Well with Arielle Lorre - 333: An Exploration of Why We Dream and the Neuroscience Behind the Phenomenon with Brain Surgeon Dr. Rahul Jandial, M.D., Ph.D

Episode Date: July 17, 2024

Dr. Rahul Jandial, M.D., Ph.D., is a dual-trained brain surgeon and neuroscientist at City of Hope in Los Angeles, California, and international bestselling author with his books translated into over twenty languages. He joins the show for a second time to discuss his latest book, This is Why You Dream, and his fascinating insights into dreaming, informed by his research and experience as a brain, spine and spinal cord cancer surgeon. We explore the science and neuroscience of dreams, what meaning dreams have in our waking lives, how to think about our dreams, the difference between a dream state and meditative or psychedelic state and the intersection of religion and science. He explains why dreaming is like high intensity interval training for the brain, why our bodies actually need sleep, how our bodies and brains are governed by the earth’s rotation and so much more. Subscribe to Patreon for exclusive weekly content: patreon.com/ArielleLorreRead Dr. Jandial’s books: https://amzn.to/3VZ0ZULThis episode may contain paid endorsements and advertisements for products and services. Individuals on the show may have a direct, or indirect financial interest in products, or services referred to in this episode.Visit Cora.Life/BLONDE and use BLONDE for 20% offGo to koraorganics.com and use code BLONDE for 20% off your first purchase. Visit article.com/BLONDE for $50 off your first purchase of $100 or more. Sign up at ro.co/BLONDE to pay $99 for your first month—and $145 a month after that. Produced by Dear MediaSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

The following podcast is a dear media production. Welcome to the Blonde Files podcast. I'm your host, Ariel Lori, and I'm here to talk all things, wellness. From how to achieve optimal health and well-being to the best beauty tips and everything in between, no topic is off limits. I know there's so much information out there, so I'm bringing on expert guests and sharing my own experiences to help you sift through all the wellness stuff without the BS. Enjoy the show.

Hi, everybody. Welcome to the show. I have a great episode for you today. I have return guest Dr. Rahul Jondial. He was on for the first time, I believe, in February 2020, and it was an incredible episode. That time we were talking about his memoir, Life on a Knife's Edge, a Brain Surgeons, Reflections on Life, Loss, and Survival. Incredible book, by the way. And he's, he's, is also the author of Life Lessons from a Brain Surgeon, and most recently, this is why you dream what your sleeping brain reveals about your waking life, and that is what we are discussing today. So Dr. John D'all is a dual-trained brain surgeon and neuroscientist. As a surgeon, he provides complex surgical treatment to patients with cancer at City of Hope, and as a scientist, his lab investigates the biology of cancer spread. He has authored 10 books and over 100 academic articles on surgery, neuroscience, and cancer biology. So today,

we are talking about, of course, dreams. And this is a really fascinating conversation. I think what I like best about Dr. John Deal, of course, he's incredibly accomplished and smart, but he has this ability to talk about these kind of dense scientific topics in more of a narrative way. And I am just really interested in how his mind works. So we are talking about how his research and experience as a brain, spine, and spinal cord surgeon informed his research and insights into dreaming. We discussed the science and neuroscience of dreams, what meaning dreams have in our waking lives, if any. We talk about how to think about our dreams, the difference between a dream state and a meditative or a psychedelic-induced state. And we talk about the intersection of religion and science. This is

towards the end of the episode. And I actually thought that that was one of the most fascinating thing, how he draws upon his experience as a surgeon and his life experience dealing with people who are dying and also his knowledge of the brain. And he ties all of that together to contemplate these really complex topics like religion, God, spirituality, etc. So he also explains why dreaming is like high intensity interval training for the brain, why our bodies actually need sleep and why they don't need sleep, how our bodies and brains are governed by the Earth's rotation, so much more. It's such a great episode. Please enjoy Dr. Rahul Jondial. All right, welcome. Hi. I always think it's funny when I have a guest on and we're talking for like 20 minutes

before about all the deep life stuff and then suddenly we start rolling. But welcome. It's good to be back. Good to have you back. A lot has happened since you were here. last, which we've been talking about a little bit off mic. You have been traveling a lot. You are very much immersed in the literary world, right? As well as the neurosurgery, neuroscience world. So maybe why don't you just catch everybody up a little bit before we dive into everything about what you have been up to? Yeah, I've been living the dream. I still get to practice cancer surgery. And I want to say it that way because it's a privilege. It's patients come to me during a difficult time and they say, can you remove this cancer from my brain? So I still get to practice cancer surgery. And I

plan on doing that, at least for another 10 years, because the craft is just, it's getting into a rhythm with my hands, with the interactions with them. It's dynamic. It's changing the world of brain science as it intersects with cancer science and changing. And so then the thing I also love is thinking about neuroscience and brain science, it started as a way to help patients, but then there was so much there that I thought, wait a second, I don't only have to talk about diseases. So book one was, you know, life lessons from a brain surgeon. It was all the practical stuff, like smart drugs, dementia, you know, what kind of food to eat. I love that book. Yeah. You got me going into a very different direction because of a conversation we had. And I guess that's what we were talking about

before it was your vibe, the interaction with you, the questions you asked, the way you made me feel to where I could just be Rahul, not Dr. John Giel. That opened up a big world for me as we were talking earlier. The second book was written in the pandemic and that was sort of my personal struggles, life, trauma, death, belief. It's raw. And so a publisher said to me, my publisher in London said, we've been wanting somebody to write a book on the science and the neuroscience of dreams.

but we didn't really have an author who would know the science that have the backstory, have the vibe. Somebody could talk about erotic dreams or nightmares, but not necessarily do it from like a professor's point of view only. And I was like, okay, that's massive. And what I said to her was, I'm not sure I'll be able to, I mean, there's going to be a lot of gaps. There are going to be a lot of holes.

