WTF is Operator Syndrome? | Dr. Chris Frueh | Ep. 357 - The Team House

Episode Transcript
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Speaker 1 (00:02):
Special Operations, Cobert Ohs Spionage, The Team House with your hopes,
Jack Murphy and David Park.

Speaker 2 (00:22):
Everybody, Welcome to episode three fifty six of The Team Mouse.

Speaker 3 (00:25):
I'm Dave. This is Jack.

Speaker 2 (00:27):
Our guest tonight is doctor Chris free, the author of
The Operator Syndrome, which is I feel like a seminal book,
like it pulls in so many things that people are
ignoring now or they're getting misdiagnosed, or just kind of
lumped altogether.

Speaker 3 (00:44):
Thank you so much for joining us. It's really great
to have you.

Speaker 4 (00:47):
Oh well, thanks for having me. I'm excited to be here.

Speaker 2 (00:51):
So real quick, before we go into your origin story
and your can you just give us a real quick
teaser on what operator syndrome is?

Speaker 3 (01:00):
Yeah?

Speaker 4 (01:00):
Sure, So.

Speaker 3 (01:01):
Operator syndrome is not a diagnosis per se, but think
of it as a framework for understanding the very complicated
and interrelated injuries and impairments that develop over time during
the career for many high risk professionals. So obviously operators

(01:22):
for military special operator operations are an extreme end of that.
The framework is relevant for first responders, firefighters, law enforcement,
for soldiers from other parts of the combat arms. Quite
a bit of my work has been with paramilitary intelligence

(01:46):
adjacent operators, and so the concept is that these professions
involve an enormous amount of physiological strain on the human body,
and we call that alostatic load. So that static or
physiological strain affects all of the physiological systems in the
human body nervous system, endocrine system, respiratory system, metabolic system,

(02:10):
muscular skeletal et cetera. And we have failed, in my opinion,
we have failed, you know, generations of soldiers and first
responders now by over relying on the diagnosis post traumatic
stress disorder. So we've used for decades now, we've used

(02:32):
PTSD as the easy button. And when we do that
to a hyper risk professional, we're saying, oh, all of
your problems that you think you have all fit into
one bucket. We call it PTSD, and we only treat
that with two issues to treatments, psychotherapy and a bucket
full of psychiatric medications. And so the concept of operator

(02:54):
syndrome is that that is that that's a fail and
that we need to be looking at brain health, traumatic
brain injuries, hormonal dysregulation, sleep dysregulation, sleep apnea, chronic joint pain,
chronic headaches, cognitive problems that develop over time, and yes,
some psychological issues anger, depression, general anxiety, addiction, and even

(03:19):
a little PTSD. Although let me say this, what I
don't see and the guys I work with and the
gals I work with, I don't see the fury activity
or the avoidance of triggers that are.

Speaker 4 (03:32):
Associated with PTSD.

Speaker 3 (03:34):
So for myself, I don't really although I'm a so
called PTSD expert. According to some people, I don't see
the I don't see it. That's not the problem. It's interesting. Yeah,
I don't want to derail.

Speaker 2 (03:48):
But about the postmatic stress stuff, I'll talk about that later.

Speaker 3 (03:52):
But first off, please tell us your origin story. Where
did you grow up? How did you get into medicine? Oh? Okay, well,
so I grew up in a lot of different places.
My dad was a physician. He joined he commissioned in
the Air Force in the early sixties, so he was
a Vietnam He became a veteran in Vietnam, a veteran

(04:14):
of the Vietnam War.

Speaker 4 (04:16):
A few years later.

Speaker 3 (04:18):
As a physician, we lived all over I think of
the Midwest is primarily my home.

Speaker 4 (04:23):
Although I was born in New York City.

Speaker 3 (04:26):
I went to high school in Missouri, Wisconsin, Michigan. I
did my graduate training in Ohio, and then I got
a PhD in clinical psychology in South Florida, Tampa, Florida.
And that was the kind of the beginning of my
journey of my career working with veterans and service members.

Speaker 2 (04:49):
So can what like around what year was that, and
then like what was your initial impressions of veterans at
that time, and then how if that changed over the years,
how did it change?

Speaker 3 (05:02):
Yeah, yeah, okay, Well, let me go back to my childhood.
So I was I was probably about five years old
when my father was served in Vietnam, and I think
that was sixty eight, sixty seven sixty eight. My great
grandfather who lived until who died when I was fourteen,

(05:25):
so I knew him very well. My great grandfather was
a veteran of the Spanish American War and he fought
at the Battle of San Juan Hill.

Speaker 4 (05:33):
So from both my.

Speaker 3 (05:34):
Father and my great grandfather, I developed a sense of,
you know, what it meant to serve, what it meant
to be a soldier, and as well as that there
is a cost associated with that that endures for years
after the war and for many people, many soldiers, and
that was kind of my why for why I wanted

(05:56):
to be a psychologist. So I went to graduate school,
started in nineteen eighty seven, graduated in nineteen ninety two.
And to put a little that into a little bit
of context, the diagnosis of PTSD was added in nineteen
eighty was added to the psychiatric nomenclature in nineteen eighty.
So when I started graduate school and was already thinking

(06:18):
about my dissertation with PTSD, it was a new diagnosis.
It only been.

Speaker 4 (06:23):
Officially books for about seven years.

Speaker 2 (06:26):
Was prior to PTSD was shell shock like was it
a diagnosable thing or was it just like parlance battle fatigue?

Speaker 4 (06:35):
Yeah, I think it was parlance.

Speaker 3 (06:36):
And I don't you know, I wasn't practicing prior to
nineteen eighty, so I don't really know how it was
handled in terms of like VA coding or insurance.

Speaker 4 (06:49):
Billing and those sorts of things.

Speaker 3 (06:51):
But we can trace it all the way back to
the Civil War, and in the years after the Civil War,
there was a syndrome that was described described by a
doctor named DaCosta. It became known as either a soldier's
heart or Dacosta's syndrome kind of interchangeably, and the idea,
the concept of it was where Civil war soldiers were

(07:13):
going in to see doctors post war and they were
describing cardiac problems for which there was no path of
physiological basis that could be identified, and guys were dropping
dead of cardiac problems.

Speaker 4 (07:28):
They were just.

Speaker 3 (07:29):
Describing shortness of breath, tightening chests. Guess what, that's probably
panic disorders. And so that was the very beginning of
really modern medicine, going wait a minute, there might be
something going on here.

Speaker 4 (07:45):
With regard to post war experiences.

Speaker 3 (07:49):
In World War One, a different, different term kind of
came out of that.

Speaker 4 (07:55):
Shell shock.

Speaker 3 (07:56):
The concept of shell shock at the time was a
veryalogical and it was the idea that soldiers on the
front lines were exposed to these bombardments of artillery, so
flashing blinding lights, loud booms, vibrations of the earth, and
they were needing to be pulled off the line. And

(08:17):
then actually they were generally sending them back to Britain,
or at least the Western Allies were sending them back
to Britain dressed homes.

Speaker 4 (08:25):
And it became known as shell shock.

Speaker 3 (08:27):
And it was thought of at the time as being
a neurological condition, and then it was promptly forgotten when
the war was over. There's some really classic writings of
some of the neurologists at the time who laid out
a research agenda for how we could understand this better.
But with the war over, nobody followed up on it

(08:47):
until we got to World War Two. In World War
two we came up with a different conceptualization of it.
So in World War Two we called it combat fatigue,
and the concept was soldiers over time would just get fatigued,
and in a sense, they normalized it as a normal reaction,

(09:09):
not an extreme reaction. It's just, you know, you can
only spend so many days at the front line in
combat and then we've got to pull you off. Now,
what they didn't do, they didn't send people to far
away rest homes for six months or a year. They
pulled They pulled soldiers back from the front lines just
a few miles where they would be in a camp

(09:31):
in a tent with a cot, warm, dry, reasonably good food,
and just three to five days with nothing to do
other than to rest and sleep. But then they would
be sent back to their units, and the concept of
that was actually turned out to be very effective from
the from the perspective of war fighting, we had very

(09:54):
few site We had very few psychiatric casualties during World
War tw using this concept of giving soldiers rest periodically. Now,
if we carry that forward to the combat fatigue concept
to Vietnam, that had implications for how we fought that war.

(10:15):
So we created the US military created the de ROS system.
DeRos is an acronym for date of expected return from overseas,
So it was a one year tour of duty. You
were if you were in the army, well, Marines are tougher,
so they had to do thirteen months. But if you
were an army it was twelve months, Marines thirteen months,

(10:35):
but you knew when you were coming home, if you lived,
if you survived, and if you weren't injured to the
point of needing to be medevact out of country.

Speaker 4 (10:43):
The idea was any.

Speaker 3 (10:45):
Soldier could go and fight for a year knowing that
on this date they were going to be they were done.
And so that was a strategy that the military used
to mitigate psychiatric casualties. And they included R and R
for so many soldiers got R and R midway or
part way through their year, like a Hawaiian vacation or

(11:07):
a trip to Japan or the Philippines. It's fascinating.

Speaker 2 (11:12):
And then you know because shell shock almost did you
read this story about the marine unit, the artillery unit
in Syria, They fired off so many rounds that guys
when they came home, we're.

Speaker 3 (11:24):
Seeing ghosts, thinking demons were after them. Like it was yeah, yep, yes,
And so I think where you're going with that is
they got it right. Yeah, they actually got it more
right than not. And we have spent now one hundred
years where we went off in a different direction, really

(11:46):
a very Freudian direction. The concept of trauma is very Freudian,
and I'm not a Freudian. It doesn't mean that that
trauma doesn't have a conditioning effect or a condition to
reaction to traumatic experiences.

Speaker 4 (12:02):
I do believe that.

Speaker 3 (12:03):
But we really pulled way back and we went very
psychological with our concepts here, and we left neurology out
of the picture, we left brain health out of the picture,
and we turned it all into the psychological thing.

Speaker 4 (12:21):
And all of our treatments focus on.

Speaker 3 (12:22):
The psychology of responding to trauma experience, and part of
the problem there is everybody responds differently. There's genetic differences,
there's upbringing differences, there's training differences. We know that soldiers
who are really well trained and are surrounded by tight

(12:43):
you know, spree to core within their units. That that
right there is a huge protective factor for any kind
of psychological or psychiatric reaction during the war, during the deployment,
as well as after words. So we we've actually lost
a lot of the good common sense that we used

(13:03):
to have in medicine one hundred years ago, and hopefully
we're bringing our way back around to get to picking
up where we left off from twenty seven.

