Theology in the Raw - S2 Ep1101: The Brain, the Body, and Dealing with Trauma: Dr. Lee Warren

Episode Date: August 10, 2023

Dr. W. Lee Warren, M.D. is a brain surgeon, inventor, Iraq War veteran, and author of several books including his recently released Hope Is the First Dose: A Treatment Plan for Recovering from Trauma, Tragedy, and Other Massive Things. Dr. Warren practices neurosurgery at Great Plains Health and loves to make connections between faith, science, and the realities of life. In this conversation, Lee and I talk about the brain, how the brain responds to trauma, how to recover from trauma in a healthy way, a theology of suffering, the relationship between our limbic system and our prefrontal cortex, and other things related to the brain, body, and the trials of life.  Learn more about Lee from his website: https://wleewarrenmd.com  If you would like to support Theology in the Raw, please visit patreon.com/theologyintheraw for more information!

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automatically be entered to win one of 10 free copies of my latest book. Hello, friends. Welcome back to another episode of Theology in the Raw. My guest today is Dr. Lee Warren. Lee is a neurosurgeon, podcaster, and an author of several books, including his recently released Hope is the First Dose, a treatment plan for recovering from trauma, tragedy, and other massive things. I had a wonderful, wonderful conversation, learned a ton from Dr. Lee Warren. So please welcome to the show for the first time, the one and only Dr. Lee Warren. Lee, thanks so much for coming on the show. I really appreciate it.

I'm excited to be with you today, Preston. Thank you so much. So you've written some really, really interesting books. And each one of these, I'm sure, could take an entire podcast episode. I definitely want to get into your most recent book that just came out, Hope is the First Dose. But just give us a background. Who are you? How did you get into what you do? And I said offline, I feel like you have probably, you have like two very kind of different career paths that you're managing. But yeah, give us a background of who you are and how you got into doing what you do. Yeah. So I'm Christian. Obviously I grew up in the church and always wanted to be a doctor. Not sure why, but that was what was on my heart.

I went to medical school in Oklahoma. I grew up in Oklahoma. And then went to med school on a scholarship from the Air Force. And ended up in the Iraq War as a neurosurgeon in a combat hospital. And did 200 brain surgeries in that tent hospital back in the hot part of the Iraq War in 2005. And came home from that. And I kind of ran into life. I had gone through a divorce and a few years later gotten remarried and then had kind of a sudden onset of PTSD. All the war stuff kind of came crashing out of me and figuring out how to

process that is when I started writing really just kind of unpack some of that stuff and that's kind of grown into a second career that really started after we lost a child in 2013 our son Mitch passed away and so it's in the writing about trauma and tragedy and recovering from all these hard things that have kind of where I started podcasting and trying to help other people figure out some of the things that we figured out. And so our family has, you know, been through some hard stuff and that's sort of what created that second career path, as you talked about, is this responsibility we feel, I guess, as a doctor to try to minister to and help other people, even if I can't fix their problem with surgery. I have to ask. I mean, your son is 19, right? And that was 10 years ago. I have a 20-year-old,

an 18-year-old, a 16-year-old, and a 14-year-old. And to be honest, I would say it is probably the biggest fear in my life is losing one of my kids. As I imagine that scenario, I don't know how I would ever recover. Can you be as vulnerable as you want? I know you write about this. What is that like and how do you recover from something like that? I'm sure people listening, at least some listening, have similar situations and maybe they haven't recovered from that. Yeah, I think, Preston, the answer really comes down to some of the things we talked about before we

started talking about the brain. If you have faith, then before some of these big things happen, hopefully you will have had some sort of plan in place for what happens in your life. And when the worst things happen, if your life is built on something solid underneath it, then like everyone, like we did, you'll crash for a while and you'll have doubt and you'll be angry and you'll go through hard things. But that floor of faith kind of gives you some place to land and you don't fall below that. And I think that's a big difference, place to land and you don't fall below that. And I think that's a big difference, I think, between how people with faith experience trauma and tragedy and those that don't. So for us,

we had this devastating event. We didn't know what the rest of our life was going to look like. We knew that it was going to be different. But every day, God would show up in some sort of way and keep one of His promises. And early on, it was little things like Psalm 34, 18, the Lord is close to the brokenhearted. And it would be somebody would send a text at just the right moment, or Lisa, my wife, would come in at just the worst moment for me, and she would be feeling a little bit hopeful and help me to find a little light. And so there was just little moments where, even in the worst times, right after it happened, there were little moments where you could see a little bit of light.

Our first granddaughter was born on the day we buried our son, which was a whole mix of hard and soft things at the same time. And so we had a little bit of light mixed in with all that darkness. And so we didn't have to look very far to know that there were still good things that God had in store for our family because we had our brand new grandbaby. And our daughter had lost her brother and couldn't be at the funeral, and we couldn't be with her when she was having her first baby. And so there was all these jumbled up emotions. But I think that the long answer to your question is you've got to have some things in your life that you know are true, even when trauma makes you think that nothing that you thought was true is. Because

that's what will happen in your brain. The trauma response is everything is negative and you blame yourself and you think God hates you or you think God isn't real and all these toxic neurochemical things are happening. And you just have to find something that you know is still true. And for us, that was we know we've got to hold on to that hope of the resurrection. We're going to get to see our son again. And if that's true, then all these other promises have to be true too, that God still loves us, that He longs to show us compassion, that He loves our son and our son is with Him where He was created to be and all that stuff. You know, he loves our son and our son is with him where he was created to be and all that stuff. And we were able to just sort of one by one add those bricks back onto the foundation.

