Transcript of 696: Dr. Zeke Emanuel - The Six Rules for Health & Longevity, The Harvard Study on Happiness, The Truth About Biohacking, Social Connection, and How to Avoid Being a Schmuck New

I don't know if it's always a good idea to rank somebody on a 1 to 10 scale, but for the purpose of this example, I'm going to. If you view yourself as an 8 or a 9 who wants to be a 10, if you're the type of person who wants to put a positive dent in the world, then I have something for you. My next book, comes out soon. It's called The Price of Becoming. I'd love it if you would preorder it now. Go to Amazon or learningleader.com. All the details on my book, The Price of Becoming. Preorder it now. Thank you. Let's get on with the show. Welcome to The Learning Leader Show presented by Insight Global. I am your host, Ryan Hoff, thank you so much for being here. Go to learningleader.com for show notes of this and all podcast episodes. Go to learningleader.com. Now, onto tonight's featured leader, Dr. Zeke Emanuel, oncologist, vice provost at the University of Pennsylvania, architect of the Affordable Care Act, and author of the new book called Eat Your Ice Cream: 6 Simple Rules for a Long and Healthy Life. During our conversation, we discussed Zeke's famous essay from 2014 titled, quote, "Why I Hope to Die at 75." He shares what he actually meant by that and whether he still believes it now that 75 is closer than ever.

And then what specifically his parents did to raise 3 sons who are putting a massive dent in the world. There is Zeke, a leading oncologist, Rahm, the White House Chief of Staff for President President Obama, and Ari, the most powerful agent in Hollywood. I love the 3 things he shared his parents did. And then why social connection is a stronger predictor of how long you live than diet, exercise, or sleep, and what that means for how you should spend your time. Ladies and gentlemen, please enjoy my conversation with Dr. Zeke Emanuel. I need to learn more about your dad, man. I, I actually, I wanna learn more about both, your mom and your dad, but your dad, who you dedicate your most recent book to. You said he modeled and thus taught me how to be curious, speak my mind without fear, be social, care about people less fortunate, walk fast, be frugal, drive poorly, and hopefully not be a schmuck. Tell me about your dad and what you learned from him.

Well, my dad was born overseas, so he is an immigrant, came to the United States to do internship and residency, uh, met my mom and they went back home and then came back to the United States where they settled in Chicago. My dad is, uh, was— he's, uh, deceased, uh, but he was first of all an incredibly hard worker. He could just work and work and work, and he was incredibly dedicated to his patients. Uh, but he was also very— they would call him Speedy, and Speedy for two reasons. I, I highlight one in the book, which is my dad never exercised. The idea of exercising in you know, pulling out time to go running or riding your bike or swimming. That wasn't his idea of fun. But he would walk fast, and he was the fastest walker. So on the weekends, we would go on hospital rounds with him, and we'd go in and see a patient, and, you know, in 60 seconds he was finished, and then he'd start walking to the next patient, and he would just zoom. And the nurses and us kids would be literally running after him. That was his form of exercise.

He loved hiking, in the mountains. We would take trips out west to Montana, Wyoming, and he loved the hiking. But again, he was just a fast walker. He was also fast as a doctor cuz patients where it was routine and he, he would just do it quick or removing stitches, you know, take seconds and he'd be onto the next patient. You know, you would think, well, people would feel like they didn't have a connection, but in fact he would take call 24 hours a day and anytime there was a difficult patient, He would really think on it. And at his memorial service, just scores and scores of grateful patients coming and remembering him. And I still get, you know, walk around Chicago and I say, "Oh, you're Dr. Emanuel's son." You know, he was my pediatrician and, you know, he was great. I just loved him. And he was that lovable guy because he was extroverted, interested in people. And even though he was fast, He would listen to you and have a good conversation with people. And so that, I think, was, he was very warm-hearted and very concerned to understand people. And so I think that was the heart and soul.

And, you know, he also had this rule that, you know, family had 3 children, the 4th one was free. He just wouldn't charge. He recognized the financial strain on a family and it just All right. And, you know, we're not making money on the 4th, 5th, or 6th. And, you know, he took care of a lot of immigrants and a lot of them had large families. And that was just his way of— we don't need to make money that way.

Did your parents ever teach a seminar on how to raise kids that are going to leave a positive dent in the world? I mean, think about your family. There's 3 boys. All 3 of you do wildly different things and you're all absolutely crushing it. I'm serious. Like, did they teach a seminar on how to raise people? Not only like people who are doing well in their careers, but you guys seem like high-character, get-after-it type good people. I mean, I'm, I'm just fascinated to learn how they, they went 3 for 3.

So I would say the following. There are probably 2 or 3 critical elements. The first critical element is both of my parents were dedicated to doing good by the people. I, I mentioned one thing my dad did, another thing in the early '60s, well before it was a national trend, he led a lot of efforts on getting rid of lead paint from apartments because he specialized in kidney care of kids and he saw a lot of kids with, you know, lead paint poisoning that was compromising their quality of life, gotten from apartment old paint. So he led that campaign. My mom was completely focused on social justice issues. In the '50s, well before whites were heavily involved in civil rights, she was marching for civil rights. And later in the '60s, she was very active in the anti-war movement. We had a lot of meetings at our house, both on civil rights and anti-war protests where she would organize them. And so they were very, very committed to social justice. She went to Martin Luther King's famous '63 speech in Washington. The I Have a Dream rally and speech. So she was very, very committed to a lot of social justice.

