#288: Columbus Batiste, MD - It's Time for a SELFISH Health Revolution!
Are you ready to put yourself first for all the right reasons?
Rip is joined by cardiologist Dr. Columbus Batiste to share that true self-care isn’t selfish—it’s essential as a foundation for helping ourselves and others.
In his new book, Selfish: A Cardiologist's Guide to Healing a Broken Heart, Dr. Batiste shares his seven key pillars of heart health: spirituality, exercise, love, food, intimacy, sleep, and humor - showing how each one plays a vital role in your well-being.
This conversation isn’t just about avoiding disease—it’s about thriving, showing up for yourself and your loved ones, and reclaiming control over your health.
And what better time than Heart Health Month to start?
Episode Highlights
Meet Dr. Columbus Batiste
The Impact of Recent Wildfires on Health
Understanding Interventional Cardiology as a “Plumber for the Heart”
Dr. Batiste’s Personal Journey to Medicine
Training at a Blue Zone and Working for Kaiser Permanente
Introducing the book, "Selfish"
Dr. Batiste’s The Seven Pillars of Health
The Role of Spirituality and Breath on Heart Health
The Importance of Exercise and Movement
How Love and Gratitude can Heal a Heart
How Procesed Foods Wreak Havoc on Heart Health
The Necessity of Community Support, Connection and Humor
About Columbus Batiste, MD
Dr. Columbus Batiste is a double board-certified Cardiologist, Interventional Cardiologist, and passionate lifestyle advocate. Through the support of many giants in the field of lifestyle medicine, he embarked on a crusade to educate and empower patients to enact change and defeat these preventable diseases thereby extending their health-span.
Order Selfish
Episode Resources
Dr. Columbus Batiste’s Website
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Full Episode Transcription via Transcription Service
I'm Rip Esselstyn, and you're listening to the PLANTSTRONG Podcast.
Heart Health for Valentine's Day
[0:05] Hello, PLANTSTRONG lovers. It's Valentine's season, and while love is in the air, I also know that many of you out there are suffering from a broken heart. And I'm not necessarily talking about a lost love here. I'm talking about those everyday stressors of life that lead to heart disease, anxiety, and depression. Well, today our Cupid comes in the form of Dr. Columbus Batiste, and he's going to share why it's okay for you to get selfish with your health. We're going to have this uplifting conversation right after these words from PLANTSTRONG.
[0:46] Music.
Heart Month Promotions
[0:52] Not only does february happen to be the month of my birthday it is also heart healthy month and there's no better time to fortify that awesome incredible heart of yours at PLANTSTRONG we're all about building a fortress against all the ultra processed foods that are out there starting with what's in your pantry. Now, in honor of Heart Month, we're giving you, podcast listeners, an exclusive 10% discount on your next order from PLANTSTRONG Foods. Stock up on wholesome, nutrient-dense staples that are free from oil, refined sugars, and all the excessive salt. Just use the code PODCAST10 at checkout and take the next step in protecting your health with foods that truly love your heart. Just go to plantstrong.com and make it happen. Attention healthcare providers and health enthusiasts, join me for a life-changing Plant Strong retreat where health, education, and personal transformation collectively meet. I am thrilled to announce that our 2025 retreats are now approved for continuing education credits for physicians, physician assistants, nurse practitioners, and nurses.
[2:20] Immerse yourself in the healing beauty of Sedona, Arizona, or Black Mountain, North Carolina, while discovering how the power of a whole food, plant-strong lifestyle can transform lives, including your patients and your own. Learn from leading experts in plant-based nutrition. Earn continuing education credits in a breathtaking setting. Experience workshops, delicious plant-based meals, and a supportive community. Whether you're a healthcare provider seeking professional growth or someone who's passionate about protecting your health, this retreat is the perfect opportunity to recharge and reimagine what's possible. Don't miss this chance to elevate your health and your practice at PLANTSTRONG Retreats. Visit liveplantstrong.com today and I look forward to seeing you in either Sedona or Black Mountain in 2025.
Meet Dr. Columbus Batiste
[3:19] Dr. Columbus Batiste, welcome back to the PLANTSTRONG podcast it's a pleasure to have you oh man it's so great to see you and thank you so much for having me listen my pleasure and for everyone that um, that doesn't know Dr. Columbus Batiste and his work, he appeared on the PLANTSTRONG Podcast probably two years ago. It was episode 115.
[3:48] Definitely check it out. But I've got Columbus on today because he has written a book. It is called Selfish. Here it is right here, Selfish. and it is a cardiologist guide to healing a broken heart and unfortunately i think way too many of us have broken hearts uh would you say that's the case yeah well you know i mean i'm sure you probably have broken plenty of hearts but but yeah that that's not the type of broken heart i'm talking about not exactly not exactly but yeah no we we do you know we're under so much strain And, you know, that way of describing what transpires when it comes to this cardiovascular occurrence from intense stress, it's so profound. It was something that I wasn't taught in med school, but it's something that really kind of came out as my career evolved and I started seeing more and more and more of it in my patients. Yeah. So I want to definitely dig into the seven pillars around living a selfish lifestyle and how it can help heal a broken heart. But before we do, let's dive into a little bit about your background because I think it's really important that people understand who you are and kind of what makes you so unique and special.
[5:14] And for starters, you grew up in LA, in Camden, right? And let me just say at the top of this how my heart, goes out to everybody in LA and the tragedy that just happened. How are you and your family doing right now?
[5:35] Yeah, no, well, first, thank you. And I agree. Our hearts and prayers go out to everyone inside Southern California who's been suffering. But even more importantly, I think it's a moment of gratitude. And we'll talk about this to all those frontline workers, to our firefighters, to the police officers, to those who have volunteered their time, their energy, their resources in order to help begin the process of rebuilding. And that's so powerful, but, you know, thankfully my family is safe, but I have had friends, um, who's lost their, they lost their homes. You know, I've had, uh, colleagues who've been displaced. And so this is real. It hits home significantly as it relates to what's transpired. And, uh, and you were talking before we kind of went live here about the, there's going to be some cardiovascular implications, ripple effect because of these fires. Can you talk a little bit about that?
[6:31] Yeah. You know, I mean, I think we get lost in the whole issue of fires and the wildfires and we think, okay, you know what? There's destruction of property, but it moves beyond the destruction of property. Obviously there's an emotional loss for many people. They lose valuables that are not, you can't put a monetary value on it. So that's one aspect of the stress that happens from there. But what lingers really is the toxic fumes. After the smoke has cleared, after the ash is gone, it still persists because these wildfires, studies have shown are about 10 times more toxic than your standard fossil fuel pollution.
[7:08] Now, why that's so important, you can imagine you're melting in all this technology, the computers, the lights, and you have all these heavy metals that are aerosolized. You have these volatile organic compounds. You have these polyaromatic hydrocarbons that are there. And what they do is they attack the lining of the vessels, the endothelium, and they are able, they become so refined. They call it particular matter 2.5 micrometers, right? So the PM 2.5, it's so small, it can bypass your lungs defenses and they can enter into your bloodstream. And so it's crazy that they've done studies looking at fires and so forth and the reverberations that literally one, two, three years up to 30% of individuals are still suffering with symptoms related to smoke inhalation. And so these things can be triggered.
Impact of Wildfires on Health
[7:59] They become embedded into your home. They can be embedded. So the cleanup becomes important. Protecting yourself becomes important with the appropriate gear, right? We have to gear up in terms of mask. And then we have to take care of ourselves, which is what you and I promote on a regular basis is so vitally important for kind of saving our hearts, even after the loss of our property and our, our valuables.
[8:25] What's the... What do you, what's the vibe there? Is it, is it, is it hopeful? Is it positive? Is it just one of despair? I mean, can you put your finger on the pulse?
[8:42] Yeah. You know, it's hard to place a finger on the pole. So thankfully I'm not in the midst, I'm not in the proverbial fire of it in the centerpiece, but I would imagine like anything else, here's the stages of grief, the stages of loss, you know, the denial, the anger, the bargaining, all these stages, they're going to take place. And this, this cleanup is going to take years.
[9:06] So, I mean, I think one of the differences when we look at the fires that, really struck Northern California several years ago and the fires here is that this is a major metropolitan area and it's expansive. So in terms of rebuilding this, first the cleanup, then the rebuild of it, this is literally going to take years. And then you mirror on top of this that Los Angeles has, guess what Los Angeles is going to have in the next four years? Oh my god yeah yeah right so so now you have this pressure to rebuild while you're building the infrastructure just to welcome the world into this this part of the country and so there's going to have to be a pouring of outpouring not only of love and support of resources of time of energy that's going to be so expansive and and you know i'm concerned really about the health during this period of time. And that's why, you know, I've gone on and I've spoken about some of the things that I've researched as it pertains to the impact of the cleanup. And I mean, I'm speaking to a firefighter, so you know about all of the impact of some of this and what it can have on you.
