Ten Percent Happier with Dan Harris - 205: Living on Overtime, David C. Fajgenbaum

Episode Date: September 18, 2019

David Fajgenbaum, a young, promising medical student, could not have imagined he would become a patient in the same hospital he was serving his residency. After being diagnosed with a very rare illness, he came close to death on multiple occasions. In the throes of one encounter, he promised himself that if he survived, he would make a difference in the fight against this disease. Through his research, he found a drug that he believes has helped him into remission. In the wake of his bouts, he has chosen to live his life "on overtime," time that he is extremely lucky to have, gifting him a unique perspective on living we can all learn from. Fajgenbaum is the Co-Founder and Executive Director of the Castleman Disease Collaborative Network and leads the Castleman Research Program at Penn Medicine. He is the author of Chasing My Cure which details his journey of going from a college athlete, living a healthy life to being diagnosed, and the hurdles he had overcome with love, determination and faith. Plug Zone Actively Moving Forward (AMF): https://healgrief.org/ The Castleman Disease Collaborative Network (CDCN): https://cdcn.org/ Book: https://chasingmycure.com/ Twitter: @DavidFajgenbaum Facebook: @davidfajgenbaum, https://www.facebook.com/davidfajgenbaum/ ***VOICEMAILS*** Have a question for Dan? Leave us a voicemail: 646-883-8326 See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Before we jump into today's show, many of us want to live healthier lives, but keep bumping our heads up against the same obstacles over and over again. But what if there was a different way to relate to this gap between what you want to do and what you actually do? What if you could find intrinsic motivation for habit change that will make you happier instead of sending you into a shame spiral? Learn how to form healthy habits without kicking your own ass unnecessarily by taking our healthy habits course over on the 10% happier app. It's taught by the Stanford psychologist Kelly McGonical and the Great Meditation Teacher Alexis

Santos to access the course. Just download the 10% happier app wherever you get your apps or by visiting 10% calm. All one word spelled out. Okay on with the show. From ABC, to baby. This is Kiki Palmer on Amazon Music or wherever you get your podcast. From ABC, this is the 10% happier podcast. I'm Dan Harris. Before we dive in, lightning quick announcement. Just want to say I'm going to be doing a public event here in New York City on Monday, November 18th at the Rubin Museum from 7 o'clock to 830. If you want to come say hello, it's in celebration of a new book written by my friend and colleague Jay Michelson. The book is called Enlightenment by Trial and Error. I haven't read it yet, but I'm pretty sure it's going to be really good about his own

personal experiences in pursuit of Enlightenment. Jay has been on the show a couple of times. He's also is in charge of the excellent talks section on the 10% happier app. So this is going to be a really fun event. If you want to check it out, you can go to Rubenmuseum.org slash events. All right, let's get to the show. Our guest today is Dr. David Fagan Baum and he was recommended by a previous guest, Adam Grant, who's a renowned author and psychologist at the University of Pennsylvania, Wharton School of Business.

So Adam, thank you for making this recommendation because it turned out to be great as you all are about to hear. David is also at the University of Pennsylvania. He is one of the youngest people to be appointed to the faculty at Penn Medicine, where he's an assistant professor of medicine in translational medicine and human genetics. He's also the co-founder and executive director of the Castleman Disease Collaborative Network. Castleman disease, you may not have heard of it, is pretty scary disease, and David happens to be a sufferer.

He's been dealing with this disease since med school and this is an unusual episode for us because we don't usually do medical mysteries and that's certainly what David's story is all about. He's just written a book called Chasing My Cure in which he endeavors to cure this little known disease which has been afflicting him. The reason why I wanted to have him on is that even though he's really just in the beginning stages of his own meditation career, is that in dealing with this extraordinary health crisis where he has nearly died four times, had his last rights, read to him with his family surrounding him, he has come up with some

guidelines, some lessons for living that are scalable to the rest of humanity. One of them is living on overtime, which I'm particularly intrigued by. So we're going to talk a lot about that and his other precepts that he's developed as a result of this ordeal. Also, stay tuned for precepts that he's developed as a result of this ordeal. Also, stay tuned for the surprise entrance at the end of the interview. We invite his wife, Caitlin, to come on and share her views, which is also incredibly interesting and moving. So, without further ado, here is Dr. David Faganbaum. So, at what point did you know things were dicey on the health front? So I was a healthy third year medical student, never had any medical problems in my whole life.

College athlete, played football at Georgetown, and I was treating patients at the hospital that I was a medical student at, and all of a sudden just started having night sweats and fatigue, and I just wasn't hungry, I had some abdominal pain and things, I wasn't that sick yet, but I had this sense that there was something really, really bad that was happening to me. I didn't know what. And over the course of the next couple of weeks,

I got more and more tired and unfortunately, just kind of started noticing fluid was accumulating in my legs and just strange things that didn't seem normal. So I went from a medical school exam that I took and then I went walk down the hall to the emergency department and they did some blood work and said, David, your liver, your kidneys and your bone marrow are not working. We need to hospitalize you.

And that was the start of what was a frightening six month period. Tell me about it. Yes. They hospitalized me and I became really, really sick really quickly. I had a retinal hemorrhage, went blind in my left eye, gained about 50 pounds of fluid. I had liver failure, kidney failure. I was on dialysis, all with no diagnosis. I went from the South of the medical student to all of a sudden, literally dying in the

ICU that I was a medical student at. And I was so sick that actually the doctors encouraged my family to say goodbye to me and encourage them to kind of prepare for me to die. So they called it a priest. Did that happen? They called it, we said goodbye. They called me a priest. They said goodbye to my family. I actually said goodbye to them three times. And then a priest came in, read my last rights to me. And unfortunately, we didn't think that I was going to survive. But right around that time, they did a procedure to diagnose this mysterious disease. It's called idiopathic multi-centric castle man disease. And they started me on chemotherapy right

away. And the chemotherapy kicked in just in time. And I survived that first deadly episode. But unfortunately, I've gone on to have multiple relapses. And so just to be clear, my own mind, the three good vies happened in that first episode or happened. No, I kept reading apps multiple times. Post getting the... Exactly. This is just number one exactly.

And so what's that? Just on the first time you're saying goodbye to your family, most people don't live to tell the tale quite literally. Tell the tale, what's it like in your mind when you were, you think you were convinced you have been told you were dying you're saying goodbye to your parents and your sister? Yeah, it was frightening. I was so sick that my brain wasn't working all that well because of the kidney failure.

So my thoughts were not totally clear, but I remember being terrified. Was that a blessing? I think so. I think that, and each time I've, all five times, I've almost died, I've been so sick that maybe that is a blessing that maybe I haven't, I've been able to think so critically. But I do remember there's one thing that has been burned into my memory. And that was after the last goodbye, and kind of I settled in thinking that, you know, I had hours.

