Julian Dorey Podcast - #321 - Kim Jong Un Psychological Profiler on China & Most DISTURBING Patient | Ken Dekleva

Episode Date: July 20, 2025

SPONSORS: 1) MANDO: Control Body Odor ANYWHERE with @shop.mando and get 20% off + free shipping with promo code JULIAN at https://shopmando.com ! #mando (***TIMESTAMPS in description below) ~ Dr. Kenneth Dekleva is a former physician-diplomat with the U.S. State Department and a Professor of Psychiatry at UT Southwestern Medical Center. He is also a senior fellow at the George H. W. Bush Foundation for U.S.-China Relations and the author of two novels, The Negotiator’s Cross and The Last Violinist. PATREON: https://www.patreon.com/JulianDorey KEN's LINKS - IG: https://www.instagram.com/thecipherbrief/# - X: https://x.com/thecipherbrief - WEBSITE: https://www.thecipherbrief.com/experts/kenneth-dekleva - KEN WORK: https://www.blackwoodadvisorysolutions.com/ FOLLOW JULIAN DOREY INSTAGRAM (Podcast): https://www.instagram.com/juliandoreypodcast/ INSTAGRAM (Personal): https://www.instagram.com/julianddorey/ X: https://twitter.com/julianddorey JULIAN YT CHANNELS - SUBSCRIBE to Julian Dorey Clips YT: https://www.youtube.com/@juliandoreyclips - SUBSCRIBE to Julian Dorey Daily YT: https://www.youtube.com/@JulianDoreyDaily - SUBSCRIBE to Best of JDP: https://www.youtube.com/@bestofJDP ****TIMESTAMPS**** 00:00 – Ken’s Past Guests, Role in State Admissions, Starting in Moscow, Truth About US Diplomats Abroad 09:23 – Intro to Psychiatry, Jim Grigson, Forensic Evaluation Techniques 20:45 – Ken’s Most Intense Case, Prison Psychiatry Reality, Core Philosophy: “Nothing Human is Alien,” Language Shifts in Interviews 32:45 – Having Empathy for Monsters, Emotional Toll, Testifying in Child Abuse Trials, Evaluating Inmates for Release 41:24 – Causes of Predatory Urges, Shocking Classmate Reveal, Reconciling Faith with Catholic Abuse Scandals 49:33 – POW Camp Stories, Parents Meeting Post-WWII, Love for Language and History 57:35 – Why Psychiatry, Ken’s Biggest Influence, Most Brilliant Interviewer Ever Met 01:07:31 – Trait of Elite Interviewers, Joining State Department 01:15:47 – First Day in Moscow, Love for Russia, Stress of Diplomatic Work 01:26:41 – Why People Distrust Psychiatrists, Balancing Career & Marriage Abroad 01:32:51 – Benefits for Kids Raised Overseas 01:37:06 – Havana Diplomats, Monthly Parties, Falling Into Geopolitics 01:47:49 – Presenting with Jerrold Post, Karadžić’s Shift, T4 Program, Why Humans Commit Atrocities 01:59:02 – Studying Putin, Evil in Human Nature, Social Media’s Dark Path 02:03:27 – Challenging Radical Beliefs, Stalin’s Hero Revival, Is Kim Jong Un Rational?, What Worries Ken 02:18:01 – Profiling Xi Jinping, His Father’s Story, Rumors of Xi’s Fall, China’s AI Race 02:26:25 – Retaining Foreign Talent, New Cold War, Kai-Fu Lee, National Space Heroes 02:35:32 – The Most Evil Mind Ken Studied, Guardrails for Social Media, Youth Mental Health, COVID Fallout 02:45:52 – Staying Tied to Government, Working with Cancer Patients, Human Side of Medicine, Does Ken Fear Death? CREDITS: - Host & Producer: Julian Dorey - Producer & Editor: Alessi Allaman - https://www.youtube.com/@UCyLKzv5fKxGmVQg3cMJJzyQ Julian Dorey Podcast Episode 321 - Ken Dekleva Music by Artlist.io Learn more about your ad choices. Visit podcastchoices.com/adchoices

Let me tell you a story. The first two cases I ever testified were capital murder cases. One was a serial killer and the other was a psychopathic f***ing dealer who had kidnapped and murdered and mutilated this person. I spent ten hours with this guy, wrote my report and told the attorney, do not put your defendant on the stand. The jury's gonna barbecue you. And he took the stand. He got 99 years. You know, in the jail, I would talk to people, how do you interview a criminal? Well, there was a patient who had been on the ward for quite some time and had obsessional, psychotic kind of fantasies of wanting to murder his parents.

Fill his room with reasons why they deserve death, but he wouldn't talk to me. So guest interviewers said, I wonder what it's like to want to murder your parents every day of your life. The patient started sobbing and then he talked. I was blown away. Who's the most evil person you ever studied? That's a good one. I was asked once in the jail to evaluate a guy who would... Hey guys, if you're not following

me on Spotify, please hit that follow button and leave a five star review. They're both a huge huge help. Thank you. Ken, you were braving the Newark airport problems this morning. I was getting nervous you weren't going to get here. Sorry about that. No, made it just fine. Thank you. It was like I bought your ticket, I think, three days before suddenly all, what was it, Deif, like 100 air traffic controllers walked off and there was one guy left. We were like,

oh boy, let's hope our people get in here, but we've been okay. That's good. I made it safely. Thank you. Thank you for having me. Of course, of course. So you come highly recommended by Shawnee, Matt, and the Mad Dog, Jim Lawler as well. It sounds like you had quite the different kind of career than they did working within the government. Yeah, that's correct. They were case officers for different intelligence agencies, whereas I was a regional medical officer and psychiatrist, as well as a diplomat.

And as well as a diplomat too. Now how, for your purposes, just so I can know that, like what were your type of diplomatic responsibilities? Was that the evaluating hospitals and stuff, like you were telling me earlier, or did it go beyond that? Kind of several things. One was taking care of our people.

The State Department runs a large medical program go beyond that? Kind of several things. One was taking care of our people. The State Department runs a large medical program for 250 or 260 embassies and consulates all over the world. So think of it as a large HMO with all these nodes and every embassy and consulate has a health unit. The places I was stationed in were large health units, like a large private practice. So they might have one or two family medicine physicians or internists, nurse practitioners, a couple of nurses, and a regional psychiatrist.

So they were like hubs. But small embassies out in the boonies, if you will, in remote areas, they might just have a nurse or a nurse practitioner. But our job was to travel regionally to take care of people. When I started, there were about 22,000 people in 2002 under what they call Chief of Mission Authority. These are all the federal agencies that are overseas in an embassy. So the State Department, what was then USAID, which no longer exists.

Oh, that's what it was. FBI, DEA, Homeland Security, after they got stood up in 2003, various intelligence agencies, Department of Commerce, Department of Transportation, all these people have people overseas. So they all buy into the medical program so we would take care of them and their families. So you're just like the government, you're kind of the jack of all trades when it comes to whoever's working for us outside these borders where you're assigned, like you're on it.

Yeah, we had a group. When I started, there was about a dozen, so very large regions if you divide 250 by 12. I think my first region when I was in Moscow, I had 18 embassies and consulates that I had to travel to. So you're traveling constantly every other week. It was enjoyable, but it's exhausting too. A lot of the flights are at night. You have to juggle visas in a lot of these countries. I had three passports because one passport was my main one,

but the other, they're all in my name. I was gonna say, wait, that was the next question. The other one, but like you'd use one passport, you had to, one passport might go to an embassy and you had to wait two, three weeks to get a visa. And so you'd use the regular passport to travel to a country that maybe you already had a visa for in the first passport, stuff like that. And then we also would respond to crises like political violence, terrorist attacks.

This was during the height of the war on terror. I went to Afghanistan a lot, Pakistan, other places. We would deal with political violence, natural disasters like an earthquake or the tsunami. In 2004, I had to respond in Sri Lanka, which was devastated. They had 30,000 deaths. Other colleagues of mine had to respond in Indonesia. We had to deal with kidnappings. If people were victims of violence or crime, an attempted rape, an assault, a kidnapping, and they were part of the embassy, we had to help them. And then we had to consult with management

and advise them on how people were coping with the different challenges, if you will, of living in these places. Something your listeners may not be aware of is most diplomats and other government officials who work in embassies overseas don't work in Europe. They work in tough places. So they spend two-thirds of their career in, you know, less greener pastures, or what President Trump notoriously called shitholes.

Sharehold country. I use the word less greener pastures. That's very diplomatic of you. But, you know, there's a lot of tough places. They're austere, they're remote. At the time, there weren't always flights out. So it's very challenging to live there, to work there. And I want to start this podcast by saying I have nothing

but great admiration for the people I help serve who do this really important work overseas. Then we also dealt, the other enjoyable part of the job was what I call medical diplomacy, which you'd go to a country and you'd visit hospitals and clinics in that country to see if there were local resources that our people could use either routinely or in an emergency. So I've been to military. I've been to military hospitals. I was the first American physician to ever visit

the 14th Russian, used to be Soviet, military hospital in Dushanbe, Tajikistan. And that was the main medevac point military hospital in Dushanbe, Tajikistan. And that was the main medevac point for all the Soviet troops in the 80s. It was their go-to point for medical evacuations out of the theater of combat in Afghanistan. Whoa. So I visited there, I had tea with the CEO

and medical director, met the chief of psychiatry. You checked the tea before you drank it? Yeah, I had to. No polonium in it. That's good. But I've been to the Millennium Hotel. When I left London, my last post, the health unit took us all out to tea

at the Millennium Hotel, which was across the street from the old embassy, where Alexander Litvinenko had his ill-fated tea with two FSB operatives. But I enjoyed going to the hospitals. I've been to hospitals and clinics all over the world. I've been to the largest, most famous neurosurgical hospital in Russia,

which during World War II was so important because of treating head injuries from combat that they had a direct metro line to the hospital from Belorussky Voxel, a large metro station in the middle of downtown Moscow. We met with the director, a very senior person, and his deputy, and they were very kind, gave us a tour of the ICUs, the operating rooms.

So I enjoyed the diplomacy part of it as well. So as a, because your personal expertise is in psychiatry, but if I'm understanding this correctly, you're making full-blown evaluations from a broad medical perspective on how capable all these different countries and their specific places would be to treat anything, as you said, like emergency evacuations, situations like that. We would help our colleagues, our primary care colleagues who did that part, but sometimes there was overlap

where we had to understand the mental health resources or neurology, head injuries, tumors, things like that. I have training in neurology as a psychiatrist, and I'm a physician. I always thought of myself as a physician first, so we would help our partners in the health unit with that. And I enjoyed it. And once you get doctors in a room and they talk,

they enjoy talking to us. If you come across as curious and humble and not the ugly American, not arrogant, I was visiting once the presidential hospital in Astana in Kazakhstan, which is built and owned by the Nazarbayev family. And the CEO gave us a tour. We had an interpreter with us, but I didn't need him. My Russian was pretty good then. So I was chatting with him. And then at the end, I said to him in Russian, thank you so much for hosting us. It's a

pleasure. This is really a remarkable hospital. And he answered me in the King's English. It's a pleasure. This is really a remarkable hospital." And he answered me in the King's English. It was a joy to have you here, Dr. DeClef. And I'm like, you made me work too hard with Russian. I could have talked English to you. And he smiled when he said it. Did you? So, I mean, was this the first job you had out of college or were you in or out of medical school or were you in private practice? No, I wasn't in private practice.

I went into psychiatry wanting to be an emergency room psychiatrist. An emergency room psychiatrist. Dallas has a huge county hospital, which is Parkland Hospital, which is famous because that's where they took President Kennedy. But at the time it had one of the largest psychiatric emergency services in the country, along with places like Cook County, LA County, Bellevue, and New York. And I like that kind of work.

It's very fast-paced, it's very exciting. So I worked in the VA for two years, and then when a job came open in the Parkland psychiatric emergency room, trance were there, and I did that for a couple years. And I also got interested kind of by chance, but it drew me in forensic psychiatry. I was-

Forensic psychiatry. Which is psychiatry and its interface with the legal system. So I became an expert in criminal forensic psychiatry, and I actually specialized in capital murder cases and murder cases. Whoa, what's that like, testifying in a case like that? I testified in five cases.

Actually, the first two cases I ever testified in my life were capital murder cases. One was a serial killer and the other was a, kind of a psychopathic drug dealer who had kidnapped and murdered and mutilated this person. So I got pulled into that because I was interested in it. And one of my mentors told me, you need to talk to Dr. Jim Griggson, who, the late Dr. Jim Griggson, you can pull this up on your screen.

He was a legendary, notorious, but legendary forensic psychiatrist. And he took a kind liking to me and kind of helped put my name out there with district attorneys and other attorneys and helped me get started. It's a hard field to break into as an expert. Gregson was a fascinating character.

He was notorious because he had testified in over, gosh, I think 200 capital murder cases and over 40,000 competency cases. 40,000? Yeah, competency to stand trial. There's only 365 days in a year. Well, he'd been doing it for a long time. And he was a good old boy from East Texas,

whose family was in the tombstone business. And he and his brother played poker to pay their way through college. Nice. Gregson was incredibly street smart. He was a brilliant guy. The establishment and the APA threw him out. They hated his guts.

Yeah, I see that right there. Because he was hard to cross examine because he was slick. He was really, really slick. But he had a photographic memory. He was smart the way Lyndon Johnson was smart that kind of Texas smart. As many of you may know from me talking about her on the show a lot of my family lives down the Jersey Shore so whenever I go to visit them it's always very last minute and I'm

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get your old self back naturally. And he had a sense of humor, but he had a photographic memory. Like he took me around the courthouse. He's introducing me to the judges, the bailiffs, you know, and he'd say, Hi, Judge, how you doing? Did your son make the football team? Oh, gosh, that's super good. How's your daughter doing? I heard son make the football team? Oh gosh, that's super good How's your daughter doing? I heard she made the cheerleading team He had a memory for everything and that would make people lighten. Yes, and he told me treat the bailiffs nice And I didn't even know what a bailiff was, you know They work in the court and they help process you never watch judge shooting Yeah later, but the bail bailiffs are responsible for the movement

of prisoners in and out of the courtrooms. That's right. And if you're not nice to them, and you go in there with a judge's order or a defense attorney says, I want you to evaluate the client, they're like, we can't find him. I think he's moved. Check the third floor.

Check the second. So you'd be wasting time on a wild goose chase. So he said, be nice to the bailiffs. Always be kind to them. So he had a lot of street smart common sense. But I testified in a murder case once where he was on the opposing side. He was on the defense side.

I was on the prosecution and they wanted, it was an agreed insanity plea, which is very rare. That happens less. Agreed insanity? Agreed, everyone agrees. So why are you testifying? They wanted it for the record. Okay.

Less than 1% of murder cases have an agreement like that. It's very rare. What made this one? He was schizophrenic and clearly delusional and psychotic in the throes of the killing. So I had reviewed all these records and met with the defendant. And then Gregson got up there and I was sitting there helping. They really weren't going to cross examine and it was just for the record. But I was

listening and they asked him, Dr. Gregson, please tell us what records you reviewed. He goes, I never reviewed any. And I was like, huh. Because most forensic psychiatrists will review a packet that's given to you, crime scene reports, mental health reports, school records, any data that may help you understand the mindset and the health of the evaluie. Rickson said, I just know what he's been charged with, I go talk to him.

Well, I said, I just know what he's been charged with. I go talk to him. Well, I said, either he's lying or there's something else going on. And then I figured it out. This is the slick part. If he's working for the defense, then the defense lawyer can give him all the facts of the case. And that's protected by attorney-client privilege.

So he can't be asked about that. That's smooth. Yes. So, and with his photographic memory, he knew all the details. And he was also very, very skilled interviewer and friendly. And back in the day when you could smoke in the jail, Gregson died from cancer.

He was a chain smoker, but he'd offered the defendant a cigarette, those kinds of things. He had a lot of tricks in his bag. And I whispered to the DA, I think either he's lying or there's something else. And then finally I told the DA, I know what he's doing. This is really slick. But he was a very, he was part of that generation

of really kind of Texas forensic experts. Ron Rosenbaum did a brilliant article in Vanity Fair called Travels with Dr. Death, where he followed him around Texas for a week where he testified in three cases. And... Called him Dr. Death. Yeah, that was his moniker. Because he always thought that the person was... He more likely thought that the person met criteria

for future dangerousness. And I testified for the state in five cases. Two of those people are teenagers at the time of the offense, 17 year olds. So their death sentence got commuted after a Supreme Court ruling in 2004 to the life without parole. But then the other three were executed.

So it's a very intense life and death testimony. It's very emotional. You can be on the stand for a long time. The first time I was on the stand for a day, maybe longer. Now what? Before you go to testify, you have to go in and evaluate the defendant, as you said. So when you go in to evaluate someone who's been accused of a homicide, what's your strategy there?

