Pushkin.
I was really angry, I said, heart cancer. Nobody gets heart cancer, kidding? Is that even a thing?
At just fifty nine years old, neuroscientist David Lindon received a startling diagnosis. He was told he only had six months to live, maybe a few more if he was lucky. But now it's been more than two years and David, thank goodness, is still here and in the face of his terminal diagnosis, he's still thinking like a scientist.
Confronting my medical diagnosis with curiosity about the world and asking how can I interrogate my own mental processes and perhaps reveal something to myself about the mind or the brain? That's therapy.
On today's episode, we hear how a student of the human mind is grappling with his own mortality. I'm Maya Shunker, and this is a slight change of plans, a show about who we are and who we become in the face of a big change. David Lindon is a professor of neuroscience in the School of Medicine at Johns Hopkins University. He's written five books in more than one hundred peerod papers on the science of memory, addiction, and brain injury.
David has always been a deeply curious person. As a kid growing up in southern California, he was obsessed with watching Jacques Cousteau on TV. For a while, he thought he become a deep sea explorer or a marine biologist. But then one day he had this life changing conversation with his father.
My father was a psychoanalyst, meeting an old fashioned lawe on the couch, tell me about your dreams four days a week, talking cure psychotherapist. And my father and I, from as long as I can remember, I think, before even kindergarten to the very last week before I left for college, had dinner together in a restaurant every Wednesday night. That was our way, and we would sit there and we would talk about all sorts of things, and one of the things we would talk about, which is weird
family conversation, was his analytic clients. Now, of course he didn't tell me any names. He obscured some details because you know, he didn't want to break confidentiality. But you know, family conversation would be something like, oh, so you know, how's your narcissist doing. Oh, well, he had this dream. I think it really was, and so I began to wonder. I said, Dad, clearly, you're talking to people makes them
better in many cases. And he said, yeah, it doesn't work every time, but most of the time it works. People feel better, and they can feel better from things like compulsions or obsessions or depression. And that's rather remarkable. I said, how does mere conversation do that? And what
my father said had an enormous impact on me. He said, when the talking cure works and makes people better, it ultimately does it not in some airy fairy realm, but by changing the brain, by changing the biology of the brain. And at that moment it was like some wheels clicked in my head and I went, wow, yeah, he's right. What's that? I thought, Well, I don't have the right personality to be a psychotherapist like my dad. I'm not
nearly nice enough. But maybe I could study the brain, and maybe that would be a different way to get at some of the same issues that my father's getting at at a more small scale biological level.
What were some of the big questions that have guided you over the course of your career.
Well, I would say the fundamental question that I've been interested in is how does experience get stored in the brain, and how does it change the function of the brain. And that's something that we can now start to understand a little bit on a biological level, and that's what I've spent most of the last forty years working on.
I want to fast forward in time to twenty twenty. You start feeling some unusual symptoms around this time. Do you mind bringing me back to that period?
That's right, So the summer of twenty twenty, of course, is not a random time. COVID is raging. There's no vaccine yet, all kinds of people are getting sick, and it's a public health disaster. And in the summer of twenty twenty, I started to feel very fatigued, and I had some respiratory symptoms, but the main thing is that I just felt surprisingly tired, Like halfway up a set of stairs, I would have to stop and catch my
breath and huff and puff. And I thought, well, I'm testing negative for COVID, but it just must be a false negative. I've got half covid, because like everybody's got COVID, and these symptoms overlap to some degree with COVID symptoms. So I just figured, all right, I got COVID. There's really nothing to do about it, you know, I just have to stay by myself and wait it out all feel better. And I just wasn't feeling better, and my wife said, you know, you're just not feeling better. You
got to go to the doctor. And so I went to the doctor and they saw that there was a big, huge mass poking up next to my heart that they didn't expect. So they imaged my heart and they found this huge mass and that was an indication that they needed to open up my chest and to open heart surgery and remove it. So they did that and it was a big, involved, unpleasant process, and I was in the hospital for ten days. And then they took the tissue that they had removed and they sent it off
to the pathologist. And after a few days the report came back and the pathologists said, well, you have a rare kind of cancer called synovial sarcoma. And my oncologist said, you've got about six to eighteen months to live. And so, you know, that was quite the shock because it wasn't clear that this mass in my heart was going to be cancer or that it would be anything quite so bad.
