Howes: Hi.

I'm Lewis Howes, New York Times bestselling author and entrepreneur.

And welcome to "The School of Greatness," where we interview the most influential minds and leaders in the world to inspire you to live your best life today.

And in this episode, we sit down with Dr.

Kevin Tracey, a neurosurgeon, bestselling author, and president of the Feinstein Institute for Medical Research.

Today, he breaks down how the vagus nerve in our body has the potential power to reverse inflammation, balance the immune system, treat chronic illness, and keep our organs humming together in harmony.

Dr.

Tracey: "You can't cure a disease without also curing the soul."

Howes: Interesting.

What does that mean?

Dr.

Tracey: That means that the networks that control your brain are linked to the networks that are controlling the health of your organs.

If the signal to turn off inflammation doesn't come, the inflammation can persist.

Chronic stress, chronic anxiety is an inflammatory condition where the presence of inflammation gets worse, not better.

Howes: I'm so excited for you.

Now let's dive in and let the class begin.

Dr.

Tracey: What is the vagus nerve?

What is the great nerve?

You have -- First, you have two of them, like two thumbs and two kidneys, one on each side.

Howes: Coming down here.

Dr.

Tracey: Starts at about the level of your ear, runs down your neck, across your chest, into your abdomen, and it touches all the organs in your body that you don't think about all day long, all the organs that are operating, when you're healthy, in complete harmony because their reflexes are being controlled by the brain and the vagus nerve to balance the function of all these organs.

So, why is it great?

Because it's the only nerve in the body that, if you cut it on both sides, up high, you die.

Howes: Wow.

Dr.

Tracey: It's required for life.

It's required for health.

Howes: What if you just cut one side?

Dr.

Tracey: Then you're okay.

Howes: You suffer.

[ Both laugh ] Dr.

Tracey: The reason that the vagus nerve cut on both sides leads to death is because it's critically important in sending signals that coordinate the function of the heart and the lung.

If you only cut one side, you can accommodate that.

Howes: Interesting.

Dr.

Tracey: But it's not good.

Howes: Okay.

So, that's the vagus nerve.

Dr.

Tracey: Well -- Howes: And does it connect to the brain and goes through the heart, as well?

Dr.

Tracey: It runs -- So, that's the next important point.

It runs from the brain to the body and back.

So, it's a two-way highway.

In fact, 80% of the signals that travel in the vagus nerve go from the body to the brain.

Only 20%, give or take, run from the brain back to the body.

Howes: Okay.

Dr.

Tracey: Now, the key to this -- We keep talking about the vagus nerve, and I already said you have two, so it should be vagus nerves.

Howes: Okay.

Dr.

Tracey: On each side, you have 100,000 fibers.

So it's much more proper, what we understand today, to say that you don't have a vagus nerve.

You have 200,000 vagus nerves.

And what we've learned, my colleagues and I, in the laboratory at the Feinstein Institute and now in dozens, if not hundreds, of labs around the world, is we've learned that each and every one of these fibers, 200,000 fibers, has a job description.

It has a beginning and an end, and the signals that it carries are incredibly specific.

So, some -- You asked about the heart.

Some go to the heart.

And the fibers that go from the brain to the heart tend to slow heart rate.

Howes: Mm.

Dr.

Tracey: Some go to the spleen and other organs of the immune system.

And my colleagues and I discovered that the fibers that go to the immune system slow inflammation or inhibit it or stop it.

Other fibers go to the pancreas to control insulin.

Other fibers go to the intestines to control the processing of your food.

So, you don't have a vagus nerve.

You have 200,000 vagus nerves.

And when someone says to me, "I want to do something to stimulate my vagus nerve," I say, "Oh, really?

Which one?"

Howes: Right, right, right.

Interesting.

Dr.

Tracey: And that's important.

Howes: And you've done -- I mean, as a neurosurgeon, you were telling me you've done over 1,000 either brain surgeries or spinal-cord surgeries over a decade of time.

What was the greatest lesson you learned about the nervous system and how the brain and body connects or works in unison through all those surgeries you did?

Dr.

Tracey: That it's complicated.

That's the main lesson.

Howes: [ Chuckles ] Dr.

Tracey: Um, the main lesson I learned about how complicated it is, is rooted in the fact that, when two neurons interact -- Let's go from 100 billion neurons in your brain and nervous system, with trillions of connections.

When you realize that each and every one of those neurons interacting interacts reflexively -- A signal into one neuron from another neuron means I'm gonna do this.

A signal in from a different neuron to that neuron means I'm gonna do that.