So the idea of making other people's lives better was front and center of our house. We had a lot of people who stayed over at our house when things weren't going well for their house, or in one case, a kid stayed with us for almost 2 years when both of his parents who had mental illness were in the hospital and, and just really couldn't raise him. That's one thing. The second thing is my mom was the definition of the anti-helicopter parent. She would, you know, when she took us to the playground, she would sit on the bench. You go play. I'm not standing there for safety reasons. You know, something goes wrong. Yeah. Okay. You fell off the slide and you know, you hit your chin. Well, okay. That's how it goes. I mean, she wouldn't ignore us, but she was not hovering. And then when we got older, she would scoot us out of the house, go play, 5 o'clock dinner, be back by 5 o'clock. Or she would take us to the beach. We have a blanket, we have a snack, and she left us there and we had to get along. We had to go figure out what we were going to do.

We had to negotiate among ourselves, the 3 boys. We had to negotiate with the neighborhood kids. We had to play. We had to have fun. And that's a lot of social interaction, a lot of negotiating on yourselves, a lot of creativity for what you would do, what games you would play and things like that. The last thing I would say is my brothers and I are very close for a lot of reasons. One is that we slept in the same bedroom for years. Another is we would take vacations in Israel for 10 weeks and it was us 3 and we were the group. So we spent a lot of time together, whether it was fishing or swimming in the Mediterranean, or shooting rubber bands at the feral cats out in the town. You know, we would do all sorts of stuff, but we would do it together. That didn't mean we agreed. We were constantly fighting and competing with each other. So that bonding, but also competition, I think that's part of what's important for us. We're very, very close. We talk to each other all the time, but we're also highly competitive. All of us want to succeed, which is why we do 3 different things and live in 3 different parts of the country.

I was just going to say the competitive nature, because I think it can create excellence in life, but you also have this like unyielding underlying love and support. So maybe describe a little bit about your relationship with your brothers and maybe the competitive aspect, if you have that or not. Maybe you outgrow that a little bit. And also a little bit about what they do and the dent they're leaving in the world and how that's different from what you're doing as a doctor.

We are totally supportive. One attacks the other and that just will send off everyone. And I think we appreciate the skills and the knowledge of each. As a matter of fact, I want to call Rahman to try to unlock a puzzle I have about politics, not about Ken Paxton's victory, but about Jared Polis in Colorado pardoning that woman for election fraud. I don't understand it, but Ram certainly has got more insights than anyone. And Ari, you know, is, has figured out, you know, he's like the most network guy, not shy about calling anybody, has a long-term vision of where entertainment, people's time is gonna go. You know, 20 years ago, 20 years ago before almost all of this stuff, he told me, you know, it's gonna become live entertainment. We're gonna have all this phone stuff, but the thing people are gonna crave is Things that can't be reproduced, that not easily shared live entertainment. And how right he was, you know, and, and brilliant 20 years ago. So he reoriented everything he was doing in that direction. We're also, you know, highly competitive, you know, all of us wanna succeed and crow to the others.

Do you guys brag? Do you have the, in the group chat?

Oh, right.

What is the group chat? What's it look like?

Uh, I, I'll sort of make fun of myself. In January, my wife and I went to get our VO2— we went to get fitted for fancy bikes and get our VO2 max. We're big bike riders. That's our main source of physical activity. And so, you know, I wanted to know what, what's my VO2 max? While she's getting fitted, I did a VO2 max and we then flipped it and I got, I did pretty damn well. I did 51.9, which for, you know, a 68-year-old guy is pretty darn good. And my watch had, you know, was way off. As they are, it said 43. So we have an internal family text where, you know, everyone in the family, all the children are on and the brothers and the spouses and everything. And I said, I just got VO2 max of 51.9. Do I win in the family? You know, it's like, okay, I'm, I'm going to brag. So the kids laugh. He says, you know, every time an article passes the transom, it's like, Zeke sending one of his articles or Rahm sending one of his op-eds, you know, we don't even read them anymore. So yes, we're inclined to, to crow about our achievements.

I love it. It's just beautiful because, you know, you're going to have each other's backs. Oh, you're going to— you're going to make fun of each other to each other's faces. But then behind their backs, right, there's probably nobody who's going to be more supportive.

That is 100% right. And I will tell you, We all trust each other. Like I was mentioning, I trust Ron's political decision. I'm a doctor. I constantly getting, you know, I have this friend. Could you talk to them about— they've got cancer, they've got some other illness. Can you talk to them and figure out what's going on and refer them to the right doctors? So happens all the time.

Yeah, it's very cool. So 12 years ago, you wrote an article titled Why I Hope to Die at 75. Okay, we're getting a little bit closer to that age now than we were 12 years ago. How do you feel about that article now?

It's my most famous article. I've written a lot of articles. I know. In the medical profession that have lasted 35 years now. And people, you know, I go to various meetings and say, oh, we learned about your stuff in medical school. But it's the article that is the most infamous, you might say, because it challenges people. I think it's also pretty damn well written. And I know that it's being taught in a lot of universities as a writing example. I'm still there. I've made some modification, mainly because of COVID about getting vaccines after 75. But I was actually just looking at the data and not, you know, let, let me give a different version of what's motivating me there. And we should be clear, Ryan, that while the title said why I want to die at 75, that's not what the article said. Titles are given by editors and publishers.

They make you click on it though, for sure.

Exactly. It's clickbait.

And then see the beautiful writing. Yeah.

Yeah.

Anyway.