There is no dream science. There's no professor of dream science, a university of experts. Y, Z. And she said, exactly. So take the dots that are out there and you tell us your ideas, the same way you do as a scientist. You try to come up with ways that Mother Nature is working. And you propose that to your National Institute of Health. Tell us what's that known out there by dreaming, bring in imagination, bring in Aristotle. And I finished the sentence for us and write a love letter to dreams and dreaming. And she's like, yeah. And so that's what I've been doing the last two years. So we're talking now, but it's been in my mind driving the LA freeways for the last 18 months and just like listening to rap music.

I've been listening a lot. I don't know. I listened to a lot of future because. Last time it was 21 Savage. Oh, wait a second. So you remember that went in the intro. There's a sentence called A Lot. And my son was like, what's a sentence?

A lot is not a sentence. But I was like, no, it's that song by 21 Savage. This time it's been future. You know, I didn't grow up writing. I had to take remedial English when I went to birth. And then I started reading newspapers and I started listening to a lot of rap music and I thought the lyrics were poetic and I just started connecting a lot of these things. So this book, a lot of what I listened to because I'm thinking through the ideas, right? I'm on the LA freeways. I've got my playlist. The music is all around me. But the playlist is a lot of Atlanta rap. And specifically I like future baritone voice, a lot of deep beats. And it kind of like, like, lets me think. And more than that, it helps me get phrases. So I always talk about like beautiful phrases or beautiful sentences. And like with the rhythm of the, of the music, it sort of teaches

you, it informs me, instructs me like, don't just make long sentences, you know. And if you have a long sentence, come back with a little punchy one, much like the way rap is constructed with the hook and something longer in the middle. And that was, I got to tell you through the complexities of life and watching my sons grow up, be on the LA freeways, going between places, listening to the future, and thinking about dreams and dreaming was a life vest, you know, life rap for sure.

You're the perfect person to write about this because even your other books, you were mentioning it was more like, do this for that, the scientific language, but you're still able to write in a very narrative way where you feel like you're reading a story.

There's an origin story for that. Really? The first thing I ever wrote was for Vice. Oh. And we got into a little bit of, a bit of an argument. I was like, no, I want to write the title. And they're like, no, you write the essay. And they choose the title. I said, no, I insist. And it was like back and forth. That's the one that got me to a literary agent. But in the title was the first time I let someone die. And they're

like, okay. And that's the subtlety of language let someone die. So right away, I don't have to explain to you, we're not all trying to save lives. And I think that for this book and dreams and dreaming, I put in there several times, I wonder, could it be? Because I'm letting the reader know, I don't know either. And I'm looking at everything and I can't figure it out. So now I got to, I got to let you know that this is a thought in my mind to connect the dots. But your thoughts are welcome. Your conversation is welcome. Your exploration is welcome. I'm not the guy that showed up and said, hey, guess what? I figured out everything about dreams and dreaming. Like, That's not the vibe in this book at all, but it's all kinds of stuff I didn't anticipate and connections I didn't anticipate.

And a few things jumped off right away. It's like Aristotle over 2,000 years ago was talking about lucid dreaming. And now scientists are putting lucid dreamers and brain machines. I was like, that's crazy if I could connect that. Things like math rarely happens in dreams. Why? I know somebody's going to be like, I do math in my dreams. I get it.

Yeah, I did. I heard you talk about this before. It was when I was taking math. classes than I was dreaming about, so that may be a little bit different. And your dream is infinitely wild and I know mine are, but when you start looking at 10, 15, 20,000 dreams over one or 2,000 years, you start to see some patterns. And those patterns in my explanations, that's kind of what this book is about and this conversation is about. So thank you. Yes, I think, and I was saying this to you before we started recording too, that one of the fundamental parts of being a good

scientist is humility, right? Humility is at the core of science. And if somebody is saying, oh, I know everything, I have all of the answers, that's a little bit of a red flag. And so I really appreciate that about you. And I think that that makes this conversation even more interesting, because we all have our different thoughts about it too. I can be like, oh, I do dream about math, you know, and my dreams are uniquely mine. Your dreams are uniquely yours. And the listener has their own experience too. And then you can kind of weave that in with this conversation. Absolutely. And then they can walk away saying, wait a second, that conversation led to interesting thoughts that are personal to me. I wasn't given a recipe. I wasn't given a playbook.