And eventually, as the acute phase of your injury, if you will, settles down, then you start to see those little bits of light again. You start connecting the dots of things that are true and you can hold on to. And that's why I circle around the word hope. things that are true and you can hold on to. And that's why I circle around the word hope. You know, in the Hebrew, the word hope is that kavah, that connotation of a rope that you're holding onto that's under tension, and God's not going to let it go. And so you have this sense that you're not going to fall,

even though your brain chemistry says you're going to fall. Your faith helps you hold on to that rope. I want to get into, yeah, hope is the first dose. Cause that's, yeah. It's related to everything you're just saying. Before we do that though, can you give us like a, like a one-on-one class, a brief one-on-one on the brain? I think, you know, conversations around the brain have become very popular and everybody kind of talks about their prefrontal cortex and their amygdala or whatever. I feel like people kind of know terms now.

Like 10 years ago, I just feel like nobody really talked about it. Can you give us kind of a one-on-one? How does the brain work and what are some main things we need to know? Well, I think the most amazing thing to me is that your brain is the organ of your mind. And so most of the other reason I wanted to be a neurosurgeon really is that most organs do one thing or a couple of things. The brain creates who you are. And so you've got this, everything you know about yourself and your personality and your memory and your life and your emotions and all of that comes out of this magical connection between the organ of the brain

and the mind that God gave us. And I think about it as sort of like the brain is the hardware and the mind is the software of how your brain works, right? So everybody, you're right. Everybody talks about the limbic system being this sort of basal sort of lizard brain that creates this fight or flight response that gives us the baseline survival instinct. And that's true. And when we go through hard things, our impulses are to run away or to go into fight mode. And our frontal lobes, the frontal cortex gives us that executive function where we can say,

wait a minute, time out. I don't have to run away here. I'm not actually in danger. And it's important to understand that your brain has a limited palette of emotions that you can feel. So the chemicals of your brain, dopamine and serotonin and GABA and all these neurotransmitters that you make are the chemicals that create feelings. And one of the things I teach when I talk about self brain surgery, I teach my listeners on my podcast is your feelings aren't facts. Feelings are chemical events that point either toward or away something that's true or not. And so a good example of that is when you

feel fear, for example, fear is a chemical response to something that might or might not be happening. So if you open your garage and there's a grizzly bear in there, you're going to be scared, right? You're going to be, you're going to be afraid of something that's real. But if you hear a noise in the middle of the night, your brain is going to tell you that an intruder is there to kill your family and you're going to feel the exact same set of chemical responses, even though the underlying thing isn't true. And so feelings aren't facts.

Feelings just tell you that a certain set of physiological things are occurring in your body and there may or may not actually be a threat. And that's super important because your frontal lobes have the ability to say, time out. I'm going to take that thought and examine it and see if it's really true or not. And then decide how you're going to respond to that perceived threat. And people that don't do that well, like PTSD victims, for example, they're constantly in that state of fight or flight. They're constantly in that state of fear, and the perceived danger is always there. Those people have a hard time doing anything productive in their life, Preston, because they're stuck in that basal part of the brain that's not very good at deciding what's good for you. And the frontal lobe is really good at calming all that stuff down and taking control. And so the most important thing is most of the feelings that you have are not true,

and most of the thoughts that you have are not true. So one of the cool things about the brain is we thought up until about 2004, we thought that the brain was fixed, that you were born with all the brain cells you were ever going to have and you were kind of stuck with them and, you know, that we could blame a lot of things on our genetics. Like, well, I feel this way because my dad felt that way or I'm this way because my parents were all that way. I drank, I drank because they did. And I, you know, cuss people out when I'm mad because my dad did. But the fact is we've learned now there's something called neurogenesis, which means you actually make new neurons every day. And that's what I think Paul's talking about when he talks about the transformation of your mind. You make a new brain every night

while you're sleeping. But the problem is those new nerve cells automatically wire into old patterns and thoughts and behaviors unless you tell them to do something different. And there's something called neuroplasticity, direct neuroplasticity, is the power that you have to determine how synaptic connections or connections between nerve cells in your brain form. And we've learned over the last 20 years that the most powerful determinant of what happens to new nerve cells is how you think. And that's why Paul, 2000 years ago, said, if you want to be less anxious, think about better stuff. Like think about better things. Think about things that are good and helpful and helpful and beautiful and all that stuff. Because when you do that, you can take those negative fear impulses or negative anxiety

impulses or negative beliefs that you may have, and you can reroute them and create new connections that will become automated over time so that you're less likely to have those harmful reactions and more likely to have helpful ones. So I think there's a lot more we could say about the brain, but I think that's the coolest part is that God gave us the ability to make a new mind for ourselves if we learn how to think properly. Is that CBT, cognitive behavioral therapy does a lot of that, right? Isn't that? Yep. You can learn how to talk yourself and think and change your life by the way that you think. Do you find, I mean, I want to be cautious not to take the ancient biblical writers and make them fully aware of all the stuff we know now today, but do you find that it is

a bit interesting, if not shocking, if not exciting, that some of the ways in which the Bible talks about our mind and thinking does actually resonate with what we have more recently discovered about how the brain works. Have you seen, I mean, if you were an atheist, so it's easy for Christians to want to find true correlations, but if you can kind of like try to not read your Christian body, is it still pretty fascinating, would you say, that the New Testament writers spoke to? Absolutely. It is fascinating to me. And I think that's why we understand about inspiration and the Holy Spirit inspiring those writers. But when I talk to people who are not believers, I say, well, everybody has things that they read that are influential to them and things that are helpful. quote, Seneca or Marcus Aurelius or one of the Greek philosophers or one of the Stoics,

because they were people who observed human behavior and noticed things that seemed to be good or bad about how we can live our lives, and they pointed things out. And so you could look at Scripture that way, and you could say, we've got these old guys from thousands of years ago that wrote stuff down after observing how humans behave, and they noticed that when you think better thoughts, you live better. But what's interesting to me is the Bible is so full of these examples of things that all turn out to be validated from a neuroscience standpoint now. So that idea about when Paul says, don't be conformed to how the world wants you to think, be transformed by the renewing of your mind, right? If you learn how to take the power of renewing your mind and apply it to your life, it is transformational, Preston. The things,