And do you remember what exact thoughts ran through your head when you first heard this diagnosis.
Well, you know, I was really angry. I said, heart cancer. Nobody gets heart cancer. You're kidding? Is that even a thing? You know? It sounds fake. You know I've even heard of heart cancer. I have never heard of heart cancer. I didn't even know it was a phenomenon. It sounded to me like a made for TV movie, not a real diagnosis. I'm like, you're kidding me. But really, the main thing I was thinking about, and I might get a little weepy here with my family. You know, I've
had a life. I'm sixty one years old. I got nothing to complain about. But you know, I don't want to leave my family behind. I don't want to leave my kids, my twenty six year old twins. I don't want to leave my wonderful wife, you know. And that's really what I was thinking about at the time. It's like, my consciousness can go away and I'm at peace with that. Leaving them behind, that prospect is what I find so hard, so wrenching.
Yeah, I'm wondering, David, if you could speak to what's been interesting to you about the way that you've responded to your diagnosis.
So one thing I noticed was that when I got my cancer diagnosis, I felt two seemingly conflicting emotions at the same time. One was I was quite hot angry at the universe for having been struck with this obscure cancer at age sixty one, when I had so much left to do. But at the very same time, I felt a deep sense of gratitude about what life has given me so far. I've really, genuinely, and I don't think this is just a cancer guy looking back with
rose colored glasses. I've really genuinely had a terrific life. I had wonderful parents, I had an unusually supportive group of friends in high school. We made our own weather, and it protected me from a lot of things that can be so painful and challenging in that stage of life. I have a job where I can follow my own own curiosity and inclinations every day, and I get paid
decently for it. And that's a gift like no other to wake up in the morning and be able to say, Huh, what interests me today and what do I want to do? So I was very grateful for that and all the people who've been around me. My kids are terrific. You know, I have a wonderful family life, I have good friends. So I was simultaneously feeling very grateful and also really angry. And my training in neuroscience made me think, well, how
can that really be? I mean, we think in terms of oppositional states, like you're either fighting or you're fleeing, and that's not the case at all. We can simultaneously occupy two very distinct mental states simultaneously, and I think, well, for many other people that would have been obvious to them to dumb me, that was a revelation.
You know, David, I'm so interested to hear. You've just given me one example that I'm so interested to hear. How your perspective as a neuroscientist has informed how you're processing your terminal cancer diagnosis. In a piece you wrote for The Atlantic, you shared how it has led to some new and fresh insights about life and death and what it means to be human. And I pulled up one quote that really had a powerful impact on me. He wrote, the deep truth of being human is that
there is no objective experience. Our brains are not built to measure the absolute value of anything. All that we perceive and feel is colored by expectation, comparison, and circumstance.
I think everyone, if they think about their lives, is led to the same conclusion. You know. The example people always use is, well, half an hour in conversation with a good friend goes by in a flash, But half an hour waiting at the Department of Motor Vehicles in a hard plastic chair seems interminable.
Right, Oh gosh, yeah, it's.
The very same thing. Because I'm interested in the sense of touch, you know, one of the examples that comes up for me is that imagine you're with your sweetheart in a very loving, connected time and they stroke your arm and you go, oh, that's so nice, what a what a nice gesture. Oh that feels good. And then imagine that you're with that very same sweetheart and it's in the middle of an argument and it's not resolved.