Speaker 2 (13:13):
Yeah, when you mentioned PTSD, it reminded me of an
article I had read before the global were on terror,
and it was it was a medical study that they
had checked the brains of people who had made it
through SFA, especially force assessment selection, that they had a

(13:34):
higher or lower amount of some neuropeptide.

Speaker 3 (13:36):
I don't remember the specifics now, but.

Speaker 2 (13:39):
They said that basically it created sort of like this
teflon layer where they didn't like revivify memories. They didn't
you know, when something happened. It just kind of was gone.
And so there was this idea that these guys would
have a lower incident of post traumatic stress. But then
after the GWATT, it left me wondering, you know, watch

(14:03):
all this post aumatic stress. But you know, you're saying
that it's not just that. You know, there's a combination
of all these things.

Speaker 4 (14:10):
It's not it's not just that.

Speaker 3 (14:12):
I mean, let's go to the extreme nature of what
it means to train to be an operator or anything
adjacent to that. It involves an enormous amount of physicality, rucking, lifting, running, combatives,
jumping out of airplanes, repelling, maybe diving, tactical driving.

Speaker 4 (14:36):
So these are all things that are.

Speaker 3 (14:38):
Not easy on the body. Then you add on top
of that the sleep deprivation, which is both necessary for
training and combat. I mean, it's an inherent part of it,
but it's also part of the selection, an assessment strategies
of youah, you got to go, you got to stay
awake for five days, and we're going to see if
you can do that and keep functioning part of the selection.

(15:02):
Then you have the blast exposures, and I think blast
exposures are the signature injury of global war on terror.
We haven't admitted that, but I think I think we are.
If we get right, we're going to come around to
that understanding. Training with with with demolitions, with shoulder fire rockets,

(15:23):
breaching sniper rifles, even handguns involved microblasts. And now we
know for about eight years now, nine years now, we've
we've we've we have some inkling of what blasts do
to the brain, which is very different from anything we've
ever understood before, and it's a different type of injury

(15:46):
than an impact impact force is. So blasts have a
shearing effect through the body and what we what was
what was revealed in a study published in twenty sixteen,
is that the sheer aring effects leave the glial cells
in the nervous system scarred. So each neuron in our system,

(16:07):
those are the messenger cells, has about ten glile cells
as its support network. They hold the neurons in place,
they protect them, they insulate them, they take out the toxins,
and they get damaged from blast exposures. So you get
this scarring pattern in the brains. It's very different from

(16:29):
the amyloid plaques, the tauel proteins that can develop and
build up after an accumulation of impact force blows to
the head.

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Speaker 3 (18:22):
So, you know, and that's like you said, we're just now.

Speaker 2 (18:26):
Starting to understand lassgers, or at least understand the effect
that they've had.

Speaker 3 (18:30):
That's very new.

Speaker 2 (18:32):
And like, has the VA or a lot of other
organizations caught up with that or is everything still just
post traumatic stress?

Speaker 3 (18:43):
Well, so I'm not in the VA right right, I
don't know exactly what happens in the VA, but I
talked to a lot of people who either work there
or veterans like yourself who may have tried to use
the VA. VA has for since the night teen eighties,
has invested heavily in PTSD treatment programs. There are there's

(19:08):
a network called the National Centers for PTSD, and there's
seven or eight of them around the country in the VA.
They're funded by Congress, so they have separate funding. And
so we've built a huge industry in the VA around PTSD.
And the people that run these centers, that run these networks,

(19:31):
many of them are scientists, clinical scientists, and so when
you look at even NIH funding, NIH grant panels often
have many VA investigators on there. When you look at
the journals, the medical journals, the psychology journals related to trauma,
many of them are led by VA employees. So the

(19:55):
VA is a very very powerful force of for supporting
the construct of PTSD and the treatment for it. And
they've been very influential on DoD and every other part
of our Western mental health systems. Law enforcement, firefighters when

(20:15):
they have trouble, they get if they're having difficulties, they
often are almost immediately diagnosed with PTSD. And so maybe
rephrase your question again. So we've kind of gotten away
far away from where we were in nineteen seventeen. We

(20:39):
know TBI is a problem for soldiers, we know it,
know it, but we don't really act on that knowledge
very efficiently. You go out of here TB and PDSD
clumped together as if they're the same thing, right, they're similar,
we can't tell them a part.

Speaker 2 (20:55):
Do you think do you think that one of the
reasons it like TV isn't in blast exposure, isn't as
recognized it because they don't really know what to.

Speaker 3 (21:06):
Do about it right now. Maybe in part we don't
understand it very well. It's hard to evaluate in a
truly objective fashion. I mean, I can talk to you
in half an hour, I can figure out if you
probably have TBI, but I would be asking questions that
other doctors might not ask. And in terms of like

(21:28):
doing an MRI and cognitive performance testing and getting that
kind of data, that's both expensive and complicated and highly
imperfect because an MRI doesn't necessarily show us brain damage,
especially at the cellular level. So when we talk about
the TAUL proteins or the glial cell scarring associated with

(21:51):
chronic traumatic encephalopathy or what's now been called interface astral
glial scarring. The only way to really know that and
look at that as post mortem. So we have to
wait till somebody's dead before we could actually go into
their brain at the level of that pathologists do. So

(22:12):
we are hampered by ignorance, we are hampered by a
lack of really good.

Speaker 4 (22:17):
Technology to really explain things.

Speaker 3 (22:21):
We're also hampered by what I'll call referred to as
a little bit of a deep state in the VA system.
So when the Global War on Terror started twenty almost
twenty five years ago, the VA system was what it
was and hasn't really evolved much since everybody who had
the power, who had the empires, who had the clinics

(22:43):
and the centers and the research funding, they weren't immediately,
they weren't changing directions or switching lanes very rapidly, if
at all. And so I think the problem we have
today is and PTSD is the number one injury that
you see, may be careful of that. It's one of

(23:04):
the top injuries that you see in VA disability claims.
So it's been so deeply ingrained and codified in the
VA's policies, in the clinicians and even in the veterans
and the patients. It's a term that gets, you know,
that gets thrown about and used widely. Could we do better, Absolutely,

(23:26):
we absolutely can do better. And where is the VA changing?
I'm not sure but I do know they have five
polytrauma centers what they call polytrauma Centers, and one of
those centers I think is soon going to incorporate the
word or the phrase operator syndrome into the name of

(23:47):
their program. And they're certainly using the concept, the construct
and the framework and what they're doing. Now that's fantastic.

Speaker 2 (23:54):
Yeah, when we get further on, I want you to
like kind of give the give us more on the
VA because you mentioned some really interesting things in your book,
But so you start out your focus on post traumatic
stress when it's relatively new, and really, what did people
know about the postmatic stress from the movies in the
seventies and eight isn't even up till today, is that

(24:14):
somebody has flashbacks. They think that, you know, Charlie's in
the wire and Huey's openside and they kill everybody in
the office.

Speaker 3 (24:21):
Right Yeah, Yeah, and really interesting question that we can
wonder about here. Did Hollywood create the PTSC that we
have today? Did all those movies in the seventies that
used flashbacks as a plot device, did that create what

(24:46):
we now have as a symptom of PTSD. I have
never had a patient, even in my years at the
PTSD clinics who really had what you what you often
saw in the movies where through flashback that involved them
acting as if they were back in that scenario. And

(25:09):
an interesting study that was done probably fifteen or twenty
years ago by the Brits. We got some of the
great research happening with veterans as comes out of Britain.
And what these guys did was they got all of that.
They got the medical records from the Boer War fought
at the very end of the nineteenth century, early twentieth century,

(25:31):
so they got the military records of British soldiers who
fought in South Africa and they went through them just qualitatively,
reading through them looking for symptoms of PTSD. And they
found a lot of symptoms of PTSD, but notably, there
was one thing they didn't find any reports of in
the medical records, and that was flashbacks. They didn't find

(25:56):
any evidence of people describing these dissociative episodes where they
thought they were reliving or re back in, you know,
in a moment of combat and acting accordingly.

Speaker 4 (26:07):
They didn't find it. That may just be a modern invention.

Speaker 3 (26:11):
Yeah, thank you all.

Speaker 2 (26:12):
Yeah, And it's interesting because uh, like people, they're still
very influenced by that idea today.

Speaker 3 (26:19):
I remember when the.

Speaker 2 (26:21):
Whole I don't know, maybe during Trump's first term, maybe
I don't remember, maybe it was Obama, but you know,
there was a school shooting and there was the armament
about like arming veterans, you know, to guard schools, and
you know, a couple of people that I knew in
New York were like, no, they can't do that because
the veterans might have postraumatic stress and I'll shoot all
the kids.

Speaker 3 (26:40):
It's like, that's not how it works at all. No,
that's a you know, that's a sad well, that's a
sad uh outcome of the of the fact that half
of all veterans of the guy, it's probably more than
half now are are rated disabled by the VA for PTSD.

(27:05):
If anybody who served in a war zone, that's the
diagnosis that they can very easily get, and it does.
It is compensable. The problem there is what kind of
message does that send us with society. We have a
whole society who's now walking around with this wrongful notion

(27:28):
in their heads that soldiers, the soldiers who deployed to
war are broken, damaged, likely to snap, risky, dangerous, and
we don't think of them as likely to be good fathers, good,
good husbands, good members of a community, good, good workers,

(27:51):
good spouses, And nothing can be further from the truth
if we look at the data, But most people just
go with the stereotypes. One thing that I that really
disturbs me, and I see this a lot nowadays is divorces.
A mother going through a divorce with somebody who's formerly

(28:14):
you know, an operator or another high risk professional often
will report to the court, to the judge that their
husband is a risk, is dangerous and they're afraid of
them because of PTSD, and judges seem to look at
that and go, okay, yep, that makes sense. So maybe
there's a restraining order, Maybe visits with children only happen

(28:36):
on a very limited basis with supervision.

Speaker 4 (28:40):
And I just I can't even begin.

Speaker 6 (28:41):
To to extol the tragedy of of veteran and responder
fathers who are losing enormously in their divorce, divorced settlements
and custody settlements because of some wrong, wrong full.

Speaker 3 (29:02):
Myths or beliefs about PTSD and how their service, how
their work may have affected them.