I remember looking back on my life and thinking about my life and when what I had done. And I didn't regret a single thing that I had done or that I had said. I only regretted the things that I had not done, had not said, and that I wouldn't be able to do in the future. One of those was that my girlfriend, or the person I dated for a few years, we had actually broken up just a few months before I got sick. And so as I kind of settled in thinking that I would die any time now, I regretted that I hadn't thought for our relationship. I regretted that I hadn't told her how I felt and And that was one of these regrets that you know, I wish I had done this and and when all of a sudden the chemotherapy saved my life

I kind of promised myself that that I'm gonna live this life where I think it do it was my motto It's like I'm not just gonna think something about how I feel about someone or about wanting to do something if I think it I'm gonna do it and and about how I feel about someone or about wanting to do something. If I think it, I'm gonna do it. And Caitlin, now my wife, we ended up, I told her how I felt, and despite all that I was going through, we got back together. There's a scene in the book where you actually,

I mean, you describe it in quite granular detail, where your belly was distended because you had excess fluid, you had a lot of your hair from the chemo, and she's sitting next to you and you're your bed and you're wanting to get back together, but thinking, you have a kind of legit body dysmorphia going on. Can you just walk us through that scene? Yeah, so at that stage, I had spent almost six months hospitalized. I had nearly died three times in that six month period.

I had multi organ failure, and I just started to come out of it I was now out of the hospital and Caitlin was there with me and it's the first time she'd seen me since I had first gotten sick and I wanted with everything inside of me for us to get back together but I didn't want her to know how badly I wanted it I wanted to know that that I loved her and that I wanted us to get back together But I wanted this to be her decision. And I remember saying, are you sure, but I'm so sick. I don't know what my future is going to look like. And I remember this look that she gave me,

which was like, are you crazy? Of course, I want to do this. And I thought to myself, I think you are crazy. And that you want to get back together in the midst of really what was a frightening period. But you said something that struck me that you, it's when you're sick, kindness is nice. But it also when you're really sick, this kind of kindness of somebody, X-Girl, for getting back together with you,

you really start to figure that she's doing it at a guilt. You worry, absolutely, you worry it's out of guilt, you worry that it's to kind of make this dying person feel better about what they're going through. But Caitlin managed to make me feel like that was not why she wanted to get back together. And she's kind of demonstrated that since then, but that was my fear of the time.

I didn't want this to be kind of, you know, just to make this dying man feel better. What is this disease? It's idiopathic multi-centric castle and disease. Yeah, it's multi-centric castle and disease. Yeah, it's basically kind of like a cross between an autoimmune disease and a cancer. So basically your immune system gets completely out of control

and then begins to attack and shut down your vital organs. So your liver, your heart, your lungs, your kidneys. Rare? Very rare, about 5,000 patients diagnosed each year in the US, which is about as common as ALS. So it's rare, but it's maybe less well-known than other diseases that are similarly rare. I actually didn't know ALS was that rare.

You see here about it a lot. Exactly because you started thinking it could happen to you. It's so devastating. And ALS is such an awful disease. And we need so much more research for it that I'm so happy that there's been so much awareness for it.

And unfortunately, there are also diseases like Castlemen's or idiopathic, multi-central Castlemen disease, also quite deadly, also rare. But man, do we need to push for it or understanding of it? So you say you got back together with your ex now wife after the third time you nearly died.

So then she was with you for two more. Two more in your death. Yeah, so at that time I was started on an experimental drug that we all hoped was going to be the treatment for my disease and that it wouldn't come back. And so I went back to medical school. I finished my third year of medical school, Caitlin and I were together during that time, and then while on this experimental drug, I had another relapse. So I was back in the hospital with all the organ failure. And at this stage, this is the only drug that was in development,

the only drug that's actually ever undergone development for my disease. And I learned from my doctor who's the world's expert, that there was nothing else coming down the pipe. There were no promising leads, and there was no one doing any sort of promising work to get us anywhere. And so I remember turning to my now-wife and my dad and sisters who were in the room with me in my hospital room, and I told them,

I said, I'm going to dedicate the rest of my life, however long that may be, to trying to cure this disease. And I was so sick at the time of my life, however long that may be, to trying to cure this disease. And I was so sick at the time that I think they were kind of like, okay, Dave, you know, it sounds good, but like, let's just get through this. But that was a commitment. I may, I survived. I got seven agent chemotherapy.

So it's a combination of seven of the worst chemotherapy drugs out there, but that obliterated my immune system and it saved my life. And so I survived that, but now I knew that there was no hope. If I wanted to cure, if I wanted a future with Caitlin, a future for my life, then I need to turn my hope for a future into action. And so I left, when I survived, thanks to chemotherapy, I left the hospital on a mission, and I've been running full speed after this disease since then. Well, how much progress have you made?

We've made a lot of progress. So actually, so when I first became ill, there was no diagnostic criteria. There were no treatment guidelines. There were no FDA-approved drugs. And today, well, since then, I started a foundation called the Castle Medicine Disease Collaborative Network.

And then I began conducting research on my own samples at the University of Pennsylvania. We developed a diagnostic criteria, we developed treatment guidelines. There's now one FDA-proved drug, and what I'm really excited about. That drug was the one you were taking. That's right, that didn't work for me.

It ended up working for about a third of patients. But for patients, it didn't work for you, but yet you survived. You survived because you did the seven-agent chemo. Exactly, but it's basically, there's just one drug and then the nuclear option. Exactly. But what I'm really excited about is that,

so unfortunately, I went on to have a fifth, a fifth, one of these flares in Caitlin, of course, was there with me throughout, but with number five, and I also approached death again, when I got out of the hospital, I dug into all the data I had generated over the previous year in the lab, and I did additional experiments on my samples, and I found a drug data I had generated over the previous year in the lab, and I did

additional experiments on my samples. And I found a drug that I thought could help me. It was a drug that was developed for kidney transplantation 25 years ago, had never been used before for my disease, but I'd run out of options. Nothing was working. I couldn't continue to have these deadly relapses with nuclear or chemotherapy, basically. And back in February of 2014, when I was recovering from number five, I decided to start myself on this drug that would have never been used

before for Castlemans. And it's now been five and a half years that I've been in remission on this drug. So I had five of these flares in the first three and a half years, none in the last five and a half years. And now we've gone on to start a clinical trial at the hospital that I work at to give the drug to other patients, other patients who don't get better on the approved drug. So this was a pre-existing drug, not a new drug that you, through your research, realized could be useful for Castlewood.

Exactly. Five and a half years. Yeah. How confident are you that there are no more relapses in your future? I'm not confident at all. I live knowing that it's been 67.7 months that I've been in remission and I realize I can't round up.

I don't know if I'm going to make it to 68 months without a relapse and you know, with the future. But I'm grateful that this drug's gotten me this far. And so I run a research lab at UPEN, where we're fully focused on identifying new treatments and a cure for this disease. And like I said, I don't know that this drug is it. I hope it is, but I also know that there's other patients who actually who don't benefit from the one FDA-approved drug, and they also don't benefit from this drug.

So we need new options for these patients. Is that sort of sort of, damn,ly, that's hanging over you, is that terrifying or invigorating or both? I think that it's both, and I think that it's terrifying and invigorating. It also inspires action. So it makes me realize that I need to work all day, every day to advance research for this disease because it's not just a sort of, for my head, it's a sort of a lot of other people's heads.