especially if you lose a child, or my new book, we talk about these massive things and they're not just, it doesn't have to be getting a brain tumor or losing a child or having somebody cheat on you. It can be the death of a dream that you've been pursuing for your whole life and you're not going to get it or you're not going to get that promotion or you're not going to make it to the NFL. It can be any of those kinds of things, these massive things that happen that hurt our view of what we thought our life was going to look like. And if you learn how to change your thinking around those events,

you can change how your life plays out. And if you don't, you can become a person whose entire life is defined by the thing that happened to them. And we all know those people. I mean, I guarantee you, whoever's listening right now, you know somebody who had something bad happen to them 20 years ago. And if you see them tomorrow and you say, hey, how's it going? They're going to go, well, you know, my dad did this thing to me 20 years ago and I just can't get, you see people like that

who become defined by the thing that happened to them. And the way you change that is to learn how to think truer thoughts about what your life means now and what you can build into the future. And that's what I think of as the word hope. Like we have hope, It's not optimism. It's not wishful thinking.

We have hope in a person who overcame death and gives us the ability to know that we can overcome the trials of our life too, which is what I think Jesus was talking about in John 10, 10 when he says, the thief comes to steal and kill and destroy, but I came that you could have an abundant life. So this is one of those conundrums. You asked me earlier, how do you get over losing a child? I think from a Christian standpoint, it goes back to, and this is kind of nerdy and forgive me if I'm kind of a nerd, I'm a brain surgeon, so I come right honestly. But I think about what the quantum physicists talk about at the quantum level, the really tiny atomic level of our lives, how the cells and molecules behave, they behave differently than they do on the big scale. So if you see an apple fall out of a tree, it's always going to fall at a predictable rate. And you can make math equations called Newtonian physics that can describe how that object is going to behave. But when you get

down to the level of quantum physics and how electrons and protons and things like that behave, they don't behave according to math that we can understand using Newtonian physics. And it's a long story, but the point is this. When you watch how electrons behave, they do things that are impossible according to how Newton described the way the world is supposed to work. One example is this. You can measure an electron's position and you can actually prove that it can be in two places at the same time on the quantum level, which is impossible for us out here in the big world. But I see that and it's been clearly proven and that's why we have computers and internets and atomic bombs and televisions and microwaves. They figured out how to use that math to describe how these particles are going to

behave so we can make technologies that use them. And when we look at something like Jesus saying in John 16, 33, that in this world, you're going to have trouble. And we all know that's true. I lost a son. Something bad's going to happen to you in your life. Everybody's going to have something hard happen to them. We all know it's true when Jesus said, in this world, you're going to have trouble. He also said, I came here that you can have an abundant life. And those two things don't square up in the math that we know how to use in our world, right? They don't square up, but they're both true.

And I'll tell you why they're true. I lost a son and I will never stop being sad about that. It will never be that Romans 8, 28 that says all things work together for good for those that love the world. That's a terrible thing to say to somebody when they lose somebody, by the way. It's another thing we ought to talk about what you ought not to say. But so that promise that he made is not true if you define it as it will become a good thing eventually, right? Me losing my son will never be a good thing. But the reason quantum physics is relative to that conversation is I'm always going to be sad about losing Mitch, but I will not die a sad man because I know those promises are true.

And they're true because I've seen them play out. And so Jesus came into this hard world and I've experienced it and you have too. And he came here so that we could have an abundant life. And just like that electron can be in two places at the same time, I can have a life that's sad and will always be sad, but is happy and full of purpose and meaning at the same time. And that's why you can survive it, right? Because it's infinite. Losing a child or losing a husband or losing a spouse, losing a wife will put you in an infinitely sad position. And unless you could replace that the way our normal math works, you'd have to replace that loss with something equally large to balance it out. But we

all know it doesn't work that way. You can't lose a child and then have another child and be okay again, be just as happy as you were before you lost one. It doesn't work that way. But what God does is he says, I'm going to give you this joy, this hope, this happiness that's big enough to not stop you from being sad, but to make you okay anyway. It's just going to be a different okay. And it works. And so for me, that's how I put the brain on all that is that he's given me this ability to transform my mind, to understand that my life isn't going to look like it did before, but it can still mean something good. And I can make something noble out of my son's loss.

I can help other people with it in a way that would make him proud. And that Romans 8, 28 promise comes out to be true eventually. I've gotten two emails since I started podcasting where somebody said, hey, today was the day I was going to take my life, Dr. Warren. And I didn't because of what you talked about today. And okay, that wouldn't happen if I hadn't lost my son. It doesn't make losing my son a good thing. But at the same time, there's a good thing that happened because I took that pain and

started writing and started talking about it and started sharing with other people the vulnerability of what happens when you, what do you feel and what do you do and how do you survive it and all that stuff. So it's a jumbled up mess, but both things work at the same time. Well, what you're doing is you're kind of unpacking just a rich theology of suffering. You know, it is fascinating that God chose to build suffering into the narrative of his son. Um, and that, you know, Jesus is called the image of God. Like, like we all bear God's image, but, but Jesus kind of embodies perfectly what it means to bear God's image. He also, uh, suffered, uh, and experienced suffering more than anybody can possibly imagine. And yet he also had hope and joy and all these things.

