I’m an anesthesiologist as an
anesthesiologist I have three tasks the
first is to put you to sleep the second
is to wake you back up and the third is
during all of that to make sure that you
don’t end up dead in the span of about
15 months three anesthesiologists that I
work with were found dead on the job the
first was taken call at the labor and
delivery floor a pregnant mom needed an
emergency c-section so the nurses
started paging the anesthesiologist
there was no response and eventually
they sent security to the on-call room
they started banging on the door and
there was no response they burst open
only to find my colleague laying face
down on the ground he had suffered a
massive stress-related stroke the second
was one of my colleagues who was taking
an overnight 27 hour long call it’s a
pretty standard call for us to call on a
Friday finished Saturday morning went
home and no one heard from him Saturday
no one heard from him Sunday no one
heard from him on Monday finally when a
family member
gained access to his apartment entered
the bedroom to find my colleague laying
dead in bed with a number of vials of
empty propofol at the bedside propofol
is a powerful anesthetic that’s used to
put people to sleep
the third was another anesthesiologist
he was taking call at our busy trauma
hospital there was an emergency that
came in overnight needed to come up to
the operating room so the nurses started
paging him so he could come set up the
operating room so it would be ready
there was no response
eventually they sent out a search party
to go look for him upon entering the
men’s locker room they found my
colleague unconscious with an IV in his
foot and a half empty syringe of
these three tragedies were a real
eye-opener for me
prior to this I wasn’t really aware of
the syndrome of burnout they made me
realize that the problems of anxiety
depression and substance abuse were
occupational hazards that affected my
field of medicine what was really
interesting also and surprising was that
none of my doctor friends were even
talking about this what was more
interesting was that I found a lot of
curiosity interest and support from my
friends working in the startup field in
cell in Silicon Valley
the high pressure field of startups and
venture capital in Silicon Valley had
seen its fair share of burnout in my
conversations about burnout with these
entrepreneurs three themes kept popping
up yoga meditation and psychedelics I
came to find that these three modalities
were being used by people in Silicon
Valley not only as rescue treatments but
also as performance enhancers now this
was all very surprising to me because in
all of my years of medical school
residency fellowship academic training
not once had I heard any mention of any
of these modalities that had been around
for thousands of years and I had not
seen them in a single one of my medical
textbooks so I decided that I was going
to use my unique background to get
answers to some of these questions on
the one hand I had all this theoretical
knowledge I knew how to read studies I
could analyze data I could identify bias
in the medical literature as well as the
news media and on the other hand I had a
lot of clinical experience now I knew
how the human body works when it’s awake
when it’s asleep and when it’s in
various states of consciousness I wanted
to draw on these polls of knowledge to
evaluate these seemingly skeptical
claims that yoga meditation and
psychedelics could help reduce burnout
and boost resilience
I started practicing yoga and meditation
several years ago I started with a
two-hour basics class that was part of a
two-week long intro program at a small
yoga studio near my apartment in New
York City
two hours turned into two weeks two
weeks turned into two months two months
turned into two years at the end of all
of that I decided I wanted to go deeper
into practice and I enrolled in a 200
hour yoga teacher training program I
finished that I decided I want to go
even deeper and I enrolled in a 500 hour
yoga teacher training program this was
at a former ashram located in the
Berkshire Mountains called the Coppola
Institute I have personal experience
both practicing as well as teaching yoga
and meditation for me yoga and
meditation have helped reduce my anxiety
have helped me balance my emotions and
have made me a happier person in
addition to my own experience I found
that there is a lot of medical evidence
to support the claims that yoga and
meditation can help reduce burnout and
boost resilience a 2016 study of 20
clinicians working in a stressful
surgical ICU showed that yoga and
meditation for eight weeks was able to
produce a 25% reduction in stress and
anxiety scores it also showed a 40
percent reduction in salivary
alpha-amylase levels salivary alpha
amylase is a surrogate marker in the
body for sympathetic activation a 2016
study used functional MRI scans to show
that meditation could improve regulation
of emotions and it worked at the
specific Network in the brain called a
default mode network furthermore it
showed that meditation could help lower
circulating levels of interleukin 6
interleukin 6 is a chemical in the body
that’s a marker for neurogenic
inflammation a 2015 study that was
published in JAMA showed in about 50
people that meditation is actually
better at improving sleep when you
compare that to putting people in a
formal education program teaching them
goods
habits specifically meditation was about
three times better we’re currently in
the midst of an opioid epidemic in this
country as an anesthesiologist and a
pain physician I know that many cases of
opioid substance abuse start in the
doctor’s office it’s when the doctor