What does that look like when you go into that? Let me make one correction. In some cases, when I was working for the prosecution, I didn't get to evaluate the defendant. You're relying on collateral information. Their crime, interviews they've given to detectives. Really? Hypothetical questions.

There's controversy there. Yeah, I don't love that. I've done that, but I've also, and looked at crime scene photos, visited crime scenes, watched video of interviews. If the defendant talked to the media or anything, you gather all the information you can. But for example, when I interviewed someone for an insanity case, both the prosecution and defense will have access to the defendant or a court appointed psychiatrist or psychologist. You're going to review all the materials and go in there and kind of have a sense of already what you're going to ask about. But the hard part about this

interviewing is you have to get the defendant to talk to you. You have to break the ice and it's not a doctor patient relationship. You're not there to treat. You have to break the ice and it's not a doctor-patient relationship. You're not there to treat. You will diagnose. They know why you're there, but if you're a skillful interviewer, they'll let their guard down. How long does that usually take for different people? Yeah, a couple hours. I'm a good interviewer. I took courses in interviewing. I had really good teachers. You're constantly refining that skill. I took courses on interrogation from cops with video and examples. So you learn how really skilled detectives interview challenging defendants. So that part, and I interviewed a lady once,

she was charged with murdering her, it was for an insanity defense, she was charged with murdering her eight-year-old daughter. And it was a horrible case where a lot of bite marks, stab wounds, this is before CSI, but it's like the worst kind of cases you'd see on CSI. And I spent eight or nine hours with her

after reviewing her medical records. She was severely mentally ill. Other experts interviewed her. And I got her to talk about the crime and what was going on then, and then what she was feeling once she got treatment and realized the horror, the horror of what she had done. She actually developed a severe depression which had to be treated. But what happened in that case that was absolutely mind-blowing for me was

I didn't hear about the case. I sent my reports to the court, to the DA who had hired me, and to the defense attorney. And you don't know what's going to happen until they call you back. Will the patient, the defendant go off to a state hospital for a long time? Will they go to prison? Will they get a plea bargain? Will they go to trial? You don't know what's happening until it happens. So I was working in another forensic setting in a county jail in Fort Worth, and I get a call from the DA, we need you in court right now. I'm like, whoa, whoa, whoa, whoa.

Normally I get a day or two notice, I gotta cancel my appointments. And she goes, well, we're starting trial. I go, you couldn't let me know this like yesterday? She goes, well, it all happened fast. So I said, give me two hours. I need to go home and put a suit on. So I show up and I said, what, why do you need me?

Are you picking a jury, going to trial? She goes, the defendant won't sign the plea bargain to go to jail for 20 years, to prison, without talking to you. And I'm like, WTF, you know? I'm like, I'm the state's expert. There's a defense expert who's a colleague of mine who's an excellent forensic psychiatrist.

That's their expert who happened to work in the jail at the time. Why can't they talk to him? And she goes, we don't know. The lawyer, I talked to her lawyer, she wants you. So I get there and I said, I want the DA there, I want the lawyer in the room and I want the other defense expert in the room. And we're in a room half the size of this room, you know, eight by ten, all of us crowded in with the defendant and I said do I have permission to speak? And the defense attorney said please proceed. So I asked the defendant, why did you ask for me here

and how can I and my colleagues help you? And she said, I'm scared. I said, I understand. I'm scared to sign the plea bargain. I said, you've discussed this with your attorney. You understand it. She goes, yeah, I'm scared. I said, what are you scared of? She goes, I'm afraid I won't get treatment and I'll get sick again, which is kind of a very powerful thing to say. And I said, talk to my colleague to work in the jail and explain when you go from the jail to the Texas prison system, you go through an intake, which includes medical and mental health. Your records and medicines go with you and they're actually psychiatric units

within the prison system. Are they any good? I mean, to be a little cynical? You know, they can get any medication that you could get in any outpatient clinic, you know, for treatment of severe mental illness at the time. So in that sense, they're good. They are in a prison,

but they can provide proper quality care for, and this lady had a psychotic illness. How do you? So she, I said, and my colleague said the same thing, we'll make sure the records go with you, and then she shook my hand and said, thank you, sign the agreement. Had she, there was a courtroom full of spectators,

it was packed, the jury's ready, the media was there, this was a big kind of case that drew a lot of attention because her history was very sad. She was a nursing student with no prior mental health or criminal history who came home from nursing school one day and butchered her kid, basically. So, but what's interesting is that the interview, something about my spending eight hours with her,

you know, in two sets of interviews, if I recall, But what's interesting is that the interview, something about my spending eight hours with her, you know, in two sets of interviews, if I recall, led her to trust me. So interviews, you've interviewed Jim Lawler on this show, we're all about empathy and trust. If you don't, and you think this person's evil, they're a psychopath, they're a sociopath, they're, you know, they're psychotic,

but as a psychiatrist, we're trained to make that human connection with anybody. And that's kind of my motto in my work, forensic work and profiling work, where I've studied people who do horrible, evil things, leaders. It's nothing which is human is alien to me. Mm-hmm.

I just... When you go into a room like that, like what I do here, the stakes are not the same. No one's, you know, in a court case or in the middle of fighting for their life or, you know, in the middle of something where they killed someone or whatever it may be.

Like, I'm just talking with all different people, with all different opinions. Sometimes some are controversial, some aren't, but low stakes as far as I'm concerned. What you're talking about though is the highest stakes. You're talking about justice at the highest level, because we're talking about murderers here. And you're talking about people who have possibly

in many cases committed those acts. And yet you have to go in there and find a way as a human being, regardless of your training and many years of, you know, beating things into you, you're still a human being. Like you have to go in there and you have to put aside any preconceived notions on this person

or opinions about maybe the unspeakable things in some cases that they've done and try to get a conclusion and and all the while I would imagine I mean I've watched enough movies and I would imagine this is pretty real you're also gonna run into a lot of people who are going to try to prove that they're insane and you have to determine whether or not they're bullshitting like how how do you, number one, how do you put your preconceived notions aside? And number two, how do you even determine whether someone is actually mentally ill? Like what's the process there?

I'll do the first question. All human beings have biases and in spite of one's training, we all have biases. But you have to put those aside and go in there with an open mind. Let me give an example. One time I was hired by the state in the capital case and the defense let me interview the defendant who was charged with capital murder, which is a very risky thing to do. I've had real top defense attorneys I work with said, I would never let someone with your skill set and talent be in the room with my client unless I thought it would help the client. But it has risk. This guy's charged with capital murder.

He beat two people to death for 200 bucks of crack money. But I'd reviewed his records and he had a lot of trauma. When he was in prison, he was beaten with a pipe. He had been a career criminal, had been in prison for other things, I think, armed robbery and other violent crime, burglary, other things. And he was beaten till he was almost unconscious and then raped. And I had the medical records of those incidents in the prison medical record and his treatment and recovery. So we talked about that.

And that's what in a capital murder case, that's what you call mitigating data. Aggravating data is the dangerousness, the horror of the crime, the lack of remorse, other psychopathic character traits, mitigating that is if this person had these horrible things happen to them, does that somehow, will the jury look at that differently? So I put that in my report, and as a result, the defense didn't call me to the state, excuse me, did not call me to testify. defense didn't call me to the state excuse me did not call me to testify and the guy I helped cross examine or write the questions and hand them to the DA

to cross examine the defense expert and in most states you need 12-0 to get to get the death penalty if you have one juror that says no they go to prison for life that's what happened in this case. So I got a call a couple months later from a defense lawyer, and he go, it was a very famous, notorious set of murders where these escapees, around 2,000, escaped out of Texas prison, including I think two of them were in there for murder.

And they killed a Irving police officer. And then were found in Colorado. They escaped, but they eventually caught them all. And I got calls on three of those cases for the defense. I said, why did you call me? I've testified for the state, as you know. And he said, well, you were honest. I saw your testimony in that case

where you evaluated the guy and you were fair. And so that meant a lot to people. It's the best compliment you could get. Yeah, you gotta be seen as fair. Getting to your other question, how do you, Getting to your other question, how do you kind of mix all this together, it's just very complicated. You have to put your biases aside and you have to sort of manage your own emotions. have to sort of manage your own emotions. And when you're interviewing a criminal in this system for a forensic evaluation,

you have to really kind of get a sense of how to best interview the person. I had a case once, very challenging case, involving a young, first time charged Mexican American woman. She was actually an illegal, she was born in Mexico, but it spent most of her life on the Texas side. And she got involved in a smuggling case.

It was a federal case. It was a very sad case. And the lawyer who was a Latina from the border called me up and said, I can't get past her defenses. I can't. I said, you speak Spanish. She goes, yeah, I'm a pure bilingual. I said, well, I speak Spanish, but the defendant spoke English. So we talked and I couldn't get past her about how the crime happened and what the drivers were for her criminal behavior. And then I switched to Spanish, and I used the to form, the informal form, and used softer words.

Se le guste. Yeah, tu, you know, and she was young, so I said, no, mija, por favor, dime algo. You know, how did you come to this? And she spoke in Spanish and confessed to the crime. And I knew she wasn't crazy. She was a planned crime, but the drivers of it were traumatic things that had happened.

She needed money. And she had lost a child. She had lost a child. Yeah, and she had guilt about that. So I put that in my report for federal sentencing guidelines that's mitigating. And the lawyer, when she got the report, she goes, I'm blown away.

But I had to shift in language to get her to tell me what happened. And once she told me what happened, we shifted back to English. This was a five-hour interview. It's a dance. Yeah. Have you had, for the people who aren't determined to be crazy, right?

But obviously something drove them to do something bad. Do you have empathy for them after the fact at all? Sometimes. Sometimes. Sometimes. I try to. I'm not perfect. I try. There are some people that have done such horrible things that it's hard to empathize with. But

those people are rare. Even most people that are in jail, I worked in a jail for a couple of years and treated thousands of inmates who have mental illness. You know, I had people who were in there for murder charges, and I'd say, why don't you take a plea bargain? And one defendant said, Doc, I can do prison time.

I've been in prison my whole life. I can survive here, I know what to do. It's comfortable, it's like home to me. But he said, but if I take my, he said, my mama, she got advanced renal disease and she ain't gonna live more than five years. So I can't take a plea bargain unless it's five years or less.

So that helps you see him as a human being with a family, with a parent, with a kid, that kind of thing. Yeah, it's... anytime we're talking about the criminal justice system, it's a very, very heavy thing for me to think about because... Discover the magic of Bet MGM Casino, It's a very, very heavy thing for me to think about because... experience to feel like you're actually at the casino. The excitement doesn't stop there. With over 3,000 games to choose from including fan favorites like Cash Eruption, UFC Goldblitz

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to an advisor free of charge. BetMGM operates pursuant to an operating agreement with iGaming Ontario. You know, you live in a nation of laws, and when people do horrible things, they got to pay for that. And that's how it works. But there's a human cost on every end, the human cost of the people that they victimize and their families when, you know.

Yeah, you see that in the murder cases, the capital murder cases, most of all, but other cases too, kidnapping, sexual assault, child sexual assault. I've testified in all those kind of cases. But what you really see too, kidnapping, sexual assault, child sexual assault, I've testified in all those kind of cases. But what you really see is, yeah, there's a human cost on two sides.

There are no real, you can think I won the case, justice was done, but there are no real winners in these situations, it's a human tragedy. How do you deal with testifying in a child sexual assault case? Because I speak for, I know pretty much everyone listening right now, it is very hard for any of us to imagine even sitting in a room with someone like that

without wanting to jump across the table. It's very hard. And I interviewed a defendant once in a case. He got 99 years for the defense. The defense lawyer was a former judge and former DA, he was very experienced. I spent 10 hours with this guy who had molested a five-year-old kid.

Oh! And... 10 hours? Yeah. Over a couple sessions. You can't be 10 hours straight, but three hours a year or another. Reviewed all the records.

I interviewed his wife. And he wasn't old, he was in his 30s. And he had no remorse for the victimization of the child. He didn't see the child as a human, but as a thing, as an object. And the defendant's narcissism was just like oozing off every pore out of his body. And I told, I wrote my report and told the attorney,

he said, what's your take, Doc? I said, do not, whatever you do, do not put your defendant on the stand. The jury's gonna barbecue him. And he goes, yeah, he read my report and said, I agree. Well, the defendant insisted on taking the stand, which he has the right to do. And the lawyer has to serve the client.

He said, I'm not, the lawyer said, I'm not suborning perjury, but it's your judgment call. I recommend against it. And he took the stand and the jury, it didn't go well. I can imagine. He got 99 years. Good, I mean. But these are difficult cases.

I had a resident once who worked with me in a prison clinic I worked at. And we would evaluate a couple times a week, people coming straight out of the prison on what's called conditional release. And she came to me kind of teary eyed. She was a very, very good resident about to graduate. And I think she was going gonna do a forensic fellowship.

And she goes, I can't interview this guy, so tell me what's going on. She goes, he's a child molester. And I got a little kid the age of the kids he molested. I said, yeah, my kid is the same age as that. You gotta do your job. And if you can't do that, then you might wanna rethink your career

in terms of this specific career path. Sure. Yeah. You guys had, someone has to do it to your point. And it's just like, I'm glad you're out there because I don't know. That's the kind of thing. I think one thing that really bothers people on that one is like, it's a personal taste that those people have and you can't undo that. It's not like, or it seems like you can't undo that. It's not like someone gets a little desperate on hard times and tries to rob a store or something. All right, maybe they won't do that again.

They're on drugs, et cetera. Right. Right, right, but for someone who soberly is attracted to a child, has there ever been a proven way that you can make sure, oh, they spend 10 years here and they're not going to do that again? I've never seen it. No, they need to, a lot of them, there are treatment programs and they need to be willing to take treatment, but even then they need careful monitoring. I've treated those folks who are on parole,

but they need very, in most states, they have very strict monitoring and treatment. You know, chemical, medical treatments that can dial down those deviant urges, if you will. But it's very, it's difficult work. But I'm kind of an empath, So working in the jail, treating people, gives you a different side than if you're just an expert. And so I had to kind of walk those two sides.

And working in the jail or in the prison clinic gives you credibility with juries. Then they see you as not just a hired gun. You treat these people, you interview them a lot. So you learn by interviewing them. How many years? You said two years you did that? I did about five, almost five years.

In jail? In jail specifically? Yeah, in jail and in the prison clinic for a couple of years. Okay. Yeah, I had one guy, this was quite a case. Remember the movie with Richard Gere where he murders a priest and fakes that he has multiple personality? What's that movie?

Oh Primal Fear. Yes. So I was asked once in the jail to evaluate a guy who had faked a seizure during a sentencing hearing as he was a three time strikeout loser, was going to go to prison during a sentencing hearing is he was a three-time strikeout loser, was gonna go to prison for a long time because it was his third felony. He was a career criminal. And they asked me to evaluate him because he had pitched a hissy fit in the courtroom.

And I said, so I asked him, I said, I'm Dr. D'Clave, I'm here to evaluate you. I reviewed his medical record and I said, tell me what happened last week. He, and he turned to me, he was an African American guy. He goes, Doc, you white boys think you so smart? I said, yeah. He goes, let me tell you something.

I said, I'm all ears, educate me. And he goes, you can be whoever you wanna be. I go, that's interesting. What do you mean by that? And he started, he switched and talked in a baby voice. This guy's in his forties. Tears start streaming down his face, talking about how he was beaten and abused and all that.

And after 10 seconds, he switched out of it. He said, see, that's not that hard, is it, doc? I'm like, holy shit. I was like just wowed, but it's like acting, it's performance. But this guy was a mess. He had an eighth grade education, but he had the street smarts

And he knew it wouldn't work. I said that's probably not going to work again. Is it he goes? Nah, i'll do my time Thanks doc So he went back got sentenced no more problems went to prison. Wow What do you think There was one other question I had on on dealing with the with with the pedophiles. I Would imagine there's Different things root causes, but what do you think were the most common root causes of people? Doing that is it in your opinion something they're born with in some way or something? Maybe they were abused

What's a good question? We don't know where there's a lot of Learning to be done about the brain and what makes them that way many of them have abuse histories which play a role very true but They're also making bad choices I've treated patients who are pedophiles in the parole release clinic who begged me. They had real guilt about their acts. They said, I like children, I don't ever wanna hurt a child again.

I don't ever wanna go back to prison. I'm willing to take any medication you can give me that will help me and do any therapy that will help me control these urges that I can give me that will help me and do any therapy that will help me control these urges that I can't live with. So there are some people that can be treated, they need careful monitoring and there are guard rails around them,

they can't work near schools, they can't work around children, things like that. I mean, I had a classmate of mine who was a pedophile. He got convicted, he got probation. A psychiatrist? Mm-hmm, child psychiatrist. Oh, my God. And he did a year of pediatrics for his internship,

so you wonder how... I worked with this guy for a couple years in the ER. I never knew it. You never would have known. And he molested the neighbor's kid. Oh, my God. And on kid. Oh, my God. And on Halloween. Oh, my God. And he kept his license and was able to work with adults,

which is really amazing. Wait, wait, he has his license today? Yeah, yeah. He was able to work with adults. No kids. He had a good lawyer. You're fucking with me. No, I'm not. He was convicted?