Yeah. So what I said is that after 75, I won't take a medical treatment where the purpose is to prolong my life. But if I like broke my hip, you know, we've had a lot of friends who've not been knocked over and had their hips broken in a ski line. Okay. Then I would get it fixed. If I had cataracts, I have a good friend who's, uh, same age. We went to college together and he had cataract surgery. Absolutely, definitely do it if I need it. But you know, here's what I think hell would be. Hell is if I am— my physical body is fantastic, my heart's still going, you know, kidneys are functioning great, et cetera, et cetera. But my mind is gone. I've got cognitive impairment or serious dementia. That is hell. I can't imagine a worse circumstance than that. What happens? So if you look at the data, basically the rate of dementia is pretty low and flat all the way to 75, and then it dramatically goes up so that by 75, about 10% of adults have frank Alzheimer's dementia, and another 20% have cognitive impairment. All right, that's 30% of the population.

By 80, just 5 years later, we're up to about 15%, I think, have Alzheimer's and 25% have cognitive impairment. All right, that's 40% of the population at 80. That's the same age as Donald Trump. Okay. I don't wanna be in that circumstance. I don't wanna be remembered as a, you know, doddering old man. Who can't remember who you are, what's going on. I've seen enough of those, uh, as a doctor. I just don't want to be that person. And I want my family to have a different memory of me, my friends to have a different memory. I am staying as busy as I possibly can, and I hope to do that as long as I can. But I also don't want to have a situation where my brain is going and my body's not. That would be horrid. So that was the motivation behind that. Now, if I'm cognitively intact, everything's going well, and we get something like COVID where two vaccines can protect you, give you a high chance of being protected from dying, that seems like a reasonable opportunity.

Your latest book's called Eat Your Ice Cream: 6 Simple Rules for a Long and Healthy Life. And I think the timing of this coming out this year is particularly good because at least if you spend too much time on Twitter like I do, you'll see over and over and over this idea of trying to have a perfect life when it comes to diet, no alcohol, you name it, all this stuff. And to me it sounds like just an awful life, quite frankly. And so when I, I started reading your book and digging into all of your past work, I thought, I like this Zeke guy.

Thank you.

And he's a doctor too, so he's got all the credibility. I, I'm gonna listen to a doctor like this. Can you just talk to me a little bit more about like this overall mentality and this ethos of, hey, let's eat the ice cream, maybe go have some beers with your buddies. I mean, you know, that type of mentality instead of trying to have perfection and Whoop scores and all that, which by the way, I just hate more than anything.

Oh, you'll notice I don't wear anything.

Same, same dude. Never. Well, I shouldn't say never, right?

But yeah. Okay. So look, there is a zeitgeist, if you will, that does live on the internet and it's got lots of mistakes, which I would suggest we avoid. First, that, you know, living a long time is something that should be an obsession of yours. Wrong. You know, living a long time and in good health is a means to an end. It's not the end of life. And I'll tell a story about that in a second. Second, maxing, whatever that is, you know, is like, no, there's no maxing. We don't know for any individual what the optimal is because you're an individual. We have population data, which is what I put in the book, what every study does. And you won't know in your quote unquote N of 1 experiment, you know, whether this combination is going to max you out because you're not gonna follow you just with that combination. You know, there are 6 rules. There are different things you have to do. Third, um, this idea of Biohacking. I don't know what the fuck biohacking means. You know, it suggests that you know better than Mother Nature, which has been evolving humans for millions of years, and you know better than the medical profession or something to what the secret is.

And it tends, again, all of these tend to be extremes. You know, if something is good for you, you ought to have a ton of it. No, the body doesn't go there. The body is about balance. Too much immune response, you get autoimmunity and it's really devastating. Too little, you get liable to infections and that's also devastating. It's about the median and sticking to a moderation and the body gets balanced in that way. So that is much of what I was arguing against. The other point that people have to be aware of is wellness and doing things for health. Is lifelong. It's not like a figure skating performance that's 4 minutes long and you, whether you get a gold or not, is determined in 4 minutes. It's something you're gonna have to do for decades. And so you're just not gonna be perfect over decades. I don't know any human that's been perfect over decades. So you have to understand, you know, life has lots of puts and takes and you know, some of those They're not gonna take seconds off your life if you eat that hot dog. I'm a Chicago boy. I love hot dogs.

I go to Chicago. I have a few dogs. Am I gonna live less long because of it?

No.

If you, I made it a routine, I had two dogs every day, then we're talking a different story. But occasional things like a few beers with friends. First of all, it's a few. If you don't do too many, you do 3 or 4 drinks a week.

Good.

It's with friends. That's an important element because you have social interaction, and social interaction we know is important for health, longevity, and happiness. So you gotta put everything in context. You know, people say, well, should I eat X? Well, the question is, all right, say you're not gonna eat X. What's you substituting for that? You know, are you substituting something healthy or something even worse? You know, you're gonna get a, a package. Tweaky, or you're gonna get— eat bacon. Yeah. All right. Well then maybe you should eat X and you shouldn't have that packaged Twinkie or bacon. There are lots of trade-offs in life and perfection is not something we're gonna get to. Maxing is not something we're gonna get to. We need to be a little more reasonable. Get good habits that you can live with, that you enjoy, that you do every day without thinking about them.

One that I think is important that you talked about is with other people. In our house, we don't really have anything to drink ever. We don't like to do that in front of our kids, things like that, unless we're with friends. But I think when you're celebrating a moment and you're happy and you're with people— we just had this a couple of weeks ago. We're out of town, we're with a bunch of friends, and we go out and the tequila was flowing, Zeke. And I'll tell you, it was an incredible day. It was so much fun. We still are in the group text talking about how much fun we had. Do we do that all the time? Hardly ever. Where you tie one on like that. But I'm so glad I did that. Was I in pain the next day? A little bit, but then I just went to the gym, sweat it out, and boom, we're back to normal by whatever, a decent hour. I don't know. I'm a big fan.