And I have the opportunity based on the laboratory I run based on the work that I've done to really make a difference. And so it's motivated me. And I think that because I spend my time fighting this disease and trying to push for the science, I know that if and when it does come back that I won't have any regrets, I will have known that I did everything I could possibly do to fight this disease.

Do you, you know, how real is the progress? I mean, you're just one lab. Yeah, and I don't know, it's a big pharma involved here, like how much firepower is being brought to bear on this and how real is the progress? So we're fire power wise, we've invested about a million dollars

after the last seven years into research, which as you know, compared to a lot of other diseases, that's a drop in the bucket. But we've invested it really efficiently. And so that million dollars into research has resulted in an additional $7 million from external funders, pharma, into pharma, academia,

and also government funding. And so we're kind of making every dollar go as far as we can. And the way we do that is kind of an innovative, a revolutionary approach to research where we don't raise money and then invite researchers to apply for it, which is kind of the typical way you raise money and you invite doctors and researchers to say, you know, how we use the money. We actually built this global community of physicians, researchers, and patients, and then we crowdsourced the best ideas for what research should be done, and then we go out and we recruit new people who have never even heard of castamins before, new researchers to do castamins

research. We find the best people in the world for particular study, and then we give them funding and also samples, and that sort of approach, rather than waiting and hoping for the right researcher at the right time, to figure out what is the right work in going out and recruiting, we felt that's really improved the efficiency of progress. And what's the state of play, man, how close do you think you are to either a cure or a new treatment? I think that we made a ton of progress, but I think that we have to see how this drug does in this clinical trial.

We're going to give the drug I'm on to 24 other patients. And we're hopeful that it's going to work for a lot of them. But unfortunately, time's going to have to tell us to how durable this drug is for treating patients. I mean, it's been five and a half years for me, but like I said, I don't know if it's going to help me through the end of the month. So we're just constantly pushing forward science,

we're constantly looking for other drugs, like we mentioned before, that might be approved for something else, but that might be able to help Castleman's patients. And I think this is a really important concept bigger than Castleman's, and that's that there are 1500 drugs already FDA approved for something, and there are 7,000 diseases that don't have any FDA approved drugs. So the really important question is how many of these 1500 already FDA approved drugs

might actually be treatments or cures for a disease that doesn't have any options. And this drug that I'm on that's saving my life, I think is a great example of that. So we on the show don't generally do medical mysteries, but the reason why I went and you're an unusual guest for that reason, I also that you're not yet really deep into meditation, although it sounds like you're starting. But why I slash we wanted to have you on is that the book is filled with a lot of, meditation is a form of training the mind. There are other ways to train the mind. And you, as a consequence of this ordeal, have come up with ways to train your mind that I think are scalable to the rest of humanity.

So I wanted to go through some of these. You mentioned one of them, which was, think it, do it. You just go back and say more about that. Sure, absolutely. So I think that, and reading your most recent book, thinking about the naysayer that kind of lives in the back of your head and sometimes tells you not to do things or talks you out of things. That's a very kind of a real connection here with Think It Do It where sometimes we think about doing something, we want to tell someone how we feel about them, we want to do something

for someone that we love and somehow we talk ourselves out of it. And so think it do it is to say that if you think about something that you want to do, and it's important to do, do it. Don't wait for this sometime in the future when times write or you'll have, something's better to do it. And I think that this is a concept that I kind of had to go through having my last rights read to me and nearly dying. And this is after the third time I nearly died where it just became so clear to me

that you need to live life recognizing that we're kind of all in overtime. I've been using the analogy of overtime to describe what I've gone through and that I had this extra time that I didn't think I would have, but in overtime, every second counts. You can have a bad play in the first quarter and you can make up for it,

but in overtime, every second counts and you need to really live with clarity and purpose. I think that there are so many parallels here between in meditation when you can get to a state where you feel clarity and recognize that you can kind of see through the waterfall. So for here, in my experience, it took nearly dying for me to get that experience, but I think it's something that, as you said, could be scalable. So, with Think It, do it, you've made clear in what I've read that it's not like, okay, so the voice in your head coughs up an idea, like, yeah, eat 85 bags of Doritos or whatever.

It's more like, if you think it and then you use your innate wisdom to think, well, actually, no actually no no this let's let's let's let's let's muzzle the nace hair for a second. Exactly. Thank you. Go for it. Exactly. That's exactly what it is and in in line with that and similarly another kind of mod that I've taken out of this is to turn hope into action and what I mean by that related is that oftentimes we hope for things in our life, we pray for things, we wish for things, and sometimes we stop after we hope, we pray, we wish,

and we kind of hope for those things to happen. But what I learned was that I hoped that someone would figure out a drug for me. I hope that progress would be made, and I was even a medical student, I was kind of semi-prepared, but I hope for the first almost three years that that someone else would do it for me. And then I realized that if I hoped for it and if I wanted it to happen, I needed to do it. And so I needed to say, if this is something I'm hoping for, something I'm praying for,

that means it's important to me. And so if anything, that should drive my actions. That should make me say, I'm going to then do something about what I'm hoping for and I'm praying for. And the third one that I want to bring up is this concept of creating silver linings. So in life, when we go through tough times, we sometimes look for a silver lining, you know, what was something positive that came from a really tough experience? But what I've learned is sometimes even more powerful is to say, I'm going through a really

tough time right now. What can I do? What can I create that would actually make this a positive? And I think what you've done with this podcast and also with meditation is a perfect example. You went through your own personal storm and difficult time and you've created a silver lining. It wouldn't have been here. There wouldn't have been the silver lining you could have found, but you created this movement and you're creating a silver lining out of the challenges that you went through. And you think that's what you're trying to do with this book, chasing my cure, bringing awareness, not only you actually chasing the

cure in the lab, but also bringing broader awareness to this disease. Absolutely. The suffering that I went through and my family went through with nearly dying five times and going through all these these difficult periods. If I can share some of those lessons with other people and they can inspire people to turn their hopes into action, that is a silver lining that wouldn't have been there without this book. Let's talk about, keep going on the lessons. You've talked about overtime, which I think is a really compelling idea. But I just wonder, how able are you to sustain that urgency now five and a half years in?