And I've also, yeah, it is fascinating that the Bible doesn't put living a meaningful and fulfilled life at odds with suffering. In fact, we could live a brave new world life, you know, just plug us into a dopamine machine and just soak our brains in excessive dopamine. And we would be, I think, miserable, right? That just doesn't... I mean, anybody who has an addiction or whatever it is, is just pumping their cells filled with dopamine and they feel just amazing in a sense. But at the end of the day, it's just kind of miserable, mean, and I think that just goes against how God has wired creation where he has built suffering into kind of what it means to live a meaningful life. And

again, even saying that, I like do not want to downplay the horrific tragedies that suffering brings us and God will redeem suffering in the end, you know, in the new creation, I don't think there's going to be suffering, right? So I don't know. I'm just kind of thinking out loud with you. It is complex and it is kind of a big web of mystery. Man, but you're bringing... I can think like this theologically, but it's fascinating for you to bring what theologians call general revelation, creation, our bodies and our brains into, in line with what the Bible talks about. You said something kind of in passing that, you know, our emotions, would you say our emotions often aren't factual? I want to build on the phrase

you use. What did you say in that regard? Yeah. So, you have a limited palette of feelings that you can feel, emotions that you can feel. There's no, they're not infinite. And those feelings are generated by the neurotransmitters in your brain. And there's only a handful of them. Right. And so that means that a particular emotion that you feel doesn't have any meaning in and of itself. It doesn't necessarily mean that something real is happening, that you should be feeling lonely or you should be feeling depressed or anxious. Sometimes those are just chemical events that happen and we attach the meaning to them and decide that they make us feel certain things or make us have to do certain things. So that's a good example about addiction, right? So dopamine is

not in and of itself a pleasurable chemical. It triggers a sense that you're going to get a reward if you do that thing again. And so it's the chemical reward really that makes you believe that if you follow that trail, you're going to be rewarded by feeling better or not having to think about this thing or whatever. And that's why we talk about, I have this little phrase, my wife and I talk about the tomorrow tax. If you pursue reward tonight to numb yourself so you don't have to feel this thing that you don't want to feel, then tomorrow you get to feel it again because you didn't fix it. And you have to pay the headache tax or the late for work or the text you shouldn't have sent or whatever happened. And so you're paying taxes because you listened to your stupid brain chemistry

instead of dealing with the thing that was really happening that you didn't want to feel or didn't want to deal with. And so the answer to your question is emotions aren't necessarily the thing that we need to react. They shouldn't be the thing that we react to because what we need to understand really is what's underneath it making us feel that emotion. And is it something that really deserves my attention or do I need to fix something else to make that not feel that way anymore?

I mean, this is just understanding everything you're saying here. And I'm sure we can go way, way deeper than you're just going to open it up a door that we can walk into. This would really help, I mean, relationships and marital fights and everything, which nine times out of 10, 99 times out of 100 involve emotions that are responding to something deeper often.

And often what happens, right, is two people, if they're in an argument or dispute, it's emotions reacting off emotions reacting off emotions. two people if they're in an argument or dispute. It's emotions reacting off emotions reacting off emotions. And there's usually underlying things that oftentimes are being not dealt with. I watched something on the brain. I think it was on Netflix or something. It was really fascinating how we can create almost whole memories of events that never existed. I think they use the illustration of 9-11, or especially when it's around some kind of traumatic event. And there was a, I might be getting this wrong,

so people can fact check me on this, but I think it was something like during 9-11, there was, they interviewed people on Long Island, you know, and they were like, yeah, and I looked out the window and I saw the smoke, you know, covering, you know, whatever. But then factually, the wind was blowing the other way in Long Island. I think this is, you window and I saw the smoke covering whatever. But then factually, the wind was blowing the other way in Long Island. I think this is – never had the smoke that way or whatever.

But they were describing it so vividly like this is what happened. Is that pretty common for people for whatever reason to have memories that they can literally see I mean, see in their mind that didn't happen, that that is their emotions, their brain, whatever, kind of like trying to do something to heal? Yeah. Can you unpack that? Yeah. That is a really complex and fascinating set of things there. And there's a thing called a mirror neuron, for example. um set of things there and there's a thing called a mirror neuron for example like you have you have neurons that are set up to perceive what other people are feeling or thinking and to mimic them and this is why you can be in a really bad mood and you can walk into a room and just stand next to somebody and their heart rate will change in response to your neurochemistry right it's really

electromagnetic field yeah you're like there Yeah, there's a whole group called the HeartMath Institute that looks into this physiological changes that people can impart on one another. And they've done some really amazing experiments where a guy can be in a room and not know there's another person in the next room and they can make this person be really angry

or feel something really intense and the heart rate of the person in the next room will change in response to the electromagnetic things that are happening. So that's a little bit off topic, but it's just the point is we can affect each other's memories and moods and emotions by the things that we say and we feel. So that's one thing. You can have some implanted and influential things. Another thing is just the intense emotional experience that happens with trauma can wire your brain into being receptive of other things that you hear. And you're so confused and so traumatized that you don't necessarily know what actually happened and what you just felt may have happened or heard somebody else say may have happened. And a good example of that is this

horrendous thing that happened in therapy in the early 90s where hundreds of kids were basically accusing their parents of abuse and things that were happening because counselors were basically planting memories and recalling experiences that never happened. And so they understand now how vulnerable children are to therapists sometimes and therapists have learned how careful they have to be to sort of not sort of plant memories that can come out as they're trying to help kids overcome certain things that have happened. So I think the answer to your question is, yeah, it's pretty common that humans can feel things that aren't actually tied to anything that's real.

And I think that's one of the reasons why Paul said in 2 Corinthians 10, 5, we have to take captive every thought and bring it into submission. And we have to understand what we're thinking because we know, and it's almost five to one, by the way, the five to one, your thoughts that happen when you're not actively thinking about them, this default mode that we call it, are negative and generally not true. So you have all these negative thoughts that are based on protective mechanisms and past memories and experiences and all that, that are just not true. And they happen all the time.