You're illustrating, Ryan, you're illustrating all the points that I totally concur. You know, if you did that once a week, there'd be a problem. If you did it, so it's a memory of yours and everyone shared it is It's a bonding thing. And the moment was also a good social relations. That is so important to your health and happiness. And I can see the smile on your face. Yeah. You know, that just attests to, wow, that is a positive memory. That's great. And yeah. Does it break a rule? Yeah. So what? Uh, again, it's a matter of moderation, occasional kind of thing. And yeah, you were celebrating something great. I don't know what it was, but Good. You know, I happen to be a teetotaler. It just never tasted good. And I've lived with people who are like real, you know, wine aficionados and they're easy. They serve hundreds of dollar bottles and it's like, eh, you know, take it or leave it. There are some wines I like, but I don't even drink a whole glass. Great. And, you know, sometimes I like that hot dog or a burger or whatever. Okay. But it's part of a whole life and it's the whole life you need to consider.

And I love how just remembering that event makes you happy.

Absolutely.

The key to a really good life, being with other people, helping other people, bringing joy to other people. That is critical to a good life. Yeah.

You wrote about your mom smoking in the book and you were poking holes in her cigarettes with sewing needles. Is this right?

It's Rob who did that. He would—

Tell me about this.

Smoke. What is this? And poke, poke them in the, in the cigarette so that she wouldn't smoke. Yeah, my mom smoked all her life. She's 92, by the way, and still alive. And as she likes to say, I don't have any diseases that are going to kill me. She, right, she doesn't have diabetes, high blood pressure. She still smokes. You know, she doesn't smoke in front of anyone, but you go into her bathroom and, you know, you can smell the cigarette smoke. It's not like this is a secret, Mom. Yeah. And we couldn't get her off it. And, you know, she was addicted to it. She went for periods of time using her willpower, which was pretty tremendous willpower, but you know, it didn't last forever. And that was her one really bad habit.

So there's 6 simple rules.

Okay.

Let's just go through them. Can we, can we go through 'em and maybe pull out some examples?

I'm, I'm here to, I'm happy to talk about that.

Okay. Well, I, I mean, I like that this smart, super educated guy is is writing it away for the rest of us. Uh, I don't know if that's the right way to put it. Meaning like you just made these simple, practical, actionable rules. Okay. Let's start with the first one, which I, I read was gonna be the title of the whole book.

Yeah.

Is that right?

Yes. Okay.

So don't be a schmuck, right? Avoid self-destructive risk out there. Again, basic, but don't be a schmuck. Say more about that.

Well, look, what's the riskiest thing we do in a day? Turn the ignition to our car on, right? Driving is actually pretty risky. The chance of dying is 1 in 8,500 every year, and over a lifetime it's about 1 in 93 if you drive an average amount. So that's your baseline because we're not getting rid of driving. We do that. So I say, you know, compared to what you're doing, look, smoking, worse. Vaping, worse. Doing drugs, Worse. Alcohol. You know, you've got to do it in the right way. We're not going to take 63% of the population that drinks down to zero. So, you know, 3 or 4 drinks a week. Don't drink alone. Make it a social engagement. Take your vaccines. RFK Jr. is just wrong. And let me circle back. You know, there are 4 vaccines, all of which reduce your risk of cognitive impairment and dementia. You better take those 4 vaccines. You know, the shingles vaccine, the pneumococcal pneumonia vaccine, Diphtheria, pertussis, tetanus vaccine, and the flu vaccine. You take those 4 to reduce your chance of mental decline. Okay. And then I talk about, you know, funny things. So when I was writing the book, I thought, you know, base jumping has to be the stupidest thing people can do, right?

That, that is the schmuckiest move there is. And I looked up the data and, you know, 1 in 2,700 jumps, someone dies. And most base jumpers think they're gonna die base jumping. I said, that's pretty stupid. And then I looked up. Climbing Mount Everest, which people pay $150,000 to do. And I'm like, the chance of dying up there for all colors, including the experts, is 1 in 100. That is whoa. Really dumb. And the chance if you're over 59, which I am, 1 in 25. I said, what the schmuck? We were just in New Zealand and we were riding bikes in Queenstown and looked over the horizon and there was a hot air balloon. And I said, to my wife, I said, we ought to do that tomorrow morning. Sunrise, hot air balloon. And she says, is that a schmuck move? So, you know, what do I do? I look it up. What's the chances? Turns out not a schmuck move at all. 1 in a million liftoffs, there's a mortality. So it's like, you know, that's the equivalent of riding my Vespa motor scooter in Washington, D.C.

So wait, how do you define a schmuck move?

Because some of the stuff that may be more risky than driving a lot more.

Oh, okay. So more risky because, because some of the stuff it's like, hey, Zeke, I want to live a little bit, man.

That's fine. I think that's absolutely the right attitude. I'm a risky guy. Everyone will tell you I'm a risk. I take risks. I'm not shy about that. There are some things I won't do because I'm not going to be that pleasurable. And there are some things I really like to do because— and they're somewhat risky and I'm willing to do it. And, you know, that's great. Probably the most risky thing I do— we don't drive very much. We've had a car for about 16, 18 months. It's got about 4,600 miles on it. I basically say I got a car. To drive my bike out to the country so I can ride my bike. I ride bikes and I like to ride fast, uh, 17, 20 miles an hour at my age. And you know, about every year, every other year, I have a kind of serious accident. And about 2 years ago, I hit a, a rock hidden under leaves. It was in November, right under leaves, and broke a, uh, the non-displaced fracture, fractured my pelvis, broke some ligaments in my shoulder, and I was out of commission for about 4 months.