Deferred adjudication 10 years, and he was able to keep his license. He had a good lawyer. But I worked with this guy, never picked up on it. I actually interviewed him for residency. But here's the thing, in your defense, even as a psychiatrist who's looking at all the little things that the regular people like us

don't necessarily think about like unless the guy comes out one day and says like oh I'm into that how do you how do you even know that you don't you can't you can't know it a priori most children who are abused and molested are molested by someone that is known to them family a boy scout leader a cub scout leader a girl scout leader, a cub scout leader, a girl scout leader, a teacher, a coach, a priest, sadly I'm Catholic, I'm well aware of the history of these abuse cases.

I was actually hired on one of the biggest ones in the country. I ended up not taking it because they wouldn't allow me access to the defendant. I said, I can't make a diagnosis of pedophilia without sitting down and getting inside his head. I know what he's done, but in this case, the diagnosis is based not only on behavior, but on fantasies.

On fantasies. Yeah, internal fantasies. You have to be able to talk to the person and get a sense of that. So I gave them the names of other experts and they got an expert that was willing to testify without interviewing the guy. He got 99 years. He was a priest. And there was a huge civil suit, some of these civil suits with the church, the payouts are, gosh, the first big one in Dallas, the biggest one in the 90s was under 30 million bucks.

I mean, you're, as you said, like a practicing Catholic. How do you, I grew up Catholic too. Yeah. But I would not call myself a practicing Catholic. And this is a large reason why. But how do you look at something like that, that listen, it's not all priests to be very clear, but it's not one or two.

No, no, it's a big problem. How do you rectify that with your own faith? I look for inspiration. The faith, my faith is deep. And the church, if you look at the history, it has at many times a sordid history. Look at the history of the church's response to the Holocaust in World War II.

Not great. It's not good. It's yeah. Of where my parents are from, the former Yugoslavia, the role of the church of Cardinal Aloysius Stepinac, who is revered by Croatian Catholics, but who was the father confessor of Ante Pavelic, the head of the Ustasha, who were the most vicious, you know, band of thugs, even the Nazis who trained them, the SS feared them. That was his... He was the father confessor

for Ante Pavelic, who was an assassin and a terrorist and a horrible person. So, I have trouble with some of the history, but I'm inspired by the good that the Church does. I'm inspired by Pope John Paul II, now St. John Paul. I'm inspired by our new pope II, now St. John Paul. I'm inspired by our new pope. You know, so, yeah. But a citizen of the world, lived 20 years in Rome,

20 years in Peru, speaks four or five languages fluently. A man of peace, his first words when he came out on the portico were, peace be with you, which were the first words spoken by Jesus after the resurrection, when he met with his apostles, his disciples with you, which were the first words spoken by Jesus after the resurrection, when he met with his apostles, his disciples. So, I have to carry my inspiration, not look at the horrible things that have happened. And I include the really very unfavorable response during my lifetime, in so many cases, of the church vis-a-vis priests who were sexual abusers.

Yeah. Do you think that is a part of why in that particular, I mean, it's not an industry, but in that particular line of work, I guess, a part of that access and desire is based on power dynamics? There's, when you have abusers and victims, there's always an imbalance of power. and desire is based on power dynamics? When you have abusers and victims,

there's always an imbalance of power. That psychologically and psychodynamically is always a part of it. So certainly that's part of it. If you have an altar boy or a young girl, an altar server, now girls do this too. Um, now there's fortunately more guardrails, but, uh, you know, horrible things have still continued to happen,

cases come up periodically that you read about in the media. So I think the power dynamics are... It's something in that person's psychology to manipulate and, you know, kind of coerce and bring a child along to do those things is a power imbalance. Because you've got an adult and you've got a child. A child is not an adult. No way.

They can't make those choices. Mm-mm. So you, you know, you've obviously... The diversity of the work you've done is incredibly impressive. Obviously you've done work around the world, we're gonna talk about that in a little bit and everything. But like, you came up through this system where you're dealing with the worst types of cases,

then you also go and you work in the jails as well. And you try to do this in as most fair and balanced of a way as you can. So it's clear to me that from day one in order to be the guy you are and have the career you've had and do all the different things you have, like, you have to you had to have some incredible passion for what you did. So you know, when you were growing up, was there was there a Do you remember a time like even as a kid where you're like, Oh, I want to do something where I work with people and trying to understand them better. Like, was there like something that really like scratched the itch for you? No, when I was growing up, not really. I liked history and languages.

I'm the child of immigrants who came from the former Yugoslavia. My mother grew up in a prisoner of war camp as a child. Prisoner of war camp? Yes, in what is now Serbia. Whoa. Because she had, part of her side of the family was German. And they were German settlers who had settled that part of Hungary,

northern Serbia, parts of Romania called Banat. During the war? No, for 300 years. Oh, 300 years? Yeah. They were part of the Austrian-Hungarian Empire and had settled. They were farmers. And so her relatives are that.

Well, during World War II, the young ones signed up to... uh, fight with the Wehrmacht, you know, with the German army. And matter of fact, and her uncle was in the Wehrmacht. He was a taken prisoner at Stalingrad in 1943. The 92,000 who surrendered. Did they live? Well, he was sent to a POW camp in Siberia for five years, where he lost both legs due to frostbite.

And he was released in an amnesty and went back to Europe and settled in Switzerland where he became a happy, successful businessman. But so she, because of her family history, even as a kid, she was tainted. So she spent several years in a camp and was released in an amnesty. My father, who's from Slovenia, grew up during the war. And right after the war, he was a teenager.

So he was drafted by the then Yugoslav military under Tito as a teenage kid, and spent two years in Bosnia building roads. The country had been destroyed, so they had to rebuild it. And then he was restless. He wanted to leave and get out, but you couldn't leave Yugoslavia then. That was a capital offense. So that was a capital offense.

So it was a capital offense just to leave. Yeah, just like in East Germany or back then, you couldn't just leave. Yeah, they're part of the Soviet block. That'd get you in a lot of trouble. So he escaped over the mountains into Austria, turned himself in and the Austrian sent him back. into Austria, turned himself in,

and the Austrians sent him back. And so the Yugoslav government threw him in prison for three years. They didn't kill him, though. No, threw him in prison for a couple years. Then they released him on an amnesty, and he escaped again. Oh!

But very wisely went all the way to Germany, crossed three borders, and found his way to an American military base and said, I wanna join the military and serve. They go, sure. He spoke three languages, four languages. We'll take you. They're like, here's a gun, let's go, boy. So he was a military police for a couple years.

Wow. And my mom had gone to Germany with her family after the amnesty when they got out. So they met in Germany and then were able to immigrate to the United States in 1956. Because he served in the army. Because he served in the army under the Lodge Act, which was a 1950s act which allowed people who were serving in the military from Eastern European communist countries at that time. So Poland, then Czechoslovakia, Bulgaria, Hungary, Yugoslavia could get basically an expedited green card

if they had served in the military. Wow. So that's how he ended up coming to the US and how I became, I was the oldest kid born in the US. But that's also built into your parents. From their childhood and growing up into young adults to where they grow up in the aftermath essentially of World War II, like you said,

your dad's grown up during the war. And then afterwards when Europe is just like, kind of a shit show, it's called what it is. And they understand regardless of what governments were vying for power at the time, of course you had communism all over the place, but then a bunch of new governments trying to like set up and like create the new future and whatever. It's like they understand, it's built into them what freedom means. Freedom means a lot.

And that was our dinner table conversation. Yeah. They got engaged on a flight to East Berlin. To East... East Berlin. I was going to make that start. That was Soviet? Yeah.

And he pulled out the ring on the plane and and the stewardesses were pouring wine, and then they get to Berlin. And he was part of the military, and he disappeared for a couple days, and my mom just walked around, and they went to Checkpoint Charlie, and he said, I'll see you in two, three days. Just hang out at the hotel.

That's how they got engaged. Wow. But I grew up with that sense of history, so that's what I like was history and languages. My first language was Slovene, and then in college. Your mom spoke that in the house? She learned it from my dad. She spoke German and Serbian. Oh, I'm sorry, that's right.

My dad spoke Serbian and Slovene. So she learned Slovene, so as a kid I learned Slovene. And then when I was in college, I studied what was then called Serbo-Croatian, because my parents moved back to Yugoslavia. I was gonna take French or Russian, and my dad said, no, I'm going to Yugoslavia for my work. Wait, he moved back there?

They moved back there, yeah. While it was still communist? No, yeah, under Tito in the mid-70s when I was in college. Why? For his work. I know, but you couldn't find work somewhere else? Well, that was his line of work, working in business. Was he a hit man?

He was an import-export businessman. So a hit man, right. I've had cartel guys in here who were import-exporters. This isn't getting by me. No, he told me I'm a businessman, and I travel and I sell things to people. Right. A great story. I'm surprised the psychiatrist didn't dig into that one a little more. That's as far as I could get. So he goes back while you're in college. And he said, take cerebral creation so you can come visit in the summers and that,

and you can communicate. So I did that, it was fun. I had a really good teacher and spent a year there. Took a year off, spent a year in Belgrade. What was that like then? Belgrade's nice. I like Belgrade, I like the people. The food's good, the people are friendly.

I was doing a few little odd jobs interpreting here and there for my dad and his business meetings. That was a trip. That was a trip, you know, interpreting with drunken Serbian businessmen. And the greetings would start with a torrent of foul language, and I said,

do you want me to translate that? He goes, yep. Dad, they're saying that they're gonna pay you for the hit after you do it. What does that mean? BLAIR So, I improved my language skills, but I didn't really know what I wanted to do. So, when I got out of college, I had a history degree, and I'd studied these languages, and I was kind of lost.

So, at that point, my family had moved to Vienna, Austria, where they've, my extended family has lived there since 79. So, I didn't have a job, I didn't know what I wanted to do, I had to be a diplomat. Not with the government, but to get a master's degree at these schools that are feeders for diplomacy like Georgetown, GW, one or two others, Hopkins. They all summarily rejected me. Interesting.

So I had all these rejections. No job. You hang that on the wall for motivation. No marketable skills, speaking a bunch of esoteric languages. And so I went and did a bunch of odd jobs for a few months in Vienna and talked to some friends who were in medical school. And I said, this sounds like fun. So then I had to go back.

That's when I moved to New York to take pre-med courses for two years. And then I went to Texas. Yeah, this wasn't when you were like 15 or anything. No, no, I was early 20s. Now, so medical school seemed cool, but what drew you to psychiatry? I was very attracted, when I went in I wasn't sure, like many medical students, I wasn't sure what I would do, but I had read a lot of stuff about psychiatry and psychology. I never took a

formal course, I liked literature, I liked people, but I also was open to things like internal medicine or surgery. But where most, I really hated the first two years of medical school, the way it was taught then is you're in a classroom all day looking at what we now would call PowerPoints. And it's just hard on the brain, a lot of information overload, memorizing.

It's like, here's the phone book, memorize it, you know, I just didn't enjoy that. Then the clinical years came, most of the third year, you're on the wards, you do two months on every specialty, medicine, we actually did four months at the time. Then you do two months of obstetrics and gynecology, two months of surgery, including trauma surgery, a month of psychiatry,

two months of pediatrics, and I'm leaving something out. I think I did a month of anesthesiology. And it's during that time when you kind of see what you're good at, what kind of patients you want to take care of, what kind of people inspire you. So I was kind of torn between surgery. I liked orthopedic surgery, but I'm glad I didn't do it. I did the right thing. I chose psychiatry.

That's way different. I liked the teams, and I was good at diagnosing when you needed to go to the surgeon. But that's different from being in the OR all day. But I enjoyed the team, the esprit de corps. I had really great teachers. So I applied to some of those, and I applied to psychiatry. And the guy who interviewed me, the program director said, look you're pretty good at

psychiatry. You've done well in this. Why don't you do that? And if you want to work with tools, just go to what Sears and Robach and get a tool, get a set of tools and work on your car in the weekends. I said okay. So I ended up in psychiatry. You went with the flow kind of. Well, it was the right thing. It fit. It clearly did. And I would do it again. I wouldn't change my thinking. Did you have, you know, when you start doing the job in the early years and really sinking into it and clearly getting into it as you demonstrated earlier with how serious the stakes were almost from day one. Like did you have, I don't know what the term is,

like psychological inspirations, meaning like people who had studied this in the past that you really gravitated towards how they broke down the human mind? Yeah, the people that I, the person that really inspired me at the time, it was kind of an intellectual approach, was Robert Coles, the legendary child psychiatrist who wrote the Children of Crisis series in the 60s and spent a lot of time in the South studying the impact

of the civil rights movement on both black and white children in the South. And I had- Robert Coles was his name? Robert Coles, he taught at Harvard for many years. And I had read all his works and I met Coles. He came to give a talk when I was working in New York. Oh, he's still around.

Yeah, he must be in his 90s. Yeah, 1929. And so I was inspired by people like that. But the real inspiration was from some of the teachers I had. I had some really outstanding teachers throughout my residency that were, a handful of them, I'd say most of them were very, very good, and there were a handful that were just absolutely

outstanding, just phenomenally skilled psychiatrists, really skilled interviewers. One of them is long retired, he was a psychoanalyst, but he's one of the most brilliant interviewers I've ever seen. I mean, the guy- What made him brilliant? His ability to get to the heart of the matter right away.

Let me tell you a story. I watched him do an interview. I was blown away. We would bring the attending physicians, and I've done these as a teacher, they'll invite you to come on the ward or to the clinic at a case conference, and a resident will present the case,

and then you interview the patient. Well, there was a patient who had been on the ward for quite some time. He was very psychotic and had obsessional psychotic kind of fantasies of wanting to murder his parents. And he would fill his the hospital wall, his room, with reasons. He would write them down for hours why they deserve death. So the walls were covered with this, but he wouldn't talk to anyone. And we thought, okay, we'll see.

This excellent interviewer's gonna get his comeuppance here. This kid ain't gonna talk to him. He was in his 20s. And so we presented the case to him and the... the, uh, guest interviewer said... he just took a deep breath and a sigh, and he took his pen, you know, like this, and kind of... And he said,

I wonder what it's like to want to murder your parents every day of your life, every minute of every day of your life. And then the young person, the patient, started sobbing and then he talked. And I'm like, wow. That, I mean, he immediately got to the heart of the matter. I still remember the case. It's like imprinted in my brain, it's like state dependent learning. I remember the interview, the case, gosh, 35 years ago, 34, or another case he did,

I was talking to another friend who's very close to this guy who's retired, and you go, tell me what your dad was like, your mom. People go, well, they were nice. They were great You just get the surface. Yeah, and He would ask I Have a question about your dad. What were your dad's hands like? They start crying oh, yeah, what his hands were like tell me about your dad's hand now

Would would it be because he knew something about the no it, it's a way to get to the inner person. The hands. Yeah, because hands hold you, hands hug you, hands touch you. We're creatures of touch. So people then start talking. And he said, when he asked that question in an intake for psychotherapy, people start bawling, they start weeping.

I mean, that's the kind of skill, a deeper kind of skill that very few people have, but I tried to learn from some really wonderful teachers. And so when you're like in the prison, you know, or in the jail, I would talk to people, how do you interview a criminal? You know, they're pretty well defended. Now you're there to help them in the jail, you're a treater, but still. And I would talk to people, how do you interview a criminal? You know, they're pretty well defended. Now you're there to help them in the jail, you're a traitor, but still. And I would, you know, I'd look at their hands, their tats, and I'd say, can I ask you a question

before you get started? Tell me about this tattoo. And then they start talking. Right, their interests. Yeah, you show interest in the person. Absolutely. They go, well, that one is, what about that one there?

Oh, well, that's my homie, or that's my girlfriend, or that's my daughter. One guy showed me a tattoo. He lifted his shirt up, and it was a tattoo of him and his wife making love. Joe, you wanna show them your tattoo on your elbow? Yeah, but what happened is when he would flex his pecs, making love. Joe, you want to show him your tattoo on your elbow? Yeah. But what happened is when he would flex his pecs, the tattoo would move.

And I was like, that is intense. He goes, I love my wife. And he's been in prison for a long time. Yeah. Yeah, he's faithful. Appreciate that. I guess he didn't have a choice, but still. Yeah, you know, I never, in doing my job, I've never really consciously studied how I do it, right?

And hopefully it's good. I mean, there's people who listen to it, so I'd like to think it's pretty good. But you know, one of the things that when I watch tape back that like I'll do that seems to be a common thread I've had since the beginning is I'll ask people questions that are more, I'd call them like bland, you know, just based on their life so it involves them but it's not, it might be something like, you know, what was your mom like? Or something like that, like something simple that's not going to get below the surface, but what ends up happening is in an answer, there will always there will be like a keyword they say or something that they inflect on just a little bit when they're describing.

