could be a dive medical officer, but I opted to do the GMO route, it's a general medical route, and so they assign me to a Marine base in Okinawa, Camp Courtney. And this is funny. They actually said, all right, Preventure, you went to the Naval Academy. I've got a few of you here, but you're the only one doing this GMO Marine Corps thing, and you've got to be able to salute.

I know you know how to salute, okay? So you're going to go to Camp Courtney, which is basically the headquarter realm in Okinawa because you're going to be walking around this base and you're going to be at least representing us well and not how to salute because you went to the Naval Academy. And so I think that's how I ended up there, at least what my boss told me. So I went to Camp Courtney and I was not entirely happy about it. I wanted to continue on residency, but that's just not how it worked then. And we went to Okinawa and it ended up being the best year.

It was just incredible and the experiences. And that's because you were in a position where you were kind of the guy. That's right. And you were the one that had answered in the mail. on whatever injuries were coming across. Yeah, that's right. And, you know, you're kind of like the town dock, you know, right there. But I don't know a ton.

I know enough and you know when to refer, but I've been through like one year of residency in surgical type of residency. And I don't have any specialty at this point. I'm not an orthopedic surgeon. And fortunately, you got the hospital there. You can refer. You know when to refer. And you got a great team behind you.

But what was great, Jacques? because you have all the corpsmen and the corpsmen you were embedded with. And the ability to teach and train and work alongside with just such great professionals in Navy corpsmen was unbelievable. And something I'll never forget. And we did all these training things and go out and camp and do simulated blast wounds and simulated heart attacks and train, train, train, train, drill, drill, drill. It's the same thing, you know, team guys are doing, same team we're doing, to prepare our craft and for the next emergency.

So where are you when 9-11 happens? So I'm in residency, and we're at Balboa when 9-11 went down. So you're back from Japan in Balboa? Back at residency at Balboa, yes. What are your thoughts when this happens? My brother called me. He's like, turn the TV on. I was like, ooh.

And he's active. duty 18 pilot at this point. He's getting ready to get ship, you know, spinning up a carrier right away, and he had a lot of activity over there. So saw the TV. You're sort of protected during this residency time, although there's been precedent and other significant conflicts in the past. Vietnam, Korea, otherwise, there they've pulled people out of residency to go assist the war effort. And so that was always on the table. They wanted us to finish residency first.

So, of course, there was the initial flurry. We didn't actually see, you know, after you got through the 9-11 and all the lockdown and all the stuff and, you know, everything sort of does sort of settles. It wasn't that busy until a couple years later. And that's when things started really ramping up for us at Balboa. So you're here in Balboa in like 2004, 2005. This is when we're in Iraq. This is when the Marines are. because you're seeing almost all Marines, I'm assuming.

For these wounds, yeah, for sure. Because the Army would go to, they'd come home to different, to Army hospitals, but Marines are going to come to the Navy hospitals. Yeah, it was interesting. This is when the Medevac system was, it was there, but to my knowledge and I don't want to speak out of turn, it hadn't been turned on now, but it had to get refined. And how do you get someone back from Afghanistan to North Island,

to Miramar as quick as possible, as safely as possible, and get them to the higher echelonic care after they're stabilized in theater. And that was, you know, imagine a massive amount of work and try service collaboration to make that happen and a massive team effort, which really the innovations that came out of this to transport, injured men and women from overseas that were service membered and injured what was amazing. the innovations that came out of that, such as the hot pocket, to keep you warm.

When you lose blood, guess what, you get hypothermic. And so you want to be able to keep their heat up, keep them normothermic, as they say, maybe a little bit warmer. And so really cool hot pocket design. And so patients are treated in these things called hot pockets. And that came out of it, a better wound vacuum. A wound vacuum that you were able to put on. blast wounds right away was really fine-tuned and innovated during this conflict.

I can't even tell you how many wound vacuums we would change out every day, every night, because we would know at Balboa when patients were coming in approximately how many were coming in, what your call night looked like. So you talk about those duty hour things. We had some really long nights, but it was a team effort. And we had some great trauma surgeons that worked with us, orthopedic trauma, general trauma. But we didn't really have a system when it first started. And then we got the C-5 system, which was a combat casually cared system,

which really helped leverage all of the important aspects of caring for our wounded warriors when they came back. So I imagine that when the C-VAC birds or Medevac birds are coming back, these are C-17s, they're coming back with a lot of wounded. personnel on them. So are you getting like 20 people at a time, 30 people at a time coming in? There were nights with that. Fortunately not every night, fortunately not every month, but there would be nights with, I would say the routine was during those years you mentioned, two, three, four a night. So if you were on call, you were heading it up, you had your residents that were with you. And if we had more that we knew were coming, guess what? You took call the night before.

You volunteered and just took it again. And we just took care of it. But it was tough. It was tough to see these young men, young women with blown off limbs, blown off legs, blown off ankles, X-Fix is on, which are like these erector sets you put on their legs and arms and pelvis to stabilize their bones, stabilize their vessels. The survivability developed by many of my colleagues out there and the innovations they developed increased dramatically during this conflict,

and it really helped save lives. So we were seeing things back at our tertiary care center, somewhere like Balbo or Bethesda or Portsmouth or San Antonio, where most of the Kazavak was that we weren't seeing in the past. You weren't necessarily seeing this stuff in Vietnam. And so you pull the war trauma books from Vietnam. There's a lot of great stuff out there. but people like Captain Dana Covey and John Webster and Mike Maserick

and some of these other great trauma folks and leaders that I worked with really helped develop this system to bring orthopedics a little bit closer to the fight so they could get stabilized and then have it super fine-tuned slick system when they got to someplace like Balboa. When you're looking at a wound, let's say, pre 9-11, you're at Balboa, there's a car accident, you know, a bad car accident. What's that wound compared to someone that was in a Humvee, armored Humvee, and they hit a roadside bomb, they hit an IED?

What's the difference between those two scenarios from a medical perspective? Yeah, that's a really important question. And as you alluded earlier, the stuff we were taking care of motor vehicle accidents, broken femur, a broken ankle, falling from a first story window. I mean, there were certainly some pretty bad injuries we saw, and you're going 50, 60, 70 miles an hour. But what you weren't accounting for with the IED blast wounds was everything else that went into it. The magnitude, the basic just shock, the awe that went into it, the materials that would go into these IEDs, the stuff we were pulling out of the, you.

wounded warriors bodies was it was beyond disheartening to be honest with you safety pins um cut up knives uh coat hangers metal cut into gazillion different pieces and sharpened and it just we kept a little glass bowl in our offices of stuff we had kind of taken out and sterilized to remind us, you know, what was some of these folks had gone through and, and, and, and, and, and, and, and, and, and, and, and, and, and, and, and, and, and, it didn't. It was, it was, it was really disheartening. How, how, what is it like when you're living, where did you live in San Diego? We lived, we lived, lived, lived in, lived in, lived in Coronado. So, you live in Coronado, probably one of the most beautiful, uh, picturesque places in the world to

live you turn on the TV you see that there's a war going on but you walk outside and it's 70 degrees and sunny you get in your car you drive to belbow and you see these these wounded warriors that are just devastated by these wounds and you're doing that day in day out what is what is that like from a i don't want to say a psychological perspective because i don't want to get too like crazy as if i'm a psychologist, but that has to be an interesting dynamic to be living in San Diego. It's 75 degrees in sunny. It's a beautiful day. You flip on the TV. You see that the push is going into Fallujah. You see the push is going into Ramadi. You see Talafar. You, oh, you see that this is happening. I mean, I can only imagine when you see the Marines going into Fallujah in 2004,

you're thinking, okay, we got, we got to be ready. And then, sure enough, 25, you're going to 48 hours later, you get it, you start to receive these wounded warriors. What is that, what does that like when you think back on that time period? It had to be, had to be, had to be very, almost like a surreal moment to, to watch something on TV and then deal with these wounded warriors. Yeah, no question, Jocko. The, the ability, first of all, the ability, my hat's off again to the Medevac system. because that has saved lives. And the ability to get these folks back in 48, 72, 96 hours,

and sometimes a stop in Bethesda, sometimes a stop in San Antonio. But the military did a great job of trying to bring these wounded warriors back closer to their families, back closer to where they deployed from, back closer to Camp Pendleton. because they knew and we knew that the mental strain on them, their families and the injuries were extreme. It was real. And I can say the same thing for many of my colleagues at Balboa, whether you're a general surgeon, orthopedic trauma surgeon.

I was an orthopedic sports surgeon. So we did a lot of this stuff and a lot of the reconstructions, but the real heroes were some of the orthopedic trauma surgeons, the general surgeons, and my hats off to them, plastics, the mental health providers, all of C-5, the combat casualty care set up at Balboa did an amazing job. But, you know, there are nights. I personally at least talk, I'd get off call and you'd be like, oh, you know, let's fix the fourth external fixator.

I've put on the 10th wound vac. We've done this and fixed the stump of the leg just above the knee. and they have no elbow, and you're putting these wound vax and X-Fixas on, and it's the flesh, the burning flesh, the hearing the helicopter, these things that, you know, we all kind of go through, it's became a little PTSD-like, in a way.

Now, fortunately, I mentioned Coronado. One of the things that my personal strategies was, when I went over the bridge from Belboa to San Diego to Coronado, I tried to use that as a decompressed time. the time over the bridge, the time there to go back to my family, to decompress, because there were some tough days in the medical team that was caring for these heroes. And your family at this point consisted of how many kids did you have, your wife? Wife and two at the time, no, four, so four soon after.

And they were all, you know, of course, very young and living in Coronado. and really great setup and great friends and military friends and pilots. And all my friends on Naval Academy, for example, they're pilots and doing helicopters or jets or on ships or subs or what have you or P.AOs or all these certain things on top of not to mention all the seals that, you know, about 20, 25 a year that the Naval Academy put out based on billets each year. So it was really great to have that. also for my wife and my family and you know for for all of us to have and and just

just lean on did you ever feel like you wanted to yell at everyone that there's a war going on I I did I but I know so many had lived through it and to be honest so much so many did way way more than than I ever did and so I was just trying to you know put my put my hat on of let's do whatever I can do to help out these wounded warriors because the usual thing when I would go to their bedside and talk and meet them whether it was in the emergency room or C5 or talking about reconstructing their knee or their shoulder doc when can I get back when can I go in the fight again when can I join my unit it was the most amazing thing to me, the Espri de core, the leadership exhibited out there to put that together. I mean, realize that.

It's like, you want to go back to that? And that was almost always the first question. It was amazing. Yeah, I know that I got home from my last deployment and I just was probably been home for less than a day and was going to grab something to eat with my wife. and I'm just walking down the street in OB, Ocean Beach. And I just remember looking, and there was clearly, for no one on this street, there was no war going on. There was no war going on. They were doing what they were doing. And I remember thinking to myself, I kind of, I was like thinking, I should just tell all these people, hey, you know, there's a freaking war going on right now.

And you should be appreciative of the fact that you're standing in line to get an ice cream. And then I remember thinking, you know what? But that's my job and that's the way it is. And I just kind of like accepted the fact that these people are never going to think about it. They're never going to think about it that three miles away in Balboa, there's a young Marine that's struggling to stay alive or struggling to keep his leg or he's going to lose his leg or lose his arm or whatever. And they can just just kind of ignore it. It's a It's very

It's a dichotomy inside this country That's Can be if you if you let it make you angry It can definitely make you angry If you let it get to you It can definitely get to you But if you look at it You know I

I remember one time One of my kids You know told me that the Wi-Fi in their bedroom Wasn't strong enough You know And I thought to myself Well I guess I'm doing a decent job as a dad if the biggest struggle you have is that the Wi-Fi in your room you

only have four bars right and you know I thought and then I said to myself you know know as these kids get older you know I'm gonna make sure that they understand that there's a lot more important things and there's people that there's people in the world that have a lot less a lot a lot bigger things to worry about than you do so I kind of got that feeling too for the country like okay you know they're they're gonna stand in line they're gonna get ice cream and it would be nice if they recognized. And I think that's one of the reasons that I do this podcast is just so people can hear from people that have served, people that have sacrificed or hear stories of people

that have served and people that have sacrificed. And that's why I mean, you know, even as I'm sitting here thinking about you, you're in Coronado, like I said, one of the most picturesque places in the world. You got your family. Your family's doing what families do, right? They're playing their sports and they're hanging out, they're going to the beach, and yet every day you've got to go in and put these broken guys back together again. And there's that constant daily reminder of what's going on in the world and how just, how totally different these worlds can be. And it's really important for people to pay attention to that and understand that that there's

a lot of suffering going on. And even though maybe your little bubble of the world is, is happy, just pay attention to the fact that there's a lot of suffering going on out there. When did you start working with NSW? Yeah, so that actually started about 2003-ish, I would say, 2002-3. One of my mentors got named Mike Lang Lurthy was down and working with NSW from an orthopedic standpoint and doing doing doing some stuff with them and in being available and he actually you know left belboa and so i was in coronado i said well i raised you want to you want to go and i said

raise my hand and i'm like sure what do we do you know he's like i don't know at this point about the the training room or you know what the medical setup was you know we're still dealing with all the stuff and the blast wounds we just talked about out. But we had this concept, which was bring our skill set closer to the fleet. And that was San Diego Y. We had smart clinics in Miramar and down the 32nd Street, a smart clinic being a sports medicine and rehabilitation type of clinic because why a lot of the injuries we see were musculoskeletal in the military. It's an onending pipeline of 18, 19, 20 year olds coming to the military. they're jacking themselves up playing basketball or whether they're deployed.

And so there's a lot of musculoskeletal burden in the military, and I felt it was a really important, and so did many of my colleagues, that we brought it and made it easier. Like go to Balboa, get a parking spot, deal with a parking situation up there, and you had an appointment, and before you know, you're gone from the command for six hours. Coming from a guy in the teams going to Balboa for anything was the worst. nightmare every like I'd rather just suffer I'd rather just sit over here and limp around yeah let it just be broken then have to go to Balboa which is

gonna take five hours yeah but that's I mean that's a fair assessment Joe and we we didn't you know that wasn't our goal was always to serve the fleet the best and this was on top of doing the smart clinics and taking care of the Marines because you know they were getting banged up taking care of you know All the men and women, not only Marine Corps, but in the Navy down 32nd Street, out at Pointe Loma, and bringing us to C Clinic alongside our incredible family practice sports medicine colleagues, our physical therapists, our athletic trainers. All of this was really starting to be born here in a nice way in San Diego.