Yeah. But I was given like an exploration from which I can have more understanding about this thing that I do one third of my life, about these feelings I have, the emotional residue I have sometimes in the morning. I had some raw dreams last night. I can't remember. why, but. Same. Yeah. You messed with me this morning, too, for like two hours. The emotional residue, right? That's interesting. So the publishers in London, they're like, everybody working on this book has been coming in, like, I'm dreaming a lot more. I'm remembering my dreams a lot more. Like, I was like, okay, wait a second. That's a rigorous group.

And it speaks to something like that the process of trying to remember our dreams can actually improve that recall. And that all of a sudden, you know what I said to me was, People who say journal your dreams, journal before you go to bed, journal when you wake up. Like there's some science to that. I don't have it all figured out. But like placebo where you believe in something, chemicals and electricity in your brain, it's not in the ether, but there's a metabolic, physiologic change that explains why belief in something, whether it's a sugar pill or anything else, can actually reduce pain, reduce headaches, can make you feel differently from a mental health. perspective. Similarly, recognizing that your brain is like on fire, whether you remember or not, that's a measurement, electrically, metabolically, that when you wake up and you try to consider

what's happened, not everybody, not every time, but a cluster of people like in the publishing house were like, wait a second, I wake up and I'm like filled with recall of dreams. So like this morning, because I knew we had this conversation or maybe we didn't or, you know, I was thinking about like what to wear or whatever it was. This morning was relevant to me. and the dreams last night weren't about talking or where we're at physically, but I just remember there was an emotional intensity to my dreams last night that persisted in the morning and I had to, I didn't try to, you know, before I would try to shake it off, like, until this book, everything was like,

all right, well, that was, that was wild, that was weird, try to shake it off. Now I'm in a different place because now I try to hold on. And I try to use that as a reminder to reflect upon all these processes in our brain in our mind that are happening without our intention. We don't ask to sleep. We don't ask to dream. And that they must serve a process. They must serve a process that is useful for us because sleep happens,

shuts us down, makes us lie down, exposes us to danger. Your brain is burning hot while you sleep. It's not a quiet time. So that's not my opinion. That's a measurement. Like electrodes on the surface of the scalp, fMRI machines. Okay, wait a second.

The dreaming brain's brain electricity is as wild as the electricity during the waking brain. So that's not a passive process, whether you remember it or not. There's something burning hot going on. It's sparking electricity. Neurotransmitters are going off. So now when I wake up in the morning and I remember a dream like or a feeling of a dream, I do the opposite. I don't try to forget about it.

That was irrelevant. Actually, it's like, wow. There was a little solar flare that is. escape from my dreaming brain. And maybe I should reflect on that, contemplate that a bit. I don't have a specific answer for each of it. Like, this dream means that. I don't think you can.

But it's made me really revisit the feelings I have as I fall asleep, called sleep entry, those 10, 15 minutes. And the feelings I have when I sort of indulge myself and wake up slowly. Like those two windows of time are very precious to me now. In 2024, we cannot be using generic feminine products anymore. I know that so many people have become more conscientious about this because not only are they not good for our bodies, but they're not good for the environment either. So it is time to make the switch to Cora. Quora makes comfortable and effective period care products with clean ingredients. Their pads and liners are made with a super

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because the dreaming brain is definitely subconscious meaning we're not conscious when we experience it experience it. But that doesn't mean all those neurons aren't firing. Like you're running from a wildebeest or moly mammoth in your dream, the neurons that are responsible for leg movement are also on fire. So it's a real thing that's happening. It's not just like in the mind. It's in the brain. The dreaming brain creates the emotions, the memories of experiences at a neuronal level. So your point about programming the subconscious, I like that a lot. I mean, I think that's more of a scientific way of thinking of it. I think of it as feeding your dream state, feeding your dreamscape.

And so he said, people are like, wait a second. He's a brain surgeon talking about feeding your dreamscape. Like, how do you get there? And what I would say is, here are a couple of quick ways how we get there. Salvador Dahlia's been talking about that, and Edison and Christopher Nolan Inception, sleep entry. The technical word is hypogic and hypnipompic, but sleep entry. How we get there now is, for me, how I get there.

get there because I'm skeptical. I want to know like how prove it right because there's too much stuff out there that's like study show so here's how we prove it here's how it was proven and convinced me as a better way of saying it that electrodes on the surface of our scalp record brain electricity the brain tissue generates electricity much like an electrical eel does those electrodes are just like an EKG on the surface of the heart it records the electrical activity on the surface of the heart that those brain waves, those patterns, think of them as, you know, an EKG has different patterns, like an arrhythmia or normal, like you have a lot of different brain waves. The 10, 15 minutes when you're drifting sleep entry, you have brain waves of the awake state

of the waking brain as well as the dreaming brain. So when I see that, then I say, okay, that's a unique time in our day. 24 hours our brain is awake. And that what I call these blurry liminal states, like there are periods. when we are both drifting off into sleep and dreaming, but still partially awake. And why that's interesting, and back to creativity, is the dreaming brain doesn't connect the dots in a firm way. It's more like designing a car, not like fixing a car. So there's something called divergent ideation. You have random associations. You have jumps of ideas, jumps of emotions.

So if you can have a bit of that more expansive thinking, out of the box thinking, but still be wake enough to remember it a little bit. There are devices in Silicon Valley and Dolly talked about it. People are trying to drift off and then wake up and write down what's going on. Drift off and wake up right at that moment and write down what's going on. So yeah, you can program your subconscious and you can actually drift a little bit into it, wake yourself up and write down what you're thinking. I'm not saying there's genius there.