It could be something that if you just read the script of it, you would never point out that word and think it's anything, but when I'm sitting across from them, you know, there's a rock to be turned over there. And I turn over those rocks and then that leads, I call it like the estuaries of a river, right? Like we to be turned over there. And I turn over those rocks, and then that leads, I call it like the estuaries of a river, right? Like we start on a main river. That's a beautiful way of putting it. And then I get all these estuaries open with people.

But what you described, that's amazing what that guy did, because all he did with that one story, to me, the way I hear it, you tell me if I'm right or wrong, is he just repeated the guy's experience back to him and kept saying, you know, you are feeling this, you have this thing, talking about the guy who wanted to kill his parents. And I don't know what that's like, so the inclination is,

you gotta tell me what that's like. But it's the felt emotion, it's the body language too, it's the felt emotion. He took his glasses off and his pen. And our mutual friend who's been on your show, Jim Lawler, talks about this. You shift your voice. And really skilled interviews, they don't consciously do that.

That happens on an unconscious level, whether it's this teacher of mine or another very gifted teacher or Jim Lawler. Really skilled interviewers don't mechanically, oh, I'm gonna change my voice to sound like this. This all happens. It's natural. It's natural, it's at a non-verbal unconscious level.

It's like being a diplomat, you know, talking to people, talking to foreigners. All the foreigners in the embassy speak English. But if you talk to people in their native language, it's an icebreaker. It shows respect. Yes. You know, and that happened to me when I was in Russia, the second tour I did. I studied martial arts for many years.

I took Russian martial arts, systema. And my teacher, who I loved to death, the late Special Forces Colonel Mikhail Rybkov, in Systema classes, they have a tradition. Classes are usually an hour. In Russia, they were two hours long. So you're taking a beating. And afterwards, you sit around in a circle,

and everyone says for 30 seconds or so, what they learned, what they enjoyed about the class. And I said something in Russian. And Mikhail said, we have many students that come from all over the world what they learned, what they enjoyed about the class. And I said something in Russian. And Mikhail said, we have many students that come from all over the world to learn Systema, but we have very few like you

who come with an interest in our language and culture. So I'm like, I'm in. I'm accepted. Now, they beat the living daylights out of me for the next three years. It was brutal. But I was accepted. It was okay. I was the first diplomat to study in that school. Yeah, you show people the respect of their norms.

And I'm a Spanish speaker, so when I see patients in the clinic I work in and speak Spanish, they open up. Yeah. You're touching the heart. It's a good way to put it, touching the heart. So how did you, you, we've gone through your early career, spending it in various places around Texas, it sounds like, within the legal system in different ways. But how did it end up translating to where you basically are brought on by the State Department? And they want you to be their guy.

I couldn't run away from who I am and that part of my past of having an interest in international affairs and history, in diplomacy, in languages and cultures. And when I was a resident, I thought, I wonder if there are jobs where I could use my skills overseas. So back then, there was no internet, of course.

This is early 90s. There's 411. So I called 411 and said, for the Washington area code, and said I'd like the State Department. So I get hooked up. They said, Department of State. I said, I need the medical department. I didn't know such a thing existed. And then they transferred me to go

Office of Medical Services, which I later worked in. And I said, I'd like to speak to the chair of mental health. I didn't know such a thing existed. They go, hold on, let me patch you through. So I end up getting connected with the then director of mental health, a regional psychiatrist who became a mentor and a dear friend and still is a dear friend to this day.

She's been retired for a while named Dr. Esther Roberts. So I asked her about the job and she goes, well, you're a resident so you can't do it right away. You gotta wait five years. She told me about the job and said, go get some experience and call us back. She, I later found out when I joined, she had been the psychiatrist who in,

on January 20th, 1981, when President Reagan was inaugurated, flew with another government psychiatrist, like government, and a US Navy captain psychiatrist from Algiers to Germany with the 52 released hostages who'd been in 453 days. And they were taken to the Air Force bases in Germany, I think it was Wiesbaden, to be debriefed, medically evaluated, psychologically,

psychiatrically evaluated to be debriefed before returning home. So I thought, this is the coolest thing in the world. And I was like, I'm all in. But I wasn't going anywhere, I was busy doing the other work. So I kind of forgot about it. The next year I was a resident,

they would, when we were residents, they would bring in speakers once a month and give you a sandwich and a bag of chips and a diet coke and they would tell you about jobs. So they'd come from hospitals, clinics, private sector, VA. One day they had this lady who was from CIA. She was clear. She was a psychiatrist whose cover was lifted and she was clear to recruit.

She was very senior. Her cover, hold on a minute. She could say, I work for the CIA. Right. Her cover was lifted. Yeah. That means she wasn't undercover. She could say I work for CIA instead of I work for the Department of Defense. I understand that. And she was a high level executive at that time. Okay. But does that mean that in the trying to think here because if I were a psychiatrist for CIA where I just dealt with CIA patients or whatever, I'm just thinking like as a civilian right now, I wouldn't think that would be something where you'd have to deny you work for CIA. The answer is it depends.

You might have to. The bureaucracy has their own way of dealing with those things. But this lady was allowed to say. This lady was allowed to say, and so unfortunately she couldn't tell us much else. She was friends with our former chair, that's how she came. And so we asked her questions like, how many people are in your unit,

overseas psychiatrists, she goes, that's classified. Where are they based? Can't tell you. How big are their regions? Don't worry about it. Big. How often do they travel? A lot.

So when we were thinking like, for a resident, it's a big deal to be on call for one hospital ward. And we're thinking, these people are on call for all these countries. Later, when I joined the State Department, my first day at work, I was in Washington for six months, I was on call for half the world. Half the world. Half the world. Because we had five psychiatrists on home leave, were there in the U.S. for six

weeks. And so, and my boss took off for Africa for two months. And I said, what do I do? He goes, just do your job. Answer the phone. Answer the phone, do your job. You'll do fine. It's kind of baptism by fire. But you're on call for half the world. They could call Washington, what do we do in this region?

We have someone who's psychotic or suicidal or whatever. So that was... So you wouldn't necessarily have to go there. You might just be advising on what to do. I'd, you wouldn't necessarily have to go there. You might just be advising on what to do. I'd be advising or you might have to go there. You might have to get a ticket and go there, or get someone else who's closer by to go there. Yeah, so I managed a couple of pretty complicated situations.

And when I was in Washington, you learn the ropes that way. When I was hired, I was hired directly to go to Moscow, which was a brand new position. What year are we talking? 2002, in the summer. And my other boss, the medical director, called me in for an outbrief before I deployed, and when, I think it was in June.

And he goes, we're sending you to Moscow, it's a very important new position, you're covering the whole, what is, what we used to call the former Soviet Union, so Ukraine, Moldova, Belarus, the Baltics, the Stans, that's your region. I'm like, yeah, I'm excited about it, and he said, I think you'll do very well,

but I have one request to make of you. This was a very diplomatic person. His father was an ambassador, he spoke perfect French, he knew the whole system. He goes, please don't fuck up. I said, okay sir, I got it. Yeah, now did you know the full scope of what they would want you doing at that point?

No, I didn't know anything, I was clueless. And I knew a little bit from talking to my boss who had kind of explained to me. And I knew about the crisis response and taking care of people, but you kind of learn as you go. You figure it out. You have to figure it out as you go.

So what was day one on the ground in Moscow like? Day one is like when I landed and the plane took us from Sheremetyevo, then the motor pool driver took us from Sheremetyevo, then the motor pool driver took us from Sheremetyevo to our house, I was like a kid in heaven. I was like, this is the coolest thing in the world, driving in Moscow, I'd read about it, I'd seen pictures and here I am,

I'm gonna be living there for two years. It was like, it's like someone coming to New York for the first time, that kind of feeling when I first moved to Manhattan as a pre-med Uh, it was like, it's like someone coming to New York for the first time, that kind of feeling. When I first moved to Manhattan as a pre-med and walked down Fifth Avenue on January 3rd... To drug. You know, I'm like, wow.

It just was, it just was so awesome. And then the work started, um... You have to do a lot of bureaucratic stuff getting started. You have to get visas. Your official Russian visa, you gotta get your shipments and all that, but I traveled, I traveled to Ukraine 10 days after I got there for my first trip. And what was that for?

That was to help people in Kiev. They were dealing with a lot of stress in the embassy, it's a very large embassy even then, and the leadership was pinging me every day saying, when are you coming? I'm like, guys, I don't have a visa yet. You need to slow down. So you're dealing with a lot of stress.

Yeah, lots of high stress, high pressure. So finally when I got the visa, we were still living out of suitcases, my wife and daughter and I, and I said, I gotta go. So off I went to Keefe. And then when I got back, I was sort of trying to figure out how to get patients, see patients in the embassy. And I asked the regional medical officer,

the primary care guy, and I said, I'm not getting a lot of patients. He goes, you need to travel and do your effing job. Get on the road, hit the road. So I said, okay. So then I started traveling and then you traveled constantly every other week, sometimes every week.

So are you just, obviously people, like you said, they're in high stress situations, they're working serious jobs in foreign countries, in some cases, places that are slightly hostile in a way. Like are you, I don't want to broad stroke this, but is it a lot of regular verbal talking it out psychiatry work you're doing with them? Or are you dealing with also some more serious cases? A mix. A mix. Most of the workforce is pretty healthy. So what you're doing is seeing what you would see

in a private practice of working people. So anxiety, depression, ADHD in their kids, other stress-related illnesses, alcoholism. Usually people with alcohol and drug issues wouldn't come to us voluntarily until they got in, like a frog in a pot of boiling water, they got in trouble. Something happened and then they'd come and we'd have to figure out how to get them help. So a mix of that and then occasionally very serious cases where you don't have the care available or they're suicidal

or in rare cases, psychotic or manic. Uh, and you have to send them back to the United States for an evaluation. But Russia's... I love Russia, it's my favorite place, and I liked all the places I worked at, but I love Moscow. But it's very stressful, if I may add, though. It's... it's big.

It's a city of 12 million people. It's the intensity. I used to tell my ambassador, who remains a dear friend, and the deputy, working for Embassy Moscow is like playing for the Yankees. Everybody's gotta hit 300. No room for failure or losers. And the decisions those people make and the policy they support is on the front page of the New York Times and Washington Post and today's CNN and Fox News every day.

So it's a pressure cooker and then the Russians add to it because when the hostile intelligence service, the FSB, they're in your Kule 24-7. You are never alone in Russia. Guy like you, especially. Oh, they were very interested in me. Very interested. But you're never alone. Your house is bugged for sound and video. Your computer they get into, you know, the local internet that you're using to, you know.

You couldn't have your guys put some protection up against this? No. If you wanted to have sensitive conversations, you had to go to special parts of the embassy that were shielded and protected. But in our everyday life, you're never alone. And they harass you. They follow you. I was followed all the time. You know, you get pulled over driving home,

the police would pull you over. Papers, passport, driver license. They're just doing it to mess with your head. To stress you even more. You're just doing it to mess with your head, to stress you even more. You're tired, you've been working all day, you're in the middle of a blizzard driving home, you're cold, you wanna get home to your family,

and they pull you over and you're sitting in the car for 40 minutes and they come out and say thank you. So it's all psychological to screw with you. Did you learn surveillance tactics as a way to deal with this? No, but I could pick up with it. I never took formal training. It wasn't required for my job. But you develop good situational awareness

living in these countries. I had pretty good awareness. So I could tell. If I was being followed, it was usually they meant for me to see them or people would pop up. I once had to be the, what they call the control officer for a medical officer from another agency. And so we would go out to the airport, meet them,

ride with them to the hotel, make sure their appointments are all set up the next day. And when I was waiting for this guy, a Russian came up to me speaking the King's English. are all set up the next day. And when I was waiting for this guy, a Russian came up to me speaking the King's English. Dr. Dekleva, you're waiting for Dr. So-and-so. Can I be of help to you? I go, your English is beautiful, I said to him in Russian.

Where did you learn such beautiful English? And he goes, well, I'm here to help. I said, thank you. My colleague is arriving on the flight. I appreciate your help. I gave him my card and said, thank you, my colleague is arriving on the flight, I appreciate your help. I gave him my card and said, do you have a card? And then he disappeared. He just walked away. He just vanished like in thin air. So you learn to deal with that, but it's always there.

That's interesting though that they would... Now people who work there, a lot of people can't handle that stress they're not Set up for it. Most Americans understand that you have Even though there is no constitutional right to privacy according to the lawyers People believe there is so there's an expectation of privacy. They're not used to living in a society like that. I had lived in Yugoslavia and that sort of stuff,

so I understood how to handle it and navigate it. When I lived in Belgrade, I went out with the girl on a date. And there was a courtyard where this old grandma would sit there, and she would watch everyone that's coming and going in our apartment. And I came back late at night, she was there knitting, and I spoke Serbian, and she goes, she goes, Ken, that's a nice girl you went out with,

you have good taste. I'm like, what? How'd you know about... She goes, she comes from a nice family. You know, so, you get, you, I've been... I've been exposed to that through my own upbringing, so it helps you kind of understand that that's the way it works. They're not gonna hurt you in that sense. Now, in a terrorist country, that's different.

But it still psychologically messes with you big time. So I would teach people to cope with it, you need to get out. Every two or three months, you leave Russia and you fly to Western Europe for a couple days. You get, take a break, let your hair down, go to Paris, go to London. You would tell this to people like in CIA?

Everyone. Yeah. And we actually increased the hardship allowance. I got the Washington, my leadership, put it in a cable to increase, if you serve in tough places, you get a bonus like danger pay. Right.

Hardship, they call it a hardship allowance. So disease, counterintelligence, terrorism, crime, whatever. So we got an increase because of the psychological variables that I was able to document the stressors on people were very real. People would walk in my office and burst into tears because of the surveillance pressures. Who did you... I just want to make sure I understand this. So like officially, I don't know, the checks that are coming to your paychecks, is it the State Department?

Yeah, I work for the State Department. Work for the State Department. But you just deal with everything. Everyone that walks in my office could be a person that I could help, or a patient. So sometimes it's helping their families, the officer, the diplomat's doing fine, but their families are struggling,

the kids struggling in school. So you're working with the families, yeah? You have to. This comes from a special forces model of care developed by a brilliant family doc named Robert Marsh, who was, he was in Black Hawk Down that day. He was injured with life threatening injuries while he was helping the wounded out of that situation.

And he was the first physician for Delta Force. And he said, in order to care for the operator, you must care for their family. Then they can focus on their job, on their mission. So I had read that and took that to heart. Wow. Now- So we're a medical, I used to tell in Russia,

we're the medical support system. We're like oxygen. When you got it, you don't think about it. When someone's choking you, then you realize you don't got it. Yeah, you're almost, the way you're describing it, and I can't remember, I think you might have said this off camera before we started, but you said something like there were 11 zones... Yeah, 11 regional people when I started.

Now there's like two dozen. 250 countries or whatever. So like you said, you're going all over. But in a lot, like not to memeify it, but it's almost, you feel like a Mr. Wolf a little bit from like, from the movie. Because there's a little bit, that movie, Pulp Fiction, sorry. But there's a little bit of movie Pulp Fiction, sorry, but there's a little bit of like you just got to show up and

It might be in this country with this Person who works for this part of the government that has a totally different set of needs than the person and working in that part Of government in this country and this one's got a family over here So you got to figure it out on the fly and then you got to be able to help be a problem solver Yeah, you've got to go to the people they people and then you got to be able to help be a problem solver for someone who's in a high stress situation. People don't naturally trust psychiatrists and mental health people. You got to go to them. If the mountain won't come to Muhammad, Muhammad got to go to the mountain.

So I would go reach out to the head of DEA in Mexico. They have a huge mission. They're under a lot of threat. If you know the story in the movie Narcos, Kiki Camarena. Every DEA office I've been in has a picture of Kiki on the wall. They never forget. So when I reach out to them, they were very appreciative. You know, they were very deeply appreciative.

So you have to understand their stress, their mission. I've met with, I've done house calls. I met with a diplom've done house calls. I met with a diplomat from another government agency once they asked me to see him because they had had an attempted home break-in. He was targeted. Oh yeah.

And because of the nature of his work, he had worked closely with all sorts of sensitive entities. And I said, can you come to the office? He goes, could you come to the house? I'm doing fine, my wife's fine, I just want you to talk to my kids. Mm. I said, sure. So I talked to the kids, they're doing their homework, you know, how you doing? You heard about what happened?

They were a little bit older, they were elementary and middle-aged, middle school age, I could talk to them and just reassure, well that goes a long way, a little bit of kindness goes a long way. There wasn't any mental illness, but it was helping cope with the stress. And the parents were appreciative, so then they tell everyone in their section or office, hey, you can trust this person, he understands your needs.