Let's face it, we have so many great commands here. We do everything here in San Diego from the Navy. And so we wanted to be able to deliver that, make it easy, take Jocco's six-hour trip. ripped a palpola, which he would never come. And then he'd really rip his biceps and we'd have to fix it. But it would be something that, you know, I was certainly passionate about. And so this was another one of our things where we delivered it to the fleet. But me being in Coronado, I would often, you know, put my bike on, get the helmet on my

bike so I can get on base, no more on helmet. And my beach cruiser around San Diego. And went and met Jason and people like Mark Rogo and, and, and, and, you know, and, you know, and others there and we had a great situation. It was amazing. And my hat's off to people like Jason where, I don't know, Jocco, you were in the closet where he started. And then you went to the trailer and this said,

the closet, I mean, this is like where the rehab, athletic training facility, you know, training room was. Yeah, somebody in NSW and I wish I knew who it was. It's weird, when something gets developed in NSW and I've been using the term NSW, that's Naval special warfare that encompasses all of the special operations elements within the within the US Navy and so when something happens in NSW I can tell you right now a human being had to take that thing and force it to happen and it took them years to get

a foothold whoever and I don't know who it is maybe you do whoever decided all right we're going to do some kind of a human performance we're going to get athletic trainers in here we're going to get the guys healed up we're going to do injury prevention with them whoever started that probably had to work for two and a half years and finally were able to hire one guy and put him in this you know little tiny maintenance closet in the back of a command somewhere that's how things start and so whoever that was thank you and was jason the first guy that got hired he he was one of the earliest for sure so we he got extracted at a major league base Just a great individual. He's still with the teams as GS now. I still text Jason if I get dinged up. I text him like hey bro

He my rolled my ankle pretty swollen. Here's a picture. What should I do? I still do that to this day with Jason and he still responds and says hey if you need me to come out look at it like that guy cares about his patients to a degree that's just incredible and he's done that for all of like every guy that would get injured to get surgery, get banged up. He was just there committed to him all the time. And then the rest of the team followed suit. That's what you got. We got this incredible group together that would provide this amazing service.

And they also had a different, you know, you go to a regular doctor. And the regular doctor might think, oh, you got hurt. Cool. We'll get you as much time off as we can. But the seal attitude is I got hurt and I want to get back in the game tonight. Like I got to I want to go tonight. Oh, you can't go tonight tomorrow. I want to get back in the game So Jason and the rest of the team Understood that their mission and their goal and our goal was to get back to work and that's a lot different than

Preserving you know, I'm gonna be per in perfect shape and everything's gonna be hunky doury I mean It's not gonna be that way if you're in the SEAL teams just like in in an MMA fighting you don't get to go into a fight a hundred percent You don't get to do like you're gonna be injured you're gonna be sort of You're going to have a bruised rib. You're going to have a tweaked neck. Your shoulder's going to be sore. That's the way it's going to be and you still got to go out there and fight. And I think Jason and the rest of the team, you guys realized, all right, we need to make sure

these guys can get the job done, but we can't. They're not going to allow themselves to be babied and coddled. No question. And you talk about the classic conundrum. And this is what we knew and this is what we were working on. And this was not all my baby or even a small fraction of it, but a, you know, a great team. And I remember us going out after work one day I got a call. Hey, meet us at McPees, you know, Barr in Coronado.

And we sat down and said, what does this look like? And to your point, two and a half, three years later, this is what it looks like. And so that was the first thing we sort of penciled out. And, you know, I was just one small cog in the wheel from some of the musculoskeletal side. but we had so many other, you know, great people from, you know, Jason, Mark Rogo and Vinny and many others. The Doc Parsley was in there. Parsley, yeah. I mean, there's so many, there's so many I'm forgetting, and I apologize if I do.

But the tactical athlete program got born. It was a tap program. And that's, you know, now it's on to the next iteration, which, you know, I hope we can talk about because that's really now, I think the future of taking care of our military members, our most important. important commodity, the human element at the best level. And so we literally napkin sketch this things out. What components? What have you seen? What do you talk to colleagues that have done pro sports teams,

taking care of the Rams and all these other organizations? And how can we affect this for the teams to make a guy like Jocko who does not want to go to medical can't stand it, but actually wants to come in. and get some wellness, get some injury prevention, so that you can go out and operate and do your job better. That was our goal. And literally no one would come in and see us. But over time, the switch has flipped,

and now it's a really impressive program, and that's what's going on down there. So the tactical athlete program that you guys sketched out, that was focused on athletic trainers, like the sleep people, They started looking at hormones. They started looking at everything to try and get the guys up to speed. And I saw it grow, like you said, from Jason and it just escalated, escalated, escalated,

to we had a good, a freaking world class. The other interesting thing was I remember talking about. I think this guy was a person that worked at Buds, but it's a similar thing. And he had come from some professional sports team, I think the NFL. And he had said, you know, when I was in the NFL, every six months, I'd see one, Patelephemoral syndrome, which is, you know, a problem that you get with your knee. He says, here, I saw nine yesterday. Like the amount of injuries that guys get is crazy.

And so you guys in this department got so much experience working on the shoulders, working on the knees, working on the lower back, working on the elbows, working on the wrist, working on the neck. Like the guys are just dinged up to a point that. And, you know, people talk about the NFL. How long what's the average NFL? Guy plays what like six years is like the average three three point eight three point something yeah so you're getting dinged up well the seals we most guys stay in

Like look some guys get out at six years or whatever most guys stay in most guys do 20 years at least and they're They're doing deployment after workup after work up after deployment after so these guys are getting dinged up and yet they still want to play that game. They still want to get in there. And so you guys put this together. What were some of the key components that you would say for, because this is what, you know, so many people that listen to this podcast,

they want to, they want to perform better. They want that longevity. They want to be, they want to optimize what they're doing. What are some of the things that you saw that help guys out? Yeah, Jaguar, I think you mentioned a lot of it.

And the, we broke it down in a kind of big buckets where you sort of, how do we optimize physical readiness? If you ask big Navy, big military, what is it all about from the medical side for caring to that duty? It's all about readiness. Are people ready? Can they go? Are they ready to go?

It's almost just like being a head team position for the NFL. Can they go? Can you? Are they ready? So physical, mental, and then more of a cognitive type of thing with sleep and other things baked in there. Nutrition was a big one. But really trying to organize the elements of all of this into a program that made sense and a program that you and your colleagues would buy into. We didn't want to set up a brick and mortar facility without you want to go and be a part of it.

So we had to have the right mindset or the right culture because that really wasn't in there. You went to medical. Preventure was going to write you a chit. you're getting four months of limb due and your biceps operated on and you're out for a while, you know, and that's not going to happen. It's not acceptable. No, it's not going to happen. I can tell you, it didn't matter what I, you know, what shit I sort of wrote, you know, fixing pecks and this and that and shoulders and knees. Like, where's, where's, uh, where's master chief so and so?

Oh, well, sir, he's deployed. He's only four weeks out of his AC joint shoulder massive reconstruction. Yeah, I know, sir, but he had to go. Yeah. Yeah, he just had to go. I'm like, okay. I'll see him when he gets back. Unfortunately, I guess my point is you and your colleagues, Jock,

tested out the strength of what we did, the strength of our repairs. We're always testing things in orthopedics. Back to my engineering days of what, is this strong enough? Is this going to hold Echo Charles biceps together? Is it going to be strong enough? Is it going to hold Master Chief so-and-so's AC joint together? Right. And because they're going to go early. I can't necessarily control that. The command has ultimate authority. I can make, we make recommendations from medical to the command. You get limited duty and all this kind of stuff. But it's amazing to me how you and your colleagues, not only, you know, tested them, but also kind of took care of some of my technical inadequacies and my colleagues technical inadequacies because you just rehabbed so well.

And with this tap program, which is now potiff, and we can talk about that in a minute, but it's really helped take care of our warriors at the highest level. Yeah, I think a huge part of it was once we understood that you understood, we trusted you guys. Because if I went to Balboa in whatever, 1996 and said, hey, my neck hurts, my shoulder hurts, my back hurts, they're going to go. put us on the protocol of, okay, well, you need six months off and you need this and that. And we realized that you realized that we wanted to get back to work. And so when you told us, listen, when Jason would look at me and say, Jocko, you cannot do pull-ups for three weeks. You cannot do pull-ups for three weeks.

He'd like look at me and nod his head and say, nod your head and say, I understand, Jocco, and I'd say, I understand, Jason. No pull-ups for three weeks because I had bursitis in my arm, right? Or whatever the case may be. there was a level of trust that we developed with you guys that when you told us to do something, we understood that you meant it and it was right. And also, to your point, when you told us, hey, here's the rehab exercises that you need to do. And if you're going to do the desert or you're going to jungle warfare or whatever you're going to do right now, you can go.

But you've got to do these rehab exercises. We would do them. So we had a very good mutually supporting relationship where you were telling us what to do. We trusted that you were going to allow us to do as much as we possibly could. But that was also a limit. And hey, you can't do this thing. But no, I really, no, no, you can't do this thing. Okay, we trusted you guys.

And that's what I think made the program so effective and makes it so effective to this day, just this incredible level of trust between both sides. Jocko, you nailed it. And I think it wasn't incumbent upon my colleagues, someone like me, to be able to earn that trust. But I have a saying, everyone around you has someone to teach you. I'm sorry, everyone around you has something to teach you. It's up to you to listen and learn.

and I learned more from my physical therapy colleagues, athletic therapy, athletic trainers, physical therapy, nutrition, parsley stuff was amazing with all the sleep and hormonal looks. And it was really great to put this together in its infancy. And now it's, you know, just in a much, much, much better space than we even started. But that's what started the culture shift for people like you and your colleagues to get better, to work more on injury prevention, and actually not view medical as something like we're going to take you out of the fight. Our goal is to get you back as soon as possible, as strong as you can, efficiently and safely. Yeah. And there was another element of trust, and that was if I showed up to medical, there was something wrong. Like Jason knew if I walked in there, it wasn't like, oh, I had a little ding and maybe I was being a whiner.

No, if I showed up there, there was something that I needed help. I'm not coming in there to miss work. I'm not coming there because I want to get a limited duty chit from you guys. No, if a seal shows up to medical, there's something wrong with them and they need help. You don't need to screen like, well, are you sure this? No, no, no. We're there because we're injured. That's what's going on.

So that's also a very good place to start is that we're not looking for a way out. We're looking for a way in. And there's plenty of places in the military and in the world where what they're looking for is a way out. Like I want to get limited duty. I don't want to have to work. The seals are not doing that. We want to work.

That's why we're in there. Fix us and give me back into game. Right. We do with plenty of injured folks that just may or may not want to go back to work. And it's hard to dissect that out. There was absolutely no question down in Coronado what you all wanted to do. The other thing is I wanted to do is I wanted to learn more. And again, back to that learning thing.

And so I went up to a lot of the beginning of hell weeks, the breakouts. And I got probably you at trade ed, like, Roger, get out of there. There's a million tons of brass there. You're going to slip. It's hot. It's like, I'm like, I don't know what I'm doing. But it was really good to see, you know, I'd just break out, but going out to the desert, going out to the island with you guys, doing stuff with you and watching and learning was absolutely invaluable. Because I could see what the stresses were going through the shoulder, the knee, the mind, the body.

And that helped us immensely understand. The reports that they came back with, I remember you guys put some kind of monitors on guys, like heart rate. monitors, movement monitors, and the guys came back from our desert training. And it was like everyone was beside themselves in terms of the output, the movement, the stress level, the heart rate. It was all off the charts. It was like they competed in, you know, world class competition triathlons with mixed in the decathlon.

You know, it was like strength, endurance, mental stress. It was all off the charts. It's crazy when you distilled down some of these numbers. And that's where we really started the data movement. Once we got the nuts and bolts in place, we had some really good people that we brought in to help us with the data and analytics. Again, all about to help you perform better. But you start looking at some of these numbers,

and it's like you can go win the tour to France tomorrow. Like the output, the watts, the climbs. It's crazy numbers. And heart rates in the 30s and 40s and blood pressures that, heart rate variability and all these things we start to look at in terms of how you recover, how you perform, fine-tune machines. It's really good. And so we had to be even better.

We had to find ways to be at our top game because we're already dealing with a pretty finely tuned human. How do we tune that person up even more? Especially, as you said, you get on with 6th, 10th year, 15th year in the teams. There's nothing more than we want to do to, to protect that human capital. So then how did this program roll into the PFF, the protection of the protection of force family? Yeah, so POTF, and I'm going to probably get this all wrong,

but this, it finally got enough legs through people like Captain Tom Chaby, Admiral McRaven, who, you know, extremely well and worked with Chaby and others, even Admiral Eric Olson. and saw the utility, I think, of what this program was about, people like Master Chief Glenn Mercer, others that really started to look holistically at, you know, strength, nutrition, conditioning, sleep, mental health, wellness, how to train, diet, etc. Learning how to take care of the body and these little injuries that would really keep the operators out of the more severe stuff. And so that's, I think, really how POTIF got born.

And, you know, Chabee, we did an incredible job of helping Shepard this through into your point. It took a while. It took a lot of time. And in fact, when you look at the family side, there was all the operational dollars are for active duty seals and direct active duty seal. But POTF is preservation of the force and family because they knew that it was important to also take care of your family while you were gone. And it was really critical to that, but from a funding standpoint, that hadn't been set up through Congress.

And so you can put family in there, but there's no dollars. It ain't going to happen. So that took a little bit of time, but then the family became a really important piece to holistically allow the operator to be at their best. And there's a bunch of elements of POTIF, which we can talk about, but they're really basically the essence of what was started with tap, but is now just so to the next level. And I want to congratulate everyone who's just done an amazing job with this program.