You know, I have not had my last rights read to me, but I've spent quite a bit of time in hospice, and I do quite a bit of meditation where the, and in the Buddhist tradition where you were really taught to contemplate death and the impermanence of everything. And yet I spent the last 24 hours literally worrying about something stupid. It's not thorough going least stupid, but it's not life or death. And it does take me away from, I'm not living it over time. Are you able to really do that all the time to be present and feel what Obama used to call the fierce urgency of now, or do you fall back into getting caught up as we all do in nonsense? You know, I think that so far I have maintained this real sense of urgency. I think that, you know, every time I touch my chest, I feel the port that's below my skin

that puts chemotherapy into my heart when I relapse. You know, I feel scars in my neck from where I had catheters to give me dialysis. I sometimes take a deep breath and I feel some pain from the deep breath, from my lungs, from fibrosis, from where fluidity accumulated. And so I look healthy and I generally feel healthy, but I'm constantly reminded with every deep breath I take. I'm constantly reminded every time I touch know, I touch my shoulder that that there is a disease brewing below the surface and and what I've also realize is there are many others with my disease that have a similar

have a similar experience and so I think that I maintain this focus, but I actually am really excited about using meditation and mindfulness to help help me because I imagine, you know, I never thought that I would have survived this long. I'm now at nine years since my diagnosis. Most patients don't make it even close to as long as me. So I didn't think this needed to be a marathon. I thought this really was a sprint, but because I sprinted so hard and I found a drug that saved my life, now I need to maybe start thinking about it being more of a marathon, but I also hesitate to say that because I found that every time I thought that maybe I'm in the clear, that's when this thing has come back. And so I'm trying

to keep focus, and I think mindfulness is a tool that could help someone like me. There's no question about it. And you may even look at the deep ends of the pool too around Buddhism. I mean, mindfulness is a great technique for being more awake in the present moment for lack of a less cliché term. And it's also great technique for not being so yanked around by whatever emotions are swirling or random thoughts or urges. But you know, the deep end, the sort of exploring what Buddhism has to say, which again, when I talk about Buddhism, I don't talk about it as a religion or say, although it certainly

is practiced as one. But more like the practical techniques and philosophical views of the Buddha, if he existed or whoever said all the stuff that he's purported to have said is incredibly interesting. And there's a lot in there about death because that nobody gets out of here alive. That's right. Yeah, I remember there's a quote in your most recent book about how I think you said, Buddhism is not

something you believe in, it's something you do. Yeah, and I didn't say that, but I still have to come up with that. I connected to that because I think so much of my book and what I'm sharing and trying to share with the world is that a lot of things get trapped inside of us and some things we think about and hope for and then they never get done. I think that what I learned from having my last rights read to me and and with these to my dear death experiences, is that it's the doing, the things that you get to do and you get to say that you really, they're powerful to you when you say goodbye.

It's the things you didn't do or you didn't say why you were here. So I think this idea of things that you think about, things that you hope for you pray for, thinking about how you turn those into action and make them something that you did in your life So you don't look back on your deathbed and say I wish I did this. I wish I said this. Yeah, it reminds me of I've been doing a story on a mom in Mexico who Mexico they have this massive crisis of drug violence and there I think at a minimum 40,000 of drug violence and there I think at a minimum 40,000 disappeared, unsolved disappearances. And the government has not until recently,

they're starting to get better, but they haven't done much of the looking for the bodies or even trying to solve the cases. And so I met a mom down there who we've been profiling, whose son was a DJ and she was a college professor. Anyway, he went missing. Wasn't even connected to the drug trade and she has been leading the charge to find him

and she's gathered all these other moms and they literally go out and they gather tips and like dig and find, and they found him as graves. Wow. It's pretty incredible. And I remember she said something to me, she speaks perfect English as it happens so we can communicate pretty clearly. She said something to me like never turn down an opportunity to spend time with your family.

And it has been the source of some guilt for me because there are times when I have to do work or whatever. But it is on my, you know, in the last couple of weeks for example. I blew off work Quite a bit to spend time with my family because they were at the beach and I wanted to so I would leave the city and go and and it it has It has It's the wisdom that people who have gone through something horrible can pass on to the rest of us She has done for me what you are trying to do through this book. You think, does that sound right to you? It does.

I think that what she said to you and the message she's sharing is so important. Also the message of what she's doing to try to solve these murders, to find these massive graves. She hoped that someone would do it. And at some point she realized that she had to stop hoping and start acting.

And I think that these are both such important lessons. And what you said about your family, something I struggle with as well. I now have Caitlin and I, we got married and we now have a one year old daughter, Amelia. She turned to one year last week. And so I struggle because I'm in this position where the more that I work, the closer I get to answers and solutions

and maybe even a long life with my family. But the less I work the more I get to spend time with them in the short term. And so I have this constant balance, which is if I work harder, I might be able to spend time with a longer versus short term. That's tough.

It's really tough. It's really tough. I think that I try to make the time that I'm with my family, longer versus short-term. That's tough. It's really tough. I do have that. It's really tough. I think that I try to make the time that I'm with my family. I try to make it really count and make sure that I'm fully present when I'm there and make sure that basically what I do is either work towards a cure or spend time with the people that I love and try to get rid of all other distractions. What other thing Lucy said to me, the Mexican mom, was that she went through a period after

her son, she doesn't know that he's dead, but she's pretty sure he is. He went through a horrible period of depression and had trouble getting out of bed. And then she started to get energized around looking for him and trying to, you know, probably to not very energetic police to do something about it. And then what really energized her was creating this network of other moms. And she described how she basically is not living

for herself anymore. Which I hear echoes of that. I found it when she said it to be very powerful, that she has in some ways that actually gives her a sense of lightness, transcended the self. Do you, does that resonate with you? 100%. My books call chasing my cure, but it's not my cure

that I'm chasing, it's our cure. And it's our in the sense of castle man's patience, but it's also in the sense of any rare disease patient who might have a disease without a solution, and there might be a drug for them. And so that sort of purpose, you know, started out personal, and then when all of a sudden you can make it bigger than, you know, what you're personally going through, it adds so much power and energy. You could think that that could weigh you down and make you feel like you have this heavy burden. It's really, I think it does add life and energy to anyone going through that.

The other parallel, which really resonates with me is, so I lost my mom to cancer while I was in college. She was diagnosed just before my freshman year, and I really struggled with her illness and death. And just before she passed away, I promised her I would create an organization in her memory to help other grieving college students. And I didn't know what that was going to be or what it would become. And it really was for me at first. It was like my own grief. I want to find other people that I can connect with. But again, the same sort of thing. Once this network started spreading around the country, and now there's chapters all over the country, I found that connecting with and supporting

and making my mom's legacy, her initials, her name was Ann Wry Faganbaum and her initials were AMF. The organization's actively moving forward, so also AMF. And the idea that her life is helping people and that AMF is supporting people now 15 years after she's passed away gives me so much satisfaction and helps me with really challenging grief that I dealt with. Yeah, I mean, it's kind of in Buddhism, there's a lot of talk about the self being the source of our suffering. And that the self is an illusion, that we have this primordial illusion that there's some David back there between your eyes.

There isn't. And what emerges from this illusion is greed because David wants stuff, hatred because David has has rivals or David has people who drive down the road He doesn't like the way they're driving and confusion about what we really are and who we really are and What I what I you know that that's pretty heavy stuff I think a way to put it that I think would be much more relatable is that focusing too much on yourself doesn't feel good. Self-centeredness doesn't feel good. And even when you're in a horrible situation, like you were when your mother died or when you had last rights right, you've five times or when Lucy lost her son, there's something actually liberating. And that's a big word, but I think it's true, when you aren't so focused on the self and you are outwardly focused and your life becomes bigger

than just your desire for a donut. I totally agree. I think that's exactly the way to describe it. Liberating, it's that sometimes you go through life thinking that there's certain things you have to do that maybe is good for you and you just kind of go through the slug of life. But I think that when you have a life event, whether it's a death or a serious illness yourself, it helps to kind of focus you on the things that are really important.