Is it hard to, like when you come into some kids like that, that you've never dealt with before, right? It's your first time going in there. And they know, you know, they're kids, and they know you're a psychiatrist, something traumatic's just happened in their life, like, they gotta have a guard up. Like, is it hard to break that kind of guard down on the fly?

I'm a parent. I'm a parent. I had a kid that was their classmate sometimes. So you just, we were living among the people we serve and work with. Go to church with them, see them in the gym, run into them at the store. So you just have to balance your boundaries. What was life like for your family traveling around

with you over these 14 years and going to different places? It was very hard. It's hard on families. People that do regional jobs, they have, the Department of State has diplomatic careers that are based like in Frankfurt, but they travel all over Central Asia, Africa, and Europe. So they're gone like 90% of the time, they're never home. I mean, that's the worst travel.

But a lot of them are single. But for families, it's hard. It was hard on my family. My dear wife often felt like a single parent. I'd be gone four or five days, home for two days, gone four or five days. She got used to it, but it wasn't easy. It's hard on families. It's hard on the marriage too,

because you're not around each other. We're not around. And she's in a foreign country. No. No. I mean, like, leave your job. You know, there were a couple times when that conversation came up, you know,

is if it's not working, I told her, if it's not working for us, then I'll walk back. I'll go back to get another job in the States. But by and large, it worked. We spent... We spent, my daughter spent eight years overseas, graduated in high school, moved back to Texas. My wife spent... I'm getting this right, a total of 11 years. No.

She was overseas, I think nine years. So, but you were in for 15. We were separated because of my work for three years. I was in Washington, she was in Texas, so I'd fly home on the weekends. Whoa. And then I was in London for a year and she was in Texas. And then I said, I think I've had weekends. And then I was in London for a year, and she was in Texas.

And then I said, I think I've had enough. And then I went home. How do you make, like, I've never been married before, but I'm gonna be someday. How do you... How do you make something like that work when you're doing an amazing thing, and your job is at, like, the highest level with high stakes, especially within your industry,

like, you're serving your country, and the people who are kind of like the tip of the spear. But you know, obviously for every one family is the number one thing. And their marriage is the priority. Like how do you keep a marriage, I don't know, healthy during such a long time period like that where there's so much sacrifice. Well, it's a challenge. And many...

The divorce rates among people that do this kind of work, friends of mine in the... in the State Department some, in the agency, DEA, FBI, where your work takes you away all the time. You've had agency people in the show, they have two jobs. DEA, FBI, where your work takes you away all the time. You've had agency people in the show, they have two jobs. They have a day job, and then on weekends and evenings, they're doing their quote, real job. So they're working long hours, it takes a toll.

They're traveling. It's very difficult, and I would have to counsel people whose marriages were in trouble, and falling apart in a lot of countries that I served in. So it was very challenging for people. And you have to balance it. You have to have a strong foundation.

I'm very fortunate. I've been married, gosh, 35, 36 years now. That's awesome. And I got grandkids and all that. It's life is, life is bueno, as a friend of mine says. But the thing that I wanted to do that I deliberately did to help my family is send them home every summer

and pay a lot of money out of pocket for airplane tickets to go home to Texas throughout the year when there was school breaks, things like that. So number one, they could be around family and stay connected, all of us. And number two, my daughter would not forget her American and Texan roots.

A lot of kids that grow up overseas get lost. Third culture kids, they don't have a lot of kids that grow, a lot of kids that grow up overseas get lost. Third culture kids, they don't have a sense of identity of who they are. Uh, so I think, and they miss out on American type things. Like, my daughter, when she was 16, she learned how to drive. You know, I'd take her out into Dallas and drive around. And then I talked to one of the admin people in Mexico, where I was stationed at the time. I said, can she drive in Mexico with a permit?

He goes, yeah. So on Sunday mornings, we would drive out to the airport, and then back home to practice. About a two-hour round trip from our house. And I said to my daughter, if you can drive in Mexico City, you can drive anywhere. Yeah. She's a good driver.

Yeah, but the benefit though of this, obviously it is tough, especially growing up, like just, obviously I didn't do it, but speaking with people who grew up on, around the world, because their parents were diplomats and stuff, like it's difficult, but your cultural appreciation and ability to adapt

is on, at least from what I've seen in the anecdotal people I've spoken with, seems to be on a different level. So, imagine, you know, your daughter and even your wife have some skill sets in dealing with people that, you know, people like us don't. Well, my wife is Asian-American. She grew up in Asia until she was 10. Where in Asia?

In the Philippines. And then came here, and then of course our travels. We've had to learn as individuals and as a family to adapt to all sorts of different cultures. That's not easy when you live in one place for two, three years, you get used to to it and suddenly your your time is done and you have to go to a completely different culture. Yeah I have a cousin who works for the State Department just put huge air quotes on that I give him shit

every time it's definitely not a State Department but he goes around the world in you know different rotations and I'm telling you I won't say the countries But you want to talk about going from opposite country to opposite country like every time It's probably been like five six rotations at this point every time like where you going now There's nothing in common. Yeah, well I went from Russia my first tour to India so you coming from Texas I didn't have any cold weather gear. So I ordered all... I ordered $2,000 of L.L. Bean for all of us. You know? And then my boss in Washington walked in and said,

oh, we may change your orders to Cairo. I'm like, are you willing to go? I'm like, look, I'm new, I have to go where I'm told. But I said, could you let me know by this date so I can get my money back? I just ordered two G's worth of cold weather clothing So but that cold weather gear isn't really useful in India and then we went to Mexico where it's a temperate climate and then went to Vienna after that so then we got the cold weather gear out for the winters. What was the total?

Like what was your your exact order just over the 14 years? Let's see, Moscow, Moscow for two, New Delhi for two, Mexico City for two, Vienna, Austria for two, then Washington for two, no, Vienna, Austria for two, then Moscow for three. I was going to do a fourth year, and they pulled me back to go to Washington for two in a leadership role. And then I went to London for a year, and so that was my 14 years. Yeah, so again, you were...

you're doing a lot of opposites too in there. Yeah. I'm picking up for sure. I like the tougher places the most. I like Moscow. Don't get me wrong, I love Vienna, I have family there. But it was, job- Vienna, I have family there. But it was, job-wise it was not as exciting.

I mean, I loved the Balkans. You like the challenge. Yeah, I loved Russia. I loved the challenge. I loved India, going to the war zones and dealing with all South Asia. The war zones. Yeah, and Mexico, I went all over Mexico,

the consulates, there are 10 or 11 consulates all of Central America, all of the Caribbean. I've been to Havana, Cuba twice. I've been to Haiti five times. They let you in Havana? It was hard. The first time I applied, they didn't give me a visa right away.

Then I sent another application in, and they must have checked with the Russian security service because then I got an answer back in a week. And they're like, this guy's okay. But they were all over me. In Havana, when I get there on one of my trips, I was in the diplomatic line and they didn't know I spoke Spanish. And so I'm there and there's a Chinese dude in front of me. And then when I go outside, I go taxi and he goes where I said Hotel Nacional, which is a famous, beautiful art deco hotel right on the ocean.

And then this dude wearing a suit slides in next to me and the driver goes, my cousin. And then they start talking. I knew he was a Cuban intelligence officer. It's a very hostile surveillance. I knew who he was and I knew he wasn't gonna hurt me. It's not like surveillance. I knew who he was and I knew he wasn't going to hurt me. You know, it's not like Mexico. Well, if that happened in Mexico, I'd get out of the car, then I'm being kidnapped.

Oh, you're more worried about a Mexican intelligence than... I'm worried about a cartel guy getting in the car. You know, but I'm... a Cuban intelligence isn't going to hurt me. He just wants to, you know, make sure I go to the hotel and don't go anywhere else. So, when they... How do you know that? I just know it, because I've been surveilled by these people in my previous life.

No, no. And so the driver tells him in Spanish, oh, I thought you were gonna go with the Chinese guy. And I burst out laughing. And then they kind of go, oh, it's a little awkward awkward moment and I said in Spanish. Yeah. Thank you guys gentlemen Just get me to the hotel safely and on the way point out the cigar factory So I get to the hotel and my room's not ready. They said dr. DeClevo. We have to prepare your room Yeah, they're bugging prepare my room. So I said

Could I get a mojito and a cigar they go? Absolutely. Here get a mojito and a cigar? They go, absolutely. Here's a mojito and the cigar store is downstairs. So I sat out on the veranda with all the tourists and lit up a cojiba and had my mojito. An hour later, they said, your room is now ready. So you just have to understand these things. They have 40 camera angles of you when you walked in there. That's fine. As long as they don't hurt you. I don't care. He's got a stripped down naked and pace around the room. Just rub it in their face.

Whoever's watching. Yeah, that's for a different type of person. Yeah, pause. But real quick, Doc, I just gotta go to the bathroom. We'll be right back. All right, we're back. What was Cuba like though to experience? Because obviously I've never been there,

but I've heard stories before about people who've gone for various reasons and they'll be in a cab with a guy who's like a neurosurgeon, but he's driving a cab that looks like a car from the 1960s to support his family. You know, did you see things like that? Or did it feel like almost like a throwback society? What was it like?

Yeah, Cuba's a fascinating place. I've been there twice. I really enjoyed it. And the work is very stressful because of the even more stressful now because of all the things that have happened with Havana syndrome and that. But I was before that time. But it's a very hostile counterintelligence environment.

So the Cubans are kind of in your face if you live there constantly. And there's a lot of poverty, people who are struggling. They may have relatives, but because of the embargo and things like that, there's a lot of poverty. So I would walk, after work, I would walk around Havana and take pictures, talk to people. And ordinary Cubans would come up to me

and ask me questions like, have you been to Miami? Do you know my cousin? You know? And, you know, but they couldn't get staples. Like, they couldn't get milk or, you know, baby formula, things like that were hard to get antibiotics. So they, you know, one lady, things like that, were hard to get antibiotics. So they, you know, one lady, I was talking to one lady in the street with her relative, and they asked, do you have any money you can give us?

We don't have money to buy milk for our kids. So that part was sad, you know. And then the, but it's a fascinating country. The people are friendly. I'd walk around Old Havana, I went and had a drink at Los Ambos Mundos, which is the famous bar where Hemingway drank. And I had Cuban minders that were following me everywhere

and I bought them a drink. Oh, you did? They're getting, they're informants, they're not the agents. You know, they're getting paid $5 a day to follow the gringo around, you, the American diplomat. So, uh... But I enjoyed it. I liked the sense of history and a lot of dedication to the mission that the people at the embassy,

at the time it wasn't a fully-fledged embassy, it was called the U.S. Interest Section. Only it became an embassy around, I think, 2014, during the Obama administration. Mm-hmm. But it was a challenging place for people Only, we came in embassy around, I think, 2014, during the Obama administration. But it was a challenging place for people, because they would have to go every three months, they would have to fly to Miami to get medical care,

appointments, dental care... Because they can't get it there. ...stock up on things that are hard to get. The Cubans would deliberately make it hard dental care, stock up on things that are hard to get. The Cubans would deliberately make it hard to bring things in through the diplomatic pouch, stuff like that, harassment of our people. So it's a very tough place to serve, even though it's very beautiful.

And we went to, one time I went, a person in the embassy said, Dr. DeCleve, we'd like to invite you to a party. Once a month, you get together with all these diplomats. And I'll say diplomats. And so, you're sitting out in this little garden restaurant owned by a family, and everyone's drinking, smoking, and I'm sitting next to a Chinese diplomat

who spent seven years at Harvard. And a senior Russian diplomat who had been an interpreter for Gorbachev and other senior leaders. He was obviously very senior, former KGB, now SVR. And there was a young guy with him who was probably on his first assignment. And the senior guy is there to observe and mentor him.

It was, when I saw the two of them, I was talking more to the senior guy, but the young guy was kind of getting his cues wrong. It was like Sean Connery and Wesley Snipes in the movie Rising Sun. Sempai Kohai. The older guy was Sempai, you know? And the younger guy was the Kohai, but he was sort of observing how he interacted

in this setting surrounded by all these diplomats from other countries. But it's like the Cold War, everyone's checking everyone out. Yeah, I was gonna say that didn't go where I thought it was going. I thought you were gonna refer to, like, some other U.S. people that were hanging out there,

but you're talking about, like, some hostile nations. No, there were. There were U.S. people there, too about some hostile nations. No, there were. There were US people there too. And they were having a cigar and a drink with their counterparts, is the best way to put it. Isn't it interesting that people in high level important jobs, diplomatic, to use your term there,

jobs like that from these different countries whose top line governments are at odds on many things, can sit there just as human beings, even if there's a little facade around it, because they're checking each other out, but smoking cigars, drinking some drinks, talking about family, talking about all the things that make us human, and yet when they leave that place

and go back to where they came from, the respective countries, it's back to the drawing board of like, okay, how do we spy on these guys? How do we pull one over on these dudes? Isn't that strange? The human beings can be like that. Yeah, it's funny.

Well, they're human. So you approach them on a human level. But I was chatting in India at a party I got invited to. It was a monsoon party. A monsoon party. At the end of the monsoon in September. A high-level official in the embassy invited me. He was a friend of mine. And, well, I can say who he was.

He was the head of CIA in that country. And he was my martial arts student. And we're still friends. Wait, wait, wait. The head of CIA was your student. Yeah. And I went to his retirement ceremony. How good are you?

You must be pretty good. I was fourth done in Aikido, fourth degree black belt, and Sistema certified as a teacher at the time. I'm not going to test you. Okay. So I'm there talking to the Russian deputy chief of mission and he was a China expert I'm talking to him in Russian and I told him he said did you like Moscow? I said, I love your country Moscow is a beautiful city. I'm so proud to have served there. The Russian people are wonderful

I'm you know trying to butter this guy up and I meant it and he goes well if you miss the Russian language We can give you free lessons at the embassy. I said, that's so kind of you, but I've traveled too much. I'm too busy. And I told my friend about that. He goes, oh, yeah, he's trying to recruit you big time. You know, they'll put you with the prettiest language teacher in the embassy and, you know, see where things lead.

That's what they do. That's the other thing. Like, you are, your job is to go around the world and work with our people like and you're doing your expertise Your job isn't to be a spy or technically like A state department negotiator type things. Obviously you were doing stuff in the hospitals like you talked about but it's all medical, right? At the same time though You are forced through your experiences to deal with all the people who are in that world which includes as you're pointing out people in other countries as well, which means you're learning about

You're getting a perspective on how the world works and what's happening You know below the surface that none of us at home Get like did you start did it did it at some point, did you start, did it, did it, at some point, did you start to notice yourself thinking, I don't really know how to ask this, but thinking about geopolitics and the ways of the world naturally and like a lot, just because of what you were witnessing,

meaning it's not your job, but like, you're naturally becoming an expert on some of these things? Well, it was both. It was kind of organic because the other way I got interested in this work was in the early 90s, I had read a profile of Saddam Hussein that was published by my friend and mentor,

the late Dr. Gerald Post, who founded the unit that profiles world leaders at CIA and worked there for 21 years. So that's the unit John Kiriakou worked for then. Yeah. Because he was Saddam's chief profiler. Kiriakou was a student of Post's at GW. Yep.

And he... Oh, he talked about him, yes. Post is a legend. Well, I got connected with Post. I had read his work, and his work on profiling terrorists and world leaders, and I thought, this is some of the coolest stuff in the world. I gotta learn more about this in the early 90s. And so I read some, I dug up whatever papers were in the open source literature and in the medical library. And then in 1995, I started working on a profile

of Dr. Radaman Karadzic, who was then the leader of the Bosnian Serb Republic, but was also a psychiatrist and published poet and had been indicted for war crimes and genocide. Yeah, he was doing the genocide. So I got Karadzic's poetry together and translated it, all of it, at the time. Took me a couple months. And it was really haunting.

And the American Psychiatric Association the year before, it condemned him for his role in the genocide, before the indictments came out and got quote unsealed. And I was really intrigued, like how could a psychiatrist who was by all reports an okay psychiatrist, he was a talented poet, cultured person, get involved in mass murder? So I wanted to write a profile about him. So I called up Post and just, out of the blue, and we talked and I told him I'd read his work and he goes, what are you working on? And I said, I'm developing a profile of Radhavan Karachich.

He goes, oh wow, that's amazing, so am I. We need to meet. So he flew down to Dallas a month later, he had to go to a wedding and we had a four hour brunch and kind of talked shop. And then we ended up publishing this profile and presenting it at GW where he was teaching. He asked me to do a presentation in 1995.

This is before you were working. Before my State Department. I was an academic. Yeah, wow. And it was real funny doing the, I was in DC to take my, back then they had these very difficult oral board exams And it was real funny doing the, I was in DC to take my, back then they had these very difficult oral board exams where you had to interview a live patient

in front of a bunch of experts, psychiatrists, and it's very stressful. A real patient. A real patient. I did my oral exam at St. Elizabeth's Hospital. Wow. I interviewed a schizophrenic for half an hour and then they're pimping you and asking you questions. What do you think of this?