Yeah, I think Chaby was like a national level mogul skier. Yeah, he was. And both of his knees were annihilated. This is before he joined the Navy. So he had to go through buds with just annihilated knees. And this is not uncommon. It's not uncommon for guys that obviously guys are going in the seal. They were in sports growing up and they already come with pre-existing issues, which I was lucky enough.

I was like, you know, young and just healed. I mean, I was just good. Warrior blood. Yeah. Wolverine blood gets some. But a lot of guys show up with already pre-existing injuries. That's a problem. So this thing with the protection of the force and family.

So now all of a sudden we can bring the wife in to she's getting knee surgery. We're going to help her heal up. This is that type of thing, right? Yeah, that's exactly right. You want to integrate, you know, the families into the units, integrate them the installations, the communities. There's a concept with POTIF to build not just resilient operators, but resilient families.

And that was something that would be able to withstand the op tempo that was just massive for you all. And you were in and out all the time. and to the point where your adrenal axis, when you came back, thanks to parsley and others, doing just, you know, magician-level work, to be able to help us discern that and put that together and really take the whole program to the next level. And lastly, I think setting up a connection with the families. And again, this is, you know, I'm way over my skis here, not my expertise, my ski tips here,

is not my expertise, but understanding the whole thing and being conversing about it and sort of my role down there to understand and be a part of it. My role down in Coronado was to have the knowledge so that we could talk about it when an operator came in and said, hey, how's your family? How are you doing? How's everything going? Like, so-and-so may not ask about that. But, you know, as Doc, I can get away with that. And I knew that.

And I knew that you would do better. I've got a great story. One of my team guys had operated on, and, you know, this is a credit to the whole pro. program, but I told you how well you all rehabbed and fix the shoulder, labrum tear, dislocated. How long you've been dislocated in your shoulder? I don't know, three years. Okay, you've been dealing with how many times you've dislocated, 125, I don't know, lost count, 500 times.

I mean, it's literally like hundreds of times you're like, the amount of resiliency, you know, that the operators demonstrate never ceased to amaze me. It was off the chart. And this is a very typical story. Well, I just lived with it. I had to deploy. I had to do my job. I had to go be there.

I'd be there for my team. My platoon, my whatever. I'm like, I get it. But he's like, listen, this is the last, I can't. It's just coming out too much. It comes out when I look the wrong way. It comes out in my sleep. It comes out.

I'm like, I've got to get it fixed. I can fix a shoulder. That we do a great job. You know, high five and classic out of the OR, whatever you do. And we get out of the OR and, you know, all of a sudden I get a call from, you know, in Coronado. It's, you know, four, five, six weeks. He's like, oh, man, he's just not making progress, really stiff.

It's not working outright. Senior chief's so-and-so, and I'm like, oh, man, this is a bummer. Should be doing better. Okay, well, I'll be down tomorrow, you know, I'm coming to the training room and see what is going on here? And again and again, we just kept working. We kept doing the therapy, doing all the right things. It wasn't from lack of trying, from lack of being there, from lack of doing the right exercises. And then I talked to Parsley, and I'm like, dude, Parsley, what's calling?

Any ideas about this guy? You know, we're just having a little bit of trouble. Yeah, so we would talk about you guys behind your back. And, you know, doctor to doctor, you know, he could because we're taking care of you. And he's like, let me run some stuff. So it does labs and basically does a bunch of labs. And Parsley's lab thing, you know, no tons of them. He's only, you know, a 10-page report or something crazy.

I look at the thing. There's like undetectable testosterone. Adrenal axis is all jacked. There's, you know, a bunch of these other. their parameters and thyroid hormone and all these other things just completely way off for someone who's 37 years old. So he's like, let me look into this. It's like, okay, three, four weeks later, Parsley Works as Magic.

And his shoulders like healed. It's like your biceps. It's magic. It's just fixed. And he's like, so the whole really got a big wake-up call for us. if I, with my hammer and nail, just focus on the shoulder, I'm going to get it wrong. I'm going to get wrong for my patients. Now I'm going to get it wrong for you and your colleagues.

And so that's where we really have to take this holistic approach, understand our patience, and use the resources and the team around you. It's a team. And you need teamwork to be able to execute this at the highest level. How complicated is the shoulder when it's jacked up? there there was no lack of challenge that you guys gave to me and my teammates and colleagues at balboa based on how jacked up some of these shoulders were you know injuries that were in your 30s that we don't see to 50 or 60 like completely torn rotator cuff arthritis in the shoulder off the chart well it doesn't really hurt that much I have no idea how this thing doesn't hurt it does I can do whatever I want I can I can do jiu jitzu I can be a sniper I can do all these other things without it. any difficulty and it really amazed me the level of injuries that some of your colleagues would present with but really just demonstrated toughness I think resiliency and focus on on their job

of the mission and it would only come in if it was really bad that's at the end of the day I figured out the shoulder though as a joint like when somebody injures it can you get it back how How close can you get it back to being good to go 100%. Yeah, it's interesting, Jocko. So we have a bunch of specialties in orthopedics, and you do your five years of orthopedic training. You get done with Balboa. And then you can do a fellowship.

Not everyone does a fellowship, but a fellowship is generally one extra year of training. And you can just do a foot and ankle fellowship. They become kind of a foot and ankle surgeon. You can just do a hand, wrist, kind of elbow fellowship. And that's some pretty complex stuff. And a hand wrist elbow is a lot of bones, a lot of tendons, a lot of lords,

There's a lot of ligaments. I mean, there's books bigger than your bookshelf here, just on hand surgery in orthopedics. I do mostly shoulder knee sports surgery, which is, it usually goes together. Sometimes we add hip surgery or hip scopes into that as well. Then we also have joint replacement surgeons that just really focus on taking care of arthritis, so that usually the hip and knee.

We have people that just do spine surgery and neck and back and lower back surgery. And so with me in the shoulder knee, I really like the shoulder again back to my engineering mind because it is a little bit of a complex joint. But every specialty in orthopedics sort of has their niche, their tough parts that you treat and take care of. But for me, the shoulder was just super fascinating. It's a joint that is quite mobile.

It's designed to be very mobile. It's designed to be moved around. It's designed to be held in by, a gazillion different muscles around the shoulder girdle from your back and your scapula with a lot of complex interactions of ligaments, muscles, and bones. And so for me, the shoulder is, was always something I wanted to study and was very passionate about. When you open that thing up, do you, do you, like, how many, how many shoulders have you opened up? Thousands? Thousands, yeah.

So you, when you open that thing up, it's just, it's, do you know exactly what's going on? You know exactly what's what you can figure it out. You're looking at like, oh, this is a little high, this thing's a little rough, this thing's a little ruptured. Like that's what it looks like to you. It is, yeah. But it's what we train and what we train to do is no different than what you did. It's discipline. It's following a process.

It's knowledge. Anatomic knowledge is surgical power, pathologic knowledge. Understand the MRI is surgical power to be able to take. care of your shoulder or knee or whatever injury efficiently and safely and to make sure that all the pathology is corrected back to normal as good as possible. It might not be able to be perfectly corrected, but we try to get it back as normal as possible. We got a lot of shrinkets to be able to do that and implants and other things. So it's a really, it's a really fun job. I'm able to put this stuff to put it together. Like I said back earlier,

in the podcast was I like using my hands, and I like being able to use that on patients to help them get better and get back to enjoy life and living life. Do you use robotics now to do any of this stuff? We do. Yeah, it's amazing. It's an exploding field in terms of replacement, the hip, the knee, the robots helping you really do it. I do some partial knee replacements in which we do robotics,

and it really helps understand the exact angle and the femur versus the tibia, the knee, and what those angles are and how you integrate that and put the right implant and the right size of implant. I mean, we have a gazillion modular combinations of implants these days, and the ability to do what I call precision medicine, precision surgery, and understand your exact bony configuration, which is different than Echo Charles, is really important to get the right outcome. We're still early. There's stuff out there that say robots might not be better than a very well-trained human,

and we might see that in your world. But I think we're getting there. What we do know is that just like everything, planning matters. And we're doing a lot of planning in the shoulder and the shoulder world. I would do a shoulder like yours, Jocko, I would have on the computer and basically almost be able to depend on what type of surgery, doing, be able to do your surgery ahead of time on the computer, manipulate things, change implants, do this, do that, and really execute the whole thing ahead of time.

Would that be based on the 3D image of my actual shoulder and what's in there, for real? That's correct, yeah, absolutely. Your exact image, your exact MRI scan or CT scan, and we would know exactly, every, I tell my patient, we know every nook and cranny about your shoulder way more than you want to know. I'm happy to show it to you. Here's what we're going to do. Here's the plan. and this is how we're going to execute it

and this is what we plan to do. I want to jump ahead a little bit just in comparison, but you end up working for the New England Patriots, you know, with the NFL, that the interesting thing or the tough thing is like you've got a seal. He's on deployment, he hurts his shoulder. He's not going to a doctor.

Like he's going to use that thing for the next four months or five months or three months until he gets home from deployment. the pro athlete, they're getting the opportunity to, like, completely, uh, uh, baby that thing. That's now, look, I know if it's the Super Bowl or a playoff game, you're going to get that guy in that game, right? No one misses the Super Bowl. That's the way it's going. I mean, unless you're, I mean, unless you had surgery.

Right. No one misses a Super Bowl. You're going to be in the game. You're in the game. Yeah. So there is some similarities from that perspective that you're going to. get this guy to play that next game. Yeah, they do.

It's interesting. When I went to the NFL and, you know, Belichick, Robert Kraft, Jonathan Kraft interviewed me for the job. And I really didn't want the job per se. I was like, okay, well, I got enough going on. I moved to Mass General. I just moved my whole family across country out of, I don't talk about culture show. I got a Coronado to Boston area and it's hot and humid. again and it's like what do we what do we just do here um but it's a great Boston's a great

town the crafts are incredible human beings Belichick is a great leader he's very disciplined he's very organized and convinced he has a photographic memory he's brilliant and what they were really interested in was what what we had built with the SEAL teams what we had done as a team there and how we had worked together and and we they had a number of the elements in this team and a lot of the NFL teams and other pro teams

baseball hockey you name it soccer had this stuff but it was still a little bit early and we helped integrate quite a bit and augment their program with a lot of the things we had what I called battle tested

in the seal teams and what wearables like if Jock was going to have a wearable, it's going to work. Otherwise, he ain't wearing it. And so I know those wearables that the team guys would use. And so, okay, well, if a player wants to use it and they have to agree to it, there's all kinds of rules with the NFLPA, the Players Association and things you can and can't do in terms of mandating and testing and use of wearables and stuff like that. So, but at the end of the day, I wanted to deliver precision medicine to every player. So just like with the teams,

they could optimize themselves and perform at the best. Give them the information. Here's where you're at. Here's where your sleep's at. Here's where your nutrition's at. Here's a 20-page lab report. You're going to sit down with our super smart nutritionist Ted and our head athletic trainer, Jim Whalen,

and you're going to sit down and work through this stuff and truly understand how to optimize your body. Oh, did you even know you had a lactose intolerance? know but I well we're going to help you with that and three to six weeks later the player feels immensely better just super simple things that were able to identify and bring with a lot of nutrition a lot of sleep hygiene wearable technology tracking sensors in performance and in play all of this was stuff we had already done with the teams the seal teams that is and so bringing that to bring that to the NFL and the Patriots was really pretty cool.

Again, they had a lot of it. It was just kind of fine-tuning, augmenting, but really saying, look, if this is going to work in a seal, there's a good chance this might work in the NFL player. And that stood pretty well. And just to back up, Belichick was down in Annapolis. Naval Academy didn't go there for college, but knew it quite well. So we had a very good relationship being, you know, his huge support for the Navy and, you know, crafts or wonderful, wonderful humans that are also, you know, hugely supportive of the military. And, you know, in fact, they would ask me routinely because they would always recognize a service member. And I brought and recommended a few people I had operated on, you know, including a Marine who had not just one Purple Heart, but two Purple Hearts. When he was about ready to get, you know, tossed out of the, tossed out of the military, you were able to tune up his knee off. operate on it fix it but he was recognized at one of the Patriots games so just trying

trying to give back and get back to the community I think is what it was all about what's the comparison between an NFL player and a T and a seal there's they're similar we um the the drive to get better the drive to optimize yourself the drive to do the job all of that's there and the resiliency the mental toughness the if you're getting at the top any level, not just the top level. You're doing things right, and it's a similar mindset at the professional athlete level. You're doing things that most other people aren't.

When I see the shows about Tom Brady, is there anyone more focused than that guy on, like, his performance? Tommy's the best, and he's focused incredibly well on, winning Super Bowl. He that's every year. That's what he wants to do and he's he's the best and a a great person, a great leader. Um, cares a ton.

I learned, I learned a lot from Tommy. It seems like there's nothing else in his head besides this game. That's what I'm doing. Yeah. I mean, it's, it's Uber focus. And it's amazing and, you know, but, but all these guys and you know, when he's thrown to whoever, you know,

Gronk, Edelman, you name it, they, it's that same, it's that same Uber-focused mindset. And there's a little bit of just almost, it depends how you, every player internalizes or doesn't internalize it, but it's, you're amped. I mean, you're ready to go on the mission. You're ready to go.

Like, it's go time. And it's really cool to see that, that comparison between, you know, the SEAL teams and the pro-exam. athletes like it's go time and you're ready yeah the weird thing about the seal teams is the game is so varied you know the missions are so different and you got to be ready to kind of do all of them and so you don't get to just have this one singular focus in your brain you've got to have you just can't you have to be able to do a bunch of different things so it's a little bit harder

to prepare for you can't just be a one trick pony I'm not saying Tom Brady's a one trick pony that's not what I'm saying but I'm saying he got to he got one game to play You know, he had to throw that damn ball, right? That's what he had to do. And, you know, in the SEAL teams, you've got to throw the damn grenade, but you've also got to climb the ladder. You've also got to shoot the rifle. You've also got to carry the rucksack. You've also got a buddy carry your friend.