I'm not saying that everything you write at that moment is going to be fantastic. But when that happens for me, I have a lot of bad ideas, but my good ideas also come from there. It's sort of an idea generator, if you will. And the same thing at sleep exit. If you don't check your phone, if you let that linger a bit, that blurry state, again, my ritual is, what am I thinking about this morning? Wow, that was a gnarly dream or a wild dream or emotional dream. Just give it a few moments.

Give it a few moments. Don't open my eyes and then reach from my phone, avoid Instagram, and then go to notes app and write down some stuff. And later in the day or tomorrow, yeah, it's not good. It's not like great stuff. But when I do have great ideas, it tends to come from those two windows, sleep entry and sleep exit. I wonder if there's any similarity, I guess back to the meditation piece, but the similarity

in those states to when you're doing certain types of meditation, I'm sure that the brain waves and the activity in the brain are different because meditation is maybe more of like a rested state without actually entering or exiting out of that sleep state where that creativity piece is coming in. But I know for myself, when I started TM years ago, like it was so profound for me because I felt like I really did kind of drift down into this transcendental state, not every time. Yeah, fair. But sometimes, and I would get that same kind of creativity coming to the surface. I mean, there's also a lot of noise, but you focus on this mantra and everything else kind of clears away. And then I just would get so inspired in those moments and some of it, to your point, was great,

some of it was terrible. And I love that. These things are unicorns and clouds. They're not meant to be just grabbed. But the fact that they exist even once for somebody or on occasion for somebody, what you're describing are universal phenomenon that have been described for thousands of years, and some people have discarded them, ridiculed them, other people, their lives have been transformed by them. And not only now can we add the neuroscience to them.

So specifically about your question about meditation, it's a great point you're raising because something just came out in the scientific American about advanced meditation, so long-term practitioners, maybe like yourself, that they can have this thing called ego dissolution. So I'm just going to get a little bit like into that. but I think your listeners will like it. Meditation, psychedelics, deep diving and holding your breath in certain patterns, and dreaming. Like, how does that look in the brain?

Because that was a question I wanted to ask, right? I went to Berkeley, so there were a lot of people on psychedelics there. The interesting thing is all of them can feel trippy or dreamy. But what's happening with dreams versus advanced meditation, as you're describing, is that there's this thing called the imagination network that's liberated and dreaming. Part of the way it works is you're fully inhabiting the moment. You are in the driver's seat of a car you can't control, but it's all happening to you. You're like dead center.

You are the actor. You are the director. You're fully inhabiting it. And what happens with psychedelics, advanced meditation, and those things, you actually have something called ego dissolution, your imagination network, technically your default mode network is dampened, allowing you to step away from fully inhabiting your life. So just stay with me. So in dreams, it feels trippy, but you're your dead center of what's going on. In meditation, psychedelics, certain patterns of breathing, you can have dream state insights, but what's going on in

the brain is very different. And I think that's what allows people to on psychedelics for like cancer treatment for people whose lives are transformed by its psychedelics done the right way, that they have the ability to actually disassociate from all the concerns and step back a bit to see their life from a different perspective and to gain a new perspective on their life. So I think there is potential there and psychedelics are being evaluated in cancer centers for treatment of existential crisis. Like how do I cope with the fact that I grew this thing that's eating me inside? And psychedelics, not every time, not for everyone in the right way, they can help with that.

So I think meditation, psychedelics is closer to a dissociative state where you have a new, different perspective on what's going on in your life. And dreams are a bit different where you're sort of fully inhabiting a wild experience you wouldn't have during the day because in the dreaming brain, the executive network that creates logic and math is dampened. So those are two different brain states. Both brain states are robust. There's nothing less. There's nothing quiet in the sense of like brain activity, but the experiences can overlap. So it's a little bit heavy neuroscience,

but it's a very important distinction because it's something we understand now that we didn't 10 years ago. All of the stuff feels dreaming, feels trippy, but the brain science is a bit different. And you've talked about how dreaming is kind of like high intensity interval training of the brain, right? It's stretching the confines. It's not just taking in the boring, mundane, monotonous day-to-day information and how that's kind of essential for our overall health and well-being. And we were talking a little bit before as well about how I've had so many experts on the show and there are so many people out there who say, sleep is the foundation of health and wellness because, that's when your body repairs. That's when this hormone does this and that hormone does this. And you are

saying, no, we sleep. It's the most important thing because we need to dream. So tell us about that. Yeah. It's a big statement. I'm going to own it. I'm going to rock it. It's not. I'm not saying they ain't right. I'm just saying it's being a bit over-presented. And I'll just take you through a conversation I had actually at a London pub with somebody. And the London pubs are different. They're like, they're sort of buttoned up and then they get to the pub and it's just like completely unleashed. And so you have to sort of like be ready for questions you were not expecting, right? And it's interesting. So, you know, so like sleep comes up.