What about this diagnosis? It's very demanding. It's so stressful they got rid of it. It's kind of strange too, because you have a human being. Yeah, they dumped it down and got rid of it because the fail rates were high. But when I was there, a post said,

could you give a presentation at GW on counter G-Check? Oh sure, so I gave an hour and a half presentation, lots of questions. They had journalists there who interviewed me in Serbian. And they had people from the government. And when you go around the table and they go, I'm George, I'm Frank, I'm Mike. I'm like, okay, I get it.

And they didn't ask any questions. They never asked direct questions. The questions would be asked through Dr. Post, and then he'd call me up a few weeks later and said, one of my friends who was at the talk asked, what do you think of this and this and this? I'm like, okay. So we published and presented this work

in various academic conferences, and one, and then later... You said, I'm sorry, if you don't mind, I want to go back to something, because we got off it. You said when you studied his poetry was particularly haunting. Yeah.

Why was that? Because in his poems that were written in the late 60s about Sarajevo, or in the early 70s, there's themes of destruction and war and horror that come out in the poetry. Like he sees Sarajevo burning. And that poem was written in 1968. So it's in the depths of his unconscious. Like he wants Sarajevo burning. And that poem was written in 1968. So it's in the depths of his unconscious.

And it's laid out 15 or 20 years later in 1992 through 95 in Bosnia. I found that just unbelievable. How does, I mean he's a whole different case because as you said, he was literally a psychiatrist. You would think someone like this would have some more awareness of human beings. Yeah, he was trained in Tavistock in group therapy in Britain. He spent a year at Columbia.

That was very interesting. We tried to dig that up. There's no, Columbia said we have no record of him being. Yeah, sure you do. Sure you don't. Yeah, I called them. We tried to dig it up. I talked to government people and they go, can't find any record.

I'm like, what was he doing in New York for a year? You know, and, and he's not, he's not on the rolls on the registry. Every student's on the registry. Well, they had White out. Yeah. Yeah. Back then. Yeah.

So, and, and he was a talented poet. Now, one of the biases that creeps in is once he got charged with war crimes and genocide, people said, oh, his poetry is crap. But he got all these awards at the time. And now with his ego and his vanity, he said, oh, well, he gave an interview where he said, I'm the greatest poet in the Serbian language.

That's probably a stretch. But he was a decent poet. So I enjoyed trying to understand how that plays out in his political decision making and his, frankly, his cunning. He managed to evade capture for close to 15 plus years. And even now, when you drive in the Bosnian Serb Republic, there are posters of him. He's a hero.

He's a hero. Yeah, to them. Genocidal maniac's a hero? Yes. How does it... All right, let's start here. How does a guy like that, especially with the background he has, psychologically speaking, from your expertise, and you also literally studied him individually. How does a guy like that? Get his mind to a point

Where not only can he accept genocide he can start it and and cheer it on and justify and justify He said in a famous quote. I'm willing to sacrifice an entire generation of Serbs so that the Bosnian Serb Republic can be pure, i.e. cleansed of the bugs. So the how did he go from being a psychiatrist to empathize with patients, to care patients, wrote poetry to a person who was responsible for genocide. He quote-unquote, and this came out in his trial, he said, with Srebrenica, this is the tragic attack in July of 1995, where 7,000 Bosnian men, women, and children were slaughtered in one day.

He said, I took full command responsibility for the actions of the Serb military, the Bosnian Serb military in Srebrenica, and I am satisfied with the outcome. So that goes to legal doctrines of command responsibility, going back to the Nuremberg trials and the Tokyo war crimes trials in World War II. So Karadžić was a figure, there was a dark, he was an interesting creative figure, but he obviously had a lot of dark matter in his DNA. That came out, the destructiveness and the brutality of what his government and his forces carried out is stunning. And now Robert Lifton, a legendary psychiatrist and scholar had written about this in the Nazi doctors.

So in trying to understand Carthage, I went back and read that work about the T4 euthanasia program. T4 euthanasia program. In Germany and in Austria, which was run by psychiatrists that allowed them to euthanize disabled children. Right. That was the precursor to the final solution,

because the... Pull that mic in a little bit. In order to commit genocide for a country, you have to dehumanize the other. That's right. And in Germany, they used a phrase. My German's not so good, but the translation would be, life unworthy of life.

Or in the Bosnian Serb case, they had to dehumanize the Muslims and and say that they were unworthy and these debates in Serbia and in the Bosnian Serb part took place in the 80s and early 90s on the front page of the news every day it wasn't secret the dehumanization preceded the genocide you have to create hatred first. And every genocide that I've studied carefully in doing this kind of profiling research has that component. Rwanda, same thing, the radio had to create the hatred against the Tutsis.

Why do we do this over and over again? Because we're human, unfortunately. The People Post and I wrote a review of a very brilliant psychobiography of Adolf Hitler written by a psychiatrist who taught at Yale named Fritz Redlich. And one of the things we wrote in that review was that as long as people are human, these kind of leaders will periodically emerge and will be asking that same excellent question that you just asked. Because they don't do it because they're mentally ill. is not mentally ill or psychotic or it's evil. And we don't, evil is a theological and moral term

more than a psychological term. We can use psychological terms like psychopathy. Evil is broader, it adds more depth to it. I testified in a capital murder case once and a prosecutor asked me, doctor, he handed me the DSM-IV and said, can you look up the diagnosis of evil in the index? And I knew where he was going with this because it's not there. I said, I looked, took my time and said, there's no such diagnosis. This is a moral concept. So I think that's the way from studying leaders like Karadzic, later we, Post and I, studied,

wrote about and presented our profile of Slobodan Milošević in 1999, the week that the war started. Oh, you did one on that too? Yes. And then, of course, my studies of Vladimir Putin, who's been indicted for genocide. Yeah. Uh, these are questions I've wrestled with my entire professional career,

trying to understand exactly what you're asking. Yeah, I sit up at night thinking about this stuff, because, like, you know, I just have a little goddamn podcast here, but I have people in, and sometimes these dark things that are realities in our world, certainly they come up and people talk about them and it makes me think about it a lot more because, you know, I'm in a job where I connect with people from different backgrounds. That's what I love. But we still have a thing in us and I don't I guess it's

like a mental wiring that we are all capable of if pushed in the wrong direction in some way, as dark as that is to say, where we could justify hating someone else, starting with hating someone else because they're X or Y different than us and whatever construct we invent for that and then somehow get that down a slippery slope to where it's like Yeah, no, they're less than human. And that that's It's just frightening to me that when we live in a world now of eight billion people interconnected like this all the time Where you know, we're all a part of the human race that we could still separate it out and try to tear it Some people obviously yeah

And and in today's world, it's more dangerous because social media. Yes can be an ex. It's a good thing Social media allows me to call my mother in Austria On whatsapp for free, but social media can be a fire accelerant for hatred. That's right. So it's a slippery slope of, you know, you tamp down on it, you're tamping down free speech and that always goes worse. But I always say like, I'm always gonna be a free speech guy. What we have to understand as human beings is that that is painful too.

Free speech is, it's a painful thing. The hard thing too with the Serbs, and even the Russians that I interacted with, I interacted with a lot of ordinary Russians. Sure. A lot of ordinary Serbs, because they speak the language. And you can have people who are well-educated, they studied in the West, you know,

they went to the top universities in Europe, or in the United States You know, they went to the top universities in Europe or in the United States, Ivy League-level schools, for their profession. But when you talk about... things like what happened in Bosnia, they're like, we had to do the right thing. They have a blind spot.

That's right. Or the Russians who were saying, we have... what we're doing in Ukraine is justified. Uh, even though they're well traveled, they've traveled throughout the world, through Europe, they're multilingual, multicultural, but they have a blind spot when it comes to certain types of... Nationalism can be a good thing.

It makes us root and say, rah rah, and weep and salute the flag, and that's all wonderful. I'm as patriotic as anybody. But it can go down a dangerous slope when you combine it with other types of thought. That's right. That's a great way to put it. There should be nothing wrong with feeling national pride and love in your country, regardless of where you are in the world. I feel very lucky that I was born in America. I'm biased. I think it's the greatest country though. Dr. Justin Marchegiani I agree. Dr. Justin Marchegiani And I understand other countries don't have the freedoms we do but

when people are born somewhere and they're part of that culture, even if it's a country that's in a down period, you have pride about where you're from and that's a great thing. But to your point, when you then use that to point your finger somewhere else about whatever problems may exist, no matter how big or small they are and say they exist because of them, it gets very, very ugly. And I think one of the things that has really opened my eyes on this just to like – and it's a great example with the social media thing you just mentioned this, open my eyes on to how people can very quickly go down the wrong diagnosis path, I guess.

It's not diagnosis, but if you pull up on your computer, Dr. Reed Malloy, R-E-I-D-M-E-L-O-Y, he's a colleague of mine. He's a brilliant forensic psychologist. He's written a lot about what they call extreme overvalued beliefs. Extreme overvalued beliefs. Yeah. What is that?

Well, they're looking at people like, they're looking at, there've been cases where, if you look at the division in our country, that's the paper with Reed and Tahirah Rahman. My eyesight's bad. Yeah, let me read the definition just so people have context. An extreme overvalued belief is shared by others in a person's cultural, religious, or subcultural group.

The belief is often relished, amplified, and defended by the possessor of the belief and should be differentiated from a delusion or obsession. Over time, the belief grows more dominant, more refined, and more resistant to challenge. The individual has an intense emotional commitment to the belief, and may carry out violent behavior in its service. Yeah, that's the, if you look at the example like in Russia today, a large percentage of the population agrees with President Putin's long time belief that Ukraine is not a real country.

He told that 20 years ago to President Bush. He told it to then ambassador. He's always said it. He told it to Ambassador Bill Burns at the time when Ambassador Burns was ambassador from 2004 to 2008 in Russia and of course later became Deputy Secretary of State and CIA Director.

So it's a long held belief. And the, so it's how do you challenge this? Or like when you look at, when I was a resident, we saw victims who had survived the Branch Davidian fire. And they, and you know, you have to put your bias aside. You're thinking, they're followers of David Koresh, who led the Branch Davidians down this horrible, tragic path. And they were grieving the loss of their friends in the fire and of Koresh. They had... Many of them had post-traumatic stress that were presented that we interviewed. So it's

but So you can have cults that have extreme overvalued beliefs. There was a cult in the mid 90s in San Diego I think it was called Heaven's Gate where they all They all killed themselves. Of course, you had the famous one in Jonestown. Yeah, Jonestown. You had if you look at the study of intense religious beliefs, when does that crawl in? It's very complicated. Oh, yeah. You know. I've seen though, the thing that has really alarmed me recently in how

quickly people can turn on stuff is the revisionism of Hitler that is happening online. Now I don't want to overstate this. It's not like, oh, half of people are actually revising this. It's a small percentage, but the fact that it's any real percentage at all is crazy. To me, what it is is you currently have a government in Israel who is, I will say objectively, at this point, practicing a disproportionate response. And people are seeing what that looks like and how ugly that is on the other end.

And you know, the children and women and the innocents outside of Hamas, obviously, not including them, that is going on and they are angry about that. And so they are now taking that anger for the decision of a current government in 2025 and saying, oh, therefore, Hitler had a point leading up to World War II. I don't know how much you've seen this. This is a very real thing online. Well, I've seen it.

I've seen it when I lived in Russia. I was seeing already the glimpses of it in the kind of restoration of Stalin as a hero. They're saying he industrialized the Soviet Union, which is a true statement. He made us a superpower. We got nuclear weapons. Those are all true statements.

He made people proud. I've had Russians of that generation say, I feel very proud when I think about my childhood in those days. I was a pioneer. I remember the pride when I first put on that red scarf for the first time and had a pin. They remember that moment 40, 50 years later. How about the tens of millions of people he killed? See, when you ask that, they're like, well, these are the cause.

Or well, you look at China with Mao. Xi Jinping is, in my profiles I've written about, they're really trying to talk about the great rejuvenation of the Chinese people and the good things that Mao did. They're papering over not only June 4th, 1989, which is the anniversary of this week, but the Cultural Revolution, the Great Leap Forward. You know, Mao, 50 million people died in Mao's reign.

Probably 30 million in Stalin's. So people can paper that over, and the same with Hitler. I've had Austrians and Germans tell me Hitler did many horrible things but he built the Autobons and you know so you rationalize the behavior. So when you study these foreign leaders you have to study their followers and how they're able to get otherwise very intelligent, rational people to go down a different kind of rabbit hole. And they're not crazy.

People say, oh, they're delusional. They're not crazy. There are so many divisions now in our country, and there are psychiatrists out there that think that they never written that anybody, and they're labeling half the country crazier more 53% anyone who voted for President Trump is delusional or maga and that's crazy, but but they don't they're not having conversations with people the the divide is so wide well, that's

That's we are fortunate We live in a country where we can still have a conversation if we wish to. In Russia, you can have a conversation about the Ukraine war. If you call it the Ukraine war instead of the special military operation, and you say that online or to the wrong person, you could go to jail. So that was the other way that I got interested in this kind of work, through my work with Dr. Post and then combining my interest in that area with working as a diplomat, as a regional psychiatrist and physician. And when I got out, I went, I'd always kept up with the profiling world.

Then I wanted to write about Putin so I wrote my first profile of Vladimir Putin when in March of 2017 Now, what did you write about him? That we misunderstand him that we don't truly understand him that the labels one uses to try to figure out what a leader can do including psychiatric labels are not terribly helpful I mean, I certainly think as I've written about Xi Jinping and Kim Jong-un. I call it the three Rs. They're rational They're ruthless and they're very very unfortunately for us very resilient Wait, so you view Kim Jong-un as rational. Absolutely. Why is he rational? Wait, so you view Kim Yong-un as rational? Absolutely.

Why is he rational? He wants to stay in power. He wants to continue the Kim family rule in North Korea. How is it rational though to completely starve all your people, have them dying around you, and lock them out of the world like the Truman Show? I don't understand. Don't get me wrong, I'm not therefore calling Xi Jinping rational as well, but I could see how you could make the argument that civilization carries on while he's in charge.

Whereas Kim Yong Un, I mean, these people don't even have an understanding of the outside world. How... Actually, I want to correct you on that statement. The North Koreans are exquisite... The North Korean diplomats in government and the people that present their opinions to Kim are exquisitely well informed. I would believe that, but the actual citizens? The actual citizens, not so much. It's going to be the elites. But they know what's going on, but they still believe in their system.

So, can you explain, like, psychiat psychiatrically the full-blown? Reasons why he's rational though. Well, he's rational in the sense that he has clear goals. He wants North Korea He has aspirational goals where he wants to rule the country But he wants it to be more prosperous when he first came to power He he made a famous speech in 2013 He said I want people to be able to loosen their belts, so to speak, after years of privation and what they call the Arduous March in the 90s, where, gosh, up to 2 million people died of starvation during the Arduous March.

From about 1995 to 1999, that's, gosh, 10% of North Korea. But in terms of our dealings with him, he can be negotiated with as a rational actor. That's really what that term means in the context I'm using it. Okay. Because I will say, when you have a guy... I.E. he's not crazy. He's not suicidal, and he's not crazy. When you do have a guy like that, that though who's willing to play around with testing his nukes and you know, Trying to show his power to the world. I do think there's something to be said for not obviously not endorsing him or like being excited about the guy at all, but

You know in Trump's first term, opening up a line of communication. Because he's there, you have to deal with him. You know what I mean? I agree. And I've written and spoken publicly about that in my profile about Kim Jong-un, published in 38 North and the Cypher Brief in 2018, that the Singapore summit, Trump's for brief in 2018 that the Singapore summit, Trump's move to go there was a very bold move. Unfortunately, and I thought Trump's, the 2019 Hanoi thing was really the high point and then it failed, which is a huge disappointment. What was that Hanoi thing again? That's where Trump walked away. They couldn't reach an agreement and he said, I'm done and he flew home. Okay.

And then he went, but then he tried to restart it by going to the DMZ, the first American president to walk into, as a sitting president, to walk into North Korea, step across the DMZ, shake hands with Kim. It's very symbolic. Unfortunately, he lost the momentum. And as I told one of my golf teachers,

who he asked me about it during the time, and I said, Trump's like a guy who gets the first ever eagle on the hardest par five in the world, but you've got to play the other 17 holes. You know, you've got to follow up. And he lost the momentum in 2019 and 2020, and then it's time for the election, and then you lose the momentum because of domestic

factors. And we also in 2017, in the UN had the support of the hardest sanctions ever from the Russians and the Chinese. We no longer have that support. So Kim has unfortunately become more aggressive and bold in his role in Ukraine. And the thing that worries me the most about Kim, everyone is talking in the news about the amazing historic Ukrainian drone attack against the Russian bombers. And we should all applaud the courage, the tenacity, the ability to keep it secret for a year and a half, amazing.

