You 2.0: What Is Your Life For?  ## Metadata - Author: [[Hidden Brain]] - Full Title: You 2.0: What Is Your Life For? - Category: #podcasts - URL: https://share.snipd.com/episode/00cc2d0d-d120-44b4-8231-2c1382eca5cd ## Document Notes ## Highlights - **Julia's Early Health Crisis** - Victor Strecher's daughter Julia was born healthy but soon diagnosed with a severely damaged heart. - He and his family debated heart transplantation while rethinking what it means to live a meaningful life. Transcript: Victor Strecher So much. Happy to be here. Shankar Vedantam Vic, I want to talk about your own journey to discover what you should be doing with your life. In 1990, your daughter Julia was born. Tell me about the first few months of her life. Victor Strecher Yeah, well, Julia was born, as she used to like to say, a 10 out of 10. So she was born healthy. I was a professor, an assistant professor at the University of North Carolina in Chapel Hill. And soon after she was born, we went to the Netherlands where I was doing a research sabbatical. Soon she started getting sick. Doctors there diagnosed it as just having some type of respiratory illness, but it seemed to keep getting worse. Finally, she ended up in the hospital in the Netherlands, and she was there for a few days, and they just didn't know what to do. And then late one evening, a cardiologist just happened to walk by, looked at her and said, she doesn't look quite right. Took an echo machine, an echocardiogram, and did the echo on her. And I'll never forget this because it was very late at night. He called a resident in, us to a small room, and said, I'm really sorry to tell you this, but your daughter's heart is ruined. And he described it almost as a chicken breast that's been smashed down, pulverized to make it tender. Said her heart is really completely destroyed, and she has no more than a month or two to live. Shankar Vedantam Devastated by the news, Vic and his wife flew back with Julia and her older sister to the United States. They rushed Julia to the medical school at the University of North Carolina. The doctors there confirmed the urgency of the situation, but they offered a silver lining. Victor Strecher After doing a lot of tests, they said, you know, her other organs have not failed. She might be okay and eligible for a heart transplant. And we have a new surgeon who just came from Stanford. He's not done a heart transplant yet here. And this would be the first heart transplant in the southeastern region of the United States. Wow. There was one girl waiting for a heart transplant, and she died waiting. So if you'd like to do that, we could put her on a list. Well, our world was kind of turned upside down. First, it was turned upside down thinking that she was going to die. The second part was turned upside down because now she might have a chance to live. But what kind of life would that be? So I went to the medical school library, and I started reading through pediatric heart transplantation. And the first thing I realized is that we were on the front wave of heart transplants for kids in 1990. Not that many had been done. There weren't that many studies. The studies that I did read said roughly 50% of children waiting for a heart die before they get one. And then if they did get a new heart, their chance of surviving five years was 50%. So you can do the math yourself. It's 50% times 50%. Her chance of living to be six years old was 25%. And so we had dinner table conversations. Should we do this? Should we get a transplant? Shankar Vedantam I understand that when you and your wife and your older daughter, Rachel, were talking about this, the gravity of the situation also meant that you were asking yourself even bigger Questions. You know, what does it mean to live a good life? What is a life worth living? Victor Strecher It's exactly, we started asking ourselves, what is a big life? If she does live to just be six, could we give her a life still worth living if she died at the age of six? And we all got together at the dinner table, what we like to call our gathering place. And we decided, yes, we can give her a big life, not just within our family, but hopefully she'll have friends. Hopefully she could engage in activities that other children engage in. Hopefully she could develop great friendships and new passions in her life, no matter how long she lived. Shankar Vedantam So I understand you went ahead and got Julia the heart transplant, but this also changed the way you were thinking about your own life, your own career troubles or challenges, your own Anxieties. How did it change how you approached your life, Vic? Victor Strecher It's so funny. As an assistant professor, I was so interested in moving up, getting tenure, becoming an associate professor, getting grants. You know, I thought that was the game. That's what I had to play. And I viewed it kind of as a game. And I was quite honestly fairly good at that game. And so I enjoyed it. I spent a lot of my time on it. And suddenly when Julia got sick, it really changed that. It stopped becoming a game. And I started