Understanding Interventional Cardiology
[10:18] Thanks for talking about that a little bit before we talk about a healthy heart. So for your background, you're an interventional cardiologist. You refer to that as a plumber for the heart, which I love that analogy. But will you let the audience know what exactly does an interventional cardiologist do?
[10:43] Yeah. Yeah. So there's multiple types of cardiologists and I love trying to break things down a little bit simply. So you have what I call your general contractor. They take kind of take care of a little bit of everything. That's a general cardiologist. Then you have your electricians of the heart and they're really dealing with all the electrical circuitry, the arrhythmias, the palpitations, the need for pacemakers and defibrillators. Then you have your, your body and fender guys. These are our heart failure specialists. When the heart becomes too stiff or too weak, that they really work to try and restore the normal function of the heart. And then you have guys like me, they dig down and get dirty with the plumbing issues. When we've all had plumbing issues, when sinks clog up and everything of that sort, the hair, the gunk, the metal. And so our job is to go in and throw us in the acute heart attack and restore blood flow. And so that's what I was trained to do was to go in and restore the blood flow through the application of either stents and or referring for open heart surgery. Now our field has evolved to also replacing what I call the doors called heart valves that allow blood to flow in directions that we now can do that through the growing and through other access points and saving individuals from, from that.
A Personal Journey
[11:52] And, you know, I mean, my evolution was, is that I was trained like every other doc. And we've heard this probably a thousand times in the ways and the arts of pills and procedures until I, I found the old ancient art of lifestyle and that and i've recognized the power of that ancient art and become a jedi so to speak in terms of in terms of using these modalities self-treatations that's fine that's fine yeah you got the the book that was hiding and had all the dust on it and you kicked it around a little bit that's right i think i you know so one of the things to me that's really powerful about your journey and you it's the first thing you talk about in your book selfish is your your father.
[12:36] And basically you watching your father suffer and die way before he should have from complications from diabetes, right? That's right. And so what kind of an impact did that have on the trajectory of kind of your career path? It had everything to do with the way my path kind of took forward. I mean, you know, my mom is still here with me and she turns 90 this year and she's great and I love her. And and I always have to acknowledge her because I talk about my dad so much, but she's really been a rock in my life. But when I think about my dad, my dad is really what drove me towards medicine. He said, are you going to be a doctor, a lawyer or a business person? Which one are you going to be?
[13:23] And, you know, he drove he was one of the driving forces for me to get into medicine. And what's so interesting is that I really was a pleasant surprise. I wasn't supposed to happen. My brother is 16 years older than me. My dad had been ravaged by diabetes for years. And as an adult, as a physician now, I understand that there were certain things that probably shouldn't have happened.
[13:46] But things came into play just at the right time for me to be here right now. And so, you know, I watched my dad deal with a reduced in his health span, but his lifespan came to an end in 2010. And that was the moment in time I was already a triple board certified doctor at that moment. I was now leading a department and I could do nothing to stop his head to help him improve. And so going through that emotional tragedy of losing your parent with a level of, of guilt that I felt. I still feel, to be honest with you, of was there something I could have done, should have done that I didn't do? I began to look and search. And so that's where, to be honest with you, Rip, our worlds collided because in my search for all those things, I was actually kind of going, I had already started to really search out like nutrition because my patients would ask me, doc, what should I eat? And I would say stupid little things. I hate to say the word stupid, but I would just, just do well for our seven days. That's good enough. Like what? Doesn't make any sense. Oh, no one does great all the time. Be moderate. What? And so our worlds collided when I stumbled on your dad's book and started reading the book and everything coalesced in that moment with a chapter titled moderation kills.
[15:08] And that characterized my dad because anyone who saw my dad, he didn't smoke, he didn't drink, he wasn't morbidly obese, he didn't eat horrible stuff all the time, but he ate enough of it that for his own body, it was enough that really threw his body into a tailspin and kept the fires of disease burning that ended his life. And that taught me so much. So out of my dad's death, I learned so much in terms of life and about how to deliver a prescription that can help someone. And that's really, that's really kind of like that, that transition of how he changed my trajectory. And I was nervous, right? Because I mean, one, there's not that many African-American, interventional cardiologists out there. And then two, for me to go off the rails and start recommending to your plant, eat some kale and some arugula and broccoli and some potatoes as your primary source,
The Power of Plant-Based Nutrition
[16:09] I'll tell you, it was, um, it was something that, that, uh, was a challenge. And when I got over myself, it was extremely rewarding.
[16:21] Yeah. That's so interesting. You said, you saying that, you know, getting over yourself and, um, you know, we talk about how, you know, you, you go to all, you do all these years of schooling, you learn all these incredible, you know procedures that you can do and then at the end of the day probably the most powerful, prescription you can give your patients is to go home and do steel cut oats and green leafies and sweet potatoes and and in some ways it kind of might feel like it kind of undermines everything that you've you've learned a little bit to go back to that kind of the basics so i think that says says.
[17:02] Just volumes about you as a human being and being able to get over yourself and move forward in a way that's best for your patients, right?
[17:13] Well, it's sort of a penance. And if we really dig into it, there is a lot of science. There's tremendous science behind it. And there are pharmacodynamics. There is a pathophys of how these foods really work to our benefit. And so I think the issue is an absence of understanding. And whenever there is a gap or an absence of understanding, there's an immediate sense of fear and there's immediate sense of, of, okay, this can't be true. But until we open up our mind and begin to look at what the data has told us, and there may not be fully data, but trying to look at the experience of life
The Role of Healthcare Providers
[17:50] lived, that's when we can grow, I believe. And that's, that's really what I try to do. Yeah. You know, you mentioned your mom. She, did she just turn 90? Did you say? No. Well, she turns 90 in June. June 1st. uh yes okay so this year she'll be 90 and it was great being for me to be introduced to your mom when i had you as part of plan stock and it was three three years ago and you and your mother cooked several dishes for us and you said that you know you've been cooking with your mom your whole life and she is just an absolute gem um reminds she's funky like your mom right like an Uh, how old was your, was your father when he, um, when he died?
[18:37] My dad was 78. So from a year chronological perspective, someone might say, well, that was a life well lived. But my dad's, the years of his life, especially the last years, were so disabling, right? And from the impact and his journey, it was, there's an analogy. I'm a sports guy. I love sports, right? And so they have an analogy of like the rising fast pitch. Rising fast pitch is actually sinking, but to the eye and the perception, you can't tell that ball is going down. That's what I want. I want that to be my journey, right? Where it's like, okay, yeah, I may be ashamed. Things aren't quite the same, but you know what? I'm improving and you can't really tell. That wasn't my dad's journey. My dad's journey was more of a steeper decline that was there. And that's the part that's tragic. Yeah. Well, yeah, no, the reason I ask is because my father's father, and my dad has just turned 91 in December, but my father's father died of complications of type 2 diabetes and prostate cancer at 72, like way, way, way too early.
Training at a Blue Zone
[19:51] And so these wonderful, wonderful men just kind of dying before they're, you know, they need to. Tragic. So let's dive into...
[20:05] A second more before we dive into the book, just a little bit more about your background. So you did your training at Loma Linda, right? Which is one of the few blue zones on planet Earth, according to Dan Buechner. What was that like? Not like you think back then. I got it. So one is I received excellent, excellent, excellent training, clinical training, but nothing at all as it relates to lifestyle. Zero. And so that was a tragedy that I actually didn't know. So in my professional career, my day job, as I'd like to say, I've helped start up a cardiac rehab program that served over 40,000 patients. And we've gone to Korea. We've adopted technology and so forth. I didn't learn anything about cardiac rehab inside of training. I didn't get exposed to it. And so that's the power of lifestyle. But with that being said, I had such caring physician mentors. I had such the vibe was one in which it was so embracive for me to learn and to deliver care that I think set the foundation for me to have the ability to learn and expand my horizon. And so for that, I'll always be in debt for indebted for to Loma Linda.
[21:26] And you're currently you're currently at Kaiser Permanente, right? I am.
Journey with Kaiser Permanente
[21:32] Yeah. And how long have you been with Kaiser? And I know you were born at Kaiser Permanente, isn't that correct? That is right. That's right. In one way or the other for a long time.