And I said to somebody, they says, come on. I mean, dreams that they've got to be accidental. It's a glitch. It's interference. It's static. It's sort of a fundamental scientific question, right? Is this just like the noise of an engine? you know is this sort of like an irrelevant thing the brain does or not and i was like i was like

i got to really tackle this head on so i was it was like in conversation mode i couldn't say like study show because there are no studies i can prove that i couldn't say like you know in 1960s you know i just want i don't want to i didn't want to be that guy in a london pub i said okay so first of all let's check this out sleep it's not really for your body only i think a little bit of sleep is enough for our body. They're like, how do you know that? So look, I used to be a transplant surgeon. When we take a liver from one person to another, we don't really connect the nerves. Like, when you're sleeping, your thigh muscle and your liver and your kidney, they're good. They're good during the day. They're good while we sleep. Like, that's not where if somebody's

lying down and you look at the whole body and you zoom out and you look at it metabolically, like where's the glucose being used. Where's the electricity being sparked? You look at the whole body, Like day and night, yes, the gut, it changes a bit. Yes, muscles, it change a bit. But that's not why you need eight hours. I got a feeling a couple hours is good enough for that, right? But then you pan up to the skull, and it's burning hot with glucose usage. And it's like sparking electricity.

I mean, it's like fireworks are going on in there. So to me, from a common sense perspective, what makes us sleep? It's not the liver. because we transplant hearts and livers and kidneys and pancreas. Like clearly the brain makes us sleep. The brain wants to sleep and shuts the body down. Okay. So sleep is for the brain.

And what does the brain do when it gets us to sleep and lie down? It dreams. The most vibrant thing a sleeping brain does is dream. And what happens when you skip a day of sleep? Like I did quite a bit in surgical training, the next day, sleep pressure builds, throws you to the ground, right? And the dreaming process is more robust and earlier into sleep. And so when you look at those common sense things, sleep is for the brain.

And what does a sleeping brain do? Dream. And so my hunch is that the dreaming process, whether we remember it or not, is vibrant, it's active, and it's necessary. back to your point. Well, why is it necessary? Well, first, let's look at what it's doing. It's hyper-emotional. It's hyper-visual, hyper-imaginative, and not a lot of logic. And so I think what it does is it's high-intensity training for the brain in the sense that it keeps our creative abilities, it keeps our emotional capacity exercised a bit, available a bit, because the brain works with use it or lose it. And if we only use the parts of the brain needed to get by during the day, no matter how complex our day is so much of the brain or mind would wither. So I think it's this like robust fireworks that happens every night. So when we approach the day, the next, when we wake up, our full capacities are with us. So to me, just like if we don't stretch our arms and it becomes limited, if the brain didn't stretch itself in a cognitive, emotional, psychological, and

mental way every night, I think our daytime ability to deal with stress, adaptation, and new environments would be limited. So I think the dreaming brain is our ultimate evolutionary advantage. It keeps us creative in a world that's constantly changing, not just for the individual before our species. That's my big idea. I'm just listening to this from an audience perspective, and I know that there are probably people listening who go,

well, this is very compelling, but I don't dream. Or I don't remember my dreams. Everybody dreams, right? But people that don't remember them. What would you say to that? So again, he's about to drink his coffee, he's getting ready. I know. No, I love it because that's another London pub question.

That's a, you know, Dodger Stadium question. That's a, you know, Century City Mall question. Because it has to be that, right? It has to be a conversation just the way you're taking it. Because if we make dreams and dreaming only explicable to, like, academics, then it's like, wait a second. This is everybody's capacity. We can't just make this techie or geeky or wonky, right?

So that was another fundamental question. Wait a second. I don't remember my dreams. So if I don't remember my dreams, how can it be good for me? It's a massive question. So what I would say is we all remember one dream, the nightmare. So we can all agree we've had, I don't have to go around. I haven't bumped into somebody yet and said, I'm writing a book or thinking about dreams.

And they're like, what is a dream? Like it's an experience we've all had. Let's accept that. Then the question is, as we get older, dream recall can change. So if I don't remember my dream, how can it be useful? And so what I would say, the first thing I would say there is, whether you remember it or not, the electricity and the glucose usage is the same. Two people, you vividly remember your dreams.

We've got the surface electrodes, wild. I wake up and I don't remember anything. If you record me during the night, the brain is still just as wild. So I think we all undergo the dreaming process, the recall, is different between us and it can be induced and cultivated as we saw with the publishers as we work on it and the loss of dreams some people believe comes with Alzheimer's i refute that because i need more proof like if you have Alzheimer's and you don't remember you might just not remember the dream recall now just stay with me because i'm taking you through nightmares as kids and then adults who have

different recall and then people who have dementia and they say i don't know remember anything, let alone my dreams, but towards the end of life, like in my cancer patients and others, genre dreams, end of life dreams return. So people, even when they've had like a couple of decades, I've been like, I don't remember my dreams. They start to as they get to the end of life, whether they've chosen to end their cancer journey or just through age, they report a burst in dreams of reconciliation. They lean positive. I would think as much struggle as you're going through they're going to be negative dreams or nightmares. No. So dreams almost return as your shepherd or ambassador as you approach the end of life. So what I would say to people is just zoom back a little

bit. Let's not hold dreams to something we wouldn't waking life and follow the pattern what happens with kids with nightmares, preteens with erotic dreams, a lot of variability in dreaming in adult life, fading of dreams it appears, and then the return of dreams at the end of life. I think that's, I think that's romantic and I think there's evidence that suggest that when you look at the pattern. I love how much reverence you have for your cancer patients by the way.