Speaker 2 (29:08):
Yeah, and you know, and like we're trying to normalize
the idea of postraumatic stress operators and drone you know,
blast exposure things like that. But what veteran is going
to come forward, what male veteran is going to come
forward when that's a looming possibility. It's like red flag laws,
you know, it's like red flag laws. And what veteran

(29:28):
is going to like, say they have postraumatic stress or
anything else going on, if they might not ever be
able to own a weapon.

Speaker 3 (29:37):
Again, that's right, that's right. So I have a good
friend who is a DEA agent and he's in his
early fifties. He actually spent five years as a DEA
agent in Afghanistan, running and gunning with drug interdictions, functioning
very much like an operator. Never mind, not to mention

(29:58):
what he does in the US. And part of his
story is a few years ago he raised his hand
and said I'm not doing well and I need help.
And he was one of the senior He wasn't the sack,
but he was one of the senior agents in his
regional office, and leadership there took his gun away from him,
they put him on a desk, and he was told

(30:19):
almost right off the bat by somebody in HR that
he certainly, probably almost certainly had PTSD and they were
going to refer him for PTSD treatment, which they did,
and he went along with it, you know, he was
trying to be a good team player. He went along
with it for several months, and what he found was
the diagnosis didn't make sense to him, the treatment didn't

(30:42):
make any.

Speaker 4 (30:42):
Sense to him, and he just stuck it out.

Speaker 3 (30:46):
He went through the motions and about a year ago
he read the Operators Syndrome book and I actually met
him at an event and we became friends since then.
And that's part of his story is he modeled for
the younger guys in his region in his office that hey,
it's you know, it's okay to say you need some help.

(31:07):
And then he was punished for it, right, and so
you know, he got slapped pretty significantly. For about two
years now, he used the Operator Syndrome framework and he
got some of the right treatments for himself, and he's
now back functioning, operating again. He's back at the full
duty that he wants. But that is such a common experience.

(31:30):
And I'll even give you another example, probably about ten
years ago, about ten years ago, there were some of
the psychologists who who were with Naval Special Warfare out
on the East coast. One was the lead, you know,
they were leaders that some of the teams out there,
including Development Group, and they had operators, they had cels

(31:53):
and EOD technicians who they realized weren't going to talk
to them because they didn't want to get pulled off
of potential deployments. And so for a while there they
were referring them my way, and you know, I'm not
in the military, I'm not in the VA, I'm not
in any of the command structures. So that was there

(32:16):
was there thinking, hey, talk to this guy. He might
be able to help, and he's not going to Nothing
is going to be put into your official records. So
you know, if I so to this point today, I've
probably worked individually with six hundred, six hundred and fifty
operatives over the last twelve years or so. Most more

(32:39):
than half of that has been entirely pro bono. The
other half of it are less than half of it
has been through work I've done for some attorneys working
with private defense contractors who needed to be evaluated for
treatments and.

Speaker 4 (32:54):
For insurance claims.

Speaker 3 (32:55):
So I was able to take advantage of that to
do full evaluations using the operators your room framework.

Speaker 2 (33:02):
So let's so you start out your Did you say
your graduate thesis was on postraumatic stress or yes?

Speaker 4 (33:11):
Okay, yeah, it was my dissertation, your.

Speaker 2 (33:13):
Dissertation, all right, So yeah, you have to forget the
uneducated amongst us who don't know the difference. But so
your dissertation is on postmatic stress, and so what was
what was post traumatic stress at that time?

Speaker 3 (33:29):
What did you learn? What did you discover? Well, I
don't want to bore the world with my dissertation because
that's that was not it was not a.

Speaker 4 (33:40):
Terribly important study.

Speaker 3 (33:41):
But maybe the question you're asking is from today, was
PTSD different at that time in the nineteen eighties early nineties,
And the answer is that it was different. We change
the DSM every ten to fifteen years. We are currently
using the fifth edition of the DSM, and I'm sorry

(34:04):
I should say what the DSM is. DSM is the
Diagnostic and Statistical Manual.

Speaker 4 (34:09):
For Psychiatric Illnesses.

Speaker 3 (34:11):
So it's put out it's a book that is created
and put out by the American Psychiatric Association, and it's
a catalog of all the psychiatric diagnoses that we recognize,
and it says what their symptoms are and some other
information about it. So PTSD was added to the DSM
in nineteen eighty for the third edition. The fourth edition

(34:36):
came out in ninety four, and the fifth edition came
out in twenty thirteen, and each of those two times
there's been significant additions or changes to the definition, And
I think this is important. This is actually an important
question that you've asked. The original definition of PTSD was

(34:57):
fairly simple and straightforward. It involved a trauma that was
considered to be quote outside the range of normal usual
human experience, such as combat, such as being sexually assaulted,
and it was primarily all the symptoms were around the
concept of fear, fear reactivity, and avoidance of things that

(35:20):
might stimulate or trigger that fear. It got watered down
a little bit in in nineteen ninety four they took
out some of the wording about outside the range of
human experience, so now it's just a traumatic experience that

(35:41):
involved the sense of fear, helplessness, or horror.

Speaker 4 (35:44):
At the time. In twenty thirteen they took even that out, So.

Speaker 3 (35:51):
Our current definition, while it involves, you know, you have
to have trauma to have post trauma stress. The definition
of trauma is very nebulous and it really left open
to the interpretation of the individual. VA took it one
step forward in twenty ten. They actually passed the lots

(36:14):
in the federal registry that a veteran meets the criteria
for PTSD. For the trauma part of PTSD if the
veteran ever set foot in a war zone during their
military career, doesn't say anything about what they do, what
they did, what they saw, what they experienced. Just merely

(36:36):
being there for a day or maybe even less than
a day, just merely having been there counts as the
criterion a trauma.

Speaker 4 (36:47):
For the diagnosis.

Speaker 3 (36:50):
We could go off, you guys know this, We could
go off on a whole conversation about society and how
everything now has become defined as stressful or traumatic.

Speaker 5 (37:01):
I mean, I imagine some of that is also a reaction
to the huge number of veteran suicides that VA was
getting a lot of bad press for at the.

Speaker 3 (37:10):
Time and hiding for a while. Yeah, and by the way,
they still are. They've not brought that those numbers down
at all. Yeah, those numbers they have stayed the same
no matter what they've done. And I mean, we are
in a society now where trauma seems to be political
currency or social currency. Students, college students will proudly tell

(37:35):
you they have PTSD and the childhood of trauma. Now,
sometimes I don't, you know, I don't go digging or exploring,
but I have certainly found many examples where somebody has
described trauma and when they describe it, you have a
little bit of a.

Speaker 4 (37:55):
Sounds stressful, It doesn't sound traumatic.

Speaker 3 (37:57):
Though, So I think we've changed the threshold of what
trauma is.

Speaker 4 (38:03):
That's one thing. The other thing we.

Speaker 3 (38:05):
Did in twenty thirteen with the revised diagnosis of PTSD
is we added a lot of symptoms in there related
to general anxiety and depression. And if you take the
questionnaire that's most commonly used, it's called a PTSD checklist.
Everybody uses it. It's a one page, simple checklist form. You

(38:28):
could give that to anybody who does not have a
traumatic history at all, but if they have depression or anxiety,
they're going to score as if they have high levels
of PTSD. So we've turned it into a diagnosis that
really doesn't have any sensitivity to separate one patient from another.

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Speaker 2 (41:19):
Yeah, it's uh, it's interesting, but I think it's like
you say, it's sort of these this opening up of
society so that everybody's lived experience is as equal to.

Speaker 3 (41:34):
The next person's lived experience.

Speaker 2 (41:36):
And you know, if somebody yelling at me in the
street is traumatic, then who's to say.

Speaker 3 (41:43):
It's not if I say it is, right.

Speaker 2 (41:47):
So, as you were, like, you know, as the GAT
was progressing and you were in this field, what were
some of the things that you were seeing that would
eventually lead you to to the operator the Operator Center.

Speaker 3 (42:05):
Well, so the story is pretty organic. I left VA
in two thousand and six, so that was just as
we were starting to get the veterans from the GAT,
the first sort of wave of them coming into the VA.
So I left just as we were starting to get
GWAT veterans coming in, so I didn't clinically, I didn't

(42:29):
have a whole lot of experience with them. In About
six years later, I was working in.

Speaker 4 (42:38):
Houston, Texas.

Speaker 3 (42:40):
Actually, I had my job here at the University of
Hawaii and I had a job at Baylor College of Medicine,
So I was commuting every month, spending a week in Houston,
and there's a small foundation that had just started up there.
They had been started by a former Naval officer and
a recently separated Navy seal who had been together and

(43:02):
they had been kind of there the night that Extortion
seventeen went down, and they were helping identify bodies and
things like that.

Speaker 4 (43:10):
I think they kind of had a bond.

Speaker 3 (43:12):
So they started this small foundation that in Houston, which
was at the time initially it was really just it
was like a happy hour thing, you know, every two weeks,
all of the soft community in the city of Houston
were invited to come together for this. And it wasn't
just Navy, it was Army, Marines, Air Force. They had

(43:34):
a lot of guys from the intelligence world, including at
least one guy who'd been on the bin Laden Task
Force for many years, and it was really just intended
to be a chance to get guys together just to
kind of hang out and connect with each other and
maybe make some job connections, employment connections and that kind
of thing. And early on when they invited me to

(43:59):
start at ten their meetings, what happened was a lot
of guys would come up to me, you know, kind
of one on one privately, ask if they could talk,
and then we'd set that up and I would do that,
you know, separately, and the typical complaint that I would
that I would hear would be go something like this, Doc,

(44:20):
I don't know what's wrong with me, but I don't
feel like I used to feel. I don't force or
perform like I used to. I'm tired, I'm apathetic, I
don't want to work out, I don't really have much
interest in sex. My girlfriend's beautiful, but just not that interested.
Trouble concentrating, trouble motivating, not sleeping. And I assumed I

(44:45):
did what psychologists did then and do still today. I
assumed it was PTSD initially until I started talking with
these guys and getting to know them, and at some level,
you know, within probably the first month or two, a
couple of months really realize this isn't PTSD, this is
something different here. So traumatic brain injury with depression were

(45:08):
kind of the two next big hypotheses. But did some stuff,
some trial and error stuff that kind of shocked me,
including we were getting blood panels and the testosterone levels
that came back were really love hadn't did not expect
that at all. Why does this thirty seven year old

(45:30):
former Navy seal, who looks healthy, who looks well, who
looks big and muscular, why does he have the same testosterone.