While they were planning it, it's a psychological blow. It won't change the course of the war, but it's a big psychological blow to the Russians to knock out a chunk of their air force. But my first thought was, oh, our enemies can now do the same thing. If you don't think Kim can send a lot of drones into South Korea, or the Iranians can do it,

so technologies are used by our enemies as well. So that absolutely scares the crap out of me. Well, you look at, to go back to Putin, again, this was a guy that I'd studied for a lot of years long before the current Ukraine war broke out. And I always I'm like, how, how do more people not talk about the fact that this dude is a full blown open dictator of a country that for years was very hostile to us and is working its way back towards being hostile again. You know, and then the war broke out and then it became popular to say that. And then people got fatigued from the war because it just kept going.

And we see all the funding that's going over to Ukraine and we got a lot of problems here and people are like, what the fuck is going on? Because Ukraine also has certainly in their government, not their people, but in their government there's, there are some corruption issues, for sure. So people are very disillusioned with the war. But one of the biggest disappointments for me is that there hasn't been an acceptance, which is a tough word, but there hasn't to me been an acceptance on the United States

side that whether we like it or not Vladimir Putin who has his beliefs as out there as they are is in charge of this in charge of this country Russia And if we want to stop hundreds of thousands of people from dying There are diplomatic solutions to do that without him taking over all of Ukraine and yet people refuse, many, not all people, but people within the government, so many of them refused to even have this conversation because God forbid, you know, you say,

all right, Crimea is yours, I'm not saying I like that. I'm saying, don't you have to be a realist at some point and look at the human cost and also realize that like Russia has a GDP the size of Italy. I mean, they're not China. You know what I mean? Like there's a dangerous power for sure, but there's a level to which they can play the game. If this were China, it'd probably be a different story. But don't you think there's some sort of psychological barrier there that we've created

that is actually hindering us and therefore hindering the people on the ground who are losing their lives? At times, yes. I think we have to be careful about the words we choose. If you read my profiles on Putin, I'm very careful in my choice of words. The Russians read my stuff. I've been quoted in Russian media. They translated my profiles. They edited out the parts they didn't like. And wrote... I found one once that said, American psychiatrists praises President Putin's leadership style. The North Koreans have quoted me.

They read this stuff. They're very well informed. But that being said, I think, again, you have to approach President Putin. If you do name calling, it's hard to negotiate with someone who you call a genocidal murderer, a psychopath or a thug or a dictator. That's not going to bring him naturally to the table to want to talk to you. So I think name calling in diplomacy, you have to be careful. Once you go down that road, it's hard to talk to you. So I think name calling in diplomacy, you have to be careful.

Once you go down that road, it's hard to walk it back. That's right. And that being said, you need realism. President Putin remains the KGB operative in the Kremlin. His belief systems are longstanding. They're not new. His inner circle is narrowed. He hasn't changed, but his inner circle has changed.

It used to be more diverse and have more people in his first two terms from 2000 to 2008. Now it's a narrower, tighter circle of people whose views are hardened and aligned very much with his. So that makes it more challenging now to negotiate with him. We don't have any levers we can pull. And he has. Why just survive back to school when you can thrive?

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We're negotiating with a nuclear armed hostage taker, basically. And he has maximalist demands that he can sort of put out there. And this is, I've written, this is the biggest challenge for President Trump and his national security team, for Special Envoy Witkoff and Secretary of State Rubio, who are very experienced. But this is a whole different level of hardcore negotiation. Yes. Because the other thing, you know, he's a smart dude, whether you like him or not, like Vladimir Putin's been around the block, and you don't want to underestimate. He's highly intelligent.

Yes, his intellect. People forget he's met with world leaders for the last 24 years, 25 years. And when he was deputy mayor of St. Petersburg in the 90s, he was in charge of all the foreign investments coming into Russia through St. Pete, and he was the liaison with all the German businessmen. He speaks fluent German, all the European businessmen, the Americans, so he has a lot of political, economic, and negotiating experience. He's a very hard negotiating partner in that regard. Now, you spent a lot of time in Moscow, so this one's close to you as well, because you were there during his reign,

and you know a lot of people and how their government works. But when we were going through the places you were, you didn't spend time in China, correct? No, I've never served in China. Okay, but you've become an expert profiler on Xi Jinping. So what initially drew you to be interested in that, just the fact that they're the other world power? I had studied.

They're very similar. They're a world power. I was very interested when Xi Jinping came to power, in his rise to power, his amazing life story. Can you go through that with people, actually? Yeah. It is pretty incredible. When I started, at first I thought,

I don't speak Chinese, and I've not lived and worked in China, so how can I really study Xi Jinping the way that I've studied Putin? And one of my colleagues who is a retired, very senior CIA officer who had served in the 70s on the National Intelligence Council. And I had sent him this stuff. He goes, you wrote, you've never been to North Korea, but you pegged Kim Jong-il in your first profile in 2010 really well.

And so you have a sensitivity for this. You'll do fine, you know, studying Xi." So I started to read everything I could about him and learn. And a guy sent me the most fascinating thing about Xi, which was hard to get at the time, but now it's on the internet, it's easy, is an interview he gave in 2000, before he was really well known. Which has been translated, where he talks about his childhood and his upbringing. And he talks about the years he spent in a remote village

in Chunji, digging latrines, being away from his family as a teenager for about eight years, and the hardships and how he overcame those hardships, how he developed inner strength. I found that fascinating. When he was arrested by the Red Guards, they said, we can kill you a hundred times. He goes, one sounds like it's good enough.

And then they let him go. You know, so there's a psychological resilience and steel in his spine that I found really kind of imp... He's a very impressive person. And the late, the late Prime Minister of Singapore, Lee Kuan Yew, who's met every Chinese leader, including Mao, called Xi Jinping a person of impressive quality, similar to a Nelson Mandela.

Which is a very, that's high praise. It sounds strange, but what he's talking about is the character and the resilience. Yeah. So I became interested in Xi and really fascinated and wrote about him, and that's what led to me eventually being named a senior fellow at the George H.W. Bush Foundation for U.S.-China Relations.

Yeah, there's one story about Xi, like everyone's got their origin story, the thing that's like, whoop, there it is. That's why they're motivated by X, Y, or Z, but the story about G's father, and the fact that his father was disgraced by the Communist Party, and then they made a young G, who I think was somewhere around seven years old at the time. Denounce him. Denounce him and stand in the middle of town

with a sign saying my dad's like a traitor or something like that and his own mom had to walk by and spit on him. Yeah. And when I look at that, again, I don't empathize with someone when they're evil and when they become evil, but I always try to learn and empathize

from where someone came from that got them there. She's father was one of the, there's a new biography out that I'm now reading by Joseph Torrigian, which he's a great writer. I highly recommend it. I've started it. But she's father was on the Long March. He was one of the founders of the People's Republic.

He was one of the youngest vice ministers in the 50s. So as a friend of mine said, she went from the penthouse to the outhouse and back to the penthouse in his life. But the party rules if she screws up, he'll go to the jailhouse. Hmm. Well, there's definitely from an event like that, and I've seen that type of story on a way lesser scale before and I'm not talking world leaders But when something like that happens

There's a thing that gets clicked off in that person says oh you're gonna do this to me fuck you I'll show you I'm gonna rule all you motherfuckers and whatever that switches It got switching him because you're right like, like from everything I've looked at too, the party does rule. But you can't deny that that guy's ability to get a firm grip on power within that government and maintain it. It's incredible. It's surreal.

It's surreal, exactly. To rise up the ranks like he did. He was barely accepted into the, he had to apply 11 times to get into the Communist Party. And he was not accepted to the Central Committee on the first vote, he was an alternate. And then yet, Amir, I think eight years later, became vice president.

And one of the things that helps me try to get a feeling for these leaders is I've talked to people who've been in the room with Kim, with Xi, with Putin, who've been in the room with them. Who'd you talk to who's in the room with Xi? If you're not allowed to say it on the phone. An American businessman who was there on business and a very senior American diplomat. How long ago we talked?

2008 when she was put in charge of the Olympics. Got it. And what they say is a different portrait than some of the other media portrait. They said he's a very good listener, he's very observant, and he was cordial to them, but he asked good questions. So there was a cable that went out in the US embassy

in 2009 that said she is of average intelligence. This is nonsense, I've said so publicly. This is complete nonsense. Who the hell wrote that cable? I don't know, but it was based on a single source who had known Xi when he was younger and had a lot of sour grapes. And he said, oh, this guy's just a political hack.

He's not that smart. No, wrong, wrong, wrong, wrong. Yeah. You know, when you look at what Xi's accomplished for China and the challenges he's had to deal with, he's probably one of the most, he's probably the most formidable leader in the world today. And I've said this publicly.

I think you're right about that. I hate saying that as an American patriot, but you know, got to give credit where credit is due. You have to be a realist about what not how you want things to be, but how they actually are. That's how you try to find the pathway forward in the world. But with him, it's like, there's always these rumors coming out. It's been happening over the last three, four years especially,

that, oh, his days are numbered. He's retreating in paranoid all the time. He's going to be taken out of power. But he never does. And the country, China can cook their books and everything like they do on some stuff, but the country does, even if you discount that, continue to grow economically and the GDP is neck and neck. And in the AI race, they're going to, I hate to say it, but if we're not careful, they're

already playing catch up and they're gonna, I hate to say it, but if we're not careful, they're already playing catch up and they're getting close. But if we're not careful in how we use our resources and our talent, they're gonna kick our ass. Did you read Kai-Fu Lee's book? Yeah. Yeah, it was an eye-opener. Yeah, that was a good one. Kai-Fu Lee's book is a good one.

Cause they're pouring money into key technologies, robotics, AI, cyber, biomedicine. We're cutting our resources and funding for these things and the Chinese are surging forward. They're behaving like we did after World War II with the NIH, the National Science Foundation, and in the 50s and 60s, 70s, 80s, 90s, even in the 2000s, and now with DARPA. With DARPA. Yeah, they're creating the same kind of mechanisms to surge their capability. So when you kick out, I'm gonna say this publicly on this show, when you kick out

tens, hundreds of thousands of really bright Chinese graduate students and post-docs, we're shooting ourselves in the foot. Now people are, I've talked to leading counterintelligence experts, I've met them at conference, shaken their head, asked these questions. They're like, they're spying on us here. Yeah, some of them are. When Deng Xiaoping did the opening up in 1979 and started sending these students to America, he was asked, are you worried that some of them won't come back? He said, no. If 5% come back and help us out, we're good with that. That's right.

You know? And that's... during Xi Jinping's time, they've tried to lure them back with the Thousand Talents program. Thousand Talents program? If you think of a Chinese scientist who got his PhD and did a postdoc at Harvard or Duke or UCLA or Stanford. And they're crackerjack scientists in biomedicine, let's say, or robotics at Caltech or something. And they tell them, we tell them, oh, you got to go stand in line and we're cutting grants for NSF, NIH and all that.

You won't be able to get a grant. And she's saying, we'll give you all the grants you want. We'll give you all the techs you want, labor, to work in the lab. We'll give you all the lab space you want. Oh, and you can have a nice apartment too. And we'll give your wife a nice job, and your kids can go to a nice school.

You know, you can help out China and be a patriot. That would be hard for somebody who's starting a family and finished their training to turn down. We need to do that. We used to do that really well. You look at the stats, a lot of Nobel Prize winners are Asian-American immigrants. A lot of, um... A lot of startups, I think half the startups

in Silicon Valley are Asian American immigrants. If you look at the Howard Hughes Medical Institute scholars around the country, Texas has like 20. Five of them are Chinese. They came in the 80s and 90s. And one of them, I think he won the Lasker Prize. That's like a precursor to a Nobel Prize. So these are people with immense talent and we want to draw them in and keep them here to help our country. We do and there's gotta be ways to your point about the, and it's a legitimate concern about spying

and stuff like that. There has to be ways to mitigate that or also take a page out of China's book. Like you said in 1979, when their leader opened up, you know, opened up the exchange for Chinese people to be able to come here he was playing the percentages game which is yeah there will be some that a lot that don't come back but we'll take the ones that do and I think to some extent you could play that game a little bit here like yeah there will be some that's by

on some things but we're gonna have enough that are here to take the talent to build, which is, some people are uncomfortable with that, but that might be the way to do it. The new Cold War is not like the old Cold War. The new Cold War of the 21st century is a war of human capital and talent. Whoever has the most talent wins. I agree. That was the thing though, the speed. In Kai-Fu Lee's book, I think it's called AI Superpowers.

Yeah. Is that right? That's right. It's funny, the very first podcast I ever recorded, I put out 10 the first day I went public with this thing, but number six was the first one I ever actually recorded. There was a whole segment where I was talking about that book because it just blew my mind. But he opened my eyes when he painted a scene in one of the early chapters, might have been the first chapter, of a college campus in China in I believe 1999 or 2000, where he was at the time living there or visiting or

whatever it was. And he witnessed that night, I think it was like on a Friday night, all these students went out onto the street and they didn't go out on the street to party. They went out on the street to like study together. And he said at this time, you could make the argument by certain metrics that China was still like a third world country. Yeah. 1998. Yeah. Right. And within a decade, not at all. Basically, what he was saying is, if you look at the gap in technology between us and them in 1999, if you're listening, not watching, I'm holding one hand way up and one hand way below.

It's like this. And then within 10 to 15 years, it goes like that and almost evens out. And now when we're talking about something that you brought up like AI, the fear here is when you have a tyrannical government who's just trying to win a race, we gotta worry about it here,

but like they're damn well not thinking about the humanity implications of what this could be. You know what I mean? And if they get somewhere fast, let's say they get to something sentient first. I mean, we might be fucked. Well, and then you look at space. The Chinese are really going forward

very aggressively with their space program. The Taikonauts. Well, they're gonna, at the rate, if we cut our NASA funding, and look at all the great things NASA's done I love NASA I love NASA too you know and we cut the funding and we we lose that momentum of wanting to get put a lunar colony on Mars and on the moon and get to Mars first the Chinese aren't slowing down there so they're they're

ramping they're ramping that up they're ramping that up. They're ramping that up. They're ramping that up, yes. The astronauts in China are national heroes. So you create role models for the next generation to say we wanna be like them, the way that the right stuff people were heroes when I was a little kid. I was obsessed with NASPA when I was a kid. I remember Mercury.

You wanna be an astronaut? No, I don't. I'm not techie enough. That's a tech culture. That's an engineering culture. I know people, I've met astronauts in Moscow. I've got to talk to them. I have friends that are... I've worked with NASA physicians. I've met astronauts at receptions for Yuri Gagarin's family in Moscow.

They're incredible people. They're incredibly brilliant people. I spent an hour talking to Chris Cassidy, who's now retired, who flew multiple space missions, was a Navy SEAL, highly decorated in Afghanistan. Then he went back to school and got a master's degree at MIT. These people are like, they get higher degrees, like, in their sleep. They're like, oh, it's fun. It's easy. And then he became an astronaut, really an amazing guy. They're at a whole different level.

It's interesting that you say, for example, in China, the astronauts are national heroes. This is one thing I bring up a lot. It sucks to say it, but you know, an advantage that a totalitarian regime does have is, I always cite the TikTok example. Since they don't have free speech and freedom of choice there, they get to decide their kids in China, their TikTok feeds for their nine year olds, turn off at nine o'clock or whatever it is. And when it's on, it's nature videos and science videos and math and making learning fun, if you will. Ours is 24 seven and kids are watching

titty videos when they're not. Right. And so another extrapolation of that is they can make their astronauts, they can make their astronauts, they can make sure those are the people that are marketed so that the kids want to grow up to be that. Whereas here, you know, the influencer who's doing a prank video on fucking Park Avenue out here might win the attention, which is fine. But like, we don't have... I remember when I was growing up, so many kids, you'd ask them what they want to do. They want to be an astronaut. They want to be a firefighter.

They want to be a police officer or whatever. And I say this as someone sitting here doing YouTube right now. But like now when you talk to kids, almost everyone's like, oh, I want to be an Instagram influencer or a YouTuber or whatever. And that's great. But when mathematically everyone wants to do that, and you're not putting forth the really the things that drive humanity forward as well in other ways.

Meaning when you don't have built-in diversity with that, because the free market is pushing all towards one area, they have an advantage over there because they can push that diversity too. Yeah. And they have numbers. Like they build up their sports program for the Olympics. That's a classic example. Their Olympic athletes are considered national heroes.

So they can sort of direct the party, and she can set the pathway where they want society to go. It's a different culture. It's a different system. It's a very tight authoritarian system, but, you know, they're gonna make an argument, It's a different culture. It's a different system. It's a very tight authoritarian system. But you know, they're going to make an argument works for us. Yes. Who's the most evil person you ever studied?

That's a good one. That I've written about? Sure. Milosevic. Why? There was just something real dark about him. I struggled to see anything that I could imagine on a connective, on a human level, about him with Putin.