Just the way that you talk about them. I know that you just kind of touched on it there but... They made me the man I am. Yeah. As much as my sons. And how strong they are. Oh yeah.

And that's what the last... And I just, just as a side riff on that, I was like, you show up every three months. Well, like tubes and bag. Not everybody, but some of them. Every three months. You don't know what the scan is going to show. Can you imagine?

You go in a scanner. And then you go to scanner on Monday. They're like, and you're going to see Dr. John Diel on Thursday. And they just get through those days, knowing that the answer is out there somewhere, whether their tumor has returned, shrunk, gone away. And they show up Thursday. Not everyone. Not every time.

But I would think like 90% would fall apart. And what I'm seeing is the majority they endure. they thrive. They are composed when they come in. So for me, being a cancer surgeon is inspiring. And I don't think the conversations I'm having now with you about dreams and dreaming would occur if I didn't have all those lessons of life about life from cancer patients, including end-of-life dreams. Like, what are you dreaming about?

Like, maybe that should be a vital sign when they come in and they see loved ones in their dreams or when they've decided to go toward hospice and they talk about their dreams. They lean, not every time, but they're surprisingly lean positive. I'm inspired by that. Yeah. I don't know how it is for you, but for me, finding effective skincare that is actually good for my body is so hard to find. I have found myself really overwhelmed by all of the clean choices and standards. But Cora Organics has made it super easy.

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So Roe's partner handles all of the insurance paperwork to help get medication covered. And if eligible for medication, patients have access to their provider on demand for any questions. You can sign up online from the comfort of your own home, which means no scheduling a doctor's appointment, no commute to the doctor. office and no waiting rooms. With Roe, the average weight loss is 15 to 20% in one year with healthy lifestyle changes. BMI and other eligibility criteria apply. Go to row.com slash blonde and sign up today and you will pay just $99 for your first month and $145 a month after that. Medication costs are separate. That's RO.co slash blonde. Again, row.com slash blonde. I guess I'm curious how much, I guess you can't quantify this, but how much waking life influences dreaming life?

Because you would think going through something like that, no matter what their attitude is, it would be so difficult to endure. So the fact that it leans positive is so interesting. And I know that going back historically, you've talked about how with the introduction of color TV, people started dreaming more in color, right? So there is evidence that the waking life does influence that. But what do you think that connection is? Again, if we zoom out, like this 24-hour brain is on the earth's rotation, as is all life, actually. What happens is your waking memories and imagination feed your dreaming imagination and memories. Like imagination and memory, actually, memories reconstructed.

It's not like it's a card you pull out. It's not like a picture on your phone. So there's this interplay waking brain, imagination and memory is always dancing, right? Dreaming brain, same thing. It's some things we remember and some things we completely fabricate imagination and memory. And then the question is, like, how much does that feed into each other? And what I would say is it depends. Like you said, color television popped up and there were more reports of color and dreams,

even though the world is in color. And so how to tease that out, the way I've come to understand it, is to think about it like in five ways. Okay. First thing is sometimes it's obvious. Like, you're going to give a speech and you have a dream about showing up naked in front of a podium. Like that's your waking anxiety feeding your dreaming anxiety, right? They're interconnected in a clear way. You don't have to interpret that.

Same thing about alarms not going off before an exam, right? So that needs no interpretation. heavy linkage between waking life and dream life. Similarly, in genre dreams like pregnancy or end of life, the dreams overlap quite a bit. You have a massive life event pregnancy, end of life, and it shows up in dreams quite a bit. The third one is junk dreams,

what I call like, you can have images, you can have different concepts, but unless they have a heavy emotional and visual stamp, to me, they're sort of just like, we don't remember a lot of our day activities, right? So similarly, and if you remember that the dreaming brain is hyper-emotional and hyper-visual, like the thoughts I had this morning, the dreams with an emotional stamp or a visual stamp that linger into the day, I think those are the ones worth exploring, like, how much of this is something my dream life made up, a dream life made up, or how much of this is something going on during

my waking life that I haven't really paid attention to? And that's where I would ask your listeners to consider is that your hyper-emotional brain can give you clues about things like divorce or trauma or depression that sometimes our waking brain does not recognize. Let me just dig into that little bit. Like you might be thinking, I'm coping well. But if you see nuance that nightmare, they show up more and more and more and more. But during the day, you're like, I'm fine. I would say that's something to pay attention to. new onset and progressive nightmares and adults because we usually don't have them.

Like that could be a warning sign that your dreaming brain is offering, that your waking brain has just not even looked at. Number two, in this one study, they asked people going through divorce, and when they had more reconciliation in their dream life, it was linked to them coping better with divorce. So I thought that was interesting. Then it's also symbolic. not going to be literal. Like some people who had PTSD from war when they were going through divorce, images of war

came back up. It wasn't always about divorce. So it's metaphorical. So if we remember hyper-emotional and symbolic and that those solar flares dreams, hyper-emotional, symbolic, visual, they might offer a clue to our life that we haven't paid attention to or haven't reflected upon. And to me, the fact that they're personalized, it's free, it's such a in the age of wellness as it should be, I just think it's a wonderful portal to our subconscious, as you said before, that has not been talked about and not been discussed. And I'm trying to add science to it so people can know, like, that's something they should look at.