You're right in the middle of it, going back and forth, and they go to give you that very same caress, and it's exactly the same. It's the same place on your arm, it's the same pressure, it's the same speed moving along your skin. In terms of just the physics of it, it's indistinguishable. But are you going to feel, Oh, that's so nice, and you can be like, oh, get off me. It feels like a bug. It's terrible. Now what are you doing touching me that way in the
middle of an argument? We're in the middle of an argument right now, right, and so the very same caress is delightful and bonding and one experience and feel so welcome and intrusive in another. In neuroscience and in psychology, we call this perception as inference, meaning that there is no objective truth out there through the world that somehow
fights its way through our senses. Everything that we perceive through all our senses is colored by what we expect, what our mood is, what's going on in our lives. And the way it came up for me in terms of my cancer diagnosis had to do with time. And so if someone had said to me prior to my diagnosis, hey, we know that you've got five years left to live, I would have said, oh, no, I should have more than that. Oh that's terrible, Oh whatoe was me only
five years to go? Whereas if someone tells me right after my cancer diagnosis, when I've been given the diagnosis of sixty eighteen months. Oh well, actually you'll have five years now. I'm going hooray. Five years. That's a whole lot better than eighteen months. Boy. I can do all kinds of things, you know. I can go traveling, I can spend time with all my good friends. I can get some work done. Five years is terrific. Thank you for the five years.
I mean, given that you're now perceiving units of time differently, right, five years feel so expansive in a way that it never would have before. Has that changed it all the way that you're spending that time. Has it changed the way that you think about moments?
Yeah, it sure does. I definitely feel like I need to ring all the delight I can out of life in the moment. I realize it's a little bit of a trite thing, but it's true. So this, I think has been manifest in some, you know, straightforward ways, like my wife and I take mortifications then we used to before my diagnosis, but also in some rather deep interpersonal ways. For example, my wife and I were not big arguers.
It's not like we have a really contentious marriage, but in any serious relationship there's always some back and forth, a little bickering, and now you did this, and you said that, of course, And I think it's definitely easier to let stuff go when you're thinking, well, maybe my time left is limited, and I don't need actually to die on this hill of how the dishwasher was loaded.
We'll be back in a moment with a spike change of plans. Neuroscientist David Lindon received a devastating diagnosis of heart cancer just shy of his sixtieth birthday. Soon after, he found himself fascinated by how his brain was reckoning with his mortality.
When you're still with yourself and you think I won't be here there will be a time when I'm not here. I really find that, even doing my very best to be quiet and concentrate on that, at some level I fail. I really can't engage in a deep way with a world without me in it. And I thought, well, this just might be because I suck and other people can. But I suspect it's not. I mean not saying that I don't suck. I do, But you know, I think I don't think that's the entire story, David.
I don't think you suck, for it's just putting it out there.
You know. Part of this, I think is revealing something that's fundamental about being human. I think we as people have a hard time truly imagining our own demise a world without us in it. And when I think about what we know about the brain, I speculate about how this may have come to be. And for me, I'm an old guy. Now, I've been doing brain research for forty years, and so I've been in it long enough to see a shift in the way we think about
brain function. Forty years ago, people thought about the brain as a fundamentally reactive structure. Oh, you're just sitting there and then you wait and something comes in through your senses, your eyes, your ears or whatever, and then some processing happens and then you react to it, you contract a muscle, you speak, whatever, And that's fundamentally what the brain is there doing. And what we have known for about more maybe the last fifteen or so years, is that really
the brain is a prediction machine. That the brain's when nothing particularly is going on, you're just kind of spacing out an idling. Really, what you're doing in the background all the time is trying to make predictions about what's going to happen in the very near future. Is that ball flying through the air going to hit me in the error or will it zing by? Is this person coming up to me, friend or foe? Am I likely to become hungry in the next two hours? And how
should I plan for that? It's something that happens continually subconsciously, and I think the fact that our brains are always predicting the future in a deep way presupposes that there will be a future, right. The wiring of our brain is built on the idea that there will be a next moment and a moment after that, And so I think this makes it very hard as a human to truly imagine yourself gone, because that next moment is a
thing that's deep in our consciousness. So that's really true is on an individual level, but it really got me thinking about the world's religions. In almost every religion, not everyone, but nearly everyone, there is a concept of the afterlife or reincarnation or melding with the divine, or some way of going on after you die, that your consciousness endures
after you die. And so my hypothesis about why after death stories are a near universal around the world is because our brains are wired to imagine that there will be a next moment, and that through culture, this has come up with all these different after death stories.