You've also got a low crawl across the field. You've got all these different things. There's a lot of stuff you're going to be generally prepared for. No offense, Tom Brady. Respect. You talked about Belichick's leadership, right? How's that leadership in the, when you're, when you're the, lead a surgeon, leadership in the medical world. What's that like? It's important. You know,

you're the leader every day. You're leader of the clinic, the operating room, but you've got an incredible cast around you to help execute on the plan of the day. And that's doing clinic, taking super high-end care of your patients, going to the operating room, you know, leading a great environment there. And it can be a stressful environment. You can get into trouble. well, you can, you know, bend there. I can knock on wind. Nick someone's vessel, you know, bleeding. And also the entire shoulder wound you just talk about is now full of red, bright blood.

And you're like, what do you do next? What's the next plan? What do you do? How do you get out of this? And that's a real deal because it doesn't take long before the rest of the vascular volume is depleted. And then things can happen really quickly. So having the ability to, Be level-headed, to be cool, to be calm, to follow the process, to have your plans set in place, B, C, D, and E, down the road in case things happen.

To take a deep breath. I was in the operating room, and I just talked about that. A vessel, and all of a sudden, that blood was in the wound, and all of a sudden he can't see anything through this six-inch decision because it's literally full of about five cups of red blood. And you're like, okay, what do you do? You get just like anything, direct pressure, and get your finger on, I put a pad on it, go to a lap pad, get the pressure on it. How do you handle that?

How do you have that cool, calm, collect, I'd be able to do that. You know, you could really, it could decompensate really quickly, but I got to thank the Naval Academy, the constant hell laid out back, the constant, what do you know,

it was always that that, you know, help me. And believe me, I'm not perfect at it, and I've had some really great, people that have taught me how to do this, but the first thing I did, okay, get the direct pressure, take immediate care of it, we're going to be okay, we've got a few seconds, turn around, talk to the perioperative nurse, talk to the scrub technician, say, here's what we got,

we got a little bit of bleeding, we got direct pressure on it, this is what we're going to do, can you please get so-and-so, can you please alert the general vascular surgeon, can you please also get two units of red blood cells from the anesthesiologist. Can you please get this gel foam and thrombin, which is a special clotting agent that you can put into the wound? And then you get back to work. But that 10, 15 seconds is so valuable to be able to reset the team rather than just diving right in.

You got 10, 15 seconds, at least in our world. You might not have 10 15 seconds to be able to just take a step back, breathe and then get the process fully defined the discipline standard operating procedures take a step back that's what we're doing exactly hey what do you think about um with going back to football again what do you think about what's it look like from the inside when they start talking about the CTE and the brain trauma and all that stuff what's the what's the feeling inside that world right now yeah it's it's the it's the it's the it's the it's the it's the It's the real deal, and it's definitely not only conversation, but to the point where there's a ton of research, you know, from the medical side, there's a ton of NFL sponsored grants for all kinds of concussion studies, CTE, how do we prevent this, how do we make it better?

And I can tell you from, you know, I was there from 13-ish to 16 in the NFL, it's way better. better even now in terms of what we have for athletic trainer spotters. We have two neurologists on affiliate with the league on the sideline and or neurosurgeons. We have brain health experts. We have a mindset that's there, at least talking to my colleagues that are in the league full time still is brain health is super important and we need to be able to make sure we're taking care of the players at the highest level and making the right return to play decisions or not return to play decisions and making that with independent neurologic consultants that truly know neurology. I was having to make that call. And believe me, I'm not the best person to make

that call as an worthy surgeon. I know enough of it. We do, we do these, you know, scat tests, we just had these iPad things going. We were doing on paper in the locker room. And, you know, do these basic verbal, three verbal questions that the players would, you know, memorize and count some sevens and, you know, what day is it? And where are you? And they would all memorize them. They knew the whole thing. Why? Because they wanted to play. Not only a jock I want to play, the NFL player wanted to play. They wanted to stay in the game. But they're also becoming, the player is also becoming much more cognizant of their brain health too. And they know when, And they know when the self-policing is really important and the team policing is really important.

I think that's the biggest mindset and culture change. The NFL is taking it super seriously. I applaud them for it. And I congratulate all the great research and science that's going on with this. And let's face it, the military can also, is learning along this side-and-side. And there's a lot of DOD research out there, obviously, from blast wounds that are way, higher in intensity and collaborating with the DOD, among many other institutions and government entities out there is going to help us, I think, get this problem nearly solved.

Did you work at the Red Sox or the Bruins when you were up there? Yeah, we did. We did, Jock. I wasn't the head doc, but it was the assistant dog. We can cover, I don't know, eight or ten games and share the 81 home games that we had to cover when we weren't the playoffs and maybe a week of spring training. And, you know, similar for the Bruins doing six, eight teams. But I had a great team in Boston that really did a good job of taking care of the teams. But that, I mean, that was just taking care of the team's full-time job on top of being Northpeak surgeon on top of running the sports division and research and running a fellowship

and training. Everyone, it was, it was a lot. I didn't have any, didn't have much. solo time, if you will. And was Johnny Kim up with you at this time? He was. Yeah, so what an amazing individual. That's another time

I remember. So when he was applying to become an officer, you and I sat on his board and did his officer interview board to write him in a recommendation to go and become an officer. And I remember he wanted

to become a doctor and I remember saying, you know, I'm sitting in the room with you and I forget who the other person was but I'm sitting here saying I don't know why you want to become a doctor I'd never want to be a doctor I don't like hospitals I don't like doctors I don't like nurses I don't like medicine and then I said but if if there was anybody I wanted to take care of my kids it'd be you Johnny and we gave him the best recommendation we possibly could but did you remember him from that time frame as well because he's a Corman he's a medic yeah no he's I remember Johnny extremely well and another one was my partner Dan Solomon who was probably there and you know I apologize if we forget exactly he wasn't on that

board but certainly that was that was very interesting. I mean, on that, we, you know, Johnny, Johnny went full bore, but he would hang out with one of my other sports colleagues, Dan Sall and myself, called to Balboa, we published research papers together. We'd come to the operator room, come to clinic, you know, just like what had been done with me. You know, he wanted to go into medicine, and I applauded him for it, and he had to go back and use some of his GI Bill and go to San Diego State and take classes and all these other things.

And what an incredible story with your podcast with him and incredibly proud of he and what he's done and who he represents because he also visited with me in Boston because he was at medical school at Harvard. And so he would come and kind of randomly show up in my clinic, which was right in downtown Boston, in on Charles Ave and pretty cool spots. He would show up and it was a nice, it was, it was really nice to see him there,

to have the connection after what he had done with the SEAL teams. But then next level, now NASA astronaut. I mean, just amazing. That's Johnny. And when you talk to him, he's still the same Johnny. He's still just, you know, do you need help with anything? What can I do? Like, just humble.

And awesome, as always. So one of the stories I told Johnny Jocko was about Balboa again, because he was asked, he was asked about the Patriots and everything else. I said, listen, it was during our Super Bowl run when the Patriots ended up beating Seattle Seahawks in the Super Bowl. And it was sometime in October before that Super Bowl, and Belichick comes, finds me. He's like, Pratcher, Doc, here's what we got. we're going to green bay in November after Thanksgiving

it's going to be cold I'm just telling you've been in green bay for a game this is calling a guy here's the deal what we're going to do is we're going to go to San Diego after Green Bay we're not coming back to Boston we're going to go to San Diego we're playing the Chargers in San Diego you know still the stadium here before the San Diego Chargers moved up to LA what can we do in San Diego

doc that is not the bleepin bleepin'bleean sea world, not the zoo, not that. That's what college teams do. We're a pro team. But what can we do in San Diego? I need like an afternoon diversion for these guys. All 53 active players plus 10 on the practice squad, plus all the coaches. I mean, it's like five buses worth of people because every player gets their own row, basically.

I said, coach, let's go visit Balboa. let's go visit our wounded warriors. And so in first week of December 2013, we had it all set up with Balboa and I don't know, maybe it's been done before, but certainly some people have called me and talked to me about it, but all 53 players, all 10 practice squad, all coaches after practice that day at USD University of San Diego in the mid, late morning, hit over to Balboa. for about two hours. And we had it set up so they knew sort of what state the player was from.

And so or what college they went to and played football. And so you went to Wounded Warriors Rooms as part of C-5, where you were from that state. So there was at least some state-to-state connection. And he was walking around and, you know, Brady was kind of sequestered in one area of the courtyard and everyone was coming in trying to get all to go. ass and hang out with him. But the rest of the team, and you know, Brady went out and saw a ton of

the other wounded warriors as well. I don't want to say he didn't do it. He was super busy that visit. But the entire teams there are all five buses. You know, usually you get like maybe, you know, three or four or five to go visit, you know, cancer, children's hospital

or something, you know, something really good that the community gives back from the NFL. But this was the entire organization, everyone and the reporters and I'm standing there in the courtyard or waiting to load the buses up these guys are getting hungry because they consume a lot and burn a lot of calories obviously so we're getting ready to go back to the hotel in Del Mar when you're standing on the racetrack at one of the hotels up there

and I see like Vince Wilfork and Edelman and some of these really respected players and names just get on the bus and tears are streaming down their face and it was a very interesting almost emotional when we went back to the hotel dinner and I was asking you know Julian Edelman and Vince and some of these other guys and grok I was like dog it was just incredibly moving I've got a wounded warrior guy with one arm, an elbow on the other side, no legs, telling me to go kick some ass on Sunday and motivating me more than I was motivating them. They were like, I'm supposed to be coming in motivating these guys. And it just was so, it was so touching. And you never

You never get praise from Belichagel. You get it indirectly. And he came up and was just very thankful. And it was very meaningful. It meant something. Yeah, I can imagine that like I was talking earlier about how there's a disconnect. You know, the country's at war. And yet most of the country is not at war.

And here you introduced these guys and showed what kind of sacrifices are being made. And, you know, these guys are an even more extreme example. you know, I was talking about you living in Coronado, and that's a nice place to live, but these guys are, you know, multi-millionaire people that play a game with a ball for a living to get paid millions of dollars to do it, and they see the sacrifices that are made by these young warriors that, you know, like you said, quadruple amputee, I mean, who's still telling people to get fired up and, hey, go kick ass today. That's just, that's the kind of thing where they realize what kind of sacrifice.

are being made for them to be able to do their job and live their life it's I can I can I can only imagine what it must have felt like for them to see these to see these young wounded warriors that's um that's heavy for sure yeah yeah was did you did you did you as you were working this kind of stuff you know NSW and and and and the NFL and stuff I know you talk about a lot about data and collecting data and then utilizing data. Well, tell me a little bit more about that. Yeah, so, I mean, this was really born out of, you know, Coronado and what some smart people were doing there. But we had to put it together.

You can collect all kinds of numbers and data and how Jocko sleeps every night and what your sleep score is and your adrenal access and how your Y balance score is. and force plate analysis and all these great things, but you've got to be able to interpret it. I mean, I already gave you like a million data points just in one day. What are you going to do with that? So we really started working hard on interpreting the data and be able to start really in its infancy, starting to use almost AI and machine learning,

artificial intelligence in a way. And, you know, super hot topic now. But we were way ahead of the curve in terms of putting this stuff together and really analyzing it in a statistical, way so that number one, we could get the operators the right resources. We knew where the ROI was going to be. We knew what resources the operators are using. And we knew precision medicine. Jocko is different than your master chief at trade it. Much different body, as you described, and much different requirements and much different biceps. So we would look at that and really

try to say, okay, this is now what a specific type of person, breacher, or sniper, and what those differences are, and start looking at from even a job standpoint. So this was really unique stuff back in the day to be able to help a sniper do better, a breacher do better, but they're not the same person for the most part, right? And we could help that person optimize their craft. when I went to the Patriots, I quickly learned, you know, that all, although Belichick was brilliant in photographic memory, he was not going to learn medical speak. So I had to learn coach speak.

So just like, you know, like I had to learn what a breacher did because I saw it and went out and went to the desert and saw what you do with Breacher. And I could understand it better what the mechanics of that were and what the shoulder and what the knee was doing to the hip and the back and the stresses across the body. I did the same thing in the NFL. And I wanted to be able to look at how to discern the medical information we had that was on our team and provide that back in coach speak.

So it's pretty basic. You play fantasy football. You do football. It's catches. It's yards. It's snap percentage. How many, if you're a running back and you do this many snaps, usually how is your snap percentage for three downs? Are you playing all three of those downs?

taking you out because they're managing load or because you got an injury or other things. And so that's where we really started to dissect this down jocco is how do the stats help a team understand their team, their position better, like a slot receiver like Edelman versus center or lineman like Vince Wolf for two totally different bodies, totally different person, but different stats to follow. But sometimes they can have the same knee injury. So how do you interpret that same knee injury, that same ankle spring? that same high ankle sprain, the low ankle sprain, the knee sprain, the meniscus, the hamstrings,

a really tough problem. How does that behave differently for someone's on the offensive line or someone was a slot receiver? So it was a quarterback, someone who was a cornerback. So that's what we really started to discern, is really taking a personalized but also specific position approach to the data so that I could deliver Bill and the team better information. Take it what they want with it. It's like me saying, okay, Jocko, you're not going on deployment. Well, it's too bad he already left.

Here's the information, but it actually really helped from helping predict performance. And now we're to the point where we're doing this on the outside of the NFL and doing a bunch of predictability models as well. Did you make a lot of money off of fantasy football during this time period? So it's interesting. We have a rule where you can. I cannot bet fantasy. In fact, my kids all want to be in a fantasy. You're like, Dad, you got me in fantasy.

You know what's going on? You know what's got, you know, what's going on with Gronk's knee? You know what's, I'm like, I can't. And neither can name my team. But speaking of team, you know, for the Patriots, we had, we built it up quite a bit, but we had almost 75 people. They were just part of the medical team. Many of those full-time, part-time.

But I guess it's taking care of the family. It's just like potiff. You've got Obie Gein. You've got a dermatologist. You've got a dentist. You've got pediatricians. You've got family practice, doc, sportsman. I mean, you've got everything.