I love the attitude of just curiosity because I think people's tendencies to ascribe meaning. And this means that I dreamt about a spider, which means whatever it is. And you're just more taking a step back and being open and curious and seeing what meaning, if any, you can derive or if there are any clues. Like I would imagine if you keep having recurring dreams about something, then that's maybe a clue as to what's going on in your waking life. And I would imagine also in our dreams were way less inhibited. That's the dreaming brain by design.

Yeah. And the insights it'll offer you are going to be more emotional. Interestingly, the emotional centers of the brain can achieve a top speed in our dreaming brain that we can't get to with our waking brain. And for people are like, well, emotions, how can they inform us? In patients who have injury to the emotional centers, they can't make any decisions. But patients who have injury to the front of lobe where the executive network is and they only have emotional centers left behind, they can still kind of function, not perfectly. But if you only want to have one reason or emotion, I would take emotion.

And what the gift of dreaming is, in a day, it kind of goes back and forth. It's like during the day, there's more executive function, but I'm excited and comforted by the fact that emotion and our subconscious will also have its day, if you will, while we dream at night. You mentioned earlier about the Earth's rotation, and you said that everything in life is governed by the rotation of the Earth, right, including our sleep, our circadian rhythms, all of that. Can you talk about that a little bit? The way I think about it is everything evolved on this gravity-based platform on Earth that's in rotation,

like tides and cells, they change, Venus fly traps, you know, they open and close. Humans were all on this rotation. And then the question becomes, is that built in or is it not built in? And the simple answer is there are a bunch of people went into caves for like six months, and they were still mostly on that rotation, right? You'd think like blackout shades for six months, and that's where travel works. works like. It'll put you on that rotation. You can, you know, jet lag is the adjustment to that, but you'll get, you'll get put on this daylight rotation, even when you're in a cave for six

months. So it's dependent on light, not so much melatonin, but more more light, but it governs everything. And so the reason why I find that fascinating is that as our brains grew from neurons to collections and dinosaurs had small brains and mammals and everything, you know, my pup to humans, it evolved on that platform. And I, in the biggest statement possible in that way is that if it needed to have a disinhibited time where the brain was going to be the creature, us were going to be at risk, that maybe the evolution was to lie down and to be disinhibited was safer under, under the cover of night. And that's why it tends to happen. Now, That's an idea. I might be completely wrong, but it's kind of an exploration or curiosity in the way that makes sense.

So to me, when I look at that, it's sort of like emotional, disinhibited brain needed for the global brain function. Let's rock that while at night in a cave hidden. During the day, more risk to predation, need to go out there and get sustenance and protection. Let's have more executive function. So that back and forth actually works like during the day, awake and outward focused, at night, a bit safer, more inward focused, our own mental workspace, our dreamscape. And that actually is at a brain scan level. Like, I want people to be like, wait a second, is you just making that up?

I was like, no. Brain scans while we're awake, show the executive network a collection of structures, not like one little spot. More, they're enhanced. It's never on off. They're liberated, if you will. They're dominant. They're alpha.

They're top. where when there is no need to focus outward, a different collection of structures takes over, called the default mode network or imagination network. And during dreaming and sleeping, they take the out for a dominant position. So this toggling between executive network dominant during the day, getting things done outward,

calculation, reason, and imagination dominant at night during dreaming, it seems like that's the perfect system for the most adaptive brain, and it follows sort of the laws and advantages of day and night cycle on the planet. That's a conversation. I'm curious, maybe this is a conversation for not on the podcast,

but I'm curious what your beliefs are, like about God, religion, science, how it intersects, if it intersects, knowing all of this. I'm sure it raises a lot of questions and ideas. Yeah, I'm happy to, you know, The concept of God spirituality is so powerful that when we stimulate the surface of the human brain, people will have visions of God, people will have reactivated nightmares,

and people will feel dissociative states floating above. It comes from a specific part of the brain, the human temporal lobe. Let me just dig into that little bit. Just walk me through this scenario. Where my ideas come from are these types of experiences. My belief, I've read all the good books, pieces. I'm open to it. I've been to many different sort of faith gatherings, whether they're in a building or outside. My sons, I expose them to people from around the world, and they've brought

people from around the world, all faiths. That said, then I've taken care of open thousands of skulls and taken care of that 10,000 patients and to care for them, I've got to be able to meet them where they want to be at their moment before surgery. So like all of that experience, open-mindedness, if you will. And then there's a moment that you can never forget. Somebody comes to you, there's a brain tumor in the left temporal lobe. It's kind of like deep to the cheek, you know, by deep to the sideburn on the left. Language is there. Language doesn't have a specific address like Elon Musk, Neurrelink. We know where movement is. It's like a little Lombard street. It's always the same place in the brain. The language is fuzzy.

So we numb up the scalp. We make an incision. They're under anesthesia. Drill off the bone like a little ice fishing. You make one hole and you run it. It's like lifting a cookie up. You don't just open the whole skull. You're trying to make the smallest portals to get to where you need to get.