thinking, have this one life to live I don't know how long I'm gonna live maybe I'll die in six years or or sooner I'm gonna have to live this life as if you know this is all I have And uh once I started doing that I started taking my life much more seriously to be honest I started thinking more about, well, what would people say about me after I die? What would be on my headstone? What would people say at my memorial service? ([Time 0:04:30](https://share.snipd.com/snip/7faac150-909e-424b-a87e-a29bdbc77bd7)) - **Miraculous Second Transplant** - Julia needed a second heart transplant after complications at age nine and nearly died. - She stunned doctors by partially recovering unexpectedly and then received a new heart, described as a miracle. Transcript: Shankar Vedantam Julia got on the heart transplant list again. She moved into the hospital. But she wasn't high on the list because her medical condition was not dire. Keeping in mind his commitment to give Julia as normal a life as possible, Vic helped Julia keep up with what her classmates were learning at school. Victor Strecher We were doing Roman numerals. We were studying because she would take her books from school and we would take them to the hospital. So we were learning Roman numerals, and that was great. She was really good at math. And then the nurses kindly let me sleep in a room next to her. So it was empty, so I could sleep in the bed. And I remember staying up watching the U.S. Open tennis tournament. I watched this tennis player, Todd Martin, play against the player. He was down, I think, two sets to nothing. I just watched this whole thing and it went deep into the night. I just remember thinking, wow, if Todd Martin could win after being down by two sets and he's throwing up the side of the court, too, he was so sick and so tired, he came back to win that match. And I thought, maybe she can win. Well, it's funny, that evening I was asleep and I was woken up by the nurse around 1 o'clock in the morning. And the nurse had tears in her eyes and I knew something was wrong. Said, Julia's had six heart attacks since you've been asleep, and they've been working on her, but things don't look good. I went down to where they were working on her in the ICU, and the doctors took me aside. I called my wife. She drove in from home. And the doctor said, it looks like she is brain dead. Her eyes are fixed and dilated. She hasn't responded to a test where they take a scalpel and scrape the bottom of your foot, which is torturous if you're awake. And they were talking about next steps, what to do. And so we went in to see her, and it didn't look like she was there. Her eyes were wide open, her pupils were fixed, dilated. She had no response. And we came back and talked to the doctor. And Jerry, my wife, had the foresight, and I think transcending foresight, to ask the doctor, is there any hope for donating her organs to other people? Because she was at the time on a respirator, and we were talking about the possibility of pulling the respirator out and just letting her go peacefully. And the doctor said, well, yeah, that would be, that is possible. Some of her organs might be donated to other people. It'll take a while, though, because the harvest team needs to fly in to do that. They call it a harvest team. Interesting. And so they would need to fly in. So while the harvest team was flying in, which is going to take a matter of hours, we walked into the Arboretum at the University of Michigan. It's a beautiful park. And I remember we looked up into the sky and I said, you know, we're not going to be a foursome anymore. We're going to be a trio, but we'll still make good music. We came back and saw her cardiologist, the senior cardiologist, who said, before we do anything, maybe you just want to see her one last time. And so we went down to the ICU, and I'll never forget this. She was moving. Her eyes were still wide open, fixed dilated, but she was moving spastically. And a neurologist was studying her and examining her. And we said, what is that? We said, this could be the last throes of life. This often happens where you become kind of spastic in your movements. So I just held her hand and I just said, Julia, if you can hear me, squeeze my hand. And I thought I felt a really, really light squeeze. And I turned to the doctor and said, I think she squeezed my hand. And the doctor said, okay. And you could tell what he was thinking. You know, everybody feels that squeeze probably. And I was thinking, okay, what if she's somehow functioning inside? If she's mentally impaired now because she's gone through six cardiac arrests over a period of five hours, if she's mentally impaired, she'll never get a new heart. She'll be dropped from the list. And I don't want her to go through more suffering. So what kind of tests could I provide to her right now in this case? So I whispered in her ear, if you can hear me, Julia, squeeze my hand IV times in Roman numerals. And she squeezed my hand four times. And I turned to the doctor and said, she squeezed my hand four times. And the doctor turned