And so it sort of falls under the head team physician purview, plus the head athletic trainer. And I mentioned before, but Jim Whalen, you know, the guy's incredible to be able to organize this whole medical system for the players and their families. It's really impressive. How much of a beast is gronk? Like as a physical human specimen.

He's that guy, just a mutant? He's, Jocko, he's one of a kind. It's amazing. I mean, I've never seen anything like it. He is, he is a mutant. Yeah, it's unbelievable. Like they should clone this dude, right? Yeah.

Just like, let's reproduce this dude and give, put him, make thousands, hundreds of thousands and put him in the military. Unstoppable. Unstoppable. Yeah, that's probably part of his name. And he seems like it's such a nice guy too. Oh, he's the best. Grong is the best.

He's one of a kind. He's just, he's amazing. but yeah he is he is a beast you did you do the work on him uh no took care of him took care of him after when we start talking about recovering from surgery like what's the biology around that what's the best way when people are recovering what do you got to do yeah so so it depends i mean say you tear your ACL you tear a ligament under the knee we need to get the that ligament to heal. It's reconstructed. You've got to get that ligament to heal. So there's a biologic healing response and then also a physiologic response. And that physiologic response

is, you know, what you're working on every day, you know, in the gym, working on your squats, your hamstrings, your core, your, all the other muscle groups that we really work on and try to get super creative in terms of our exercises. But we also have to balance that with the biology because you can go out right away at four to six weeks after an ACL reconstruction. Guess what? That ligament has not undergone what we call ligamentization or the ability to even heal into the bone. Because that ligament has to heal bone to bone, both in the femur and the tibia. That's where the ACL connects.

And so if you rush biology, and by the way, if we could find a way to improve the efficiency of biology and to get people's muscles back, we could really make an impact on some of these longer, recoveries. But we're looking at this from a very holistic standpoint. So that's why we want to optimize their nutrition, their sleep, their recovery time, their musculoskeletal program, the core. If you just, while your quads are two weeks, your quads are two week after ACL, well, that's just not it. You need your hamstring. I need your core. I need your back. I need your abdominal muscles, lower extremity, your calf, your perineal muscles. We need everything, that whole kinetic chain, as we say, to function better before you go back. And that's why, that's why. I'm going to, you

That's why I love this job is you have the ability to not only fix the knee, but then help coach that patient back to a successful outcome. Do you do Seth Stone surgery on his knee? I did. Seth's amazing. Yeah, he had a, and I wish he was still with us, Joaquin. I know he was a great friend of yours and I miss him and a great, great individual. He had very bad knee dislocation, multi-legged knee,

And we, with that, sometimes we have to do not just one surgery, but two surgeries, because sometimes there's four main ligaments of the knee, the ACL, the PCL, the MCL, and the LCL. It's all around the knee. On top of other structures, your meniscus, your capsule, your cartilage, and he dinged a number of them. Yeah. And he did it really, he did it really well, that landing. And so anyway, we reconstructed it in two surgeries staged about six, eight weeks apart. You know, great news is he was able to, you know, again, do what I talked about, take care of my technical inadequacies and rehab beyond and do an incredible job and get back to his craft.

I was, went down, he was doing rehab there in the clinic, and I went down, and whatever he was doing was hurting really bad. Like, he's trying to bend it to a certain angle, right? This is, you know, you've got to make it to a certain angle. There was some kind of a device that was measuring the angle that he was bending his knee to for the first time. And he's pushing past to try and get a little bit more. And he's, it's a machine that's doing it, if I remember correctly. There's a literal machine that's moving his leg for him. Am I right?

That's right. Yeah. It's a CPM, passive motion machine. Yeah. Yeah, it puts you through the pace. So he's in that thing. Yep. And I come down and he's in absolute agony, which is making me laugh hysterically.

So I'm standing next to it and I'm waiting for the machine to go and push his leg again and I'm laughing and I finally get out my phone and start recording him as I'm laughing. So now he's in absolute agony, but he's also laughing because I'm laughing at him. So he's got this look on his face of, you know, I'm in absolute agony right now and this is hilarious. But, yeah, he was able to heal up, but it's a long, it's a long process. long road and yeah you're you're describing exactly what you know that type of injury he had and that's what we all worry about is you know orthopedic sports knee knee surgeons is stiffness loss of motion you can't get your motion pack guess what you don't have the muscle excursion your quad doesn't work as well your hamster doesn't work as well so i don't you don't care how much you work it and how many leg presses but if you don't get the joint mobility back you can't optimize your muscle groups and so it's it's a really tricky balance and we're always trying to get people back as efficiently and quickly as we can.

But, you know, that, whatever he was doing and there worked. And I appreciate him, you know, gritting and bearing through it. And I'd love to see that video. But he's that, but to be able to do that, that's the only reason he was able to get back and do his craft. You've got to do the PT correctly. For sure. Yeah.

Can't blow it off. So as you're, as you're, I mean, with all the knowledge that you've got, everything you gain from the teams, what kind of, kind of daily protocol are you doing to stay healthy, to stay fit? Like, what do you do? Yeah, and Jocko, I've always tried to be good about this. I mean, I have to admit even back in the day, I almost got a little burnt out from, you know, all the rowing and the U.S. national team kind of training stuff that was in and out of that

circuit. And, you know, so I wouldn't, if I saw an erg, I saw one here, I was like, I can get the PTSD. I get the shakes. I'm like, but I've gotten through that. So that was a big, that was a big thing. But with our life sometimes, especially, you know, in health care, and I've taken care of a lot of colleagues.

And there's no greater honor than not only operating on, you know, a SEAL team, but also other orthopedic surgery surgeon colleagues or other professional, medical professional colleagues. And I love, you know, I love taking care of, you know, all walks of life. We do a ton of pro athletes to college to the other docs. but I always find myself telling them, and it's really probably me telling myself when I'm talking out loud is,

look, you've taken care of people your entire life. You're now 58. You've got a bad rotator cuffed hair. Wow, but I've got to get back. I'm like, listen, take a little bit of time. Take care of yourself first, and then everything else will follow and you'll be able to take better care of your patients.

And so I've tried to follow more and more of that. I wasn't always the best at it, to be honest. because we get so busy. We get so busy with our life. We're also teaching. We're traveling. We're teaching residents, taking care of our patients, teaching fellows. It's a busy life.

It's extremely rewarding. But I've got to tell you, you've helped inspire me, among others, to make sure that I'm taking care of myself. And I use that all the time. And I think about you a lot. I take your supplements. I use the stuff. I like it a lot.

All natural. and, you know, it's amazing stuff. And I feel better on them, but it's also helping me do my routine better. And my most predictable time, just like you, just like your watch at 430 is, I'm up about 5, 515, 530. I go to the gym. I've also crafted my schedule so that I can do that and push some start times back by 15, 20 minutes. It's unbelievable when you can do that and control your life because you've got to take care of yourself so that you can take care of others yeah so you're um you were at you're at boston

you were working with the with the patriots seems like this might be the dream job of a freaking doctor right you got that super bowl team you got brady you got gronk you got bellichick you got this seems like a yeah pretty much a dream job for someone in your position but you left i left Yeah. What drew you away? I know. Statement to the question. So not only that, Jocko, but growing up in New Hampshire, I lived through some pretty tough Red Sox years, pretty tough Patriots years.

Kraft bought the team, and they had one playoff appearance before he bought the team. And you've seen what they'd done. So it was my team. Listen to it, watched it, everything. You know, part of it, was. was and I think the biggest thing was it was almost you know like the Navy I did 16 and a half years of active duty another 10 years of reserves and I felt number one like I was ready for the next challenge but also I had been gone a lot you know taking care of a pro team and you know to my

colleagues that have done it much much longer than I have we're still doing it or getting ready to do it whether it's a college team we're taking care of seal teams or the Patriots or you name whatever team, pro team out there, Olympic. It's a massive time commute. I bet if I added my hours up, which I did because Mass General wanted me to keep track how many hours I did the Patriots, it was actually 55, 60 hours a week, just with the Patriots. Not let alone my surgeries and clinic and run the fellowship. So was that like your day job at Mass General?

No, my day job was being an orthopedic surgeon and being head of sports at Harvard Mass General. That was my day job. That was a side gig at 50 to 60 hours a week. So there's your answer, Chaco. I needed, you know, it gets back to your question, but also taking care of yourself. I love the job, believe me. But I had a young family.

I wanted to be around. I didn't want to go to their games, you know, and because they're like, hey, they loved it. I mean, they got 50-yard-line seats. I mean, they've been to a couple Super Bowls before the age of, they went to, my first Super Bowl was age 45. They were at two Super Bowls before they were 14.

It was crazy. And they were there the whole week and bedded with the team. I mean, talk about an incredible experience. But, you know, it's tough when they said, hey, are you going to Kansas City this weekend? Are you coming to my soccer game? Yeah. So these are life choices.

And I made a conscious life choice to, you know, take a pause from that life, but still continue to give back. And that's why we moved to Vail, Colorado, where we take care of the ski team and a few other teams. I do some U.S. rowing team stuff, but I really just, you know, focused on family, enjoying what's, you know, in Vail and also a busy practice where we take care of a lot of great, you know, athletes and all walks of lives. And that's at the Stedman Clinic?

That's right, Chucky. So what's the deal with the Stedman Clinic? Yeah, it's a guy named Richard Stedman who started. I actually started in Tovho, and he actually just passed away this past year. I mean, a big memorial service for him in June. June and Vail and really set up an incredible clinic that, you know, the culture just resumes with me so well. Why? Because it's, the motto is just take great care of your patient and really focus on that, spend time with them, and truly try to do the best. And we get, we get

tough cases there. We get tough situations, patients with tough problems. And, um, But we get all walks of life. We get pro athletes, college athletes, Olympic athletes. We're also one of the Olympic, the main Olympic provider, USOPC provider from a musculoskeletal standpoint. So we're closely with the USOPC. So it's really great to see just all walks of lives, all kinds of, you know, incredible, incredible athletes of all of all different disciplines and sports. So I love the job. We love Vail.

It's like Coronado in the mountains in a way. You're standing in the mountains. It's beautiful. The weather's great. And we know you have winter. And we take care of advantage of all the seasons there. And still occasionally I get to come back to San Diego and 72 in sunshine. I know.

You have it rough here, Jock. So how many hours a week do you work now? So now I'm probably 50 to 60, 60-ish. It's busy. But, you know, I was well over, I was well over 110, 120. You, I mean, it's incredible. And, you know, my hat's all to, like, athletic trainers, therapists. Everyone on these pro teams.

So say we're playing Kansas City, you know, on Patriots on a Sunday night. You can do the game. You're there. The NFL makes you fly out Saturday morning. So you leave your family Saturday morning. I leave there super early Saturday. Because you've got to do, you know, Belichick wants to know who's finally traveling with the team. You got to check out.

You go to do a couple of final physicals. So you get there about 7 a.m. Saturday. You fly out, get to Kansas City. take the two planes, one or two planes, and private contracted plane. Now they have their own plane, or a lot of teams do. And you're in Kansas City, you're hanging out, you do the game. It's a Sunday night game, so you know the time on that.

It's done late. About an hour later, you're an hour and a half after the game. You're aboard the plane flying back to Providence, and you land at about 4 or 5 a.m. Maybe with a couple hours of sleep, and then you're going to work the next morning. And so sometimes I'd try to go home and see the family, see the kids, and then go to work. And then you have a thing phenomenal called post-game checks.

And so Monday, we always do post-game injury checks. And so the players would come in after a reason we want to sleep. And so if you're back early in the morning, you're seeing the players at 11 a.m. noon, something like that. And so then your Monday's kind of gone. And then you're on to the next game. And it's a very, very busy life. And so mine was only part of that. people that are embedded with the team and the athletic trainers, therapists, everyone.

It's a very busy life, especially during the season. And you were doing, this whole time you were also teaching? You were teaching? Did you teach at Harvard for a while? We did. We, yeah, Chuck, we all get an appointment at Harvard, but wait you, I mean, you're teaching residents, you're teaching fellows. People did through that, you know, that kind of five-year system plus a year of fellowship. And you're also trying to do research.

to publish papers, you're trying to do all these things that are quote-unquote academic, they consider somebody's practices, you know, academic as you're a filler with the university that they require because they want you to say, well, at Harvard, we discovered how to fix biceps tendons better and stronger with this thing and fix that, et cetera. And so we publish on that and that's what they'd like you to do. And it's part of the, quote, unquote, academic requirement, if you will. So there's a lot of, there's a lot of responsibilities. I mean, I love it, but part of that conscious decision was to still do academics at Stebman Clinic where we have a very robust lab.

We have PhD scientists. You've got people like Mark Philippon who just want an incredible award for all his work in hip surgery. We have great people that help us take super high-end care of our patients, and we still can do research. We can still teach. You just take some other aspects. because he only had so much time in the day. Yeah, I looked at your, on LinkedIn, you have your CV on there, and it's like, it's literally over 110 pages.

I think it's 111 pages or something like, it's everything you've ever written and done. I was like, what are we going to do, a 17-hour podcast? It was kind of crazy. That's why echo Charles needed vacation, right? Just did mentally prepare for this. No, I'm sorry you had to see that. that actually, it was really just for my mom, but no, it's...

Even I was impressed. Sure your mom was completely stoked. No, it's kind of the way we just track what we do and, you know, and how we contribute to, you know, the craft we're in. So it's, that Jocko, though, is 100% a reflection of team. And I've always been about building a team. those things and papers we publish and things we've written down are so many other people you know i've got tyler zajak here with me and incredible human worked with me at the patriots

and you know he's doing a ton of stuff you know for us and with uh with some of our with some of our business things we have going on but you bring people like that uh into the fold and help mentor them and give back. It's my time to give back. You know, it's not about me and not about me anymore. It's not about me at all, but all of that was only possible with the team and cultivating the team. And then there's, I look at it, not too often, but I look back and it's just cool to

see where all of those people and those names land and where they are now and what an incredible impact, an impact much, even way, way beyond whatever I've done and many others have made. And I'm so proud of these people that I've been able to, you know, help along the way. Because now they're doing it way better than I ever did. Well, yeah, it's interesting, too, because I was, we have a friend that we trained with here, Dr. Luke Pomerance. Yeah. And, you know, I told him, oh, I said, yeah, we have another, because he's an orthopedic surgeon. He's a hand specialist now.