prescribes a prescription of an opioid
narcotic like percocet or vicodin for a
simple case of low back pain
what about alternatives to opioids for
the treatment of low back pain well my
group looked into it we did a systematic
review and a meta-analysis to evaluate
whether yoga was could be a treatment
for low back pain and what we saw was
that yoga can produce about a forty to
almost sixty percent reduction in pain
symptoms in people suffering low back
pain finally a 2016 study published in
JAMA showed the results of about 350
people with low back pain what it showed
was that approximately 60% of people
that were being taught meditation could
help treat their low back pain this was
compared to only 40 percent of people
who are getting usual medical care
things like physical therapy and mostly
medications yoga is a low-impact
physical activity that’s vigorous enough
to increase your heart rate to give you
cardiovascular benefits and it’s
versatile enough to stretch open tight
muscles and fashio so that you can be
more mobile and more flexible it’s
really what you want out of a physical
activity it’s safe it’s effective and
it’s accessible now before I tell you
what meditation is let me tell you what
meditation is not meditation is not
about stopping your thoughts from
wandering meditation is not about
completely emptying emptying your mind
meditation is simply bringing your
attention to the present moment
meditation is about bringing awareness
to your thoughts to your emotions and to
for the past few years I’ve started to
teach our first-year incoming
anesthesiology residents at NYU how to
practice yoga and how to meditate and a
number of them have come back to me and
given me the feedback that they feel
that these practices have helped them
perform better in the operating room at
their jobs for them most likely yoga and
meditation are helping to reduce burnout
and boost resilience I’ve been lucky
enough to travel recently to cities such
as San Francisco Tulum Berlin and Black
Rock City it’s expanded my exposure in
interaction to people working in amazing
fields such as software AI artificial
intelligence electronic music
cryptocurrency it’s really opened my
horizons I would tell my stories and
give my lectures on burnout and
increasingly I was being met with these
unsolicited recommendations to look into
psychedelic therapy to friends that were
recommending that I look into these
psychedelic therapies based on their
personal experience I would always be
curious now I would ask them how would
you describe this psychedelic experience
they would use words like mystical
spiritual oceanic out-of-body
life-changing more than a few of them
told me this was the most life-changing
psychedelics put you in a non ordinary
state of consciousness to allow you to
have a life altering experience
anesthetics put you in a non ordinary
state of consciousness to allow you to
have life-saving surgery I set out to
use my background as a medical
researcher and as an anesthesiologist to
evaluate these seemingly skeptical
claims that psychedelics could help
plant based psychedelics have been
around for thousands of years at as a
part of holistic healing regimens in
several cultures they grow in many
aspects of the world and they’ve even
been used in Western psyche
when LSD was used as a part of
psychotherapy in the 1950s now all of
this was stopped and all medical
research as well were halted in the
1970s when these substances were
classified as drugs of abuse we’ve seen
a recent resurgence in their use and we
now have more modern clinical studies
that are using very careful experimental
design to evaluate their efficacy now my
interest was to set out to find if
psychedelics could help with anxiety
with depression and with substance abuse
these are all symptoms that share a lot
of commonalities with this syndrome of
burnout in 2016 roland griffiths
published a double-blind randomized
placebo-controlled trial of 50 depressed
patients
he showed that a single dose of
psilocybin was able to produce
improvements in both anxiety as well as
depression 80% of patients at 5 weeks
these effects were sustained as six
months later that year one of my
colleagues from NYU Steven Ross was able
to replicate these results he showed
that in depressed patients about he had
30 patients in this study they showed
that a single dose of psilocybin was
able to produce reductions in anxiety
and depression again in about 80% of
patients at 7 weeks these effects were
sustained at 6 months 20:17 Robyn
Carhartt published an open-label trial
of about 20 patients suffering from
treatment resistant depression treatment
resistant depression is a syndrome where
medications don’t work therapy doesn’t
work these patients have tried every
treatment out there and they’re at the
end of the treatment algorithm what they
showed in this study was that two doses
of psilocybin dosed one week apart were
able to produce significant improvements
in depression and again these effects
were sustained at six months now the
reason why I keep bringing up that these
effects were sustained as six months is
it’s an important point because it’s
very different than traditional
psychiatric depression anxiety treatment
right now where if you get put on a
medication and it’s working you’re
basically on that medication almost
forever in these experimental trials
we’re getting one or two doses of
medication and the effects were lasting
for several months without needing any
more medication so modern studies have
started to show that there is a role for
psychedelics in this symptom Sinha’s
syndrome of burnout which can be thought
of as mental illness
well what about psychedelics and their
role in mental wellness or boosting