All the leaders I've written about have done evil things. Putin, Xi with the genocide in Xinjiang. Their system of, their justice system where they lock people up indefinitely with no due process, that disappear into the system if they cross the party wrong. You know, things like that are fundamentally evil to me. But, but Putin, you could sort of see a human side when you see videos of him interacting with ordinary Russians

on campaign rallies or his judo videos, which I've watched many times. You know, there's a playful quality to them. He's throwing people, they're throwing him, he's interacting in a respectful way. He's laughing, he's posing for selfies. You can see that with Kim too, when he visits all the military bases and missile bases. He's... You know, North Koreans are weeping and he's hugging them.

They're all doing selfies with him. It's a big deal. You can see that to some extent with Xi, but with Milošević, I couldn't see that part of it. No humanity. He was just really cold. And you're talking for people out there, you're talking about the Serbian leader during the 90s. Yeah, the late Slobodan Milošević, who really led to the destruction, caused a lot of

destruction when you have the destructive wars in Bosnia and Kosovo, which he really was the driver behind those. When you look at the brain drain, we're in a country of 10 million people When you look at the brain drain, we're in a country of 10 million people in the 90s. 200,000 college-educated Serbs left Serbia each year. Brain drains aren't good for countries. Russia's had this problem now with the Ukraine War where a million Russians, between the ages of 20 and 45, have left the country. they're not going back when the war ends. You know, they're in Europe, they've plugged roots down, they have families, their kids are in school, why would they go back?

Right. So that's a problem. Braindrains, we've historically benefited from braindrains. A million Russians left in the 90s after 91, because of the collapse of their economy. And a lot of them went to the West, a lot came here. So I think in this kind of... war of human talent, these things matter a lot.

Oh, for sure. Sometimes I wonder about it with our own systems too. You talk about the brain drain, things interesting. It's like... you know, we've created this is a different context than what you're talking about, of course. But we created this amazing education system in this country. And now we've kind of inflated it to the point where we tell every kid they have to go to college and every college is like overloaded and overpriced and a degree is not worth what it's used to what it used to be and so many kids are drowning

In debt and you know working a shitty job that you know, they can't even keep up with their bill Dave Ramsey made a documentary about this. That's really good. I'm not to check that out. Yeah, but like Sometimes I wonder if part of bar either stolen futures or borrowed futures. Mm-hmm sometimes I wonder if a part of that is like us sinking our system in on itself and it's going to lead to a brain drain, not necessarily because people are leaving and going to other places but because people get disillusioned with the upside of education in this country and far fewer of us in the next generations actually get educated. Do you agree with that?

Well, that's a concern. It's a different type of, it's where they tune out. This is what happened in Japan with a whole generation of young people in the 90s and 2000s that were educated and no longer wanted to participate in the system, if you will, and would retreat and just stay in their rooms. They're called the hikikomori.

And they've written, there have been books written about this. There are therapists that try to work with, where they shut down, just didn't work, didn't go to school, and stayed in their room with no human connection for a decade or more. So that's the risk if the educational system isn't working for young people, you'll have people that tune out in a way that's not creative. I think some of that's probably already happening a

little bit, maybe not at that extent, but I mean Joe's not in this head over here too. It's like Disillusionment it's it's really as it's not it's a social psychology phenomenon that you you look at that social psychologists study when they look at these societies I'm not a social psychologist, but I have to when I write about a leader to profile them I have to understand the historical and cultural context of the society and what's happening during that time period. It's not just attaching a label to a leader and saying they're a narcissist or they're a psychopath, they're a thug. That stuff's useless.

All politicians are narcissists. I was just gonna ask that. It goes with the territory. Yeah. Now, there are degrees of it. Some are worse than others. So I think you have to look at different perspectives on it. And that's what I try to do in my work.

How much... I mean, you've mentioned today, you've talked about social media and the forest fire that can be, and obviously the instantaneous nature of that and how it can galvanize people behind certain ideas. But how much worse is like the madness of like the crowd going to get in our society? Or do you think we're gonna learn to deal with that better? I don't know, but I hope that we'll put some guardrails

around some of that with social media. People are talking about it. And there could be the companies can built in the guardrails where it doesn't work after a certain hour for kids, things like that. You put more filters and things like that on what people can access without getting into free speech. But there are certain things that we don't want

young people accessing, and because it could be potentially harmful. I think the scary thing for a lot of young people is the, we've seen this in the mental health field, is the terrible effects of the pandemic on socialization. And now people are coming out of that slowly, but there's a risk that there will be a subgroup of society that won't get past that.

They'll be kind of forgotten or lost because they were kind of under-socialized during a key part of their growing up years. A subgroup? I think you're being generous. I think it's more in a subgroup. I see it with adults. That was a real, like I was in my parents' house for three and a half years doing this job.

The pandemic broke out. My job is to talk with people and have people coming in and out all the time. So in some ways, I'm very grateful for that because I kinda was disconnected from a lot of the immediate after effects that were happening like out there, you know? Because I really just worked all the time.

But when I moved up here and I would walk down the street and just see people's inability to even hold their head up when you go by them, that opened my eyes. And it's all different age groups. I mean, there's people I see every day who look down when I walk by them. I just laugh afterwards. Like, I'll, and I will even look right at them down and away. And that is, to me, I'm sure some of that existed before the pandemic. It's just the law of averages. We're still learning about, we're still learning. The mental health effects have certainly been profound. My, I and my colleagues in the psychiatric space, the psychological space, psychotherapists,

our workloads are through the roof. I can imagine. We all have waiting lists of months. And I'm a practicing psychiatrist. I see patients every day, all week, and waiting lists all over the country. It's not just in where I live, in Dallas, everywhere. I get a lot of phone calls from people who need help.

From the national security space that know me, people that are retired, they may have a family member, or a child that needs help if they're still in the system, and they can't access the system. So I try to help them and access the system, and they can't access the system. So I try to help them and access the system and use workarounds to help their loved ones. So it's very rewarding, but it's difficult. And we cannot train enough psychiatrists in residency programs, even if they triple their quadrupled insights,

we still wouldn't meet the demand. So that's why we're using a lot of, I work with a lot of mid-level providers, nurse practitioners, PAs, they're very good, but that's, we can scale up more by using them. Because the pipeline to become a psychiatrist, a long pipeline, you're talking about four years of college, university, four years of med school, four or five years of residence.

It's a long 12, 13 year pipeline before you're practicing. So that's the challenge in the field. Whereas a nurse practitioner gets a BSN, a bachelor's in nursing, two years, and then they can start, they get a license, they can start seeing patients. So that's an advantage and done properly. Now you've been out of government for what, almost a decade? Yeah, 2016. Okay.

Obviously, there's ways that you use your experiences to stay connected to that, especially when you're writing profiles of world leaders and staying involved with some of the institutions you're involved with. But in your day-to-day work as a psychiatrist, you know, kind of back in America, I guess, I don't want to undersell it at all, but like the stakes are lower than what you were doing in the sense that, you know, you had to be a plug man going all over at all different places at all different times with the most stressed people as we said at the tip of the spear you know do you find your work now even if it's not as adventurous fully fulfilling?

Yes, it's different. The stakes were higher on the national security level but it was a largely healthy workforce that's highly stressed with some emergencies that would come through, and dealing with cases I dealt with, like kidnappings and hostage takings and things that are super intense. Now what I have is a very much sicker patient, so a really challenging population of patients

with chronic medical problems, neurologic illness. Uh, I take care of late stage cancer patients. I've probably have had over 100, 150 patients with stage four lung cancer, prostate cancer, other cancers, pancreatic cancer. The last couple of years, I've lost eight or nine patients to cancer. The last couple years I've lost eight or nine patients to cancer. Oh my God. You know, and patients with horrible neurologic diseases that also have psychiatric illness, depression, anxiety, who have Parkinson's or Huntington's or have had multiple strokes or dementia.

So it's a very acutely ill outpatient population I work with. So the challenges are intense in a different way. Sure. The, and I just see adults, I don't see kids. When I was in the government, you had to take care of everyone, so I had to learn how to treat kids in adolescence. How do you approach working with someone

who's stage four lung cancer and has been told they have six months to live? Like what's that like working with someone who's stage four lung cancer and has been told they have six months to live. Like, what's that like working with someone like that? It's very emotionally intense. Let me tell you a story what happened. I had a patient who came to me, he died of prostate cancer. He'd had it for 10 years, stage four. And he came into me and I said,

how can I best help you? And he said, I want you to help me die with dignity. I'm like, holy moly. That's not what I typically hear in a chief complaint. I said, the fact that you're already here and able to articulate it shows the dignity. But I'm here to... I'm not good at helping you die, but I can help you live until you die.

And I treated him for a couple years, he hung in there, and then his cancer kind of dramatically worsened. And he came to my office with his family, and went to hospice, weeping, the family's weeping, and he died three days later. And the family came back after, they sent me a thank you note and a card for caring for him. So the message here is the famous article from Francis Peabody in 1927 in the New England Journal of Medicine. He was an internist at Harvard who said the secret of caring for the patient lies in caring for the patient.

So you care for people, whatever they bring to you, you gotta deal with. I had a resident once, another case like this, where I saw the patient, he was a veteran, had been an officer, and he died of a late stage cancer. He'd been stable for years. He'd been retired from the military, had a good retirement.

He was, I think, in his 50s, enjoying family life, grandchildren. And then suddenly from out of the blue, his prostate cancer took a bad turn, an aggressive bad turn. And he came to my office and said, I'm going to hospice. And he said, this is our last visit. I said, how are you handling this? He goes, Doc, I'm a military officer. I've been shot at. He used to be a pilot.

I get it. I said, I'm concerned about my family. So we talked about it. And he had a tear came down his face. And the resident watching the video with me started crying. And she goes, I didn't sign up for this on this elective. I go, welcome to my world. This is what we deal with as physicians.

You know, it's not all pretty. It's hard. Of course. So you have to see the human side and try to help people. And I think part of the challenge for patients with cancer that I've had is when I was a medical student resident a long time ago, if you got a stage four diagnosis of any cancer, you were dead in a year. We didn't have to deal with these things.

Now these people can live with the sophisticated treatments. They can live for many years, but it's like having an albatross perched on your shoulder. You don't know what's gonna happen. Patients who ask me, should I have a bucket list? In jest, but it's serious. I had a patient once tell me, he said, now with technology, people are recording videos

for their children and grandchildren. I've had patients talk to me. I asked him, what did you record? What kind of music do you want played at your funeral? You know, so you have to, a lot of what we do in psychiatry, it's not about adjusting your Zoloft dose or all that. That's easy. It's psychotherapy. That's the hard part. That's the human part. That's what makes it enjoyable. It's just prescribing pills, they have boring. I mean, they help. I use pills all the time.

I write 100 prescriptions a day. I write 50 to 100 Adderall and Valium and Xanax and Clonazobam controlled seven scripts daily. We're like pill pushers, I get it. But the psychotherapy part is the part that makes it real. Yeah. Speaking of the real, yeah, that's the hat I'm wearing is the Real Mental Health Foundation, which is founded by a friend of mine

who's a former Wall Street executive named Sean Lesser. And he started about a year ago after he had a painful depressive experience. He's in his late 40s, early 50s. And he wanted to do something different. He had been involved in what they call impact investing. He was very successful, very wealthy, and his life kind of took a turn, so he started this foundation,

and the goal is to raise $10 billion in mental health investment in the next decade. And I'm one of now, I think, 80 or 100 around the world ambassadors for this, where we do a walk once a month and take a picture with a hat and walk with people and try to promote this. All right, we're going to stick that link down below. And I see right there people can... I know that guy on the left. That's Chin. I've had lunch with him a few months ago. People can see what you're doing. You can also donate if you like the organization. Yeah.

That's really cool. Yeah, or buy a hat. I like the hat. You can go on the website and shop and get a hat. There's a white color and they, I think, oh, they have other things too. They have a hoodie. Yeah, they got some swag. Yeah, they got a pullover. I see it.

Yeah, that's cool. One last question for you, Doc. I see it. Yeah, that's cool One last question for you doc. It's been awesome today, by the way I really appreciate you coming up here and doing this but you know, I did I'm just curious because of the nature of some of the people you're dealing with now that you were just explaining how they how they look at things when when they're faced with with death like Do you do you fear death? No. No. You know, I'm not saying it to be facetious. I'm a scaredy cat like anybody else. You know,

when I was going to war zones, I was taking a risk, you know. I've been to consulates and embassies the day after a terror attack. Had to show up and provide support. You know, there's risky places I've been to, so it's in the back of my mind you're taking a risk. And I was a rock climber as a kid, a big time rock climber in Yosemite. So that was real scary stuff back then, and it's kinda out there.

I was a pretty hardcore rock climber. If you've ever seen the movie Free Solo, I didn't, I free soloed easier stuff than Alex Honnold. But I've been out there on hard climbs without a rope, and I was a teenager, you fall, you die. But I was stupid then. So, the... If I ask about my fear, it would be, I, you know, I'm a religious person. When God takes me,

I don't know when He's gonna take me. I've had a great life. I'm grateful for so many blessings in my life. But I'd kind of like to see my grandkids graduate from college and get married. Knock on wood, have good health. But you can't predict when you get older, you can be in good health and suddenly not in good health. I lost a very dear friend a year ago. I'm a board member of One Community USA. You might put that up there. It's a great organization. The late Toni Brinker,

I mean, who started this in 2015, she was married to Norm Brinker, the founder of Chili's, and then Boone Pickens. And she took whatever money she had and started this amazing foundation to help communities, to help law enforcement, to help people who are going from jail and prison back into the community, what they call reentry.

So I'm on the board of this organization. And Tony was this super amazing, charismatic, lovely person, extremely healthy, super health, super slender, ate right, no bad habits. And then suddenly she got stage four lung cancer and was dead within six months. So when she was 73 at the time, she didn't look 73, she looked like she was in her early 60s. But bad things can happen. So one has to kind of psychologically, spiritually, mentally

be okay with that. Yeah. Yeah. It's, you know, life can change in an instant too. You walk outside of the one thing. The other thing I want to share with you and your listeners too is one other piece of me is a writer, a novelist, I've written spy novels. Oh, that's right. You have a couple published, right? The Negotiator's Cross was my first one, and then most recently this spring,

uh, The Russian Diplomat's Wife, which is set in Vienna, the city of spies. That feels like it's based on true events. Well, it's about the Russian diplomat's wife is... Jim Lawler wrote a blurb in the book where he even said that I'm not really a psychiatrist, that I was under some kind of deep cover doing other things. I thought that was cute, but it's false.

I don't think so. I'm thinking he's onto something there. But the story began, the cover is a Gustav Klimt painting, Death and Life, Totunleben. I was in the Leopold Museum last fall when I was visiting family, and I walked in the room and there's this amazing painting. That painting is, I think, eight or nine feet in height and I'd seen it many many

times before but it just grabbed me and it became the nidus for this novel. So the beginning chapter of the novel is where a an American deep cover non-official cover officer who spent their whole life in Europe, in Vienna and other places, is looking at the painting and a Russian woman walks in and is looking at it. And for some odd reason, they're the only two people in the room. So what happens then is he notices she's weeping and he asks her in German, why are you crying? And they have their first interaction. And that intrigues him and intrigues her. He wonders who she is.

And later finds out that she's married to a Russian diplomat, but not really married. So he gets more curious and they have more encounters. Now, Vienna's interesting because it's a beautiful city. But it's thought that half of the... In the 2000s, an Austrian writer named Emil Boebi wrote a book called Die Schattenstadt, City of Spies, where he argued that half the diplomats in Vienna, which has all these international organizations there, out of 20,000, half of

them are Intel officers. So it's the right setting for it. It has 15,000 coffee houses. But it's also the city of Sigmund Freud. And according to Freud, there are no accidents in the unconscious. So this meeting between this American and Russian is fated to happen.

And then the novel develops how their relationship develops. They fall in love. And then some of the how their relationship develops. They fall in love. And then some of the... When this happens, some of the American officer, his nickname is Copernicus, and his agents that he's recruited are named after planets, start showing up dead. And then it develops from there.

It's a very psychological portrait. And I was very pleased that Paul Vittich, who's a wonderful spy novelist, said that this novel is like a thinking man's spy novel on the level of Eric Ambler and Alan Furze. That's pretty high praise. That's awesome. And you got a psychological spy thriller written by a psychological spy, so what could possibly go wrong? Ken, it's been awesome, man.

Thank you so much for coming. We're going to put the links to your books down below so people can check that out. We'll also have the links to both organizations as well. And then, you know, we'll have to do this again sometime. Okay. Thank you for having me. All right. Thank you.

Everyone else, you know what it is. Give it a thought. Get back to me. Peace. Thank you guys for me. All right. Thank you everyone else. You know what it is. Give it a thought get back to me. Peace Thank you guys for watching the episode If you haven't already, please hit that subscribe button and smash that like button on the video They're both a huge huge help And if you would like to follow me on Instagram and X those links are in my description below