Yeah.

Yeah. And, and my, my wife says, well, you know, you're, you're not for— forget this dying by dementia, you're going to die in an accident. But I enjoy that, and I know that, you know, I got to be careful, uh, but there are serious risks here. And everyone I know who's a serious biker has had some serious accidents. Is it worth it to me? Absolutely. And so your point is, you know, live it up at some time. Yeah, you want to go bungee jumping? God bless you. You know, I, not for me. I like whitewater rafting. There are a lot of things I do that, you know, are reasonable risk, but great. Yeah.

With you.

Okay.

Talk to people. That's number 2. Yeah. So, and I know this is a thing with your mom and your dad had different versions of that, which you write about, but talk about why talk to people is one of these simple rules.

Well, the best data comes from something called the Harvard Adult Development Study, started in the late '30s. John Kennedy was part of the group. The legendary Washington Post editor, Ben Bradley, was part of the group, and they wanted to figure out what makes people healthy and happy over a lifetime. So they enrolled a bunch of Harvard sophomores, and then they combined it with kids, less privileged kids from inner city Boston, and follow them. And they've been following 'em for 85 years, and turns out close friends and being married, healthiest, longest lived, and happiest. There's been probably studies of 3 million people worldwide about loneliness, friendship, the number of close friends you have, the, uh, number of times you talk to them and things like that to quantify how many you have and the quality of those relationships. And those people who have more friends, see them more, live longer, have fewer health problems. So as someone pointed out, you know, uh, not having friends or having zero warm, close friends, I think is the way the study went, uh, is equivalent of smoking 15 cigarettes a day. Gives you an indication of how bad it is for you.

And it's not just psychological, it's physical, it's illnesses. Talking to someone, doing social interaction like we're doing, you know, decreases your stress level. You know, your hypothalamus, pituitary, adrenal cortex, downregulate your cortisol, the stress hormone. So there's physical manifestations of actually interacting with people and friends, and we could go on and on about the genes that get turned on and off and things like that. But in general, talking and being with people, sharing with your close friends, super important to your health, physical biological health.

I mean, uh, the feeling I get, just to make this a little personal, And I know this is going to happen today. I'm going to go home for lunch and eat lunch with my wife, and I'm going to be— and she'll see it— on top of the world because I'll say, I just had this great talk with Zeke. And she knows I've been preparing for this for a while, and it literally physically changes how I enter a space from having a deep long-form conversation with a thoughtful, competent person. So that's one thing. And I'm more of an introverted person. I enjoy, like, time— my wife knows this too— I enjoy time to myself to recharge. To think, to write, to watch TV, whatever, and work out. But those nights when we go out with friends or hang out with friends or celebrate something, man, that's the juice. Like, that's the juice. We just did it this weekend. You know, that's the juice of life. Go swimming, like, have fun, see our kids play with other kids and the kids of our friends. And I feel on top of the world after those moments too. And so I think this one of like being with people, literally bumping shoulders, having conversations with somebody who's wiser than you, all these things.

I think that's really like the whole game of life right there.

That's why it's where it is in the book.

Yeah.

Because it is, as you point out, it's the most important thing you do in your life. Almost all the wellness books besides mine, you know, emphasize eating, exercise, and sleeping. All important, don't get me wrong, but they're not the most important wellness thing you can do. The most important wellness thing you can do is really about friendships and about social interactions. And I live in Washington, DC, which has the second highest Ethiopian population in the world after Addis Ababa, the capital of Ethiopia. And almost all the cab drivers and Uber drivers are Ethiopians. You get in, I ask a person, where are you from? And he says, I'm from Ethiopia. And I said, oh, I've been to Ethiopia 5 times. And I said, where in Ethiopia are you? Which tribe are you? And suddenly we have a conversation. Just for the length of the ride. And they are— someone's been to my country, someone knows, you know, Gondar or wherever, or been to the churches at Lalibela. And they are so thrilled. And then, you know, once I even got into a heated political conversation with a guy about what's going on in Ethiopia. Fascinating.

I learned all sorts of things about the politics. So these moments, or, you know, you're sitting next to someone on an airplane, just ask them, you know, We're going to Denver. Why are you going to Denver? Is it business or is it, uh, pleasure? It's very energizing. And I like to joke that, you know, starting a conversation, you know, you're being virtuous. Not only is it good for you, it's good for them. And this is true, by the way. So you mentioned that you're, uh, somewhat introverted. It's true for introverted people as much as extroverted people. Very interesting studies outta the University of Chicago, a guy named Epley. Did these studies by telling people, you know, just casually on the commute in on the train or the bus, talk to someone. You have to talk to someone, one person at least. Um, and then, you know, you did a bunch of psychological studies beforehand and then asked them how happy they were, what they talked about, how long the conversation lasts. Turns out introverted people, they thought they wouldn't like to engage with people. Turns out they like to engage. They're happier when they do engage.

It's just like extroverted people. There's no difference. So I, I think that's a really revealing point. When introverted people act extroverted, they actually turn out to be happier because we're people. We love social interaction.