[21:43] Yeah. No, I'll tell you. Well, one crazy thing. And this is just, I don't know what I think about this whole idea of manifestation, right? I don't know. But- What I can tell you is that when I was in college, I said, I want to become the chief of cardiology at UCLA. I didn't become the chief of cardiology at UCLA, but I became the chief of cardiology at Kaiser Permanente inside of my medical center. And then subsequently, I oversee Southern California program in my current role right now for cardiovascular services, that is. And, you know, it's been it's been an honor. It's been a blessing to practice in an organization that is, at the end of the day, is centered on trying to make patients better and healthier. Now, and what's so interesting is that it's comprised of humans, which means it's going to be an imperfect system. But on Earth, I think it's about as close conceptually as you can come to the way in which health care should be delivered and which is predicated upon doing the right thing. So blending of technology, blending in the personalized touch that's there. So everyone has a different experience, but it's been an honor to practice there. How long have you been the chief of cardiology at Kaiser?
[22:58] I served in a role of 12 years locally, and I have been three years in my current role as overseeing the regional program. And how do your peers view and react to your preventative-oriented slant?
Shifting Perspectives on Nutrition
[23:21] At first, and I'll tell you, that's a great question, because that was one of the limiting factors I was concerned about. But locally it was so interesting that my colleagues started saying i don't know much about nutrition but you know you can check out dr batiste and his program or whatever and they would start to refer people to me into my program on a large scale i would have individuals who slowly have started to creep in as they would make their little jokes and i make my jokes right back i started kind of you know shifting and so all of a sudden now they're like Columbus, I have a black bean burger. I was like, oh, look at you. Look at you have the black bean burger for lunch. I was like, I'm proud of you. I was like, come on. So it's become more of from like a little bit of like turning the nose up to then joking to now starting to transition slowly and recognizing the power of medicine. And I won't take credit for that. I think what happened is the grassroots efforts of everyone out there promoting the values and benefits that docs have to sit up and listen and start to pay attention to some of the, some of the, uh, the important aspects, but there's a lot of work that needs to be done. There's still this, there's a lot of work that has to be done.
Introducing "Selfish"
[24:37] Yeah. Well, speaking of a lot of work, I know a lot of work went into this, this new book of yours, right? Selfish. Yes. What.
[24:48] I mean, you're a busy, you're a busy doc. You are the heart healthy doc. Why in the world, how did you make time to write a book? And what was it that drove you to write the book? Wow. You know, to be honest, what the truth is, in the gap between when I stepped down or I stopped being local chief and before I took on the new role, it was like all of a sudden you took out this big part of my life. And so I was so used to just kind of going, it was like, you know what, I need to put some of these things down on paper that I've been lecturing about that I've talked to patients about and go from there.
The Seven Pillars of Health
[25:28] And that was really what happened and started to kind of look at delivering the message. And I'll tell you the reason why is that in practice, what I realized is that there's folks who are vegan and plant-based who are still having heart attacks and they're having events. And the question is why?
[25:45] The level of stress and the absence of true components that can build us together. And I believe that life is like a recipe. Yeah, the central part of it may be whatever the central part of that recipe, maybe flour. It could be the eggplant. It could be the cauliflower, but it's added together by other components, the spices, the this, the that, the other, the vegetable broth, all build it together. And so that's how I see the idea of selfish. The central piece is the F in food, real food, whole food, plant-rich food that nourishes your soul, but is bolstered on each end of, By the other components. And that's what led to me really writing the book and trying to as a message to my patients and message of hope that there that's life is it's it's the collective aggregate of our experiences and it's food is a central component, but it's not the only one. No, no, you've made that abundantly clear in this book. And do you have a stack of 500 of these in your office? And do you hand one out to every one of your patients and say, you know, read this just to kind of bolster everything we've talked about here today?
[26:58] I don't have a stack of 500 of them. But ironically, my time with patients is somewhat limited in that I only see them in the cath lab, which I think is a vitally important period of time. And the rest of my time is completely administrative there. But I have had colleagues who have been, thankfully, have been very supportive of the book, and they have told patients about it. Okay. Okay. Yeah. Well, you should definitely make sure every one of your patients gets a copy of these. So let's dive into Selfish. And one of the things that I think is so special and endearing about this book is not only the science that you share under each one of these seven pillars, but also the stories that you tell that connect it right back to you and your family, your father, your mother, your brothers and sisters, and then to a patient called Angie, right? That it's kind of you're walking her through and us through this all together.
Spirituality and Heart Health
[28:07] And so it's done really, really well. But why don't we start at the top? And I know that this is a super important part of who you are and your life and your upbringing, and that is spirituality.
[28:20] So talk to me about that. Yeah, no. So, you know, I believe that everything kind of begins inside of this, this concept of spirituality. And so in this irrespective of a person's belief system, right? So obviously I have a strong belief system. And, but what studies have told us is that there actually is a science behind this idea of spirituality and spirituality can seem a little bit kind of out there. But when we look at the Latin root of spirit, it's breath. And so it starts first with breath, that simply breathing. And we look at how selfish can cure a stressed and broken heart. And that's really how I walk folks through each and every component. So when we look at the aspect of stress, we understand that what begins to happen when we meditate or pray, or we have moments of mindfulness, is that it accentuates our prefrontal cortex. And what it does is it slows down the inner parts of our limbic system in the amygdala, which houses our fear.
[29:16] That's important. That allows us to deal with the stress of life. That allows us to regain this focus, which is where we plan our day, where we plan our intention. And so it's so important as a core component, because with all the distractions in life, it's so easy to lose focus and to stay focused that's there. So I walk folks through that studies have shown it impacts your endothelial health, It impacts your blood pressure. That impacts your actual stress hormones. And when you put this all together, it's so much power. And so for those who are not into, they're like, I'm not quite sure I'm feeling, I'm vibing with the whole meditation or prayer.
[29:55] Breathing has been shown to be very similar in its effect. And you think about it. I know this. I started watching myself doing procedures in a hairy situation with patients who are not doing well on the table. And I'm inadvertently holding my breath or I'm having shallow breathing. I mean, I'm not physically holding my breath, but I'm not taking a nice deep breath. And we do that so commonly when we're stressed and we're building up toxins. And when we breathe out, we actually activate the parasympathetic tone, which helps relax.
[30:29] And so there's actually science of pathophysiology, the science of the heart and the vascular system. We look at things like heart rate variability. We look at the beat-to-beat variability. We understand what begins to happen as a metric of stress and its impact on our body from the autonomic nervous system, sympathetic and parasympathetic. And so that's why spirituality is essential. It's essential for your cardiovascular health, for your stress, and it can help give you purpose, a sense of purpose as well. And so for somebody that doesn't feel like they have a spiritual connection, do you have.
[31:10] Where do you start? Just kind of focus on your breathing or where? Yeah, that's the easiest way. Is that just breathing, right? So you don't have to necessarily have a belief system that is the same as everyone else, but start with breathing. The second thing you can do, the calming effect of nature and green space. It's so powerful. Sometimes people feel a sense of calm inside when they're outdoors inside of green space. There's so many people, especially in the city who don't have access to green space with trees. It's so hilarious. I was watching, I'm a sports guy. So I was watching these sports podcasters and they were talking about going to, there were some basketball players and they were talking about going to the home of an actor, musician. And he's like, man, I walked there. It was like, I was in heaven. Yet all these open fields of lawns and trees, I didn't grow up like that. I didn't know anything about it. And I, it had me dying laughing because I was thinking I didn't grow up like that either, but I live in a place in which it's very green, or I should say there's plentiful amounts of trees and there's parks and I enjoy it when I get out, when the air quality is right, right? Going back to the whole virus and the air quality is right. Got to check that air quality.
[32:21] It's, it's great. It's great. And that's a simple way that anyone can begin the process of that focus of taking time you go slow to go far and another thing you talk about i think this is important as you say it doesn't have to be about perfection just start being intentional that's right and i think that's that's nice to nice to have in the back of your mind as you kind of go out and and start to become a little more spiritual yeah i mean you know and and the concept is is that But your mind's going to wander. It's going to wander. You're going to do things. You're going to say, this is boring. This is not doing anything for me.
[33:05] But I actually will take moments because we make so many decisions throughout the day. We make we're all under so much large amounts of pressure that when we're not taking moments to allow our brain to really settle down and focus, that leads to this heightened level of persistent stress that's there. And it only is impacting us from a disease perspective. And that's why so many people take it out by getting like, well, I don't drink. I don't smoke. But they're eating these foods. Right. And now there's plentiful amounts of these vegan junk foods to fill the void on everything else. And we'll get into that a little bit under F food.