You know. One thought experiment I've used to try to imagine a world without me is simply to imagine the year before I was born. And for some reason it's very very comfortable for me to imagine that that world existed. So like nineteen eighty four, that was a year everyone was in it. Mayo is not here. And so I do wonder, David, whether it's possible to kind of transfer that psychological state of comfort where it's like, of course,
the world existed without me in it. In fact, it existed without me in it up until that very point where I came into existence, to the current situation you're in, because in many ways, your pre birth state is exactly what you're going to be occupying.
Yeah, well that is a really interesting and valuable point, And yet somehow it doesn't seem quite.
The same, doesn't It doesn't Because we have this entire lived experience and self identity that we're clinging onto and a consciousness that we're clinging onto, and that because that consciousness is now going to be annihilated. I completely agree. It is not easy to view things effortlessly through the lens I just described. I just wondered if it was something that can make all of us feel a little more comfy with the idea of our non existence.
I think it's a great idea. Yes, I'm with you, And I also think it's crucial to ask the question, you know, if there's something that is so prevalent in human culture, and even if you don't share those beliefs, it's arrogant and annoying to just say, well, people who believe that are just dumb, and what are they thinking? In these are made up stories? You know, that doesn't I mean, first of all, it's a dick move, and second of all, is intellectually it doesn't get you anywhere
at all. So, okay, maybe you're a non believer. But if you're a non believer, then you should be really interested in why are certain things so prevalent cross culturally? I mean, these are fundamental aspects of our being human. And to have your answer be well, people are stupid. I think it's not just arrogant. I think it's fundamentally incurious.
It seems like you're really calling upon your curiosity about how our minds work to help you navigate this time, to help you get through this time. Tell me more about the role that this kind of curiosity is playing in your life right now.
Well, you know, I think curiosity to me is like the grease that makes all the gears go around, right, It's fundamental, as like oxygen. And I think generally there are many endeavors not just science, where you think about in question the world around you. And when you get a cancer diagnosis or something similar like that, you're really feeling buffeted and at the whims of fate. And you know, a lot of the medical treatments you have to endure, chemotherapy, radiation,
you know, it's not an empowering process. You really don't feel like you're in charge. And so I think it's so crucial in these times to have some sense of agency and individual volition. And so for me confronting my medical diagnosis with curiosity about the world and asking what does this make me think about the world generally, and how can I interrogate my own mental processes and perhaps reveal something to myself about the mind or the brain.
That's therapy. And so to me, curiosity is what allows me to continue to have a positive outlook even in dire circumstances.
You know, it strikes me that curiosity is one of those things that you can hold on to that the world simply cannot take away from you in this moment. It cannot deny you the right to be interested and intrigued and to marvel at how things work.
That's right. And you can even make you marvel about things that are deeply unpleasant in the moment. You know, I'm blessed to have a rather sunny disposition. I've been fortunate to not have much of a predisposition for depression, and I don't take any credit for that. I was
lucky to be born that way. But when I was undergoing chemotherapy and radiation, the radiation was aimed at my heart, but it then burns your esophagus because you can't help it hit the esophagus when you're aimed at the heart, and it means you can't swallow. So for weeks I couldn't eat food. I could only swallow liquids. I couldn't eat anything solid, and it hurt like hell all the time, and my energy was low, and thing just didn't feel right, and I felt messed around with, you know, and you're
talking about a sense of agency. I always feeling like I do not have my normal sense of agency. I am at the mercy of these treatments. And you know, even though I'm a pretty positive person, I started to feel pretty low in those days. Day after day, you wake up and you feel bad in your body. It's almost impossible to have a sunny disposition. But the one thing that really kind of kept me going then was curiosity. I'm like, well, why am I feeling so bad? Is
it because of inflammation? Is it because the radiation and the chemo are causing my immune system to produce a class of molecule we call pro inflammatory cytokines, and we know that those tend to lead to depression in the brain. So while I'm lying there feeling terrible in the midst of chemo, I'm kind of going, huh, I wonder if I wonder what I interlutin six levels. You're like right now, you know, you know, which is a deeply nerdly thing
to do. But it's also empowering, right, It's also it's also you know, claws back a tiny bit of agency from a situation that is otherwise pretty bereft of it.