A hundred percent true. Like the feeling you get of that. This is why this may sound like an old person, I guess, but looking at like our daughters who went to college, they all wanna wear headphones. They don't look older than us. I know. Well, we are. They all want to wear headphones all the time and they don't want to listen to mom and dad. Obviously, you know how that goes. So maybe they'll listen to Dr. Zeke here, but I just want them to take the headphones off, especially as freshmen, because you want to have the opportunity to potentially talk to somebody as you're walking to class or you're walking to work out. But if you're wearing headphones, I think that really stops— this may sound like a nichey, weird thing, but I think this is very real— of take the headphones off when you're walking from class to class or to the gym, especially on college campuses and in New York City where people are walking, cuz now I, when I go to New York, I feel like everyone's wearing AirPods. What do you think about this idea of like, take the headphones out so that you could maybe have a random encounter conversation with a person?

All of that is super important. So in my classroom at Penn, I, uh, prohibit phones. So you have to turn 'em off and put 'em in your backpack or coat. No computers that can connect to the internet. And people come in and now they're talking to each other when before they weren't, they were scrolling. And increasingly that's true in high schools, but I, I'm 100% with you about, you know, random events. You have no idea who you're gonna interact with, where it might be fun, et cetera. And by the way, I'm older than you and in the early 2000s, even late 1990s when the Apple created the, what was it?

The iPod.

The iPod, right? And people were beginning to walk down the street. It drove me nuts. And I would accost people who were walking down listening. I said, you know, take those things out and interact. I have a very good friend, but one of my best friends from college who lives in LA, and he often reminds me of this, you know, when we would walk down, 'cause we were in graduate school together in Cambridge and we would, You know, remind me of, of how difficult I was to walk down the street with, cuz I was always accosting people and saying, you know, engage in the world. Don't retreat from it into your own little cocoon.

You just never know like who you might meet or whatever, what opportunity. Not, not, it's not a transactional thing. I'm just saying like in general, you just never know. You may meet a friend for life.

You also just might meet someone who tells you one interesting thing. Sure.

Sure. You know, I like the idea of increasing your surface area for lucky moments in your life. Again, that could be just one thing you learned or a friendship for life, or who knows what it could be. But whenever somebody looks at somebody else says, oh, they're just luckier than me, I'm like, well, let's actually analyze what they do every day. Maybe they don't wear headphones in between class. Maybe they, you know, there's a lot of things that probably could increase their surface area for lucky things or what appears to be. Lucky things. Well, let's do all that. One of the things you brought up, so you mentioned New Zealand, you've mentioned Ethiopia. I mean, the third one is expand your mind. So maybe that's part of travel. Where does travel come into play when it comes to like living a healthy life?

You're exactly right. It is in expanding your mind because one of the things that's good about travel is, you know, if you do it right, you are learning about someone else's culture, their food, You know what activity is going on there, what the politics is. We were just in New Zealand, you know, coffee culture there. We learned that New Zealand is brand new. So the Māori, the so-called natives, just arrived there in the 1400s, not very long ago. And white people arrived in the 1840s. And there was a lot of Māori wars among Māoris there. And we thought, well, all the New Zealanders came from Britain. Wrong. It's a very multicultural, diverse. So you learn tons of stuff and then you go to restaurants and, you know, I talk to chefs all the time. I'm having a good meal. I want to talk to the chef. I want to find out.

Do you really? You just walk to the back or what do you do?

I ask the waiter, could you ask the chef to come out and talk to him? And we had two fabulous meals in New Zealand. American Samoan, talked to the Chef who created this, like, why did he create it? You know, he learned about him being in the military and coming. Fascinating. And then a British guy who came to New Zealand and he was talking about one dish where he and his daughter were going foraging for mushrooms and how she talked about how the mushrooms were popping out through the leaves. And so the dish is, you know, leaves made out of sweet potatoes, celeriac, and parsnips and other things, and sautéed mushrooms underneath. And it was like, Wow. Fantastic. Brilliant. You know, just beautiful, fantastic tasting, great story. You know, I'll never forget it. And he was happy. And I'll tell you another. So the meal was so outstanding. Uh, we rearranged our schedule to come back for a second meal in Queenstown at the end of our trip. And I called the guy up before we came. I said, you know, maybe you can have a few other dishes. So he obviously did some research on me.

The meal comes in and we— there were a few substitutions that were already on the menu and he added them for us. And then at the end, when dessert was over, he brings out something special. We open up the container and it's got ice cream in it. He read that I had published the book, so he made a special ginger ice cream for us. You know, I will never forget that story as long as I live. And I've referred probably 25 people from New Zealand as well as people going to New Zealand already to check out that restaurant because it's so fantastic. But, you know, I just said, could we talk to him? I want to talk to this guy. He's a brilliant chef.

What it shows me, Zeke, though, is to be interesting, you got to be interested.

Yeah.

And it feels like you're a super curious dude who's also unafraid to say, what a great meal. Let me talk to the person who made it, which seems like a, well, yeah, obviously, uh, I wanna talk to the person who made this thing when most people don't do that. But it feels like, well, what does your wife think? Is she like this way too? Or, or is she like, oh, here goes Zeke again. He wants to talk to the guy who made the food. Like, what's it like?

Yes. That's what she says. And my daughter, when I sent them some pictures of the meal and I told them that we met the chef and they said, how'd you meet the chef? Did he come to you? I said, Well, I asked to meet him. Well, I mean, not a big deal. You know, we were in another restaurant in San Francisco and I hate fennel cuz I don't like licorice flavors. You know, there were like 7 dishes with fennel in them and all sorts of, including the dessert. And I went up to the kitchen and I said, you know, you're the chef. I said, you know, I hate fennel, but you made this fantastic meal that didn't taste— all the fennel didn't taste like fennel. It tasted Korean. Yeah. And then I learned that the guy's a competitive bicyclist. So we talked about bicycling. You know, all you have to do, and I think you said it right, all you have to do is be interested. Yeah. Curious. That is gonna keep you going. So I have a big hero in Ben Franklin, most brilliant man ever in America. Everything he did was world fast.