pale. And suddenly there were about 10 people working on her. They had already pulled all her tubes out. And they put all the tubes back in, basically. And the doctor said, this has never happened to us before. We've never seen this happen. And I didn't blame them whatsoever. They did everything according to protocol. They did everything that was supposed to be done. And yet somehow she was in there and she was alive. And gradually she started coming back, started asking her things and she could nod her head. Gradually she started being able to communicate with us. She couldn't speak because she had, I'm sorry, She couldn't speak because she had a respirator. She was blind, and in fact, she was blind for at least a couple of days because the part ([Time 0:12:04](https://share.snipd.com/snip/4e640f8c-9ede-4cff-8138-1bb7cf2290c7)) - **Julia's Final Days** - Julia died suddenly at 19 after struggling with health during nursing school. - Her father's final words from her capture a poignant moment of acceptance and loss. Transcript: Victor Strecher Was in nursing school her first year, she was really struggling the first semester. She was having a hard time. She had a lot of headaches. She was pretty sick quite a bit. But she was trying to work through it. She lived in a dorm. And I would meet with her every once in a while because I was a professor there at the university. So we could have lunch together. And she was having a tough time. So I said, well, how about if we go down to the Caribbean? We go to someplace warm because it's very cold. And, you know, I think she was feeling the cold weather much more than other people, maybe because her heart was having a hard time. She had passed other tests of her heart, but this was 10 years past her previous heart transplant. She was 19 years old. So we took her to the Caribbean along with her sister, and we took their boyfriends with us as well. And I remember on the third night, we were all out on the beach at the gathering place. We had a table out on the beach, and we were just enjoying it. And we were walking back, and she turned to her boyfriend, and she said, I'm so happy now that I could die. And it turns out that those were her last words that I heard. Because she died in the middle of the night, that night of a massive heart attack, very suddenly and very unexpectedly. ([Time 0:22:10](https://share.snipd.com/snip/c54b643c-e128-4705-a63e-d47036413db7)) - **Grieving Alone in Cabin** - After Julia's death, Vic retreated to a cabin and struggled deeply with grief, feeling dissolved and fragmented. - This intense personal suffering prompted profound reflection on purpose and life. Transcript: Shankar Vedantam I understand that at one point you retreated alone to a cabin in northern Michigan. What did you do there? Victor Strecher You know, when Julia died, I remember my wife and I went to a therapist, a grief counselor, who was also a marriage counselor, which is great. And I remember being the smart professor that I am. I went in and said, well, I've done the research and I've read that 80% of couples who lose a child break up. And so that's why we're seeing you because we want to make sure that our marriage continues to survive. And she kind of smiled gently and said, well, you know, Vic, 50% of marriages end up in divorces anyway. So I forgot to realize that. And of course, so there certainly is a greater risk of getting a divorce if you lose a child. But it doesn't go from zero to 80%. But then she turned to me and said, but I will tell you this, if you judge how your wife, Jerry, is grieving, or if she judges how you're grieving, maybe you're not grieving enough, maybe You're grieving too much, maybe you're doing this and it's not good for you, whatever, you'll split up. So what I recommend you do is you go on your own journeys of grief. You respect the other person's journey of grief. You communicate, but you may end up doing things differently. My wife, who's a sculptor, an artist, and a gardener, started sculpting and gardening more in Ann Arbor. I went up to northern Michigan to a cabin we had right in Lake Michigan. And I was by myself for long weeks at a time, and I basically started eating and drinking myself to death. I started watching TV all the time. It didn't matter what I was watching, not at all. I just started finding myself almost dissolving. It was like entropy was in my body. ([Time 0:25:35](https://share.snipd.com/snip/70c2809e-a073-4725-a85a-1663f2bbb6c2)) - **Purpose Fuels Resilience** - People with strong purpose adopt healthier coping strategies like seeing the big picture and nature walks. - Purpose fuels energy and persistence, making stressful tasks feel more manageable and worth enduring. Transcript: Shankar Vedantam Can you describe this finding and also what are emotion regulation strategies and why are they important? Victor Strecher Well, first of all, we all have stressors in our lives, right? All of us. And the question really is how do you cope with those stressors? Turns out that of 16 coping strategies that we looked at, strategies like drinking alcohol or