And I told him, oh, yeah, we have a guy coming on, you know, Dr. Matt Proventure. And he goes, oh, yeah. He goes, I guess he worked as some intern or whatever it is for you. but he didn't talk about your surgery stuff. He just said, oh, he's really respected in the academic world for all the papers he's written. I was like, this guy's doing a lot of stuff. Getting a little bit crazy.

Yeah, it's a little crazy. Yeah, no, Palmerance is great. He was with me at 17, did an incredible job. And I kind of turned over the reins, a senior medical officer there to him. He's done a great job and done way better than I have, taken it to the next level. So when you talk about these, quote, business things that you and Tyler are working on,

these are business things? What does that account for? It does that all about. guy well we my passions now are just it's really coming full circle and everything we sort of talked about jaco is i love the human performance side helping people perform better and helping those around me make informed decisions whether it's coach whether it's shamansky admiral whether it's jason whether giving people opportunities making informed decisions with that is what i love to do based on what we know,

what we know in human performance. And so one of the things we're working on, we call it the predictors, the predictors.com, but it's a, it's looking at how we analyze human performance. Our motto is health matters. And health truly matters, whether you're taking care of a SEAL team guy

or NFL player or an NBA or what have you, it matters for, how you perform when you come back, how you come back, and potentially what else can happen. And so we're using pretty heavy analytics and a lot of information that we garner and have garnered over the years and cultivated to help people, whether you're playing fantasy sports or gambling or betting

or whatever you want to use it or teams that want to use it, to be able to have information to make better informed decisions. Now this is specific to NFL and you know future MBA and and NHL baseball that kind of stuff. And this is called the this is at the predictors.com. That's right, Jack. And what? People can go in there and enter data into the system. They can go and get information.

Yeah. There's a lot of data information, articles, etc. Cultivated stuff that we have. And I think what we've done is kind of really take AI and machine learning to the next level and really help interpret, you know, every little thing about you know what how a cornerback or running back how a quarterback how Brady's going to do in a performance it's it's pretty cool stuff and it's all about modeling and but using you know health is one of the major metrics on top of everything else at someone like Vegas or fantasy point predictions use things like that it's pretty cool when we know how the thing is why

it's called health matters is health really matters it's amazing because there's a reason reason why you turn on an NFL show and half of it's dedicated to injuries when they're coming back. That's interesting. That's that's kind of amazing. You did all this stuff to help people get better, heal, recover, and you're also going to help them in the gambling field, help them with their fantasy football. That's right. However they want to use it. Correct. That's right. Is there any other business things that you have going on? We're trying to help really deliver health care, I think, in a more simplified, easier fashion. You know, administrators, doctors, nurses, techs, everything. There's a ton of burnout in health care.

All of us can get burnt out in our craft at times. Health care was tough. It was tough after COVID, during COVID, et cetera. And so we're really trying to help make it better for the patient. and make it better for the provider, the doc, the nurse, the PA, the tech, and... Through what mechanism? I mean, I've got people like Scott Lago working on delivery of health care much better through app mechanisms. Healthcare at your fingertips is really what we call it,

and really trying to demystify the entire care, if you will, when you tear your biceps, we know what that looks like and we're going to help you with that. How much, how much, how much, how much competition is there from Google Medicine? Because I am the Google Medicine master. I can basically, you know, tell any, listen to someone's symptoms and I can tell them exactly what's wrong with them, myself and every other idiot on Google. But, uh, what's that like? Well, how does that change the medical world?

Yeah, Jocco, it's, it's the real deal. I mean, it's, uh, information at fingertips is, is very, very, powerful. And for someone like you, I've actually almost joked that I would put a printer in my waiting room. Hopefully you don't have to wait too long. I would say you don't, but I put a printer in my waiting room so that just in case you didn't get to print out your Google medicine stuff, you would be able to print it out and bring it to the clinic for the visit. Tell you what's up. Well, this is what I've heard. This is how we treat this biceps and that's not right. And da-da-da-da. And I need a PRP. I need a biologic injection. I need some of my own stem cells.

I need some of its own stuff. I mean, it's really, it's actually great. conversation starters in a way. It's kind of opens a tour, but sometimes it's too much. You've got like 10 articles printed out. You're like, okay. Well, yeah, because you can get one article that says one thing and you get another article that says the complete opposite. So by the time they come to you, they're like lost. Totally. Yeah. You got to and you have to sift through that. And that's where you're, you know, that's where experience comes through. That's where you've done it before. This is what we have found. In our hands, this works the best. And look, I want to try to solve as much as we can without surgery. I mean, that's, that's sports medicine, in essence.

And we did that with your biceps. It's all without surgery. You're still out there grappling, no problem. And you didn't need to get it fixed, unlike Echo Charles. Twice. It was genetically weak. It was, we're always, we're always trying to show those, you know, that cause and effect and use our experience and coach patients, coach patients through a,

decision. I mean, my general mindset is said, listen, here are your options, everything from three, no surgery options. We can do this, this, this, this and this, two, here's surgery, if that doesn't work out. And that's, that's generally been a pretty good approach, you know, at least in my hands with patients to give them the options, give them some information. You've got to be careful of Dr. Google can get in the way. But it also, I find it just opens up the conversation really well. Yeah. So what's the app then? The app is coordinate all this stuff. Yeah, exactly, yeah.

Provide information. Everything provides info, exactly right. And is this thing up and running? Is it available? Yep, it's available. So where can people find that? Yeah, we have to get it through our clinic. Oh, okay.

Yeah, so you've got to come out to Steuben and we can get you hooked up with it. Are you planning to broaden this to let other people use it? Yeah, we are. Just not there yet? Yeah, not there yet. Is it in the works? It's in the works. All right, we can talk offline about that.

Yeah, it's really close. And what's amazing is, you know, the, DoD super interested and how we deliver precision medicine and healthcare. It's all the same themes that we've done since day one for me at Bellbow, which is really what I love. So it's coming full circle again. Yeah, it must be crazy because you're seeing a patient and then you don't see this patient again for six weeks or four weeks or three months.

And like what did I talk to them about last time and what information have they got in the meantime? And it just seems like if they automated that stuff and made it more friendly, you know, to the patient, obviously, that would be helpful. Yeah, correct. So that's the type of thing this does? Yeah, that's exactly right. I should have started this company. What do you think, Echo?

Approved, yeah, I like it. There's time you can get in. Like I said, we'll talk offline. Exactly. So what else is, what else, what have we missed? I think, you know, you know, what's interesting. We touched on it a little bit. You know, I think the, you know, some of the things we get asked about a lot and, you know,

probably, you know, right here, right here at, you know, Victor Ramam-A, you've got people that are trying to perform. You're at professionals. They want to compete at the highest level. And we get a lot of questions about biologics. You know, meaning, spin my blood down, put in some PRP, plateleture plasma, put in some stem cells, spin it down. And how does that help things? How does that do?

And I think that's a pretty unique field that's going to be rapidly emerging. And the nice thing about it, it's very precise. It's precise to you. but the problem is we're regulated by the FDA in terms of how much we can manipulate this blood product. So we have to, it's called minimally manipulated blood product rule by the FDA, federal drug administration. So we can only do so much with it now. But that's why you see, well, so-and-so went out to Germany for stem cell treatment,

so-and-so went to South America or wherever, were regulated. And I think we're going to see this very exciting field continue to over. We're doing a ton of research and be able to top of you know a lot of other places in the world in terms of how to Optimize biologics for your Precision game So are you doing that right now? Are you doing what the FDA will allow you to do right now? Yeah, we're doing what the FDA allows us to do and and It must be pretty easy to research this when Germany's do it Mexico's doing it whatever South America's doing it is it? Is it or no? I? Oh no? I'm

Yeah, it's, so we, it is, again, Dr. Gulley, have to be a little bit careful, but you have, well, Google said that out of Germany we have this, this and this. Sometimes studies are hard to reproduce. You know, you don't have the same conditions, you know, the same methodology. We're always scrutinizing that. And we want to, you know, of course, provide something that's going to be meaningful, that's going to be value-driven. And, you know, if you're going to, you know, right now a lot of these are, cash pay. There's really no insurer in the world that pays for biologics at this point. I think that's

going to change, but when that does change, or even now, I want to provide value if you're going to pay for it. So we want to try to really titrate what conditions this works in, do better randomized trials, put in the biologic versus saline solution and figure out what's going to work for your knee and hip and keep you going longer. What is the FDA? What's their concern? If they're doing it in Germany or something like it. They're doing it in Mexico, something like it. What's their concern? Yeah, the concern, I think, is just keeping control of a biologic product in that it is something,

something that they know what the end product is. And I think, you know, it's a little more complex than that, but I think it's going to change at some point. Is it in legislation to change like right now? Are they currently looking at it? Not that I know of, no, but we need to work on it. So we're stuck going overseas if you want these kind of treatments? If you want some, you know, more extravagant, advertised, quote unquote stem cell, basically concentrating stem cells. So if we take blood off your pelvis with a needle,

concentrate it, the stem cell population of that blood is probably less than 1%. It's not a lot. We can't concentrate it. We can only minimally manipulate it. So we have to put back in. We spin it down. There's only so many things we can do. But in Germany, they can concentrate it.

You can amplify it. You can do other things. You can do PCR techniques, all these other stuff, to help amplify and get a much more robust stem cell products. That's basically what you're getting when you go overseas. And then is it beneficial? Is it more beneficial? They say it is. We can't study in the United States. We don't really know at this point. So what about the studies from Germany? They're promising. Yeah, I think it's it's promising. And we'll get there. I mean, there's a lot of stuff that comes from overseas. It just takes a little longer for FDA to get

through. But we're getting there. Let's go FDA. Get it together. Yeah, and I think, I mean, the other thing I mentioned to Jocko is your, you know, the supplements. I mean, I've got to congratulate. I think you, you know, you didn't even know I was going to talk about this, but I'm going to is you've done a great job with this because I think you know that you need to perform and continue performing in your gym so you can hang or at least partially hang with some of these professional athletes that I saw hanging around today. It's pretty impressive. Some beasts in here for sure. Yeah, there's no question. But you're, I mean, your stuff from the greens to the, you know, the joint.

warfare, the jaco comet tested in the mulk, and I mean, all this stuff. I'm really, I've been studying it. It's good stuff. It's all natural. I use it. And, you know, the, you kind of taken the right approach from a supplement standpoint to help optimize. I can tell you, I feel better on it. Yeah. Yeah. Yeah. One of the, I think one of the most impressive confirmations of the efficacy of it is the, subscribers so people subscribe to joint warfare they subscribe to the greens like they get that and they take it and they've you know we've got people that have been taking this stuff for two three years now and they you know they're they're subscribed to it they're not going on I say all the time I'm I you won't get me to not be on

this stuff because the way it makes me feel even the the the time war which anecdotal it improved my vision. It made my vision better. We have a certain size monitor that we use at some of our events and there'll be notes on the monitor. And we do a duplicate event every six months or so.

And I showed up at one of the events. The next event I show up and I'm looking down at the downstage monitor and I say, do we get bigger monitors? And they're like, no, it's the same monitor. I said, did we get, are we using a bigger fonts or something? They're like, no, it's the same exact slides.

And I said, this is freaking awesome. Like I can see way more clearly. And I've always been blessed with good vision, unfortunately, not like you. Or, you know, not like you unfortunately. You got, you got jinxed. I was blessed with, I've always had good vision. I'm 52 years old. I've see a lot of people.

Knock on what, I see a lot of my friends. They're having to get, you know, reading glasses and whatnot. I'm still able to be okay. But I was starting to see a little bit of aggregate. Don't tell anyone echo Charles. I was starting to see like a little bit, occasionally a little degradation. And I was like, oh, no. And then sure enough, now it's time war.

Now I can see again, like clear. So the stuff is, is effective. We're testing it like crazy. Great people helping us put together. So maybe you'll be on that now. Yeah. No, it's, I take it. I mean, the Time War stuff has this, the target of what's in there is to the mitochondria,

which is the energy machine of the cell, and to be able to provide that anti-aging, you know, cellular support, improve NAD levels, which is what we use for energy, you know, can help cells turn over better, get rid of dead cells, promote cardiovascular effects, eyes, heart health, etc. That's all what this is targeted to and all done in a very natural way, which I applaud you for, Jock. It's the right approach and the right way to look at a line.

Because, you know, if you just sell NAD3, like, that's too hard. I applaud how you, you know, I'm putting my MBA hat on now, which I did when I was bored and finally finished up during COVID, was the subscription model, like you said, so that's not going away. It's, you know, you know, it's done a great job because that's the hardest thing to keep. with a customer is keeping them going and renewing that so I applaud you for it I think it's the way you put it together put to get the line together makes it very simple it's stuff that we can use and apply no not only to our patients but into our everyday life

freaking taste good too by the way I showed up here too I did legs today by the way I go Charles okay and then I didn't then I had call call call came right here I was going catabolic let's be frank but I rolled right in here grabbed a vanilla ready to drink Molk hammered that thing, 30 grams of protein coming in hot. All right, I don't want to turn this into, you know, an infomercial for Jocko fuel. No, and I didn't, this was not planned. I didn't, you know, I came here with this just because it's, it's good stuff. Well, I appreciate it.

And, you know, coming from somebody of your background, obviously, that's, that's awesome to hear. For sure, you know, that's, like, what better seal of approval than someone like yourself that's worked with the highest performing people in the world. and is a freaking doctor from Dartmouth. I mean, let's go. So much appreciated. What else? Is there anything else?