One of his defining characteristics that he had, two key defining character— three key defining characteristics. One was, endlessly curious. Something went on. He said, well, why did that happen? The second is he always tried to grow, overcome his defects, his prejudices. The third is he was a very social guy. He came back to the United States at 80 years old after negotiating the end of the Revolutionary War, and the first thing he did was to build a library for his curiosity and a dining room for his social dinners. That's the way to live.

Yeah, I think I've been a lot of inspired. I don't know the correct pronunciation of Junto or Junto. Do you know?

Yeah. Junto. Seriously? That's the way they do it in Latin America, which it's a, it's a Spanish word. Junto. Yeah.

Oh, so I would've been wrong either way.

Okay. Okay.

But that has inspired me to be an organizer of dinners and getting together people who I'm curious about and want to learn from, and hopefully that they than do it with each other. And that is also a very satisfying thing, to be a catalyzer of curious people coming together, having great dialogue, conversation, especially if they don't know each other, but maybe I'm— I do. And seeing those connections happening, that is a— I don't know, man, I don't know the right word.

Wellness trifecta, because you're eating good food, you're getting together with people, and your mind is being stretched by good conversation. You got to— I mean, 3 things from 1 activity. Fabulous.

Anybody can do it. Takes some work. Takes some work. Worth it. Worth it. Get on the calendar, book the reservation, get the room, whatever. Get the people.

Okay.

Number 4 is the title, right? Eat your ice cream. Right? And so, yeah, healthy foods and drink, but, but also we, we're gonna eat some ice cream.

Absolutely. Look, ice cream, it's a cream dairy product, which is good. Got protein. Eggs, again, excellent. Yes, it's got sugar and then flavoring. The key thing to note is that ice cream actually is the single food that decreases your risk of type 2 diabetes the most. Now you say, why? How? Well, probably because first of all, you're doing it with other people. Second of all, most importantly, it doesn't have as big a glycemic bump in your blood sugar, even though it's got a lot of sugar cuz of the way the fat protects the colon and, and, and the, uh, intestines. So it's good. There are a few things you should stop doing. Sodas, which 140 calories, no nutritional benefit. Ultra-processed foods because they're also not good for you. The to-dos are fermented foods. Our colon, our, our guts have 100 trillion bacteria, more cells, more bacteria than cells in our body. We need the good ones and we need a lot of diversity and fermented foods, whether yogurt or cottage cheese or sauerkraut, kimchi, those are really good for your gut. So I just had breakfast with my wife, you know, she broke out the sauerkraut to have with the nice omelet I made her.

So that's fermented foods. And then fiber. One of the big defects in American diets is not enough fiber. We've got all this craze about protein. Go to Dunkin' Donuts and they got protein, protein, protein. They add protein to everything. We all get enough protein. That's not our problem. There are a few people who don't, but generally Americans, 90% of Americans get enough protein, but 90+ percent of Americans don't get enough fiber. So you gotta eat some fruit in the morning. I like berries with my yogurt and granola, and then a salad for dinner, and you're most of the way to enough fiber, but fermented food and fiber. Very important to gut health. Okay.

Something that I feel like I see everywhere now, maybe it's based on being in my forties, but that's testosterone replacement therapy and peptides everywhere. Everywhere, everywhere, everywhere. Where are you at on this?

I'm at no.

Really? First of all, yeah.

So peptides are terrible. They're unregulated. You don't know what's in 'em. Now there are some peptides that we use like GLP-1s and insulin. But the peptides you're going to get from your corner store— disaster. First of all, you don't know what's in them. You don't know how they're manufactured. Lots of cases of where they're bad. And then people— the latest craze is stacking.

Please, do you think that will change though? Because I know some of them are getting them from random other countries. Is that changing? I mean, there's all these wellness doctors, there's anti-aging stuff. I get— I see it all the time. I have friends who are doing it. So I'm—

no good randomized trials. That are large enough and serious enough, and especially on the stacking where you're taking more than one. Yeah, you have no idea what shit you're injecting into yourself. You're spending all this time like, should I—

isn't it crazy that this— I mean, maybe it's just where—

that's crazy.

It feels like in your world, are a lot of people doing this? Because in mine they are. So I'm wondering what—

I stay away from that world. I am an anti-wellness industrial complex. There's just another element of sell it to people, make money on it.

What about all the testosterone stuff? As you get older and you're losing it, you don't feel the need to replace or do anything like that?

I don't want to say this, but I have— my testosterone was a little high.

So yeah, why do you want to say that?

I don't control it. I don't— I would not—

no, you probably do, don't you?

I would do that for, for one thing, let's be serious, you know, all men are going to age and end up with prostate cancer. Testosterone's gonna accelerate that. So, you know, don't do that. You, you might have a serious testosterone deficiency. That's a whole nother issue. Don't self-prescribe and certainly don't start it without measuring it and making sure that, uh, your doctor has— if you're at an, a certain age, you probably have other health issues and you gotta make sure that it's not gonna exacerbate them. And the last thing is growth hormone. Growth hormone associated with promoting cancers. Really stupid idea. That's being a schmuck.

Got you. I brought this up with my doctor. I was like, hey man, like, what do you think? I'm seeing all these guys around me looking great, feeling great. And he's just like, dude, here's what you do. And he's basically said exactly what you just said. And it was about mostly about just eating good foods, getting rid of stupid sugar. You're going out with a doctor.

What can I say?