For me, it's my work and it's the people that I love. All the other stuff, the people who drive bad, badly down the street, that doesn't bother me. It's about, you know, it's the things that are so critical because all that other stuff doesn't matter when you're on your deathbed. Let's go back to overtime. The idea of, you know, every second counts. One of the things you talk about was it's easy for you

to remember because always put your hand on your heart or take a deep breath, which you're probably doing even more than putting your hand on your heart and you feel it. That drives with something that I talk about in the show a lot, which is that through meditation or through Buddhism or Eastern spirituality or any spirituality, we hear a lot of inspiring stuff, but we are programmed for denial. We're programmed to forget that we're gonna die and to be super focused on the next donut or the next sandwich or the next movie or whatever.

For good reason because on the Savannah we survived by finding food and sexual partners and avoiding the saber tooth tiger. So that's how we have this voice in our head. So we need to be reminded and in, the original translation of the word mindfulness in the ancient, in the ancient, in the language of Pali, the word was sati. That word means recollecting. So remembering that you're in overtime is incredibly powerful. It is the gains. This may be an impossible question for you to answer, but is there a Way that the rest of us can remember that we're all effectively on over time. We don't know it, but we are So you're right. I think that is a hard question to answer, but but I think that it's through hearing Stories from from people like you and I it It's from hearing from your friend who's

sharing her story about what she has learned through her life. I think that if you can kind of put yourself in those shoes and say, you know what? I see where they're coming from. I get it. Here are these stories. I think that you can kind of like kind of store those memories away and remember that, you know, we are all in overtime. Like I said before early on, I was like, oh my gosh, I'm in overtime, you know, every second counts. And then I started realizing, no, we are all in overtime,

none of us know how much time we have. And I made the comment earlier, you know, in the first quarter, you can have a bad play, you can make up for it. But the reality is, is none of us are in the first quarter, you know, we're all in overtime. And so we need to live like we're in over time and that doesn't mean to be afraid of every move. In fact, it should be liberating that I have to make the right move and I'm gonna, you know, make the most to every second that I have.

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Let me combine the wisdom of Faganbaum here. Another technique that you've come up with post-diagnosis is your 40 minute walk to work in the morning and how it has a meditative component. Can you talk about that? Yeah, for me, it's the walk to and the walk home. It's my chance to start to kind of when I'm going into work to start getting into a mindset that's ready for a full day. In my evenings when it's coming back, it's getting ready to move from that work world, trying to cure my disease, to try to make every second count with my wife and my daughter. And so it's kind of like my reset in both

directions, moving from, as I said before, I have this, you know, almost like kind of polar challenges where it's, you know, spend, be there present with my family that I love, but also drive forward science so I can be with my family in the future. And so I think for me, I have to really, it's hard for me to break in and break out. So I need that 40 minute walk to break from one day to the other. Yeah, so what I hear there, and you just tell me if I'm right, is like the, this is a grantee experiment,

but this kind of, we need rituals. Yeah. You know, we need to take care of ourselves. It's kind of self-care, which is a little bit of a annoyingly invogue term right now. But we need to have moments of reflection, taking care of ourselves, and moving skillfully and thoughtfully from one phase of our life, one mode, we're in a professional, to personal mode, and this helps you do that.

Does that sound like an accurate summation? That's exactly right. And I've kind of been, I guess maybe by trial and error, I figured out ways to make it work better or worse along the way. But I actually am pretty excited about being able to start to introduce some mindfulness practices. And I just, I've been kind of going going on the fly with those 40 minute periods. And I'm excited that my sister, I was sharing with you earlier, my sister told me about this podcast and aboutminute periods. And I'm excited that my sister, I was sharing with you earlier. My sister told me about the podcast and about you.

And so I'm excited to start introducing some of those into that 40-minute walk. And I'll have to tell you how it goes. Clearly your sister is the brain. That's exactly right. I think that's a great idea. I really do. I'm not going to tell you. I think clearly whatever you're doing is working, So just based on being in the room with you, but what is there, there's some Zen expression.

Everything is perfect, but it can use a little improvement. Absolutely. I'm sure your walk could be improved by that. Do let me know how it goes. Another thing that you've found to be really helpful in this may seem obvious, but I think it's hard for people to do in extremists when things are bad is humor, especially apparently Borat. So talk to me about the importance of humor. Cher, so I've found I'm both going all the way back to my mom's illness and then also

through my own, I'm just how critical a humor can be, share a couple examples. So my mom had brain cancer and when she went in for her first surgery, we didn't know if she would emerge the same person as before, as before the surgery. And when the doctors told us we could go back to see her in the waiting area, we were all so scared. You know, is this going to be our mom when we go back there? A large portion of her brain was taken out. we were all so scared. You know, is this gonna be our mom when we go back there?

A large portion of her brain was taken out. And when we got back and they opened up the curtain, she had a wrap around her head and she had a bulb coming out where some fluid was collecting. And she looked at us and she said, she'd been anna-lady. And we burst into tears, we laughed so hard.

You know, we didn't know, and this is our mom. This is who she is. And she was saying that because she knew we needed that. first into tears be laughed so hard. You know, we didn't know, and this is our mom. This is who she is. And she was saying that because she knew we needed that. And so we needed the humor to say, oh my gosh, our mom's with us. And so fast forward several years, and then, you know, here I am in the hospital. I just spent almost six months hospitalized now. I'd almost died three times. And I'd gotten the seven-h and chemotherapies

And now I'm feeling better And it's kind of crazy to say but the chemo actually made me feel better every dose of chemo because I was so sick before and It was New Year's Eve of 2010 and That evening my dad decided to go for a walk around the hematology oncology floor And we passed a gentleman who was kind of swaying in his chair He looked like he'd been drinking too much in New Year's Eve and on our next lap around we saw that he'd fallen to the floor and so my dad helped him back up into his chair and he looked at my dad and I and he said thanks so

much good luck to you and your wife and I kind of looked around and said why what's he talking about I looked at my belly he thought I was my dad's pregnant wife walking around to deliver our child and so I turned to my belly. He thought I was my dad's pregnant wife walking around to deliver our child. So I turned to my dad and said, man, you've got an ugly wife. But we laughed so hard. You could imagine that that could have gone a couple of different ways. It could have gone, oh my gosh, this guy thinks that I'm my dad's pregnant wife. This is terrible.

Life is awful. Life was pretty awful at that time. But I'd learned from my mom that in the midst of really tough times and literally facing death, sometimes humor can actually help us to get through these really tough times. Yeah, I mean it was also you said some friends played you some Sasha Baron Cohen videos and awesome. Yeah, so Sasha Baron Cohen is I think he is the funniest person in the world. He is my second to David Chappelle. But fair enough.