I'm a loser. Nobody likes me. Nobody's ever going to buy my book. All those things that happen, right? You have these thoughts and then you have to take them captive. And as a brain surgeon, I call it the thought biopsy. Like if you came into my office tomorrow and you said, hey, doc, I've been having headaches for a couple of weeks, been having headaches. If the next thing I said to you, Preston, was, OK, well, let's go to the operating room and I'll cut your head open and look around and see if there's a tumor in there. You'd say, well, wait a second. Like, shouldn't we do a biopsy? I mean, shouldn't we do a CAT scan or something and make sure there's, it's not just allergies or something, right? Shouldn't you do

some testing? Right. But we do it all the time with our thoughts and especially in our relationships, like you just said, like she said this and my synapses triggered a time when my dad said that thing. And I feel exactly what I remember feeling when he said that thing to me. And I'm going to defend myself because I don't appreciate the fact that she made me feel what my dad used to make me feel when I was eight. And so I'm going to attack. And I'm not even mad at her. It's just the emotional thing got triggered.

And that's a synapse that I built based on a past experience, not based on the reality of what's happening now. That's why it's so important to take that thought and biopsy it, let your frontal lobe get involved. The limbic system is faster than the frontal lobe. The limbic system is designed to keep you alive. If you touch that hot stove, you're going to jerk your hand back because you've trained it and built synapses to keep you from burning your hand.

But the frontal lobe takes a little bit longer. It's a little bit farther away, and it has to take control by analyzing the data and deciding what the most appropriate response is. And you can overcome that initial reaction with an appropriate response if you learn how to take that thought captive and look at it before you react to it. This episode is sponsored by Faithful Counseling. Faithful Counseling is biblically-based online therapy that can help you grow closer to whom God has created you to be. Here's the thing with counseling. We usually just avoid it until we hit some major crisis in life, but why not build in healthy rhythms before a crisis hits

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What does it, is it true that some people anecdotally just seems like some people are very very rational like their frontal lobe seems to be firing and you know really well and they're just very rational very logical while other people it seems like the opposite like it seems like their their emotional side is just dominating how they view life, how they react and everything. And maybe one has had little to no trauma. Maybe the other has had a lot of trauma or maybe there's reasons for that. But would that be true that this kind of, if I can call it, battle or tension between kind of this part on the back, the stem, the emotional, the reaction? Yeah, your brain stem, amygdala, and all that.

Are people, I mean, would that be an accurate observation that some people, one is more dominant than the other? Yeah, and I think it's just like some people are better athletes than others. We have different baseline ways of thinking. Also, it's probably a lot of nature and nurture, how our parents behaved and how we were raised and our baseline philosophical and religious backgrounds and all that stuff. But I think part of it too is, is a lot of us don't ever for one second think about our thinking. We don't ever think about it. We just react to it. Right. And so I tell people all the time, like, like you have a plan. I guarantee you, Preston, we haven't talked about this, but I guarantee you somebody in school when you were five or six or seven taught you what to

do if you catch on fire, right? What are you supposed to do? Stop, drop and roll, right? They taught you that in grade school, that everybody has this plan in place for what they're going to do if they catch on fire. And I'm 54 years old. I've never caught on fire yet, but I have a plan, right? We don't have a plan. Most of us haven't planned for what am I going to do if somebody says something offensive to me? What am I going to do if I find out my wife has a brain tumor? What am I going to do if, you know, this particular thing happens? We don't think about it ahead of time. And so we don't make a plan for it. So then we are in the position where

our limbic system has an advantage over our frontal lobe because we haven't preloaded a plan to sort of take charge when the pressure's on. There's a great book by an FBI hostage negotiator named Chris Voss that he a few years ago called Never Split the Difference. I don't know if you read that or not, but he had this line that's exactly right. It should have been a neuroscience line. He says, when the pressure's on, we do not rise to the occasion. We fall to our preparation. And that's exactly right.

It's exactly true. Like when you're on the football field and the pressure's on, you don't become Tom Brady all of a sudden. You become the guy that practiced all week to implement a game plan, right? And you're better because you've prepared and practiced for that scenario. And so I think it would be wise of us to look at our lives and say, hey, here's five things that are pretty likely to happen today when I get to work. I know my boss and I are in conflict and they're probably going to say something offensive and I should be prepared for what I'm going to say and how I'm going to respond.

Instead, we do the shower preparation all the time where if this guy says that, I'm going to let him have it. I'm going to tell him this. We do all those plans like that, like how we're going to handle somebody. But we don't plan for the proper and healthy emotional response very well. And I think it would behoove us to have a treatment plan in place. Is this your first book, A Peak Under the Hood? Is a lot of the stuff you're talking about, does this deal with a lot of that? Or what do you talk most about this stuff? No, A Peak Under the Hood is really, it was a self-published little book of some stories from

my practice, some amazing kind of miraculous things that I tied to some biblical kind of lessons and all of that. So it's just kind of a little that I tied to some biblical kind of lessons and all that. So it's just kind of a little look at the nervous system. Okay. Okay. Well, let's dive into, I have so many questions, but I want to stay on track here. Hope is the First Dose. This is a book that just came out. The subtitle is A Treatment Plan for Recovering from Trauma, Tragedy, and Other Massive Things. Can you give us the, what's your overarching kind of argument here, the main kind of elevator pitch of what you're doing in this book? Well, I think it's some of the stuff we've already covered.