Yeah, no, I mean, and he's done a lot of work. He's written a lot, he studied a lot. And so I was like, okay, all right, all right, all right.

Right.

The last two are, are moving and sleep like a baby. So, this importance of moving your body. This is one that I maybe take too far. The last one I'm not good enough at. So I'm just curious, this idea of just moving a lot as well as sleeping well.

The most important thing in terms of physical activity is going from horizontal— too many Americans are couch potatoes— to doing some physical activity. Now, your way, you know, you have a routine, you do all of it. You do aerobic exercise, getting your heart rate up. You do strength training and you do probably balance and flexibility through yoga or some other combination of activities and stretches. That's the combo. That's what you should get yourself to do. You know, I personally, I do, uh, yoga 20 minutes every morning to get the stretching. I ride the bike. I love riding. As a matter of fact, for my birthday, we're thinking about a 100-mile ride. Um, and, uh, You know, strength training. I lift weights. I'm not great at strength training, but I know that after 60 we lose a lot of muscle mass, so we have to actually consciously reverse that by lifting weights and doing other strengthening. My bottom leg's fine because I ride the bicycle, but the top, you know, I don't swim. If you swim, you get the top. And then sleep. Sleep is the one wellness activity you can't will yourself to do. You can set the bed.

Dark room, cool, not be drinking caffeine or alcohol 8 hours before you go to bed. Don't look at your phone and put it in another room. Read a book before you go to bed. Those are the things you can do. Taking medications, yes, we all want a quick fix to our insomnia, but they don't help. They only complicate problems. You know, I did take Halcyon for sleep for a while. And then it would just, I'd wake up and I was like, uh, a little groggy. And that's exactly why I wanted to go to sleep, not to be groggy in the morning, but I, I taking the pills was making me groggy. So it's a, it's a bad thing to do.

Got you. That's the one I struggle with, uh, the most.

Yeah, we all do. Yeah.

Do you, are you a good sleeper?

Oh yeah.

You are?

I'm a terrible sleeper.

No, you're a bad sleeper.

Yeah. Yeah.

So are you concerned about that?

I can't do anything about it. I know.

Look, how many hours a night you sleep?

So I'm a 7-hour-15, 7-hour-30-minute sleeper.

That seems good.

It's good, but I don't get, that's, I don't get all those hours all the time. I wake up multiple times a night and the deep sleep is probably on the shy end. I get about 10% of my sleeping is deep sleep. And I know that when I'm writing and I'm thinking, you know, how to say something, how to get it right, I, uh, likely to stay up longer. And so I just don't fight it.

Yeah, I got you. One more question, Zeke, before we run. It's called the champagne question, regardless if you drink champagne or not. It's one year from today. You're with the people you love, your wife, your daughters, whoever, brothers, your mom. You guys are all popping bottles and spraying it all over each other. What are, what are you celebrating? One year from today.

A year from now.

One year from today.

One year from today. It's, uh, uh, hopefully I'll finish my next book that, that Better be this year, and maybe it'll, uh, be coming out. One of the other things I was celebrating is I'll be close to 70. Ooh. That'll probably, uh, you know, September 2027, 70 years old.

Awesome. What's the next book about?

Uh, it's how to fix the fucked up American healthcare system. Excuse the French. I hope your listeners will, but everything is broken and we really need a comprehensive ref— And so I'm thinking it through. Okay.

That's ambitious. Love it. Love it, man. I love people who are like, I'm just going for it, man. Like, why not? Why not me? I mean, you seem to be the guy to write that. This one's called Eat Your Ice Cream: 6 Simple Rules for a Long and Healthy Life. Zeke, this is awesome, man. Thank you so much. I would love to continue our dialogue as we both progress, man.

I think you said we could go on for hours and I have the feeling we could. Exchange notes about various things that we've both done, both smart and schmucky. Yes.

Oh, for sure. For sure. I'd love to, man. Thank you so much, man.

All right, Ryan, it's been fantastic. Thank you.

It is the end of the Podcast Club. Thank you for being a member of the End of the Podcast Club. If you are, send me a note, ryan@learningleader.com. Let me know what you learned from this great conversation with Dr. Zeke Emanuel. A few takeaways from my notes: invest in your relationships. The Harvard Adult Development Study has the facts, the scientific research. Close social relationships are the single strongest predictor of a long, healthy life. So schedule the dinner, make the call, get together in person with your friends. Then to be interesting, be interested. That's one of the biggest things I took from Zeke. He's just so curious about people, places, food, travel, just about life. The next time you have a great meal, ask to talk with the chef. I've never done this, but I think I'm going to try it. Talk to the stranger at the next table. Being curious and open Makes for a really interesting life. And then how about his parents? How did they raise 3 boys who are putting such a dent in the world? I love a few of the things he said about them. Do good by people. They modeled what it meant to love and care for others.

His dad didn't charge a family after their 3rd kid for medical care. His mom marched for civil rights, including there at the I Have a Dream speech. Dr. Martin Luther King, and she was the anti-helicopter parent. She created an environment where her boys had to get back up on their own when they fell down and had to figure things out. We all could learn a lot from that. Once again, I would say thank you so much for continuing to spread the message and telling a friend or two, hey, you should listen to this episode of the Learning Leader Show with Dr. Z. Emmanuel. I think he'll help you become a more effective leader because you continue to do that. And you also go to Spotify, Apple Podcasts, you subscribe to the show, you rate it, hopefully 5 stars. You write a thoughtful review. By doing all of that, you are continually giving me the opportunity to do what I love on a daily basis. And for that, I will forever be grateful. Thank you so, so much. Talk to you soon.

Can't wait.