Well, one of the fathers of neuroscience explained it in the nineteen-teens very, very simply and in a way that can't be better explained.

Charles Sherrington said, "If you understand a simple reflex --" So, that's when the doctor hits your knee with a reflex hammer, your leg goes up, and you say, "Who did that?"

Basically, what happens is there's a sensory activation, there's a sensory neuron into your spinal cord and that activates one of these connections called a synapse, which sends signals back down through a motor neuron to the muscles in your quadriceps femoris and your leg goes up.

Sherrington said, "If you understand a simple reflex, then you realize, if you put two reflexes together, or three or four or more -- and on and on and on -- till you get up to however many billions, you can assemble a nervous system.

But the basis of what's happening is reflexive."

Howes: Mm.

Dr.

Tracey: The third thing he said -- So, you understand a reflex, you can build a nervous system.

And the third thing he said was, "There's no such thing as a simple reflex because they are all connected."

Howes: Mm.

Dr.

Tracey: So, that's what I learned is the most complicated thing.

We, as researchers, as scientists, as doctors, we tend to reduce complicated things to simpler and simpler component parts.

And you have to do that to figure out how things work.

But at the end of the day, they're all connected.

Howes: Everything's connected.

Dr.

Tracey: Everything's connected.

So, the brain, as the source of your "mind," and your body as the part of your nervous system, is, in fact, all connected.

Plato was right.

You can't cure a disease without also curing the soul.

Howes: Interesting.

What does that mean?

Dr.

Tracey: That means that the networks that control your brain and your mind are inextricably linked to the networks that are controlling the health of your organs.

Howes: And there's something you said about a quote from Plato?

What was that quote again?

Dr.

Tracey: That you can't heal the body unless you also heal the soul.

Howes: So, if someone is feeling some type of pain in their body or inflammation in their body or chronic illness that's been going on for a long time or whatever -- something's going on, they have anxiety, depression, they have irritable bowel syndrome, they have something happening where it's like, "How do I get through?"

-- eczema, some type of condition that they don't know where it's from, am I hearing you say that, when you can start to heal the soul or the mind that's connected to the soul, the thinking, the intention behind the soul, then you can create harmony within the body and heal the body?

Is that what I'm hearing you say?

Dr.

Tracey: I think what Plato meant is that they're the same thing.

And it depends.

Howes: Mm-hmm.

Dr.

Tracey: So, let's break it down to, like, something -- first principle, something.

So, pick one of the conditions you listed.

Howes: Let's call it, like, an eczema or something or, like -- or inflammation in the body and the joints.

Dr.

Tracey: How about inflammation in the joints?

Howes: There you go.

Dr.

Tracey: Inflammation in the joints -- Howes: Like an arthritis or inflammation.

Dr.

Tracey: Like arthritis.

Inflammation in the joints can come on very noticeably with pain.

Inflammation is pain, swelling, redness, heat.

So, that can come on, and it can be quite noticeable.

And the pain and the presence of inflammation activates -- all of that activates sensory nerves to send signals into the brain.

In a case of mild, say, inflammation of a joint 'cause you jammed your finger catching a football, that inflammation is usually self-limited and self-resolving because the signals that go into the brain and through the autonomic nervous system activate signals that come back down to the body to slow down the inflammation when the joint is healed or healing.

Now, let's imagine for a second, in that simplest of cases, that the wires going in or out aren't working properly for whatever reason.

The... If the signal to turn off inflammation doesn't come, the inflammation can persist.

Howes: Mm-hmm.

Dr.

Tracey: And persisting inflammation now can cause damage to the tissues it originally started to protect.

So, that's the simplest of examples.

And that's just right now focusing on the body.

We haven't said anything about the mind.

Now let's put the mind in place.

The arrival of a pain signal in the brain activates reflexes to protect the body.

Howes: Yes.

Dr.

Tracey: Some of those -- they're called "stress reflexes" or "fight-or-flight" or "sympathetic reflexes" -- have significant benefit if you need to run away from an attacker or a lion or a bad guy.

Then it's clearly beneficial to have the energy and the -- and to not be worried about the pain.

Forget about it.

That's what happens.

Howes: So you're flooding adrenaline into the body so you don't feel the pain for that period of time.

Dr.

Tracey: Right.

The young woman who picks the car up off her injured child.

Howes: Yeah, yeah.

Dr.

Tracey: So, this -- these signals coming back down acutely in large amounts will tend to dampen and slow down inflammation.

Acute fight-or-flight inhibits inflammation.

Howes: Interesting.

Dr.

Tracey: But let's say the wires are broken again.