The big thing is you are going to encounter some really hard things in your life. That's a promise Jesus made in John 16, 33. You're going to have some trouble in your life. That's a promise Jesus made in John 16, 33. You're going to have some trouble in your life. And I had this idea first when I was thinking about a time when I was in the Air Force and we got some training in fighter aircraft and I was going to get a ride in a T-37 trainer and the crew chief, as he was strapping me into the chair, he said, look between your legs, there's a handle down there, a yellow handle. That's the ejection seat handle. And it had this big caution on it and says, caution, do not pull. And he said, this, this aircraft will launch you and you will die if you don't have enough altitude. If you

pull that handle, right, you're going to die. If you have less than a thousand feet of altitude and you pull that handle, so keep your hands off the handle. And the massive thing is what happens when you're going on your life and you've got this plan and somebody pulls that handle and you weren't ready for it. And all of a sudden your life is going to look different than you thought it was going to look. And that happens to all of us. These massive things occur, whether it's emotional or mental or physical or medical or whatever. And so the book, Hope is the First Dose, is what happened after our son died, which was our massive thing. That's when life pulled the yellow handle on us. And how do you put a treatment plan together for finding your feet again and not having that particular

massive thing become the only thing that your whole life is defined by for the rest of your life? So what can you do to put your brain and your heart and your faith back together in a way that makes sense so that you can find your way back to a life that is hopeful and maybe even happy again after these big things occur? So that's why I wrote the book. So what is the big, I mean, what are, yeah, what's the main thing to do? Is it just making sure that you're, I don't want to, it's going to sound cliche, but I think it's true. Before that big thing happens or even after it happens, I mean, making sure that your faith in God through the resurrection of Christ is the most important thing in your life. And that you truly, truly believe in that and put your hope in that.

Is it as simple as that? I mean, or... Well, sort of. It sort of is, but there are plenty of people that have faith and would say that they believe in God, that when this big thing happens, their life's kind of wrecked. And I think that's why there's a difference between hope and faith. Like, yeah, I know I'm going to go to heaven and I know that God's going to redeem this and all of that. But boy, in the meantime, I'm really hosed because I'm never going to feel any joy again because this thing happened to me. You know, people like that, Christians that are basically in the spiritual ICU, you know, for the rest of their life because they never find their way again.

But Jesus said it plain. I came here that you can have an abundant life. And so for me, I was always this optimistic, hopeful guy who, I mean, if something happened to me, I'd be like, it's going to be okay. It's going to be okay. God's got a plan. It's going to be okay. But after I lost my son, Preston, for a couple of years, I didn't think that anymore. And I lost something I thought I knew. And it sounds really naive, especially for a neurosurgeon, because I work in a world where people's kids die all the time and people get brain tumors and they die. And I deal with it. I'm the guy delivering the

bad news all the time. So it was naive of me to think that because I was a Christian and tried to do things well, that I wouldn't have something like this happen to me. But when it did, it really unearthed a lot of stuff in me and I wasn't sure what I believed or if I believed for a little while. And so, yeah, having a faith ahead of time would seem to be the antidote for these things. But the truth is, if you're not actually sure that you believe that stuff and you're not actually sure that it's real, then the foundation can crumble, and it may take you a while to find out if it's really true or not. And so it's not quite as simple as that, because all of us, I think,

especially listening to a podcast about theology, most of us listening here are going to think that we have that kind of faith. But I think the truth is you've got to make some decisions about who God is to you and what He can do and will do for you, even if bad circumstances occur. So I think that's the number one most important thing I've discovered in now 20 years of practicing neurosurgery and 10 years of being a bereaved father is that you've got to decide who God is.

And that's when the bottom falls out. You can remind yourself what you decided before that bad thing happened, and that's what you're going to hold on to that gives you that kavah, that rope to hold on to. And so for us, it took a while to remember those things that we had decided. But once we did, we started building the rungs and the ladder to climb out of that furnace of suffering again. If a tragedy like that hit me, specifically losing one of my kids or something similar to where it's just, you know, as I imagine something like that happened, it just seems like it would be like impossible for me to come out on the other side of that. I don't know if I just personally, I don't know if I would struggle with my just raw intellectual faith. Because I guess I know this stuff happens every day. I know we live in a world of suffering, a world of sin and tragedy, and it wouldn't interrupt my worldview. I think

I would probably battle with just apathy. I think that would just, I think that's where I would go. I would just feel like, you know what, who cares? I'd probably swear a lot and not care. You know, I'd probably just like, whatever, you know, or just, I don't know how I would, I'd probably be more cynical or just apathetic towards loving my neighbor, especially loving my enemy. You know, like I, I think that's where I would go. I feel like I would battle turning into almost like a functional deist, where it's like, yeah,

God's there. Yes, I know this fits right in line with my theology, but I think I'd kind of throw my arms up and just whatever. I think that would be my response. What does that tell about me? What should I, if that's a true analysis of myself, what are some things I need to build in now maybe to build that foundation ahead of time? I think you're right. I think you would go through an apathy stage. I think that's one of the stages of grief.

And grieving well and learning how to actually process that pain and move back through it is super critical. You're going to go through things like that. All of us do. You get to this, why does it even matter? Why do I even bother? And that's not necessarily about saying that that's something to almost be embraced. Yeah, and I think you're going to have a grief response.

And the worst thing to do, and in fact, I'll take a little detour here if we have time. There's a story in 2 Kings when David, the King David, had committed adultery and Bathsheba was going to have the baby. And God said, this baby is going to die as a punishment for your sin, which is terrible. But that's the story. And it tells the story of David in mourning and praying and fasting and begging God for this thing not to happen. Right. And then the baby dies. And David gets up and washes his face and changes clothes and calls for something to eat and basically goes back to work right after the baby died. And his advisors say, wait a second, your son just died.