eating too much or venting were negatively associated with sense of purpose. Whereas seeing a big picture, knowing this won't last forever, taking walks in nature, engaging in a family or religious ritual. Those were strongly associated with a sense of purpose. And along with that, emotional self-regulation. I remember I was talking to a colleague in the business school at Michigan, and he said his son has a child who is in Montessori school, five-year child, comes home, and they're getting In a big argument. And they're almost yelling at each other. And finally, the five-year child says, you know what? I'm going to change my own weather. And suddenly, they have an adult conversation. And I was thinking, I wish a lot senior leaders had that ability to change their own weather, going from cloudy to sunny. And so what that requires, I think, is a sense of understanding what your emotion is and also having the agency to be able to change it. Shankar Vedantam There's been work that looks at the relationship between having a sense of purpose and feeling more energy and willpower. And in some ways, it makes sense. If you're actually driven by something, it feels like you should have more energy and willpower to stick in it. Victor Strecher Studies show that if you put a backpack on a person that's 25 pounds and say, this backpack is just dead weight, or put another backpack on another group of people and say, this backpack Has important scientific equipment that you're carrying. It's a very important, purposeful backpack. And you put both of them on a ramp, and they estimate how steep the ramp is. The group carrying the purposeful backpack, even though it still just had dead weight, it wasn't carrying scientific equipment, the people carrying that backpack perceive the slope To be far lower. In fact, as if they weren't carrying any backpack. So I think when you have a sense of purpose, just think about if you're trying to swim as a child underwater as far as you can. ([Time 0:40:02](https://share.snipd.com/snip/3a90ef96-c694-4fb8-99f7-3152687f1b81)) - **Shift and Persist Strategy** - The "shift and persist" strategy helps people adapt to stress by accepting challenges while maintaining hope through purpose. - This approach is especially vital when controlling stressors is unrealistic, offering resilience despite adversity. Transcript: Victor Strecher Well, the idea is that coping efforts that help you accommodate to stressors, as opposed to just trying to change stressors, may be an important thing for people who don't have resources For dealing with the stressors or when those resources are really limited. So if you're poor, you might not be able to control everything in your life. In fact, none of us control everything in our lives. Some therapies work really hard on having you try to control stressors, understand what the stressors are and control them. I think in Shift and Persist, the idea would be the more you're trying to control everything in your life, it's almost like trying to struggle out of quicksand. It may actually have you sink deeper. Not good. But if you try to accommodate the stressors, you accept the fact that you will have stressors. And at the same time, you want to develop a strong purpose in life that helps you hold on to hope despite adversity. So this is what shift and persist is. The persist part is having a purpose, persisting on the focus of that purpose, helping you organize the important things that matter most in your life. ([Time 0:47:25](https://share.snipd.com/snip/dd19e48f-9e9b-4da3-a7b8-1469f2dd28a8)) - **Brain Benefits of Transcending Values** - Self-transcending values like kindness activate brain regions linked to long-term planning and reduce fear responses. - Focusing on hedonic values leads to less well-being compared to living aligned with higher self values. Transcript: Victor Strecher Whenever we talk about purpose, we have to talk about what we value. What are the core values in our lives? And if you're asking, what do I value? Maybe the first place to look is on the wallpaper of your smartphone. When you turn on your smartphone, what's there? For me, it's my two granddaughters, but for other people, it might be their sports car. It could be a work of poetry. It could be a work of art. There are many things, a work of nature, many things people put on their smartphone. But what that tells me almost right away about a person is what they value. Our core values could be very transcending and related to peace, kindness, love, compassion, or they could be very self-enhancing. They could be related to my appearance or my wealth or what other people think about me. And it turns out that those values have different outcomes for people. People who tend to care more about these self-enhancing or what we might call hedonic values tend to not do as well as people who have self-transcending values. Even Aristotle said, we all have hedonic values and we all have what he called eudaimonic values. Eudaimonia is being in touch with your inner daemon or true self or godlike self. The daemon was almost an angel that