The Importance of Exercise
[33:47] So let's in order, let's move on to exercise now. I think everybody knows that exercise is good for you. But you really do a nice job in this chapter of tying it into heart health and why exercise should be a foundational practice. and you call it a keystone habit. Yes, yes. It is a building block. When you're moving, all of a sudden you get this sense of clarity that's there. That when you're moving, your body in motion, all of a sudden, not just the clarity, but now your body responds internally in terms of how the heart functions. That's so powerful, not only from the endothelial health, but just from the entire blood sugar regulation, the inflammation that's there. And here's the misconception. The greatest misconception out there is that you have to run a marathon, that you have to get on your elliptical or your peloton. And you absolutely don't. You just have to get neat with it, I like to say. On exercise activity thermogenesis.
[34:47] That means I'm standing, I'm walking, I'm moving, I'm fidgeting, I'm taking the laundry, and I'm picking up that basket. I'm climbing the stairs. I'm parking further away. hey, I'm doing all these simple things throughout my day that's allowing me and keeping my body in motion. Because our life has transformed over the years. We aren't out there tilling the ground, most of us, right? So that means we have to be very intentional with our efforts in order to do it. That's why I'm all tracked up. I have my different rings, my watch, all these things like that. So in that way, it tracks my activity. I know exactly. Is it time to stand, move? How am I doing? What's my response like? But it's powerful. So give me an example with all your rings and tracking devices. Do you try not to sit for more than, I don't know, an hour at a time before you stand? And how many steps are you trying to get a day? Are you tracking that? So I do. Apart from doing these sorts of things where I'm actually on camera, I actually have a standing desk in my office at work. At home, I have a configuration, I figure what you call it, that allows my laptop to go at eye level. I have a desk for my treadmill. So when I'm not having to actively lead my meetings, I will actually go and walk on the treadmill while I'm taking my meetings too as well. So I'm very intentional about it because I understand the benefits of it. But here's the most important part about exercise that people forget.
[36:17] The exercising of belief, the power of the mind that you actually can overcome some of the ailments that are there, that you can overcome some of the conditions that you're faced with, the life circumstances. And when we begin to look from a psychology perspective at the power of the mind, it's irrefutable in terms of the benefits. And I always bring patients back to one thing. I prescribe medications all the time. Those medications are tested against what? Placebo, right? And what is a placebo? It's an inorganic, inert substance that has no biological activity. So that means that this medication that we're espousing has to beat out what? Your mind. In order for us to say that it's therapeutic. And that tells us in and of itself that even the medication, there's a level of belief in that medication. And so I think it's not only exercising our power of belief and purpose, but it's also in addition to exercising our body that we have to engage in. And that's why the E is so powerful for me. It's one of the most powerful ones.
[37:30] Yeah, I've never heard it put that way. That was, that's really nice.
The Role of Love
[37:34] Uh, all right. Are you ready to move on? Let's go. Okay. So let's talk about L, which is love. Love. Yes. It is. It is. Yeah. I used to joke saying I'm going to be a love doctor when I was in college, you know? So this is my chance. Yeah. Where do you start when it, when you're talking about something is big and grandiose as love? Yeah. You know, I think the easiest way is it's not static. It's not a noun.
[38:08] Love is a verb. When you think of love being a verb, that means it has action. It means it takes effort, right? That you have to put forth if you're really loving something or someone. And that means that there are components, there are expressions of love, whether or not it's forgiveness. It actually takes power, right? That takes a mental conscious mindset to forgive, true forgiveness, gratitude. Not the, oh, thank you, but really being grateful for what you have and really thinking and reflecting on what is it that I have that I can be thankful for, right? And volunteering. What greater expression of love is other than me doing something for someone else for free of charge, right? There's no, I get nothing in return. Like I always say that if I give a gift, if I'm really giving you a gift.
[39:02] I don't even expect a thank you back in return. I have zero expectations if it's a true gift. A true gift means I have zero expectations back from it. It's coming just solely from the heart. How often do any of us give something freely? I'm talking to myself. That's even me. I still expect a gift, right? A thank you or something of that sort. So that's where we look at where science is beginning to tell us. There's small studies, but aggregated over multiple venues, you see the impact on the heart, the blood flow, the endothelium, the stress hormones, longevity, blood pressure. You start to see this when we begin to live in a positive mindset on things. You know, what you just said about, thank you. My brother was telling me a story the other day about a good friend of his, because my brother said thank you to him. And he said, you know, that whole thank you, it just vastly undermines the whole nature of the gift that I just gave you.
[40:05] Pretty, pretty, pretty crazy. Yeah. Wow. That's hilarious. Yeah. Yeah. But, you know, when you say at the very top, you said love is not a noun, it's a verb, right? Yeah. And you have a quote on page 34 from Mother Teresa, love cannot exist in isolation. It derives its meaning from action. Right. Perfect. Right there. Absolutely. Yeah. So if you don't mind and I'll help help you walk you through it.
The Gratitude Challenge
[40:41] But you talk, you suggest that people take the gratitude challenge. And there's five parts of the gratitude challenge. And the first thing is keep a gratitude journal. What does that mean? That means you simply, whether it's your phone, I'm a big believer in, I, you know, I heard this from someone, from Eric Thomas, the hip hop preacher. And so he was like, put pen to paper, right? When we actually write down, it's almost cathartic. You start to put it down that it seems to kind of embed in our systems a little bit more. So I love writing for that particular instance of putting down, writing down just simply three things I'm grateful for. Or you can put in the app. That's a gratitude journal. It doesn't have to be long or written out, but just something simple. I had green lights today. Oh, you know what? The person smiled at me. They held the door. Hey, you know what? It was sunny. Hey, for me, everyone did really well. No one told me, thank you. I'm really grateful for the fact that they appreciated what I did. You know, those are simple things. Okay. So, and number two on this is just, and take away what I just said, but say thank you, right?
[41:49] Especially, I think, what when you when you mean it right and people can usually tell yeah yeah you know it's old saying fake it till you make it right so sometimes you may not mean it but but keep at it but you know here's the thing i'm gonna say rip, Don't just say thank you to a stranger. Say thank you to a loved one. Say thank you to someone where this is just what they normally do. Your spouse, your significant other, your kids, your parent, whomever it is that you otherwise might overlook. We're oftentimes better to strangers than we are to our loved ones.
[42:25] Yeah, no, very true. I'll just give you an example. Yesterday, I told my wife after coming home from shopping, right which is takes a lot of time and cook an amazing meal i said you know jill thank you so much for going shopping cooking this meal so appreciate the time that you spent to do all that and the energy and you know she heard it and she really appreciated it but you're right we don't tell sometimes the people we're closest to how much we appreciate them yeah um now.
[43:00] Random acts of kindness you have on the list yes yes i mean those are things i mean what we think of like the honda commercials we think of starbucks or these other places where you hear about people who are just buying someone else a drink or whatever it is but sometimes doing something without someone knowing is powerful you know it could be taking care of a grocery for someone it It could be something very simple that you're just saying someone, a thank you note, or you notice that they're having a hard day and you bring them something. You know, those are whatever that simple act of kindness. It doesn't have to be grandiose. It can be very small and it can mean a lot. It may be able to be the precise moment that someone is suffering and you enlighten their moment and that brighten their day and it changes everything. Yeah. Yeah. Um, four on your list is affirm others and five is forgive. Yeah. Um.
[44:03] Yeah. And what would you like to say about those two? Well, I mean, you know, to some people, it's very natural for them to affirm others, to kind of uplift them and say, speak positively about what they're doing or did a good job or whatever it is. And I'll be honest, I can be kind of a, I'm easygoing in procedures, but at the same time, I can be very intense because the patient is there in my expectations. And so making sure i'm conscious to my colleagues that are non-physicians and affirming them hey you did a good job thank you for for making sure you did a great job with kind of getting everything ready or this is a tough case you did a great job that's powerful that kid builds confidence and it brings a different level of spirit as opposed to if i'm solemn and i just walk out i don't say that they have no idea what i'm thinking they're wondering and so there's power that's there. And forgiveness, that's more for me than it is for the other person to be, believe it or not.
[45:03] Right? That's for us. Because the person that we're harboring something against, they probably have no idea, could care less, and have moved on. But we're ruminating over these thoughts. We're stressing over these negative thoughts. And it's taking up our energy and creating a stress in our system. And so simply by releasing that and saying, you know what, I, I, I recognize what they did. I forgive them for the impact, um, of, of, of what it is, whether it was intentional or unintentional.
Stress and Heart Health
[45:35] And so you're able to move on and grow from it. I think it's important. It really is important. Um, yeah.
[45:44] And if you're, if you're stressed, I mean, you talk a lot about stress, right? And how stress can pay, can play a very important role in kind of breaking people's hearts. And it sounds like all these things that we've talked about so far, spirituality, exercise, you know, love and gratitude. And I think everything surrounding that, it sounds like all these things will help to reduce, right? That, that, that stress and the impact that has on the heart in a negative way.