Speaker 4 (45:38):
Level of an eighty year old man.

Speaker 3 (45:42):
Sleep studies they kept coming back with sleep apnia, which
didn't make any sense to me either. Why do these
these thirty late thirties, early forty guys.

Speaker 4 (45:52):
Why are they having sleep apnia? That didn't compute for me.

Speaker 3 (45:58):
Also, through my research program, I had a ticket and
all you could scan at the Baylor College of Medicine
Brain Neuroimaging Center. So I was taking all of my
research subjects from the hospital. We're getting their brain scanned.
So let's try this with some of these operators. We
put them through the same protocol and working with the

(46:20):
neurologist friend of mine, looking at them. What his reaction
was was, well, these it all.

Speaker 4 (46:27):
I told him, these are men. He didn't know what
he was looking at, not really, so these are men.

Speaker 3 (46:31):
And he looked at him and he's just like, so,
these look like relatively healthy brains, no lesions, no tumors,
no great big white matter spots, relatively healthy brains for
an eighty year old man. He thought he was looking
at elderly brains because of the ventricle atrophy. So now

(46:54):
it's like, holy shit, And I wasn't you know, these
guys were not describing the index events of head injuries.
They weren't. None of them were diagnosed with traumatic brain injury.
None of them had any history being blown up like
in an ied explosion, so they didn't. None of them

(47:15):
were even had even been evaluated for a TBI.

Speaker 4 (47:19):
And so that became part of what we were doing.
And then the more we the more, you know, the.

Speaker 3 (47:24):
More I talk with these guys, and then their friends
and then their friends, it was a snowball thing that happened.

Speaker 4 (47:31):
All just had the same pattern over and over again.

Speaker 3 (47:34):
Every single guy had evidence of TBI, evidence of lotustosterone
and other hormonal dysregulation, insomnia, sleep, apnea, chronic pain, chronic headaches,
cognitive impairments, and then of course social impairments that you
know that all bleeds out into your into your family life,

(47:54):
your marital life, your work, other aspects of your world.
And that's when I started in my own thoughts thinking,
this is a syndrome. This is not a simple one diagnosis.
These all go together, and when we go well, why
does somebody have why would a man thirty seven year

(48:16):
old seal have low testosterone? And then you go through well,
why wouldn't he have low testosterone? And it's probably multiple factors.
The brain injury, So the pituitary is the master land
that's in the brain. The high op tempo of never

(48:37):
taking a knee, of going going, going, never quit, you
come back from deployment, you start training, you go through
those intense training evolutions. So there isn't a time There
just isn't time for those court for the cortisol and
other stress hormones to normalize.

Speaker 5 (48:51):
Hasn't it also been linked to like sleep deprivation and
poor diet stress, The burns out the deference.

Speaker 3 (48:58):
Right, so TBI sleep deprivation, sleep problems, that high op tempo,
poor diet, alcohol, abuse, chronic pain, so all these things
go together and teasing them out. Well, what percentage is
related to blasts versus a high opt tempo?

Speaker 4 (49:18):
I don't know.

Speaker 3 (49:19):
I don't know that we're ever going to know that
in me and at least for right now, it doesn't matter.
We gotta we got to jump on this this body,
this body of injuries and impairments and treat it now
because guys are you know, they're hurting. Uh, They're losing
the good things in their life, their marriages, their jobs,
and we we we we do have a very serious

(49:40):
suicide rate in all of the.

Speaker 4 (49:44):
High profession high risk professionals of Chris.

Speaker 2 (49:48):
Where does the sleep app being come from, because that's
not something you think of, how a relatively fit guy
having totally and I don't know, I don't know the
answer to that, is it is a from Does it
come from some aspect of the TBI. Does it come
from some aspect of neck and head, you know, muscular.

Speaker 3 (50:09):
Injuries in this area. Is it something that builds up
over time when you're just not sleeping and not getting
enough quality sleep? So I'm gonna just like I'm ignorant,
I don't know the answer to your question. Yeah, I
don't know that anybody does.

Speaker 2 (50:25):
So how were you How were you putting together this
framework as you were capturing it? Because in your book,
like there are I don't remember how many chapters, but
there were like twelve to fifteen chapters of like different things.

Speaker 3 (50:40):
How are you compiling that? Yeah? You know, early on,
I wrote up a document for myself. It was just
kind of notes, and then I thought, you know what,
I need to something to educate and share information with
the guys I'm talking to in their spouse. So I

(51:02):
took that document and I gave it a title. I
titled it the Operator's Sleep Manual. No operator wants to
talk about mental health, and I don't blame them, So
let's talk about sleep. And when you put everything it
takes to sleep better, you're really taking care of everything.

Speaker 4 (51:20):
So that was the hook that was sleep.

Speaker 5 (51:22):
And the wormy gets them as they call it, like,
what is it like performance enhancement or something like that,
that we're evaluating you and to improve your performance and
they can get guys into the clinic for that.

Speaker 3 (51:34):
Yeah, that's exactly right. You want to perform better in sleep,
you got to do these things.

Speaker 7 (51:39):
Yeah.

Speaker 4 (51:39):
Yeah, And as.

Speaker 3 (51:41):
I was learning. I just that document was a living document.
So it kept getting longer, it kept getting having things
added to it. And at some point in twenty eighteen
or nineteen, with some colleagues, we took that document and
we turned it into a paper that we submitted to
Medical Journal and it was probably and so that was

(52:01):
that's the twenty twenty medical paper titled Operator Syndrome. And
just for your readers, anybody can find that online if
you just Google or search, do a search for operator
Syndrome Medical paper. It should come right up.

Speaker 4 (52:13):
It'll be a PDF. You can print it off.

Speaker 3 (52:16):
It's actually pretty easy to understand because it was written
initially as a as a document to help educate operators
and their spouses. Now, Chris, you start running in.

Speaker 2 (52:27):
First off, you talked about the VA earlier, and one
thing you mentioned in your book was you know is
like I didn't know that the VA research in order
to be a researcher you had to be a VA employee,
like they don't take research from anyplace else. But you
also ran into people who were like no, like uh

(52:47):
soft guys like we don't like don't make them prema donnas,
like social justice demands that they don't get any special attention,
like people were trying to shut you down, right.

Speaker 3 (52:59):
Yeah, yeah, well.

Speaker 4 (53:02):
Maybe some people trying to shut me down.

Speaker 3 (53:04):
I certainly have been on the receiving end of some
you know, smarrows here and there. The VA does not,
I mean, some of the people from the VA PTSD world,
I would say, really don't want to hear this. One
of the leaders in the VA said to me in
a meeting, she said, well, this is all kind of

(53:26):
silly because their problems are really PTSD and I will
I said, well, what do you base that on? She goes, well,
they all have very high scores on the PCL checklist. Okay,
so now we go down to this. We go down
this little rabbit hole of PTSD. Checklist measures a lot
of things, it's not very specific to PTSD. Also asked
her about her about her data. Where you get these

(53:48):
one hundred and fifty operators you say you have, Well,
they come to our clinic. Okay, how do you know
their operators? Oh? Well, they self identify. Do you know
what brand? No, we don't have that. Do you know
what kind of units? No, we don't have that.

Speaker 4 (54:03):
Do you have anything on their deployments.

Speaker 3 (54:05):
No, we don't have. So all she had is people
saying that they had been an operator without any other details,
and she didn't soon understand why that might be a
problem or a concern. And I said, well, you know,
most of the guys I talked to an interview and
talk to you very deeply at length, don't report these
symptoms of these very specific symptoms of PTSD. And a

(54:28):
response to that was she just kind of smile, goes, Yeah,
that's denial.

Speaker 4 (54:31):
They're all in denial.

Speaker 3 (54:33):
Wow. And so it's a no when situation with somebody
like that, you either endorse all the symptoms and you
have PTSD, or you don't endorse the symptoms and then
you're in denial.

Speaker 4 (54:44):
And you have PTSD. Right, So, no matter what, you're
going to have it.

Speaker 3 (54:50):
So there's a little bit of that. We were trying
to get get a program funded at Houston Methodist Hospital
some years ago and a large site visitor team came
out and met with us. There were I think six
or seven of them. This was the Marcus, the Marcus
Brain Health folks. And in working with the Green Beret

(55:17):
who was the veterans point person for this group, I'd
been in calms with him for probably about six months
by this time, and I thought we were going to
be funded.

Speaker 4 (55:27):
I thought this was almost more of a formality.

Speaker 3 (55:30):
And it came out and the guy, the neurologist, and
they're also named Jim Kelly, who was the leader of
the team. In the first five minutes, literally the very
beginning of the day. We had a whole day and
an evening blocked out to spend with them, and as
we were going through our sort of our opening introductions,
when he realized that we were only proposing to treat

(55:53):
operators in our program, he said, Nope, I won't approve that.
And he didn't stand up and leave at that point,
but mentally he did. He didn't participate in the discussions
or the meetings the rest of the time. In fact,
when we met with the hospital, the hospital, the CEO
of the hospital later that day, he sat in this

(56:15):
nice mahogany walled office and pretended to fall asleep during
that meeting. What he said was, we're not going to
do this. We're not going to fund this. It's not right,
it's not fair. Operators have already been treated special their
whole careers, and we're going to treat everybody we have socially,
just to give the same treatment available to anybody. And

(56:37):
his own point person, the green beret sitting at the table,
said to him, wait, hold on, we're talking here about
a group of operators as a group of people who
have unique injuries, unique experiences, unique exposures. So the idea,
I mean, he laid out what I had already given
to him, which is, it's not about doing something special

(57:01):
for somebody special special. It's about giving every patient the
treatment they need to be well and healthy. And for
somebody whose job took them to very specific certain types
of of experiences that would reduce produce injuries, we have
a we have a responsibility as a nation, as a

(57:21):
society to give those individuals the treatments that they need.

Speaker 4 (57:27):
That did not fly.

Speaker 3 (57:28):
He was not persuaded by that, So that didn't so
we didn't get the funding for that that It just
just died right there.

Speaker 4 (57:34):
In that moment.

Speaker 3 (57:36):
And it's sad too, because.

Speaker 2 (57:39):
Just like in the military, things that you know, soft
gets that the rest of the army does and or
the rest of the military doesn't.

Speaker 3 (57:46):
Eventually, you know, trickle down, trickle down, That's true, that's right.