I mean, okay, it's it's such a charming story. And you know, I will say I think I'm a pretty curious person, but I think my curiosity has limits. And you know, it feels relatively easy to feel wonder about the world or how things work when things are going well, But man, is it hard when you're in the middle of chemotherapy and radiation or you're facing a terminal illness. Like I can tell you, if my esophagus was being burned in any way whatsoever, you would hear zero curiosity
from me. Okay, I'd be like, what the f this is awful? Well, I'm not that interested in whether it's a roading tissue or whether the cells are doing x RA, while if you like, this effing sucks. And so I want to get some advice from you in this moment, Like you know, the mere plebeians among us, the normal people here who are listening to you, David, the neuroscientists who aren't empowered with all the knowledge you have and
maybe aren't as curious as you are. How can we cultivate more curiosity during moments of extreme hardship, because that is actually a tall order.
Yeah. Well, I guess it's almost like a procrresplanation problem. In other words, it's like, how do you take the first step? If you can get yourself like a little curious about one aspect of it, maybe you'll feel enough reward that you'd be motivated to go a little further and a little further. This is really speculative.
Now, right, Yeah, you're getting your foot in the door.
Yeah, I'm just imagining.
Yeah, But I also think maybe a more modest recommendation for people who are just trying to get their feet wet filing a bit more curious is to say, look, you don't have to be captivated by the details of your illness. Okay, that is a tall order. It might require some biological or neuroscientific expertise like that, that's too hard of a task. But we can be curious about something in the throes of hartshet. We can be curious
about why we feel the way that we feel. We can be curious about why the sun sets in the way that it sets. There are endless topics for us to be curious about and to learn about. And what I'm hearing from Your whole story is that curiosity can be a companion for us in these really tough moments
because it won't abandon us. It's always there. It's always something that we can feed and that's a very stabilizing force against the backdrop of complete uncertainty and calamity, which is what we often experience when we're going through the hardest moments of our lives.
Right, And I would add that you can be curious about the social world, you can be curious about art. Your curiosity can manifest like how can I convey what I'm feeling now in a song or a poem or a painting or a.
Drawing, yeah, or what the meaning of life is?
In other words, these are all fundamentally acts of curiosity, and they don't have to involve science. Those are the ones that I'm drawn to because that's my background. I would say, in a more global sense, harnessing curiosity can happen in so many different ways.
Yeah, you are living well beyond the prognosis you were given. So as you mentioned in April twenty twenty one, you were told you had six to eighteen months to live, and now it has been over two years. As you look towards the future and what lies ahead. How do you feel? What do you see?
It's all gravy, That's how I feel. You know, there's a cognitive shift in the sense that I've got these extra innings and so it would be a shame to not use them in a way that is enjoyable and connecting and empowering and fulfilling. So yeah, there's a silver lining to terminal illness when you're granted a little extra and I certainly feel compelled to live it as well as possible.
Hey, thanks so much for listening. If you enjoyed this conversation with David, you may also enjoy another episode called The Life Changing Diagnosis. It features my friend Scott, who I spoke with just after he received a stage four cancer diagnosis. I then followed up with him a year later after he successfully completed cancer treatment. We'll link to
both episodes in the show notes. And I'm excited to share that this summer we're curating a series to showcase your favorite episodes, So stick around for some of the all time greats recommended by your fellows Slight Change listeners, and later this fall, we're back with brand new episodes of a Slight Change of Plans. I hope you have a wonderful rest of your summer. See you soon. A Slight Change of Plans is created, written, and executive produced
by me Maya Shunker. The Slight Change family includes our showrunner Tyler Green, our senior editor Kate Parkinson Morgan, our producer Trisha Bobida, and our sound engineer Andrew Vestola. Luis Scara wrote our delightful theme song and Ginger Smith helped arrange the vocals. A Slight Change of Plans is a production of Pushkin Industries, so big thanks to everyone there, and of course a very special thanks to Jimmy Lee. You can follow A Slight Change of Plans on Instagram at doctor Maya Shunker.