What are you doing? Like, you need to grieve. And he said, can't do anything about it now. Like, I might as well just, you know, God didn't answer my prayer. I need to just get back after it. And that's, that's the story. And we often don't notice what happens next, but what happens next is his family becomes a nightmare, right? One of his sons rapes one of his daughters. Another son murders that son in response to the rape of the daughter. And then Absalom, the son that did the murdering, goes off into exile. And the Bible says David wanted to go to Absalom for three years, but never went. And so he just let this bad thing happen,

and he never went and stood up as a dad and tried to take care of it. And another one of his sons tries to take the throne by force. And the Bible says that happened because David never said, why do you do the things that you do, son? Why do you act that way? He never parented them. And ultimately, the scripture says the sword never departed from his house. And I think, Preston, looking back on that from a neuroscience perspective, 2000 years later, David did not grieve properly. And he didn't learn how to put his life back together and still manage his other kids and his family. And they suffered a curse of generations because he failed as a parent to process his grief and pain properly. And that's

what will happen. It's fascinating, right? That section in 2 Samuel, I would say, let's see, 21 to 24 are an appendix. So that happens in chapter... So from 2 Samuel 12 to 20 are some of the most under-read sections of the Old Testament, even though it's about David. It's kind of harder to follow, in my opinion, that the narrative, it's less familiar, but it's some of the most psychologically interesting and complex portions of scripture. And I think exactly what you, I never thought about it in the precise terms you did, but I think that actually, that makes a lot of sense. He does seem to be very distant. He's not parenting well. There's, he just seems, yeah, he seems apathetic. He seems like he's, it's just not

the same kind of David that existed before that event. Yeah. And so you would say it's because he just didn to process his grief and pain without having processed them. And it turns his life into a mess. So if you feel that apathy, your response to that needs to be to understand it's part of the process and to keep working towards becoming healthy again and manage that pain in a healthy way. What would you counsel somebody listening? And I can, you know, like, you know, there's such a range of different events that are deeply traumatic that probably most, at least many people have not recovered from well. I'm thinking specifically of the,

of the horrifically high number of people who have been victims of sexual abuse, especially as a child, usually from somebody that's a trusted family member or something. In most cases, I mean, how do you even process that? What would be your advice to somebody who has had some traumatic event in their past that they really haven't dealt with well? What's the first few steps they should take? I think the work of Bessel van der Kolk and the work of Gaber Mate are two of the best writers on this in recent years. It's this concept that's come along of what we call trauma-informed care, where used to, if you were behaving, if you were my patient and you're behaving in a certain way, I would say, what's wrong with you? Why are you doing that stuff? And now we've learned to say, what happened to you? What happened in your past that's producing this behavior?

So the first thing I would say is if you've been through something like that and your life doesn't seem to be working anymore, the first thing is understand and hear me clearly. I don't know if you see this video or if you're just hearing my voice, but your trauma is not what happened to you because you can't ever change what happened to you because you can't ever change what happened to you. I can't ever change the fact that my son was stabbed to death. You can't ever change the fact that you were abused or whatever terrible thing happened to you. You can't change it. So if you define your trauma as the thing that happened, you really are hopeless because you can't change that. But what the truth is, the truth is that your trauma is your brain's responses to what happened to you. And you can do something about that, friend. You can learn to change those behaviors and responses. You can learn to get that brain chemistry under control, even if it takes medicine and therapy and all those things. But you can change that. You can change the response

that your brain and your emotional states and your hormones and your body have to the event that occurred to you. And you don't have to accept the lie and the label that trauma will put on you that this thing has broken you irrevocably and you can't ever be redeemed from it. And that's not true. You can't change the event, but you can change the response. And so, Preston, I think that's the most important message to give anybody is change how you're responding if the response isn't working for you. If the response is producing behaviors that are harmful to you, if it's producing psychological realities that are harmful to you, change those responses, no matter what the cost. If you've got to go to a treatment center or get yourself a therapist or something like that, you need to do it because you can change it and that'll change your life. That's, I've never heard it put in those terms. That's super helpful. You mentioned medication. I would say, yeah, therapy. I mean, to me, I'm a huge fan of therapy and I think that that would be kind of an obvious first step and not all therapy is good therapy. So I mean, make sure you're, you're seeing a good godly therapist with a strong worldview.

To me, obviously, that would be a first step. When would you say medication – I know that's debated. I read Bessel van der Kolk's The Body Keeps the Score, which, goodness, that book is incredible. He seemed, if I remember correctly, he didn't come right on Seah, but, you know, it's a little, but basically saying medication is kind of like, if I remember, again, fact check me on this, but like, you know, that shouldn't be the first response.

Oftentimes there's underlying things that need to be dealt with and medication is almost temporary. You know, it can be a temporary kind of, a band-aid really, until the wound is truly dealt with. And it can be harmful. It can be. Yeah. Yeah. But if, I'm just thinking out loud, if a lot of this comes down to chemicals

being released in the brain, then what would, and you have medication that can alter those chemicals, what is the downfall? Is it just that once you get off the medication, those chemicals will come back if it's not dealt with, and then you're just hooked long-term? Or what would be the negative effect? No, it's more complicated than that. And it really comes down. I'm not a psychiatrist, okay?

I'm a brain surgeon. So I am good friends with Dr. Daniel Amen, who's probably one of the most famous psychiatrists in the United States, if not the world. And he is a leader in that field because he was the first mainstream psychiatrist to say, hey, we got it all wrong. We're writing prescriptions based on symptoms, but we don't look at the organ and what it's actually doing. Like everybody, if you have chest pain, the cardiologist does not put you on a medication until they've done a cath and an angiogram and an echocardiogram.