resilience in 2017 Crain Minh showed
that psychedelics can produce
improvements in your mood that can make
you happier later that your Carhartt
showed that psychedelics can increase
associations between feelings of
connectedness the people around you or
better mental well-being
20:17 Sampedro showed that psychedelics
can improve your skills of mindfulness
it’s possible that they could make you a
better meditator now how does this all
work and I think that boils down to two
questions the first is how does
psychedelics work in your body the
second how does psychedelics work as a
therapy psychedelics work at the level
of your genes they have effects on your
DNA psychedelics work on your cells
specifically the work on neurons working
through the serotonin 5-htt to a
receptor finally psychedelics work on
various networks in the brain producing
changes in consciousness they’re able to
put you in what we call non-ordinary
states of consciousness psychedelics are
neurologically invasive substances and
for this reason they carry significant
risks risks such as putting you into a
potential psychosis and having
persistent hallucinations these risks
are not to be minimized psychedelics are
still in an early experimental stage
based on very preliminary studies when
you consider our Western medical model
in my opinion they’re not yet ready for
widespread clinical application until
some of these preliminary studies can be
now how do these work as a therapy
currently all research treatment
protocols are being overseen by trained
medical professionals it’s critical to
have a proper set which is the
psychological expectations proper
setting which is the physical
environment and the proper therapeutic
relationship between the clinician and
the patient the most important points to
drive home are these these substances
are natural these substances have been
around for thousands of years in many
places of the world they grow in the
wild there’s a growing body of
literature suggest that in certain
clinical cases they may actually be
effective despite all of that these can
be extremely powerful substances and
need to be treated with the utmost
respect and extreme caution to wrap up
there is evidence that these three
ancient and holistic modalities can and
may be used to help reduce burnout and
boost resilience when you’re on a flight
before takeoff the flight attendant
comes on and gives a safety debriefing
in the event of a drop in cabin pressure
oxygen masks may fall from the overhead
compartment please put on your own mask
before helping those around you now why
did they say this it’s because if you
pass out yourself you won’t be able to
help anyone else around you as
caregivers we know that the more tools
we have to heal ourselves the better off
we’ll be to be able to heal everyone
else thank you [Applause]
anesthesiologist I have three tasks the
first is to put you to sleep the second
is to wake you back up and the third is
during all of that to make sure that you
don’t end up dead in the span of about
15 months three anesthesiologists that I
work with were found dead on the job the
first was taken call at the labor and
delivery floor a pregnant mom needed an
emergency c-section so the nurses
started paging the anesthesiologist
there was no response and eventually
they sent security to the on-call room
they started banging on the door and
there was no response they burst open
only to find my colleague laying face
down on the ground he had suffered a
massive stress-related stroke the second
was one of my colleagues who was taking
an overnight 27 hour long call it’s a
pretty standard call for us to call on a
Friday finished Saturday morning went
home and no one heard from him Saturday
no one heard from him Sunday no one
heard from him on Monday finally when a
family member
gained access to his apartment entered
the bedroom to find my colleague laying
dead in bed with a number of vials of
empty propofol at the bedside propofol
is a powerful anesthetic that’s used to
put people to sleep
the third was another anesthesiologist
he was taking call at our busy trauma
hospital there was an emergency that
came in overnight needed to come up to
the operating room so the nurses started
paging him so he could come set up the
operating room so it would be ready
there was no response
eventually they sent out a search party
to go look for him upon entering the
men’s locker room they found my
colleague unconscious with an IV in his
foot and a half empty syringe of
these three tragedies were a real
eye-opener for me
prior to this I wasn’t really aware of
the syndrome of burnout they made me
realize that the problems of anxiety
depression and substance abuse were
occupational hazards that affected my
field of medicine what was really
interesting also and surprising was that
none of my doctor friends were even
talking about this what was more
interesting was that I found a lot of
curiosity interest and support from my
friends working in the startup field in
cell in Silicon Valley
the high pressure field of startups and
venture capital in Silicon Valley had
seen its fair share of burnout in my
conversations about burnout with these
entrepreneurs three themes kept popping
up yoga meditation and psychedelics I
came to find that these three modalities
were being used by people in Silicon
Valley not only as rescue treatments but
also as performance enhancers now this
was all very surprising to me because in
all of my years of medical school
residency fellowship academic training
not once had I heard any mention of any
of these modalities that had been around
for thousands of years and I had not
seen them in a single one of my medical