[46:25] Yeah, no, absolutely. It does. And what's so interesting is that it pertains to all aspects. So whether or not you're speaking in terms of like a business sector, team building and growth, these principles really apply. They apply across the board. And the reality of it is, as a country, as a people, we are just increasingly stressed. We have all the technology, all of the latitudes, but yet we're stressed, right? This desire to get more, desire of sickness, and we're wondering what's going on. And so I think it's so important as I've seen it in taking care of patients, that really was at the heart. There are some estimates that haven't really been confirmed. And I acknowledge that the 80% of all physician visits are due to stress. I really feel that whenever I talk to patients that always comes up, it comes up all the time.
Nutrition and Processed Foods
[47:19] Yeah. All right. Well, let's move on to something. I think that this audience knows really, really well, and that's the food. But one of the things that I didn't know, Well, I think I knew it, but you laid it out there pretty concretely, and that is that you said that more than 70% of packaged food in the USA is classified as ultra-processed and represents a whopping 60% of America's calories consumed. Wow and then right on the heels of that you mentioned how the cdc discovered that more than one-third of americans eat drive-through food on a daily basis i mean wow that's that's brutal it is it is and and it's not uncommon when you live in cities and you see this plethora this excess of fast food, quick serve restaurants that are there and you see an absence of well-formed fruits and vegetables. And even if they are present, their studies have shown this.
[48:28] Once you get into all these chemicals and the process nature that becomes so addictive, what am I going to choose? Am I going to choose to make a salad or go get a burger and fries for for $2, get five burgers and two fries for $2 because of the subsidies, right? And so we understand the burden that's there. And because it immediately acts as a stress reliever for people as they're eating these ultra processed foods, but it's not sustained, which means it becomes addictive and they're going back for more and more and more. I'm not telling you or your audience anything that you don't know, but that's why we're seeing increased research that points to the consumption of these foods with even stress and depression and mental illness that's there we're seeing this relationship as we're throwing off with our all of the the chemical toxins that are banned in other countries but allowed inside of our inside of our country and that's problematic yeah you also talk about obviously we just talked about a lot of stress on people's hearts but you also talk about nutritional stress and i think when you're eating this way it um it unloads a certain nutritional stress on our body and it decreases our resiliency and and i i never, kind of equated it like that and so i found that to be really kind of eye-opening.
[49:53] Yeah you know i mean everything we're doing is either adding to our resiliency or adding to our stress including the foods we eat yeah and these foods although we're thinking that they're restoring us in terms of our mindset and we're driven towards it, it's actually not. It's draining it through oxidative stress. I can call out a thousand pathways and how it's harming our vasculature and our mental health. But the true answer is, what I ask patients in my, in my, in the, in that clinic anymore, but inside of the cath lab, tell me what you eat for your health. And they're always baffled. Like, huh? What do you mean? I said, well, tell me what you eat for your health.
[50:30] And they pause and you will be amazed at the answers that start to come out of your mouth. I said, well, it's not that. I mean, tell me what's healthy that you're eating. And they, well, I'm working on it. And so I said, the question is, are you eating more foods that are not healthy for you or that are healthy for you? And how can we move and change the tide? Because we're feeding our body. We're building in our resiliency. And you're resilient. Your bank account's drained right now. And your body's trying to write checks it can't cash. And that's the problem. So, you know, it's interesting conceptually in terms of a person's perspective. And I understand food is culture, it's family, it's passion, it's more than just medicine. But what I tell people is that if I place you in an environment for a long period of time, that will automatically become your culture. It's somewhat of a facade. I said, you can build a new culture. You can build a new you and a new family for you based upon the choices that you make that can have reverberations, generations to come. What would you say, Columbus, is the demographic of your patients?
[51:46] Gosh, well, it's predominantly Caucasian. I probably would say in my practice, Hispanic be next in an African-American and Asian will probably be tiered order of individuals that I see where I currently practice in the cath lab. That's in a clinical setting in the community where I do a lot of work through with my nonprofit. We tend to take care of a large percentage of black and brown communities and really kind of digging in and going in the heart of where there's so much despair.
[52:19] And are they receptive to the message? They are because I'm not, I don't approach it from a perspective of all or none, nor of completely vilification of what they're doing, but really from a perspective of knowledge and trying to pretend health literacy. Health literacy doesn't mean they're illiterate but it means that if i were to go inside anyone's business and i'm not familiar with it i'm illiterate to what they're talking about unless it's explained in simple terms that they can that i can understand and that's what my passion is is trying to break down information in a way that's palatable bite-sized and get people to begin the movement yes i would love all or none but i recognize especially in many of these communities where there's such a long history, they're not going to go all or none, but they're going to take small steps. Potentially, they potentially will make small steps with the right guidance. And so that's the approach I take. And then some individuals who are willing, we go 140% and we go all that. Mm-hmm, mm-hmm. Mm-hmm.
[53:30] Yeah. Food is tricky. It is. It is. It is. And you're not going to get the, here's the balance. And I recognize this. You're not getting all the benefits you need or will see if you only take incremental steps. But at the same point in time, that balance of how do I get someone who's used to eating fast food, the highest consumers of fast food are African-American women. We know that in many instances, women are set the foundation and the table for their entire family. So now we have this whole generation. We have this whole mindset and culture that's built. So shifting that, that takes time and that takes effort. that's there and a willingness to undergo it. And so we began that process and we have those conversations. And so I'm proverbially fishing when I go out into these communities. I'm not going to folks who are seeking me out, not typically in the community like that. Those who may go to a lecture are perhaps seeking out, but those other than that, they're not. So I'm trying to see, can I make, can I change one life? Can I impact 10 lives out of a hundred or out of 1,000 is really what I'm going in. For me, that's success. My goal is that if I can get more people to adopt this diet than who adhere to medications, because the adherence to medications is horrible, it's abysmal across the United States, then there's power that's there.
[54:58] When you say the adherence to medications is abysmal, do you have any numbers to give us an idea? Oh, gosh. I want to throw out numbers, but right now it's, I'm blanking on it, but somewhere around that 30 to 40%, we know that adherence after a heart attack to medications is low. And we see as a result of it, recurrent heart attacks and strokes. And so I tell people, you can't have your proverbial cake in it too. You can't have both. You have to choose lifestyle or medications. And sometimes it still requires both. But I said, it's a seesaw effect. Those old seesaws, as you go up on the lifestyle, you may be able to completely get off your medications. Now there's some individuals who won't, and we understand that. And it should not be a scarlet letter placed against you if you have to be on medications. But are you doing everything you need to do? Are you eating food that's pre-chewed? Are you eating food that you have to chew, right? In terms of the process versus not across the board. And so walking folks through that is so imperative. Mm-hmm.
Responsibility to Communities
[56:07] How much of a responsibility do you feel, kind of in the position you're in, knowing what you know, to go out into the brown and the black communities and share your message as an interventional cardiologist? It's everything. So, I mean, the honest truth is, I'll give you an example of the responsibility I feel and I think that many people of color may feel. I was watching a TV show. I was waiting to pick my wife up from the airport late last night at 11 o'clock and I was working all day. Um, and I got tired and I started watching this little silly little show, uh, not silly show. It was a show on TV and it was a doctor's show. And I was like, let me take a look at this new show. I'm looking at it. And this African-American, um, intern comes in and he's carrying himself while he does well. And he chastises folks who are making fun of this attending who had this tragedy. In my mind, I was happy and proud. And I was like, why are you happy and proud?
[57:08] And I was like, because it is, that's a responsibility to put forth a good foot, to express ourselves, to do right. That's there because of all the other images that are out there. I feel such a tremendous responsibility knowing the fact that so many individuals of color suffer with reversible disease that doesn't have to be there, that we understand the impact of adopting a whole food plant-based lifestyle and the tremendous impact it can have in transforming people, not throughout any stage. It's about the most important stage when you're working, when you're making money and to not be disabled, to now you can actually build generational health. You can have retirement. You can get you're all these things and not die suddenly that puts your family in despair, that's a responsibility I have to give back to everyone across the board by specifically feeling inclined towards African-American communities because of the fact that they're so disparate in terms of disease outcomes. But my message, as I say, and all of our message, I always equate it. It's like a superhero movie, right? It's always the good guys versus the bad guys. But guess what? It's framed around Wonder Woman, Batman, Superman, Black Panther, Green Lantern. It's going to capture different people, but the same message applies to everyone. And that's really what my intent is, is deliver a message of health and wellness and empowerment to everyone.
[58:36] And knowing that the prescription to health is 100%. But even if you start on that direction, you're going to be better off. It may be 1% improve every day instead of 100% after one day. Cumulative, there's power that's there.