Then the brain isn't there. It's covered by a sheath. And then it shimmers. Once you open the sheath, it's beautiful. It's white. It's not gray. It's like got these fine mesh of blood vessels.

It's stunning. Like there's a sense of awe and wonder right when you look at that. You're like, it takes your breath away. Still does before you get to the work at hand. There's still a moment I have like, so then because the brain itself doesn't feel pain, you can touch it, you can dissect it if the patient were to wake up. So we slowly wake them up. Anesthesiologist does.

The scalp is numb so they don't hurt from that. And then you have this little fountain pen with a little zap electricity and you zap on the surface. And what we're looking for is areas where you zap and they continue to. to talk. So they're asked to count one, two, three, four, five, six, seven, and you zap a certain area of the brain. If they keep talking, you put a white piece of confetti there, meaning I could dissect through that to get deeper and not hurt their language ability. If you stimulate and they go one, two, three, three, three, then you put a red confetti and so you map out the surface of the brain. sometimes when you, and this has been described since the 1950s, is sometimes when you tickled that area with a faint electricity, they'll say, as I mentioned the book, that's a nightmare I've had since I was a kid.

So you can activate a recurrent nightmare. It's always on the left temporal lobe, by the way. And then other people, if you look at all the records in neurosurgery since the 1950s, so that's why I try to pull everything in this book and in books in my thinking. in general, they'll say, you know, I feel like, I feel like I'm being touched by the hand of God. They'll say, you know, I see whoever's faith they have, they'll mention that. Whichever faith they have, I mean. And so when you look at that, the big question is, are you activating something that they learn?

Like you grew up Christian and then you tickle the surface of the brain and they have faith that's consistent in the way they were raised. and what I've always wanted to know, and I wrote about this, was in the Amazon where I go to South America and do surgery there, there are still tribes that have not been fully exposed to sort of the modern world. And I always thought, like, what if they had never known about Christ or Buddha or whatever your faith is, and you stimulated the brain of a person who had not heard about Christ or Buddha or whatever, and they had a thought of. about Christ, that would answer a massive question that God was built into the brain versus we learn about God. And when you tickle the brain, spiritual, emotional, dreamlike experiences tend to come from the human temporal lobe.

So I wrote about that in my last book. The publishers loved it. But that's how I approach my beliefs, my faith. On a more personal level, I'm super open-minded. That doesn't mean I'm gullible. I'm skeptical. but like, and my cancer patients again have taught me that. Like, in that moment, if they say a word that's coarse or even racist or if they have a belief that's like stifling, it's not really about me at that moment.

Like the 10 minutes before surgery, I'm talking to them. They want to hold hands. They want to pray. It's all about you. This is not a time to be judging you. I'm there for you. This arrangement is you've come to me for help. And the trust isn't just what I'm going to do.

with my hands inside your skull, it's also the judgment I'm going to make about should I do more or less inside your skull, maybe better to leave a little tumor behind and not injure your function. But also at the human level, I'm there for you. I'm your pilot. And if your airplane crashes, you know, I have the luxury and sometimes the regret that I will, I will bail out. I will parachute out. And so I used to tell my kids, I'm an expert at pulling up the nose on crashing airplanes. This cancer surgery for patients who are stage four cancer, there is no stage five. So in those moments when they know the finish line is near, and they're showing this like

determination and strength and style and panache and gravitas. Like I don't come in there narrow-minded about a word they may use, about a feeling they may share, about a slight they may have or feel. You know, like, I go in there, like, it's just all about you. And to do that, you have to be open-minded about faith because, you know, I used to say there's no atheist at the cancer center. You might be atheist at one point in your life. But when you're facing that moment, I haven't had, I'm not saying it's not possible, but I haven't had anybody go like, I'm good. I believe in science. Like in that Natsal Libre movie, but like that moment.

So people's faith and my faith and my beliefs, they're like dreams. They're accompanying me through my life. And so for those listeners, you're like, nah, there's no such thing as God. I was like, well, I respect that. But I haven't heard that five minutes before brain surgery. So that's my answer on my beliefs and faith. You're such an incredible storyteller and thinker. And that was really beautiful.

And thank you so much for coming back on. My pleasure. It's so great talking to you. Tell everybody where they can follow you, where they can get your book. This is why we dream. It's so good. We'll link it in the show notes too. I work at City of Hope Cancer Center and then otherwise on Amazon and other places.

But I love being on your show in particular because the conversation is one that is liberating to have. It's a different environment for me. It's not just in the medical space, and yet you always include and welcome my insights from my cancer surgery background. And I really appreciate you very much for doing that. Thank you so much. I hope you enjoyed that episode. And if you liked it, and if you like the show in general, please take a second to rate review and subscribe.

It goes a long way. And it's actually the best way to support the show. Also, if you want to see more about each episode, you can head over to The Blond Files podcast on Instagram. You can go to Arialore.com. And I'm always posting about each episode over on my personal page at Arial Lori. Please note that this episode may contain paid endorsements and advertisements for products and services. Individuals on the show may have a direct or indirect financial interest in products or services referred to in this episode.