Now the inflammation is not inhibited, okay?

'Cause the signal didn't get there.

Now what do you have?

Now you have pain day after day after day after day.

Now you don't have massive fight-or-flight.

Now you have chronic, low-grade activation of fight-or-flight.

That's pro-inflammatory.

So, chronic stress, chronic anxiety actually is an inflammatory condition where the presence of inflammation gets worse, not better.

So, it's -- Howes: Mm-hmm.

Dr.

Tracey: It's complicated.

Howes: Yeah.

Dr.

Tracey: But if you walk through it step by step, you can break down the components.

Howes: But doesn't the inflammation -- I mean, obviously, it's in the body, but what I'm hearing you say is that there's a strong connection to the way we think, the intention behind our thinking, the emphasis -- the quality of our thinking that is influencing, I guess, the electricity to send or not send or flow or not flow, whatever it needs to actually heal.

Or am I off there?

Dr.

Tracey: No, you're not off, but you're -- you're correctly paraphrasing what billions and billions of Web impressions and Web recommendations say.

Howes: Really?

Dr.

Tracey: Absolutely.

So, there's -- there's -- this is -- Many of these things are being repeated over and over, like mantras.

When you break down to, "What is the -- What are the reflexes, what are the neural circuits that underlie this that we can put under conscious control?"

you kind of run -- you run up against a wall very quickly.

What is it you can consciously control?

You can consciously control your breath rate.

Howes: Mm-hmm.

Dr.

Tracey: You can slow down your breathing, you know, if it's not some -- You can't always, but in this example, you can slow down your breathing.

Have you just stimulated your vagus nerve?

Well, maybe, right?

Howes: Maybe you calmed it?

Right?

Or no?

Dr.

Tracey: Well, you haven't really calmed your vagus nerve.

You've calmed your mind.

Howes: Ah.

Which impacts your vagus nerve.

Dr.

Tracey: Yeah, it impacts maybe a few hundred fibers of the 200,000.

Howes: Ah, okay, okay.

Dr.

Tracey: We're back to like, what is it we really understand?

And do we know that slowing breathing one way -- you know, let's say, in on three, out on seven or box breathing... Howes: Uh-huh.

Dr.

Tracey: ...four, four, four, in on four, hold four, out four, hold four -- These are all -- And how many techniques are there?

Howes: Tons.

Dr.

Tracey: Hundreds.

Dozens.

Hundreds.

Howes: Yes.

Dr.

Tracey: Do we know what each of those methods does to the vagus nerve fi-- No.

We don't.

Howes: No.

We know it might help us feel better in that moment.

It might help us calm our mind.

Dr.

Tracey: Great.

Howes: Yeah.

Dr.

Tracey: Great.

Here's what we do know.

If, in general, these activities -- and we can go through them one by one -- but the cognitive behavioral therapy, prayer, some breathing modalities, not others -- 'cause what I'm gonna say will make sense -- Complicated, but let's do just relaxation.

Meditation.

That's what I couldn't think of.

So, you've got these states where you induce relaxation.

They almost always slow heart rate.

If your heart rate slows from something you did, then you did stimulate -- arguably "stimulate" the fibers in your vagus nerve that go to your heart because that's what it does.

Howes: Uh-huh.

Dr.

Tracey: But you may have also inhibited the fibers in your sympathetic nervous system that accelerate your heart rate.

Howes: Right.

Dr.

Tracey: These things that are being promoted, many of them are grounded in some basic science facts.

But to extrapolate it further than that -- Howes: Mm.

Dr.

Tracey: First of all, it's -- No way to be proven true or false.

But second of all, it puts -- in the case of a patient with an illness, it runs the dangerous risk of putting the blame on the patient.

Let's go back to the example I gave before.

If you have an infection that damaged your vagus nerve and you have arthritis and you go online and someone tells you to do 10 extra push-ups because that'll stimulate your vagus nerve and stop your inflammation, no, it might not for you.

So, I, as a physician scientist, never want to be in the situation where we say, "We know this to be true, therefore it will work in you."

Howes: Right.

Dr.

Tracey: That's not -- That's not always the case.

Howes: It may or may not work.

You have to try it out.

Dr.

Tracey: It may or may not work at all.

It may or may not work in you.

It may or may not work in somebody else, you know?

So, how do we get past that in the modern era, with all of our powerful tools?

We did discover that you can -- you can put a computer chip on the vagus nerve of people with severe inflammation from rheumatoid arthritis and that can make many of them better.

Howes: Really?

Dr.

Tracey: Yeah.