He I think he's a layers and and the Sasha Baron Cohen, my affinity for him actually goes also back to when my mom was ill. Though I could laugh when I was with her, I actually, when I was back at college, I always felt guilty being too happy while she was going through what she was going through. I felt guilty laughing and I was with my best friend Ben and Sasha Baron cone's TV show came on and the BOROT character came on. In this period where I didn't want to laugh, and I just burst into tears in laughter because I thought he was like the funniest person.

There's, you know, folk has a standing television reporter, and from that moment BOROT has become like the person that I, the character that, you know, that makes me laugh more than anyone else can. And so exactly when when I recovered and I was back to medical school, my friends put together kind of a celebration that I was back. And somehow through friends or friends, they were able to get Sasha Baron Cohen to make a two minute video for me. It was incredible about, and he was so funny. He actually called me the wrong name a couple times during the video. He called me Jonathan a couple times. And he was so funny, he actually called me the wrong game a couple of times during the video. He called me Jonathan a couple of times.

And he told, he said, Jonathan, I mean, Dave, I can understand what you're going through because last week I went through five boxes of tissues with a really, really bad cold. I was like, this is so awesome. So he's a real hero, my. Funny, my dad's been having some health problems. Like literally just last night, he landed in the hospital.

And my brother and I found out, and we had a, we kind of did a video call, me, my brother, my mom, and we could see my dad in the bed, and he could understand us. And we were joking, you know? I don't know if it's, you know, maybe a Jewish cultural thing in part, but I think a lot of people do it. And yeah, I mean, it was a mixture of concern and love,

but also our love language in the family is, you know, verbal abuse. So, and it wasn't directed at him, it was directed mostly at me, frankly. But nonetheless, yeah, what do my brothers say? We're talking to my dad about how his 50th, his, in my mom's 50th anniversary is coming up. And he was able to kind of articulate that there would be a lot of kids there for the thing. And my brother said, yeah, a lot of small Harris is including Dan. That's awesome. Yes, yes. And so I do think it's if it can feel wrong in a way, but it also is,

I mean, you would know better than anybody. As the patient in that situation, I got the sense that my dad was bullied by the lightness. Absolutely. I think that I didn't fully appreciate it when I was the loved one. I knew my mom made that joke to make us happy and there were many times where she did that. And I knew it was really more for me. But when I was in that position, I realized just how powerful and how helpful it is. Because when you're the patient, you feel guilty that everyone's, you know, stop their life to be around you and they're with you and it's typically pretty sad and grim. So anytime you can get them laughing, get them smiling, it is so special. My wife had the best line of our entire marriage.

She was about to have a double best act to me and as she's fine now. And she kind of looked at me and then looked down into her hospital gown and then looked back at me and said, say goodbye to your little friends. Scarface reference. That's awesome. Yes. So I do think I think humor is incredibly important. Another thing you talk about continuing with the wisdom of David or Jonathan is the moment with eating a hamburger. So you were pretty hard. It sounds like you're pretty hard on yourself about your diet. And so you allowed yourself to have a hamburger which seems simple but is actually quite revelatory. Can you talk about that? Yeah. So before I became ill, I was a division one football player played quarterback at Georgetown.

I was also a personal trainer and exercise and health was everything to me. That's what, while I was in college. And I even, I did a public health degree at Oxford, focused on cancer prevention with a particular focus on diet and exercise and in relation to cancer prevention before medical school. And so I like, I talk about in the book, I hadn't had ground meat, a hamburger in a decade, I hadn't had chicken without peeling the skin off of the chicken in a decade.

And I lived this life of kind of like, I'm hyper focused on things. And I kind of don't ever snap out of it. And so, you know, I ate healthy always. I never broke out of it. Never had a cheat day. Never cheated. And so, for about a decade, from the time I was 15 to 25,

I was just crazy focused on exercise and health. And for me, it was, I wanted to play college football. And then when I was playing college football, I wanted to be as best as I could. Do you think it was entirely healthy? Probably not. Yeah. Would you put it was entirely healthy? Probably not. Would you put it in the category of eating disorder or disorder thinking around eating or

body to morph you? I think it was, it's kind of how I'm kind of wired in your book you talk about a friend of yours who's hyper-focus. So I actually, I was diagnosed with ADD, the hyper-focus variant from the time I was a child. And so, when I focus on something, whether it's cure and castle and disease or creating a network in memory of my mom or playing college football,

I kind of do everything to get towards that goal. And so this was kind of one of those steps. And so, and of course, then I spent six months almost dying in the hospital with a disease that is kind of like a cancer, kind of like an autoimmune disease. And I got out of the hospital and I talked about the concept of think it, do it and how how, you know, maybe it's okay to, as you said, maybe it's actually healthy to maybe break

out and to not live such like kind of a structured, focused life and that it's actually better. And so yeah, I remember one of the thoughts that I have when I was in the airport coming back from this last hospitalization was, you know, hamburger sounds pretty good. And it was really, really good. And as you said, it's not, you know, it's not this crazy philosophical concept of eating a hamburger, but for me, it was just this idea that, you know, life is short. And, you know, eating so perfectly healthy and exercising all the time didn't prevent in me a serious disease not saying that it isn't so important for health and well-being but that maybe we don't have control over everything and that we should embrace

the uncertainty of life a bit. So where are you now with hamburgers? I love hamburgers. And so you, because you're slim, healthy looking dude. So you allow yourself, you peel and you're chicken still or like, no, I, sometimes I do, sometimes I tell them. Okay. That's kind of like more of a middle ground. Right. So that seems them to go back to the Buddha where I keep quoting, which is probably annoying.

But anyway, the middle way is the thing. It's the middle way between indulgence and being a monk is to, you know, once in a while, you don't pay your chicken. Exactly. And I think that that's really, for me, you know, it was almost a dying that gave me that sort of revelation. And I've been able to live that way since then.

It's that, you know, maybe life isn't always blocker white Maybe where we really should be is in that gray area We should really embrace it and and feel comfortable in that gray area Okay, the final thing that I want to explore in terms of what I can see as the sort of scalable nuggets that you glean through this ordeal is Again, I don't I can't think of any other way to say this that isn't going to sound a little, you know, hallmarky, but love is a big deal to state the blazingly obvious. But what did you learn about love?

I, first off, you're exactly right. I learned that love and support and the people that are your friends and your family, they can provide something that and a strength that you just can't have on your own. We were talking about earlier, kind of the inward, verse outward. And I think that those people around you that you love, whether it's my sister's, my dad, Caitlin, now my daughter, Amelia, they provide such an important source of strength when you're going through difficult times, both helping you get through the difficult times,

but also motivating you and inspiring you to make sure that you do everything you can, so you can be with them for a long time. I think that my experience with nearly dying each time, it really helped to focus in that, like I said, I spend my time on working for a care and with the people I love. And I think that that experience helps you to focus in on

those are the things that your purpose and your people are the most important things in the world. If you were in Caitlin's position, would you have thrown your lot in with somebody who might be dying? And what is to be learned from the leap she made? So I would like to think that I think all of us would hope that we would transcend and think beyond the physical and the fear of disease. But I think that she's really a hero for the fact that she was able to look beyond the fact that I looked like my dad's pregnant wife at the time. And I was bald and looked beyond that.