Speaker 2 (57:52):
So so had this gotten off the round with you know,
with the operators, then it would have become a platform
for you know, those infantry units that were out there
hooking and jabbing all the time. And I see what
you're saying though, also that you know, with with operators,
you know, or soft guys. You you, you know what

(58:13):
that group is, right, you know what they've been through.

Speaker 3 (58:17):
With everybody else in the military.

Speaker 2 (58:19):
There there are infantry guys and marines who were out there,
like in it, right.

Speaker 3 (58:24):
Slugging away.

Speaker 2 (58:26):
But with this really broad, expansive thing of post traumatic stress,
suddenly you guys get flooded with you know, people who
spent their time, you know, behind the wire the whole time.

Speaker 3 (58:37):
Right, And so you're exactly right about that, and so
that that becomes you know, that's that's also a real
problem for the va IS, most clinicians, most people in
civilian society don't understand that. When you think of the
Department of Defense and the different branches, there are people
there are soldiers who are in the combat arms, and

(59:00):
then there are soldiers who are who do all the
other things, very important things, critical things, But that doesn't
mean they're being shot at or shooting at enemy, and
we really have. I mean, I don't know the exact proportion,
but I think it's about a third of soldiers or
in the combat arms, and about two thirds are in

(59:21):
play these very important support roles for those of the
combat arms. And we never talked about that the difference there,
never even heard about it. When I worked at the VA,
I came to realize it myself because I read a
lot and I talk to a lot of people. But
I don't think your average VA clinician really has that awareness, right,

(59:42):
And so when they get a patient who comes in
and says, Doc, oh I have PTSD, and yeah, I
served in Iraq for a year, there isn't an understanding.

Speaker 4 (59:52):
They even can't even picture what was in I Rock.

Speaker 3 (59:55):
They don't know what the bases or the fobs or
the different regions were about the We don't know that
if this person was a mechanic, they were likely to
be doing certain things that would be very different from
somebody who was infantry.

Speaker 4 (01:00:09):
And of course even.

Speaker 3 (01:00:10):
There, you know, we know that some of those mechanics
did end up at it remote fobs, maybe stationed there
or moving around and rotating. So those mechanics also may
have experienced quite a bit of indirect fire or whatever,
and so they may themselves be different from others who

(01:00:32):
are not in the combat arms. We're just not We
just haven't done a very sensible job of training medical clinicians.

Speaker 4 (01:00:43):
Right on these nuances.

Speaker 2 (01:00:45):
Well, and you know, and it's like you say, like
with them opening up the definition of post traumatic stress
and what trauma is. I mean, I'm sure somebody who
is in one firefight one time at their base or
got rocketed, and you know, maybe somebody who was heard
or whatever, I'm sure that was traumatic for them, right,
no question. But then but then to take that and

(01:01:08):
then to try to compare that to like you say,
the allostatic load that people who were doing it over
and over and over every night.

Speaker 3 (01:01:17):
You know, it's so you know where you like, you have.

Speaker 2 (01:01:21):
To draw a line somewhere when you're starting out a
pilot program like this.

Speaker 4 (01:01:24):
Yeah, yeah, yeah, that's right.

Speaker 3 (01:01:27):
Here's another here's another excerluience that happened kind of along
these lines. So it isn't just the VA, and it
isn't just the PTSD industry, folks. It's also I think
officers in some corners of SOCOM so I had heard
for a number of years from people who who you know,

(01:01:49):
were a little bit on the inside, that the generals
and admirals at SOCOM really didn't want to hear about
operator syndrome. They weren't curious. It wasn't something they wanted
to know about. I presented last year to a civilian
foundation or to a foundation not active military, and in

(01:02:13):
the room in the audience was a was a recently
retired admiral and I say recent last five years retired
admiral who had more than one star, and he stood
up after my short presentation and he said, I don't
like this. I haven't read your book, but your ideas

(01:02:35):
seemed very dangerous.

Speaker 4 (01:02:36):
And he was in part talking about.

Speaker 3 (01:02:38):
Things he'd been thinking and hearing for several years because
he referenced the medical paper, but he essentially said, you know,
shame on you. These ideas are dangerous. They're going to
hurt recruitment and it sends the wrong message about you know,
operators and who they are and what they are. The
very next person to stay to stand up in that

(01:03:01):
room was I think she was a social worker from
the Warrior of Care coalition, and she completely pushed back
on him. She says, sir, you know, I got to disagree.
We use this, it's relevant, it resonates, and it has
been what we've used successfully to get so many guys
to engage in various treatments that they need. And so

(01:03:23):
by labeling it as a dangerous idea or a dangerous
concept and just saying we're going to ignore it and
not not even engage in the conversation, he's going to
be really harmful to, you know, to so many people.

Speaker 5 (01:03:38):
I think the military has been very I was just
I'll politely say, they've been very slow to recognize traumatic
brain injury. And you know this part is I would
speculate that it may be because they're concerned about personnel
issues that they'll have to take people off of their
positions to be treated and maybe discharged out of the military.

(01:04:00):
Like I spoke to a senior he was a senior
leader in Delta Force where they started putting the sensors
on their bodies, you know, to measure blast over pressure.
And he made he wasn't in denial about it. He's like, yes,
this is a real thing, it's a real issue. But
his point was, if we're gonna avoid blast over pressure.

(01:04:21):
It becomes that we can't do our job from riding
on helicopters, shooting guns, explosive breaches, all of these things.

Speaker 3 (01:04:30):
Well, we have to stipulate, of course, that we are
not going to stop training. We have to do those things.
Those those are you can't. You can't you don't have
special operations. You don't have soldiers if you don't train.
So there's no part of me saying we need to
stop training. And I'm not even saying we need to
train lasts or differently. I don't know.

Speaker 4 (01:04:52):
That's not my area of expertise.

Speaker 3 (01:04:54):
There probably are ways in which we could train smarter
people will find smart people will find oh yeah, our
people will.

Speaker 4 (01:05:00):
Find them, I think loud.

Speaker 3 (01:05:02):
We can do to mitigate those injuries along the way
along during the career. There's there's many things we can
do that don't involve you know that don't that aren't complicated,
aren't expensive? Aren't aren't you getting the soldier's baseline? Yeah,
that would be one, getting getting baselines of cognitive functioning,

(01:05:23):
hormone levels, probably a handful of other things. One.

Speaker 2 (01:05:27):
It's interesting though, because that admiral was basically saying, fuck
the guys, who are suffering. We need more guys, like,
let those guys suffer, Like we're done with them, We've
used them, we're not worried about them, but we don't
want the bad pr And and it's very short sighted anyway,
because like anybody who like saw Muhammad Ali when he

(01:05:49):
was later on in life, they didn't that didn't stop
the boxing injury or in the industry like uh, football,
you know, never suffered from knowing all the things that
those guys go through. When you're young, you think you're invulnerable.
You don't think about the future. You're not worried about it.
You're like, I want to do this thing. I'm going
to do this thing.

Speaker 4 (01:06:08):
Yeah, yeah, And actually that you're absolutely right.

Speaker 3 (01:06:11):
I don't think I don't think the fear of death
or injury keeps people from going into special operations, because
if it did, there wouldn't be anybody in special operations.
So it's kind of a it's almost a ridiculous argument
to make. And we were a year ago we did
have a recruitment problem in the US military, and then

(01:06:33):
that has changed under the current presidential administration. So maybe
the problem wasn't so much operator syndrome as it was
other things. I you know, this this resistance anything new,
certainly in medicine but probably everywhere, is something that takes
a little time to fade away.

Speaker 4 (01:06:55):
What I'm seeing.

Speaker 3 (01:06:56):
Now is more of the leaders, the one in the
two star office flag officers. Many of them are people
that I may have known five or ten years ago
before they got a star on their shoulder. So they've
kind of almost like come through the ranks with some
awareness and understanding, and their perceptions are going to be

(01:07:19):
very different. So I have some level of optimism that
there's going to be more openness. I did the last year,
last May, I was invited to present it Softweek in Tampa,
so I did that. That was kind of a marker.

Speaker 4 (01:07:36):
Of maybe a little bit of a change.

Speaker 3 (01:07:39):
And then in January of this year, I recorded a
podcast for I did the Sokon podcast with Matt Parrish
and it hasn't been published yet because something.

Speaker 4 (01:07:53):
Happened in the recording, so we got to re record it.

Speaker 3 (01:07:56):
But my sense of even being asked to be on
that is also a Marre's There's more interest and there's
more willingness to engauge this specific conversation, Chris.

Speaker 2 (01:08:06):
I want to check how we're doing on time, because
all right, an hour in, I think, yeah, okay, because
I actually want to ask you or just kind of
go over a few of the things you mentioned, just
for anybody who's watching. You know, maybe you know somebody,
you are somebody, or knows somebody. So the syndrome you

(01:08:32):
start out with TBIs sleep diservance of sleep disorders. How like,
how big is the sleep diservance sleep disorder aspect of
this massive?

Speaker 3 (01:08:42):
It's massive. Sleep is so important for our health. It's
we can't think of.

Speaker 4 (01:08:47):
It as optional anymore.

Speaker 3 (01:08:48):
And what we know today we didn't know ten years ago.
Sleep is critical for everybody bodily function. So if you're
not getting enough sleep, your body is not going to
regulate its metabolism.

Speaker 4 (01:09:05):
Well, so you're going to gain weight.

Speaker 3 (01:09:08):
If you're not getting enough sleep, your hormones aren't going
to get produced and managed and regulated. Everything in our
body has some aspect where it needs it needs sleep.
And when we talk about sleep, we need several things.
One is we need enough of it, So seven and
a half or eight hours for most of us, we
need time sufficient time in rem state and slow wave

(01:09:31):
state sleep. Each of those states has very specific purposes
that happen things that happen in those states, and we
really need to sleep most more or less through the
night without a lot of interruptions and awakenings so that
we can go through our normal sleep cycles. Rem sleep

(01:09:51):
is when our cognition is really being sharpened. Our experiences
and things that we learned during the day are being
sore it through and makes you know, and we're making
sense out of things. When we're in slow wave sleep,
that's when our testosterone is being produced. That's when our
body is healing. If we're sick or fighting off an

(01:10:12):
infection anywhere, that's that's very important time to have more
time in slow wave sleep. We also know that during
slow wave sleep that's when our brain.

Speaker 4 (01:10:23):
Is cleaning itself.