And that's based on, oh, 28 years of work in the lab, first in my lab and now in literally dozens, as I said before, hundreds of labs around the world.

And what we discovered are, of the probably 100,000 vagus nerve fibers on the left side of people, of humans, several hundred, maybe a thousand of them travel down into the area of your spleen, in your abdomen, which is one of the major organs of the immune system.

And when these signals arrive there -- And we can activate the signals with this little computer chip.

These signals arriving in the spleen are a calm-down signal to the white blood cells that pass through the spleen.

So, the spleen gets 20% of your cardiac output every minute.

That means a huge percentage of your circulating white blood cells go through that spleen every hour.

If the vagus nerve signal is sending a calm-down signal to the cells that are passing through the spleen, they get -- they get pacified.

They get calmed down.

Howes: Mm-hmm.

Dr.

Tracey: Now when they arrive at that injured finger, they don't attack what they see.

They actually switch into a more tissue-reparative mode.

So, it's as if, rather than a soldier arriving at the front and shooting, it's a team of medics that come and start patching things up.

Howes: Interesting.

That's what you want.

Dr.

Tracey: That's what you want, and that's -- We know that works if you directly stimulate the vagus nerve with a chip.

Howes: So, if someone's had chronic arthritis for years and it only seems like it's getting worse, is that a soul healing or is that a vagus nerve healing and total-body healing?

You know?

And it sounds like no drugs can really heal something like this.

Maybe they can help some people sometimes, but it doesn't seem like there's a drug that can help reverse arthritis or certain conditions.

Dr.

Tracey: So, let's talk about, again, rheumatoid arthritis, which is one type of arthritis, and what we know and what we don't know.

We know that rheumatoid arthritis is a very common condition.

It affects up to perhaps 1% of the population or 1.5% of the population worldwide.

It's very common.

It tends to affect younger people, more women than men, and it's not sort of like the old football injury, "My knee gets sore when it rains."

This is a serious illness that affects all the joints.

And many of these patients can't pick up a pencil, can't ride their -- can't ride their bike, can't sometimes button their -- button their shirt.

Howes: Yeah.

Dr.

Tracey: And we also know that we have powerful drugs that have treated very well many, many of these patients.

These drugs go by the names of DMARDs, for disease-modifying antirheumatic drugs, or biologics, which are typically antibodies.

You see them advertised on the nightly news.

You see them advertised on all the sports on TV.

These are very powerful drugs.

They work because -- not because they cure inflammation, but because they suppress the immune system.

Howes: But do you want to suppress your immune system?

Dr.

Tracey: You don't want to suppress it too much.

Howes: Yeah.

Dr.

Tracey: If you suppress your immune system too much, you leave yourself open to secondary infections, even to cancer.

So, many of these drugs that are u-- Howes: Some side effects to those then.

Dr.

Tracey: Many of these drugs, the side effects have the most serious label that the FDA can give, which is called a black box warning.

And many patients, even though -- Let's be clear.

Millions of patients have benefited from these drugs.

Millions of patients have benefited from these drugs.

But many patients, despite the benefit, don't want to take them.

Howes: Yeah.

Dr.

Tracey: Many of them have to be injected, so they're invasive.

Many of them cost between $30,000 and $100,000 annually.

Howes: Oh, my goodness.

Dr.

Tracey: Many, if not all of them, have dangerous side effects.

And so people are reasonably concerned.

Howes: There's no guarantees for "healing," and it's like you have to stay on these things forever, it sounds like.

Dr.

Tracey: Not only is there no guarantees, but in most studies, these drugs are effective about half the time.

So, despite the fact they're invasive, have side effects, and are expensive, they work half the time.

Howes: They may not work.

Yeah.

Dr.

Tracey: So, what's the point of all this?

The point is, yes, some people are benefited.

They don't need anything, and that's wonderful.

But a lot of people want other options.

And what this vagus nerve stimulation, which, by the time this airs, may be approved by the FDA in the United States -- If not, hopefully it'll be approved in the coming months after this airs.

What that will allow is patients who have tried these other therapies, but, as you said, are not getting better in their body or their mind -- Howes: Mm-hmm.

Dr.

Tracey: That they now will have an option of having an implant.

The implant will be put in.

It's about the size of a fish oil pill.

It'll be put in through about a one-inch or 1 1/2-inch incision in the neck by a neurosurgeon, right about the level of your Adam's apple, down deep where you feel the pulse in your neck.

You won't be able to see it.

And it will operate for about one minute a day.

Howes: Wow.

Dr.

Tracey: And many of the patients -- I've met many of them.