But also made me feel like it really was genuine. And I think that that was just the start of it. Then I went on and I nearly died two more times. During the last one, I had such low platelets that I was at constant risk of a fatal brain bleed and that I would die really at any moment. In order to prevent that, I needed to get platelet transfusions, and they needed to be shipped in from another state to be matched to my particular type. And so every day, these platelets would get sent in, and every day, they needed to blunt my fevers. They needed to put ice packs all over my body to get my fevers down, so I could get the platelets

because you can't get platelets if you're in the minutes of having a fever, you'll reject them. And so I remember at this distinct memory of the fifth time I almost died watching Caitlyn with the nurse and they're putting packs of ice all over my body and I'm mostly in and out of consciousness and not really knowing what's going on. But here she is, like physically, you know, getting me in a place to be able to, you know, get these life saving platelets. And unfortunately, I didn't have that brain bleed. I didn't die. I survived.

But it's little memories like that that sometimes come up when I see her with my daughter, Amelia. And I'm just like sitting next to her on the couch watching TV. And those are memories. And there's such special moments that not all of us get to have with the ones that we love. And certainly not at our young age. And I think having gone through that with her makes life so much more special. She's right over there. Want to come in here, Caitlin?

You want to come in? Yes, she doesn't want to, but she's doing it anyway. Here's Caitlin. Hi, sorry. I didn't get you to a motion one there, did I? You might have asked you a few questions. Okay. So, I just, you're sitting next to this guy, you guys had broken up and he's, you know,

really sick. And I forget the how he looked, that I don't think is the issue. But you don't know if he's even gonna be around. And I'm just projecting myself into your shoes. I could imagine having a cocktail of thoughts like, does he wanna get to back together because he's really vulnerable and weak and lonely. If I get back together with him, is he gonna die?

If I don't, am I gonna live with regret that I hurt this dying person? And also if I don't, am I going to live with regret that I hurt this dying person? And also, if I don't, am I going to regret because maybe he was the love of my life. Is that an accurate description of what was going through your head? Absolutely. I think there's a lot of things that go through your head where you guys have talked about it before feeling that sense of guilt.

I don't think I felt that sense of guilt to get back together with him. I just felt that that I loved him. I wanted to be with him. I couldn't imagine my life without him. And so I was ready. Even though you'd broken up. Yeah, I feel like we're broken up. And I received a caring bridge message saying that he, the David had taken a turn for the worse.

So I went to the hospital to go see him. And I knew that no matter what I wanted him in my life, I didn't know how. I didn't know if we were going to get back together, I just wanted him back in my life. And I wanted to work on that relationship. And if we did get back together, then we would take that next step and figure things out. But I was willing to take that next step and figure things out, but I was willing to take that next step. You were willing to take the next step, even though you didn't know if he was going to

be around to keep taking steps. Yes. Yeah. Why? I don't know. It's a really hard question. I don't know. I need to think about this.

I'm not sure. I think partly because you're just an amazing person and wanted to, for yourself, make sure that you're doing what was right, but I think you also, you know, you really cared about me. I think, I mean, here I am putting words in the Caitlin's mouth, but I think that, yeah, I mean, what we didn't talk about earlier was that the first time Caitlin came to see me in the hospital, and when I said goodbye to family and friends, I actually told my sisters that I didn't want her Caitlin

to see me like that. And so they actually stopped her in the lobby and said, David doesn't want you to see him. And so I turned her away. And in hindsight, I regret that. I wish I hadn't done that. But I remembered that some of my final memories of my mom kind of were burned into my head.

And of course, I remember all the good times with her. But I didn't want those final mute being that sick to be what was burned into Caitlin's said, because even though we weren't together, she was the love of my life. And I did that again with my second episode, and she came down to North Carolina to see me when I was hospitalized. And again, I turned her away. And so it was the third time when we got back together.

And it was kind of like, you know, she was just proving, or showing that this is something that really meant a lot to her. Let me guess at what the answer is. But you tell me if I'm right, because I don't know if I'm right. But it's Huey Lewis to be annoying about it. It's like the power of love that, what else are we here for, you know? And it sounds to me like whether you were conscious of it or not, you were like, well, what else am I here to do than being in love with somebody and live like that?

Absolutely. I think absolutely right. But it was a big, it was a big, big move. So I respected. Thank you. Thank you. I respected. What do you think is for people listening to this who may not have life circumstances that

are as dramatic as yours? What do you think you've taken out of this that could be, you know, usable and operationalizable if that's even a word for regular folks who are living more humdrum lives like me. I think that you just, I thought a lot about the bigger picture. And I think what you're saying about love is that it is this, this bigger picture. And so I just, um, just thought about our life that we could have and how, and how we could be together, how we could start a family. And so I thought more about the bigger picture than I did about each individual step with him of getting him better.

I mean, I did think about getting him better, but I definitely thought more about the bigger picture of love. My meditation teacher has a little thing that when you're kind of thinking about your life or any decision a useful phrase to bring to mind is what matters most. Yeah I think I definitely resonate with that and what matters most is David and my family and our daughter and everything else doesn't really matter. Yeah, it's just hard.

I'm just thinking about what I was saying to David earlier that the last 24 hours I've been worrying about something which in the grand scheme of things I know isn't that big of a deal and yet it keeps popping into my mind even while my dad is sick, you know. And I feel something like shame about that, but that's the way the mind works. It's hard to keep what matters most in your mind all the time, and that's why having these kinds of conversations, I'll just say for myself,

it's useful to be reminded. It's useful to be reminded. Thank you for letting me drag you in here. I know we didn't keep you any warning. It's okay, I reminded. Thank you for letting me drag you in here. I know we didn't get any warning. It's okay. Happy to do it. Thank you. Is there anything I should have asked you but that I didn't ask David? No, I think that we really covered everything. I think that, you know, as Caitlin said, we now have this one-year-old beautiful daughter, Amelia. And something that she was mentioning too is that so much of my illness and nearly dying, I thought about the future and kind of escalates up like what could be.

We, Caitlin and I could be married, we could have a family together and that was kind of like the dream that I think kept me motivated and helped me to fight through each of these real lapses. And now we are married, now we do have a daughter together, and now it's kind of keeping this dream going is what really motivates me to keep working every day. And I hope that this example of someone who's nearly died several times, who's gone through so many health challenges, I hope that this can be inspiring to other people that are also going through health challenges that sometimes that vision this can be inspiring to other people that are also going through health challenges

that sometimes that vision in the future that maybe we didn't know that we would ever see, but we hoped for can actually become reality. And hopefully that can inspire other people to start to turn those hopes and those dreams and prayers into reality. Yeah, me too. And I hope that your health continues to be strong.

And I hope Amelia continues to be strong too. Thank you guys. Before we go though, can you just tell people where if they want to learn more about you, obviously the book again chasing my cure, David Faganbaum, it's spelled F-A-G-G-E-N-B-A-U-M, but are there websites for the organization for college kids dealing with grief or for with castman's that people should know about? That's right, yeah. So the group for grieving college students is called AMF and heelgreaf.org is the website for AMF actively moving forward.