[58:55] Incredibly well said. And I love when you said build generational health and how many families are doing just the opposite of that. Right. And that is what a what a gift to be able to do that. And I'm so grateful for my parents for doing that and instilling that generational health in in all of our families. Powerful um all right let's let's um let's move on to i and the i is intimacy yes and if if well i'll let you say a few words about intimacy before i i ask you my next question.
[59:37] Yeah so intimacy is not what everyone thinks although that's a major component when it comes to uh relations between adults right i'm really talking about relationships that we can become vulnerable, that we can let down our guard. As I like to joke and say, you know what? I've been married now over 20 years. And the key is, can I actually let down my guard and be corny, be a nerd, be all these things and my wife still loves me? That's what I'm saying. And the answer is yes so far. That's why we're still together. And that's what it's about, is having someone that you can share your intimate thoughts and feelings and not feel as if you're going to be attacked. And we all need that. And that's a part of a larger community. And I'll tell you, Rip.
[1:00:25] It hit me as I was transitioning out of clinic. I wonder why patients who are otherwise stable were coming back to see me for an appointment. And all of a sudden, it struck me. They don't have anyone else. I'm like in a game of like tag. I'm touching home and then I'm going back out. That's what they were doing with me. I was community. I was their support system. And just to kind of say, hey, am I staying on the straight and narrow? Am I doing what I'm supposed to? What do you think, Doc? Numbers are great, but they had to come back in and see me. We all need somebody, a community to be a part of, to keep us going and to build. No man's an island, right? Or a woman, that is. And so it's important. And that's really the power of community that's there. And the community, and that's why I love the analogy with trees. I brought that forth when I read that many years ago. It's so powerful to share resources about covering even the big ones that are stronger, still helping the ones that are weaker and don't get the sunlight the same way. And I think it's so much that we can learn from trees, from other animals and so forth in terms of how we're supposed to live. Yeah. You...
[1:01:34] So you also talk about loneliness i think kind of as the as the antithesis uh of of intimacy and you have a story and i never had known this about calvin coolidge one of the united state presidents um and how after he lost his son calvin coolidge jr he just kind of went into a death spiral. So, yeah.
[1:02:01] And he couldn't seem to pull himself out of it. Yeah, no, absolutely. And you think of the aggregate nature, he had loss, prior family loss, and then he suffered the loss with his son. He felt somehow responsible for it. And that responsibility, that grief was so tremendous. It's a stress. It's a stress that's there. I mean, everything boils back down to, And it's not like just to kind of highlight this six letter word, but the fact that it's so pervasive in all of our aspects, aspects of our life and loneliness. I learned this from my mom. Right. Yeah. We're all around as family. After my dad died in 2010 and we're around, she has friends and she can still feel lonely. She can still feel lonely because she doesn't feel connected in the same way generationally with someone that she had lived the majority of her life with and so that can be imperative for someone to have once again individuals you can feel lonely amidst a group of people and so it's understanding once again about the relationships and understanding about having individuals that you're able to bond and connect to on a regular basis you know you just brought up your mom.
[1:03:17] And I think one of the interesting things is you talked about companion animals, right? And how your mom has a dog named Precious and is absolutely precious to her. And, you know, I think it's important for people to know that I think pets can do an amazing job at helping to alleviate that, that sense of loneliness. Don't you? Oh, absolutely. Precious is amazing. And I'll tell you, that's why you have support animals and the emotional support animals. And all of our, these beings, they help, they actually can raise our oxytocin, our, you know, the tend to be friend, which is the antithesis of the stress hormone cascade that can help heal the heart. And there's so much power and the joy that's there when all they want to do is love you. So why precious is so important and powerful for my mom is that my mom may not feel like going outside, but guess what she has to do with precious? Take her out for a walk, take her out to go pee. Now that she's out there with her dog, guess what she has to do? She has to interact with neighbors. Who are walking their dogs. And so this whole community begins to happen. That's there. The funny part was that we've had my mom participates in our Christmas cards. She lives with me. And we didn't have a picture with Precious this year. So we had several people saying, where's Precious?
[1:04:37] Card was great, but where's Precious? Because Precious is the family. She's part of the family right right uh let's talk about sleep and and you know i think we all know sleep's important but i found it really interesting you talked about your dad and how you your you your dad he was what you said he was like um he was night owl up a lot and then during the day you'd see him working on like a business or something like that and um so it It sounds like your dad didn't sleep as much as he probably should have. No, he absolutely did not sleep as much as he should have. He worked night shifts. He was always had this energy. It's crazy how we start becoming like our parents a little bit. So I get my sleep, but I'm always working on a thousand things. I always have a thousand ideas, just like my dad.
[1:05:28] But it's so powerful about this idea of sleep. And when I contrast or I look back at my father-in-law and my father passed away in the same exact year, right? separated by about nine months. And my father-in-law struggled with sleep because he worked nights for years and could never get back on a consistent sleep pattern afterwards. And my dad worked nights periodically. And so the same sort of scenario started to happen. And so many people have no choice but to work nights. And so I acknowledge that and understand from a financial standpoint, but the moments of rest... Whether it's naps or taking time away, staycations or vacations are so important to recharge. And I tell people all the time, and this I think pertains even to like my dad as I look back, is that if you ever try charging your phone and using it at the same time, it takes forever. It doesn't charge.
[1:06:25] You know, we oftentimes we say that we're taking a rest and a break and we keep, I'm preaching to myself right now because this is my wife's like, you need to listen. can you read your book? Cause you're, you're not doing what you're supposed to, you know, but it's like taking those moments. And so I have committed my, my time for my sleep. And that's one of the main reasons why I wear my, I have these wearables. How much true rest am I getting? And all these things feed into each other. So the mindfulness and meditation helps me when I'm preparing to go to sleep, the exercise prepares my body to get sleep. When I get outside and outdoors in the sunlight and the melatonin, it helps prepare me for sleep. The sleep helps me perform more exercise and helps my mindset and my focus that's there. And so they're all interweaving together and can be powerful for building an overall healthful lifestyle.
[1:07:11] Yeah. And you also talk about how lack of sleep, um, it, uh, like raises, I think stress hormones that increase inflammation, it leads to poor decisions.
[1:07:25] Cravings of junk food, right? So it's amazing to me how you just said it, how everything is so interconnected. And when you start to do a couple things, let's just say incorrectly or not in the best way, it has just a cascade of detrimental effects. Absolutely. Absolutely. And the decision part right there, like how many times have people made poor decisions when they haven't gotten sleep? You know, and we know the relationship comparison to alcohol consumption and being drunk and inebriated to lack of sleep and decision making. And it's powerful that that happens. And so I think I talk about in the book and it's shameful, but it was true. And I felt this way even early on. It's like my daughter was born and my wife was like, can you stay up? Can you stay up? I need to get sleep. And I was like, if I don't get sleep, people can die. If you don't get sleep, you may lose a million dollar contract. In fact, it wasn't my most sensitive moment. And trust me, I have learned the power of asking for forgiveness for the past 20 years since that time. But it wasn't my finest moment. But, you know, I've learned from that in terms of the fact of respecting everyone's need for sleep, but also prioritizing as best we can. Yeah.
[1:08:51] Yeah. Here's to a good night's sleep. So while we're laughing, let's talk about your last, the seventh pillar, which is humor, right? And laughter. Oh, we need, we need a lot more of that, don't we? Yeah, we do. Yeah, we do. It's, I'll take, what's weird is, as I've gotten more mature years lived, that's how I like to characterize my patients. You know, they're not old, they're more mature years lived. As I've, as I'm growing in maturity and years lived, I recognize I don't tolerate the stressful movies like I used to. I can feel it actually. And so, but I love watching the comedies. I love things that make me laugh. The honest truth is, I literally, this isn't even anything that's in jest. I'm literally playing TV shows I never had a chance to watch while I'm reading studies or after I've rounded on releasing patients in the hospital and I'm laughing. I'll listen to him driving home. And my wife will say, you know, if people saw you, they don't perceive you this way as like laughing, like how you do, but it's so important in terms of what begins to happen in the body. And so I felt it before I read the research. I felt the benefits before I read the research on it.
[1:10:05] Well, and you talked earlier about, you know, asking your patients, like, so do you eat healthy or however, however you phrased that but you also I love you ask them so when was the last time you had a really good laugh yes right and a lot of people probably can't remember, No, not at all. Not at all. It was, I mean, it's amazing when you ask questions. I would love asking questions about what's the last thing that they did just for themselves. What's the last time that you laughed, a hearty laugh? What's the last time that, you know, and, and they would really stop. And for some patients, my appointment wasn't anything about regulating their heart failure medications or their angina or anything. It was solely about counseling them on their assignment was to, I want you to write down things that you're grateful for. This, that, don't come back and see me until you can write down something that you're doing. Here's your assignment. I will give them assignments and tell them to email me on top of everything else. And so I do miss that. I had a great time with many of my patients in helping them see the power of these simple tools. And they came back and they told me about it. That's the part that I love. They told me about the impact it had on their lives. And that's what kept me going. And that's what made me write this book. Yeah.