Speaker 3 (01:10:24):
Those glial cells are taking out the toxins that build
up in the neurons.

Speaker 4 (01:10:29):
So we if we don't get enough of that good sleep.

Speaker 3 (01:10:33):
All of our physiological systems are getting wrecked and we're
not recovering, and we're going to gain weight, and our
hormones are going to be a mess, and our cognitive
functioning is going to be very much suboptimal, and over time,
we're aging ourselves and slowly killing ourselves if we're really
really not getting the sleep we need. And you know,

(01:10:55):
you mentioned, you know, people using pendrala.

Speaker 2 (01:10:57):
You brought up like ambient, the hypnotics and you know,
and things like that, but none of those are good long.

Speaker 3 (01:11:03):
Term solutions, right yeah, right, your best bet.

Speaker 4 (01:11:07):
I mean, yeah, we have medications that will put you
to sleep.

Speaker 3 (01:11:10):
The problem is they aren't going to give you the
quality of sleep that you need, and they mean it
may not be sleep that's any good at all. So
just because you're unconscious doesn't mean that you're getting good sleep. Well,
I mean, yeah, I was gonna say.

Speaker 2 (01:11:26):
The other problem with ambient is you end up with
an Amazon order of like a whole bunch of D
and D books or you know, you find out that
you tried to make candy by putting a home whole
bunch of honey.

Speaker 3 (01:11:35):
Well that happens if you're drinking too to get get
to sleep.

Speaker 2 (01:11:38):
Yeah yeah, I mean the things I've done on ambien,
like because I didn't fall right asleep.

Speaker 3 (01:11:46):
You say, D D books, Dungeons and Dragons.

Speaker 2 (01:11:49):
Oh yeah, yeah, yeah, a whole like stack of fifth
books all yeah, yeah.

Speaker 3 (01:11:57):
But like cooking while I'm on it like crazy with
no recollection. I've known guys that have woken up in
the morning and discovered they cooked and ate an entire meal. Yeah,
I've done that. I've done that.

Speaker 4 (01:12:12):
Shape off their beard.

Speaker 3 (01:12:14):
I have not done that, walked into the bathroom in
the morning, looked in the mirror, and just jumped out
of their skin.

Speaker 4 (01:12:21):
I know guys that have gone for a ride in
the middle of the night. They wake up, why is my.

Speaker 3 (01:12:26):
Truck parked the front yard and are realizing, Oh, here's
a receipt from seven to eleven. Yeah, I've bought some cigarettes.
I don't even smoke. Why did I buy.

Speaker 4 (01:12:35):
Cigarettes and smoke two of them?

Speaker 3 (01:12:37):
Yeah? And there's take lightly and there's the panic.

Speaker 2 (01:12:41):
You check all your social media to make sure that
you didn't like, but generally, even if you do post, it's.

Speaker 3 (01:12:47):
Unintelligible, like nobody knows what it is.

Speaker 2 (01:12:51):
Yeah, did I mention monkeys with wings?

Speaker 3 (01:12:54):
One time?

Speaker 7 (01:12:54):
Do you?

Speaker 3 (01:12:55):
Jack?

Speaker 2 (01:12:55):
I don't know anyway. Hormonal dysfunction, that's a big one too, right.

Speaker 3 (01:13:01):
Huge, huge for a man with low testosterone. It isn't
just that that affects sex drive and sex performance. Low
testosterone for a man is gonna mimic depression. That guy
is going to feel tired no matter how much sleep
he gets. Although low testosterone also contributes to insomnia, It's

(01:13:23):
gonna affect his concentration, his muscle mass, his energy, his motivation.
He's gonna be irritable and cranky. He's gonna look in
the mirror and his face isn't going to look the same.
He's going to be like, why do I have this
extra flesh around my jaw and my neck? And maybe

(01:13:44):
at the extreme end of it, kind of chomastia man
boobs can develop in some guys. Now, that's usually when
testosterone is down for a long time and estrogen is
up for a significant period of time. But that's why
I say get a full panel, not just testosterone, because
it might be thyroid, it could be human growth hormone,

(01:14:05):
It could be estrogen, and it could be testosterone.

Speaker 4 (01:14:07):
It could be all of them affected well.

Speaker 2 (01:14:10):
And like the next one is chronic pain and in headaches,
and like it's all it's it almost seems like it's
all this cascade and you don't know, like which came first?
Am I not sleeping because like lying on either shoulder hurts?

Speaker 3 (01:14:25):
And then I.

Speaker 2 (01:14:26):
Can't sleep, so my testosterone goes down, which means that
everything like it's it's just a non stop loop.

Speaker 3 (01:14:33):
Isn't it.

Speaker 4 (01:14:34):
Everything is interrelated.

Speaker 3 (01:14:35):
Yeah, and that's the bad news when you talk about
an injury to one system, But it's also the good
news when we talk about an intervention for one system.
Uh huh. So if we can help you sleep better,
there will be a ripple effective benefits if we treat
your testosterone, whether that's with testosterone replacement therapy or something else,

(01:14:57):
and there are.

Speaker 4 (01:14:57):
Other ways of treating it for many people.

Speaker 3 (01:15:00):
As the testosterone comes back up, we're going to start
to see better sleep, which is going to lead to
better brain health, better cognitive clarity. And we have treatments
now that we know are really effective, not just for
treating the psychological aspect of things, but for example, Stella
ganglion block, ketamine infusions.

Speaker 4 (01:15:22):
These are treatments.

Speaker 3 (01:15:23):
That have pretty quick and profound benefits to existential concerns,
to depression anxiety, but they also we're pretty sure now
stimulate neurogenerativity. Interesting meaning we're now we're growing new neurons,
we're growing new connections in the brain, and so we're

(01:15:44):
not just like the Stelli Ganglion block is a one.
It's basically a one stop, outpatient procedure, just takes a
few minutes. Inject the medicine into the nerve Stelli Ganglian nerve.
That's the sympathetic nervous system that brings was that fight
or flight arousaled down, So a lot of guys and

(01:16:05):
gals and the high risk professions are just baseline, day in,
day out, somewhere out of seven eight nine on that
physiological arousal. With this shot, it drops that down to
a two or a three. So there's a sense of relaxing,
of feeling calm, of actually thinking, being more sharp cognitively

(01:16:27):
because all that noise isn't going on. But it also
now we also see that this is creating physiological benefits
to the brain, to the neurons and the glial cells
in the brain. So we're getting better brain health from
these interventions as well. That's fascinating.

Speaker 2 (01:16:45):
And then depression, anxiety, anger, hyper vigilance, I think is
a big one that you know, and somebody explained it
one time that I thought was really good. They said,
it's like having one foot on the gas and one
foot on the brake.

Speaker 3 (01:16:58):
All the time.

Speaker 4 (01:17:00):
Yeah, yeah, always in the red.

Speaker 3 (01:17:02):
Yeah red limon. Yeah. Oh please, yeah, I just that's
just agree. That's good analogy.

Speaker 2 (01:17:09):
Yeah, post amount of stress, substance abuse. This was an
interesting one to me was the perceptual system's empairment.

Speaker 3 (01:17:17):
Can you talk about that a little bit?

Speaker 4 (01:17:19):
Sure?

Speaker 3 (01:17:20):
Well, so if you're if you're playing with toys that
go boom, that is going on to affect hearing. Blast
exposures in particular may affect the delicate muscles around the eyes.
TBI in general can affect vision, so a lot of
some people describe blurry vision double vision. Tb I also

(01:17:44):
can cause disequilibrium, so some people have trouble with their balance,
and that can be mild the mild end, it looks like,
well I'm just a little clumsier than I used to be,
or I don't have the same hand eye coordination that
I used to have. At a more extreme level, it
can it can manifest as vertigo. Be this combined with

(01:18:05):
nauseousness or vomiting, and that can be really miserable. Yeah,
we have a treatment for that. It's called vestibular therapy,
and that seems to be really powerfully beneficial for a
lot of people, no medications, no surgeries. It's literally, I
don't want to say literally, it's physical therapy for the interior.

Speaker 5 (01:18:26):
Basically, they did that too the guys that have Havana syndrome,
whole other issue, but they did vestibular therapy and it
did show a lot of results for at least a
good number of those people.

Speaker 3 (01:18:40):
You know. Oh, okay, very interesting. Yeah, I just learned something. Well,
so again, this is a treatment that is not expensive,
it's not invasive, it does not involve a lifetime of
being on medications forever. Why are we not making it

(01:19:00):
for individuals who need it to get this intervention?

Speaker 2 (01:19:05):
It's uh, Now, would you consider both visual and uh
auditory hallucinations as part of that or is that something else?

Speaker 4 (01:19:17):
Something else?

Speaker 3 (01:19:18):
Okay, hallucinations, that's that's more psychosis Okay, Okay. Cognitive impairments definitely, uh.

Speaker 2 (01:19:30):
Marital family concerns, intimacy concerns, milody of civilian transition concerns.

Speaker 3 (01:19:37):
Can you talk about that a little bit? Uh yeah, well,
let me let me go back to the emotional intimacy. Okay, please, yeah,
is it there's there's there's something I want to say
that touches on a few of these. Physical intimacy sex
is often a challenge. A lot of guys will do

(01:19:59):
have a rec toile dysfunction, but also emotional intimacy is
a challenge. A lot of guys describe feeling numb or
they describe not not being able to feel the feelings
they know people expect them to show in certain situations.
So for some guys, that means they fake, they show it,

(01:20:21):
They show fake. They smile when they know they're supposed
to smile, They look sad when they know everybody else
is looking sad, that kind of thing. A lot of
guys get told by their intimate partners that they're just
not very sensitive. Anybody ever told you you're not very
sensitive or you're insensitive. I think there's emotion, there's an

(01:20:44):
emotional intimacy peace around patience and sensitivity and empathy, and
the empathy threshold gets reset for people who see death
and destruction and the horrors that men do perpetrate on
each other on a regular basis, and that can lead

(01:21:04):
to I mean, the way the way I look at
it is just like with anything else in our life
that involves a little bit of learning or conditioning. What
one person. What a civilian views is traumatic or stressful
might be not that at all to somebody else. I'm

(01:21:25):
not being very articulate here. If the three of us
are sitting in a classroom with some of some undergraduate
college students who are talking about the stress of being
in college and having final exams and maybe having a
sick grandparent at the same time, and they're stressing out,

(01:21:48):
and they might use the word traumatized. Of the three
of us, and you guys, you know seen and done
and been a.