Does this get us up to speed? Yeah, no, I think that's pretty comprehensive, Jocko. Yeah, sorry to take up so much of your time. No, not at all. And, you know, I think when you come back on, what we'll do is we'll roll in with like a legit, like, best practices, protocols just for, for injury prevention, for recovery. and then like post surgery,

because let's face it, most people are going to get surgery at some point in their life. I had neck surgery. Echo's had a couple surgeries on his biceps. Do you have knee surgeries too? Yeah. Knee surgeries.

So we're going to get surgery. So it's good to know some kind of protocols around that. We can do that next time you come on. That'd be awesome. And yeah, but is there anything else for today? No, love it. No, I think it would be great.

I think understanding some, you know, specific injuries, optimizing human performance, optimizing your health, putting these elements together in your own life that we've talked about, you know, since day one at the teams. That's reasonably available to most of you out there. And you've helped that with your company.

And now to really holistically look at how you want to achieve your goals, what you want to do, sports specific, precision medicine stuff. These are all things that we can help you with. things that we're, frankly, specialists of and really like to optimize that. Because there's nothing that puts a smile on my face better than seeing you be able to go back to what you want to do, to be able to play with your kids, to be able to enjoy life, to be, whether it's a full professional athlete, to what we say, the weekend warrior, I want you to be able to get back there.

And there's nothing that makes me happier. Yeah. And we take it for granted. I mean, I take my health for granted every day and then all of a sudden I get into. All of a sudden I you know my knee gets tweaked my back gets tweaked whatever and then you go oh my gosh So let's get ahead of it first of all get some protocols in place and then let's get Ready to respond to it when it happens and then let's get it ready to recover from it those are Things you got to do things you got to do echo Charles yes sir you got any questions yes because I know you're over there football

We got surgery what do you got you're taking notes Yeah, yeah, yeah. So, you know, so I talk to Dr. Luke about this every once in a while where, you know, a typical person, they see like an injury, you know, on Instagram, you know, like Dean likes to post these ones. The gymnastics get her, gets her, or the gymnastics practice practitioner gets her knee bent back. Right, right. Me, like a lot of people, we see that kind of stuff and we're like, Brad, I want to look at that. It, like, makes you, you know, you can't look at that kind stuff. Was that ever a problem for you?

And then if so, how did you get past it? Yeah, you know, Echo Charles, the first real up and close I had of that was in the cadaver lab at Dartmouth in Hanover, New Hampshire. And you walk in and you've got this 40 cadavers. I mean, it's a human body, deceased and filled with formaldehyde. And so you walk in and you've got this forever etched in my brain smell of formaldehyde in the cadaver lab in the basement of formaldehyde. of Dartmouth Medical School and you're starting to cut open someone's skull to get at their brain. And you get over it pretty quickly, I'll tell you, you have to. And if you don't, it's pretty hard to study anatomy and pass anatomy and get through medical school.

But I mean, there's nothing that really, there's no like cadaver prep course. I mean, they tell you how to, you know, what's going to go on and what to explain. and things like that. And with the injuries, I'll tell you what's really important is, you know, you talk about this knee bent backwards and things like that. So on the sideline, just so you know, we have, you know, I mean, there's a ton of healthcare professionals on the sideline of an NFL game, but we also have access to the video of the injury.

Right. Yeah, that's the, see exactly what it. Super powerful to be able to analyze it. You know, Jim Whalen head trainer's like, okay, check, check, so-and-so's knee out, okay, do-do-do, check the knee, do this, go check the video. I'll take care of. Come back, go to go to the video and come back, video and come back. So I get, you know, Zajak here, he's helping me out.

We're here on the sideline. We get everything dialed up with that video of the injury, you know, and obviously the sensationalized ones of these, you know, bent-back knees, and all the tough ones we see or the bad ankle, the fractured dislocations in blood on the field or in the ring or cage match or whatever you have, you know, is all there. It's part of some of these sports. Yeah. You would like this job because you'll watch that over and over again and see what happened.

Yeah. Two things on this. My daughter just graduated from Cal Poly and she had cadaver labs and she would kind of like text me, I was just cutting open a cadaver. That's number one. Number two, she just got hurt doing the jiu-jitsu.

She was rolling with tabs. You know tabs? Yeah, Alex. And I was videoing. You know, just like showed up. I was kind of on the mat just videoing and she got her toe like he landed on her foot and her toe got bent all the way up to touch the top of her foot I have it on video and I watched the video because I couldn't really tell what happened and I watched the video and I was like oh no like

this is bad and sure enough she's like you know she's young and she's very athletic and she just healed like Wolverine blood sure she's pretty much good to go now it's in her DNA but I watched it and I go I I was like, oh my gosh, she's injured. Like, this is going to be a long time. And she wouldn't watch it. She's like, I'm not watching it. I don't know. I don't want to see that.

I'll show it to you later. No, thank you. It's jacked up, man. Is it worse? So I think the, and this is me personally, like the cadaver part, that's less squeamish than the injury, especially when it happens. But, you know, like, okay, so great train, right, x-ray tech. And he's in the trauma center, trauma. So he sees all the car accident people.

and the femur sticking or the tibia sticking out of the leg like that kind of stuff so that stuff messes me up or that kind but the dead people and that's not as much or like even like the cutting open i think not as much but just like the crazy trauma part of it is there do you lean towards one as being like less sensitive or as far as like what gets or got to you back in the day echo psychosis right now dude yeah no i think no it's just none of that really phases. I mean, I'd say probably most, you know, orthopedic serves to do it, you know, because you're just, you know, you're conditioned to it, you're part of it, you're in the system, and certainly may, you know, certainly may at first, you know, I will, you know, some of the,

you know, some of the, you know, I mentioned it earlier, some of the, you know, we use special instruments to cauterize or, you know, some of the burning flesh reminds me of, you know, the wounded warrior, blown off limb type days. That, that's what personally still gets me which is you know pretty heavy for me personally and I know many of my colleagues as well but it's you kind of get used to how about when you're just breaking out like a chisel and a hammer yeah because that's what you do right yeah no of course the first thing I look at is how sharp it is like I'm like how okay is this thing's sharp is this thing got a good blade because you know sometimes you know you dinged it on something or the bone is super hard and the thing's dull and I'm like

oh I got I got another chisel because that's what you're doing like you're like you're going to do a knee replacement surgery on someone, you got to hack through some bone. Yeah, yeah, you need, you need good chisels. You got a hack through. You need, we have, we have whatever business I got you, you just lost. Sorry, bro. Yeah, no, no, we're elegant. We're elegant about it, but the, the way to be elegant is to have great instrumentation. I mean, we, our drills, our burrs, our saws and things like that. I mean, these are surgical level. I mean, they're really, really, really, nice and super high RPMs and Dremels that are like at

50,000, 70,000 RPM so it spins so fast that it doesn't wrap up tissue, doesn't wrap up a nerve or wrap up a vessel and cause all kinds of harm. So we have some pretty cool stuff. It's expensive. Like why is hell it's this stuff's you know it's expensive

drills are probably $20, 30, $40,000 $40,000. Oh, yeah. Yes to have. The DeWalt doesn't cut it? Walt doesn't get it. Do you think it would? Like the Milwaukee. It doesn't. Yeah, it doesn't.

It's expensive. So if you, okay, so you're doing a surgery. I don't know, shoulder, right? And do you see that as just more of a specimen? More so than like, oh, this is a person's shoulder and you're relating it to your own shoulder and all this stuff, whatever. It's just more like a diet, not a diagram, but like a specimen, you know, that's how you see it? Yeah, I think it, yeah, I think it's at echo Charles.

You're following the process for what this patient has to, get them better. And we all want our patients to do well. And so we're trying to follow the process, understand we're doing ahead of time. You know, we're meeting you, again, right before surgery, right before you go to sleep. And so, you know, it's very, for me, it's very personal still. You know, you want that, and everyone's got a little bit different, you know, although it might be the same procedure four or five, six times in a row, just based on the day you have, everyone's pathology, anatomy is different. We're all human. We're different. Huh. So then even if like you know the person personally, it's still the same protocol for you then.

Yeah, because that must have been weird because in the SEAL teams, you were working with guys you knew. Yeah. Yeah. And here's, oh here. So here's a great one for you and you know, you deal with this in the teams is you're operating on a colleague, an orthopedic surgeon or a neurosurgeon or, you know, some of the teams that knows enough. I'm like, hey, prevention. I know you're going to do my surgery next week or a few days next week. And I've got. The anesthesiologist for you picked out really good, really good person. She's going to do my anesthesia. And so-and-so, this tech is really good I've worked with as well or something. They're going to do the tech. And I'm like, dude, no, let me take care of you, okay? Let me go in with my A-team.

Let me go in with my platoon and let me know the people I work with because that's what you want all the time. And they think they're kind of doing your service. Oh, my God. So-and-so to kind of kind of. off vacation, they're going to do anesthesia for me and this and that. I'm like, fine, but no, let me just take care of you that we know how to do at the highest level. I would not give any input other than like, I trust you, do what you got to do. What about as far as surgeries go? What's the most, I mean, probability wise, right? Someone's

coming in. You got a surgery today. What's the most common injury you think? Like, what do you think that surgery is going to be most likely? Yeah, a lot of. A lot of what I do is shoulder knee, so we're fixing ligaments, we're fixing meniscus, cartilage, shoulder rotator cuff injuries, cuff tears, biceps, labrum injuries, things like that. Those are kind of the common shoulder and knee things we see. Is there anything game-changing for like ligaments coming,

or is we just going to be using cadavers and whatever, taking it from another part of your body? Are we still there? Yeah, it's a good question. So, you know, you get an ACL tear and you're reasonably young. You use your own tissue. But guess what? Nothing's for free in orthopedics.

Nothing's for free if we take it from your body. We take it from another spot of your body. Nothing's for free because you might have pain there. You might have a little bit of deficiency. You might have if we harvest a hamstring for your ACL. We have a little hamstring weakness. Where does that manifest? If you're trying to bring your heel to your buttock,

you might get a little hamstring weakness there. So we try to really make an individualized approach. and if you're someone who needs their foot all the way up to their buttock really quickly, hurdler, high jumper, maybe a grappler, depending on how you're behaving on the mat, long jumper, maybe a sprinter. You need that flexion torque of the knee. Maybe the hamstring is not the best graph. But what I think the biggest thing, Jocko, is we're trying to get better biology,

better healing to get you back quicker. You know, current state of the heart for an ACL surgery is still about seven to nine months because of muscle, hamstring, core. I mean, that's, I hear your breath. It's a lot. I mean, that would crush someone like you and echo Charles right now.

That being said, I mean, you've had ACL, right? That was going to be my last and final question, I promise. So when I had, I was 19, by the way, though. Okay. So a lot different than, you know, my current state of being. But I had ACL surgery, a little bit meniscus. I was cleared to play in three and a half months. None of my coaches believed it.

They were like, we're not going to put you in or whatever, but all the doctors and all my tests all passed three and a half months. But then it made me think when you mentioned the ligamentation part of it, because I don't know how much they, or how can they even test that without, I don't know, some weird ray gun or something. Because, you know, the test for that is like there's all these like exercise you got to do, But then there's this Sybex machine that, like, you've got to have a certain amount of strength, certain amount of strength back, right? Hamstring and what do you call, Patela, like, or flexion and extension or whatever.

And then all this other stuff that I had to do. And at like three months, they were like, hey, you're impressively close, given how quick this is. And then at three and a half months, they were like, you pass all the minimums to actually go play. Echo Charles, you may actually have that wolverine. A little bit of Wolverine blood. going around your knee, I would say. But when you passed, we look at functional screening, we look at all these other things,

but you went through some functional screening, and the docs that you were with felt that you were ready to go. And you probably passed those with flying colors. That's amazing. And that's, but that was a big part. We can definitely get people like you back that are super physiologic, have access to all the best stuff, access to all the best care.

But there's a risk if you go back early because that ligamentization of biology hasn't fully taken hold. And that rupture risk of your ACL is probably highest between three and five months, three and six months, maybe a little bit longer. Why? Because the muscles are so strong and stuff, but the ligmentation is weak kind of a scenario? Yeah, the body just hasn't fully healed to the bone and your muscles are weak, like you said. Yeah, it's bad, bad combo. You got lucky.

You got lucky. Muscles are weak is what I heard. Yeah. But, no, no, no. Well, I thought maybe the muscles are strong. But the ligament, you know, so I might be out there running routes or whatever, make a cut, and my muscles can do it. But you know how like your ligaments kind of hold your bone, or they do hold your bone together.

So my bone might slide in a way that. I don't know. That was another claim from Echo Charles. He claims to have loose knees. Is that a thing? It is. Yeah, they're, yeah, hyperlaxity. I'll totally let you check it.

Yeah. And you can be like, hey, these are loose knees or whatever your conclusion is. But the one key factor is I focus super, super hard on the physical things. therapy. Like I treated it like a workout program. Yeah. And I think you're a testament to if you want to get back from injury, from surgery, from non-operative, whatever is quick as possible, you have to, you have to spend the time because it's the body shuts down. It's not your fault, but it's what we call proprioception or how you know where your joint is behaving in space and these other things and how your kinetic chain is just kind of shut down. You got your kinetic chain back really quickly,

Charles. And that's a testament to who you are and, and what you did. But for those listening, if you want to do this, you don't want to overdo it. And you still have to follow recommendations, follow the protocol, but you can get yourself back officially and safely through these means. You're awesome. Good to meet you in person. So where can people find you? You're on, you're on Twitter and Instagram. You're at Dr. Preventure. You're on Facebook at Matthew Preventure, M.D. You got a YouTube channel. We do. Not highly active right now.

Nope. But it is there. You're probably working it. It's coming. That's probably by the time you hear this, it'll be a little more active. Matthew Preventure 28. That's right. 28?

What's that 28 have to do with? I don't know what that is. Yeah. It's your YouTube channel. Your name's on it and you're in the YouTube videos. Yeah. So it's out there. Definitely me.