lived inside of us in ancient Greece. And he said, we all have both of those, but if we only live according to hedonic values, then we are like, and I'm quoting him from Nicomachean Ethics, then we are like grazing animals. And we all like to graze, but at the same time, we need to transcend and live to this higher self, which is what Aristotle talked about 2,400 years ago and now turns out to be true scientifically. People with transcending values have less activation in a part of the brain that relates to fear and aggression called the amygdala. They have more activation in a part of the brain that relates to what our self is, executive decision-making, long-term orientation, a future orientation, and that's called the ventral Medial prefrontal cortex, right up in the front of the brain. It's a very modern part of the brain. Humans have more than any other animal by a large amount. ([Time 0:49:56](https://share.snipd.com/snip/1b21781f-5667-4c37-bd4b-4a93116dba37)) - **Craft Purpose from Values** - Identify your core values by choosing a few important things, then write why they matter to you to affirm your true self. - Transform these values into a clear purpose statement using the "headstone test" to guide your life. Transcript: Shankar Vedantam You suggest people pick a few things from a long list of possibilities. What's on this list? Victor Strecher When people think about their values, it could be values that are like money. It could be appearance. It could be what people think about you. You know, there are a lot of hedonic values, and everybody has those to some extent, but there are also transcending values, self-transcending values, meaning values that are bigger Than yourself. So values such as compassion. I really think one of the most moral values to consider is kindness to strangers. We're all kind, probably, or most of us are kind to our family members, our loved ones. But can you be kind to people you don't know? I think that's a very self-transcending value. The things that people value very often aren't things, they're people. But when they're people who go beyond your direct sphere of knowledge, and you can build purposes around that, that's what I would call a truly self-transcending purpose. Shankar Vedantam You say that once people identify their top values, the top things they care about, they should spend some time thinking about or better yet writing about why each value is important To them. Why is this? What does that do? This is a process we call self-affirmation. Victor Strecher So the idea of affirming who you are when you're affirming your core values, it's almost like you're affirming these are the roots in my tree, of my tree. This is like the bedrock of who I am. From that, my strengths grow, kind of the trunk of the tree. And from that, my behaviors and my emotions develop and respond, which are almost like the branches of our tree. But I like to start not with the behaviors, but with that root system. And starting with our core values, that is where we build our purpose. Shankar Vedantam You see that another step is to boil down our values into a statement of purpose, what you call the headstone test. What is the headstone test? Victor Strecher Well, I think the idea is, what would you want people to say about you 100 years from now, 200 years from now? You know, Jonas Salk once said late in his life, we should all be good ancestors. And I love that quote because I think back, you know, I would think back to times I've walked through a cemetery. I love walking through a cemetery and I love looking at really old headstones and seeing what's on those headstones. But even more importantly, what would be said at your memorial service? What kinds of people would be at your memorial service? What kind of legacy are you leaving? When you start thinking about that, you start then thinking about how you live your life. ([Time 0:55:54](https://share.snipd.com/snip/0014572e-64cc-4ce7-88e9-7a8d5dc2d02d)) - **Align Actions with Purpose** - Regularly question if your daily habits and obsessions align with your core purpose and goals. - Limit time spent on activities that do not truly matter to you to live more intentionally and meaningfully. Transcript: Victor Strecher I wonder if we did a time motion study of everybody's lives and could parse out the part that really matters a lot to us and the part that really doesn't matter to us that we're doing just Due to habit. Maybe there's social media engagements that don't really matter. Maybe I am worried about what Kim Kardashian is wearing today. Whatever those things are, you have to stop and ask yourself, are these really important to me? Are these important to my purpose and my goals that I've set in my life? Are they important to my core values? And I would guess that a large portion of our time is spent engaged in things that are not all that important. Now, sometimes you need downtime. Sometimes you do need to just chill out and do something or watch something that may be meaningless. ([Time 1:01:24](https://share.snipd.com/snip/7d05b482-d6a2-4c33-96bf-71302f185d1a))