Speaker 4 (01:21:57):
Part of things I never have been.

Speaker 3 (01:22:00):
But I'll include myself on your side of the conversation
here just because I've heard so much. Are we going
to find these college Are we going to have much
empathy or sympathy for these college students who are who
are lamenting their stressful life with final exams? Probably not.
Probably we might struggle to. Yeah, And I've learned to

(01:22:21):
fake it with college with my undergraduate students. I've learned
to fake being a little bit sympathetic. But so much
of what we lament our first world problems, right, and
you guys have seen the third world problems and then some.

Speaker 4 (01:22:39):
So how do you how.

Speaker 3 (01:22:41):
Do you connect emotionally with your wife or your girlfriend,
with your children. How do you how do you come
into a space that's your home, your loved ones, and
yet you know there's a You've habituated to certain things,
and so the things that cause other people to cry

(01:23:02):
may not affect you in the same way. Now, let's
take that and move that. You've gone from being a
soldier to being a civilian. That transition the way. The
way I've described this before is if somebody came to
me and said, Okay, Chris, you were taking away your PhD.

(01:23:24):
You can still have it, frame it, keep it on
the wall, whatever, but you're no longer you can no
longer practice as a psychologist. We're going to strip your license.
Everything you've ever written before, we're going to put that
in a vault somewhere. So that's that's not really relevant anymore,
and good luck to you. Go find something new to do.
Oh and by the way, everybody you're you're going to

(01:23:45):
be with speaks the same language, but words don't mean
the same things. Handshake doesn't mean the same thing. Trust
and cooperation may be different, and a lot of the
wage you're not even gonna be sure of what they're saying.
Because the words are familiar, but they may have different meanings.

(01:24:07):
Good luck see it. Oh, and try to do all
this with a brain injury that makes it hard to
learn new things. Try to do all of that with.

Speaker 4 (01:24:17):
A sense of cognitive impairments.

Speaker 3 (01:24:21):
Try to do that with a lot of anger and
feeling in a short, short temper or short fuse. It's hard.
Transition from the military out into or from any of
the high risk professions to a civilian job or to
a civilian life, massive challenge, massive stressor I tell guys

(01:24:46):
that have done, you know, twenty years in the military
to think of it, of the transition as probably being
about a five year experience. And you're never going to
truly not be a soldier, right, and nor should you
try to be.

Speaker 5 (01:25:03):
The way I try to, you know, impart some advice
on guys is to tell them, like, you know how
hard you had to fight to get into special operations
and go through selection and all that, Well, you're gonna
have to work that hard to transition.

Speaker 3 (01:25:15):
Out of it.

Speaker 2 (01:25:17):
And and you know, and when you throw like mission
and sense of purpose in there too, and that you
know you were doing something that you that is a
was a dream for many of us, right, and and
you were doing it and then you get out in
the civilian world and it's like that, I think that, uh,

(01:25:38):
that's probably where like a lot of the Anhedonia Anaedonia
am I saying that right comes from and everything that
that Once you've like been where you wanted to be,
it's like you have to dig really deep to find
a new place that you want to be that brings
that same sense of purpose.

Speaker 3 (01:25:54):
Yeah.

Speaker 4 (01:25:55):
Yeah, and let's add the tribe on there.

Speaker 3 (01:25:57):
Now you're now you're not Now you're trying to do this,
but you're not part of a team of like minded
people that you're doing it with.

Speaker 4 (01:26:06):
Now you're separate from that.

Speaker 3 (01:26:08):
You left the unit. Those guys are all still doing
their thing. They're not even thinking about you. They're pretty occupied.
Now you're back to wherever your home is, trying to go, Okay,
how do I make how do I fit in here?

Speaker 4 (01:26:20):
And make sense out of this.

Speaker 3 (01:26:23):
We've also seen that even for those marriages are that
endure to the point of retirement, that that first year
after retirement is a stressor. It's a really challenging period
for marriages. The wife is like, who is this stranger
that's now in my house all the time, spur domain,

(01:26:44):
she runs the place. She knows how everything goes and
where it goes and how it works and who to call.

Speaker 4 (01:26:50):
You don't know anything, maybe, and.

Speaker 3 (01:26:55):
So so there's not just a whole new set of
skills that have to be learned and developed habits, but
how do you do that? How do you fit that
together at the family level, And that's a real challenge.

Speaker 2 (01:27:09):
Yeah, toxic exposure to illnesses and cancers, existential concerns, suicide,
and then we're go.

Speaker 3 (01:27:18):
Into part through the healing and recovery, which is phenomenal. Yeah,
it's uh.

Speaker 2 (01:27:23):
Look, I recommend this book to everybody. It it puts
so many things together that that I thank you so
thank you. Uh, and then link is down in the description.
I highly recommend it. It's for me. It put a
lot of stuff together that I've been trying to figure

(01:27:44):
out that I've been wrestling with.

Speaker 3 (01:27:45):
So, you know, yeah, very valuable. If can I have
a favor to ask of you and your listeners if
you do look at the book, One thing that it
would be very much appreciated would be a review on Amazon.
I've been a little concerned that some of my things
have been kind of shadow band. I know they have
been on social media when I was on social media,

(01:28:09):
and so getting through some of the Amazon algorithms. It
helps if you have some reviews for the book. I'm
gonna do it right now, just because I'll forget if
I don't. Thanks.

Speaker 2 (01:28:20):
But yeah, so what's what's next? Like where can people
find you? What's next for the operator syndrome? And also
if you know, obviously one of the things you mentioned
is you know, taking that you mentioned to me before
the show, take in the document to the VA, to
your primary careac position and just pointing out like these

(01:28:41):
are all things that I'm suffering from, Like they don't
have to buy into the operator syndrome, but can I
get these tests and things like that?

Speaker 3 (01:28:48):
This is a medical document. That strategy seems to work
for a lot of people. I tell them, print the
paper off, go through it with a highlighter, take it
to your medical providers, educate them, and use it as
a as a conversation starter to ask for what you need.
And you know, more often than not, that seems to

(01:29:08):
have a very positive effect. I would also say, you know,
it is a challenge to find the treatments that that
are that are helpful for me. The three kind of
low hanging fruits are get a sleep study if you
haven't had one, Get your hormones checked if you haven't
already done that, and addressed if need be. And then

(01:29:31):
the Stella Ganglian block is a very low invasiveness treatment.
It's literally a one time only outpatient procedure takes just
a few minutes. It's it's very similar treatment to when
the dentist injects little novacane into a nerve tooth nerve
before drilling on that tooth. It's a different nerve, it's

(01:29:54):
a different medication, but it's essentially that's essentially what it is.
Just it just it just kind of block that nerve
for several months. Now, a lot of guys will get
the benefit, and the benefits will endure for months and months,
even years. Sometimes they never go back. Some people go
and do it again a year later. But it also

(01:30:14):
opens a window of opportunity because you're feeling relaxed, you're
feeling better. It makes it easier to start doing some
of the other things to take good care of herself,
which might even include psychotherapy or journaling.

Speaker 4 (01:30:26):
But it's it's that's one of the few. It's one
of the things I encourage people to look into.

Speaker 3 (01:30:31):
So that can you say those three things one more time?

Speaker 4 (01:30:34):
Please?

Speaker 3 (01:30:35):
Yeah? The three the three things that I would recommend
right off the bat, sleep study, hormone, pianel and stellic
ganglian block therapy.

Speaker 4 (01:30:46):
And then go from there.

Speaker 2 (01:30:47):
Okay, and then what because I know you mentioned protein
you talked about you know that we don't we aren't
get enough protein. And some people say up to one
gram of protein per pound.

Speaker 4 (01:31:01):
Or pound of body weight.

Speaker 3 (01:31:02):
Yep, And it's it's probably slight correction there. On myself,
it should be one pound one gram of protein per
pound of desired body weight. If you weigh three hundred
pounds but you're trying to get down to two hundred pounds,
then you should have two two hundred grams of protein.

Speaker 4 (01:31:22):
And there is a there is there's different ways of
getting protein.

Speaker 3 (01:31:24):
Obviously, different foods have different different types of different levels
of proteins.

Speaker 4 (01:31:28):
But one thing you can use.

Speaker 3 (01:31:31):
To give yourself a jump start on the protein is
essential amino acids EA's, which are the nine essential amino
acids that our body cannot produce on its own.

Speaker 4 (01:31:44):
If you take about ten.

Speaker 3 (01:31:45):
Grams of essential amino acids with a big sixteen ounces
of water in the morning.

Speaker 4 (01:31:52):
You're giving your your body.

Speaker 3 (01:31:53):
Not only are you hydrating yourself, but you're giving your
body the equivalent of about fifty grams of protein you
can get, you know, twenty five to fifty percent of
your daily protein needs this way. It's cheap, it's easy,
it's very effective, you get really good protein synthesis, and
it doesn't break your fast.

Speaker 4 (01:32:14):
So if you're doing intermittent.

Speaker 3 (01:32:15):
Fasting, baas only have like four four calories, so it
doesn't it doesn't end your fast if you're doing intermittent fasting.

Speaker 2 (01:32:27):
And then you also mentioned creating, which you know, like
I used to use when I was lifting, but apparently
it has more benefits than just.

Speaker 3 (01:32:35):
For working. I've come to believe we should all be
taking creating at least five grams. I take fifteen grams
a day, and it is important for lifting and strength training,
but it's also a really good brain health supplement.

Speaker 4 (01:32:52):
And that's recent news. That's recent data.

Speaker 3 (01:32:54):
In the last three or four years, a number of
studies come out showing how good creating is for our brain.

Speaker 5 (01:33:01):
Creatine is like I think it's considered the only supplement
that really has like robust medical you know, academic backing.

Speaker 3 (01:33:10):
Yeah. Yeah, that plus plus megative B vitamins. But that's
more complicated. Interesting. Yeah. One thing, one thing just to
throw out there for you guys and your listeners. There
is an online magazine called Havoc Journal, hav Okay, Havoc Journal,

(01:33:33):
and they they are it's free, it's online, and they're
mostly targeted towards veteran soldiers first responders. I just published
essentially a super abridged version of the Operator Syndrome book
on Havoc Journal.

Speaker 4 (01:33:50):
So it's in four parts.