[1:11:24] Well, you, you, in this chapter, you talk about two people. One is Charlie Chaplin. He has a, he has a quote that is, and I'll read it in order to truly last. You need to be able to take your pain and play with it. I think that's awesome because I find that the older that I get, the more the more pain that you typically are exposed to in life. And how are you how are you dealing with it? And then the other thing, and if you can remember, I'd love for you to talk about it. And that's the case of Norman Cousins. Yeah. That I thought that was fascinating story about him. He was given just a few months to live and then house himself away inside of a hotel and started just learning to laugh and watching uh shows and so forth and the transformation his ability to go back to work as a core component of of just adopting laughter as part of as part of his uh his ethos and who he was and and it's just i think the thing is is that there's not just one, magic panacea, aggregate of everything that's there, right? You know, we can't live in this world and be alive. I used to have an attending who morbidly said, listen, none of us are going to escape this world alive.
[1:12:49] He's like, the question is how you're living in between the hash marks, right? And what you're doing. And I believe wholeheartedly, and I have to keep pulling myself back to it. The reason for getting selfish is to live a life of purpose.
[1:13:06] It's not just to collect things like that. It can't be all what being alive is about. For this limited period of time that we're on this earth, it's just, let me collect as many toys as I can get. Let me just go in and visit here and here, but not do anything that's lasting. What I mean by lasting is we're all going to be forgotten. I don't want to be morbid like that. But the impact that we leave on people is what's going to be remembered. You know, I think it was Maya Angelou said, you remember how people made you feel, right?
[1:13:42] It's there. That is where the power lies and that I want to be remembered for how I made people feel about how I tried to help transform their life that then had domino effect on others inside their family. And I think that's ultimately the goal. That's why I call my dad's name out because of the impact he had on me. My father-in-law, your father is still with us and I'm grateful for it. But, you know, the one thing is that when I started on this journey and when I received a phone call, I've said this before from S, he called me on the phone after I've been reading his, I read his book and, and I was going through all the research associated with it. And then I got a call from him and Hans Diel. That was so empowering. Those words of encouragement, moments of uplifting of affirmation, right? In a moment of saying, yeah, you can do this. Yes, there's a large work that you can do that can be transformative and you can impact people. That's so powerful for someone who's starting out in their career, especially in a journey that's here, that that is taking them slightly different pathway in terms of lifestyle. And that's where I'm trying to emulate that things that your dad has done, what my dad had did for me in terms of saying the foundation. So, well.
[1:15:03] Yeah, no, thank you for saying all that. And, you know, you're right. I think each and every one of us, more than anything, we want to have a life of purpose, right? A total reason to, and a passion to get up every morning and to move through, move through the day, right? As a verb, with action and purpose. What was, what was your father's first name? Columbus. Oh, really? Okay. I didn't know that's why. So they waited until the sixth child to use his name. Wow. He said, I'm finally getting one, and this is going to be Columbus right here. He was a proud man, and he was the youngest. His sister actually was studying history at the time he was born. They said, why don't we name him Columbus?
[1:15:53] But here's the most interesting part of the story of my name, right? Right. So when I got married and my wife, we were going to have our son. My wife said, oh, maybe I'll name my maybe I'll name him the third. And she said, no, I always wonder why your name was Columbus. And I think I'm not going to do that. So his name ended up being Bryce Colin Batiste. That's what we named Bryce Colin Batiste. And so growing up as a young kid, he's now 18. He said, Dad, why am I? How come I'm not named after you? Like you're named after your dad. I said, all that matters is you're my son. That's all that matters. Yeah my last name and so he always asked this until the time he was about to turn 10 he was like why am i i goes why am i not named after you it's like okay sonny what you want to change your name i want to change my name and so my wife and i we looked at him and so my wife was like a little bit perturbed and she said okay fine no birthday no christmas and we'll change your name he said okay we said what he said okay no birthday or christmas i want my name changed and we said And Bryce, we were like, okay, yeah, fine. But we didn't do it, of course. My mother-in-law comes out the following year, and he's grumpy. We're thinking it's the hormones. And he tells her, my parents said they were going to change my name, and they didn't do it. So I go and I have a conversation with him. I said, Bryce, I said, do you want to change your name? He said, yes, Dad. I said, okay, we're going to start the process. So I send him over, all this stuff like that. And he says to me, he's like, excited. What's my nickname going to be?
[1:17:20] I was like, okay. And we actually go to the courthouse. He gets up in front of the judge and he says, I want, he, and so the judge grills him on why he wanted to change his name. And he eloquently said it. And so he changed his name at the age of like 11 to Columbus Dennis Batiste III.
[1:17:38] And wow. I was just, I was just like. Okay, what's going to happen? Is he going to get mad at me and then want to shift it back? You know, I mean, what, you know, and I, cause I, I definitely wasn't pushing him because I understand the burden. It's a different name. And all of his friends immediately started calling him Columbus. He goes, he goes by Columbus. Even now he'll be okay if you call him Bryce. And so I think as I've had time and separation, man, it's been the greatest honor that he's bestowed on me to want to take my name. In name of my dad, although even though I tried to dissuade him in part, not completely from it, but it was it was certainly an honor for him to him to do that. Thank you, man. He's an old, old man. Old man. Old soul. How old is he now? He's 18 now. 18. Yeah. Yeah. So he's lived with it for seven years. Yeah. Well, tell me, how long have you now been a cardiologist?
[1:18:45] Officially for 21 years.
[1:18:50] And so you ever think like, how much longer do you want to be doing this?
[1:18:56] I do. I do. I do. I, you know, I want to help people move in the right direction more. Right. You know, and I can do that in part. Medicine is it's it's been an honorable profession. And it's my dream job, to be honest with you. It's my second dream job. My first dream job would have been like the Lakers announcer working with Chick Hearn back in the day. That would have been my my dream job. But apart from that, it really, truly was being a cardiologist was something I've always wanted to do. And it's lived up to the billing for me on every aspect. And it's given me different avenues to express myself from lifestyle, technology, procedures, et cetera. So I'm really grateful for it. I enjoy it. And I just want to continue to be an agent of change. Right. And so if that agency of change takes me slightly different area where I'm still helping folks improve their health and less of the procedures and so forth, I'm open to it. And so I don't know what the future holds, but I'm definitely at a point in my career where I'm open for redirection in this agency of change. Whereas before I was nose to the grind, building my career, building out aspects of lifestyle, integrating it, all of which are important.
[1:20:20] Hopefully that wasn't too political of a question of an answer, but it was somewhat direct. Yeah, yeah, yeah, yeah. Yeah.
[1:20:29] Let me ask you this as we're winding down. And again, I can't tell you much. I appreciate your time today. So we're in 2025. And it seems like there's a lot of newfangled tests that are out there, meds.
[1:20:51] From your vantage point and what you've seen, are there any tests that you recommend people get? Like, I don't know, this LP little a has been popping up all over the place in the last couple of years that wasn't there 10 years ago. LP, you know, little b.
[1:21:09] Are there any secret meds that are out there, whether it's a statin or something else that, you know, is it has a lot of efficacy that you recommend people be on? Just as we as we exit, love to get your thoughts on that. No, it's important. That's an important question. Important thought that we expect nothing else from you. I mean, we have, here's the thing, we need to understand our risk that surrounds us. And I think knowing our numbers is quintessentially important in this journey of life. And so whether or not it's our blood pressure, whether or not it's our blood sugar of having a sense of what our A1C is, specific to the heart, there was a study that was recently published out of New England Journal of Medicine, and although it was looking specifically at women, it pertains to all of us. Apoprotein B, the combination of C-reactive protein, the combination of your small dense LDL as a predictor of future cardiovascular events in women, over 30,000 women, I think that's imperative for us to have a sense of what those numbers are. Now, when you throw in lipoprotein A, when we look at residual risk, so I have begun to order that, although we don't have a treatment that's been shown to not only lower the levels, but to actually decrease events. So there was recent studies that have looked at lowering of lipoprotein A, but not necessarily in terms of, we still need additional studies in terms of reducing events, which is the quintessential.