Yeah. So we, another one of my side job businesses is we're the, in our third year of working with Fox. sports as their director of performance and injury analytics and so we've been going up to LA in the Fox Sports studios and working really closely with them to help especially on their digital media side to do injury interpretations how does it what does it look like when Mahomes hurts his ankle in playoffs and what's it going to look like for the Super Bowl I was a Super Bowl going to be for him so we do a lot of analytics we do a lot of broadcast we do podcasts we do video all affiliated with

Fox Sports so so all that stuff can be found on Fox Sports. And Fox Sports as well, and the predictors.com and also at the Stebman Clinic, Matthew Preventure, MD.com as well. Matthewpreventure.com is like your main place. You can find these other things linked from there. Exactly. Yeah.

Awesome. That's what we can find you. Thank you. Doctor, any closing thoughts from you? No, I just, I just want to, you know, thank, you know, everyone that's been a part of this journey. It's truly been. humbling when you know someone was not going to be able to fly the jet back in the day and

this kid from de hampshire in the sticks that has now been to 50 countries and seen the world you know to inspire and give back any of you out there can can do that and achieve this and achieve you know really great things and i just want to thank all my mentors and incredible people so many of which, you know, we didn't even close, get close to get mentioning today, but that have helped me along my journey because I'm truly indebted and humbled to those around. I'm indebted to my team, my family, my mom, dad, my brother, wife and kids, and I really want to thank all of them for enduring the journey as well because it takes a village to do what we all do around this table. and I'm so appreciative.

And then lastly, you know, Giacosco and Echo Charles really honored to be here today and honored to be on your podcast and I'm really proud of what you've all done and how you represent, you know, the community that I had, you know, a very small part of being a part of.

Yeah, appreciate that, Doc. And, you know, again, thanks. You know, we're talking to you, but as you said, I know, and you know the many hundreds of people that have participated in in making all this stuff happen. So thanks to all those people. Thanks to you for coming down. Thanks for joining us.

Most important, thanks for your service. You know, we barely touched on 27 years in the U.S. Navy. That's just awesome. And what you were doing that whole time, taking care of our wounded and our injured warriors. I know so many friends that you literally personally took care of. and got them either back on the battlefield or to live the best possible life that they could live with the wounds that they received. So thanks for all you did for us and thanks for all your continuing to do now to make people healthy. I don't think there's any greater service than that.

So thanks for everything, Doc. Jocko, thanks a lot. Health matters and let's keep the journey going. Appreciate it. Appreciate it. Thank you. And with that, Doc, Reventure has left the building.

Gotta stay healthy, Equitrals. Yes. And then if you take a hit, you got to get back. Get back in the game. Need to be on the path. Need to stay on the path. It's a big part of being on the path. It's true.

He mentioned something that it took me like probably a good 10 minutes to kind of kind of clarify it in my own head. And it was this where he was like, and he spoke about his maybe early experience where he maybe implied or whatever that he was kind of surprised that the guys wanted so much to get back onto the battlefield when it's like dude you you're all jammed up it's kind of like why do you want to go it's like there was and i'm not saying he was saying that but it was like that was kind of what was going on right like kind of maybe in his head or was he talking about somebody else at that he was talking about himself right he was saying these guys wanted to go

back on the battlefield he's looking at him like hey man you may not walk and you want to go back, damn. Right. Yeah. Like all that is going on. Respect to the highest level, admiration to the highest level. Yeah. Yeah.

So it felt like what I'm trying to reconcile or trying to relate maybe to what goes on in someone's mind that's like, oh yeah, I don't care about that kind of stuff. I just want to go back out. And it's one of those, I guess, maybe to use a common term, like their dedication to duty, their dedication to their job. For sure. And I kind of think I was not in the military. You know that about me.

But I kind of think it's one of those things where they actually enjoy the environment. Like enjoy the, I don't necessarily enjoy war and all that part of it. But the environment, they enjoy the environment. You know what you're missing is just, they just want to be with their brothers. Yeah. And that's what I think is the element of the environment that makes the whole

environment now, no matter how shitty it is. The whole environment, what they want to be in is yes, because of their brothers. So, like, yeah, and it's obviously you can make that easy comparison to, like, a sports person, you know, or a professional athlete, even like a college athlete, even a Pop Warner athlete. Where it's like, because that's the first thing you ask the doctor when you, you know, jam up your knee or your ankle or whatever. And they'd be like, hey, they'll look at the x-rays. And the first thing you wonder is, like, how long am I out? Because I want to, you know, get back or whatever.

It's the same exact thing. But it doesn't seem like the same exact thing because it's as far as that little element goes. It's not the same exact thing. It's, there's a similarity between the two. Yeah, yeah. But as far as the mindset, it's not like, oh, you know, like freaking, sure, I'm jammed up, but at least I don't have to do that anymore. It's not that.

It doesn't exist, you know, kind of a thing. So I was like, huh, that is crazy. It's extreme. Dedication of our military personnel. That's what it is. Amazing stuff. Yeah. So, yeah, he spoke about Jocco Fuel.

Yeah, he did. Yeah. So, hey, man, that does. Man, that's a big part of it. Nutrition, supplementation, all this stuff, staying on the path, getting on the path, staying on the path, getting back on the path. Trust me.

It's a big one. Yeah. Well, yeah, like you said, he talked about it. And not much I can say to double down on all the stuff that he was talking about. Just the, you know, he and he brought it like a whole review. He brought like a whole typed out review of all of our different supplements and like what the benefits were and how good they were. It was pretty awesome.

Yeah, I was kind of impressed too, but then after like a few seconds, I was like, wait a second. Of course he did. Yeah. Freaking doctor over here. Of course that's what he did. I think that's probably what most doctors would do on that kind of stuff. He's like, and that was like the first thing he talked to when he got here today. He was just talking about joint warfare.

He's talking about time war. He's talking about mold. Like he's just, it's awesome. So there you go. Go to joccofuel.com and get some of this awesome stuff so you can stay healthy and stay in the game. That's what we're doing. You can get it at Wawa. You can get a vitamin shop.

Get it G and C you can do the military commissaries afees Hanifer dash stores Wakefern shop right H-E-B down in teahas myer up in the midwest Harris teeter lifetime fitness shields those big shield stores dang 300 000 square feet of goodness you can get jaco fuel in there small gyms actually out there little gyms little crossfit gyms little jitzu gyms they have it and if you Own a CrossFit gym, you own a little gym, you own a Jiu-Gitoo Academy, email JF Sales at joccofuel.com. Sell the stuff wholesale. First of all, take care of your people,

take care of your clientele, take care of your students, and also add a little bit to the bottom line, right? Make a little bit more money. Look, I know what it's like, I own a gym. I know that it's lean in the gymnasium. It's lean in the Jiu-Jitsu Academy. It's lean in the CrossFit box. Guess what?

Get yourself a little bit more. Supplemental income and in the meantime take care of your clientele Like I said Jf sales at joccofuel.com. That's what we're doing check it out joccofuel.com go get some what else we got true that origin USA Boom American made apparel durable goods Jiu Jitsu geese rash guards the whole deal stuff made in America. That's not it's not as common as you might think No, it's not as common as you might think in fact it doesn't really exist other than what we're doing and here at origin USA.com and these other companies that are out there

that's saying that they care about the environment and they say they care about people, they don't care about either. They're lying to you. And they're trying to cover it up by saying they give, you know, 1% to the environment or whatever they're saying. I'm giving 1% of the environment,

but I'm building a factory in a place that has no regulations whatsoever and they're just going to allow me to dump chemicals into the atmosphere and dump chemicals into the river and dump chemicals into the ocean. That's what I'm doing. But no, no, I'm a nice person.

I'm giving my 1%. Oh, no, I care about people. That's why I have a slave labor plant in China, because I care about people so much. These people are liars. Don't do it. Don't support them. Don't support these communist regimes.

Don't support the adversaries of freedom, the adversaries of America. Help the national security of the, this country go to origin usa.com buy a pair of blue jeans buy a freaking hoodie i know it's summertime i know there's a heat wave going on the heat wave is going to end it's going to get cold even out there in arizona it's going to get cold even in new mexico it's going to get cold even in eastern california out in the imperial valley where it's 120 degrees right now it's going to get cold get a hoodie get a pair of jeans get a jihitsu gie get rash guards origin

USA.com American made let's go. It's true also jocco store called jocco store store com for this stuff discipline equals freedom got some shirts on there some hats on there some hoodies on there lightweight and regular weight not because they heavy do you guys a disservice there but yes so yes jocco store.com also there's a a little program subscription program called the shirt locker new shirt every month different kind of designs but same same vein different design I saw a lot of a shirt locker represent situations going on at the jaco live events yep it was kind of impressive

yeah it's kind of is very impressive that's that's like people who's just ultimate game is used out there representing a wall on the path so jocco store.com thanks for thanks for the support on the shirt locker if you know sometimes people were like oh what does that even mean the different kind of designs whatever you can go if you go to the website and you click on the shirt locker. If you scroll down a little bit, it'll show like a sneak peek of this month's one.

It won't show the whole shirt, but you get a little, a little of what's kind of going on at the, in the current moment, I was going to show you next month's design. I was going to do it. I got inspired by design a song in Hawaii. Okay. We'll check it out after this. It's good. But yes, jocco store.com.

Also subscribe to this podcast, subscribe to jocco underground.com. Subscribe to your YouTube channel. subscribe to psychological warfare go to flipside canvas.com and get some cool stuff to hang on your wall that's made by an american hero dakota mire books i've written a bunch of books get them i've written a bunch of kids books look prioritize your kids this isn't like when you're on an airplane and the mask comes down from the ceiling you got to take care of yourself first in this situation i'd say take care of your kids first get your kid the way the warrior kid books because guess what You read them.

It's going to help you too. Prioritize and execute for your neighbor. Your neighbor's kids. Your nephew. Your niece. Your grandkid. Get them these books. Make their entire life better.

So there you go. A bunch of books. You know what they are. Eshlam Front. We solve problems through leadership. Go to Eshalonfront.com. We just sold out the Dallas muster. We're going to sell out what we do.

So if you want to come to one of our events, go to eschlamfront.com, check out events. FTX, council, battlefield. Just all kinds of awesome events going on. So check those out. We have a women's assembly coming up, Jamie Cochran, the C.O. Of Eschlam Front, she is running a leadership seminar for women. So September 14th through the 16th in Phoenix, Arizona, check that out. Also, we have an online training academy, Extreme Ownership.com.

Leadership is a skill. Life is a skill. Isn't that weird? People say life skills. I'm going to tell you life is a skill. And one of the skills, one of the skills of life is leadership. And it helps you in every aspect of life. It's little tricks.

It's little techniques, tactics and procedures that you can actually use. And it's going to make your entire life better. Go to extreme ownership.com. Take some classes. There's a free class on there. There's a free class. The barriers to extreme ownership. Take that free class.

I'm just giving you something for free that's going to help every aspect of your life. We have the framework of extreme ownership. Go take that class. It's free. I don't want anything from you. Just go take that class. It's going to make your life better.

We'll start there. Then if you need more, you can get more. There's a couple other free courses, but start with that. those two. We're here to help you become a better human extreme ownership.com. And if you want to help service members active and retire, you want to help their families, you want to help Gold Star families. Check out Mark Lee's mom. Mama Lee. She's an incredible woman. She has an incredible charity organization that is truly and pragmatically helping veterans. There's no, there's no

like mystery as to what she's doing. She's got programs that are set up that are having a huge impact on veterans and gold star families as well so if you want to donate or you want to get involved go to america's mighty warriors dot org and also don't forget about heroes and horses dot org we got micah think he's in the hinterland he's up in the wilderness right now last report was he had he was living in a cave in a small cave with a couple bears and he was the alpha That's the last report that I got. So he is taking veterans up into the wilderness so they can find themselves. Heroes and Horses.org.

Also, if you want to connect with us on the interwebs, Doc Preventure. Matthewpreventure.com. He's got ThePredictors.com. He's on Twitter and Instagram at Dr. Proventure. He's on Facebook at Matthew Preventure, MD. He's got a YouTube channel, Matthew Preventure 28. So that's where you can find the doc and also Echo is at Equitralz. I am at Jocco Wellington.

We're on the social media platforms. We're on there. Just be careful. You guys know the deal. The algorithm is there to grab you and try and utilize your brain for its profit. That's what they're trying to do. Trying to utilize your brain for its profit. It's like the matrix.

in the movie The Matrix. They're trying to utilize your body in that movie for what? Fuel? What is it? Heat? Yeah, fuel. Battery. Battery?

Batteries. Yeah. This is the opposite. They use your mind for their profit. So don't let it happen. That's what I'm saying. Also, thanks to all the military personnel out there. Obviously, thanks to Doc Preventure for coming down here.

And thanks to a special thanks to all the military medical person. now out there. There's thousands and thousands of you in the medical field inside the military, doctors, nurses, Corman, medics, PAs, ATs. Thanks to all of you for your incredible dedication to keeping us alive and keeping us healthy. We thank you. And also thanks to our police law enforcement, firefighters, paramedics, EMTs, dispatchers, correctional officers, border patrol, secret service, all first responders out there. Thank you for your dedication, keeping us safe and keeping us alive here at home. And to everyone else out there, you got one body.

You got one body. You don't get a spare. And that body requires discipline to maintain. And it doesn't get easier, by the way. It's one of those things. Unfortunately, I'm sorry. I hate to break the news to you. It doesn't get easier to maintain as time goes on.

there's some things in life oh you you start playing guitar it gets easier the more you practice the easier it gets you start doing jiu jih Tjitsu gets easier the more you do it maintaining your physical health gets harder over time now look it might get easier from you know age 14 to age what 45 something like that if you're lucky yeah then it's something starts going the resistance becomes harder it doesn't get easier it gets harder but let me tell you what's even worse is you let that slide you let that slide and your physical fitness slide life is going to get harder don't let that happen and listen there's no shortcuts you have to put in the work you have to put in the work so put in the work

take care of yourself your body isn't a rental car In the military, we had a little saying, what's the fastest car in reverse? It's a rental car and an E3 drive in it. It's the fastest car in the world in reverse. Well, listen, your body is not a rental car. You've got one, and it's the only one you're ever going to have. So please take care of it. And you do that by going out there every day and getting after it.

And until next time, this is ECHO. Jocko out