textbooks so I decided that I was going
to use my unique background to get
answers to some of these questions on
the one hand I had all this theoretical
knowledge I knew how to read studies I
could analyze data I could identify bias
in the medical literature as well as the
news media and on the other hand I had a
lot of clinical experience now I knew
how the human body works when it’s awake
when it’s asleep and when it’s in
various states of consciousness I wanted
to draw on these polls of knowledge to
evaluate these seemingly skeptical
claims that yoga meditation and
psychedelics could help reduce burnout
and boost resilience
I started practicing yoga and meditation
several years ago I started with a
two-hour basics class that was part of a
two-week long intro program at a small
yoga studio near my apartment in New
York City
two hours turned into two weeks two
weeks turned into two months two months
turned into two years at the end of all
of that I decided I wanted to go deeper
into practice and I enrolled in a 200
hour yoga teacher training program I
finished that I decided I want to go
even deeper and I enrolled in a 500 hour
yoga teacher training program this was
at a former ashram located in the
Berkshire Mountains called the Coppola
Institute I have personal experience
both practicing as well as teaching yoga
and meditation for me yoga and
meditation have helped reduce my anxiety
have helped me balance my emotions and
have made me a happier person in
addition to my own experience I found
that there is a lot of medical evidence
to support the claims that yoga and
meditation can help reduce burnout and
boost resilience a 2016 study of 20
clinicians working in a stressful
surgical ICU showed that yoga and
meditation for eight weeks was able to
produce a 25% reduction in stress and
anxiety scores it also showed a 40
percent reduction in salivary
alpha-amylase levels salivary alpha
amylase is a surrogate marker in the
body for sympathetic activation a 2016
study used functional MRI scans to show
that meditation could improve regulation
of emotions and it worked at the
specific Network in the brain called a
default mode network furthermore it
showed that meditation could help lower
circulating levels of interleukin 6
interleukin 6 is a chemical in the body
that’s a marker for neurogenic
inflammation a 2015 study that was
published in JAMA showed in about 50
people that meditation is actually
better at improving sleep when you
compare that to putting people in a
formal education program teaching them
goods
habits specifically meditation was about
three times better we’re currently in
the midst of an opioid epidemic in this
country as an anesthesiologist and a
pain physician I know that many cases of
opioid substance abuse start in the
doctor’s office it’s when the doctor
prescribes a prescription of an opioid
narcotic like percocet or vicodin for a
simple case of low back pain
what about alternatives to opioids for
the treatment of low back pain well my
group looked into it we did a systematic
review and a meta-analysis to evaluate
whether yoga was could be a treatment
for low back pain and what we saw was
that yoga can produce about a forty to
almost sixty percent reduction in pain
symptoms in people suffering low back
pain finally a 2016 study published in
JAMA showed the results of about 350
people with low back pain what it showed
was that approximately 60% of people
that were being taught meditation could
help treat their low back pain this was
compared to only 40 percent of people
who are getting usual medical care
things like physical therapy and mostly
medications yoga is a low-impact
physical activity that’s vigorous enough
to increase your heart rate to give you
cardiovascular benefits and it’s
versatile enough to stretch open tight
muscles and fashio so that you can be
more mobile and more flexible it’s
really what you want out of a physical
activity it’s safe it’s effective and
it’s accessible now before I tell you
what meditation is let me tell you what
meditation is not meditation is not
about stopping your thoughts from
wandering meditation is not about
completely emptying emptying your mind
meditation is simply bringing your
attention to the present moment
meditation is about bringing awareness
to your thoughts to your emotions and to
for the past few years I’ve started to
teach our first-year incoming
anesthesiology residents at NYU how to
practice yoga and how to meditate and a
number of them have come back to me and
given me the feedback that they feel
that these practices have helped them
perform better in the operating room at
their jobs for them most likely yoga and
meditation are helping to reduce burnout
and boost resilience I’ve been lucky
enough to travel recently to cities such
as San Francisco Tulum Berlin and Black
Rock City it’s expanded my exposure in
interaction to people working in amazing
fields such as software AI artificial
intelligence electronic music
cryptocurrency it’s really opened my
horizons I would tell my stories and
give my lectures on burnout and
increasingly I was being met with these
unsolicited recommendations to look into
psychedelic therapy to friends that were
recommending that I look into these
psychedelic therapies based on their
personal experience I would always be
curious now I would ask them how would
you describe this psychedelic experience
they would use words like mystical
spiritual oceanic out-of-body
life-changing more than a few of them
told me this was the most life-changing
psychedelics put you in a non ordinary
state of consciousness to allow you to
have a life altering experience
anesthetics put you in a non ordinary
state of consciousness to allow you to