[1:22:34] Now, with all that being said, it still gets us back to the same question is, what is the impact of lifestyle in terms of this, the juxtaposition between taking the medication versus not. And that's where I say you have to live the lifestyle and you have to take it a hundred percent to its prescribed dosing for the medications and for the other aspects, excuse me, for the food. So in terms of a whole food plant rich foods of having plentiful amounts of dark green leafy vegetables, you know, that are going to help with dietary nitrates. They're also going to provide bowel, decrease your bowel acids and soak up more of your cholesterol. And so the mechanistic perspective with vitamin K and mixing that with vitamin K2 with other fermented vegetables becomes so important for your atherosclerotic health. But once you do all that.
[1:23:25] And you've now been elevated to another level of living, now you have to inspect and see, well, what are the results of my efforts? What are my values in terms of these values? Apoprotein B, C-reactive protein, LP, little A, small, dense LDL. You look at that in the context of everything else, and now you figure out what is your risk according to our calculated scores, your atheroscopy cardiovascular disease risk based on your age, your numbers as a whole. And if you find that your numbers are high or that you've had a prior heart related event, now you have to have a tough decision of, should I be on medications on top of this? So that's usually where I will intervene with patients when I was seeing patients in clinic and I might check a calcium score. If they're Rip Esselstyn and they're eating extremely well and their numbers are still, their numbers are borderline and they have questions and others have said, I'm checking your calcium score. If your calcium score is low, if it's zero, that tells me there's no visible evidence of atherosclerosis combined with your low levels, your low numbers. Your risk is very good, and there may not be a reason for us to go in and put medication on board at all.
[1:24:41] So there's a sequence, and there actually is a thought process that should be impacted. The problem, that's actually inside of guidelines. So I'm not speaking of American College of Lifestyle Medicine guidelines. I'm speaking of American Heart Association, American College of Cardiology guidelines that speak to this process. The problem is doctors ignore one of the top one class one recommendations, which is lifestyle and nutrition. And we bypass that and jump. So we have to look at everything in an aggregate perspective and make a decision that's personalized for an individual that's best for you and knowing your situation. Yeah.
[1:25:17] Um, I was talking to Dr. Robert Osfeld from Montefiore. Yeah. Great guy. I'm sure you know, Robert. And, uh, he was saying that like, he likes it at this point, he likes some of his patients to have an, an LDL that's down there, like below 40. I think he was saying, and I was like, what I go, I've never heard that getting down that low. I mean, and I don't, it's hard to get that low, I think without being on meds. Yeah so i mean have do you subscribe to that at all or have you heard anything about that so there's data especially out of the european society of cardiology that's looking at actually 55 and ldl less than 55 showing a tremendous benefit now of course those studies were in in the context of medications right and so reducing that psk9 inhibitors and.
[1:26:08] Statins and so forth and reducing those that level down and i think in part i'm looking at the overall profile and, you know, what their total cholesterol is, is that close to 150 and below their triglycerides reflective of the quality of foods that they're eating. And then I'm looking at their LDL, but I'm really digging in. I want to know that in the context of the other markers of inflammation. So that's where the April protein B, which is a probably a better reflection and C-reactive protein tells me about the level of inflammation. And so looking at those as a whole gives me a perspective. Now, the vast majority of patients I'm seeing, listen, their numbers are so high. Yeah, they probably do need to be on a statin. And I tell them, it doesn't necessarily have to be a death sentence that this is forever. But here's the problem, Rip. And this is the part that I think is important for your audience to understand.
[1:27:03] As a physician, theoretically, I already mentioned that the adherence to medications is variable. I can at least check in the era of electronic medical records. I know if you've refilled your medications, which implies that you're taking the medication if you're getting it refilled. Right. You're not going to just stockpile medications. So that's it. That's a fairly rational assumption. I have zero idea if you're adherent to a whole food plant based diet. it.
[1:27:31] I have zero objective data, that is, outside of subjective data. And so as an example, I'll never forget this patient I took care of early on in my career after I transitioned, and he did remarkably. His wife made everything from scratch. He dropped weight, symptoms went away, was doing so wonderfully, got lost to follow-up. He had multiple tragedies in his life, loss of loved ones and job situation, and he had backtracked on his eating. And now his levels were through the roof high. His numbers were bad. Now, did I put him at risk by allowing him to come off of the medications while he was on the nutrition solely? That left him at risk, whereas he would have some level of protection by being on the medications when he backslid. That's a question that really arises practically from a clinical perspective, is how do you balance that? How much on this falls on the physician versus the patient? The power of informed consent, the empower of the community of support of that reliance. I told you earlier about that touch point of touching back home, almost home base. And so it's not simple. In an ideal world, everyone would start and they wouldn't stop. Yeah. And they'd have the family support to keep moving forward towards greatness and health and health span.
[1:28:57] But it's convoluted. So, yes, the lower, the better. Long-winded way of saying. I agree.
Closing Thoughts on "Selfish"
[1:29:06] Well, I feel like I've been very greedy with you today. You know, yeah, we're bumping up at 90 minutes here. But let me just, you know, this for anybody, what's the best way to get this? Can you get this book, Selfish, on Amazon? Amazon, Barnes & Noble, IngramSparks, Books.com, available there. Audio, too, is Audible. Okay, we're ending, but I have to kind of tell you this. So you ever look at people sometimes, or you'll listen to someone, and they have these emotions that spring up. You're like okay that's fake i mean i don't know i guess i judge people you're you're either i'm like i think we all know what you're talking about yeah yeah i'll tell you my wife was like we went to my cousin does voiceovers and does stuff inside of the industry so we did we worked on this the book and had me go into the studio with uh and and do it great time and we came to a chapter i was talking about my dad my wife was like are you gonna be okay i was like.
[1:30:11] Come on, it's me Right, I'm good, I'm good, I had to stumble and re-tape multiple times. And I'm like, what on earth is happening to me? This was a long time ago. I'm okay. But every once in a while, the emotions and those unhealed wounds, they peek open and they break open and things come out. But, yeah, so it's audible, too, as well. So if you hear a little voice crackling around certain points, that was not manufactured or intended at all. Yeah. Well, good for you for, for reading, reading your book. I'm, I still regret that I didn't read the, my first book, The Engine 2 Diet. I wish I had.
[1:30:53] It's a great book. Great. It's great. It's a great book. It's a great book. I still recommend it to patients. Yeah. Well, thanks. But anyway, thank you for today for sharing with the audience, you know, what's needed to obtain health from a mental, spiritual, and holistic kind of standpoint through your seven pillars. I think they're all brilliant and wonderful. And, um, you know, Columbus, you are a class act. You are a total class act. Love having you back on the podcast. Thank you for, uh, for sharing all your insights and, uh, man, all the best to you. Everything that's going on in LA. Um, and, uh, thank you for continuing to do your best to show people the light when it comes to heart health.
[1:31:42] Yeah, no. And right back at you. I've always appreciated you and the work you're doing. I mean, transforming lives. And I love the new angle you're taking out there. I've been checking it out. I love the new angle going in. No, I think it's wonderful. And that's what people need. And so keep up the incredible work. You don't need me to tell you that. And I will continue to support you from afar. I will recommend your products to patients because I think they're one, they tastes great. And then two, that's not a plug. He's not paying me y'all. He's not paying me to say that I'm saying, cause it's true. And then two, because of the healthful benefits of it. So, I mean, your family has a special place in my heart. Your mom, your dad, you, I don't know, I don't know your sister as well, but I know she has to be amazing as well. But you know, you all hold a special place in my heart. And I speak so highly of you when I meet patients and refer them when they need another voice apart from mine to peer into, I refer them over to you all. Thank you. Hey, will you give me a PLANTSTRONG fist bump on the way out? That's right. Absolutely. Columbus, PLANTSTRONG, my brother. Boom. Love it. Love it. Love it. All the best. All right. Take care. Yeah. If you're interested in grabbing yourself a copy of Selfish, A Cardiologist's Guide to Healing a Broken Heart, I'll be sure to put a link on how to purchase in today's show notes.
[1:33:10] Truly prioritizing your mental, emotional, and physical well-being may be one of the most profound acts of love that you can commit to today and every day. And I can think of no better message for National Heart Health Month. Next week, for the first time to the podcast, I want to welcome Dr. Joel Kahn as we continue to focus on matters of the heart for February. Have a great week. Keep your heart strong and always, always keep it PLANTSTRONG. The PLANTSTRONG podcast team includes Carrie Barrett, Laurie Kortowich, and Ami Mackey. If you like what you hear, do us a favor and share the show with your friends and loved ones. You can always leave a five-star rating and review on Apple Podcasts or Spotify. And while you're there, make sure to hit that follow button so that you never miss an episode. As always, this and every episode is dedicated to my parents, Dr. Caldwell B. Esselstyn Jr. And Anne Crile Esselstyn. Thanks so much for listening.
