Overall: It’s been a tiring 2-3 months, with a big push over the past couple weeks getting moved into the new office. Have been falling asleep around 8-8:30p just from being tired. I might have found the new solution to avoiding doomscrolling, being too tired to pick up the phone. Of course there’s been hiccups moving into the new space including a last minute audible of having to put in a claim for the roof because of the amount of damage from the recent storms and leaks it

Automate Your Health the Way You'd Automate Your Money Health and wealth are highly correlated, and I'm a fan of automating both. The people who build real wealth aren't the ones making heroic financial decisions every morning. They set up the system once and let it run. Health works the same way. At some point you want a set-it-and-forget-it posture toward the major decisions. You work out because it's on the schedule, not because you negotiated with yourself about it. You e

Health Is a Set of Ratios — Not a Series of Extremes A long time ago Martin Rooney wrote something I copied onto my medical school desktop and kept as a note. The advice was simple. Read twenty-five pages a day. Go to two conferences a year. Talk to an expert in your field once a month. Do that for seven years and you'll be an expert in almost anything. But the line that actually stuck wasn't about expertise. It was about your entertainment-to-education ratio — how much of yo

Overall It's been a strong push getting everything ready for the move over the next two weeks. Stressful — these have been a challenging couple of weeks, and I'm excited to have it behind me soon. The coordination has been the hardest part. Once it's complete, I want to make time to reflect on it and celebrate what's ahead. This is a major milestone — the culmination of nine months of work. Physically, the back rehab continues to progress. I'm pushing a little harder in the g

Right now everyone wants to know their biological age. The wearables sell it, the clinics sell it, the supplement companies sell it. People walk in genuinely rattled that an app told them their "true age" is seven years north of their driver's license. I understand the appeal. It's a more interesting question than how many times you've circled the sun. But you don't have one age. You have at least four — chronological, biological, functional, and emotional — and the inconveni

Overall: Shoulder/pec is feeling better week over week. PT finally got out of the ROM only phase and started doing light resistance. Still ahead of schedule on rehabbing that but suspect it will be another couple of months to get back into drilling only with BJJ. Went in and seeing some of the guys from BJJ on Sundays is good, but just makes me want to get back on the mats. Move is coming up in 3 weeks to the new building. Hopeful that ends up being a good thing for patient

When it comes to your long-term health — how long you live, and how long you stay functional while you do — I'm not sure anything matters more than your metabolic health. That's a big claim. Here's why I make it. Metabolic health is how efficiently your body manages fuel. It's the ability to take in energy and process it without the system backing up. Almost every other topic in this series eventually drains into this one. Sleep, exercise, nutrition, cellular function — they

I love birthdays. For the past decade I've done a review twice a year and set goals for the year ahead. One lands in December. The other lands around my birthday, July 18, and I start it about two weeks out. Last December the reflection stretched across the whole month, which tells you something about the year I was having. Most of life is swimming. Head down, arms turning over, working hard just to stay afloat. That's not a complaint — it's the job. But you can swim for year

Overall: Being busy continues. Continue to feel like there's improvement in the pack healing and range of motion. Had follow up physical therapy this week and it seemed like range of motion was objectively improving. Still have significant restrictions in the right arm to only work on range of motion exercises without loading. Subjectively can start working on back exercises for that arm in the next two weeks. Training with Mike has gone really well. Certainly a change and t

Two terms have been making the rounds lately: cellular health and mitochondrial health. The pitch is roughly the same in both cases. If the cell is functioning efficiently, the whole organism is healthy. Optimize the mitochondria and the rest of the body falls in line. This gets positioned as a more sophisticated alternative to traditional medicine, which is framed as a reductionist, organ-system-by-organ-system approach that misses the deeper picture. I don't have a problem

Overall: Happy 4th of July and Happy 250th Birthday to the United States of America. Just finished the third week being post-op from my right pec major repair. Came out of the sling more or less full time this week. Pain has still overall been limited and things feel better in the shoulder on almost a daily basis. Rough week for my left leg because my patellar tendinitis and then turf toe on the left flared up from doing too much on the leg and then limping around. Second

Longevity VII: The Mind Is Not a Wellness Topic If we're being honest about the longevity stack, mental health belongs in the top tier — alongside sleep, exercise, diet, and not smoking. Not in a separate "wellness" bucket where it gets lip service and a meditation app recommendation. The data is too strong for that. Depression carries an all-cause mortality hazard ratio in the 1.5–2.0 range. That's the same neighborhood as smoking and sedentary behavior. Loneliness and chron

The People in Your Life Are Keeping You Alive Human beings are wired for connection. Underneath most of our frustrations, our political tribalism, our late-night arguments with people we barely know on the internet — there's a more basic craving. We want to feel heard. We want someone to understand our perspective. The trouble is that's an unreasonable expectation. No one will ever fully understand your personal narrative because they haven't lived it. I write more than most

Overall Happy Father's Day to all the dads out there One week postoperative. Recovery has been much better than expected from a physical standpoint. Mental to no pain since the time of surgery. Swelling is significantly down over the course of the past week. Mentally been a very challenging week. What's efficient at work and difficulties navigating normal human functions with one arm. Challenging week for a bunch of people that I really care about and just hope to be suppo

Nutrition is the longevity topic everyone wants a clean answer to and almost nobody acts on. Most patients want to know which diet correlates with the longest lifespan. Then under 1% of them will make a sustainable change over the following year. The information isn't the bottleneck. It hasn't been for a long time. So this piece is going to do two things. First, lay out what actually moves the needle. Second, name the reasons people don't follow through, because that's the mo

Overall, an interesting week. I had surgery and things went well overall on Friday.Was notified that I'd have a morning surgery on Thursday. Had significant concerns going into surgery and was second-guessing everything. Continuation of the denial and grieving stage of knowing that I'd be rehabbing in normal life would not continue until the rehab process was complete, which will take approximately 9 to 12 months. I thought Dr. Backes did an absolutely wonderful job of just b

Exercise is the closest thing we have to a wonder drug, and yet most people get it wrong in predictable ways. I covered the mechanics in an earlier four-part series on exercise, and a year later, my thinking hasn’t really shifted. The way I find it most useful to think about training is through four lenses — strength, cardiovascular, psychological, and social. Each one matters. Most people are heavily underweighted in at least two of them. The one principle that governs stren

Overall: Challenging week. Ruptured my pec tendon and confirmed that with planned surgery next week. From a patient perspective it was interesting how much denial I was in. I more or less diagnosed myself at the time of injury, then did mental gymnastics up until I got the MRI trying to convince myself that it didn’t happen. As much as I hate the thought of surgery, I think it’s the long term responsible choice even though it’s going to be a frustrating 3-6 months just to ge

Pills, Potions, and Sorcery - Longevity Drugs, Supplements and Interventions The single most common question I get in the longevity space is some version of: is there a chemical that will actually make me live longer? People want the holy grail — a pill, a peptide, a protocol — that requires minimal effort and delivers more years on the clock. I understand the appeal. I also have to tell you the truth. The Core Problem: We Don't Have the Data Before we can talk about specific

Overall: Back was sore post the dead lift day and I need to be more mindful of doing some glute activation work. Also am rethinking adding in some sort of mobility during the clinic day. I’ve been too sedentary during the work day lately and need to think of more ways to get in a little more movement. Unfortunately strained my pec this morning. Will probably be a month or a month and a half before I can get back to normal training. I’ll know where things stand in the next w