Speaker 3 (01:33:53):
The fourth and final part just published today and the
other three parts published each of the the previous three mondays.
So if you go to have a journal search Operator Syndrome,
this four part series should show up, and it's essentially
a condensed you know, four magazine articles that condenses a
lot of the book into one place. Yeah great, And

(01:34:16):
where can people find you?

Speaker 4 (01:34:20):
What do you mean by that?

Speaker 3 (01:34:21):
I don't want to be Okay, Well, what I.

Speaker 2 (01:34:23):
Meant is, I mean, I know you mentioned that you
weren't really on social media.

Speaker 3 (01:34:27):
I know you had.

Speaker 2 (01:34:29):
Unfortunatetion with LinkedIn and stuff like that. You know, are
you anywhere where people can like follow your work or.

Speaker 4 (01:34:38):
I have I have a website.

Speaker 3 (01:34:40):
It doesn't necessarily change very often, so it's not like
there's a web newslink or a newsletter there. Chris free
dot com is the website. But I'm trying more and
more to just kind of keep a low profile. I
live in rural Hawaii. I don't be my house very often. Yeah.
I want to do and want I do. It's not

(01:35:00):
things I'm gonna I want to publish or put out
there on social media. So I mean I maybe intentionally
a little bit art art defined.

Speaker 2 (01:35:09):
Okay, yeah, and are there any follow ups to I mean,
I'm sure you guys are constantly learning new things. I mean,
it almost feels like it's going to be a living
documented you know.

Speaker 3 (01:35:20):
Well, yeah, so I am working on a couple of
papers right now. You know, there will be scientific publications,
I hope at some point in the next couple of years,
and that will add a little bit. I think the
transformative research going forward is not going to come from me.

Speaker 4 (01:35:41):
It's going to have to come from other people.

Speaker 3 (01:35:42):
I'm I'm old, I'm not that invested in my in
the academic world anymore. But there are people who are
There's a psychologist in the VIA system who is who's essentially,
you know, I think, trying to make that his career
goal to collect the longitudinal not just the cross sectional,

(01:36:06):
but the longitudinal data to begin to better understand operator syndrome.
And he's at one of the polytrauma centers that may
change their name to the to something something Operator Syndrome program.
At least that's their tentative plan. Do we have questions? Yep,

(01:36:27):
we got one from m Corbin.

Speaker 7 (01:36:29):
Could any treatments help address the negative cognitive effects linked
to digital device addiction?

Speaker 3 (01:36:36):
M If I had a simple answer for that question,
I would probably become a very very wealthy person. I
don't know if specific treatments other than any the kinds
of things that work for addiction.

Speaker 4 (01:36:54):
Might be relevant.

Speaker 3 (01:36:56):
The cognitive therapies the there's probably If you look at
one series of books that I kind of like, are
the Easy Way books, The Easy Way to Stop Drinking,
the Easy Way to Stop smoking. I wonder if they
have an easy way to reduce the digital But when
it comes to digital porn addiction, things like that, those

(01:37:19):
are those are those are medically different, physiologically different from
building up tolerance and then experiencing withdrawal from a substance
like alcohol or opiates. On the other hand, they have
a lot of similarities, including how the brain brain, the

(01:37:40):
reward centers of the brain fire. So I don't have
I'm sorry, I don't have a really good answer for that,
other than what's out there for addictions.

Speaker 2 (01:37:53):
Are there any emerging treatments that aren't really widely known
yet that you're excited about or decide about the possible?

Speaker 4 (01:38:02):
Ah?

Speaker 3 (01:38:02):
Well, I think a lot of the things that we're
looking at right now with related to psychedelic medicines, transcranial
magnetic stimulations, hyperbaric oxygen therapy. I think those are some
of the things we're going to know a whole lot
more about in a few years. And there's some really

(01:38:23):
promising things that we're learning in each of those areas.

Speaker 4 (01:38:27):
Hyperbaric oxygen therapy.

Speaker 3 (01:38:29):
Five years ago, I thought we kind of, you know,
we kind of looked at it and then decided it
wasn't worth it, it didn't produce enough benefits. We're going
back to that now. I think it is in part
because the Israeli research program. The Israelis have changed the
protocol that they're using for hyperbarics and getting very very

(01:38:50):
different and very good results with it. So I think
for all people who've heard, well hyperbarics don't help with
TBI or PTSD, maybe they do. We just haven't been
giving enough of a dose. So more sessions and at
a higher level of pressure, I think is what the
Israelis are doing. Please go ahead. I'm just gonna offer

(01:39:15):
one other thing. I mean, there's I'm sure there's many
things I don't know of or understand. There are probably
a hardly a month goes by when I don't have
somebody reach out to me with a new product or
a new gizmo or gadget the purports to do this
or that. Some of those probably have you know, value

(01:39:35):
right now, I think it. The part of the challenge
is sifting through all the noois to find the signal
there is something I'm intrigued by. There's a there's a
mono keytne ester called Delta G and it was initially funded.
The research on this was initially funded twenty five years
ago by DARPA through their you know, their their super

(01:39:57):
Soldier program, and then it got kind of shifted over
and it was a scientists at Oxford University in Britain
and with the NIH funding. Anyway, this thing is on
the market now. You can go look for Delta G
and you can find this keytne ester.

Speaker 5 (01:40:15):
And I took a Havy Tone energy drink before we
started Delta Delta G key Tone Ester, Delta G key
Tone Ester.

Speaker 3 (01:40:24):
It's there's a number of them on the market and
I'm not trying to be a salesperson for this. This
this product other than it's different from the other products.
It will put you if you take about thirty grams
of the stuff, it will put you into a very
deep state of katosis in about fifteen to twenty minutes,
so it's very happens very fast, and it will last

(01:40:47):
for four or five hours, so a deep state, almost
immediate and lasting. And one of the thoughts and I've
I've gappled.

Speaker 4 (01:40:57):
With the stuff. I've used the stuff.

Speaker 3 (01:41:00):
It probably a pretty good two month run and found
it to be very helpful in a variety of ways
for myself, including cognitive sharpness. And part of what DARPA
was looking for was to be able to take a
soldier who sleep deprived and physically exhausted, give him a
little shot of this stuff and have him him cognitively

(01:41:23):
restored to be sharp again. There's another piece of this though,
the deep katosis seems to produce a very an anti
inflammatory response in the body. And so one of the
things that I've wondered about, and this is just me
spitballing here, but as a use case, could you use

(01:41:46):
this with some operators that are going to go on
let's say a breaching or a shoulder fire rocket training day.
Take a dose of this stuff before the training and
then maybe four or five hours later or maybe at
the end of the day. If you do that while
you're training and really reduce the inflammation in the in

(01:42:06):
the nervous system, Yeah, that be neuroprotective.

Speaker 4 (01:42:10):
And I don't know the answer.

Speaker 3 (01:42:12):
This is a this is just me spitballing here, but
there are things like that that I think we're we're
going to be digging much more deeply into and as
the as the years go by. The Delta g you
can buy it, you can purchase it. You can get
their website and purchase it, but it's very expensive, so
there aren't many of us that are going to use

(01:42:32):
it on a regular basis unless we have the DoD
or the Tour de Frant's money supporting supporting our habit. Yeah.

Speaker 2 (01:42:41):
And one last thing that you mentioned that caught my
attention because people have mentioned them before to me, but
I don't quite understand them is peptides.

Speaker 3 (01:42:51):
Can you tell us a little bit about that? Not
very much, because I don't know very much, but I
will say. What I will say is one of the
places where a lot lot of guys are finding relief
or a regenerative medicine clinics or sometimes referred to as
functional medicine clinics where they're using peptides X homes AD

(01:43:12):
plus infusions stem cells to treat a variety of things
related to brain health, joint health. A lot of these
clinics also do the stelic ganglia and the aketamine infusions,
so they can be one stop shops for a lot
of the different kinds of interventions that might be useful.

(01:43:33):
And they will do.

Speaker 4 (01:43:34):
A deep dive on nutrition and.

Speaker 3 (01:43:40):
You know, they'll get a full panel of all kinds
of things like about your vitamin D levels, but with
fifty other metabolic markers, and then they will tailor a
treatment or a supplement regime for you, reasurement for you
based on your numbers.

Speaker 4 (01:43:59):
So I think I think.

Speaker 3 (01:44:00):
Regenerative medicine functional medicine is going to be a place
that we see much more important things happening for people
with operators syndrome. Chris has been amazing. We really appreciate it.

Speaker 4 (01:44:17):
Thank you for having me. This has been good.

Speaker 3 (01:44:19):
Yeah, thank you for coming on.

Speaker 5 (01:44:20):
The book is amazing and winks will all be down
in the description for people who want to find the
book or want to find Chris's website.

Speaker 3 (01:44:27):
Yeah.

Speaker 2 (01:44:28):
Yeah, was there anything that we failed to ask you
or anything that we left out there if you wanted
to talk.

Speaker 4 (01:44:34):
About nothing comes to mind.

Speaker 3 (01:44:42):
We probably could sit here for another five hours, though,
and find a steady stream of.

Speaker 4 (01:44:47):
Things to talk about.

Speaker 3 (01:44:48):
Oh I could.

Speaker 4 (01:44:50):
So you'll just have to invite me back another time.

Speaker 2 (01:44:53):
Absolutely, Thank you so much, Chris. We really appreciate it.
You bet, Thanks, thank you, Thanks everybody.

Speaker 3 (01:44:59):
Good night. Hey guys, it's Jack.

Speaker 5 (01:45:02):
I just want to talk to you for a moment
about how you can support the show. If you've been
watching it, enjoying it, but you'd like to get a
little bit more involved and help us continue to do this.
You can check out our Patreon It is patreon dot
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Speaker 3 (01:45:21):
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Speaker 5 (01:45:23):
The same goes with our affiliated podcast eyes On with
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The Patreon members are literally what has helped this company
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(01:45:46):
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Speaker 3 (01:45:54):
So we really appreciate all of you guys.

Speaker 5 (01:45:57):
There's going to be a link down in the description
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(01:46:18):
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Speaker 3 (01:46:35):
Thank you,

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WTF is Operator Syndrome? | Dr. Chris Frueh | Ep. 357

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.css-14f5ked{margin:0;word-break:break-word;display:-webkit-box;-webkit-box-orient:vertical;box-orient:vertical;-webkit-line-clamp:2;overflow:hidden;}WTF is Operator Syndrome? | Dr. Chris Frueh | Ep. 357