Many of the patients sleep through the therapy at 4:30 in the morning or something like that.

Other patients told me that it's like a little alarm clock for them, but when it goes off, they smile because they realize immediately their hands don't hurt anymore.

Howes: Really?

Dr.

Tracey: There are patients with very famous, widely publicized stories.

There are stories of people, as you say, who were unable to walk up a flight of stairs and are now riding their bicycle several miles every weekend.

I met a patient named Kelly, who was one of the first patients implanted in a study that we did in Europe years ago.

And Kelly was one of these patients who couldn't walk up a flight of stairs.

She was told by her physicians that she had to retire as a teacher.

And she and her husband, Sean, were out of options.

They had been nearly bankrupted by the expense of her drugs that weren't working.

They sold everything they owned.

Kelly talked her way into the clinical trial in Europe.

She moved to Amsterdam.

Howes: Wow.

How old was she when she did this?

Dr.

Tracey: Um, I'm not sure exactly.

Late 20s, early 30s?

Howes: Oh.

Young.

Dr.

Tracey: Yep.

Howes: Very young.

Wow.

Was it arthritis or was it, like, inflammation in her feet or...?

Dr.

Tracey: It was actually inflammatory bowel disease, but a complication of Crohn's disease that she had was -- affected her joints... Howes: Mm-hmm.

Dr.

Tracey: ...to the point that her father, for one of her birthdays, gave her a cane... Howes: Oh, man.

Dr.

Tracey: ...because she was in and out of wheelchairs.

Howes: Ugh.

In her 20s.

Yeah.

Dr.

Tracey: Yeah.

So, Kelly and Sean moved to Holland.

They -- Kelly received one of the first.

I call it a gen-one implant.

It's not -- It wasn't the small chip we have today.

And she had to stay there for a few months afterwards for her follow-up checks.

And they were running late to the doctor's appointment.

And there was an elevated train, and Kelly saw it coming.

And this is a few weeks or a month post-op.

And she ran up the stairs.

Howes: No way.

Dr.

Tracey: And she's about to get on the train.

She realizes Sean's not with her, so she stops and she looks at Sean like, "What the heck?"

And Sean's at the bottom of the stairs crying... Howes: Oh, my gosh.

Dr.

Tracey: ...'cause he couldn't remember when she did -- Howes: Oh wow.

Dr.

Tracey: Gets better.

I didn't know any of this till I got an e-mail.

And I invited Kelly -- I never met her, didn't know who she was.

She came to see me.

And she gave me a gift.

And it's still -- It's in my office.

It's her cane.

Howes: Oh, my gosh.

Wow, that's powerful.

Dr.

Tracey: I left the bow on it.

I have a picture I can get today.

Howes: Oh, that's beautiful.

Two final questions for you.

This is called the Three Truths.

So, imagine it's your last day on earth, many years away.

You get to live as long as you want.

But for whatever reason, all of your written work -- your publication, your scientific research -- for whatever reason, we don't have access to it anymore.

But on your last day, you get to leave behind three things you know to be true, whether it's from your personal experience in life, your personal philosophy, your lessons, anything you can think of.

What would be those three lessons you would share with the world?

Dr.

Tracey: You find, uh -- You find -- You find love and true meaning and joy in your family... Howes: Mm.

Dr.

Tracey: ...every day.

Howes: Mm.

Dr.

Tracey: That would be number one.

Howes: Wow.

Dr.

Tracey: Number two is, a single person working diligently for a lifetime can change the world.

And we all have the opportunity to do that.

That would be -- That's the second truism.

Um, and number three is probably related to that.

But humans -- human beings, people, don't have any problem accomplishing their goals.

They have problems, but any goal can be accomplished.

The hardest thing for a person to do is to pick the goal.

Howes: Mm-hmm.

Dr.

Tracey: If everybody knew that and spent more time picking their goals, the world would be a better place.

Howes: Mm.

Final question for you -- what's your definition of greatness?

Dr.

Tracey: [ Chuckles ] Leaving the world better than you found it.

Howes: Kevin, thanks for being here.

Dr.

Tracey: Thanks for having me.

I really appreciate it.

Howes: If today's conversation moved you, there's so much more where that came from.

Make sure to scan the QR code on the screen or visit greatness.com/tv to follow the "School of Greatness" podcast.

And sign up for our free newsletter.

And stay tuned for more episodes on "The School of Greatness" right here on public television.

Again, my name is Lewis Howes, and if no one has told you lately, I want to remind you that you are loved, you are worthy, and you matter.

Now it's time to go out there and do something great.

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