They've imaged your organ and seen what it's actually doing. And the psychiatrists for years were writing prescriptions based on symptoms. And what Daniel did was Dr. Amen came along and said, wait a minute, we need to do functional imaging to see what the brain is actually doing before we decide what we need to be treating. And what he learned is fascinating. And that's been verified by thousands of studies across numerous systems is this. There are probably seven or eight different brain disorders that create symptoms that look like what we call ADHD, for example. And all of them need different kinds of treatment. And few of them actually need medication. And so you've got nurse practitioners and family practice doctors

and school nurses and all kinds of people telling parents that their child has ADHD and needs to be on Adderall or Vyvanse, right? But none of those kids have had brain imaging to say, wait, maybe we're treating a concussion we didn't know about, and that's producing these symptoms, and we need to be treating this child differently than just putting them on medication. So the first thing I would say is, you're right, medication sometimes in some cases can be helpful, and sometimes people need it for especially short-term management of certain mood disorders can be damaging or dangerous.

But most people need brain imaging to figure out what they're actually, what's actually happening inside your brain and what areas are involved. And most of those things can be managed by supplements, diet, cognitive behavioral therapy, different kinds of management other than just SSRIs or antidepressants or whatever. So you're right. Be careful with medication. Make sure you have a doctor who understands what they're actually treating and what symptoms you're dealing with and why those things are there. And I think brain imaging is super important. Is it? Okay. So I'm going to get into some debated waters here, just even with the nature of my

questions. So for a little heads up to everybody, I don't know what I'm talking about. I'm just asking questions because I'm curious. But in your opinion, are we as a society over-diagnosing something like ADHD is my one question that I've had. Because I've had, at least in some cases, again, this is my anecdotal non-educated observation, that some things, you know, people might be diagnosed with ADHD when it's just they're you know well he won't sit still in class for eight hours a day it's like well what seven-year-old kid is design even design like is that is that really something abnormal or is is it our educational system or environment that we're expecting not right is a question a genuine question is somebody can prove to me no no seven-year-old male well female humans should be sitting in class all day and if they're kind of bouncy and jumping around that's abnormal human behavior i'm open to that being the case it just sometimes i'm like really do we need to medicalize

kids with some of this stuff i i don't know like it's a yeah genuine question and then i have a question about a potential conspiracy theory about money being wrapped up in all this but i'll save that for that's not a conspiracy theory. I mean, that's really the problem. I mean, again, I'm not a psychiatrist, but I can say as a father of five children and as somebody that would have... If I grew up now, I would 100% be diagnosed with ADHD because I couldn't sit still, stood up all the time, had a hard time. I don't look at you when you're teaching me something. I turn my head and listen. I'm a hearer, and teachers always thought I wasn't paying attention to them, and I classroom and we tell the children that they're

supposed to conform to this particular behavior. And if they can't conform to it, instead of saying this system doesn't work for every human, we say there's something broken with this child and we need to medicate them into compliance with our system. Right. And that's just a fact. There's a lot of people that are diagnosed with certain disorders or believe they have certain disorders when the real problem is they learn differently and they think differently and in a different environment that accounted for those differences, they would probably thrive. And so I think that's becoming less and less controversial as time goes along. But then on the other side of it, as you said, there's a huge industry here that makes its money off of making prescriptions. And we could go into all kinds of waters that

might get us in trouble about that right now, about surgical procedures that are being performed based on parents' feelings about children and all kinds of things like that that aren't necessarily based on science, but they're based on societal things. And that's a whole different topic. But you're right. Medication is not the first place to start with your child if their behavior is giving them trouble. Yeah. I mean, that's again, you said you're not a psychologist a few times.

I'm definitely not a psychologist and I'm not even a medical practitioner. So again, my questions are just observational. But yeah, it just, I don't know, like I, and more and more, maybe it's through, you know, some of the post COVID things that have come out or whatever. It's just, you start to look at kind of the medical industry. And I guess for me, having, I've lived outside of the United States and in the United Kingdom where, where it is a much more socialized medical health care system. And it was just different there.

Like it was almost hard to get the doctor to prescribe something. You go in with like an ear infection, and it was kind of like – we used to always laugh. You know, Calpol is their Tylenol in the UK, and it's like you give them Calpol for everything saying, you know what? Like it was really hard to even get like a prescription. If I brought my kids in and hey, they got an ear infection. Like, yeah, they do. It'll, you know, it's going to hear some pain, you know, whatever. But like it was like medicalized

and it was kind of last resort. But I'm thinking, wait a minute, the whole system's different there. It's not. And again, I don't, I don't want to pretend like I know all the ins and outs of capitalized medical, whatever, but, um, I don't know. It was just, it was just like different experience. And I'm like, well, these are medical professionals too. And they care for you, but it's just, they're very way slower at giving medicine. We're here. It's just like, gosh, it just seems like doctors for the most part would be just jumping at

any chance to kind of give a prescription that that's maybe an overstatement i might get some emails on this but i don't know um but at the end of the day i think we can all agree the best not they're not no medicalizing but let's not make this the first resort let's assume there's probably some underlying things causing um you know the response that that might probably should be dealt, you know, the response that, that might probably should be dealt with. You know, I think that was Bessel van der Kolk's, uh, point that people that are experiencing trauma and triggers and all these things in life, there's, there's usually almost always deep down things that need to be dealt with. And some of these symptoms, you know, um, would relieve themselves if it's dealt with. So, well, uh, Lee, I've, I've kept you, uh,

about an hour here, um, working. So you, well, uh, Lee, I've, I've kept you, uh, about an hour here. I'm working. So you, you have several books here. I've already mentioned them in the introduction that you're the most recent one is hope is the first dose would invite people to check that out. Where, where can people, uh, can they contact you or you, you mentioned a podcast, you have a website where all this stuff is listed, right? How can people find you? So my name, uh, W Lee Warren MD is my website,, wleewarrenmd.com and everything's there. Substack newsletter that goes all around the world every week called self brain surgery. And then the podcast is there and love to connect with new folks. It's been an honor to be with you today,

Preston. Thank you for coming on. I really appreciate it. This show is part of the Converge Podcast Network.