There's also for the Castleman disease network, the work that we're doing to try to cure Castleman disease and also create a blueprint and a path forward for curing many more rare diseases. It's called the Castleman disease collaborative network and our website cdcn.org. Of course, you know, so grateful for any support of our work and our mission. And then to learn more about the book, there's a website now for the book called chasingmycare.com where you can hear, read a little bit more about some parts of the book that maybe didn't make it in, see photos from the before and after. Excellent. Thank you both. Thank you.

Thank you. It was fun. You're a good sport. Thank you. Again, big thanks to David, his book, Chasing My Cure, just came out last week. If you want to learn more about his story, go check that out and we've got links to it in our show notes. Let's do some vo mails. Here's number one. Hey, Dan. Big send us a show.

Good question. I am in the middle of a divorce and struggling with the personal feelings of my own. I've been wanting to get a medication practice started. But at this point, I am afraid of the thoughts and the feelings that are going to come up. So I was just curious if this is a matter of will and me just making a leap and getting it going or if there are some suggestions that you have for me to get a practice started. Again, a huge round of the show.

Thank you for what you're doing and I appreciate you taking the call. Take care. Thanks for of the show. Thank you for what you're doing, and I appreciate you taking the call. Take care. Thanks for making the call. Thanks for talking about what is clearly difficult stuff for you. I don't want to sugar code it. I mean, my experience, difficult things can come up in meditation,

and I think it's fair for you to be concerned about that. I'll say though that in my experience, it's better, I have not endured a divorce, but plenty of other ups and downs. In my experience, it's better to deal forthrightly and see clearly all of my difficult thoughts and urges and emotions within the container of meditation rather than having it kind of stewing in the background of my psyche and driving my actions in a way that is kind of blind and reflexive.

So I think the upside is clear, but I'm not gonna lie to you and say that the process won't be difficult. Because I wanted to make sure I really gave you good advice. We also reached out to Ray Hausman, who's the head of the coaches. On the 10% happier app, we have this incredible cadre of coaches, who are experienced meditators, who are right there to answer your questions. If you're a subscriber, if you go to your profile page on the app, you can go look up your

coach and send her or him questions and they'll answer them as long as you want to ask them. And Ray is a very experienced meditator. Having heard your question, she agrees with me that you're right to have some concern and it's wise to want to sort of protect yourself as you dip your toes into these particular waters. She latched onto this notion that you asked is this a matter of will. Her response was that it's probably best not to approach this practice from a place of will that you want kind of want to do it slowly with care, self-care, as the millennial say, so that you can build

confidence over time. A couple of practical pieces of advice you've passed along that I agree with. One is at the beginning, at least you might want to try sitting for short periods of time, maybe just five minutes a day, so that you can grow that confidence and interest slowly. And the other thing is that she recommended is that walking meditation can be a good way to practice when you're in distress because the attention gets directed in a little bit more of an external direction rather than in an external way rather than having it so focused internally. And if you go to the on-the-go section on our singles tab in the app, you'll find great guided walking meditations.

Hang in there, man. This sounds like a really difficult time. I do think meditation can help, but I also think you're right to want to approach it carefully. Let's do voicemail number two. Hi, Dan. This is Lisa. I am a podcast insider as well as a 10% happier app subscriber and user. My question is, during all the guided meditation, the teachers never give the option of lying down, except of course in some of the sleep meditations. Why is that? Is it because people are more prone to falling asleep if they're lying down? No, it's always talked about sitting up straight.

As a mom of three, the only time that I can be alone is right before bed. And so for the last several years, I've meditated right before bed. And I do so in my bed, lying down. As a former yogi, that's what I know at the. I'm at it. I'm at it. I'm at it. I'm at it. I'm at it. I'm at it.

I'm at it. I'm at it. I'm at it. I'm at it. I'm at it. I'm at it. I'm at it. I'm at it.

I'm at it. I'm at it. I'm at it. I'm at it. I'm at it. I'm at it. I'm at it. I'm at it.

I'm at it. I'm at it. I'm at it. I'm at it. I'm at it. I'm at it. about this before, but podcast insiders are volunteers who give up their time to give us insights and response and feedback to our podcast episode so that we can do a better job and it's actually enormously helpful. So thank you for that. I also have so much, I don't know what the right word is, empathy may be the right word, but I don't know that I can fully empathize with what it's like to be a mom I live with one, but there are Lots of pressures and stresses that I'm sure I can't even imagine So if you are actually keeping up a semi-regular meditation practice while being a mom and in your case a mom of three

That's awesome. So I hope you're not in some sort of cycle of wondering whether you're doing it right because let me just say from the outside outset that you're doing it at all is a big deal. The rest of what I'm going to have to say is also encouraging for you know I may have mentioned this in the podcast before but if I my memory serves there were four traditional postures, postures from way back in the day when the Buddha was talking about meditation. One is the traditional sitting posture, which is quite familiar to all of us. The other is standing, then walking, which we just talked about a few moments ago, and then lying down. So there's nothing wrong with lying down to meditate. It's been right there in the documentation and the scriptures from the beginning, so no worries. The one reason why I think we generally teach meditation on the app and on our app and

on other apps, and if you go to meditation teacher the way the reason why I think often it's taught in a seated posture is that's a good combination of being somewhat relaxed while also being alert. The fear with lying down is that it will turn into an unintentional nap. But according to the aforementioned Ray Hasman, if you're able to sustain your attention without falling asleep and lying down is the way you prefer to practice, then go for it. You know, the other thing that Ray mentioned is that you may want to experiment with other postures if you get a minute or two throughout the day. Maybe there's like little cracks in your schedule

where you can do a sitting or a standing or a walking meditation that might be something to experiment with. But I think the bottom line is I don't think you need to worry about the fact that your practice at right now and perhaps in perpetuity consists of lying meditations, especially if it's not making you fall asleep. Although having said that, we do on the app, but as you mentioned, do a lot of meditations that guide people into falling asleep.

And if that's your only practice, that too is great. I mean, I'm really of the view, this is just me talking here, that more practice is better than less practice. And I think being overly dogmatic about when and where and how to do it can be counterproductive. So keep going. Thank you again for being a podcasting center.

I really appreciate it. I want to thank everybody involved putting this show together. Ryan Kessler, Samuel Johns, Grace Livingston, Lauren Hartzog, Mike Debusky, who always operates the boards when I come in and record the intros and outros on Saturday mornings. And I just want to tell you two things.

One is next week after three years of being a podcast, we finally have Joseph Goldstein, my meditation teacher on the show. This has been long delayed, but we got him. It's a long one and a great one, so stick around for that. And ask before we go, I know every podcast host asks for this, but I really mean it. If you can take a minute to share the show with friends, either just one on one or on social media. We love that. It helps us grow, which we want to keep doing.

I will see you next week with Joseph. Hey, hey, prime members. You can listen to 10% happier early and ad free on Amazon Music. Download the Amazon Music app today. Or you can listen early and add free with Wondery Plus in Apple Podcasts. Before you go, do us a solid and tell us all about yourself

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