have life-saving surgery I set out to
use my background as a medical
researcher and as an anesthesiologist to
evaluate these seemingly skeptical
claims that psychedelics could help
plant based psychedelics have been
around for thousands of years at as a
part of holistic healing regimens in
several cultures they grow in many
aspects of the world and they’ve even
been used in Western psyche
when LSD was used as a part of
psychotherapy in the 1950s now all of
this was stopped and all medical
research as well were halted in the
1970s when these substances were
classified as drugs of abuse we’ve seen
a recent resurgence in their use and we
now have more modern clinical studies
that are using very careful experimental
design to evaluate their efficacy now my
interest was to set out to find if
psychedelics could help with anxiety
with depression and with substance abuse
these are all symptoms that share a lot
of commonalities with this syndrome of
burnout in 2016 roland griffiths
published a double-blind randomized
placebo-controlled trial of 50 depressed
patients
he showed that a single dose of
psilocybin was able to produce
improvements in both anxiety as well as
depression 80% of patients at 5 weeks
these effects were sustained as six
months later that year one of my
colleagues from NYU Steven Ross was able
to replicate these results he showed
that in depressed patients about he had
30 patients in this study they showed
that a single dose of psilocybin was
able to produce reductions in anxiety
and depression again in about 80% of
patients at 7 weeks these effects were
sustained at 6 months 20:17 Robyn
Carhartt published an open-label trial
of about 20 patients suffering from
treatment resistant depression treatment
resistant depression is a syndrome where
medications don’t work therapy doesn’t
work these patients have tried every
treatment out there and they’re at the
end of the treatment algorithm what they
showed in this study was that two doses
of psilocybin dosed one week apart were
able to produce significant improvements
in depression and again these effects
were sustained at six months now the
reason why I keep bringing up that these
effects were sustained as six months is
it’s an important point because it’s
very different than traditional
psychiatric depression anxiety treatment
right now where if you get put on a
medication and it’s working you’re
basically on that medication almost
forever in these experimental trials
we’re getting one or two doses of
medication and the effects were lasting
for several months without needing any
more medication so modern studies have
started to show that there is a role for
psychedelics in this symptom Sinha’s
syndrome of burnout which can be thought
of as mental illness
well what about psychedelics and their
role in mental wellness or boosting
resilience in 2017 Crain Minh showed
that psychedelics can produce
improvements in your mood that can make
you happier later that your Carhartt
showed that psychedelics can increase
associations between feelings of
connectedness the people around you or
better mental well-being
20:17 Sampedro showed that psychedelics
can improve your skills of mindfulness
it’s possible that they could make you a
better meditator now how does this all
work and I think that boils down to two
questions the first is how does
psychedelics work in your body the
second how does psychedelics work as a
therapy psychedelics work at the level
of your genes they have effects on your
DNA psychedelics work on your cells
specifically the work on neurons working
through the serotonin 5-htt to a
receptor finally psychedelics work on
various networks in the brain producing
changes in consciousness they’re able to
put you in what we call non-ordinary
states of consciousness psychedelics are
neurologically invasive substances and
for this reason they carry significant
risks risks such as putting you into a
potential psychosis and having
persistent hallucinations these risks
are not to be minimized psychedelics are
still in an early experimental stage
based on very preliminary studies when
you consider our Western medical model
in my opinion they’re not yet ready for
widespread clinical application until
some of these preliminary studies can be
now how do these work as a therapy
currently all research treatment
protocols are being overseen by trained
medical professionals it’s critical to
have a proper set which is the
psychological expectations proper
setting which is the physical
environment and the proper therapeutic
relationship between the clinician and
the patient the most important points to
drive home are these these substances
are natural these substances have been
around for thousands of years in many
places of the world they grow in the
wild there’s a growing body of
literature suggest that in certain
clinical cases they may actually be
effective despite all of that these can
be extremely powerful substances and
need to be treated with the utmost
respect and extreme caution to wrap up
there is evidence that these three
ancient and holistic modalities can and
may be used to help reduce burnout and
boost resilience when you’re on a flight
before takeoff the flight attendant
comes on and gives a safety debriefing
in the event of a drop in cabin pressure
oxygen masks may fall from the overhead
compartment please put on your own mask
before helping those around you now why
did they say this it’s because if you
pass out yourself you won’t be able to
help anyone else around you as
caregivers we know that the more tools
we have to heal ourselves the better off
we’ll be to be able to heal everyone
else thank you [Applause]
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